Tumor Location as a Prognostic Factor in T1 Colorectal Cancer

Katsuro Ichimasa; Shin-ei Kudo; Yuta Kouyama; Kenichi Mochizuki; Yuki Takashina; Masashi Misawa; Yuichi Mori; Takemasa Hayashi; Kunihiko Wakamura; Hideyuki Miyachi

doi:10.23922/jarc.2021-029

Review Article

Tumor Location as a Prognostic Factor in T1 Colorectal Cancer

Katsuro Ichimasa, Shin-ei Kudo, Yuta Kouyama, Kenichi Mochizuki, Yuki Takashina, Masashi Misawa, Yuichi Mori, Takemasa Hayashi, Kunihiko Wakamura, Hideyuki Miyachi

Author information

Katsuro Ichimasa
Digestive Disease Center, Showa University Northern Yokohama Hospital
Shin-ei Kudo
Digestive Disease Center, Showa University Northern Yokohama Hospital
Yuta Kouyama
Digestive Disease Center, Showa University Northern Yokohama Hospital
Kenichi Mochizuki
Digestive Disease Center, Showa University Northern Yokohama Hospital
Yuki Takashina
Digestive Disease Center, Showa University Northern Yokohama Hospital
Masashi Misawa
Digestive Disease Center, Showa University Northern Yokohama Hospital
Yuichi Mori
Digestive Disease Center, Showa University Northern Yokohama Hospital
Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo
Takemasa Hayashi
Digestive Disease Center, Showa University Northern Yokohama Hospital
Kunihiko Wakamura
Digestive Disease Center, Showa University Northern Yokohama Hospital
Hideyuki Miyachi
Digestive Disease Center, Showa University Northern Yokohama Hospital

Keywords: tumor location, T1 colorectal cancer, lymph node metastasis, recurrence, risk factor, treatment strategy

JOURNAL OPEN ACCESS

2022 Volume 6 Issue 1 Pages 9-15

DOI https://doi.org/10.23922/jarc.2021-029

Details

Abstract

The incidence of T1 colorectal cancer is expected to increase because of the prevalence of colorectal cancer screening and the progress of endoscopic treatment such as endoscopic submucosal dissection or endoscopic full-thickness resection. Currently, the requirement for additional surgery after endoscopic resection of T1 colorectal cancer is determined according to several treatment guidelines (in USA, Europe, and Japan) referring to the following pathological findings: lymphovascular invasion, tumor differentiation, depth of invasion, and tumor budding, all of which are reported to be risk factors for lymph node metastasis. In addition to these factors, in this review, we investigate whether tumor location, which is an objective factor, has an impact on the presence of lymph node metastasis and recurrence. From recent studies, left-sided location, especially the sigmoid colon in addition to rectum, could be a risk factor for lymph node metastasis and cancer recurrence. The treatment of T1 colorectal cancer should be managed considering these findings.

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