Transanal endoscopic microsurgery for T1 rectal cancer: size matters
Background Transanal endoscopic microsurgery (TEM) is considered a curative option for selected T1 rectal cancer. Although TEM is safe, local recurrence (LR) rates after TEM are unacceptably high. Evidence on selection criteria, however, is not abundant. To expand evidence on low- versus high-risk T...
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| Veröffentlicht in: | Surgical endoscopy 2012-02, Vol.26 (2), p.551-557 |
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| creator | Doornebosch, Pascal G. Zeestraten, Eliane de Graaf, Eelco J. R. Hermsen, Pleun Dawson, Imro Tollenaar, Rob A. E. M. Morreau, Hans |
| description | Background
Transanal endoscopic microsurgery (TEM) is considered a curative option for selected T1 rectal cancer. Although TEM is safe, local recurrence (LR) rates after TEM are unacceptably high. Evidence on selection criteria, however, is not abundant. To expand evidence on low- versus high-risk T1 rectal cancer with respect to LR, this study aimed to identify predictive histopathologic factors in a selected group of T1 rectal cancers treated with TEM only.
Methods
The study enrolled 62 patients for whom specimens of the primary tumor containing an invasive T1 carcinoma could be reevaluated. Tumors were scored according to predefined criteria, and analysis of predictive factors for locoregional failure was performed.
Result
Local recurrence rates at 3 years for tumors 3 cm in size or smaller were significantly lower than for tumors larger than 3 cm (16 vs. 39%;
P
|
| doi_str_mv | 10.1007/s00464-011-1918-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_917156346</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2564345381</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-213e2140a68072bc133bdc6ba864429cf2cd96434a7ba5db9c67404dfaf6e8a93</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMo7rr6A7xIEcRTdSZJ08abrJ-w4GU9hzRNpUs_1qQ9rL_elF1dEDzNYZ55Z-Yh5BzhBgHSWw_ABY8BMUaJWcwPyBQ5ozGlmB2SKUgGMU0ln5AT71cQcInJMZlQlJJJRqfkYel063Wr68i2RedNt65M1FTGdX5wH9ZtorJz0RIjZ00fKKNbY91d5KsvGzW6763zp-So1LW3Z7s6I-9Pj8v5S7x4e36d3y9iwwH6mCKzFDlokUFKc4OM5YURuc4E51SakppCCs64TnOdFLk0IuXAi1KXwmZashm53uauXfc5WN-rpvLG1rVubTd4JTHFRDAuAnn5h1x1gwtfjpBIKSAd43ALjc96Z0u1dlWj3UYhqFGw2gpWQbAaBSseZi52wUPe2OJ34sdoAK52gPZG12XQayq_55KEckghcHTL-dBqg-j9hf9v_wYaApGD</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>916720129</pqid></control><display><type>article</type><title>Transanal endoscopic microsurgery for T1 rectal cancer: size matters</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Doornebosch, Pascal G. ; Zeestraten, Eliane ; de Graaf, Eelco J. R. ; Hermsen, Pleun ; Dawson, Imro ; Tollenaar, Rob A. E. M. ; Morreau, Hans</creator><creatorcontrib>Doornebosch, Pascal G. ; Zeestraten, Eliane ; de Graaf, Eelco J. R. ; Hermsen, Pleun ; Dawson, Imro ; Tollenaar, Rob A. E. M. ; Morreau, Hans</creatorcontrib><description>Background
Transanal endoscopic microsurgery (TEM) is considered a curative option for selected T1 rectal cancer. Although TEM is safe, local recurrence (LR) rates after TEM are unacceptably high. Evidence on selection criteria, however, is not abundant. To expand evidence on low- versus high-risk T1 rectal cancer with respect to LR, this study aimed to identify predictive histopathologic factors in a selected group of T1 rectal cancers treated with TEM only.
Methods
The study enrolled 62 patients for whom specimens of the primary tumor containing an invasive T1 carcinoma could be reevaluated. Tumors were scored according to predefined criteria, and analysis of predictive factors for locoregional failure was performed.
Result
Local recurrence rates at 3 years for tumors 3 cm in size or smaller were significantly lower than for tumors larger than 3 cm (16 vs. 39%;
P
< 0.03). Combining smaller tumors with submucosal invasion depth and budding led to identifying tumors that likely will not recur (3-year LR rates, 7 and 10%, respectively).
Conclusions
The findings showed that low- and high-risk criteria are too robust for identifying tumors at risk for LR. Tumor size alone or in combination with submucosal invasion depth or tumor budding appeared to be a significant predictive factor for locoregional failure after TEM for T1 rectal cancer.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-011-1918-4</identifier><identifier>PMID: 21993932</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Aged, 80 and over ; Anal Canal ; Biological and medical sciences ; Blood vessels ; Colorectal cancer ; Endoscopy ; Female ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Gynecology ; Hepatology ; Humans ; Male ; Medical prognosis ; Medical sciences ; Medicine ; Medicine & Public Health ; Microsurgery ; Microsurgery - methods ; Middle Aged ; Natural Orifice Endoscopic Surgery - methods ; Neoplasm Invasiveness - pathology ; Neoplasm Recurrence, Local - etiology ; Proctology ; Proctoscopy - methods ; Prospective Studies ; Rectal Neoplasms - pathology ; Rectal Neoplasms - surgery ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Treatment Outcome ; Tumor Burden ; Tumors</subject><ispartof>Surgical endoscopy, 2012-02, Vol.26 (2), p.551-557</ispartof><rights>Springer Science+Business Media, LLC 2011</rights><rights>2015 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-213e2140a68072bc133bdc6ba864429cf2cd96434a7ba5db9c67404dfaf6e8a93</citedby><cites>FETCH-LOGICAL-c400t-213e2140a68072bc133bdc6ba864429cf2cd96434a7ba5db9c67404dfaf6e8a93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-011-1918-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-011-1918-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25524070$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21993932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Doornebosch, Pascal G.</creatorcontrib><creatorcontrib>Zeestraten, Eliane</creatorcontrib><creatorcontrib>de Graaf, Eelco J. R.</creatorcontrib><creatorcontrib>Hermsen, Pleun</creatorcontrib><creatorcontrib>Dawson, Imro</creatorcontrib><creatorcontrib>Tollenaar, Rob A. E. M.</creatorcontrib><creatorcontrib>Morreau, Hans</creatorcontrib><title>Transanal endoscopic microsurgery for T1 rectal cancer: size matters</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Transanal endoscopic microsurgery (TEM) is considered a curative option for selected T1 rectal cancer. Although TEM is safe, local recurrence (LR) rates after TEM are unacceptably high. Evidence on selection criteria, however, is not abundant. To expand evidence on low- versus high-risk T1 rectal cancer with respect to LR, this study aimed to identify predictive histopathologic factors in a selected group of T1 rectal cancers treated with TEM only.
Methods
The study enrolled 62 patients for whom specimens of the primary tumor containing an invasive T1 carcinoma could be reevaluated. Tumors were scored according to predefined criteria, and analysis of predictive factors for locoregional failure was performed.
Result
Local recurrence rates at 3 years for tumors 3 cm in size or smaller were significantly lower than for tumors larger than 3 cm (16 vs. 39%;
P
< 0.03). Combining smaller tumors with submucosal invasion depth and budding led to identifying tumors that likely will not recur (3-year LR rates, 7 and 10%, respectively).
Conclusions
The findings showed that low- and high-risk criteria are too robust for identifying tumors at risk for LR. Tumor size alone or in combination with submucosal invasion depth or tumor budding appeared to be a significant predictive factor for locoregional failure after TEM for T1 rectal cancer.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anal Canal</subject><subject>Biological and medical sciences</subject><subject>Blood vessels</subject><subject>Colorectal cancer</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Microsurgery</subject><subject>Microsurgery - methods</subject><subject>Middle Aged</subject><subject>Natural Orifice Endoscopic Surgery - methods</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Proctology</subject><subject>Proctoscopy - methods</subject><subject>Prospective Studies</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - surgery</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Tumors</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kE1LxDAQhoMo7rr6A7xIEcRTdSZJ08abrJ-w4GU9hzRNpUs_1qQ9rL_elF1dEDzNYZ55Z-Yh5BzhBgHSWw_ABY8BMUaJWcwPyBQ5ozGlmB2SKUgGMU0ln5AT71cQcInJMZlQlJJJRqfkYel063Wr68i2RedNt65M1FTGdX5wH9ZtorJz0RIjZ00fKKNbY91d5KsvGzW6763zp-So1LW3Z7s6I-9Pj8v5S7x4e36d3y9iwwH6mCKzFDlokUFKc4OM5YURuc4E51SakppCCs64TnOdFLk0IuXAi1KXwmZashm53uauXfc5WN-rpvLG1rVubTd4JTHFRDAuAnn5h1x1gwtfjpBIKSAd43ALjc96Z0u1dlWj3UYhqFGw2gpWQbAaBSseZi52wUPe2OJ34sdoAK52gPZG12XQayq_55KEckghcHTL-dBqg-j9hf9v_wYaApGD</recordid><startdate>20120201</startdate><enddate>20120201</enddate><creator>Doornebosch, Pascal G.</creator><creator>Zeestraten, Eliane</creator><creator>de Graaf, Eelco J. 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M.</creator><creator>Morreau, Hans</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20120201</creationdate><title>Transanal endoscopic microsurgery for T1 rectal cancer: size matters</title><author>Doornebosch, Pascal G. ; Zeestraten, Eliane ; de Graaf, Eelco J. R. ; Hermsen, Pleun ; Dawson, Imro ; Tollenaar, Rob A. E. M. ; Morreau, Hans</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-213e2140a68072bc133bdc6ba864429cf2cd96434a7ba5db9c67404dfaf6e8a93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anal Canal</topic><topic>Biological and medical sciences</topic><topic>Blood vessels</topic><topic>Colorectal cancer</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Microsurgery</topic><topic>Microsurgery - methods</topic><topic>Middle Aged</topic><topic>Natural Orifice Endoscopic Surgery - methods</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Proctology</topic><topic>Proctoscopy - methods</topic><topic>Prospective Studies</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - surgery</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doornebosch, Pascal G.</creatorcontrib><creatorcontrib>Zeestraten, Eliane</creatorcontrib><creatorcontrib>de Graaf, Eelco J. R.</creatorcontrib><creatorcontrib>Hermsen, Pleun</creatorcontrib><creatorcontrib>Dawson, Imro</creatorcontrib><creatorcontrib>Tollenaar, Rob A. E. M.</creatorcontrib><creatorcontrib>Morreau, Hans</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doornebosch, Pascal G.</au><au>Zeestraten, Eliane</au><au>de Graaf, Eelco J. R.</au><au>Hermsen, Pleun</au><au>Dawson, Imro</au><au>Tollenaar, Rob A. E. M.</au><au>Morreau, Hans</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transanal endoscopic microsurgery for T1 rectal cancer: size matters</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2012-02-01</date><risdate>2012</risdate><volume>26</volume><issue>2</issue><spage>551</spage><epage>557</epage><pages>551-557</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
Transanal endoscopic microsurgery (TEM) is considered a curative option for selected T1 rectal cancer. Although TEM is safe, local recurrence (LR) rates after TEM are unacceptably high. Evidence on selection criteria, however, is not abundant. To expand evidence on low- versus high-risk T1 rectal cancer with respect to LR, this study aimed to identify predictive histopathologic factors in a selected group of T1 rectal cancers treated with TEM only.
Methods
The study enrolled 62 patients for whom specimens of the primary tumor containing an invasive T1 carcinoma could be reevaluated. Tumors were scored according to predefined criteria, and analysis of predictive factors for locoregional failure was performed.
Result
Local recurrence rates at 3 years for tumors 3 cm in size or smaller were significantly lower than for tumors larger than 3 cm (16 vs. 39%;
P
< 0.03). Combining smaller tumors with submucosal invasion depth and budding led to identifying tumors that likely will not recur (3-year LR rates, 7 and 10%, respectively).
Conclusions
The findings showed that low- and high-risk criteria are too robust for identifying tumors at risk for LR. Tumor size alone or in combination with submucosal invasion depth or tumor budding appeared to be a significant predictive factor for locoregional failure after TEM for T1 rectal cancer.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21993932</pmid><doi>10.1007/s00464-011-1918-4</doi><tpages>7</tpages></addata></record> |
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| subjects | Abdominal Surgery Adult Aged Aged, 80 and over Anal Canal Biological and medical sciences Blood vessels Colorectal cancer Endoscopy Female Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen General aspects Gynecology Hepatology Humans Male Medical prognosis Medical sciences Medicine Medicine & Public Health Microsurgery Microsurgery - methods Middle Aged Natural Orifice Endoscopic Surgery - methods Neoplasm Invasiveness - pathology Neoplasm Recurrence, Local - etiology Proctology Proctoscopy - methods Prospective Studies Rectal Neoplasms - pathology Rectal Neoplasms - surgery Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Treatment Outcome Tumor Burden Tumors |
| title | Transanal endoscopic microsurgery for T1 rectal cancer: size matters |
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