演題抄録

臓器別シンポジウム

開催概要
開催回
第55回・2017年・横浜
 

内視鏡的摘除pT1(SM)癌の治療方針に関わる病理診断

演題番号 : OSY1-1

[筆頭演者]
味岡 洋一:1 

1:新潟大学・大学院医歯学総合研究科・分子・診断病理学分野

 

The treatment strategy for pT1 (SM) colorectal cancer (pT1- CRC) after endoscopic resection is determined by the risk of lymph node metastasis of the lesion. The risk of lymph node metastasis can be predicted from the histopathological findings. Risk factors for lymph node metastasis are; "unfavorable histologic features (G3)", "SM invasion of 1000μm or more", "angiolymphatic invasion" and "Grade 2/3 budding". pT1-CRCs without any of these risk factors can be curative by endoscopic treatment. Rate of lymph node metastasis for these lesion is estimated as 0.3% by the result of a project study of JSCCR. On the other hand, pT1-CRC with any of these factors is non-curative by endoscopic treatment and additional intestinal resection including lymph node dissection is considered. However, in recent project study of JSCCR revealed that actual lymph node metastasis of these pT1-CRC can be stratified by combination of histopathological risk factors, and lymph node metastasis of pT1-CRC with the risk factor of SM invasion alone is only 1.4%. This data implies that possibility of endoscopic treatment can be expanded to pT1-CRCs which has been included in the group considered to be fallen into additional intestinal resection.

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