Impact of ≥ 0.1-mm free resection margins on local intramural residual cancer after local excision of T1 colorectal cancer

Kim M. Gijsbers; Lisa van der Schee; Tessa van Veen; Annemarie M. van Berkel; Femke Boersma; Carolien M. Bronkhorst; Paul D. Didden; Krijn J.C. Haasnoot; Anne M. Jonker; Koen Kessels; Nikki Knijn; Ineke van Lijnschoten; Clinton Mijnals; Anya N. Milne; Freek C.P. Moll; Ruud W.M. Schrauwen; Ramon-Michel Schreuder; Tom J. Seerden; Marcel B.W.M. Spanier; Jochim S. Terhaar Sive Droste; Emma Witteveen; Wouter H. de Vos tot Nederveen Cappel; Frank P. Vleggaar; Miangela M. Laclé; Frank ter Borg; Leon M.G. Moons; Dutch T1 CRC Working Group

doi:10.1055/a-1736-6960

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(04): E282-E290
DOI: 10.1055/a-1736-6960

Original article

Impact of ≥ 0.1-mm free resection margins on local intramural residual cancer after local excision of T1 colorectal cancer

Kim M. Gijsbers

¹Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

²Department of Gastroenterology & Hepatology, Deventer Hospital, Deventer, The Netherlands

,

Lisa van der Schee

¹Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Tessa van Veen

¹Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Annemarie M. van Berkel

³Department of Gastroenterology & Hepatology, Noordwest Hospital, Alkmaar,
The Netherlands

,

Femke Boersma

⁴Department of Gastroenterology & Hepatology, Gelre Hospital, Apeldoorn, The Netherlands

,

Carolien M. Bronkhorst

⁵Pathology-DNA, Jeroen Bosch Hospital, Den Bosch, The Netherlands

,

Paul D. Didden

¹Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Krijn J.C. Haasnoot

¹Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Anne M. Jonker

⁶Department of Pathology, Gelre Hospital, Apeldoorn, The Netherlands

,

Koen Kessels

⁷Department of Gastroenterology & Hepatology, St. Antonius Hospital, Nieuwegein,
The Netherlands

,

Nikki Knijn

⁸Pathology-DNA, Rijnstate Hospital, Arnhem, The Netherlands

,

Ineke van Lijnschoten

⁹Department of Pathology, PAMM, Eindhoven, The Netherlands

,

Clinton Mijnals

¹⁰Department of Pathology, Amphia Hospital, Breda, The Netherlands

,

Anya N. Milne

¹¹Pathology-DNA, St. Antonius Hospital, Nieuwegein, The Netherlands

,

Freek C.P. Moll

¹²Department of Pathology, Isala Clinics, Zwolle, The Netherlands

,

Ruud W.M. Schrauwen

¹³Department of Gastroenterology & Hepatology, Bernhoven, Uden, The Netherlands

,

Ramon-Michel Schreuder

¹⁴Department of Gastroenterology & Hepatology, Catharina Hospital, Eindhoven, The Netherlands

,

Tom J. Seerden

¹⁵Department of Gastroenterology & Hepatology, Amphia Hospital, Breda, The Netherlands

,

Marcel B.W.M. Spanier

¹⁶Department of Gastroenterology & Hepatology, Rijnstate Hospital, Arnhem, The Netherlands

,

Jochim S. Terhaar Sive Droste

¹⁷Department of Gastroenterology & Hepatology, Jeroen Bosch Hospital, Den Bosch, The Netherlands

,

Emma Witteveen

¹⁸Department of Pathology, Noordwest Hospital, Alkmaar, The Netherlands

,

Wouter H. de Vos tot Nederveen Cappel

¹⁹Department of Gastroenterology & Hepatology, Isala Clinics, Zwolle, The Netherlands

,

Frank P. Vleggaar

¹Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Miangela M. Laclé

²⁰Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Frank ter Borg‡

²Department of Gastroenterology & Hepatology, Deventer Hospital, Deventer, The Netherlands

,

Leon M.G. Moons‡

¹Department of Gastroenterology & Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands

,

Dutch T1 CRC Working Group

› Institutsangaben

Abstract

Background and study aims A free resection margin (FRM) > 1 mm after local excision of a T1 colorectal cancer (CRC) is known to be associated with a low risk of local intramural residual cancer (LIRC). The risk is unclear, however, for FRMs between 0.1 to 1 mm. This study evaluated the risk of LIRC after local excision of T1 CRC with FRMs between 0.1 and 1 mm in the absence of lymphovascular invasion (LVI), poor differentiation and high-grade tumor budding (Bd2–3).

Patients and methods Data from all consecutive patients with local excision of T1 CRC between 2014 and 2017 were collected from 11 hospitals. Patients with a FRM ≥ 0.1 mm without LVI and poor differentiation were included. The main outcome was risk of LIRC (composite of residual cancer in the local excision scar in adjuvant resection specimens or local recurrence during follow-up). Tumor budding was also assessed for cases with a FRM between 0.1 and 1mm.

Results A total of 171 patients with a FRM between 0.1 and 1 mm and 351 patients with a FRM > 1 mm were included. LIRC occurred in five patients (2.9 %; 95 % confidence interval [CI] 1.0–6.7 %) and two patients (0.6 %; 95 % CI 0.1–2.1 %), respectively. Assessment of tumor budding showed Bd2–3 in 80 % of cases with LIRC and in 16 % of control cases. Accordingly, in patients with a FRM between 0.1 and 1 mm without Bd2–3, LIRC was detected in one patient (0.8%; 95 % CI 0.1–4.4 %).

Conclusions In this study, risks of LIRC were comparable for FRMs between 0.1 and 1 mm and > 1 mm in the absence of other histological risk factors.

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Referenzen

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