Pedunculated Morphology of T1 Colorectal Tumors Associates With Reduced Risk of Adverse Outcome.

摘要: Background & Aims Risk stratification for adverse events, such as metastasis to lymph nodes, is based only on histologic features of tumors. We aimed compare outcomes pedunculated vs nonpedunculated T1 colorectal cancers (CRC). Methods performed a retrospective study 1656 patients diagnosed with T1CRC from 2000 through 2014 at 14 hospitals in The Netherlands. median follow-up time was 42.5 months (interquartile range, 18.5–77.5 mo). evaluated the association between tumor morphology and primary composite end point, outcome, adjusted clinical variables, resection margins, treatment approach. Adverse outcome defined distant metastases, local recurrence, or residual tissue. Secondary points were metastasis, incomplete resection. Results occurred 67 723 (9.3%) T1CRCs 155 933 (16.6%) T1CRCs. Pedunculated independently associated decreased risk (adjusted odds ratio [OR], 0.59; 95% CI, 0.42–0.83; P = .003). Metastasis, resection, recurrence observed 5.8%, 4.6%, 3.9% 10.6%, 8.0%, 6.6% T1CRCs, respectively. reduced OR, 0.62; 0.41–0.94; .03), 0.57; 0.36–0.91; .02), hazard ratio, 0.52; 0.32–0.85; .009). did not differ significantly low-risk (0.8% 2.9%, .38; 1.5% 0%, .99; 0%; .99). However, lower high-risk (6.5% 12.5%; .007; 4.4% 8.6%; .03). Conclusions In T1CRC, we found be population high outcome. Incorporating morphologic tumors assessment could help predict identify best candidates surgery.