Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2022 Apr 1;117(4):603-604.
doi: 10.14309/ajg.0000000000001670.

Endoscopic R1/Rx Resection of T1 Colorectal Cancer-What Next?

Arthur Schmidt  1 , Hannes Philipp Neeff  2 , Michael Quante  1
Affiliations
Editorial

Endoscopic R1/Rx Resection of T1 Colorectal Cancer-What Next?

Arthur Schmidt et al. Am J Gastroenterol. .

Abstract

T1 carcinoma is often not recognized as such, and inappropriate endoscopic resection techniques are selected, resulting in positive (R1) or nonassessable (Rx) resection margins. Full-thickness resection has been proposed as an alternative to completion surgery. Gijsbers et al. compared oncological outcomes of both strategies. The main finding was that colorectal cancer recurrence was significantly higher in the full-thickness excision of the scar compared with the completion surgery group (9.0% vs 2.2%). However, metastasis-free survival and overall survival were not significantly different in both groups. The results of this study favor full-thickness excision of the scar as the first-line approach for Rx/R1-resected margins but otherwise low-risk tumors.

PubMed Disclaimer

Comment on

  • Full-Thickness Scar Resection After R1/Rx Excised T1 Colorectal Cancers as an Alternative to Completion Surgery.
    Gijsbers KM, Laclé MM, Elias SG, Backes Y, Bosman JH, van Berkel AM, Boersma F, Boonstra JJ, Bos PR, Dekker PAT, Didden PD, Geesing JMJ, Groen JN, Haasnoot KJC, Kessels K, van Lent AUG, van der Schee L, Schrauwen RWM, Schreuder RM, Schwartz MP, Seerden TJ, Spanier MBWM, Terhaar Sive Droste JS, Tuynman JB, de Vos Tot Nederveen Cappel WH, van Westreenen EHL, Wolfhagen FHJ, Vleggaar FP, Ter Borg F, Moons LMG; Dutch T1 CRC Working Group. Gijsbers KM, et al. Am J Gastroenterol. 2022 Apr 1;117(4):647-653. doi: 10.14309/ajg.0000000000001621. Am J Gastroenterol. 2022. PMID: 35029166

References

    1. Di Gregorio C, Bonetti LR, de Gaetani C, et al. Clinical outcome of low- and high-risk malignant colorectal polyps: Results of a population-based study and meta-analysis of the available literature. Intern Emerg Med 2014;9(2):151–60.
    1. Schmiegel W, Buchberger B, Follmann M, et al. German S3-guideline colorectal carcinoma [in German]. Z Gastroenterol 2017;55(12):1344–498.
    1. Schmidt A, Beyna T, Schumacher B, et al. Colonoscopic full-thickness resection using an over-the-scope device–a prospective multicenter study in various indications. Gut 2017;67(7):1280–89.
    1. Kuellmer A, Mueller J, Caca K, et al. Endoscopic full-thickness resection for early colorectal cancer. Gastrointest Endosc 2019;89(6):1180–9.e1.
    1. Zwager LW, Bastiaansen B, van der Spek B, et al. Endoscopic full-thickness resection of T1 colorectal cancers: A retrospective analysis from a multicenter Dutch eFTR registry. Endosc Germany 2021 (doi: 10.1055/a-1637-9051).

LinkOut - more resources