Patients with high-risk T1 rectal cancer have a higher risk of recurrence after surgical resection compared to those with colon cancer, according to a study published in Gastroenterology. The research, led by Tatsunori Minamide, MD, and colleagues, analyzed data from 3,789 patients who underwent complete resection of T1 colorectal cancer. The study found no significant differences in recurrence after endoscopic local resection of low- or high-risk colorectal cancer (CRC) lesions.
In the study, 1,044 patients underwent local resection (LR) and 2,745 underwent surgical resection (SR), all for high-risk lesions. Recurrence rates were 1.2% for LR and 1.8% for SR, while mortality rates were 8.5% for LR and 4.8% for SR. Among patients who underwent LR for low-risk lesions, no significant differences in recurrence or mortality were observed between colon and rectal cancer patients. Similar results were seen in patients who underwent LR for high-risk lesions.
However, significant differences were noted in patients who underwent SR for high-risk colon and rectal cancer. The overall and distant recurrence rates were notably higher in the rectal group. Risk factors for cumulative recurrence in this group included rectal location, tumor size of 20 mm or greater, and high budding grade. The study concludes that rectal location impacts recurrence after SR of high-risk T1 CRC, suggesting the need for careful surveillance, whereas LR may be an optimal approach for low-risk lesions given its low recurrence rate.