AI Article Synopsis
- If a T1 colorectal tumor is suspected, it should be completely removed (en-bloc resection) rather than biopsied.
- Recent advances in endoscopic techniques allow for better complete removal of T1 colorectal tumors.
- High-risk T1 colorectal tumors exhibit certain features (like poor differentiation or positive resection margins) that suggest surgical resection with lymphadenectomy is essential, as the risk of recurrence with only endoscopic treatment is unclear.
Article Abstract
In case of suspicion of a T1 colorectal tumor, the tumor should not be biopsied but removed completely (so-called en-bloc resection). With more recent endoscopic techniques, T1 colorectal tumors can be more often radical resected. If at least one of the following four characteristics is present, there is a high-risk T1 colorectal tumor and it is recommended to consider surgical resection with adequate lymphadenectomy; poor differentiation, presence of (lymphatic) angioinvasion, high-grade tumor budding (grade 2-3) and a positive resection margin (where the malignant cells approach the cut edge to 0.1mm). The risk of recurrent disease after endoscopic resection of a high-risk T1 colorectal tumor without additional surgery is not well known. Scheduled surgery for bowel cancer at an early stage is associated with the same risk of a serious complication and/or death as scheduled surgery at a more advanced stage.
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