National Cohort Study on Postoperative Risks After Surgery for Submucosal Invasive Colorectal Cancer

Overview

Journal BJS Open

Publisher Oxford University Press

Specialty General Surgery

Date 2019 Apr 9

PMID 30957069

Citations 30

Authors

N C A Vermeer

Y Backes

H S Snijders

E Bastiaannet

G J Liefers

L M G Moons

C J H van de Velde

K C M J Peeters

Affiliations

Soon will be listed here.

Abstract

Background: The decision to perform surgery for patients with T1 colorectal cancer hinges on the estimated risk of lymph node metastasis, residual tumour and risks of surgery. The aim of this observational study was to compare surgical outcomes for T1 colorectal cancer with those for more advanced colorectal cancer.

Methods: This was a population-based cohort study of patients treated surgically for pT1-3 colorectal cancer between 2009 and 2016, using data from the Dutch ColoRectal Audit. Postoperative complications (overall, surgical, severe complications and mortality) were compared using multivariable logistic regression. A risk stratification table was developed based on factors independently associated with severe complications (reintervention and/or mortality) after elective surgery.

Results: Of 39 813 patients, 5170 had pT1 colorectal cancer. No statistically significant differences were observed between patients with pT1 and pT2-3 disease in the rate of severe complications (8·3 9·5 per cent respectively; odds ratio (OR) 0·89, 95 per cent c.i. 0·80 to 1·01, = 0·061), surgical complications (12·6 13·5 per cent; OR 0·93, 0·84 to 1·02, = 0·119) or mortality (1·7 2·5 per cent; OR 0·94, 0·74 to 1·19, = 0·604). Male sex, higher ASA grade, previous abdominal surgery, open approach and type of procedure were associated with a higher severe complication rate in patients with pT1 colorectal cancer.

Conclusion: Elective bowel resection was associated with similar morbidity and mortality rates in patients with pT1 and those with pT2-3 colorectal carcinoma.

Citing Articles

ASO Author Reflections: Pushing the Boundaries of Local Excision: How Does the Risk of Lymph Node Metastases Compare to Those Associated with Major Surgery in T2 Colon Cancer Patients?.

Hanevelt J, Brohet R, Moons L, Lacle M, Vleggaar F, van Westreenen H Ann Surg Oncol. 2025; .

PMID: 39948310 DOI: 10.1245/s10434-025-16997-4.

Risk of Lymph Node Metastasis in T2 Colon Cancer: A Nationwide Population-Based Cohort Study.

Hanevelt J, Brohet R, Moons L, Lacle M, Vleggaar F, van Westreenen H Ann Surg Oncol. 2025; .

PMID: 39847281 DOI: 10.1245/s10434-025-16921-w.

Artificial Intelligence Models May Aid in Predicting Lymph Node Metastasis in Patients with T1 Colorectal Cancer.

Baek J, Yi H, Hong S, Song S, Lee J, Hwang S Gut Liver. 2025; 19(1):69-76.

PMID: 39778879 PMC: 11736321. DOI: 10.5009/gnl240273.

Deep learning for segmentation of colorectal carcinomas on endoscopic ultrasound.

Noort F, Ter Borg F, Guitink A, Faber J, Wolterink J Tech Coloproctol. 2024; 29(1):20.

PMID: 39671056 DOI: 10.1007/s10151-024-03056-5.

The risk factors of lymph node metastasis in early colorectal cancer: a predictive nomogram and risk assessment.

Xu J, Yin F, Ren L, Xu Y, Min C, Zhang P Int J Colorectal Dis. 2024; 39(1):191.

PMID: 39607559 PMC: 11604734. DOI: 10.1007/s00384-024-04760-2.

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