|
KMID : 0614720220650090558
|
|
Journal of Korean Medical Association
2022 Volume.65 No. 9 p.558 ~ p.567
|
|
|
Multidisciplinary treatment strategy for early colon cancer
|
|
Son Gyung-Mo
Park Su-Bum
Kim Tae-Un
Park Byung-Soo
Lee In-Young
Na Joo-Young
Shin Dong-Hoon
Oh Sang-Bo
Cho Sung-Hwan
Kim Hyun-Sung
Kim Hyung-Wook
|
|
|
Abstract
|
|
|
Background: Treatment for early colon cancer has progressed rapidly with endoscopic resection and minimally invasive surgery. Selection of patients without risk of lymph node metastasis is necessary before deciding on endoscopic resection for early colon cancer treatment. We aimed to review the optimal multidisciplinary treatment strategies for early colon cancer, including endoscopy and surgery.
Current Concepts: Pathological risk factors include histologic grade of cancer cell differentiation, lymphovascular invasion, perineural invasion, tumor budding, and deep submucosal invasion. These risk factors for predicting lymph node metastasis are crucial for determining the treatment strategy of endoscopic excision and radical resection for early colon cancer. Prediction of the depth of invasion in early colon cancer using endoscopic optical assessments is vital to determine the appropriate treatment method for endoscopic or surgical resection.
Furthermore, optical assessment of pit and vascular patterns is useful for estimating the depth of submucosal invasion using magnifying chromoendoscopy and narrow-band imaging endoscopy. Performing an endoscopic and pathologic evaluation of the risk factors for lymph node metastasis is imperative when selecting endoscopic or surgical resection. Endoscopic treatments include cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection. In addition, appropriate surgical treatment should be recommended for patients with early colon cancer with a high risk of lymph node metastasis.
Discussion and Conclusion: A multidisciplinary approach should be recommended to establish an optimized treatment strategy, minimize the risk of complications, and obtain excellent oncologic outcomes via patient tailored treatment in patients with early colon cancer.
|
|
|
KEYWORD
|
|
|
Colonic neoplasms, Lymph nodes, Endoscopic mucosal resection, Minimally invasive surgical procedures, Laparoscopy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
 
|
|