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Session: ePoster: Colon and Colorectal Cancer 14 (Mon1015)

EP716 - Risk Factors for Residual Cancer and Lymph Node Metastasis after Non-Curative Endoscopic Resection of Colorectal Cancer: A Multicenter Retrospective Study

Monday, May 12, 2025
10:47 AM – 10:52 AM PT

    ePoster Presenter(s)

  • Soo Young Oh, Korean Board of Colorectal Specialist

    Clinical Medical Assistant Professor
    Asan Medical Center
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • WK

    Won Kyung Kang, n/a

    Professor
    Yeouido St. Mary’s Hospital, The Catholic University of Korea
    Seoul, Seoul-t'ukpyolsi, Republic of Korea

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • HO

    Hyung-Hoon Oh, n/a

    Clinical Assistant Professor
    Chonnam National University Medical School
    Gwangju, Kwangju-jikhalsi, Republic of Korea

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Soo Young Oh, Korean Board of Colorectal Specialist: This individual has no financial relationships with ineligible companies.
Won Kyung Kang, n/a: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Endoscopic resection is one of organ-preserving approaches for colorectal cancers (CRCs) with minimal risk of lymph node metastasis (LNM). However, when residual cancer or a high risk of LNM is suspected in the histopathological results following non-curative endoscopic resection, surgical intervention is typically recommended. Despite this practice, the actual risk of residual cancer or LNM following endoscopic resection of CRCs is still not fully understood. This study aims to identify the risk factors associated with residual cancer and LNM after non-curative endoscopic resection.

Methods/Interventions: Patients who underwent radical resection after non-curative colorectal endoscopic resection at four tertiary hospitals between 2015 and 2020 were retrospectively identified. Clinicopathological characteristics before and after surgery were analyzed to determine the predictors of residual cancer and LNM.

Results/Outcomes: A total of 537 patients who underwent surgery after endoscopic resection of early colorectal cancer at four tertiary hospitals from 2015 to 2020 were included. The rates of residual cancer and LNM were 3.5% (19/537) and 7.6% (41/537), respectively. Patients with positive horizontal or vertical margins exhibited significantly higher rates of residual cancer (60.0% vs. 13.5%, p=0.43; 80.0% vs. 31.2%, p=0.045, respectively). Multivariate analysis identified a positive vertical margin as the only significant risk factor for residual cancer, with an odds ratio (OR) of 5.504 (95% CI: 1.055–28.715; p=0.043). Notably, only one patient with a submucosal (SM) invasion depth of less than 1 mm exhibited LNM, while patients with SM invasion depth greater than 1 mm had an 8.5% rate of LNM. Additionally, patients with lymphovascular invasion (LVI) showed a significantly higher rate of LNM (14.3% vs. 8.2%, p=0.049).

Conclusion/Discussion: This study highlights that positive vertical margins are significant predictors of residual cancer, while submucosal invasion depth and LVI are crucial predictors of LNM following non-curative endoscopic resection for CRC.