Long-term Outcomes of Endoscopic Submucosal Dissection in T1 CRC

Endoscopic submucosal dissection (ESD) offers compelling insights into managing T1 colorectal cancer (CRC), shaping surgical strategies.

Of 383 T1 CRC patients, 3.6% had recurrences and 1.8% died in the high-risk group; none occurred in low-risk patients.
In high-risk cases, local recurrence was 6.8% without surgery versus 0% with surgery (p < .001).

Consider ESD alone for low-risk T1 CRC, but opt for additional surgery in high-risk patients to minimize local recurrence.

Five-year overall survival was significantly better with surgery (95.2%) compared to follow-up (79.7%) in high-risk patients (p < .001).

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