Retrospective endoscopic study of developmental and configurational changes of early colorectal cancer: Eight cases and a review of the literature

Matsui, Toshiyuki; Tsuda, S.; Iwashita, Akinori; Ohshige, Kaname; Kikuchi, Y.; Yorioka, Makoto; Furukawa, Keiichi; Hirai, Fumihito; Yao, Tsuneyoshi

doi:10.1111/j.1443-1661.2004.00303.x

Cited by 13 publications

(6 citation statements)

References 15 publications

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“…Observational studies have shown that when left untreated, NP-CRNs with carcinomas can progress to advanced cancer within a similar time frame. 10,26,27 Once the NP-CRNs become advanced cancer, their appearance is indistinguishable from In situ and submucosal invasive carcinoma…”

Section: Commentmentioning

confidence: 99%

Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults

Soetikno

Kaltenbach

Rouse³

et al. 2008

JAMA

558

360

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Context Colorectal cancer is the second leading cause of cancer death in the United States. Prevention has focused on the detection and removal of polypoid neoplasms. Data are limited on the significance of nonpolypoid colorectal neoplasms (NP-CRNs). Objectives To determine the prevalence of NP-CRNs in a veterans hospital population and to characterize their association with colorectal cancer. Design, Setting, and Patients Cross-sectional study at a veterans hospital in California with 1819 patients undergoing elective colonoscopy from July 2003 to June 2004. Main Outcome Measures Endoscopic appearance, location, size, histology, and depth of invasion of neoplasms. Results The overall prevalence of NP-CRNs was 9.35% (95% confidence interval [95% CI], 8.05%-10.78%; n=170). The prevalence of NP-CRNs in the subpopulations for screening, surveillance, and symptoms was 5.84% (95% CI, 4.13%-8.00%; n=36), 15.44% (95% CI, 12.76%-18.44%; n=101), and 6.01% (95% CI, 4.17%-8.34%; n=33), respectively. The overall prevalence of NP-CRNs with in situ or submucosal invasive carcinoma was 0.82% (95% CI, 0.46%-1.36%; n=15); in the screening population, the prevalence was 0.32% (95% CI, 0.04%-1.17%; n=2). Overall, NP-CRNs were more likely to contain carcinoma (odds ratio, 9.78; 95% CI, 3.93-24.4) than polypoid lesions, irrespective of the size. The positive size-adjusted association of NP-CRNs with in situ or submucosal invasive carcinoma was also observed in subpopulations for screening (odds ratio, 2.01; 95% CI, 0.27-15.3) and surveillance (odds ratio, 63.7; 95% CI, 9.41-431). The depressed type had the highest risk (33%). Nonpolypoid colorectal neoplasms containing carcinoma were smaller in diameter as compared with the polypoid ones (mean [SD] diameter, 15.9 [10.2] mm vs 19.2 [9.6] mm, respectively). The procedure times did not change appreciably as compared with historical controls. Conclusion In this group of veteran patients, NP-CRNs were relatively common lesions diagnosed during routine colonoscopy and had a greater association with carcinoma compared with polypoid neoplasms, irrespective of size.

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Section: Commentmentioning

confidence: 99%

Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults

Soetikno

Kaltenbach

Rouse³

et al. 2008

JAMA

558

360

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“…Thereafter, some analyses, including retrospective endoscopic analyses, were reported. Because endoscopy can give a much more detailed picture of small lesions, it is suitable for understanding cancer development arising from a minute or superficial type of cancer . In a meta‐analysis of five retrospective radiographic studies of 81 lesions with a final diagnosis of advanced cancer in which the initial lesion was presumed to be early cancer, the initial morphology was 0‐Is in 35 lesions (43.2%) and 0‐IIa in 18 lesions (22.2%).…”

Section: Initial Morphology In Advanced Cancermentioning

confidence: 99%

“…In our multicenter retrospective radiographic studies of 110 cancers, the mean DT was 26.5 months for intramucosal cancer, 25.9 months for submucosal cancer, and 12.3 months for advanced cancer. In a meta‐analysis of radiographic studies, the DT ranged from 9.4 to 55.4 months for intramucosal cancer and 4.7 to 12.2 months for advanced cancer. Colorectal cancer grew rather slowly when the cancer was limited to the mucosa.…”

Section: Growth Speed Of Cancermentioning

confidence: 99%

“…Because endoscopy can give a much more detailed picture of small lesions, it is suitable for understanding cancer development arising from a minute or superficial type of cancer. 10 In a meta-analysis of five retrospective radiographic studies 11 of 81 lesions with a final diagnosis of advanced cancer in which the initial lesion was presumed to be early cancer, the initial morphology was 0-Is in 35 lesions (43.2%) and 0-IIa in 18 lesions (22.2%). In an analysis of 35 lesions from 25 retrospective endoscopic reports 10 of 13 lesions with a final diagnosis of advanced cancer, the initial morphology was 0-Is in four lesions (30.8%) and 0-Ip and 0-IIa in two lesions each (each 15.4%).…”

Section: Initial Morphology In Advanced Cancermentioning

confidence: 99%

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Development and progression of colorectal cancer based on follow‐up analysis

Hisabe

Hirai

Matsui

2014

Digestive Endoscopy

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Elucidating the pathway of colorectal cancer development and progression can lead to identification of lesions that must be treated appropriately. The aim of the present review was to summarize the development and progression of colorectal cancer based on radiological and endoscopic follow-up analyses. These studies revealed several characteristic findings, including that initial morphology with progression to advanced cancer was most commonly 0-Is, followed by 0-IIa. Based on the doubling time, 0-Ip grew slowly in comparison with other morphologies. The observation period from adenomas measuring <10 mm to intramucosal cancers was more than 5 years. This makes it difficult to draw any accurate conclusions about the natural history of colorectal cancer based on follow-up observation alone and it is difficult to exclude the selection bias because of the difficulty of follow up for flat and depressed tumor. However, the only reliable way to elucidate the natural history is to accumulate cases.

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“…The growth rate of colorectal carcinoma is not constant but accelerates during later stages [13]. Matsui et al [14] retrospectively analyzed and concluded that development of superficialtype cancers were diverse, and sessile-type cancers with marked configuration changes and early cancers developed slowly, although the speed of their growth accelerated according to downward invasion of the cancer. Therefore, the short doubling time of this case-2 months-provides evidence that polypoid-type cancers develop with marked configuration changes.…”

Section: Discussionmentioning

confidence: 98%

Sigmoid colon carcinoma that developed from a sessile-type cancer in a short period of time

Tomiki

Ono

Ishiyama

et al. 2010

Clin J Gastroenterol

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We report a case of sigmoid colon carcinoma that developed from a sessile-type cancer in a short period of time. An 83-year-old man was found to have a round sessile polyp, about 2 cm in diameter, in the sigmoid colon. Because he had taken anticoagulants, immediate endoscopic mucosal resection and biopsy were not performed. Forty-three days later, the apical surface of the sessile polyp had become depressed and ulcerated, and we judged that an endoscopic resection was not indicated for this lesion. The histologic diagnosis of the biopsy specimens was a well-differentiated adenocarcinoma. We recommended surgical treatment; however, the patient was not in favor of surgical treatment and would not consent to surgery. Two more examinations were performed and the tumor was found to have developed into an invasive cancer with ulcerated, nodular margins involving 3/4 of the colonic lumen. At 271 days after the initial examination, the patient finally consented to surgery and a partial resection of the sigmoid colon was performed. The tumor was classified as stage I (T2N0M0). The several examinations performed from presentation within a short time span provide evidence of the morphologic changes that occur when a sessile-type cancer develops into an ulcerating invasive cancer. We hypothesize that remarkable configuration changes and development take place when a tumor becomes invasive in the muscularis propria from massive submucosal invasion. Our findings suggest that among the tumors discovered as typical ulcerating invasive type colon cancers are those that developed from protuberant tumors in a short period of time.

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Retrospective endoscopic study of developmental and configurational changes of early colorectal cancer: Eight cases and a review of the literature

Cited by 13 publications

References 15 publications

Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults

Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults

Development and progression of colorectal cancer based on follow‐up analysis

Sigmoid colon carcinoma that developed from a sessile-type cancer in a short period of time

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