Early Colorectal Cancer

ABSTRACT

Purpose : Early colorectal cancer is defined as the depth of tumor invasion limited to mucosa or submucosa regardless of the presence or absence of lymph node metastasis. We performed a retrospective study to determine the chronological changes in frequencies of early colorectal cancer and clinicopathologic differences between early colorectal cancer (ECC) and advanced colorectal cancer (ACC). Methods : We reviewed hospital records of the patients with colorectal cancer operated between January 1990 and December 1995. We classified the patients into two groups, ECC and ACC, according to the depth of tumor invasion and compared the clinicopathologic characteristics. Results : Fifty eight patients (5.2%) were diagnosed with early colorectal cancer among 1113 colorectal cancer patients operated at the same period. The frequency of ECC has increased from 1.9% in 1970~1989 to 5.2% in 1990~1995. The average age of patients with ECC at the time of surgery was 55.8 compared to 56.5 for patients with ACC group (p>0.05). Most patients (72.4%) with ECC had bleeding symptoms and majority of the ECCs were located in the rectum (72.4%). The mean size of tumors was 2.6 cm in its greatest diameter and was significantly smaller than that of ACC (5.7 cm). Compared to ACC, ECC had better histologic differentiation and fewer lymph node metastases (p<0.05). Thirty six of the ECC patients underwent bowel resection and remaining 22 underwent local excision. After a mean follow up period of 39.1 months (range 2~81months), recurrence was detected in one case. There was no death during the follow up period. Conclusion : The frequency of ECC has increased recently. Compared to patients with ACC, patients with ECC had more favorable clinicopathologic characteristics and better outcome. In selected patients, minimal operation can be applied without compromising the clinical outcome.