Post written by Yuxiang Chen, MM, and Kai Deng, MD, from the Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, and Sichuan University–Oxford University Huaxi Gastrointestinal Cancer Centre, Department of Gastroenterology & Hepatology, West China Hospital, Sichuan University, Chengdu, China.

Our study was performed as a systematic retrieval of data from existing studies and pooled analysis by means of meta-analysis to quantify the short-, medium-, and long-term net benefits of local resection (LR) versus those of surgical resection (SR) for patients with high-risk T1 colorectal cancer (CRC).

It was important to conduct this study to clarify the difference in survival risk between additional surgery and no additional surgery in patients with T1 CRC and thus provide individualized treatment plans for this population.

We found that, among high-risk T1 CRC patients, the difference in disease-specific survival between the group that received LR and the group that received additional surgery might not emerge until a decade later.

In other words, in older patients with poorer underlying conditions, the most significant cause of death may not be the tumor, but more likely advanced age or severe comorbidities.

To our knowledge, this is the first meta-analysis that compares the clinical outcomes of LR and SR in patients with high-risk T1 CRC over short-, medium-, and long-term periods. Furthermore, our study exclusively focused on a high-risk population, aiming to address the perplexity in clinical practice.

However, this study has some limitations. Because articles included were all retrospective studies, the number of cases was small, and some were missing data, the study’s credibility needs to be verified. It is hoped that more and more can pay attention to this direction to provide additional case numbers for exploration.

A, Flowchart of the search process. B, Long-term survival outcomes of patients in the local resection (LR) and surgical resection (SR) groups. C, Long-term recurrence-free survival outcomes of patients in the LR and SR groups. D, Long-term disease-specific survival outcomes of patients in the LR and SR groups.

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