{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T08:16:59Z","timestamp":1783325819624,"version":"3.54.6"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background and Aim<\/jats:title>\n Emerging endoscopic techniques are expanding opportunities for minimally invasive therapy in early colorectal cancers (CRCs). Data regarding the clinicopathological features and outcomes of colon versus rectal cancers in Tis, T1, and T2 stages remain limited. This study evaluates and compares these two entities to clarify their oncologic differences.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We retrospectively analyzed patients with pTis\u2010T2 CRCs treated by endoscopic or surgical resection at a single Japanese center between 2001 and 2022. Tumor location was classified as rectum (Ra, Rb) or colon (cecum to RS). Clinical variables (sex and age), pathological features (tumor size, differentiation, lymphatic invasion [Ly], vascular invasion [V], and tumor budding), and recurrence and metastasis rates were compared according to tumor location.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The proportion of rectal cancer rose with invasion depth, from 16.2% (271\/1673) in Tis to 18.5% (248\/1337) in T1 and 26.4% (178\/675) in T2 (\n p<\/jats:italic>\n < 0.01). Compared with T1 colon cancer, T1 rectal cancer showed higher rates of Ly1\u20102 (35.1%\u00a0vs. 27.4%), V1\u20102 (37.9%\u00a0vs. 24.6%), and recurrence (4.4%\u00a0vs. 0.6%) (all\n p<\/jats:italic>\n < 0.05). Similarly, T2 rectal cancer showed higher V1\u20102 (68.5%\u00a0vs. 54.1%) and recurrence rates (13.5%\u00a0vs. 5.0%) compared with colon cancer (all\n p<\/jats:italic>\n < 0.05). No significant differences were observed in lymph node or distant metastasis at either T1 or T2 stages.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Rectal cancers demonstrate more aggressive features and higher recurrence rates than colon cancers. Consequently, these patients require more stringent therapeutic approaches and rigorous postoperative surveillance, even in early stages.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Umin Clinical Trials Registry, UMIN 000042622.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/deo2.70371","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:41:05Z","timestamp":1783323665000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse Pathological Features and Worse Prognosis in Rectal Cancer Compared With Colon Cancer in T1 and T2 Stages"],"prefix":"10.1002","volume":"7","author":[{"given":"Shunto","family":"Iwasaki","sequence":"first","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin\u2010ei","family":"Kudo","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Kouyama","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuro","family":"Ichimasa","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigenori","family":"Semba","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taishi","family":"Okumura","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Nakahara","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuharu","family":"Maeda","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Ogata","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takemasa","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naruhiko","family":"Sawada","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Baba","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Nemoto","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology and Laboratory Medicine Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Misawa","sequence":"additional","affiliation":[{"name":"Digestive Disease Center Showa Medical University Northern Yokohama Hospital Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"issue":"9","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1055\/s-0030-1255675","article-title":"Long\u2010Term Outcomes of Endoscopic Submucosal Dissection for Colorectal Epithelial Neoplasms","volume":"42","author":"Niimi K.","year":"2010","journal-title":"Endoscopy"},{"issue":"2","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"805","DOI":"10.3892\/ol.2016.5464","article-title":"Comparative Clinicopathological Characteristics of Colon and Rectal T1 Carcinoma","volume":"13","author":"Ichimasa K.","year":"2017","journal-title":"Oncology 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M. G.","year":"2022","journal-title":"Endoscopy"},{"issue":"5","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1055\/a-1637-9051","article-title":"Endoscopic Full\u2010Thickness Resection of T1 Colorectal Cancers: A Retrospective Analysis From a Multicenter Dutch eFTR Registry","volume":"54","author":"Zwager L. W.","year":"2022","journal-title":"Endoscopy"},{"issue":"12","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1080\/00365521.2022.2089858","article-title":"Endoscopic Full\u2010Thickness Resection for Complex Colorectal Lesions\u2014What's the Next Step?","volume":"57","author":"Ichimasa K.","year":"2022","journal-title":"Scandinavian Journal of Gastroenterology"},{"issue":"7","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/S2468-1253(17)30074-2","article-title":"A Watch\u2010And\u2010Wait Approach for Locally Advanced Rectal Cancer After a Clinical Complete Response Following Neoadjuvant Chemoradiation: A Systematic Review and Meta\u2010Analysis","volume":"2","author":"Dossa F.","year":"2017","journal-title":"Lancet Gastroenterology & Hepatology"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.humpath.2022.05.006","article-title":"The Association Between Tumour Sub\u2010Site and Local Nodal and\/or Distant Metastasis at the Time of Resection of Colorectal Cancer: A Prospective Study of 3,360 Consecutive Cases","volume":"126","author":"Newland R.","year":"2022","journal-title":"Human Pathology"},{"issue":"8","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.ctrv.2015.06.007","article-title":"Rectal and Colon Cancer: Not Just a Different Anatomic Site","volume":"41","author":"Tamas K.","year":"2015","journal-title":"Cancer Treatment Reviews"},{"issue":"8","key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1097\/DCR.0b013e31828f9a57","article-title":"Colon and Rectal Cancer Survival by Tumor Location and Microsatellite Instability: The Colon Cancer Family Registry","volume":"56","author":"Phipps A. I.","year":"2013","journal-title":"Diseases of the Colon and Rectum"},{"issue":"2","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s00535-010-0341-2","article-title":"Characteristics of Recurrence After Curative Resection for T1 Colorectal Cancer: Japanese Multicenter Study","volume":"46","author":"Kobayashi H.","year":"2011","journal-title":"Journal of Gastroenterology"},{"issue":"1","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","DOI":"10.1111\/den.70042","article-title":"Artificial Intelligence\u2010Assisted Whole Slide Image Analysis for Lymph Node Status Prediction in Early Colorectal and Gastric Cancer","volume":"38","author":"Ichimasa K.","year":"2026","journal-title":"Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society"},{"issue":"5","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1111\/den.14220","article-title":"Current Problems and Perspectives of Pathological Risk Factors for Lymph Node Metastasis in T1 Colorectal Cancer: Systematic Review","volume":"34","author":"Ichimasa K.","year":"2022","journal-title":"Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society"},{"issue":"1","key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10147-019-01485-z","article-title":"Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2019 for the Treatment of Colorectal Cancer","volume":"25","author":"Hashiguchi Y.","year":"2020","journal-title":"International Journal of Clinical Oncology"},{"key":"e_1_2_12_18_1","volume-title":"Digestive System Tumours","author":"WHO Classification of Tumours Editorial Board","year":"2019"},{"issue":"4","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.23922\/jarc.2019-018","article-title":"Japanese Society for Cancer of the Colon and Rectum Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma: The 3rd English Edition [Secondary Publication]","volume":"3","year":"2019","journal-title":"Journal of the Anus, Rectum and Colon"},{"issue":"2","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1053\/j.gastro.2004.04.022","article-title":"Risk Factors for an Adverse Outcome in Early Invasive Colorectal Carcinoma","volume":"127","author":"Ueno H.","year":"2004","journal-title":"Gastroenterology"},{"issue":"1","key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S0016-5107(96)70222-5","article-title":"Diagnosis of Colorectal Tumorous Lesions by Magnifying Endoscopy","volume":"44","author":"Kudo S.","year":"1996","journal-title":"Gastrointestinal Endoscopy"},{"issue":"11","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"2700","DOI":"10.1111\/j.1572-0241.2008.02190.x","article-title":"Efficacy of the Invasive\/Non\u2010Invasive Pattern by Magnifying Chromoendoscopy to Estimate the Depth of Invasion of Early Colorectal Neoplasms","volume":"103","author":"Matsuda T.","year":"2008","journal-title":"American Journal of Gastroenterology"},{"issue":"5","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1111\/den.12644","article-title":"Narrow\u2010Band Imaging (NBI) Magnifying Endoscopic Classification of Colorectal Tumors Proposed by the Japan NBI Expert Team","volume":"28","author":"Sano Y.","year":"2016","journal-title":"Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society"},{"issue":"3","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.1443-1661.2010.00983.x","article-title":"Diagnostic Accuracy of Pit Pattern and Vascular Pattern Analyses in Colorectal Lesions","volume":"22","author":"Wada Y.","year":"2010","journal-title":"Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society"},{"issue":"6","key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/S0016-5107(03)02159-X","article-title":"The Paris Endoscopic Classification of Superficial Neoplastic Lesions: Esophagus, Stomach, and Colon: November 30 to December 1, 2002","volume":"58","author":"Participants in the Paris Workshop","year":"2003","journal-title":"Gastrointestinal Endoscopy"},{"key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.gie.2025.06.009","article-title":"Comparison of Survival and Recurrence Between Colonic and Rectal Tumors After Resection in T1 Colorectal Cancer: Long\u2010Term Cohort Study","volume":"103","author":"Okumura T.","year":"2025","journal-title":"Gastrointestinal Endoscopy"},{"key":"e_1_2_12_27_1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1055\/s-0033-1344238","article-title":"Predicting Lymph Node Metastasis in pT1 Colorectal Cancer: A Systematic Review of Risk Factors Providing Rationale for Therapy Decisions","volume":"45","author":"Bosch S. 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D.","year":"2018","journal-title":"BMJ Open"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:41:10Z","timestamp":1783323670000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,6]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2027,4]]}},"alternative-id":["10.1002\/deo2.70371"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70371","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,6]]},"assertion":[{"value":"2026-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70371"}}