{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:08:58Z","timestamp":1788822538047,"version":"build-2803163510"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Advances in colorectal cancer (CRC) screening and endoscopic techniques have led to increased detection of T1 CRC. Patient management relies on histopathological criteria predicting lymph node metastasis (LNM), including submucosal invasion depth (SID) &gt;1000 \u00b5m. However, the independent prognostic value of isolated deep invasion remains unclear.<\/jats:p>\n                  <jats:p>We performed a retrospective multicenter study of patients treated at 18 European centers between 2009 and 2022. Patients with T1 CRC endoscopically resected en bloc and with isolated SID &gt;1000 \u00b5m (without other high-risk features) were included. Two groups were analyzed: patients who underwent additional surgery and those who were followed with surveillance. Rates of LNM (surgery group) and recurrence (local and distant; surveillance group) were assessed. Exploratory multivariable analyses were performed to evaluate clinicopathological factors associated with LNM.<\/jats:p>\n                  <jats:p>Among 179 included patients (124 surgery, 55 surveillance), LNM was found in 16\/124 surgical specimens (12.9%; 95%CI 7.7\u201320.4) and recurrence occurred in 2\/55 patients undergoing surveillance (3.6%; 95%CI 0.4\u201312.6). LNM occurred in 1\/50 patients (2.0%) with SID &lt;2000 \u00b5m and in 15\/74 patients (20.3%) with SID \u22652000 \u00b5m. Multivariable analysis revealed SID \u22652000 \u00b5m (odds ratio [OR] 3.59; 95%CI 1.14\u201313.71) and colonic (vs. rectal) tumor location (OR 3.63; 95%CI 1.07\u201316.77) as factors associated with LNM.<\/jats:p>\n                  <jats:p>Isolated deep submucosal invasion in T1 CRC was associated with a non-negligible rate of LNM in this real-world cohort. In exploratory analyses, SID \u22652000 \u00b5m was associated with LNM.<\/jats:p>","DOI":"10.1055\/a-2925-6629","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T23:38:15Z","timestamp":1787355495000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk of lymph node metastasis in T1 colorectal cancer with isolated deep submucosal invasion: a multicenter European study"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3107-2208","authenticated-orcid":false,"given":"Lucas","family":"Barthet","sequence":"additional","affiliation":[{"name":"Hospital Group Edouard Herriot, France","place":["Lyon"],"department":["Gastroenterology and Endoscopy Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8628-5120","authenticated-orcid":false,"given":"Felix","family":"Corre","sequence":"additional","affiliation":[{"name":"Hospital Cochin, 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Zong","year":"2021","journal-title":"Gastroenterol Rep (Oxf)"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1055\/a-1811-7025","article-title":"Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline \u2013 update 2022","volume":"54","author":"P Pimentel-Nunes","year":"2022","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"publisher","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":"Y Hashiguchi","year":"2020","journal-title":"Int J Clin Oncol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1007\/s00384-020-03795-5","article-title":"Clinical significance of immunohistochemical lymphovascular evaluation to determine additional surgery after endoscopic submucosal dissection for 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Nakadoi","year":"2012","journal-title":"J Gastroenterol Hepatol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1111\/den.14878","article-title":"Outcomes of noncurative endoscopic submucosal dissection for T1 colorectal cancer: prospective, multicenter, cohort study in Japan","volume":"36","author":"S Tsuji","year":"2024","journal-title":"Dig Endosc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1093\/bjs\/znab168","article-title":"Histopathological risk factors for lymph node metastases in T1 colorectal cancer: meta-analysis","volume":"108","author":"AL Ebbeh\u00f8j","year":"2021","journal-title":"Br J Surg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1111\/jgh.13257","article-title":"Management of T1 colorectal cancers after endoscopic treatment based on the risk stratification of lymph node metastasis","volume":"31","author":"H Miyachi","year":"2016","journal-title":"J Gastroenterol 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