Comparison between JSCCR (Japan) and NCCN (USA) Guidelines
These guidelines indicate the need for additional treatment after endoscopic resection of T1 colorectal cancers. The presence of any high-risk feature generally indicates consideration for surgical resection with lymph node dissection.
| High-risk Feature | JSCCR Guidelines (Japan) | NCCN Guidelines (USA) |
|---|---|---|
| Submucosal invasion depth | ≥ 1000 µm | Deep invasion (qualitatively assessed; no numeric cutoff) |
| Tumor budding | High-grade (≥5 buds per microscopic field) | Considered a risk factor, not explicitly mandated |
| Lymphovascular invasion (LVI) | Presence | Presence. Colon - Deep invasion (qualitative, no numeric cutoff specified); Rectum - SM3 (lower third of submucosa) |
| Histologic differentiation | Poorly differentiated (G3) | Poorly differentiated (G3) or undifferentiated (G4) |
| Resection margins | Positive or unclear margins (secondary consideration) | Positive or indeterminate margins |
References:
- JSCCR Guidelines: Watanabe T, Muro K, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol. 2020;25(1):1-42. https://doi.org/10.1007/s10147-019-01485-z
- NCCN Guidelines: National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Colon Cancer (Version 1.2024). Available from: https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf
- NCCN Rectal Cancer Guidelines:NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer (Version 1.2024). https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf
Medical Disclaimer
This information is provided for educational purposes only and is intended for use by healthcare professionals. It should not replace clinical judgment or current medical practice guidelines. Always consult the most recent official guidelines and literature for clinical decision-making.