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High-Risk Pathological Features in T1 CRC

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

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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.