Abstract
The clinicopathological features and treatment of flat elevation with central depression (IIa + IIc) type early colorectal cancer were studied. Three hundred and twenty four cases of early colorectal cancer were experienced in the past 7 years. There were 17 cases of IIa + IIc type early colorectal cancer comprising 5.2% of all early colorectal cancer cases. Seven of the 17 cancers were mucosal and 10 were submucosal. When the 17 cancers were examined macroscopically, they were found to be divided into U1 (+) type which had clear ulceration and U1 (-) type without it. Eight of the 17 cases were of the U1 (+) type. They were all submucosal cancer and the incidence of vessel invasion, lymphnode metastasis and liver metastasis was high. There were 9 cases of the U1 (-) type of which 7 were mucosal cancer and 2 submucosal cancer. One of the 17 patients underwent endoscopic polypectomy alone and 2 underwent curative trans-anal and trans-sacral resection respectively. This division of IIa + IIc type early colorectal cancer into U1 (+) and U1 (-) is clinically useful and for U1 (-) type at the lower rectum, local excision could be done at the first trial and the need for radical resection should be decided on the basis of the pathological findings.
