The purpose of this study was to investigate the pathological features and survival of 85 early stage colorectal cancer (CRC) patients who underwent endoscopy followed by radical surgery.

The data of 85 patients who were diagnosis as early stage CRC patient in Cancer Hospital, Chinese Academy of Medical Sciences between Sep.2011 and Sep.2019 were retrospectively collected. The clinicopathological features and survival of the patients were analyzed.

Among the 85 patients, 78 (91.7%) had high risk factors after endoscopic treatment (e.g., the endoscopic resection margin could not be evaluated, the resection margin was positive, the depth of submucosal infiltration was greater than 1 000 μm, the differentiation was poor, accompanied by vascular tumor thrombosis and nerve invasion, etc.). Sixty-six patients (74.2%) had neither residual tumor nor lymph node metastasis after radical resection. One patient (1.2%) had both residual tumor and lymph node metastasis. There were 9 patients (10.6%) with residual tumor. Pathological findings showed lymph node metastasis in another 11 patients (12.9%). Analysis showed that lymph node metastasis was easy to occur under the microscope with pathological accompanied by vascular infiltration (χ²=5.057, P=0.039). The median follow-up time was 24.0 months (P₂₅-P₇₅:12.0~41.1). Among the follow-up patients, two were lost to follow-up, and the remaining 83 patients had no recurrence or metastasis, and all survived.

The treatment of patients with high risk factors after endoscopic resection of early colorectal cancer should be carefully considered. Vascular infiltration may be one of the risk factors for lymph node metastasis. Additional radical surgery is safe and reliable.