Since the introduction of population-based screening, increasing numbers of T1 rectal cancers are detected and removed by local endoscopic resection. Patients can be cured with endoscopic resection alone, but there is a possibility of residual tumor cells remaining after the initial resection. These can be located intraluminally at the resection site or extraluminally in the form of (lymph node) metastases. To decrease the risk of residual cells progressing towards more advanced disease, additional treatment is usually needed. However, with the currently available risk stratification models, it remains challenging to determine who should and should not be further treated after non-curative endoscopic resection. In this review, the different management strategies for patients with non-curatively treated T1 rectal cancers are discussed, along with the available evidence for each strategy and relevant considerations for clinical decision making. Furthermore, we provide practical guidance on the management and surveillance following non-curative endoscopic resection of T1 rectal cancer.

中文翻译：

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T1期直肠癌非治愈性内镜切除术后的治疗

自从引入基于人群的筛查以来，越来越多的 T1 直肠癌通过局部内镜切除术被检测到并切除。仅通过内镜切除即可治愈患者，但初次切除后可能存在残留肿瘤细胞。这些可以位于切除部位的管腔内或以（淋巴结）转移的形式位于管腔外。为了降低残留细胞发展为更晚期疾病的风险，通常需要额外的治疗。然而，利用目前可用的风险分层模型，确定非治愈性内镜切除术后哪些人应该或不应该接受进一步治疗仍然具有挑战性。在这篇综述中，讨论了针对非治愈性 T1 直肠癌患者的不同治疗策略，以及每种策略的现有证据和临床决策的相关考虑因素。此外，我们还为 T1 直肠癌非治愈性内镜切除术后的管理和监测提供实用指导。