T1结直肠癌（CRC）息肉切除术后残留恶性细胞（肠壁/区域淋巴结）的复发风险必须与手术相关并发症相权衡。我们的目标是描述大规模前瞻性队列中T1 CRC的管理和结果。所有于2007年3月至2017年3月在格拉斯哥皇家医院诊断的T1 CRC患者均纳入研究。根据息肉切除术、直肠局部切除术和正式切除术状况对患者进行分组。进行χ2检验、多元二元logistic回归和Cox回归分析。在236名患者中，90名（38.1%）仅接受了息肉切除术，6名（2.6%）先进行了息肉切除术，然后进行直肠切除术，57名（24.2%）先进行了息肉切除术，然后进行了切除术，14名（5.9%）仅接受了直肠切除术，69名（29.2%）进行了原发切除术。仅进行息肉切除术与男性性别（P=0.028）、年龄较大（P<0.001）、远端CRC（P<0.001）和有蒂息肉（P<0.001）相关；原发切除术与较大的息肉（P<0.001）相关；息肉切除术后进行切除术与碎块切除术（P=0.002）和涉及到的息肉切除术边缘（P<0.001）相关。差异较大（OR 7.860，95% CI 1.117-55.328；P=0.038）独立预测淋巴结受累。粘膜下静脉侵犯（风险比[HR] 10.154，95% CI 2.087-49.396；P=0.004）和黏液样亚型（HR 7.779，95% CI 1.566-38.625；P=0.012）独立预测复发。粘膜下静脉侵犯（HR 5.792，95% CI 1.056-31.754；P=0.043）预测CRC特异性生存。虽然64.4%的仅进行息肉切除术的患者存在切缘受累/其他风险因素，但没有发生复发。94例中有切缘受累的患者中，有5例（5.3%）证实存在残留肿瘤。总体来说，淋巴结转移（7.1%）、复发（4.2%）和癌症特异性死亡率（3.0%）很少见。癌症特异性5年生存率较高：仅进行息肉切除术（100%），息肉切除术后进行切除术（98.2%），原发切除术（100%）。对于更多的T1 CRC息肉患者，随访可能是安全的。跨学科团队讨论和知情选择对此至关重要。 © 2023作者。《结直肠疾病》由约翰·威利和大不列颠及爱尔兰结直肠与直肠外科学会代表出版。

The recurrence risk associated with residual malignant cells (bowel wall/regional nodes) following T1 colorectal cancer (CRC) polypectomy must be weighed against operative morbidity. Our aim was to describe the management and outcomes of a large prospective cohort of T1 CRCs.All T1 CRCs diagnosed between March 2007 and March 2017 at the Glasgow Royal Infirmary were included. Patients were grouped by polypectomy, rectal local excision and formal resection status. χ2 testing, multivariate binary logistic and Cox regression were performed.Of 236 patients, 90 (38.1%) underwent polypectomy only, six (2.6%) polypectomy and then rectal excision, 57 (24.2%) polypectomy and then resection, 14 (5.9%) rectal excision only and 69 (29.2%) primary resection. Polypectomy only correlated with male sex (P = 0.028), older age (P < 0.001), distal CRCs (P < 0.001) and pedunculated polyps (P < 0.001); primary resection with larger polyps (P < 0.001); polypectomy then resection with piecemeal excision (P = 0.002) and involved polypectomy margin (P < 0.001). Poor differentiation (OR 7.860, 95% CI 1.117-55.328; P = 0.038) independently predicted lymph node involvement. Submucosal venous invasion (hazard ratio [HR] 10.154, 95% CI 2.087-49.396; P = 0.004) and mucinous subtype (HR 7.779, 95% CI 1.566-38.625; P = 0.012) independently predicted recurrence. Submucosal venous invasion (HR 5.792, 95% CI 1.056-31.754; P = 0.043) predicted CRC-specific survival. Although 64.4% of polypectomy-only patients had margin involvement/other risk factors, none developed recurrence. Of 94 with polypectomy margin involvement, five (5.3%) had confirmed residual tumour. Overall, lymph node metastases (7.1%), recurrence (4.2%) and cancer-specific mortality (3.0%) were rare. Cancer-specific 5-year survival was high: polypectomy only (100%), polypectomy and then resection (98.2%), primary resection (100%).Surveillance may be safe for more T1 CRC polyp patients. Multidisciplinary team discussion and informed patient choice are critical.© 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.