The T1 CRC Working Group aims to perform multicenter multidisciplinairy research. Here, we summarize our current research projects.
Research projects
COMET T1 CRC
The aim of the COMET T1 CRC project is to develop a computer-aided diagnosis system based on artificial intelligence to improve the endoscopic recognition of early colorectal carcinoma.
In this project, we collect endoscopic images and videos of colorectal lesions in all available image enhancement techniques with the gold standard histopathology. We use this data to train and test the computer-aided diagnosis system.
Inclusion criteria
Patient ≥ 18 years old with an untreated colorectal lesion
– ≥10 mm with or without a suspicion of colorectal carcinoma
– <10 mm with a suspicion of colorectal carcinoma
Exclusion criteria
– Familial adenomatous polyposis
– Active inflammation around the colorectal lesion
Principal investigator: Erik Schoon
Coordinating researcher:
Miranda Adams, miranda.adams@maastrichtuniversity.nl, +31433882540
Recruitment
Data analysis
Complete
LIMERIC 2 study
Colonoscopy-Assisted Laparoscopic Wedge Resection (CAL-WR) is a promising local resection technique for both superficial and deeply invasive T1 colon cancer. It may bridge the gap between endoscopic local resection techniques and major oncologic surgery for tumors that are macroscopically suspected of deep submucosal invasion, thereby providing more patients with an organ-preserving treatment option. However, its long-term oncological outcomes are not yet known. Therefore, a prospective multicenter study (LIMERIC-II) commenced in January 2023, with sixteen participating centers.
Coordinating investigator
J. Hanevelt MD- PhD candidate
Gastroenterology and hepatology department, Isala
E-mail: j.hanevelt@isala.nl / limeric@isala.nl
Tel: +31 88 624 4340 / 06 37421727
J. Hanevelt MD- PhD candidate
Gastroenterology and hepatology department, Isala
E-mail: j.hanevelt@isala.nl / limeric@isala.nl
Tel: +31 88 624 4340 / 06 37421727
Principal Investigator
Dr. H.L. van Westreenen
Department of Surgery Isala
E-mail: h.l.van.westreenen@isala.nl
Tel: +31 38 424 6299
Dr. H.L. van Westreenen
Department of Surgery Isala
E-mail: h.l.van.westreenen@isala.nl
Tel: +31 38 424 6299
Recruitment
Data analysis
Complete
LOCAL study
“Long-term oncological outcomes of eFTR after previous incomplete resection of low-risk T1 CRC”
Goal
The aim of this nationwide, multicentre, prospective cohort study is to evaluate the feasibility and oncological safety of eFTR scar excision after incomplete resection of low-risk T1 CRC. We aim to include a total of 153 patients with histologically confirmed T1 CRC less than 3 cm in diameter. Patients with additional histological risk factors other than Rx/R1 resection margins will be excluded. A second review by one of our study pathologists will be performed to confirm the absence of other histological risk factors. After eFTR scar excision, patients will be followed according to the current protocol for high-risk T1 CRC as outlined in the Dutch CRC guideline. The primary endpoint is the 2-year and 5-year luminal local recurrence rate. Secondary endpoints include the proportion of curative eFTR resections, the feasibility of complete scar excision on histology, 2-year and 5-year nodal and/or distant recurrence rates, 5-year disease-specific and overall survival, and procedure-related adverse events and safety of eFTR compared to surgery.
The aim of this nationwide, multicentre, prospective cohort study is to evaluate the feasibility and oncological safety of eFTR scar excision after incomplete resection of low-risk T1 CRC. We aim to include a total of 153 patients with histologically confirmed T1 CRC less than 3 cm in diameter. Patients with additional histological risk factors other than Rx/R1 resection margins will be excluded. A second review by one of our study pathologists will be performed to confirm the absence of other histological risk factors. After eFTR scar excision, patients will be followed according to the current protocol for high-risk T1 CRC as outlined in the Dutch CRC guideline. The primary endpoint is the 2-year and 5-year luminal local recurrence rate. Secondary endpoints include the proportion of curative eFTR resections, the feasibility of complete scar excision on histology, 2-year and 5-year nodal and/or distant recurrence rates, 5-year disease-specific and overall survival, and procedure-related adverse events and safety of eFTR compared to surgery.
Contact information
Principal investigator: Barbara A.J. Bastiaansen
Project leader: Sander C. Albers,
s.c.albers@amsterdamumc.nl
Principal investigator: Barbara A.J. Bastiaansen
Project leader: Sander C. Albers,
s.c.albers@amsterdamumc.nl
Recruitment
Data analysis
Complete
PATCH study
The PATCH study aims to validate a previously developed risk model for pedunculated T1 CRC and to train pathologists in the assessment of histopathologic features involved in the model. Principal investigators: M.M. Lacle, L.M.G. Moons, S.G. Elias. Project leader: L. van der Schee
Recruitment
Data analysis
Complete
TESAR trial
Complementerende TME vs. small-field adjuvantechemoradiatie vs. close surveillance na lokale excisie vanhigh-risk T1 en low-risk T2 rectumcarcinoom
The TESAR study aims to determine the oncological safety, treatment relatedmorbidity, and the functional outcomes of rectal preserving therapy for intermediate risk earlyrectal cancer. In this international multicentre, partially randomised patient preference trial,patients with complete excision of intermediate risk T1 2 rectal cancer by transanal endoscopicsurgery (TEM/TAMIS) or endoscopic excision (snare polypectomy/EMR/ESD/EFTR/EID) can choose between completion surgery, adjuvant chemoradiotherapy or close surveillance. Patients who have had complete local excision of a rectal adenocarcinoma with an intermediate risk of recurrence: T1 adenocarcinoma with a diameter of 3 to 5 cm or a diameter of <3 cm with at least poor differentiation and/or sm3/Haggit4 and/or tumour budding and/or lymphatic and/or venous invasion, or a T2 adenocarcinoma with a maximum size of 3 cm and well/moderate differentiated and without lymphatic or venous invasion. Complete resection is defined as R0 (>0.1 mm) or Rx but with no macroscopic residual tumour, or R0 after re-excision of an earlier R1 resection. Patients are eligible if no suspicious mesorectal or other regional lymph nodes are observed on MRI. The primary outcome of the study is three year local recurrence rate. Secondary outcomes are short term morbidity, unsalvageable pelvic disease at three years, disease free and overall survival, stoma rate, long term morbidity, functional outcomes, health related quality of life and costs.
Contact information
Principal investigator:
Principal investigator:
Prof. J.B. Tuynman
Project leader: L.R Moolenaar
Email: tesartrial@amsterdamumc.nl / l.r.moolenaar@amsterdamumc.nlTel: +316 30886252
Recruitment
Data analysis
Complete
Contamination study
The contamination study aims to study whether tumor seeding by contamination of colonoscopy instruments could be a cause of mCRC Principal investigator: T. Seerden
Recruitment
Data analysis
Complete
Surgical outcomes
This study aims to assess the short term outcomes (morbidity and mortality) after surgical treatment for T1 CRC, and to compare this with surgical resection of advanced CRC Principal investigator: K.C.M.J. Peeters Project leader: N.C.A. Vermeer
Recruitment
Data analysis
Complete
Liquid biopsy pilot
This pilot aims to test whether liquid biopsies could be of value for risk stratification of T1 colorectal cancer Principal investigator: M.M. Lacle, L.M.G. Moons Project leader: C. Spoto, Y. Backes
Recruitment
Data analysis
Complete