Novel Predictors for Lymph Node Metastasis in Submucosal Invasive Colorectal Carcinoma

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2017 Sep 22

PMID 28932085

Citations 20

Authors

Kwangil Yim

Daeyoun David Won

In Kyu Lee

Seong-Taek Oh

Eun Sun Jung

Sung Hak Lee

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate a novel grading system to predict lymph node metastasis (LNM) in patients with submucosal invasive colorectal carcinoma (SICRC).

Methods: We analyzed the associations between LNM and various clinicopathological features in 252 patients with SICRC who had undergone radical surgery at the Seoul Saint Mary's hospital between 2000 and 2015.

Results: LNM was observed in 31 patients (12.3%). The depth and width of the submucosal invasion, lymphatic invasion, tumor budding, and the presence of poorly differentiated clusters (PDCs) were significantly associated with the incidence of LNM. Using multivariate analysis, the receiver operating characteristic curvewas calculated and the area under curve (AUC) was used to compare the ability of the different parameters to identify the risk of LNM. The most powerful clinicopathological parameter for predicting LNM was lymphatic invasion (difference AUC = 0.204), followed by the presence or absence of tumor budding (difference AUC = 0.190), presence of PDCs (difference AUC = 0.172) and tumor budding graded by the Ueno method (difference AUC = 0.128).

Conclusion: Our results indicate that the tumor budding and the depth multiplied by the width measurements of submucosal invasion can provide important information for patients with SICRC.

Citing Articles

Histological Risk Factors for Lymph Node Metastasis in pT1 Colorectal Cancer: Does Submucosal Invasion Depth Really Matter?.

Yue B, Jia M, Xu R, Chen G, Jin M Curr Med Sci. 2024; 44(5):1026-1035.

PMID: 39390217 DOI: 10.1007/s11596-024-2926-7.

How secure can we expect the surveillance policies to be after the implementation in T1 polyps with carcinoma?.

Mateos Sanchez C, Quintanilla Lazaro E, Rabago L World J Gastrointest Endosc. 2024; 16(9):502-508.

PMID: 39351175 PMC: 11438583. DOI: 10.4253/wjge.v16.i9.502.

A Retrospective Multicenter Study of Risk Factors, Stratification, and Prognosis of Lymph Node Metastasis in T1 and T2 Colorectal Cancer.

Kim E, Son I, Kim B, Park J, Kang B, Kim J J Clin Med. 2023; 12(24).

PMID: 38137813 PMC: 10743749. DOI: 10.3390/jcm12247744.

Weighing the benefits of lymphadenectomy in early-stage colorectal cancer.

Baik S, Lee R Ann Surg Treat Res. 2023; 105(5):245-251.

PMID: 38023437 PMC: 10648610. DOI: 10.4174/astr.2023.105.5.245.

Lymph node metastasis in T1-2 colorectal cancer: a population-based study.

Xiong X, Wang C, Cao J, Gao Z, Ye Y Int J Colorectal Dis. 2023; 38(1):94.

PMID: 37055602 DOI: 10.1007/s00384-023-04386-w.

References

Wang H, Liang W, Lin T, Chen W, Jiang J, Yang S . Curative resection of T1 colorectal carcinoma: risk of lymph node metastasis and long-term prognosis. Dis Colon Rectum. 2005; 48(6):1182-92. DOI: 10.1007/s10350-004-0935-y. View

Lagoudianakis E, Pappas A, Koronakis N, Tsekouras D, Dallianoudis J, Kontogianni P . Lymph node harvesting in colorectal carcinoma specimens. Tumori. 2011; 97(1):74-8. DOI: 10.1177/030089161109700114. View

Stocchi L, Fazio V, Lavery I, Hammel J . Individual surgeon, pathologist, and other factors affecting lymph node harvest in stage II colon carcinoma. is a minimum of 12 examined lymph nodes sufficient?. Ann Surg Oncol. 2010; 18(2):405-12. DOI: 10.1245/s10434-010-1308-5. View

Kikuchi R, Takano M, Takagi K, Fujimoto N, Nozaki R, Fujiyoshi T . Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines. Dis Colon Rectum. 1995; 38(12):1286-95. DOI: 10.1007/BF02049154. View

Okabe S, Shia J, Nash G, Wong W, Guillem J, Weiser M . Lymph node metastasis in T1 adenocarcinoma of the colon and rectum. J Gastrointest Surg. 2004; 8(8):1032-9. DOI: 10.1016/j.gassur.2004.09.038. View

Haggitt R, Glotzbach R, Soffer E, WRUBLE L . Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. Gastroenterology. 1985; 89(2):328-36. DOI: 10.1016/0016-5085(85)90333-6. View

Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y . Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol. 2011; 17(1):1-29. DOI: 10.1007/s10147-011-0315-2. View

Chok K, Lun Law W . Prognostic factors affecting survival and recurrence of patients with pT1 and pT2 colorectal cancer. World J Surg. 2007; 31(7):1485-90. DOI: 10.1007/s00268-007-9089-0. View

Kalluri R . EMT: when epithelial cells decide to become mesenchymal-like cells. J Clin Invest. 2009; 119(6):1417-9. PMC: 2689122. DOI: 10.1172/JCI39675. View

10.

Lugli A, Karamitopoulou E, Zlobec I . Tumour budding: a promising parameter in colorectal cancer. Br J Cancer. 2012; 106(11):1713-7. PMC: 3364122. DOI: 10.1038/bjc.2012.127. View

11.

Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y . Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol. 2015; 20(2):207-39. PMC: 4653248. DOI: 10.1007/s10147-015-0801-z. View

12.

Ueno H, Mochizuki H, Hashiguchi Y, Shimazaki H, Aida S, Hase K . Risk factors for an adverse outcome in early invasive colorectal carcinoma. Gastroenterology. 2004; 127(2):385-94. DOI: 10.1053/j.gastro.2004.04.022. View

13.

Egashira Y, Yoshida T, Hirata I, Hamamoto N, Akutagawa H, Takeshita A . Analysis of pathological risk factors for lymph node metastasis of submucosal invasive colon cancer. Mod Pathol. 2004; 17(5):503-11. DOI: 10.1038/modpathol.3800030. View

14.

Kitajima K, Fujimori T, Fujii S, Takeda J, Ohkura Y, Kawamata H . Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study. J Gastroenterol. 2004; 39(6):534-43. DOI: 10.1007/s00535-004-1339-4. View

15.

Ueno H, Hase K, Hashiguchi Y, Shimazaki H, Yoshii S, Kudo S . Novel risk factors for lymph node metastasis in early invasive colorectal cancer: a multi-institution pathology review. J Gastroenterol. 2013; 49(9):1314-23. DOI: 10.1007/s00535-013-0881-3. View

16.

Kawachi H, Eishi Y, Ueno H, Nemoto T, Fujimori T, Iwashita A . A three-tier classification system based on the depth of submucosal invasion and budding/sprouting can improve the treatment strategy for T1 colorectal cancer: a retrospective multicenter study. Mod Pathol. 2015; 28(6):872-9. DOI: 10.1038/modpathol.2015.36. View

17.

Sohn D, Chang H, Park J, Choi D, Han K, Hong C . Histopathological risk factors for lymph node metastasis in submucosal invasive colorectal carcinoma of pedunculated or semipedunculated type. J Clin Pathol. 2006; 60(8):912-5. PMC: 1994481. DOI: 10.1136/jcp.2006.043539. View

18.

Tateishi Y, Nakanishi Y, Taniguchi H, Shimoda T, Umemura S . Pathological prognostic factors predicting lymph node metastasis in submucosal invasive (T1) colorectal carcinoma. Mod Pathol. 2010; 23(8):1068-72. DOI: 10.1038/modpathol.2010.88. View

19.

Schmoll H, Van Cutsem E, Stein A, Valentini V, Glimelius B, Haustermans K . ESMO Consensus Guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making. Ann Oncol. 2012; 23(10):2479-2516. DOI: 10.1093/annonc/mds236. View

20.

Dekker J, Peeters K, Putter H, Vahrmeijer A, van de Velde C . Metastatic lymph node ratio in stage III rectal cancer; prognostic significance in addition to the 7th edition of the TNM classification. Eur J Surg Oncol. 2010; 36(12):1180-6. DOI: 10.1016/j.ejso.2010.09.007. View