Histopathological risk factors for lymph node metastasis in submucosal invasive colorectal carcinoma of pedunculated or semipedunculated type

Aims: To evaluate the histopathological risk factors for lymph node metastasis in cases of pedunculated or semipedunculated submucosal invasive colorectal carcinoma (SICC). Methods: A total of 48 patients with non-sessile SICC who underwent systematic lymph node dissection were included. Tumour size, histological grade, angiolymphatic invasion, tumour budding, dedifferentiation, objective submucosal invasion depth from the identified muscularis mucosa, relative invasion depth of the submucosal layer, and depth of stalk invasion were investigated histopathologically. Results: Lymph node metastasis was observed in seven cases (14.6%). Univariate analysis showed angiolymphatic invasion and tumour budding to be significantly associated with lymph node metastasis. Multivariate analysis showed that tumour budding was the only independent factor associated with lymph node metastasis in cases of non-sessile SICC. Conclusions: Results indicate that tumour budding is a useful risk factor for predicting lymph node metastasis in cases of pedunculated or semipedunculated SICC.

[1]  Shin-ei Kudo,et al.  Early colorectal cancer: concept, diagnosis, and management , 2006, International Journal of Clinical Oncology.

[2]  Y. Nakanishi,et al.  Predictive Histopathologic Factors for Lymph Node Metastasis in Patients With Nonpedunculated Submucosal Invasive Colorectal Carcinoma , 2005, Diseases of the colon and rectum.

[3]  J. Guillem,et al.  Lymph node metastasis in T1 adenocarcinoma of the colon and rectum , 2004, Journal of Gastrointestinal Surgery.

[4]  H. Ueno,et al.  A New Prognostic Staging System for Rectal Cancer , 2004, Annals of surgery.

[5]  Hidetaka Mochizuki,et al.  Risk factors for an adverse outcome in early invasive colorectal carcinoma. , 2004, Gastroenterology.

[6]  Toshihide Kumamoto,et al.  Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study , 2004, Journal of Gastroenterology.

[7]  I. Hirata,et al.  Analysis of pathological risk factors for lymph node metastasis of submucosal invasive colon cancer , 2004, Modern Pathology.

[8]  K. Hase,et al.  Tumor Budding at the Invasive Margin Can Predict Patients at High Risk of Recurrence After Curative Surgery for Stage II, T3 Colon Cancer , 2003, Diseases of the colon and rectum.

[9]  Y. Atomi,et al.  Budding as a useful determinant of the optimal treatment for T1 rectal carcinomas. , 2003, Hepato-gastroenterology.

[10]  M. Yamaguchi,et al.  Budding (sprouting) as a useful prognostic marker in colorectal mucinous carcinoma. , 2002, Japanese journal of clinical oncology.

[11]  H. Ueno,et al.  Histologic indices in biopsy specimens for estimating the probability of extended local spread in patients with rectal carcinoma , 2002, Cancer.

[12]  V. Yajnik,et al.  Pathology and genetics of tumors of the digestive system , 2001 .

[13]  S. Nivatvongs.  Surgical Management of Early Colorectal Cancer , 2000, World Journal of Surgery.

[14]  M E Hammond,et al.  Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. , 2000, Archives of pathology & laboratory medicine.

[15]  R. Doci,et al.  Prognostic factors in colorectal cancer , 1998, Diseases of the colon and rectum.

[16]  Shin-ei Kudo,et al.  Endoscopic Diagnosis and Treatment of Early Colorectal Cancer , 1997, World Journal of Surgery.

[17]  H. Iishi,et al.  Endoscopic resection of large pedunculated colorectal polyps using a detachable snare. , 1996, Gastrointestinal endoscopy.

[18]  S. Hirohashi,et al.  Cancer cell morphology at the invasive front and expression of cell adhesion‐related carbohydrate in the primary lesion of patients with colorectal carcinoma with liver metastasis , 1996, Cancer.

[19]  R. Nozaki,et al.  Management of early invasive colorectal cancer , 1995, Diseases of the colon and rectum.

[20]  S. Kudo,et al.  Endoscopic Mucosal Resection of Flat and Depressed Types of Early Colorectal Cancer , 1993, Endoscopy.

[21]  K. Hase,et al.  Prognostic value of tumor “budding” in patients with colorectal cancer , 1993, Diseases of the colon and rectum.

[22]  R. Beart,et al.  The risk of lymph node metastasis in colorectal polyps with invasive adenocarcinoma , 1991, Diseases of the colon and rectum.

[23]  M. Sivak,et al.  When is endoscopic polypectomy adequate therapy for colonic polyps containing invasive carcinoma? , 1986, Gastroenterology.

[24]  R. Haggitt,et al.  Prognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy. , 1985, Gastroenterology.

[25]  F. Macrae,et al.  Histopathology and prognosis of malignant colorectal polyps treated by endoscopic polypectomy. , 1984, Gut.

[26]  H. Cooper.  Surgical pathology of endoscopically removed malignant polyps of the colon and rectum , 1983, The American journal of surgical pathology.

[27]  C. Balch,et al.  AJCC Cancer Staging Manual. 6th ed , 2002 .

[28]  R J Salmon,et al.  [Prognostic factors of colorectal cancer]. , 1989, Pathologie-biologie.

[29]  R. Haggitt.  Management of the patient with carcinoma in an adenoma. , 1988, Progress in clinical and biological research.

[30]  Haggitt Rc.  Management of the patient with carcinoma in an adenoma. , 1988 .