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KMID : 0371420170930050266
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Annals of Surgical Treatment and Research
2017 Volume.93 No. 5 p.266 ~ p.271
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Histopathologic risk factors for lymph node metastasis in patients with T1 colorectal cancer
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Ha Ryun-Kyong
Han Kyung-Su
Sohn Dae-Kyung
Kim Byung-Chang
Hong Chang-Won
Chang Hee-Jin
Hyun Jong-Hee
Kim Min-Jung
Park Sung-Chan
Oh Jae-Hwan
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Abstract
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Purpose: Evaluating the risk of lymph node metastasis (LNM) is critical for determining subsequent treatments following endoscopic resection of T1 colorectal cancer (CRC). This study analyzed histopathologic risk factors for LNM in patients with T1 CRC.
Methods: This study involved 745 patients with T1 CRC who underwent endoscopic (n = 97) or surgical (n = 648) resection between January 2001 and December 2015 at the National Cancer Center, Korea. LNM in endoscopically resected patients, which could not be evaluated directly, was estimated indirectly based on follow-up results and histopathologic reports of salvage surgery. The relationships of depth of submucosal invasion, histologic grade, budding, vascular invasion, and background adenoma with LNM were evaluated statistically.
Results: Of the 745 patients, 91 (12.2%) were found to be positive for LNM. Univariate and multivariate analyses identified deep submucosal invasion (P = 0.010), histologic high grade (P < 0.001), budding (P = 0.034), and vascular invasion (P < 0.001) as risk factors for LNM. Among the patients with one, two, three, and four risk factors, 6.0%, 18.7%, 36.4%, and 100%, respectively, were positive for LNM.
Conclusion: Deep submucosal invasion, histologic high grade, budding, and vascular invasion are risk factors for LNM in patients with T1 colorectal cancer. If any of these risk factors are present, additional surgery following endoscopic resection should be determined after considering the potential risk of LNM and each patient's situation.
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KEYWORD
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Colorectal neoplasm, Colonoscopy, Lymphatic metastasis
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