Absence of extramural venous invasion is an excellent predictor of metastasis-free survival in colorectal carcinoma stage II—a study using tangential tissue sectioning

Abstract

Tangential sectioning of the tumour periphery in CRC stage II yields a high rate of histologically evaluable extramural veins and permits proper assessment of EVI. Absence of EVI is significantly associated with metastasis-free survival, a finding of potential therapeutic value. On the other hand, one-third of the patients with EVI and circumferential tumour growth develop MHM, a setting in which the option for adjuvant chemotherapy should be considered. This study emphasises the importance of tangential sectioning of the invasive tumour front in CRC compared with the recommended perpendicular technique. The sensitivity and specificity of this method regarding MHM are characterised.

Pathological diagnostic criterion of blood and lymphatic vessel invasion in colorectal cancer: a framework for developing an objective pathological diagnostic system using the Delphi method, from the Pathology Working Group of the Japanese Society for Cancer of the Colon and Rectum

“…Clinicopathological factors including the TNM stage according to the Open Access Scan to access more free content fifth edition of TNM classification, 3 the presence of BLI, number of paraffin blocks taken to examine primary tumours, use of megablock, tangential tissue sectioning, histochemical staining and immunohistochemical staining were reviewed and compared. 17 The range of histochemical staining and antibody used for immunohistochemical staining were also reviewed.…”

Rectal Site and Suboptimal Nodal Yield Predict Systemic Recurrence in Resected Colorectal Carcinoma

“…23 Histological identification of tumor within large veins beyond the muscularis propria in resection specimens is associated with a high risk of subsequent SR. 4,24 Its absence is a useful predictor of metastasis-free survival when the pericolic fat is tangentially sectioned in stage II disease. 25 IMVI has been shown to be prognostically significant in only 1 study. 26 We found EMVI to be predictive of recurrence only on univariate analysis, and we had insufficient statistical power to determine the impact of IMVI.…”

Extramural venous invasion in colorectal cancer stage I

“…Up to about one-third of all patients with pT2 tumours in stage I have detectable invasion of veins;5 however, for unknown reasons, the risk of developing metachronous haematogenic metastases seems to be low as long as the tumour only involves intramural veins. In conclusion, the likelihood of metachronous haematogenic metastases depends on whether or not the tumour has transversed the bowel wall.…”