Blood and lymphatic vessel invasion in pT1 colorectal cancer: an international concordance study

Kojima, Masaru; Puppa, Giacomo; Kirsch, Richard; Basturk, Olca; Frankel, Wendy L.; Lugli, Alessandro; Sheahan, Kieran; Yeh, Matthew M.; Lauwers, Greg Y.; Risio, Mauro; Shimazaki, Hideyuki; Iwaya, Keiichi; Kage, Masayoshi; Akiba, Jun; Ohkura, Yasuo; Horiguchi, Shinichiro; Shomori, Kohei; Kushima, Ryoji; Nomura, Shosaku; Ajioka, Yoichi; Adsay, Volkan; Ochiai, Atsushi

doi:10.1136/jclinpath-2014-202805

Cited by 23 publications

(20 citation statements)

References 24 publications

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“…Many NETs were found to be smaller than 10 mm in this study. Therefore, vascular invasion in rectal NET with a small size can be concordantly assessed ( 15 , 16 ). Pathological analyses used in treatment algorithms should be designed to ensure objectivity in the assessment of vascular invasion in NET.…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine Tumors of the Large Intestine: Clinicopathological Features and Predictive Factors of Lymph Node Metastasis

et al. 2016

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A new histological classification of neuroendocrine tumors (NETs) was established in WHO 2010. ENET and NCCN proposed treatment algorithms for colorectal NET. Retrospective study of NET of the large intestine (colorectal and appendiceal NET) was performed among institutions allied with the Japanese Society for Cancer of the Colon and Rectum, and 760 neuroendocrine tumors from 2001 to 2011 were re-assessed using WHO 2010 criteria to elucidate the clinicopathological features of NET in the large intestine. Next, the clinicopathological relationship with lymph node metastasis was analyzed to predict lymph node metastasis in locally resected rectal NET. The primary site was rectum in 718/760 cases (94.5%), colon in 30/760 cases (3.9%), and appendix in 12/760 cases (1.6%). Patients were predominantly men (61.6%) with a mean age of 58.7 years. Tumor size was <10 mm in 65.4% of cases. Proportions of NET G1, G2, G3, and mixed adeno-neuroendocrine carcinoma (MANEC) were 88.4, 6.3, 3.9, and 1.3%, respectively. Of the 760 tumors, 468 were locally resected, and 292 were surgically resected with lymph node dissection. Rectal NET showed a higher proportion of NET G1, and colonic and appendiceal NET was more commonly G3 and MANEC. Of the 292 surgically resected cases, 233 NET G1 and G2 located in the rectum were used for the prediction of lymph node metastasis. Lymphatic and blood vessel invasion were independent predictive factors of lymph node metastasis. NET G2 cases showed more frequent lymph node metastasis than that seen in NET G1 cases, but this was not an independent predictor of lymph node metastasis. Of the 98 surgically resected cases <10 mm in size, we found 9 cases with lymph node metastasis (9.2%). All cases were NET G1, and eight of the nine cases were positive either for lymphatic invasion or blood vessel invasion. Using the WHO classification, we found NET in the large intestine showed a tumor-site-dependent variety of histological and clinicopathological features. Risk of lymph node metastasis in rectal NET was confirmed even in lesions smaller than 10 mm. Concordant assessment of vascular invasion will be required to estimate lymph node metastasis in small lesions.

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Section: Discussionmentioning

confidence: 99%

Neuroendocrine Tumors of the Large Intestine: Clinicopathological Features and Predictive Factors of Lymph Node Metastasis

et al. 2016

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“…Lymphovascular invasion was confirmed by D2‐40 immunostaining and EM staining and morphological criteria as previously described …”

Section: Methodsmentioning

confidence: 99%

“…Lymphovascular invasion was confirmed by D2-40 immunostaining and EM staining and morphological criteria as previously described. 23 Regarding tumour budding, an epithelial focus in the tumour with no more than five cells on H&E staining was defined as a bud. 6,16,24 CK AE1/AE3 immunostaining was used for confirmation of the buds.…”

Section: Pathological Study Pointsmentioning

confidence: 99%

Intramucosal colorectal carcinoma with lymphovascular invasion: clinicopathological characteristics of nine cases

Hashimoto

Horiuchi

Kurata³

et al. 2019

Histopathology

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Aims Recent studies have provided the concept of invasive intramucosal colorectal carcinoma (CRC), and a case of intramucosal CRC with lymphatic invasion has been reported; however, the characteristics of such cases and the risk of lymph node metastasis have never been investigated. Therefore, we aimed to assess the pathological characteristics of intramucosal CRCs with lymphovascular invasion as well as the possibility of lymph node metastasis as an indication for additional surgery. Methods and results To delineate the histological features of intramucosal CRCs with lymphovascular invasion, we analysed several histological features and compared their incidence among nine such cases, as well as 20 other cases of intramucosal CRCs without lymphovascular invasion. High‐grade tumour budding and a pattern of ‘eosinophilic cytoplasm and round nuclei with inflammatory reaction (ERI)’ were morphological characteristics of intramucosal CRCs with lymphovascular invasion, compared with those without lymphovascular invasion (both P < 0.05). Among the seven lymph node‐dissected cases of intramucosal CRCs with lymphovascular invasion, none showed lymph node metastasis. Conclusions In intramucosal CRCs with lymphovascular invasion, high‐grade tumour budding and the ‘ERI’ pattern are morphological characteristics that are distinct from those of non‐invasive CRC, which is synonymous with high‐grade dysplasia. Further studies using a larger number of cases by focusing on the above‐mentioned histological pattern are expected to clarify the potential of lymph node metastasis of such cases.

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“…Numerous studies have examined the quality of microscopic evaluation by comparing the results of slide sets scored by different groups of pathologists [25][26][27][28] ; however, clinical relevance is more directly investigated if the relation of a prognostic factor with outcome is evaluated. Therefore, we examined the prognostic value of the different histologic factors in both the SSR and NR settings and compared their AIC values, as is often used in comparing different staging systems.…”

Section: Year Of Diagnosis Proportion Of Reports (%)mentioning

confidence: 99%

Improvement of Care in Patients With Colorectal Cancer: Influence of the Introduction of Standardized Structured Reporting for Pathology

Sluijter

Workum

Wiggers³

et al. 2019

JCO Clinical Cancer Informatics

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PURPOSE The use of standardized structured reporting (SSR) can improve communication between cancer specialists, which might improve clinical care; however, there are no reliable data on whether the introduction of SSR is associated with improvements in clinical outcome. PATIENTS AND METHODS We performed a retrospective cohort study in the Netherlands, including all patients with colorectal cancer (CRC) from 2009 to 2014. As a reference, cohorts of 2007 and 2008 were included. Data from the Netherlands Cancer Registry were used and combined with data from the Dutch Pathology Registry (PALGA) and the Dutch ColoRectal Audit. We tested the preformulated hypothesis that use of SSR improves the care of patients with CRC by improving the completeness of the pathology reports, the quality of the pathology evaluation, and patient outcomes with respect to treatment and survival. RESULTS We included 72,859 patients with CRC (23.8% reference, 32.9% SSR, and 43.3% narrative reports). Use of SSR increased over time, which resulted in more complete pathology reports (95.8% v 89.8%; P < .001). Risk assessment in stage II colon cancer was more adequate and resulted in an increased delivery of adjuvant therapy in patients with SSR (19.6% v 15.1%; P = .001). Risk of death for patients in the SSR group was significantly lowered (corrected hazard ratio, 0.94; 95% CI 0.90 to 0.97). CONCLUSION We demonstrate that use of SSR improved patient care in those with CRC by providing more complete reports of higher quality, which had significant effects on the delivery of adjuvant therapy and patient outcomes.

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Blood and lymphatic vessel invasion in pT1 colorectal cancer: an international concordance study

Cited by 23 publications

References 24 publications

Neuroendocrine Tumors of the Large Intestine: Clinicopathological Features and Predictive Factors of Lymph Node Metastasis

Neuroendocrine Tumors of the Large Intestine: Clinicopathological Features and Predictive Factors of Lymph Node Metastasis

Intramucosal colorectal carcinoma with lymphovascular invasion: clinicopathological characteristics of nine cases

Improvement of Care in Patients With Colorectal Cancer: Influence of the Introduction of Standardized Structured Reporting for Pathology

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