Histological factors predicting loco-regional lymph node metastasis in early invasive colorectal adenocarcinoma pT1

Machado, Isidro; Valera‐Alberni, Miriam; Juan, F; Löpez‐Guerrero, José Antonio; Fadrique, Alfonso García; Cruz, Julia; Lapiedra, Carmen Martínez; Alcantara, Fernanda Maia de; Yayá, Ricardo; Campos, Jorge; Fernández-Martos, Carlos; Estevan, Rafael

doi:10.1016/j.gastre.2015.12.004

Cited by 6 publications

(11 citation statements)

References 29 publications

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“…The rate of LNM has been previously reported to range from 7-15% [5][6][7][8], which is higher than our findings. Previously, it has been established that LNM may be highly correlated with lympho-vascular invasion [10][11], tumor size [12][13][14][15][16][17], TB [18] ,tumor invading in submucosa [19][20][21][22][23][24] and pathological differentiation [25][26][27]. In our study, lympho-vascular invasion was identified to be an independent risk factor for LNM in ECC.…”

Section: Discussionsupporting

confidence: 60%

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Zeng

Xiong

Cheng

et al. 2020

Preprint

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Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors for LNM and the effectiveness of postoperative chemotherapy in patients with ECC.MethodsWe retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January, 2007 and October, 2018. The correlations between LNM and gender, age, tumor size, tumor location, endoscopic morphology, Pathology, depth of invasion and tumor budding (TB), were estimated directly based on postoperative pathology results. We also observed the overall survivals (OS) and recurrences between ECC patients with and without LNM after the base-line being matched.Results There were 473 ECC patients observed, 288 patients of them were enrolled, 17 patients had LNM (5.90%). Univariate analysis revealed that tumor size, pathology, lympho-vascular invasion were associated with LNM in ECC (P = 0.026, 0.000, 0.000, respectively), and multivariate logistic regression confirmed that tumor size, pathology, lympho-vascular invasion were risk factors for LNM (P = 0.021, 0.023, 0.001, respectively). There were no significant differences for the OS and recurrence between the ECC patients with and without LNM whose base-lines were matched (P = 0.158,0.346, respectively), neither no significant difference between chemotherapy and no chemotherapy ECC patients without LNM after surgery (P = 0.729,0.052).Conclusion Tumor size, pathology, lympho-vascular invasion were risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve the overall survival and recurrence in patients with LNM, but no necessary for the ECC patients without LNM.

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Section: Discussionsupporting

confidence: 60%

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Zeng

Xiong

Cheng

et al. 2020

Preprint

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“…The rate of LNM has been previously reported to range from 7-15% [5][6][7][8], which is higher than our ndings. Previously, it has been established that LNM may be highly correlated with lympho-vascular invasion [10][11], tumor size [12][13][14][15][16][17], TB [18] ,tumor invading in submucosa [19][20][21][22][23][24] and pathological differentiation [25][26][27]. In our study, lymphovascular invasion was identi ed to be an independent risk factor for LNM in ECC.…”

Section: Discussionsupporting

confidence: 54%

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Zeng

Xiong

Cheng

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background Estimating the risk of lymph node metastasis (LNM) is crucial for determining subsequent treatments following curative resection of early colorectal cancer (ECC). This multicenter study analyzed the risk factors of LNM and the effectiveness of postoperative chemotherapy in patients with ECC.Methods We retrospectively analyzed the data of 473 patients with ECC who underwent general surgery in five hospitals between January 2007 and October 2018. The correlations between LNM and sex, age, tumor size, tumor location, endoscopic morphology, pathology, depth of invasion and tumor budding (TB) were directly estimated based on postoperative pathology results. We also observed the overall survival (OS) and recurrence in ECC patients with and without LNM after matching according to baseline measures. Results In total, 473 ECC patients were observed, 288 patients were enrolled, and 17 patients had LNM (5.90%). The univariate analysis revealed that tumor size, pathology, and lymphovascular invasion were associated with LNM in ECC (P=0.026, 0.000, and 0.000, respectively), and the multivariate logistic regression confirmed that tumor size, pathology, and lymphovascular invasion were risk factors for LNM (P=0.021, 0.023, and 0.001, respectively). There were no significant differences in OS and recurrence between the ECC patients with and without LNM after matching based on baseline measures (P=0.158 and 0.346, respectively), and no significant difference was observed between chemotherapy and no chemotherapy in ECC patients without LNM after surgery (P=0.729 and 0.052).Conclusion Tumor size, pathology, and lymphovascular invasion are risk factors for predicting LNM in ECC patients. Adjuvant chemotherapy could improve OS and recurrence in patients with LNM but not always in ECC patients without LNM.

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“…After screening the titles and abstracts, 94 full‐text articles were assessed for eligibility (first review). Of those, 24 studies reported all four risk factors, lymphovascular invasion, histological differentiation, depth of submucosal invasion, and tumor budding, and were included for systematic review (second review) 3,11–33 …”

Section: Resultsmentioning

confidence: 99%

“…3a-c). 3,[11][12][13][14]16,[18][19][20][21][22][23][25][26][27][28][29][30][31][32][33] In 15 of the 24 studies, adverse histological type (poorly differentiated adenocarcinoma, signet ring cell carcinoma, and mucinous carcinoma) was correlated with a higher risk of LNM than well to moderately differentiated adenocarcinoma, ORs ranging from 2.47-90.92 (Fig. 4).…”

Section: Study Selection and Inclusionmentioning

confidence: 99%

“…4). 3,[11][12][13]16,19,21,23,[25][26][27][30][31][32][33] According to multivariate analysis, adverse histological type was an independent risk factor for LNM, ORs ranged from 2.08-18.444 in eight of 16 studies. 3,13,16,19,26,30,31,33 Fifteen of 24 studies reported that depth of invasion was not significantly associated with the presence of LNM (Fig.…”

Section: Study Selection and Inclusionmentioning

confidence: 99%

See 1 more Smart Citation

Current problems and perspectives of pathological risk factors for lymph node metastasis in T1 colorectal cancer: Systematic review

Ichimasa

Kudo

Miyachi

et al. 2022

Digestive Endoscopy

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With the prevalence of endoscopic submucosal dissection and endoscopic full thickness resection, which enable complete resection of T1 colorectal cancer with a negative margin, the treatment strategy following endoscopic resection has become more important. The necessity of secondary surgical resection is determined on the basis of the risk of lymph node metastasis according to the histopathological findings of resected specimens because ~10% of T1 colorectal cancer cases have lymph node metastasis. The current Japanese treatment guidelines state four risk factors for lymph node metastasis: lymphovascular invasion, histological differentiation, depth of submucosal invasion, and tumor budding. These guidelines have succeeded in stratifying the low‐risk group for lymph node metastasis, in which endoscopic resection alone is acceptable for cure. On the other hand, there are some problems: there is variation in diagnosis methods and low interobserver agreement for each pathological factor and 90% of surgical resections are unnecessary, with lymph node metastasis negativity. To ensure patients with T1 colorectal cancer receive more appropriate treatment, these problems should be addressed. In this systematic review, we gave some suggestions to these practical issues of four pathological factors as predictors.

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Histological factors predicting loco-regional lymph node metastasis in early invasive colorectal adenocarcinoma pT1

Cited by 6 publications

References 29 publications

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Retrospective analysis for the LNM risk factors and effect of chemotherapy for the early colorectal cancer: A Chinese multicenter study

Current problems and perspectives of pathological risk factors for lymph node metastasis in T1 colorectal cancer: Systematic review

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