Lymph Node Metastases in Early Rectal Cancer

Management of early rectal cancer

“…The overall metastatic lymph node rate for ERC or T1 tumours ranges from 5·7 to 25 per cent6, 7, 79, 93–96. The rate of lymph node metastasis increases with the Kikuchi level: there is a 1–3 per cent risk with Sm1, 8 per cent with Sm2 and 23 per cent with Sm36.…”

“…ERC is a relatively uncommon finding in Western populations. The incidence of malignant colorectal polyps as a proportion of all adenomas removed varies between 2·6 and 9·7 per cent, with an average of 4·7 per cent5; 3–8·6 per cent of all resected colorectal adenocarcinomas are stage T14, 6, 7. The incidence of ERC will rise following the start of the UK screening programme.…”

Analysis of Risk Factors for Lymph Nodal Involvement in Early Stages of Rectal Cancer: When Can Local Excision Be Considered an Appropriate Treatment? Systematic Review and Meta-Analysis of the Literature

“…The presence of estrogen receptors (ERs) has been clearly demonstrated in 70% of CRCs [16]. Moreover, a number of other authors have shown that tamoxifen has a potent inhibitory action on metastatic cells from colo-rectal cancer in murine models [17]. It must be underlined that in our analysis this association is close to the inferior limits of the statistical significance and hampered by the fact that only two studies analyse this aspect (I2 : 55%).…”

“…After referring to full texts, 65 studies which did not satisfy the inclusion/exclusion criteria were removed from consideration. A total of 8 studies were left for analysis, involving a total of 1560 patients (Figure 1) [5,[13][14][15][16][17][18][19]. All 8 works were retrospective case studies of T1/T2 primary rectal cancer treated with RS and TME, ranging from 2++ to 2− according to the SIGN classification for grading evidence (Scottish Intercollegiate Guidelines Network) [13].…”

Rectal cancer recurrence: factors and mechanisms

“…The presence of lymph node metastases [ 53–55] strongly increases the risk of recurrence, independent of the depth of tumour invasion. Some early rectal tumours will metastasize to lymph nodes before the tumour has penetrated the rectal wall [ 56, 57]. However, extended tumour staging has been shown to influence clinical decisions in patients with rectal carcinoma [ 58], and though there have been considerable advances in preoperative tumour staging with the use of endoanal ultrasound and magnetic resonance imaging (MRI), it remains inexact [ 59].…”