New scoring system to distinguish deep invasive submucosal and muscularis propria colorectal cancer during colonoscopy: a development and global multicenter external validation study (e-T2 Score)

Koyama, Yohei; Yamada, Masayoshi; Makiguchi, Mai Ego; Sekiguchi, Masau; Takamaru, Hiroyuki; Sakamoto, Taku; Kono, Shin; Fukuzawa, Masakatsu; Wu, Shih Yea Sylvia; Sugumaran, Arjun; Kawai, Takashi; Matsuda, Takahisa; Itoi, Takao; Saito, Yutaka

doi:10.1016/j.gie.2022.03.002

Cited by 10 publications

(5 citation statements)

References 42 publications

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“…Type 2B lesions exhibited a sensitivity of 99.1% and speci city of 43.5% in differentiating HGD and shallow submucosal invasive carcinoma from other lesions. Lastly, Type 3 lesions showed a sensitivity of 99.5% and speci city of 83.3% in differentiating deep submucosal invasive carcinoma from other lesions [24].…”

Section: Discussionmentioning

confidence: 89%

Impact of narrow-band imaging in prediction of histology of colorectal neoplasia: a prospective study

Grega,

Kmochova,

Hejcmanova

et al. 2024

Preprint

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Aims: We assessed the diagnostic performance of the Narrow-Band Imaging (NBI) International Colorectal Endoscopic Classification (NICE) and the Japan NBI Expert Team classification (JNET) in predicting histological outcomes of colorectal lesions. We aimed to compare their accuracy, particularly in identifying high-grade colorectal lesions (including high-grade adenomas, intramucosal carcinomas, T1 and T2 carcinomas). Methods: This was a prospective study involving 211 patients (130 men, mean age 60 years) who underwent colonoscopy with endoscopic resection of advanced colorectal neoplasia (lesions ≥ 10 mm). Lesions were classified using both NICE and JNET criteria, and final histopathological results were used for comparison. Results: Of the 257 lesions analyzed, the NICE classification demonstrated higher accuracy, correctly classifying 93.8% of lesions compared to 77.4% with JNET. Specifically, the sensitivity and positive predictive value (PPV) of NICE 2 for high-grade lesions were 100% and 24.4%, respectively. In comparison, JNET 2B had a sensitivity of 54.5% and a PPV of 52.2% for high-grade lesions. Conclusion: The NICE classification shows higher sensitivity for high-grade colorectal lesions (HGD adenomas, intramucosal carcinomas, T1 and T2 carcinomas), whereas the JNET classification, with a positive predictive value for high-grade lesions nearly double that of NICE, is more favourable for guiding therapy decisions. Trial Registration clinicaltrials.gov identifier: NCT05929365

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Section: Discussionmentioning

confidence: 89%

Impact of narrow-band imaging in prediction of histology of colorectal neoplasia: a prospective study

Grega,

Kmochova,

Hejcmanova

et al. 2024

Preprint

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“…It is reported that endoscopic ultrasound can further improve the accuracy of preoperative T-stage diagnosis and guide surgery more accurately [17]. Methods of improving the accuracy of preoperative T staging need to be further considered in the future as clinicians evaluate various techniques for improved diagnosis of the clinical T stage [8,[18][19][20].…”

Section: Discussionmentioning

confidence: 99%

D3 lymph node dissection improves the survival outcome in patients with pT2 colorectal cancer

Wang

Song

Chen

et al. 2023

Int J Colorectal Dis

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Background: The extent of lymphadenectomy in patients with pT2 colorectal cancer (CRC) remains controversial. This study aimed to elucidate the effects of D3 and D2 lymph node dissection (LND) on survival in patients diagnosed with pT2 CRC.Methods: This was a retrospective cohort study from a high-volume cancer center in Japan. From April 2007 to December 2020, 6,273 patients with primary CRC were included in the study; among these, 616 patients diagnosed with pT2 CRC underwent radical colorectal resection. Propensity score matching (PSM) was applied to balance potential confounding factors and a total of 104 matched pairs were extracted from the entire cohort. Independent risk factors associated with prognosis were determined by Cox regression analysis. The main outcome measures were overall survival (OS) and cancer-speci c survival (CSS).Results: Before PSM, there was a statistically signi cant difference across the cohort in OS and CSS (p=0.000 and 0.013) between D3 and D2 LND groups; the estimated hazard ratio (HR) was 2.2 (95% con dence interval (CI), 1.1-4.4, p=0.031) for OS in the D3 LND and 4.4 (95% CI, 1.7 to 11, p=0.0027) for CSS (p=0.013). There was also a signi cant difference (p=0.024) in OS between the D3 and D2 LND groups in the matched cohort, with an estimated HR for OS of 3.3 (95% CI, 1.2 to 9.1, p=0.024) and an estimated HR for CSS of 7.2 (95% CI, 1.6 to 33, p=0.011). Conclusions:D3 LND had a signi cant survival advantage in the treatment of pT2 colorectal cancer. The results of this study provide a theoretical basis for the application of D3 LND in radical surgery for pT2 colorectal cancer.LND to the origin of the main supplying artery has been recognized [2]. However, the optimal range of LND for pT2 colorectal cancer remains unclear [1,5].Propensity score matching (PSM) has been widely used in recent clinical studies to minimize the in uence of confounding variables between study groups [6]. In this context, the objective of this study was to evaluate the effect of D3 LND on the long-term prognosis of patients with pT2 CRC. Patients And Methods De nition of T-stage and extent of lymph node dissectionThis study was conducted according to the 7th Edition of the Japanese Colorectal Cancer Protocol. The tumor (T) stage and extent of LND were classi ed. Two Japanese pathologists examined all postoperative specimens. Stage pT2 is de ned as tumor in ltration into but not extending beyond the muscularis propria (Fig. 1). The mesenteric lymph nodes from the tissues surrounding the tumor to the root of the nutrient vessels supplying the tumor are de ned as the regional lymph nodes, and are divided into pericolic lymph nodes, intermediate lymph nodes, and apical lymph nodes (Fig. 2). Dissection to the level of the pericolic lymph nodes is de ned as D1 LND; dissection of both pericolic and intermediate lymph nodes is de ned as D2 LND; and dissection of pericolic, intermediate, and apical lymph nodes is de ned as D3 LND.According to the depth of tumor invasion, adequate resection of CRC requires resectio...

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“…Primary patient-matched, normal-tumor fibroblast pairs of nonadvanced adenomas, advanced adenomas, intramucosal carcinomas, and T2CRCs were isolated from endoscopic biopsy specimens in a similar way as the NF-T1CAF pairs. Targeted tumor biopsy specimens were taken based on optical diagnosis (features of noninvasive polyps: eg, Kudo III–IV pit pattern 66 and Sano II vessel pattern 67 ; features of T2CRCs: eg, Kudo Vn pit pattern, 66 Sano IIIb vessel pattern, 67 and Borrmann type 2 or 3 tumor 68 ), which subsequently was confirmed on histology. Advanced adenomas were defined as tubular adenomas >10 mm or adenomas with villous histology, and nonadvanced adenomas as tubular or tubulovillous adenomas ≤10 mm.…”

Section: Methodsmentioning

confidence: 99%

Cancer-Associated Fibroblasts Are Key Determinants of Cancer Cell Invasion in the Earliest Stage of Colorectal Cancer

Harryvan¹,

Liao²,

Danen³

et al. 2023

Cellular and Molecular Gastroenterology and Hepatology

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New scoring system to distinguish deep invasive submucosal and muscularis propria colorectal cancer during colonoscopy: a development and global multicenter external validation study (e-T2 Score)

Cited by 10 publications

References 42 publications

Impact of narrow-band imaging in prediction of histology of colorectal neoplasia: a prospective study

Impact of narrow-band imaging in prediction of histology of colorectal neoplasia: a prospective study

D3 lymph node dissection improves the survival outcome in patients with pT2 colorectal cancer

Cancer-Associated Fibroblasts Are Key Determinants of Cancer Cell Invasion in the Earliest Stage of Colorectal Cancer

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