Variables correlated with the risk of lymph node metastasis in early rectal cancer

Abstract

To ascertain the risk of lymph node metastasis (LNM) from early rectal cancer, the authors retrospectively analyzed 154 patients with pT1 or pT2 rectal cancer treated by radical resection. Gross and microscopic pathologic characteristics of the primary tumor were examined as predictors of LNM. Comparisons were done by Fisher's test; significance was defined as a P value of less than 0.05. The incidence of LNM for T1 and T2 tumors was 3 of 26 (12%) and 28 of 128 (22%), respectively. LNM occurred significantly less often in well‐differentiated cancers (0 of 12, 0%). The incidence of LNM for T1/T2 tumors without lymphatic vessel invasion (LVI) or blood vessel invasion (BVI) (20 of 119, 17%) was significantly less than that for T1/T2 tumors with LVI or BVI (10 of 32,31%). None of the T1 tumors without LVI or BVI had LNM. There was a trend toward decreased LNM for sessile nonulcerated tumors compared with nonpolypoid, exophytic, or ulcerated lesions (P = 0.06). Tumor size and colloid histologic characteristics were not significant predictive features for LNM. The data suggest that local excision alone is adequate for well‐differentiated or moderately differentiated T1 rectal cancer in the absence of LVI or BVI and for well‐differentiated T2 tumors. Radical resection or local excision combined with pelvic radiation therapy may be more appropriate for the remainder of early cancers.

The Factors Effecting Lymphovascular Invasion in Adenocarcinoma of the Colon and Rectum

“…In addition, the histological identification of lymphovascular invasion (LVI) has long been recognized as a potential indication of LNM and prognostic indicator and predictor of patient outcome. Many studies have investigated the presence of LVI in colorectal cancer (CRC) and have determined it to be a strong stage-independent prognostic marker [5][6][7]. Patients with LVI usually have a higher chance of disease progression and poorer prognosis [6][7][8].…”

Expression of CuZn- and Mn-Superoxide Dismutase in Human Colorectal Neoplasms

“…We investigated whether there was a correlation between SOD expression and either malignancy or differentiation grade of colorectal carcinomas. Because of a possible role of SOD in malignant transformation, we correlated CuZn-SOD and Mn-SOD protein expression and total SOD activity with survival and clinicopathological parameters for prognosis of colorectal carcinomas, such as Dukes staging, 21 presence of local lymph node metastases, 22 and vascular invasion. 23 …”

Transanale endoskopische mikrochirurgische Exzision von pT2-Rektumkarzinomen

“…Die Gesamtrate an Lymphknotenmetastasen bei unseren reoperierten Patienten betrug 18% (3/17; Tabelle 6). Dieses Ergebnis stimmt mit den von Sitzler et al [48] und Brodsky et al [49] berichteten Erfahrungen überein, die bei 21% bzw. 22% ihrer Patienten mit pT2-Karzinomen Lymphknotenmetastasen fanden.…”