Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?

Purpose Submucosa-limited (pathological T1, pT1) colorectal cancers (CRCs) pose a continuing challenge in the choice of treatment options, which range from local excision to radical surgery. The aim of this study was to evaluate the morphometric and morphologic risk factors associated with regional...

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Main Authors: Olga Maynovskaia, Evgeny Rybakov, Stanislav Chernyshov, Evgeniy Khomyakov, Sergey Achkasov
Format: Article
Language:English
Published: Korean Society of Coloproctology 2023-12-01
Series:Annals of Coloproctology
Subjects:
Online Access:http://coloproctol.org/upload/pdf/ac-2023-00087-0012.pdf
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author Olga Maynovskaia
Evgeny Rybakov
Stanislav Chernyshov
Evgeniy Khomyakov
Sergey Achkasov
author_facet Olga Maynovskaia
Evgeny Rybakov
Stanislav Chernyshov
Evgeniy Khomyakov
Sergey Achkasov
author_sort Olga Maynovskaia
collection DOAJ
description Purpose Submucosa-limited (pathological T1, pT1) colorectal cancers (CRCs) pose a continuing challenge in the choice of treatment options, which range from local excision to radical surgery. The aim of this study was to evaluate the morphometric and morphologic risk factors associated with regional lymph node metastasis (LNM) in pT1 CRC. Methods We performed a histological review of patients who underwent oncological resection between 2016 and 2022. Tumor grade, budding, poorly differentiated clusters (PDCs), cancer gland rupture, lymphovascular invasion (LVI), and presence of deep submucosal invasion (DSI), as well as width, length, total area, and area of DSI, were evaluated as potential risk factors for LNM. Results A total of 264 cases of colon and rectal carcinomas with invasion into the submucosal layer (pT1) were identified. LNM was found in 46 of the 264 cases (17.4%). All morphometric parameters, as well as DSI (P=0.330), showed no significant association with LNM. High grade adenocarcinoma (P=0.050), budding (P=0.056), and PDCs (P<0.001) were associated with LNM. In the multivariate analysis, LVI presence remained the only significant independent risk factor (odds ratio, 15.7; 95% confidence interval, 8.5–94.9; P<0.001). Conclusion The DSI of T1 CRC, as well as other morphometric parameters of submucosal tumor spread, held no predictive value in terms of LNM. LVI was the only independent risk factor of LNM.
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spelling doaj.art-6492a4a45b594e1781a7bc9b637847b82023-12-29T04:32:54ZengKorean Society of ColoproctologyAnnals of Coloproctology2287-97142287-97222023-12-0139648449210.3393/ac.2023.00087.00122018Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?Olga Maynovskaia0Evgeny RybakovStanislav Chernyshov1Evgeniy Khomyakov2Sergey Achkasov3 Ryzhikh National Medical Research Center of Coloproctology, Moscow, Russia Ryzhikh National Medical Research Center of Coloproctology, Moscow, Russia Ryzhikh National Medical Research Center of Coloproctology, Moscow, Russia Ryzhikh National Medical Research Center of Coloproctology, Moscow, RussiaPurpose Submucosa-limited (pathological T1, pT1) colorectal cancers (CRCs) pose a continuing challenge in the choice of treatment options, which range from local excision to radical surgery. The aim of this study was to evaluate the morphometric and morphologic risk factors associated with regional lymph node metastasis (LNM) in pT1 CRC. Methods We performed a histological review of patients who underwent oncological resection between 2016 and 2022. Tumor grade, budding, poorly differentiated clusters (PDCs), cancer gland rupture, lymphovascular invasion (LVI), and presence of deep submucosal invasion (DSI), as well as width, length, total area, and area of DSI, were evaluated as potential risk factors for LNM. Results A total of 264 cases of colon and rectal carcinomas with invasion into the submucosal layer (pT1) were identified. LNM was found in 46 of the 264 cases (17.4%). All morphometric parameters, as well as DSI (P=0.330), showed no significant association with LNM. High grade adenocarcinoma (P=0.050), budding (P=0.056), and PDCs (P<0.001) were associated with LNM. In the multivariate analysis, LVI presence remained the only significant independent risk factor (odds ratio, 15.7; 95% confidence interval, 8.5–94.9; P<0.001). Conclusion The DSI of T1 CRC, as well as other morphometric parameters of submucosal tumor spread, held no predictive value in terms of LNM. LVI was the only independent risk factor of LNM.http://coloproctol.org/upload/pdf/ac-2023-00087-0012.pdft1 colorectal carcinomasubmucosal invasionlymphatic metastasislymphovascular invasiontumor budding
spellingShingle Olga Maynovskaia
Evgeny Rybakov
Stanislav Chernyshov
Evgeniy Khomyakov
Sergey Achkasov
Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?
Annals of Coloproctology
t1 colorectal carcinoma
submucosal invasion
lymphatic metastasis
lymphovascular invasion
tumor budding
title Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?
title_full Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?
title_fullStr Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?
title_full_unstemmed Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?
title_short Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?
title_sort are the width length depth and area of submucosal invasion predictive of lymph node metastasis in pt1 colorectal cancer
topic t1 colorectal carcinoma
submucosal invasion
lymphatic metastasis
lymphovascular invasion
tumor budding
url http://coloproctol.org/upload/pdf/ac-2023-00087-0012.pdf
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