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Journal of Gastroenterology

, Volume 39, Issue 6, pp 534–543 | Cite as

Correlations between lymph node metastasis and depth of submucosal invasion in submucosal invasive colorectal carcinoma: a Japanese collaborative study

  • Kazuaki Kitajima
  • Takahiro Fujimori
  • Shigehiko Fujii
  • Jun Takeda
  • Yasuo Ohkura
  • Hitoshi Kawamata
  • Toshihide Kumamoto
  • Shingo Ishiguro
  • Yo Kato
  • Tadakazu Shimoda
  • Akinori Iwashita
  • Yoichi Ajioka
  • Hidenobu Watanabe
  • Toshiaki Watanabe
  • Tetsuichiro Muto
  • Ko Nagasako
Article

Abstract

Background

Depth of submucosal invasion (SM depth) in submucosal invasive colorectal carcinoma (SICC) is considered an important predictive factor for lymph node metastasis. However, no nationwide reports have clarified the relationship between SM depth and rate of lymph node metastasis. Our aim was to investigate the correlations between lymph node metastasis and SM depth in SICC.

Methods

SM depth was measured for 865 SICCs that were surgically resected at six institutions throughout Japan. For pedunculated SICC, the level 2 line according to Haggitt’s classification was used as baseline and the SM depth was measured from this baseline to the deepest portion in the submucosa. When the deepest portion of invasion was limited to above the baseline, the case was defined as a head invasion. For nonpedunculated SICC, when the muscularis mucosae could be identified, the muscularis mucosae was used as baseline and the vertical distance from this line to the deepest portion of invasion represented SM depth. When the muscularis mucosae could not be identified due to carcinomatous invasion, the superficial aspect of the SICC was used as baseline, and the vertical distance from this line to the deepest portion was determined.

Results

For pedunculated SICC, rate of lymph node metastasis was 0% in head invasion cases and stalk invasion cases with SM depth <3000 µm if lymphatic invasion was negative. For nonpedunculated SICC, rate of lymph node metastasis was also 0% if SM depth was <1000 µm.

Conclusions

These results clarified rates of lymph node metastasis in SICC according to SM depth, and may contribute to defining therapeutic strategies for SICC.

Key words

submucosal invasive colorectal carcinoma (SICC) depth of submucosal invasion (SM depth) lymph node metastasis collaborative study 

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Copyright information

© Springer-Verlag Tokyo 2004

Authors and Affiliations

  • Kazuaki Kitajima
    • 1
    • 2
  • Takahiro Fujimori
    • 1
  • Shigehiko Fujii
    • 1
  • Jun Takeda
    • 1
  • Yasuo Ohkura
    • 1
  • Hitoshi Kawamata
    • 1
  • Toshihide Kumamoto
    • 2
  • Shingo Ishiguro
    • 3
  • Yo Kato
    • 4
  • Tadakazu Shimoda
    • 5
  • Akinori Iwashita
    • 6
  • Yoichi Ajioka
    • 7
  • Hidenobu Watanabe
    • 7
  • Toshiaki Watanabe
    • 8
  • Tetsuichiro Muto
    • 9
  • Ko Nagasako
    • 10
  1. 1.Department of Surgical and Molecular PathologyDokkyo University School of MedicineTochigiJapan
  2. 2.The Third Department of Internal MedicineOita University Faculty of MedicineOitaJapan
  3. 3.Department of PathologyOsaka Medical Center for Cancer and Cardiovascular DiseaseOsakaJapan
  4. 4.Department of PathologyCancer InstituteTokyoJapan
  5. 5.Pathology DivisionNational Cancer Center Research Institute and HospitalTokyoJapan
  6. 6.Department of Pathology, Chikushi HospitalFukuoka UniversityFukuokaJapan
  7. 7.Division of Molecular and Functional Pathology, Department of Cellular Function, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
  8. 8.Department of Surgical Oncology, School of MedicineTokyo UniversityTokyoJapan
  9. 9.Cancer Institute HospitalTokyoJapan
  10. 10.Gunma Cancer CenterGunmaJapan

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