Effect of skip lymphovascular invasion on hepatic metastasis in colorectal carcinomas
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“Skip” lymphovascular invasion presenting as discontinuous foci of tumor cells within the colon wall is now excluded from consideration when determining T stage in the TNM classification. The purpose of this study was to assess the clinicopathological characteristics of colorectal cancer (CRC) patients with such skip lymphovascular invasion.
First, a retrospective questionnaire survey of the incidence of skip lymphovascular invasion was performed for a total of 1,868 patients with CRCs at ten institutions. Next, we comparatively assessed clinicopathological data for 896 CRC patients with or without skip lymphovascular invasion.
The incidence of skip lymphovascular invasion was 1.1 % (20 out of 1,868). Most of the affected cases were rectal, pT2, and node negative, with moderately differentiated histology. Skip lymphovascular invasion was present in the muscularis propria and subserosa, with the tumors directly invading submucosa (pT1) or muscularis propria (pT2). Hepatic metastasis was greater in CRC with skip lymphovascular invasion (25 %) than in pT1/2 CRC (0 %; P < 0.001) or pT3 CRC without such invasion (13.8 %; P = 0.185).
Our study suggests that skip lymphovascular invasion is associated with hepatic metastasis in CRC cases. Thus, definition of a T category including such invasion would be useful for clinical practice.
KeywordsSkip metastasis Lymphovascular invasion Colon carcinoma Liver metastasis
For kindly supplying the data the authors greatly thank: Hideki Ueno, Department of Surgery, National Defense Medical College; Gen Watanabe, Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences; Tetsuro Higuchi, Department of Digestive Surgery, Graduate School, Tokyo Medical and Dental University; Keiji Matsuda, Department of Surgery, Teikyo University; Hiroshi Kashida, Department of Gastroenterology and Hepatology, Kinki University; Shiro Oka, Department of Endoscopy, Hiroshima University Hospital; Tomio Arai, Department of Pathology, Tokyo Metropolitan Geriatric Hospital; Masamitsu Unakami, Department of Pathology, Watari Hospital; Ryo Wada, Department of Pathology, Juntendo Shizuoka Hospital, Juntendo University School of Medicine; Hisashi Nakamura, Department of Gastroenterology and Endoscopy, Chofu Surgical Clinic; Akinori Iwashita, Department of Pathology, Fukuoka University; Tomoo Ito, Department of Pathology, Kobe University Graduate School of Medicine; Atsushi Ochiai, Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East; Yasuo Ohkura, Department of Pathology, Kyorin University; Tadayoshi Kakemura, Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center; Hiroshi Kijima, Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine; Ryoji Kushima, Division of Molecular and Diagnostic Pathology, Shiga University of Medical Science Hospital; Kazutomo Togashi, Department of Gastroenterology, Fukushima Medical University; Takashi Nishigami, Department of Pathology, Steel Memorial Hirohata Hospital and Tamotsu Sugai, Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine.
Conflict of interest
The authors declare no conflict of interest.
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