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Effect of skip lymphovascular invasion on hepatic metastasis in colorectal carcinomas

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Abstract

Background

“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.

Methods

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.

Results

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).

Conclusions

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.

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Acknowledgments

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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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan

    Yosuke Okamoto & Yoshinori Igarashi

  2. Department of Surgical and Molecular Pathology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan

    Hiroyuki Mitomi

  3. Regional Medical Support Center, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan

    Kazuhito Ichikawa

  4. Department of Pathology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan

    Shigeki Tomita

  5. Department of Pathology, Shinko Hospital, 1-4-47 Wakihama-cho, Chuo-ku, Kobe, Hyogo, 651-0072, Japan

    Kazuhito Ichikawa & Takahiro Fujimori

Authors
  1. Yosuke Okamoto
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  2. Hiroyuki Mitomi
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  3. Kazuhito Ichikawa
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  4. Shigeki Tomita
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  5. Takahiro Fujimori
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  6. Yoshinori Igarashi
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Consortia

Study Group for Depth of Tumor Invasion projected by the Japanese Society for Cancer of the Colon and Rectum (JSCCR)

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Correspondence to Hiroyuki Mitomi.

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Okamoto, Y., Mitomi, H., Ichikawa, K. et al. Effect of skip lymphovascular invasion on hepatic metastasis in colorectal carcinomas. Int J Clin Oncol 20, 761–766 (2015). https://doi.org/10.1007/s10147-014-0778-z

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  • DOI: https://doi.org/10.1007/s10147-014-0778-z

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