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Curative Resection of T1 Colorectal Carcinoma: Risk of Lymph Node Metastasis and Long-Term Prognosis

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Diseases of the Colon & Rectum

PURPOSE

The features of T1 colorectal adenocarcinoma and the risk determination of lymph node metastasis were reviewed. Prognostic factors were assessed to verify whether the risk of lymph node metastasis would influence the long-term prognosis.

METHODS

Patients undergoing curative resection of T1 colorectal adenocarcinoma at the Taipei Veterans General Hospital from December 1969 to August 2002 were retrospectively studied. Patients with synchronous colorectal cancer, distant metastasis, familiar adenomatous polyposis, or inflammatory bowel disease were excluded. The associations between lymph node metastasis and clinicopathologic variables were evaluated univariately using chi-squared test, Fisher’s exact test, or Student’s t -test, and multivariately using logistic regression. Univariate analysis by the log-rank test and multivariate analysis by Cox regression hazards model determined the factors influencing the overall survival.

RESULTS

A total of 159 patients were included. Sixteen patients (10.1 percent) had lymph node metastasis. The risk of lymph node metastasis included histologic grade (P = 0.005), lymphatic vessel invasion (P = 0.023), inflammation around cancer (P = 0.049), and budding at the invasive front of tumor (P = 0.022). Age (P = 0.001) and number of total sampling lymph nodes (P < 0.0001) were found to be the factors influencing the overall survival.

CONCLUSIONS

Variables that predict lymph node metastasis in surgically resected T1 colorectal carcinoma may not impact the long-term prognosis.

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REFERENCES

  1. S Kyzer LR Begin PH Gordon B Mitmaker (1992) ArticleTitleThe care of patients with colorectal polyps that contain invasive adenocarcinoma. Endoscopic polypectomy or colectomy? Cancer 70 2044–50 Occurrence Handle1:STN:280:ByyD3cjntlE%3D Occurrence Handle1394034

    CAS  PubMed  Google Scholar 

  2. S Nivatvongs A Rojanasakul HM Reiman et al. (1991) ArticleTitleThe risk of lymph node metastasis in colorectal polyps with invasive adenocarcinoma Dis Colon Rectum 34 323–8 Occurrence Handle1848810 Occurrence Handle1:STN:280:By6C2snotFY%3D

    PubMed  CAS  Google Scholar 

  3. T Suzuki S Sadahiro S Mukoyama et al. (2003) ArticleTitleRisk of lymph node and distant metastases in patients with early invasive colorectal cancer classified as Haggitt’s level 4 invasion: image analysis of submucosal layer invasion Dis Colon Rectum 46 203–8 Occurrence Handle10.1007/s10350-004-6525-1 Occurrence Handle12576894

    Article  PubMed  Google Scholar 

  4. S Tanaka K Haruma CR Teixeira et al. (1995) ArticleTitleEndoscopic treatment of submucosal invasive colorectal carcinoma with special reference to risk factors for lymph node metastasis J Gastroenterol 30 710–7 Occurrence Handle10.1007/BF01211386 Occurrence Handle1:STN:280:BymH3c7otVE%3D Occurrence Handle8963387

    Article  CAS  PubMed  Google Scholar 

  5. R Nascimbeni LJ Burgart S Nivatvongs DR Larson (2002) ArticleTitleRisk of lymph node metastasis in T1 carcinoma of the colon and rectum Dis Colon Rectum 45 200–6 Occurrence Handle11852333

    PubMed  Google Scholar 

  6. M Sakuragi K Togashi F Konishi Y Kawamura M Okada H Nagai (2003) ArticleTitlePredictive factors for lymph node metastasis in T1 stage colorectal carcinomas Dis Colon Rectum 46 1626–32 Occurrence Handle14668587

    PubMed  Google Scholar 

  7. NS Goldstein J Hart (1999) ArticleTitleHistologic features associated with lymph node metastasis in stage T1 and superficial T2 rectal adenocarcinomas in abdominoperineal resection specimens Am J Clin Pathol 111 51–8 Occurrence Handle1:STN:280:DyaK1M7htFyhtw%3D%3D Occurrence Handle9894454

    CAS  PubMed  Google Scholar 

  8. D Blumberg PB Paty AI Picon et al. (1998) ArticleTitleStage I rectal cancer: identification of high-risk patients J Am Coll Surg 186 574–80 Occurrence Handle10.1016/S1072-7515(98)00018-0 Occurrence Handle1:STN:280:DyaK1c3ktlSmtQ%3D%3D Occurrence Handle9583699

    Article  CAS  PubMed  Google Scholar 

  9. JT Brodsky GK Richard AM Cohen BD Minsky (1992) ArticleTitleVariables correlated with the risk of lymph node metastasis in early rectal cancer Cancer 69 322–6 Occurrence Handle1:STN:280:By2D1Mnps1U%3D Occurrence Handle1728363

    CAS  PubMed  Google Scholar 

  10. HS Cooper LM Deppisch WK Gourley et al. (1995) ArticleTitleEndoscopically removed malignant colorectal polyps: clinicopathologic correlations Gastroenterology 108 1657–65 Occurrence Handle1:STN:280:ByqB1crpsl0%3D Occurrence Handle7768369

    CAS  PubMed  Google Scholar 

  11. R Bleday E Breen JM Jessup A Burgess SM Sentovich G Steele (1997) ArticleTitleProspective evaluation of local excision for small rectal cancers Dis Colon Rectum 40 388–92 Occurrence Handle9106685 Occurrence Handle1:STN:280:ByiB28%2Fls1E%3D

    PubMed  CAS  Google Scholar 

  12. R Kikuchi M Takano K Takagi et al. (1995) ArticleTitleManagement of early invasive colorectal cancer: risk of recurrence and clinical guidelines Dis Colon Rectum 38 1286–95 Occurrence Handle7497841 Occurrence Handle1:STN:280:BymC3c7lsF0%3D

    PubMed  CAS  Google Scholar 

  13. T Masaki H Matsuoka M Sugiyama et al. (2003) ArticleTitleBudding as a useful determinant of the optimal treatment for T1 rectal carcinomas Hepatogastroenterology 50 388–91 Occurrence Handle12749229

    PubMed  Google Scholar 

  14. HS Wang JK Lin CY Mou et al. (2004) ArticleTitleLong-term outcome of patients with the obstructing carcinoma of the right colon Am J Surg 187 497–500 Occurrence Handle10.1016/j.amjsurg.2003.12.028 Occurrence Handle15041498

    Article  PubMed  Google Scholar 

  15. A Sakatani K Koizumi M Maruyama et al. (1991) ArticleTitleDiagnosis of sm cancer of the large intestine with special reference to its x-ray diagnosis [in Japanese] Stomach and Intestine 26 726–35

    Google Scholar 

  16. RS Grinnell (1939) ArticleTitleThe grading and prognosis of carcinoma of the colon and rectum Ann Surg 109 500–33 Occurrence Handle17857341 Occurrence Handle1:STN:280:DC%2BD2srkt1Cisw%3D%3D

    PubMed  CAS  Google Scholar 

  17. JR Jass WS Atkin J Cuzick et al. (1986) ArticleTitleThe grading of rectal cancer: historical perspectives and a multivariate analysis of 447 cases Histopathology 10 437–59 Occurrence Handle1:STN:280:BimB2cbht1E%3D Occurrence Handle3721406

    CAS  PubMed  Google Scholar 

  18. JR Jass SB Love JM Northover (1987) ArticleTitleA new prognostic classification of rectal cancer Lancet 1 1303–6 Occurrence Handle10.1016/S0140-6736(87)90552-6 Occurrence Handle1:STN:280:BiiB38jntFw%3D Occurrence Handle2884421

    Article  CAS  PubMed  Google Scholar 

  19. JR Jass (1986) ArticleTitleLymphocytic infiltration and survival in rectal cancer J Clin Pathol 39 585–9 Occurrence Handle1:STN:280:BimB2M7jvVY%3D Occurrence Handle3722412

    CAS  PubMed  Google Scholar 

  20. H Kim J Jen B Vogelstein SR Hamilton (1994) ArticleTitleClinical and pathological characteristics of sporadic colorectal carcinomas with DNA replication errors in microsatellite sequences Am J Pathol 145 148–56 Occurrence Handle1:CAS:528:DyaK2cXlsFCns78%3D Occurrence Handle8030745

    CAS  PubMed  Google Scholar 

  21. T Morodomi H Isomoto K Shirouzu K Kakegawa K Irie M Morimatsu (1989) ArticleTitleAn index of estimating the probability of lymph node metastasis in rectal cancers Cancer 63 539–43 Occurrence Handle1:STN:280:BiaC3cngvVE%3D Occurrence Handle2912530

    CAS  PubMed  Google Scholar 

  22. JR Jass K Miller JM Northover (1986) ArticleTitleFat clearance method versus manual dissection of lymph nodes in specimens of rectal cancer Int J Colorectal Dis 1 155–6 Occurrence Handle10.1007/BF01648442 Occurrence Handle1:STN:280:BiiB1c3gtlE%3D Occurrence Handle3611943

    Article  CAS  PubMed  Google Scholar 

  23. RC Haggitt RE Glotzbach EE Soffer LD Wruble (1985) ArticleTitlePrognostic factors in colorectal carcinomas arising in adenomas: implications for lesions removed by endoscopic polypectomy Gastroenterology 89 328–36 Occurrence Handle1:STN:280:BiqB3s7ovVI%3D Occurrence Handle4007423

    CAS  PubMed  Google Scholar 

  24. S Kudo (1993) ArticleTitleEndoscopic mucosal resection of flat and depressed types of early colorectal cancer Endoscopy 25 455–61 Occurrence Handle1:STN:280:ByuD1crjtFE%3D Occurrence Handle8261988 Occurrence Handle10.1055/s-2007-1010367

    Article  CAS  PubMed  Google Scholar 

  25. JM Geraghty CB Williams IC Talbot (1991) ArticleTitleMalignant colorectal polyps: venous invasion and successful treatment by endoscopic polypectomy Gut 32 774–8 Occurrence Handle1:STN:280:By6A3cbptFw%3D Occurrence Handle1855684

    CAS  PubMed  Google Scholar 

  26. BD Minsky C Mies (1989) ArticleTitleThe clinical significance of vascular invasion in colorectal cancer Dis Colon Rectum 32 794–803 Occurrence Handle1:STN:280:BiaA3sjpsVw%3D Occurrence Handle2474414

    CAS  PubMed  Google Scholar 

  27. K Hase C Shatney D Johnson M Trollope M Vierra (1993) ArticleTitlePrognostic value of tumor “budding” in patients with colorectal cancer Dis Colon Rectum 36 627–35 Occurrence Handle8348847 Occurrence Handle1:STN:280:ByyA2M7ltVY%3D

    PubMed  CAS  Google Scholar 

  28. K Hase CH Shatney H Mochizuki et al. (1995) ArticleTitleLong-term results of curative resection of “minimally invasive” colorectal cancer Dis Colon Rectum 38 19–26 Occurrence Handle7813339 Occurrence Handle1:STN:280:ByqC3M3mvVw%3D

    PubMed  CAS  Google Scholar 

  29. T Okuyama M Oya H Ishikawa (2002) ArticleTitleBudding as a risk factor for lymph node metastasis in pT1 or pT2 well-differentiated colorectal adenocarcinoma Dis Colon Rectum 45 628–34 Occurrence Handle12004212

    PubMed  Google Scholar 

  30. T Masaki T Muto (2000) ArticleTitlePredictive value of histology at the invasive margin in the prognosis of early invasive colorectal carcinoma J Gastroenterol 35 195–200 Occurrence Handle10.1007/s005350050330 Occurrence Handle1:STN:280:DC%2BD3c3hs1Cltg%3D%3D Occurrence Handle10755688

    Article  CAS  PubMed  Google Scholar 

  31. T Okuyama T Nakamura M Yamaguchi (2003) ArticleTitleBudding is useful to select high-risk patients in Stage II well-differentiated or moderately differentiated colon adenocarcinoma Dis Colon Rectum 46 1400–6 Occurrence Handle10.1007/s10350-004-6757-0 Occurrence Handle14530682

    Article  PubMed  Google Scholar 

  32. JL Svennevig OC Lunde J Holter D Bjorgsvik (1984) ArticleTitleLymphoid infiltration and prognosis in colorectal carcinoma Br J Cancer 49 375–7 Occurrence Handle1:STN:280:BiuC2MvkvF0%3D Occurrence Handle6704315

    CAS  PubMed  Google Scholar 

  33. HJ Nielsen U Hansen IJ Christensen CM Reimert N Brunner F Moesgaard (1999) ArticleTitleIndependent prognostic value of eosinophil and mast cell infiltration in colorectal cancer tissue J Pathol 189 487–95 Occurrence Handle10.1002/(SICI)1096-9896(199912)189:4<487::AID-PATH484>3.0.CO;2-I Occurrence Handle1:STN:280:DC%2BD3c%2Fps12gsw%3D%3D Occurrence Handle10629548

    Article  CAS  PubMed  Google Scholar 

  34. MJ Fernandez-Acenero M Galindo-Gallego J Sanz A Aljama (2000) ArticleTitlePrognostic influence of tumor-associated eosinophilic infiltrate in colorectal carcinoma Cancer 88 1544–8 Occurrence Handle10.1002/(SICI)1097-0142(20000401)88:7<1544::AID-CNCR7>3.0.CO;2-S Occurrence Handle1:STN:280:DC%2BD3c3gsVWqtw%3D%3D Occurrence Handle10738211

    Article  CAS  PubMed  Google Scholar 

  35. G Sacchi E Weber M Agliano et al. (2003) ArticleTitleLymphatic vessels in colorectal cancer and their relation with inflammatory infiltrate Dis Colon Rectum 46 40–7 Occurrence Handle10.1007/s10350-004-6494-4 Occurrence Handle12544520

    Article  PubMed  Google Scholar 

  36. V Violi N Pietra M Grattarola et al. (1998) ArticleTitleCurative surgery for colorectal cancer: long term results and life expectancy in the elderly Dis Colon Rectum 41 291–8 Occurrence Handle1:STN:280:DyaK1c7ntlemug%3D%3D Occurrence Handle9514423

    CAS  PubMed  Google Scholar 

  37. C Ratto L Sofo M Ippoliti et al. (1999) ArticleTitleAccurate lymph node detection in colorectal specimens resected for cancer is of prognostic significance Dis Colon Rectum 42 143–58 Occurrence Handle1:STN:280:DyaK1M3is1Cksw%3D%3D Occurrence Handle10211489

    CAS  PubMed  Google Scholar 

  38. CC Compton LP Fielding LJ Burgart et al. (2000) ArticleTitlePrognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999 Arch Pathol Lab Med 124 979–94 Occurrence Handle1:STN:280:DC%2BD3czptVKrug%3D%3D Occurrence Handle10888773

    CAS  PubMed  Google Scholar 

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ACKNOWLEDGMENT

The authors thank Hui-Chen Lee, Biostatistics Task Force, Division of Experimental Surgery, Department of Surgery, Taipei Veterans General Hospital, for her statistical advice and calculations.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China

    Huann-Sheng Wang M.D., Tzu-Chen Lin M.D., Wei-Shone Chen M.D., Ph.D., Jeng-Kae Jiang M.D., Ph.D., Shung-Haur Yang M.D., Ph.D., Shih-Ching Chang M.D. & Jen-Kou Lin M.D., Ph.D.

  2. Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China

    Wen-Yih Liang M.D.

  3. National Yang-Ming University, School of Medicine, Taipei, Taiwan, Republic of China

    Huann-Sheng Wang M.D., Wen-Yih Liang M.D., Tzu-Chen Lin M.D., Wei-Shone Chen M.D., Ph.D., Jeng-Kae Jiang M.D., Ph.D., Shung-Haur Yang M.D., Ph.D., Shih-Ching Chang M.D. & Jen-Kou Lin M.D., Ph.D.

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  1. Huann-Sheng Wang M.D.
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Supported by a grant from the Research Foundation of Taipei Veterans General Hospital.

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Wang, HS., Liang, WY., Lin, TC. et al. Curative Resection of T1 Colorectal Carcinoma: Risk of Lymph Node Metastasis and Long-Term Prognosis. Dis Colon Rectum 48, 1182–1192 (2005). https://doi.org/10.1007/s10350-004-0935-y

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  • DOI: https://doi.org/10.1007/s10350-004-0935-y

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