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International Journal of Colorectal Disease

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Open Access 01-10-2020 | Metastasis | Original Article

Left-sided location is a risk factor for lymph node metastasis of T1 colorectal cancer: a single-center retrospective study

Authors: Kenichi Mochizuki, Shin-ei Kudo, Katsuro Ichimasa, Yuta Kouyama, Shingo Matsudaira, Yuki Takashina, Yasuharu Maeda, Tomoyuki Ishigaki, Hiroki Nakamura, Naoya Toyoshima, Yuichi Mori, Masashi Misawa, Noriyuki Ogata, Toyoki Kudo, Takemasa Hayashi, Kunihiko Wakamura, Naruhiko Sawada, Fumio Ishida, Hideyuki Miyachi

Published in: International Journal of Colorectal Disease | Issue 10/2020

Abstract

Purpose

Although some studies have reported differences in clinicopathological features between left- and right-sided advanced colorectal cancer (CRC), there are few reports regarding early-stage disease. In this study, we aimed to compare the clinicopathological features of left- and right-sided T1 CRC.

Methods

Subjects were 1142 cases with T1 CRC undergoing surgical or endoscopic resection between 2001 and 2018 at Showa University Northern Yokohama Hospital. Of these, 776 cases were left-sided (descending colon to rectum) and 366 cases were right-sided (cecum to transverse colon). We compared clinical (patients age, sex, tumor size, morphology, initial treatment) and pathological features (invasion depth, histological grade, lymphatic invasion, vascular invasion, tumor budding) including lymph node metastasis (LNM).

Results

Left-sided T1 CRC showed significantly higher rates of LNM (left-sided 12.0% vs. right-sided 5.4%, P < 0.05) and lymphatic invasion (left-sided 32.7% vs. right-sided 23.2%, P < 0.05). Especially, the sigmoid colon and rectum showed higher rates of LNM (12.4% and 12.1%, respectively) than other locations. Patients with left-sided T1 CRC were younger than those with right-sided T1 CRC (64.9 years ±11.5 years vs. 68.7 ± 11.6 years, P < 0.05), as well as significantly lower rates of poorly differentiated carcinoma/mucinous carcinoma than right-sided T1 CRC (11.6% vs. 16.1%, P < 0.05).

Conclusion

Left-sided T1 CRC, especially in the sigmoid colon and rectum, exhibited higher rates of LNM than right-sided T1 CRC, followed by higher rates of lymphatic invasion. These results suggest that tumor location should be considered in decisions regarding additional surgery after endoscopic resection.

Trial registration

This study was registered with the University Hospital Medical Network Clinical Trials Registry (UMIN 000032733).

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Title: Left-sided location is a risk factor for lymph node metastasis of T1 colorectal cancer: a single-center retrospective study
Authors: Kenichi Mochizuki
Shin-ei Kudo
Katsuro Ichimasa
Yuta Kouyama
Shingo Matsudaira
Yuki Takashina
Yasuharu Maeda
Tomoyuki Ishigaki
Hiroki Nakamura
Naoya Toyoshima
Yuichi Mori
Masashi Misawa
Noriyuki Ogata
Toyoki Kudo
Takemasa Hayashi
Kunihiko Wakamura
Naruhiko Sawada
Fumio Ishida
Hideyuki Miyachi
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 10/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03668-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Left-sided location is a risk factor for lymph node metastasis of T1 colorectal cancer: a single-center retrospective study

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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