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Diseases of the Colon & Rectum
Published in: Diseases of the Colon & Rectum 1/2005

01-01-2005 | Original Contributions

Predictive Histopathologic Factors for Lymph Node Metastasis in Patients With Nonpedunculated Submucosal Invasive Colorectal Carcinoma

Authors: Kenji Tominaga, M.D., Yukihiro Nakanishi, M.D., Satoshi Nimura, M.D., Kimio Yoshimura, M.D., Yoshihiro Sakai, M.D., Tadakazu Shimoda, M.D.

Published in: Diseases of the Colon & Rectum | Issue 1/2005

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PURPOSE

Risk factors for lymph node metastasis in patients with nonpedunculated submucosal invasive colorectal carcinoma remain to be characterized. This study examines the relationship between lymph node metastasis and clinicopathologic factors in nonpedunculated submucosal invasive colorectal carcinoma.

METHODS

The study cohort comprised 155 patients who had undergone surgical treatment for nonpedunculated submucosal invasive colorectal carcinoma. The clinicopathologic factors investigated included gender, age, tumor location, macroscopic type, tumor size, histologic type and grade, intramucosal growth pattern, lymphatic invasion, venous invasion, degree of focal dedifferentiation at the submucosal invasive front, status of the remaining muscularis mucosa, and the depth and width of submucosal invasion.

RESULTS

Lymph node metastases were found in 19 patients (12.3 percent). Univariate analysis showed that lymphatic invasion, focal dedifferentiation at the submucosal invasive front, status of the remaining muscularis mucosa, and depth of submucosal invasion all had a significant influence on lymph node metastasis. Multivariate analysis showed lymphatic invasion (P = 0.014) and high-grade focal dedifferentiation at the submucosal invasive front (P = 0.049) to be independent factors predicting lymph node metastasis. No lymph node metastasis was found in tumors with a depth of submucosal invasion of <1.3 mm.

CONCLUSIONS

Lymphatic invasion and high-grade focal dedifferentiation at the submucosal invasive front are important predictors of lymph node metastasis in patients with nonpedunculated submucosal invasive colorectal carcinoma. Depth of submucosal invasion can be used as an identifying marker for patients who do not require subsequent surgery after endoscopic resection.
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Metadata
Title
Predictive Histopathologic Factors for Lymph Node Metastasis in Patients With Nonpedunculated Submucosal Invasive Colorectal Carcinoma
Authors
Kenji Tominaga, M.D.
Yukihiro Nakanishi, M.D.
Satoshi Nimura, M.D.
Kimio Yoshimura, M.D.
Yoshihiro Sakai, M.D.
Tadakazu Shimoda, M.D.
Publication date
01-01-2005
Publisher
Springer-Verlag
Published in
Diseases of the Colon & Rectum / Issue 1/2005
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-004-0751-4

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