Predictive histopathologic factors for lymph node metastasis in patients with nonpedunculated submucosal invasive colorectal carcinoma

Kenji Tominaga, Yukihiro Nakanishi, Satoshi Nimura, Kimio Yoshimura, Yoshihiro Sakai, Tadakazu Shimoda

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)92-100
Number of pages9
JournalDiseases of the colon and rectum
Volume48
Issue number1
DOIs
Publication statusPublished - 2005 Jan 1
Externally publishedYes

Keywords

  • Clinicopathologic study
  • Depth of submucosal invasion
  • Histopathologic factor
  • Lymph node metastasis
  • Submucosal invasive colorectal carcinoma

ASJC Scopus subject areas

  • Gastroenterology

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