Depth of invasion in early invasive colorectal cancer is considered an important predictive factor for lymph node metastasis. However, no large-scale reports have established the relationship between invasion depth of pedunculated type early invasive colorectal cancers and risk of lymph node metastasis. The aim of this retrospective cohort study was to clarify the risk of lymph node metastasis in pedunculated type early invasive colorectal cancers in a large series. Patients with pedunculated type early invasive colorectal cancer who underwent endoscopic or surgical resection at seven referral hospitals in Japan were enrolled. Haggitt's line was used as baseline and the invasion depth was classified into two groups, head invasion and stalk invasion. The incidence of lymph node metastasis was investigated between patients with head and stalk invasion. We analyzed 384 pedunculated type early invasive colorectal cancers in 384 patients. There were 154, 156, and 74 endoscopic resection cases, endoscopic resection followed by surgical operation, and surgical resection cases, respectively. There were 240 head invasion and 144 stalk invasion lesions. Among the lesions treated surgically, the overall incidence of lymph node metastasis was 3.5% (8 ⁄ 230). The incidence of lymph node metastasis was 0.0% (0 ⁄ 101) in patients with head invasion, as compared with 6.2% (8 ⁄ 129) in patients with stalk invasion. Pedunculated type early invasive colorectal cancers pathologically diagnosed as head invasion can be managed by endoscopic treatment alone. (Cancer Sci 2011; 102: 1693-1697 I t has been reported that intramucosal colorectal cancers show no lymph node metastasis and are good candidates for endoscopic resection.(1,2) In contrast, 6-12% of early invasive colorectal cancers (i.e. cancer cells invade through the muscularis mucosae into the submucosal layer but do not extend into the muscularis propria) are associated with lymph node metastasis requiring surgical resection including lymph node dissection for curative treatment.(3-7) Recently, increasing evidence suggests that lesions with submucosal invasion limited to <1000 lm without lymphovascular invasion and ⁄ or poorly differentiated components do not metastasize to lymph nodes.(8) Endoscopic resection is an appropriate treatment for early stage colorectal cancers, however, the resected specimen must be examined to determine whether there is a clinically significant risk of lymph node metastasis that would warrant additional surgery. Colorectal lesions can be subdivided according to endoscopic appearance using the Paris classification (Fig. S1), whereas Haggitt's classification is frequently used to define the depth of invasion of pedunculated lesions.(9) Haggitt and colleagues stratified the level of cancer invasion according to the following criteria: level 0, carcinoma in situ (i.e. has not extended below the muscularis mucosae); level 1, carcinoma invading through the muscularis mucosae but limited to the head of the polyp (i.e. above the junction between the aden...

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Abstract:Plasma facing components in TFTR contain an important record of plasma wall interactions in reactor grade DT plasmas. Tiles, flakes, wall coupons, a stainless steel shutter and dust samples have been retrieved from the TITR vessel for analysis. Selected samples have been baked to release tritium and assay the tritium content. The in-vessel tritium inventoq is estimated to be 0.56 g and is consistent with the in-vessel tritium inventory derived from the difference between tritium fueling and tritium exhaust. The distribution of tritium on the limiter and vessel wall showed complex patterns of co-deposition. Relatively high concentrations of tritium were found at the top and bottom of the bumper limiter, as predicted by earlier BBQ modeling.

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