Characteristics of rectal carcinomas that predict the presence of lymph node metastases: implications for patient selection for local therapy

Zenni, Gregory C.; Abraham, Kurian P.; Harford, Frank J.; Potocki, Donna M.; Herman, Chester J.; Dobrin, Philip B.

doi:10.1002/(sici)1096-9098(199802)67:2<99::aid-jso5>3.0.co;2-g

Cited by 48 publications

(24 citation statements)

References 21 publications

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“…Nodal involvement is associated with an increased risk of local recurrence and shorter overall and disease-free survival time (18)(19)(20). Lymph node metastasis generally occurs in approximately 10% of patients with T1 colorectal carcinoma (8,9).…”

Section: Discussionmentioning

confidence: 99%

Comparative clinicopathological characteristics of colon and rectal T1 carcinoma

et al. 2016

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Abstract. Lymph node metastasis significantly influences the management of patients with colorectal carcinoma. It has been observed that the biology of colorectal carcinoma differs by location. The aim of the current study was to retrospectively compare the clinicopathological characteristics of patients with colon and rectal T1 carcinomas, particularly their rates of lymph node metastasis. Of the 19,864 patients who underwent endoscopic or surgical resection of colorectal neoplasms at Showa University Northern Yokohama Hospital, 557 had T1 surgically resected carcinomas, including 457 patients with colon T1 carcinomas and 100 patients with rectal T1 carcinomas. Analysed clinicopathological features included patient age, gender, tumor size, morphology, tumor budding, invasion depth, vascular invasion, histological grade, lymphatic invasion and lymph node metastasis. Rectal T1 carcinomas were significantly larger than colon T1 carcinomas (mean ± standard deviation: 23.7±13.1 mm vs. 19.9±11.0 mm, P<0.01) and were accompanied by significantly higher rates of vascular invasion (48.0% vs. 30.2%, P<0.01). Significant differences were not observed among any other clinicopathological factors. In conclusion, tumor location itself was not a risk factor for lymph node metastasis in colorectal T1 carcinomas, even though on average, rectal T1 carcinomas were larger and accompanied by a significantly higher rate of vascular invasion than colon T1 carcinomas.

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Section: Discussionmentioning

confidence: 99%

Comparative clinicopathological characteristics of colon and rectal T1 carcinoma

et al. 2016

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“…This can be the result of one of three possibilities: 1) incomplete excision of all microscopic foci within the rectal wall; 2) failure to address disease previously present in the regional lymph nodes; or 3) failure to treat distant metastatic disease present at diagnosis but has not manifested yet. [24][25][26] Failure of complete excision can be relatively easy to identify by carefully evaluating resection margins including the deep and circumferential mucosal margins. In addition, careful surgical technique, which limits tumor handling and requires excision into the perirectal fat, may minimize the risk of treatment failure.…”

Section: Discussionmentioning

confidence: 99%

“…22 The risk of nodal metastases seems to be directly related to the depth of rectal wall invasion and is estimated at 0 to 12 percent for T1, 10 to 27 percent for T2 cancers, and 36 to 67 percent for T3 lesions. 11,[24][25][26] The incidence of perirectal lymph node metastases progressively rises as the tumor penetrates from the submucosa through the muscularis propria to the perirectal fat. High-grade malignancy such as poor differentiation, lymphovascular, or perineural invasion carries a higher risk of nodal metastases compared with lower grades with the same depth of invasion of the rectal wall.…”

Section: Discussionmentioning

confidence: 99%

Recurrence After Transanal Excision of T1 Rectal Cancer: Should We Be Concerned?

Madbouly

Remzi

Erkek

et al. 2005

Diseases of the Colon &Amp; Rectum

159

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“…Conversely, some authors found that size was not a predictive factor. [32][33][34][35] There was no significant difference in terms of nodal disease with tumor size < 3 cm (33 percent) vs. > 3 cm (22 percent). 35 Brodsky et al 33 corroborated these results, showing no significant difference in terms of node involvement after local excision of lesions > 4 cm (18 percent) and < 4 cm (21 percent).…”

Section: Clinical and Pathologic Criteriamentioning

confidence: 99%

Local Therapy for Rectal Cancer: Still Controversial?

Brétagnol¹,

Rullier²,

George³

et al. 2007

Diseases of the Colon &Amp; Rectum

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The key to potentially curative local treatment for rectal cancer is patient selection by identifying the best candidates with preoperative tumor staging and clinical and pathologic assessment of favorable features. Low-risk T1 is suitable for local excision alone. Limited data suggest that adjuvant chemoradiotherapy may be helpful in patients with unfavorable T1 and T2 lesions, achieving a local recurrence rate<20 percent. However, the efficacy of salvage surgery after local excision is uncertain.

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Characteristics of rectal carcinomas that predict the presence of lymph node metastases: implications for patient selection for local therapy

Cited by 48 publications

References 21 publications

Comparative clinicopathological characteristics of colon and rectal T1 carcinoma

Comparative clinicopathological characteristics of colon and rectal T1 carcinoma

Recurrence After Transanal Excision of T1 Rectal Cancer: Should We Be Concerned?

Local Therapy for Rectal Cancer: Still Controversial?

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