Risk factors of regional lymph node metastases in pT1 colorectal cancer

Чернышов, С. В.; Shelygin, Yu. A.; Кашников, В. Н.; Maynovskaya, O. A.; Rybakov, E. G.

doi:10.17116/hirurgia20180824

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…We identified 3451 records from various databases until December 10, 2022. After screening for duplicates, we included 64 studies with 18,097 patients, 17,18,22,36–96 of them, 59 studies evaluated the diagnostic accuracies of HE and additional staining for LVI in LNM in patients with T1 CRC, four reported the interobserver agreement among pathologists for positive LVI, and one reported both outcomes, with eight studies comprising 4062 patients in multivariable analysis.…”

Section: Resultsmentioning

confidence: 99%

Additional staining for lymphovascular invasion is associated with increased estimation of lymph node metastasis in patients with T1 colorectal cancer: Systematic review and meta‐analysis

Watanabe,

Ichimasa,

Kataoka

et al. 2023

Digestive Endoscopy

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ObjectivesLymphovascular invasion (LVI) is a critical risk factor for lymph node metastasis (LNM), which requires additional surgery after endoscopic resection of T1 colorectal cancer (CRC). However, the impact of additional staining on estimating LNM is unclear. This systematic review aimed to evaluate the impact of additional staining on determining LNM in T1 CRC.MethodsWe searched five electronic databases. Outcomes were diagnostic odds ratio (DOR), assessed using hierarchical summary receiver operating characteristic curves, and interobserver agreement among pathologists for positive LVI, assessed using Kappa coefficients (κ). We performed a subgroup analysis of studies that simultaneously included a multivariable analysis for other risk factors (deep submucosal invasion, poor differentiation, and tumor budding).ResultsAmong the 64 studies (18,097 patients) identified, hematoxylin‐eosin (HE) and additional staining for LVI had pooled sensitivities of 0.45 (95% confidence interval [CI], 0.32–0.58) and 0.68 (95% CI, 0.44–0.86), specificities of 0.88 (95% CI, 0.78–0.94) and 0.76 (95% CI, 0.62–0.86), and DORs of 6.26 (95% CI, 3.73–10.53) and 6.47 (95% CI, 3.40–12.32) for determining LNM, respectively. In multivariable analysis, the DOR of additional staining for LNM (DOR, 5.95; 95% CI, 2.87–12.33) was higher than that of HE staining (DOR, 1.89; 95% CI, 1.13–3.16) (p = 0.01). Pooled κ values were 0.37 (95% CI, 0.22–0.52) and 0.62 (95% CI, 0.04–0.99) for HE and additional staining for LVI, respectively.ConclusionsAdditional staining for LVI may increase the DOR for LNM and interobserver agreement for positive LVI among pathologists.

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Section: Resultsmentioning

confidence: 99%

Additional staining for lymphovascular invasion is associated with increased estimation of lymph node metastasis in patients with T1 colorectal cancer: Systematic review and meta‐analysis

Watanabe,

Ichimasa,

Kataoka

et al. 2023

Digestive Endoscopy

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New morphological risk factors for metastasis to regional lymph nodes in rectal cancer with invasion into the submucosa

et al. 2021

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AIM to assess prognostic significance of pathologic features of T1 rectal carcinoma in relation to regional lymph nodes involvement (N+).MATERIAL AND METHODS: surgical specimens (n = 66) from rectal resection for carcinoma pT1 were investigated. Following prognosticators were evaluated: depth of submucosal invasion, grade of differentiation, lymphovascular invasion (LVI), tumor budding (Bd), poorly differentiated clusters (PDC) of tumor and rupture of cancer glands (CGR).RESULTS: lymph nodes metastases were found in 13 (19.7%) specimens. LVI was associated lymphatic spread in great possibility OR 38.0 95% CI 2.1-670 (p < 0.0001). Tumor budding of high grade (Bd3) OR 6.2 95% CI 1.2-31 (p < 0.0001) and poorly differentiated clusters (p = 0,03) also increased risk of lymph node metastases. Depth of submucosal invasion, grade of differentiation, and rupture of cancer glands failed to demonstrate significant association with N+. Logistic regression analysis allowed to determine LVI as independent prognostic factor of lymph node tumor involvement.CONCLUSION: lymphovascular invasion, tumor budding and poorly differentiated clusters of tumor are risk factors of T1 rectal carcinoma lymph node metastases.

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Risk factors of regional lymph node metastases in pT1 colorectal cancer

Abstract: Lymphovascular invasion and poorly differentiated carcinoma are indications for transabdominal mesorectal excision.

Cited by 2 publications

References 17 publications

Additional staining for lymphovascular invasion is associated with increased estimation of lymph node metastasis in patients with T1 colorectal cancer: Systematic review and meta‐analysis

Additional staining for lymphovascular invasion is associated with increased estimation of lymph node metastasis in patients with T1 colorectal cancer: Systematic review and meta‐analysis

New morphological risk factors for metastasis to regional lymph nodes in rectal cancer with invasion into the submucosa

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