Kouyama Y, Kudo SE, Miyachi H, Ichimasa K, Hisayuki T, Oikawa H, Matsudaira S, Kimura YJ, Misawa M, Mori Y, Kodama K, Kudo T, Hayashi T, Wakamura K, Katagiri A, Hidaka E, Ishida F, Hamatani S. Practical problems of measuring depth of submucosal invasion in T1 colorectal carcinomas.
Int J Colorectal Dis 2016;
31:137-146. [PMID:
26428364 PMCID:
PMC4701783 DOI:
10.1007/s00384-015-2403-7]
[Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2015] [Indexed: 02/04/2023]
Abstract
PURPOSE
Submucosal invasion depth (SID) in colorectal carcinoma (CRC) is an important factor in estimating risk of lymph node metastasis, but can be difficult to measure, leading to inadequate or over-extensive treatment. Here, we aimed to clarify the practical aspects of measuring SID in T1 CRC.
METHODS
We investigated 568 T1 CRCs that were resected surgically at our hospital from April 2001 to December 2013, and relationships between SID and clinicopathological factors, including the means of measurement, lesion morphology, and lymph node metastasis.
RESULTS
Of these 568 lesions, the SID was ≥1000 μm in 508 lesions. SIDs for lesions measured from the surface layer were all ≥1000 μm. Although lesions with SIDs ≥1000 μm were associated with significantly higher levels of unfavorable histologic types and lymphovascular infiltration than shallower lesions, a depth of ≥1000 μm was not a significant risk factor for lymph node metastasis (LNM) (6.7 vs. 9.8 %; P = 0.64), and no lesions for which the sole pathological factor was SID ≥1000 μm had lymph node metastasis. Protruded lesions showed deeper SIDs than other types.
CONCLUSIONS
Although we found several problems of measuring SID in this study, we also found, surprisingly, that SID is not a risk factor for lymph node metastasis, and its measurement is not needed to estimate the risk of lymph node metastasis.
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