Clinical-alimentary tractRisk factors for an adverse outcome in early invasive colorectal carcinoma
Section snippets
Early invasive colorectal cancers examined
Data on 292 early invasive colorectal adenocarcinomas from 285 consecutive patients treated between 1980 and 2002 were gathered from the National Defense Medical College Hospital (251 cancers, including 33 cancers treated first with local excision at other hospitals and National Defense Medical College Hospital provided the second opinions about their additional laparotomy) and the Self-Defense Forces Central Hospital (41 cancers). These tumors were confirmed pathologically to invade through
Qualitative parameters as risk factors for lymph node metastases
Neither the type of growth pattern, the presence of a depression zone on the tumor surface, the presence of an adenoma component, or mucin production was found to have a significant impact on lymph node metastases. The incidence of nodal involvement was, however, significantly affected by the following histologic parameters: cribriform formation, tumor grade, vascular invasion, and tumor budding (Table 3). Multivariate logistic analysis showed that these 4 parameters have an independent impact
Discussion
In specimens of early invasive colorectal cancer, there are more than a few potential indicators of adverse outcomes after minor excision (Table 1). Qualitative parameters such as the tumor grade, vascular invasion, tumor budding, and cribriform formation, and quantitative parameters such as Haggitt’s system and the width and depth of submucosal invasion, are the parameters significantly related to nodal involvement. Obviously, what is practically important is to determine the ultimate
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