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5 "Lymphatic metastasis"
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Original Articles
Colorectal cancer
Are the width, length, depth, and area of submucosal invasion predictive of lymph node metastasis in pT1 colorectal cancer?
Olga Maynovskaia, Evgeny Rybakov, Stanislav Chernyshov, Evgeniy Khomyakov, Sergey Achkasov
Ann Coloproctol. 2023;39(6):484-492.   Published online December 26, 2023
DOI: https://doi.org/10.3393/ac.2023.00087.0012
  • 2,555 View
  • 136 Download
  • 1 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
Submucosa-limited (pathological T1, pT1) colorectal cancers (CRCs) pose a continuing challenge in the choice of treatment options, which range from local excision to radical surgery. The aim of this study was to evaluate the morphometric and morphologic risk factors associated with regional lymph node metastasis (LNM) in pT1 CRC.
Methods
We performed a histological review of patients who underwent oncological resection between 2016 and 2022. Tumor grade, budding, poorly differentiated clusters (PDCs), cancer gland rupture, lymphovascular invasion (LVI), and presence of deep submucosal invasion (DSI), as well as width, length, total area, and area of DSI, were evaluated as potential risk factors for LNM.
Results
A total of 264 cases of colon and rectal carcinomas with invasion into the submucosal layer (pT1) were identified. LNM was found in 46 of the 264 cases (17.4%). All morphometric parameters, as well as DSI (P=0.330), showed no significant association with LNM. High grade adenocarcinoma (P=0.050), budding (P=0.056), and PDCs (P<0.001) were associated with LNM. In the multivariate analysis, LVI presence remained the only significant independent risk factor (odds ratio, 15.7; 95% confidence interval, 8.5–94.9; P<0.001).
Conclusion
The DSI of T1 CRC, as well as other morphometric parameters of submucosal tumor spread, held no predictive value in terms of LNM. LVI was the only independent risk factor of LNM.

Citations

Citations to this article as recorded by  
  • IMMUNOREACT 8: Immune markers of local tumor spread in patients undergoing transanal excision for clinically N0 rectal cancer
    Giulia Becherucci, Cesare Ruffolo, Melania Scarpa, Federico Scognamiglio, Astghik Stepanyan, Isacco Maretto, Andromachi Kotsafti, Ottavia De Simoni, Pierluigi Pilati, Boris Franzato, Antonio Scapinello, Francesca Bergamo, Marco Massani, Tommaso Stecca, An
    Surgery.2025; 178: 108902.     CrossRef
  • Long-term outcomes and lymph node metastasis following endoscopic resection with additional surgery or primary surgery for T1 colorectal cancer
    Pin-Chun Chen, Yi-Kai Kao, Po-Wen Yang, Chia-Hung Chen, Chih-I Chen
    Scientific Reports.2025;[Epub]     CrossRef
Colorectal cancer
Stratification of rate of lymph node metastasis according to risk factors and oncologic outcomes in patients who underwent radical resection for rectal neuroendocrine tumors
Myung Jae Jin, Sung Sil Park, Dong-Eun Lee, Sung Chan Park, Dong Woon Lee, Kiho You, Hee Jin Chang, Chang Won Hong, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Byung Chang Kim, Jae Hwan Oh
Ann Coloproctol. 2023;39(6):467-473.   Published online April 28, 2023
DOI: https://doi.org/10.3393/ac.2022.00913.0130
  • 3,192 View
  • 131 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
Most predictive factors for lymph node metastasis in rectal neuroendocrine tumors (NETs) have been based on local and endoscopic resection. We aimed to evaluate the risk factors for lymph node metastasis in patients who underwent radical resection for rectal NETs and stratify the risk of lymph node metastasis.
Methods
Sixty-four patients who underwent radical resection for rectal NETs between January 2001 and January 2018 were included. We investigated the risk factors of lymph node metastasis using clinicopathologic data. We also performed a risk stratification for lymph node metastases using the number of previously known risk factors. For oncologic outcomes, the 5-year overall survival and recurrence-free survival were evaluated in both groups.
Results
Among the patients who underwent radical surgery, 32 (50.0%) had lymph node metastasis and 32 (50.0%) had non–lymph node metastasis. In the multivariable analysis, only the male sex was identified as a risk factor for lymph node metastasis (odds ratio, 3.695; 95% confidence interval, 1.128–12.105; P=0.031). When there were 2 or more known risk factors, the lymph node metastasis rate was significantly higher than when there were one or no risk factors (odds ratio, 3.667; 95% confidence interval, 1.023–13.143; P=0.046). There was also no statistical difference between the 2 groups in 5-year overall survival (P=0.431) and 5-year recurrence-free survival (P=0.144).
Conclusion
We found that the rate of lymph node metastasis increased significantly when the number of known risk factors is 2 or more.

Citations

Citations to this article as recorded by  
  • Lateral pelvic lymph nodes dissection of rectal neuroendocrine neoplasms: A prospective case-series and literature review
    Yueyang Zhang, Yi Yang, Changyuan Gao, Hong Zhao, Haitao Zhou
    Surgery.2024; 176(5): 1360.     CrossRef
Case Reports
Rare disease & stoma
A small, low-grade rectal neuroendocrine tumor with lateral pelvic lymph node metastasis: a case report
Seonhui Shin, Young-In Maeng, Seyun Jung, Chun-Seok Yang
Ann Coloproctol. 2022;38(4):327-331.   Published online March 7, 2022
DOI: https://doi.org/10.3393/ac.2021.00899.0128
  • 3,619 View
  • 172 Download
  • 4 Web of Science
  • 7 Citations
AbstractAbstract PDF
Rectal neuroendocrine tumors (NETs) are typically small lesions that are confined to the submucosa and have favorable behavior at the time of diagnosis. Local endoscopic or surgical resection is recommended because lymph node metastasis is very rare. In this report, we present the case of a 36-year-old male presenting with an incidentally found rectal mass during screening colonoscopy. Pathologic examination of the primary tumor revealed a 9-mm grade 1 NET with submucosal invasion and no significant aggressive factors except for central ulceration. However, radiologic studies revealed a suspected 2.6-cm mesorectal lymph node metastasis and multiple left internal iliac lymph node metastases. We performed laparoscopic intersphincteric resection with left lateral pelvic lymph node dissection. The final pathologic report revealed a metastatic lymph node with low grade, low mitotic count, and low Ki-67 index. We describe an overview of lymph node metastasis of rectal NETs focusing on lateral pelvic lymph node metastasis.

Citations

Citations to this article as recorded by  
  • Risk factors for and prognostic impact of lateral pelvic lymph node metastasis in patients with rectal neuroendocrine tumors: a single-center retrospective analysis of 214 cases with radical resection
    Tsubasa Sakurai, Y. Hiyoshi, N. Daitoku, S. Matsui, T. Mukai, T. Nagasaki, T. Yamaguchi, T. Akiyoshi, H. Kawachi, Y. Fukunaga
    Surgery Today.2025; 55(2): 144.     CrossRef
  • Construction and evaluation of the prediction model for advanced disease in well-differentiated colorectal neuroendocrine neoplasms less than 2 cm in diameter
    Hongda Yin, Yanan Chen, Wei Zhao, Fuqiang Zhao, Zhijun Huang, Aimin Yue, Zhijie Wang
    Heliyon.2025; 11(1): e41197.     CrossRef
  • Primary small rectal neuroendocrine tumor with pelvic lateral lymph nodes metastasis: A case report and review of literature
    Lihong Li, Ziyue Chen, Dajian Zhu, Qianbao Lv, Tianpeng Zhang, Jinsong Lai
    International Journal of Surgery Case Reports.2025; 127: 110963.     CrossRef
  • Risk factors for lateral pelvic lymph node metastasis in patients with rectal neuroendocrine tumors: a systematic review and meta-analysis
    Ziyue Chen, Dajian Zhu
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • Successfully Resected Isolated Lateral Lymph Node Recurrence in a Patient with T1 Lower Rectal Cancer: Case Report and Literature Review
    Kazuma Rifu, Koji Koinuma, Hisanaga Horie, Katsusuke Mori, Daishi Naoi, Mineyuki Tojo, Yuko Homma, Satoshi Murahashi, Atsushi Kihara, Toshiki Mimura, Joji Kitayama, Naohiro Sata
    Journal of the Anus, Rectum and Colon.2024; 8(3): 259.     CrossRef
  • Clinical application of endoscopic ultrasonography in the management of rectal neuroendocrine tumors
    Soo-Young Na, Seong Jung Kim, Hyoun Woo Kang
    International Journal of Gastrointestinal Intervention.2023; 12(3): 105.     CrossRef
  • Multiple rectal neuroendocrine tumors: An analysis of 15 cases and literature review
    Shu Pang, Ye Zong, Kun Zhang, Haiying Zhao, Yongjun Wang, Junxiong Wang, Chuntao Liu, Yongdong Wu, Peng Li
    Frontiers in Oncology.2022;[Epub]     CrossRef
TisN0M1 Sigmoid Colon Cancer: A Case Report
Kyung Ha Lee, Jin Su Kim, Kwang Sik Cheon, In Sang Song, Dae Young Kang, Ji Yeon Kim
Ann Coloproctol. 2014;30(3):141-146.   Published online June 23, 2014
DOI: https://doi.org/10.3393/ac.2014.30.3.141
  • 4,708 View
  • 68 Download
  • 10 Web of Science
  • 8 Citations
AbstractAbstract PDF

Distant metastasis of a colon carcinoma in situ has not yet been reported. We experienced a case of a sigmoid colon carcinoma in situ with common hepatic lymph node metastasis. After the first operation, we diagnosed dual intramucosal adenocarcinomas of the sigmoid colon without any regional lymph node metastasis. After the second operation, a metastatic adenocarcinoma was found in the common hepatic lymph nodes. We suggest that metastasis in cases of a colonic carcinoma in situ is rare, but possible. The parallel progression model of tumors can explain this early metastasis.

Citations

Citations to this article as recorded by  
  • Potential for Metastasis and Recurrence in Colorectal Carcinoma In Situ: A Retrospective Analysis of 1069 Patients
    Seijong Kim, Jung Kyong Shin, Yoonah Park, Jung Wook Huh, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee, Yong Beom Cho
    Clinical Colorectal Cancer.2024; 23(3): 245.     CrossRef
  • Rectal intramucosal carcinoma with lymph node metastasis and tumor deposit
    Wenhao Chen, Liang Kang, Yan Huang, Zhao Ding
    Asian Journal of Surgery.2022; 45(9): 1719.     CrossRef
  • Presacral lymph node recurrence of rectal intramucosal adenocarcinoma after endoscopic mucosal resection: a case report
    Taichi Horino, Yukiharu Hiyoshi, Yuji Miyamoto, Naoya Yoshida, Hideo Baba
    Surgical Case Reports.2020;[Epub]     CrossRef
  • Recurrence, death risk, and related factors in patients with stage 0 colorectal cancer
    Ming-Hao Hsieh, Pei-Tseng Kung, Wen-Yin Kuo, Tao-Wei Ke, Wen-Chen Tsai
    Medicine.2020; 99(36): e21688.     CrossRef
  • Recurrence rate of lateral margin-positive cases after en bloc endoscopic submucosal dissection of colorectal neoplasia
    Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
    International Journal of Colorectal Disease.2018; 33(6): 735.     CrossRef
  • Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer
    Hyo Jeong Lee, Byong Duk Ye, Jeong-Sik Byeon, Jihun Kim, Young Soo Park, Yong Sang Hong, Yong Sik Yoon, Dong-Hoon Yang
    Clinical Endoscopy.2017; 50(1): 91.     CrossRef
  • Lymph node pooling: a feasible and efficient method of lymph node molecular staging in colorectal carcinoma
    Natalia Rakislova, Carla Montironi, Iban Aldecoa, Eva Fernandez, Josep Antoni Bombi, Mireya Jimeno, Francesc Balaguer, Maria Pellise, Antoni Castells, Miriam Cuatrecasas
    Journal of Translational Medicine.2017;[Epub]     CrossRef
  • Inter- and intra-tumor profiling of multi-regional colon cancer and metastasis
    Akihiro Kogita, Yasumasa Yoshioka, Kazuko Sakai, Yosuke Togashi, Shunsuke Sogabe, Takuya Nakai, Kiyotaka Okuno, Kazuto Nishio
    Biochemical and Biophysical Research Communications.2015; 458(1): 52.     CrossRef
Original Article
Clinical Significance of Lymph Node Micrometastasis in Patients with Dukes' B Colorectal Cancer.
Lee, Hyo Won , Jang, Yong Seog
J Korean Soc Coloproctol. 2004;20(1):57-63.
  • 923 View
  • 2 Download
AbstractAbstract PDF
PURPOSE
This study aimed to provide immunohistochemical evidence of micrometastasis in patients with node-negative Dukes' B colorectal cancer and to evaluate the clinical implications, including prognostic significance, of lymphatic metastasis.
METHODS
A retrospective study of 90 patients who underwent a curative operation due to colorectal neoplasms from 1996 to 2001 was performed. Two consecutive sections of lymph nodes were prepared: one for ordinary hematoxylin-eosin staining, and the other for immunohistochemistry with pancytokeratine antibody. All clinical factors, including survival rate, were compared between patients with and without lymph-node metastasis. The mean follow- up period was 36.1 months.
RESULTS
Micrometastasis was confirmed in 115 nodes (7.9%) from 32 patients (35.6%). No correlations were observed between micrometastases and prognostic factors, including survival rate, except for lymphatic invasion and postoperative TNM staging. Twenty-six of the 32 (81.3%) patients with micrometastases belonged to stage T3N0M0 (P<0.003).
CONCLUSIONS
The immunohistochemical assay may be a useful way to identify micrometastasis in patients with Dukes' B colorectal neoplasms, but we were not able to demonstrate the prognostic significance of micrometastasis.
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