Predictive relevance of lymphovascular invasion in T1 colorectal cancer before endoscopic treatment

Abstract Background and aim The depth of tumor invasion is currently the only reliable predictive risk factor for lymph node metastasis before endoscopic treatment for colorectal cancer. However, the most important factor to predict lymph node metastasis has been suggested to be lymphovascular invasion rather than the depth of invasion. Thus, the aim of this study was to investigate the predictive relevance of lymphovascular invasion before endoscopic treatment. Methods The data on pT1 colorectal cancers that were resected endoscopically or surgically from 2007 to 2015 were retrospectively reviewed. The cases were categorized into two groups: positive or negative for lymphovascular invasion. The following factors were evaluated by univariate and multivariate analyses: age and sex of the patients; location, size, and morphology of the lesion; and depth of invasion. Results The positive and negative groups included 229 and 457 cases, respectively. Younger age (P < 0.01), smaller lesion size (P = 0.01), non-LST (LST: laterally spreading tumor) (P < 0.01), presence of depression (P < 0.01), and pT1b (P < 0.01) were associated with lymphovascular invasion. In multivariate analysis, younger age (comparing patients aged ≤ 64 years with those aged > 65 years, OR, 1.81; 95 %CI, 1.29 – 2.53), presence of depression (OR, 1.97; CI, 1.40 – 2.77), non-LST features (OR, 1.50; CI, 1.04 – 2.15), and pT1b (OR, 3.08; CI, 1.91 – 4.97) were associated with lymphovascular invasion. Conclusion Younger age, presence of depression, T1b, and non-LST are associated with lymphovascular invasion. Therefore, careful pathological diagnosis and surveillance are necessary for lesions demonstrating any of these four factors.

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Prognostic Factors of Patients with Left-sided Obstructive Colorectal Cancer: Post-hoc Analysis of a Retrospective Multi-center Study in the Japan Colonic Stent Safe Procedure Research Group

10.21203/rs.3.rs-919306/v1 ◽

2021 ◽

Author(s):

Shungo Endo ◽

Noriyuki Isohata ◽

Koichiro Kojima ◽

Yoshihiro Kadono ◽

Kunihiko Amano ◽

...

Keyword(s):

Colorectal Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Lymph Node Metastasis ◽

Depth Of Invasion ◽

Post Hoc Analysis ◽

Node Metastasis ◽

Obstructive Colorectal Cancer ◽

Post Hoc

Abstract Background There are many reports on the choice of treatment and prognosis of left-sided obstructive colorectal cancer; only few studies focus on the prognostic factors of LOCRC. Therefore, we analyzed the prognostic factors of left-sided obstructive colorectal cancer by post-hoc analysis of a retrospective multicenter study in the Japan Colonic Stent Safe Procedure Research Group. Methods This study was conducted as a post-hoc analysis of a retrospective multi-center observational study which enrolled a total of 301 patients, with the aim of investigating prognostic factors for relapse-free survival. The relationships among sex, age, decompression for bridge to surgery, depth of invasion, lymph node metastasis, postoperative complications, adjuvant chemotherapy, carcinoembryonic antigen, carbohydrate antigen 19 − 9, neutrophil-to-lymphocyte ratio, and relapse-free survival were examined. Results T3 of depth of invasion, negative postoperative complication (grade 0–1 of Clavien-Dindo classification), and administration of adjuvant chemotherapy (in Stage III) indicated a significantly good prognosis using Cox’s univariate analyses. Lymph node metastasis was not selected as a prognostic factor. Then, excluding patients with < 12 harvested lymph nodes, which may indicate stage migration, lymph node metastasis was also determined to be a prognostic factor. Using Cox’s multivariate analysis, depth of invasion, lymph node metastasis (excluding N0 cases with < 12 harvested lymph nodes), and adjuvant chemotherapy (all cases) were found to be prognostic factors. Conclusions In left-sided obstructive colorectal cancer, depth of invasion, lymph node metastasis and adjuvant chemotherapy were found to be prognostic factors, and patients with < 12 dissected lymph nodes could cause stage migration. This may result in disadvantages, such as not being able to receive adjuvant chemotherapy.

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Abstract 1168: Increased expression of ATG10 in colorectal cancer is associated with lymphovascular invasion and lymph node metastasis .

10.1158/1538-7445.am2013-1168 ◽

2013 ◽

Author(s):

Dong-Hyung Cho ◽

Yoon Kyung Jo ◽

Seung Cheol Kim ◽

In Ja Park ◽

Jin Cheon Kim

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymphovascular Invasion ◽

Node Metastasis

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Risk factors for lymph node metastasis in submucosally invasive colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.542 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 542-542

Author(s):

Liyong Huang ◽

Xinxiang Li ◽

Sanjun Cai

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Growth Pattern ◽

Lymphovascular Invasion ◽

Invasive Front ◽

Node Metastasis ◽

Independent Risk Factors ◽

Histopathological Type

542 Background: The aim of this study was to identify risk factors for lymph node metastasis (LNM) in submucosally invasive colorectal cancer (SICC) that might be used in selecting patients for local excision. Methods: Records were reviewed from consecutive patients who had undergone curative resection of SICC at the Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China, between 2006 and 2013. Clinical features such as age, gender, tumor size, and location were reviewed. Histopathologic examinations including tumor growth type, growth pattern at the invasive front, histopathological type, depth of tumor invasion, tumor budding, lymphovascular invasion, and neural invasion were performed. The expression of E-cadherin, p53, and Ki-67 were examined by immunohistochemistry. The association between the clinicopathologic factors and LNM was evaluated. Results: A total of 265 patients (140 men and 125 women) treated for SICC were included. The overall LNM rate was 12.8%. The incidence of LNM was significantly associated with growth pattern at the invasive front (p=0.028), tumor budding (p=0.006), histopathological type (p<0.001), and lymphovascular invasion (p<0.001). Other clinicopathologic and immunohistochemical factors were irrelevant to LNM. In multiple variable logistic analysis, histopathological type, and lymphovascular invasion were the two independent risk factors of LNM (p=0.015 and p=0.007, respectively). Conclusions: Histopathological type and lymphovascular invasion are significant independent risk factors for LNM in SICC. Careful selection for local excision in SICC should be considered.

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Depth of invasion determined by MRI in cT1N0 tongue: is it an indicator for elective neck dissection?

10.21203/rs.2.10891/v1 ◽

2019 ◽

Author(s):

Chunmiao Xu ◽

Junhui Yuan ◽

Liuqing Kang ◽

Xiaoxian Zhang ◽

Lifeng Wang ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Neck Dissection ◽

Lymphovascular Invasion ◽

Cox Model ◽

Elective Neck Dissection ◽

Depth Of Invasion ◽

Neck Lymph Node ◽

Node Metastasis ◽

Neck Lymph Node Metastasis

Abstract Abstracts Background Depth of invasion (DOI) could be calculated by MRI preoperatively, whether MRI-determined DOI could predict the prognosis and whether it could be used as an indicator for neck dissection for cT1N0 tongue squamous cell carcinoma (SCC) remain unknown, the main goal of the current study aimed to answer the questions. Methods Patients with surgically treated cT1N0 tongue SCC were retrospectively enrolled, MRI-determined DOI was measured based on T1-weigthed layers by a 1.5T scan. A multivariate logistic regression analysis model was used to determine the independent predictors for occult neck lymph node metastasis. The main study endpoints were locoregional control survival (LRC) and disease specific survival (DSS), the Cox model was used to determine the independent prognostic factors for the LRC and DSS. Results Occult neck lymph node metastasis was noted in 26 (17.2%) patients, ROC curve indicated the optimal cutoff value of MRI-determined DOI was 7.5mm for predicting neck lymph node metastasis with sensitivity of 86.9%. The factors of lymphovascular invasion, MRI-determined DOI, pathologic DOI, and pathologic tumor grade were significantly associated with the presence of neck lymph node metastasis in univariate analysis, further logistic regression analysis confirmed the independence of lymphovascular invasion, MRI-determined DOI, and pathologic DOI in predicting the neck lymph node metastasis. The 5-year LRC and DSS rates were 84% and 90%, respectively. Cox model analysis suggested the MRI-determined DOI was an independent prognostic factor for both the LRC and DSS. Conclusions Elective neck dissection is suggested if MRI-determined DOI is greater than 7.5mm in cT1N0 tongue SCC, and MRI-determined DOI ≥7.5mm indicates more risk for disease recurrence and cancer caused death.

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Increased Expression of ATG10 in Colorectal Cancer Is Associated with Lymphovascular Invasion and Lymph Node Metastasis

PLoS ONE ◽

10.1371/journal.pone.0052705 ◽

2012 ◽

Vol 7 (12) ◽

pp. e52705 ◽

Cited By ~ 28

Author(s):

Yoon Kyung Jo ◽

Seung Cheol Kim ◽

In Ja Park ◽

So Jung Park ◽

Dong-Hoon Jin ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymphovascular Invasion ◽

Node Metastasis

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The risk of lymph node metastasis makes it unsafe to expand the conventional indications for endoscopic treatment of T1 colorectal cancer

Medicine ◽

10.1097/md.0000000000004373 ◽

2016 ◽

Vol 95 (37) ◽

pp. e4373 ◽

Cited By ~ 16

Author(s):

Bun Kim ◽

Eun Hye Kim ◽

Soo Jung Park ◽

Jae Hee Cheon ◽

Tae Il Kim ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Endoscopic Treatment ◽

Node Metastasis ◽

T1 Colorectal Cancer

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Microenvironmental markers are correlated with lymph node metastasis in invasive submucosal colorectal cancer

Histopathology ◽

10.1111/his.14388 ◽

2021 ◽

Author(s):

Tamotsu Sugai ◽

Noriyuki Yamada ◽

Mitsumasa Osakabe ◽

Mai Hashimoto ◽

Noriyuki Uesugi ◽

...

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Node Metastasis ◽

Submucosal Colorectal Cancer

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Increased Expression of VANGL1 is Predictive of Lymph Node Metastasis in Colorectal Cancer: Results from a 20-Gene Expression Signature

Journal of Personalized Medicine ◽

10.3390/jpm11020126 ◽

2021 ◽

Vol 11 (2) ◽

pp. 126

Author(s):

Noshad Peyravian ◽

Stefania Nobili ◽

Zahra Pezeshkian ◽

Meysam Olfatifar ◽

Afshin Moradi ◽

...

Keyword(s):

Gene Expression ◽

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Candidate Genes ◽

Case Series ◽

Gene Expression Signature ◽

Gene Panel ◽

Expression Levels ◽

Node Metastasis

This study aimed at building a prognostic signature based on a candidate gene panel whose expression may be associated with lymph node metastasis (LNM), thus potentially able to predict colorectal cancer (CRC) progression and patient survival. The mRNA expression levels of 20 candidate genes were evaluated by RT-qPCR in cancer and normal mucosa formalin-fixed paraffin-embedded (FFPE) tissues of CRC patients. Receiver operating characteristic curves were used to evaluate the prognosis performance of our model by calculating the area under the curve (AUC) values corresponding to stage and metastasis. A total of 100 FFPE primary tumor tissues from stage I–IV CRC patients were collected and analyzed. Among the 20 candidate genes we studied, only the expression levels of VANGL1 significantly varied between patients with and without LNMs (p = 0.02). Additionally, the AUC value of the 20-gene panel was found to have the highest predictive performance (i.e., AUC = 79.84%) for LNMs compared with that of two subpanels including 5 and 10 genes. According to our results, VANGL1 gene expression levels are able to estimate LNMs in different stages of CRC. After a proper validation in a wider case series, the evaluation of VANGL1 gene expression and that of the 20-gene panel signature could help in the future in the prediction of CRC progression.

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