Size does not determine the grade of malignancy of early invasive colorectal cancer
AIM: To clarify the clinicopathological characteristics of small and large early invasive colorectal cancers (EI-CRCs), and to determine whether malignancy grade depends on size. METHODS: A total of 583 consecutive EI-CRCs treated by endoscopic mucosal resection or surgery at the National Cancer Cen...
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Published in | World journal of gastroenterology : WJG Vol. 15; no. 22; pp. 2708 - 2713 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Endoscopy Division,National Cancer Center Hospital,Tokyo 104-0045,Japan%Clinical Laboratory Division,National Cancer Center Hospital,Tokyo 104-0045,Japan%Division of Digestive Endoscopy and Gastrointestinal Oncology,National Cancer Center Hospital East,Kashiwa 277-8577,Japan%Department of Surgical and Molecular Pathology,Dokkyo University School of Medicine,Shimotsuga,Tochigi 321-0293,Japan
14.06.2009
The WJG Press |
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Summary: | AIM: To clarify the clinicopathological characteristics of small and large early invasive colorectal cancers (EI-CRCs), and to determine whether malignancy grade depends on size. METHODS: A total of 583 consecutive EI-CRCs treated by endoscopic mucosal resection or surgery at the National Cancer Center Hospital between 1980 and 2004 were enrolled in this study. Lesions were classified into two groups based on size: small (≤10 ram) and large (〉10 ram). Clinicopathological features, incidence of lymph node metastasis (LNM) and risk factors for LNM, such as depth of invasion, lymphovascular invasion (LVI) and poorly differentiated adenocarcinoma (PDA) were analyzed in all resected specimens. RESULTS: There were 120 (21%) small and 463 (79%) large lesions. Histopathological analysis of the small lesion group revealed submucosal deep cancer (sin: 1〉1000 μm) in 90 (75%) cases, LVI in 26 (22%) cases, and PDA in 12 (10%) cases. Similarly, the large lesion group exhibited submucosal deep cancer in 380 (82%) cases, LVI in 125 (27%) cases, and PDA in 79 (17%) cases. The rate of LNM was 11.2% and 12.1% in the small and large lesion groups, respectively.CONCLUSION: Small EI-CRC demonstrated the same aggressiveness and malignant potential as large cancer. |
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Bibliography: | Lymph node metastasis Submucosal invasion 14-1219/R Colorectal cancer Endoscopic mucosal resection TP368.33 Q64 Colorectal cancer; Submucosal invasion; Lymph node metastasis; Endoscopic mucosal resection ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Correspondence to: Takahisa Matsuda, MD, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. tamatsud@ncc.go.jp Author contributions: Matsuda T, Saito Y and Fujii T contributed equally to this work; Matsuda T, Uraoka T, Nakajima T and Kobayashi N designed the research; Matsuda T, Ikematsu H, Fu KI and Sano Y performed the research; Shimoda T and Fujimori T performed the histopathology; Matsuda T, Saito Y, Emura F and Ono A wrote the paper. Fax: +81-3-35423815 Telephone: +81-3-35422511 |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.15.2708 |