Colorectal Cancer Research Today is a free monthly online journal that collates and summarizes the latest research about Colorectal Cancer, including details on symptoms, genetics, screening, treatment, information. | ||||||||
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Location of early colorectal cancers at fold-top may reduce the risk of lymph node metastasis.Pan W, Terai T, Abe S, Sakamoto N, Nagahara A, Ohkusa T, Ogihara T, Sato N Department of Gastroenterology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan. PURPOSE: This study was designed to look for significant correlations between location of early colorectal cancer, distance from muscularis mucosae to muscularis propria, and the frequency of lymph node metastasis. METHODS: A total of 166 early colorectal cancers, including 67 surgically resected lesions, were evaluated. The cancers were divided into two groups: metastatic and nonmetastatic. Cancer lesions were further subtyped at the fold-top or fold-bottom. Macroscopic classifications and histology were performed. Absolute invasive depth and distance from muscularis mucosae to muscularis propria was measured. Multivariate analysis was used to assess relationships among the variables. RESULTS: The percentage of polypoid cancer lesions at fold-bottom was higher than at fold-top (74.5 vs. 51.8 percent), whereas flat-type cancer lesions at fold-bottom occurred less often than at fold-top (8.2 vs. 30.4 percent). Logistic regression showed that deep absolute invasive depth, lymphatic and vessel invasion, and cancer location (at fold-bottom) were the significant risk factors for early colorectal cancers leading to lymph-node metastasis. The distance from muscularis mucosae to muscularis propria with lymph-node metastasis (1,396.7 +/- 728.4 microm) was shorter than without lymph-node metastasis (3,533.9 +/- 2,507.8 microm; P < 0.01). Multivariate analysis showed that distance from muscularis mucosae to muscularis propria was a statistically significant factor for early colorectal cancers leading to lymph node metastasis (P = 0.0054). CONCLUSIONS: We conclude that early colorectal cancers at the fold-top or with a long distance from muscularis mucosae to muscularis propria have less tendency to metastasize to lymph nodes. Clinically, these results provide evidence of a new indicator of endoscopic mucosal resection for early colorectal cancers at the fold-top. Published 8 May 2006 in Dis Colon Rectum, 49(5): 579-87.
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