CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(12): E1278-E1283
DOI: 10.1055/s-0043-117952
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

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

Kazuya Inoki1, 4, Taku Sakamoto1, Hiroyuki Takamaru1, Masau Sekiguchi1, Masayoshi Yamada1, Takeshi Nakajima1, Takahisa Matsuda1, Hirokazu Taniguchi2, Shigeki Sekine2, Yukihide Kanemitsu3, Yuichiro Ohe4, Yutaka Saito1
  • 1Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • 2Pathology and Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan
  • 3Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan
  • 4Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, National Cancer Center Hospital, Tokyo, Japan
Further Information

Publication History

submitted 03 January 2017

accepted after revision 26 June 2017

Publication Date:
06 December 2017 (online)

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.