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Severe tumor budding is a risk factor for lateral lymph node metastasis in early rectal cancers
Author(s) -
Homma Yoichiro,
Hamano Takashi,
Otsuki Yoshiro,
Shimizu Shinichi,
Kobayashi Hiroshi,
Kobayashi Yasuyuki
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21606
Subject(s) - medicine , metastasis , colorectal cancer , dissection (medical) , pathological , adenocarcinoma , submucosa , lymph node , tumor budding , cancer , oncology , gastroenterology , pathology , surgery , lymph node metastasis
Background Lateral lymph node (LLN) metastasis sometimes occurs in patients with early rectal cancer that has invaded the submucosa (SM) and muscularis propria (MP). This study aims to identify the risk factor(s) for LLN metastasis in such patients. Method We retrospectively analyzed 65 patients with pathological SM or MP lower rectal adenocarcinoma, for whom radical resection had been performed at a single institution. Results We performed LLN dissection in 52 (80%) patients. The LLN dissection rates in the case of pathological SM and MP tumors were 65.6% and 94.4%, respectively, and the corresponding LLN metastasis rates were 6.9% and 11.1%. Severe tumor budding was found to be a risk factor for LLN metastasis ( P = 0.002). Further, of six patients with LLN metastasis, four did not have coincident mesenteric lymph node metastasis. Conclusion In rectal cancer that has pathologically invaded SM and MP, LLN metastasis is not negligible. LLN dissection could lower the local recurrence rate of SM and MP rectal cancer. In case LLN dissection is not performed, patients with a high tumor budding grade should be administered adjuvant therapy. J. Surg. Oncol. 2010;102:230–234. © 2010 Wiley‐Liss, Inc.