Open AccessNew morphological risk factors for metastasis to regional lymph nodes in rectal cancer with invasion into the submucosa
Author(s) -
O. A. Maynovskaya,
Е. Г. Рыбаков,
С. В. Чернышов,
Yu. A. Shelygin,
С. И. Ачкасов
Publication year - 2021
Publication title -
koloproktologiâ
Language(s) - English
Resource type - Journals
eISSN - 2686-7303
pISSN - 2073-7556
DOI - 10.33878/2073-7556-2021-20-4-22-33
Subject(s) - tumor budding , lymphovascular invasion , submucosa , medicine , colorectal cancer , lymph , lymph node , pathology , lymphatic system , metastasis , carcinoma , lymph node metastasis , cancer , oncology
AIM to assess prognostic significance of pathologic features of T1 rectal carcinoma in relation to regional lymph nodes involvement (N+). MATERIAL AND METHODS : surgical specimens (n = 66) from rectal resection for carcinoma pT1 were investigated. Following prognosticators were evaluated: depth of submucosal invasion, grade of differentiation, lymphovascular invasion (LVI), tumor budding (Bd), poorly differentiated clusters (PDC) of tumor and rupture of cancer glands (CGR). RESULTS : lymph nodes metastases were found in 13 (19.7%) specimens. LVI was associated lymphatic spread in great possibility OR 38.0 95% CI 2.1-670 (p < 0.0001). Tumor budding of high grade (Bd3) OR 6.2 95% CI 1.2-31 (p < 0.0001) and poorly differentiated clusters (p = 0,03) also increased risk of lymph node metastases. Depth of submucosal invasion, grade of differentiation, and rupture of cancer glands failed to demonstrate significant association with N+. Logistic regression analysis allowed to determine LVI as independent prognostic factor of lymph node tumor involvement. CONCLUSION : lymphovascular invasion, tumor budding and poorly differentiated clusters of tumor are risk factors of T1 rectal carcinoma lymph node metastases.