TY - JOUR
T1 - Histopathological risk factors for lymph node metastases in T1 colorectal cancer
T2 - meta-analysis
AU - Ebbehøj, A L
AU - Jørgensen, Lars Nannestad
AU - Krarup, P-M
AU - Smith, H G
N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: [email protected].
PY - 2021/7/23
Y1 - 2021/7/23
N2 - BACKGROUND: National screening programmes increase the proportion of T1 colorectal cancers. Local excision may be possible, but the risk of lymph node metastases (LNMs) could jeopardize long-term outcomes. The aim of the present study was to review the association between histopathological findings and LNMs in T1 colorectal cancer.METHODS: A systematic literature search was conducted using PubMed,Embase, and Cochrane online databases. Studies investigating the association between one or more histopathological factors and LNMs in patients who underwent resection for T1 colorectal cancer were included.RESULTS: Sixteen observational studies were included in the meta-analysis, including a total of 10 181 patients, of whom 1 307 had LNMs. Lymphovascular invasion (odds ratio (OR) 7.42; P < 0.001), tumour budding (OR 4.00; P < 0.001), depth of submucosal invasion, whether measured as at least 1000 µm (OR 3.53; P < 0.001) or Sm2-3 (OR 2.12; P = 0.020), high tumour grade (OR 3.75; P < 0.001), polypoid growth pattern (OR 1.59; P = 0.040), and rectal location of tumour (OR 1.36; P = 0.003) were associated with LNMs.CONCLUSION: Distinct histopathological factors associated with nodal metastases in T1 colorectal cancer can aid selection of patients for local excision or major excisional surgery.
AB - BACKGROUND: National screening programmes increase the proportion of T1 colorectal cancers. Local excision may be possible, but the risk of lymph node metastases (LNMs) could jeopardize long-term outcomes. The aim of the present study was to review the association between histopathological findings and LNMs in T1 colorectal cancer.METHODS: A systematic literature search was conducted using PubMed,Embase, and Cochrane online databases. Studies investigating the association between one or more histopathological factors and LNMs in patients who underwent resection for T1 colorectal cancer were included.RESULTS: Sixteen observational studies were included in the meta-analysis, including a total of 10 181 patients, of whom 1 307 had LNMs. Lymphovascular invasion (odds ratio (OR) 7.42; P < 0.001), tumour budding (OR 4.00; P < 0.001), depth of submucosal invasion, whether measured as at least 1000 µm (OR 3.53; P < 0.001) or Sm2-3 (OR 2.12; P = 0.020), high tumour grade (OR 3.75; P < 0.001), polypoid growth pattern (OR 1.59; P = 0.040), and rectal location of tumour (OR 1.36; P = 0.003) were associated with LNMs.CONCLUSION: Distinct histopathological factors associated with nodal metastases in T1 colorectal cancer can aid selection of patients for local excision or major excisional surgery.
KW - Colorectal Neoplasms/diagnosis
KW - Humans
KW - Lymph Nodes/pathology
KW - Lymphatic Metastasis
KW - Neoplasm Staging
KW - Risk Factors
UR - http://www.scopus.com/inward/record.url?scp=85112487035&partnerID=8YFLogxK
U2 - 10.1093/bjs/znab168
DO - 10.1093/bjs/znab168
M3 - Journal article
C2 - 34244752
SN - 0007-1323
VL - 108
SP - 769
EP - 776
JO - The British journal of surgery
JF - The British journal of surgery
IS - 7
ER -