Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer
Objectives: Pure well-differentiated adenocarcinoma (PWDA) could be a safe factor against lymph node metastasis (LNM) and recurrence in patients with T1 colorectal cancer. We investigated the utility and endoscopic features of PWDA to determine its predictive ability. Methods: We analyzed the LNM an...
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2025-07-01
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| Series: | Journal of the Anus, Rectum and Colon |
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| Online Access: | https://www.jstage.jst.go.jp/article/jarc/9/3/9_2024-105/_pdf/-char/en |
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| _version_ | 1850078024688467968 |
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| author | Ken Inoue Naohisa Yoshida Reo Kobayashi Ryohei Hirose Naoto Iwai Osamu Dohi Takaaki Murakami Yutaka Inada Tomohiro Arita Yukiko Morinaga Eiichi Konishi Yoshito Itoh |
| author_facet | Ken Inoue Naohisa Yoshida Reo Kobayashi Ryohei Hirose Naoto Iwai Osamu Dohi Takaaki Murakami Yutaka Inada Tomohiro Arita Yukiko Morinaga Eiichi Konishi Yoshito Itoh |
| author_sort | Ken Inoue |
| collection | DOAJ |
| description | Objectives: Pure well-differentiated adenocarcinoma (PWDA) could be a safe factor against lymph node metastasis (LNM) and recurrence in patients with T1 colorectal cancer. We investigated the utility and endoscopic features of PWDA to determine its predictive ability.
Methods: We analyzed the LNM and recurrence rates, along with various clinicopathological factors, including PWDA, in 315 patients with T1 colorectal cancer who underwent surgical resection at our center. PWDA was defined as a lesion consisting of well-differentiated adenocarcinoma only. Three pathologists evaluated the consistency of the PWDA diagnosis and performed inter- and intraobserver assessments of PWDA and lymphatic invasion. Endoscopic features of PWDA was also examined.
Results: The LNM, recurrence, and PWDA rates in patients with T1 colorectal cancer were 9.5%, 2.9%, and 31.1%, respectively. Significant differences were observed in T1b (100% vs. 82.8%; p = 0.014) and non-PWDA (100% vs. 65.6%; p < 0.001) between patients with and without LNM. Multivariate analyses showed that non-PWDA was an independent risk factor for LNM (odds ratio [OR], 12.09; 95% confidence interval [CI], 1.59-92.0; p = 0.016). Furthermore, significant differences in venous invasion (44.4% vs. 19.6%; p < 0.001), and non-PWDA (100% vs. 68.0%; p < 0.001) were observed between patients with and without recurrence. The agreement among three pathologists on the diagnosis of PWDA was acceptable (kappa value > 0.5). Surface redness (p < 0.001), a rugged surface (p < 0.01), fold convergence (p < 0.001), and an impression of fullness (p = 0.031) were significantly related with PWDA.
Conclusions: PWDA can predict safety against LNM and recurrence in patients with T1 colorectal cancer. |
| format | Article |
| id | doaj-art-3cd35e8840334b13982c16c1fbfa056e |
| institution | DOAJ |
| issn | 2432-3853 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj-art-3cd35e8840334b13982c16c1fbfa056e2025-08-20T02:45:41ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532025-07-019330230910.23922/jarc.2024-1052024-105Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal CancerKen Inoue0Naohisa Yoshida1Reo Kobayashi2Ryohei Hirose3Naoto Iwai4Osamu Dohi5Takaaki Murakami6Yutaka Inada7Tomohiro Arita8Yukiko Morinaga9Eiichi Konishi10Yoshito Itoh11Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMolecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMolecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineDepartment of Infectious Disease, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMolecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineMolecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineDepartment of Gastroenterology, Aiseikai Yamashina HospitalDepartment of Gastroenterology and Hepatology, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of MedicineDepartment of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineDepartment of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of MedicineDepartment of Gastroenterology, Kyoto Saiseikai HospitalObjectives: Pure well-differentiated adenocarcinoma (PWDA) could be a safe factor against lymph node metastasis (LNM) and recurrence in patients with T1 colorectal cancer. We investigated the utility and endoscopic features of PWDA to determine its predictive ability. Methods: We analyzed the LNM and recurrence rates, along with various clinicopathological factors, including PWDA, in 315 patients with T1 colorectal cancer who underwent surgical resection at our center. PWDA was defined as a lesion consisting of well-differentiated adenocarcinoma only. Three pathologists evaluated the consistency of the PWDA diagnosis and performed inter- and intraobserver assessments of PWDA and lymphatic invasion. Endoscopic features of PWDA was also examined. Results: The LNM, recurrence, and PWDA rates in patients with T1 colorectal cancer were 9.5%, 2.9%, and 31.1%, respectively. Significant differences were observed in T1b (100% vs. 82.8%; p = 0.014) and non-PWDA (100% vs. 65.6%; p < 0.001) between patients with and without LNM. Multivariate analyses showed that non-PWDA was an independent risk factor for LNM (odds ratio [OR], 12.09; 95% confidence interval [CI], 1.59-92.0; p = 0.016). Furthermore, significant differences in venous invasion (44.4% vs. 19.6%; p < 0.001), and non-PWDA (100% vs. 68.0%; p < 0.001) were observed between patients with and without recurrence. The agreement among three pathologists on the diagnosis of PWDA was acceptable (kappa value > 0.5). Surface redness (p < 0.001), a rugged surface (p < 0.01), fold convergence (p < 0.001), and an impression of fullness (p = 0.031) were significantly related with PWDA. Conclusions: PWDA can predict safety against LNM and recurrence in patients with T1 colorectal cancer.https://www.jstage.jst.go.jp/article/jarc/9/3/9_2024-105/_pdf/-char/enpure well-differentiated adenocarcinomacolorectal cancerlymph node metastasisrecurrence |
| spellingShingle | Ken Inoue Naohisa Yoshida Reo Kobayashi Ryohei Hirose Naoto Iwai Osamu Dohi Takaaki Murakami Yutaka Inada Tomohiro Arita Yukiko Morinaga Eiichi Konishi Yoshito Itoh Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer Journal of the Anus, Rectum and Colon pure well-differentiated adenocarcinoma colorectal cancer lymph node metastasis recurrence |
| title | Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer |
| title_full | Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer |
| title_fullStr | Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer |
| title_full_unstemmed | Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer |
| title_short | Pure Well-differentiated Adenocarcinoma as a Safe Factor for Lymph Node Metastasis and Recurrence of T1 Colorectal Cancer |
| title_sort | pure well differentiated adenocarcinoma as a safe factor for lymph node metastasis and recurrence of t1 colorectal cancer |
| topic | pure well-differentiated adenocarcinoma colorectal cancer lymph node metastasis recurrence |
| url | https://www.jstage.jst.go.jp/article/jarc/9/3/9_2024-105/_pdf/-char/en |
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