Clinicopathological characteristics of advanced colorectal cancer 30 mm or smaller in diameter.
OBJECTIVE
To investigate the clinicopathological characteristics of advanced colorectal cancer which was 30 mm or smaller in diameter.


METHODS
Retrospective analysis documented 80 patients with small advanced colorectal cancer from May 1985 to May 2002. According to the diameter of tumors, all patients were divided into three groups: Group A (10 mm or less), Group B (11-20 mm), Group C (21-30 mm). Considering the number of patients in Group A was smaller, we combined Group A with Group B as Group D. Then various clinicopathological characteristics were compared between Group C and Group D.


RESULTS
The most common site of small advanced colorectal cancer was sigmoid colon and rectum that accounted for 36.2% and 35.0% of all cases. The average diameter of total tumors was 23.3 mm. Type 2 was the most common macroscopic type (63.7%) and the moderate differentiation was seen in 77.5% of cases. Thirty-eight (47.5%) cases had lymph node metastasis. Three (3.8%) cases had liver metastasis and three (3.8%) cases had peritoneal metastasis. The frequency of lymph node metastasis was found significantly different between Group C and Group D (54.2% vs. 28.6%, P < 0.05) , as well as between the groups with different depth of invasion (P < 0.05). Curability A resection was performed in 69 (86.2%) cases.


CONCLUSIONS
Tumor size and depth of invasion are related to lymph node metastasis in small advanced colorectal cancer. However, the small size of tumor may not always be a reliable parameter for estimating the risk of lymph node metastasis. Small colorectal cancers also do not always mean the early stage. Surgeons should be aware of the features of small advanced colorectal cancers to select ideal management and perform perfect resection.
Zhang
Hong
H
Department of General Surgery, the Second Affiliated Hospital of China Medical University, Shenyang 110004. zhanghong1203@yahoo.com.cn
Chen
Chun-Sheng
CS
Cong
Jin-Chun
JC
Qiao
Lei
L
Hasegawa
Taisuke
T
Takashima
Shigeki
S
D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007564:Japan; D007813:Laparotomy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies
D002272:Carcinoembryonic Antigen