title: Analysis of lymph node metastatic pattern according to the depth of in-growth in the muscularis propria in T2 rectal cancer for lateral lymph node dissection.
abstract: OBJECTIVE
  The biological behavior of rectal cancers that invade the muscularis propria (pT2) has not been well studied. We retrospectively studied the pattern of lymph node metastases in patients with T2 rectal cancer.
  
  
  METHODS
  We enrolled 88 patients who had undergone curative resection of T2 colorectal cancer through mesorectal excision and lateral pelvic lymph node dissection; we microscopically estimated the maximum depth of muscularis propria invasion and classified the results into 3 groups representing distinct growth patterns.
  
  
  RESULTS
  In cases of pT2 colorectal carcinomas, lateral pelvic lymph node metastases depended on the degree of muscularis propria invasion, and the frequency of metastasis increased with the depth of muscularis propria invasion. Lateral pelvic lymph node metastases were not observed when the depth of muscularis propria invasion was less than half of the thickness of the inner circular layer.
  
  
  CONCLUSIONS
  These findings suggest that lateral pelvic lymph node metastasis of pT2 colorectal cancer depends on the depth of vertical invasion, which is analogous to the findings in pT1 and pT3 cancers. This information will be useful in select cases in which resection of the lateral pelvic lymph node is required for the treatment of rectal cancer invading the muscularis propria (pT2).
authors: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors: Koji
authors: K
authors: Komori
authors: Yukihide
authors: Y
authors: Kanemitsu
authors: Seiji
authors: S
authors: Ishiguro
authors: Yasuhiro
authors: Y
authors: Shimizu
authors: Tsuyoshi
authors: T
authors: Sano
authors: Tomoyuki
authors: T
authors: Kato
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010388:Pelvis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult