title: Risk factors for lymph node metastasis in pT1 and pT2 rectal cancer: a single-institute experience in 943 patients and literature review.
abstract: BACKGROUND
  Local excision has become an alternative for radical resection in rectal cancer for selected patients. The purpose of this study was to assess the clinicopathologic factors determining lymph node metastasis (LNM) in patients with T1-2 rectal cancer.
  
  
  METHODS
  Between January 1995 and December 2009, a total of 943 patients with pT1 or pT2 rectal adenocarcinoma received radical resection at a single institution. Clinicopathologic factors were evaluated by univariate and multivariate analyses to identify risk factors for LNM.
  
  
  RESULTS
  A total of 943 patients (544 men and 399 women) treated for T1-2 rectal cancer were included in this study. LNM was found in 188 patients (19.9%). In multivariate analysis, lymphovascular invasion (LVI; P < 0.001, hazard ratio 11.472), poor differentiation (PD; P = 0.007, hazard ratio 3.218), and depth of invasion (presence of pT2; P = 0.032, hazard ratio 1.694) were significantly related to nodal involvement. The incidence for LNM lesions in the presence of LVI, PD, and pT2 was 68.8, 50.0, and 23.1%, respectively, while that for pT1 carcinomas with no LVI or PD was 7.5%.
  
  
  CONCLUSIONS
  LVI, PD, and pT2 are independent risk factors predicting LNM in pT1-2 rectal carcinoma.
authors.affiliation: Department of Surgery, Colorectal Section, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Hao-Cheng
authors.initials: HC
authors.lastname: Chang
authors.forename: Shih-Chiang
authors.initials: SC
authors.lastname: Huang
authors.forename: Jinn-Shiun
authors.initials: JS
authors.lastname: Chen
authors.forename: Reiping
authors.initials: R
authors.lastname: Tang
authors.forename: Chung Rong
authors.initials: CR
authors.lastname: Changchien
authors.forename: Jy-Ming
authors.initials: JM
authors.lastname: Chiang
authors.forename: Chien-Yuh
authors.initials: CY
authors.lastname: Yeh
authors.forename: Pao-Shiu
authors.initials: PS
authors.lastname: Hsieh
authors.forename: Wen-Sy
authors.initials: WS
authors.lastname: Tsai
authors.forename: Hsin-Yuan
authors.initials: HY
authors.lastname: Hung
authors.forename: Jeng-Fu
authors.initials: JF
authors.lastname: You
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000401:mortality* / Q000473:pathology*; D012196:Review Literature as Topic; D015996:Survival Rate; D055815:Young Adult