title: T1 colorectal cancer: poor histological grading is predictive of lymph-node metastases.
abstract: BACKGROUND
  After complete local excision of pT1 colorectal cancers, prediction of the absence of lymph-node involvement represents an interesting perspective in order to avoid unnecessary additional radical surgery, reducing morbidity, mortality and costs of care. We aimed to identify independent risk factors predictive of nodal involvement in pT1 colorectal cancer patients.
  
  
  METHODS
  Data regarding depth of submucosal invasion, histological grading, tumour budding and lymphovascular invasion in a consecutive series of 48 pT1 surgically resected colorectal cancers have been retrospectively collected and related to the nodal status.
  
  
  RESULTS
  A 12.5% rate of nodal involvement has been found. The poor differentiation was found as the only independent predictor of nodal metastases in pT1 colorectal cancer (p = 0.01).
  
  
  CONCLUSIONS
  Poor differentiation was the only independent significant predictor of nodal involvement in pT1 colorectal tumours. Our and literature's data confirm that risk factors must be prospectively collected and reported; further genetic and epigenetic predictive factors have to be investigated in order to carefully evaluate the needing of major surgery for pT1 colorectal cancer.
authors.affiliation: Department of General Surgery, University Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy. Electronic address: d.caputo@unicampus.it.
authors.forename: Damiano
authors.initials: D
authors.lastname: Caputo
authors.affiliation: Department of General Surgery, University Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Caricato
authors.affiliation: Department of General Surgery, University Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: La Vaccara
authors.affiliation: Department of Pathology, University Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Taffon
authors.affiliation: Department of General Surgery, University Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
authors.forename: Gabriella Teresa
authors.initials: GT
authors.lastname: Capolupo
authors.affiliation: Department of General Surgery, University Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200, 00128 Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Coppola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Colorectal cancer; Grading; Lymph-nodes metastases; pT1