title: Pathological Predictors for Defining a Therapeutic Strategy for Early Colon Cancer after Endoscopic Resection: Multicenter Retrospective Analysis from Surgically Resected Specimens.
abstract: OBJECTIVE
  For the possibility of regional lymph node metastasis (LNM), early colon cancer (ECC) is a boundary lesion between endoscopic resection and surgery. The aim of study is to clarify risk factors for LNM and to determine therapeutic strategy after endoscopic resection in patients with ECC.
  
  
  METHODS
  The histopathology of patients with ECC underwent surgery with LN dissection in 8 university hospitals were reviewed by experienced pathologist blinded to LN status.
  
  
  RESULTS
  In total, 370 patients (107 with mucosal cancer, 263 with submucosal invasive colorectal carcinoma [SICC]) were enrolled. Excluding mucosal cancer, the LNM rate was 11.8% (31/263, including 15.4% [8/52] with pedunculated SICC [P-SICC] and 10.9% [23/211] with non-pedunculated SICC [NP-SICC]). Multivariate analysis showed that tumor sprouting (P < 0.001; odds ratio [OR], 8.83; 95% confidence interval [CI], 3.04-25.69), submucosal invasion depth (SM depth) > 2000 μm (P = 0.024; OR, 3.68; 95% CI, 1.19-11.37), and lymphatic invasion (P = 0.022; OR, 3.48; 95% CI, 1.19-10.13) were related to LNM. All LNMs with SM depth < 2000 μm showed tumor sprouting without lymphatic invasion.
  
  
  CONCLUSIONS
  Significant risk factors for predicting LNM in patients with SICC were tumor sprouting, SM depth > 2000 μm, and lymphatic invasion.
authors.forename: Suck-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Hyun Deuk
authors.initials: HD
authors.lastname: Cho
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.forename: Woon Je
authors.initials: WJ
authors.lastname: Heo
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Sohn
authors.forename: Seong-Eun
authors.initials: SE
authors.lastname: Kim
authors.forename: Min Sun
authors.initials: MS
authors.lastname: Cho
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Shin
authors.forename: Won Ae
authors.initials: WA
authors.lastname: Lee
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Han
authors.forename: Young Ha
authors.initials: YH
authors.lastname: Oh
authors.forename: Seun Ja
authors.initials: SJ
authors.lastname: Park
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Chang
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.forename: Chang Ho
authors.initials: CH
authors.lastname: Cho
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young
authors.initials: Y
authors.lastname: Hwangbo
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery*; D016009:Chi-Square Distribution; D003082:Colectomy / Q000379:methods; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery*; D003113:Colonoscopy; D016208:Databases, Factual; D055088:Early Detection of Cancer; D005260:Female; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome