Study of Recurrence Risk Factors of Submucosally (sm) Invasive Colorectal Cancer

Atsushi Ihara, Yoshimasa Otani, Yusuke Furukawa, Yukihito Kokuba, Yoshiki Hiki, Akira Kakita

Department of Surgery School of Medicine, Kitasato University

Of the 1,219 patients with colorectal cancer who underwent laparotomy at our facility during a 22-year period from May 1971 to December 1992,76 (6.2%) had sm colorectal cancers that were surgically removed. Fifty-four patients were studied clinicopathologically for recurrence risk factors. Of the 54 patients, 11 (20.4%) had metastasis to lymph nodes, and all of them had a depth of invasion of sm₁c or more. Three (5.6%) developed postoperative recurrence: one at the sigmoid colon and two at the rectum (Ra: 1, Rb: 1). On macroscopic examination, there was one case, each of type 1, Ip, IIa and IIc with depth of invasion sm₂ or greater and metastasis to lymph nodes of ly₃ or more. Seventy-five percent of poorly differentiated adenocarcinomas had metastasis to lymph nodes, and 50% recurred. The results of this study suggest that the followings are risk factors for recurrence: 1) depth of invasion of sm₂ or greater, 2) a histological finding of poorly differentiated adenocarcinoma, 3) vessel invasion (especially ly₃ or more), and 4) metastasis to lymph nodes.

Key words
colorectal submucosally invasive cancer, recurrence factor, poorly differentiated adenocar cinoma, lymph node metastasis

Reprint requests
Atushi Ihara Department of Surgery School of Medicine, Kitasato University
1-15-1 Kitasato, Sagamihara, 228 JAPAN

Accepted
April 13, 1994

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