Clinicopathological Analysis and Therapeutic Plan of Early Invasive Colorectal Cancer

Nobuyuki Sakai, Masahiko Watanabe, Tatsuo Teramoto, Hideki Nishibori, Seiichirou Yamamoto, Youhei Chiba, Yoshiyuki Ishii, Shin Narai, Masami Ishihara, Masaki Kitajima

Department of Surgery, Keio University School of Medicine

A total of 202 patients (139 males and 63 females) with early invasive colorectal cancer underwent resection in our department between 1970 and 1995. The mean age of the patients was 60.0±12.0 years and the average tumor diameter was 20.3+13.9 mm. The incidence of Ip (pedunculated) Isp (subpedunculated) and Is (sessile) type configuration was 140 cases (69.3%) and that of IIa (flat elevated) and IIa+IIc (flat elevated with depression type) was 62 cases (30.7%). Early invasive colorectal cancer was located in the sigmoid colon and rectum in 80.7% of the patients. The 10 patients with lymph-node metastasis represented 4.9% of all early invasive cancer patients and the lymphovascular invasion, level of invasion, location and configuration were risk factors for development of lymph-node metastasis. Is (sessile) type and IIa+IIc (flat elevated with depression) type early colorectal cancer had a high rate of lymph-node metastasis, and bowel resection must be performed as the treatment of first choice. All of the lymph-node metastases were paracolic lymph-node metastasis, and dissection of intermediate lymph nodes was thought to be enough for a curative operation of early invasive colorectal cancer.

Key words
early invasive colorectal cancer, lymph node metastasis, the level of invasion, distant metastasis, endoscopic polypectomy

Reprint requests
Masahiko Watanabe Department of Surgery, Keio University School of Medicine
35 Shinanomachi, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
September 11, 1996

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