Theme |
Invasive colorectal cancer current status and practical issues of depth 1,000μm |
Title |
Benefits of measuring depth of submucosal invasive colorectal cancer |
Author |
Akiko Chino |
Division of Gastroenterology, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Masahiro Igarashi |
Division of Gastroenterology, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Yoshiya Fujimoto |
Digestive Surgery, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Mizuka Imai |
Division of Gastroenterology, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Yuko Hayashi |
Division of Gastroenterology, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Teruhito Kishihara |
Division of Gastroenterology, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Naoyuki Uragami |
Division of Gastroenterology, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Yoshiro Tamegai |
Division of Gastroenterology, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
Author |
Masashi Ueno |
Division of Surgery, Cancer Institute Ariake Hospital of Japanese Foundation for Cancer Research |
[ Summary ] |
Current guidelines stipulate that an "SM depth ≥1,000μm" is a predictive factor for lymph node metastasis. This has become an established standard for measuring depth of SM. There are minor variations in these standards from hospital to hospital. Additionally, we must be aware of the risks of lymph node metastasis, indicated by lymphatic and venous invasion, histological type, sprouting, etc. Previously, our hospitals' guidelines recommend additional surgical resection in cases with SM depth ≥ 300μm after endoscopic local resection. After adoption of those guidelines, 26 % (19 cases) with SM depth of 300-1,000μm were deemed not to be candidates for resection, out of a total of 73 cases with SM depth ≥ 300 μm. It is worth noting that 17 % of the cases with lymph node metastasis exhibited risk factors including SM depth of 300-1,000μm, and that 4 % of these cases did not exhibit risk factors or SM depth of 300-1,000μm. |