| [ Summary ] |
It is clearly important from the point of view of additional surgery of polypectomized submucosal invasive cancer of the colon and rectum, that the metastatic potential be predicted. Several reports have demonstrated the connection between desmoplasia and invasiveness in the prognosis of colorectal cancer. However, histologic predictions of metastasis in submucosal cancer are as yet controversial. We described how we evaluated the relationship between desmoplasia, and tumor size, invasiveness, inflammatory reaction and metastasis. In submucosal invasive cancer, desmoplasia is enhanced along with increasing tumor size, depth of invasion, and degree of inflammation. This relationship is more common in polypoid-type cancer than in the flat-type. In addition, tumor budding (pseudo-dedifferentiation), which is associated with lymphatic involvement, is frequently observed at the invasive front, with prominent desmoplasia. In deeply invasive cancer, lymph node metastasis is more common in cancer with marked desmoplasia, than in that with mild desmoplasia. These findings suggest that evaluations of desmoplasia may be predictive of metastasis in polypectomized submucosal cancer. |