| Theme |
Advanced colorectal cancer arisen from LST (laterally spreading tumor) |
| Title |
Clinicopathological differences between advanced colorectal cancers between with or without intramucosal extension |
| Author |
Chikatoshi Katada |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Yasushi Sano |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Takayuki Yoshino |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Fu Kuang-I |
Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East |
| Author |
Yasushi Endoh |
Division of Pathology, National Cancer Center Hospital East |
| Author |
Takahiro Fujii |
Division of Digestive Endoscopy, National Cancer Center Hospital |
| [ Summary ] |
We experienced a case of an 80-year-old woman who had advanced colon cancer, developing from a laterally spreading tumor (LST) during the follow-up period. Histologically, the resected specimen revealed an intramucosal extension related to tubulovillous adenoma at the margin of the tumor. It was then theorized that advanced colorectal cancers (adv-CRCs), with intramucosal extension, might derive from LST, and a study was made of the clinicopathological differences between adv-CRCs which had intramucosal extension and those which did not. A total of 490 adv-CRCs in 482 consecutive patients were treated with surgical resection between January 1998 and December 2001 and later examined. A total of 121 (25%) of 490 adv-CRCs showed intramucosal extensions histologically. All lesions were classified into 4 groups according to the degree of longitudinal intramucosal extension length ie., maximum length of the tumor: over one-third (40 lesions; 33%), one-fourth to one-third (9 lesions; 7%), one-fifth to one-fourth (12 lesions; 10%), under one-fifth (60 lesions; 50%). Adv-CRCs, with intramucosal extension were more frequently located in the right-sided colon (48%) and those which were not, were more frequently located in the rectum (46.9%)(p<0.01). Adv-CRCs with intramucosal extension had a significantly lower incidence of invasive cancer than those which did not (80.2 vs. 88.1%) (p<0.05). Low-grade cancerous and/or adenomatous component were observed in 60.3% of adv-CRCs with intramucosal extension. In conclusion, there was the clinicopathological difference between adv-CRCs with intramucosal extension and those without it. |