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Related Experiment Video

Updated: May 12, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

Published on: February 13, 2026

Identifying rectal carcinoma with distal submucosal spread.

Kraemer¹, Seow-Choen, Ho

¹Department of Colorectal Surgery, Singapore General Hospital, Singapore, Department of Histopathology, Singapore General Hospital, Singapore.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland

|April 13, 2013

Summary

Identifying rectal cancer patients at high risk for distal submucosal spread is possible. Poorly differentiated tumors and advanced lymph node involvement indicate a higher risk, guiding surgical decisions.

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Area of Science:

Oncology
Surgical Pathology

Background:

Rectal carcinoma poses challenges in predicting tumor spread.
Understanding submucosal invasion is crucial for surgical planning.

Purpose of the Study:

To identify preoperative predictors of distal submucosal spread in rectal cancer.
To assess the correlation between tumor characteristics and distal spread.

Main Methods:

Prospective examination of 124 rectal carcinoma resected specimens.
Correlation of submucosal spread with patho-anatomical, histological, and operative findings.

Main Results:

Distal submucosal spread occurred in 3% of patients, exclusively in advanced (Dukes' C) or disseminated cancers.
Advanced lymph node involvement (N3) and poorly differentiated tumors were significantly associated with distal spread (P=0.0005 and P=0.0002, respectively).

Related Experiment Videos

Last Updated: May 12, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

Published on: February 13, 2026

The combination of these features yielded a 31% risk of distal submucosal spread.

Conclusions:

Distal submucosal spread in rectal cancer is linked to poorly differentiated histology and advanced lymph node metastasis.
Preoperative identification of high-risk patients for distal spread is feasible, enabling tailored surgical approaches.