[Lymph node metastasis of colorectal cancer with submucosal invasion]

Endoscopic local resection is currently feasible for the treatment of early colorectal cancer (CRC) with submucosal invasion. Approximately 10% of patients with CRC with submucosal invasion have lymph node( LN) metastasis. The JSCCR guidelines have established surgical indications following endoscopic treatment based on analysis of patients with submucosal invasive CRC( T1 CRC) who had undergone further surgical resection. We reviewed the outcomes of 314 patients who had undergone surgical resection for T1 CRC from 2001 to 2009. The incidence of LN metastasis overall and in cases treated by further bowel resection was 10.5% and 10%, respectively. Curative surgical resection was performed in all cases. Recurrence occurred in 17 cases( 5.4%), including 14 cases exhibiting distant metastases; the other cases of recurrence exhibited LN metastasis,local recurrence, and peritoneal dissemination. There was no statistically significant difference in postoperative survival between patients treated by D2 dissection and D3 surgery.