Predicting lymph node metastases in pT1 rectal cancer

With the widespread introduction of population screening for colorectal cancer in Europe, the number of early rectal cancers is expected to increase. In the past, approximately 25 % of rectal cancers presented with early disease, defined as stage I disease. First, results from population screening in the UK demonstrate an increase to approximately 50 % stage I for screen-detected carcinomas. In the absence of lymph node metastases, local excision of the tumor might be an attractive option, with considerably less morbidity due to surgery and a lower mortality. This option demonstrates the need for a reliable method of lymph node metastasis prediction in early rectal cancer. The overall risk of lymph node metastasis in pT1 tumors is still considerable, 11.4 %. In order to avoid both under-and overtreatment, we need adequate risk factors.