Risk Factors Associated With Lymph Node Metastasis and Recurrence in Surgical Cases of pT1 Colorectal Cancer

Area of Science:

• Oncology
• Gastroenterology
• Surgical Pathology

Background:

• pT1 colorectal cancer (pT1-CRC) requires understanding risk factors for lymph node metastasis (LNM) and recurrence.
• Accurate risk stratification is crucial for guiding treatment decisions and improving patient outcomes.

Purpose of the Study:

• To identify significant risk factors for lymph node metastasis (LNM) in pT1-CRC patients.
• To determine predictors of postoperative recurrence in this patient cohort.

Main Methods:

• Retrospective analysis of 150 pT1-CRC patients undergoing surgery and lymph node dissection.
• Univariate and multivariate analyses examining sex, invasion depth, venous/lymphatic invasion, tumor budding (BD), and histology.
• Recurrence-free survival (RFS) analysis.

Main Results:

• Lymph node metastasis (LNM) observed in 14% of patients.
• Independent risk factors for LNM included female sex, undifferentiated histology, and tumor budding grade 2/3 (BD2/3).
• Five-year RFS was significantly lower for patients with LNM (66.4%) versus without LNM (97.3%). BD2/3 independently predicted recurrence.

Conclusions:

• Female sex, undifferentiated histology, and BD2/3 are significant risk factors for LNM in pT1-CRC.
• LNM is associated with a higher risk of postoperative recurrence.
• Tumor budding grade (BD2/3) is a critical predictor of recurrence, irrespective of LNM status.