The Importance of Being "That" Colorectal pT1: A Combined Clinico-Pathological Predictive Score to Improve Nodal Risk Stratification.
age at diagnosis
colorectal carcinoma
lymph node metastasis
lymphovascular invasion
pT1
predictive score
tumor budding
tumor-infiltrating lymphocytes
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
17
12
2021
accepted:
14
01
2022
entrez:
3
3
2022
pubmed:
4
3
2022
medline:
4
3
2022
Statut:
epublish
Résumé
The management of endoscopically resected pT1 colorectal cancer (CRC) relies on nodal metastasis risk estimation based on the assessment of specific histopathological features. Avoiding the overtreatment of metastasis-free patients represents a crucial unmet clinical need. By analyzing a consecutive series of 207 pT1 CRCs treated with colectomy and lymphadenectomy, this study aimed to develop a novel clinicopathological score to improve pT1 CRC metastasis prediction. First, we established the clinicopathological profile of metastatic cases: lymphovascular invasion (OR: 23.8; CI: 5.12-110.9) and high-grade tumor budding (OR: 5.21; CI: 1.60-16.8) correlated with an increased risk of nodal metastasis, while age at diagnosis >65 years (OR: 0.26; CI: 0.09-0.71) and high tumor-infiltrating lymphocytes (OR: 0.19; CI: 0.06-0.59) showed a protective effect. Combining these features, we built a five-tier risk score that, applied to our series, identified cases with a higher risk (score ≥ 2) of nodal metastasis (OR: 7.7; CI: 2.4-24.4). Notably, a score of 0 was only assigned to cases with no metastases (13/13 cases) and all the score 4 samples (2/2 cases) showed nodal metastases. In conclusion, we developed an effectively combined score to assess pT1 CRC nodal metastasis risk. We believe that its adoption within a multidisciplinary pT1 unit could improve patients' clinical management and limit surgical overtreatment.
Identifiants
pubmed: 35237635
doi: 10.3389/fmed.2022.837876
pmc: PMC8882765
doi:
Types de publication
Journal Article
Langues
eng
Pagination
837876Informations de copyright
Copyright © 2022 Gambella, Falco, Benazzo, Osella-Abate, Senetta, Castellano, Bertero and Cassoni.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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