T1 colorectal cancer: poor histological grading is predictive of lymph-node metastases

INTRODUCTION: After complete local excision of pT1 colorectal cancers, predictionof the absence of lymph-node involvement represents an interesting perspective inorder to avoid unnecessary additional radical surgery, reducing morbidity,mortality and costs of care. We aimed to identify independent risk factorspredictive of nodal involvement in pT1 colorectal cancer patients..METHODS: Data regarding depth of submucosal invasion, histological grading,tumour budding and lymphovascular invasion in a consecutive series of 48 pT1surgically resected colorectal cancers have been retrospectively collected andrelated to the nodal status.RESULTS: A 12.5% rate of nodal involvement has been found. The poordifferentiation was found as the only independent predictor of nodal metastasesin pT1 colorectal cancer (p = 0.01).CONCLUSIONS: Poor differentiation was the only independent significant predictor of nodal involvement in pT1 colorectal tumours. Our and literature's data confirmthat risk factors must be prospectively collected and reported; further geneticand epigenetic predictive factors have to be investigated in order to carefullyevaluate the needing of major surgery for pT1 colorectal cancer.