Brief Article
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World J Gastroenterol. Apr 21, 2011; 17(15): 2003-2006
Published online Apr 21, 2011. doi: 10.3748/wjg.v17.i15.2003
Extracapsular invasion as a risk factor for disease recurrence in colorectal cancer
Takaaki Fujii, Yuichi Tabe, Reina Yajima, Satoru Yamaguchi, Soichi Tsutsumi, Takayuki Asao, Hiroyuki Kuwano
Takaaki Fujii, Yuichi Tabe, Reina Yajima, Satoru Yamaguchi, Soichi Tsutsumi, Takayuki Asao, Hiroyuki Kuwano, Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma 371-8511, Japan
Author contributions: Fujii T designed the study, performed the majority of experiments and wrote the manuscript; Tabe Y, Yajima R, Yamaguchi S, Tsutsumi S and Asao T provided the collection of all the human material; Kuwano H involved in editing the manuscript.
Supported by Grants-in-Aid from the Japanese Ministry of Education, Culture, Sports, Science, and Technology
Correspondence to: Takaaki Fujii, MD, PhD, Department of General Surgical Science, Graduate School of Medicine, Gunma University 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. ftakaaki@med.gunma-u.ac.jp
Telephone: +81-27-2208224  Fax: +81-27-2208230
Received: November 4, 2010
Revised: November 25, 2010
Accepted: December 2, 2010
Published online: April 21, 2011
Abstract

AIM: To evaluate the presence of extracapsular invasion (ECI) in positive nodes as a predictor of disease recurrence disease in colorectal cancer.

METHODS: Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 46 had positive lymph nodes. Among 46 cases with stage IIIcolorectal cancer, 16 had ECI at positive nodes and 8 had disease recurrence. The clinical and pathological features of these cases were reviewed.

RESULTS: In the univariate analysis, the number of positive lymph nodes and depth of tumor invasion were significantly associated with the presence of ECI at positive nodes. Multivariate analysis demonstrated that only ECI was a predictor of recurrence. The recurrence-free interval differed significantly among patients with ECI at positive nodes.

CONCLUSION: Our results suggest that ECI at metastatic nodes can identify which cases are at high risk of short-term disease recurrence in colorectal cancer.

Keywords: Extracapsular invasion; Lymph node; Metastasis; Colorectal cancer; Risk factor; Adjuvant therapy