Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2019; 25(23): 2887-2897
Published online Jun 21, 2019. doi: 10.3748/wjg.v25.i23.2887
Predicting systemic spread in early colorectal cancer: Can we do better?
Scarlet Fiona Brockmoeller, Nicholas Paul West
Scarlet Fiona Brockmoeller, Nicholas Paul West, Pathology and Data Analytics, Leeds Institute of Medical Research at St. James’s, University of Leeds, School of Medicine, Leeds LS9 7TF, United Kingdom
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Supported by Yorkshire Cancer Research; and the National Institute for Health Research, the Pelican Cancer Foundation and the Pathological Society of Great Britain and Ireland.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Nicholas Paul West, BSc, MBChB, PhD, Doctor, Senior Lecturer, Pathology and Data Analytics, University of Leeds, Level 4 Wellcome Trust Brenner building, St. James’s University Hospital, Beckett Street, Leeds LS9 7TF, United Kingdom.
Telephone: +44-113-3438626
Received: March 20, 2019
Peer-review started: March 20, 2019
First decision: April 4, 2019
Revised: May 7, 2019
Accepted: May 8, 2019
Article in press: May 8, 2019
Published online: June 21, 2019
Core Tip

Core tip: Since the implementation of national bowel cancer screening programmes we have seen a three-fold increase in early colorectal cancers but how these lesion should surgical managed is currently unclear. Conventional histopathological parameters such as tumour grading or lymphovascular invasion have been shown to be predictive of lymph node metastasis but the inter- and intra-observer variation in reporting is significant. This review present the various conventional histopathological risk factors for predicting systemic spread in pT1 colorectal cancer and introduces novel quantitative variables and multivariable risk models that could be used to better define the optimal treatment of this increasingly common disease.