Lymphovascular invasion is an independent risk factor of recurrence in T2 colorectal cancer
Selma Medic, Emelie Nilsson, Carl-Fredrik Rönnow, Henrik ThorlaciusAbstract
Introduction
Local treatment might be an alternative to surgical resection in selected patients with T2 colorectal cancer. The aim of this study was to identify histopathological and clinical risk factors predicting recurrence following surgical resection in T2 colorectal cancer.
Methods
Data were collected retrospectively from a population-based registry on patients with T2 colorectal cancer treated with surgical resection in Sweden between 2009 and 2021. Variables including age, gender, histologic grade, mucinous cancer, lymphovascular invasion (LVI), lymph node metastases (LNM), number of lymph nodes examined and perineural invasion (PNI) were analyzed separately in colon and rectal cancers. Uni- and multivariate Cox regression analyses were used to identify risk factors of recurrence.
Results
Recurrence occurred in 119 out of 1193 patients (10%) with T2 rectal cancer. LVI (HR = 1.88, P<0.005), PNI (HR = 1.91, P = 0.048) and LNM (HR = 2.65, P<0.001) were independent risk factors of recurrence. In colon cancer, 239 out of 3364 patients (7.1%) had recurrence. LVI (HR = 1.54, P = 0.013), and LNM (HR = 3.60, P<0.001) were independent risk factors of recurrence. Male sex was an independent risk factor of recurrence in both colon and rectal cancers.
Discussion
LVI, LNM, and male gender are independent risk factors of recurrence in both colon and rectal cancer. In addition, PNI is an independent risk factor of recurrence in rectum. These findings might be useful to identify patients needing surgical resection after local resection of T2 CRC.