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Clinicopathologic details and prognoses in patients with nodes negative colorectal cancers


, : Clinicopathologic details and prognoses in patients with nodes negative colorectal cancers. Journal of the Japan Society of Coloproctology 43(4): 583-589

In a series of 327 colorectal cancer patients surgically treated in Hiratsuka City Hospital during 1970-1989, 179 patients without regional lymph node metastasis and without distant metastasis (n(-) group were selected to compare the clinicopathologic findings and the prognosis with those in 105 patients with regional lymph node metastasis and without distant metastasis (n(+) group). The mean age of the n(-) group was significantly higher than that of the n(+) group (P < 0.05) and the proportion of male patients in the n(-) group was also significantly higher than that in the n(+) group (P < 0.05). Proportion of the cases without lymphatic vessel invasion in the n(-) group was 64.0% and was significantly higher than that in the n(+) group (P < 0.01). However, the number of patients without venous invasion was not significantly different between the two group. There was no difference in cumulative survival rate of patients in the n(-) group in respect to the background factors such as sex, tumor site, histological type, and venous invasion. However, survival rate of patients whose cancer invasion was limited within the mucosa, submucosa and proper muscle was significantly better than that of patients whose cancer extended from the mucosa beyond the proper muscle. (P < 0.01). Survival rate in patients with and without lymphatic vessel invasion was not significantly different (P < 0.05). Among patients in the n(-) group, 11 patients eventually died of recurrence. The tumor site in 9 patients was the lower rectum and the depth of invasion in these patients was beyond the proper muscle. The mean survival was 35 months. Eight patients developed distant metastasis such as lung, liver and bone. These data indicated that rectal cancers which appeared especially in the lower rectum and extended beyond the proper muscle had a high risk of recurrence among colorectal cancer patients without lymph node involvement.

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