| Title: |
The Importance of Being “That” Colorectal pT1: A Combined Clinico-Pathological Predictive Score to Improve Nodal Risk Stratification |
| Authors: |
Gambella A.; Falco E. C.; Benazzo G.; Osella-Abate S.; Senetta R.; Castellano I.; Bertero L.; Cassoni P. |
| Contributors: |
Gambella A.; Falco E.C.; Benazzo G.; Osella-Abate S.; Senetta R.; Castellano I.; Bertero L.; Cassoni P. |
| Publication Year: |
2022 |
| Collection: |
Università degli studi di Torino: AperTo (Archivio Istituzionale ad Accesso Aperto) |
| Subject Terms: |
age at diagnosi; colorectal carcinoma; lymph node metastasi; lymphovascular invasion; predictive score; pT1; tumor budding; tumor-infiltrating lymphocytes |
| Description: |
The management of endoscopically resected pT1 colorectal cancer (CRC) relies on nodal metastasis risk estimation based on the assessment of specific histopathological features. Avoiding the overtreatment of metastasis-free patients represents a crucial unmet clinical need. By analyzing a consecutive series of 207 pT1 CRCs treated with colectomy and lymphadenectomy, this study aimed to develop a novel clinicopathological score to improve pT1 CRC metastasis prediction. First, we established the clinicopathological profile of metastatic cases: lymphovascular invasion (OR: 23.8; CI: 5.12–110.9) and high-grade tumor budding (OR: 5.21; CI: 1.60–16.8) correlated with an increased risk of nodal metastasis, while age at diagnosis >65 years (OR: 0.26; CI: 0.09–0.71) and high tumor-infiltrating lymphocytes (OR: 0.19; CI: 0.06–0.59) showed a protective effect. Combining these features, we built a five-tier risk score that, applied to our series, identified cases with a higher risk (score ≥ 2) of nodal metastasis (OR: 7.7; CI: 2.4–24.4). Notably, a score of 0 was only assigned to cases with no metastases (13/13 cases) and all the score 4 samples (2/2 cases) showed nodal metastases. In conclusion, we developed an effectively combined score to assess pT1 CRC nodal metastasis risk. We believe that its adoption within a multidisciplinary pT1 unit could improve patients' clinical management and limit surgical overtreatment. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/35237635; info:eu-repo/semantics/altIdentifier/wos/WOS:000762004300001; volume:9; issue:837876; firstpage:N/A; lastpage:N/A; numberofpages:10; journal:FRONTIERS IN MEDICINE; https://hdl.handle.net/2318/1851353; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85125337662; https://www.frontiersin.org/articles/10.3389/fmed.2022.837876/full |
| DOI: |
10.3389/fmed.2022.837876 |
| DOI: |
10.3389/fmed.2022.837876/full |
| Availability: |
https://hdl.handle.net/2318/1851353; https://doi.org/10.3389/fmed.2022.837876; https://www.frontiersin.org/articles/10.3389/fmed.2022.837876/full |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.F2910D4C |
| Database: |
BASE |