Clinicopathological Analysis and Management of Early Colorectal Cancer with Submucosal Invasion(Recent topics on early detection and treatments of colon cancer)

The lesions of one hundred and twenty three early colorectal carcinomas (117 cares) with submucosal (sm) invasion were investigated. Metastatic involvement of regional lymphnodes was seen in 9.4% of all cases and lymphatic permeation in 21.4%. The incidence of venous spread was 19.7%. The close relationship between these rates and the level of sm invasion was observed. The policy for management of sm carcinomas should be decided on their location and the level of sm invasion. Except the carcinomas with invasive level of smla, sm-invasive cancer which is located on colon and rectum above the line of 2 cm from Dentate line seems to necessitate a further radical operation. However the radical operation for the carcinomas on lower rectum below the line of 2 cm from Dentate line should be restricted only to cases with sm 3, lymphatic and/or venous permeation, and poorly differentiated adenocarcinoma or undifferentiated carcinoma, for reducing the number of patients suffering from permanent sigmoidostomy