Treatment of Colorectal sm-Carcinomas S. Kudo 1 , J. Soga 2 , M. Yamamoto 1 , S. Koyama 1 , T. Muto 1 1The First Department of Surgery, Niigata University, School of Medicine pp.1349-1356
Published Date 1984/12/25
DOI https://doi.org/10.11477/mf.1403109526
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 Sixty-one cases with colorectal submucosal (sm) carcinomas, histologically proved, were classified into sm1, sm2 and sm3 according to the level of sm-invasion. The sm1 carcinomas were further subclassified into a, b and c categories depending on the horizontal extension.

 The gross configuration and level of sm-invasion were well correlated. Ⅰp (pedunculated) type sm-carcinomas (9 cases) were located within sm1c, Ⅰps (subpedunculated) type (12 cases), within sm2, Ⅰs (sessile) type (15 cases) and Ⅱa (flat-elevated) type (13 cases) were various, but mainly in sm3.

 Eleven sm-carcinomas (18.2%) with lymph node metastasis belonged to sm1b through sm3. Ⅱa and Ⅱa+Ⅱc (flat-elevated with depression) type sm-carcinomas had a high rate of lymph node metastasis.

 The gross size of sm-carcinomas was not always correlated to the level of sm-invasion because of frequent involvement by non-malignant or adenomatous element.

 These data indicate that the gross configuration of sm-carcinomas is closely related to their biologic characteristics and that radical operation with lymphadenectomy is necessary for Ⅱa and Ⅱa+Ⅱc type sm-carcinomas. The policy for treatment of Ⅰp, Ⅰps and Ⅰs type sm-carcinomas should be decided on the basis of histology after polypectomy, and sm1a carcinoma with well-differentiated histology type and without lymphovascualr invasion may be on further follow-up observation, but most of other sm-carcinomas are considered to necessitate radical operation.

Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.


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