Sato et al quantified venous invasion in colorectal carcinoma by several metrics. The presence of venous invasion can negatively impact survival. The authors are from the National Defense Medical College in Japan.
Patient selection: pT3 or pT4 colorectal cancer
Method: vessels identified with elastic van Gieson stain
Sections: from the deepest area of tumor penetration and the transition between benign and malignant mucosa.
The extent of venous invasion is determined by the average number of venous invasions observed on a glass slide.
Number of Veins Invaded
Term
5-Year Survival Rate
none
GO
92%
1 to 3
G1
78%
4 or more
G2
56%
Independent prognostic factors:
(1) number of venous invasions, with G2 worse than G1
(2) depth of invasion (higher pT)
(3) lymph node metastases (N1 or N2)
Unfavorable survival:
(1) G2
(2) lymph node metastasis AND G1
Limitations:
• Variation in the size and location of the tissue sample on a slide.
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