Yim et al identified risk factors associated with lymph node metastases in patients with colorectal cancer with invasion limited to the submucosa (T1). The authors are from St. Mary's Hospital and The Catholic University of Korea in Seoul.
Parameters:
(1) area of submucosal invasion in square mm
(2) lymphovascular invasion
(3) tumor budding
(4) poorly differentiated clusters (PDCs)
area of submucosal invasion =
= (depth below muscularis mucosae in microns) * (width in microns) / 10^6
Parameters
Findings Points
Points
area of invasion
< 6.5 square mm
0
>= 6.5 square mm
1
lymphovascular invasion
absent
0
present
1
tumor budding
absent
0
present
1
poorly differentiated clusters
absent
0
present
1
where:
• Tumor budding can also be graded by the method of Ueno et al (Bd1, Bd2, Bd3).
number of risk factors for lymph node metastases =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the risk for lymph node metastases.
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