T1 colon cancer in the era of screening: risk factors and treatment

F. Bianco, S. De Franciscis, A. Belli, A. Falato, R. Fusco, D. F. Altomare, A. Amato, C. R. Asteria, A. Avallone, G. A. Binda, L. Boccia, P. Buzzo, M. Carvello, Claudio Coco, P. Delrio, P. De Nardi, M. Di Lena, A. Failla, F. La Torre, M. La TorreM. Lemma, P. Luffarelli, G. Manca, I. Maretto, F. Marino, A. Muratore, A. Pascariello, S. Pucciarelli, D. Rega, V. Ripetti, Gianluca Rizzo, A. Serventi, A. Spinelli, F. Tatangelo, E. D.L. Urso, G. M. Romano, On Behalf Of The Italian Society Of Colo-Rectal Surgery (Siccr) Cancer Group

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3 Citations (Scopus)


Background: The aim of this study was to identify risk factors for lymph node positivity in T1 colon cancer and to carry out a surgical quality assurance audit. Methods: The sample consisted of consecutive patients treated for early-stage colon lesions in 15 colorectal referral centres between 2011 and 2014. The study investigated 38 factors grouped into four categories: demographic information, preoperative data, indications for surgery and post-operative data. A univariate and multivariate logistic regression analysis was performed to analyze the significance of each factor both in terms of lymph node (LN) harvesting and LN metastases. Results: Out of 507 patients enrolled, 394 patients were considered for analysis. Thirty-five (8.91%) patients had positive LN. Statistically significant differences related to total LN harvesting were found in relation to central vessel ligation and segmental resections. Cumulative distribution demonstrated that the rate of positive LN increased starting at 12 LN harvested and reached a plateau at 25 LN. Conclusions: Some factors associated with an increase in detection of positive LN were identified. However, further studies are needed to identify more sensitive markers and avoid surgical overtreatment. There is a need to raise the minimum LN count and to use the LN count as an indicator of surgical quality.
Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalTechniques in Coloproctology
Publication statusPublished - 2017


  • Adult
  • Aged
  • Colonic Neoplasms
  • Early Detection of Cancer
  • Early-stage colon cancer
  • Female
  • Gastroenterology
  • Humans
  • Logistic Models
  • Lymph Node Excision
  • Lymph Nodes
  • Lymph node metastases
  • Lymphatic Metastasis
  • Male
  • Medical Audit
  • Medical Overuse
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Quality assurance
  • Retrospective Studies
  • Risk Factors
  • Screening
  • Surgery


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