Prognostic importance of isolated peritumoral lymphangiosis carcinomatosa in lymph-node-negative colorectal carcinoma

Background: The prognostic value of microinvasion of lymph vessels and lymp h nodes has become increasingly important, there is a wide range in prognos is of patients with nodal-negative e tumor stages after curative resection for co-lorectal cancer. Aim: Detection of the prognostic importance of isol ated lymph-vessel invasion as a possible precursor of lymph-node metastasis in patients with nodal-negative tumor stages. Patients/methods: Retrospect ive analysis of 894 patients with R0-resected colorectal cancer, uni- and m ultivariate analysis of tumorbiologic prognostic factors, immunohistochemic al proof of tumor cells in negative lymph nodes (pN0) using the epithelial marker HEA-125 (human epithelial antigen). Results: The incidence of lymph-vessel invasion (L) was 37.7% in total. A p N0,L1 status was found in 144 patients (16.1% of all analyzed patients). Co mparing patients with pN0,L1 status to these with pN+,L0 status showed that both groups have similar rates of overall survival and tumor relapse. Lymp h-node status, lymph-vessel invasion, depth of tumor infiltration (pT) stag e? and age were detected as independent prognostic factors by multivariate analysis. After reanalysis of 54 cases primarily classified as 18.5% pNO,LI , microinvasion in lymph nodes was detected by immunohistochemistry. We fou nd a higher rate of tumor relapse (similar to 20%) for those patients. In r egard to the overall survival rate, however, there was no difference when c ompared to patients without immunohistochemical pl oof of microinvasion. Co nclusion: Isolated lymph-vessel invasion in nodal-negative tumor stages and a lymph-node-positive tumor status have equivalent prognostic importance i n colorectal cancer.