@article{oai:dmu.repo.nii.ac.jp:00000757, author = {Kimura, Tokiko and Yamagishi, Hidetsugu and Ichikawa, Kazuhito}, issue = {1}, journal = {Dokkyo journal of medical sciences}, month = {Mar}, note = {Indication of endoscopic treatment for colorectal cancer with submucosal invasion( called as early colorectalcancer) is expanding although such lesions have a high potential to metastasize. Therefore, pathologicalevaluation of early colorectal caner is important. In practice, surgical resection is required after endoscopictreatment of early colorectal cancer when lymphovascular invasion is obvious, the treated lesion is a poorlydifferentiated adenocarcinoma or an undifferentiated carcinoma, or carcinoma is invading massively to thevicinity of the stump. However, lymph node metastasis is indeed found only at about 10 %, nevertheless anadditional colectomy is performed to exclude the risk of lymph node metastasis. From the viewpoint of pathology,the measurement of vertical invasion distance and/or the evaluation of tumor budding appearancein its invasive front may be useful for the precise prediction of lymph node metastasis in patients with earlycolorectal cancers. Then, the Project Committee for Handling Submucosal Carcinomas, the Japanese Societyfor Cancer of the Colon and Rectum, have recently collected 865 cases of early colorectal cancers and analyzedclinicopathological factors including the distance of submucosal invasion. Subsequently, the committesuggested the outline to determine the early colorectal cancer without lymph node metastasis and moreoverclarified that budding appearance is important to predict lymph node metastasis in patients with early colorectalcancers. In the present article, we explain the detailed discussion in the process of establishment forthe outline., Review}, pages = {71--74}, title = {Introduction of the General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus:Evaluation of invasion distance and budding appearance in early colorectal cancer}, volume = {36}, year = {2009} }