Extramural Venous Invasion as Prognostic Factor of Recurrence in Stage 1 and 2 Colon Cancer

Abstract EN

Aim.

Extramural venous invasion (EMVI) is a prognostic indicator in patients with colorectal cancer.

However, its additional value in patients with stage 1 and 2 colorectal cancer is uncertain.

In the present study, the incidence of EMVI and the hazard ratio for recurrence in patients with stage 1 and 2 colon cancer were studied.

Methods.

184 patients treated for stage 1 and 2 colon cancer were included with a follow-up of at least 5 years.

Chart review was performed and EMVI was assessed by two separate pathologists.

EMVI was scored with additional caldesmon staining on the resection specimen.

Primary outcomes were recurrence-free survival (RFS) measured through the Cox regression analysis and prevalence of EMVI.

Results.

There were 10 cases of EMVI and 3 cases of intramural venous invasion (IMVI) all occurring in patients with stage 2 disease corresponding to a prevalence of 9%.

Thirty-one percent of the patients with venous invasion experienced recurrence versus 14% in patients without, corresponding with a hazard ratio of 2.39 (p=0.11).

Conclusion.

The present study demonstrates a trend towards an increased risk of recurrence in patients with stage 2 colon cancer with venous invasion.

This warrants consideration of adjuvant chemotherapy despite the lack of lymph node metastases.