ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2020
Associations of non-pedunculated T1 colorectal adenocarcinoma outcome with consensus molecular subtypes, immunoscore, and microsatellite status: a multicenter case-cohort study.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Risk assessment of lymph node metastasis and comparison of treatment modalities for low-risk T1b colorectal cancer: a meta-analysis.Surgical endoscopy · 2025Pooled it
- Additional staining for lymphovascular invasion is associated with increased estimation of lymph node metastasis in patients with T1 colorectal cancer: Systematic review and meta-analysis.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2024Pooled it
- Clinical Value of Consensus Molecular Subtypes in Colorectal Cancer: A Systematic Review and Meta-Analysis.Journal of the National Cancer Institute · 2022Pooled it
- Article
- Utility of quantitative pathologic analysis of pT1 colorectal carcinomas to improve prediction of lymph node metastasis.Virchows Archiv : an international journal of pathology · 2026Article
- Interobserver variability of histopathological assessment in pT1 colorectal carcinoma.Histopathology · 2026Article
- Development of a prognostic risk model for colorectal cancer based on microsatellite stability-associated genes.BMC cancer · 2025Article
- The prognostic value of immunoscore in the early-onset colorectal cancer.BMC gastroenterology · 2025Article
- Risk of Lymph Node Metastasis in T2 Colon Cancer: A Nationwide Population-Based Cohort Study.Annals of surgical oncology · 2025Article
- Review
- Article
- Benefit of adjuvant chemotherapy on recurrence free survival per consensus molecular subtype in stage III colon cancer.International journal of cancer · 2025Article
- Clinical Challenges of Consensus Molecular Subtype CMS4 Colon Cancer in the Era of Precision Medicine.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024Review
- Article
- Principles of Molecular Utility for CMS Classification in Colorectal Cancer Management.Cancers · 2023Review
- CINSARC signature outperforms gold-standard TNM staging and consensus molecular subtypes for clinical outcome in stage II-III colorectal carcinoma.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
- Article
- Molecular and clinicopathological differences between depressed and protruded T2 colorectal cancer.PloS one · 2022Article
- A Liquid Biopsy Assay for Noninvasive Identification of Lymph Node Metastases in T1 Colorectal Cancer.Gastroenterology · 2021Article
- Fibroblast Subsets in Intestinal Homeostasis, Carcinogenesis, Tumor Progression, and Metastasis.Cancers · 2021Review
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Authors and funding
33 authors.
Funding
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Abstract
Advanced colorectal cancer (CRC) consensus molecular subtype 4 (CMS4) or CRC with a low immunoscore is associated with shorter survival times. Non-metastatic CRC with microsatellite instability (MSI) is associated with a lower risk of recurrence. We evaluated outcome (lymph node metastases [LNM] or cancer recurrence) in these tumor subtypes in patients with surgically-removed non-pedunculated T1 CRC by performing a multicenter case-cohort study. We included all patients in 13 hospitals in the Netherlands from 2000-2014 (n = 651). We randomly selected a subgroup of patients (n = 223) and all patients with LNM or recurrence (n = 63), and median follow-up of 44 months. We centrally reviewed tumor-slides, and constructed and immunostained tissue microarrays determining MSI, CMS (MSI/CMS1, CMS2/3, or CMS4), and immunoscore (I-low/I-high). We used weighted Cox proportional hazard models to evaluate the association of MSI, CMS, and immunoscore with LNM or recurrence, adjusting for conventional histologic risk factors. In the randomly selected subgroup of patients, 7.1% of tumors were MSI/CMS1, 91.0% CMS2/3, 1.8% CMS4, and 25% I-low. In the case-cohort, patients with CMS4 tumors had an increased risk for LNM or recurrence compared with patients with tumors of other CMSs (adjusted hazard ratio [HR], 3.97; 95% CI, 1.12-14.06; P = 0.03). Albeit not significant, tumors with MSI had a lower risk for LNM or recurrence than other tumor subtypes (adjusted HR, 0.52; 95% CI, 0.12-2.30; P = 0.39), whereas tumors with a low immunoscore had an increased risk for LNM or recurrence (adjusted HR, 1.30; 95% CI, 0.68-2.48; P = 0.43). In conclusion, in a case-cohort study of patients with non-pedunculated T1 CRC, MSI, and immunoscore were not significantly associated with adverse outcome after surgery. CMS4 substantially increased the risk of adverse outcome. However, CMS4 is rare in T1 CRCs, limiting its value for determining the risk in patients.
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