Peer-Reviewed Publication
Virchows Arch2026;488(6):1319-1330.June 1, 2026Journal Article
Utility of quantitative pathologic analysis of pT1 colorectal carcinomas to improve prediction of lymph node metastasis.
Priya Nayak1, Heidi Kosiorek2, Reetesh K Pai3, Sameer Shivji4, Catherine E Hagen5, Rondell P Graham5, Daniel D Buchanan6,7,8, Mark A Jenkins7,9, Amanda I Phipps10,11, Loic Le Marchand12, Christina Wu13, Niloy J Samadder14, Carol J Swallow15,16,17,18, Steven J Gallinger15,19,20, Robert C Grant21, Thomas Westerling-Bui22, James Conner4,23, David P Cyr15,18, Richard Kirsch4,23, Rish K Pai24,25
1Department of Pathology and Laboratory Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
2Department of Quantitative Health Sciences, Mayo Clinic, Phoenix, AZ, USA.
3Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
4Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Ave, Toronto, ON, Canada.
5Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN, USA.
6Colorectal Oncogenomics Group, Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, Australia.
7University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia.
8Genomic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Parkville, VIC, Australia.
9Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, VIC, Australia.
10Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
11Department of Epidemiology, University of Washington, Seattle, WA, USA.
12Population Sciences in the Pacific Program (Epidemiology), University of Hawaii, Honolulu, HI, USA.
13Division of Medical Oncology, Department of Medicine, Mayo Clinic, Phoenix, AZ, USA.
14Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Phoenix, AZ, USA.
15Sinai Health System, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada.
16Department of Surgical Oncology, Princess Margaret Cancer Centre, Mount Sinai Hospital, Toronto, ON, Canada.
17Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
18Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
19Ontario Institute for Cancer Research, Toronto, ON, Canada.
20Surgical Oncology Program, University Health Network, Toronto, ON, Canada.
21Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada.
22Aiforia Inc., Cambridge, MA, USA.
23Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
24Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Ave, Toronto, ON, Canada. rish.pai@sinaihealth.ca.
25Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. rish.pai@sinaihealth.ca.
Abstract
According to the National Comprehensive Cancer Network (NCCN), submucosally invasive (pT1) colorectal carcinomas (CRCs) should be evaluated for tumor grade, lymphatic invasion, and tumor budding to determine the risk of lymph node metastasis. The presence of any one of these high-risk features is an indication for surgery in endoscopically removed pT1 CRCs. In this study, we determined if quantita…
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