AMSOEC

Since the NHS started screening for bowel cancer, the number of cases where colorectal cancer is detected at an early stage (when the tumour is small and has not spread) has tripled, reaching 17%. Many patients with early cancers can be treated successfully without the need for a major operation (i.e. the cancer can just be cut out with a limited procedure inside the bowel rather than removing the whole segment of bowel containing the tumour). With this approach, there is concern that cancer could be left behind if it has spread to the lymph nodes (or glands) around the bowel, so doctors need to predict which patients are at risk of lymph node spread before deciding on the best treatment approach.

This study looked at data from 207 patients with early colorectal cancer and the researchers used statistical tests to analyse the data and created a model to predict if cancer might have spread to the lymph nodes. They found that certain factors were linked to cancer spread, including the appearance of the tumour's surrounding tissue, how far the cancer had spread into the tissue underneath, how well the tumour cells were differentiated, and if there was evidence of lymphatic invasion (spread into channels leading to lymph nodes). This model identified 90-95% of patients where cancer had spread to the lymph nodes, and suggested surgery for about 34% to 35% of the patients. Using this model could therefore potentially predict the 65-66% of patients who could safely avoid a major operation. Although these results are encouraging, this approach needs to be tested further before it can be used widely.

Pelican supported this study with a grant of £20,000.