The predictive value of grading relevant to nodal invasion is controversial. Although a less differentiated cancer theoretically metastasises more easily to regional lymph node and distant organs compared to a well differentiated one, statistically significant data supporting this concept have been observed in uni-variate analysis only . Hase et al.  showed how the risk of nodal metastasis increased in those cancers with evidence of undifferentiated histology at the front margin compared to those in which an undifferentiated component was detected within the neoplastic mass. In his paper Kikuchi notes that among 64 patients with T1sm1 no one developed local recurrence or lymph node metastasis although 12.5% of cases have been diagnosed a poorly differentiated lesion .
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