In the majority of studies, depth of tumour invasion through the rectal wall is considered the most important independent prognostic factor for nodal involvement. As a matter of fact the risk for N+ has been estimated from 0 to13% in T1, 12-28% in T2 and 36-79% in T3 and T4 [2, 4, 5]. Kikuchi et al.  have divided T1 tumours into 3 subgroups according to the level of submucosal invasion. Tlsml stands for slight submucosal layer infiltration, Tlsm2 for intermediate infiltration and Tlsm3 for whole thickness submucosa involvement [6-8]. The Tlsm3 subgroup bears a risk of lymph node metastasis estimated from 20 to 27%; this represents a contraindication to curative LE.
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