Published online Jun 21, 2019. doi: 10.3748/wjg.v25.i23.2887
Peer-review started: March 20, 2019
First decision: April 4, 2019
Revised: May 7, 2019
Accepted: May 8, 2019
Article in press: May 8, 2019
Published online: June 21, 2019
Core tip: Since the implementation of national bowel cancer screening programmes we have seen a three-fold increase in early colorectal cancers but how these lesion should surgical managed is currently unclear. Conventional histopathological parameters such as tumour grading or lymphovascular invasion have been shown to be predictive of lymph node metastasis but the inter- and intra-observer variation in reporting is significant. This review present the various conventional histopathological risk factors for predicting systemic spread in pT1 colorectal cancer and introduces novel quantitative variables and multivariable risk models that could be used to better define the optimal treatment of this increasingly common disease.