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The working group
History
Our goal
Participating centers
Meetings
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Research projects
Limeric II
Publications
T1 CRC Symposium
Photos Symposium 2018
Videos Symposium 2018
Photos Symposium 2020
Colorectal cancer guideline
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Calculator
Examples of the histological factors
Evidence
When to use
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Calculator for the risk of metastasis in pedunculated T1 CRC
Fill in the fields below to calculate the percentage of the risk of metastasis in pedunculated T1 CRC
Differentiation grade
More information
Differentiation grade
×
Assessed for the tumor as a whole according to the WHO classification of tumors:
- Good:
exhibits glandular structures in >95% of the tumor
- Moderate:
exhibits glandular structures in 50-95% of the tumor
- Poor or undifferentiated:
exhibits glandular structures in <50%
Good/moderate
Poor
Haggitt level
More information
Haggitt level
×
Assessed according to the method as proposed by Haggitt et al:
- Level 1:
invasion of the submucosa but limited to the head of the polyp
- Level 2:
invasion extending into the neck of polyp
- Level 3:
invasion into any part of the stalk
- Level 4:
invasion beyond the stalk but above the muscularis propria
In polypectomy specimens, Haggitt level 3 invasion with positive resection margins was considered Haggitt level 4 invasion.
Haggitt level 1-3 or unassessable
Haggitt level 4
Tumor budding
More information
Tumor budding
×
Cancer cell nest consisting of 1-4 cells that infiltrates the interstitium at the invasive margin. After selecting one field where budding was the most intensive, the number of buddings was counted in a field measuring 0.785 mm2 observed through a 209 objective lens (WHK 109 ocular lens). The grade was defined as follows:
- Grade 1: 0-4 buds
- Grade 2: 5-9 buds
- Grade 3: 10 or more buds
Negative for tumor budding (budding grade 1)
Positive for tumor budding (tumor budding grade 2-3)
Poorly differentiated clusters (PDC)
More information
Poorly differentiated clusters (PDC)
×
Cancer clusters in the stroma composed of ≥5 cancer cells and lacking a gland-like structure. After selecting one field where PDC was the most intensive, the number of PDCs was counted in a field measuring 0.785 mm2 observed through a 209 objective lens (WHK 109 ocular lens). The grade was defined as follows:
- Grade 1: 0-4 PDCs
- Grade 2: 5-9 PDCs
- Grade 3: 10 or more PDCs
Negative for tumor PDC (PDC grade 1)
Positive for tumor PDC (PDC grade 2-3)
Lymphovascular invasion
More information
Lymphovascular invasion
×
The presence of cancer cells within endothelial-lined channels. Distinction between lymphatic-invasion and blood vessel-invasion was not made.
Absent
Present
Status of the muscularis mucosa
More information
Status of the muscularis mucosa
×
The status of the muscularis mucosa was classified as:
- Type A:
shattered but aligned muscularis mucosa
- Type B:
incompletely or completely disrupted muscularis mucosa
Type A
Type B
The field below will show the calculated score.
Predicted probability (%) of metastasis in penduculated T1 CRC
Untitled
Below an overview of all the possible outcomes.
Disclaimer
The Pedunculated T1 CRC Risk Calculator estimates the chance of metastasis (lymph node metastasis, distant metastasis or intramural recurrence after R0-resection) for pedunculated T1 CRC. The prediction rule of this risk calculator was developed in a study published by the T1 CRC working group (Backes et al, Gastroenterology 2018, on behalf of the T1 CRC working group). As stated in the article: before considering implementation of the calculator in general practice, the model first needs to be formally validated in another cohort, preferably prospectively but at least in another independent set of archival slides. Please note the risk percentages provided are only estimates. The risk estimate only takes certain information into account. There may be other factors that are not included in the estimate which may increase or decrease the risk. These estimates are not a guarantee of results. Metastasis may happen even if the risk is low. This information is not intended to replace the advice of a doctor or healthcare provider about the diagnosis, treatment, or potential outcomes. The T1 CRC working group is not responsible for medical decisions that may be made based on the risk calculator estimates, since these estimates are provided for informational purposes only.