Kikuchi Level (Sessile Submucosal Invasion)
Kikuchi classification (Kikuchi 1995) of submucosal invasion in a sessile malignant colorectal lesion.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Kikuchi level
- Sm3 — lower third, adjacent to muscularis propria (~25% node metastasis)
Result: Kikuchi Sm3: invasion into the lower third of the submucosa; highest node-metastasis risk (~25%).
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What the result means
- Sm1
- Upper (superficial) third of the submucosa. Low node-metastasis risk (~0-3%); often managed by endoscopic resection alone when other features are favorable.
- Sm2
- Middle third of the submucosa. Higher node-metastasis risk (~10%); surgical resection generally considered.
- Sm3
- Lower third, adjacent to the muscularis propria. Highest node-metastasis risk (~25%); surgical resection generally considered.
What you enter
- Kikuchi level
How this is calculated
Kikuchi R, Takano M, Takagi K, et al. Management of early invasive colorectal cancer: risk of recurrence and clinical guidelines. Dis Colon Rectum. 1995;38(12):1286-1295. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.