Clinical significance of colorectal cancer: Metastases in lymph nodes &lt;5 mm in size

Rodrı́guez-Bigas, Miguel A.; Maamoun, Sherif; Weber, Thomas K.; Penetrante, Remedios; Blumenson, Leslie E.; Petrelli, Nicholas J.

doi:10.1007/bf02305790

Cited by 119 publications

(68 citation statements)

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“…33 The size of lymph nodes, however, has received attention in only a few studies. [20][21][22][23] Using advanced lymph node dissection techniques, we collected a relatively large number of colon cancer cases with optimal lymph node staging starting in 2007. 14 As the study was conducted at a single center and a standardized dissection technique was used, we were able to reduce confounding factors that might hamper large database studies.…”

Section: Discussionmentioning

confidence: 99%

“…18 Our impression, however, is that larger lymph nodes are often not involved in metastatic disease but show lymphofollicular hyperplasia. [19][20][21][22][23] This might explain the relatively disappointing results of diagnosis based on radiological lymph node status assignment, which is mainly dependent upon lymph node size. 24 Moreover, one could hypothesize that lymphatic hyperplasia in colon cancer could be a prognostic marker indicating an especially effective immunological response against the cancer.…”

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confidence: 99%

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The clinical significance of lymph node size in colon cancer

et al. 2012

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To date, the clinical value of lymph node size in colon cancer has been investigated only in a few studies. Only in radiological diagnosis is lymph node size routinely recognized, and nodes Z10 mm in diameter are considered pathologic. However, the few studies regarding this topic suggest that lymph node size is not a reliable indicator of metastatic disease. Moreover, we hypothesized that increasing lymph node size is associated with favorable outcome. By performing a morphometric study, we investigated the clinical significance of lymph node size in colon cancer in terms of metastatic disease and prognosis. A cohort of 237 cases with excellent lymph node harvest (mean lymph node count: 33±17) was used. The size distribution in node-positive and -negative cases was almost identical. In all, 151 out of the 305 metastases detected (49.5%) were found in lymph nodes with diameters r5 mm. Only 25% of lymph nodes 410 mm showed metastases. Minute lymph nodes r1 mm were involved only very rarely (2 of 81 cases). In 67% of the cases, the largest positive lymph node was o10 mm. The prognostic relevance of lymph node size was investigated in a subset of 115 stage I/II cases. The occurrence of Z7 lymph nodes that were 45 mm in diameter was significantly associated with better overall survival. Our data show that lymph node size is not a suitable factor for preoperative lymph node staging. Minute lymph nodes have virtually no role in correct histopathological lymph node staging. Finally, large lymph nodes in stage I/II disease might indicate a favorable outcome.

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Section: Discussionmentioning

confidence: 99%

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The clinical significance of lymph node size in colon cancer

et al. 2012

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“…The small size of involved lymph nodes in some cases is relevant. It has been reported that up to 70% of lymph nodes with metastases are <5 mm in diameter [23]. Such lymph nodes can easily be missed if palpation is the main technique used by the pathologist to identify lymph nodes.…”

Section: The Role Of the Surgery/pathology Team In Lymph Node Retrievalmentioning

confidence: 99%

Clinically important aspects of lymph node assessment in colon cancer

Wright

Law

Berry

et al. 2009

Journal of Surgical Oncology

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There has been considerable discussion in the literature regarding the importance and validity of lymph node retrieval and lymph node count for patients with colon cancer. In this article we summarize the importance of lymph node resection and assessment in contemporary colon cancer care, key clinical determinants of lymph node assessment, and discuss the role of lymph node assessment as a quality marker in colon cancer care.

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“…Conventional methods for examining lymph nodes have specific limitations and are subject to sampling error, which increases the risk of understaging. Since up to 70% of tumor-involved lymph nodes are less than 0.5 cm in diameter, nodes that contain small metastases can be easily missed in the gross dissection or microscopic examination (5,6).…”

Section: Introductionmentioning

confidence: 99%