Diagnosing occult tumour cells and their predictive value in sentinel nodes of histologically negative patients with colorectal cancer

Zaag, Edwin S. van der; Kooij, N.; Vijver, Marc J. van de; Bemelman, Willem A.; Peters, H. M.; Buskens, C J

doi:10.1016/j.ejso.2009.11.008

Cited by 21 publications

(13 citation statements)

References 32 publications

(24 reference statements)

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“…We have demonstrated in a previous study that OTC are preferentially found in peritumoral SNs [5]. Since lymphatic drainage to peritumoral lymph nodes is not disturbed by early ligation, it is unlikely that solely a medial to lateral approach would result in decreased numbers of ITC.…”

Section: Discussionmentioning

confidence: 88%

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Decreased incidence of isolated tumor cells in lymph nodes after laparoscopic resection for colorectal cancer

et al. 2011

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BackgroundLaparoscopic surgery has potential for less tumor cell spread because of the no-touch technique. We assessed the effect of the surgical approach (open versus no-touch laparoscopic) on the presence of tumor cells in sentinel lymph nodes (SN) of patients with stage I and II colorectal cancer.MethodsA single-center consecutive prospective series of patients operated on for colorectal cancer was analyzed. After conventional hematoxylin and eosin (H&E) staining, 107 patients without lymphatic metastases were included; 59 patients had open surgery, and 48 patients underwent laparoscopic resection. Patients in the laparoscopic group underwent a no-touch medial to lateral approach, whereas the conventional lateral to medial approach was applied in open surgery. A SN procedure was performed in all patients. The SNs were immunohistochemically analyzed for presence of occult tumor cells (OTC). According to the American Joint Committee on Cancer (AJCC) these tumor cells were divided into micrometastases (0.2–2 mm) or isolated tumor cells (ITC, < 0.2 mm).ResultsIn ten patients micrometastases were found, equally distributed between the two groups. However, ITC were more often found after open surgery (18 versus 5 patients, p = 0.03). Presence of OTC was related to depth of tumor invasion and tumor diameter > 3.5 cm. Logistic regression analysis identified lymphovascular invasion as a predictor for micrometastases [odds ratio (OR) 18.4], whereas open resection was predictive for presence of ITC (OR 3.3).ConclusionsNo-touch medial to lateral laparoscopic surgery results in less isolated tumor cells in lymph nodes compared with open lateral to medial surgery in patients with stage I and II colorectal cancer.

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Section: Discussionmentioning

confidence: 88%

“…Based on the sentinel lymph node (SN) concept in which the lymphatic drainage from the primary tumor follows a specific order, we showed that OTC are preferentially found in the SN of patients with colorectal cancer [5]. …”

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confidence: 99%

Decreased incidence of isolated tumor cells in lymph nodes after laparoscopic resection for colorectal cancer

et al. 2011

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“…In group A, serial sectioning of all SNs was performed at 500‐μm intervals and three serial sections per level were stained with Ber‐EP4 (Dako, Eindhoven, The Netherlands), CK20 (Euro Diagnostica, Arnhem, The Netherlands) and Cam5.2 (Becton Dickinson, Alphen aan den Rijn, The Netherlands) to reveal occult tumour cells (OTCs). Non‐SNs were not analysed immunohistochemically because we previously demonstrated that OTCs are predominantly found in the SN [14].…”

Section: Methodsmentioning

confidence: 99%

Implications of sentinel lymph node mapping on nodal staging and prognosis in colorectal cancer

et al. 2012

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“…Most studies therefore have reported the use of 2 to 3 H&E-stained serial sections on SLN. 37 In another, 8% of SLN metastases were found only after multilevel sectioning and staining with anticytokeratin and anti-CEA antibodies. In 1 study, 21% of patients with histologically negative SLN had additional disease identified using anti-MNF116 keratin on up to 4 serial sections, although 75% of patients "upstaged" had isolated tumor cells.…”

Section: Colorectal Cancermentioning

confidence: 95%

Pathologic Evaluation of Sentinel Nodes

Messina¹,

Rosa²

2015

The Cancer Journal

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Optimal utilization of sentinel node biopsy in the care of cancer patients requires cooperation between the radiologist, surgeon, and the pathologist. Accurate pathologic diagnosis of the sentinel node is central to correct staging, optimal treatment decisions, and precise prognostication of patients with melanoma, breast, colorectal, lung, and gastric cancer. Intraoperative handling, gross dissection, and histologic/immunohistochemical evaluation techniques are all key components of this process. Although not currently part of routine handling, newer molecular techniques may potentially add to the valuable information gained from evaluating sentinel node specimens.

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Diagnosing occult tumour cells and their predictive value in sentinel nodes of histologically negative patients with colorectal cancer

Cited by 21 publications

References 32 publications

Decreased incidence of isolated tumor cells in lymph nodes after laparoscopic resection for colorectal cancer

Decreased incidence of isolated tumor cells in lymph nodes after laparoscopic resection for colorectal cancer

Implications of sentinel lymph node mapping on nodal staging and prognosis in colorectal cancer

Pathologic Evaluation of Sentinel Nodes

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