Incidence and Prognostic Implications of Isolated Tumor Cells in Lymph Nodes from Patients with Dukes B Colorectal Carcinoma

Choi, Hong-Jo; Choi, Yun-Young; Hong, Sook-Hee

doi:10.1007/s10350-004-6291-0

Cited by 58 publications

(32 citation statements)

References 26 publications

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“…[19][20][21][23][24][25][26] Nonetheless, the prognostic significance of IHC-and/ or RT-PCR-detected micrometastases remains unclear (Table 4). 8,[59][60][61][62][63][64][65][66][67][68][69] Only 3 of the 12 reported studies found that the presence of nodal micrometastases correlates with a significantly worse survival. 62,63,65 Three studies reported that the detection of micrometastases is related to a higher risk for recurrent disease.…”

Section: Figmentioning

confidence: 99%

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

et al. 2007

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Background: The primary role of sentinel lymph node (SLN) mapping in colon cancer is to increase the accuracy of nodal staging by identifying those lymph nodes with the greatest potential for harbouring metastatic disease. Ultrastaging techniques aim to identify the otherwise undetected metastases. Until now, no consensus exists as to the most optimal procedure in patients with colon cancer.Methods: A systematic literature search on the value of different SLN mapping techniques in patients with colon cancer was performed using the electronic search engine PubMed. Prospective studies published before 1 December 2005 were included and further articles were selected by cross-referencing. The results of different techniques using either blue dye or radiocolloid, were investigated.Results: The literature search yielded 17 relevant articles. SLN mapping using blue dye was described in 15 studies. Two studies reported the results of SLN mapping using a combination of blue dye and radiocolloid. The reported results on identification rate varied between 71 and 100%. Accuracy rates were between 78 and 100%, sensitivity rates between 25 and 100% and true upstaging rates between 0 and 26%. The results were not affected by the addition of radiocolloid to blue dye.Conclusions: Sentinel lymph node mapping in patients with colon cancer remains an experimental procedure with varying results. Further evaluation may lead to a standardized technique that offers the potential for significant upstaging of stage II patients. This may have important implications as to tailor adjuvant chemotherapeutic regimens in these patients.

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Section: Figmentioning

confidence: 99%

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

et al. 2007

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“…With IHC and molecular genetics methods, occult tumor cells in regional lymph nodes are detected in 25% to 50% of patients with node-negative colorectal cancer (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Because up to 25% of patients with node-negative colorectal cancer ultimately die as a result of disease relapse, occult cancer metastasis has been suspected as a potential marker for systemic spread of tumor cells (1).…”

Section: Introductionmentioning

confidence: 99%

“…Because up to 25% of patients with node-negative colorectal cancer ultimately die as a result of disease relapse, occult cancer metastasis has been suspected as a potential marker for systemic spread of tumor cells (1). However, the prognostic value of molecular tumor cell detection in patients with node-negative colorectal cancer has remained uncertain because of lack of evidence from prospective studies (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Micrometastasis Volume in Lymph Nodes Determines Disease Recurrence Rate of Stage II Colorectal Cancer: A Prospective Multicenter Trial

Yamamoto

Murata

Fukunaga

et al. 2016

Clinical Cancer Research

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Purpose: We reported in a retrospective study that the presence of micrometastasis in lymph nodes, when assessed by carcinoembryonic antigen (CEA)-specific RT-PCR, is a significant prognostic factor in stage II colorectal cancer. The aim of this study was to clarify the clinical value of micrometastasis in a prospective multicenter trial.Experimental Design: From November 2001 to December 2005, a total of 419 colorectal cancer cases were preoperatively registered at a central data center. Of them, 315 node-negative stage II colorectal cancer cases were enrolled. After RNA quality check, 304 colorectal cancer cases were analyzed for CEA mRNA in lymph nodes by both conventional RT-PCR (a band method) and quantitative RT-PCR. Long-term prognosis of the patients was determined by each method.Results: A positive band for CEA mRNA was detected in 73 (24.0%) of 304 patients. Postoperative adjuvant chemotherapy was applied in 31 CEA band-positive cases with an oral 5-fluorouracil derivative HCFU (1-hexylcarbamoyl-5-fluorouracil) for 1 year, whereas chemotherapy was not administered to CEA band-negative group. Multivariate Cox regression analyses revealed that a high micrometastasis volume (high MMV, n ¼ 95) was an independent poor prognostic factor for 5-year disease-free survival (DFS; P ¼ 0.001) and 5-year overall survival (OS; P ¼ 0.016).Conclusions: This prospective clinical trial demonstrates that micrometastasis volume is a useful marker in identifying patients who are at high or low risk for recurrence of stage II colorectal cancer.

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“…The presence of micrometastases (MCMs) within LNs that are not detected by conventional hematoxylin and eosin (H-E) staining provides a possible explanation for this discrepancy. However, although the presence of LN MCMs in CRC patients has been investigated, no consensus has been reached regarding the prognostic significance of this finding (4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Lymph Node Micrometastasis in Stage I and II Colon Cancer

2008

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Purpose: A 25% rate of recurrence after performing complete resection in node-negative colon cancer patients suggests that their nodal staging is frequently suboptimal. Moreover, the value of occult cancer cells in tumor-free lymph nodes still remains uncertain. The authors evaluated the prognostic significance of the pathologic parameters, including the lymph node occult disease (micrometastases) detected by immunohistochemistry, in patients with node-negative colon cancer. Materials and Methods:The study included 160 patients with curatively resected stage I or II colon cancer and they were without rectal cancer. 2852 lymph nodes were re-examined by re-do hematoxylin and eosin (H-E) staining and immunohistochemical staining. The detection rates were compared with the clinicopathologic characteristics and with the cancer-specific survival.Results: Occult metastases were detected in 8 patients (5%). However, no clinicopathologic parameter was found to be correlated with the presence of micrometastasis. Twenty patients developed recurrence at a median follow-up of 45.7 months: 14 died of colon cancer and 9 died from noncancer-related causes. Univariate analysis showed that lymphatic invasion and the number of retrieved lymph nodes significantly influenced survival, and multivariate analysis revealed that the stage, the number of retrieved lymph nodes and lymphatic invasion were independently related to the prognosis.Conclusions: Inadequate lymph node retrieval and lymphatic invasion were found to be associated with a poorer outcome for node-negative colon cancer patients. The presence of immunostained tumors cells in pN0 lymph nodes was found to have no significant effect on survival, but these tumor were identified by re-do H-E staining.

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Incidence and Prognostic Implications of Isolated Tumor Cells in Lymph Nodes from Patients with Dukes B Colorectal Carcinoma

Cited by 58 publications

References 26 publications

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

Micrometastasis Volume in Lymph Nodes Determines Disease Recurrence Rate of Stage II Colorectal Cancer: A Prospective Multicenter Trial

Clinical Significance of Lymph Node Micrometastasis in Stage I and II Colon Cancer

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