Pattern of lymph node micrometastasis and prognosis of patients with colorectal cancer

Citation
K. Yasuda et al., Pattern of lymph node micrometastasis and prognosis of patients with colorectal cancer, ANN SURG O, 8(4), 2001, pp. 300-304
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology
Journal title
ANNALS OF SURGICAL ONCOLOGY
ISSN journal
1068-9265 → ACNP
Volume
8
Issue
4
Year of publication
2001
Pages
300 - 304
Database
ISI
SICI code
1068-9265(200105)8:4<300:POLNMA>2.0.ZU;2-W
Abstract
Background: Studies of lymph node micrometastases in patients with colorect al cancer have ignored the prognostic significance of the number and level of lymph node micrometastases. The aim of this study was to clarify the pro gnostic significance of the status of lymph node micrometastases in histolo gically node-negative colorectal cancer. Methods: We used immunohistochemistry with anti-cytokeratin antibody CAM5.2 to examine 1013 lymph nodes in 42 patients (12 recurrent and 30 nonrecurre nt) with histologically determined Dukes: B colorectal cancer. Five serial 6-mum sections were used for immunohistochemical staining. The frequency, t umor tell pattern, and number and level of lymph node micrometastases were compared between the recurrent and nonrecurrent groups. Results: Micrometastasis was confirmed in 16% (59/373) of lymph nodes in th e recurrent group and 12% (77/640) of lymph nodes in the nonrecurrent group , and the frequency of lymph node micrometastases was 92% (11/12) in the re current group and 70% (21/30) in the nonrecurrent group. The tumor cell pat tern in the metastatic lymph nodes was similar in the recurrent and nonrecu rrent groups. Micrometastasis in four or more lymph nodes occurred more fre quently in the recurrent group than in the nonrecurrent group (58% vs. 20%, P < .05), and micrometastasis to N2 or higher nodes occurred more frequent ly in the recurrent group than in the nonrecurrent group ((92% vs. 47%, P < .01). Conclusions: The number and level of positive micrometastatic lymph nodes w as significantly correlated with postoperative recurrence of histologically determined Dukes' B colorectal cancer. This parameter is a useful prognost ic indicator in histologically node-negative colorectal cancer and is helpf ul in planning adjuvant chemotherapy.