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Original Articles
- Impact on Prognosis of Lymph Node Micrometastasis and Isolated Tumor Cells in Stage II Colorectal Cancer
- Tai Young Oh, Sun Mi Moon, Ui Sup Shin, Hyang Ran Lee, Sun Hoo Park
- J Korean Soc Coloproctol. 2011;27(2):71-77. Published online April 30, 2011
- DOI: https://doi.org/10.3393/jksc.2011.27.2.71
- 6,617 View
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- 12 Citations
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Abstract
PDF Purpose Even though the importance of micrometastases (MMS) and isolated tumor cells (ITC) has been brought up by many physicians, its impact on the prognosis in stage II colorectal cancer is uncertain. In this research, we tried to investigate the clinical features of MMS and ITC and to prove any correlation with prognosis.
Methods The research pool was 124 colorectal cancer patients who underwent a curative resection from April 2005 to November 2009. A total of 2,379 lymph nodes (LNs) were examined, and all retrieved LNs were evaluated by immunohistochemical staining with anti-cytokeratin antibody panel. Clinicopathologic parameters and survival rates were compared based on the presence of MMS or ITC and on the micrometastatic lymph node ratio (mmLNR), which is defined as the number of micrometastatic LNs divided by the number of retrieved LNs.
Results Out of 124 patients (26.6%) 33 were found to have MMS or ITC. There were no significant differences in clinicopathologic features, such as gender, tumor location and size, depth of invasion, histologic grade, except for age (P = 0.04). The three-year disease-free survival rate for the MMS or ITC positive group was 85.7%, and that for MMS and ITC negative group was 92.8% (P = 0.209). The three-year disease-free survival rate for the mmLNR > 0.25 group was 73.3%, and that for the mmLNR ≤ 0.25 group was 92.9% (P = 0.03).
Conclusion The presence of MMS or ITC was not closely correlated to the prognosis. However, mmLNR is thought to be a valuable marker of prognosis in cases of stage II colorectal cancer.
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Citations
Citations to this article as recorded by
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Stefano Uccella, Anna Fagotti, Gian Franco Zannoni, Robert L Coleman
International Journal of Gynecological Cancer.2019; 29(1): 216. CrossRef - Impact of compliance with an enhanced recovery after surgery pathway on patient outcomes in open gynecologic surgery
Maria D Iniesta, Javier Lasala, Gabriel Mena, Andrea Rodriguez-Restrepo, Gloria Salvo, Brandelyn Pitcher, Lakisha D Washington, Melinda Harris, Larissa A Meyer, Pedro T Ramirez
International Journal of Gynecologic Cancer.2019; 29(9): 1417. CrossRef - Lymph Node Micrometastasis Cannot be Considered as Positive Lymph Node in Nonmetastatic Colorectal Cancer
Kwang Dae Hong, Jun Won Um, Byung Wook Min, Woong-Bae Ji, Jung-Woo Choi, Young-Sik Kim
The American Surgeon™.2017; 83(2): 127. CrossRef - Lymph node micrometastasis in gastrointestinal tract cancer—a clinical aspect
Shoji Natsugoe, Takaaki Arigami, Yoshikazu Uenosono, Shigehiro Yanagita, Akihiro Nakajo, Masataka Matsumoto, Hiroshi Okumura, Yuko Kijima, Masahiko Sakoda, Yuko Mataki, Yasuto Uchikado, Shinichiro Mori, Kosei Maemura, Sumiya Ishigami
International Journal of Clinical Oncology.2013; 18(5): 752. CrossRef - Prognostic significance of isolated tumor cells in patients with colorectal cancer in recent 10-year studies
YOSHITO AKAGI, TETSUSHI KINUGASA, YOSUKE ADACHI, KAZUO SHIROUZU
Molecular and Clinical Oncology.2013; 1(4): 582. CrossRef - Prognostic significance of histologically detected lymph node micrometastases of sizes between 0.2 and 2 mm in colorectal cancer
Bruno Märkl, C. Herbst, C. Cacchi, T. Schaller, I. Krammer, G. Schenkirsch, A. Probst, H. Spatz
International Journal of Colorectal Disease.2013; 28(7): 977. CrossRef - Molecular Detection of Tumor Cells in Regional Lymph Nodes Is Associated With Disease Recurrence and Poor Survival in Node-Negative Colorectal Cancer: A Systematic Review and Meta-Analysis
Nuh N. Rahbari, Ulrich Bork, Edith Motschall, Kristian Thorlund, Markus W. Büchler, Moritz Koch, Jürgen Weitz
Journal of Clinical Oncology.2012; 30(1): 60. CrossRef - Prognostic Significance of EpCAM-Positive Disseminated Tumor Cells in Rectal Cancer Patients With Stage I Disease
Sameer Dhayat, Sorina Sorescu, Daniel Vallböhmer, Sebastian Kraus, Stephan Ernst Baldus, Alexander Rehders, Feride Kröpil, Andreas Krieg, Wolfram Trudo Knoefel, Nikolas Hendrik Stoecklein
American Journal of Surgical Pathology.2012; 36(12): 1809. CrossRef - Prognostic Signifi cance of the Lymph Node Ratio Regarding Recurrence and Survival in Rectal Cancer Patients Treated with Postoperative Chemoradiotherapy
Ji-Yoon Kim, Su-Mi Chung, Byung-Ock Choi, In-Kyu Lee, Chang-Hyeok An, Jong-Man Won, Mi-Ryeong Ryu
Gut and Liver.2012; 6(2): 203. CrossRef
- Are deeper sections and immunohistochemistry useful in detecting micrometastases and isolated tumour cells in colorectal cancer?
- Clinical Significance of Occult Micrometastases in Colorectal Cancer.
- Lee, Suk Hwan , Kim, Tae Young , Kim, Yoon Wha , Koh, Suck Hwan , Yoon, Choong , Oh, Soo Myung , Lee, Kee Hyung
- J Korean Soc Coloproctol. 2000;16(2):78-86.
- 1,501 View
- 9 Download
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Abstract
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- BACKGROUND
One of the most important prognostic factors in colorectal cancer is lymph node metastasis, which predicts a reduced survival time. Although lymph node metastases were not detected by a conventional hematoxylin-eosin stain technique, 20 to 30 percent of patients fail long-term survival on account of a local or systemic recurrence. Recurrent disease in these patients is believed to develop from occult tumor in lymph nodes. PURPOSE: The authors have conducted an immunohistochemical study with two different antibodies against cytokeratin to identify occult micrometastases in lymph nodes which were diagnosed as tumor negative by conventional histopathology.
METHODS
Paraffin blocks of sixty-five patients with colorectal cancer (T2/3, N0, M0) after a curative resection between January 1991 and December 1993 at Kyung-Hee University Hospital were stained with avidin-biotin-peroxidase complex technique using two monoclonal antibodies (anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, DAKO, Hamburg, Germany). To assess the clinical correlation between micrometastasis in lymph node and patients survial, 5-year disease-free survival rates were calculated by Kaplan-Meier method and the significance of the differences was estimated by the log-rank test. P values <0.05 were taken to be significant.
RESULTS
Of the sixty-five patients with 1133 lymph nodes, tumor cells detected by anti-cytokeratin AE1/AE3 and anti-cytokeratin No. 20, were 2.4 percent (27/1133) and 3.4 percent (38/1133), respectively. Micrometastases were detected in twenty-six patients (40.0 percent). The histologic stage of four cytokeratin positive cases was upstaged from T2, N0, M0 to T2, N1/2, M0, and twenty-two of T3, N0, M0 to T3, N1/2, M0. Cytokeratin-positive cases showed statistically significant recurrence rate (42.3 percent) compared to that of cytokeratin -negative cases (17.9 percent)(x2 test, p=0.032). With the median follow-up of 62 months, 5-year disease-free survival rates of the micrometastses negative and positive cases were 81.7 percent and 61.3 percent, respectively (p=0.0438).
CONCLUSIONS
In conclusion, immunohistochemical technique to identify the occult micrometastases in lymph nodes overlooked in conventional histopathology is a useful staging method to anticipate a recurrence and a prognosis more precisely.
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