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Implications of sentinel lymph node mapping on nodal staging and prognosis in colorectal cancer.
- Source :
-
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2012 Jun; Vol. 14 (6), pp. 684-90. - Publication Year :
- 2012
-
Abstract
- Aim: Sentinel lymph node (SN) mapping for staging in colorectal cancer remains controversial and needs to be validated before it can be implemented in daily practice. We prospectively assessed the effect of SN mapping on nodal staging and its implication on survival in patients with colorectal cancer.<br />Method: Between November 2005 and July 2009, 331 patients underwent a resection for colorectal cancer. In 189 patients (group A) an ex-vivo SN procedure was performed with immunohistochemical analysis of the SN. Tumour cell deposits between 0.2 mm and 2.0 mm were referred to as micrometastases (pN1mi+). The remaining patients (n = 142, group B) had standard nodal staging. Multivariate Cox regression analysis was performed to identify prognostic factors for disease recurrence.<br />Results: The average number of harvested lymph nodes was higher in group A than in group B (15.5 ± 7.3 vs 12.1 ± 5.2, P < 0.0001). After conventional staging, 81 (43%) patients of group A were judged to have nodal metastasis. This increased to 89 (47%) patients when immunohistochemically detected micrometastases were included. In group B, 50 (35%) patients had nodal metastasis. During follow up, a lower recurrence rate was seen in N0 patients after SN mapping compared with the conventional staging group (4%vs 15.2%, P = 0.04). The SN procedure (hazard ratio = 4.1) was an independent predictor of disease recurrence.<br />Conclusion: The SN procedure results in a more accurate staging of patients with colorectal cancer. This is reflected by a better prognosis of N0 patients after SN mapping.<br /> (© 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.)
- Subjects :
- Aged
Aged, 80 and over
Colonic Neoplasms surgery
Female
Humans
Immunohistochemistry
Kaplan-Meier Estimate
Lymphatic Metastasis
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Prognosis
Proportional Hazards Models
Rectal Neoplasms surgery
Colonic Neoplasms pathology
Neoplasm Micrometastasis pathology
Neoplasm Recurrence, Local pathology
Rectal Neoplasms pathology
Sentinel Lymph Node Biopsy
Subjects
Details
- Language :
- English
- ISSN :
- 1463-1318
- Volume :
- 14
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
- Publication Type :
- Academic Journal
- Accession number :
- 22252038
- Full Text :
- https://doi.org/10.1111/j.1463-1318.2012.02949.x