Detailed examination of lymph nodes improves prognostication in colorectal cancer.


:Up to 30% of stage II patients with curatively resected colorectal cancer (CRC) will develop disease recurrence. We evaluated whether examination of lymph nodes by multilevel sectioning and immunohistochemical staining can improve prognostication. Lymph nodes (n = 780) from 36 CRC patients who had developed disease recurrence (cases) and 72 patients who showed no recurrence of disease for at least 5 years (controls) were analyzed. Sections of 4 levels at 200-microm interval were immunohistochemically stained for cytokeratin expression. The first level was analyzed by conventional and automated microscopy, and the 3 following levels were analyzed by automated microscopy for the presence of tumor cells. Overall, cases showed more micrometastases (3 patients) than controls (1 patient). Analysis of a second level led to the additional detection of 1 patient with micrometastases (case) and 1 patient with macrometastasis (case). Examining more levels only led to additional isolated tumor cells, which were equally divided between cases and controls. Likewise, automated microscopy resulted only in detection of additional isolated tumor cells when compared with conventional microscopy. In multivariate analysis, micrometastases [odds ratio (OR) 26.3, 95% confidence interval (CI) 1.9-364.8, p = 0.015], T4 stage (OR 4.8, 95% CI 1.4-16.7, p = 0.013) and number of lymph nodes (OR 0.9, 95% CI 0.8-1.0, p = 0.028) were independent predictors for disease recurrence. Lymph node analysis of 2 levels and immunohistochemical staining add to the detection of macrometastases and micrometastases in CRC. Micrometastases were found to be an independent predictor of disease recurrence. Isolated tumor cells were of no prognostic significance.


Int J Cancer


Doekhie FS,Mesker WE,Kuppen PJ,van Leeuwen GA,Morreau H,de Bock GH,Putter H,Tanke HJ,van de Velde CJ,Tollenaar RA




Has Abstract


2010-06-01 00:00:00












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    journal_title:International journal of cancer

    pub_type: 杂志文章


    authors: Katzav S,Segal S,Feldman M

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  • CpG methylation of viral DNA in EBV-associated tumours.

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    journal_title:International journal of cancer

    pub_type: 杂志文章


    authors: Allday MJ,Kundu D,Finerty S,Griffin BE

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  • Thymidine kinase in epithelial ovarian cancer: relationship with the other pyrimidine pathway enzymes.

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    journal_title:International journal of cancer

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    authors: Fujiwaki R,Hata K,Nakayama K,Moriyama M,Iwanari O,Katabuchi H,Okamura H,Sakai E,Miyazaki K

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  • Risk of invasive cervical cancer in relation to clinical investigation and treatment after abnormal cytology: a population-based case-control study.

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    journal_title:International journal of cancer

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    authors: Silfverdal L,Kemetli L,Sparén P,Andrae B,Strander B,Ryd W,Dillner J,Törnberg S

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  • Genes and molecular pathways related to radioresistance of oral squamous cell carcinoma cells.

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    authors: Ishigami T,Uzawa K,Higo M,Nomura H,Saito K,Kato Y,Nakashima D,Shiiba M,Bukawa H,Yokoe H,Kawata T,Ito H,Tanzawa H

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    journal_title:International journal of cancer

    pub_type: 杂志文章


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    journal_title:International journal of cancer

    pub_type: 杂志文章,评审


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    更新日期:2011-11-15 00:00:00

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    journal_title:International journal of cancer

    pub_type: 杂志文章


    authors: Marks M,Gravitt PE,Gupta SB,Liaw KL,Kim E,Tadesse A,Phongnarisorn C,Wootipoom V,Yuenyao P,Vipupinyo C,Rugpao S,Sriplienchan S,Celentano DD

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    journal_title:International journal of cancer

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    journal_title:International journal of cancer

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    journal_title:International journal of cancer

    pub_type: 杂志文章


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    pub_type: 临床试验,杂志文章,随机对照试验


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    journal_title:International journal of cancer

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    更新日期:2000-04-15 00:00:00

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    pub_type: 杂志文章


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    更新日期:2014-01-15 00:00:00

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    pub_type: 杂志文章,评审


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    journal_title:International journal of cancer

    pub_type: 杂志文章


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    pub_type: 杂志文章


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    journal_title:International journal of cancer

    pub_type: 杂志文章


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    更新日期:2014-06-15 00:00:00

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    journal_title:International journal of cancer

    pub_type: 杂志文章


    authors: Riesenfeld I,Tufveson G,Alm GV

    更新日期:1980-04-15 00:00:00