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Sentinel node staging of resectable colon cancer: results of a multicenter study.

Abstract：

OBJECTIVE AND SUMMARY BACKGROUND DATA:Sentinel lymph node (LN) sampling, a technique widely used to manage breast cancer and melanoma, seeks to select LNs that accurately predict regional node status and can be extensively examined to identify nodal metastatic disease not detected by standard histopathological staging. For patients with resectable colon cancer, improved identification of LN disease would significantly advance patient care by identifying patients likely to benefit from adjuvant therapy. This study, conducted by 25 surgeons at 13 institutions, examined whether sentinel node (SN) sampling accurately predicted LN status for patients with resectable colon cancer. METHODS:SN sampling involved peritumor injection of 1% isosulfan blue, followed by identification of all LN visualized within 10 minutes. SN sampling was performed on 79 of 91 patients enrolled, followed by multilevel sectioning (MLS) of the nodes and examination by a single study pathologist. RESULTS:By standard histopathology, 7 patients had primary disease that was either benign or not colon cancer and were therefore excluded from further studies. Of 72 colon cancer cases studied, 48 (66%) were node-negative and 24 (33%) contained nodal metastases. SNs were successfully located in 66 cases (92%), with an average of 2.1 nodes per patient. SNs were negative in 14 of 24 node-positive cases (58%). MLS revealed tumor in a SN in 1 of these cases, bringing the false-negative rate of SN examination to 54%. CONCLUSION:This multi-institutional study found that for patients with node-positive colon cancer, SN examination with MLS failed to predict nodal status in 54% of cases. We conclude that SN sampling with MLS, used alone, is unlikely to improve risk stratification for resectable colon cancer.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Bertagnolli M,Miedema B,Redston M,Dowell J,Niedzwiecki D,Fleshman J,Bem J,Mayer R,Zinner M,Compton C

doi

10.1097/01.sla.0000140753.41357.20

subject

Has Abstract

pub_date

2004-10-01 00:00:00

pages

624-8; discussion 628-30

issue

eissn

0003-4932

issn

1528-1140

pii

00000658-200410000-00008

journal_volume

240

pub_type

临床试验,杂志文章,多中心研究

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Sentinel node staging of resectable colon cancer: results of a multicenter study.