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. 2011 Apr;27(2):71-7.
doi: 10.3393/jksc.2011.27.2.71. Epub 2011 Apr 30.

Impact on Prognosis of Lymph Node Micrometastasis and Isolated Tumor Cells in Stage II Colorectal Cancer

Tai Young Oh  1 , Sun Mi Moon, Ui Sup Shin, Hyang Ran Lee, Sun Hoo Park
Affiliations

Impact on Prognosis of Lymph Node Micrometastasis and Isolated Tumor Cells in Stage II Colorectal Cancer

Tai Young Oh et al. J Korean Soc Coloproctol. 2011 Apr.

Abstract

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.

Keywords: Colorectal neoplasm; Isolated tumor cells; Lymph node; Micrometastases; Ratio.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
(A) Foci of nodal micrometastases detected with haematoxylin-eosin (H&E, × 200). (B) Foci of nodal micrometastases detected with immunohistochemistry for cytokeratin (IHC, × 200).
Fig. 2
Fig. 2
Foci of isolated tumor cells detected with immunohistochemical staining (IHC, × 400).
Fig. 3
Fig. 3
Survival according to presence of micrometastases or isolated tumor cells: (A) disease-free survival and (B) overall survival. MMS, micrometastasis; ITC, isolated tumor cells.
Fig. 4
Fig. 4
Survival according to micrometastasis lymph node ratio (mmLNR): (A) disease-free survival and (B) overall survival.
See this image and copyright information in PMC

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