Micro-metastases in stages I and II colon cancer are a predictor of the development of distant metastases and worse disease-free survival

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• 作者：P.M. van Schaik ; E. Hermans ; J.C. van der Linden ; J.R.M. Pruijt ; M.F. Ernst ; K. Bosscha
• 关键词：Micro-metastases ; Colon ; Carcinoma ; Sentinel lymph node mapping ; Disease-free survival ; Overall survival
• 刊名：European Journal of Surgical Oncology (EJSO)
• 出版年：2009
• 出版时间：May 2009
• 年：2009
• 卷：35
• 期：5
• 页码：492-496
• 全文大小：189 K

文摘

Approximately 30 % of the patients with Dukes A/B colon carcinoma will develop loco-regional recurrence or distant metastases. The aim of this study was to evaluate if patients with micro-metastases are at higher risk for developing distant metastases and therefore a worse disease-free survival and overall survival.

In the period January 2000–January 2002, 137 patients underwent curative surgery for colon cancer. When patients had a Dukes A/B colon carcinoma, additional staining and sectioning on the harvested lymph nodes were performed retrospectively. Lymph nodes were examined using 4 multilevel sections at 250-μm intervals and stained with Pan-Cytokeratin.

There were 11 patients with a Dukes A and 61 patients with a Dukes B colon carcinoma. Twenty-two patients developed metastases in time (group I) whereas 50 patients did not (group II).

After additional staining and sectioning 41 % of the patients of group I and 16 % of the patients of group II showed micro-metastases (p < 0.05).

The 5-year overall survival rate in the group with micro-metastases was 62 % against 79 % in the group without micro-metastases. The disease-free survival (DFS) was 51 % and 72 % (p < 0.05), respectively.

Patients with micro-metastases develop significant more distant metastases in time and have a significant worse DFS.