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Prognostic Implications of Sentinel Lymph Node Mapping in Stage I and II Colorectal Cancer Patients

  • Bogdan Vasile MicuEmail author
  • C. M. Micu
  • D. Chirila
  • H. Silaghi
  • D. R. Miclaus
  • M. S. Muresan
  • T. R. Pop
  • N. Constantea
  • C. Ionescu
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 71)

Abstract

The aim of the study was to identify lymph node micrometastases in order to demonstrate the prognosis of colorectal cancer patients staged I and II undergoing curative surgery. We conducted a prospective study on a total of 44 patients with stage I–III colorectal cancer, undergoing radical surgery at the Fifth Department of Surgery of Cluj-Napoca Municipal Clinical Hospital between September 2012 and January 2015. For the identification of micrometastases we used the sentinel lymph node mapping by two techniques, in vivo and ex vivo. In N0 patients we conducted an immunohistochemical study to identify micrometastases. Patients were followed 3 years after surgery to identify possible relapses. The mean age was 63 years, 24 patients were males and 20 (45.5%) women. Ten patients (12.8%) had stage I cancer, 12 patients (27.3%) had stage II cancer, and 22 had stage III cancer. Sentinel lymph node detection rate was similar for the in vivo technique and for the ex vivo technique. The percentage for the detection of micrometastases was 25% in vivo and 33.3% ex vivo. The 3-year postoperative recurrence rate was 25% in overstaged patients. The presence of micrometastases should be considered as a negative prognostic factor in patients with stage I and II colorectal cancer.

Keywords

Micrometastases Colorectal cancer Prognosis Sentinel lymph node 

Notes

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Stephen, B.E., Byrd, D.R., Compton, C.C., et al.: Part III Digestive system: colon and rectum. In: Anonymous AJCC Cancer Staging Manual, 2017, 8th edn. Springer, New York (2017)Google Scholar
  2. 2.
    Figueredo, A., Coombes, M.E., Mukherjee, S.: Adjuvant therapy for completely resected stage II colon cancer. Cochrane Database Syst. Rev. 3 (2008)Google Scholar
  3. 3.
    Micu, B., Micu, C., Gherman, A., Sava, M., Pop, T.R., Constantea, N.: The role of sentinel lymph node analysis in patients with colorectal cancer undergoing surgery. HVM Bioflux 7(2), 114–117 (2015)Google Scholar
  4. 4.
    Sloothaak, D.A., Sahami, S., van der Zaag-Loonen, H.J., van der Zaag, E.S., Tanis, P.J., Bemelman, W.A., et al.: The prognostic value of micrometastases and isolated tumour cells in histologically negative lymph nodes of patients with colorectal cancer: a systematic review and meta-analysis. Eur. J. Surg. Oncol. 40(3), 263–269 (2014)CrossRefGoogle Scholar
  5. 5.
    Märkl, B., Herbst, C., Cacchi, C., et al.: Prognostic significance of histologically detected lymph node micrometastases of sizes between 0.2 and 2 mm in colorectal cancer. Int. J. Colorectal Dis. 28(7), 977–983 (2013)Google Scholar
  6. 6.
    van der Zaag, E.S., Bouma, W.H., Tanis, P.J., et al.: Systematic review of sentinel lymph node mapping procedure in colorectal cancer. Ann. Surg. Oncol. 19(11), 3449–3459 (2012)CrossRefGoogle Scholar
  7. 7.
    Saha, S., Wiese, D., Badin, J., et al.: Technical details of sentinel lymph node mapping in colorectal cancer and its impact on staging. Ann. Surg. Oncol. 7(2), 120–124 (2000)CrossRefGoogle Scholar
  8. 8.
    Wong, J.H., Steineman, S., Calderia, C., et al.: Ex vivo sentinel node mapping in carcinoma of the colon and rectum. Ann. Surg. 233(5), 155–221 (2001)Google Scholar
  9. 9.
    Iddings, D., Ahmad, A., Elashoff, D., Bilchik, A.: The prognostic effect of micrometastases in previously staged lymph node negative (N0) colorectal carcinoma: a meta-analysis. Ann. Surg. Oncol. 13, 1386 (2006)Google Scholar
  10. 10.
    Viehl, C.T., Guller, U., Langer, I., et al.: Factors influencing the success of in vivo sentinel lymph node procedure in colon cancer patients: Swiss prospective, multicenter study sentinel lymph node procedure in colon cancer 37(4), 873–877 (2013)Google Scholar
  11. 11.
    Wang, F.L., Shen, F., Wan, D.S., Lu, Z.H., Li, L.R., Chen, G., et al.: Ex vivo localization and immunohistochemical detection of sentinel lymph node micrometastasis in patients with colorectal cancer can upgrade tumor staging. Diagn Pathol. 22(7), 71 (2012)CrossRefGoogle Scholar
  12. 12.
    Sloothaak, D.A.M., van der Linden, R.L.A., van de Velde, C.J.H., Bemelman, W.A., Lips, D.J., van der Linden, J.C., et al.: Prognostic implications of occult nodal tumour cells in stage I and II colon cancer: the correlation between micrometastasis and disease recurrence. Eur. J. Surg. Oncol. 43(8), 1456–1462 (2017)CrossRefGoogle Scholar
  13. 13.
    Estrada, O., Pulido, L., Admella, C., Hidalgo, L.A., Clavé, P., Suñol, X.: Sentinel lymph node biopsy as a prognostic factor in non-metastatic colon cancer: a prospective study. Clin. Transl. Oncol. 19(4), 432–439 (2017)CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Bogdan Vasile Micu
    • 1
    Email author
  • C. M. Micu
    • 1
    • 2
  • D. Chirila
    • 1
  • H. Silaghi
    • 1
  • D. R. Miclaus
    • 1
  • M. S. Muresan
    • 1
  • T. R. Pop
    • 1
  • N. Constantea
    • 1
  • C. Ionescu
    • 1
  1. 1.5th Surgical Department“Iuliu Hateganu” University of Medicine and PharmacyCluj-NapocaRomania
  2. 2.Department of Anatomy and Embryology“Iuliu Hateganu” University of Medicine and PharmacyCluj-NapocaRomania

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