Prognostic implications of occult nodal tumour cells in stage I and II colon cancer

Publication date: Available online 5 May 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Didi.A.M. Sloothaak, Ragna. L.A. van der Linden, Cornelis J.H. van de Velde, Willem A. Bemelman, Daan.J. Lips, J.C. van der Linden, Heleen Doornewaard, Pieter.J. Tanis, Koop Bosscha, Edwin S. van der Zaag, Christianne J. Buskens
INTRODUCTIONOccult nodal tumour cells should be categorised as micrometastasis (MMs) and isolated tumour cells (ITCs). A recent meta-analysis demonstrated that MMs, but not ITCs, are prognostic for disease recurrence in patients with stage I/II colon cancer.AIMS & METHODS: The objective of this retrospective multicenter study was to correlate MMs and ITCs to characteristics of the primary tumour, and to determine their prognostic value in patients with stage I/II colon cancer.RESULTS192 patient were included in the study with a median follow up of 46 month (IQR 33-81 months). MMs were found in eight patients (4.2%), ITCs in 37 (19.3%) and occult tumour cells were absent in 147 patients (76.6%). Between these groups, tumour differentiation and venous or lymphatic invasion was equally distributed. Advanced stage (pT3/pT4) was found in 66.0% of patients without occult tumour cells (97/147), 72.9% of patients with ITCs (27/37), and 100% in patients with MMs (8/8), although this was a non-significant trend. Patients with MMs showed a significantly reduced 3 year-disease free survival compared to patients with ITCs or patients without occult tumour cells (75,0% versus 88,0% and 94,8%, respectively, p=0.005). When adjusted for T-stage, MMs independently predicted recurrence of cancer (OR 7.6 95%CI 1.5-37.4, p=0.012)CONCLUSIONIn this study, the incidence of MMs and ITCs in patients with stage I/II colon cancer was 4.2% and 19.3%, respectively. MMs were associated with an reduced 3 year disease free survival rate, but ITCs were not.

Teaser

This study analysed the occurrence of nodal micrometastasis (MMs) and isolated tumour cells (ITCs) in relation to characteristics of the primary tumour and oncological outcome in 192 patients with stage I/II colon cancer. Nodal micrometastasis were associated with pT-stage and disease recurrence, but ITCs were not.


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