title: In vitro detection of occult bone marrow metastases in patients with colorectal cancer hepatic metastases.
abstract: OBJECTIVE
  The purpose of this study was to assess the immunocytochemical status of bone marrow aspirates from patients with clinically isolated hepatic metastases to test the hypothesis that such findings would allow improved patient selection for liver-directed treatment.
  
  
  METHODS
  All patients had biopsy-proven or presumed colorectal cancer metastatic to the liver and were scheduled for an operative procedure for hepatic resection or for hepatic artery catheter and chemotherapy pump implant. Immunocytochemical analysis of bone marrow aspirate smears was performed with a panel of monoclonal antibodies directed toward cytokeratins, Lewis Y antigen and A-33 colorectal epitopes.
  
  
  RESULTS
  Data from 80 patients indicated that bone marrow reactivity was present in 9.5 percent of those with resectable hepatic metastases and in 34 percent of those not resected (P = 0.03). No single monoclonal antibody or combination produced better discrimination.
  
  
  CONCLUSIONS
  Presence or absence of presumed occult colorectal cancer cells in the bone marrow of patients with isolated hepatic metastases is biologically interesting, but not useful in selecting or altering patient management.
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Cohen
authors.forename: P
authors.initials: P
authors.lastname: Garin-Chesa
authors.forename: M
authors.initials: M
authors.lastname: Hanson
authors.forename: K
authors.initials: K
authors.lastname: Weyhrauch
authors.forename: N
authors.initials: N
authors.lastname: Kemeny
authors.forename: Y
authors.initials: Y
authors.lastname: Fong
authors.forename: P
authors.initials: P
authors.lastname: Paty
authors.forename: S
authors.initials: S
authors.lastname: Welt
authors.forename: L
authors.initials: L
authors.lastname: Old
mesh_terms: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis; D001853:Bone Marrow / Q000473:pathology; D001856:Bone Marrow Examination; D019046:Bone Marrow Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D007124:Immunoenzyme Techniques; D007633:Keratins / Q000032:analysis; D007983:Lewis Blood Group Antigens / Q000032:analysis; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D011379:Prognosis
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D007983:Lewis Blood Group Antigens; C094162:Lewis Y antigen; D007633:Keratins