title: Predicting recurrence and metastasis of stage II/Dukes' B colorectal cancer without lymph node metastasis.
abstract: This study was designed to compare the prediction of recurrence based on detection of occult neoplastic cells (ONCs) in lymph nodes or by using high-risk criteria for recurrence/metastasis in patients with Dukes' B colorectal cancer. Prediction of recurrence based on the detection of ONCs had a sensitivity of 59.1% (13/22), a false-positive rate of 7.8% (8/102), a specificity of 92.2% (94/102), and a negative predictive value (NPV) of 91.3% (94/103). Prediction of recurrence based on positivity for at least 2 of the 3 high-risk criteria had a sensitivity of 90.9% (20/22), a false-positive rate of 49.0% (50/102), a specificity of 51.0% (52/102), and an NPV of 96.3% (52/54). Among the 21 patients in whom ONCs were detected, prediction of recurrence based on the presence of all 3 high-risk criteria including ONCs had a sensitivity of 84.6% (11/13) and a positive predictive value (PPV) of 78.6% (11/14). These results suggest that colorectal cancer is unlikely to recur in patients without ONCs, while recurrence is likely in patients who fulfill 2 or more of the high-risk criteria. Accordingly, a combination of these parameters may be useful for the early prediction of recurrence/metastasis to assist in the choice of postoperative systemic chemotherapy.
authors.affiliation: Department of Surgery, Tokai University, Oiso Hospital, Oiso, Kanagawa 259-0198, Japan. onc-res@oiso.u-tokai.ac.jp
authors.forename: Masaya
authors.initials: M
authors.lastname: Mukai
authors.forename: Shinkichi
authors.initials: S
authors.lastname: Sato
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tajima
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ninomiya
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kimura
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Komatsu
authors.forename: Hisao
authors.initials: H
authors.lastname: Nakasaki
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D012307:Risk Factors; D012680:Sensitivity and Specificity