Isolated tumor cell in lateral lymph node has no influences on the prognosis of rectal cancer patients.
OBJECTIVE
The aim of this study was to determine the incidence of isolated tumor cells (ITC) and micrometastasis in lateral lymph nodes of patients with rectal cancer and its possible correlation with prognosis.


METHODS
One hundred seventy-seven rectal cancer patients who underwent curative resection with lateral lymph node dissection were enrolled. Dissected lymph nodes were examined using hematoxylin-eosin staining (HE) and immunohistochemistry (IHC) with anti-keratin antibody (AE1/AE3). States of lymph node metastasis were divisible into three groups: detectable with HE (HE+), detectable with only IHC (HE-/IHC+), and undetectable even with IHC (IHC-). Almost all the HE-/IHC+ group was classified as ITC consisting of a few tumor cells according to the UICC criteria (ITC+). Survival rates were compared among HE+, ITC+, and IHC-.


RESULTS
ITC+ were detected in 24.1% of patients with HE-negative lateral lymph nodes. No significant difference in overall 5-year survival was observed between ITC+ and IHC- patients (76.1 and 82.9%, respectively, p = 0.25). Multivariate analysis showed that perirectal HE+ lymph nodes, but not ITC+ lateral lymph nodes, was an independent prognostic factor.


CONCLUSIONS
ITC in lateral lymph nodes does not contribute to the prognosis of rectal cancer in patients who undergo extended lateral lymph node dissection, unlike HE+ lateral lymph node metastasis.
Hara
M
M
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Nagoya, Aichi, Japan.
Hirai
T
T
Nakanishi
H
H
Kanemitsu
Y
Y
Komori
K
K
Tatematsu
M
M
Kato
T
T
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures; D004801:Eosine Yellowish-(YS); D005260:Female; D005500:Follow-Up Studies; D006416:Hematoxylin; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007633:Keratins / Q000032:analysis; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013194:Staining and Labeling / Q000379:methods; D016896:Treatment Outcome
D007633:Keratins; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin