title: Micro-metastases in stages I and II colon cancer are a predictor of the development of distant metastases and worse disease-free survival.
abstract: Approximately 30% of the patients with Dukes A/B colon carcinoma will develop loco-regional recurrence or distant metastases. The aim of this study was to evaluate if patients with micro-metastases are at higher risk for developing distant metastases and therefore a worse disease-free survival and overall survival. In the period January 2000-January 2002, 137 patients underwent curative surgery for colon cancer. When patients had a Dukes A/B colon carcinoma, additional staining and sectioning on the harvested lymph nodes were performed retrospectively. Lymph nodes were examined using 4 multilevel sections at 250-microm intervals and stained with Pan-Cytokeratin. There were 11 patients with a Dukes A and 61 patients with a Dukes B colon carcinoma. Twenty-two patients developed metastases in time (group I) whereas 50 patients did not (group II). After additional staining and sectioning 41% of the patients of group I and 16% of the patients of group II showed micro-metastases (p<0.05). The 5-year overall survival rate in the group with micro-metastases was 62% against 79% in the group without micro-metastases. The disease-free survival (DFS) was 51% and 72% (p<0.05), respectively. Patients with micro-metastases develop significant more distant metastases in time and have a significant worse DFS.
authors.affiliation: Jeroen Bosch Hospital, Department of Surgery, Nieuwstraat 34, 5211 NL's-Hertogenbosch, The Netherlands. pvanschaik@hotmail.com
authors.forename: P M
authors.initials: PM
authors.lastname: van Schaik
authors.forename: E
authors.initials: E
authors.lastname: Hermans
authors.forename: J C
authors.initials: JC
authors.lastname: van der Linden
authors.forename: J R M
authors.initials: JR
authors.lastname: Pruijt
authors.forename: M F
authors.initials: MF
authors.lastname: Ernst
authors.forename: K
authors.initials: K
authors.lastname: Bosscha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D015996:Survival Rate