title: Impact on Prognosis of Lymph Node Micrometastasis and Isolated Tumor Cells in Stage II Colorectal Cancer.
abstract: OBJECTIVE
  Even though the importance of micrometastases (MMS) and isolated tumor cells (ITC) has been brought up by many physicians, its impact on the prognosis in stage II colorectal cancer is uncertain. In this research, we tried to investigate the clinical features of MMS and ITC and to prove any correlation with prognosis.
  
  
  METHODS
  The research pool was 124 colorectal cancer patients who underwent a curative resection from April 2005 to November 2009. A total of 2,379 lymph nodes (LNs) were examined, and all retrieved LNs were evaluated by immunohistochemical staining with anti-cytokeratin antibody panel. Clinicopathologic parameters and survival rates were compared based on the presence of MMS or ITC and on the micrometastatic lymph node ratio (mmLNR), which is defined as the number of micrometastatic LNs divided by the number of retrieved LNs.
  
  
  RESULTS
  Out of 124 patients (26.6%) 33 were found to have MMS or ITC. There were no significant differences in clinicopathologic features, such as gender, tumor location and size, depth of invasion, histologic grade, except for age (P = 0.04). The three-year disease-free survival rate for the MMS or ITC positive group was 85.7%, and that for MMS and ITC negative group was 92.8% (P = 0.209). The three-year disease-free survival rate for the mmLNR > 0.25 group was 73.3%, and that for the mmLNR ≤ 0.25 group was 92.9% (P = 0.03).
  
  
  CONCLUSIONS
  The presence of MMS or ITC was not closely correlated to the prognosis. However, mmLNR is thought to be a valuable marker of prognosis in cases of stage II colorectal cancer.
authors: Department of Surgery, Korea Cancer Center Hospital, Seoul, Korea.
authors: Tai Young
authors: TY
authors: Oh
authors: Sun Mi
authors: SM
authors: Moon
authors: Ui Sup
authors: US
authors: Shin
authors: Hyang Ran
authors: HR
authors: Lee
authors: Sun Hoo
authors: SH
authors: Park
references: Br J Surg. 1985 Sep;72(9):698-702
references: 4041728
references: JAMA. 1990 Sep 19;264(11):1444-50
references: 2202842
references: J Gastroenterol. 1997 Dec;32(6):758-64
references: 9430013
references: Mod Pathol. 2004 Apr;17(4):402-6
references: 14976530
references: Ann Surg. 2006 Oct;244(4):602-10
references: 16998369
references: Clin Transl Oncol. 2008 Sep;10(9):572-8
references: 18796374
references: Dis Colon Rectum. 1997 Dec;40(12):1465-71
references: 9407986
references: J Clin Oncol. 2002 Oct 15;20(20):4232-41
references: 12377967
references: J Clin Pathol. 2004 Nov;57(11):1165-7
references: 15509677
references: J Surg Oncol. 2006 Jan 1;93(1):13-8; discussion 18-9
references: 16353185
references: Ann Surg Oncol. 2008 Jun;15(6):1600-8
references: 18327530
references: J Mol Diagn. 2007 Nov;9(5):563-71
references: 17916603
references: Cancer Res Treat. 2008 Jun;40(2):75-80
references: 19688052
references: Ann Surg. 2007 Oct;246(4):568-75; discussion 575-7
references: 17893493
references: Eur J Surg. 1996 Aug;162(8):637-42
references: 8891622
references: Dis Colon Rectum. 2009 Jul;52(7):1244-50
references: 19571700
references: Cancer. 2003 Dec 15;98(12):2740-1
references: 14669301
references: World J Gastrointest Surg. 2010 Mar 27;2(3):70-7
references: 21160853
references: Ann Surg Oncol. 2001 May;8(4):300-4
references: 11352302
references: N Engl J Med. 1998 Jul 23;339(4):223-8
references: 9673300
references: Ann Surg Oncol. 2008 Jun;15(6):1557-8
references: 18363073
references: Cancer Res. 1995 Aug 1;55(15):3417-20
references: 7542169
references: Dis Colon Rectum. 1997 Jan;40(1):51-9
references: 9102262
references: Ann Surg. 1971 Jan;173(1):44-6
references: 5543548