title: High lymph node yield is related to microsatellite instability in colon cancer.
abstract: BACKGROUND
  Lymph node (LN) yield in colon cancer resection specimens is an important indicator of treatment quality and has especially in early-stage patients therapeutic implications. However, underlying disease mechanisms, such as microsatellite instability (MSI), may also influence LN yield, as MSI tumors are known to exhibit more prominent lymphocytic antitumor reactions. The aim of the present study was to investigate the association of LN yield, MSI status, and recurrence rate in colon cancer.
  
  
  METHODS
  Clinicopathological data and tumor samples were collected from 332 stage II and III colon cancer patients. DNA was isolated and PCR-based MSI analysis performed. LN yield was defined as "high" when 10 or more LNs were retrieved and "low" in case of fewer than 10 LNs.
  
  
  RESULTS
  Tumors with high LN yield were significantly associated with the MSI phenotype (high LN yield: 26.3% MSI tumors vs low LN yield: 15.1% MSI tumors; P=.01), mainly in stage III disease. Stage II patients with high LN yield had a lower recurrence rate compared with those with low LN yield. Patients with MSI tumors tended to develop fewer recurrences compared with those with MSS tumors, mainly in stage II disease.
  
  
  CONCLUSIONS
  In the present study, high LN yield was associated with MSI tumors, mainly in stage III patients. Besides adequate surgery and pathology, high LN yield is possibly a feature caused by biologic behavior of MSI tumors.
authors: Department of Surgery, VU University Medical Centre, Amsterdam, The Netherlands.
authors: E J Th
authors: EJ
authors: Belt
authors: E A
authors: EA
authors: te Velde
authors: O
authors: O
authors: Krijgsman
authors: R P M
authors: RP
authors: Brosens
authors: M
authors: M
authors: Tijssen
authors: H F
authors: HF
authors: van Essen
authors: H B A C
authors: HB
authors: Stockmann
authors: H
authors: H
authors: Bril
authors: B
authors: B
authors: Carvalho
authors: B
authors: B
authors: Ylstra
authors: H J
authors: HJ
authors: Bonjer
authors: G A
authors: GA
authors: Meijer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging