title: Sentinel lymph node biopsy as a prognostic factor in non-metastatic colon cancer: a prospective study.
abstract: OBJECTIVE
  Around a third of node-negative patients with colon cancer experience a recurrence after surgery, suggesting poor staging. Sentinel lymph node techniques combined with immunochemistry could improve colon cancer staging. We prospectively assessed the effect of Sentinel node mapping on staging and survival in patients with non-metastatic colon cancer.
  
  
  METHODS
  An observational and prospective study was designed. 105 patients with colon cancer were selected. Patients were classified according to node involvement as: N1, with node invasion detected by the conventional techniques; up-staged, with node invasion detected only by sentinel node mapping; and N0, with negative lymph node involvement by both techniques. Five-year survival and disease-free survival rates were analysed. Multivariate regression analyses were performed to identify prognostic factors for disease-free and overall survival.
  
  
  RESULTS
  Sentinel node mapping was successfully applied in 78 patients: 33 % were N1; 24.5 % were up-staged (18 patients with isolated tumour cells and 1 patient with micrometastases); and 42.5 % were N0. N1 patients had the poorest overall 5-year survival (65.4 %) and 5-year disease-free survival (69.2 %) rates compared with the other two groups. No significant 5-year survival differences were observed between N0 patients (87.9 %) and up-staged patients (84.2 %).
  
  
  CONCLUSIONS
  Patients up-staged after sentinel node mapping do not have a poorer prognosis than patients without node involvement. Detection of isolated cancer cells was not a poor prognosis factor in these patients.
authors.affiliation: General Surgery Department, Colorectal Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain. oestrada@csdm.cat.
authors.forename: O
authors.initials: O
authors.lastname: Estrada
authors.affiliation: General Surgery Department, Colorectal Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Pulido
authors.affiliation: Pathology Department, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Admella
authors.affiliation: General Surgery Department, Colorectal Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.
authors.forename: L-A
authors.initials: LA
authors.lastname: Hidalgo
authors.affiliation: General Surgery Department, Colorectal Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Clavé
authors.affiliation: General Surgery Department, Colorectal Unit, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Suñol
mesh_terms: D000368:Aged; D003082:Colectomy / Q000401:mortality*; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D015996:Survival Rate
keywords: Colorectal cancer; Isolated cancer cells; Sentinel node; Up-stage