BACKGROUND: Standard treatment of colorectal cancer includes adjuvant chemotherapy for patients with stage III disease (defined by the presence of lymph-node metastases), but not for patients with stage II tumors (who have no lymph-node metastases). However, 20 percent of patients with stage II tumors die of recurrent disease. We investigated whether the detection of micrometastases can be used to identify patients with stage II disease who are at high risk for recurrence. METHODS: We analyzed 192 lymph nodes from 26 consecutive patients with stage II colorectal cancer, using a carcinoembryonic antigen-specific nested reverse-transcriptase polymerase chain reaction. Five-year follow-up information was obtained on all patients. Observed and adjusted survival rates were assessed in the patients with and the patients without micrometastases. RESULTS: Micrometastases were detected in one or more lymph nodes from 14 of 26 patients (54 percent). The adjusted five-year survival rate (for which only cancer-related deaths were considered) was 50 percent in this group, whereas in the 12 patients without micrometastases, the survival rate was 91 percent (P=0.02 by the log-rank test). The observed five-year survival rates were 36 percent and 75 percent, respectively (P=0.03). The groups were similar with respect to age, sex, tumor side (location in relation to the flexura lienalis), degree of tumor differentiation (grade), and diameter of the primary tumor. CONCLUSIONS: Molecular detection of micrometastases is a prognostic tool in stage II colorectal cancer.
BACKGROUND: Standard treatment of colorectal cancer includes adjuvant chemotherapy for patients with stage III disease (defined by the presence of lymph-node metastases), but not for patients with stage II tumors (who have no lymph-node metastases). However, 20 percent of patients with stage II tumors die of recurrent disease. We investigated whether the detection of micrometastases can be used to identify patients with stage II disease who are at high risk for recurrence. METHODS: We analyzed 192 lymph nodes from 26 consecutive patients with stage II colorectal cancer, using a carcinoembryonic antigen-specific nested reverse-transcriptase polymerase chain reaction. Five-year follow-up information was obtained on all patients. Observed and adjusted survival rates were assessed in the patients with and the patients without micrometastases. RESULTS: Micrometastases were detected in one or more lymph nodes from 14 of 26 patients (54 percent). The adjusted five-year survival rate (for which only cancer-related deaths were considered) was 50 percent in this group, whereas in the 12 patients without micrometastases, the survival rate was 91 percent (P=0.02 by the log-rank test). The observed five-year survival rates were 36 percent and 75 percent, respectively (P=0.03). The groups were similar with respect to age, sex, tumor side (location in relation to the flexura lienalis), degree of tumor differentiation (grade), and diameter of the primary tumor. CONCLUSIONS: Molecular detection of micrometastases is a prognostic tool in stage II colorectal cancer.
Authors: Thomas F Wood; Dean T Nora; Donald L Morton; Roderick R Turner; Decio Rangel; William Hutchinson; Anton J Bilchik Journal: J Gastrointest Surg Date: 2002 May-Jun Impact factor: 3.452
Authors: Ulrich Guller; Paul Zajac; Annelies Schnider; Beatrix Bösch; Stefan Vorburger; Markus Zuber; Giulio Cesare Spagnoli; Daniel Oertli; Robert Maurer; Urs Metzger; Felix Harder; Michael Heberer; Walter Richard Marti Journal: Ann Surg Date: 2002-12 Impact factor: 12.969
Authors: Liqiang Xi; Michael C Coello; Virginia R Litle; Siva Raja; William E Gooding; Samuel A Yousem; Talal El-Hefnawy; Rodney J Landreneau; James D Luketich; Tony E Godfrey Journal: Clin Cancer Res Date: 2006-04-15 Impact factor: 12.531
Authors: Carsten T Viehl; Christian T Hamel; Walter R Marti; Ulrich Guller; Lukas Eisner; Uz Stammberger; Luigi Terracciano; Hans P Spichtin; Felix Harder; Markus Zuber Journal: World J Surg Date: 2003-11-06 Impact factor: 3.352