Lymph Node Size and Metastatic Infiltration in Colon Cancer
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Background: Detection of metastatic lymph nodes in colon cancer is essential for determining stage and adjuvant treatment modalities. Lymph node size has been used as one possible criterion for nodal metastasis. Although enlarged regional lymph nodes are generally interpreted as metastases, few data are available that correlate lymph node size with metastatic infiltration in colon cancer.
Methods: In a prospective morphometric study, the regional lymph nodes from 30 colon specimens from consecutive patients with primary colon cancer were analyzed. The lymph nodes were counted and the largest diameter of each lymph node was measured and analyzed for metastatic involvement by histological examination.
Results: A total of 698 lymph nodes were present in the 30 specimens examined for this study. A mean number of 23 (range, 19–39) lymph nodes was found in each specimen. Of these nodes, 566 (81%) were tumor-free and 132 (19%) contained metastases. The mean diameter of the lymph nodes free of metastases was 3.9 mm, whereas those infiltrated by metastases averaged 5.9 mm in diameter (P< 0.0001). Of the tumor-free lymph nodes, 528 (93%) measured < 5 mm in diameter, whereas 70 (53%) lymph nodes containing metastases measured < 5 mm in diameter.
Conclusions: Lymph node size is not a reliable indicator for lymph node metastasis in colon cancer. A careful histological search for small lymph node metastasis in the specimen should be undertaken to avoid false-negative node staging.
- Cohen AM, Tremiterra S, Candela F. Prognosis of node-positive colon cancer. Cancer 1991;67:1859–1861.
- Koren R, Siegal A, Klein B, Halpern M, Kyzer S, Veltman V, Gal R. Lymph-node revealing solution: simple new method for detecting minute lymph nodes in colon carcinoma. Dis Colon Rectum 1997;40:407–410.
- Herrera-Ornelas L, Justiniano J, Castillo N, Petrelli NJ, Stulc JP, Mittelman A. Metastases in small lymph nodes from colon cancer. Arch Surg 1987;122:1253–1256.
- Herfarth C, Runkel N. Surgical standards in primary colorectal carcinoma. Chirurg 1994;65:514–523.
- Sobin LH, Wittekind C. Stomach. In: Sobin LH, Wittekind C. eds. UICC. TNM classification of malignant tumors (5th ed.) New York, Wiley & Sons, 1997;59–62.
- Hermanek P. Lymphadenectomy: pathological aspects. Langenbecks Arch Chir 1996;Suppl:II:64–69.
- Okuda I, Kokubo T, Udagawa H, Furukawa T, Kurosaki A, Tsurumaru M, Hara M. Mediastinal lymph node metastasis from esophageal carcinoma: CT assessment with pathological correlation. Nippon Igaku Hoshasen Gakkai Zasshi 1997;57:391–394.
- Noda N, Sasako M, Yamaguchi N, Nakanishi Y. Ignoring small lymph nodes can be a major cause of staging error in gastric cancer. Br J Surg 1998;85:831–834.
- Kotanagi H, Fukuoka T, Shibata Y, Yoshioka T, Aizwa O, Saito Y, Tur GE, Koyama K. The size of lymph nodes does not correlate with the presence or absence of metastasis in lymph nodes in rectal cancer. J Surg Oncol 1993;54:252–254.
- Dworak O. Number and size of lymph nodes and node metastases in rectal carcinomas. Surg Endosc 1989;3:96–99.
- Thoeni RF. Colorectal cancer. Radiologic staging. Radiol Clin North Am 1997;35:457–458.
- Lymph Node Size and Metastatic Infiltration in Colon Cancer
Annals of Surgical Oncology
Volume 6, Issue 6 , pp 579-581
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- Colon cancer
- Lymph node metastasis
- Lymph node size
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- Author Affiliations
- 1. Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany
- 3. Department of isceral and Vascular Surgery, University of Cologne, Joseph-Stelzmann-Straße 9, 50924, Cologne, Germany
- 2. Institute of Pathology, University of Cologne, Cologne, Germany