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Prognostic significance of histologically detected lymph node micrometastases of sizes between 0.2 and 2 mm in colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Minimal lymph node involvement is a potential prognostic factor in colorectal cancer. The International Union Against Cancer defined tumour deposits between 0.2 and 2 mm as micrometastases and clusters and single-cell infiltrations below this cutoff as isolated tumour cells. Nevertheless, only a minority of studies discriminated metastatic involvements according to this definition.

Methods

In order to investigate the prognostic significance of micrometastases (0.2–2 mm), we performed a retrospective study enrolling 44 routinely diagnosed micrometastatic cases within 15 years which represent about 1 % of our cases. These cases have been re-evaluated.

Results

Seven of the micrometastatic cases turned out to be macrometastases after step sectioning. Complete follow-up was available in 33 remaining cases. Collections of node-negative and macrometastatic cases served as control groups. The Kaplan–Meier curves of macro- and micrometastatic cases showed a similar adverse course (p = 0.830) especially during the first 40 months. The 5-year-survival rates were 51, 60 and 64 months for macro-, micrometastatic and node-negative cases, respectively. The difference in overall survival, however, reached only a statistical trend and was not significant (p = 0.137). After re-evaluation with step sections and cytokeratin immunohistochemistry out of an initial 91 node-negative cases, 11 (12 %) cases were identified with isolated tumour cells and one (1 %) case with a micrometastasis.

Conclusions

Our data show that micro- and macrometastatic colorectal cancers show very similar survival rates. Therefore, efforts to improve the detection of lymph node micrometastases seem to be justified.

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Acknowledgments

The authors are grateful to Jenny Müller for the excellent technical assistance and Robert A. Herrmann, Ph.D. for critically revising the manuscript as a native English scientist.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Institute of Pathology, Klinikum Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany

    Bruno Märkl, C. Herbst, C. Cacchi, T. Schaller & I. Krammer

  2. Clinical and Population-Based Cancer Registry Augsburg, Klinikum Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany

    G. Schenkirsch

  3. III. Medical Clinic, Klinikum Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany

    A. Probst

  4. Visceral Surgery, Klinikum Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany

    H. Spatz

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  1. Bruno Märkl
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  2. C. Herbst
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  3. C. Cacchi
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  4. T. Schaller
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  8. H. Spatz
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Correspondence to Bruno Märkl.

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Märkl, B., Herbst, C., Cacchi, C. et al. Prognostic significance of histologically detected lymph node micrometastases of sizes between 0.2 and 2 mm in colorectal cancer. Int J Colorectal Dis 28, 977–983 (2013). https://doi.org/10.1007/s00384-012-1636-y

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  • DOI: https://doi.org/10.1007/s00384-012-1636-y

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