Clinical and Translational Oncology

, Volume 10, Issue 9, pp 572–578 | Cite as

Prognostic value of the detection of lymph node micrometastases in colon cancer

  • Carlos E. Bosch RoigEmail author
  • Ester Roselló-Sastre
  • Sonia Alonso Hernández
  • Daniel Almenar Cubells
  • Enrique Grau Cardona
  • Natalia Camarasa Lillo
  • Daniel Bautista
  • Carmen Molins Palau
Research Articles


Introduction and objectives

A study is made of the clinical repercussions of occult metastases-micrometastases (MMs+)-or isolated tumour cells (ITCs+) in the lymph nodes of patients with stage IIA and IIB colon adenocarcinoma initially considered as corresponding to N0.

Material and methods

A retrospective study of 39 patients with stage IIA and IIB (T3–T4 N0 M0) colon adenocarcinoma, subjected to similar surgical and adjuvant chemotherapy treatment, with long and careful follow-up (minimum: 5 years, mean: 81.7 months) was performed on their previously resected lymph nodes, with the aid of new histological and immunohistochemical (cytokeratin) sections, in order to detect MMs or ITCs. Disease-free survival (DFS) and global survival (GS) in the two groups (patients with MMs+ or ITCs+ vs. patients without MMs or ITCs) were compared at 5 years based on the corresponding Kaplan-Meier survival curves, with the Breslow test.


A total of 382 lymph nodes from the 39 patients (mean: 9.8; standard deviation: 6.09) were revised. MMs+ were detected in 2 cases and ITCs+ in 2 more cases on the Cytokeratin study. GS of the whole series at 5 years was 89.74% (35 patients alive) with a DFS at 5 years of 79.49% (31 patients free of disease), but the 2 cases with MMs+ were dead at 5 years, with high statistical differences between both groups (MMs+/MMs−) (p<0.0001). When comparing the group of MMs+/ITCs+ patients and the group of MM−/ITCs− patients, the DFS and GS times at 5 years were higher in the MMs−/ITCs− group (p=0.0692 and p=0.006 respectively).


Although the incidence of MMs+ or ITCs+ in the examined lymph nodes was low, the presence of MMs is related to a dramatic reduction in GS and DFS at 5 years. We encourage a detailed histological study of lymph nodes resected in patients with deep penetrating colon tumours in order to assure a pN0 status.


Colon cancer Micrometastases Lymph nodes Global survival Disease-free survival 


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Copyright information

© Feseo 2008

Authors and Affiliations

  • Carlos E. Bosch Roig
    • 1
    Email author
  • Ester Roselló-Sastre
    • 2
  • Sonia Alonso Hernández
    • 2
  • Daniel Almenar Cubells
    • 1
  • Enrique Grau Cardona
    • 3
  • Natalia Camarasa Lillo
    • 2
  • Daniel Bautista
    • 4
  • Carmen Molins Palau
    • 1
  1. 1.Medical Oncology UnitDr. Peset University HospitalValenciaSpain
  2. 2.Service of PathologyDr. Peset University HospitalValenciaSpain
  3. 3.General and Digestive Surgery ServiceDr. Peset University HospitalValenciaSpain
  4. 4.Preventive Medicine UnitDr. Peset University HospitalValenciaSpain

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