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Sentinel lymph node biopsy as a prognostic factor in non-metastatic colon cancer: a prospective study

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Abstract

Purpose

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.

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Acknowledgments

The authors would like to thank Mateu Serra for their collaboration in writing the paper; and Elisabet Palomera for performing the statistical analyses for the study.

Conflict of interest

All authors expose and have no financial or personal relationships with other people or organisations that could inappropriately influence in the study.

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Correspondence to O. Estrada.

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Estrada, O., Pulido, L., Admella, C. et al. Sentinel lymph node biopsy as a prognostic factor in non-metastatic colon cancer: a prospective study. Clin Transl Oncol 19, 432–439 (2017). https://doi.org/10.1007/s12094-016-1543-8

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  • DOI: https://doi.org/10.1007/s12094-016-1543-8

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