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Sentinel node staging of resectable colon cancer: Results of CALGB 80001.

Publication ,  Journal Article
Bertagnolli, MM; Redston, M; Miedema, B; Dowell, J; Niedzwiecki, D; Mayer, R; Fleshman, J; Bem, J; Compton, C
Published in: J Clin Oncol
July 15, 2004

3506 The most important outcome predictor for resectable colon cancer (RCC) is the status of locoregional lymph nodes. This information is critical, as patients with positive nodes may benefit from post-operative adjuvant therapy. A subset of patients with node-negative RCC experiences a poor outcome, suggesting that improved staging would benefit this population by identifying patients who should receive additional treatment. CALGB 80001, a study conducted by 25 surgery-pathology teams at 12 institutions, was designed to determine whether sentinel lymph node sampling (SLNS) could identify a subset of lymph nodes that predict the status of the nodal basin for RCC, and therefore could be extensively evaluated for the presence of metastases. SLNS was performed on 79 of 91 patients enrolled, followed by multilevel sectioning (MLS) of the nodes, and examination by H&E as well as IHC to identify cells positive for cytokeratin (CK) and carcinoembryonic antigen (CEA). Sentinel nodes (SN) were successfully located in 66 of 72 colon cancer cases (92%), with an average of 2.0 sentinel nodes per patient. SNs were negative in 14 of 25 node-positive cases (56%). MLS revealed tumor in a SN in one of these cases, bringing the sensitivity of SN examination by H&E and MLS to 48%. Results of further sentinel node studies are as follows: [Figure: see text] The addition of IHC for CK and CEA doubled the total number of node positive colon cancer cases from 25 to 50 of 62 (40 to 81%). CONCLUSION: These results show that SN examined by H&E and MLS failed to predict nodal status in 52% of cases. Analysis of SNs from colon cancer is unlikely to predict the nodal status of the patient, and studies to examine micrometastatic disease should involve all draining nodes removed. No significant financial relationships to disclose.

Duke Scholars

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

July 15, 2004

Volume

22

Issue

14_suppl

Start / End Page

3506

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

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Bertagnolli, M. M., Redston, M., Miedema, B., Dowell, J., Niedzwiecki, D., Mayer, R., … Compton, C. (2004). Sentinel node staging of resectable colon cancer: Results of CALGB 80001. J Clin Oncol, 22(14_suppl), 3506.
Bertagnolli, M. M., M. Redston, B. Miedema, J. Dowell, D. Niedzwiecki, R. Mayer, J. Fleshman, J. Bem, and C. Compton. “Sentinel node staging of resectable colon cancer: Results of CALGB 80001.J Clin Oncol 22, no. 14_suppl (July 15, 2004): 3506.
Bertagnolli MM, Redston M, Miedema B, Dowell J, Niedzwiecki D, Mayer R, et al. Sentinel node staging of resectable colon cancer: Results of CALGB 80001. J Clin Oncol. 2004 Jul 15;22(14_suppl):3506.
Bertagnolli, M. M., et al. “Sentinel node staging of resectable colon cancer: Results of CALGB 80001.J Clin Oncol, vol. 22, no. 14_suppl, July 2004, p. 3506.
Bertagnolli MM, Redston M, Miedema B, Dowell J, Niedzwiecki D, Mayer R, Fleshman J, Bem J, Compton C. Sentinel node staging of resectable colon cancer: Results of CALGB 80001. J Clin Oncol. 2004 Jul 15;22(14_suppl):3506.

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

July 15, 2004

Volume

22

Issue

14_suppl

Start / End Page

3506

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences