Kantonsspital St.Gallen
login

Isolated tumor cells in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival

B Weixler, Rene Warschkow, Ulrich Gueller, A Zettl, U Von Holzen, B M Schmied & M Zuber

abstract

BACKGROUND
Lymph node (LN) involvement represents the strongest prognostic factor in colon cancer patients. The objective of this prospective study was to assess the prognostic impact of isolated tumor cells (ITC, defined as cell deposits ≤ 0.2 mm) in loco-regional LN of stage I & II colon cancer patients.

METHODS
Seventy-four stage I & II colon cancer patients were prospectively enrolled in the present study. LN at high risk of harboring ITC were identified via an in vivo sentinel lymph node procedure and analyzed with multilevel sectioning, conventional H&E and immunohistochemical CK-19 staining. The impact of ITC on survival was assessed using Cox regression analyses.

RESULTS
Median follow-up was 4.6 years. ITC were detected in locoregional lymph nodes of 23 patients (31.1 %). The presence of ITC was associated with a significantly worse disease-free survival (hazard ratio = 4.73, p = 0.005). Similarly, ITC were associated with significantly worse overall survival (hazard ratio = 3.50, p = 0.043).

CONCLUSIONS
This study provides compelling evidence that ITC in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival. Based on these data, the presence of ITC should be classified as a high risk factor in stage I & II colon cancer patients who might benefit from adjuvant chemotherapy.
   
citation Weixler B, Warschkow R, Gueller U, Zettl A, von Holzen U, Schmied B M, Zuber M. Isolated tumor cells in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival. BMC Cancer 2016; 16:106.
   
type journal paper/review (English)
date of publishing 16-02-2016
journal title BMC Cancer (16/1)
ISSN electronic 1471-2407
pages 106
PubMed 26879046
DOI 10.1186/s12885-016-2130-7