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Article

Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer

  • Authors:
    • Xiutian Guo
    • Cun Wang
    • Xiao-Gang Shen
    • Si-Qin Ding
    • Yong-Yang Yu
    • Zong-Guang Zhou
  • View Affiliations / Copyright

    Affiliations: Department of Anal and Rectal Surgery, Longhua Hospital, Shanghai University of TCM, Shanghai 200032, P.R. China, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R. China
  • Pages: 411-414
    |
    Published online on: November 17, 2011
       https://doi.org/10.3892/ol.2011.490
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Abstract

The aim of the present study to evaluate the application of sentinel lymph node (SLN) pathology in rectal cancer using ex vivo mapping and to investigate the incidence and prognostic value of occult SLN metastasis in routine node-negative specimens. Specimens (n=117) of rectal cancer were examined using a combination of routine pathology and ex vivo SLN mapping. The inspected SLNs were further treated with immunohistochemical staining for occult cancer foci. The log-rank test was used to assess survival. SLNs were examined in 112 of the included specimens with a total number of 212, resulting in an identification rate of 95.7% (112/117). The status of SLNs accurately reflected N stage in 93.8% (105/112) of cases and the sensitivity was 75.6% (31/41) in detecting nodal metastasis. The accuracy of SLN pathology decreased in cancers of more advanced TNM stages (P=0.001). In 74 cases with routine node-negative (N0) disease, SLN micrometastasis (MIC) and isolated tumor cells (ITC) were examined in 9 and 4 cases, while the remaining 61 were regarded as negative (NEG). The log-rank test revealed poorer disease-free and overall survival of the MIC group compared with the NEG group. However, the findings from the ITC group were not significant compared with those from the MIC and NEG groups. In conclusion, ex vivo SLN pathology is practical and accurate in rectal cancer; however, its utility is limited in cases of advanced disease. Immunohistochemically detected SLN micrometastasis in node-negative cases is therefore a predictor of poorer outcome, and may therefore be listed as a marker for adjuvant therapy.
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Copy and paste a formatted citation
Spandidos Publications style
Guo X, Wang C, Shen X, Ding S, Yu Y and Zhou Z: Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer. Oncol Lett 3: 411-414, 2012.
APA
Guo, X., Wang, C., Shen, X., Ding, S., Yu, Y., & Zhou, Z. (2012). Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer. Oncology Letters, 3, 411-414. https://doi.org/10.3892/ol.2011.490
MLA
Guo, X., Wang, C., Shen, X., Ding, S., Yu, Y., Zhou, Z."Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer". Oncology Letters 3.2 (2012): 411-414.
Chicago
Guo, X., Wang, C., Shen, X., Ding, S., Yu, Y., Zhou, Z."Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer". Oncology Letters 3, no. 2 (2012): 411-414. https://doi.org/10.3892/ol.2011.490
Copy and paste a formatted citation
x
Spandidos Publications style
Guo X, Wang C, Shen X, Ding S, Yu Y and Zhou Z: Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer. Oncol Lett 3: 411-414, 2012.
APA
Guo, X., Wang, C., Shen, X., Ding, S., Yu, Y., & Zhou, Z. (2012). Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer. Oncology Letters, 3, 411-414. https://doi.org/10.3892/ol.2011.490
MLA
Guo, X., Wang, C., Shen, X., Ding, S., Yu, Y., Zhou, Z."Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer". Oncology Letters 3.2 (2012): 411-414.
Chicago
Guo, X., Wang, C., Shen, X., Ding, S., Yu, Y., Zhou, Z."Occult tumor metastasis and the prognostic value of sentinel lymph nodes in rectal cancer". Oncology Letters 3, no. 2 (2012): 411-414. https://doi.org/10.3892/ol.2011.490
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