Excellent prognosis of node negative patients after sentinel node procedure in colon carcinoma: A 5-year follow-up study

A. E. Braat, R. A. Pol, J. W.A. Oosterhuis, J. E. De Vries, W. E. Mesker, R. A.E.M. Tollenaar

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Aim Investigate the prognostic impact and clinical relevance of the sentinel node (SN)-procedure in colon carcinoma. Patients and methods Between May 2002 and January 2004, the SN-procedure was performed in 55 patients that underwent elective resection for clinically non-advanced colon carcinoma. A control group of 110 patients was identified from a cohort between January 2000 and April 2002. All lymph nodes were analysed by conventional haematoxylin-eosin staining. All negative SNs underwent in-depth analysis using immunohistochemical-staining and automated microscopy with the Ariol-system. Patients with positive lymph nodes were offered adjuvant chemotherapy. All patients were routinely monitored at 6-month intervals and follow-up was more than 5 years. Results The SN was successfully identified in 98% of the patients, with 94% sensitivity. In-depth analysis with immunohistochemistry and automated microscopy (Ariol-system) upstaged 3 and 4 patients respectively. When only node-negative patients were analysed, overall 5-year-survival was significantly better in the SN group (91% vs. 76%, p = 0.04). Cancer-specific-mortality was even 0% (vs. 8%, p = 0.08). Disease-free-survival was significantly improved to 96% (vs. 77%, p < 0.01). Conclusions This study describes the prognostic impact of the SN-procedure in colon carcinoma after 5-year-follow-up. Only one patient had recurrent disease after a negative SN procedure (disease-free- survival 96%). These results indicate that the SN-procedure is of prognostic relevance and might be useful to select patients for adjuvant chemotherapy. Patients that are lymph node negative after an SN-procedure have an excellent prognosis and do not need adjuvant treatment.

Original languageEnglish
Pages (from-to)747-755
Number of pages9
JournalEuropean Journal of Surgical Oncology
Volume40
Issue number6
DOIs
Publication statusPublished - Jun 2014
Externally publishedYes

Keywords

  • Colonic neoplasms
  • Colorectal neoplasms
  • Follow-up studies
  • Lymphatic metastasis
  • Neoplasm staging
  • Sentinel lymph node biopsy

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