In a sample of patients statistically similar to the sample in the NCDB report, the examination of at least 14 nodes after resection of T2 or T3 carcinoma of the colon and rectum will accurately stage the lymphatic basin.

ObjectiveIncreasing evidence supports that the sentinel node (SN) is at greatest risk for harboring metastatic disease. This study describes a novel technique to identify the SN in colorectal carcinoma. MethodsWithin 30 minutes of resection, colorectal specimens were injected submucosally with isosulfan blue in four quadrants. Blue lymphatic channels were identified in the mesentery and followed to the blue-stained SN(s), which were then harvested. The specimen was fixed in formalin and subsequently analyzed in the usual fashion. Blue-stained nodes that were negative by hematoxylin and eosin staining were further analyzed by immunohistochemical staining. ResultsDuring a 6-month period, 26 patients with adenocarcinoma of the colon and/or rectum undergoing routine resection were studied. There were 18 men and 8 women ranging in age from 29 to 86 years (median 66). Blue-stained SNs were identified in 24 of 26 specimens. The mean number of SNs identified per patient was 2.8 Ϯ 1.6. Seventy-three SNs were identified from a total of 479 lymph nodes harvested. The mean number of nodes identified per patient was 18.4 Ϯ 7. A total of 67 lymph nodes in 12 patients were identified by hematoxylin and eosin staining to have evidence of metastatic disease. Fourteen (20%) of these nodes in six patients were stained blue. However, with immunohistochemical staining, only one blue node did not have evidence of metastatic tumor in a lymphatic basin with tumor present. Four patients (29%) whose lymphatic basins were negative by hematoxylin and eosin staining were upstaged by immunohistochemical staining of the SN. ConclusionsEx vivo mapping of the colon and rectum is technically feasible and may provide a useful approach to the ultrastaging of colorectal carcinoma.

compared using log-rank statistics. These factors were assessed as to their interdependence and correlation with the clinical course using a Cox proportional hazards regression model. RESULTSAlthough there were no statistical differences in patient background, JAM who had received hormonal treatment had a better outcome than CM for overall and cause-specific survival rate ( P = 0.001 and 0.036, respectively). Race was one of the significant prognostic factors in the multivariate analysis ( P = 0.03). The findings suggest a difference in the effectiveness of hormonal therapy for prostate cancer in JAM living in Hawaii compared to CM. CONCLUSIONSThere were marked racial differences in clinical outcome after hormonal therapy between JAM and CM. A prospective study with more patients might be necessary to elucidate the differential effectiveness of hormonal therapy for prostate cancer in different races, especially between Japanese and Caucasians.