Analysis of Micrometastatic Disease in Sentinel Lymph Nodes From Resectable Colon Cancer: Results of Cancer and Leukemia Group B Trial 80001

Abstract

By examining both SNs and non-SNs, this multi-institutional study showed that SNs did not accurately predict the presence of either conventionally defined nodal metastases or MMD. As a result, SLNS is not a useful technique for the study of MMD in patients with colon cancer.

Newer Pathologic Assessment Techniques for Colorectal Carcinoma

“…Lymphatic mapping and sentinel lymph node identification may help the surgeon identify lymphatic drainage routes, including those lymph nodes in the resection, and permit the pathologist to apply ultrastaging techniques to first-draining lymph nodes. Although some studies have suggested that this procedure is useful in micrometastasis detection (40 -44), others have highlighted the lack of established techniques and high false-negative rates (45). One important observation with the sentinel lymph node procedure in colorectal carcinoma is that few patients (usually <20%) are sentinel lymph node-only positive (46).…”

Technique of sentinel lymph node biopsy and lymphatic mapping during laparoscopic colon resection for cancer

“…Some studies have found that patients with a clear SN have better survival than those with micro-metastases [44,45]; other studies indicate that micro-metastases and ITCs have no prognostic significance [35,46].…”

“…Since 1999 numerous papers on the SN technique in colorectal cancer have been published, with a wide range of results in terms of accuracy and false negatives: False-negative rates in fact vary from 0% to 60% [26][27][28][29][30][31][32][33][34][35][36]. This astonishing range has several explanations.…”

Cancer and Leukemia Group B Gastrointestinal Cancer Committee

“…Depending on the immunohistochemical criteria used to assign lymph node positivity, sentinel node exam resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%; ref. 43). By examining both sentinel and nonsentinel nodes, this multi-institutional study showed that sentinel nodes from resectable colon cancers did not accurately predict the presence of either conventionally defined nodal metastases or MMD.…”