Detection of micrometastases in histologically negative lymph nodes in esophageal cancer

Transhiatal Esophagectomy: Clinical Experience and Refinements

“…26 The finding of occult cervical nodal metastases in 35% of patients undergoing a 27 only further attests to the aggressiveness of this malignancy, in which systemic spread is so often present at the time of diagnosis. Luketich et al 28 have used a reverse transcriptase-polymerase chain reaction assay to identify micrometastases in esophageal cancer and have found that 49% of resected histologically negative lymph nodes contain micrometastases. This type of information only reinforces our belief that it is the stage of the tumor and its biologic behavior when esophageal cancer is diagnosed, not the size of the specimen or the number of lymph nodes resected, that determine survival in the vast majority of these patients.…”

Detection of lymph node metastasis of oesophageal cancer by RT-nested PCR for SCC antigen gene mRNA

“…They reported that Ber-EP4-positive cells in 'tumour free' lymph nodes were independently predictive of significantly reduced relapse-free survival and overall survival. Luketich et al (1998) used RT-PCR for carcinoembryonic antigen (CEA) mRNA to detect occult lymph node metastasis of oesophageal cancer and reported that a positive RT-PCR with negative histological findings may have poor prognostic implications. On the other hand, McGuckin et al (1996) analysed 208 axillary node-negative breast cancer patients using a combination of limited step-sectioning and immunohistochemical staining (with cytokeratin (MNF.116) and MUC1 (BC2) antibodies) and, though they found that the presence and increasing size of occult nodal metastases were significantly associated with poorer disease-free survival, occult nodal metastases did not affect overall survival.…”

“…It is still controversial whether occult metastases found by recent techniques have an impact on patients' prognosis or not. As for oesophageal cancer, Izbicki et al (1997) and Luketich et al (1998) reported that microlymph node metastasis indicates poor prognosis. On the other hand, Glickman et al (1999) do not recommend extensive lymph node sectioning with keratin immunohistochemistry because occult lymph node metastasis was not an independent poor prognostic feature in their study.…”

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

“…In oesophageal cancer, it has been shown that between 11% and 50% of pN0 patients have nodal micrometastases [46][47][48][49][50][51][52][53][54]. There is a strong body of evidence suggesting that immunohistochemically detected micrometastatic deposits in oesophageal cancer are associated with reduced survival and increased risk of disease recurrence [55][56][57][58][59][60][61][62][63][64][65].…”