Nodal staging of colorectal carcinomas and sentinel nodes

Down-regulated MYH11 Expression Correlates with Poor Prognosis in Stage II and III Colorectal Cancer

“…Multidisciplinary treatments induce clinical remission in about 60% of stage II and III cases. However, 40% to 50% of patients will relapse, and most of them will die from secondary diseases (Cserni, 2003;de Gramont et al, 2007). Tumor stage by American Joint Committee on Cancer (AJCC) (Compton et al, 2000) and differentiation are the main prognostic factors used in clinical practice.…”

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

“…The main goal of SN mapping in colon cancer is to improve lymph-nodal staging to identify the number of patients classified as stage II, and varying from 20% to 30%, that will die within five years from tumour relapse or distant metastases and will thus benefit from adjuvant chemotherapy [4][5][6]. Furthermore, patients with advanced diseases will receive adjuvant chemotherapy anyway.…”

“…The probability of finding an involved node increases with number of nodes recovered, suggesting that all palpable nodes, even small ones, should be harvested [2]. Similarly, the conventional node examination method-single-level sectioning and haematoxylin and eosin (H&E) staining-may fail to detect tumour cells [4]. At the same time methods of lymph node ultrastaging, such as multi-level sectioning, immunohistochemistry and polymerase chain reaction, are costly and time-consuming particularly if applied to all nodes harvested.…”

“…The metastatic status of regional lymph nodes is a major prognostic factor in colon cancer and is particularly important for determining adjuvant therapy [1][2][3][4]. Five-year survival is 85-95% for stage I colon cancers, 60-80% for stage II, but 30-60% for stage III disease (characterized by nodal involvement) [5,6].…”

“…Key variables determining whether lymph node metastases are found (and what stage is assigned) are the number of nodes harvested [2,3] and the method of node evaluation [4]. The probability of finding an involved node increases with number of nodes recovered, suggesting that all palpable nodes, even small ones, should be harvested [2].…”