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BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

Isolated tumor cells in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival

Authors: B. Weixler, R. Warschkow, U. Güller, A. Zettl, U. von Holzen, B. M. Schmied, M. Zuber

Published in: BMC Cancer | Issue 1/2016

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Abstract

Background

Lymph node (LN) involvement represents the strongest prognostic factor in colon cancer patients. The objective of this prospective study was to assess the prognostic impact of isolated tumor cells (ITC, defined as cell deposits ≤ 0.2 mm) in loco-regional LN of stage I & II colon cancer patients.

Methods

Seventy-four stage I & II colon cancer patients were prospectively enrolled in the present study. LN at high risk of harboring ITC were identified via an in vivo sentinel lymph node procedure and analyzed with multilevel sectioning, conventional H&E and immunohistochemical CK-19 staining. The impact of ITC on survival was assessed using Cox regression analyses.

Results

Median follow-up was 4.6 years. ITC were detected in locoregional lymph nodes of 23 patients (31.1 %). The presence of ITC was associated with a significantly worse disease-free survival (hazard ratio = 4.73, p = 0.005). Similarly, ITC were associated with significantly worse overall survival (hazard ratio = 3.50, p = 0.043).

Conclusions

This study provides compelling evidence that ITC in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival. Based on these data, the presence of ITC should be classified as a high risk factor in stage I & II colon cancer patients who might benefit from adjuvant chemotherapy.
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Metadata
Title
Isolated tumor cells in stage I & II colon cancer patients are associated with significantly worse disease-free and overall survival
Authors
B. Weixler
R. Warschkow
U. Güller
A. Zettl
U. von Holzen
B. M. Schmied
M. Zuber
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2130-7

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