Abstract
Abstract Involvement of the lymph nodes (LN) is the most important prognostic factor in CRC and pN+ve status identifies patients requiring adjuvant chemotherapy. Among pN0-patients, 20-30% develop recurrent disease. ITC+ve LNs in such patients (as assessed by immunohistochemistry) may potentially predict cancer recurrence. No prospective long-term follow-up trial has consistently validated the prognostic meaning of ITCs. ITCs in regional LNs were prospectively assessed in a cohort of 361 consecutive pN0-CRC patients. From each gross surgical specimen, LNs were microdissected according to a standardized protocol (mean LNs per patient=16.4; range 5-107). In all, 5,920 pN0-ve LNs were collected and immunohistochemically assessed (MNF116 staining was performed in 2 serial histology sections of each LN [11,840 histology specimens in all]). Overall cancer death and recurrence rates were calculated. The prognostic impact of ITC was also tested by multivariate statistics. ITCs were documented in 200 of 361 patients (55.5%). No relationship was documented between ITC+ve status and overall survival. CRC recurred in 36/361 (9%) cases and 29/36 (80%) recurrences were documented among ITC+ve patients. The prevalence of recurrent CRC among ITC+ve and ITC-ve patients was 14.5% and 4.3%, respectively. ITC+ status significantly correlated with cancer recurrence (p = 0.002, OR = 3.57; 95% CI=1.46-9.95; case-control Pearson's chi-squared) and disease-free interval (p=0.0005). In multivariate analysis, ITC-status was the only variable significantly associated with cancer recurrence. These results suggest considering ITC+ve status a reliable marker of cancer recurrence, and that pN0 ITC+ve cancer patients form a subgroup of candidates for adjuvant chemotherapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3219. doi:10.1158/1538-7445.AM2011-3219
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