Analysis of micrometastatic disease in sentinel lymph nodes from resectable colon cancer: Results of cancer and leukemia group B trial 80001

Mark Redston, Carolyn Compton, Brent W. Miedema, Donna Niedzwiecki, Jeannette M. Dowell, Scott D. Jewell, James M. Fleshman, Jiri Bem, Robert J. Mayer, Monica M. Bertagnolli

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Abstract

Purpose: To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer. Patients and Methods: Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1% isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti-carcinoembryonic antigen and anticytokeratin antibodies. Results: Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54%) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)878-883
Number of pages6
JournalJournal of Clinical Oncology
Volume24
Issue number6
DOIs
StatePublished - Feb 20 2006
Externally publishedYes

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Colonic Neoplasms
Leukemia
Neoplasms
Neoplasm Micrometastasis
Carcinoembryonic Antigen
Sentinel Lymph Node
Neoplasm Metastasis
Injections
cyhalothrin
Antibodies

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Analysis of micrometastatic disease in sentinel lymph nodes from resectable colon cancer : Results of cancer and leukemia group B trial 80001. / Redston, Mark; Compton, Carolyn; Miedema, Brent W.; Niedzwiecki, Donna; Dowell, Jeannette M.; Jewell, Scott D.; Fleshman, James M.; Bem, Jiri; Mayer, Robert J.; Bertagnolli, Monica M.

In: Journal of Clinical Oncology, Vol. 24, No. 6, 20.02.2006, p. 878-883.

Research output: Contribution to journalArticle

Redston, M, Compton, C, Miedema, BW, Niedzwiecki, D, Dowell, JM, Jewell, SD, Fleshman, JM, Bem, J, Mayer, RJ & Bertagnolli, MM 2006, 'Analysis of micrometastatic disease in sentinel lymph nodes from resectable colon cancer: Results of cancer and leukemia group B trial 80001', Journal of Clinical Oncology, vol. 24, no. 6, pp. 878-883. https://doi.org/10.1200/JCO.2005.03.6038
Redston, Mark ; Compton, Carolyn ; Miedema, Brent W. ; Niedzwiecki, Donna ; Dowell, Jeannette M. ; Jewell, Scott D. ; Fleshman, James M. ; Bem, Jiri ; Mayer, Robert J. ; Bertagnolli, Monica M. / Analysis of micrometastatic disease in sentinel lymph nodes from resectable colon cancer : Results of cancer and leukemia group B trial 80001. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 6. pp. 878-883.
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abstract = "Purpose: To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer. Patients and Methods: Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1{\%} isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti-carcinoembryonic antigen and anticytokeratin antibodies. Results: Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54{\%}) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20{\%}) or a low sensitivity for detection of MMD (40{\%}). Conclusion: 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.",
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T2 - Results of cancer and leukemia group B trial 80001

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AU - Compton, Carolyn

AU - Miedema, Brent W.

AU - Niedzwiecki, Donna

AU - Dowell, Jeannette M.

AU - Jewell, Scott D.

AU - Fleshman, James M.

AU - Bem, Jiri

AU - Mayer, Robert J.

AU - Bertagnolli, Monica M.

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N2 - Purpose: To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer. Patients and Methods: Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1% isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti-carcinoembryonic antigen and anticytokeratin antibodies. Results: Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54%) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%). Conclusion: 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.

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