TY - JOUR
T1 - Adenocarcinoma of the lower third of the rectum
T2 - Metastases in lymph nodes smaller than 5 mm and occult micrometastases; preliminary results on early tumor recurrence
AU - Andreola, S.
AU - Leo, E.
AU - Belli, F.
AU - Gallino, G.
AU - Sirizzotti, G.
AU - Sampietro, G.
PY - 2001
Y1 - 2001
N2 - Background: The number of examined lymph nodes and metastases in lymph nodes smaller than 5 mm (small lymph nodes) are a determining factor in the stage of rectal cancer although the clinical significance of occult micrometastases is controversial. We are reporting our preliminary results on the identification and prognostic utility of metastases in small lymph nodes and occult micrometastases. Methods: We searched small metastatic lymph nodes in 101 cases of adenocarcinoma of the lower third of the rectum. We used the manual technique to dissect mesorectal fat and occult micrometastases in the lymph nodes of 52 Dukes' A and B patients, using a pool of anticytokeratin antibodies. Results: Forty-five percent of the metastatic lymph nodes were smaller than 5 mm in diameter and determined the Dukes' stage in 15 (30.6%) of 49 Dukes' C patients. Occult micrometastases were found in 21 (40.4%) patients: five recurred but vascular invasion, positive distal margin of the rectum, and positive circumferential margin of the mesorectum were present. Conclusions: Small metastatic lymph nodes, vascular invasion, positive distal margin of the rectum, and positive circumferential margin of the mesorectum were found to be more important than occult micrometastases in predicting early recurrence of rectal cancer.
AB - Background: The number of examined lymph nodes and metastases in lymph nodes smaller than 5 mm (small lymph nodes) are a determining factor in the stage of rectal cancer although the clinical significance of occult micrometastases is controversial. We are reporting our preliminary results on the identification and prognostic utility of metastases in small lymph nodes and occult micrometastases. Methods: We searched small metastatic lymph nodes in 101 cases of adenocarcinoma of the lower third of the rectum. We used the manual technique to dissect mesorectal fat and occult micrometastases in the lymph nodes of 52 Dukes' A and B patients, using a pool of anticytokeratin antibodies. Results: Forty-five percent of the metastatic lymph nodes were smaller than 5 mm in diameter and determined the Dukes' stage in 15 (30.6%) of 49 Dukes' C patients. Occult micrometastases were found in 21 (40.4%) patients: five recurred but vascular invasion, positive distal margin of the rectum, and positive circumferential margin of the mesorectum were present. Conclusions: Small metastatic lymph nodes, vascular invasion, positive distal margin of the rectum, and positive circumferential margin of the mesorectum were found to be more important than occult micrometastases in predicting early recurrence of rectal cancer.
KW - Lymph nodes
KW - Occult micrometastases
KW - Rectal cancer
KW - Serial sectioning
UR - http://www.scopus.com/inward/record.url?scp=0035014910&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035014910&partnerID=8YFLogxK
U2 - 10.1245/aso.2001.8.5.413
DO - 10.1245/aso.2001.8.5.413
M3 - Article
C2 - 11407515
AN - SCOPUS:0035014910
VL - 8
SP - 413
EP - 417
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 5
ER -