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The clinical significance of lymph node size in colon cancer.
- Source :
-
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2012 Oct; Vol. 25 (10), pp. 1413-22. Date of Electronic Publication: 2012 Jun 08. - Publication Year :
- 2012
-
Abstract
- To date, the clinical value of lymph node size in colon cancer has been investigated only in a few studies. Only in radiological diagnosis is lymph node size routinely recognized, and nodes ≥10 mm in diameter are considered pathologic. However, the few studies regarding this topic suggest that lymph node size is not a reliable indicator of metastatic disease. Moreover, we hypothesized that increasing lymph node size is associated with favorable outcome. By performing a morphometric study, we investigated the clinical significance of lymph node size in colon cancer in terms of metastatic disease and prognosis. A cohort of 237 cases with excellent lymph node harvest (mean lymph node count: 33±17) was used. The size distribution in node-positive and -negative cases was almost identical. In all, 151 out of the 305 metastases detected (49.5%) were found in lymph nodes with diameters ≤5 mm. Only 25% of lymph nodes >10 mm showed metastases. Minute lymph nodes ≤1 mm were involved only very rarely (2 of 81 cases). In 67% of the cases, the largest positive lymph node was <10 mm. The prognostic relevance of lymph node size was investigated in a subset of 115 stage I/II cases. The occurrence of ≥7 lymph nodes that were >5 mm in diameter was significantly associated with better overall survival. Our data show that lymph node size is not a suitable factor for preoperative lymph node staging. Minute lymph nodes have virtually no role in correct histopathological lymph node staging. Finally, large lymph nodes in stage I/II disease might indicate a favorable outcome.
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma surgery
Aged
Cohort Studies
Colonic Neoplasms mortality
Colonic Neoplasms surgery
Female
Germany epidemiology
Humans
Lymph Node Excision
Lymphatic Metastasis
Male
Neoplasm Staging
Predictive Value of Tests
Prognosis
ROC Curve
Sentinel Lymph Node Biopsy
Survival Rate
Adenocarcinoma secondary
Colonic Neoplasms pathology
Lymph Nodes pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1530-0285
- Volume :
- 25
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
- Publication Type :
- Academic Journal
- Accession number :
- 22684222
- Full Text :
- https://doi.org/10.1038/modpathol.2012.92