Colorectal Cancer: Open Access

Sentinel Lymph Node and Occult Tumor Cells in Colon Cancer; the Good, the Bad, and the Ugly

Background: Node negative colon cancers pose a therapeutic dilema, as there is a subset of patients who will have disease recurrence and who probably would benefit from chemotherapy. Sentinel lymph node biopsy (SNLB) and molecular diagnosis in search of occult tumor cells (OTC) in lymph nodes may aid in detecting these patients.
Methods: We performed a review of the literature in Medline and selected the most relevant articles which deal with SLNB and the molecular diagnosis of lymph nodes and discuss their relevance.
Findings: There is much heterogeneity among published studies (techniques and definitions). However, the presence of OTC in SLNB confer a negative impact on DFS and OS in Colon Cancer patients. OTC positive nodes is associated with disease recurrence of around 15-20% and 3 year DFS and OS of around 80%, much worse when compared with OTC negative patients.
Conclusions: The available literature suggests that the presence of OTC in Colon Cancer is an important psrognostic variable. However, there is much heterogeneity among studies, and no prospective trials have been conducted to determine if these patients will benefit from chemotherapy.

Author(s):

Adrian murillo

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