Ultrastaging of sentinel lymph nodes (SLNs) vs. non-SLNs in colorectal cancer-do we need both?

David Wiese, Saad Sirop, Brian Yestrepsky, Maher Ghanem, Nader Bassily, Peter Ng, Weimin Liu, Ernesto Quiachon, Aamir Ahsan, Julio Badin, Sukamal Saha

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Background: The aim of this study to analyze whether ultrastaging of initially negative nonsentinel lymph nodes (non-SLNs) would increase nodal positivity in colon cancer and rectal cancer. Methods: After SLN mapping (SLNM), SLNs were ultrastaged by 4 hematoxylin and eosin and 1 immunohistochemistry sections. A blinded pathologist reexamined initially negative non-SLNs by 3 additional hematoxylin and eosin and 1 immunohistochemistry sections. Results: In 156 colon cancer and 44 rectal cancer patients, 2,755 nodes were identified (494 SLNs and 2,261 non-SLNs). Metastases were detected in 20.9% of SLNs and 8.6% of non-SLNs (P < .0001). After ultrastaging non-SLNs, only .58% became positive for metastases in 12 patients. Of these, 10 already had positive lymph nodes, hence no change of staging occurred. Ultrastaging upstaged only 2 of 200 patients (1%). Conclusions: The chance of finding additional metastases by ultrastaging of all non-SLNs is extremely low (<1%) and of little benefit.

Original languageEnglish (US)
Pages (from-to)354-358
Number of pages5
JournalAmerican journal of surgery
Volume199
Issue number3
DOIs
StatePublished - Mar 1 2010

Keywords

  • Colorectal cancer
  • Nonsentinal lymph node
  • Sentinel lymph node mapping
  • Ultrastaging

ASJC Scopus subject areas

  • Surgery

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