Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma.
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Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma. / Scheunemann, Peter; Stoecklein, Nikolas H; Rehders, Alexander; Bidde, M; Metz, Sylvia; Peiper, Matthias; Eisenberger, Claus F; Jan, Schulte Am Esch; Knoefel, Wolfram T; Hosch, Stefan B.
in: LANGENBECK ARCH SURG, Jahrgang 393, Nr. 3, 3, 2008, S. 359-365.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma.
AU - Scheunemann, Peter
AU - Stoecklein, Nikolas H
AU - Rehders, Alexander
AU - Bidde, M
AU - Metz, Sylvia
AU - Peiper, Matthias
AU - Eisenberger, Claus F
AU - Jan, Schulte Am Esch
AU - Knoefel, Wolfram T
AU - Hosch, Stefan B
PY - 2008
Y1 - 2008
N2 - BACKGROUND AND AIMS: Occurrence of tumor relapse is frequent in patients with pancreatic cancer despite the absence of residual tumor detectable at primary surgery and in histopathological examination. Therefore, it has to be assumed that current tumor staging procedures fail to identify minimal amounts of disseminated tumor cells, which might be precursors of subsequent metastatic relapse. The aim of this study was to assess the prognostic impact of minimal tumor cell spread detected in lymph nodes classified as "tumor-free" in routine histopathologic evaluation. MATERIALS AND METHODS: A total of 154 "tumor-free" lymph nodes from 59 patients with pancreatic cancer who underwent intentionally curative tumor resection were examined by immunohistochemistry for disseminated tumor cells. RESULTS: Fifty (32.5%) of the "tumor-free" lymph nodes obtained from 36 (61%) patients displayed disseminated tumor cells. Multivariate survival analysis revealed that the presence of disseminated tumor cells in "tumor-free" lymph nodes is an independent prognostic factor for both a significantly reduced relapse-free survival (p = 0.03) and overall survival (p = 0.02). CONCLUSIONS: The frequent occurrence and prognostic impact of immunohistochemically identifiable disseminated tumor cells in lymph nodes of patients with operable pancreatic cancer supports the need for a refined staging system of excised lymph nodes, which should include immunohistochemical examination.
AB - BACKGROUND AND AIMS: Occurrence of tumor relapse is frequent in patients with pancreatic cancer despite the absence of residual tumor detectable at primary surgery and in histopathological examination. Therefore, it has to be assumed that current tumor staging procedures fail to identify minimal amounts of disseminated tumor cells, which might be precursors of subsequent metastatic relapse. The aim of this study was to assess the prognostic impact of minimal tumor cell spread detected in lymph nodes classified as "tumor-free" in routine histopathologic evaluation. MATERIALS AND METHODS: A total of 154 "tumor-free" lymph nodes from 59 patients with pancreatic cancer who underwent intentionally curative tumor resection were examined by immunohistochemistry for disseminated tumor cells. RESULTS: Fifty (32.5%) of the "tumor-free" lymph nodes obtained from 36 (61%) patients displayed disseminated tumor cells. Multivariate survival analysis revealed that the presence of disseminated tumor cells in "tumor-free" lymph nodes is an independent prognostic factor for both a significantly reduced relapse-free survival (p = 0.03) and overall survival (p = 0.02). CONCLUSIONS: The frequent occurrence and prognostic impact of immunohistochemically identifiable disseminated tumor cells in lymph nodes of patients with operable pancreatic cancer supports the need for a refined staging system of excised lymph nodes, which should include immunohistochemical examination.
M3 - SCORING: Zeitschriftenaufsatz
VL - 393
SP - 359
EP - 365
JO - LANGENBECK ARCH SURG
JF - LANGENBECK ARCH SURG
SN - 1435-2443
IS - 3
M1 - 3
ER -
