FCCC LOGO Faculty Publications
Hyslop T , Weinberg DS , Schulz S , Barkun A , Waldman SA
Analytic lymph node number establishes staging accuracy by occult tumor burden in colorectal cancer
J Surg Oncol. 2012 Jul 1;106(1) :24-30
PMID: 22252429    PMCID: PMC3370134    URL: https://www.ncbi.nlm.nih.gov/pubmed/22252429
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Abstract
BACKGROUND AND OBJECTIVES: Recurrence in lymph node-negative (pN0) colorectal cancer suggests the presence of undetected occult metastases. Occult tumor burden in nodes estimated by GUCY2C RT-qPCR predicts risk of disease recurrence. This study explored the impact of the number of nodes analyzed by RT-qPCR (analytic) on the prognostic utility of occult tumor burden. METHODS: Lymph nodes (range: 2-159) from 282 prospectively enrolled pN0 colorectal cancer patients, followed for a median of 24 months (range: 2-63), were analyzed by GUCY2C RT-qPCR. Prognostic risk categorization defined using occult tumor burden was the primary outcome measure. Association of prognostic variables and risk category were defined by multivariable polytomous and semi-parametric polytomous logistic regression. RESULTS: Occult tumor burden stratified this pN0 cohort into categories of low (60%; recurrence rate (RR) = 2.3% [95% CI 0.1-4.5%]), intermediate (31%; RR = 33.3% [23.7-44.1%]), and high (9%; RR = 68.0% [46.5-85.1%], P < 0.001) risk of recurrence. Beyond race and T stage, the number of analytic nodes was an independent marker of risk category (P < 0.001). When >12 nodes were analyzed, occult tumor burden almost completely resolved prognostic risk classification of pN0 patients. CONCLUSIONS: The prognostic utility of occult tumor burden assessed by GUCY2C RT-qPCR is dependent on the number of analytic lymph nodes.
Notes
Hyslop, Terry Weinberg, David S Schulz, Stephanie Barkun, Alan Waldman, Scott A eng R21 CA112147/CA/NCI NIH HHS/ CA75123/CA/NCI NIH HHS/ R01 CA095026-02/CA/NCI NIH HHS/ R01 CA095026-04S1/CA/NCI NIH HHS/ R01 CA075123-04/CA/NCI NIH HHS/ R01 CA075123-07/CA/NCI NIH HHS/ R01 CA095026-03/CA/NCI NIH HHS/ R01 CA095026-01A2/CA/NCI NIH HHS/ R01 CA095026-04/CA/NCI NIH HHS/ R01 CA095026/CA/NCI NIH HHS/ CA95026/CA/NCI NIH HHS/ RC1 CA146033-02/CA/NCI NIH HHS/ R01 CA075123-06/CA/NCI NIH HHS/ R01 CA095026-06/CA/NCI NIH HHS/ CA112147/CA/NCI NIH HHS/ R01 CA075123-02/CA/NCI NIH HHS/ CA146033/CA/NCI NIH HHS/ R01 CA095026-05S1/CA/NCI NIH HHS/ R01 CA075123-03A1/CA/NCI NIH HHS/ R01 CA075123-05/CA/NCI NIH HHS/ R01 CA095026-05/CA/NCI NIH HHS/ R01 CA075123/CA/NCI NIH HHS/ R33 CA112147/CA/NCI NIH HHS/ RC1 CA146033/CA/NCI NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't J Surg Oncol. 2012 Jul 1;106(1):24-30. doi: 10.1002/jso.23051. Epub 2012 Jan 17.