Originally published as JCO Early Release 10.1200/JCO.2005.03.6038 on January 17 2006

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Analysis of Micrometastatic Disease in Sentinel Lymph Nodes From Resectable Colon Cancer: Results of Cancer and Leukemia Group B Trial 80001

From the Brigham and Women's Hospital; Dana-Farber Cancer Institute, Boston, MA; University of Missouri/Ellis Fischel Cancer Center, Columbia; Washington University Medical Center, St Louis, MO; Cancer and Leukemia Group B Statistical Center, Duke University, Durham, NC; Ohio State University, Columbus, OH; State University of New York Upstate Medical University and Veteran's Administration Medical Center, Syracuse, NY; and McGill University, Montreal, Quebec, Canada

Address reprint requests to Monica M. Bertagnolli, MD, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115; e-mail: mbertagnolli{at}partners.org

PURPOSE: To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer.

PATIENTS AND METHODS: Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1% isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti–carcinoembryonic antigen and anticytokeratin antibodies.

RESULTS: Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54%) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%).

CONCLUSION: By examining both SNs and non-SNs, this multi-institutional study showed that SNs did not accurately predict the presence of either conventionally defined nodal metastases or MMD. As a result, SLNS is not a useful technique for the study of MMD in patients with colon cancer.

Supported in part by Grant No. CA31946 from the National Cancer Institute to the Cancer and Leukemia Group B (CALGB) and Grant No. CA59594 to the CALGB Surgery Committee.

Presented at the 40th Annual Meeting of the American Society of Clinical Oncology, New Orleans, LA, June 5-8, 2004.

The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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