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    The impact of bone marrow micrometastases on metastatic disease-free survival in patients with colorectal carcinoma.

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    Authors
    O'Connor, O J
    Cahill, R A
    Kirwan, W O
    Redmond, H P
    Affiliation
    Department of Academic Surgery, Cork University Hospital, Wilton, Cork, Ireland.
    Issue Date
    2012-02-03T15:07:06Z
    MeSH
    Adult
    Aged
    Aged, 80 and over
    Antineoplastic Agents/therapeutic use
    Bone Marrow Examination
    Bone Marrow Neoplasms/pathology/*secondary
    Cohort Studies
    Colectomy
    Colorectal Neoplasms/*pathology/therapy
    Disease-Free Survival
    Female
    Humans
    Male
    Middle Aged
    Neoplasm Staging
    Predictive Value of Tests
    Survival Analysis
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    Citation
    Colorectal Dis. 2005 Jul;7(4):406-9.
    Journal
    Colorectal disease : the official journal of the Association of Coloproctology of, Great Britain and Ireland
    URI
    http://hdl.handle.net/10147/208908
    DOI
    10.1111/j.1463-1318.2005.00792.x
    PubMed ID
    15932568
    Abstract
    AIMS: The biological relevance of bone marrow micrometastases (BMM) in colorectal cancer remains unknown. Here, we investigate their nature by examining the impact of the presence of BMM on metastatic disease-free survival in a cohort of patients with this disease. METHODS: Sixty-three consecutive patients undergoing surgery for colorectal cancer of any stage were studied after approval of the study protocol by the local ethics committee and with full individual informed consent. All had bilateral iliac crest bone marrow aspirates prior to operation. Aspirates were then examined for the presence of aberrant cytokeratin-18-positive cells by a blinded observer using both flow cytometric and APAAP immunohistochemical techniques. RESULTS: Mean follow-up after surgery was 4.6 years (range 1.9-6.9) for those without hepatic metastases at diagnosis. Seven of 34 patients with Dukes' stage A or B developed metastatic disease after a mean interval of 4.7 years (range 3.8-6.8). However, only 2 of these patients demonstrated BMM at the time of surgery. Nine of 15 patients with Dukes' C carcinoma at the time of surgery subsequently developed metastases after a mean interval of 4.4 years (range 1.9-6.9). Again, only two of these patients had BMM detectable initially. In only three of the 14 patients known to have metastases at the time of operation (i.e. Dukes''D' disease) were BMM found. CONCLUSION: The presence of BMM as detected by this methodology was not predictive of tumour recurrence or metastasis. This study does not support the consideration of adjuvant therapy based on the presence of BMM at a single pre-operative time point in patients with colorectal cancer.
    Language
    eng
    ISSN
    1462-8910 (Print)
    1462-8910 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1463-1318.2005.00792.x
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    Cork University Hospital

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