The impact of bone marrow micrometastases on metastatic disease-free survival in patients with colorectal carcinoma.
Affiliation
Department of Academic Surgery, Cork University Hospital, Wilton, Cork, Ireland.Issue Date
2012-02-03T15:07:06ZMeSH
AdultAged
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
Metadata
Show full item recordCitation
Colorectal Dis. 2005 Jul;7(4):406-9.Journal
Colorectal disease : the official journal of the Association of Coloproctology of, Great Britain and IrelandDOI
10.1111/j.1463-1318.2005.00792.xPubMed ID
15932568Abstract
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
engISSN
1462-8910 (Print)1462-8910 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1111/j.1463-1318.2005.00792.x