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dc.contributor.authorO'Connor, O J*
dc.contributor.authorCahill, R A*
dc.contributor.authorKirwan, W O*
dc.contributor.authorRedmond, H P*
dc.date.accessioned2012-02-03T15:07:06Z
dc.date.available2012-02-03T15:07:06Z
dc.date.issued2012-02-03T15:07:06Z
dc.identifier.citationColorectal Dis. 2005 Jul;7(4):406-9.en_GB
dc.identifier.issn1462-8910 (Print)en_GB
dc.identifier.issn1462-8910 (Linking)en_GB
dc.identifier.pmid15932568en_GB
dc.identifier.doi10.1111/j.1463-1318.2005.00792.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/208908
dc.description.abstractAIMS: 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.
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAntineoplastic Agents/therapeutic useen_GB
dc.subject.meshBone Marrow Examinationen_GB
dc.subject.meshBone Marrow Neoplasms/pathology/*secondaryen_GB
dc.subject.meshCohort Studiesen_GB
dc.subject.meshColectomyen_GB
dc.subject.meshColorectal Neoplasms/*pathology/therapyen_GB
dc.subject.meshDisease-Free Survivalen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshNeoplasm Stagingen_GB
dc.subject.meshPredictive Value of Testsen_GB
dc.subject.meshSurvival Analysisen_GB
dc.titleThe impact of bone marrow micrometastases on metastatic disease-free survival in patients with colorectal carcinoma.en_GB
dc.contributor.departmentDepartment of Academic Surgery, Cork University Hospital, Wilton, Cork, Ireland.en_GB
dc.identifier.journalColorectal disease : the official journal of the Association of Coloproctology of, Great Britain and Irelanden_GB
dc.description.provinceMunster
html.description.abstractAIMS: 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.


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