Document Detail

Occult tumor cells in lymph nodes as a predictor for tumor relapse in pancreatic adenocarcinoma.
MedLine Citation:
PMID:  17704938     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Occurrence of tumor relapse is frequent in patients with pancreatic cancer despite the absence of residual tumor detectable at primary surgery and in histopathological examination. Therefore, it has to be assumed that current tumor staging procedures fail to identify minimal amounts of disseminated tumor cells, which might be precursors of subsequent metastatic relapse. The aim of this study was to assess the prognostic impact of minimal tumor cell spread detected in lymph nodes classified as "tumor-free" in routine histopathologic evaluation. MATERIALS AND METHODS: A total of 154 "tumor-free" lymph nodes from 59 patients with pancreatic cancer who underwent intentionally curative tumor resection were examined by immunohistochemistry for disseminated tumor cells. RESULTS: Fifty (32.5%) of the "tumor-free" lymph nodes obtained from 36 (61%) patients displayed disseminated tumor cells. Multivariate survival analysis revealed that the presence of disseminated tumor cells in "tumor-free" lymph nodes is an independent prognostic factor for both a significantly reduced relapse-free survival (p = 0.03) and overall survival (p = 0.02). CONCLUSIONS: The frequent occurrence and prognostic impact of immunohistochemically identifiable disseminated tumor cells in lymph nodes of patients with operable pancreatic cancer supports the need for a refined staging system of excised lymph nodes, which should include immunohistochemical examination.
Peter Scheunemann; Nikolas H Stoecklein; Alexander Rehders; Minu Bidde; Sylvia Metz; Matthias Peiper; Claus F Eisenberger; Jan Schulte Am Esch; Wolfram T Knoefel; Stefan B Hosch
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Publication Detail:
Type:  Journal Article     Date:  2007-08-18
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie     Volume:  393     ISSN:  1435-2451     ISO Abbreviation:  Langenbecks Arch Surg     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-03-24     Completed Date:  2009-05-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  359-65     Citation Subset:  IM    
Department of General Surgery, Heinrich-Heine University, University Hospital Düsseldorf, Düsseldorf, Germany.
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MeSH Terms
Aged, 80 and over
Carcinoma, Pancreatic Ductal / mortality,  pathology*,  surgery
Disease-Free Survival
Kaplan-Meiers Estimate
Lymph Node Excision
Lymph Nodes / pathology
Middle Aged
Neoplasm Staging
Pancreatic Neoplasms / mortality,  pathology*,  surgery

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