ARE LYMPH-NODE MICROMETASTASES OF ANY CLINICAL-SIGNIFICANCE IN DUKES STAGE-A AND STAGE-B COLORECTAL-CANCER

PURPOSE: The aim was to investigate the significance of lymph node mic rometastases in Dukes Stages A and B colorectal cancer. METHODS: Archi val specimens were examined from 147 patients (96 colon, 51 rectum; 44 Stage A, 103 Stage B) who had surgery between 1987 and 1994. One lymp h node section from each node (colon, 1-11; median, 4; rectum, 1-15; m edian, 3) was examined with use of an anticytokeratin antibody. RESULT S: Forty-seven (32 per cent) patients had micrometastases. At follow-u p in June 1996, 23 patients had died of cancer or with known tumor rel apse. after a median time of 28 (range, 5-67) months; 8 of 47 (17 perc ent) patients had micrometastases, 15 of 100 (15 percent) did not. No statistically significant differences were observed according to micro metastases when the results were analyzed with respect to Dukes stage or survival time. The median survival time of living patients with mic rometastases was 48 (range, 18-97) months, and for patients without mi crometastases. 48 (range; 19-111) months. Six of 36 Living patients ha d a tumor relapse; three of these displayed micrometastases. CONCLUSIO N: Lymph node micrometastases are not a useful prognostic marker in Du kes Stages A and B and do not imply different strategies for additiona l therapy or follow-up.