Prognostische Relevanz eines erweiterten postoperativen Tumorstagings mit Tumorzelldisseminationsnachweis im Knochenmark, Peritoneallavage und Lymphknoten beim Kolorektalen Karzinom - Ergebnisse einer prospektiven Studie

Autor:	Michael Vieth, M. Hantschick, Ralf Steinert, M. A. Reymond, F. Kühnel, Ingo Gastinger
Jazyk:	němčina
Rok vydání:	2005
Předmět:	medicine.medical_specialty Univariate analysis Colorectal cancer business.industry medicine.disease Gastroenterology Peritoneal cavity medicine.anatomical_structure ddc: 610 Tumor progression Internal medicine Cytology medicine Bone marrow Lymph business Lymph node
Zdroj:	122. Kongress der Deutschen Gesellschaft für Chirurgie; 20050405-20050408; München; DOC05dgch3814 /20050615/ Chirurgisches Forum 2005 ISBN: 3540248889
Popis:	Surgery is considered as curative treatment in colorectal cancer (CRC) when tumor can be completely removed. However, all patients can not be cured by surgery alone because of systemic disease at time of surgery. Current definition of local cancer disease is challenged by discovery of disseminated tumor cells into various body compartments using modern analytic tools. Methods: Epithelial cell dissemination was determined prospectively in 222 patients operated for colorectal tumor using immunohistochemistry (IHC) or cytology with anti-pan-cytokeratin (CK1 to 19) and Ber-EP4 anti-bodies. We investigated simultaneously the presence of epithelial cells in bone marrow, in the peritoneal cavity and in histologically negative lymph nodes. Prognostic significance was determined in relation to 140 clinical and pathology data, including established risk factors for tumor progression. Median follow-up time was 44,6 months (56,4 months in survived patients), and follow-up was 100%. Results: Out of 205 patients having undergone surgery for CRC, 67 (32.7%) died of colorectal cancer-related causes, 13 (6.3%) of other causes, 22 patients (10.7%) developed local recurrence. Presence of epithelial cells was detected in bone marrow in 135 of 205 (65.9%) of patients, and was not associated with tumor stage nor with poorer disease-free survival. Presence of metastatic cells in peritoneal cavity are detectable in 50 of 194 patients. They are associated with lymph node involvement (p
Databáze:	OpenAIRE
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