The prognostic effect of micrometastases in previously staged lymph node negative (N0) colorectal carcinoma: A meta-analysis
The prognostic effect of micrometastases in previously staged lymph node negative (N0) colorectal carcinoma: A meta-analysis
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DOI：
10.1245/s10434-006-9120-y
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发表时间：
2006-11-01
影响因子：
3.7
通讯作者：
Bilchik, Anton
中科院分区：
文献类型：
--
作者：
Iddings, Douglas;Ahmad, Aziz;Bilchik, Anton
Background: The prognostic relevance of lymphatic micrometastases in colorectal carcinoma is unclear. To determine the prognostic significance of micrometastases in colorectal cancer, a meta-analysis was performed on all studies, which reported 3-year disease-free survival (DFS) and overall survival (OS).Methods: Published studies selected for meta-analysis contained sufficient data from which to extrapolate estimates of 3-year DFS and/or OS. From 1991-2003, 25 studies re-examined NO lymph nodes by serial sectioning and immunohistochemical (IHC) staining or reverse transcriptase-polymerase chain reaction (RT-PCR) assay. Eight studies (566 patients) with IHC detected micrometastases and three (173 patients) with RT-PCR micrometastases were used to determine DFS and OS. Weighted estimates of 3-year survival were combined across studies within each group, and the combined survival estimates were compared across groups using a binomial test.Results: Micrometastases were identified in all IHC studies; upstaging, including N1, N1mi and N0((i+)), was achieved in 32% (179/566 patients). All RT-PCR studies identified micrometastases; upstaging to N0((mol+)) was achieved in 37% (64/173 patients). There was a statistically significant difference in 3-year OS between RT-PCR positive N0((mol+)) patients (77.8%) and those for whom micrometastases were not detected (96.6%) (P
