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Targeted lymph node examination improves staging of colon cancer

Examining more carefully the lymph nodes to which colorectal cancer is most likely to have spread may improve the accuracy of colon cancer staging and spare some patients the cost and toxicity of chemotherapy, according to a report in the June issue of Archives of Surgery, one of the JAMA/Archives journals.

Colon cancer is the second most common cause of cancer death in the United States, according to background information in the article. To determine the stage to which the cancer has progressed as well as assess treatment options, physicians surgically remove and examine cancer patients' lymph nodes. Patients whose cancer has spread to the lymph nodes have been shown to benefit from chemotherapy in addition to surgery, while those whose cancer has not spread to the lymph nodes (referred to as node negative) may not see any benefit to combination treatments over surgery alone. "One-third of patients with tumor-free lymph nodes have recurrences, and therefore, adjuvant [supplemental] chemotherapy may be beneficial in these patients," the authors write. "However, if all node-negative patients are treated, 70 percent will be subjected to unnecessary chemotherapy because surgery alone is curative. A better understanding of high-risk, node-negative patients and improved methods of lymph node evaluation are therefore needed."

Anton J. Bilchik, M.D., Ph.D., John Wayne Cancer Institute and Saint Johns Health Center, Santa Monica, Calif., and colleagues studied 132 patients (63 men and 69 women, median age of 74 years) with stage I and II colon cancer who were recruited from four referral cancer centers between March 2001 and June 2005. In a process known as lymphatic mapping, blue dye was injected near the site of each participant's tumor. The dye stained the sentinel (first) lymph nodes down the lymph channel, the pathway through which lymph--a fluid containing lymphocytes and the bacteria, cancer cells and other organisms they have attacked--drain
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Contact: Trace Longo
714-600-9811
JAMA and Archives Journals
19-Jun-2006


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