REVIEW

Nodal staging of colorectal carcinomas and sentinel nodes

G Cserni

Correspondence to:
Correspondence to:
Dr G Cserni, Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyiri ut 38, POB 149, Kecskemét, Hungary;
cserni{at}freemail.hu

This review surveys the staging systems used for the classification of colorectal carcinomas, including the TNM system, and focuses on the assessment of the nodal stage of the disease. It reviews the quantitative requirements for a regional metastatic work up, and some qualitative features of lymph nodes that may help in the selection of positive and negative lymph nodes. Identification of the sentinel lymph nodes (those lymph nodes that have direct drainage from the primary tumour site) is one such qualitative feature that is claimed to allow the upstaging of colorectal carcinomas via an oriented, enhanced pathological work up. Current evidence in favour of a change in the requisite of assessing as may lymph nodes as is possible, and concentrating the efforts on only a selected number of lymph nodes, is weak.

Keywords: colorectal cancer; micrometastasis; sentinel lymph nodes; staging; TNM

Abbreviations: CK-20, cytokeratin 20; CRC, colorectal carcinoma; LN, lymph node; RT-PCR, reverse transcription polymerase chain reaction; SN, sentinel lymph node; TME, total mesorectal excision

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