Isolated tumour cells in pathological node-negative lymph nodes (pn0) adversely affect prognosis in cancer of the oesophagus or oesophago-gastric junction

Abstract

Objectives: The aim of this study was to both determine the prevalence of isolated tumour cells (ITC) in lymph nodes of patients with pN0 tumours and to assess their impact on disease-free and overall survival. Methods: Paraffin embedded lymph nodes from oesophagogastrectomy specimens were examined immunohistochemically using monoclonal anti-cytokeratin antibody (MNF118). Clinical and pathological features were summarised and overall and relapse-free survival were estimated. Results: Isolated tumour cells were detected in 12 of 146 patients (8%), and 24 of 1,694 (1%) lymph nodes. With a median follow-up time of 28 months (range 0 to 160 months), both relapse free and overall survival were significantly (p<0.05) associated with the presence of isolated tumour cells in pN0 lymph nodes. There was no significant difference in the prevalence of ITC between patients who underwent multimodal therapy and those treated with surgery alone. Conclusions: Isolated tumour cells in pN0 lymph nodes may be less frequent than previously considered, but their presence is associated with poorer outcomes compared with true node negative disease.