Prognostic Implications of Sentinel Lymph Node Mapping in Stage I and II Colorectal Cancer Patients

The aim of the study was to identify lymph node micrometastases in order to demonstrate the prognosis of colorectal cancer patients staged I and II undergoing curative surgery. We conducted a prospective study on a total of 44 patients with stage I-III colorectal cancer, undergoing radical surgery at the Fifth Department of Surgery of Cluj-Napoca Municipal Clinical Hospital between September 2012 and January 2015. For the identification of micrometastases we used the sentinel lymph node mapping by two techniques, in vivo and ex vivo. In N0 patients we conducted an immunohistochemical study to identify micrometastases. Patients were followed 3 years after surgery to identify possible relapses. The mean age was 63 years, 24 patients were males and 20 (45.5%) women. Ten patients (12.8%) had stage I cancer, 12 patients (27.3%) had stage II cancer, and 22 had stage III cancer. Sentinel lymph node detection rate was similar for the in vivo technique and for the ex vivo technique. The percentage for the detection of micrometastases was 25% in vivo and 33.3% ex vivo. The 3-year postoperative recurrence rate was 25% in overstaged patients. The presence of micrometastases should be considered as a negative prognostic factor in patients with stage I and II colorectal cancer.