The interval between surgery and adjuvant chemotherapy (AC) is a predictive factor of survival in high-risk colon cancer (CC). This study aimed to evaluate the impact of intraoperative sentinel lymph node (SLN) analysis using the one-step nucleic acid amplification (OSNA) technique on the time interval between surgery and AC.
We performed a prospective study analyzing 56 consecutive patients who had surgery for CC between July 2012 and October 2014, including 20 patients needing AC. SLN status was determined intraoperatively in 17 patients in the OSNA group; when positive, a portacath (PAC) was placed during the procedure for upcoming AC. In the remaining patients, we proceeded without SLN status determination and the PAC was installed after definitive histopathological analysis of the specimen if needed.
There was no difference between the groups regarding cancer staging, duration of hospitalization (7.5 days in the OSNA group and 10 days in the control group, p = 0.43) and major complications (20% vs 30% respectively, p = 0.55). The time interval between surgery and adjuvant chemotherapy was significantly shorter in the OSNA group at 35 (±8) days vs 67 (±36) days (p = 0.021).
SLN status determination by the OSNA technique is safe, feasible and could significantly reduce time between surgery and adjuvant chemotherapy in a pilot study.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Digestive and Liver Disease
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Global cancer statistics.CA Cancer J Clin. 2011; 61: 69-90
- Adjuvant therapy for patients with colon and rectal cancer.JAMA. 1990; 264: 1444-1450
- Cancer du côlon.Thésaurus National de Cancérologie Digestive. 2016
- New therapeutic opportunities based on DNA mismatch repair and BRAF status in metastatic colo central venous access device (CVAD) Cancer.Curr Oncol Rep. 2016; 18: 18
- Colorectal cancer.Lancet. 2014; 383: 1490-1502
- Factors implicated for delay of adjuvant chemotherapy in colorectal cancer: a meta-analysis of observational studies.Ann Surg Oncol. 2015; 22: 3793-3802
- Etiology of delays in the initiation of adjuvant chemotherapy and their impact on outcomes for stage II and III rectal cancer.Dis Colon Rectum. 2009; 52: 1054-1063
- A randomised comparison between 6 months of bolus fluorouracil/leucovorin and 12 weeks of protacted venous infusion fluorouracil as adjuvant treatment in colorectal cancer.Ann Oncol. 2005; 16: 549-557
- Nordic Gastrointestinal Tumour Adjuvant Therapy Group. Adjuvant chemotherapy in colorectal cancer: a joint analysis of randomised trials by the Nordic Gastrointestinal Tumour Adjuvant Therapy Group.Acta Oncol. 2005; 44: 904-912
- Optimal time of initiating adjuvant chemotherapy after curative surgery in colorectal cancer patients.Ann Coloproctol. 2013; 29: 150-154
- Timing of adjuvant chemotherapy and its relation to survival among patients with stage III colon cancer.Eur J Cancer. 2015; 51: 2553-2561
- Association between time to initiation of adjuvant chemotherapy and survival in colorectal cancer: a systematic review and meta-analysis.JAMA. 2011; 305: 2335-2342
- PRODIGE 34-FFCD 1402-ADAGE: adjuvant chemotherapy in elderly patients with resected stage III colon cancer: a randomized phase 3 trial.Dig Liver Dis. 2016; 48: 206-207
- The diagnostic value of one-step nucleic acid amplification (OSNA) for sentinel lymph nodes in colon cancer patients.Ann Surg Oncol. 2014; 21: 3924-3930
- Breast cancer metastasis burden in sentinel nodes analysed using one-step nucleic acid amplification predicts axillary nodal status.Breast. 2015; 24: 568-575
- OSNA-based novel molecular testing for lymph node metastases in colorectal cancer patients: results from a multicenter clinical performance study in Japan.Ann Surg Oncol. 2011; 18: 1891-1898
- One step nucleic acid amplification (OSNA)—a new method for lymph node staging in colorectal carcinomas.J Transl Med. 2010 Sep; 6: 83
- Molecular investigation of lymph nodes in colon cancer patients using one-step nucleic acid amplification (OSNA): a new road to better staging?.Cancer. 2012; 118: 6039-6045
- Adjuvant 5FU plus levamisole in colonic or rectal cancer: improved survival in stage II and III.Br J Cancer. 2001; 85: 1437-1443
- Intergroup study of fluorouracil plus levamisole as adjuvant therapy for stage II/Dukes’ B2 colon cancer.J Clin Oncol. 1995; 13: 2936-2943
- All nine hospitals in the Leiden region of the comprehensive cancer centre The Netherlands. Complicated postoperative recovery increases omission, delay and discontinuation of adjuvant chemotherapy in patients with Stage III colon cancer.Colorectal Dis. 2013; 15: e582-e591
- he impact of anastomotic leak and its treatment on cancer recurrence and survival following elective colorectal cancer resection.World J Surg. 2015; 39: 1052-1058
- Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis.Ann Surg. 2011; 253: 890-899
- Anastomotic leak increases distant recurrence and long-term mortality after curative resection for colonic cancer: a nationwide cohort study.Ann Surg. 2014; 259: 930-938
- Distinct mechanisms of immunosuppression as a consequence of major surgery.Infect Immun. 1997; 65: 2283-2291
- Presence of a growth-stimulating factor in serum following primary tumor removal in mice.Cancer Res. 1989; 49: 1996-2001
- Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer.J Clin Oncol. 2011; 29: 1465-1471
- Groupe Coopérateur Multidisciplinaire en Oncologie, the Fédération Francophone de la Cancérologie Digestive, and the UNICANCER Investigators of the PRODIGE Intergroup. Feasibility of Capecitabine and Oxaliplatin Combination Chemotherapy Without Central Venous Access Device in Patients With Stage III Colorectal Cancer.Clin Colorectal Cancer. 2016; 15: 250-256
Published online: May 30, 2017
Accepted: May 17, 2017
Received in revised form: May 1, 2017
Received: February 16, 2017
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.