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Eur J Surg Oncol. 2014 Jun;40(6):747-55. doi: 10.1016/j.ejso.2013.10.003. Epub 2013 Oct 23.

Excellent prognosis of node negative patients after sentinel node procedure in colon carcinoma: a 5-year follow-up study.

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Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address:
Department of Surgery, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
Department of Surgery, VU Medical Centre, P.O. Box 7075, 1007 MB Amsterdam, The Netherlands.
Department of Surgery, Isala Klinieken, Locatie Sophia, Dokter van Heesweg 2, P.O. Box 10400, 8000 GK Zwolle, The Netherlands.
Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.



Investigate the prognostic impact and clinical relevance of the sentinel node (SN)-procedure in colon carcinoma.


Between May 2002 and January 2004, the SN-procedure was performed in 55 patients that underwent elective resection for clinically non-advanced colon carcinoma. A control group of 110 patients was identified from a cohort between January 2000 and April 2002. All lymph nodes were analysed by conventional haematoxylin-eosin staining. All negative SNs underwent in-depth analysis using immunohistochemical-staining and automated microscopy with the Ariol-system. Patients with positive lymph nodes were offered adjuvant chemotherapy. All patients were routinely monitored at 6-month intervals and follow-up was more than 5 years.


The SN was successfully identified in 98% of the patients, with 94% sensitivity. In-depth analysis with immunohistochemistry and automated microscopy (Ariol-system) upstaged 3 and 4 patients respectively. When only node-negative patients were analysed, overall 5-year-survival was significantly better in the SN group (91% vs. 76%, p = 0.04). Cancer-specific-mortality was even 0% (vs. 8%, p = 0.08). Disease-free-survival was significantly improved to 96% (vs. 77%, p < 0.01).


This study describes the prognostic impact of the SN-procedure in colon carcinoma after 5-year-follow-up. Only one patient had recurrent disease after a negative SN procedure (disease-free-survival 96%). These results indicate that the SN-procedure is of prognostic relevance and might be useful to select patients for adjuvant chemotherapy. Patients that are lymph node negative after an SN-procedure have an excellent prognosis and do not need adjuvant treatment.


Colonic neoplasms; Colorectal neoplasms; Follow-up studies; Lymphatic metastasis; Neoplasm staging; Sentinel lymph node biopsy

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