Molecular Lymph Node Staging with One‐Step Nucleic Acid Amplification and its Prognostic Value for Patients with Colon Cancer: The First Follow‐up Study

World Journal of Surgery, vol. 45, pp. 1526–1536

Abstract

BACKGROUND: Molecular lymph node workup with one-step nucleic acid amplification (OSNA) is a validated diagnostic adjunct in breast cancer and also appealing for colon cancer (CC) staging. This study, for the first time, evaluates the prognostic value of OSNA in CC. PATIENTS AND METHODS: The retrospective study includes patients with stage I-III CC from three centres. Lymph nodes were investigated with haematoxylin and eosin (H&E) and with OSNA, applying a 250 copies/μL threshold of CK19 mRNA. Diagnostic value of H&E and OSNA was assessed by survival analysis, sensitivity, specificity and time-dependent receiver operating characteristic curves. RESULTS: Eighty-seven patients were included [mean follow-up 53.4 months (± 24.9)]. Disease recurrence occurred in 16.1% after 19.8 months (± 12.3). Staging with H&E independently predicted worse cancer-specific survival in multivariate analysis (HR = 10.77, 95% CI 1.07-108.7, p = 0.019) but not OSNA (HR = 3.08, 95% CI 0.26-36.07, p = 0.197). With cancer-specific death or recurrence as gold standard, H&E sensitivity was 46.7% (95% CI 21.3-73.4%) and specificity 84.7% (95% CI 74.3-92.1%). OSNA sensitivity and specificity were 60.0% (95% CI 32.3-83.7%) and 75.0% (95% CI 63.4-84.5%), respectively. CONCLUSIONS: In patients with CC, OSNA does not add relevant prognostic value to conventional H&E contrasting findings in other cancers. Further studies should assess lower thresholds for OSNA (< 250 copies/μL).

Authors 10

1. Benjamin Weixler Aachen Department of Surgery Leiden University Medical Centre Leiden The Netherlands Department of Surgery, Leiden University Medical Centre

   Leiden University · Leiden University Medical Center · Charité - Universitätsmedizin Berlin

   Affiliation as printed

   Department of General, Visceral and Vascular Surgery Charité University Hospital Campus Benjamin Franklin Berlin Germany

   Department of Surgery Leiden University Medical Centre Leiden The Netherlands

   Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

2. Sofia Teixeira da Cunha
   Affiliation as printed

   Department of Surgery Cantonal Hospital Olten Olten Switzerland

   Department of Surgery, Cantonal Hospital Olten, Olten, Switzerland

3. René Warschkow

   Kantonsspital St. Gallen

   Affiliation as printed

   Department of Surgery Cantonal Hospital St. Gallen St. Gallen Switzerland

   Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland

4. Nicolas Demartines

   Centre Hospitalier Universitaire Vaudois

   Affiliation as printed

   Department of Surgery Vaudois University Hospital Centre Lausanne Switzerland

   Department of Surgery, Vaudois University Hospital Centre, Lausanne, Switzerland

5. Ulrich Güller

   Spital STS

   Affiliation as printed

   Department of Oncology Spital STS AG Thun Switzerland

   Department of Oncology, Spital STS AG, Thun, Switzerland

6. Andreas Zettl
   Affiliation as printed

   Department of Pathology Viollier AG Basel Switzerland

   Department of Pathology, Viollier AG, Basel, Switzerland

7. Alexander L. Vahrmeijer Aachen Department of Surgery Leiden University Medical Centre Leiden The Netherlands Department of Surgery, Leiden University Medical Centre

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Surgery Leiden University Medical Centre Leiden The Netherlands

   Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

8. Cornelis J.�H. van de Velde Aachen Department of Surgery Leiden University Medical Centre Leiden The Netherlands Department of Surgery, Leiden University Medical Centre

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Surgery Leiden University Medical Centre Leiden The Netherlands

   Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

9. Carsten Thomas Viehl

   Spitalzentrum Centre hospitalier Biel- Bienne

   Affiliation as printed

   Department of Surgery Hospital Centre Biel Biel Switzerland

   Department of Surgery, Hospital Centre Biel, Biel, Switzerland

10. Markus Zuber corresponding

    University of Basel · University Hospital of Basel · St. Claraspital

    Affiliation as printed

    Department of Surgery Cantonal Hospital Olten Olten Switzerland

    Visceral Surgery Centre Clarunis, St. Clara Hospital and University Hospital Basel University of Basel Spitalstrasse 21 CH‐4031 Basel Switzerland

    Visceral Surgery Centre Clarunis, St. Clara Hospital and University Hospital Basel, University of Basel, Spitalstrasse 21, CH-4031, Basel, Switzerland