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The Prognostic Relevance of Sentinel Lymph Node Metastases Assessed by PHGR1 mRNA Quantification in Stage I to III Colon Cancer.

The Prognostic Relevance of Sentinel Lymph Node Metastases Assessed by PHGR1 mRNA Quantification in Stage I to III Colon Cancer.
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Oltedal S, Kørner H, Aasprong OG, Hussain I, Tjensvoll K, Smaaland R, Søreide JA, Søreide K, Lothe RA, Heikkilä R, Gilje B, Nordgård O,


Oltedal S, Kørner H, Aasprong OG, Hussain I, Tjensvoll K, Smaaland R, Søreide JA, Søreide K, Lothe RA, Heikkilä R, Gilje B, Nordgård O, (click to view)

Oltedal S, Kørner H, Aasprong OG, Hussain I, Tjensvoll K, Smaaland R, Søreide JA, Søreide K, Lothe RA, Heikkilä R, Gilje B, Nordgård O,

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Translational oncology 2018 02 2011(2) 436-443 pii 10.1016/j.tranon.2018.01.015

Abstract
BACKGROUND
Regional lymph node (LN) metastasis is a strong and well-established prognostic factor in colon cancer, and recent data suggest a prognostic value of detecting micrometastases and isolated tumor cells in regional LNs. The aim of the study was to investigate the clinical relevance of detecting sentinel lymph node (SLN) metastases in colon cancer patients by measuring the novel metastasis marker PHGR1 mRNA.

METHODS
Using quantitative reverse-transcription polymerase chain reaction, we measured PHGR1 mRNA levels in SLNs and primary tumors from 206 patients surgically treated for stage I to III colon cancer and 52 normal LNs from patients undergoing surgery for benign colon diseases. The prognostic impact of these findings was evaluated by Kaplan-Meier analysis and Cox proportional-hazards regression.

RESULTS
Compared to normal LNs, elevated PHGR1 mRNA levels were detected in SLNs from 56 (89%) of the 63 patients with pN+ disease. Furthermore, 68 (48%) of the 143 node-negative (pN0) patients had elevated PHGR1 mRNA levels in SLNs, suggesting occult metastases. With a median follow-up of 7.2 years, a significantly shorter recurrence-free (P=.005) and disease-specific (P=.02) survival was observed in patients with elevated PHGR1 mRNA levels in SLNs. Multivariable modeling showed that the SLN PHGR1 mRNA level was an independent prognostic factor. However, when the survival analyses were restricted to pN0 patients, no significant prognostic information was found.

CONCLUSION
Measuring PHGR1 mRNA in SLNs provided independent prognostic information on operable colon cancer patients but not in the pN0 subgroup.

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