48 - Preissitzung
Felix Largiadèr Preissitzung
16. Mai 2019, 10:15 - 11:45, Bellavista 3+4, 6. OG
Has molecular lymph node staging a prognostic value in patients with colon cancer? – The first follow-up study
S. Teixeira da Cunha1, B. Weixler2, F. G. Bader3, D. Cabalzar-Wondberg4, R. S. Croner5, N. Demartines6, C. I. Geppert7, U. Güller8, I. Langer9, X. Matias-Guiu10, U. Nitsche3, M. S. Reimers11, R. Rosenberg12, V. Smit11, C. Späth3, M. Stürzl7, J. Tarragona10, A. Vahrmeijer11, C. J. van de Velde11, C. T. Viehl13, R. Warschkow8, M. Worni9, A. Zettl14, M. Zuber1, Presenter: S. Teixeira da Cunha1 (1Olten, 2Berlin/DE, 3Munich/DE, 4Zurich, 5Magdeburg/DE, 6Lausanne, 7Erlangen/DE, 8St. Gallen, 9Bern, 10Leida/ES, 11Leiden/NL, 12Liestal, 13Biel, 14Basel)
Molecular lymph node (LN) work-up with one-step nucleic acid amplification (OSNA) is a validated diagnostic adjunct in breast cancer surgery. The technique is also appealing for colon cancer (CC) surgery since it is fast and standardized. Previous studies of our group show a high level of concordance between OSNA, conventional Hematoxylin-Eosin (HE), and immunohistochemistry techniques in CC patients. The here presented study – for the first time – evaluates the prognostic value of OSNA in CC patients.
This prospective follow-up study includes patients with stage I-III CC from 3 previously published cohort studies designed to evaluate the clinical performance of OSNA. The studies were carried out between January 2007 and December 2013. The LN of patients with CC were investigated for metastases with conventional HE, multilevel sectioning with HE and immunohistochemistry for CK19, and OSNA. The 3 involved centers used an identical study protocol. The patients’ follow-up data were collected from medical files and general practitioners until October 2017. To determine the loss of diagnostic information of HE and OSNA methods Akaike information criterion (AIC) was obtained. A 5-year CSS prediction model was developed for both methods using Receiver Operating Characteristic curves.
87 patients, stage I to III, were included. The mean follow-up time is 53.4 months (+/- 24.9). Disease recurrence occurred in 16.1% with a mean time to recurrence of 19.8 months (+/-12.3). The 5-year CSS is 97.7% in the OSNA negative group and 85.4% in the OSNA positive group. The 5-year cancer disease free survival is 69.1% in the OSNA negative group and 76.8% in the OSNA positive group. The multivariate analysis of CSS shows a HR of 1.04 (0.2-64.01 95% CI, p=0.983) for patients with OSNA positive LN compared to negative LN. HE and OSNA have an AIC of 65.6 and 68.3 respectively (p<0.001). Both methods combined have an AIC of 66.6 (p=0.323). The Area Under the Curve for 5-year CSS for HE and OSNA is 0.740 and 0.730 respectively.
The here presented study – for the first time – shows that OSNA does not provide better prognostic value in patients with non-metastatic CC than conventional HE. Despite its wide use in breast cancer surgery OSNA seems to have no prognostic value in patients with CC.