The clinical significance of the existence of lymph node micrometastases i?n rectum cancers

Colorectal cancer is very common carcinoma. According to cancer statistics of the Heath Ministry in our country 2005, Colorectal Cancers are ranked as the sixth row with the ratios % 6.31 in females , %8.69 in males and the seventh row with the ratio of % 7.51 overall Turkey. Rectum Cancers form the part of one-third of the Colorectal Cancers.Due to Rectal Cancer, recurrence develops at about 30 % to 20 % of patients who undergoing curative surgery and had negative lymph node as histologically .Micrometastasis which are detected in lymph node has been associated with the local recurrence.In our study,the clinical significance of micrometastases detected by immunohistochemical methods was investigated in the lymph nodes of the patients with rectal cancer.May 1996 - December 2005 with a diagnosis of adenocarcinoma of the rectum that underwent LAR or Miles operations, the lymph nodes which were obtained from pathological specimens of hundred patients who underwent lymph nodes were stained with H&S and IHC dyes.Lymph node metastases in the 46 patients (LN +) and 54 patients without lymph node metastasis (LN-) were detected.15 out of 54 patients without lymph node metastasis (27.7%) micrometastases (MM +) was detected.In the lymph node of the remaining 39 patients had no micro-and makrometastaz (MM-).LN (-) patients with LN (+) patients and MM (+) patients with MM (-) patients were compared between the clinicopathological factors and survival.The mean follow-up perid of LN (-) and LN (+) between patients, histopathological diagnosis, local recurrence, distant metastasis, lymphatic and perineural invasion, 5-year survival and disease-free survival, overall survival, and overall 5-year disease-free survival have statistically been founded meaningful(p <0.05)Similar to the studies in this issue, the relation between the clinicopathological parameters, recurrence, metastasis and survival have not been founded when MM (-) patients compared with MM (+) patients.In our study, it has been shown that lymph nodes micrometastases have no clinical significance and micrometastases can be detected by IHC staining in patients without lymph node metastases.Micrometastaseses are said to be the harbinger of systemic disease in the long-term but The overall tendency is in the form that there is no clinical relevant. Therefore, It does not seem possible to decide on additional treatment to surgical treatment with current symptoms only by referring to the existence of micrometastases in the lymph nodes . To decide this, the number of studies, the lenght of follow-up and the number of patients are required to be increased.