Trial reportAnnals of surgery2010
Surgical quality and nodal ultrastaging is associated with long-term disease-free survival in early colorectal cancer: an analysis of 2 international multicenter prospective trials.
Trial report in Annals of surgery, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Brazilian Society of Surgical Oncology: Guidelines for the Lymphadenectomy in Colorectal Cancer.Journal of surgical oncology · 2025Guideline
- Prognostic Effect of Ultra-Staging Node-Negative Colon Cancer Without Adjuvant Chemotherapy: A Prospective National Cancer Institute-Sponsored Clinical Trial.Journal of the American College of Surgeons · 2015Trial
- Immunoprofiling for prognostic assessment of colon cancer: a novel complement to ultrastaging.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015Trial
- Improved lymph node harvest from resected colon cancer specimens did not cause upstaging from TNM stage II to III.World journal of surgery · 2011Trial
- The influence of micrometastases on prognosis and survival in stage I-II colon cancer patients: the Enroute⊕ Study.BMC surgery · 2011Trial
- A multistage drug delivery approach for colorectal primary tumors and lymph node metastases.Nature communications · 2025Article
- Open Versus Laparoscopic Oncological Resections for Colon Cancer: An Experience at an Average-Volume Center.Cureus · 2024Article
- Prognostic and predictive value of examined lymph node count in stage III colorectal cancer: a population based study.World journal of surgical oncology · 2024Article
- Proteasome inhibitors restore the STAT1 pathway and enhance the expression of MHC class I on human colon cancer cells.Journal of biomedical science · 2021Article
- Oncologic long-term outcomes of emergency versus elective resection for colorectal cancer.International journal of colorectal disease · 2019Observational
- Budget Impact Analysis of Molecular Lymph Node Staging Versus Conventional Histopathology Staging in Colorectal Carcinoma.Applied health economics and health policy · 2019Article
- A prospective trial of acute normovolemic hemodilution in patients undergoing primary cytoreductive surgery for advanced ovarian cancer.Gynecologic oncology · 2018Article
- Article
- Urgent surgery after emergency presentation for colorectal cancer has no impact on overall and disease-free survival: a propensity score analysis.BMC cancer · 2016Article
- Lymph Node Micrometastases are Associated with Worse Survival in Patients with Otherwise Node-Negative Hilar Cholangiocarcinoma.Annals of surgical oncology · 2015Article
- Intranodal Mapping Using Carbon Dye Results in More Accurate Lymph Node Staging in Colon Cancer Patients.World journal of surgery · 2015Article
- Blue dye injection does not induce dissemination of epithelial cells during SLN procedure in colon cancer patients.International journal of colorectal disease · 2014Article
- Short term results of complete (D3) vs. standard (D2) mesenteric excision in colon cancer shows improved outcome of complete mesenteric excision in patients with TNM stages I-II.Techniques in coloproctology · 2014Article
- Prognostic significance of histologically detected lymph node micrometastases of sizes between 0.2 and 2 mm in colorectal cancer.International journal of colorectal disease · 2013Article
- Differential expression of colon cancer associated transcript1 (CCAT1) along the colonic adenoma-carcinoma sequence.BMC cancer · 2013Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundThe National Quality Forum has endorsed a minimum of 12 lymph node (LN) as a surrogate measure of quality in colorectal cancer (CRC). The prognostic value of ultrastaging hematoxylin and eosin (H&E) negative LNs (N0) using pan-cytokeratin immunohistochemistry (pan-CK-IHC) is unknown. PURPOSE: To assess the effect on survival of surgical quality and focused pathologic analysis. PATIENTS AND
methodsBetween 2001 and 2007, 253 evaluable patients with resectable CRC were enrolled. Multiple sectioning and pan-CK-IHC were performed on N0 LNs (American Joint Commission on Cancer Stage II). Follow-up was performed at 6-month intervals with a 4-year disease-free survival (DFS) primary end-point.
resultsThere were 253 patients, 177 N0 and 76 N1/N2 patients, staged conventionally. Thirty-six (20%) N0 patients were upstaged using ultrastaging (N0-->N0i+ [n = 27] and N0-->N1mi [n = 9]). At a mean follow-up of 3.4 +/- 1.6 years, 38 (15%) have recurred. Only 3% (3/108) of patients with > or =12 LNs, negative by H&E and pan-CK-IHC (N0i-), compared with 18% (6/33) with <12 LNs/N0i- (6/33; P = 0.0015) have recurred. Four-year DFS differed significantly according to surgical quality (<12 vs. > or =12 LNs) among Stage II patients only (DFS, <12 vs. > or =12 LNs: Stage I, 90.5% vs. 97.7%, P = 0.22; Stage II, 67.5% vs. 94.7%, P = 0.0036; Stage III, 61% vs. 61%, P = 0.61).
conclusionThis represents the first prospective report demonstrating that both surgical quality and nodal ultrastaging impacts survival in Stage II CRC. Patients with Stage II CRC having > or =12 LNs negative for micrometastases (N0i-) are likely cured by surgery alone. Both surgical and pathologic quality measures are imperative in early CRC to improve patient selection for adjuvant chemotherapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.