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1Oncological and General Surgery Unit, St. Giuseppe Moscati Hospital of National Relevance and High Specialty, Avellino, Italy
2General and Emergency Surgery Unit, Civico Benfratelli Di Cristina Hospital, Palermo, Italy
3Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
4Institute of Pathology, St. Giuseppe Moscati Hospital of National Relevance and High Specialty, Avellino, Italy
Copyright © 2019 The Korean Society of Coloproctology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
Characteristic | All patients (n = 34) | OSNA (−) (n = 25) | OSNA (+) (n = 9) | P-value |
---|---|---|---|---|
Age (yr) | 69.3 ± 11.8 | 71 ± 9.9 | 64.6 ± 15.8 | 0.82 |
Male sex | 21 (61.8) | 16 (64.0) | 5 (55.6) | 0.70 |
Body mass index (kg/m2) | 24.8 ± 2.7 | 25.1 ± 2.3 | 23.9 ± 3.4 | 0.33 |
Tumor location | ||||
Right colon | 10 (29.4) | 6 (24.0) | 4 (44.4) | 0.39 |
Left colon | 11 (32.4) | 8 (32.0) | 3 (33.3) | 1.00 |
Rectum | 13 (38.2) | 11 (44.0) | 2 (22.2) | 0.42 |
Neoadjuvant chemotherapy | 2 (5.9) | 0 (0) | 2 (22.2) | 0.06 |
Surgical approach | ||||
Open | 26 (76.5) | 17 (68.0) | 9 (100) | 0.07 |
Laparoscopic | 8 (23.5) | 8 (32.0) | 0 (0) | |
Stadiation | ||||
pT stage | ||||
pT1–pT2 | 9 (26.5) | 9 (36.0) | 0 (0) | 0.07 |
pT3–pT4 | 25 (73.5) | 16 (64.0) | 9 (100) | 0.07 |
pN stage | ||||
Negative | 21 (61.8) | 21 (84.0) | 0 (0) | 0.00* |
Positive | 13 (38.2) | 4 (16.0) | 9 (100) | |
Sentinel lymph node number examined | 1.5 ± 0.6 | 1.5 ± 0.7 | 1.3 ± 0.5 | 0.31 |
Total lymph node number | 19.9 ± 11.1 | 18.2 ± 10.2 | 24.7 ± 12.9 | 0.19 |
Metastatic lymph node number | 1.38 ± 3.5 | 0.16 ± 0.3 | 4.8 ± 5.8 | 0.04* |
>3 Metastatic lymph nodes | 3 (8.8) | 0 (0) | 3 (33.3) | 0.01* |
Lymph node level (JSCCR) | ||||
1 | 12 (35.2) | 7 (28.0) | 5 (55.6) | 0.22 |
2 | 11 (32.4) | 8 (32.0) | 3 (33.3) | 1.00 |
3 | 11 (32.4) | 10 (40.0) | 1 (11.1) | 0.21 |
M1 | 2 (5.9) | 0 (0) | 2 (22.2) | 0.06 |
Histological grade | ||||
G1 (well differentiated) | 1 (2.9) | 1 (4.0) | 0 (0) | 1.00 |
G2 (moderate differentiated) | 28 (82.4) | 23 (92.0) | 5 (55.6) | 0.03* |
G3 (poorly differentiated) | 5 (14.7) | 1 (4.0) | 4 (44.4) | 0.01* |
Stage | ||||
I | 7 (20.6) | 7 (28.0) | 0 (0) | 0.15 |
II | 14 (41.2) | 14 (56.0) | 0 (0) | 0.00* |
III | 11 (32.4) | 4 (16.0) | 7 (77.8) | 0.00* |
IV | 2 (5.9) | 0 (0) | 2 (22.2) | 0.06 |
Adjuvant chemotherapy | 12 (35.3) | 4 (16.0) | 8 (88.9) | 0.00* |
Time to start adjuvant chemotherapy (day) | 42.8 ± 6.1 | 50.2 ± 4.1 | 39.1± 1.9 | 0.01* |
OSNA | Histology (+) | Histology (−) | Total |
---|---|---|---|
(+) | 9 | 0 | 9 |
(−) | 0 | 8 | 8 |
Total | 9 | 8 | 17 |
H&E | Histology (+) | Histology (−) | Total |
---|---|---|---|
(+) | 5 | 0 | 5 |
(−) | 4 | 8 | 12 |
Total | 9 | 8 | 17 |
OSNA | Histology (+) | Histology (−) | Total |
---|---|---|---|
(+) | 9 | 0 | 9 |
(−) | 4 | 21 | 25 |
Total | 13 | 21 | 34 |
Characteristic | All patients (n = 34) | OSNA (−) (n = 25) | OSNA (+) (n = 9) | P-value |
---|---|---|---|---|
Age (yr) | 69.3 ± 11.8 | 71 ± 9.9 | 64.6 ± 15.8 | 0.82 |
Male sex | 21 (61.8) | 16 (64.0) | 5 (55.6) | 0.70 |
Body mass index (kg/m2) | 24.8 ± 2.7 | 25.1 ± 2.3 | 23.9 ± 3.4 | 0.33 |
Tumor location | ||||
Right colon | 10 (29.4) | 6 (24.0) | 4 (44.4) | 0.39 |
Left colon | 11 (32.4) | 8 (32.0) | 3 (33.3) | 1.00 |
Rectum | 13 (38.2) | 11 (44.0) | 2 (22.2) | 0.42 |
Neoadjuvant chemotherapy | 2 (5.9) | 0 (0) | 2 (22.2) | 0.06 |
Surgical approach | ||||
Open | 26 (76.5) | 17 (68.0) | 9 (100) | 0.07 |
Laparoscopic | 8 (23.5) | 8 (32.0) | 0 (0) | |
Stadiation | ||||
pT stage | ||||
pT1–pT2 | 9 (26.5) | 9 (36.0) | 0 (0) | 0.07 |
pT3–pT4 | 25 (73.5) | 16 (64.0) | 9 (100) | 0.07 |
pN stage | ||||
Negative | 21 (61.8) | 21 (84.0) | 0 (0) | 0.00 |
Positive | 13 (38.2) | 4 (16.0) | 9 (100) | |
Sentinel lymph node number examined | 1.5 ± 0.6 | 1.5 ± 0.7 | 1.3 ± 0.5 | 0.31 |
Total lymph node number | 19.9 ± 11.1 | 18.2 ± 10.2 | 24.7 ± 12.9 | 0.19 |
Metastatic lymph node number | 1.38 ± 3.5 | 0.16 ± 0.3 | 4.8 ± 5.8 | 0.04 |
>3 Metastatic lymph nodes | 3 (8.8) | 0 (0) | 3 (33.3) | 0.01 |
Lymph node level (JSCCR) | ||||
1 | 12 (35.2) | 7 (28.0) | 5 (55.6) | 0.22 |
2 | 11 (32.4) | 8 (32.0) | 3 (33.3) | 1.00 |
3 | 11 (32.4) | 10 (40.0) | 1 (11.1) | 0.21 |
M1 | 2 (5.9) | 0 (0) | 2 (22.2) | 0.06 |
Histological grade | ||||
G1 (well differentiated) | 1 (2.9) | 1 (4.0) | 0 (0) | 1.00 |
G2 (moderate differentiated) | 28 (82.4) | 23 (92.0) | 5 (55.6) | 0.03 |
G3 (poorly differentiated) | 5 (14.7) | 1 (4.0) | 4 (44.4) | 0.01 |
Stage | ||||
I | 7 (20.6) | 7 (28.0) | 0 (0) | 0.15 |
II | 14 (41.2) | 14 (56.0) | 0 (0) | 0.00 |
III | 11 (32.4) | 4 (16.0) | 7 (77.8) | 0.00 |
IV | 2 (5.9) | 0 (0) | 2 (22.2) | 0.06 |
Adjuvant chemotherapy | 12 (35.3) | 4 (16.0) | 8 (88.9) | 0.00 |
Time to start adjuvant chemotherapy (day) | 42.8 ± 6.1 | 50.2 ± 4.1 | 39.1± 1.9 | 0.01 |
OSNA | Histology (+) | Histology (−) | Total |
---|---|---|---|
(+) | 9 | 0 | 9 |
(−) | 0 | 8 | 8 |
Total | 9 | 8 | 17 |
H&E | Histology (+) | Histology (−) | Total |
---|---|---|---|
(+) | 5 | 0 | 5 |
(−) | 4 | 8 | 12 |
Total | 9 | 8 | 17 |
OSNA | Histology (+) | Histology (−) | Total |
---|---|---|---|
(+) | 9 | 0 | 9 |
(−) | 4 | 21 | 25 |
Total | 13 | 21 | 34 |
Variable | No. | Sensitivity (95% CI) | Specificity (95% CI) | Accuracy (%) | PPV (95% CI) | NPV (95% CI) |
---|---|---|---|---|---|---|
Comparing definitive histology with OSNA analysis of SLN also evaluated with H&E | 17 | 1 (0.77–1.00) | 1 (0.77–1.00) | 100 | 1 (0.77–1.00) | 1 (0.77–1.00) |
Comparing definitive histology with H&E analysis of SLN also evaluated with OSNA | 17 | 0.55 (0.30–0.78) | 1 (0.77–1.00) | 76.4 | 1 (0.77–1.00) | 0.66 (0.40–0.86) |
Comparing definitive histology with OSNA analysis of all retrieved SLN | 34 | 0.69 (0.51–0.81) | 1 (0.87–1.00) | 88.2 | 1 (0.87–1.00) | 0.84 (0.66–0.93) |
Values are presented as mean ± standard deviation or number (%). OSNA, one-step nucleic acid; JSCCR, Japanese Society for Cancer of the Colon and Rectum. P < 0.05, significant difference.
OSNA, one-step nucleic acid.
H&E, hematoxylin and eosin.
OSNA, one-step nucleic acid.
CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value; OSNA, one-step nucleic acid; H&E, hematoxylin and eosin; SLN, sentinel lymph node.