A MARKER FOR POSITIVE LYMPH NODES IN COLORECTAL CANCER PATIENTS

Association of GUCY2C Expression in Lymph Nodes With Time to Recurrence and Disease-Free Survival in pN0 Colorectal Cancer

Waldman SA, Hyslop T, Schulz S, et al
JAMA. 2009;301:745-752

Summary

The aim of this study was to determine whether GUCY2C, a suspected molecular marker for metastatic colorectal cancer, could be a useful adjunct to indicate the presence of occult nodal cancer in patients undergoing surgery for colorectal cancer. A total of 257 patients with colorectal cancer were followed for a median period of 2 years. Of the 32 patients with nodes negative for GUCY2C, only 2 developed a recurrence. In contrast, 21% of patients classified as being node negative but whose nodes were GUCY2C positive developed a recurrence (P = .006). Patients whose nodes were pathologically negative but GUCY2C positive had a shorter time to recurrence (P = .03).

Viewpoint

Although the follow-up period was relatively short, GUCY2C already appears to be a promising prognostic indicator. We know that many negative nodes must harbor cancer cells because about 25% of node-negative patients develop recurrent disease. This molecular marker could help in the more accurate staging of patients with colorectal cancer and thus give additional information about the need for adjunct therapy.