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OSNA - Improved staging for Colon cancer with optimised lymph node analysis

The lymph node status is the most important prognostic factor and staging parameter in the treatment of colon cancer. For patients whose lymph nodes demonstrate no metastatic involvement, adjuvant chemotherapy is not indicated in accordance with the therapy guidelines. According to current guidelines the histopathological assessment of at least 12 lymph nodes is recommended for the investigation of metastases.
In the post-operative processing of the lymph nodes the microscopic investigation of only one level of dissection after HE staining is the general standard. A more detailed examination of all dissected lymph nodes by histologically processing a series of dissection levels or by immunohistochemistry (IHC) staining (ultra-staging) takes time and money, and is therefore not routine practice.

However, up to 30% of all patients classified in stage II suffer from local recurrence or distant metastases within 5 years of undergoing surgery, leading to significantly poorer survival rates. This could indicate that in a relevant number of patients - because only one level of dissection is analysed - metastases in the lymph nodes are missed. These patients are classified in a lower lymph node status (false-negative rates up to 24%), which impacts on the decisions made concerning their further therapy options.

OSNA® allows the investigation of the entire lymph node and its results are comparable with ultra-staging. Studies have shown that a lymph node analysis of pN0 patients with OSNA® yielded an upstaging rate of approximately 26%, compared with the standard histological test method. These patients' therapies could thus be adjusted accordingly.

Benefits of using OSNA® Colon Cancer include:

•    More sensitive than standard methods
•    Improved staging
•    Automated and standardised procedure
•    Faster availability of results, even intra-operatively if required
•    Reduced workload for the pathology laboratory

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