The prognostic factors for survival after curative resection of distal cholangiocarcinoma: perineural invasion and lymphovascular invasion

Abstract Background Both lymphovascular invasion, which is characterized by penetration of tumor cells into the peritumoural vascular or lymphatic network, and perineural invasion, which is characterized by involvement of tumor cells surrounding nerve fibers, are considered as an important step for tumor spreading, and are known poor prognostic factors in esophageal cancer. However, the information of these histological features is unavailable until pathological examination of surgical resected specimens. We aim to predict the presence or absence of these factors by positron emission tomography images during staging workup. Methods The positron emission tomography images before treatment and pathological reports of 278 patients who underwent esophagectomy for squamous cell carcinoma were collected. Stepwise convolutional neural network was constructed to distinguish patient with either lymphovascular invasion or perineural invasion from those without. Results Randomly selected 248 patients were included in the testing set. Stepwise approach was used in training our custom neural network. The performance of fine-tuned neural network was tested in another independent 30 patients. The accuracy rate of predicting the presence or absence of either lymphovascular invasion or perineural invasion was 66.7% (20 of 30 were accurate). Conclusion Using pre-treatment positron emission tomography images alone to predict the presence of absence of poor prognostic histological factors, i.e. lymphovascular invasion or perineural invasion, with deep convolutional neural network is possible. The technique of deep learning may identify patients with poor prognosis and enable personalized medicine in esophageal cancer. Disclosure All authors have declared no conflicts of interest.

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Outcome of rectal carcinoma patients receiving adjuvant chemoradiotherapy in Marmara University Hospital

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.13584 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 13584-13584

Author(s):

F. Dane ◽

M. Gumus ◽

S. Iyikesici ◽

F. Yumuk ◽

G. Basaran ◽

...

Keyword(s):

Rectal Cancer ◽

Treatment Outcome ◽

Prognostic Factors ◽

Survival Time ◽

Adjuvant Treatment ◽

Curative Resection ◽

Perineural Invasion ◽

Stage Ii ◽

Adjuvant Chemoradiotherapy ◽

Disease Free

13584 Background: Surgical resection is the cornerstone of curative therapy for rectal cancer. Relapse rate following potentially curative resection is high in patients with stage II/III disease. Thus, chemoradiotherapy is the standard adjuvant treatment in resected stage II/III rectal carcinoma. There are limited studies, if any, analyzing the outcome of rectal cancer patients with stage II/III who received adjuvant chemoradiotherapy after curative resection in Turkey. Therefore, we aimed to analyze the treatment outcome, and the prognostic significance of various parameters in these patients. Methods: 106 patients with stage II/III rectal cancer treated with adjuvant chemoradiotherapy since 1997 until present were analyzed retrospectively. Patients received 5-fluorouracil (370–425mg/m2/day × 5days) and calcium leucovorin (20mg/m2/day × 5days), q4weeks, two courses before and two courses after radiotherapy. The 5-fluorouracil dose was reduced to, 225mg/m2/day given continuously as protracted short-term infusion during radiotherapy. 45–50.4 Gy radiotherapy was given to the pelvic region. Patients were followed-up every 3 months for the first 2 years and every 6 months thereafter. Age, gender, T stage, N stage, histological grade, lymphatic, vascular, and perineural invasion were analyzed as prognostic factors. Results: The median follow-up was 34 months. Median age was 59.5 years. Forty-four percent of the patients were node-negative. Lymphatic, vascular, and perineural invasion rate were 50.5%, 47.3%, and 32.3% respectively. Five-year disease-free and overall survival rates were 68.8% and 72.2%, respectively. Median survival time and median disease free-survival time were not reached at the time of analysis. In multivariate Cox regression analysis; T stage (p: 0.022), nodal stage (0.019), presence of lymphatic invasion (p: 0.0001), and the presence of vascular invasion (p:0.01) were independent prognostic factors. Conclusion: The adjuvant treatment outcome in Turkish patients in our department with stage II/III rectal cancer is similar to those reported in the Western studies. No significant financial relationships to disclose.

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The Prognostic factors and prognostic impact of metastatic lymph node count after curative resection for distal cholangiocarcinoma

HPB ◽

10.1016/j.hpb.2018.06.1362 ◽

2018 ◽

Vol 20 ◽

pp. S690

Author(s):

H.J. Kim ◽

C.K. Cho ◽

H.J. Kim

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Curative Resection ◽

Metastatic Lymph Node ◽

Prognostic Impact ◽

Distal Cholangiocarcinoma ◽

Lymph Node Count ◽

Metastatic Lymph ◽

Node Count

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Association of higher proliferation of Ki67 with unfavorable prognostic factors and shorter survival in breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e11083 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e11083-e11083

Author(s):

Saadettin Kilickap ◽

Yalcin Kaya ◽

Birsen Yucel ◽

Ersin Tuncer ◽

Sahande Elagoz

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Lymphovascular Invasion ◽

Perineural Invasion ◽

Lymph Node Involvement ◽

Free Survival ◽

Ki67 Expression ◽

Node Involvement ◽

The Mean ◽

Estrogen Receptor Negativity

e11083 Background: The prognostic value of Ki67 expression level is yet unclear in breast cancer (BC). The aim of this study was to investigate the association between Ki67 expression levels and other prognostic factors in BC. Methods: Demographic, clinical and pathological features of the pts were retreived from the hospital records. Results: In this study, 163 pts with BC were analyzed. The mean age of the pts was 53.4±12.2 years. Median Ki67 level was 20% in this study. Ki67-high tumors were significantly associated with high grade (p<0.001), lymphovascular invasion (p=0.001), estrogen receptor negativity (ER-) (p=0.035), Her2 (+) (p=0.001), advanced stage (p<0.001) and lymph node involvement (LNI) (p<0.003) of the tumor. There was no relationship between the age, perineural invasion, progesterone receptor and Ki67 positivity. Lower Ki67 levels were significantly associated with longer median relaps-free survival (RFS) compared to those of higher Ki67 levels (p=0.008). The overall survival (OS) was longer in pts with lower Ki67 levels than those with higher levels (p=0.017). Conclusions: High Ki67 expression was associated with ER-, Her2 (+), higher grade and LNI in BC. The level of Ki67 expression was a prognostic factor predicting the RFS and OS in BC pts. [Table: see text]

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Relationship between Microsatellite Status and Other Prognostic Factors in Patients with Colon Cancer

Journal of Cancer and Tumor International ◽

10.9734/jcti/2020/v10i330129 ◽

2020 ◽

pp. 18-23

Author(s):

Ogün Erşen ◽

Serdar Çulcu ◽

Ferit Aydın ◽

Ümit Mercan ◽

Cemil Yüksel ◽

...

Keyword(s):

Colon Cancer ◽

Prognostic Factors ◽

Lymph Node ◽

Microsatellite Instability ◽

Lymphovascular Invasion ◽

Perineural Invasion ◽

Colon Resection ◽

Colorectal Cancers ◽

Node Metastasis ◽

Signet Ring

It is reported that 0.5-13 % of all colorectal cancers are hereditary. Many mutations that cause genomic instability have been described lately in this cancers; the most famous one is yet microsatellite instability pathway. Investigating the presence of these mutations is important in tailoring patients' treatment and predicting prognosis. Aims: We evaluated the association between micro satellite status and other pathologic prognostic factors like grade, tumor size, lymph node metastasis, lymphovascular invasion and perineural invasion in patients who underwent curative colon resection for colorectal cancers (CRC) in our clinic in the past five years. Study Design: A total of 205 sequential patients who were older than 18 and had curative colon resection for CRC in Ankara University Surgical Oncology Unit and been tested for microsatellite instability (MSI) were analyzed on behalf of the facultys’ database. Methodology: Pathology results had been determined and tumor localizations, lymph node metastasis status, grade, lymphovascular and perineural invasion status were evaluated. Information about MSI status and defected genes were obtained from detailed pathology reports. Patients were divided into two groups as MSI and MSS. Results: No significant difference was found between two the groups in the context of microsatellite instability status. Lymphovascular invasion had been seen higher in high frequency microsatellite instability (MSH-H) compared to low frequency microsatellite instability (MSH-L) group (76.4% vs 53.1%, P =.02). There was no statistical difference in perineural invasion between the two groups (P = 0.102). Signet ring cell status between the groups we found a higher rate of signet ring cells and consequently a higher grade in MSH-H group (17.6% vs 10.6%, P = 0.042). Conclusion: In conclusion, although many important points have been identified in our study, more studies are needed to compare the evaluation of MSI in colon cancer with other prognostic factors and to investigate its effect on the course of the disease.

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The relationship between tumor budding and survival in colorectal carcinomas

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.12.1442 ◽

2019 ◽

Vol 65 (12) ◽

pp. 1442-1447 ◽

Cited By ~ 1

Author(s):

Songul Peltek Ozer ◽

Saime Gul Barut ◽

Bahri Ozer ◽

Oguz Catal ◽

Mustafa Sit

Keyword(s):

Prognostic Factors ◽

Lymphovascular Invasion ◽

Perineural Invasion ◽

Histological Grade ◽

Prognostic Significance ◽

Tumor Budding ◽

Colorectal Carcinomas ◽

Pathology Reports ◽

Lymph Node Stage ◽

The Relationship

SUMMARY OBJECTIVE Tumor budding is a parameter that is increasingly understood in colorectal carcinomas. We aimed to investigate the relationship between tumor budding, prognostic factors, and survival METHODS A total of 185 patients who had undergone colorectal surgery were observed. Tumor budding, the tumor budding score, and the relationship between these and prognostic factors, and survival investigated. RESULTS Tumor budding was found in 91 (49.2%) cases. The relationship between the tumor budding score and histological grade, lymphovascular invasion, perineural invasion, pathological lymph node stage, and mortality rates were significant. CONCLUSION In our study, the relationship between tumor budding and survival is very strong. Considering these findings and the literature, the prognostic significance of tumor budding becomes clear and should be stated in pathology reports.

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