scholarly journals Lymph node metastasis in melanoma: a debate on the significance of nodal metastases, conditional survival analysis and clinical trials

2018 ◽  
Vol 35 (5-6) ◽  
pp. 431-442 ◽  
Author(s):  
Mark B. Faries ◽  
Dale Han ◽  
Michael Reintgen ◽  
Lauren Kerivan ◽  
Douglas Reintgen ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Survival Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Conditional Survival ◽  
Nodal Metastases ◽  
Node Metastasis

scholarly journals Indications of Lymph Node Metastasis and Survival Analysis in T1N+M0 Gastric Cancer: a Population-Based Study

2020 ◽  
Author(s):  
Peng Jin ◽  
Yang Li ◽  
Shuai Ma ◽  
Wenzhe Kang ◽  
Hao Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Survival Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Multivariate Analyses ◽  
Invasion Depth ◽  
Node Metastasis ◽  
Definition Of

Abstract Background Since the definition of early gastric cancer (EGC) was first proposed in 1971, the treatment of gastric cancer with or without lymph node metastasis (LNM) has changed a lot. The present study aims to identify risk factors for LNM and prognosis, and to further evaluate the indications for adjuvant chemotherapy (AC) in T1N + M0 gastric cancer. Methods A total of 1291 patients with T1N + M0 gastric cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate analyses were performed to identify risk factors for LNM. The effect of LNM on overall survival (OS) and cancer-specific survival (CSS) was compared with patients grouped into T1N0-1 and T1N2-3, as the indications for AC. Results The rate of LNM was 19.52%. Multivariate analyses showed age, tumor size, invasion depth, and type of differentiation and retrieved LNs were associated with LNM (p < 0.05). Cox multivariate analyses indicated age, sex, tumor size, N stage were independent predictors of OS and CSS (p < 0.05), while race was indicator for OS (HR 0.866; 95%CI 0.750–0.999, p = 0.049), but not for CSS (HR 0.878; 95% CI 0.723–1.065, p = 0.187). In addition, survival analysis showed the proportion of patients in N+/N0 was better distributed than N0-1/N2-3b. There were statistically significant differences in OS and CSS between patients with and without chemotherapy in pT1N1M0 patients (p༜0.05). Conclusions Both tumor size and invasion depth are associated with LNM and prognosis. LNM is an important predictor of prognosis. pT1N + M0 may be appropriate candidates for AC. Currently, the treatment and prognosis of T1N0M0/T1N + M0 are completely different. An updated definition of EGC, taking into tumor size, invasion depth and LNM, may be more appropriate in an era of precision medicine.

Lymphovascular space invasion and Ki67 as predictors of lymph node metastasis in primary low grade serous ovarian cancer

2020 ◽  
Vol 31 (1) ◽  
pp. 98-103
Author(s):  
Jacek P Grabowski ◽  
Joanna Glajzer ◽  
Rolf Richter ◽  
Helmut Plett ◽  
Mustafa-Zelal Muallem ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymphatic Metastasis ◽  
Low Grade ◽  
Nodal Metastases ◽  
Serous Ovarian Cancer ◽  
Ki67 Expression ◽  
Node Metastasis ◽  
Lymphovascular Space Invasion

ObjectiveLow grade serous ovarian cancers characterize a unique clinical pattern and likely less frequent incidence of lymphatic metastasis. The expression level of Ki67 is associated with differences in prognosis and therapy outcome. However, its expression in combination with lymphovascular space invasion has not been evaluated in the prediction of lymphatic metastasis.MethodsPatients with low grade serous ovarian cancer were identified in an institutional database. Patients with primary low grade serous ovarian cancer diagnosed and/or treated at our center between September 2000 and December 2018 were identified. Receiver operator characteristics curve analysis was performed to find the cut-off values of per cent Ki67 to discriminate patients with lymph node metastasis. The association between the presence of lymphovascular space invasion and lymph node involvement was analyzed.ResultsA total of 109 patients with primary low grade serous ovarian cancer were identified in our institution's database. Of these, 72 (66.1%) patients underwent primary surgery with pelvic and para-aortic lymph node dissection. Complete data for Ki67 expression and lymphovascular space invasion were obtained for 61 (84.7%) of these patients. Among them, 37 (60.7%) patients had lymph node metastasis. The presence of lymphovascular space invasion was associated with an increased risk of lymph node metastases (odds ratio (OR)=12.78, 95% confidence interval (CI) 3.15 to 51.81; p<0.001). In multivariate analysis including age >65 years, peritoneal carcinomatosis, and ascites>500 mL, lymphovascular space invasion remained a significant risk factor for lymphatic metastases (OR=35.11, 95% CI 2.38 to 517.69; p=0.010). Ki67 ≥6% was associated with a higher risk of lymphovascular space invasion (OR=3.67, 95% CI 1.26 to 10.64; p=0.017). No significant correlation between Ki67 expression level and nodal metastases was found (OR=2.19, 95% CI 0.76 to 6.26; p=0.14). Neither presence of lymphovascular space invasion or nodal metastases was associated with a statistically poorer prognosis.ConclusionsWe showed an association between lymphovascular space invasion, Ki67 expression, and risk of lymph node metastasis in primary low grade ovarian cancer. Further prospective trials evaluating lymphovascular space invasion and Ki-67 as predictors of lymph node metastasis are needed.

The mutational profile analysis of extramural vascular invasion in rectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15128-e15128
Author(s):  
Mingtian Wei ◽  
Yane Song ◽  
Xiangbing Deng ◽  
Lijia Wu ◽  
Wenjian Meng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Survival Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Vascular Invasion ◽  
Molecular Mechanisms ◽  
Negative Group ◽  
Kras Mutations ◽  
Node Metastasis

e15128 Background: Extramural vascular invasion(EMVI) is a known independent predictor of poor prognosis in rectal cancer, as evidenced by a higher risk of developing metastases and a shorter DFS compared with negative tumours. However, the molecular mechanisms of EMVI genesis remains unclear. The objective of this study is to clarify the distinct molecular characterization of EMVI-positive tumours from that of EMVI-negative tumours. Methods: DNA was extracted from FFPE tumor specimens and matched normal tissue samples from rectal cancer patients who underwent surgical resection. Comprehensive genomic profiling analysis was performed using a 2.41M size panel covering exon regions of 1,622 genes based on next generation sequencing assay. Somatic Mutations were analyzed to determine the difference of molecular features between EMVI-positive and EMVI-negative patients. Results: In this retrospective study, a total of 48 rectal cancer patients without distant metastases were included: 17 patients in the EMVI-positive group and 31 patients in the EMVI-negative group. All the EMVI-postive patients had lymph node metastasis and 15 patients had lymph node metastasis in EMVI-negative group. Among all the tumours, the most frequently mutated genes were TP53, APC, KRAS, SMAD4, CHEK2, TCF7L2 and FBXW7. Mutations of TCF7L2 and CHEK2 were more frequently observed in EMVI-positive tumours than that in EMVI-negative tumours with p < 0.05. Survival analysis (Kaplan-Meier) indicated that patients with KRAS mutations(n = 9) had a shorter DFS than patients without KRAS mutations(n = 23) in patients with lymph node metastasis (p < 0.05). In addition, age was significantly associated with DFS according to the survival analysis (p < 0.05). Conclusions: Several possible candidate genes that may be helpful to characterize the distinct mutational profile of EMVI-positive tumours from EMVI-negative tumours were identified, which may be of great significance in disclosing the molecular mechanism underlying in EMVI initiation and progression. Expanded prospective cohorts are warranted to further elucidate these findings.

Hilar Lymph Nodes in N2 Disease: Survival Analysis of Patients with Non-Small Cell Lung Cancers and Regional Lymph Node Metastasis

Surgery Today ◽  
2002 ◽  
Vol 32 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Kazuhiro Ueda ◽  
Yoshikazu Kaneda ◽  
Kouichi Saeki ◽  
Nobuhiro Fujita ◽  
Nobuya Zempo ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancers ◽  
Node Metastasis ◽  
N2 Disease

scholarly journals Topographic distribution of lymph node metastasis in patients with stage IB1 cervical cancer: an analysis of 8314 lymph nodes

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jing Cai ◽  
Xiaoqi He ◽  
Hongbo Wang ◽  
Weihong Dong ◽  
Yuan Zhang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Pelvic Lymphadenectomy ◽  
Individual Treatment ◽  
Nodal Metastases ◽  
Tumor Spread ◽  
Node Metastasis ◽  
Parametrial Invasion

Abstract Background Systematic pelvic lymphadenectomy or whole pelvic irradiation is recommended for the patients with stage IB1 cervical cancer. However, the precise pattern of lymphatic tumor spread in cervical cancer is unknown. In the present study we evaluated the distribution of nodal metastases in stage IB1 cervical cancer to explore the possibilities for tailoring cancer treatment. Methods A total of 289 patients with cervical cancer of stage IB1, according to FIGO 2009, were retrospectively analyzed. All patients underwent laparoscopic radical hysterectomy (Querleu and Morrow type C2) and systematic pelvic lymphadenectomy with or without para-aortic lymphadenectomy (level 2 or level 3 according to Querleu and Morrow) from October 2014 to December 2017. Lymph nodes removed from 7 well-defined anatomical locations as well as other tissues were examined histopathologically, and typed, graded, and staged according to the WHO/IARC classification. Results Totally 8314 lymph nodes were analyzed with the average number of 31.88 ± 10.34 (Mean ± SD) lymph nodes per patient. Nodal metastases were present in 44 patients (15.22%). The incidence of lymphatic spread to different anatomic sites ranged from 0% (presacral) to 30.92% (obturator nodes). Tumor size above 2 cm, histologically proven lymphovascular space involvement (LVSI) and parametrial invasion were shown to be significantly correlated with the higher risk of lymphatic metastasis, while obesity (BMI ≥ 25) was independently negatively associated with lymphatic metastases. Conclusions The incidence of lymph node metastasis in patients with stage IB1 cervical cancer is low but prognostically relevant. Individual treatment could be considered for the selected low-risk patients who have smaller tumors and obesity and lack of the parametrial invasion or LVSI.

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