Tumor Size Predicts Vascular Invasion and Histologic Grade Among Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma

2014 ◽  
Vol 18 (7) ◽  
pp. 1284-1291 ◽  
Author(s):  
Gaya Spolverato ◽  
Aslam Ejaz ◽  
Yuhree Kim ◽  
Georgios C. Sotiropoulos ◽  
Andreas Pau ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Histologic Grade

scholarly journals Tumor size predicts vascular invasion and histologic grade: Implications for selection of surgical treatment for hepatocellular carcinoma

2005 ◽  
Vol 11 (9) ◽  
pp. 1086-1092 ◽  
Author(s):  
Timothy M. Pawlik ◽  
Keith A. Delman ◽  
Jean-Nicolas Vauthey ◽  
David M. Nagorney ◽  
Irene Oi-Lin Ng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Treatment ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Histologic Grade ◽  
Selection Of

scholarly journals Intrahepatic cholangiocarcinoma: An international, multi-institutional analysis of prognostic factors and lymph node assessment.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 162-162 ◽  
Author(s):  
T. M. Pawlik ◽  
C. Pulitano ◽  
S. Alexandrescu ◽  
T. C. Gamblin ◽  
C. Ferrone ◽  
...  
Keyword(s):  
Lymph Node ◽  
Median Survival ◽  
Intrahepatic Cholangiocarcinoma ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Primary Liver Cancer ◽  
Margin Status ◽  
Prognostic Information ◽  
Factors Associated ◽  
The Impact

162 Background: Intrahepatic cholangiocarcinoma (ICC) is a rare and poorly understood primary liver cancer. The role of routine lymphadenectomy at the time of surgical resection remains poorly defined. We sought to identify factors associated with outcome following surgical management of ICC and examine the impact of lymph node (LN) assessment on survival. Methods: 411 patients who underwent curative intent surgery for ICC between 1973-2010 were identified from an international multi-institutional database. Clinical and pathologic data were evaluated using uni- and multivariate analyses. Results: Median tumor size was 6.5 cm. Most patients had a solitary tumor (55%) and no evidence of vascular invasion (64%). Resection involved ≥hemi-hepatectomy (74%) and margin status was R0 (82%). Overall median survival was 28 months and 5-year survival was 32%. Factors associated with adverse prognosis included positive margin status (HR=3.11; p<0.001), multiple lesions (HR=2.16; p=0.007) and vascular invasion (HR=2.13; p=0.01). Tumor size was not a prognostic factor (HR=1.05; p=0.08). Lymphadenectomy was performed in 233 (57%) patients; 87 (37%) had LN metastasis. LN metastasis was associated with worse outcome (median survival: N0 39 months vs. N1 21 months; p=0.02). Preoperative factors such as tumor size, number, and morphologic subtype did not predict presence of LN metastasis (all p>0.05); however, vascular invasion did (OR=2.24; p=0.003). Conclusions: While tumor size provides no prognostic information, tumor number, vascular invasion, and LN metastasis were associated with survival. Presence of LN metastasis cannot be predicted using preoperative tumor features. Lymphadenectomy should be routinely performed for ICC as up to one-quarter of patients will have LN metastasis. No significant financial relationships to disclose.

scholarly journals Intrahepatic Cholangiocarcinoma: An International Multi-Institutional Analysis of Prognostic Factors and Lymph Node Assessment

2011 ◽  
Vol 29 (23) ◽  
pp. 3140-3145 ◽  
Author(s):  
Mechteld C. de Jong ◽  
Hari Nathan ◽  
Georgios C. Sotiropoulos ◽  
Andreas Paul ◽  
Sorin Alexandrescu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Median Survival ◽  
Intrahepatic Cholangiocarcinoma ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Relative Effect ◽  
Prognostic Information ◽  
Factors Associated ◽  
Tumor Number ◽  
The Impact

Purpose To identify factors associated with outcome after surgical management of intrahepatic cholangiocarcinoma (ICC) and examine the impact of lymph node (LN) assessment on survival. Patients and Methods From an international multi-institutional database, 449 patients who underwent surgery for ICC between 1973 and 2010 were identified. Clinical and pathologic data were evaluated using uni- and multivariate analyses. Results Median tumor size was 6.5 cm. Most patients had a solitary tumor (73%) and no vascular invasion (69%). Median survival was 27 months, and 5-year survival was 31%. Factors associated with adverse prognosis included positive margin status (hazard ratio [HR], 2.20; P < .001), multiple lesions (HR, 1.80; P = .001), and vascular invasion (HR, 1.59; P = .015). Tumor size was not a prognostic factor (HR, 1.03; P = .23). Patients were stratified using the American Joint Committee on Cancer/International Union Against Cancer T1, T2a, and T2b categories (seventh edition) in a discrete step-wise fashion (P < .001). Lymphadenectomy was performed in 248 patients (55%); 74 of these (30%) had LN metastasis. LN metastasis was associated with worse outcome (median survival: N0, 30 months v N1, 24 months; P = .03). Although patients with no LN metastasis were able to be stratified by tumor number and vascular invasion (N0; P < .001), among patients with N1 disease, multiple tumors and vascular invasion, either alone or together, failed to discriminate patients into discrete prognostic groups (P = .34). Conclusion Although tumor size provides no prognostic information, tumor number, vascular invasion, and LN metastasis were associated with survival. N1 status adversely affected overall survival and also influenced the relative effect of tumor number and vascular invasion on prognosis. Lymphadenectomy should be strongly considered for ICC, because up to 30% of patients will have LN metastasis.

Detection of Isolated Tumor Cells in Bone Marrow Is an Independent Prognostic Factor in Breast Cancer

2003 ◽  
Vol 21 (18) ◽  
pp. 3469-3478 ◽  
Author(s):  
G. Wiedswang ◽  
E. Borgen ◽  
R. Kåresen ◽  
G. Kvalheim ◽  
J.M. Nesland ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Prognostic Factor ◽  
Tumor Cells ◽  
Vascular Invasion ◽  
Independent Prognostic Factor ◽  
Histologic Grade ◽  
Separate Analysis ◽  
Node Negative ◽  
Node Positive

Purpose: This study was performed to disclose the clinical impact of isolated tumor cell (ITC) detection in bone marrow (BM) in breast cancer. Patients and Methods: BM aspirates were collected from 817 patients at primary surgery. Tumor cells in BM were detected by immunocytochemistry using anticytokeratin antibodies (AE1/AE3). Analyses of the primary tumor included histologic grading, vascular invasion, and immunohistochemical detection of c-erbB-2, cathepsin D, p53, and estrogen receptor (ER)/progesterone receptor (PgR) expression. These analyses were compared with clinical outcome. The median follow-up was 49 months. Results: ITC were detected in 13.2% of the patients. The detection rate rose with increasing tumor size (P = .011) and lymph node involvement (P < .001). Systemic relapse and death from breast cancer occurred in 31.7% and 26.9% of the BM-positive patients versus 13.7% and 10.9% of BM-negative patients, respectively (P < .001). Analyzing node-positive and node-negative patients separately, ITC positivity was associated with poor prognosis in the node-positive group and in node-negative patients not receiving adjuvant therapy (T1N0). In multivariate analysis, ITC in BM was an independent prognostic factor together with node, tumor, and ER/PgR status, histologic grade, and vascular invasion. In separate analysis of the T1N0 patients, histologic grade was independently associated with both distant disease-free survival (DDFS) and breast cancer–specific survival (BCSS), ITC detection was associated with BCSS, and vascular invasion was associated with DDFS. Conclusion: ITC in BM is an independent predictor of DDFS and BCSS. An unfavorable prognosis was observed for node-positive patients and for node-negative patients not receiving systemic therapy. A combination of several independent prognostic factors can classify subgroups of patients into excellent and high-risk prognosis groups.

Histologic Grade Remains a Prognostic Factor for Breast Cancer Regardless of the Number of Positive Lymph Nodes and Tumor Size: A Study of 161 708 Cases of Breast Cancer From the SEER Program

2014 ◽  
Vol 138 (8) ◽  
pp. 1048-1052 ◽  
Author(s):  
Arnold M. Schwartz ◽  
Donald Earl Henson ◽  
Dechang Chen ◽  
Sivasankari Rajamarthandan
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Tumor Size ◽  
Nodal Status ◽  
Histologic Grade ◽  
Axillary Lymph Nodes ◽  
Low Grade ◽  
Axillary Lymph ◽  
Data Set

Context.—The appropriate staging of breast cancers includes an evaluation of tumor size and nodal status. Histologic grade in breast cancer, though important and assessed for all tumors, is not integrated within tumor staging. Objective.—To determine whether the histologic grade remains a prognostic factor for breast cancer regardless of tumor size and the number of involved axillary lymph nodes. Design.—By using a new clustering algorithm, the 10-year survival for every combination of T, N, and the histologic grade was determined for cases of breast cancer obtained from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. There were 36 combinations of TN, defined according to the American Joint Committee on Cancer, and grade. Results.—For each combination of T and N, a categorical increase in the histologic grade was associated with a progressive decrease in 10-year survival regardless of the number of involved axillary lymph nodes or size of the primary tumor. Absolute survival differences between high and low grade persisted despite larger tumor sizes and greater nodal involvement, though trends were apparent with increasing breast cancer stage. Statistical significance depended on the number of cases for each combination. Conclusions.—Histologic grade continues to be of prognostic importance for overall survival despite tumor size and nodal status. Furthermore, these results seem to indicate that the assignment of the histologic grade has been consistent among pathologists when evaluated in a large data set of patients with breast cancer. The incorporation of histologic grade in TNM staging for breast cancer provides important prognostic information.

scholarly journals Tumor Size Drives the Prognosis After Hepatic Resection of Solitary Hepatocellular Carcinoma Without Vascular Invasion

2019 ◽  
Vol 24 (5) ◽  
pp. 1040-1048 ◽  
Author(s):  
Hiroji Shinkawa ◽  
Shogo Tanaka ◽  
Shigekazu Takemura ◽  
Takuma Ishihara ◽  
Kouji Yamamoto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Resection ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Solitary Hepatocellular Carcinoma

PS02.098: LONG-TERM OUTCOMES OF ADDITIONAL THERAPY FOLLOWING ENDOSCOPIC RESECTION FOR T1B-SM ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 148-149
Author(s):  
Tsuyoshi Tanaka ◽  
Masaki Ueno ◽  
Toshiro Iizuka ◽  
Shu Hoteya ◽  
Shusuke Haruta ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Lymphatic Invasion ◽  
Additional Treatment ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Risk Factors For Recurrence ◽  
Recurrent Patterns

Abstract Background Esophagectomy is the standard treatment strategy for superficial esophageal cancer diagnosed as pT1b(sm) following endoscopic resection (EMR/ESD). However, chemoradiotherapy (CRT) is expected to be an alternative treatment option. This study retrospectively compared the long-term outcomes of surgery and CRT as additional treatments for EMR/ESD pT1b esophageal cancer. Methods In a retrospective single-center study, the data of 83 consecutive patients who underwent EMR/ESD and were diagnosed with pT1b(sm) from January 2002 to December 2013 were collected, and additional treatment was administered to 59 of these patients (26 surgery and 33 CRT). Long-term outcomes, recurrent patterns, and risk factors for recurrence were analyzed. Results Median patient age was 63 (range, 43–79) years, and male/female ratio was 54:5. Tumor characteristics were as follows: location, Ce/Ut/Mt/Lt/Ae/EG = 1/6/32/13/3/4; median size, 25 (range, 5–88) mm; depth, sm1/sm2 = 18/41; vascular invasion (ly, v), + / − = 37/22; and cut end (HM, VM), + or × / − = 17/42. Sex, Charlson comorbidity index, tumor size, macroscopic type, cut end, and resection state were not different between the two groups. Meanwhile, age, tumor location, histological type, tumor depth, and vascular invasion were different between the two groups. The 5-year survival rates (relapse-free survival rate; RFS) were 92.3% (92.3%; RFS) and 80.3% (70.4%; RFS) in the surgery and CRT groups, respectively. The surgery group was significantly superior to the CRT group in terms of RFS (P = 0.042). All tumor recurrence was observed in the CRT group (P = 0.030). Recurrent patterns were as follows: hematogenous metastases (lung, bone, and adrenal gland) in three patients and lymph node metastases (four regional and an extra-regional) in four patients. In multivariate analysis, tumor size (P = 0.048) and lymphatic invasion (P = 0.032) were revealed as significant risk factors for recurrence in the CRT group. Conclusion Surgery is recommended as the additional treatment for ESD/EMR-pT1b esophageal cancer for better recurrent-free survival. Although CRT could be an acceptable treatment choice, the indication should be carefully decided, particularly in cases with large tumor size or lymphatic invasion. Disclosure All authors have declared no conflicts of interest.

Prognostic Significance of Nottingham Histologic Grade in Invasive Breast Carcinoma

2008 ◽  
Vol 26 (19) ◽  
pp. 3153-3158 ◽  
Author(s):  
Emad A. Rakha ◽  
Maysa E. El-Sayed ◽  
Andrew H.S. Lee ◽  
Christopher W. Elston ◽  
Matthew J. Grainge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Strong Predictor ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Operable Breast Cancer ◽  
Histologic Grade ◽  
Grading System ◽  
Consecutive Series ◽  
Staging Systems

Purpose The three strongest prognostic determinants in operable breast cancer used in routine clinical practice are lymph node (LN) stage, primary tumor size, and histologic grade. However, grade is not included in the recent revision of the TNM staging system of breast cancer as its value is questioned in certain settings. Materials and Methods This study is based on a large and well-characterized consecutive series of operable breast cancer (2,219 cases), treated according to standard protocols in a single institution, with a long-term follow-up (median, 111 months) to assess the prognostic value of routine assessment of histologic grade using Nottingham histologic grading system. Results Histologic grade is strongly associated with both breast cancer–specific survival (BCSS) and disease-free survival (DFS) in the whole series as well as in different subgroups based on tumor size (pT1a, pT1b, pT1c, and pT2) and LN stages (pN0 and pN1 and pN2). Differences in survival were also noted between different individual grades (1, 2, and 3). Multivariate analyses showed that histologic grade is an independent predictor of both BCSS and DFS in operable breast cancer as a whole as well as in all studied subgroups. Conclusion Histologic grade, as assessed by the Nottingham grading system, provides a strong predictor of outcome in patients with invasive breast cancer and should be incorporated in breast cancer staging systems.

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