Lymph node invasion might have more prognostic impact than R status in advanced esophageal adenocarcinoma

Abstract Background In esophageal carcinoma, the numbers of metastatic and total removed lymph nodes (LN) are well-established variables of long-term prognosis. The overall rate of retrieved LN depends on neoadjuvant treatment, the extent of surgical lymphadenectomy, and the modality of the pathological workup. The question in this study is whether technically extended histopathological preparation can increase the number of detected (metastatic) LN with an impact on nodal UICC staging. Patients and Methods A cohort of 77 patients with esophageal adenocarcinoma was treated with Ivor Lewis esophagectomy including standardized two-field lymphadenectomy. The specimens were grossed, and all manually detectable LN were retrieved. The remaining tissue was completely embedded by the advanced “acetone compression” retrieval technique. The primary outcome parameter was the total number of detected lymph nodes before and after acetone workup. Results A mean number of 23,1 LN was diagnosed after standard manual LN preparation. With complete embedding of the fatty tissue using acetone compression, the number increased to 40.5 lymph nodes (p < 0.0001). The mean number of metastatic LN increased from 3.2 to 4.2 nodal metastases following acetone compression (p < 0.0001). Additional LN metastases which caused a change in the primary (y)pN stage were found in ten patients (13.0%). Conclusions Advanced lymph node retrieval by acetone compression allows a reliable statement on the real number of removed LN. Results demonstrate an impact on the nodal UICC stage. A future multicenter study will examine the prognostic impact of improved lymph node retrieval on long-term oncologic outcome.

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Prognostic Impact of Lymphadenectomy in Different Stages of Malignant Germ Cell Tumor of the Ovary Based on Propensity Score Matching

Combinatorial Chemistry & High Throughput Screening ◽

10.2174/1386207322666181220121836 ◽

2019 ◽

Vol 21 (9) ◽

pp. 652-661 ◽

Cited By ~ 2

Author(s):

Ying Chen ◽

Yang Ning ◽

Qinghua Zhang ◽

Ying Xie

Keyword(s):

Lymph Node ◽

Propensity Score ◽

Germ Cell ◽

Propensity Score Matching ◽

Germ Cell Tumor ◽

Cell Tumor ◽

Stage I ◽

Prognostic Impact ◽

Lymph Node Resection ◽

Malignant Germ Cell Tumor

Background: Lymphadenectomy has been widely used in the treatment of malignant germ cell tumor of the ovary (OGCT), which is a kind of ovarian cancers occurred mostly in young women and adolescent girls. But the clinical decision mainly depends on the doctor’s experience without a well-defined guideline. This population-based study aimed to evaluate the prognostic impact of lymphadenectomy in different stages of malignant germ cell tumors of the ovary. Methods: Patients with known status of lymphadenectomy in different stages of OGCT were explored from the Surveillance, Epidemiology, and End Results (SEER) program database from 1973 to 2013. We used propensity score matching algorithm to reduce the selection bias between the two study groups. Survival curves, univariate and multivariate Cox proportional hazards model were applied to evaluate the prognostic impact of lymphadenectomy in different stages of OGCT. Results: We included 1,996 OGCT patients in the study, and 818 (41%) of them had lymph node resection. Compared to the LND- group, patients with lymph node resection tended to be at stage II and III, had larger tumor sizes and diagnosed as dysgerminoma. The influence of diagnosis ages, marital status and tumor grades were significantly decreased by applying the propensity score matching. Lymphadenectomy-positive (LND+) group demonstrated significantly worse survival than the lymphadenectomy-negative (LND-) group in later stages (stage III, overall, P=0.027, cancerspecific, P=0.006; stage IV, overall, P=0.034, cancer-specific, P=0.037). While, both the overall and cancer-specific survival showed no significant differences between LND+ and LND- in stage I (overall, P=0.411, cancer-specific, P=0.876) and stage II (overall, P=12, cancer-specific, P=0.061). Univariate (overall, HR=1.497, CI=1.010-2.217, P=0.044; cancer-specific, HR=1.524, CI=1.067- 2.404, P=0.050) and multivariate (overall, HR=1.580, CI=1.046-2.387, P=0.030; cancer-specific, HR=1.661, CI=1.027-2.686, P=0.039) Cox proportional model both verified the association between the lymph node resection and better survival in the whole cohort. Conclusion: Lymphadenectomy significantly increased the survival probability of OGCT patients in stage III and IV, but had no significant influence on early-stage patients (stage I and II), indicating lymphadenectomy should be performed in a stage-dependent manner in clinical utility.

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Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01466-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xuan Liu ◽

Leilei Wu ◽

Dongkun Zhang ◽

Peng Lin ◽

Hao Long ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cox Regression ◽

Left Gastric Artery ◽

Prognostic Impact ◽

Gastric Artery ◽

Term Survival

Abstract Background Although the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC. Methods This study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan–Meier analysis and the log-rank test were used to present a classifying effect based on LN status. Results LNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P < 0.001). Conclusions This study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).

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Prognostic impact of examined lymph node count in pT1N0M0 esophageal cancer: A population‐based study

Thoracic Cancer ◽

10.1111/1759-7714.13130 ◽

2019 ◽

Vol 10 (7) ◽

pp. 1636-1643 ◽

Cited By ~ 3

Author(s):

Ying Liu ◽

Heli Yang ◽

Hao Fu ◽

Meng Li ◽

Zhen Feng ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Node ◽

Population Based ◽

Prognostic Impact ◽

Population Based Study ◽

Lymph Node Count ◽

Node Count

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Significance of Concurrent Chemoradiotherapy as Primary Treatment in Patients with Metastatic Cervical Cancer

Current Oncology ◽

10.3390/curroncol28030155 ◽

2021 ◽

Vol 28 (3) ◽

pp. 1663-1672

Author(s):

Satomi Hattori ◽

Nobuhisa Yoshikawa ◽

Kazumasa Mogi ◽

Kosuke Yoshida ◽

Masato Yoshihara ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Size ◽

Concurrent Chemoradiotherapy ◽

Primary Treatment ◽

Prognostic Impact ◽

Primary Tumor Size ◽

Node Metastasis ◽

Aortic Lymph Node

(1) This study investigated the prognostic impact of tumor size in patients with metastatic cervical cancer. (2) Methods: Seventy-three cervical cancer patients in our institute were stratified into two groups based on distant metastasis: para-aortic lymph node metastasis alone (IIIC2) or spread to distant visceral organs with or without para-aortic lymph node metastasis (IVB) to identify primary tumor size and concurrent chemoradiotherapy. (3) Results: The overall survival (OS) for patients with a tumor >6.9 cm in size was significantly poorer than that for patients with a tumor ≤6.9 cm in the IVB group (p = 0.0028); the corresponding five-year OS rates in patients with a tumor ≤6.9 and >6.9 cm were 53.3% and 13.4%, respectively. In the multivariate analysis, tumor size and primary treatment were significantly associated with survival in metastatic cervical cancer. (4) Conclusions: Tumor size ≤6.9 cm and concurrent chemoradiotherapy as the primary treatment were favorable prognostic factors for patients with metastatic cervical cancer.

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Identifying Biomarkers in Lymph Node Metastases of Esophageal Adenocarcinoma for Tumor-Targeted Imaging

Molecular Diagnosis & Therapy ◽

10.1007/s40291-020-00448-9 ◽

2020 ◽

Vol 24 (2) ◽

pp. 191-200 ◽

Cited By ~ 1

Author(s):

D. J. J. M. de Gouw ◽

M. Rijpkema ◽

T. J. J. de Bitter ◽

V. M. Baart ◽

C. F. M. Sier ◽

...

Keyword(s):

Lymph Node ◽

Esophageal Adenocarcinoma ◽

Lymph Node Metastases ◽

Targeted Imaging ◽

Node Metastases

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The Prognostic Impact of Occult Lymph Node Metastasis in Node-negative Gastric Cancer: A Systematic Review and Meta-analysis

Annals of Surgical Oncology ◽

10.1245/s10434-013-3021-7 ◽

2013 ◽

Vol 20 (12) ◽

pp. 3927-3934 ◽

Cited By ~ 22

Author(s):

Jin-yu Huang ◽

Ying-ying Xu ◽

Min Li ◽

Zhe Sun ◽

Zhi Zhu ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Meta Analysis ◽

Prognostic Impact ◽

Node Negative ◽

Node Metastasis ◽

Occult Lymph Node Metastasis

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Prognostic impact of extracapsular lymph node involvement in colorectal cancer

Annals of Oncology ◽

10.1093/annonc/mdw031 ◽

2016 ◽

Vol 27 (5) ◽

pp. 955 ◽

Cited By ~ 4

Author(s):

Q. Huang ◽

X. Qin

Keyword(s):

Colorectal Cancer ◽

Lymph Node ◽

Lymph Node Involvement ◽

Prognostic Impact ◽

Node Involvement

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116 PROGNOSTIC IMPACT OF THE SHORT-AXIS DIAMETER FOR THE NODAL ASSESSMENT BEFORE PREOPERATIVE CHEMOTHERAPY IN ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doab052.116 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Hiroshi Ichikawa ◽

Natsuru Sudo ◽

Takeo Bamba ◽

Takaaki Hanyu ◽

Yosuke Kano ◽

...

Keyword(s):

Lymph Node ◽

Preoperative Chemotherapy ◽

Primary Treatment ◽

Prognostic Impact ◽

Short Axis ◽

Metastatic Node ◽

Nodal Diameter ◽

Number Of Patients ◽

Group 5

Abstract Clinical N category (cN) is generally assessed by measuring the nodal diameter by CT before the initiation of primary treatment in esophageal squamous cell carcinoma (ESCC). The short-axis diameter is recommended for evaluating treatment response in solid tumors by RECIST. This study aimed to elucidate the prognostic implication of the maximum short-axis diameter of lymph node (cN-size) before preoperative chemotherapy for ESCC. Methods We enrolled a total of 152 patients who underwent preoperative cisplatin/5-fluorouracil therapy (CF) followed by esophagectomy from 2005 to 2011. There were 127 men and 25 women with a median age of 65 years (range: 47–79 years). Clinically metastatic node was defined as follows; the node with cN-size ≥10 mm or that with 5 mm ≤ cN-size <10 mm and contrast enhancement, round shape and/or central necrosis in CT before starting CF. The association between the maximum cN-size and the overall survival (OS) after surgery was statistically investigated. The median follow-up period was 87 months (range: 36–145 months). Results The number of patients with cN0 and cN1–3 was 60 and 92, respectively. Twenty-seven and 65 patients with cN1–3 were classified into cN-size <10 mm and cN-size ≥10 mm group, respectively. The 5-year OS rates in cN0, cN-size <10 mm and cN-size ≥10 mm groups were 70%, 51% and 45%, respectively (P = 0.006). Among Ut-Mt tumors, the OS in the cN-size <10 mm group was significantly worse than that in the cN0 group (5-year OS rate: 45% vs. 74%, P = 0.048). However, there were no significant differences in the OS between these two groups in Lt tumors (67% vs. 64%, P = 0.789). Conclusion The maximum short-axis diameter of lymph node before preoperative chemotherapy is significantly associated with OS in patients with ESCC. Lymph node with 5 mm ≤ cN-size <10 mm in the short axis should be treated as a metastatic node especially in Ut or Mt tumors, considering the poor prognosis.

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