Lymph Node Involvement and Survival of Pathological Predominant Subtype in Clinical Stage I Adenocarcinoma Using the Forthcoming Eighth Staging System

The results of foot lymphography in 161 patients with endometrial carcinoma, observed from 1968 to 1977 at the Istituto Nazionale Tumori of Milan are reported. Ninety-three were new cases, 40 were recurrences, and 28 were patients who underwent restaging diagnostic procedures without clinical evidence of disease. The majority of the cases were adenocarcinomas (146/161, or 91%), 10 were mixed adenosquamous carcinomas (6%) and 5 (3%) were adenoacanthomas. The overall incidence of pathologic lymphograms was 30% (46/161 patients). The incidence of the lymphatic spread was related to the clinical stage and to the extent of recurrent disease. In fact, in the 93 new cases, lymphography was positive in 11% of patients at stage I, 39% at stage II, 57% at stage III and 67% at stage IV disease. In the 40 pretreated patients, lymph node involvement was 33% in vaginal recurrences, 52% in pelvic abdominal recurrences and 73% in widespread diffusion. Finally, in 28 pretreated patients with no evidence of disease, the incidence of lymph node involvement was 7%. Metastases were found only in the pelvic nodes in 59% of the patients and only in the para-aortic nodes in 10%; in 31%, both chains were simultaneously involved; bilateral involvement was found in 45% of the patients with radiologically proven metastases. The 5-yr survival rate for patients at stage I-II and III disease with positive lymphography was 47.6% as compared with 83.5% for negative cases. In patients at stage I and II, the difference of survival was equal to 23.4%. The reliability of the results is confirmed by the concordance with the data of the literature on histologic involvement, by the first radiologic-anatomic comparison, and by the clinical course of the positive cases. Lymphography is of unquestionable value for an appropriate staging and for a correct treatment. The prognostic significance of the procedure is evident and such as to justify a major therapeutic aggressiveness in positive cases.

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A prospective study to evaluate the impact and independency of depth of invasion in comparison with other clinicopathologic prognostic variables in oral cavity malignancy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200149 ◽

2020 ◽

Vol 6 (2) ◽

pp. 347

Author(s):

Subbiah Shanmugam ◽

Gopu Govindasamy ◽

X. Gerald Anand Raja

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Oral Cavity ◽

Staging System ◽

Lymph Node Involvement ◽

Stage Migration ◽

Depth Of Invasion ◽

Node Metastasis ◽

Node Involvement ◽

The Impact

Background: Depth of invasion is included in the staging of oral cavity malignancies in the recent 8th edition of American Joint Committee on Cancer or tumour, node and metastasis staging system. This study analyses the impact of diffuse optical imaging (DOI) on incidence of lymph node involvement, stage migration, postoperative margin and independency.Methods: Postoperative HPE of fifty patients with oral cavity malignancy operated in our institute from January 2018 were collected. Depth of invasion and other pathological parameters were documented. DOI divided into three groups and statistical analysis done. Results: No lymph node metastasis is found in superficial tumours, 43% of intermediate thickness and 76% of deep tumours had lymph node involvement. Positive margin is seen only in patients with tumour DOI more than 0.5 cm, more than 50% of deep tumours had close margins while 75% of superficial tumours had adequate margin. Out of the 24 T3 tumours in this study 13 were upstaged due to inclusion of DOI, which would have been T2 according to the previous staging system. There is 54.1% (13 out of 24) upstaging in T3 tumours (T2 to T3), 23% (3 out of 13) in T2 (T1 to T2). There is no significant correlation between DOI and anatomical site, tumour size, tumour thickness, lymphovascular invasion and grade.Conclusions: Depth of invasion in oral cavity malignancies impacts adversely lymph node metastasis and margin status. It is an independent prognostic factor in oral cavity malignancy.

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Recent Prediagnostic Aspirin Use, Lymph Node Involvement, and 5-Year Mortality in Women with Stage I–III Breast Cancer: A Nationwide Population-Based Cohort Study

Breast Diseases A Year Book Quarterly ◽

10.1016/j.breastdis.2015.01.027 ◽

2015 ◽

Vol 26 (1) ◽

pp. 32-33

Author(s):

R. Gopal

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Lymph Node ◽

Lymph Node Involvement ◽

Population Based ◽

Stage I ◽

Node Involvement

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Role of Bilateral Pelvic Lymphadenectomy in Prostatic Cancer

Urologia Journal ◽

10.1177/039156039706400313 ◽

1997 ◽

Vol 64 (3) ◽

pp. 348-350

Author(s):

A. Fandella ◽

L. Maccatrozzo ◽

F. Merlo ◽

L. Faggiano ◽

P. Cecchin ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Clinical Stage ◽

Specific Antigen ◽

Elevated Serum ◽

Lymph Node Involvement ◽

Radical Retropubic Prostatectomy ◽

Low Risk ◽

Retropubic Prostatectomy ◽

Node Involvement

Objectives: to identify a group of patients with prostate cancer for whom open staging pelvic lymph node dissection (PLND) could be superfluous. Methods: the medical records of all patients presenting with prostate cancer from January 1992 to December 1996 were reviewed. A total of 118 patients with clinically localized disease were selected to undergo radical retropubic prostatectomy (RRP) preceded by open PLND. Final nodal status was correlated with the value of the preoperative serum prostate specific antigen (PSA) concentration, clinical stage (TNM), and grading (by OMS) to evaluate the predictivity of nodal involvement. We identified 3 groups: PSA <10 ng/ml, T1–2, G1-2, = 1st very low risk, PSA 10 −15, T1-2 - G1-2 = 2nd low risk, PSA <15 T3 or G3 or PSA >15 every T and G = 3rd high risk. Results: overall, only 21 patients (18%) had lymph node metastases. Lymph node involvement was significantly correlated with elevated serum PSA values, high grading, and advanced clinical stage. 35 patients belonged to the first 2 groups, presenting with low PSA and favorable clinical stage and grade, none with lymph node involvement. These patients could have avoided PLND with a very low risk of missing something. Conclusions: open staging PLND may no longer be justified on a routine basis in patients undergoing radical retropubic prostatectomy.

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