Factors Affecting 18F-FDG Uptake by Metastatic Lymph Nodes in Gastric Cancer

PURPOSE To determine which is the better prognostic determinant in gastric cancer: number of positive metastatic lymph nodes or current nodal stage. PATIENTS AND METHODS Seven hundred seventy-seven patients who underwent potentially curative resections for gastric cancer were divided into three groups according to the depth of invasion. The influence of the number of positive nodes on their survival rate was analyzed. A multivariate analysis by the Cox proportional hazards model was used to determine independent prognostic factors. RESULTS A decreased survival rate was associated with an increased number of positive nodes in all of the subjects and in each of the three groups. Patients with one to three positive nodes had as good a prognosis as those without nodal involvement when each of the three groups was analyzed separately. Using a multivariate analysis in the patients with four or more positive nodes, we found that the number of positive nodes was the most important prognostic determinant (P < .0001), followed by the depth of invasion (P < .02), and that the nodal stage was not significantly prognostic. Further multivariate analysis in the patients with one to three positive nodes showed that nodal stage and number of positive nodes were not significantly prognostic. CONCLUSION The number of metastatic nodes should be adopted for classification of nodal stage in gastric cancer.

Download Full-text

Nuclear karyopherin-α2 expression in primary lesions and metastatic lymph nodes was associated with poor prognosis and progression in gastric cancer

Carcinogenesis ◽

10.1093/carcin/bgt214 ◽

2013 ◽

Vol 34 (10) ◽

pp. 2314-2321 ◽

Cited By ~ 37

Author(s):

Bolag Altan ◽

Takehiko Yokobori ◽

Erito Mochiki ◽

Tetsuro Ohno ◽

Kyoichi Ogata ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Nodes ◽

Poor Prognosis ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph

Download Full-text

Validation study of sentinel lymph node mapping using radio- and dye-guided methods in gastric cancer: 431 cases at a single institution.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.76 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 76-76

Author(s):

M. Niihara ◽

H. Takeuchi ◽

S. Kamiya ◽

T. Kaburagi ◽

T. Oyama ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Early Gastric Cancer ◽

Lymph Nodes ◽

False Negative ◽

Tumor Diameter ◽

Remnant Gastric Cancer ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph

76 Background: Some papers have reported that sentinel lymph node (SLN) concept can be applied in patients with early gastric cancer, in particular clinically T1N0M0 or T2N0M0 with a tumor diameter of 4cm or less. Little is, however, available on the SLN study with the other criteria than listed above. The aim of the present work was to investigate the accuracy of the SLN biopsy of gastric cancer with various stages and evaluate the indication for SLN navigated gastrectomy. Methods: A total of 431 consecutive patients were diagnosed with operable gastric cancer during the period April 1999 through December 2007. Reasons for inclusion were, in principle, T1N0M0 or T2N0M0 gastric cancer. However, several patients diagnosed preoperatively with T3N0M0, T2N1M0, remnant gastric cancer, multiple gastric cancers and additional treatment after endoscopic therapy were also enrolled in this study according to their request. All patients underwent a radical gastrectomy with SLN mapping with an informed consent. The SLNs were identified using both radio-guided and dye-guided method. Results: Detection rate of hot and/or blue node was 95.8% (413/431). The accuracy of metastatic status based on SLN was 97.6% (403/413). In six of 10 false-negative cases, some clinical backgrounds and problems were present; scirrhous gastric cancer, the tumor penetration of serosa, multiple lesions, remnant gastric cancer after partial resection and the technical issue of tracer injection. Nine of these 10 false-negative cases had the metastatic lymph nodes within only the sentinel basins. Specifically, in the group of clinically T1N0M0 untreated gastric cancer with a tumor diameter of 4 cm or less, there were only 3 false- negative cases. In addition, all the metastatic lymph nodes of the 3 cases located within the sentinel basins. Conclusions: Our study suggested that SLN concept for untreated early gastric cancer could be validated. The sentinel basin dissection might be used to advantage to improve curativity for gastric cancer. No significant financial relationships to disclose.

Download Full-text

Expression of PI3K/p-AKT/p-mTOR in gastric carcinoma and its correlation with clinicopathologic characteristics.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.73 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 73-73

Author(s):

Ying Jieer ◽

Xu Qi ◽

Liu Bixia ◽

Cheng Xiangdong

Keyword(s):

Gastric Cancer ◽

Lymph Nodes ◽

Expression Patterns ◽

Clinicopathological Characteristics ◽

Mtor Pathway ◽

Clinicopathologic Characteristics ◽

Primary Tumors ◽

Metastatic Lymph Nodes ◽

Metastatic Lymph ◽

Tumor Specificity

73 Background: The objective of this study was to explore the expression patterns of PI3K/p-AKT/p-mTOR in gastric cancer (GC) and its relationship with clinicopathological characteristics and thereby to understand the role of activated PI3K/AKT/mTOR pathway in the initiation and development of gastric cancer. Methods: Envision immunohistochemistry assay was used to examine the expression patterns of PI3K, p-AKT and p-mTOR in primary GC sites, metastatic lymph nodes and peritumoral mucosa among 50 patients who underwent radical gastrectomy for stage I-IV (M0) gastric cancer. Results: The PI3K, p-AKT and p-mTOR showed significantly higher expressions in primary tumor sites and metastatic lymph nodes as compared to that of the peritumoral mucosa. The study of the pathway components and clinicopathological characteristics revealed that p-AKT and p-mTOR expressions were selectively higher in primary tumors with less than 5 cm diameter. The PI3K, p-AKT and p-mTOR positive patients had shorter median survival time as compared to the patients negative for them (42.8 m vs. 57.0 m, 46.8 m vs. 55.9 m, 47.2 m vs. 53.0 m). However, the differences were not statistically significant. Conclusions: Activation of PI3K/AKT/mTOR pathway was associated with the development and prognosis of gastric cancer. The expression of PI3K/p-AKT/p-mTOR was correlated well with tumor specificity in gastric cancer and they might have some potential as promising targets for clinical therapy.

Download Full-text