The risk of nodal metastasis in early adenocarcinoma of the uterine cervix*

2004 ◽  
Vol 14 (1) ◽  
pp. 104-109 ◽  
Author(s):  
J. Balega ◽  
H. Michael ◽  
J. Hurteau ◽  
D. H. Moore ◽  
J. Santiesteban ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Medical Center ◽  
Conservative Surgery ◽  
Disease Recurrence ◽  
Nodal Metastasis ◽  
Pelvic Lymphadenectomy ◽  
Depth Of Invasion ◽  
Nodal Metastases ◽  
Node Metastases

A functional and widely accepted definition of microinvasive cervical adenocarcinoma remains elusive. The purpose of this study was to determine at which depth of invasion the likelihood of lymph node metastasis or disease recurrence was so small that conservative surgery could be considered appropriate. Charts of patients with adenocarcinoma of the cervix (ACC) who underwent radical hysterectomy and pelvic lymphadenectomy (n = 98) at Indiana University Medical Center from 1987 to 1998 were retrospectively reviewed. Patients with stage IA1–IB1 lesions were included in the study. Patients treated with preoperative radiotherapy were excluded. Pathologic parameters evaluated included histologic type, depth of stromal invasion (DOI), and the presence of lymphatic vascular space invasion, or lymph node metastases. The patient median age was 39 years (20–65). The median time of follow-up was 30 months (4–124). Lymph node metastases were found in ten patients and 11 developed recurrences. The precise DOI could be measured in 84 patients. Of the 48 patients with cancers with a DOI ≤ 5 mm, none had involved parametria or nodes; whereas eight of the 36 with a DOI > 5 mm had nodal metastases (P = 0.00069). None of these 48 patients with a tumor DOI ≤ 5 mm developed a recurrence whereas six of the 36 patients with a tumor DOI > 5 mm developed recurrent disease (P = 0.0048). The risk of nodal metastases and recurrence is so low in patients with ACC and DOI ≤ 5 mm that for patients with such depth documented on conization with negative margins pelvic lymphadenectomy may be omitted.

856 NODAL METASTASES AFTER NEOADJUVANT CHEMORADIATION AND R0 RESECTION IN ESOPHAGEAL ADENOCARCINOMA: PATTERNS AND PROGNOSIS

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Caitlin Harrington ◽  
Rebecca Carr ◽  
Smita Sihag ◽  
Prasad Adusumilli ◽  
Manjit Bains ◽  
...  
Keyword(s):  
Lymph Node ◽  
Esophageal Adenocarcinoma ◽  
Lymph Node Metastases ◽  
Cox Regression ◽  
Neoadjuvant Chemoradiation ◽  
Nodal Metastasis ◽  
Nodal Metastases ◽  
Risk Of Recurrence ◽  
Increased Risk ◽  
Node Metastases

Abstract   Although the pattern of nodal metastasis and the prognosis of number and location of positive nodes have been well described with esophageal cancer undergoing upfront surgery, little is known about nodal metastasis after neoadjuvant treatment. The aim of this study is to assess the pattern of nodal metastases in esophageal adenocarcinoma treated with neoadjuvant chemoradiation and surgery and evaluate its effect on prognosis. Methods All patients with esophageal adenocarcinoma who had undergone neoadjuvant chemoradiation and an R0 esophagectomy between 2010 and 2018 at our institution were included (n = 577). Pathology reports were reviewed for sites of lymph node metastases. Patients were excluded if nodal stations were not listed separately (n = 40). Age, sex, race, tumor location, TRG, pT stage, number of positive lymph nodes, number of positive nodal stations, and specific nodal stations were analyzed for risk of recurrence using univariable Cox regression, and significant covariates were included in multivariable Cox regression model. Results Of 537 patients, 193(36%) had pathologic nodal metastases. 153 patients(28%) had single-station disease: 135(88%) at the paraesophageal station, 16(10%) at the left gastric, 1 at the subcarinal and 1 at the paratracheal station(0.65% each). 32 patients(6.0%) had two-station and 8(1.5%) had three-station disease. The majority of patients with multiple positive nodal stations had positive nodes in the paraesophageal(90%) and/or left gastric artery stations(60%). On multivariable analysis, the number of positive nodal stations (HR 1.59, CI 1.35–1.84, p < 0.001), subcarinal (HR 2.78, CI 1.54–5.03, p < 0.001), and paraesophageal stations (HR 2.0, CI 1.58–2.54, p < 0.001) were associated with increased risk of recurrence. Conclusion Patients who have undergone neoadjuvant and R0 esophagectomy for adenocarcinoma often have lymph node metastases at time of surgery, most commonly at the paraesophageal station. The number of nodal stations, along with subcarinal and paraesophageal metastases, were associated with increased risk of recurrence.

1849 LOCATION OF TUMOR IN THE BLADDER PREDICTS LIKELIHOOD OF LYMPH NODE METASTASES AT RADICAL CYSTECTOMY AND DISEASE RECURRENCE

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Robert Svatek ◽  
Clark Wilson ◽  
Vipal Durkal ◽  
Stephen Culp ◽  
H. Barton Grossman ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Cystectomy ◽  
Lymph Node Metastases ◽  
Disease Recurrence ◽  
Node Metastases

RE: PELVIC LYMPH NODE METASTASES FROM BLADDER CANCER: OUTCOME IN 83 PATIENTS AFTER RADICAL CYSTECTOMY AND PELVIC LYMPHADENECTOMY

2002 ◽  
Vol 167 (2 Part 1) ◽  
pp. 651-651
Author(s):  
R.D. Mills ◽  
W.H. Turner ◽  
A. Fleischmann ◽  
R. Markwalder ◽  
G.N. Thalmann ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Radical Cystectomy ◽  
Lymph Node Metastases ◽  
Pelvic Lymphadenectomy ◽  
Pelvic Lymph Node ◽  
Node Metastases ◽  
Cancer Outcome

Multivariate analysis of prognostic factors among 706 mucosal melanoma patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 9569-9569
Author(s):  
Bin Lian ◽  
Chuanliang Cui ◽  
Li Zhou ◽  
Xin Song ◽  
Xiaoshi Zhang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Survival Rate ◽  
Lymph Node Metastases ◽  
Distant Metastases ◽  
Mucosal Melanoma ◽  
Depth Of Invasion ◽  
Prognostic Analysis ◽  
Node Metastases

9569 Background: Mucosal melanoma is rare and associated with extremely poor prognosis. Little is known about its outcome and prognostic analysis. In this study, we evaluated prognostic factors among mucosal melanomas. Methods: The survival rates, Relapse Free Survival (RFS), Overall Survival (OS) and prognostic factors were compared for 706 mucosal melanomas at different anatomical sites. Results: Mucosal melanoma from nasal pharyngeal and oral (268 pts), upper and lower gastrointestinal (GI) (221 pts), gynecological and urological (196 pts) had a similar survival with a 1-y survival rate (88%, 83%, 86%), 2-y survival rate (66%, 57%, 61%), 5-y survival rate (27%, 16%, 20%), respectively. Multivariate analysis revealed that Depth of Invasion (p < 0.001), Lymph node metastases (p < 0.001), Distant metastases (p < 0.001) were three independent prognostic factors for OS among 706 pts. Anatomical site (p = 0.031), Depth of Invasion (p < 0.001), Lymph node metastases (p < 0.001) were three independent prognostic factors for RFS among 543 pts. KPS status, Depth of Invasion, Lymph node metastases, Distant metastases were independent factors for OS among nasal pharyngeal and oral pts. Depth of Invasion, Lymph node metastases, CKIT Mutation were independent factors for RFS among nasal pharyngeal and oral pts. Gender, Lymph node metastases, Distant metastases were independent factors for OS among GI pts. Gender, Depth of Invasion, Lymph node metastases were independent factors for RFS among GI pts. Lymph node metastases, Distant metastases were independent factors for OS among Gynecological and Urological pts. Depth of Invasion, Lymph node metastases were independent factors for RFS among Gynecological and Urological pts. Conclusions: This is the first prognostic analysis for mucosal melanoma with the largest sample size for the first time. with few exceptions, It revealed that Depth of Invasion, Lymph node metastases, Distant metastases were independent prognostic factors for OS, Depth of Invasion and Lymph node metastases were independent prognostic factors for RFS. These results should be incorporated into the establishment of stage system and design of future clinical trials involving patients with mucosal melanoma.

Prediction of lymph node metastases in vulvar cancer: a review

2006 ◽  
Vol 16 (3) ◽  
pp. 963-971 ◽  
Author(s):  
M. H.M. Oonk ◽  
H. Hollema ◽  
J. A. De Hullu ◽  
A. G.J. Van Der Zee
Keyword(s):  
Lymph Node ◽  
Minimally Invasive ◽  
Negative Predictive Value ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
Imaging Techniques ◽  
Diagnostic Methods ◽  
Depth Of Invasion ◽  
Sentinel Node Procedure ◽  
Node Metastases

The aim of this study was to review the literature on currently available non- and minimally-invasive diagnostic methods and analysis of primary tumor characteristics for prediction of inguinofemoral lymph node metastases in patients with primary squamous cell carcinoma of the vulva. We used the English language literature in Pubmed and reference lists from selected articles. Search terms included vulvar carcinoma, prognosis, lymph node metastases, ultrasound, computer tomography, magnetic resonance imaging, positron emission tomography, and sentinel lymph node. No study type restrictions were imposed. Currently no noninvasive imaging techniques exist that are able to predict lymph node metastases with a high enough negative predictive value. A depth of invasion ≤1 mm is the only histopathologic parameter that can exclude patients for complete inguinofemoral lymphadenectomy. No other clinicopathologic parameter allows exclusion of lymph node metastases with a high enough negative predictive value. The minimally invasive sentinel node procedure is a promising technique for selecting patients for complete lymphadenectomy, but its safety has not been proven yet.

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