Metastatic Spread of Stage I Melanoma of the Skin

1983 ◽  
Vol 69 (5) ◽  
pp. 449-454 ◽  
Author(s):  
◽  
Natale Cascinelli ◽  
Ferdinando Preda ◽  
Maurizio Vaglini ◽  
Sergio Orefice ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Regional Lymph Node ◽  
Distant Metastases ◽  
Stage I ◽  
Regional Lymph Nodes ◽  
Prognostic Criteria ◽  
Regional Node ◽  
Node Metastases

1164 patients with stage I melanoma of the skin who were submitted to wide excision only of the primary tumor were studied to evaluate the rates of regional lymph node and distant metastases. Of these, 516 (44.3%) had a recurrence of the disease which was at regional lymph nodes in 264 (22.7%), at distant sites in 91 (7.8%), and simultaneously at regional lymph nodes and distant sites in 161 (13.8%). Most of the patients had a relapse within 5 years: regional node metastases were most frequently observed during the first 3 years, and distant metastases appeared later. The ratio regional:distant metastases was not different (P > 0.05) when subgroups of patients were considered according to prognostic criteria (sex, site of origin, levels, thickness, ulceration). Sex, levels, thickness and ulceration were found to be significantly related with the frequency of recurrences (regional and distant). It is concluded that the prognostic criteria considered do not predict whether the tumor will metastasize to regional nodes or to distant sites.

scholarly journals Origins of lymphatic and distant metastases in human colorectal cancer

Science ◽  
2017 ◽  
Vol 357 (6346) ◽  
pp. 55-60 ◽  
Author(s):  
Kamila Naxerova ◽  
Johannes G. Reiter ◽  
Elena Brachtel ◽  
Jochen K. Lennerz ◽  
Marc van de Wetering ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Phylogenetic Trees ◽  
Evolutionary Relationship ◽  
Distant Metastases ◽  
Human Colorectal Cancer ◽  
Regional Lymph Nodes ◽  
Primary Tumors

The spread of cancer cells from primary tumors to regional lymph nodes is often associated with reduced survival. One prevailing model to explain this association posits that fatal, distant metastases are seeded by lymph node metastases. This view provides a mechanistic basis for the TNM staging system and is the rationale for surgical resection of tumor-draining lymph nodes. Here we examine the evolutionary relationship between primary tumor, lymph node, and distant metastases in human colorectal cancer. Studying 213 archival biopsy samples from 17 patients, we used somatic variants in hypermutable DNA regions to reconstruct high-confidence phylogenetic trees. We found that in 65% of cases, lymphatic and distant metastases arose from independent subclones in the primary tumor, whereas in 35% of cases they shared common subclonal origin. Therefore, two different lineage relationships between lymphatic and distant metastases exist in colorectal cancer.

Breast Cancer: Primary Tumor Characteristics Related to Lymph Node Involvement

1981 ◽  
Vol 67 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Alessandro Rasponi ◽  
Alberto Costa ◽  
Rosaria Bufalino ◽  
Alberto Morabito ◽  
Maurizio Nava ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Lymph Node Involvement ◽  
Maximum Diameter ◽  
Histologic Type ◽  
Regional Lymph Nodes ◽  
The Status ◽  
Node Involvement ◽  
Node Metastases

From November 1st 1977 to August 31st 1978, 842 consecutive patients with operable breast cancer were observed at the National Cancer Institute of Milan. Characteristics of the primary tumor and the status of regional lymph nodes were evaluated at clinical and postsurgical examination: it was found that qualitative characteristics of the primary were properly defined by clinicians, who usually overestimated maximum diameter of the primary. The status of regional lymph nodes is not reliable at clinical examination: 34.5 % of clinically uninvolved nodes were found to contain metastatic growth at histologic examination. Age of patients, maximum diameter of the primary, histologic type and quadrant of origin of the primary tumor were significantly related to the frequency of regional node metastases. Multifactorial analysis showed that the last three factors were independent variables, while age, which is significant by itself, loses importance when adjusted by at least one of the other three factors. Frequency of extension of node metastases beyond the lymph node capsule was found to be related to the number of involved nodes: maximum diameter, histologic type and site of origin are significantly related to the frequency of extracapsular invasion. This study confirms that the evaluation of the status of regional lymph nodes is not reliable at clinical examination and indicates that characteristics of the primary may be useful in predicting regional lymph node involvement. The direct correlation between the number of involved nodes and the frequency of infiltration beyond the capsule suggests that prognosis of patients with positive nodes depends more on this factor than on the number of involved nodes.

Additional Prone 18F-FDG PET/CT Acquisition to Improve the Visualization of the Primary Tumor and Regional Lymph Node Metastases in Stage II/III Breast Cancer

2016 ◽  
Vol 41 (4) ◽  
pp. e181-e186 ◽  
Author(s):  
Suzana Cipriano Teixeira ◽  
Bas B. Koolen ◽  
Wouter V. Vogel ◽  
Jelle Wesseling ◽  
Marcel P. M. Stokkel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Regional Lymph Node ◽  
Pet Ct ◽  
Node Metastases ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals Clinical, morphological, and molecular genetic predictors of metastatic lesions in the regional lymph nodes in breast cancer

2018 ◽  
Vol 5 (3) ◽  
pp. 8-16
Author(s):  
Yu. A. Dergunova ◽  
V. V. Podionov ◽  
V. K. Bozhenko ◽  
V. V. Kometova ◽  
M. V. Dardyk
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Molecular Genetic ◽  
Regional Lymph Nodes ◽  
Genetic Characteristics ◽  
Metastatic Lesions ◽  
Genetic Predictors ◽  
Node Metastases ◽  
High Degree

Despite the sufficient amount of data accumulated in the literature, there are still no factors, on the basis of which it would be possible to estimate the regional lymph nodes status in breast cancer with a high degree of accuracy. The review presents literature data relating to the influence of clinicopathological, molecular-biological and genetic characteristics of primary tumor on lymph node metastases. Data of 66 foreign and Russian articles are included.

scholarly journals Clonal evolution of esophageal squamous cell carcinoma from normal mucosa to primary tumor and metastases

2019 ◽  
Author(s):  
Wenqing Yuan ◽  
Zhen Liu ◽  
Yu Wang ◽  
Mengfei Liu ◽  
Yaqi Pan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Phylogenetic Analysis ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Node Metastases ◽  
Primary Tumor ◽  
Regional Lymph Node ◽  
Clonal Evolution ◽  
Normal Mucosa ◽  
Node Metastases

Abstract The clonal evolution which drives esophageal squamous cell carcinoma (ESCC) from initiation in normal cell to primary carcinoma and metastases is poorly understood. In this study, multi-region whole-exome sequencing (WES) (284X) and whole-genome single nucleotide polymorphism genotyping were performed on a total of 109 samples of ESCC from 10 patients. This included 42 apparently normal samples of esophageal mucosa at increasing distances from the upper or lower boundaries of the primary tumor to the surgical margins of resection, 43 spatially separated tissue samples within primary tumor and 24 regional lymph node metastases. Phylogenetic analysis was performed to reconstruct ancestor–descendant relationships of clones and the clonal composition of multi-region samples. Mutations of cancer-related genes were validated by deep targeted sequencing (1,168X). Both inter- and intra-tumoral genetic heterogeneity were obvious across multi-region samples among ESCC patients. Clones varying in number from one to seven were discovered within each regional tumor or metastatic sample. Phylogenetic analysis demonstrated complex clonal evolution patterns. Regional lymph node metastases had characteristics of early initiation and polyclonal spreading, and could be derived from carcinoma in situ (CIS) directly. TP53 was the only gene harboring non-silent mutations identified across all multi-region tumor samples of all ten patients. Mutations of TP53 were also found in histologically normal mucosa in sites away from primary tumor.

scholarly journals Simultaneous Renal Oncocytoma and Lymphoma: Interest of Lymphadenectomy

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Angela Orcurto ◽  
Benoît Lhermitte ◽  
Alain Sermier ◽  
Dominik Berthold
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Renal Oncocytoma ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Regional Lymph Node Dissection ◽  
Histological Confirmation ◽  
Kidney Lesions

Kidney lesions may be difficult to diagnose only by radiological exams, often requiring proof by tissue biopsy. Moreover, if enlarged regional lymph nodes are also present, the spectrum of differential diagnoses is even greater. The role of regional lymph node dissection in this setting is not clearly established. We show the case of a patient with a kidney mass associated with a conglomerate of para-aortic and iliac lymphadenopathies corresponding to an oncocytoma and a nodular lymphocyte predominant Hodgkin' lymphoma, respectively. Diagnosis of these two lesions was performed by morphology and immunohistochemistry. This case reflects how imaging can mislead to diagnosis and how histological confirmation helps decide treatment management.

Recurrences in the Soft Tissues of the Neck after Surgery or Radiotherapy plus Surgery on Regional Lymph Nodes in Patients Bearing Carcinomas of the Head and Neck

1983 ◽  
Vol 69 (3) ◽  
pp. 255-259 ◽  
Author(s):  
Sante Basso-Ricci ◽  
Roberto Molinari ◽  
Gian Franco Brambilla
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Soft Tissues ◽  
Postoperative Radiotherapy ◽  
Cervical Region ◽  
Preoperative Radiation ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Node Metastases

A series of 45 recurrences in the soft tissues of the neck following lymph node dissection in 497 patients bearing carcinoma of the upper aerodigestive passages is reported. Only 22 cases that presented perilymph node metastases and/or in which there were reasons to indicate insufficient surgical radicality had been subjected to radiotherapy after surgical lymph node dissection; the other 23 cases had not been subjected to radiotherapy because the aforementioned premises had been lacking. All the recurrences therefore occurred in patients with clinically and histologically ascertained metastatic lymph nodes. The presence of perilymph node metastases and the judgement of surgical radicality was thus found insufficient criteria to plan future complementary postoperative radiotherapy. However, even in those cases in which postoperative radiotherapy was performed, there was a rather high incidence of recurrences, as high as 64.7% in patients with carcinoma of the tongue. Our data indicate the opportunity of a clinical trial with preoperative radiation therapy in patients with clinically evident lymph node metastases. Thirty-six of these recurrences were situated in the upper parts of the cervical region. The prognosis is very poor in such cases, so much so that only 2 of our series were disease free at 3 years after the treatment.

scholarly journals Dermatofibrosarcoma Protuberans of Scalp With Cervical Lymph Node Metastasis

Sarcoma ◽  
2004 ◽  
Vol 8 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Pawan Lal ◽  
Arun Goel ◽  
A. K. Mandal
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Regional Lymph Node ◽  
Radical Neck Dissection ◽  
Dermatofibrosarcoma Protuberans ◽  
Wide Excision ◽  
High Rate ◽  
Regional Lymph Nodes ◽  
Node Metastasis

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, slow growing and locally aggressive tumor of the skin with a high rate of recurrence even after supposedly wide excision. The reports of regional lymph node metastasis and distant metastasis are very rare. Because of the extreme rarity of these cases with metastasis, the experience with management of such patients is very limited. A case of recurrent DFSP of scalp, with metastasis to the regional lymph nodes, in a 17-year-old boy is reported here. This is the second case of DFSP involving scalp and 16th case of DFSP of all sites metastasizing to the regional lymph nodes reported in literature. The patient was treated with wide excision of the lesion and ipsilateral radical neck dissection (including excision of overlying involved skin).

Clinical outcomes of adjuvant external-beam radiotherapy for differentiated thyroid cancer

2009 ◽  
Vol 48 (03) ◽  
pp. 89-98 ◽  
Author(s):  
M. K. Pixberg ◽  
B. Riemann ◽  
A. Schuck ◽  
A. Heinecke ◽  
K. W. Schmid ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Differentiated Thyroid Cancer ◽  
Regional Lymph Node ◽  
Statistical Significance ◽  
External Beam Radiotherapy ◽  
Distant Metastases ◽  
External Beam ◽  
Node Metastases

Summary Aim: Evaluate the clinical benefit of external beam radiotherapy (RTx) for locally invasive thyroid carcinoma with follicular cell differentiation (DTC). Patients, methods: The Multicentre Study on Differentiated Thyroid Cancer (MSDS) was planned as a prospective multicenter trial on the benefit of adjuvant RTx in locally invasive DTC (pT4; UICC 1997) with or without lymph node metastases and no known distant metastases. All patients were treated with thyroidectomy, 131I-therapy, and TSH-suppression and were randomized to receive additional RTx or not. In 4/2003 the trial became a prospective cohort study after only 45 of then 311 patients had consented to randomization. 351 of 422 patients met the trial's inclusion criteria. Age was 48 ± 12 years (mean ± SD). 25% were men. Tumours were papillary in 90% and follicular in 10%. Of 47 patients randomized or allocated to RTx, 26 actually received RTx. Results: Mean followup was 930 days. In an actual treatment analysis, 96% (25/26) of the RTx-patients reached complete remission (CR) vs. 86% in the non-RTx patients. Recurrences occurred in 0 vs. 3 % of patients: 6 reoperated for regional lymph node metastases, 1 tracheal invasion treated with tracheoplasty, 1 local invasion necessitating laryngectomy, 2 distant metastases (1 lung, 1 lung + bone). Serious chronic RTx toxicity occurred in 1/26 patients. Conclusion: The MSDS trial showed low mortality and recurrence rates and a weak benefit of RTx in terms of local control that did however not reach statistical significance. Routine RTx in locally invasive DTC can no longer be recommended .

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