Histology as a Prognostic Factor in Early Gastric Cancer

Of 431 patients with gastric cancer observed in our Istitution, 23 (5.3 %) had early gastric cancer (EGC). Macroscopic presentation, histology, depth of invasion, and lymph node involvement were evaluated in all the cases. All patients underwent surgery and an intensive follow-up was performed. Five of the 23 patients progressed, and the risk factors were examined. Histology seemed to be the main prognostic factor in our study, since intestinal type of EGC was associated to a significantly better prognosis. Total gastrectomy is indicated in the proximal localization of EGC, and should perhaps be performed also in cases presenting undifferentiated histology.

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Risk Factors for Lymph Node Involvement of Early Gastric Cancer. Indications of Endoscopic Resection.

The Japanese Journal of Gastroenterological Surgery ◽

10.5833/jjgs.27.17 ◽

1994 ◽

Vol 27 (1) ◽

pp. 17-22

Author(s):

Shingo Yagi ◽

Takuhisa Kawakami ◽

Matsuhei Tanaka ◽

Kouichi Yokoyama ◽

Yasuhiko Tatsuzawa ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Lymph Node Involvement ◽

Node Involvement

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False-Positive Lymph Node Involvement by PET-CT in an Early Gastric Cancer: Kikuchi Fujimoto Disease

Turkiye Klinikleri Journal of Case Reports ◽

10.5336/caserep.2020-77721 ◽

2021 ◽

Vol 29 (1) ◽

pp. 13-16

Author(s):

Sami ACAR

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Early Gastric Cancer ◽

False Positive ◽

Lymph Node Involvement ◽

Positive Lymph Node ◽

Pet Ct ◽

Node Involvement

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Prognostic value of Serum and Tumor Tissue CA 72-4 Content in Gastric Cancer

The International Journal of Biological Markers ◽

10.1177/172460080301800104 ◽

2003 ◽

Vol 18 (1) ◽

pp. 21-27 ◽

Cited By ~ 15

Author(s):

S. Aloe ◽

R. D'alessandro ◽

A. Spila ◽

P. Ferroni ◽

S. Basili ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Prognostic Value ◽

Tumor Tissue ◽

Prognostic Significance ◽

Lymph Node Involvement ◽

Depth Of Invasion ◽

Free Survival ◽

Tissue Content ◽

Node Involvement

To date no general agreement has been reached regarding the prognostic significance of CEA, CA 19-9 and CA 72-4 as serum markers in gastric cancer, and only scattered information is available on the predictive value of marker expression in tumor tissue. Therefore, a longitudinal study was designed to analyze the presurgical serum and tumor tissue content of CA 72-4, CEA and CA 19-9 in 166 patients at different stages of gastric cancer, and to evaluate the possible correlation with clinicopathological features in respect to prognostic information on relapse-free survival. The results obtained showed that 48.4% of patients with tumor recurrence had positive presurgical CA 72-4 levels compared to approximately 24% of patients who remained free of disease. Furthermore, the median presurgical serum CA 72-4 levels were significantly elevated in relapsing patients. Serosa and lymph node involvement as well as positive presurgical serum CA 72-4 levels had independent prognostic value in predicting recurrence. A significant association between disease-free survival and lymph node involvement, depth of invasion and tumor tissue content of CA 72-4 was also demonstrated. We may therefore conclude that CA 72-4 antigen can be considered the marker of choice in the follow-up of gastric cancer patients and may be used as a prognostic indicator of relapse.

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Predictors of lymph node metastasis and residual tumor in early gastric cancer patients after noncurative endoscopic resection: a systematic review and meta-analysis

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820935033 ◽

2020 ◽

Vol 13 ◽

pp. 175628482093503

Author(s):

Bolun Jiang ◽

Li Zhou ◽

Jun Lu ◽

Yizhi Wang ◽

Junchao Guo

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Early Gastric Cancer ◽

Tumor Size ◽

Meta Analysis ◽

Residual Tumor ◽

Node Metastasis

Background: It is challenging to identify the prevalence of lymph node metastasis (LNM) and residual tumor in patients with early gastric cancer (EGC) who underwent noncurative endoscopic resection (ER). This present meta-analysis was aimed to establish imperative potential predictive factors in order to select the optimal treatment method. Methods: A systematic literature search of PubMed, Embase, and Cochrane Library databases was performed through 1 February 2019 to identify relevant studies, which investigated risk factors for LNM and residual tumor in patients with EGC who underwent noncurative ER. Eligible data were systematically reviewed through a meta-analysis. Results: Overall, 12 studies investigating the risk factor of LNM were included, totaling 3015 patients, 7 of which also involved cancer residues. After the present meta-analysis, six predictors, including tumor size >30 mm, tumor invasion depth (⩾500 μm from the muscularis mucosae), macroscopic appearance, undifferentiated histopathological type, positive vertical margin, and presence of lymphovascular invasion (including lymphatic invasion and vascular invasion) were significantly associated with LNM, whereas tumor size >30 mm, positive horizontal margin, and positive vertical margin were identified as significant predictors for the risk of residual tumor. No evidence of publication bias was observed. Conclusions: Six and three variables were established as significant risk factors for LNM and residual tumor in patients with EGC who underwent noncurative ER, respectively. Patients with EGC who present these risk factors after noncurative ER are strongly suggested to receive additional surgery, while others might be suitable for strict follow-up. This might shed some new light on the selection of follow-up treatment for noncurative ER.

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Tumor Budding Is Independently Predictive for Lymph Node Involvement in Early Gastric Cancer

International Journal of Surgical Pathology ◽

10.1177/1066896915581200 ◽

2015 ◽

Vol 23 (5) ◽

pp. 349-358 ◽

Cited By ~ 14

Author(s):

Mine Gulluoglu ◽

Gulcin Yegen ◽

Yasemin Ozluk ◽

Metin Keskin ◽

Serap Dogan ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Early Gastric Cancer ◽

Lymph Node Involvement ◽

Tumor Budding ◽

Node Involvement

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Impact of extra-nodal metastasis on survival in gastric cancer patients with lymph node involvement.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.57 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 57-57

Author(s):

Noriyuki Nishiwaki ◽

Masanori Tokunaga ◽

Kenichiro Furukawa ◽

Keiichi Fujiya ◽

Hayato Omori ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Lymph Nodes ◽

Cancer Patients ◽

Multivariable Analysis ◽

Lymph Node Involvement ◽

Nodal Metastasis ◽

Node Involvement ◽

Gastric Cancer Patients

57 Background: Extra-nodal metastasis (ENM) is defined as a tumor nodule without lymph node structure, and distinguished from lymph node metastasis by histological findings. Despite the possible difference in metastatic mechanism, both are counted as metastasized lymph nodes according to the 3rd English edition of Japanese Classification of Gastric Carcinoma, and thus the prognostic value of ENM remains unclear. The aim of this study was to clarify the clinicopathogical characteristics and prognostic impact of ENM in gastric cancer patients with lymph node involvement. Methods: This study included 388 patients who underwent curative gastrectomy for primary gastric cancer between January 2009 and August 2013. A total of 2093 pathologically positive tumor nodules, including both metastatic lymph nodes and ENM, were examined. Clinicopathological characteristics and survival outcomes were compared between an ENM positive (ENMP) group (95 patients) and an ENM negative (ENMN) group (293 patients). In addition, multivariable analysis was performed to clarify the independent prognostic factors. Results: ENM was found in 269 of 2093 tumor nodules (12.9 percent). The incidence of ENM was significantly higher in patients with large tumor size, high pathological T stage (pT), high pathological N stage (pN) and in those with macroscopic infiltrative tumors, vascular and lymphatic invasion. Three-year relapse free survival was significantly worse in the ENMP group (56.5%) than in the ENMN group (82.4%, p < 0.001). Multivariable analysis revealed that ENM as well as age, pT and histological type was an independent prognostic factor. Conclusions: ENM is an independent prognostic factor in gastric cancer patients with lymph node involvement. A new N classification stratified by the presence of ENM might be considered.

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Tumor volume in advanced gastric cancer as a prognostic factor correlating with lymph node involvement

Medicinski pregled ◽

10.2298/mpns0508351r ◽

2005 ◽

Vol 58 (7-8) ◽

pp. 351-356

Author(s):

Dragan Radovanovic ◽

Nebojsa Mitrovic ◽

Dejan Stevanovic ◽

Ivan Pavlovic ◽

Milena Vukovic ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Lymph Nodes ◽

Tumor Invasion ◽

Tumor Volume ◽

Lymph Node Involvement ◽

Tumor Diameter ◽

Node Involvement ◽

Drainage Group

Introduction It has been established that measurement of tumor volume, rather than its diameter, is a better indicator of the depth of tumor invasion and lymph node involvement. The present study evaluates the significance of tumor volume as a prognostic factor in gastric cancer. Material and methods This prospective clinical trail included 87 patients with gastric cancer admitted to Surgery Clinic "Dr. Dragisa Misovic" in Belgrade from 1998 to 2003. All patients were evaluated by standard diagnostic procedures, and after that underwent radical surgical treatment. Oncologic-surgical principles recommended by Japanese Research Society for Gastric Cancer were respected. Tumor volume was determined by measurement of specimens that had been obtained during surgery and by histopathological analysis. These criteria were analyzed and correlated with the lymph node status and clinicopathological factors. Results Single-factor analysis showed that lymph node metastases correlated with larger tumor diameter, larger tumor volume, depth of tumor invasion, diffuse and low-grade differentiation of the intestinal type of gastric carcinoma. Using a linear correlation coefficient, it was found that there was a highly significant correlation of tumor volume and number of metastatic nodes in groups between lymph nodes r=0.567; p<0,0001 in drainage group I, r=0.511; p<0.0001 in drainage group II, r=0.579; p<0.0001 in drainage group III. Also, there was highly significant correlation with the total number of metastatic nodes (r=0.577; p<0.0001) and significant correlation with the depth of tumor invasion and tumor diameter (p<0.05). With 97% sensitivity and 88% specificity, "cut off point was established by determining the tumor volume above which there were metastases into lymph nodes. In this study that volume was 2750 cmm. Conclusion Tumor volume can be used as a valuable prognostic factor for advanced gastric cancer, and hopefully it will be calculated preoperatively by 3D-EUS volumetric analysis.

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Vulvar melanoma: report on eleven cases and review of the literature

Sao Paulo Medical Journal ◽

10.1590/s1516-31802010000100008 ◽

2010 ◽

Vol 128 (1) ◽

pp. 38-41 ◽

Cited By ~ 10

Author(s):

Glauco Baiocchi ◽

João Pedreira Duprat ◽

Rogerio Izar Neves ◽

Elza Mieko Fukazawa ◽

Gilles Landman ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Node Involvement ◽

Depth Of Invasion ◽

High Tendency ◽

Inguinal Lymphadenectomy ◽

Initial Symptoms ◽

Node Involvement ◽

Vulvar Melanoma

CONTEXT AND OBJECTIVE: Vulvar melanoma is a rare disease. We describe the experience of a single institution and review the literature. DESIGN AND SETTING: Retrospective study at the Department of Gynecology, Hospital do Cancer A. C. Camargo. METHODS: Eleven patients with vulvar melanoma attended between January 1987 and December 2006 were reviewed regarding clinicopathological characteristics, surgical therapy and follow-up. RESULTS: The initial symptoms were vulvar lesions, pruritus, pain and bleeding. The median age was 64.8 years. The median depth of invasion was 3.08 mm. The staging ranged from IB to IIIC (American Joint Committee on Cancer, 2002). All the patients underwent vulvectomy. Two patients did not undergo primary elective lymphadenectomy. Bilateral inguinal lymphadenectomy was performed on five patients, and one had unilateral inguinal lymphadenectomy. Sentinel lymph node investigation was performed on three patients. Five patients had locoregional recurrence. Prolonged survival was only achieved in the absence of lymph node involvement. The median follow-up was 56 months. The median disease-free survival was 15 months and the median overall survival was 29 months. CONCLUSIONS: The prognosis for patients with vulvar melanoma is generally poor, with a high tendency towards regional and distant recurrence. Depth of invasion and lymph node involvement are the most important prognostic factors. In most cases, resection of the lesion with adequate margins may replace vulvectomy. Elective inguinal femoral lymphadenectomy remains the standard lymph node staging procedure. Sentinel lymph node investigation is feasible and should be performed by a multidisciplinary team with experience of this method.

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