scholarly journals Prognostic significance of enlarged paraaortic lymph nodes detected during left-sided colorectal cancer surgery: a single-center retrospective cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jaram Lee ◽  
Hyeong-min Park ◽  
Soo Young Lee ◽  
Chang Hyun Kim ◽  
Hyeong Rok Kim
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Predictive Factors ◽  
Prognostic Significance ◽  
Left Colon ◽  
R0 Resection ◽  
Colorectal Cancer Surgery ◽  
Colon And Rectal Cancer ◽  
Paraaortic Lymph Nodes ◽  
T4 Stage

Abstract Background Very few studies have been conducted on the treatment strategy for enlarged paraaortic lymph nodes (PALNs) incidentally detected during surgery. The purpose of this study was to investigate the benefit of lymph node dissection in patients with incidentally detected enlarged PALNs. Methods We retrospectively reviewed patients with left colon and rectal cancer who underwent surgical resection with PALN dissection between January 2010 and December 2018. The predictive factors for pathologic PALN metastasis (PALNM) were analyzed, and survival analyses were conducted to identify prognostic factors. Results Among 263 patients included, 19 (7.2%) showed pathologic PALNM and 5 (26.33%) had enlarged PALNs incidentally detected during surgery. These 5 patients accounted for 2.2% of 227 patients who had no evidence of PALNM on preoperative radiologic examination. Radiologic PALNM (odds ratio [OR] 12.737, 95% confidence interval [CI] 3.472–46.723) and radiologic distant metastasis other than PALNM (OR = 4.090, 95% CI 1.011–16.539) were independent predictive factors for pathologic PALNM. Pathologic T4 stage (hazard ratio [HR] 2.196, 95% CI 1.063–4.538) and R2 resection (HR 4.643, 95% CI 2.046–10.534) were independent prognostic factors for overall survival (OS). In patients undergoing R0 resection, pathologic PALNM was not associated with 5-year OS (90% vs. 82.2%, p = 0.896). Conclusion Dissection of enlarged PALNs incidentally detected during colorectal surgery may benefit patients with favorable survival outcomes.

scholarly journals Prognostic Significance of Enlarged Paraaortic Lymph Nodes Detected During Left-sided Colorectal Cancer Surgery: A Single-Center Retrospective Cohort Study

2020 ◽  
Author(s):  
Jaram Lee ◽  
Hyeong-min Park ◽  
Soo Young Lee ◽  
Chang Hyun Kim ◽  
Hyeong Rok Kim
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Predictive Factors ◽  
Prognostic Significance ◽  
Left Colon ◽  
R0 Resection ◽  
Colorectal Cancer Surgery ◽  
Colon And Rectal Cancer ◽  
Paraaortic Lymph Nodes ◽  
T4 Stage

Abstract Background: Very few studies have been conducted on the treatment strategy for enlarged para-aortic lymph nodes (PALNs) incidentally detected during surgery. The purpose of this study was to investigate the benefit of lymph node dissection in patients with incidentally detected enlarged PALNs.Methods: We retrospectively reviewed left colon and rectal cancer patients who underwent surgical resection with PALN dissection between January 2010 and December 2018. The predictive factors for pathologic PALN metastasis (PALNM) were analyzed, and survival analyses were conducted to identify prognostic factors.Results: Among 263 patients included, 19 (7.2%) patients showed pathologic PALNM, and 5 (26.33%) of them had enlarged PALNs incidentally detected during surgery. These 5 patients accounted for 2.2% of 227 patients who had no evidence of PALNM in preoperative radiologic examination. Radiologic PALNM (odds ratio [OR] 12.737, 95% confidence interval [CI] 3.472–46.723) and radiologic distant metastasis other than PALNM (OR = 4.090, 95% CI 1.011–16.539) were independent predictive factors for pathologic PALNM. Pathologic T4 stage (hazard ratio [HR] 2.196, 95% CI 1.063–4.538) and R2 resection (HR 4.643, 95% CI 2.046–10.534) were independent prognostic factors for overall survival (OS). In patients undergoing R0 resection, pathologic PALNM was not associated with the 5-year OS (90% vs. 82.2%, p = 0.896). Conclusions: Dissection of enlarged PALNs incidentally detected during colorectal surgery may benefit patients, with favorable survival outcomes.

scholarly journals Clinical Outcome and Prognostic Factors of Intensity-Modulated Radiotherapy for T4 Stage Nasopharyngeal Carcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yangkun Luo ◽  
Yang Gao ◽  
Guangquan Yang ◽  
Jinyi Lang
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Nasopharyngeal Carcinoma ◽  
Lymph Nodes ◽  
Distant Metastasis ◽  
Intensity Modulated Radiotherapy ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Intensity Modulated ◽  
T4 Stage

Objective. To analyze the clinical outcomes and prognostic factors of intensity-modulated radiotherapy (IMRT) for T4 stage nasopharyngeal carcinoma (NPC).Methods. Between March 2005 and March 2010, 110 patients with T4 stage NPC without distant metastases were treated. All patients received IMRT. Induction and/or concurrent chemotherapy were given. 47 (42.7%) patients received IMRT replanning.Results. The 5-year local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 90.1%, 97.0%, 67.5%, 63.9%, and 64.5%, respectively. Eleven patients experienced local-regional failure and total distant metastasis occurred in 34 patients. 45 patients died and 26 patients died of distant metastasis alone. The 5-year LRFS rates were 97.7% and 83.8% for the patients that received and did not receive IMRT replanning, respectively (P=0.023). Metastasis to the retropharyngeal lymph nodes (RLN) was associated with inferior 5-year OS rate (61.0% versus 91.7%,P=0.034). The gross tumor volume of the right/left lymph nodes (GTVln) was an independent prognostic factor for DMFS (P=0.006) and PFS (P=0.018). GTVln was with marginal significance as the prognostic factor for OS (P=0.050).Conclusion. IMRT provides excellent local-regional control for T4 stage NPC. Benefit of IMRT replanning may be associated with improvement in local control. Incorporating GTVln into the N staging system may provide better prognostic information.

scholarly journals Re-resection in Incidental Gallbladder Cancer: Survival and the Incidence of Residual Disease

2019 ◽  
Vol 27 (4) ◽  
pp. 1132-1142 ◽  
Author(s):  
Elise A. J. de Savornin Lohman ◽  
Lydia G. van der Geest ◽  
Tessa J. J. de Bitter ◽  
Iris D. Nagtegaal ◽  
Cornelis J. H. M. van Laarhoven ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Gallbladder Cancer ◽  
Residual Disease ◽  
Multivariable Analysis ◽  
Optimal Timing ◽  
R0 Resection ◽  
Significant Prognostic Factor ◽  
Netherlands Cancer Registry ◽  
Incidental Gallbladder Cancer

Abstract Background Re-resection for incidental gallbladder cancer (iGBC) is associated with improved survival but little is known about residual disease (RD) and prognostic factors. In this study, survival after re-resection, RD, and prognostic factors are analyzed. Methods Patients with iGBC were identified from the Netherlands Cancer Registry, and pathology reports of re-resected patients were reviewed. Survival and prognostic factors were analyzed. Results Overall, 463 patients were included; 24% (n = 110) underwent re-resection after a median interval of 66 days. RD was present in 35% of patients and was most frequently found in the lymph nodes (23%). R0 resection was achieved in 93 patients (92%). Median overall survival (OS) of patients without re-resection was 13.7 (95% confidence interval [CI] 11.6–15.6), compared with 52.6 months (95% CI 36.3–68.8) in re-resected patients (p < 0.001). After re-resection, median OS was superior in patients without RD versus patients with RD (not reached vs. 23.1 months; p < 0.001). In patients who underwent re-resection, RD in the liver (hazard ratio [HR] 5.54; p < 0.001) and lymph nodes (HR 2.35; p = 0.005) were the only significant prognostic factors in multivariable analysis. Predictive factors for the presence of RD were pT3 stage (HR 25.3; p = 0.003) and pN1 stage (HR 23.0; p = 0.022). Conclusion Re-resection for iGBC is associated with improved survival but remains infrequently used and is often performed after the optimal timing interval. RD is the only significant prognostic factor for survival after re-resection and can be predicted by pT and pN stages.

Prognostic Factors of Cervical Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma

1997 ◽  
Vol 83 (6) ◽  
pp. 922-926 ◽  
Author(s):  
Mauro Magnano ◽  
Antonella De Stefani ◽  
Walter Lerda ◽  
Antonio Usai ◽  
Riccardo Ragona ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Prognostic Significance ◽  
Cervical Lymph Nodes ◽  
Tumor Spread

Aims and background The metastatic spread of squamous cell carcinoma of the head and neck (SCCHN) to the cervical lymph nodes is a negative prognostic factor in terms of survival. We have used multivariate analysis to identify the possible prognostic significance of a number of clinical and pathological characteristics in relation to possible involvement of the cervical lymph nodes in a series of 396 patients. Method 396 patients with SCCHN were studied. Variables regarding the patient, the carcinoma and histology were analysed by multivariate analysis using BMDP's PLR programme. Results Some variables appear to represent predisposing factors for tumor spread to the lymph nodes: tumor site (supraglottic larynx: P=0.005; base of the tongue: P=0.02; hypopharynx: P=0.02), grading (P=0.001), and a number of histological parameters (lower degree of histological differentiation: P=0.001; vascular permeation: P=0.04; perineural invasion: P<0.05; prevalently plasmocytic infiltrate: P<0.05). Conclusion The identification of cases at risk for metastasis can be improved by the assessment of prognostic factors, with a consequent improvement in treatment strategies.

scholarly journals Positive lymph node ratio is an index in predicting prognosis for remnant gastric cancer with insufficient retrieved lymph node in R0 resection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Honghu Wang ◽  
Hao Qi ◽  
Xiaofang Liu ◽  
Ziming Gao ◽  
Iko Hidasa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Prognostic Index ◽  
Staging System ◽  
R0 Resection ◽  
Remnant Gastric Cancer ◽  
Curative Intent ◽  
Node Ratio

AbstractThe staging system of remnant gastric cancer (RGC) has not yet been established, with the current staging being based on the guidelines for primary gastric cancer. Often, surgeries for RGC fail to achieve the > 15 lymph nodes needed for TNM staging. Compared with the pN staging system, lymph node ratio (NR) may be more accurate for RGC staging and prognosis prediction. We retrospectively analyzed the data of 208 patients who underwent R0 gastrectomy with curative intent and who have ≤ 15 retrieved lymph nodes (RLNs) for RGC between 2000 and 2014. The patients were divided into four groups on the basis of the NR cutoffs: rN0: 0; rN1: > 0 and ≤ 1/6; rN2: > 1/6 and ≤ 1/2; and rN3: > 1/2. The 5-year overall survival (OS) rates for rN0, rN1, rN2, and rN3 were 84.3%, 64.7%, 31.5%, and 12.7%, respectively. Multivariable analyses revealed that tumor size (p = 0.005), lymphovascular invasion (p = 0.023), and NR (p < 0.001), but not pN stage (p = 0.682), were independent factors for OS. When the RLN count is ≤ 15, the NR is superior to pN as an important and independent prognostic index of RGC, thus predicting the prognosis of RGC patients more accurately.

scholarly journals Modifiable and Nonmodifiable Predictive Factors Associated with the Outcomes of Total Knee Arthroplasty

Joints ◽  
2019 ◽  
Vol 07 (01) ◽  
pp. 013-018
Author(s):  
Davide E. Bonasia ◽  
Anna Palazzolo ◽  
Umberto Cottino ◽  
Francesco Saccia ◽  
Claudio Mazzola ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Prognostic Factors ◽  
Treatment Option ◽  
Predictive Factors ◽  
Knee Arthroplasty ◽  
Factors Associated ◽  
Modifiable Factors ◽  
Valuable Treatment ◽  
Total Knee ◽  
The Right

AbstractTotal knee arthroplasty (TKA) is a valuable treatment option for advanced osteoarthritis in patients unresponsive to conservative treatments. Despite overall satisfactory results, the rate of unsatisfied patients after TKA remains high, ranging from 5 to 40%. Different modifiable and nonmodifiable prognostic factors associated with TKA outcomes have been described. The correction, whenever possible, of modifiable factors is fundamental in preoperative patients' optimization protocols. Nonmodifiable factors can help in predicting the outcomes and creating the right expectations in the patients undergoing TKA. The goal of this review is to summarize the modifiable and nonmodifiable prognostic factors associated with TKA outcomes.

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