ASO Author Reflections: Which is More Suitable for Surrogate Indicator of Gastric Cancer Patients’ Long-Term Prognosis: Lymph Nodes Examined Number or Lymph Node Noncompliance Rate?

2020 ◽  
Vol 27 (9) ◽  
pp. 3294-3295
Author(s):  
Guang-Tan Lin ◽  
Qi-Yue Chen ◽  
Mi Lin ◽  
Ze-Ning Huang ◽  
Chang-Ming Huang
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Long Term Prognosis ◽  
Noncompliance Rate ◽  
Gastric Cancer Patients

How to improve the lymph node detection and staging accuracy in gastric cancer patients: A randomized controlled trial in single center.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15577-e15577
Author(s):  
Zengwu Yao ◽  
Lixin Jiang
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Carbon Nanoparticles ◽  
Gastrointestinal Surgery ◽  
Lymph Node Resection ◽  
Staging Accuracy ◽  
Radical Lymph Node ◽  
Gastric Cancer Patients

e15577 Background: To evaluate the effects of carbon nanoparticles by subserosa injection and different Lymph node retrievals by surgeon or pathologist in improving the positive and total lymph node detection and staging accuracy in patients who undergone the standard D2 gastrectomy. Methods: We collected 200 gastric cancer patients who undergone the standard D2 radical lymph node resection gastrectomy from November 2013 to November 2014 in Gastrointestinal Surgery Ward of Yantai Yuhuangding Hospital. The cases were randomly devidided into 4 groups (N = 50): Pathologist group(PA), surgeon group(SU), surgeon plus carbon nanoparticles group(SU+CN), pathologist plus carbon nanoparticles group (PA+CN) . The number of lymph nodes and the proportion of TNM stages were calculated respectively. Results: In the positive and total number of lymph nodes in all cases, it is significantly higher in Group SU than Group PA (3.64±4.32 VS 2.63±3.45),( 25.46±5.24 VS 20.23±6.32),Group SU+CN than Group PA (4.56±3.86 VS 2.63±3.45 ),(30.76±8.42 VS 20.23±6.32), Group PA+CN than Group PA(3.83±2.09 VS 2.63±3.45),(24.98±6.01 VS 20.23±6.32), Group SU+CN than Group SU(4.56±3.86 VS 2.63±3.45),(30.76±8.42 VS 25.46±5.24), Group SU+CN than Group PA+CN(4.56±3.86 VS 3.83±2.09),( 30.76±8.42 VS 24.98±6.01) (P < 0.05). The proportion of each TNM stage is significantly different in Group SU VS Group PA, Group SU+CN VS Group PA, Group PA+CN VS Group PA, Group SU+CN VS Group SU, Group SU+CN VS Group PA+CN(P < 0.05), while it is similar in Group PA+CN VS Group SU(P < 0.05). The highest proportion of Stage I and II and the lowest proportion of Stage III is in Group PA, and in Group SU+CN by contrary. Multivariate analysis shows carbon nanoparticles by subserosa injection and lymph node retrievals by surgeon are independent factors. Conclusions: Carbon nanoparticles by subserosa injection and lymph node retrievals by surgeon could be used as independent factors to improve the number of positive and total lymph nodes in standard D2 radical lymph node resection gastrectomy. It may also improve the accuracy of pathological staging of gastric cancer patients. Clinical trial information: ChiCTR-TRC-14876411.

scholarly journals DETECTION OF OCCULT LYMPH NODE TUMOR CELLS IN NODE-NEGATIVE GASTRIC CANCER PATIENTS

2017 ◽  
Vol 30 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Marina Alessandra PEREIRA ◽  
Marcus Fernando Kodama Pertille RAMOS ◽  
Andre Roncon DIAS ◽  
Osmar Kenji YAGI ◽  
Sheila Friedrich FARAJ ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Node Negative ◽  
Occult Tumor ◽  
Increased Risk ◽  
Gastric Cancer Patients ◽  
Occult Tumor Cells

ABSTRACT Background: The presence of lymph nodes metastasis is one of the most important prognostic indicators in gastric cancer. The micrometastases have been studied as prognostic factor in gastric cancer, which are related to decrease overall survival and increased risk of recurrence. However, their identification is limited by conventional methodology, since they can be overlooked after routine staining. Aim: To investigate the presence of occult tumor cells using cytokeratin (CK) AE1/AE3 immunostaining in gastric cancer patients histologically lymph node negative (pN0) by H&E. Methods: Forty patients (T1-T4N0) submitted to a potentially curative gastrectomy with D2 lymphadenectomy were evaluated. The results for metastases, micrometastases and isolated tumor cells were also associated to clinicopathological characteristics and their impact on stage grouping. Tumor deposits within lymph nodes were defined according to the tumor-node-metastases guidelines (7th TNM). Results: A total of 1439 lymph nodes were obtained (~36 per patient). Tumor cells were detected by immunohistochemistry in 24 lymph nodes from 12 patients (30%). Neoplasic cells were detected as a single or cluster tumor cells. Tumor (p=0.002), venous (p=0.016), lymphatic (p=0.006) and perineural invasions (p=0.04), as well as peritumoral lymphocytic response (p=0.012) were correlated to CK-positive immunostaining tumor cells in originally negative lymph nodes by H&E. The histologic stage of two patients was upstaged from stage IB to stage IIA. Four of the 28 CK-negative patients (14.3%) and three among 12 CK-positive patients (25%) had disease recurrence (p=0.65). Conclusion: The CK-immunostaining is an effective method for detecting occult tumor cells in lymph nodes and may be recommended to precisely determine tumor stage. It may be useful as supplement to H&E routine to provide better pathological staging.

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

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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