Impacts Of Tumor Location On Prognosis Of Patients With Gallbladder Carcinoma

Abstract Objective: To investigate the impacts of tumor location on the prognosis of patients with T1-3N0-1M0 gallbladder carcinoma(GBC) after radical surgery.Methods: Totally, 136 patients with stage T1-3 gallbladder carcinoma after radical surgery from 2000 to 2018 were enrolled and divided into two groups according to anatomic location of GBC (neck /body and fundus). The clinicopathological features and survival time were compared between these two groups. At last, in combination with the difference between the liver side and the peritoneal side of the tumor, survival analysis and multivariable Cox-proportional hazards regression models were performed in GBC patients with survival differences between gallbladder neck and body/fundus tumors.Results: The bile duct invasion, lymph node metastasis, tumor growth pattern, jaundice, albumin, and tumor markers were significantly related to the tumors in neck of gallbladder(P<0.05). Besides, patients with GBC in body and fundus of gallbladder had a higher rate of appearing microscopic liver metastasis(P<0.05). Survival analysis showed that there was significant difference on patients with stage T2 GBC in different tumor location (neck /body and fundus), but no significant difference on stage T1 and T3. Further combining the differences between the liver side and the peritoneal side of the tumor, tumor location, lymph node metastasis, bile duct invasion, microscopic liver metastasis, tumor differentiation, and jaundice were deemed as prognostic factors according to univariable survival analysis. Among these factors, multivariable Cox analysis showed that lymph node metastasis and tumor location were independent prognostic factors for survival of patients with T2 GBC (P <0.05).Conclusions: Tumor location is an important prognostic factor for GBC, especially for the patients with T2 stage. Besides the survival differences between the hepatic-side and peritoneal-side tumors, tumor in neck is also one of the factors predicting the poor prognosis at T2 stage. GBC in neck was more prone to cause bile duct invasion, lymph node metastasis and jaundice. However, tumors in body and fundus were more likely to appear microscopic liver metastasis. Further refinement of the surgery for T2 GBC according to the tumor location may improve their survival time.

Download Full-text

ATL

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001334 ◽

2018 ◽

Vol 28 (8) ◽

pp. 1514-1519 ◽

Cited By ~ 6

Author(s):

Xinxin Zhu ◽

Ling Zhao ◽

Jinghe Lang

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Protein Expression ◽

Tumor Location ◽

Clinicopathologic Features ◽

Gene Methylation ◽

Node Metastasis ◽

Menstrual Status ◽

Significant Difference ◽

L1 Protein

ObjectiveThis study aimed to assess the relationship between BRCA1 gene methylation, PD-L1 protein expression, and the clinicopathologic features of sporadic ovarian cancer (OC).MethodsBisulfite pyrosequencing and immunohistochemistry were used to detect BRCA1 gene methylation and PD-L1 protein expression, respectively, in tumor tissues from 112 patients with sporadic OC. Their levels were analyzed against clinicopathologic characteristics and prognosis using standard statistical methods.ResultsTwenty percent (22/112) of the OC cases exhibited BRCA1 gene hypermethylation. The frequency of BRCA1 hypermethylation was significantly higher in serous OC (25%) than in nonserous OC (8%; P < 0.05). No significant correlations were discovered between BRCA1 hypermethylation and age, menstrual status, tumor location, stage, lymph node metastasis, and prognosis (P > 0.05). Among the 112 OC cases, 59% (66/112) cases were positive for PD-L1 protein expression. No significant difference existed between PD-L1 expression and age, menstrual status, histological type, tumor location, stage, lymph node metastasis, and prognosis (P > 0.05). Moreover, no correlation existed between BRCA1 methylation and PD-L1 expression (P > 0.05, r = 0.002).ConclusionsThis is the first study linking BRCA1 hypermethylation variability to PD-L1 protein expression and the clinicopathologic features of OC. The data demonstrated that an epigenetic alteration of BRCA1 was closely associated with serous OC. The expression of PD-L1 was unrelated to the clinicopathologic features or BRCA1 hypermethylation in sporadic OC.

Download Full-text

Is combined extra-hepatic bile-duct resection justified for advanced gallbladder carcinoma?

Gastroenterology Report ◽

10.1093/gastro/goz018 ◽

2019 ◽

Vol 7 (6) ◽

pp. 426-433 ◽

Cited By ~ 1

Author(s):

Jun-Ke Wang ◽

Wen-Jie Ma ◽

Zhen-Ru Wu ◽

Qin Yang ◽

Hai-Jie Hu ◽

...

Keyword(s):

Lymph Node ◽

Bile Duct ◽

Lymph Node Metastasis ◽

Gallbladder Carcinoma ◽

Curative Surgery ◽

Hepatic Bile ◽

Hepatic Bile Duct ◽

Resection Group ◽

Node Metastasis ◽

T Category

Abstract Background Whether the extra-hepatic bile duct (EHBD) should be routinely resected for gallbladder carcinoma (GBC) remains controversial. The current study aimed to determine the clinical impact of combined EHBD resection during curative surgery for advanced GBC. Methods In total, 213 patients who underwent curative surgery for T2, T3 or T4 GBC were enrolled. The clinicopathological features were compared between the patients treated with EHBD resection and those without EHBD resection. Meanwhile, univariable and multivariable Cox-proportional hazards regression models were used to identify risk factors for overall survival (OS). Results Among the 213 patients identified, 87 (40.8%) underwent combined EHBD resection. Compared with patients without EHBD resection, patients with EHBD resection suffered more post-operative complications (33.3% vs. 21.4%, P = 0.046). However, the median OS of the EHBD resection group was longer than that of the non-EHBD resection group (25 vs. 11 months, P = 0.008). Subgroup analyses were also performed according to tumor (T) category and lymph-node metastasis. The median OS was significantly longer in the EHBD resection group than in the non-EHBD resection group for patients with T3 lesion (15 vs. 7 months, P = 0.002), T4 lesion (11 vs. 6 months, P = 0.021) or lymph-node metastasis (12 vs. 7 months, P < 0.001). No survival benefit of EHBD resection was observed in GBC patients with T2 lesion or without lymph-node metastasis. T category, lymph-node metastasis, margin status, pre-operative CA19-9 level and EHBD resection were identified as independent prognostic factors for OS of patients with advanced GBC (all P values <0.05). Conclusions EHBD resection can independently affect the OS in advanced GBC. For GBC patients with T3 lesion, T4 lesion and lymph-node metastasis, combined EHBD resection is justified and may improve OS.

Download Full-text

Faculty Opinions recommendation of Mesenteric tumor deposits in midgut small intestinal neuroendocrine tumors are a stronger indicator than lymph node metastasis for liver metastasis and poor prognosis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726786900.793528248 ◽

2017 ◽

Author(s):

Noam Harpaz ◽

Alexandros Polydorides

Keyword(s):

Lymph Node ◽

Liver Metastasis ◽

Lymph Node Metastasis ◽

Neuroendocrine Tumors ◽

Poor Prognosis ◽

Mesenteric Tumor ◽

Node Metastasis ◽

Small Intestinal

Download Full-text

Comparison of Postoperative Adjuvant Chemotherapy and Concurrent Chemoradiotherapy for FIGO2018 Stage IIIC1 Cervical Cancer: A Retrospective Study

Medicina ◽

10.3390/medicina57060548 ◽

2021 ◽

Vol 57 (6) ◽

pp. 548

Author(s):

Masahiro Kagabu ◽

Takayuki Nagasawa ◽

Shunsuke Tatsuki ◽

Yasuko Fukagawa ◽

Hidetoshi Tomabechi ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Lymph Node Metastasis ◽

Radical Hysterectomy ◽

Concurrent Chemoradiotherapy ◽

Postoperative Adjuvant Chemotherapy ◽

Node Metastasis ◽

Significant Difference ◽

Advanced Stages

Background and Objectives: In October 2018, the International Federation of Gynecology and Obstetrics (FIGO) revised its classification of advanced stages of cervical cancer. The main points of the classification are as follows: stage IIIC is newly established; pelvic lymph node metastasis is stage IIIC1; and para-aortic lymph node metastasis is stage IIIC2. Currently, in Japan, radical hysterectomy is performed in advanced stages IA2 to IIB of FIGO2014, and concurrent chemoradiotherapy (CCRT) is recommended for patients with positive lymph nodes. However, the efficacy of CCRT is not always satisfactory. The aim of this study was to compare postoperative adjuvant chemotherapy (CT) and postoperative CCRT in stage IIIC1 patients. Materials and Methods: Of the 40 patients who had undergone a radical hysterectomy at Iwate Medical University between January 2011 and December 2016 and were pathologically diagnosed as having positive pelvic lymph nodes, 21 patients in the adjuvant CT group and 19 patients in the postoperative CCRT group were compared. Results: The 5 year survival rates were 77.9% in the CT group and 74.7% in the CCRT group, with no significant difference. There was no significant difference in overall survival or progression-free survival between the two groups. There was no significant difference between CT and CCRT in postoperative adjuvant therapy in the new classification IIIC1 stage. Conclusions: The results of the prospective Japanese Gynecologic Oncology Group (JGOG) 1082 study are pending, but the present results suggest that CT may be a treatment option in rural areas where radiotherapy facilities are limited.

Download Full-text

Retropharyngeal lymph node metastasis in oral cancer. Systematic review and survival analysis

British Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.bjoms.2021.06.001 ◽

2021 ◽

Author(s):

Ahmed Abdelrahman ◽

David McGoldrick ◽

Aaina Aggarwal ◽

Matthew R. Idle ◽

Prav Praveen ◽

...

Keyword(s):

Systematic Review ◽

Survival Analysis ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Oral Cancer ◽

Retropharyngeal Lymph Node ◽

Node Metastasis

Download Full-text

Indications of Lymph Node Metastasis and Survival Analysis in T1N+M0 Gastric Cancer: a Population-Based Study

10.21203/rs.3.rs-36648/v1 ◽

2020 ◽

Author(s):

Peng Jin ◽

Yang Li ◽

Shuai Ma ◽

Wenzhe Kang ◽

Hao Liu ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Survival Analysis ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Size ◽

Multivariate Analyses ◽

Invasion Depth ◽

Node Metastasis ◽

Definition Of

Abstract Background Since the definition of early gastric cancer (EGC) was first proposed in 1971, the treatment of gastric cancer with or without lymph node metastasis (LNM) has changed a lot. The present study aims to identify risk factors for LNM and prognosis, and to further evaluate the indications for adjuvant chemotherapy (AC) in T1N + M0 gastric cancer. Methods A total of 1291 patients with T1N + M0 gastric cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate analyses were performed to identify risk factors for LNM. The effect of LNM on overall survival (OS) and cancer-specific survival (CSS) was compared with patients grouped into T1N0-1 and T1N2-3, as the indications for AC. Results The rate of LNM was 19.52%. Multivariate analyses showed age, tumor size, invasion depth, and type of differentiation and retrieved LNs were associated with LNM (p < 0.05). Cox multivariate analyses indicated age, sex, tumor size, N stage were independent predictors of OS and CSS (p < 0.05), while race was indicator for OS (HR 0.866; 95%CI 0.750–0.999, p = 0.049), but not for CSS (HR 0.878; 95% CI 0.723–1.065, p = 0.187). In addition, survival analysis showed the proportion of patients in N+/N0 was better distributed than N0-1/N2-3b. There were statistically significant differences in OS and CSS between patients with and without chemotherapy in pT1N1M0 patients (p༜0.05). Conclusions Both tumor size and invasion depth are associated with LNM and prognosis. LNM is an important predictor of prognosis. pT1N + M0 may be appropriate candidates for AC. Currently, the treatment and prognosis of T1N0M0/T1N + M0 are completely different. An updated definition of EGC, taking into tumor size, invasion depth and LNM, may be more appropriate in an era of precision medicine.

Download Full-text