Deep Muscularis Propria Tumor Invasion Without Lymph Node Metastasis as a Unique Subclassification of Stage IB Gastric Cancer: A Retrospective Study

Abstract Background The prognosis difference based on the depth of tumor muscularis propria invasion in gastric cancer (GC) was still debated. Methods A total of 380 patients with pT2 GC after radical surgery were retrospectively analyzed, including 185 in superficial muscularis propria (sMP) group and 195 in deep muscularis propria (dMP) group. Results The overall survival (OS) was significantly better for patients in sMP group than for patients in dMP group (P=0.007). In multivariate analysis, depth of tumor invasion, pN stage, age, primary location, positive expression of p53, elevated maximal LDH, elevated initial CA19-9 and AFP level were independent prognostic factors for OS. The sMP group had a significantly better OS than dMP group (P=0.014) in pN0 stage. After further stratification, the survival outcomes were not significantly different between deep muscularis propria tumor invasion without lymph node metastasis (dMPN0) group (stage IB) and superficial muscularis propria tumor invasion with stage 1-2 lymph node metastasis (sMPN1-2) group (stage II) (P=0.100). Patients with adjuvant chemotherapy had a statistically better survival than those without in dMPN0 group (P=0.045) and dMPN0 patients with adjuvant chemotherapy had better OS than sMPN1-2 patients (P=0.015). In addition, greater postoperative survival could be observed in sMPN0 patients than dMPN0 patients in p53-positive group (P=0.002), and similar OS could be seen between dMPN0 patients with p53-positive and T2N1-2 patients (P=0.872). Conclusion As a unique subclassification of stage IB GC, appropriate adjuvant chemotherapy should be considered for patients with dMPN0 stage. In addition, positive expression of p53, elevated LDH could be potential factors in identifying the different prognoses for stage IB GC patients.

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Deep Muscularis Propria Tumor Invasion Without Lymph Node Metastasis as a Unique Subclassification of pT2 Gastric Cancer: A Retrospective Study

SSRN Electronic Journal ◽

10.2139/ssrn.3834599 ◽

2021 ◽

Author(s):

Kang He ◽

Cheng Chen ◽

Lei Xia ◽

Lixiang Si ◽

Xiaohua Pan ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Retrospective Study ◽

Lymph Node Metastasis ◽

Tumor Invasion ◽

Muscularis Propria ◽

Node Metastasis

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Kindlin-2: a novel adhesion protein related to tumor invasion, lymph node metastasis, and patient outcome in gastric cancer

The American Journal of Surgery ◽

10.1016/j.amjsurg.2011.06.050 ◽

2012 ◽

Vol 203 (2) ◽

pp. 222-229 ◽

Cited By ~ 32

Author(s):

Zhanlong Shen ◽

Yingjiang Ye ◽

Lingyi Dong ◽

Sanna Vainionpää ◽

Harri Mustonen ◽

...

Keyword(s):

Gastric Cancer ◽

Patient Outcome ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Invasion ◽

Adhesion Protein ◽

Node Metastasis

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Risk factors for peritoneal recurrence in stage II/III gastric cancer patients who received S-1 adjuvant chemotherapy after D2 gastrectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.4_suppl.51 ◽

2013 ◽

Vol 31 (4_suppl) ◽

pp. 51-51

Author(s):

Toru Aoyama ◽

Takaki Yoshikawa ◽

Junya Shirai ◽

Hirohito Fujikawa ◽

Tsutomu Hayashi ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Peritoneal Recurrence ◽

Tumor Diameter ◽

Node Metastasis ◽

Gastric Cancer Patients

51 Background: Peritoneum is still the most frequent site of the recurrence in stage II/III gastric cancer patients although the survival was improved by S-1 adjuvant chemotherapy. The objective of this retrospective study was to clarify the risk factors of peritoneal recurrence in patients who received S-1 adjuvant chemotherapy. Methods: Peritoneal recurrence free survival (P-RFS) was examined in 100 gastric cancer patients who underwent curative D2 surgery, were diagnosed with stage II or III pathologically, and received adjuvant S-1 between June of 2002 and March of 2011. Uni- and multi- variate analyses were performed to identify risk factors by Cox’s proportional hazard analyses. Results: P-RFS was 64.3% at 3 years and 58.8% at 5 years. A total of 18 patients were diagnosed with peritoneal recurrence. Macroscopic tumor diameter, depth of tumor invasion, and lymph node metastasis were the significant factors by univariate analysis, while tumor diameter and lymph node metastasis were the only significant independent risk factors by multivariate analysis. Conclusions: The macroscopic tumor diameter and lymph node metastasis were the most important risk factors for P-RFS. When patients had these risk factors, S-1 was not sufficient to inhibit peritoneal recurrence. When developing a novel adjuvant chemotherapy targeting peritoneal metastasis in the future, clinical trials should be limited to these patients.

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Clinically Early Gastric Cancer: Features and Treatment Strategy

International Surgery ◽

10.9738/intsurg-d-15-00245.1 ◽

2016 ◽

Vol 101 (11-12) ◽

pp. 562-569

Author(s):

Si-Hak Lee ◽

Cheol Woong Choi ◽

Su Jin Kim ◽

Dae-Hwan Kim ◽

Chang In Choi ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Early Gastric Cancer ◽

Treatment Strategy ◽

Treatment Strategies ◽

Muscularis Propria ◽

Clinicopathologic Features ◽

Curative Gastrectomy ◽

Node Metastasis

This study aimed to clarify the clinicopathologic features and explore treatment strategies for patients with pathologically confirmed advanced gastric cancer (AGC) diagnosed as clinically early gastric cancer (cEGC) before surgery. We included 955 patients who were treated by curative gastrectomy between 2008 and 2013; 42 patients had cEGC. The clinicopathologic features of the patients with cEGC were compared with those of patients with early gastric cancer (EGC); AGC; cancer of the muscularis propria (MP cancer, gastric cancer invading the muscularis propria of the stomach); or SM3 cancer (gastric cancer invading all 3 parts of the submucosal layer). Patients with cEGC had more tumor lymph node metastasis; more lymphatic invasion; and more perineural invasion (all P < 0.001) compared with those with EGC. Patients with cEGC had more tumor lymph node metastasis (P = 0.017) than did patients with SM3. Compared with patients with AGC or MP cancer, patients with cEGC were more likely to be operated on using a laparoscopic procedure and less likely to receive lymph node dissection. Multivariate analysis showed that gross type III [odds ratio (OR), 12.92; P < 0.001] and tumor location (middle body, OR, 2.691; P = 0.009) were significant predictors of cEGC before surgery. Although patients with cEGC had clinicopathologic features similar to those of patients with MP cancer, they were treated like patients with SM3 cancer (e.g., limited use of lymphadenectomy). These findings suggest that patients with cEGC should be given a more aggressive treatment strategy.

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Gender and Age Differences in Risk Factors of Lymph Node Metastasis in Patients With Early Gastric Cancer and Analysis Prognosis of Early Gastric Cancer

10.21203/rs.3.rs-104733/v1 ◽

2020 ◽

Author(s):

Jingjing Wang ◽

Tao Meng ◽

Ke Chen ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Early Gastric Cancer ◽

Tumor Invasion ◽

Lymphovascular Invasion ◽

Univariate Analysis ◽

Node Metastasis ◽

Gender And Age

Abstract ObjectiveTo explore the effects of gender and age differences in the risk factors for lymph node metastasis in patients and analysis prognosis of patients of early gastric cancer (EGC). MethodsA total of 411 patients with EGC who underwent surgical treatment at the First Affiliated Hospital of Anhui Medical University from 2011 to 2017 were included in this study and grouped according to gender and age. Retrospective analysis of the effects of gender and age on tumor size, histological type, depth of invasion, and ulcer type was performed, and differences in the clinicopathological characteristics of lymphovascular invasion were noted. Follow-up of the postoperative recurrence and metastasis of the patients and analysis of their prognosis were finally conducted. All follow-ups ended in August 2020. ResultThe participants in this study ranged in age from 25 years to 85 years (average, 60.27 ± 10.77 years). A total of 57 (13.9%) of the patients showed lymph node metastasis. Females accounted for 25.5% (105/411) while males accounted for 74.5% (306/411) of the study population. Patients aged ≤60 years accounted for 55.5% (228/411) while patients aged >60 years accounted for 44.5% (183/411) of the study population. Univariate analysis of male patients showed that tumor size, depth of tumor invasion, ulcerative tumors, and lymphovascular invasion are related to lymph node metastasis (P < 0.05). Univariate analysis of female patients showed that tumor size, depth of tumor invasion, tumor histology, and lymphovascular invasion are related to lymph node metastasis (P < 0.05). Univariate analysis of patients aged ≤60 years showed that depth of tumor invasion, ulcerative tumors, and lymphovascular invasion are related to lymph node metastasis (P < 0.05). Univariate analysis of patients aged >60 years showed that depth of tumor invasion, ulcerative tumors, and lymphovascular invasion are related to lymph node metastasis (P < 0.05). Multivariate analysis of male patients, female patients, and patients aged ≤60 years showed that depth of tumor invasion is an independent risk factor for lymph node metastasis. Multivariate analysis of patients aged >60 years showed that depth of tumor invasion, ulcerative tumors, and lymphovascular invasion are independent risk factors for lymph node metastasis. ConclusionThe risk factors for lymph node metastasis in patients with EGC differed according to gender and age. The results provide a reference for choosing suitable treatment options for these patients.

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Single Nucleotide Polymorphism of the Enhancer of Zeste Homolog 2 Gene rs2072408 is Associated with Lymph Node Metastasis and Depth of Primary Tumor Invasion in Gastric Cancer

Clinical Laboratory ◽

10.7754/clin.lab.2016.160302 ◽

2016 ◽

Vol 62 (11/2016) ◽

Cited By ~ 3

Author(s):

Baochang Sun ◽

Youdong Lin ◽

Xiaoting Wang ◽

Fenghua Lan ◽

Yinghao Yu ◽

...

Keyword(s):

Gastric Cancer ◽

Single Nucleotide Polymorphism ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Primary Tumor ◽

Tumor Invasion ◽

Nucleotide Polymorphism ◽

Single Nucleotide ◽

Node Metastasis ◽

Enhancer Of Zeste

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Significance as a recurrence predictor of postoperative neutrophil-lymphocyte ratio in patients with stage II/III gastric cancer: A retrospective study.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.45 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 45-45

Author(s):

Hiroaki Tanaka ◽

Kazuya Muguruma ◽

Katsunobu Sakurai ◽

Takahiro Toyokawa ◽

Naoshi Kubo ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Adjuvant Chemotherapy ◽

Lymph Node Metastasis ◽

Peritoneal Dissemination ◽

Stage Ii ◽

Diffuse Type ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Node Metastasis

45 Background: Tumor markers such as carcinoembryonic antigen (CEA) and CA 19-9 are both widely used in the follow up of patients with gastric cancer. However, there are no definitive predictive markers for postopetrative recurrence. It has been reported that preoperative neutrophil lymphocyte ratio (NLR) was associated with prognosis of patients with gastrointestinal cancer. The aim of this study was to examine the impact of postoperative NLR on prediction for postoperative recurrence of gastric cancer. Methods: We retrospective reviewed data from 318 patients with Stage II/III gastric cancer who underwent curative surgical resection followed by adjuvant chemotherapy for between 2006 and 2013. Patients treated with preoperative chemotherapy or multiple cancers were excluded. Results: We found 118 recurrent diseases which mainly included 47 cases with peritoneal dissemination, 27 with distant lymph node metastasis and 24 with liver metastasis. Postoperative NLR was calculated every 6 months and the data at the time of recurrence or last survival were used for analysis. In univariate analysis, histological diffuse type, mascroscopical type 4 cancer, regional lymph node metastasis, lymphatic invasion in primary tumor, tumor diameter, elevated CEA or CA19-9, and elevated NLR were associated with poor prognosis. In multivariate analysis, we found that elevated CA19-9 and NLR were independent predictive markers. Increased NLR was associated with diffuse type, peritoneal dissemination, elevated CEA and preoperative NLR but not with adverse effect of adjuvant chemotherapy. Conclusions: The postoperative NLR might be one of the surrogate markers for recurrence after curative surgery for patients with Stage II/III gastric cancer.

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Overexpression of FXYD-3 Is Involved in the Tumorigenesis and Development of Esophageal Squamous Cell Carcinoma

Disease Markers ◽

10.1155/2013/740201 ◽

2013 ◽

Vol 35 ◽

pp. 195-202 ◽

Cited By ~ 4

Author(s):

Zhen-Long Zhu ◽

Bao-Yong Yan ◽

Yu Zhang ◽

Yan-Hong Yang ◽

Ming-Wei Wang ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Esophageal Squamous Cell Carcinoma ◽

Tumor Invasion ◽

Tumor Location ◽

Node Metastasis ◽

Positive Expression ◽

Esophageal Epithelial Cells ◽

Clinicopathological Variables

Objective.To investigate the association of FXYD-3 expression with clinicopathological variables and PINCH in patients with ESCC.Patients and Methods.Expression of FXYD-3 protein was immunohistochemically examined in normal esophageal mucous (n=20) and ESCC (n=64).Results.Expression of FXYD-3 in the cytoplasm markedly increased from normal esophageal epithelial cells to primary ESCC (P=0.001). The expression of FXYD-3 was correlated with TNM stages and depth of tumor invasion. Furthermore, the cases with lymph node metastasis tended to show a higher frequency of positive expression than those without metastasis (P=0.086), and FXYD-3 expression tended to be positively related to the expression of PINCH (P=0.063). Moreover, the cases positive for both proteins had the highest frequency of lymph node metastasis (P=0.001). However, FXYD-3 expression was not correlated with patient’s gender (P=0.847), age (P=0.876), tumor location (P=0.279), size (P=0.7710.771), grade of differentiation (P=0.279), and survival (P=0.113).Conclusion.Overexpression of FXYD-3 in the cytoplasm may play an important role in the tumorigenesis and development in the human ESCC, particularly in combination with PINCH expression.

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