scholarly journals Risk Factors for Lymph Node Metastasis of Soft Tissue Sarcomas of the Head, Neck and Extremities, And the Clinical Significance of Negative Lymph Node Dissection

2021 ◽  
Author(s):  
Qikun Liu ◽  
Xiaojun Yu ◽  
Mengwei Li ◽  
Zhiwei Li ◽  
Yongqiao Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Soft Tissue Sarcomas ◽  
Node Dissection ◽  
Cancer Specific Survival ◽  
Node Metastasis ◽  
Specific Mortality ◽  
Size Grade ◽  
Cancer Specific Mortality ◽  
Head Neck

Abstract Background: To determine the risk factors for lymph node metastasis (LNM) of soft tissue sarcomas (STS) of the head, neck, and extremities, and the clinical outcome of negative lymph node dissection (NLND). Methods: We pooled patients of STS using the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2015. Logistics regression analysis to identify risk factors for LNM, the Cox proportional hazards model and Fine-Grey’s model were used for survival analysis, Propensity score matching analysis (PSM) was further used to clarify the impact of NLND on patient prognosis.Results: A total of 3,276 patients were enrolled in our study, of whom 283 (8.6%) developed LNM. Rhabdomyosarcoma had the highest rate of LNM (25.3%), followed by clear cell sarcoma (16.8%) and epithelioid sarcoma (12.4%), while leiomyosarcoma had the lowest rate of LNM (1.3%). Sex, tumor size, grade, histology, and site were significantly associated with LNM. Age, tumor size, grade, stage, histology, and marital status were independent prognostic factors for the cancer-specific survival for patients without LNM. For specific histologic subtypes of STS, NLND significantly improves overall survival (HR: 0.718, 95%CI, 0.535-0.962; P=0.026) and cancer-specific survival (HR: 0.699, 95%CI, 0.506-0.967; P=0.031) and reduces cancer-specific mortality (Gray’s test, P=0.017). However, for patients with leiomyosarcoma, NLND did not improve overall survival (P=0.46) or reduce cancer-specific mortality (Gray’s test, P=0.772).Conclusions: We identified the rate of LNM and risk factors for LNM in STS of the head, neck and extremities. In addition, prophylactic NLND treatment is necessary and has a clinical benefit for patients with STS who are at high risk for LNM, but has no significant impact on the prognosis of patients with leiomyosarcoma.

scholarly journals Lymph Node Dissections for T3T4 Stage Penile Cancer Patients Without Preoperatively Detectable Lymph Node Metastasis Bring More Survival Benefits: A Propensity Matching Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Han Li ◽  
Yucheng Ma ◽  
Zhongyu Jian ◽  
Xi Jin ◽  
Liyuan Xiang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Penile Cancer ◽  
Cox Regression ◽  
Regression Analyses ◽  
Node Dissection ◽  
Cancer Specific Survival ◽  
Node Metastasis ◽  
Propensity Matching

Background and AimsThe current guidelines for the treatment of penile cancer patients with clinically non-invasive normal inguinal lymph nodes are still broad, so the purpose of this study is to determine which patients are suitable for lymph node dissection (LND).MethodsHistologically confirmed penile cancer patients (primary site labeled as C60.9-Penis) from 2004 to 2016 in the Surveillance, Epidemiology, and Results database were included in this analysis. Univariate and multivariate Cox regression analyses were applied to determine an overall estimate of LND on overall survival and cancer-specific survival. A 1:1 propensity matching analysis (PSM) was applied to enroll balanced baseline cohort, and further Kaplan–Meier (KM) survival analysis was used to get more reliable results.ResultsOut of 4,458 histologically confirmed penile cancer patients with complete follow-up information, 1,052 patients were finally enrolled in this analysis. Age, pathological grade, T stage, and LND were identified as significant predictors for overall survival (OS) in the univariate Cox analysis. In the multivariate Cox regression, age, pathological grade, T stage, and LND were found significant. The same results were also found in the univariate and multivariate Cox regression analyses for cancer-specific survival (CSS). After the successful PSM, further KM analysis revealed that LND could bring significant OS and CSS benefits for T3T4 patients without lymph node metastasis.ConclusionLymph node dissection may bring survival benefits for penile cancer patients without preoperatively detectable lymph node metastasis, especially for T3T4 stage patients. Further randomized control trial is needed.

RA09.07: SURGICAL MANAGEMENT OF EARLY ESOPHAGEAL CANCER BASED ON LYMPH NODE METASTASIS RISK.

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 41-41
Author(s):  
Xiaofeng Duan ◽  
Zhentao Yu
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Tumor Location ◽  
Individual Risk ◽  
Node Dissection ◽  
Early Esophageal Cancer ◽  
Node Metastasis ◽  
The Individual

Abstract Background Esophagectomy and lymph node dissection is still the main treatment for esophageal cancer. Endoscopic mucosal resection and submucosal dissection are increasingly becoming a treatment of choice to preserve the integrity of the esophagus and decrease the surgical trauma in early esophageal cancer. However, lymph node metastasos (LNM) risk is still a debate focus for the decision of treatment selection. Our objective was to evaluate the prevalence, pattern and risk factors of LNM in early stage esophageal cancer to improve surgical treatment allocation. Methods We identified patients with pathological T1 stage esophageal cancer who underwent esophagectomy and lymph node dissection. The pattern of LNM was analyzed and the risk factors related to LNM were assessed by univariate and multivariable logistic regression analysis.The nomogram model was used to estimate the individual risk of lymph node metastasis. Results In 143 patients, LNM rates were: all patients 17.5%, T1a 8.0%, and T1b 22.5% for T1b. Depth of tumor infiltration (P < 0.05), tumor size (P < 0.01), tumor location (P < 0.05), and tumor differentiation (P < 0.01) were independent risk factors related to LNM. These four parameters allowed the compilation of a nomogram to estimate the individual risk of LNM. Fig. Nomogram to estimate the individual risk of LNM. Each characteristic of the included parameters scores a specific number of points (points per parameter). The summarized total points score indicates the probability of LNM. For a middle esophageal cancer with middle differentiated (G2), 3 cm tumor (> 2.5cm) that invades the submucosa (pT1b), the calculated total scores is 129.5 = 87.5 + 21 + 0 + 21, hence the corresponding LNM risk is 20%. Conclusion T1 esophageal cancer has a relatively high LNM rate, and the depth of tumor infiltration, tumor size, tumor location and tumor differentiation are correlated with LNM. Nomograms that include factors can be used to predict individual LNM risk. The LNM risk and extent must be considered comprehensively in decision-making of a better surgical treatment and lymph node dissection strategy. Disclosure All authors have declared no conflicts of interest.

scholarly journals Clinical Analysis of Cervical Lymph Node Metastasis Risk Factors and the Feasibility of Prophylactic Central Lymph Node Dissection in Papillary Thyroid Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yifan Chen ◽  
Shuo Chen ◽  
Xiaoying Lin ◽  
Xiangqing Huang ◽  
Xiaofang Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Cervical Lymph Node Metastasis ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Node Metastasis ◽  
Central Lymph

Objective. To identify the risk factors for cervical lymph node metastasis (CLNM) and the feasibility of prophylactic central lymph node dissection. Methods. The characteristics of 1107 patients were extracted and analyzed. Univariate and multivariate analyses were used to identify risk factors associated with lymph node metastasis. The relationship between the central lymph node dissection (CLND) and lateral lymph node metastasis (LLNM) was analyzed using the correlation analysis. Results. The probability of CLNM was closely related to the male gender, age <55, and the increase of tumor size. Those patients with an increase in tumor size and CLNM were extremely prone to LLNM. Also, LLNM was more likely to happen in those with the more positive central lymph nodes. Routine prophylactic central lymph node dissection (P-CLND) did not increase the risk of complications. Conclusion. P-CLND should be considered as a reasonable surgical treatment for PTC.

scholarly journals Risk Factors for Lymph Node Metastasis in Clinical Stage IA3 Lung Adenocarcinoma Patients

2021 ◽  
Author(s):  
Yuan-Liang Zheng ◽  
Ju Sheng ◽  
Ri-Sheng Huang ◽  
Jun Zhao
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lung Adenocarcinoma ◽  
Lymph Node Dissection ◽  
Mediastinal Lymph Node ◽  
Clinical Stage ◽  
Node Dissection ◽  
Node Metastasis ◽  
Systematic Lymph Node Dissection

Abstract Background: lymph node metastasis is a poor prognostic factor for lung cancer; however, the risk of lymph node metastasis has not been clarified yet, so it is controversial to conduct systematic lymph node dissection for early lung cancer. Therefore, this study aimed to focus on analyzing the predictive factors for lymph node metastasis in patients with clinical stage IA3 lung adenocarcinoma.Methods: Our study group retrospectively analyzed all surgical patients admitted to our hospital from January 1, 2017 to June 2021, and these patients were considered having stage IA3 lung adenocarcinoma. A total of 334 patients underwent lobectomy combined with systematic lymph node dissection. Univariate and multivariate logistic regression analysis were adopted to predict the risk factors of lymph node metastasis.Results: Among the 334 patients eligible for this study, the overall mediastinal lymph node metastasis rate was 15.27%. There were 45 cases of N1 metastasis and 11 cases of N2 metastasis, 5 cases had both N1 and N2 metastasis at the same time. The patients were divided into three groups according to consolidation tumor ratio (CTR) values (<0.25, 0.25-0.5, >0.5). The lymph node metastasis rates in each CTR group were 1.8% (2/112), 11.7% (17/145) and 41.6% (32/77), respectively. The mediastinal lymph node metastasis rate in patients with carcinoembryonic antigen (CEA>5ng/ml) was 57.89% (22/38). The receiver operating characteristic curve (ROC) showed that the area under the curve (AUC) of CTR, pathological type and CEA were 0.790 [95% confidence interval (CI): 0.727 – 0.853，P<0.001]; 0.800（95% CI:0.735–0.865，P<0.001）;0.682（95% CI: 0.591–0.773, P<0.001）;respectively. Multivariate regression analysis showed that these listed factors were significantly correlated with lymph node metastasis of clinical stage IA3 lung adenocarcinoma: CEA [Odds Ratio (OR)=3.05, P=0.016], CTR 0.25 to 0.5 (OR=14.12, P<0.017), CTR>0.5 (OR=7.75, P=0.015), micropapillary adenocarcinoma (OR=15.704, P<0.001), and solid adenocarcinoma (OR=8.971, P=0.001).Conclusions: CEA (>5ng/ml), histologic subtype and CTR (>0.25) are important predictors of lymph node metastasis in clinical stage IA3 lung adenocarcinoma, systematic lymph node dissection should be the prior choice for patients with clinical stage IA3 incorporated with risk factors. The lymph node dissection method in stage IA3 should be alternative from those in stage IA1 and IA2.

scholarly journals Risk Factors of Lymph Node Metastasis and Its Prognostic Significance in Early Gastric Cancer: A Multicenter Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jinfeng Wang ◽  
Liang Wang ◽  
Sha Li ◽  
Fei Bai ◽  
Hailong Xie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Prognostic Significance ◽  
Clinicopathological Factors ◽  
Node Dissection ◽  
Node Metastasis ◽  
Group 2

BackgroundEarly gastric cancer (EGC) is invasive gastric cancer that invades no deeper than the submucosa, regardless of lymph node metastasis (LNM). It is mainly treated by surgery. Recently, the resection range of EGC has been minimized, but cancer recurrence and overall survival in some patients should be given high status. LNM is an important indicator of prognosis and treatment in gastric cancer. The law of the number and location of metastatic lymph nodes in EGC is not yet clear. Therefore, we aimed to identify the risk factors of LNM in radically resected EGC and guide treatment.MethodsThe clinicopathological factors of 611 patients with EGC were retrospectively analyzed in six hospitals between January 2010 and December 2016. The relationship between clinicopathological factors and LNM, as well as their prognostic significance, were analyzed by univariate and multivariate analyses.ResultsThe rate of LNM was 20.0% in the 611 EGC patients. The depth of invasion, differentiation type, tumor diameter, morphological ulceration, and lymphovascular invasion were independent risk factors for LNM (P&lt;0.05) by logistic regression analysis. Tumor location in the proximal third of the stomach and morphological ulceration were significant factors for group 2 LNM. Moreover, the 5-year survival rate was 94.9% for patients with no positive nodes, 88.5% for patients with 1-2 positive nodes, 64.3% for patients with 3-6 positive nodes, and 41.8% for patients with &gt;6 metastatic nodes. Interestingly, the 7-year risk of relapse diminished for patients with no LNM or retrieved no less than 15 lymph nodes.ConclusionsFifteen lymph node dissection and D2 radical operation are the surgical options in case of high risk factors for LNM. Extended lymph node dissection (D2+) is recommended for morphological ulceration or disease located in the proximal third of the stomach due to their high rate of group 2 LNM. Furthermore, LNM is a significant prognostic factor of EGC. Moreover, lymph nodes can also play a significant role in the chemotherapeutic and radiotherapy approach for non-surgical patients with EGC.

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