Characteristics And Prognostic Value of Lymph Node Metastasis Along Recurrent Laryngeal Nerves in Thoracic Esophageal Squamous Cell Carcinoma

Author(s):  
Ligong Yuan ◽  
Feng Li ◽  
Shugeng Gao ◽  
Yousheng Mao ◽  
jie he

Abstract Background: Though the value of lymph node (LN) dissection along bilateral recurrent laryngeal nerve (RLN) has been debated and emphasized in recent years in thoracic esophageal squamous cell carcinoma (ESCC). However, the characteristics of nodal metastasis along RLN chain has not been clarified. This study aimed to investigate the characteristics of nodal metastasis along recurrent laryngeal nerves and the influence of these metastasis on the prognosis of thoracic ESCC.Patients and Methods: 339 eligible patients with thoracic ESCC who underwent esophagectomy with a three-field(3-FL) or two-field(2-FL) lymph node dissection from March 2015 to December 2018 were included in this study, consisting of 282 males and 57 females with a mean age of 60.6 years (range,40-80 years). The association of LN metastasis near RLN with clinicopathologic factors and its influence on survival were analyzed. Results: Among the 339 patients, 96 (28.3%) had LN metastasis along bilateral recurrent laryngeal nerves, 76 (22.4%) with positive LNs along right RLN and 47 (13.9%) along the left RLN. There was a significant difference in the metastasis rate between the LNs along right RLN and along the left RLN (P=0.004). The LN metastasis rate along RLN was significantly correlated with primary tumor locations (upper vs middle vs lower: 35.1% vs 30.9% vs 15.6%; P=0.015), tumor invasion depth (T3/T4 vs T1 vs T2: 36.2% vs 15.8% vs 26.2%, P=0.001 ) and degree of differentiation (well vs moderately vs poorly: 9.3% vs 29.3% vs 33.9%; P=0.009), subcarinal and left tracheobronchial lymph node metastasis (positive vs negative:58.1% vs 25.3%, P<0.001), abdominal LN metastasis (positive vs negative:41.2% vs 24.0%, P=0.003 ), but was not significantly correlated with age, gender and tumor length. The median follow-up time for this study was 34 months. The cumulative 1-, 2- and 3-year overall survival rates were 95.7%, 86.6% and 82.2% in RLN-LN(-) group versus 81.5%, 67.4% and 53.7% in the RLN-LN(+) group, with a significant difference between two group (HR=2.975,95% CI:1.918-4.614, P<0.01). Conclusions: The lymph node metastasis along RLNs was significantly correlated with primary tumor locations, tumor invasion depth, tumor differentiation, metastasis in the LNs of other stations, and indicate poor prognosis in ESCC.

2009 ◽  
Vol 127 (3) ◽  
pp. 145-149 ◽  
Author(s):  
Marília Buenos Aires Cabral Tavares ◽  
Rodrigo Beserra Sousa ◽  
Thiago Oliveira e Silva ◽  
Larissa Almeida Moreira ◽  
Loyana Teresa Teófilo Lima Silva ◽  
...  

CONTEXT AND OBJECTIVE: Cancer of the uterine cervix is still very common in Brazil. It is important to evaluate factors that influence its prognosis. The aim here was to analyze the prevalence of prognostic anatomoclinical factors among patients with carcinoma of the uterine cervix undergoing radical hysterectomy. DESIGN AND SETTING: Cross-sectional study on 301 patients with invasive carcinoma of the uterine cervix who underwent Level III Piver-Rutledge hysterectomy surgery at São Marcos Hospital. METHODS: The following variables were analyzed: age, histological type, degree of differentiation, invasion of lymphatic, vascular and perineural space, lymph node metastasis, distance to nearest margin, tumor invasion depth, vaginal cuff size, largest diameter of the tumor, presence of necrosis and surgical margin involvement. Descriptive statistics, multiple regression analysis, Kaplan-Meier survival curves and the log-rank test were performed. A significance level of 5% was used. RESULTS: The mean age was 48.27 years. The following were not important for the prognosis, in relation to survival analysis: degree of differentiation and tumor invasion depth; presence of lymphatic, blood and perineural invasions; distance to nearest margin; and vaginal cuff size. Tumor size (P < 0.036), presence of lymph node metastasis (P < 0.0004), necrosis (P < 0.05) and surgical margin involvement (P < 0.0015) presented impacts on survival. The overall survival with 98 months of follow-up was 88.35%. CONCLUSION: The most prevalent prognostic factors were the presence of lymph node metastasis, tumor size and surgical margin involvement.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Xia Liu ◽  
Xiuming Tang ◽  
Shaoyan Zhang ◽  
Yun Wang ◽  
Xiaofeng Wang ◽  
...  

Background. Retinoblastoma (RB) and transforming growth factor-β1 (TGF-β1) are important tumor-related factors.Methods. A series of 30 EBV-associated gastric carcinoma (EBVaGC) and 38 matched EBV-negative gastric carcinoma (EBVnGC) tissues were examined for the promoter methylation ofRBby methylation-specific PCR (MSP) method. The expression ofRBandTGF-β1in gastric carcinoma tissues was detected by immunohistochemistry.Results. The methylation rate ofRBgene in EBVaGC and EBVnGC was 80.0% (24/30) and 50.0% (19/38), respectively. The difference ofRBmethylation rate between EBVaGC and EBVnGC was significant(χ2=6.490,  P=0.011). There was no significant difference forRBexpression between EBVaGC (43.3%, 13/30) and EBVnGC (63.2%, 24/38), and also forTGF-β1between EBVaGC (56.7%, 17/30) and EBVnGC (63.2%, 24/38).RBmethylation was not reversely correlated withRBexpression in gastric carcinoma tissues(χ2=2.943,  P=0.086,  r=0.208).RBmethylation, loss expression ofRB, andTGF-β1expression were significantly associated with tumor invasion and lymph node metastasis (P<0.05), but was not associated with sex, age, histological subtype (differentiation status) and tumor location.Conclusions. Methylation ofRBis a common event in gastric carcinomas and EBV induces methylation ofRBin EBVaGC, which may contribute to the development of gastric carcinomas. EBV has no significant effect on induction ofTGF-β1expression. Detection ofRBmethylation,RBexpression, andTGF-β1expression may be helpful to judge the status of tumor invasion and lymph node metastasis in gastric carcinomas.


2020 ◽  
Author(s):  
Shuhei Kushiyama ◽  
Masakazu Yashiro ◽  
Yurie Yamamoto ◽  
Tomohiro Sera ◽  
Atsushi Sugimoto ◽  
...  

Abstract Background: Trophoblast cell-surface antigen 2 (TROP2) is a transmembrane glycoprotein expressed in epithelial cells. TROP2 overexpression has been reported to be correlated with malignant progression in most carcinomas, but TROP2 showed a tumor-suppressive function in some types of cancers. We currently developed a novel antibody against phospho-TROP2 (pTROP2). Since the function of TROP2 is controversial, we then aimed to clarify the clinicopathologic significance of TROP2 and pTROP2 expression in human gastric cancer (GC) in this study.Methods: We retrospectively analyzed the cases of 704 GC patients who underwent gastrectomy. The expressions of TROP2 and pTROP2 in each tumor were evaluated by immunohistochemistry. We analyzed the correlation between the GC patients' clinicopathologic features and the TROP2 and pTROP2 expression in their tumors.Results: Overexpression of TROP2 and that of pTROP2 were identified in 330 (46.9%) and 306 (43.5%) of the 704 GC patients, respectively. TROP2 overexpression was significantly correlated with the histological intestinal type, high tumor invasion depth (T3/T4), lymph node metastasis, lymphatic invasion, and venous invasion. In contrast, pTROP2 overexpression was significantly correlated with intestinal type, low tumor invasion depth (T1/2), no lymph node metastasis, and no lymphatic invasion. TROP2 overexpression was significantly associated with poorer overall survival (p<0.01, log rank), whereas pTROP2 overexpression was significantly associated with better overall survival (p<0.01, log rank).Conclusion: TROP2, but not pTROP2, might be associated with the metastatic ability of GC, resulting in poor prognoses for GC patients.


2016 ◽  
pp. 56-60
Author(s):  
Van Minh Nguyen ◽  
Hong Loi Nguyen ◽  
Thi Kim Anh Dang

Background: To evaluate the clinical, hystopathologycal features and correlation between lymph node metastasis and hystopathologycal grade in patients with carcinoma of the oral cavity. Materials and Methods: From July 2015 to July 2016, 32 patients with carcinoma of the oral cavity at Hue Central Hospital Results: The most common age group from 51 to 60 years and the male/female ratio was 1.9/1. Tumor were usually observed around the the tongue (40.6%) and oral floor (34.4%). Most of the tumor size is larger than 2 cm diameters (> 80%). The regional lymph node metastasis rate was 43.8% and there was a positive correlation between lymph node metastasis and tumor size (p <0.05). Squamous-cell carcinoma was mainly type of histopathology. Difference between the rate of lymph node metastasis in patient groups with different histopathological grade show no statistical significance (p> 0.05). Conclusion: the greater tumor, the higher regional lymph node metastasis. There is no relationship between the lymph node metastasis rate and histopathological grade of oral carcinoma. Key words: : carcinoma of oral cavity, tumor size, lymph node metastasis, histopathology


Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 548
Author(s):  
Masahiro Kagabu ◽  
Takayuki Nagasawa ◽  
Shunsuke Tatsuki ◽  
Yasuko Fukagawa ◽  
Hidetoshi Tomabechi ◽  
...  

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.


2021 ◽  
Vol 29 (1) ◽  
pp. 41-46
Author(s):  
Mahmud Asif Rifat ◽  
Mostafa Kamal Arefin ◽  
Abu Yusuf Fakir ◽  
SK Nurul Fattah Rumi ◽  
Husne Qumer Osmany ◽  
...  

Background: Oral cancer is a common neoplasm worldwide which has a increased incidence and mortality rate over the past decades. In spite of skilled surgical and radio therapeutic modalities it is characterized by poor prognosis and a low survival rate. Lymph node metastasis is an important negative prognostic factor in oral cancer. In this study, pattern of cervical lymph node metastasis in oral carcinoma has been described. Such information may contribute to the understanding of oral cancer management plan. Methods: This cross-sectional observational study was conducted in the Otolaryngology and Head-Neck surgery department of Dhaka Medical College Hospital. The study period was from January 2018 to June 2018. A total of 50 patients were selected by purposive sampling technique. Data were collected by study physician himself. Then these collected data were recorded in structured case report forms. Clinical examination and relevant investigations were done. After planned surgical procedure post operative histopathological reports were collected. All collected questionnaire were checked very carefully. Data were processed and analyzed with the help of computer program SPSS and Microsoft excel. Quantitative data were expressed as mean and standard deviation and qualitative data as frequency and percentage. Comparison were done by tabulation and graphical presentation in the form of tables, pie chart, graphs, bar diagrams, histogram & charts etc. Result: Overall demographic features of 50 patients revealed that, the maximum incidence was seen in the age group 31-50 years (54.0%), mean age of the patient was 49.6 ±9.2 year. Male and female ratio was 4.5:1. In this study most of the tumors were well and moderately differentiated, 34.0% and 62.0% respectively. Aetiology and predisposing factors revealed that the most common were cigarette smoking, betal quid and alcohol consumption, present in 52.0%, 28.0% and 22.0% of patients respectively. Post operative histopathology reports showed that 24 patients (48.0%) had neck node metastasis among which 59.4% were with tumor size >1 cm. Tumors with the depth of invasion >3 mm had a very high risk of metastasis (P<0.0001), as compared to tumor less than 3 mm in thickness. Out of the 24 patients with nodal metastasis 17(34.0%) patients had a single node metastasis (N1). Level I and Level II were the commonest site to be involved (14 patients). Nodal metastasis predominantly occurred from primary tumour site of tongue (22.0%) and floor of the mouth (14.0%). It was seen that patients with higher grade had a higher risk of metastasis (grade 1:–29.4%, grade 2:- 54.8%, grade 3:– 100.0%). Conclusion: Oral carcinoma may appear at any sub site, although there are certain areas in which it is found more frequently, such as the oral tongue, cheek and floor of the mouth. Lymph node metastasis is more common in oral carcinoma mostly level I & II, which is one of the most relevant prognostic factors. Elective neck dissection can be considered in all patients with tumors more than 3 mm in thickness. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 41-46


Author(s):  
Suresh Phatak ◽  
Raju Shinde ◽  
Nipun Gupta ◽  
Gaurangi Pawar ◽  
Pallavi Phatak

AbstractLymph node metastasis is an important prognostic factor in cases of carcinoma breast. In this pictorial essay, various sonographic and elastographic signs of lymph node metastasis are described with classical images.


2018 ◽  
Vol 28 (8) ◽  
pp. 1514-1519 ◽  
Author(s):  
Xinxin Zhu ◽  
Ling Zhao ◽  
Jinghe Lang

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.


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