scholarly journals Residual disease in lymph nodes has no influence on survival in patients with incidental gallbladder cancer – institution experience with literature review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mihajlo Đokic ◽  
Urban Stupan ◽  
Sabina Licen ◽  
Blaz Trotovsek
Keyword(s):  
Lymph Node ◽  
Survival Rate ◽  
Lymph Nodes ◽  
Gallbladder Cancer ◽  
Lymph Node Metastases ◽  
Residual Disease ◽  
Treatment Strategies ◽  
Node Metastases ◽  
Incidental Gallbladder Cancer

Abstract Background A better appreciation of the course and factors that influence incidental gallbladder cancer (iGBC) is needed to develop treatment strategies aimed to improve outcomes. The purpose of the study was to determine the influence of residual disease in the liver and lymph nodes on overall survival in re-resected patients with iGBC. Patients and methods Patients undergoing radical re-resection for iGBC from January 2012 to December 2018 were retrospectively identified. Patients with a 5-year follow-up and submitted to complete resection with stage I, II and III disease were analysed. The influence of residual disease (RD) in liver and lymph nodes on survival was assessed using the Kaplan-Meier curves. In addition, the rest of the group was assessed based on type of primary/secondary procedure, number of harvested lymph nodes and RD in liver and/or lymph nodes. Results In this retrospective study 48 out of 58 (83%) patients underwent re-resection. Among the group with a 5-year follow-up (re-operation between 2012–2014), 22 patients out of 28 (79%) were re-resected. Survival analysis showed that patients with no RD in the liver and lymph nodes had statistically significant better 5-year survival than those with RD. Comparing 5-year survival rate in patients with RD in the liver or lymph nodes against no RD group, patients with RD in the liver had statistically significantly worse 5-year survival, while lymph node metastases did not show any statistically significant different in 5-year survival. Besides, a statistically significant better prognosis was found in stage II disease compared to stage III, as expected. Conclusions The most important predictors of a 5-year survival in our study were RD in liver and stage of the disease. Lymph node metastases did not have any impact on the overall 5-year survival rate.

Utility of Gallium-67 in Determining the Radicality of Lymph Node Dissections of the Neck for Metastatic Lymph Nodes with Extranodal Spread in Patients Affected by Carcinoma of the Head and Neck

2000 ◽  
Vol 86 (4) ◽  
pp. 273-276
Author(s):  
Sante Basso Ricci ◽  
Arturo Chiti ◽  
Roberto Molinari ◽  
Giuseppe Borsa ◽  
Paolo Basso Ricci ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Soft Tissues ◽  
Postoperative Radiotherapy ◽  
Control Group ◽  
False Negatives ◽  
Node Metastases ◽  
Gallium 67

Aims and background Based on the fact that scintigraphy more readily reveals uptake of a radioisotope in a superficial position owing to incomplete surgical radicality, the authors examined by 67Ga scintigraphy a group of patients who had undergone dissection of lymph nodes of the neck from carcinoma with extranodal spread. They then checked the follow-up to ascertain the efficacy of 67Ga scintigraphy in relation to the eventual recurrences in the soft tissues of the neck. Methods A group of 136 patients were examined by 67Ga scintigraphy and followed for a minimum of 3 years after complementary radiotherapy. A group of 20 patients with no lymph node metastases was used as control to evaluate eventual false positives or false negatives. Results Recurrences in the soft tissues of the neck occurred in 35 (42.7%) of the 82 patients positive at 67Ga scintigraphy and in 6 (11.1%) of the 54 patients negative at the examination (P = 0.0001). All the patients in the control group were negative at 67Ga scintigraphy and without recurrences. Conclusions 67Ga scintigraphy can give reliable information on the risk of recurrences in the soft tissues of the neck. Since in spite of postoperative radiotherapy the percentage of local recurrences in cases with positive 67Ga scintigraphy was rather high (42.7%), the authors propose a scheme of radiotherapy based on administration of a higher dose per fraction on the scintigraphically positive area.

Surgical Management of Patients with Neuroendocrine Neoplasms of the Appendix: Appendectomy or More

2017 ◽  
Vol 106 (3) ◽  
pp. 242-251 ◽  
Author(s):  
Nikhil Pawa ◽  
Ashley K. Clift ◽  
Helai Osmani ◽  
Panagiotis Drymousis ◽  
Andrzej Cichocki ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Residual Disease ◽  
Disease Recurrence ◽  
Right Hemicolectomy ◽  
Neuroendocrine Neoplasms ◽  
Number Of Patients ◽  
Node Metastases ◽  
Current Guidelines

Background: Appendiceal neuroendocrine neoplasms (ANEN) are mostly indolent tumours treated effectively with simple appendectomy. However, controversy exists regarding the necessity of oncologic right hemicolectomy (RH) in patients with histologic features suggestive of more aggressive disease. We assess the effects of current guidelines in selecting the surgical strategy (appendectomy or RH) for the management of ANEN. Methods/Aims: This is a retrospective review of all ANEN cases treated over a 14-year period at 3 referral centres and their management according to consensus guidelines of the European and the North American Neuroendocrine Tumor Societies (ENETS and NANETS, respectively). The operation performed, the tumour stage and grade, the extent of residual disease, and the follow-up outcomes were evaluated. Results: Of 14,850 patients who had appendectomies, 215 (1.45%) had histologically confirmed ANEN. Four patients had synchronous non-ANEN malignancies. One hundred and ninety-three patients had index appendectomy. Seventeen patients (7.9%) had lymph node metastases within the mesoappendix. Forty-nine patients underwent RH after appendectomy. The percentages of 30-day morbidity and mortality after RH were 2 and 0%, respectively. Twelve patients (24.5%) receiving completion RH were found to have lymph node metastases. Two patients had liver metastases, both of them synchronous. The median follow-up was 38.5 months (range 1-143). No patient developed disease recurrence. Five- and 10-year overall survival for all patients with ANEN as the only malignancy was both 99.05%. Conclusions: The current guidelines appear effective in identifying ANEN patients at risk of harbouring nodal disease, but they question the oncological relevance of ANEN lymph node metastases. RH might present an overtreatment for a number of patients with ANEN.

scholarly journals Triple metachronous primary pancreatic and gallbladder cancer associated with pancreaticobiliary maljunction: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuta Kuhara ◽  
Yasushi Hashimoto ◽  
Satoshi Hirahara ◽  
Haruna Kubota ◽  
Kenji Shirakawa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Gallbladder Cancer ◽  
Histological Examination ◽  
Lymph Node Metastases ◽  
Pancreatic Head ◽  
Pancreaticobiliary Maljunction ◽  
Curative Surgery ◽  
Initial Surgery ◽  
Node Metastases

Abstract Background Metachronous pancreatic and gallbladder cancer is a rare condition and has a dismal prognosis. Herein, we present a patient with triple metachronous primary pancreatic and gallbladder cancer associated with pancreaticobiliary maljunction who achieved long-term survival after undergoing repeat curative surgery. Case presentation A 65-year-old female patient with advanced gallbladder cancer associated with pancreaticobiliary maljunction underwent extended cholecystectomy with extrahepatic bile duct resection. The pathological diagnosis was T3N0M0 stage III A papillary adenocarcinoma with hepatic invasion. During a monthly follow-up, a diffuse hypovascular 2.0 × 1.5-cm mass was detected in the pancreatic head 6.2 years after the initial surgery. Hence, the patient underwent pancreaticoduodenectomy. Histological examination revealed T3N0M0 stage IIA well-differentiated adenocarcinoma without lymph node metastases. Marked inflammatory reaction was observed in the non-cancerous lesions of the proximal pancreatic head parenchyma containing bile pigment within ductular lumens. After 12.5 years from the initial surgery, total pancreatectomy for a 4.0 × 3.0-cm mass in the remnant pancreas was performed. Histological examination revealed T3N1M0 stage IIB moderately differentiated adenocarcinoma with lymph node metastases. Hence, surgical curative resection was achieved. Based on the pathological findings, a definitive diagnosis of triple metachronous pancreatic and gallbladder cancer was made. The pathology suggests no precursor lesions such as pancreatic intraepithelial neoplasia (PanIN) and atypical flat lesions, but marked inflammations in the non-cancerous lesions, strengthening our hypothesis that chronic inflammation induced by the pancreaticobiliary maljunction is related to carcinogenesis of the pancreas. Despite further adjuvant chemotherapy, the patient’s general condition worsened; however, she remained alive 15.2 years after the initial surgery while receiving the best supportive care. Conclusions Repeat curative surgery for triple metachronous cancer was associated with a favorable prognosis. Both the biliary tract and the pancreas should be closely monitored during follow-up among patients with pancreaticobiliary maljunction, which can be managed with curative surgery.

Lymphographic Evaluation of 116 Cases of Malignant Melanoma

1972 ◽  
Vol 58 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Renato Musumeci ◽  
Luigi Acerbi ◽  
Gian Paolo Balzarini ◽  
Sergio Orefice ◽  
Ferdinando Preda ◽  
...  
Keyword(s):  
Lymph Node ◽  
Malignant Melanoma ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Lower Limbs ◽  
Histologic Examination ◽  
Node Metastases ◽  
The Individual

The use and limitations of lymphography in malignant melanoma are evaluated on the basis of 116 cases, nearly all of the lower limbs, and the possibilities of use both preoperatively and during follow-up are discussed. In 53.5% of the cases lymphography revealed lymph node metastases in the inguino-iliac-lumboaortic chains, a datum that justifies the use of lymphography. Histologic examination of the lymph nodes removed at operation proved to be just as important. The two investigations agreed in 89.1% of the cases, taking the material as a whole, and in 90.5%, taking the individual lymph chains (157).

Carcinoma del pene: Chirurgia e chemioterapia

1997 ◽  
Vol 64 (1_suppl) ◽  
pp. 100-102
Author(s):  
R. Iantorno ◽  
M. Nicolai ◽  
G. Cipollone ◽  
G. Peracchia ◽  
G. Mastroprimiano ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Pelvic Lymphadenectomy ◽  
Inguinal Lymphadenectomy ◽  
Node Metastases ◽  
Disease Free

Spinocellular carcinoma of the penis is rare and potentially fatal, especially when there are lymph node metastases. From January 1992 to December 1995 we treated 6 stage T3 N1 M0 tumours of the penis. Six to eight weeks after total penectomy, bilateral inguinal lymphadenectomy and pelvic lymphadenectomy were carried out. These patients also underwent 8 cycles of chemotherapy with vincristine, bleomycin and methotrexate. At an average follow-up of 36 months, all the patients are disease-free with no signs of recurrence either in the lymph nodes or in any organ.

Pulmonary Sclerosing Hemangioma With Lymph Node Metastases

2003 ◽  
Vol 127 (3) ◽  
pp. 321-325 ◽  
Author(s):  
Aya Miyagawa-Hayashino ◽  
Henry D. Tazelaar ◽  
Desiree J. Langel ◽  
Thomas V. Colby
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Residual Disease ◽  
Regional Lymph Node ◽  
Lung Nodule ◽  
Sclerosing Hemangioma ◽  
Pulmonary Sclerosing Hemangioma ◽  
Node Metastases ◽  
Pulmonary Tumors

Abstract Context.—Sclerosing hemangioma is an unusual pulmonary tumor. Previously, 4 patients with pulmonary sclerosing hemangioma and lymph node metastases have been described in the literature. Objective.—To report 4 additional cases of metastatic sclerosing hemangioma. Design.—Retrospective review of the authors' consultation files and review of histologic sections of pulmonary tumors and lymph node metastases. Results.—Four cases of a morphologically benign pulmonary sclerosing hemangioma with regional lymph node metastases (including hilar, peribronchial, and interlobar metastases) were identified. The patients (3 female, 1 male) had a mean age of 39 years (range, 10–56 years). The tumors ranged in size (greatest dimension) from 1.5 to 4.7 cm (mean, 3.1 cm). The pulmonary tumors were typical circumscribed sclerosing hemangiomas without mitotic activity, angiolymphatic invasion, or necrosis. One tumor had focal cytologic atypia. The metastases were identified in hilar lymph nodes that were removed at operation for the lung nodule. One patient received adjuvant chemotherapy for adenocarcinoma. All of the patients are alive. No recurrences or residual disease has been detected at a mean follow-up of 4.7 years (range, 2.3–10 years). Conclusions.—On the basis of case data from the 4 patients described here and the 4 patients described previously, metastases to regional lymph nodes from pulmonary sclerosing hemangioma may occur but are rare and do not appear to affect prognosis.

Assessment of cervical lymph node metastases using indirect computed tomography lymphography with iopamidol in a tongue VX2 carcinoma model

2011 ◽  
Vol 125 (8) ◽  
pp. 820-828 ◽  
Author(s):  
Y Shu ◽  
X Xu ◽  
Z Wang ◽  
W Dai ◽  
Y Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Cervical Lymph Node ◽  
Cervical Lymph Nodes ◽  
Cervical Lymph Node Metastases ◽  
Computed Tomography Images ◽  
Vx2 Carcinoma ◽  
Node Metastases

AbstractObjective:To investigate the performance of indirect computed tomography lymphography with iopamidol for detecting cervical lymph node metastases in a tongue VX2 carcinoma model.Materials and methods:A metastatic cervical lymph node model was created by implanting VX2 carcinoma suspension into the tongue submucosa of 21 rabbits. Computed tomography images were obtained 1, 3, 5, 10, 15 and 20 minutes after iopamidol injection, on days 11, 14, 21 (six rabbits each) and 28 (three rabbits) after carcinoma transplantation. Computed tomography lymphography was performed, and lymph node filling defects and enhancement characteristics evaluated.Results:Indirect computed tomography lymphography revealed bilateral enhancement of cervical lymph nodes in all animals, except for one animal imaged on day 28. There was significantly slower evacuation of contrast in metastatic than non-metastatic nodes. A total of 41 enhanced lymph nodes displayed an oval or round shape, or local filling defects. One lymph node with an oval shape was metastatic (one of 11, 9.1 per cent), while 21 nodes with filling defects were metastatic (21/30, 70 per cent). The sensitivity, specificity, accuracy, and positive and negative predictive values when using a filling defect diameter of 1.5 mm as a diagnostic criterion were 86.4, 78.9, 82.9, 82.6 and 83.3 per cent, respectively.Conclusion:When using indirect computed tomography lymphography to detect metastatic lymph nodes, filling defects and slow evacuation of contrast agent are important diagnostic features.

Sign in / Sign up

Export Citation Format

Share Document