Lymphovascular invasion is an important predictor of lymph node metastasis in endoscopically resected early gastric cancers

BackgroundLymph node involvement is a major feature in tumor spread of endometrial cancer and predicts prognosis. Therefore, evaluation of lymph vessel invasion (LVI) in tumor tissue as a predictor for lymph node metastasis is of great importance. Immunostaining of D2-40 (podoplanin), a specific marker for lymphatic endothelial cells, might be able to increase the detection rate of LVI compared with conventional hematoxylin-eosin (H-E) staining. The aim of this retrospective study was to analyze the eligibility of D2-40–based LVI evaluation for the prediction of lymph node metastases and patients’ outcome.Patients and MethodsImmunohistochemical staining with D2-40 monoclonal antibodies was performed on paraffin-embedded tissue sections of 182 patients with primary endometrioid adenocarcinoma treated in 1 gynecologic cancer center. Tumors were screened for the presence of LVI. Correlations with clinicopathological features and clinical outcome were assessed.ResultsImmunostaining of D2-40 significantly increased the frequency LVI detection compared with conventional H-E staining. Lymph vessel invasion was identified by D2-40 in 53 (29.1%) of 182 tumors compared with 34 (18.3%) of 182 carcinomas by routine H-E staining (P = 0.001). D2-40 LVI was detectable in 81.0% (17/21) of nodal-positive tumors and significantly predicted lymph node metastasis (P = 0.001). Furthermore, D2-40 LVI was an independent prognostic factor for patients overall survival considering tumor stage, lymph node involvement, and tumor differentiation (P < 0.01). D2-40–negative tumors confined to the inner half of the myometrium showed an excellent outcome (5-year overall survival, 97.8%).ConclusionsD2-40–based LVI assessment improves the histopathological detection of lymphovascular invasion in endometrial cancer. Furthermore, LVI is of prognostic value and predicts lymph node metastasis. D2-40 LVI detection might help to select endometrial cancer patients who will benefit from a lymphadenectomy.

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Lymph node metastasis risk according to the depth of invasion in early gastric cancers confined to the mucosal layer

Gastric Cancer ◽

10.1007/s10120-015-0535-7 ◽

2015 ◽

Vol 19 (3) ◽

pp. 860-868 ◽

Cited By ~ 11

Author(s):

Young-Il Kim ◽

Jun Ho Lee ◽

Myeong-Cherl Kook ◽

Jong Yeul Lee ◽

Chan Gyoo Kim ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Depth Of Invasion ◽

Gastric Cancers ◽

Node Metastasis ◽

Mucosal Layer

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The prognostic impact of pelvic lymph node metastasis and lymphovascular invasion on bladder cancer

International Journal of Urology ◽

10.1111/j.1442-2042.2008.02059.x ◽

2008 ◽

Vol 15 (7) ◽

pp. 607-611 ◽

Cited By ~ 11

Author(s):

Edwin Herrmann ◽

Eva Stöter ◽

Arndt van Ophoven ◽

Stefan Bierer ◽

Christian Bolenz ◽

...

Keyword(s):

Bladder Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymphovascular Invasion ◽

Pelvic Lymph Node ◽

Prognostic Impact ◽

Node Metastasis ◽

Pelvic Lymph Node Metastasis

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Development and Validation of a Nomogram for the Prediction of Inguinal Lymph Node Metastasis Extranodal Extension in Penile Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.675565 ◽

2021 ◽

Vol 11 ◽

Author(s):

Chong Wu ◽

Zaishang Li ◽

Shengjie Guo ◽

Fangjian Zhou ◽

Hui Han

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Penile Cancer ◽

Lymphovascular Invasion ◽

Clinical Laboratory ◽

Inguinal Lymph Node ◽

Inguinal Lymph Node Dissection ◽

Node Metastasis ◽

Extranodal Extension ◽

Individualized Prediction

PurposeTo determine whether a clinicopathologic and laboratory-based nomogram is capable of predicting the risk of lymph node extranodal extension (ENE) in patients with penile cancer.Materials and MethodsFrom June 2006 to January 2021, 234 patients who underwent bilateral inguinal lymph node dissection (ILND) surgery were included in the analysis. A Lasso regression model was utilized to select the most useful predictive features from among 46 laboratory variables. Then, a logistic regression analysis was used to develop the prediction model. Calibration curves, concordance index (C-index) and Areas under the receiver-operating characteristic curves (AUCs) were performed to evaluate the performance of the nomogram. We also investigated model fit using changes in Akaike Information Criteria (AICs). Decision curve analyses (DCAs) were applied to assess the clinical usefulness of this nomograms. Its internal validation was confirmed.ResultsAmong the 234 patients, 53 were confirmed to have ENE. The platelet-lymphocyte ratio (PLR) and Squamous cell carcinoma antigen (SCC-Ag) were significantly associated with ENE (P<0.05). The individualized prediction nomogram, including the PLR, SCC-Ag, lymphovascular invasion (LVI), and pathologic tumor stage(pT-stage), showed good discrimination, with a C-index of 0.817 (95% CI, 0.745 to 0.890) and good calibration. Clinical-laboratory nomogram (AIC, 180.034) become the best-fitting model. DCA findings revealed that the clinical-laboratory nomogram was more clinically useful than the pT-stage or tumor grade.ConclusionsThis study presents a clinicopathologic and laboratory-based nomogram that incorporates PLR, SCC-Ag, lymphovascular invasion (LVI), and pT-stage, which can be conveniently utilized to facilitate the individualized prediction of lymph node metastasis ENE in patients with penile cancer.

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Diagnostic Model Incorporating Clinicopathological Characteristics of Delphian Lymph Node Metastasis Risk Profiles in Papillary Thyroid Cancer

Frontiers in Endocrinology ◽

10.3389/fendo.2021.591015 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xingchen Li ◽

Yuansheng Duan ◽

Dandan Liu ◽

Hongwei Liu ◽

Mengqian Zhou ◽

...

Keyword(s):

Thyroid Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Tumor Size ◽

Lymphovascular Invasion ◽

Diagnostic Model ◽

Papillary Thyroid ◽

Central Lymph Node ◽

Node Metastasis ◽

Central Lymph

The Delphian lymph node (DLN), also known as the prelaryngeal node, is one component of the central lymph node. The DLN has been well studied in laryngeal cancer, although its significance in papillary thyroid cancer (PTC) remains unclear. We retrospectively analyzed 936 patients with PTC who underwent thyroidectomy by a single surgeon in Tianjin Cancer Hospital from 2017 to 2019. Moreover, 250 PTC patients who underwent thyroidectomy by another surgeon in Tianjin Cancer Hospital from January 2019 to April 2019 were used as a validation cohort. Among the 936 patients with PTC, 581 patients (62.1%) had DLNs, of which 177 samples with metastasis (177/581, 30.5%) were verified. DLN metastasis was significantly correlated with sex, age, tumor size, bilateral cancer, multifocality, extrathyroidal extension, lymphovascular invasion and central and lateral neck lymph node metastasis. Multivariate analysis revealed that independent risk factors for DLN metastasis included age, gender, tumor size, extrathyroid extension, lymphovascular invasion and central lymph node metastasis, which determined the nomogram. In particular, tumor size was proven to be one of the most predominant single predictors. The diagnostic model had an area under the curve (AUC) of 0.829 (95% confidence interval, 0.804–0.854). The internal and external validations of the nomogram were 0.819 and 0.745, respectively. Our results demonstrate that DLN metastasis appears to be a critical parameter for predicting metastatic disease of the central compartments. Furthermore, this study provides a precise criterion for assessing DLN metastasis and has great clinical significance for treating PTC.

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P48 MEDIASTINOSCOPY-ASSISTED ESOPHAGECTOMY FOR AN UPPER THORACIC SQUAMOUS CELL CARCINOMA IN A PATIENT WITH LIVER CIRRHOSIS

Diseases of the Esophagus ◽

10.1093/dote/doz092.48 ◽

2019 ◽

Vol 32 (Supplement_2) ◽

Author(s):

Z Faiz ◽

C Rihuete-Caro ◽

H Daiko

Keyword(s):

Squamous Cell Carcinoma ◽

Liver Cirrhosis ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cell Carcinoma ◽

Squamous Cell ◽

Lymphovascular Invasion ◽

Surgical Approaches ◽

Less Invasive ◽

Node Metastasis

Abstract Background The standard treatment for T1a esophageal cancer (EC) is endoscopic submucosal dissection (ESD), whereas in T1b cancer is esophagostomy with lymph node dissection performed. The lesions infiltrated into the middle one-third (SM2) have in 36% of cases lymph node metastasis. Moreover, 41% of patients with SM2 cancer and lymphovascular invasion can develop recurrent cancer. Surgical resection is the recommended treatment. However, surgery could deteriorate the general condition and quality of life of patients with several chronic diseases. Hence, it is necessary to develop less invasive surgical approaches for this category of patients [1-2]. Methods Mediastinoscopy-assisted esophagectomy (MAE) is one of the less invasive surgical approaches for EC patients with severe co-morbidities [3]. MAE facilitates direct visualization of the mediastinal organs and dissection of the mediastinal lymph nodes [3]. Thoracotomy could be avoided in MAE with less retention time and reduced volume of drainage in 24 h. However, MAE is still not widely performed because of the controversy about lymphadenectomy. This disadvantage could be covered by improving the surgical technique and instruments [4, 5]. Results A 49-year-old man with Child Pugh Class A liver cirrhosis and portal hypertension underwent MAE with side to end anastomosis after ESD of an upper (23-30 cm) pT1b (SM2) well differentiated squamous cell carcinoma with lymphovascular invasion. The considerations for the mediastinoscopy-assisted esophagostomy were the presence of co-morbidities, not having lymph node metastasis in the clinical stage and the presence of lymphovascular invasion in the specimen. After esophagectomy, pathological investigation revealed squamous cell carcinoma in-situ (Tis, 12 x 8 mm) of the upper part of esophagus with no ductal involvement, absence of lymphovascular invasion and no lymph node metastasis (0/9). The patient had no postoperative complications. Conclusion MAE is a feasible and less invasive surgical approach in EC patients with severe co-morbidities, although there is a limitation in curative dissection of the mediastinal nodes. Direct vision of the mediastinal structures during MAE predicts organ injury and may affect postoperative morbidity and mortality.

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