scholarly journals The effect of lymph node metastasis on overall survival and disease-free survival in vulvar cancer patients

2020 ◽  
Vol 91 (2) ◽  
pp. 62-67
Author(s):  
Volkan Karataşlı ◽  
Selçuk Erkılınç ◽  
İlker Çakır ◽  
Behzat Can ◽  
Tuğba Karadeniz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Vulvar Cancer ◽  
Disease Free Survival ◽  
Free Survival ◽  
Node Metastasis ◽  
Disease Free

scholarly journals Clinicopathological Significance of TARBP2, APP, and ZNF395 in Breast Cancer

2016 ◽  
Vol 10 ◽  
pp. BCBCR.S40820
Author(s):  
Ryoko Oi ◽  
Hirotaka Koizumi ◽  
Ichiro Maeda ◽  
Akira Noguchi ◽  
Shinobu Tatsunami ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Disease Free Survival ◽  
Clinicopathological Parameters ◽  
Free Survival ◽  
Expression Levels ◽  
Node Metastasis ◽  
Disease Free

The double-stranded RNA-binding protein TARBP2 has been suggested to act as an upstream regulator of breast cancer metastasis by destabilizing transcripts of the possible metastasis suppressors amyloid precursor protein (APP) and ZNF395. We examined this hypothesis by immunostaining of TARBP2, APP, and ZNF395 in 200 breast cancer specimens using tissue microarrays and analyzed the relationships between expression levels and clinicopathological parameters and prognosis. Increased TARBP2 overexpression was associated with shorter overall survival and disease-free survival, and increased but not reduced APP expression correlated with lower overall survival and disease-free survival. ZNF395 expression levels had no prognostic value, but reduced expression correlated with reduced lymph node metastasis. There was no significant relationship between TARBP2 overexpression and reduced APP and/or ZNF395 expression. Patients with tumors with higher TARBP2 or APP expression had unfavorable prognoses. Although reduced ZNF395 expression was significantly related to reduced lymph node metastasis, further studies are needed to clarify the role of TARBP2/APP/ZNF395 in breast cancer.

scholarly journals High CD38 expression in tumor-infiltrating immune cells is a favorite prognosis factor in esophageal squamous cell carcinoma with perigastric lymph node metastasis

2020 ◽  
Author(s):  
Feng Shi ◽  
Shuo Xiao ◽  
Yanjie Zhao ◽  
Yuchen Li ◽  
Ying Gao ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Immune Cells ◽  
Disease Free Survival ◽  
Free Survival ◽  
Node Metastasis ◽  
Cd38 Expression ◽  
Expression Rate ◽  
Disease Free

Abstract Background The present study aimed to investigate the prognostic effect of CD38 in patients with esophageal squamous cell carcinoma (ESCC). Methods We performed a retrospective cohort study by consecutively recruiting 142 patients with ESCC. The clinicopathological features and expression of CD38, CD4, CD8, Ki-67, PD-L1 and PD-1 in tumor and immune cells were independently evaluated by two pathologists. Results CD38 was expressed in immune cells but not tumor cells and the median expression rate of CD38 in immune cells was 60%. Among ESCC patients with perigastric lymph node metastasis, the expression rate of CD38 was not associated with the disease-free survival (p = 0.207), but had a significant association with the overall survival (p = 0.042). The median overall survival was 13 months and not observed among patients with low and high expression rate of CD38, respectively. The crude and adjusted hazard ratio (HR) of high CD38 expression was 0.37 (95%CI 0.14, 0.95) and 0.21 (95%CI 0.06, 0.70). The expression rate of CD38 had a negative correlation with PD-L1 expressed in tumor cells and CD4 expressed in immune cells. Among patients without perigastric lymph node metastasis, the expression rate of CD38 showed a significant association with the disease-free survival (p < 0.05). The median disease-free survival was 45 months and not achieved for patients with high and low expression of CD38; the adjusted HR of high CD38 expression was 2.13 (95%CI 0.85, 5.33). CD38 did not have significant association with the overall survival for patients without perigastric lymph node metastasis. The expression rate of CD38 had a negative correlation with PD-L1 expressed in tumor cells and a positive correlation with PD-L1 expressed in immune cells. Conclusion The high expression rate of CD38 was associated with a better survival for ESCC with perigastric lymph node metastasis. The prognostic effect of CD38 on esophageal cancer should be warranted in future prospective studies.

Multidisciplinary personalized approach in the management of vulvar cancer – the Vul.Can Team experience

2020 ◽  
Vol 30 (7) ◽  
pp. 932-938
Author(s):  
Luca Tagliaferri ◽  
Giorgia Garganese ◽  
Andrea D'Aviero ◽  
Valentina Lancellotta ◽  
Simona Maria Fragomeni ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
Local Control ◽  
Adjuvant Radiotherapy ◽  
Vulvar Cancer ◽  
Disease Free Survival ◽  
Tumor Board ◽  
Free Survival ◽  
Personalized Approach ◽  
Disease Free

IntroductionMultidisciplinary treatment strategy involving adjuvant radiotherapy for advanced vulvar cancer could be useful in offering the best personalized clinical approach. In 2013, the VULvar CANcer Multi-Disciplinary Team (Vul.Can MDT) was set up in our institution, in order to share knowledge and expertise, high-quality diagnosis, and evidence-based decision making in the context of personalized medicine. The aim of this observational study was to report on our series of vulvar cancer patients managed postoperatively with radiotherapy within the framework of a formal multidisciplinary tumor board.MethodsCoupling surgical and oncological international guidelines with “case-by-case” discussions, a multi-specialist consensus was progressively reached and internal recommendations were developed and introduced in the daily routine. Data from vulvar cancer patients who underwent primary surgery and adjuvant radiotherapy throughout a 5-year period were retrospectively collected. Actuarial local control was the primary endpoint, while secondary end-points were acute and late toxicities, disease-free survival, and overall survival. Toxicity was evaluated according to the Common Toxicity Criteria Adverse Event v 4.0 scale.ResultsThe analysis included 35 patients with squamous vulvar cancer treated with adjuvant radiotherapy±chemotherapy, from April 2013 to September 2017. Median age was 70 years (range 18–87), all patients underwent surgery followed by concomitant chemoradiation (45.7%) or radiotherapy alone (54.3%). The median prophylactic dose on lymphatic drainage was 45 Gy, while positive nodes and perineal area received 51.2 Gy and 52.6 Gy, respectively. Chemotherapy involved the cisplatin-based regimen (45.7%)±5-fluorouracil (37.1%). Median follow-up was 32 months (range 6–72): the 24-months local control, disease-free survival, and actuarial overall survival rates were 88.6%, 82.0%, and 91.0%, respectively. Low rates of severe acute (12%) and late (3%) toxicities occurred.DiscussionThe outcomes of this series support the benefit of a multidisciplinary personalized approach in the management of vulvar cancer.

scholarly journals Overexpression of HHLA2 is Markedly Associated with the Poor Prognosis in Medullary Thyroid Carcinoma

2021 ◽  
Author(s):  
Yongzhi Niu ◽  
Wei Wang ◽  
Xiaodan Jiang ◽  
Jisheng Zhang ◽  
Yichuan Huang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Disease Free Survival ◽  
Free Survival ◽  
Medullary Thyroid ◽  
Node Metastasis ◽  
Tumor Tissues ◽  
Disease Free

Abstract Human endogenous retrovirus-H long terminal repeat-associating protein 2 (HHLA2) is a newly identified immune checkpoint molecule that was aberrantly expressed in many malignant tumors. However, its expression in medullary thyroid carcinoma (MTC) is still unclear. This study aimed to investigate the HHLA2 expression in MTC tissues and to evaluate the relationships between its expression and clinicopathologic together with prognostic relevance. Using 51 surgical specimens obtained from MTC patients, the expression levels of the HHLA2 protein in MTC tumor tissues and adjacent noncancerous tissues were measured by immunohistochemistry, and its correlations with clinicopathologic and prognostic features were analyzed. Status of CD8+ tumor-infiltrating lymphocytes (TILs) was also investigated. The results showed that HHLA2 was only detected in tumor tissues, and that 31.4% of the MTC patients had high expression of HHLA2. High HHLA2 expression was significantly associated with lymph node metastasis and advanced AJCC stages (P=0.005). There existed an inverse trend between HHLA2 expression and CD8+ TILs infiltration in MTC tumor samples (P=0.042). The log-rank test showed a shorter disease-free survival in patients with high HHLA2 expression (P=0.002). The disease-free survival rates were also significantly low in cases of MTC with lymph node metastasis, AJCC stages III-IV and multifocality. Multivariate Cox analysis confirmed that HHLA2 acted as an independent predictive factor in the disease-free survival of MTC patients (HR=4.138, 95%CI: 1.027-16.667, P=0.046). Taken together, HHLA2 is highly expressed in MTC patients, and is a poor prognostic biomarker of disease-free survival of MTC patients.

Lymphatic metastasis in well-differentiated appendiceal cancer: Prognostic factors and associations with outcome.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 406-406
Author(s):  
Joshua S. Hill ◽  
Safia Rafeeq ◽  
Matthew H.G. Katz ◽  
Michael J. Overman ◽  
Laura A. Lambert ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Disease Free Survival ◽  
Nodal Metastasis ◽  
Free Survival ◽  
Node Metastasis ◽  
Increased Risk ◽  
Well Differentiated ◽  
Disease Free

406 Background: Well-differentiated appendiceal adenocarcinomas (WDAA) are rare tumors characterized by peritoneal spread. Lymph node metastasis can occur, yet the association between nodal spread and recurrence is poorly understood. Methods: A single institution retrospective review of patients seen between August 1993 and January 2010 with a pathologic diagnosis of WDAA who underwent colectomy was conducted. Patients with zero lymph nodes found during pathologic review were excluded. Parameters evaluated included demographics, presence of lymph node metastasis, completeness of cytoreduction and time to recurrence. Results: Of 688 patients with appendiceal neoplasms, 160 (23.3%) had WDAA. The mean age at diagnosis was 50.7 years and 81 (50.6%) were male. Median follow-up after diagnosis was 58.5 months. One hundred patients (62.5%) had regional or distant metastasis present at the time of colectomy. Seventy-eight (48.8%) colectomies were performed at outside institutions. The median number of nodes examined was 12. Twelve patients (7.5%) were found to have nodal metastasis. The rate of peritoneal metastasis did not correlate with the presence of nodal metastasis (node positive 9/12, 75% versus node negative 91/148, 61.5%; p=0.35). No difference in the ability to perform complete cytoreduction existed for those with and without nodal metastasis (66% versus 51% p=0.19). Examining patients with complete cytoreduction and ≥ 12 months of follow-up, there was an increased risk of recurrence among patients with lymphatic metastasis compared to those without (5/8, 62.5% versus 15/61, 24.6%; p=0.03). In this subset, median disease-free-survival in lymph node positive patients was 53 months compared to 109.1 months in patients without nodal metastasis (p=0.08). Conclusions: Patients with WDAA tumors have an overall favorable prognosis; however, patients with lymph node metastasis appear to have an increased risk of recurrence and apparent shortened disease free survival. Right colectomy may be warranted in this patient population.

Nomogram for lymph node metastasis prediction with early gastric cancer patients: To decide additional gastrectomy after endoscopic dissection.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4045-4045
Author(s):  
Su Mi Kim ◽  
Byung-Hoon Min ◽  
Ji Yeong An ◽  
Min-Gew Choi ◽  
Keun Won Ryu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Cancer Patients ◽  
External Validation ◽  
Disease Free Survival ◽  
Free Survival ◽  
Node Metastasis ◽  
Gastric Cancer Patients

4045 Background: Accurate prediction of metastatic lymph node is critical to avoid unnecessary gastrectomy and improve quality of life for patients with early gastric cancer. The aim of this study was to develop and validate a nomogram for prediction of lymph node metastasis in early gastric cancer patients. Methods: We reviewed the clinicopathological data of 10595 patients who underwent curative resection for early gastric cancer from 2001 to 2015 at Samsung Medical Center. This model was externally validated by 2100 patients who underwent curative resection for gastric cancer in National Cancer Center. Multivariate analysis using the Cox proportional hazard regression model was performed to develop the nomogram, and discrimination and calibration were evaluated by external validation. Overall survival, disease free survival, and recurrence free survival were compared between gastrectomy groups of 6641 patients and endoscopic dissection group of 999 patients who was performed the treatment in Samsung Medical Center for early gastric cancer by risk on nomogram to demonstrate the efficacy of nomogram. Results: Multivariate analyses revealed that age, tumor size, lymphatic invasion, depth of invasion, and histologic differentiation were significant prognostic factors for lymph node metastasis. The nomogram had good discrimination with a concordance index of 0.845 [95% confidence interval 0.832-0.858], supported by an external validation point of 0.813[95% confidence interval 0.786-0.84]. In low risk on nomogram, endoscopic dissection group had similar overall survival (P = 0.319), disease free survival (P = 0.469) and recurrence free survival (P = 0.091) compared to gastrectomy group. Conclusions: We developed and validated a nomogram predicting lymph node metastasis for early gastric cancer based on a large database. This personalized nomogram is useful to avoid unnecessary gastrectomy after endoscopic dissection resulting in improved quality of life for early gastric cancer patients.

scholarly journals High Level of ASXL1 Protein Is Associated With Better Disease-Free Survival in Colorectal Cancer

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 200s-200s
Author(s):  
K. Lee
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Protein Expression ◽  
Disease Free Survival ◽  
Colorectal Cancers ◽  
Free Survival ◽  
Node Metastasis ◽  
Positive Expression ◽  
Disease Free

Background: ASXL1 gene is on chromosome region 20q11.21. Either amplification in cervical cancer or truncation mutations in colorectal cancers with microsatellite instability (MSI), malignant myeloid diseases, chronic lymphocytic leukemia, liver, prostate and breast cancers occurred. The functional and the prognostic roles of ASXL1 mutations and the expression of protein in colorectal cancer are still unknown. Aim: The aim of this study is to investigate the functional roles of ASXL1 mutations and the expression of protein in colorectal cancer. Methods: We performed NGS of 10 colorectal cancer with peritoneal seeding to find genetic markers for aggressive phenotype. All showed a frameshift deletion at codon 1934delG. To clinically validate the functional and the prognostic roles of the mutations, we performed an immunohistochemical staining (IHC) on tissue microarrays of 414 consecutive colorectal cancers. Results: The ASXL1 protein expression was strong positive in 5.8% (24 patients), moderate positive in 38.5% (157 patients) and negative in 55.6% (227 patients). The patients with negative ASXL1 expression had more lymph node metastasis than the patients with strong positive expression [59.0% (134/227 patients) vs 33.3% (8/24 patients), P = 0.038]. None of the patients with strong positive expression had recurrent disease in the stage I-III cancers [0% (0/21 patients) vs 19.4% (27/139 patients) vs 18.9% (34/180 patients)] and the disease-free survival rate of the patients with strong positive expression was significantly better than that of the patients with moderate positive or negative expression ( P = 0.037; P = 0.031). Conclusion: The decreased level of the expression of the ASXL1 protein was associated with lymph node metastasis in its progression of cancer. Strong positive ASXL1 protein expression was a 'good' prognostic factor of colorectal cancers. The ASXL1 protein might be tumor suppressive in colorectal cancer.

scholarly journals Lower Collagen Area and Contralateral Lymph Node Metastasis Type Associated with Lower Disease-Free Survival in Thyroid Papillary Carcinoma

2020 ◽  
Author(s):  
Chengyun Dou ◽  
Fen Tang ◽  
Jianping Li ◽  
Qiang Zhao ◽  
Chuangjie Cao
Keyword(s):  
Lymph Node ◽  
Statistical Analysis ◽  
Lymph Node Metastasis ◽  
Disease Free Survival ◽  
The Novel ◽  
Free Survival ◽  
Node Metastasis ◽  
Risk Algorithm ◽  
Thyroid Papillary ◽  
Disease Free

Abstract Objectives: To introducing a novel prognostic risk scheme which based on collagen area and lymph node metastasis type in thyroid papillary carcinoma (PTC).Method: Tumor collagen area and lymph node matastasis type as well as several other histomorphological factors with disease-free survival (DFS) were investigated in a corhort of 101 PTC patients. Results: Median follow-up time of DFS was 76 months(inter quartile range: 71–83 months). Low collagen area and contralateral lymph node matastasis type were associated with dismal patient disease-free survival (DFS) significantly. While tumors with high collagen area showed a mean DFS of 77.37 months, gradually decreased to 76.53 months for tumors with moderate collagen area and to 66.67 months for tumors with low collagen area (p =0.028). Negtive, central and ipsilateral lymph node metastasis showed mean DFS of 72.72, 74.8 and 72.81 months respectively, decreased to 62.17 months with bilateral lymph node metastasis and 59.43 months with contralateral lymph node metastasis (p=0.029). In the cohort, uinivariate statistical analysis of the novel risk scheme revealed that the hazard ratio (HR) for DFS was 5.18 for R2 and 15.53 for R3 tumors compared to R1 PTC (p=0.003). Disease free survival dropped from 77.74 months for R1 tumors to 68.7 months for R2 and 56.38 months for R3. Multivariate statistical analysis of the novel risk scheme revealed that the HR for DFS was 3.259 (95% confident interval [CI] 1.122–9.469, p=0.03).Conclusion: Our novel risk algorithm incorporating tumor collagen area and lymph node matastasis type allows strongly prognostic stratification of PTC. We suggest this risk algorithm as a morphology-based parameter for the routine diagnostic assessment of this tumor entity.

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