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Lymph Node Invasion (lymph + node_invasion)
Selected AbstractsHP37 PROGNOSTIC FACTORS IN OESOPHAGEAL CANCER: NUMBER OF LYMPH NODES AND EXTRACAPSULAR LYMPH NODE INVASION , AN INTERIM ANALYSISANZ JOURNAL OF SURGERY, Issue 2007S. K. Thompson Purpose Controversy exists over the 2nd edition of the TNM staging system introduced by the American Joint Committee in Cancer in 1988, and revised in 2002. Prognostic pathological factors such as the number of positive lymph nodes and any extracapsular lymph node invasion may refine this current staging system and optimize patient treatment. Methodology All patients who underwent surgical resection for oesophageal cancer were identified in a prospectively-maintained database. Patients without invasive adenocarcinoma or squamous cell cancer were excluded. Pathology slides were reviewed by a single pathologist. Survival data was calculated using Kaplan-Meier curves, and prognostic factors were examined using the log rank test. Results 235 surgical specimens met inclusion criteria, and 95 specimens have been reviewed so far. The 5-yr overall survival rate was 43% (median 31.4 months). Subdividing pN-stage into 1,2 positive nodes and >2 positive nodes showed significant differences in 5-yr survival between both groups: 41% vs. 6.0%, respectively (P = 0.0003). Similarly, including absence and presence of extracapsular lymph node invasion into our pathology review showed significant differences in 5-yr survival: 40% vs. 7.8%, respectively (P < 0.01). A negative circumferential margin, and the absence of both vascular and perineural invasion were also found to significantly improve survival rates. Conclusions The number and characteristics of metastatic invasion of lymph nodes should be included in current oesophageal cancer staging systems. Clinicians will then have more accurate prognostic information, and treatment can be better tailored to patients' needs. [source] Usefulness of follow-up after pancreatoduodenectomy for carcinoma of the ampulla of VaterHPB, Issue 2 2007LAURENCE CHICHE Abstract Background: The prognosis for carcinoma of the ampulla of Vater (CAV) is better than for pancreatic cancer. The 5-year survival median rate after resection of CAV is 45%, but late recurrences remain possible. Several survival factors have been identified (lymph nodes, perineural invasion), but few data are available on the type of recurrences, their impact and their management. Patients and methods: A total of 41 patients treated by pancreatoduodenectomy (PD) for CAV from 1980 to 2003 were studied retrospectively. Patient selection, long-term survival recurrence rate and recurrence treatment were reviewed. Univariate and multivariate proportional hazards analysis were conducted on this series. Results: The mean follow-up was 48 months. Five-year survival was 62.8%. Eleven patients had recurrences (6,67 months). Recurrence was associated with time to all-causes death (hazard ratio [HR] 4.3, p=0.003). Factors predictive of recurrence were perineural invasion (HR 5.3, p=0.02), lymph node invasion (HR 5.3, p=0.02) and differentiation (HR 0.2, p=0.05). Three patients underwent surgical R0 treatment of their recurrences. Two who presented with solitary liver metastasis are alive and disease-free. Conclusions: Recurrence represents a serious threat in the prognosis of CAV after surgery. Some of these recurrences, in particular liver metastases, are accessible for a curative treatment. This finding supports the usefulness of a close and long-term follow-up after surgery to improve survival of patients with CAV, especially in the group of patients with a good prognosis. [source] Angiopoietin-2 expression in breast cancer correlates with lymph node invasion and short survivalINTERNATIONAL JOURNAL OF CANCER, Issue 4 2003Christian Sfiligoi Abstract Angiogenic factors produced by tumor cells are essential for tumor growth and metastasis. In our study, the expression of Angiopoietin-1 (ANG1) and Angiopoietin-2 (ANG2) mRNA in archival human breast cancer tumor samples and in 6 breast cancer cell lines was investigated. Total RNA from biopsies of 38 breast cancer patients was extracted and ANG1 and ANG2 mRNA expression was measured by means of quantitative real-time RT-PCR (Taqman®). Matching data with available clinicopathologic and biochemical data revealed a significant association between ANG2 expression and axillary lymph node invasion. Univariate and multivariate survival analysis, by means of Kaplan-Meier method and Cox's proportional hazards model, showed significant and independent association between ANG2 mRNA level and both disease-free (p < 0.0001) and overall survival (p < 0.0003). An important fact is that, notwithstanding the small number of cases examined, this association was confirmed also in the group of lymph node-negative patients (DFS, p < 0.003; OS, p < 0.020). Immunohistochemical analysis demonstrated that Ang2 is expressed by both tumor cells and endothelial elements. Expression in tumor cells was confirmed by studying a panel of human breast carcinoma cell lines in culture by RT-PCR. In ZR75.1 and T47D cells, expression of ANG2 mRNA was increased up to 10-fold by treatment with estrogen within 24 hr. Although preliminary, these data suggest a possible role of ANG2 as a prognostic factor for primary breast cancer. © 2002 Wiley-Liss, Inc. [source] STAT3 expression in gastric cancer indicates a poor prognosisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 4 2009Dae-Young Kim Abstract Background and Aim:, Signal transducers and activators of transcription (STAT) behave as signal transducers in the cytoplasm and as transcription factors in the nucleus. In the current study, we analyzed the immunohistochemical staining patterns of gastrectomy tissue specimens. We investigated the expression of STAT3 and STAT5 and estimated the relationship between STAT and cancer prognosis. Methods:, One hundred patients who underwent gastrectomy due to gastric adenocarcinoma at Bundang CHA hospital between January 2000 and May 2005 were studied. Immunohistochemistry was carried out using antibodies against STAT3 and STAT5. The interpretation of the immunohistochemical staining was based on the proportion of stained cells in the field: positive, > 10% stained cells; and negative, < 10% stained cells. Results:, The longest diameter of tumor was 4.67 cm in the positive group and 3.76 cm in the negative group, and these results were not statistically different (P -value = 0.112). Higher T (primary tumor) value (P -value = 0.05), more regional lymph node invasion (P -value = 0.008) and higher TNM staging (P -value = 0.069) were significantly related to STAT3 positivity, but Helicobacter pylori infection or atrophic gastritis were not related. A lower survival rate was observed in the STAT3-positive group (P -value = 0.001). The results of STAT5 were not statistically different with respect to TNM staging and survival (P -value = 0.958). We thus report that the immunohistochemical results of STAT3 revealed a significant association with TNM staging and survival. Conclusion:, We anticipate that STAT3 may be used as a molecular staging biomarker predicting poor prognosis of gastric cancer. [source] HP37 PROGNOSTIC FACTORS IN OESOPHAGEAL CANCER: NUMBER OF LYMPH NODES AND EXTRACAPSULAR LYMPH NODE INVASION , AN INTERIM ANALYSISANZ JOURNAL OF SURGERY, Issue 2007S. K. Thompson Purpose Controversy exists over the 2nd edition of the TNM staging system introduced by the American Joint Committee in Cancer in 1988, and revised in 2002. Prognostic pathological factors such as the number of positive lymph nodes and any extracapsular lymph node invasion may refine this current staging system and optimize patient treatment. Methodology All patients who underwent surgical resection for oesophageal cancer were identified in a prospectively-maintained database. Patients without invasive adenocarcinoma or squamous cell cancer were excluded. Pathology slides were reviewed by a single pathologist. Survival data was calculated using Kaplan-Meier curves, and prognostic factors were examined using the log rank test. Results 235 surgical specimens met inclusion criteria, and 95 specimens have been reviewed so far. The 5-yr overall survival rate was 43% (median 31.4 months). Subdividing pN-stage into 1,2 positive nodes and >2 positive nodes showed significant differences in 5-yr survival between both groups: 41% vs. 6.0%, respectively (P = 0.0003). Similarly, including absence and presence of extracapsular lymph node invasion into our pathology review showed significant differences in 5-yr survival: 40% vs. 7.8%, respectively (P < 0.01). A negative circumferential margin, and the absence of both vascular and perineural invasion were also found to significantly improve survival rates. Conclusions The number and characteristics of metastatic invasion of lymph nodes should be included in current oesophageal cancer staging systems. Clinicians will then have more accurate prognostic information, and treatment can be better tailored to patients' needs. [source] Postoperative reduced dose of cisplatin concomitant with radiation therapy in high- risk head and neck squamous cell carcinoma,CANCER, Issue 11 2009Giovanni Franchin MD Abstract BACKGROUND: The role of low doses of cisplatin and concomitant postoperative radiotherapy in high risk head and neck squamous cell carcinoma has not yet been defined. METHODS: Patients treated with definitive surgery, who had histological evidence of involvement of more than 2 lymph nodes, extracapsular extension of disease, perineural and/or intravascular invasion, involved or close surgical margins, received postoperative radiotherapy plus 75 mg/m2 of cisplatin every 3 weeks during the radiotherapy cycle. The primary endpoints were to evaluate treatment compliance and overall, cause-specific, and disease-free survival. RESULTS: A total of 142 patients were enrolled. With a median follow-up of 40 months, 5-year overall survival was 68%, cause-specific survival 78% and disease-free survival 82%. At multivariate analysis surgical margins status and extracapsular lymph node invasion were the only statistically significant prognostic factors. Fifty-three percent of the patients developed severe mucositis and 14% hematologic toxicity of grade 3. The 3 planned concomitant chemotherapy cycles were delivered to 48% of the patients. CONCLUSIONS: Postoperative radiotherapy and concomitant low-dose cisplatin was an effective treatment in high risk head and neck patients. The total toxicity observed was lower compared with that reported with higher doses of cisplatin, although the delivery of all the 3 planned chemotherapy cycles was challenging. The distant failure rate was high, which was an unsatisfactory result. Cancer 2009. © 2009 American Cancer Society. [source] Overexpression of synuclein-, in pancreatic adenocarcinomaCANCER, Issue 1 2004Zhongkui Li Ph.D. Abstract BACKGROUND Currently, pancreatic adenocarcinoma is the fourth leading cause of cancer-related death in the United States. Despite the advances in pancreatic carcinoma research, patients with this devastating disease have a very poor prognosis. To identify the gene expression profile of pancreatic carcinoma, an important step in the process of developing new diagnostic and therapeutic strategies, the authors investigated the alteration of gene expression in this disease. METHODS The authors analyzed a public serial analysis of gene expression (SAGE) database and examined in greater detail the expression of synuclein-, mRNA in several pancreatic carcinoma cell lines and tumor tissue samples by reverse transcriptase,polymerase chain reaction (RT-PCR) analysis and Northern blot analysis. The expression of synuclein-, protein was investigated further by immunohistochemical and Western blot analyses using tumor cell lines, tumor tissue, and serum samples. RESULTS Synuclein-, mRNA was overexpressed in 11 of 12 pancreatic carcinoma cell lines, including AsPc-1, MDAPanc28, Capan-1, Capan-2, PANC-1, HS766T, MDAPanc3, MDAPanc48, Colo357FG, MiaPaCa2, CFPac1, and BxPc3. The expression of synuclein-, protein was detectable in 8 of 12 pancreatic carcinoma cell lines (67%) and in 22 of 32 pancreatic tumor tissue samples (69%) by Western blot analysis. On immunohistochemical staining, synuclein-, protein was present in 61% of the tumor tissue samples examined from patients with Stage I and II pancreatic carcinoma. The overexpression of synuclein-, is correlated with perineural and lymph node invasion. Synuclein-, protein also was detectable by Western blot in serum samples from 21 of 56 patients (38%) with pancreatic carcinoma. CONCLUSIONS Synuclein-,, which initially was described as a breast carcinoma,specific gene involved in invasion, metastasis, and chemotherapy resistance, was frequently overexpressed in pancreatic carcinoma. Overexpression of synuclein-, may play a role in pancreatic carcinoma invasion. Further studies will be necessary to determine the role of synuclein-, in pancreatic carcinoma. Cancer 2004. © 2004 American Cancer Society. [source] | ||||||||||||||||||||||