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LN Metastasis (ln + metastasis)
Selected AbstractsAN ENDOCRINE CELL CARCINOMA WITH GASTRIC-AND-INTESTINAL MIXED PHENOTYPE ADENOCARCINOMA COMPONENT IN THE STOMACHDIGESTIVE ENDOSCOPY, Issue 4 2009Tsutomu Mizoshita A 77-year-old man complained of bodyweight loss, and a Borrmann 3 type lesion was observed endoscopically in the anterior wall of angular region of the stomach. The endocrine cell carcinoma (ECC) having the cytoplasmic staining of chromogranin A (CgA) was detected pathologically in the biopsy samples. The patient underwent distal gastrectomy plus systemic lymph node (LN) dissection (D2 LN dissection), and pathological examination revealed ECC invading the subserosa, and no LN metastasis (pT2N0M0). None of the gastric and intestinal endocrine cell marker expression was apparent in the ECC cells. The lesion also contained a moderately differentiated type tubular adenocarcinoma component, which was judged to be gastric-and-intestinal mixed (GI type) phenotype, using gastric and intestinal exocrine cell markers. After the surgery, he left the hospital and started oral doxifluridine (600 mg/day). The patient now (March 2008, about 19 months since the surgery) continues this chemotherapy with no recurrence. In conclusion, we experienced ECC with a GI type adenocarcinoma component. The ECC cases with the GI type adenocarcinoma component may have a relatively good prognosis, being similar to the results of advanced gastric cancers from the viewpoint of gastric and intestinal phenotypic expression. [source] Reduction rate of lymph node metastasis as a significant prognostic factor in esophageal cancer patients treated with neoadjuvant chemoradiation therapyDISEASES OF THE ESOPHAGUS, Issue 2 2007S. Aiko SUMMARY., Tumor regression is used widely as a measure of tumor response following radiation therapy or chemoradiation therapy (CRT). In cases of esophageal cancer, a different pattern of tumor shrinkage is often observed between primary tumors and metastatic lymph nodes (MLNs). Regression of MLNs surrounded by normal tissue may be a more direct measure of the response to CRT than regression of a primary tumor as exfoliative mechanical clearance does not participate in shrinkage of MLNs. In this study we evaluated the significance of the reduction rate (RR) of MLNs as a prognostic factor in esophageal cancer patients treated with neoadjuvant CRT. Forty-two patients with marked MLNs were selected from 93 patients with esophageal carcinoma who had received neoadjuvant CRT. The RRs of the primary tumor and the MLNs were calculated from computed tomography scans. In 20 patients, surgical resection was carried out following CRT. Univariate analysis was used to determine which of the following variables were related to survival: size of the primary tumor and MLNs; RRs of both lesions; degree of lymph node (LN) metastasis; clinical stage; and surgical resection. Multivariate analysis was then performed to assess the prognostic relevance of each variable. The primary tumor was larger than the MLNs in 69% of patients before CRT and in 40% of patients after CRT. In 79% of the patients, the RR of the primary tumor was greater than the RR of the MLNs. The results of the univariate analyses showed that a high RR of the MLNs and surgical resection after CRT were associated with significantly improved survival. The multivariate analysis demonstrated that the RR of MLNs had the strongest influence on survival. The RR of LN metastasis should be evaluated as an important prognostic predictor in patients with marked LN metastasis of esophageal cancer treated with CRT. [source] Assessment of open versus laparoscopy-assisted gastrectomy in lymph node-positive early gastric cancer: A retrospective cohort analysisJOURNAL OF SURGICAL ONCOLOGY, Issue 1 2010Ji Yeong An MD Abstract Background Laparoscopy-assisted gastrectomy (LAG) is still limited for early gastric cancer (EGC) with low possibility of lymph node (LN) metastasis, due to the concern for incomplete LN dissection and controversial long-term outcomes. We assessed oncological outcomes of laparoscopy-assisted versus open gastrectomy (OG) for patients with LN positive EGC. Methods Between 2003 and 2007, 204 patients underwent surgery for LN positive EGC. We evaluated adequacy of LN dissection and early and long-term outcomes after OG (n,=,162) and LAG (n,=,42). Results Operative time was longer but hospital stay was shorter for LAG than OG. Postoperative complications occurred in 14 patients (8.6%) after OG and 1 patient (2.4%) after LAG (P,=,0.316). Mean number of retrieved LNs and number of retrieved and metastatic LNs for each station did not differ between the two groups. During median 35 months of follow-up, 14 patients (8.6%) developed recurrence after OG, compared with 4 patients (9.5%) after LAG (P,=,0.769). Overall 5-year disease-free survival was 89.9% and 89.7% after OG and LAG. Status of LN metastasis was the only independent prognostic factor for disease-free survival. Conclusions LAG is an oncologically safe procedure even for LN positive EGC. Adequate LN dissection and comparable long-term outcomes to OG can be achieved by LAG. J. Surg. Oncol. J. Surg. Oncol. 2010;102:77,81. © 2010 Wiley-Liss, Inc. [source] Clinical relevance of serum levels of matrix metallopeptidase-2, and tissue inhibitor of metalloproteinase-1 and -2 in patients with malignant melanomaTHE JOURNAL OF DERMATOLOGY, Issue 4 2008Yuichiro YOSHINO ABSTRACT The interaction and/or balance between matrix metallopeptidase (MMP)-2 and tissue inhibitor of metalloproteinase (TIMP)-2 in vivo may play important roles in the process of tumor growth, invasion and metastasis of malignant melanoma. In this study, we investigated the serum levels and immunohistochemical expression of MMP-2, TIMP-1 and TIMP-2 in patients with melanoma and analyzed the correlation with clinicopathological parameters. The level of serum MMP-2 in patients was significantly higher than that of the control. Moreover, the level of MMP-2 was significantly higher than that of the control in patients who were: (i) female; (ii) pT1 and pT4; (iii) with and without lymph node (LN) metastasis; (iv) in stage I and stage IV; (v) with and without recurrence; and (v) alive and dead. The level of serum TIMP-1 in patients with melanoma was significantly higher than that of the control. Among melanoma patients, the level of TIMP-1 with pT4 was significantly higher for patients who were: (i) pT1 and pT3; (ii) with LN metastasis (vs those without); (iii) in stage IV (vs those in stages I, II and III); and (iv) dead (vs those alive). The level of serum TIMP-2 in patients with melanoma was not different from the control. However, the level of TIMP-2 in patients with pT4 was significantly higher than for patients who were: (i) pT1, pT3 and control; (ii) with LN metastasis (vs those without metastasis and control); (iii) with stage IV (vs those in stages I and II and control); (iv) in recurrence (vs control); and (v) dead (vs those alive and control). These results suggest that increased serum levels of TIMP-1 and TIMP-2 reflected the extent of metastatic melanoma lesions, and that serum levels of TIMP-1 may be a new useful marker for melanoma progression. [source] Presence of prostate cancer metastasis correlates with lower lymph node reactivity,THE PROSTATE, Issue 16 2006Gannon Philippe Olivier Abstract BACKGROUND Several reports suggest that the dissemination of neoplastic cells and cancer progression are associated with the generation of an immunosuppressive environment. METHODS In this report, we investigated immunological effects of prostate cancer by comparing metastastic and non-metastatic pelvic lymph nodes (LNs) from 25 patients with carcinomatous involvement of LNs to the non-metastatic LNs from 26 control patients with no metastatic involvement by immunohistochemistry and histological analyses. RESULTS Our results showed a decreased abundance of CD20+ B lymphocytes (P,=,0.031), CD38+ activated lymphocytes (P,=,0.038), and CD68+ macrophages (P,<,0.001), and less evidence of follicular hyperplasia (P,=,0.014), sinus hyperplasia (P,<,0.001), and fibrosis (P=0.028) in metastatic LNs comparatively to control LNs. Finally, we observed that metastatic LNs were significantly smaller than control LNs (P,=,0.005). CONCLUSIONS Our results suggest that the development of prostate cancer LN metastasis is accompanied with smaller LN size and decreased LN reactivity suggesting the development of an immununosuppressive microenvironment. © 2006 Wiley-Liss, Inc. [source] The association of genomic variation of Epstein,Barr virus BamHI F fragment with the proliferation of nasopharyngeal carcinomaAPMIS, Issue 9 2010QIUYU LIU Liu Q, Han A, You S, Yang Q, Liang Y, Dong Y. The association of genomic variation of Epstein,Barr virus BamHI F fragment with the proliferation of nasopharyngeal carcinoma. APMIS 2010; 118: 657,64. To investigate the f variant of Epstein,Barr virus (EBV) in nasopharyngeal carcinogenesis, we detected the f variant in primary nasopharyngeal carcinoma (NPC), metastatic carcinoma of the lymph node (LN), and chronic inflammation of the nasopharynx from the Guangdong region. Meanwhile, we analyzed the relationship between the f variant of EBV and LMP1, Fascin, pStat3, p53, Bcl-2, and Ki-67 expression in NPC. The results showed that the f variant of EBV was found in 11 cases of primary NPCs with LN metastasis, 12 LN metastases, and 18 primary NPCs without LN metastasis. However, only one demonstrated the F/f variant in 50 cases of chronic inflammation of the nasopharynx. The expression rate of LMP1, Fascin, pStat3, p53, Bcl-2, and Ki-67 in NPC with the f or F/f variant was higher than that with the F prototype. Furthermore, there was a significantly positive correlation between the f variant of EBV and Ki-67 expression (p < 0.05). Our study suggests that the f variant of EBV may be closely related to nasopharyngeal carcinogenesis. [source] The number of lymph nodes with metastasis predicts survival in patients with esophageal or esophagogastric junction adenocarcinoma who receive preoperative chemoradiationCANCER, Issue 5 2006Yan Gu M.D. Abstract BACKGROUND The survival of patients with locoregional adenocarcinoma of the esophagus or the esophagogastric junction (EGJ) who receive preoperative chemoradiation is reported to be better among patients who achieve a pathologic complete response than among patients who have residual tumor, including lymph node (LN) metastasis. However, the prognostic significance of the number of LNs with residual metastasis remains unclear. METHODS The authors studied 187 consecutive patients who received chemoradiation followed by an esophagectomy. The number of positive LNs and the size of metastatic tumor in each positive LN were examined with regard to overall survival (OS) and recurrence-free survival (RFS). RESULTS A pathologic complete response was achieved by 29% of patients. No LN metastasis (posttherapy pathologic negative LN status [ypN0]) was present in 49% of patients who had residual carcinoma, and LN metastasis (ypN1) was present in 51% of patients. The 5-year OS and 2-year RFS rates achieved by patients who had 1 positive LN (34% and 45%, respectively) were similar to the rates achieved by patients in the ypN0 group (38% [P = 0.84] and 50% [P = 0.77], respectively) but were significantly better than the rates achieved by patients who had , 2 positive LNs (6% [P = 0.02] and 18% [P = 0.01], respectively). The size of metastatic tumor in LNs among patients who had 1 positive LN was a prognostic factor (, 4 mm vs. < 4 mm; P = 0.04). In multivariate analysis, OS was better in patients who had 1 LN metastasis among patients in the ypN1 group (P = 0.02) independent of their posttherapy pathologic tumor status. CONCLUSIONS The current results suggested that the number of LNs with metastasis is an independent prognostic factor in patients with residual adenocarcinoma of the esophagus or the EGJ after preoperative chemoradiation. The authors suggest modification of the tumor-lymph node-metastasis (TNM) staging classification (ypTNM) to include the number of positive LNs in the ypN1 category. Cancer 2006. © 2006 American Cancer Society. [source] Papillary microcarcinoma of the thyroid,Prognostic significance of lymph node metastasis and multifocalityCANCER, Issue 1 2003Sin-Ming Chow M.B.B.S Abstract BACKGROUND It is known that patients with papillary microcarcinoma (PMC) of the thyroid gland have a very favorable prognosis. The rising incidence of PMC among papillary thyroid carcinoma (PTC) necessitates the identification of prognostic factors and the formulation of treatment protocols. METHODS The authors conducted a retrospective analysis of 203 patients with PMC who were diagnosed on or before 1999 and were treated at the Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong. RESULTS The cause specific survival, locoregional (LR) failure free survival, and distant metastases failure free survival rates at 10 years were 100%, 92.1%, and 97.1%, respectively. Five patients had lung metastases; 2 patients died of their metastases 12.9 years and 14.8 years after diagnosis, and 3 patients achieved clinical remission after radioiodine (RAI) treatment. Twelve patients had LR recurrences. Patients with LR recurrence were highly salvageable with a combination of surgery, RAI treatment, and external radiotherapy; all but one (who refused treatment) were alive without disease at last follow-up. Multivariate analyses did not reveal any independent prognostic factor for survival. The risk of cervical lymph node (LN) recurrence increased 6.2-fold (P = 0.01) and 5.6-fold (P = 0.02) when LN metastases and multifocal disease were present at diagnosis. RAI ablation reduced the LN recurrence rate to 0.27 (P = 0.04). The presence of LN metastasis increased the rate of distant metastasis 11.2-fold (P = 0.03). Age was not a significant factor in predicting disease recurrence or survival. Subdivision by tumor sizes , 5 mm and > 5 mm did not affect the outcome, but no patient with tumors , 5 mm had mortality related to PMC. CONCLUSIONS Despite the overall excellent prognosis for patients with PMC, PMC was associated with a 1.0% disease-related mortality rate, a 5.0% LN recurrence rate, and a 2.5% distant metastasis rate. Therefore, the treatment of patients with PMC should be no different from the treatment of patients with conventional PTC: i.e., complete surgery with consideration for RAI and/or external radiation therapy if poor prognostic factors are present. Cancer 2003;98:31,40. © 2003 American Cancer Society. DOI 10.1002/cncr.11442 [source] Tumor carbonic anhydrase 9 expression is associated with the presence of lymph node metastases in uterine cervical cancerCANCER SCIENCE, Issue 3 2007Sun Lee Tumor hypoxia has a pronounced effect on malignant progression and metastatic spread of human tumors. As carbonic anhydrases (CA) 9 and 12 are induced by the low-oxygen environment within tumors, we investigated the relationship between the expression of these two CA and the presence of metastatic lymph nodes (LN) in uterine cervical cancer. CA9/CA12 expression was evaluated histochemically in primary cervical cancer tissues of 73 patients who underwent laparoscopic LN staging and two patients with clinical staging before definitive radiotherapy at the National Cancer Center, Korea. We also evaluated CA9 expression in 33 patients with pathologically confirmed metastatic LN. CA9 expression in the primary tumors was significantly associated with LN metastasis (P = 0.03) and poorer disease-free survival (relative risk, 6.1; 95% confidence interval, 1.3,28.3, P = 0.02, multivariate analysis), whereas CA12 expression did not show such a relationship. In addition, 21 of 24 metastatic LN revealed similar CA9 expression (P = 0.001), suggesting that CA9-expressing tumor cells had a higher metastatic potential. CA9 was expressed in 45 of 75 (60%) primary tumors, with positive tumor cells observed predominantly in the area away from the blood vessels. In contrast, CA12 expression was observed in only 29 of 74 primary tumors (39%), without a specific pattern. These findings indicate that expression of CA9, but not CA12, in tumors is associated with the presence of LN metastases and poorer prognosis. Selective application of new treatment modalities based on CA9 expression to prevent LN metastases may improve overall treatment outcome in patients with uterine cervical cancer. (Cancer Sci 2007; 98: 329,333) [source] | ||||||||||