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17 "Lymph node metastasis"
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Genitourinary cancer
The Prognosis and the Role of Adjuvant Chemotherapy for Node-Positive Bladder Cancer Treated with Neoadjuvant Chemotherapy Followed by Surgery
Hyehyun Jeong, Kye Jin Park, Yongjune Lee, Hyung-Don Kim, Jwa Hoon Kim, Shinkyo Yoon, Bumsik Hong, Jae Lyun Lee
Cancer Res Treat. 2022;54(1):226-233.   Published online May 6, 2021
DOI: https://doi.org/10.4143/crt.2021.365
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study aims to evaluate the prognosis of pathologically node-positive bladder cancer after neoadjuvant chemotherapy, the role of adjuvant chemotherapy in these patients, and the value of preoperative clinical evaluation for lymph node metastases.
Materials and Methods
Patients who received neoadjuvant chemotherapy followed by partial/radical cystectomy and had pathologically confirmed lymph node metastases between January 2007 and December 2019 were identified and analyzed.
Results
A total of 53 patients were included in the study. The median age was 61 years (range, 34 to 81 years) with males comprising 86.8%. Among the 52 patients with post-neoadjuvant/pre-operative computed tomography results, only 33 patients (63.5%) were considered positive for lymph node metastasis. Sixteen patients (30.2%) received adjuvant chemotherapy (AC group), and 37 patients did not (no AC group). With the median follow-up duration of 67.7 months, the median recurrence-free survival (RFS) and the median overall survival (OS) was 8.5 months and 16.2 months, respectively. The 2-year RFS and OS rates were 23.3% and 34.6%, respectively. RFS and OS did not differ between the AC group and no AC group (median RFS, 8.8 months vs. 6.8 months, p=0.772; median OS, 16.1 months vs. 16.3 months, p=0.479). Thirty-eight patients (71.7%) experienced recurrence. Distant metastases were the dominant pattern of failure in both the AC group (91.7%) and no AC group (76.9%).
Conclusion
Patients with lymph node-positive disease after neoadjuvant chemotherapy followed by surgery showed high recurrence rates with limited survival outcomes. Little benefit was observed with the addition of adjuvant chemotherapy.

Citations

Citations to this article as recorded by  
  • A Predictive Nomogram for Development of Lymph Node Metastasis in Muscle-Invasive Bladder Cancer Following Neoadjuvant Therapy
    Garrett K. Harada, Steven N. Seyedin, Olivia Heutlinger, Armon Azizi, Audree Hsu, Arash Rezazadeh, Michael Daneshvar, Greg E. Gin, Edward M. Uchio, Giovanna A. Giannico, Jeremy P. Harris, Aaron B. Simon, Jeffrey V. Kuo, Nataliya Mar
    Advances in Radiation Oncology.2025; 10(1): 101671.     CrossRef
  • Influence of Neoadjuvant Chemotherapy on Survival Outcomes of Radical Cystectomy in Pathologically Proven Positive and Negative Lymph Nodes
    Krystian Kaczmarek, Bartosz Małkiewicz, Karolina Skonieczna-Żydecka, Artur Lemiński
    Cancers.2023; 15(19): 4901.     CrossRef
  • Comparison of responses to neoadjuvant and adjuvant chemotherapies in muscle-invasive bladder cancer
    Serhat Sekmek, Gökhan Ucar, Irfan Karahan, Dogan Bayram, Selin Aktürk Esen, Ismet Seven, Mehmet Ali Nahit Sendur, Dogan Uncu
    African Journal of Urology.2023;[Epub]     CrossRef
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Head/neck cancer
Nomogram for Predicting Central Lymph Node Metastasis in Papillary Thyroid Cancer: A Retrospective Cohort Study of Two Clinical Centers
Zheyu Yang, Yu Heng, Jianwei Lin, Chenghao Lu, Dingye Yu, Lei Tao, Wei Cai
Cancer Res Treat. 2020;52(4):1010-1018.   Published online June 9, 2020
DOI: https://doi.org/10.4143/crt.2020.254
AbstractAbstract PDFPubReaderePub
Purpose
Central lymph node metastasis (CNM) are highly prevalent but hard to detect preoperatively in papillary thyroid carcinoma (PTC) patients, while the significance of prophylactic compartment central lymph node dissection (CLND) remains controversial as a treatment option. We aim to establish a nomogram assessing risks of CNM in PTC patients, and explore whether prophylactic CLND should be recommended.
Materials and Methods
One thousand four hundred thirty-eight patients from two clinical centers that underwent thyroidectomy with CLND for PTC within the period 2016–2019 were retrospectively analyzed. Univariate and multivariate analysis were performed to examine risk factors associated with CNM. A nomogram for predicting CNM was established, thereafter internally and externally validated.
Results
Seven variables were found to be significantly associated with CNM and were used to construct the model. These were as follows: thyroid capsular invasion, multifocality, creatinine > 70 μmol/L, age < 40, tumor size > 1 cm, body mass index < 22, and carcinoembryonic antigen > 1 ng/mL. The nomogram had good discrimination with a concordance index of 0.854 (95% confidence interval [CI], 0.843 to 0.867), supported by an external validation point estimate of 0.825 (95% CI, 0.793 to 0.857). A decision curve analysis was made to evaluate nomogram and ultrasonography for predicting CNM.
Conclusion
A validated nomogram utilizing readily available preoperative variables was developed to predict the probability of central lymph node metastases in patients presenting with PTC. This nomogram may help surgeons make appropriate surgical decisions in the management of PTC, especially in terms of whether prophylactic CLND is warranted.

Citations

Citations to this article as recorded by  
  • Risk nomogram for papillary thyroid microcarcinoma with central lymph node metastasis and postoperative thyroid function follow-up
    Yuting Huang, Pengwei Lou, Hui Li, Yinhui Li, Li Ma, Kai Wang
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Ultrasonic Feature Prediction of Large-Number Central Lymph Node Metastasis in Clinically Node-Negative Solitary Papillary Thyroid Carcinoma
    Weihan Xiao, Xiaomin Hu, Chaoxue Zhang, Xiachuan Qin
    Endocrine Research.2023; 48(4): 112.     CrossRef
  • Nomogram for predicting central lymph node metastasis in T1-T2 papillary thyroid cancer with no lateral lymph node metastasis
    Yubo Sun, Wei Sun, Jingzhe Xiang, Hao Zhang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • An integrated nomogram combining deep learning, clinical characteristics and ultrasound features for predicting central lymph node metastasis in papillary thyroid cancer: A multicenter study
    Luchen Chang, Yanqiu Zhang, Jialin Zhu, Linfei Hu, Xiaoqing Wang, Haozhi Zhang, Qing Gu, Xiaoyu Chen, Sheng Zhang, Ming Gao, Xi Wei
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Central and lateral neck involvement in papillary thyroid carcinoma patients with or without thyroid capsular invasion: A multi-center analysis
    Zheyu Yang, Yu Heng, Jian Zhou, Lei Tao, Wei Cai
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Development and validation of nomograms for predicting the risk of central lymph node metastasis of solitary papillary thyroid carcinoma of the isthmus
    Yonghao Li, Xuefei Gao, Tiantian Guo, Jing Liu
    Journal of Cancer Research and Clinical Oncology.2023; 149(16): 14853.     CrossRef
  • Development and validation of an individualized nomogram for predicting the high-volume (> 5) central lymph node metastasis in papillary thyroid microcarcinoma
    X. Wei, Y. Min, Y. Feng, D. He, X. Zeng, Y. Huang, S. Fan, H. Chen, J. Chen, K. Xiang, H. Luo, G. Yin, D. Hu
    Journal of Endocrinological Investigation.2022; 45(3): 507.     CrossRef
  • Preoperative Prediction of Central Cervical Lymph Node Metastasis in Fine-Needle Aspiration Reporting Suspicious Papillary Thyroid Cancer or Papillary Thyroid Cancer Without Lateral Neck Metastasis
    Kai Zhang, Lang Qian, Jieying Chen, Qian Zhu, Cai Chang
    Frontiers in Oncology.2022;[Epub]     CrossRef
  • Relationship between subgroups of central and lateral lymph node metastasis in clinically node-negative papillary thyroid carcinoma
    Jing Zhou, Da-Xue Li, Han Gao, Xin-Liang Su
    World Journal of Clinical Cases.2022; 10(12): 3709.     CrossRef
  • Hashimoto’s Thyroiditis Is Associated With Central Lymph Node Metastasis in Classical Papillary Thyroid Cancer: Analysis from a High-Volume Single-Center Experience
    Bin Zeng, Yu Min, Yang Feng, Ke Xiang, Hang Chen, Zijing Lin
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Nomogram model based on preoperative serum thyroglobulin and clinical characteristics of papillary thyroid carcinoma to predict cervical lymph node metastasis
    Qungang Chang, Jieming Zhang, Yaqian Wang, Hongqiang Li, Xin Du, Daohong Zuo, Detao Yin
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Ultrasound-based radiomics nomogram combined with clinical features for the prediction of central lymph node metastasis in papillary thyroid carcinoma patients with Hashimoto’s thyroiditis
    Peile Jin, Jifan Chen, Yiping Dong, Chengyue Zhang, Yajun Chen, Cong Zhang, Fuqiang Qiu, Chao Zhang, Pintong Huang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Lateral Involvement in Different Sized Papillary Thyroid Carcinomas Patients with Central Lymph Node Metastasis: A Multi-Center Analysis
    Yu Heng, Zheyu Yang, Pengyu Cao, Xi Cheng, Lei Tao
    Journal of Clinical Medicine.2022; 11(17): 4975.     CrossRef
  • Risk factors and prediction models of lymph node metastasis in papillary thyroid carcinoma based on clinical and imaging characteristics
    Yanyuan Deng, Jie Zhang, Jiao Wang, Jinying Wang, Junping Zhang, Lulu Guan, Shasha He, Xiudan Han, Wei Cai, Jixiong Xu
    Postgraduate Medicine.2022;[Epub]     CrossRef
  • A prognostic nomogram for papillary thyroid cancer lymph node metastasis based on immune score
    Yihua Lu, Kai Qian, Mengjia Fei, Kai Guo, Yuan Shi, Zhuoying Wang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Risk factors for central and lateral lymph node metastasis in papillary thyroid carcinoma
    Ji Hyun Ahn, Hee Kyung Chang
    Kosin Medical Journal.2022; 37(4): 311.     CrossRef
  • Construction and validation of a nomogram for predicting cervical lymph node metastasis in classic papillary thyroid carcinoma
    Y. Feng, Y. Min, H. Chen, K. Xiang, X. Wang, G. Yin
    Journal of Endocrinological Investigation.2021; 44(10): 2203.     CrossRef
  • Application of Machine Learning Algorithms to Predict Central Lymph Node Metastasis in T1-T2, Non-invasive, and Clinically Node Negative Papillary Thyroid Carcinoma
    Jiang Zhu, Jinxin Zheng, Longfei Li, Rui Huang, Haoyu Ren, Denghui Wang, Zhijun Dai, Xinliang Su
    Frontiers in Medicine.2021;[Epub]     CrossRef
  • Preoperative Predictors of Lymph Node Metastasis in Colon Cancer
    Yansong Xu, Yi Chen, Chenyan Long, Huage Zhong, Fangfang Liang, Ling-xu Huang, Chuanyi Wei, Shaolong Lu, Weizhong Tang
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Preoperatively Predicting the Central Lymph Node Metastasis for Papillary Thyroid Cancer Patients With Hashimoto’s Thyroiditis
    Yu Min, Yizhou Huang, Minjie Wei, Xiaoyuan Wei, Hang Chen, Xing Wang, Jialin Chen, Ke Xiang, Yang Feng, Guobing Yin
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Reevaluation of Criteria and Establishment of Models for Total Thyroidectomy in Differentiated Thyroid Cancer
    Zhenghao Wu, Yunxiao Xiao, Jie Ming, Yiquan Xiong, Shuntao Wang, Shengnan Ruan, Tao Huang
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • Influencing Factors and Cumulative Risk Analysis of Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma
    Yirong Yin, Xiang Xu, Liyan Shen, Wenjuan Zhao, Hongcui Diao, Chengqian Li
    Frontiers in Oncology.2021;[Epub]     CrossRef
  • A Specific Predicting Model for Screening Skip Metastasis From Patients With Negative Central Lymph Nodes Metastasis in Papillary Thyroid Cancer
    Zheyu Yang, Yu Heng, Qiwu Zhao, Zichao Cao, Lei Tao, Weihua Qiu, Wei Cai
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Computed Tomography-Based Radiomics Model to Predict Central Cervical Lymph Node Metastases in Papillary Thyroid Carcinoma: A Multicenter Study
    Jingjing Li, Xinxin Wu, Ning Mao, Guibin Zheng, Haicheng Zhang, Yakui Mou, Chuanliang Jia, Jia Mi, Xicheng Song
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively


    Ning Li, Ju-hua He, Chao Song, Li-chun Yang, Hong-jiang Zhang, Zhi-hai Li
    Cancer Management and Research.2020; Volume 12: 10789.     CrossRef
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Establishment and Validation of a Nomogram for Nasopharyngeal Carcinoma Patients Concerning the Prognostic Effect of Parotid Lymph Node Metastases
Chao Lin, Xue-Song Sun, Sai-Lan Liu, Xiao-Yun Li, Nian Lu, Xin-Ling Li, Lin-Quan Tang, Ling Guo
Cancer Res Treat. 2020;52(3):855-866.   Published online March 10, 2020
DOI: https://doi.org/10.4143/crt.2019.772
AbstractAbstract PDFPubReaderePub
Purpose
The prognosis of nasopharyngeal carcinoma (NPC) patients with parotid lymph node (PLN) metastasis remains unclear. This study was performed to investigate the prognostic significance and optimal staging category of PLN metastasis and develop a nomogram for estimating individual risk.
Materials and Methods
Clinical data of 7,084 non-metastatic NPC patients were retrospectively reviewed. Overall survival (OS) was the primary endpoint. A nomogram was established based on the Cox proportional hazards regression model. The accuracy and calibration ability of this nomogram was evaluated by C-index and calibration curves with bootstrap validation.
Result
Totally, 164/7,084 NPC patients (2.3%) presented with PLNs. Multivariate analyses showed that PLN metastasis was a negative prognostic factor for OS, progression-free survival (PFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS). Patients with PLN metastasis had a worse prognosis than N3 disease. Five independent prognostic factors were included in the nomogram, which showed a C-index of 0.743. The calibration curves for probability of 3- and 5-year OS indicated satisfactory agreement between nomogram-based prediction and actual observation. All results were confirmed in the validation cohort.
Conclusion
NPC patient with PLN metastasis had poorer survival outcome (OS, PFS, DMFS, and LRFS) than N3 disease. We developed a nomogram to provide individual prediction of OS for patients with PLN metastasis.

Citations

Citations to this article as recorded by  
  • Risk factors analysis and nomogram for predicting recurrence in periocular basal cell carcinoma
    Xincen Hou, Alexander C. Rokohl, Katharina Berndt, Senmao Li, Xiaojun Ju, Philomena A. Wawer Matos, Wanlin Fan, Ludwig M. Heindl
    Canadian Journal of Ophthalmology.2025;[Epub]     CrossRef
  • Analysis of patients with parotid recurrence after parotid-sparing IMRT for nasopharyngeal carcinoma: case series and review of the literature
    Sezin Yuce Sari, Melek Tugce Yilmaz, Gozde Yazici, Sepideh Mohammadipour, Gokhan Ozyigit, Ibrahim Gullu, Mustafa Cengiz
    Strahlentherapie und Onkologie.2024; 200(12): 1057.     CrossRef
  • Nomogram Based on Liver Function Test Indicators for Survival Prediction in Nasopharyngeal Carcinoma Patients Receiving PD-1 Inhibitor Therapy
    Lixia Liang, Yan Li, Yansui Hong, Tianxing Ji, Hao Chen, Zhifang Lin
    Current Oncology.2023; 30(8): 7189.     CrossRef
  • A Randomized Controlled Trial on Evaluation of Plasma Epstein-Barr Virus Biomarker for Early Diagnosis in Patients With Nasopharyngeal Carcinoma
    Wen Liu, Huilan Li, Hui Sheng, Xiaohua Liu, Peidong Chi, Xueping Wang, Minjie Mao
    Advances in Therapy.2020; 37(10): 4280.     CrossRef
  • Prognosis prediction signature of seven immune genes based on HPV status in cervical cancer
    Qianqian Xia, Hua Jin, Xing Zhang, Wenjing Yan, Dan Meng, Bo Ding, Jian Cao, Dake Li, Shizhi Wang
    International Immunopharmacology.2020; 88: 106935.     CrossRef
  • 14,994 View
  • 127 Download
  • 3 Web of Science
  • 5 Crossref
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The Role of Expression of Vascular Endothelial Growth Factor (VEGF)-A and VEGF-C in Early Gastric Cancer
Jeong Hwan Yook, Shoji Natsugoe, Xiangming Che, Sumiya Ishigami, Shuichi Hokita, Masamichi Baba, Sonshin Takao, Aikou Takashi
J Korean Cancer Assoc. 2001;33(2):93-98.
AbstractAbstract PDF
PURPOSE
Tumor spread is mainly dependent on both hematogenous and lymphogeneous systems, and recently, several angiogenic factors have been identified. In the present study, we investigated whether the expressions of VEGF-A and -C are related with angiogenesis and lymph node metastasis in early gastric cancer. MATERIALS AND METHODS: A total of 97 specimens btained from patients with early gastric cancer were studied by immunohistochemical methods using anti- VEGF-A and -C polyclonal antibodies, anti-Factor VIII- related antigen antibody, and anti-p53 antibody.
RESULTS
The percentage of the positive expressions of VEGF-A and -C were 24.7% (24/97) and 25.7% (25/97), respectively. Significant differences were found between the expression of VEGF-A and lymphatic invasion and lymph node metastasis, and between expression of VEGF-C and gross type, lymphatic invasion, and lymph node metastasis (p<0.05). The mean microvessel counts in VEGF-A and -C positive tumors were significantly higher than those in VEGF-A and -C negative tumors (p<0.05). In multivariate analysis, tumor size, lymphatic invasion and VEGF-C were identified as independent factors related to lymph node metastasis (p<0.05).
CONCLUSION
The expressions of VEGF-A and -C were found to be related to angiogenic activity and VEGF-C expression correlated significantly with lymph node metastasis. The determination of VEGF-C expression may be helpful for predicting lymph node metastases in early gastric cancer, and further studies involving many specimens are warranted.
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Analysis of Clinicopathological Factors Associated with Lymph Node Metastasis in Early Gastric Cancer Review of 2,137 cases
Chang Shin Kwak, Hyeon Kook Lee, Sam Je Cho, Han Kwang Yang, Kun Uk Lee, Kuk Jin Choe, Jin Pok Kim
J Korean Cancer Assoc. 2000;32(4):674-681.
AbstractAbstract PDF
PURPOSE
The majority of patients with early gastric cancer show long-term survival after surgery. So a special attention must be directed to preserving gastric function in these patients. When node-negative early gastric cancer could be diagnosed preoperatively, then minimally invasive surgery can be performed to ensure a postoperative better quality of life.
MATERIALS AND METHODS
The pathological records of 2,137 consecutive patients with early gastric cancer who underwent curative operations from January 1986 to December 1998 at Seoul National University Hospital were reviewed.
RESULTS
Lymph node metastases were observed in 285 patients (13.3%). In mucosal carcinoma, lymph node metastases were observed in 50 of 1,108 cases (4.5%), and in submucosal carcinoma, in 234 of 1,026 cases (22.8%). The tumor size, depth of invasion and gross appearance were associated with lymph node metastasis. In mucosal carcinoma, the size and histologic differ entiation were associated with lymph node metastasis. In submucosal carcinoma, the size and gross appearance were associated with lymph node metastasis.
CONCLUSION
In early gastric cancer, the limited surgery can be applied only to cases satisfying the following criteria; (1) mucosal tumor, (2) size < or =2 cm, (3) elevated type or (4) depressed type which are histologically differentiated and (5) size < or =1 cm among the depressed type his tologically undifferentiated.
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Radioresponse of Hepatdegrees Celluar Carcinoma Treatment of Lymph Node Metastasis
Jong Hoon Kim, Eun Kyung Choi, Young Wha Chung, Young Sang Lee, Dong Jin Seo
J Korean Cancer Assoc. 2000;32(3):571-577.
AbstractAbstract PDF
No abstract available.
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Clinicopathological Analysis for Recurrence after Surgery for Early Gastric Cancer
K W Chung, S J Cho, H K Yang, W H Kim, K U Lee, K J Choe, Y I Kim, J P Kim
J Korean Cancer Assoc. 2000;32(2):312-320.
AbstractAbstract PDF
PURPOSE
The incidence of early gastric cancer (EGC) is increasing in Korea. The prognosis of EGC is excellent but a small portion of patients experience recurrence after curative resection. We aimed to study recurrence rate of EGC, recurrence pattern of EGC and to find predicting factors for recurrence. We analyzed treatment results after recurrence in EGC.
MATERIALS AND METHODS
One thousand four hundred fifty eight patients with EGC at Department of Surgery, Seoul National University Hospital (1986~1995) were reviewed for recurrence retrospectively.
RESULTS
Twenty-six patients had recurrence after curative resection (1.79%). Thirteen cases (50%) recurred within 24 months (early recurrence) and late recurrence after 60 months occured in 4 cases (15%). The common modes of recurrence were locoregional (9, 34.6%) and distant metastasis (9, 34.6%). Submucosal invasion was in 19 cases and lymph node metastasis was positive in 14 cases. Median survival after recurrence was 5.6 months. Median survival after recurrence was 3.1 months after conservative management, 5.8 months after chemotherapy, and 46.8 months after resection. Recurrence rate was significantly higher in submucosal invasion group than mucosal invasion group (2.6% vs. 1.0%, p<0.05) and lymph node metastasis positive group than negative group (7.4% vs. 1.0%, p <0.001) by univariate analysis. Multivariate analysis revealed significantly high correlation between positive lymph node metastasis and recurrence (p < 0.001).
CONCLUSION
Lymph node metastasis is the most significant predictor of recurrence. Resection for locoregional recurrence can be beneficial.
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Prognostic Significance of Occult Lymph Node Metastases in Breast Cancer
Won Cheol Park, Kyoung Keun Lee, Kwong Man Lee, Ki Jung Yun
J Korean Cancer Assoc. 1999;31(6):1195-1201.
AbstractAbstract PDF
PURPOSE
About 20% to 30% of patients with node-negative breast cancer die of systemic metastases in 10 years after surgery. This may be due to either early occult systemic spread before node metastasis or occult lymph node metastasis (OLNM) which is undectected by routine pathologic evaluation. The purpose of this study was to assess the incidence and its prognostic significance of OLNM in breast cancer.
MATERIALS AND METHODS
Paraffin blocks of axillary lymph nodes from 50 patients with invasive breast carcinoma initially diagnosed as node-negative by routine histological examination were evaluated. All nodes were serially sectioned by 40 pm thickness interval, followed by hematoxylin-eosin (H-E) staining and cytokeratin immunohistochemical staining.
RESULTS
OLNM were detected in 6 patients (12%) by immunohistochemical method; in 3 of these 6 patients, it were also detectable by serial sectioning and H-E staining. OLNM correlated with the primary tumor size (r=0.43, p <0.05). During mean follow- up of 57 months, there were 4 systemic recurrences and one death. Of 6 patients with OLNM, 2 had multiple systemic recurrences (33.3%). Of 44 patients without OLNM, in contrast, only 3 had systemic recurrences (6.8%). Five year disease-free survival rates of patients with and without OLNM were 66.7% and 93.0%, respectively (p=0.087).
CONCLUSION
These results suggest that about 10% of patients with "node-negative" breast cancer have OLNM, and the presence of OLNM may have marginal prognostic significance. Serial sectioning and cytokeratin immunohistochemical staining of axillary lymph nodes should be considered as a part of the routine histologic examination especially in the patients with a large primary tumor.
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Comparision between New Version of UICC-TNM Classification with Old Versions Including Japanese Classifications of Gastric Cancer Patientw
Sung Sik Bae, Jong Inn Lee, Nan Mo Moon, Nam Sun Paik, Dong Wook Choi, Dae Yong Hwang, Ho Yoon Bang, Woo Chul Noh
J Korean Cancer Assoc. 1999;31(1):43-53.
AbstractAbstract PDF
PURPOSE
This study was designed to examine the reliability and easy applicability of new version of UICC-TNM classification (UICC, 1997) compared with old version of UICC-TNM classification (UICC, 1992) and JRSGC (Japanese Research Society for Gastric Cancer) classification of gastric cancer.
MATERIALS AND METHODS
For 1043 patients who underwent curative resection from Jan. 1992 to Dec. 1996 in Korea Cancer Center (KCCH), old version of UICC-TMN classification and JRSGC classification were compared with the new version of UICC-TNM classification.
RESULTS
Correlation coefficient between topographic classification (old UICC-TNM, JRSGC) of lymph node and numeric classification was 0.9 (p<0.05). 5-year survival rates according to old UICC, TRSGC, new UICC classification were 94.9% at stage Ia; 96.6, 96.5, 97.1% at stage Ib; 73.8, 73.8, 73.0% at stage II; 54.1, 55.8, 58.0% at stage IIIa; 35.5, 42.0, 36.0% at stage IIlb; 25.9, 22.3, 23.9% at stage IV. 5-year survival rates of each classification had significant difference among stages (p<0.0001), but there was no significant difference among each classification.
CONCLUSION
The new version of UICC-TNM classification based on the number of involved lymph nodes allows a staging system as reliable as the old version of UICC-TNM and JRSGC classification. In addition, the new version of UICC-TNM classification can be applied without methodologic problems and seems more convenient and reproducible.
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Clinical Results of Para-aortic Lymph Node Dissection in Advanced Gastric Cancer
Ik Haeng Jo, Dae Hyun Yang, Jin Pok Kim, Won Jin Choi, Il Myung Kim, Jin Youn, Sang Su Park, Byung Ook Yoo, Seung Ik Ahn, Shin Eun Choi
J Korean Cancer Assoc. 1999;31(1):31-42.
AbstractAbstract PDF
PURPOSE
In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data.
MATERIALS AND METHODS
The authors analyzed retrospectively pathological features of 95 patients who underwent paraaortic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation from May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unknown causes of death in survival analysis.
RESULTS
The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSR's) in relation to the paraaortic lymph node (No16) status was 0.0% in No16 , and 57.8% in No16 with D4 of advanced gastric cancer. The 5 YSR's were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, n1, n2 and n3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively.
CONCLUSION
The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Borrmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p<0.05).
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Granisetron in the Prevention of Nausea and Vomiting in Patients Receiving Platinum - Containing Chemotherapy
Woo Shik Kim, Si Young Kim, Kyung Sam Cho, Jeong Hee Kim, Hwi Joong Yoon
J Korean Cancer Assoc. 1998;30(6):1249-1258.
AbstractAbstract PDF
PURPOSE
In gastric cancer, metastasis to the paraaortic lymph nodes had been regarded as an incurable factor, but many cases of long term survival have been reported with dissection of metastatic paraaortic nodes. And several reports suggested survival benefit with paraaortic lymph node dissection (D4) in advanced gastric cancer. In patients with advanced gastric cancer who underwent paraaortic lymph node dissection we tried to evaluate the factors predisposing metastasis in these nodes and survival data.
MATERIALS AND METHODS
The authors analyzed retrospectively pathological features of 95 patients who underwent paraacntic lymph node dissection for advanced gastric cancer at Kangnam General Hospital Public Corporation Bom May 1991 to Feb. 1998. And we also analysed survival results of 72 cases among them. We excluded 18 cases of distant metastasis (3 liver metastasis, 15 peritoneal seeding), 2 operative mortalities, 1 other disease mortality, and 2 unlmown causes of death in survival analysis.
RESULTS
The frequencies of paraaortic lymph node metastasis were 0.0% (0 of 32 cases) in T2, 19.2% (10 of 52 cases) in T3, 18.2% (2 of 11 cases) in T4. And those of paraaortic lymph node metastasis were 5.8% (3 of 52 cases) in antrum, 14.3% (3 fo 21 cases) in body, 20.0% (3 of 15 cases) in cardia, and 42.9% (3 of 7 cases) in whole area. The five-year survival rates (5 YSRs) in relation to the paraaortic lymph node (No16) status was 0.096 in No16+, and 57.8Po in Nol6 with D4 of advanced gastric cancer. The 5 YSRs were 78.1%, 40.8% and 0% in T2, T3 and T4, respectively and 93.8%, 64.2%, 24.2% and 0.0% in n0, nl, n2 and n.3, respectively and 88.9%, 80.5%, 57.9% and 0.0% (47.6%) and 0.0% in stage IB, II, IIIA, IIIB and IV, respectively.
CONCLUSION
The depth of gastric wall invasion and the location of primary tumor were significant predisposing factors to para-aortic lymph node metastasis in multivariate analysis (p<0.05). Survival of No16 metastasis was very poor. And three factors of T stage, n stage, and Bonmann type were also prognostically significant in terms of five year survival in cases of D4 of advanced gastric cancer in multivariate analysis (p < 0.05).
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The Predicition of Axillary Lymph Node Metastasis in T1 Breast Cancer
Jae Woo Kim, Ja Yun Koo, Hy Do Lee, Woo Hee Jung
J Korean Cancer Assoc. 1998;30(6):1140-1146.
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PURPOSE
The axillary lymph node status is the most important prognostic factor in breast cancer. The axillary node dissection is usually performed in infiltrating brcast cancer for the information of therapeutic decision and prediction of prognosis. But this procedure may result in lymphedema of affected upper extremity nearly about 25%, increased axillary drainage, sensory abnormality and pain. Many researches are focussed to find the patients group who do not need axillary dissection according to the status of tumor size, patient age, hormonal receptor and histologic grade. MATERIAL AND METHODS: We evaluated the axillary lymph node status in patients with tumor size less than 2 cm in diameter and thein correlation of other prognostic factor. We reviewed 127 women with histologically diagnosed infiltrating ductal carcinoma of breast who were treated by one surgeon at Yongdong Severance Hospital, Yonsei University College of medlcine between 1991 and 1996.
RESULTS
Five patients (3.9%) had Tla lesion (<5 mm), 24 patients (18.9%) had Tlb tumors (6-10 mm), and 98 cases (77.2%) had Tlc lesion (11-20 mm). The average numbers of axillary lymph nodes dissected were 14.2. We found that smallcr tumor size, good histologic grade, estrogen receptor positivity, old age (over 50 years) showed a tendency of decreased axillary node metastasis but without statistical significance.
CONCLUSION
There are possibility of finding subset with low risk of axillary lymph node metastasis in small sized tumor with addition of good prognostic indicators such as good histologic grade, hormonal receptors and old age.
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Quantitative Analysis of Metastatic Lymph Nodes after Curative Surgery in Gastric Cancer
Wansik Yu, Yeon Sik Ji, Gyu Seok Choi, Ilwoo Whang, In Soo Suh
J Korean Cancer Assoc. 1997;29(1):62-68.
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PURPOSE
A consecutive series of 710 patients who underwent curative gastrectomy for carcinoma was studied with a special reference to the number or frequency of lymph node metastasis and the patient's prognosis. MATERIAL AND METHODS: Survival rates were calculated by the Kaplan-Meier method, and the difference between each group was evaluated statistically by the log-rank method. Follow-up was obtained for 709 patients (99.9%).
RESULTS
According to the number of lymph nodal metastases, the five year survival rate for group 1 (1~3 positive nodes) was 50.9%; for group 2 (4~6 positive nodes), 56.7%; and for group 3 (more than 6 positive nodes), 12.0% (p<0.0001). According to the frequency of lymph node metastases, the five year survival rate for those with up to 25 per cent frequency of metastases was 47.5%; for those with up to 50 per cent frequency of metastases, 15.6%; and for those with greater than 50 per cent metastases, 6.3% (p<0.0001). According to the frequency of the regional lymph nodes (which include perigastric nodes along the lesser and greater curvatures, nodes located along the left gastric, common hepatic, splenic, and celiac arteries) metastasis, we categorized them as group 0 (N0: no metastasis), 1 (N1: metastasis in up to 25%), and 2 (N2: metastasis in greater than 25%).
CONCLUSION
This subdivision could be successfully applied to the clinical evaluation of gastric carcinoma (five year survival rate for N0, 86.9%; for N1, 49.0%; and for N2, 10.7% (p<0.0001)) without difficulty in dividing certain lymph nodes into the correct location.
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Prediction of Lymph Node Metastasis in Early Gastric Cancer
Wan Sik Yu, Il Woo Whang, Jong Hoon Park
J Korean Cancer Assoc. 1994;26(5):728-735.
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The frequency of lymph node metastasis according to sex, age, presence or absence of clinical symptoms, duration of symptoms, location and size of tumor, gross and histologic type, and depth of invasion was analysed in 269 patients with early gastric cancer who were surgically treated at the Department of Surgery, Kyungpook National University between 1982 and 1993. Metastases were present in the dissected lymph nodes of 24 patients(8.9%). Among nine factors, size of tumor(p=0.002) and depth of invasion(p=0.010) correlated significantly with node involvement. Other seven factors revealed not statistically significant differences. Univariate analysis showed significant differences in five year survival rates(82.9% vs. 94.0%) and ten year survival rates(82.9% vs. 90.6%) between patients with and without lymph node metastases(p = 0.022). Tumors which satisfy the following criteria may not metastasize to lymph nodes: (1) confined to the mucosa: (2) less than 2 cm in diameter; (3) macroscopic type I, IIa and IIb. It can be concluded that early gastric cancer which satisfies above criteria can be treated by minimal local procedures such as endoscopic treatment or laparoscopic wedge resection.
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Analysis of High Risk Factors for Lymph Node Metastasis in Early Gastric Cancer
Sung Hoon Noh, Wan Soo Kim, Ki Hyeok Lah, Yong Il Kim, Seung Ho Choi, Coong Bai Kim, Jin Sik Min, Kyung Shik Lee
J Korean Cancer Assoc. 1996;28(1):27-35.
AbstractAbstract PDF
The prognosis of early gastric cancer (EGC) is generally excellent, and the proportion of EGC cases to advanced gastric cancer cases is steadily increasing nowadays. The presence or absence of lymph node metastasis in EGC is important prognostic factor, in other words, the survival rate or recurrence rate of node negative EGC is known to be much better than that of node positive ones. Retrospective analysis was performed for 682 EGC cases which underwent more than D2 resection in Yonsei medical center between 1986 Jan. to 1993 Dec, in order to investigate the clinicopathological factors to predict the possibility of lymph node metastasis. In this study, several factors such as age, sex, tumor location, tumor size, multiplicity, depth of invasion, macroscopic and histologic type were evaluated to determine the significance. In the analysis of these eight factors, sex, tumor size, depth of invasion and macroscopic type were statistically correlated with lymph node metastasis. We consider these factors to be possible high risk factors for lymph node metastasis in early gastric cancer.
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Prediction of Lymph Node Metastasis Based on p53 and nm23-H1 Expression in Muscle Invasive Grade 3 Transitional Cell Carcinoma of Bladder
Dong Soo Park, Jin Moo Lee
J Korean Cancer Assoc. 1996;28(2):326-336.
AbstractAbstract PDF
Objecetive: Surgically positive lymph node in invasive bladder cancer generally imply distant micrometastasis, thus preoperative identification of lymph node status is important. Various antioncoproteins were evaluated for their validity of predicting lymph node metastasis. Subjects and Methods: 57 cases who had invasive, grade III(WHO) transitonal cell carcinoma at transurethral resection of bladder(TURB), and then confirmed to have stage T2, T3a, and T3b tumor after radical cystectomy from 1985 to 1994 were selected. Tissues acquired from transurethral resection were immunostained with tumor suppressor gene p53(DO7 and PAb1801) and antimetastatic gene nm23-Hl(NM301). Results of staining and pathological stagings were compared with the status of lymph node metastasis. Reault: Expression of p53 was 42.1% (24/57) for DO7 and 22.8% (13/57) for PAbl801, DO7 exhibiting superiority over PAbl801. Expresion of nm23-Hl was seen in 50.9% (29/57). Combined analysis of p53 and nm23-Hl expression and nodal status(N stage) was not significant. However pathological nodal status was statistically significantly correlated with pathological tumor(T) stage and p53 expression. Conclnsion: ¨c High risk of lymph node metastasis can be predicted when Grade III, muscle invasive tumor and p53 expression is seen from TURB specimen.¨e Lymph node metastasis is correlated with the degree of invasion in Grade III muscle invasive tumor, and especially in T3b tumors, where there is highest probability of node involvement.
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An Immunohistochemical Study of Correlation between Expression of Plasminogen Activator Inhibitor-1 and Lymph Node Metastasis in Gastric Adenocarcinoma
Yeong Ok Kim, Man Ha Huh
J Korean Cancer Assoc. 1996;28(3):405-141.
AbstractAbstract PDF
Plasminogen activator inhibitor-1 (PAI-1) is inhibitor of plasminogen activator(PA) which is serine protease involving proteolytic degradation of the extracellular matrix and tumor invasion and metastasis. Detailed analysis of the PAI-1 in malignant tissues has not yet been reported. To investigate whether expression of PAI-1 in gaatric adenacarcinoma correlates with lymph node metastasis, immunohistochemical analysis using monoclonal antibody for this antigen was performed in 101 cases of gastric adenocarcinomas. Specific immunostaining was detected in the cytoplasm of the cancer cells and was not detected in stromal cells. Expression of PAI-I was evident in 61% of gastric adenocarcinomas with lymph nade metastasis and 38% without lymph node metastasis (p<0.05) But, the PAI-1 expressian is not related to the number of lymph node metastasis and histopathologic grade. The results support the suggestion that PAI-1 may play a crucial role in metastatic progression of gastric adenocarcinoma and may serve to modulate proteolysis by PA.
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