scholarly journals The impact of total retrieved lymph nodes on staging and survival of patients with pT3 gastric cancer

Cancer ◽  
2007 ◽  
Vol 110 (4) ◽  
pp. 745-751 ◽  
Author(s):  
Jia Yun Shen ◽  
Sungsoo Kim ◽  
Jae-Ho Cheong ◽  
Yong Il Kim ◽  
Woo Jin Hyung ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
The Impact

scholarly journals The Role of the Lymph Node Ratio in Advanced Gastric Cancer After Neoadjuvant Chemotherapy

Cancers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1914 ◽  
Author(s):  
Karol Rawicz-Pruszyński ◽  
Bogumiła Ciseł ◽  
Radosław Mlak ◽  
Jerzy Mielko ◽  
Magdalena Skórzewska ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factor ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Tumor Regression ◽  
Surgical Oncology ◽  
Independent Prognostic Factor ◽  
Tumor Diameter ◽  
Histological Subtype ◽  
The Impact

The ratio of positive lymph nodes (LNs) to the total LN harvest is called the LN ratio (LNR). It is an independent prognostic factor in gastric cancer (GC). The aim of the current study was to evaluate the impact of neoadjuvant chemotherapy (NAC) on the LNR (ypLNR) in patients with advanced GC. We retrospectively analyzed the data of patients with advanced GC, who underwent gastrectomy with N1 and N2 (D2) lymphadenectomy between August 2011 and January 2019 in the Department of Surgical Oncology at the Medical University of Lublin. The exclusion criteria were a lack of preoperative NAC administration, suboptimal lymphadenectomy (<D2 and/or removal of less than 15 lymph nodes), and a lack of data on tumor regression grading (TRG) in the final pathological report. A total of 95 patients were eligible for the analysis. A positive correlation was found between the ypLNR and tumor diameter (p < 0.001), post treatment pathological Tumour (ypT) stage (p < 0.001), Laurén histological subtype (p = 0.0001), and the response to NAC (p < 0.0001). A multivariate analysis demonstrated that the ypLNR was an independent prognostic factor in patients with intestinal type GC (p = 0.0465) and in patients with no response to NAC (p = 0.0483). In the resection specimen, tumor diameter and depth of infiltration, Laurén histological subtype, and TRG may reflect the impact of NAC on LN status, as quantified by ypLNR in advanced GC.

scholarly journals The log odds of negative lymph nodes/T stage: a new prognostic and predictive tool for resected gastric cancer patients

2021 ◽  
Author(s):  
Jiebin Xie ◽  
Yueshan Pang ◽  
Xun Li ◽  
Xiaoting Wu
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Clinicopathological Factors ◽  
Predictive Tool ◽  
T Stage ◽  
Log Odds ◽  
Gastric Cancer Patients ◽  
The Impact ◽  
Negative Lymph Nodes

Abstract Purpose When only the TNM classification is used to predict survival in gastric cancer (GC) patients, the impact of the degree of lymphadenectomy on the prognosis is neglected. This study aimed to establish a more effective nomogram based on the log odds of negative lymph nodes/T stage ratio (LONT) to predict survival in surgically treated GC patients. Methods The data of resected GC patients were extracted from the Surveillance, Epidemiology, and End Results Program (SEER) database. Univariate and multivariate Cox regression analyses were used to identify the significant prognostic factors. The prognostic performance was assessed using a calibration plot, concordance index (C-index), and area under the (time-dependent receiver operating characteristic) curve (AUC) to compare the predicted survival probability based on the nomogram score groups. Results The results showed LONT as an independent prognostic factor for cancer-specific survival (CSS) and overall survival (OS), independent of clinicopathological factors. After removing potential redundancy, only LONT, T stage, N stage, location and age were used in the final nomogram model. The model had a higher C-index (0.736 ± 0.012) and AUC (0.798) than the TNM staging system (0.685 ± 0.012 and 0.744). The nomogram score could predict a significant survival difference between any two adjacent groups in terms of CSS and OS. Conclusion High LONT is associated with improved survival of gastric cancer patients, independent of other clinicopathological factors. The prognostic nomogram model based on LONT could effectively predict CSS and OS for resectable GC patients.

scholarly journals Impact of the Number of Lymph Nodes Examined on Differences in Survival for Surgically Treated Gastric Cancer Patients Between the US and Japan Using Nationwide Databases

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 94s-94s
Author(s):  
I. Miyashiro ◽  
Y. Ito ◽  
T. Ishikawa ◽  
K. Akazawa ◽  
H. Katai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Registry ◽  
Relative Survival ◽  
The United States ◽  
Population Based ◽  
Stage Migration ◽  
High Survival ◽  
The Us ◽  
The Impact

Background: Although incidence and mortality have decreased, gastric cancer (GC) is still a public health issue globally. The international collaborative study for cancer survival using population-based cancer registry showed that the survival of GC was higher in Korea and Japan than other countries, including the United States of America (US). Aim: We examined the determinant factors of the high survival in Japan, compared with the US, with particular focus on the impact of the number of lymph nodes (LNs) examined for surgically treated patients. Methods: We obtained data on 88,447 cases from the nationwide GC registration project, the Japanese Gastric Cancer Association (JGCA), from 2004-2007. We also obtained 18,995 GC cases from US population-based cancer registry data from the Surveillance, Epidemiology, and End Results Program (SEER), diagnosed from 2004-2010. We estimated five-year relative survival and applied a multivariate excess hazard model to compare the two countries. We considered the effect of LNs examined on differences in survival. Results: Five-year relative survival in Japan was 79.8%, compared with 40.1% in the US. After controlling for confounding factors, we still observed significantly higher survival in Japan. The distribution of number of LNs examined showed notable differences between two countries. In over 50% of patients in the US, only 1 to 15 LNs were examined. A higher number of LNs examined showed better survival in both countries. The differences in excess death from cancer between countries were reduced in the category when more than 30 LNs were examined. Conclusion: Although it is difficult to remove biases to compare the two countries, stage migration, related to the more detailed retrieving strategy for LNs in Japan, is a key explanation for high survival in Japan.

scholarly journals Retrieval of 30 Lymph Nodes Is Mandatory for Selected Stage II Gastric Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Yong-He Chen ◽  
Jun Lu ◽  
Run-Cong Nie ◽  
Dan Liu ◽  
Ai-Hong Liu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Survival Benefit ◽  
Positive Lymph Node ◽  
Stage Ii ◽  
Clinicopathological Parameters ◽  
Ajcc Staging ◽  
Gastric Cancer Patients ◽  
The Impact

BackgroundAccording to the 8th edition AJCC staging manual, a least of 16 lymph nodes retrieval (LNRs) is the minimal requirement for lymph nodes (LNs) dissection of gastric cancer surgery. Previous studies have shown that increasing the number of LNRs (≥30) prolongs survival for selected patients. However, the necessity of retrieving 30 or more LN for stage II gastric cancer patients is still under debate.AimThis study aims to explore the impact of retrieving 30 or more lymph nodes on the survival of stage II cancer patients.MethodsA total of 1,177 patients diagnosed with stage II gastric cancer were enrolled in this study. The clinicopathological parameters and the impact of different LNRs (&lt;30 or ≥30) and positive lymph node ratio (NR) on overall survival (OS) were retrospectively analyzed.ResultsThe mean number of LNRs was 34 ± 15. A total of 44% (518/1,177) of patients had an LNRs &lt;30, while 56% (659/1,177) of patients had an LNRs ≥30. The 5-year survival rate was 81% for all patients, 76% for the LNRs &lt;30 group, and 86% for LNRs ≥30 group, respectively (P = 0.003). The survival benefit of retrieving 30 lymph nodes was significant in certain subgroups: age &gt;60 years/male/underwent total gastrectomy/stage IIB. For N+ patients, higher NR was significantly correlated with poor survival.ConclusionThe survival benefit of retrieving 30 LNs varies in different subgroups. An LNRs of 30 is mandatory for selected stage II gastric cancer patients.

scholarly journals Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Harsh Kanhere ◽  
Raghav Goel ◽  
Ben Finlay ◽  
Markus Trochsler ◽  
Guy Maddern
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Gastric Carcinoma ◽  
Lymph Nodes ◽  
Survival Data ◽  
Early Stage ◽  
Radical Gastrectomy ◽  
Perioperative Chemotherapy ◽  
Lymph Node Yield ◽  
The Impact

Background and Objectives. Most gastric cancer patients now undergo perioperative chemotherapy (POCT) based on the MAGIC trial results. POCT consists of neoadjuvant chemotherapy (NACT) as well as postoperative adjuvant chemotherapy. This study assessed the applicability of perioperative chemotherapy and the impact of radical gastrectomy encompassing a detailed lymph-node resection on outcomes of gastric cancer. Methods. Medical and pathology records of all gastric carcinoma resections were reviewed from 2006 onwards. Pathological details, number of lymph-nodes resected, and proportion of involved nodes, reasons for nonadministration of NACT, complications, recurrence, and survival data were analysed. Results. Only twenty-eight (37.8%) out of 74 patients underwent NACT and only nine completed POCT. NACT was declined due to comorbidities/patient refusal n=24, early stage n=14, and emergency presentation n=8. Patients receiving NACT were much younger. Anastomotic leaks, hospital-mortality, lymph-node yield, and proportion of involved lymph-nodes were similar in both groups. Thirty-two patients died due to recurrence with lymph-node involvement heralding higher recurrence risk and much poorer survival (HR 2.66; p=0.013). Conclusion. More than 60% patients with resectable gastric carcinoma did not undergo NACT. Radical gastrectomy with lymphadenectomy remained the cornerstone of treatment in this period.

A case of primary biliary cirrhosis with sarcoid reaction in the regional lymph nodes after surgery of early gastric cancer

Kanzo ◽  
2005 ◽  
Vol 46 (7) ◽  
pp. 437-442 ◽  
Author(s):  
Tadashi YOSHIDA ◽  
Atsushi NAGASAKA ◽  
Yayoi OGAWA ◽  
Syuji NISHIKAWA ◽  
Akifumi HIGUCHI
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Primary Biliary Cirrhosis ◽  
Lymph Nodes ◽  
Biliary Cirrhosis ◽  
Regional Lymph Nodes ◽  
Sarcoid Reaction

BIOPSY OF THE SIGNALING LYMPH NODES IN GASTRIC CANCER - CURRENT STATUS OF THE PROBLEM AND PROSPECTS

2018 ◽  
Vol 64 (3) ◽  
pp. 335-344
Author(s):  
Aleksey Karachun ◽  
Yuriy Pelipas ◽  
Oleg Tkachenko ◽  
D. Asadchaya
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Stomach Cancer ◽  
Current Status ◽  
Regional Lymph Nodes ◽  
Systematic Analysis ◽  
Tumor Spread ◽  
Special Value

The concept of biopsy of sentinel lymph node as the first lymph node in the pathway of lymphogenous tumor spread has been actively discussed over the past decades and has already taken its rightful place in breast and melanoma surgery. The goal of this method is to exclude vain lymphadenectomy in patients without solid tumor metastases in regional lymph nodes. In the era of minimally invasive and organ-saving operations interventions it seems obvious an idea to introduce a biopsy of sentinel lymph node in surgery of early gastric cancer. Meanwhile the complexity of lymphatic system of the stomach and the presence of so-called skip metastases are factors limiting the introduction of a biopsy of sentinel lymph node in stomach cancer. This article presents a systematic analysis of biopsy technology of signaling lymph node as well as its safety and oncological adequacy. Based on literature data it seems to us that the special value of biopsy of sentinel lymph nodes in the future will be in the selection of personalized surgical tactics for stomach cancer.

scholarly journals Positive lymph node ratio is an index in predicting prognosis for remnant gastric cancer with insufficient retrieved lymph node in R0 resection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Honghu Wang ◽  
Hao Qi ◽  
Xiaofang Liu ◽  
Ziming Gao ◽  
Iko Hidasa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Prognostic Index ◽  
Staging System ◽  
R0 Resection ◽  
Remnant Gastric Cancer ◽  
Curative Intent ◽  
Node Ratio

AbstractThe staging system of remnant gastric cancer (RGC) has not yet been established, with the current staging being based on the guidelines for primary gastric cancer. Often, surgeries for RGC fail to achieve the > 15 lymph nodes needed for TNM staging. Compared with the pN staging system, lymph node ratio (NR) may be more accurate for RGC staging and prognosis prediction. We retrospectively analyzed the data of 208 patients who underwent R0 gastrectomy with curative intent and who have ≤ 15 retrieved lymph nodes (RLNs) for RGC between 2000 and 2014. The patients were divided into four groups on the basis of the NR cutoffs: rN0: 0; rN1: > 0 and ≤ 1/6; rN2: > 1/6 and ≤ 1/2; and rN3: > 1/2. The 5-year overall survival (OS) rates for rN0, rN1, rN2, and rN3 were 84.3%, 64.7%, 31.5%, and 12.7%, respectively. Multivariable analyses revealed that tumor size (p = 0.005), lymphovascular invasion (p = 0.023), and NR (p < 0.001), but not pN stage (p = 0.682), were independent factors for OS. When the RLN count is ≤ 15, the NR is superior to pN as an important and independent prognostic index of RGC, thus predicting the prognosis of RGC patients more accurately.

Sign in / Sign up

Export Citation Format

Share Document