Critical number of lymph node involvement in esophageal and gastric cancer and its impact on long‐term survival—A single‐center 8‐year study

2020 ◽  
Vol 122 (7) ◽  
pp. 1364-1372
Author(s):  
Alan Askari ◽  
Alex B. Munster ◽  
Periyathambi Jambulingam ◽  
Amjid Riaz
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Involvement ◽  
Critical Number ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival ◽  
Node Involvement

Long-term prognosis of patients with gastric cancer in stage UICC I without lymph-node involvement.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15068-e15068
Author(s):  
Christoph Treese ◽  
Pedro Sanchez ◽  
Ioannis Anagnostopoulos ◽  
Peter M. Schlag ◽  
Michael Kruschewski ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Risk Factor ◽  
Lymph Node ◽  
Early Stage ◽  
Expression Profiles ◽  
Lymph Node Involvement ◽  
Term Survival ◽  
Immunohistochemical Markers ◽  
Node Involvement

e15068 Background: Despite radical oncologic resection with extended lymph node removal, patients with adenocarcinoma of the gastro-esophageal junction or stomach in UICC stage I show only a 5-year survival of 60-80% (Hölscher et al, 2009; Siewert et al. 1998). The aim of this retrospective study was to analyze the long-term survival of caucasian patients with early stage gastric cancer as for this population exist only sparse data. Patients with lymph-node involvement were not included as this parameter is a well-known negative prognostic marker. Methods: Tissue specimens and clinical data from patients with gastric cancer treated in the years 1993 to 2010 at the Charité, Berlin were collected retrospectively. Patients with stage T1 and T2 pN0M0 gastric cancer treated only by surgery including D1- and D2-lymphnode dissection were included in this study. Patients without relapse were followed-up for a minimum period of 24 months. Results: 97 patients (w = 36, m = 61, age 29-90 years) with a follow-up time from 6 to 208 months were identified. The 5-year survival was 94.85% (for details, see Table). Conclusions: The present data indicate a much better prognosis (5-year survival of 95%) of UICC I patients than previously described (60-80%). In harmony with other studies, our data demonstrate that R1, L1 or V1 resection seem to be a risk factor for recurrence whereas signet-ring differentiation was not found as a risk factor in our patient cohort. Ongoing work involves a broad panel of immunohistochemical markers to select prognostic expression profiles which help to identify patients with early gastric cancer at higher risk. This study was supported by the Berliner Krebsgesellschaft, grant DAFF201101. [Table: see text]

Histology, not Lymph Node Involvement, Predicts Long-Term Survival in Bronchopulmonary Carcinoids

2011 ◽  
Vol 77 (12) ◽  
pp. 1669-1674 ◽  
Author(s):  
Rebecca Johnson ◽  
Steven Trocha ◽  
Marc Mclawhorn ◽  
Mitchell Worley ◽  
Grace Wheeler ◽  
...  
Keyword(s):  
Lymph Node ◽  
Cox Regression ◽  
Lymph Node Involvement ◽  
Term Survival ◽  
Pulmonary Carcinoid ◽  
Long Term Survival ◽  
Cox Regression Analysis ◽  
Node Involvement ◽  
Bronchopulmonary Carcinoid

Recently, the incidence of bronchopulmonary carcinoid has increased substantially, whereas survival associated with both subtypes has declined. We reviewed our experience with bronchopulmonary carcinoid to identify factors associated with long-term survival. We reviewed our cancer registry from 1985 to 2009 for all patients undergoing surgical resection for bronchopulmonary carcinoid. Cox regression analysis was used to evaluate prognostic factors. Fifty-two patients met criteria for inclusion. Forty-three patients (82%) presented with typical histology. The likelihood of lymph node metastasis was similar for patients with typical histology and patients with atypical histology. For patients with typical histology, the 5-year survival rates with and without lymph node metastases were 100 per cent and 97 per cent, respectively ( P = 0.420). The overall survival rate for patients with typical histology (97% at 5 years; 72% at 10 years) was significantly better than for patients with atypical histology (35% at 5 years, 0% at 10 years) ( P < 0.001). Univariate and multivariate analyses demonstrated that long-term survival was associated with histology but not lymph node involvement (hazards ratio = 14.6, 95% confidence interval: 1.7, 125.2). Our data suggests that long-term survival is associated with histology, not lymph node involvement. We found tumor histology to be the strongest predictor of long-term survival in patients with pulmonary carcinoid tumors.

Is Adjuvant Radiochemotherapy Always Mandatory in Patients with Resected N2 Non-Small Cell Lung Cancer?

2021 ◽  
Author(s):  
Samantha Taber ◽  
Joachim Pfannschmidt ◽  
Torsten T. Bauer ◽  
Torsten G. Blum ◽  
Christian Grah ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Adjuvant Treatment ◽  
Lymph Node Involvement ◽  
Small Cell ◽  
Small Cell Lung ◽  
Term Survival ◽  
Node Involvement ◽  
The Mean

Abstract Background In patients with non-small cell lung cancer (NSCLC), the pathologic union for international cancer control (UICC) stage IIIA is a heterogeneous entity, with different forms of N2-lymph node involvement representing different prognoses. Although a multimodality treatment approach, including surgery, systemic therapy, and/or radiotherapy, is almost always recommended, in this retrospective observational study, we sought to determine whether long-term survival might be possible in selected patients who are treated with complete surgical resection alone. Methods Between 2013 and 2018, we retrospectively identified 24 patients with NSCLC (16 men and 8 women), who were found to have pathologic N2-lymph node involvement, and were treated with complete surgical lung resection and systematic mediastinal and hilar lymph node dissection but no neoadjuvant or adjuvant treatment. Results The most frequent reason (n = 14) for forgoing adjuvant treatment was patient refusal. The mean overall survival (OS) was 34.5 months (interquartile range [IQR]: 15.5–53.5 months). The mean disease-free survival (DFS) was 18 months (IQR: 4.75–46.75 months). We identified five patients who survived at least 5 years without recurrence (21%). In each of these cases, the nodal metastases were restricted to a single level and no extracapsular lymph node involvement were detected. Additionally, worse DFS was associated with pT3/4 (vs. a lower T-stage), as well as microscopic lymphovascular invasion. Conclusion Although the small sample size precludes any definitive conclusions, it was possible to demonstrate that long-term survival without neoadjuvant and adjuvant treatment is possible in some patients if complete tumor and nodal resection is performed.

scholarly journals Multiorgan resection in patients with gastric cancer

2004 ◽  
Vol 57 (9-10) ◽  
pp. 480-486 ◽  
Author(s):  
Dragan Radovanovic ◽  
Dejan Stevanovic ◽  
Ivan Pavlovic ◽  
Aleksandar Bajec ◽  
Berislav Vekic ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Subtotal Gastrectomy ◽  
Postoperative Mortality ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
Systematic Lymphadenectomy

Introduction Multiorgan resection for a malignancy is a very comlicated procedure, but there is always the question: does it work? In everyday clinical practice gastric cancer in phases III and IV is rather frequent. Unfortunately, our patients are under the age of 55 years. D2 lymphadenectomy is not as extensive as D2 %/ or D3, so one must ask himself if multiorgan resection is worth the risk. Material and methods We evaluated two groups of patients: group I consisted of 34 patients who underwent total or subtotal gastrectomy, systematic lymphadenectomy and resection of one or more organs; group II (control) consisted of 167 patients who underwent total or subtotal gastrectomy and systematic lymphadenectomy. These two groups of patients were analzyed in regard to: Bormann's classification, histopathologic type, early mortality, early postoperative complications, lymph node dissection and long-term survival. Results According to Bormann's classification the most common type of carcinoma in both groups was ulcerovegetativ tumor (70.6% in I and 58% in II). In the first group of patients a great number of patients had poorly differentiated adenocarcinomas (47%), while in the second group the most common histologic type was well differentiated intestinal carcinoma (28%). Patients with multiorgan resections had higher rates of early postoperative mortality and morbiditiy (mortality - 14.7% and complications - 26.5%) than patients in control group (mortality - 4.8% and complications - 11.4%). The most frequent causes of postopertive mortality and morbidity were anastomotic leakage and wound infections in both groups. Metastatic lymph node invelvement was higher in the first group (41%), than in the second (28%). Long-term survival was best in the control group (38.5 months). Patients with multiorgan resection had better survival (25.4 months) than inoperable cases (only 5 months). Discussion Patients undergoing multiorgan resection usually have advanced gastric cancer with tumor infiltration in surrounding structures. Only these cases are absolute indications for this radical operation, because patients have better chances fo survival. Conclusion Multiorgan resections are extensive procedures with high rates of postoperative mortality and morbiditiy, but represent the only way for better survival of patients with advanced gastric cancer.

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