scholarly journals Analysis of Risk Factors for Lymph Nodal Involvement in Early Stages of Rectal Cancer: When Can Local Excision Be Considered an Appropriate Treatment? Systematic Review and Meta-Analysis of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Alessandro Carrara ◽  
Daniela Mangiola ◽  
Riccardo Pertile ◽  
Alberta Ricci ◽  
Michele Motter ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Local Excision ◽  
Radical Surgery ◽  
Meta Analysis ◽  
Nodal Involvement ◽  
Node Metastasis ◽  
Early Stages

Background. Over the past ten years oncological outcomes achieved by local excision techniques (LETs) as the sole treatment for early stages of rectal cancer (ESRC) have been often disappointing. The reasons for these poor results lie mostly in the high risk of the disease's diffusion to local-regional lymph nodes even in ESRC.Aims. This study aims to find the correct indications for LET in ESRC taking into consideration clinical-pathological features of tumours that may reduce the risk of lymph node metastasis to zero.Methods. Systematic literature review and meta-analysis of casistics of ESRC treated with total mesorectal excision with the aim of identifying risk factors for nodal involvement.Results. The risk of lymph node metastasis is higher inG≥2andT≥2tumours with lymphatic and/or vascular invasion. Other features which have not yet been sufficiently investigated include female gender, TSM stage >1, presence of tumour budding and/or perineural invasion.Conclusions. Results comparable to radical surgery can be achieved by LET only in patients with T1N0G1tumours with low-risk histological features, whereas deeper or more aggressive tumours should be addressed by radical surgery (RS).

scholarly journals PREDICTION OF RISK FACTORS OF LATERAL LYMPH NODE METASTASIS IN RECTAL CANCER

2015 ◽  
Vol 174 (4) ◽  
pp. 30-33 ◽  
Author(s):  
A. A. Zakharenko ◽  
M. A. Belyaev ◽  
A. N. Morozov ◽  
I. N. Danilov ◽  
A. A. Statsenko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lateral Lymph Node Metastasis ◽  
Nodal Involvement ◽  
Additional Method ◽  
Lateral Lymph Node ◽  
Standard Methods ◽  
Node Metastasis

Standard methods of diagnostics haven’t got a proper sensitivity and specificity concerning assessment of regional nodal involvement in case of rectal cancer. Therefore it is necessary to look for new method of diagnostics, detect risk factors and unfavorable prognosis in relation to lateral lymph node metastasis. At the same time, there should be a differentiated approach to the choice of therapeutic management in rectal cancer. Investigation of variability of blood supply of the rectum could be an additional method of diagnostics in rectal cancer.

Uterine corpus invasion as a risk factor in patients with early-stage cervical carcinoma receiving radical surgery.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17012-e17012
Author(s):  
Yifan Li ◽  
Ning Li ◽  
Lingying Wu
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Carcinoma ◽  
Radical Surgery ◽  
Early Stage ◽  
Univariate Analysis ◽  
Uterine Corpus ◽  
Node Metastasis

e17012 Background: To explore whether pathologically verified uterine corpus invasion (UCI) is a risk factor for patients with early-stage (IB1-IIA2) cervical carcinoma receiving radical surgery. Methods: A mathed-case comparison of early-stage cervical carcinoma patients with pathologically verified UCI to patients without UCI on a 1:1 ratio was conducted. High risk factors (lymph node metastasis, paremetrial invasion, vaginal margin invasion) and intermediate risk factors (lymphovascular space invasion (LVSI) and deep stromal invasion) were completely matched between UCI and non-UCI groups. Kaplan-Meier and Log-rank test were applied for univariate analysis, and COX proportional hazard regression models were used for multivariate analysis. Results: 1320 consecutive patients with cervical carcinoma received surgery in our centerfrom Jan. 1st2009 to Dec 31st2014. 79 (5.98%) cases with UCI were identified. Median follow-up time was 43 months. There were 22 cases with recurrence. In UCI group, the recurrence rate was 20.3% (16/79), and in non-UCI group the recurrence rate was 7.6% (6/79). On univariate analysis, SCC, neoadjuvant chemotherapy (NACT), lymph node metastasis, parametrial invasion, LVSI, deep stromal invasion, vaginal invasion and UCI were significantly associated with disease free survival (DFS). After multivariate analysis, UCI ( p= 0.02, RR3.832, 95% CI1.235-11.893)and lymph node metastasis ( p= 0.042, RR 2.890, 95% CI1.038-8.045) were still independent risk factors for deceased DFS. Conclusions: Pathologically verified uterine corpus invasion might be an independent risk factor for decreased DFS in patients with early-stage cervical carcinoma receiving radical surgery.

Risk Factors for Lymph Node Metastasis in pT1 and pT2 Rectal Cancer: A Single-Institute Experience in 943 Patients and Literature Review

2012 ◽  
Vol 19 (8) ◽  
pp. 2477-2484 ◽  
Author(s):  
Hao-Cheng Chang ◽  
Shih-Chiang Huang ◽  
Jinn-Shiun Chen ◽  
Reiping Tang ◽  
Chung Rong Changchien ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Literature Review ◽  
Node Metastasis

P11 Risk factors of lymph node metastasis in rectal cancer following preoperative chemoradiotherapy

2014 ◽  
Vol 50 ◽  
pp. S12-S13
Author(s):  
J.W. Park ◽  
J.H. Oh ◽  
E.G. Youk ◽  
S.-B. Kang ◽  
S.C. Heo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Preoperative Chemoradiotherapy ◽  
Node Metastasis

scholarly journals Analysis of clinical and pathological factors in patients undergoing surgery for rectal cancer: a single-centre experience with 692 patients in China

2020 ◽  
Author(s):  
Liping Xu ◽  
Chi Zhang ◽  
Zhaoyue Zhang ◽  
Xinyu Tang ◽  
Qin Qin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Perineural Invasion ◽  
Radical Surgery ◽  
Node Metastasis ◽  
T Stage ◽  
Significant Difference ◽  
Tumour Location ◽  
Poorly Differentiated

Abstract Background: The management of rectal carcinoma has substantially evolved over the past two decades, so as AJCC staging and NCCN guidelines. The inherent relationships of pathologic factors warrant further study. The present study aimed to assess the associations of clinical and pathological factors in rectal cancer patients undergoing radical surgery.Methods: From October 2015 to February 2019, all rectal cancer patients treated with radical surgery without neoadjuvant therapy were identified. The analysis was performed with data obtained from the prospectively collected database. Predictive factors for lymph node metastasis were analysed.Results: In total, 692 patients with a median age of 61.64 years (range: 22-89) were included. There was no significant difference in onset age between male and female patients (61.75±11.10 vs 61.43±11.92, P=0.723).Tumour location (P=0.004), perineural invasion (PNI) (P=0.000), lymphovascular invasion (LVI) (P=0.000), tumour deposit (TD) (P=0.000), and differentiation grade (P=0.000) were significantly related to pathologic T stage in univariate analysis, while sex was not (p=0.192).Compared to patients with T1 disease, there was a significantly higher proportion of positive LVI in patients with stage T3 disease (P=0.011, OR=3.404, 95% CI: 1.319-8.787) but not in those with T2 (P=0.686, OR=0.804, 95% CI: 0.280-2.310) and T4 (P=0.063, OR=3.200, 95% CI: 0.941-10.886) disease. Compared to patients with T2 disease, there was a significantly higher proportion of perineural invasion in patients with stage T3 (P=0.000, OR=6.2376, 95% CI: 3.371-11.685) but not T4 (P=0.172, OR=2.309, 95% CI: 0.694-7.676) disease. Compared to patients with T1 disease, a significantly higher proportion of TDs occurred in patients with stage T3 (P=0.013, OR=6.106, 95% CI: 1.455-25.631) and stage T4 (P=0.019, OR=7.146, 95% CI: 1.378-37.044) but not stage T2 (P=0.435, OR=0.503, 95% CI: 0.089-2.824) disease. The overall incidence of lymph node metastasis was 44.9% (19.6% for T1, 23.6% for T2, 56.7% for T3, and 67.8% for T4). Patient age, sex, and tumour location did not significantly affect lymph node metastasis (LNM). The presence of LVI (OR=3.882, 95% CI=2.338-6.440, P=0.000), TD (OR=27.645, 95% CI=9.805-77.947, P=0.000), higher T stage (OR=1.969, 95% CI=1.471-2.635, P=0.000), and poorly differentiated histology (OR=2.255, 95% CI=1.544-3.293, P=0.000) were associated with a higher incidence of LNM on multivariate analysis. Perineural invasion (P=0.000) significantly affected LNM in univariate but not multivariate analysis (OR=1.213, 95% CI=0.734-2.003, P=0.452).Conclusion: There was no significant difference between male and female patients in onset age. Tumour location, PNI, LVI, TD, and differentiation grade were significantly related to pathologic T stage. Patients with the presence of LVI and TD, higher T stage, and poorly differentiated histology have a significantly higher chance of LNM.

Prediction model for ypΝ status after preoperative chemoradiotherapy in patients with rectal cancer.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 513-513 ◽  
Author(s):  
Eunjin Jwa ◽  
Jong Hoon Kim ◽  
Seungbong Han ◽  
Jin-hong Park ◽  
Jin Cheon Kim ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Prediction Model ◽  
Cancer Patients ◽  
Local Excision ◽  
Preoperative Chemoradiotherapy ◽  
Lymph Node Status ◽  
Node Metastasis ◽  
Nodal Stage

513 Background: Pelvic lymph node status after preoperative chemoradiotherapy (CRT) is not only an important indicator for oncologic outcome but critical information to determine the type of a subsequent surgical resection (i.e. curative surgery or local excision) in patients with locally advanced rectal cancer. The purpose of this study is to develop a nomogram to predict the lymph node status after preoperative CRT in rectal cancer patients whose ypT information is available. Methods: Using logistic regression analyses, we constructed a prediction model to predict the probability of lymph node metastasis after preoperative CRT in a cohort of 1,099 patients with rectal cancer treated with preoperative CRT and total mesorectal excision (TME) from 2007 to 2011. The model was internally validated for discrimination and calibration using bootstrap resampling. Results: Pretreatment clinical nodal stage, distant metastasis, pre- and post-treatment tumor differentiation, and ypT stage were reliable predictors for lymph node metastasis after preoperative CRT. The nomogram developed using these parameters represents a valid and accurate method for predicting lymph node metastasis after preoperative CRT in rectal cancer patients. (c-index: 0.75) Patients with low pretreatment nodal stage, nonmetastatic, and well differentiated rectal adenocarcinoma downstaged to ypT0-1 after preoperative CRT will have low chance of pelvic lymph node involvement. Conclusions: Our model is expected to assist clinicians in quantifying the benefit of radical resection and finding out the patient group who can be treated with local excision after preoperative CRT for rectal cancer.

scholarly journals Predictors of lymph node metastasis and residual tumor in early gastric cancer patients after noncurative endoscopic resection: a systematic review and meta-analysis

2020 ◽  
Vol 13 ◽  
pp. 175628482093503
Author(s):  
Bolun Jiang ◽  
Li Zhou ◽  
Jun Lu ◽  
Yizhi Wang ◽  
Junchao Guo
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Gastric Cancer ◽  
Tumor Size ◽  
Meta Analysis ◽  
Residual Tumor ◽  
Node Metastasis

Background: It is challenging to identify the prevalence of lymph node metastasis (LNM) and residual tumor in patients with early gastric cancer (EGC) who underwent noncurative endoscopic resection (ER). This present meta-analysis was aimed to establish imperative potential predictive factors in order to select the optimal treatment method. Methods: A systematic literature search of PubMed, Embase, and Cochrane Library databases was performed through 1 February 2019 to identify relevant studies, which investigated risk factors for LNM and residual tumor in patients with EGC who underwent noncurative ER. Eligible data were systematically reviewed through a meta-analysis. Results: Overall, 12 studies investigating the risk factor of LNM were included, totaling 3015 patients, 7 of which also involved cancer residues. After the present meta-analysis, six predictors, including tumor size >30 mm, tumor invasion depth (⩾500 μm from the muscularis mucosae), macroscopic appearance, undifferentiated histopathological type, positive vertical margin, and presence of lymphovascular invasion (including lymphatic invasion and vascular invasion) were significantly associated with LNM, whereas tumor size >30 mm, positive horizontal margin, and positive vertical margin were identified as significant predictors for the risk of residual tumor. No evidence of publication bias was observed. Conclusions: Six and three variables were established as significant risk factors for LNM and residual tumor in patients with EGC who underwent noncurative ER, respectively. Patients with EGC who present these risk factors after noncurative ER are strongly suggested to receive additional surgery, while others might be suitable for strict follow-up. This might shed some new light on the selection of follow-up treatment for noncurative ER.

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