scholarly journals Predictive Value of Positive Surgical Margins after Radical Prostatectomy for Lymph Node Metastasis in Locally Advanced Prostate Carcinoma

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Wolfgang Otto ◽  
Peter Gerber ◽  
Wolfgang Rößler ◽  
Wolf F. Wieland ◽  
Stefan Denzinger
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Prostate Carcinoma ◽  
Locally Advanced ◽  
Lymph Node Involvement ◽  
Positive Surgical Margins ◽  
Positive Margins ◽  
Node Metastasis ◽  
Antihormonal Treatment ◽  
Node Involvement

Introduction. Suspected locally advanced prostate carcinoma shows lymph node involvement in a high percentage of cases. For a long time, such patients were not radically prostatectomised. In recent years, however, this viewpoint has changed.Material and Methods. We analysed a single-centre series of 34 patients with suspected locally advanced prostate cancer to establish predictive parameters for lymph node metastasis. All patients underwent radical prostatectomy between 2007 and 2010.Results. Of the 34 patients, 26% showed pathological stage T3a, 59% pT3b, and 15% pT4. Median preoperative PSA level was 25 ng/mL, and five patients had had neoadjuvant antihormonal treatment. Positive margins were found in 76% of patients. Patients without neoadjuvant treatment showed it in 79%, and after preoperative antihormonal treatment the rate was 60%. Positive margins were associated with lymph node involvement in 85% of cases, complete resection was associated only in 50% of cases.Conclusions. Positive surgical margins play an important predictive role when estimating lymph node involvement in patients with locally advanced prostate carcinoma. Neoadjuvant antihormonal therapy is associated with a relevant reduction in the rate of positive margins but not with the rate of lymph node metastasis. As such, a combination of antihormonal and surgical treatment should be considered.

scholarly journals Colorectal Cancer Presenting as Single Pulmonary Hilar Lymph Node Metastasis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Ahmed M. Habib ◽  
Xenophon Kassianides ◽  
Samuel Chan ◽  
Mahmoud Loubani ◽  
Syed Qadri
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Mediastinal Lymph Node ◽  
Lymph Node Involvement ◽  
Pulmonary Metastasectomy ◽  
Hilar Lymph Node ◽  
Node Metastasis ◽  
Mediastinal Metastasis ◽  
Node Involvement ◽  
Hilar Lymph Node Metastasis

Colorectal carcinoma is the second biggest cancer responsible for mortality. Lung metastasis is the commonest, following the liver. It is not uncommon to perform pulmonary metastasectomy and identify mediastinal metastasis. Previous studies have identified incidental lymph node involvement following routine mediastinal lymph node clearance in 20–50% of cases. However, solitary intrathoracic lymph node metastasis is exceedingly rare. Even when present, it is usually metachronous. In our case, we present an exceedingly rare case whereby the intrathoracic lymph node metastasis is solitary, not accompanying pulmonary disease and with no liver metastasis. We also review the evidence for mediastinal lymphadenectomy in the literature.

scholarly journals A prospective study to evaluate the impact and independency of depth of invasion in comparison with other clinicopathologic prognostic variables in oral cavity malignancy

2020 ◽  
Vol 6 (2) ◽  
pp. 347
Author(s):  
Subbiah Shanmugam ◽  
Gopu Govindasamy ◽  
X. Gerald Anand Raja
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Oral Cavity ◽  
Staging System ◽  
Lymph Node Involvement ◽  
Stage Migration ◽  
Depth Of Invasion ◽  
Node Metastasis ◽  
Node Involvement ◽  
The Impact

<p class="abstract"><strong>Background:</strong> Depth of invasion is included in the staging of oral cavity malignancies in the recent 8<sup>th</sup> edition of American Joint Committee on Cancer or tumour, node and metastasis staging system. This study analyses the impact of diffuse optical imaging (DOI) on incidence of lymph node involvement, stage migration, postoperative margin and independency.</p><p class="abstract"><strong>Methods:</strong> Postoperative HPE of fifty patients with oral cavity malignancy operated in our institute from January 2018 were collected. Depth of invasion and other pathological parameters were documented. DOI divided into three groups and statistical analysis done.  </p><p class="abstract"><strong>Results:</strong> No lymph node metastasis is found in superficial tumours, 43% of intermediate thickness and 76% of deep tumours had lymph node involvement. Positive margin is seen only in patients with tumour DOI more than 0.5 cm, more than 50% of deep tumours had close margins while 75% of superficial tumours had adequate margin. Out of the 24 T3 tumours in this study 13 were upstaged due to inclusion of DOI, which would have been T2 according to the previous staging system. There is 54.1% (13 out of 24) upstaging in T3 tumours (T2 to T3), 23% (3 out of 13) in T2 (T1 to T2). There is no significant correlation between DOI and anatomical site, tumour size, tumour thickness, lymphovascular invasion and grade.</p><p class="abstract"><strong>Conclusions:</strong> Depth of invasion in oral cavity malignancies impacts adversely lymph node metastasis and margin status. It is an independent prognostic factor in oral cavity malignancy.</p>

Detection of Lymphovascular Invasion by D2-40 (Podoplanin) Immunoexpression in Endometrial Cancer

2012 ◽  
Vol 22 (8) ◽  
pp. 1442-1448 ◽  
Author(s):  
Sarah K. Weber ◽  
Axel Sauerwald ◽  
Martin Pölcher ◽  
Michael Braun ◽  
Manuel Debald ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymphovascular Invasion ◽  
Lymph Node Involvement ◽  
Lymph Vessel ◽  
Node Metastasis ◽  
Lymph Vessel Invasion ◽  
Node Involvement

BackgroundLymph node involvement is a major feature in tumor spread of endometrial cancer and predicts prognosis. Therefore, evaluation of lymph vessel invasion (LVI) in tumor tissue as a predictor for lymph node metastasis is of great importance. Immunostaining of D2-40 (podoplanin), a specific marker for lymphatic endothelial cells, might be able to increase the detection rate of LVI compared with conventional hematoxylin-eosin (H-E) staining. The aim of this retrospective study was to analyze the eligibility of D2-40–based LVI evaluation for the prediction of lymph node metastases and patients’ outcome.Patients and MethodsImmunohistochemical staining with D2-40 monoclonal antibodies was performed on paraffin-embedded tissue sections of 182 patients with primary endometrioid adenocarcinoma treated in 1 gynecologic cancer center. Tumors were screened for the presence of LVI. Correlations with clinicopathological features and clinical outcome were assessed.ResultsImmunostaining of D2-40 significantly increased the frequency LVI detection compared with conventional H-E staining. Lymph vessel invasion was identified by D2-40 in 53 (29.1%) of 182 tumors compared with 34 (18.3%) of 182 carcinomas by routine H-E staining (P = 0.001). D2-40 LVI was detectable in 81.0% (17/21) of nodal-positive tumors and significantly predicted lymph node metastasis (P = 0.001). Furthermore, D2-40 LVI was an independent prognostic factor for patients overall survival considering tumor stage, lymph node involvement, and tumor differentiation (P < 0.01). D2-40–negative tumors confined to the inner half of the myometrium showed an excellent outcome (5-year overall survival, 97.8%).ConclusionsD2-40–based LVI assessment improves the histopathological detection of lymphovascular invasion in endometrial cancer. Furthermore, LVI is of prognostic value and predicts lymph node metastasis. D2-40 LVI detection might help to select endometrial cancer patients who will benefit from a lymphadenectomy.

scholarly journals Effect of Cervical Conization with Positive Margins on Lymph Node Metastasis in Cervical Cancer

2021 ◽  
Author(s):  
Yukari Nagao ◽  
Akira Yokoi ◽  
Kosuke Yoshida ◽  
Masanori Sumi ◽  
Masato Yoshihara ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Pelvic Lymph Node ◽  
Positive Margins ◽  
Node Metastasis ◽  
Significant Difference ◽  
Cervical Conization

Abstract Radical surgery after cervical conization is a common approach for the treatment of cervical cancer. Clinically, rapid disease progression is sometimes observed in patients with positive margins at conization, but the details are unclear. This study aimed to investigate the clinical impact of positive margins at conization in cervical cancer. The medical records of patients with cervical cancer between 2010 and 2020 were reviewed retrospectively and we identified 101 eligible patients who underwent radical hysterectomy, including pelvic lymph node dissection. The association between the positive margins of the conization samples and outcomes, including subsequent lymph node metastasis, was evaluated. The rate of lymphovascular space invasion positivity at radical surgery was significantly higher in patients with positive margins (p = 0.017) than in those with negative margins, although there was no significant difference in the rate of pelvic lymph node metastasis (p = 0.155). Moreover, Kaplan–Meier curves showed that there were no significant difference in overall survival or progression-free survival between the two groups (p = 0.332 and p = 0.200, respectively). A positive margin at conization presented no significant prognostic disadvantage, and therefore, diagnostic conization is one of the reasonable options for locally advanced cervical cancer.

scholarly journals Pelvic Lymphadenectomy in Vulvar Cancer – Does it make sense?

2020 ◽  
Vol 80 (12) ◽  
pp. 1221-1228
Author(s):  
Linn Woelber ◽  
Mareike Bommert ◽  
Katharina Prieske ◽  
Inger Fischer ◽  
Christine zu Eulenburg ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Involvement ◽  
Pelvic Lymphadenectomy ◽  
Pelvic Lymph Node ◽  
Node Metastasis ◽  
Node Positive ◽  
Pelvic Lymph Node Metastasis ◽  
Node Involvement ◽  
Pelvic Lymph Node Involvement

AbstractSince the publication of the updated German guideline in 2015, the recommendations for performing pelvic lymphadenectomy (LAE) in patients with vulvar cancer (VSCC) have changed considerably. The guideline recommends surgical lymph node staging in all patients with a higher risk of pelvic lymph node involvement. However, the current data do not allow the population at risk to be clearly defined, therefore, the indication for pelvic lymphadenectomy is still not clear. There are currently two published German patient populations who had pelvic LAE which can be used to investigate both the prognostic effect of histologically verified pelvic lymph node metastasis and the relation between inguinal and pelvic lymph node involvement. A total of 1618 patients with primary FIGO stage ≥ IB VSCC were included in the multicenter AGO CaRE-1 study (1998 – 2008), 70 of whom underwent pelvic LAE. During a retrospective single-center evaluation carried out at the University Medical Center Hamburg-Eppendorf (UKE), a total of 514 patients with primary VSCC treated between 1996 – 2018 were evaluated, 21 of whom underwent pelvic LAE. In both cohorts, around 80% of the patients who underwent pelvic LAE were inguinally node-positive, with a median number of three affected groin lymph nodes. There were no cases of pelvic lymph node metastasis without inguinal lymph node metastasis in either of the two cohorts. Between 33 – 35% of the inguinal node-positive patients also had pelvic lymph node metastasis; the median number of affected groin lymph nodes in these patients was high (> 4), and the maximum median diameter of the largest inguinal metastasis was > 40 mm in both cohorts. Pelvic lymph node staging and pelvic radiotherapy is therefore probably not necessary for the majority of node-positive patients with VSCC, as the relevant risk of pelvic lymph node involvement was primarily found in node-positive patients with high-grade disease. More, ideally prospective data collections are necessary to validate the relation between inguinal and pelvic lymph node involvement.

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