scholarly journals Stromal scoring in advanced colon and rectal cancer: Stroma-rich tumors and their association with aggressive phenotypes

2021 ◽  
pp. 3-3
Author(s):  
Ricella Souza da Silva ◽  
Eduardo Queiroga ◽  
Cynthia de Toledo Osório ◽  
Karin Cunha ◽  
Eliane Dias
Keyword(s):  
Lymph Node ◽  
Distant Metastasis ◽  
Colorectal Adenocarcinoma ◽  
Staging System ◽  
Tumor Stroma ◽  
Lymph Node Involvement ◽  
Neoplastic Cell ◽  
Observer Agreement ◽  
Depth Of Invasion ◽  
Colon And Rectal Cancer

Background: Our aim was to explore relevance of the proportion between neoplastic cell component and tumor-associated stroma in order to assess its association with confirmed aggressive phenotypes of right/left colon and rectum cancers in a large series of patients. Methods: The quantification of stroma component was performed in patients diagnosed with colorectal adenocarcinoma who underwent surgical resection. The analyzed variables were age, gender, anatomical/pathological features, and tumor-stroma proportion. Tumor-stroma proportion was estimated based on slides used in routine pathology for determination of T status and was described as low, with a stromal percentage ?50% or high, with a stromal percentage >50%. The tumor-stroma proportion was estimated by two observers, and the inter-observer agreement was assessed. Results: The sample included 390 colorectal adenocarcinoma patients. Stroma-rich tumors were observed in 53.3% of cases. Well-differentiated tumors had the lowest stromal proportions (p = 0.028). Stroma-poor tumors showed less depth of invasion (p<0.001). High stromal content was observed in association with tumor budding, perineural, angiolymphatic, and lymph node involvement, and distant metastasis (p?0.001). Colorectal adenocarcinoma without lymph node or distant metastasis involvement had lower stromal proportion, while metastatic ones exhibited high stromal content (p <0.001). The inter-rater reliability (concordance) between the estimations of pathologists for tumor-stroma proportions was high (?=0.746). Conclusion: The tumorstroma proportion in colorectal adenocarcinoma was associated with adverse prognostic factors, reflecting the stage of the disease. Stroma-rich tumors showed a significant correlation with advancement of the disease and its aggressiveness. Due to its availability tumor-stroma proportion evaluation has high application potential and can complement current staging system for colorectal adenocarcinoma.

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>

No relationship is indicated between FHIT expression and clinicopathologic prognostic parameters in early stage cervical carcinoma

2003 ◽  
Vol 13 (2) ◽  
pp. 192-196
Author(s):  
C. Baykal ◽  
A. Ayhan ◽  
A. Al ◽  
K. YÜCE ◽  
A. Ayhan
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Depth Of Invasion ◽  
Prognostic Parameters ◽  
Node Involvement ◽  
Disease Free

In this study we investigated FHIT (Fragile Histidine Triad) protein alterations in cervical carcinomas to assess the relation of this gene with cervical cancer. Eighty-eight patients with surgically treated FIGO (International Federation of Gynecology and Obstetrics) stage IB carcinomas of the cervix were included in this study. Clinicopathologic prognostic factors were compared with FHIT expression status. Disease-free and overall survival was evaluated according to prognostic factors and FHIT expression. The FHIT gene was found to be depressed in 53% (47/88) of the tumors. None of the clinicopathologic prognostic parameters showed a correlation with FHIT expression. Univariate survival analysis with the Kaplan-Meier method showed that only the age of the patient is significantly correlated with disease-free survival. Interestingly, when the same analysis was done for 5-year overall survival; diameter of the primary tumor, depth of invasion, occurrence of lymph node involvement, and number of metastatic lymph nodes were found to be statistically significant. Furthermore, multivariate analysis with Cox regression revealed that lymph node involvement was the only independent variable for 5-year overall survival. In the present study there was no statistical correlation between FHIT expression and clinicopathologic prognostic factors or survival figures of the patients. These findings may be explained with the carcinogenic role of FHIT in tumoral progression but not in the tumoral development that takes place after the carcinogenetic period.

Histology as a Prognostic Factor in Early Gastric Cancer

1992 ◽  
Vol 78 (3) ◽  
pp. 181-184
Author(s):  
Massimo Ferrari ◽  
Enrico Ghislandi ◽  
Giuseppe Landonio ◽  
Margherita Majno ◽  
Tiziano Porretta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Early Gastric Cancer ◽  
Lymph Node Involvement ◽  
Depth Of Invasion ◽  
Undifferentiated Histology ◽  
Node Involvement

Of 431 patients with gastric cancer observed in our Istitution, 23 (5.3 %) had early gastric cancer (EGC). Macroscopic presentation, histology, depth of invasion, and lymph node involvement were evaluated in all the cases. All patients underwent surgery and an intensive follow-up was performed. Five of the 23 patients progressed, and the risk factors were examined. Histology seemed to be the main prognostic factor in our study, since intestinal type of EGC was associated to a significantly better prognosis. Total gastrectomy is indicated in the proximal localization of EGC, and should perhaps be performed also in cases presenting undifferentiated histology.

scholarly journals Surgical management of urachal tumors: Can the umbilicus be sparred in localized disease?

Rare Tumors ◽  
2019 ◽  
Vol 11 ◽  
pp. 203636131984728
Author(s):  
Cristian Pavelescu ◽  
Alexandra Pavelescu ◽  
Cristian Surcel ◽  
Cristian Mirvald ◽  
Mario Alvarez-Maestro ◽  
...  
Keyword(s):  
Lymph Node ◽  
Surgical Treatment ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Lymph Node Involvement ◽  
Partial Cystectomy ◽  
En Bloc ◽  
Node Involvement ◽  
Urachal Adenocarcinoma

Urachal adenocarcinoma represents the third most common histological type of non-urotelial bladder cancer. A very low incidence of this disease and the lack of prospective studies have led to a rich and heterogeneous treatment history. Currently, the standard of care for these patients is represented by partial cystectomy en bloc with resection of the urachal ligament and total omphalectomy. The aim of this article is to present our experience and results in the management of patients with urachal adenocarcinoma. Between 2005 and 2015, 16 patients have undergone surgical treatment for urachal adenocarcinoma in “Fundeni” Clinical Institute and Madrid University Hospital “Infanta Sofia.” Partial cystectomy was performed in 11 (68.76%) patients, while radical cystectomy en bloc with omphalectomy was performed in 5 (31.25%) patients, which were not amendable to a limited resection. The Sheldon classification was used, as it provides appropriate disease staging and is the most commonly utilized. Postoperative pathological results showed that 7 (43.75%) patients had localized tumors, and more than one-third (37.5%) of the patients had locally advanced Sheldon III disease, while 3 patients had distant metastasis at the time of surgery. Lymph node involvement was present in 3 patients (18.75%). Mean follow-up time was 2.5 years, ranging from 4 months to 7.6 years. Three patients (18.75%) were lost to follow-up, without any documented signs of local or systemic recurrence and were cancer free at the time of the last evaluation. In cases with lymph node involvement, local recurrence or distant metastasis, patients underwent cisplatin- or 5-fluorouracil-based salvage chemotherapy. Surgical treatment represents the gold standard, while adjuvant chemotherapy has a limited impact on overall survival. The utility of navel resection is questionable due to the rarity of direct invasion or local recurrence.

The Pediatric Oncology Group experience with the international staging system criteria for neuroblastoma. Member Institutions of the Pediatric Oncology Group.

1994 ◽  
Vol 12 (11) ◽  
pp. 2378-2381 ◽  
Author(s):  
R P Castleberry ◽  
J J Shuster ◽  
E I Smith
Keyword(s):  
Lymph Node ◽  
Pediatric Oncology ◽  
Regional Lymph Node ◽  
Staging System ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Oncology Group ◽  
International Consensus ◽  
Age Related ◽  
Pediatric Oncology Group

PURPOSE An international consensus on the criteria for surgicopathologic staging (INSS) of patients with neuroblastoma has been published, but has not been validated. A retrospective study was conducted to assess if the INSS definitions identified prognostic subsets of patients with neuroblastoma. PATIENTS AND METHODS The initial operative and pathology reports were reviewed from 675 patients on Pediatric Oncology Group (POG) #8104, a stage- and age-related treatment study that used the POG surgicopathologic staging system. RESULTS Of 596 eligible cases, there was concordance between the POG and INSS stages for the 193 patients with localized, resected disease (POG stage A), the 202 with distant metastases, the 51 with POG stage Ds (IVs) tumors, and 40 of the cases with grossly unresected, localized tumor without lymph node involvement (POG stage B). Of the remaining 19 patients with POG stage B tumors, five were INSS stage 2B and 14 INSS stage 3. All of the 91 cases with nonadherent, regional lymph node metastases (POG stage C) conformed to the definitions for INSS stage 2B (n = 42) or 3 (n = 49). In infants, there was no difference in event-free survival (EFS) among INSS stages 2A, 2B, or 3. In contrast, older children with INSS stage 3 disease had inferior EFS compared with INSS stage 2A or 2B tumors. CONCLUSION We conclude the following: (1) the INSS identifies distinct patient subsets, particularly in children; (2) infants remain a favorable group, regardless of INSS/POG stage; and (3) the INSS deserves further prospective study especially in the light of recent biologic prognostic variables.

Clinical relevance of angiogenesis and lymphangiogenesis in patients with sex cord-stromal ovarian tumors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5575-5575
Author(s):  
J. Brown ◽  
M. T. Deavers ◽  
A. M. Nick ◽  
L. Milojevic ◽  
D. M. Gershenson ◽  
...  
Keyword(s):  
Lymph Node ◽  
Distant Metastasis ◽  
Clinical Relevance ◽  
Lymph Node Involvement ◽  
Nodal Metastasis ◽  
Ovarian Tumors ◽  
Vegf Expression ◽  
Institutional Review ◽  
Increased Risk ◽  
Lymphatic Markers

5575 Background: Distant metastasis is common in patients with sex cord-stromal ovarian tumors (SCSTs), but lymph node involvement is extremely rare. Given the lack of lymphatics in the normal granulosa layer, we examined the clinical relevance of angiogenesis and lymphangiogenesis in patients with SCSTs. Methods: After Institutional Review Board approval, 80 tumor samples (46 primary, 34 recurrent) were obtained from 65 patients and stained for CD31 (microvessel density; MVD), D2–40 (lymphvascular density; LVD), and VEGF. Clinical data were extracted by chart review and correlated with the angiogenesis and lymphatic markers. Results: The median age of the patients was 42.1 years (range, 8.6–78.6 years). At presentation, 53% of patients had stage I disease, 8% had stage II, 16% had stage III, and 23% were unstaged. Although VEGF expression was noted at some level in 99% of samples, VEGF overexpression (upper tertile of overall score) was noted in 35% of samples. On the basis of ROC analysis, vessel density was stratified into high versus low at a mean MVD cutoff of 12.3. High MVD was present in 41% of all tumors. High MVD was significantly associated with shorter disease-specific survival (mean 16.7 versus 32.3 months; p = 0.024), increased risk of recurrence (p < 0.04), and shorter overall survival (median 108.6 versus 388.5 months; p < 0.001). High MVD was strongly related to VEGF overexpression (p = 0.009). While VEGF expression was not related to the pattern of recurrence, high MVD was strongly associated with distant metastasis (abdomen, liver, lung, bone) compared with local recurrence (p < 0.001). Lymph node metastasis was clinically evident in only 3 of the 65 patients. Most tumors had either absent or low LVD. Interestingly, all 3 tumors with nodal metastasis had significantly greater LVD (LVD = 35.8 vessels/hpf) compared to those without nodal metastasis (LVD = 2.7 vessels/hpf; p < 0.001). Conclusions: Increased angiogenesis is a significant predictor of poor clinical outcome in patients with sex-cord stromal tumors. Most of these tumors have poor lymphatic development that might explain the low likelihood of nodal metastasis. These data provide support for further investigation of antiangiogenic biological agents in these patients. No significant financial relationships to disclose.

scholarly journals Expression of p53 protein in Barrett’s adenocarcinoma and adenocarcinoma of the gastric cardia and antrum

2005 ◽  
Vol 62 (12) ◽  
pp. 879-885 ◽  
Author(s):  
Ivan Jovanovic ◽  
Vera Todorovic ◽  
Tomica Milosavljevic ◽  
Marijan Micev ◽  
Predrag Pesko ◽  
...  
Keyword(s):  
Lymph Node ◽  
P53 Protein ◽  
Lymph Node Involvement ◽  
Depth Of Invasion ◽  
Tumor Differentiation ◽  
Tumor Depth ◽  
Protein Overexpression ◽  
Significant Difference ◽  
Sex Type ◽  
Node Involvement

Background/Aim. Most studies of esophageal and gastric adenocarcinomas have shown a very high rate of p53 gene mutation and/or protein overexpression, but the influence of the tumor site upon the frequency of p53 protein expression has not been evaluated (gastroesophageal junction, Barret's esophagus, and antrum). The aim of our study was to analyze the correlation between the selected clinico-pthological parameters, and p53 protein overexpression in regards to the particular tumor location. Methods. The material comprised 66 surgical specimens; 10 were Barrett?s carcinomas, 25 adenocarcinomas of the gastric cardia (type II adenocarcinoma of the esophagogastric junction - EGJ), and 31 adenocarcinomas of the antrum. Immunostaining for p53 protein was performed on formalin-fixed, paraffin-embedded tissue sections, using the alkaline phosphatase - antialkaline phosphatase (APAAP) method. The cases were considered positive for p53 if at least 5% of the tumor cells expressed this protein by immunostaining. Results. There was no significant difference observed between the studied groups in regards to age, sex, Lauren?s classification and tumor differentiation. There was, however, a significant difference observed in the depth of tumor invasion between Barrrett?s adenocarcinoma and adenocarcinoma of the cardia compared with the adenocarcinoma of the antrum. Namely, at the time of surgery, both Barrett?s adenocarcinomas and adenocarcinomas of the cardia, were significantly more advanced comparing with the adenocarcinomas of the antrum. Overexpression of p53 was found in 40% (4/10) of Barrett?s adenocarcinomas, 72% (18/25) of adenocarcinoma of the cardia and 65% (20/31) of adenocarcinoma of the antrum. No significant differences in p53 expression in relation to sex, type (Lauren) of tumor, depth of invasion, lymph node involvement, or tumor differentiation were observed in any of the analyzed groups of tumors. Patients with more advanced Barrett?s adenocarcinoma and in the cases of lymph node invasion revealed tendency for the greater p53 positivity compared with the early forms and lymph node-negative cases; however, this difference was not significant according to the statistical analysis. With regard to adenocarcinoma of the cardia, higher rates of p53 positivity were recorded in poorly differentiated, more advanced cases with lymph node invasion. Nevertheless, none of these differences was statistically significant. On the contrary, in the patients with adenocarcinoma of the antrum, greater p53 positivity was revealed in early forms without lymph node involvement, but the observed difference was not statistically significant. Conclusion. No significant differences in p53 protein expression in terms of sex, type (Lauren) of tumor, depth of invasion, lymph node involvement, or tumor differentiation were observed in any of the analyzed groups of tumors (Barrett?s adenocarcinoma, adenocarcinoma of the cardia and adenocarcinoma of the antrum).

scholarly journals Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study

2022 ◽  
Vol 2022 ◽  
pp. 1-8
Author(s):  
Agnes Stephanie Harahap ◽  
Desty Gusti Sari ◽  
Marini Stephanie ◽  
Alvita Dewi Siswoyo ◽  
Litta Septina Mahmelia Zaid ◽  
...  
Keyword(s):  
Lymph Node ◽  
Mortality Rate ◽  
Thyroid Carcinoma ◽  
Distant Metastasis ◽  
Disease Recurrence ◽  
Lymph Node Involvement ◽  
Common Type ◽  
Thyroid Malignancy ◽  
Node Involvement

Introduction. Thyroid cancer is the third most common cancer that occurs in children and adolescents. Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Although the mortality rate of thyroid malignancy in children is usually low, the disease recurrence is higher in children with more severe clinical presentation than in adults. This study aimed to determine the demographic and clinicopathological characteristics and outcome of pediatric and adolescent patients with thyroid malignancy in Indonesia. Methods. The retrospective study included all patients diagnosed with thyroid carcinoma aged <20 years, from January 1, 2015, to December 31, 2019. Twenty-nine subjects fulfilled the inclusion and exclusion criteria. We retrieved baseline characteristics, pathology features, TSH and fT4 status, radioactive iodine therapy data, and patients’ outcomes. Then, data were analyzed using the chi-square or Fisher’s exact method. Results. We identified 29 eligible subjects, including 3 boys and 26 girls. The most common type of thyroid carcinoma was PTC (96.5%), and follicular type (31%) was the predominant variant of PTC. Lymph node involvement occurred in 24% of patients, while distant metastasis occurred in 17.2% of patients with PTC. Twenty-four (82.7%) patients had stage 1 disease. Disease recurrence was recorded in 31% of patients during the study period with a median follow-up time of 24 months. Conclusion. PTC is the most frequent type of thyroid carcinoma among children and adolescents. This malignancy has a low mortality rate, but the recurrence rate remains high among younger patients than adults even during a short-term follow-up analysis. Distant metastasis and lymph node involvement are commonly found in this age group.

Primary tonsillar histiocytic sarcoma in two dogs

2020 ◽  
Vol 8 (3) ◽  
pp. e001106
Author(s):  
Cesar Llanos ◽  
Ana Lara ◽  
James Elliott
Keyword(s):  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Distant Metastasis ◽  
Regional Lymph Node ◽  
Lymph Node Involvement ◽  
Histiocytic Sarcoma ◽  
Clinical Staging ◽  
Golden Retriever ◽  
Excellent Outcome ◽  
Disseminated Disease

An eight-year-old, female-spayed Golden Retriever was presented with a tonsillar mass, which was diagnosed as histiocytic sarcoma (HS), following tonsillectomy. Clinical staging revealed no regional lymph node or distant metastasis. Following adjuvant lomustine treatment, the patient remains alive with no evidence of tumour recurrence 18 months after diagnosis. Additionally, a five-year-old, male-entire Golden Retriever presented with an enlarged retropharyngeal lymph node was also diagnosed with HS. A primary tonsillar mass, extensive regional lymph node involvement and suspected early pulmonary metastasis were discovered following clinical staging. After a cytoreductive surgery and no adjuvant chemotherapy, the dog was euthanased two months following diagnosis with progressive distant metastasis. To the authors’ knowledge, this is the first report documenting primary tonsillar HS in the dog. This case report illustrates an excellent outcome of a dog with localised HS following surgery and adjuvant chemotherapy. However, prognosis remains guarded for dogs with disseminated disease, especially when chemotherapy is not used.

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