scholarly journals Vas deferens invasion: A neglected issue in the sampling of radical prostatectomy materials

2014 ◽  
Vol 8 (7-8) ◽  
pp. 554 ◽  
Author(s):  
Nuri Yigit ◽  
Yildirim Karslioglu ◽  
Bulent Kurt

A radical prostatectomy affects the prostate, bilateral seminal vesicles (SV), and the distal parts of the bilateral vasa deferentia (VD). SV invasion (SVI) is associated with an increased risk of lymph node metastasis and recurrence. However, the significance of VD invasion (VDI), either with or without the involvement of their surgical margins, has not been fully appreciated. We think VDI might have an independent prognostic significance, as does SVI, and should be incorporated into the pathology guidelines and the staging systems of prostatic adenocarcinoma. Our case illustrates this.

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10077-10077
Author(s):  
L. Lessard ◽  
P. Bellon-Gagnon ◽  
M. Alam-Fahmy ◽  
P. Karakiewicz ◽  
A. Mes-Masson ◽  
...  

10077 Background: Pelvic lymph node metastases are associated with a greater risk of prostate cancer recurrence and peripheral metastasis. Unfortunately, markers predictive of lymph node metastasis and/or recurrence after radical prostatectomy are limited and new molecular markers are needed to identify patients at higher risk of progression. NF-kB (p65) is a candidate molecular marker already associated with poor clinical outcomes such as biochemical recurrence and bone metastasis. We have also reported elevated nuclear p65 expression in prostate cancer lymph node metastasis. Pertinent to this issue, we tested whether the nuclear localization of p65 in radical prostatectomy specimens could predict the presence of lymph node metastases. Methods: Following informed consent, 51 patients who underwent radical prostatectomy were included in the study: 20 patients had lymph node metastasis at surgery and 31 patients had no evidence of lymph node metastasis and were used as the control group. All cases in the control group had no biochemical relapse 5 years following radical prostatectomy. NF-kB expression in prostate tumor sections was assessed by immunohistochemistry using a monoclonal NF-kB p65 antibody. The relation between nuclear p65 expression in primary tumors and lymph node metastasis was tested in univariate and multivariate Cox regression models. Results: Primary tumors of metastatic patients had an average of 21.25% of tumor cells with nuclear p65 expression as opposed to 9.42% of tumor cells of control patients (p=0.001). Univariate Cox regression demonstrated a 7.5% increased risk of having lymph node metastases for each percent increase in p65 nuclear staining (p=0.003). In the multivariate model, after controlling for pre-operative PSA (p=0.175), Gleason patterns (p=0.382), pathological stage (p=0.436), extracapsular extension (p=0.243) and seminal vesicle invasion (p=0.016), nuclear p65 was associated with an 8.8% increased risk for lymph node metastases (p=0.024). Conclusion: In univariate and multivariate analyses, p65 nuclear expression was strongly predictive of lymph node invasion. We propose that nuclear NF-kB (p65) may serve as a useful independent molecular marker for stratifying patients at risk for lymph node metastases. No significant financial relationships to disclose.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiling Wang ◽  
Shuo Zhang ◽  
Yifei Ma ◽  
Wenhui Li ◽  
Jiguang Tian ◽  
...  

Abstract Background This study aimed to explore the risk factors for lymph node metastasis (LNM) in patients with endometrial cancer (EC) and develop a clinically useful nomogram based on clinicopathological parameters to predict it. Methods Clinical information of patients who underwent staging surgery for EC was abstracted from Qilu Hospital of Shandong University from January 1st, 2005 to June 31st, 2019. Parameters including patient-related, tumor-related, and preoperative hematologic examination-related were analyzed by univariate and multivariate logistic regression to determine the correlation with LNM. A nomogram based on the multivariate results was constructed and underwent internal and external validation to predict the probability of LNM. Results The overall data from the 1517 patients who met the inclusion criteria were analyzed. 105(6.29%) patients had LNM. According the univariate analysis and multivariate logistic regression analysis, LVSI is the most predictive factor for LNM, patients with positive LVSI had 13.156-fold increased risk for LNM (95%CI:6.834–25.324; P < 0.001). The nomogram was constructed and incorporated valuable parameters including histological type, histological grade, depth of myometrial invasion, LVSI, cervical involvement, parametrial involvement, and HGB levels from training set. The nomogram was cross-validated internally by the 1000 bootstrap sample and showed good discrimination accuracy. The c-index for internal and external validation of the nomogram are 0.916(95%CI:0.849–0.982) and 0.873(95%CI:0.776–0.970), respectively. Conclusions We developed and validated a 7-variable nomogram with a high concordance probability to predict the risk of LNM in patients with EC.


2008 ◽  
Vol 26 (5) ◽  
pp. 698-702 ◽  
Author(s):  
Emiel J.T. Rutgers

The sentinel node procedure is an adequate tool to identify lymph node metastasis in breast cancer. Sentinel nodes are generally examined with greater attention mainly to exclude, as reliably as possible, lymph node metastasis. To achieve this, many protocols are used, resulting in different rates of micrometastasis or isolated tumor cells encountered. Since the prognostic significance of isolated tumor cells or micrometastasis in the sentinel nodes, and the risk of further axillary lymph node involvement in patients with isolated tumor cells, is uncertain and at most limited, these findings may pose difficulties for clinicians in clinical decision making. Protocols that identify lymph node metastasis, from which the clinical relevance is known, are warranted. Unnecessary lymph node dissections should be avoided.


2012 ◽  
Vol 15 (1) ◽  
pp. e13-e20 ◽  
Author(s):  
J. Peng ◽  
H. Wu ◽  
X. Li ◽  
W. Sheng ◽  
D. Huang ◽  
...  

Surgery Today ◽  
1999 ◽  
Vol 29 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Hideo Ozaki ◽  
Takehisa Hiraoka ◽  
Ryuji Mizumoto ◽  
Seiki Matsuno ◽  
Yoshiro Matsumoto ◽  
...  

2019 ◽  
Vol 6 (2) ◽  
pp. 53
Author(s):  
Alessio Pierini ◽  
George Lubas ◽  
Eleonora Gori ◽  
Diana Binanti ◽  
Francesca Millanta ◽  
...  

Canine mast cell tumours (MCTs) present a wide variety of challenging clinical behaviours in terms of predicting the prognosis and choosing appropriate treatment. This study investigated the frequency, risk, and prognostic factors of MCTs in dogs admitted to a single veterinary teaching hospital (VTH). Breed, age, sex, and sexual status in ninety-eight dogs with MCTs (MCT-group) were compared with a control group of 13,077 dogs (VTH-group) obtained from the VTH clinical database from January 2010 to January 2016. Within the MCT-group, signalment, location, size, mass number, ulceration, histopathological grading, presence of lymph node, or distant metastases were compared with each other and with the outcome. Boxers (OR 7.2), American Pit Bull Terriers (OR 5.4), French Bulldogs (OR 4.4) and Labrador Retrievers (OR 2.6) were overrepresented. The MCT-group was significantly older than the VTH-group (p < 0.0001). In comparison with the VTH group, in the MCT-group neutered dogs (OR 2.1) and spayed females (OR 2.3) were predominant compared to intact dogs and intact females, respectively. Ulceration (OR 5.2) and lymph node metastasis (OR 7.1) occurred more frequently in larger MCTs. Both ulceration and MCTs > 3 cm were highly associated with lymph node metastasis (OR 24.8). Recurrence was associated with MCT-related death (OR 10.50, p = 0.0040), and the latter was associated with shorter survival times (p = 0.0115). Dogs with MCTs > 3 cm (p = 0.0040), lymph node metastasis (p = 0.0234), or elevated WHO stage (p = 0.0158) had shorter survival times. A significantly higher frequency of MCTs was found in specific breeds, and in older and neutered dogs. MCTs > 3 cm and lymph node or distant metastases were associated with shorter survival times.


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