A Standardized Pathology Report for Gastric Cancer: 2nd Edition

Park, Young Soo; Kook, Myeong–Cherl; Kim, Baek-hui; Lee, Hye Seung; Kang, Dong Wook; Gu, Mi Jin; Shin, Ok Ran; Choi, Young Sang; Lee, Wonae; Kim, Hyun Ki; Song, In Hye; Kim, Kyoung‐Mee; Kim, Hee Sung; Kang, Gyu-Hong; Park, Do Youn; Jin, So-Young; Kim, Joon Mee; Choi, Yoon Jung; Chang, Hee Kyung; Ahn, Soomin; Chang, Mee Soo; Han, Song Hee; Kwak, Yoonjin; Seo, An Na; Lee, Sung Hak; Cho, Mee Yon

doi:10.5230/jgc.2023.23.e7

Cited by 13 publications

(34 citation statements)

References 174 publications

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“…Some studies included the assessment of both lymphatic and nerve invasion, which was associated with a significant prognostic impact on disease-free survival and overall survival in patients with GC with stage II or III. The study patients had a worse prognosis compared to patients who did not have lymphatic vessels and nerve invasion [23,24]. Additionally, GC patients with coexisting LVI and PNI after preoperative treatment have more advanced disease than patients without these factors or with only one of them [24].…”

Section: Discussionmentioning

confidence: 82%

“…The study patients had a worse prognosis compared to patients who did not have lymphatic vessels and nerve invasion [23,24]. Additionally, GC patients with coexisting LVI and PNI after preoperative treatment have more advanced disease than patients without these factors or with only one of them [24]. Lu et al showed that the invasion of lymphatic vessels is an independent prognostic factor in patients who have no lymph node metastases, i.e., N0 according to the TNM classification.…”

Section: Discussionmentioning

confidence: 93%

“…However, the prognostic value of LVI in GC is still undefined [22]. Some data in scientific publications show that LVI is an independent prognostic factor for GC [23][24][25][26][27][28]. Some studies included the assessment of both lymphatic and nerve invasion, which was associated with a significant prognostic impact on disease-free survival and overall survival in patients with GC with stage II or III.…”

Section: Discussionmentioning

confidence: 99%

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Lymphovascular Invasion in Gastric Cancer—Important or Unimportant?

Janiczek-Polewska,

Borowczak,

Szylberg

et al. 2024

Preprint

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Introduction: Gastric cancer (GC) is one of the most common cancers in the world. It is a very aggressive and heterogeneous tumor. GC does not cause symptoms, so it is often diagnosed in an advanced stage and associated with poor prognosis. Despite new treatment options, it still remains a therapeutic problem. An important element determining the method of treatment of locally advanced gastric cancer (LAGC) is the assessment of lymph node metastases in preoperative and postoperative imaging and/or histopathological examination.Aim: The assessment of lymphovascular invasion (LVI) in histopathological examination in patients with LAGC after gastrectomy. The groups of patients were divided into patients who received preoperative chemotherapy, patients without preoperative chemotherapy, and all patients. Additionally, we assessed the correlation between the presence of LVI and the number of lymph nodes collected during gastrectomy.Material and method: We collected patients with histologically confirmed GC after gastrectomy. The collected samples were divided into three subgroups: patients with neoadjuvant chemotherapy (NAC), patients without NAC, and all patients. Histopathological examination assessed the presence of LVI infiltration. We then assessed the correlation between the presence of LVI and the presence of lymph node metastasis in GC. Additionally, we assessed the correlation between LVI and the number of lymph nodes evaluated in patients in each group. The statistical analyses were performed using Statistica v13.3 and Microsoft Excel 2021. The significance limit was set at p<0.05.Results:The presence of LVI strongly correlated with node involvement, and the result was statistically significant in all patients and the group of patients treated with NAC. The difference was not statistically significant in the group not treated by NAC. Additionally, we did not observe a correlation between the presence of LVI and the number of metastatic lymph nodes in GC.Summary and Conclusions: The presence of LVI in a patient with GC indicates a high probability of lymph node metastasis, which should translate into therapeutic procedures. Assessment of LVI may help identify potential patients with lymph node metastases, particularly in patients undergoing endoscopic resection without planned lymphadenectomy. It is advisable to expand research on a larger scale in order to establish clear standards in this area.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Lymphovascular Invasion in Gastric Cancer—Important or Unimportant?

Janiczek-Polewska,

Borowczak,

Szylberg

et al. 2024

Preprint

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“…For further detailed information about the pathology for gastric cancer, please refer to the Guideline for Standardized Pathology Report for Gastric Cancer, first edition and the upcoming revised version [ 133 134 ].…”

Section: General Considerationsmentioning

confidence: 99%

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

et al. 2023

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Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

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“…When two or more pathological types were mixed, papillary adenocarcinoma was defined only when >50% had a papillary component, and it was classified separately as a mixed papillary-type group. 14 Pathologic staging was confirmed, including of tumor size, invasion depth, lymphovascular invasion (LVI), ulcers, and lateral and basal margin involvement.…”

Section: Methodsmentioning

confidence: 99%

Clinical Outcome of Endoscopic Submucosal Dissection for Papillary Type Early Gastric Cancer: A Multicenter Study

et al. 2023

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Background/Aims Papillary adenocarcinoma is classified to differentiated-type gastric cancer and is indicated for endoscopic submucosal dissection. However, due to its rare nature, there are limited studies on it. The purpose of this study was to determine the outcome of endoscopic submucosal dissection in patients with papillary-type early gastric cancer and to find the risk factors of lymph node metastasis. Methods Patients diagnosed with papillary-type early gastric cancer at eight medical centers, who underwent endoscopic submucosal dissection or surgical treatment, were retrospectively reviewed. The clinical results and long-term outcomes of post-endoscopic submucosal dissection were evaluated, and the risk factors of lymph node metastasis in the surgery group were analyzed. Results One-hundred and seventy-six patients with papillary-type early gastric cancer were enrolled 44.9% (n=79) in the surgery group and 55.1% (n=97) in the endoscopic submucosal dissection group. As a result of endoscopic submucosal dissection, the en bloc resection and curative resection rates were 91.8% and 86.6%, respectively. The procedure-related complication rate was 4.1%, and local recurrence occurred in 3.1% of patients. Submucosal invasion (odds ratio, 3.735; 95% confidence interval, 1.026 to 12.177; p=0.047) and lymphovascular invasion (odds ratio, 7.636; 95% confidence interval, 1.730 to 22.857; p=0.004) were the risk factors of lymph node metastasis in papillary-type early gastric cancer patients. Conclusions The clinical results of endoscopic submucosal dissection in papillary-type early gastric cancer were relatively favorable, and endoscopic submucosal dissection is considered safe if appropriate indications are confirmed by considering the risk of lymph node metastasis.

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A Standardized Pathology Report for Gastric Cancer: 2nd Edition

Cited by 13 publications

References 174 publications

Lymphovascular Invasion in Gastric Cancer—Important or Unimportant?

Lymphovascular Invasion in Gastric Cancer—Important or Unimportant?

Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach

Clinical Outcome of Endoscopic Submucosal Dissection for Papillary Type Early Gastric Cancer: A Multicenter Study

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