Extracapsular Lymph Node Spread as a Negative Prognostic Factor of Adenocarcinoma of the Pancreas and Cancer of the Papilla of Vater

Prenzel, Klaus L.; Hölscher, Arnulf H.; Drebber, Uta; Bollschweiler, Elfriede; Gutschow, Christian A.; Stippel, Dirk L.; Mönig, Stefan P.

doi:10.1097/mpa.0b013e3182a44a91

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…[ 84 85 159 ] For example, in GI and pancreatic cancer approximately 50% of metastatic infiltrations are found in LNs with the largest diameter being ≤5 mm, which are almost undetectable for the standard imaging techniques. [ 86 87 88 89 90 91 ] In gastric cancer, the percentage of LNs with a diameter of ≥10 mm is the same in patients with LNs metastases as in patients without metastatic nodal involvement. Also in pulmonary cancer, LN size is not a reliable indicator of LN metastases.…”

Section: Nodal Staging In Carcinoma Patientsmentioning

confidence: 99%

Endoscopic ultrasound: Elastographic lymph node evaluation

et al. 2015

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Different imaging techniques can bring different information which will contribute to the final diagnosis and further management of the patients. Even from the time of Hippocrates, palpation has been used in order to detect and characterize a body mass. The so-called virtual palpation has now become a reality due to elastography, which is a recently developed technique. Elastography has already been proving its added value as a complementary imaging method, helpful to better characterize and differentiate between benign and malignant masses. The current applications of elastography in lymph nodes (LNs) assessment by endoscopic ultrasonography will be further discussed in this paper, with a review of the literature and future perspectives.

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Section: Nodal Staging In Carcinoma Patientsmentioning

confidence: 99%

Endoscopic ultrasound: Elastographic lymph node evaluation

et al. 2015

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“…AoV adenocarcinoma is a rare lesion, accounting for 0.2% of all malignant neoplasms of the gastrointestinal (GI) tract and almost 6% of periampullary neoplasms [1]. Its incidence is 2.9 new cases per million/year [7]. Diagnosis relies on several clinical, radiological, and endoscopic investigations.…”

Section: Discussionmentioning

confidence: 99%

“…In high-risk patients, local or endoscopic treatment can be offered [8]. Five-year survival rates are about 10% in pancreatic adenocarcinoma and 40% in AoV adenocarcinoma after adequate resection [7].…”

Section: Discussionmentioning

confidence: 99%

Ampullary Adenocarcinoma with Incidental Pancreatic Neuroendocrine Tumor: Report of an Extremely Rare Case and Review of Literature

Viti

Lombardi

Marinelli

et al. 2019

Cureus

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Periampullary neoplasms are a heterogeneous group of tumors arising within 2 cm of the ampulla of Vater. Neuroendocrine tumors can originate throughout the entire body, from neuroendocrine cells. These neoplasms exhibit deep differences, according to their origin and biological behavior. We describe a case of a 79-year-old man who underwent pancreaticoduodenectomy for adenocarcinoma of the ampulla of Vater after proper staging. At gross histology, an incidental pancreatic neuroendocrine tumor was also documented. Despite two synchronous neoplasms, the patient survived 34 months with no evidence of recurrence at follow-up. The synchronous presence of a second primitive tumor in patients affected by a neuroendocrine tumor is reported in the literature; incidence is variable and the most common site is the gastrointestinal tract. Diagnostic workup for ampullary neoplasms includes abdominal computed tomography (CT) scan, magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS). These investigations infrequently may detect subcentimetric lesions. We believe this case is currently extremely rare. Preoperative diagnosis of synchronous PanNET would not have changed our approach since surgical therapy represents the gold standard in resectable ampullary neoplasms, and it has a primary role in the prognosis of the present patient.

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“…Extranodal extension (ENE) of LNMs portends an even worse prognosis. ENE has similarly been implicated in worse outcomes in carcinoma of the bladder, breast, pancreas, stomach, and cervix (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for the Prediction of Inguinal Lymph Node Metastasis Extranodal Extension in Penile Cancer

Guo

et al. 2021

Front. Oncol.

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PurposeTo determine whether a clinicopathologic and laboratory-based nomogram is capable of predicting the risk of lymph node extranodal extension (ENE) in patients with penile cancer.Materials and MethodsFrom June 2006 to January 2021, 234 patients who underwent bilateral inguinal lymph node dissection (ILND) surgery were included in the analysis. A Lasso regression model was utilized to select the most useful predictive features from among 46 laboratory variables. Then, a logistic regression analysis was used to develop the prediction model. Calibration curves, concordance index (C-index) and Areas under the receiver-operating characteristic curves (AUCs) were performed to evaluate the performance of the nomogram. We also investigated model fit using changes in Akaike Information Criteria (AICs). Decision curve analyses (DCAs) were applied to assess the clinical usefulness of this nomograms. Its internal validation was confirmed.ResultsAmong the 234 patients, 53 were confirmed to have ENE. The platelet-lymphocyte ratio (PLR) and Squamous cell carcinoma antigen (SCC-Ag) were significantly associated with ENE (P<0.05). The individualized prediction nomogram, including the PLR, SCC-Ag, lymphovascular invasion (LVI), and pathologic tumor stage(pT-stage), showed good discrimination, with a C-index of 0.817 (95% CI, 0.745 to 0.890) and good calibration. Clinical-laboratory nomogram (AIC, 180.034) become the best-fitting model. DCA findings revealed that the clinical-laboratory nomogram was more clinically useful than the pT-stage or tumor grade.ConclusionsThis study presents a clinicopathologic and laboratory-based nomogram that incorporates PLR, SCC-Ag, lymphovascular invasion (LVI), and pT-stage, which can be conveniently utilized to facilitate the individualized prediction of lymph node metastasis ENE in patients with penile cancer.

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Extracapsular Lymph Node Spread as a Negative Prognostic Factor of Adenocarcinoma of the Pancreas and Cancer of the Papilla of Vater

Abstract: Extracapsular LN spread is an independent negative prognostic factor in PC and CPV. In future staging systems, ELNS should be included.

Cited by 15 publications

References 26 publications

Endoscopic ultrasound: Elastographic lymph node evaluation

Endoscopic ultrasound: Elastographic lymph node evaluation

Ampullary Adenocarcinoma with Incidental Pancreatic Neuroendocrine Tumor: Report of an Extremely Rare Case and Review of Literature

Development and Validation of a Nomogram for the Prediction of Inguinal Lymph Node Metastasis Extranodal Extension in Penile Cancer

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