Lymph Node Metastases

Cady, Blake

doi:10.1001/archsurg.1984.01390210063014

Cited by 184 publications

(27 citation statements)

References 51 publications

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“…There seems to be, however, a problem; Cady [3] quoted reports indicating that lymphadenectomy did not favor the prognosis in breast carcinoma and malignant mela noma. He stated that these facts emphasize that regional lymph node metastases are indicators, but not gover nors, of survival in cancer.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Gastric Cancer after Absolute Curative Resection

Habu¹,

Sunagawa²,

Takeshita³

et al. 1987

Dig Surg

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Among 428 patients who had undergone absolute curative resection of gastric cancer, 57 died of cancer recurrence. One hundred and seventeen patients who had survived longer than 5 years were used as controls. In the recurrence group, the primary lesion was larger and the lymph node metastasis more common as compared with the surviving controls. Prognostic serosal invasion was positive in 74% of the recurrence group and negative in 85% of the surviving controls. The most frequent mode of recurrence was hematogenous metastasis in negative prognostic serosal invasion (75%) and peritoneal disseminated metastasis in positive prognostic serosal invasion (52%).

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Section: Discussionmentioning

confidence: 99%

Recurrent Gastric Cancer after Absolute Curative Resection

Habu¹,

Sunagawa²,

Takeshita³

et al. 1987

Dig Surg

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“…General consensus, prevalent in the 1980s and 1990s, about extended lymphadenectomy being a tool for accurate staging of disease without added survival benefit continues to persist. The driving principle that lymph nodes are regarded as indicators rather than governors of disease, as outlined by Dr. Cady, relegated D2 lymphadenectomy in gastric surgery to a staging tool rather than exerting a therapeutic effect [2]. …”

Section: Introductionmentioning

confidence: 99%

“…These approaches clearly relied on the notion that certain gastric cancer spread in a Halstedian fashion. It is locally aggressive and spreads through a pre-determined nodal drainage pattern and, eventually, via blood-borne metastases [2]. The role of D2 dissection would have become irrelevant if not for the persistent discrepancy in survival data compared with the Asian literature.…”

Section: Introductionmentioning

confidence: 99%

Evolution in the surgical management of gastric cancer: is extended lymph node dissection back in vogue in the USA?

et al. 2017

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BackgroundGastric cancer remains a formidable treatment challenge. For decades, treatment consisted mostly of surgical intervention for this deadly disease. With improvements in the multi-disciplinary management of solid organ malignancies, the approach to this disease is being stepwise refined.Main bodyOne of the prevalent controversies in the surgical management of gastric cancer rests on the need for adequate harvesting of lymph nodes. For decades, lymph node dissection is regarded as a staging technique useful in only upstaging the disease. The adoption of D2 lymphadenectomy has been particularly slow to mature. But with prevailing data from Asia consistently demonstrating a survival benefit from lymphadenectomy, it calls into question the notion of lymphadenectomy as being solely a staging procedure.ConclusionsAs gastric resection techniques are being better defined in western countries and surgical morbidities lowered on its execution, D2 lymphadenectomy is becoming more accepted as the new standard in the management of gastric cancer.

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“…In the pre-SLN era, regional lymph node metastasis has been considered as an indicator rather than governor regarding cancer progression [33]. This concept may be challenged in the SLN era if micrometastasis in the SLN is merely an indicator of systemic disease or if it is being incubated within the SLN to become more aggressive to spread to the systemic sites.…”

Section: Discussionmentioning

confidence: 99%

Is the non-sentinel lymph node compartment the next site for melanoma progression from the sentinel lymph node compartment in the regional nodal basin?

Rios-Cantu

Lü

Melendez-Elizondo

et al. 2017

Clin Exp Metastasis

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Melanoma patients with additional positive lymph nodes in the completion lymph node dissection (CLND) following a positive sentinel lymph node (SLN) biopsy would have a poorer prognosis than patients with no additional positive lymph nodes. We hypothesize that the progression of disease from the SLN to the non-SLN compartment is orderly and is associated with the worsening of the disease status. Thus, the SLN and non-SLN compartments are biologically different in that cancer cells, in general, arrive in the SLN compartment before spreading to the non-SLN compartment. To validate this concept, we used a large cohort of melanoma patients from our prospective SLN database in an academic tertiary medical center. Adult cutaneous melanoma patients (n = 291) undergoing CLND after a positive SLN biopsy from 1994 to 2009 were analyzed. Comparison of 5-year disease-free survival and 5-year overall survival between positive (n = 66) and negative (n = 225) CLND groups was made. The 5-year disease-free survival rates were 55% (95% CI 49–62%) for patients with no additional LN on CLND versus 14% (95% CI 8–26%) in patients with positive LN on CLND (p < 0.0001, log-rank test). The median disease-free survival time was 7.4 years with negative CLND (95% CI 4.4–15+ years) and 1.2 years with positive CLND (95% CI 1.0–1.8 years). The 5-year overall survival rates were 67% (95% CI 61–74%) for negative CLND versus 38% (95% CI 28–52%) for positive CLND (p < 0.0001, log-rank test). The median overall survival time was 12.1 years for negative CLND (95% CI 9.3–15+ years) and 2.5 years for positive CLND (95% CI 2.2–5.7 years). This study shows that CLND status is a significant prognostic factor for patients with positive SLNs undergoing CLND. Also, it suggests an orderly progression of metastasis from the SLN to the non-SLN compartment. Thus, the SLN in the regional nodal basin draining the primary melanoma may serve as an important gateway for metastasis to the non-SLN compartment and beyond to the systemic sites.

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Lymph Node Metastases

Cited by 184 publications

References 51 publications

Recurrent Gastric Cancer after Absolute Curative Resection

Recurrent Gastric Cancer after Absolute Curative Resection

Evolution in the surgical management of gastric cancer: is extended lymph node dissection back in vogue in the USA?

Is the non-sentinel lymph node compartment the next site for melanoma progression from the sentinel lymph node compartment in the regional nodal basin?

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