Lymphovascular invasion and presence of embryonal carcinoma as risk factors for occult metastatic disease in clinical stage I nonseminomatous germ cell tumour: a systematic review and meta‐analysis

Blok, Joost M.; Pluim, Ilse; Daugaard, Gedske; Wagner, Thomas; Jóźwiak, Katarzyna; Wilthagen, Erica A.; Looijenga, Leendert H. J.; Meijer, Richard P.; Bosch, J.L.H. Ruud; Horenblas, Simon

doi:10.1111/bju.14967

Cited by 46 publications

(26 citation statements)

References 62 publications

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“…LVI has also been identified as a strong predictor for LNM in other cancer types. 15 , 18 The number of lymphatic tumor emboli was an independent predictor for LNM in early gastric cancer with LVI. 15 The more lymphatic tumor emboli were present, the higher the LNM risk.…”

Section: Discussionmentioning

confidence: 94%

Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma

et al. 2021

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Aim To quantify lymphovascular invasion (LVI) and to assess the prognostic value in patients with pT1b esophageal adenocarcinoma. Methods In this nationwide, retrospective cohort study, patients were included if they were treated with surgery or endoscopic resection for pT1b esophageal adenocarcinoma. Primary endpoint was the presence of metastases, lymph node metastases, or distant metastases, in surgical resection specimens or during follow‐up. A prediction model to identify risk factors for metastases was developed and internally validated. Results 248 patients were included. LVI was distributed as follows: no LVI (n = 196; 79.0%), 1 LVI focus (n = 16; 6.5%), 2–3 LVI foci (n = 21; 8.5%) and ≥4 LVI foci (n = 15; 6.0%). Seventy‐eight patients had metastases. The risk of metastases was increased for tumors with 2–3 LVI foci [subdistribution hazard ratio (SHR) 3.39, 95% confidence interval (CI) 2.10–5.47] and ≥4 LVI foci (SHR 3.81, 95% CI 2.37–6.10). The prediction model demonstrated a good discriminative ability (c‐statistic 0.81). Conclusion The risk of metastases is higher when more LVI foci are present. Quantification of LVI could be useful for a more precise risk estimation of metastases. This model needs to be externally validated before implementation into clinical practice.

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Section: Discussionmentioning

confidence: 94%

Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma

et al. 2021

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“…Histologic evidence of lymphovascular invasion (LVI) is the most widely adopted tool for identifying patients at high risk of progression [ 23 ]. Patients with this histologic feature develop relapses upon surveillance in 42–78% of cases [ 22 , 24 ], while patients without LVI will relapse in 13–25% [ 16 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Testicular germ cell tumours’ clinical stage I: comparison of surveillance with adjuvant treatment strategies regarding recurrence rates and overall survival—a systematic review

et al. 2022

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Purpose Testicular germ cell tumours (GCTs) represent the most common malignancy in young adult males with two thirds of all cases presenting with clinical stage I (CSI). Active surveillance is the management modality mostly favoured by current guidelines. This systematic review assesses the treatment results in CSI patients concerning recurrence rate and overall survival in non-seminoma (NS) and pure seminoma (SE) resulting from surveillance in comparison to adjuvant strategies. Methods/systematic review We performed a systematic literature review confining the search to most recent studies published 2010-2021 that reported direct comparisons of surveillance to adjuvant management. We searched Medline and the Cochrane Library with additional hand-searching of reference lists to identify relevant studies. Data extraction and quality assessment of included studies were performed with stratification for histology (NS vs. SE) and treatment modalities. The results were tabulated and evaluated with descriptive statistical methods. Results Thirty-four studies met the inclusion criteria. In NS patients relapse rates were 12 to 37%, 0 to 10%, and 0 to 11.8% for surveillance, chemotherapy and for retroperitoneal lymph node dissection (RPLND) while overall survival rates were 90.7−100%, 91.7−100%, and 97−99.1%, respectively. In SE CSI, relapse rates were 0−22.3%, 0−5%, and 0−12.5% for surveillance, radiotherapy, chemotherapy, while overall survival rates were 84.1−98.7%, 83.5−100%, and 92.3−100%, respectively. Conclusion In both histologic subgroups, active surveillance offers almost identical overall survival as adjuvant management strategies, however, at the expense of higher relapse rates. Each of the management strategies in CSI GCT patients have specific merits and shared-decision-making is advised to tailor treatment.

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“…There are numerous prognostic factors in patients with testicular cancer. The postoperative risk of relapse is increased in patients with tumour size of >4 cm and invasion of the rete testis in cases of seminoma and lymphovascular invasion in peri-tumoral tissue in cases of non-seminoma tumours [ 81 , 82 , 83 ].…”

Section: Diagnosis and Prognosis Of Genitourinary Cancersmentioning

confidence: 99%

piRNAs and PIWI Proteins as Diagnostic and Prognostic Markers of Genitourinary Cancers

et al. 2022

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piRNAs (PIWI-interacting RNAs) are small non-coding RNAs capable of regulation of transposon and gene expression. piRNAs utilise multiple mechanisms to affect gene expression, which makes them potentially more powerful regulators than microRNAs. The mechanisms by which piRNAs regulate transposon and gene expression include DNA methylation, histone modifications, and mRNA degradation. Genitourinary cancers (GC) are a large group of neoplasms that differ by their incidence, clinical course, biology, and prognosis for patients. Regardless of the GC type, metastatic disease remains a key therapeutic challenge, largely affecting patients’ survival rates. Recent studies indicate that piRNAs could serve as potentially useful biomarkers allowing for early cancer detection and therapeutic interventions at the stage of non-advanced tumour, improving patient’s outcomes. Furthermore, studies in prostate cancer show that piRNAs contribute to cancer progression by affecting key oncogenic pathways such as PI3K/AKT. Here, we discuss recent findings on biogenesis, mechanisms of action and the role of piRNAs and the associated PIWI proteins in GC. We also present tools that may be useful for studies on the functioning of piRNAs in cancers.

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Lymphovascular invasion and presence of embryonal carcinoma as risk factors for occult metastatic disease in clinical stage I nonseminomatous germ cell tumour: a systematic review and meta‐analysis

Cited by 46 publications

References 62 publications

Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma

Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma

Testicular germ cell tumours’ clinical stage I: comparison of surveillance with adjuvant treatment strategies regarding recurrence rates and overall survival—a systematic review

piRNAs and PIWI Proteins as Diagnostic and Prognostic Markers of Genitourinary Cancers

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