Prognostic significance of intramural metastasis in patients with esophageal carcinoma

Takubo, Kaiyo; Sumii, Koji; Yamashita, Kiyohiko; Tanaka, Yoïchi; Fujita, Kousuke

doi:10.1002/1097-0142(19900415)65:8<1816::aid-cncr2820650825>3.0.co;2-l

Cited by 67 publications

(52 citation statements)

References 7 publications

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“…Compared with primary lesions without IM in esophageal squamous cell carcinoma, the clinicopathological features of primary lesions with IM are reported to include advanced stage grouping, a higher rate of lymph node metastasis (79-99 %), and a higher rate of capillary invasion (76-100 %) [1][2][3]9], features that correspond to the results of this study in gastric cancer. Distant metastasis was detected in 37.9 % of IM in this study, whereas the reported rate of IM is 29.2 % in esophageal cancer [2].…”

Section: Discussionsupporting

confidence: 69%

“…Distant metastasis was detected in 37.9 % of IM in this study, whereas the reported rate of IM is 29.2 % in esophageal cancer [2].…”

Section: Discussioncontrasting

confidence: 63%

“…The frequency reportedly ranges from 10.8 to 15.5 % in advanced esophageal cancers [2,3,8,9]. In this study, the incidence of IM was only 0.6 % in cases of resected gastric cancer and 1 % in advanced cancer cases, and it was a very rare pathology, compared with the incidence in esophageal cancer.…”

Section: Discussionmentioning

confidence: 48%

“…Regarding the positional relationship between the primary lesion and the IM in esophageal cancers, Takubo et al [2] reported that IM was equally present on both sides of the primary lesion. Similarly, in our study, IM was present equally on both sides.…”

Section: Discussionmentioning

confidence: 99%

“…However, esophageal squamous cell carcinoma is often accompanied by IM, and such cases have been reported to have a poor prognosis. As a result, the presence of IM with carcinoma is considered to be one of the most important prognostic factors [1][2][3]. There have been no detailed clinicopathological descriptions of IM in gastric cancer, to date.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of intramural metastasis in gastric cancer

et al. 2013

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Background Intramural metastasis (IM) in gastric cancer is rare. However, it often occurs with esophageal squamous cell carcinoma and has been reported to have a poor prognosis. Methods In 4,714 cases of gastric cancer that underwent gastrectomy, the clinicopathological features and postoperative prognoses of 29 cases with IM were evaluated and compared with 2,770 cases of advanced gastric cancer without IM. Results Of the 4,714 cases, 29 (0.6 %) were histopathologically diagnosed with gastric cancer with IM. There were significant differences in the number of lymph node metastases, capillary invasion, and stage grouping between cases with IM and advanced gastric cancer without IM. Metastasis size was approximately within 2 cm, and many metastases occurred within 2 cm of the primary lesion. Multiple metastases were observed in 38 % of cases and occurred mainly in the submucosa and muscularis propria. IM was detected preoperatively in 17.2 % of cases and was present equally on both sides of the primary lesion. Nine cases had IM outside the stomach. The median survival time with IM was significantly less than in cases of advanced gastric cancer without IM (p \ 0.0001). A subgroup of cases with IM within 1 cm of the primary lesion had a relatively favorable prognosis. Conclusions The presence of IM is thought to be one of the most important prognostic factors in gastric cancer. Aggressive resection is recommended to increase longterm survival if curative resection is possible.

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Section: Discussionsupporting

confidence: 69%

“…Distant metastasis was detected in 37.9 % of IM in this study, whereas the reported rate of IM is 29.2 % in esophageal cancer [2].…”

Section: Discussioncontrasting

confidence: 63%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characteristics of intramural metastasis in gastric cancer

et al. 2013

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Cancer of the Esophagus

Stein

Feith

2014

TNM Online

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In contrast to other tumors of the gastrointestinal tract, independent prognostic factors have only recently been identified in patients with esophageal carcinoma. This is because most studies assessing the prognosis of patients with esophageal cancer were retrospective univariate analyses of small patient populations that were usually not treated according to standardized protocols. Due to interrelations between various patient‐ and tumor‐related factors and their alterations by therapeutic strategies, the independent prognostic effect of individual parameters cannot be deducted from these analyses. This can only be achieved by multiple stepwise regression analysis applied to a sufficiently large patient population that has undergone standardized treatment and has been followed for a sufficiently long period of time. Studies that meet these criteria have become available only during the past decade. The chapter critically reviews the currently available literature on prognostic factors in patients with esophageal cancer, which are classified into the three categories: (1) tumor‐ or disease‐related prognostic factors; (2) patient‐related factors; and (3) environment‐ or treatment‐related factors.

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