Prognostic Significance of Lymphovascular Invasion in Node‐Negative Gastric Cancer

Lee, Ju Hee; Kim, Min; Jung, Moon Sik; Kwon, Sung Joon

doi:10.1007/s00268-014-2846-y

Cited by 51 publications

(43 citation statements)

References 27 publications

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“…Nevertheless, the trend remained consistent after adjusting for poor prognostic factors such as lymphatic and/or blood vessel invasion (24)(25)(26), perineural invasion (27), stage and treatment.…”

Section: Discussionmentioning

confidence: 73%

Effect of Helicobacter pylori infection on outcomes in resected gastric and gastroesophageal junction cancer

Kolb

Özbek

Harpaz

et al. 2017

J. Gastrointest. Oncol.

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Background:Helicobacter pylori (H pylori) infection is a known risk factor for gastric cancer (GC) and has been linked with gastroesophageal junction (GEJ) cancer. Studies examining the relationship between H.pylori infection, GC characteristics and prognosis are limited and have yielded conflicting results. We report on the clinicopathologic characteristics and oncologic outcomes of gastric and GEJ cancer patients with and without a history of H. pylori treated at our institution. Results: Ninety-five patients were identified. The majority of patients were male (61%), white (36%) or Asian (34%), with median age at diagnosis 64. Tumors were stage I (51%), stage II (23%), stage III (25%), and stage IV (1%). H pylori infection status was documented at the time of cancer diagnosis in 89 (94%) patients, and following cancer diagnosis and treatment in 6 (6%) patients. Younger age at diagnosis, Asian race and Lauren histologic classification were associated with H Pylori infection. H pylori positive patients exhibited higher 5-year OS and 5-year RFS compared to H pylori negative patients, though the difference was not statistically significant in either univariate or multivariate analyses. Conclusions:In this retrospective series of predominantly early stage GC and GEJ cancers, H. pylori positive patients were significantly younger at cancer diagnosis and were more frequently Asian compared to H. pylori negative patients. Other demographic and histologic classifications except for Lauren histologic classification were similar between the two groups. H pylori positive patients appeared to have improved outcomes compared to H. pylori negative patients.

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Section: Discussionmentioning

confidence: 73%

Effect of Helicobacter pylori infection on outcomes in resected gastric and gastroesophageal junction cancer

Kolb

Özbek

Harpaz

et al. 2017

J. Gastrointest. Oncol.

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“…In patients without lymph node metastases, lymph vascular invasion (LVI) should be finely investigated by pathologists, as LVI is a well-known risk factor for distant and nodal recurrences (14,15). Lee et al found LVI to be an indicator of biological aggressiveness and a reliable independent and prognostic factor in pT1-3 pN0 gastric cancer patients, with an impact similar to that of the N1 group (16). Coherently, LVI should be considered in the postoperative management of pN0 gastric cancer.…”

Section: Clinical Impact Of Detected Lymph Nodesmentioning

confidence: 99%

N staging: the role of the pathologist

Marco¹,

Biondi²,

Ricci³

2017

Transl. Gastroenterol. Hepatol.

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Gastric cancer is the second cause of cancer-related mortality worldwide. Metastases, including lymph nodes ones, heavily influence the prognosis of this disease. The pathological detection of positive lymph nodes is pivotal for an optimal prognostication and clinical management of affected individuals.Several factors influence the pathological investigation of surgical specimens, ultimately affecting the number of retrieved lymph nodes and, with it, the reliability of N staging. The pathologist plays a central role in optimizing this process. Factors influencing lymph node retrieval and analysis will be herein reviewed, together with the procedures adopted for an optimal pathological analysis of lymph nodes in gastric cancer.

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“…The incidence of LN MM is lower than 10% in patients with node negative EGC [20] but it is higher in histologically diffuse type tumors [21] . The presence of MM influenced DFS, although the OS analysis revealed no significant difference between MMpositive and MMnegative patients [19] . The reverse transcriptase polymerase chain reaction proved to be the most sensitive method in the detection of MM [22] .…”

Section: Ln Involvementmentioning

confidence: 87%

“…These results are potentially associated with the elimination of MM in negative LNs [25] . Based on these findings, LVI and MM should be considered in posto perative management of gastric cancer [19] .…”

Section: Ln Involvementmentioning

confidence: 91%

“…While the prognostic significance of macrometastasis in the LNs is obvious, the role of lymphovascular invasion (LVI) or micrometastasis (MM) is controversial. Lee et al [19] confirmed that the recurrence-free survival is lower in N0/LVI(+) patients than in N0/LVI() patients, however they did not find any effect of LVI+ on overall survival. The incidence of LN MM is lower than 10% in patients with node negative EGC [20] but it is higher in histologically diffuse type tumors [21] .…”

Section: Ln Involvementmentioning

confidence: 96%

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Clinical significance of lymphadenectomy in patients with gastric cancer

Tóth

Plósz

Török

2016

WJGO

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Approximately thirty percent of patients with gastric cancer undergo an avoidable lymph node dissection with a higher rate of postoperative complication. Comparing the D1 and D2 dissections, it was found that there is a significant difference in morbidity, favoured D1 dissection without any difference in overall survival. Subgroup analysis of patients with T3 tumor shows a survival difference favoring D2 lymphadenectomy, and there is a better gastric cancer-related death and non-statistically significant improvement of survival for node-positive disease in patients with D2 dissection. However, the extended lymphadenectomy could improve stage-specific survival owing to the stage migration phenomenon. The deployment of centralization and application of national guidelines could improve the surgical outcomes. The Japanese and European guidelines enclose the D2 lymphadenectomy as the gold standard in R0 resection. In the individualized, stageadapted gastric cancer surgery the Maruyama computer program (MCP) can estimate lymph node involvement preoperatively with high accuracy and in addition the Maruyama Index less than 5 has a better impact on survival, than D-level guided surgery. For these reasons, the preoperative application of MCP is recommended routinely, with an aim to perform "low Maruyama Index surgery". The sentinel lymph node biopsy (SNB) may decrease the number of redundant lymphadenectomy intraoperatively with a high detection rate (93.7%) and an accuracy of 92%. More accurate stage-adapted surgery could be performed using the MCP and SNB in parallel fashion in gastric cancer.

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Prognostic Significance of Lymphovascular Invasion in Node‐Negative Gastric Cancer

Abstract: LVI could be an indicator of biological aggressiveness and may be a reliable prognostic factor for node-negative gastric cancer. LVI should be considered in postoperative management of gastric cancer.

Cited by 51 publications

References 27 publications

Effect of Helicobacter pylori infection on outcomes in resected gastric and gastroesophageal junction cancer

Effect of Helicobacter pylori infection on outcomes in resected gastric and gastroesophageal junction cancer

N staging: the role of the pathologist

Clinical significance of lymphadenectomy in patients with gastric cancer

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