Prognostic significance of the concomitant existence of lymphovascular and perineural invasion in locally advanced gastric cancer patients who underwent curative gastrectomy and adjuvant chemotherapy

Hwang, Jun‐Eul; Hong, Jeongsoo; Kim, Ji Eun; Shim, Hyungbo; Bae, Woo-Kyun; Hwang, Eu Chang; Jeong, Oh; Lee, Kyung‐Hwa; Lee, Jae-Hyuk; Cho, Sang‐Hee; Chung, Ik‐Joo

doi:10.1093/jjco/hyv031

Cited by 30 publications

(46 citation statements)

References 23 publications

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“…11 Vascular and perineural invasion were also important prognostic factors in patients with gastric cancers, which nowadays can only be assessed microscopically based on postoperative specimens. 3,27 We found that most of the entropy-related parameters in gastric cancers with vascular or perineural invasion was significantly higher than those without invasion, indicating that tumor lesions with higher entropy values showed more aggressiveness. Moreover, firstorder ADC entropy could predict vascular and perineural invasion of gastric cancers, with the largest AUC value of 0.819 and 0.714, respectively, while the role of mean ADC value in this field has not been established.…”

Section: Discussionmentioning

confidence: 73%

“…Vascular and perineural invasion were also important prognostic factors in patients with gastric cancers, which nowadays can only be assessed microscopically based on postoperative specimens . We found that most of the entropy‐related parameters in gastric cancers with vascular or perineural invasion was significantly higher than those without invasion, indicating that tumor lesions with higher entropy values showed more aggressiveness.…”

Section: Discussionmentioning

confidence: 76%

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Whole‐volume apparent diffusion coefficient‐based entropy parameters for assessment of gastric cancer aggressiveness

Liu

Zheng

Zhang

et al. 2017

Magnetic Resonance Imaging

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Purpose: To explore the role of whole-volume apparent diffusion coefficient (ADC)-based entropy parameters in the preoperative assessment of gastric cancer's aggressiveness. Materials and Methods: In all, 64 patients with gastric cancers who underwent 3.0T magnetic resonance imaging (MRI) were retrospectively included. Regions of interest were drawn manually using in-house software, around gastric cancer lesions on each slice of the diffusion-weighted images and ADC maps. Entropy-related parameters based on ADC maps were calculated automatically: (1) first-order entropy; (2-5) second-order entropies, including entropy(H) 0 , entropy(H) 45 , entropy(H) 90 , and entropy(H) 135 ; (6) entropy(H) mean ; and (7) entropy(H) range . Correlations between entropy-related parameters and pathological characteristics were analyzed with the Spearman correlation test. The parameters were compared among different pathological characteristics with independent-samples Kruskal-Wallis or Mann-Whitney U-test. Additionally, diagnostic performances of parameters in differentiating different pathological characteristics were analyzed by receiver operating characteristic (ROC) curve analysis. Results: All the entropy-related parameters significantly correlated with T, N, and overall stages, especially the firstorder entropy (r 5 0.588, 0.585, and 0.677, respectively, all P < 0.05). All the entropy-related parameters showed significant differences in gastric cancers at different T, N, and overall stages, as well as at different status of vascular invasion (P < 0.001-0.027). And four parameters, including entropy, entropy(H) 0 , entropy(H) 45 , and entropy(H) 90 , showed significant differences between gastric cancers with and without perineural invasion (P 0.006-0.040). Conclusion: Entropy-related parameters derived from whole-volume ADC texture analysis could help assess the aggressiveness of gastric cancers via analyzing intratumoral heterogeneity quantitatively, especially the first-order entropy. Level of Evidence: 2 Technical Efficacy: Stage 2

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 76%

Whole‐volume apparent diffusion coefficient‐based entropy parameters for assessment of gastric cancer aggressiveness

Liu

Zheng

Zhang

et al. 2017

Magnetic Resonance Imaging

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“…Previous studies reported a strong association between lymphovascular invasion and PNI 7 15 26. The abundant lymphatic network around the nerves and direct infiltration of the vasa nervorum by cancer cells may partly explain why PNI and lymphovascular invasion were more likely to be simultaneously detected in resected specimens 15.…”

Section: Discussionmentioning

confidence: 93%

Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis

Zhao

Mei

et al. 2020

J Clin Pathol

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AimsThe prognostic significance of perineural invasion (PNI) for gastric cancer (GC) patients was under debate. This study aimed to review relevant studies and evaluate the impact of PNI on the survival outcome of GC patients.MethodsSystematic literature search was performed using PubMed and Embase databases. The relevant data were extracted, and the association between PNI and clinicopathological characteristics or survival outcome in GC patients were evaluated using a fixed-effect model or random-effect model.ResultsA total 13 studies involving 7004 GC patients were included in this meta-analysis. The positive rate of PNI was 35.9% (2512/7004) in GC patients, ranging from 6.9% to 75.6%. There were significant relationships between PNI and a series of unfavourable clinicopathological factors including undifferentiated histology type (OR: 1.78, 95% CI 1.37 to 2.33, p<0.001; I2=75.3%), diffuse type (OR: 1.96, 95% CI 1.07 to 3.60, p=0.029; I2=79.5%), lymphatic invasion (OR: 7.00, 95% CI 3.76 to 13.03, p<0.001; I2=83.6%), vascular invasion (OR: 5.79, 95% CI 1.59 to 21.13, p=0.008; I2=95.8%), deeper tumour invasion (OR: 4.79, 95% CI 3.65 to 6.28, p<0.001; I2=65.0%) and lymph node metastasis (OR: 3.60, 95% CI 2.37 to 5.47, p<0.001; I2=89.6%). In addition, PNI was significantly associated with worse survival outcome in GC patients (HR: 1.69, 95% CI 1.38 to 2.06, p<0.001; I2=71.0%).ConclusionPNI was frequently detected in surgically resected specimens of GC patients, and it was a predictive factor for survival outcomes in these patients.

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“…LVI, where tumour cell emboli are observed directly within lymphatic and/or vascular spaces in the primary tumour, is the pathological equivalent of the detection of circulating tumour cells or tumour cell clusters in the blood and, as such, should be associated with an inherently increased risk of disease dissemination and recurrence a priori . It is therefore not surprising that LVI has been shown to be an independent predictor of poor prognosis in many of the most prevalent cancers, including urothelial cancers , rectal cancer , gastric cancer , melanoma , invasive breast cancer , non‐small‐cell lung cancer and hepatocellular carcinoma . As previously seen with prostate cancer there are varying results for oesophageal cancer .…”

Section: Discussionmentioning

confidence: 99%

Routinely reported ‘equivocal’ lymphovascular invasion in prostatectomy specimens is associated with adverse outcomes

et al. 2016

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Prognostic significance of the concomitant existence of lymphovascular and perineural invasion in locally advanced gastric cancer patients who underwent curative gastrectomy and adjuvant chemotherapy

Abstract: The concomitant existence of lymphovascular and perineural invasion has a significant prognostic impact on disease-free survival and overall survival in patients with Stage II or III gastric cancer.

Cited by 30 publications

References 23 publications

Whole‐volume apparent diffusion coefficient‐based entropy parameters for assessment of gastric cancer aggressiveness

Whole‐volume apparent diffusion coefficient‐based entropy parameters for assessment of gastric cancer aggressiveness

Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis

Routinely reported ‘equivocal’ lymphovascular invasion in prostatectomy specimens is associated with adverse outcomes

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