The Impact of Immunohistochemical Detection of Positive Lymph Nodes in Early Stage Lung Cancer

Tezel, Çağatay; Ersev, Ayşe; Kıral, Hakan; Ürek, Şenol; Koşar, Altuğ; Keleş, Musa Kemal; Canan, Dudu; Arman, Bülent

doi:10.1055/s-2005-872867

Cited by 18 publications

(13 citation statements)

References 10 publications

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“…Some authors have reported a significant impact of micrometastasis on prognosis. 18,19 The prognostic value of IHC-detected micrometastasis has been shown in cancers of the breast and lung, 20,21 and this encouraged us and others to evaluate its use in EC. Prenzel et al reported that patients with clinical response following neoadjuvant chemoradiation had significantly fewer lymph node micrometastases.…”

Section: Discussionmentioning

confidence: 99%

The impact of the number of occult metastatic lymph nodes on postoperative relapse of resectable esophageal cancer

et al. 2013

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Clinical stage II/III esophageal cancer (EC), as defined by the Japanese Classification, relapses at a moderately high rate even after curative resection. The number of lymph node metastases is known to be associated with tumor relapse. Recently, the prognostic significance of occult metastatic lymph nodes (MLNs), as well as that of overt MLNs, has been reported. The aim of this study was to investigate the impact of the total number of MLNs including occult MLNs on postoperative relapse in clinical stage II/III EC. One hundred and five patients with clinical stage II/III EC who underwent esophagectomy accompanied by radical lymphadenectomy at the Department of Surgical Oncology in Osaka City University Hospital between January 2000 and October 2008 were included in this study. Occult MLNs, metastases not detected by hematoxylin-eosin staining, were identified by immunohistochemistry (IHC) using antipancytokeratin antibody AE1/AE3. The clinicopathological features of occult MLNs were compared between the relapse and no relapse groups. A total of 6558 lymph nodes (1357 from two-field dissection and 5201 from three-field dissection) were examined by IHC staining; 362 overt MLNs and 143 occult MLNs were detected. The number of occult MLNs increased in proportion to the International Union Against Cancer pathological (p)N-status and pStage. When the number of occult MLNs was added to the number of pNs, the number of total MLNs was associated with postoperative relapse. With respect to tumor, node, metastasis stage, 6 of 22 patients (27%) who were pathological node-negative converted to node-positive by considering total MLNs. The number of N3 patients with relapse increased markedly with restaging by total MLNs. The number of total MLNs, but not overt MLNs, was an independent prognostic factor on multivariate analysis. These results suggest that occult MLNs were often found, and they were associated with postoperative relapse of resectable esophageal cancer. The total number of MLNs including occult MLNs could contribute to evaluating the precise stage of patients with esophageal cancer.

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Section: Discussionmentioning

confidence: 99%

The impact of the number of occult metastatic lymph nodes on postoperative relapse of resectable esophageal cancer

et al. 2013

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“…Of the 43 articles, 10 presented insufficient information for extracting HRs, 5 not exclusively recruiting pN 0 patients (14-18). Moreover, 7 studies enrolled less than 10 cases in the OTC group (19)(20)(21)(22)(23)(24)(25). Two duplicated articles (26,27) with the same authors were less informative than 2 enrolled articles (7,28).…”

Section: Resultsmentioning

confidence: 99%

Detection of occult tumor cells in regional lymph nodes is associated with poor survival in pN0 non-small cell lung cancer: a meta-analysis

Xia

Tang³

et al. 2016

J. Thorac. Dis.

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“…While some authors have indicated that the presence of micrometastasis or ITC does not affect the postoperative survival of NSCLC patients, 8 many investigators have reported that the survival of NSCLC patients with micrometastasis or ITC is poorer than that of NSCLC patients without micrometastasis or ITC. 5,6 The clinical significance of distinguishing between micrometastasis and ITC in NSCLC has yet to be established. 9 Because of their unclear clinical significance, we now have a policy to carry out completion lobectomy, even a few days after segmentectomy, in patients with micrometastasis or ITC in lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

“…Many investigators have reported that IHC or reverse transcription polymerase chain reaction (RT-PCR) can determine the presence of microscopic metastasis in 16-28% of NSCLC patients in the p-N0 stage. 5,6 However, it is almost impossible to examine all dissected lymph nodes with IHC and/or RT-PCR. Because SNs have a greater likelihood of developing metastases than non-SNs, we believe that SN identification could target the lymph nodes to determine the presence of micrometastasis using several step sections, IHC, and/or RT-PCR.…”

Section: Discussionmentioning

confidence: 99%

Sentinel Node Microscopic Metastasis Detected after Segmentectomy for Lung Cancer Followed by Completion Lobectomy: Two Case Reports

Fukutomi

Kohno

Izumi

et al. 2011

Thorac cardiovasc Surg

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We performed sentinel node identification using radioisotopic and/or dye techniques to determine the final indication after segmentectomy in cases with non-small cell lung cancer. Sentinel nodes were examined using intraoperative frozen sections stained with hematoxylin and eosin. We present 2 cases with completion lobectomy performed 7 and 11 days after segmentectomy because immunohistochemical staining of the sentinel nodes showed the presence of microscopic metastases that were not detected by the examination of intraoperative frozen sections.

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The Impact of Immunohistochemical Detection of Positive Lymph Nodes in Early Stage Lung Cancer

Abstract: Our study provides some indication that patients with lymphatic micrometastasis have a reduced DFS. Before creating a new TNM staging system, more information is needed to understand the prognostic impact of micrometastatic dissemination.

Cited by 18 publications

References 10 publications

The impact of the number of occult metastatic lymph nodes on postoperative relapse of resectable esophageal cancer

The impact of the number of occult metastatic lymph nodes on postoperative relapse of resectable esophageal cancer

Detection of occult tumor cells in regional lymph nodes is associated with poor survival in pN0 non-small cell lung cancer: a meta-analysis

Sentinel Node Microscopic Metastasis Detected after Segmentectomy for Lung Cancer Followed by Completion Lobectomy: Two Case Reports

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