Tumor‐cell dissociation at the invasion front: A new prognostic parameter in gastric cancer patients

Gabbert, Helmut E.; Meier, Stephanie; Gerharz, C. D.; Hommel, G.

doi:10.1002/ijc.2910500208

Cited by 89 publications

(70 citation statements)

References 21 publications

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“…Similar findings have been reported in patients with squamous cell carcinoma, [21][22][23] gastric cancer, 24 adenocarcinoma of the cardia, and subcardial gastric cancer. 25 The current study was a retrospective analysis, and all patients were accrued before study entry and followed, some of them for 17 years.…”

Section: Discussionsupporting

confidence: 84%

Lymphovascular invasion as a tool to further subclassify T1b esophageal adenocarcinoma

Cen

Hofstetter

Correa

et al. 2008

Cancer

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BACKGROUND.Lymphovascular invasion (LVI) and/or lymph node metastases (LNM) adversely influence the overall survival (OS) of patients with T1 esophageal adenocarcinoma. Although endoscopic therapy may be adequate for patients with T1a cancer, patients with T1b cancer require esophagectomy/lymphadenectomy. The authors hypothesized that LVI status would subclassify T1b cancers and facilitate new therapeutic strategies.METHODS.Ninety‐nine consecutive patients with T1 adenocarcinoma were analyzed after they underwent esophagectomy/lymphadenectomy. LNM was assessed in all patients, and LVI was assessed in 89 patients. OS was correlated with pathologic cancer stage in association with LVI and LNM.RESULTS.The 5‐year OS rate for patients with T1a tumors (88%) was superior to that for patients with T1b tumors (62%; P = .001). The 5‐year OS rate for patients who had cancers without LVI (85%) was superior to the rate for patients who had cancers with LVI (36%; P = .0001). It is noteworthy that, for cancers without LVI, the 5‐year OS rate for patients with T1b tumors (77%) was similar to the rate for patients with T1a tumors (90%; P = .08), but it was superior to the rate for patients with T1b tumors that had LVI (27%; P = .006). The presence of LVI and/or LNM resulted in worse 5‐year OS (≤37%) compared with the lack of LVI and/or LNM (88%; P < .001). The rate of LNM for patients who had T1b tumors without LVI still was 19%, and the relapse rate was 16%.CONCLUSIONS.The current results demonstrated that LVI distinguishes the biologic behavior of early esophageal cancer, and patients who have T1b cancer without LVI have a clinical biology similar to that of patients with T1a cancer. If LNM before surgery can be diagnosed with high sensitivity by better endoscopic techniques and/or molecular biomarkers, then a new therapeutic paradigm for T1b cancers could emerge. Further research is needed on patients with T1b esophageal adenocarcinoma. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionsupporting

confidence: 84%

Lymphovascular invasion as a tool to further subclassify T1b esophageal adenocarcinoma

Cen

Hofstetter

Correa

et al. 2008

Cancer

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“…LVI has been regarded as an indicator of tumour aggressiveness in several cancers. The prognostic value of LVI has been demonstrated for diverse tumour entities like gastric carcinoma, adenocarcinoma of the OGJ and squamous cell carcinoma of the oesophagus (Gabbert et al, 1992;Brucher et al, 2001;von Rahden et al, 2005). Therefore, our findings in this study may show the greater aggressiveness of C-Ca than that of D-Ca.…”

Section: Discussionsupporting

confidence: 50%

Differences in the histological findings, phenotypic marker expressions and genetic alterations between adenocarcinoma of the gastric cardia and distal stomach

et al. 2007

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Adenocarcinoma of the gastric cardia (C-Ca) is possibly a specific subtype of gastric carcinoma. The purpose of this study was to clarify the differences in the clinicopathological characteristics between C-Ca and adenocarcinoma of the distal stomach (D-Ca), and also the differences in the expressions of gastric and intestinal phenotypic markers and genetic alterations between the two. The clinicopathological findings in 72 cases with C-Ca were examined and compared with those in 170 cases with D-Ca. The phenotypic marker expressions examined were those of human gastric mucin (HGM), MUC6, MUC2 and CD10. Furthermore, the presence of mutations in the APC, K-ras and p53 genes and the microsatellite instability status of the tumour were also determined. C-Ca was associated with a significantly higher incidence of differentiated-type tumours and lymphatic vessel invasion (LVI) as compared with D-Ca (72.2 vs 48.2%, P ¼ 0.0006 and 72.2 vs 55.3%, P ¼ 0.0232, respectively). Oesophageal invasion by the tumour beyond the oesophago-gastric junction (OGJ) was found in 56.9% of cases with C-Ca; LVI in the area of oesophageal invasion was demonstrated in 61% of these cases. Also, LVI was found more frequently in cases of C-Ca with oesophageal invasion than in those without oesophageal invasion (82.9 vs 58.1%, P ¼ 0.0197). The incidence of undifferentiated-type tumours was significantly higher in cases with advanced-stage C-Ca than in those with early-stage C-Ca (5 vs 36.5%, P ¼ 0.0076). A significantly greater frequency of HGM expression in early-stage C-Ca and significantly lower frequency of MUC2 expression in advanced-stage C-Ca was observed as compared with the corresponding values in cases of D-Ca (78.9 vs 52.2%, P ¼ 0.0402 and 51.5 vs 84.6%, P ¼ 0.0247, respectively). Mutation of the APC gene was found in only one of all cases of C-Ca, and the frequency of mutation of the APC gene was significantly lower in cases of C-Ca than in those of D-Ca (2.4 vs 20.0%, P ¼ 0.0108). The observations in this study suggest that C-Ca is a more aggressive tumour than D-Ca. The differences in biological behavior between C-Ca and D-Ca may result from the different histological findings in the wall of the OGJ and the different genetic pathways involved in the carcinogenesis.

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“…'1.31.32 For tumor cell differentiation (G), results are controversial.' 1,[33][34][35][36] Multivariate prognostic impact of tumor cell dissociation at invasion fronts was reported by Gabbert et al 33, and Nakane et al34 revealed significant relevance of grading. Other studies, including ours, did not find an association with prognosis.'…”

Section: Discussionmentioning

confidence: 95%

Clinical Value of Extended Biologic Staging by Bone Marrow Micrometastases and Tumor-Associated Proteases in Gastric Cancer

Heiss¹,

Allgayer²,

Gruetzner³

et al. 1997

Annals of Surgery

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Tumor‐cell dissociation at the invasion front: A new prognostic parameter in gastric cancer patients

Cited by 89 publications

References 21 publications

Lymphovascular invasion as a tool to further subclassify T1b esophageal adenocarcinoma

Lymphovascular invasion as a tool to further subclassify T1b esophageal adenocarcinoma

Differences in the histological findings, phenotypic marker expressions and genetic alterations between adenocarcinoma of the gastric cardia and distal stomach

Clinical Value of Extended Biologic Staging by Bone Marrow Micrometastases and Tumor-Associated Proteases in Gastric Cancer

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