scholarly journals Lymph node metastasis pattern and significance of left gastric artery lymph node dissection in esophagectomy for esophageal cancers

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiu-Mei Deng ◽  
Tian-Yu Zhu ◽  
Guo-Jun Wang ◽  
Bu-Lang Gao ◽  
Jing-Tao Wang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Lymphatic Drainage ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
En Bloc ◽  
Node Metastasis ◽  
Metastasis Rate ◽  
Upper Thoracic

Abstract Purpose To investigate the lymph node metastasis pattern and significance of dissection of the left gastric artery lymph nodes in radical en bloc esophagectomy for esophageal squamous carcinomas based on the lymphatic drainage pathway revealed by carbon nanoparticle labeling. Materials and methods Patients who underwent en bloc esophagectomy endoscopically were retrospectively enrolled. Carbon nanoparticles were injected in the submucosa of upper thoracic esophagus to label the relevant draining lymph nodes. The clinical data, lymph nodes dissected, surgical technique, and complications were analyzed. Results En bloc esophagectomy was successful in all 179 patients. Metastases to the left gastric artery lymph nodes were positive in 42 patients (23.5%) but negative in 137 (76.5%). The left gastric lymph nodes were labeled, whereas no celiac lymph nodes were labeled by carbon nanoparticles. A total of 4652 lymph nodes were resected, with 26 lymph nodes per patient. Seventy-three patients had lymph node metastasis (73/179). Seventeen patients had metastasis to the recurrent laryngeal nerve lymph nodes (9.5%). The metastasis rate of the lower thoracic esophageal cancer to the left gastric artery lymph nodes was 37.0%, significantly greater than that at the middle (15.4%) or upper (6.7%) thoracic segment. The lymph node metastasis rate was significantly (P < 0.05) increased with the length of the cancerous lesion, infiltration depth, and poor differentiation. Univariate analysis revealed that the metastasis rate to the left gastric artery lymph nodes was significantly (P < 0.05) associated with paraesophageal lymph node metastasis, para-cardial lymph metastasis, and TNM classification. Multivariate analysis indicated that cancer location (odds ratio 8.32, 95% confidence interval 2.12–32.24) was significantly (P < 0.05) associated with metastasis to the left gastric artery lymph nodes, with the cancer at the middle and lower thoracic segments significantly more than in the upper thoracic segment. Conclusion Certain patterns exist in lymph node metastasis of esophageal cancer, and in radical esophagectomy of esophageal cancers, dissection of the left gastric artery lymph nodes is necessary to prevent possible residual or metastasis of esophageal squamous carcinomas based on the lymphatic drainage pathway of esophageal carcinomas demonstrated by carbon nanoparticle labeling.

Clinical study of the clinical characteristics and prognosis of 1219 cases of endometrial cancer with lymph node metastasis

2021 ◽  
pp. 096032712110085
Author(s):  
Z Li ◽  
W Zhang ◽  
Z Luo ◽  
J Huang ◽  
L Li
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Clinical Characteristics ◽  
Infiltration Depth ◽  
Pelvic Lymph Nodes ◽  
Node Metastasis ◽  
Metastasis Rate

To analyze the clinical characteristics and prognosis of endometrial cancer patients with lymph node metastasis to provide a reference for lymphadenectomy in endometrial cancer. The data used in this study were extracted from a tertiary hospital in Guangxi, China based on the hospital information system. 1219 patients with endometrial malignancy who were treated in our hospital. The lymph node metastasis rate was 9.8%. The metastasis rate of the abdominal aorta + pelvic lymph nodes (56.7%) was significantly higher than that of the pelvic (24.2%) or para-aortic (19.2%) lymph nodes alone. The proportion of postmenopausal patients with lymph node metastasis was higher than that of premenopausal patients. The proportion of patients with lymph node metastasis with vaginal and uterus involvement, HPV detection, Thinprep Cytologic Testresults, CRP level <10 ug/mL, G3 tumor grade, postoperative pathology indicating cervical invasion, lymphovascular invasion, and muscular infiltration depth > 1/2 was higher than that of patients without lymph node metastasis. The proportion of endometrial cancer patients with lymph node metastasis with CA125 ≥ 35 U/ml was higher than that of those with CA125 < 35 U/ml. The lymph node-positive rate is related to tissue differentiation, lymphangitic infiltration, cervical invasion, muscle infiltration depth > 1/2, and CA125 level. The metastasis rate of pelvic and para-aortic lymph nodes is higher than that of pelvic lymph nodes or para-aortic lymph nodes alone. There was no statistically significant difference in the overall survival rate among the three groups.

PS02.097: PROGNOSTIC IMPACT OF LYMPH NODE METASTASIS STATIONS IN PN1 STAGE ESOPHAGEAL SQUAMOUS CARCINOMA PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 148-148
Author(s):  
Peng Tang ◽  
Zhao Ma ◽  
Zhentao Yu
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Median Survival ◽  
Left Gastric Artery ◽  
Lymph Node Staging ◽  
Prognostic Impact ◽  
Gastric Artery ◽  
Cox Regression Analysis ◽  
Node Metastasis ◽  
Significant Difference

Abstract Background Although numerically based lymph node staging system of UICC/AJCC of esophageal squamous cell carcinoma (ESCC) offers excellent prognostic performance, it doesn’t offer information on the anatomical extent of disease. The aim was to evaluate prognostic impact of lymph node metastasis (LNM) stations and regions in pN1 stage patients. Methods Among patients with ESCC undergone esophagectomy classified as R0 from January 2005 to December 2010, 185 patients diagnosed as pN1 were selected for analysis with univariate and multivariate Cox regression analysis. Results The most common metastasis areas in pN1 patients were middle and lower thoracic paraesophageal LN (28.6%), left gastric artery LN (27.6%) and paracardial LN (24.3%). Non- middle and lower paraesophageal LNM (P = 0.049), subcarinal LNM (P = 0.041) and multiple left gastric artery LNM (P = 0.010) were independent risk factors for worse survival. The median survival of the N1 (JES) group was significantly better than the N2 (JES) (40.1 months vs. 22.4 months, P = 0.012). However, no significant difference was found in median survival rate among intra-thoracic LNM, upper-abdominal LNM and both LNM. Conclusion Paraesophageal LNM, subcarinal LNM and left gastric artery LNM are predictive factors for survival and should be swept routinely in pN1 stage ESCC patients. On the basis of UICC/AJCC lymph node Classification system, anatomical lymphatic spread pattern analysis could further improve prognosis prediction. Disclosure All authors have declared no conflicts of interest.

scholarly journals Different Primary Sites of Hypopharyngeal Cancer Have Different Lymph Node Metastasis Patterns: A Retrospective Analysis From Multi-Center Data

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiwei Zhang ◽  
Ye Zhang ◽  
Xiaoduo Yu ◽  
Ying Sun ◽  
Susheng Miao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Multivariate Analyses ◽  
Posterior Wall ◽  
Lymphatic Drainage ◽  
Primary Tumor Site ◽  
Node Metastasis ◽  
Level Ii

BackgroundMost hypopharyngeal cancers (HPCs) develop lymph node metastasis (LNM) at initial diagnosis. Understanding the pattern of LNM in HPC could help both surgeons and radiologists make decisions in the management of cervical lymph nodes.MethodsA total of 244 newly diagnosed HPC patients between January 2010 and December 2018 were recruited from three specialized cancer hospitals in mainland China. All patients received pre-treatment magnetic resonance imaging (MRI), and definitive radiotherapy with or without concurrent chemotherapy. We reassessed the features of the primary tumor (tumor size, primary location, and extent of invasion) and the involvement of lymph nodes at each level. According to the incidence of LNM, these levels were sequenced and sorted into drainage stations. Univariate and multivariate analyses were used to determine the risk factors for bilateral and regional lymph node metastasis.ResultsThe cohort consisted of 195 piriform sinus cancers (PSC), 47 posterior wall cancers (PWC), and 2 post-cricoid cancers (PCC). A total of 176 patients (72.1%) presented with MRI-detectable LNMs. The overall LNM rates for level II-VI and retropharyngeal lymph nodes (RPLNs) were 59.0%, 52.9%, 14.3%, 1.6%, 2.9%, and 16.4%, respectively. Based on the prevalence of LNM at each level, we hypothesize that the lymphatic drainage of PSC was carried out in sequence along three stations: Level II and III (61.0% and 55.4%), Level IV and RPLN (15.9% and 11.3%), and Level V and VI (1.5% and 3.1%). For PWCs, lymphatic drainage is carried out at two stations: Level II, III, and RPLN (48.9%, 40.4%, and 34.0%) and Level IV-VI (6.4%, 0%, and 2.1%). According to univariate and multivariate analyses, posterior wall invasion was significantly correlated with bilateral LNM (P = 0.030, HR = 2.853 95%CI, 1.110-7.338) and RPLN metastasis (P = 0.017, HR = 2.880 95%CI, 1.209-6.862). However, pyriform sinus invasion was less likely to present with bilateral LNM (P = 0.027, HR = 0.311, 95%CI, 0.111-0.875) and RPLN metastasis (P = 0.028, HR = 0.346, 95%CI, 0.134-0.891).Conclusions and RelevanceThe primary tumor site and extent of invasion are related to the pattern of lymph node metastasis. That is, the metastasis would drainage station by station along different directions.

EVALUATION OF CLINICAL AND PARACLINICAL FEATURES IN PATIENTS WITH CARCINOMA OF ORAL CAVITY

2016 ◽  
pp. 56-60
Author(s):  
Van Minh Nguyen ◽  
Hong Loi Nguyen ◽  
Thi Kim Anh Dang
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Oral Cavity ◽  
Tumor Size ◽  
Regional Lymph Node ◽  
Regional Lymph Node Metastasis ◽  
Female Ratio ◽  
Histopathological Grade ◽  
Node Metastasis ◽  
Metastasis Rate

Background: To evaluate the clinical, hystopathologycal features and correlation between lymph node metastasis and hystopathologycal grade in patients with carcinoma of the oral cavity. Materials and Methods: From July 2015 to July 2016, 32 patients with carcinoma of the oral cavity at Hue Central Hospital Results: The most common age group from 51 to 60 years and the male/female ratio was 1.9/1. Tumor were usually observed around the the tongue (40.6%) and oral floor (34.4%). Most of the tumor size is larger than 2 cm diameters (> 80%). The regional lymph node metastasis rate was 43.8% and there was a positive correlation between lymph node metastasis and tumor size (p <0.05). Squamous-cell carcinoma was mainly type of histopathology. Difference between the rate of lymph node metastasis in patient groups with different histopathological grade show no statistical significance (p> 0.05). Conclusion: the greater tumor, the higher regional lymph node metastasis. There is no relationship between the lymph node metastasis rate and histopathological grade of oral carcinoma. Key words: : carcinoma of oral cavity, tumor size, lymph node metastasis, histopathology

scholarly journals Dedicated Axillary MRI-Based Radiomics Analysis for the Prediction of Axillary Lymph Node Metastasis in Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 757
Author(s):  
Sanaz Samiei ◽  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey Primakov ◽  
Marc B. I. Lobbes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Axillary Lymph Node ◽  
Axillary Lymph Node Metastasis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Mr Images ◽  
Node Metastasis

Radiomics features may contribute to increased diagnostic performance of MRI in the prediction of axillary lymph node metastasis. The objective of the study was to predict preoperative axillary lymph node metastasis in breast cancer using clinical models and radiomics models based on T2-weighted (T2W) dedicated axillary MRI features with node-by-node analysis. From August 2012 until October 2014, all women who had undergone dedicated axillary 3.0T T2W MRI, followed by axillary surgery, were retrospectively identified, and available clinical data were collected. All axillary lymph nodes were manually delineated on the T2W MR images, and quantitative radiomics features were extracted from the delineated regions. Data were partitioned patient-wise to train 100 models using different splits for the training and validation cohorts to account for multiple lymph nodes per patient and class imbalance. Features were selected in the training cohorts using recursive feature elimination with repeated 5-fold cross-validation, followed by the development of random forest models. The performance of the models was assessed using the area under the curve (AUC). A total of 75 women (median age, 61 years; interquartile range, 51–68 years) with 511 axillary lymph nodes were included. On final pathology, 36 (7%) of the lymph nodes had metastasis. A total of 105 original radiomics features were extracted from the T2W MR images. Each cohort split resulted in a different number of lymph nodes in the training cohorts and a different set of selected features. Performance of the 100 clinical and radiomics models showed a wide range of AUC values between 0.41–0.74 and 0.48–0.89 in the training cohorts, respectively, and between 0.30–0.98 and 0.37–0.99 in the validation cohorts, respectively. With these results, it was not possible to obtain a final prediction model. Clinical characteristics and dedicated axillary MRI-based radiomics with node-by-node analysis did not contribute to the prediction of axillary lymph node metastasis in breast cancer based on data where variations in acquisition and reconstruction parameters were not addressed.

Peritumoral lymph nodes in pancreatic cancer revisited; is it truly equivalent to lymph node metastasis?

2021 ◽  
Author(s):  
Yoonhyeong Byun ◽  
Kyoung‐Bun Lee ◽  
Jin‐Young Jang ◽  
Youngmin Han ◽  
Yoo Jin Choi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Node Metastasis

scholarly journals Development and Validation a Nomogram for Predicting the Third Station Lymph Node Metastasis in Early Gastric Cancer

2021 ◽  
Author(s):  
Xiaoxiao Wang ◽  
Cong Li ◽  
Mengjie Fang ◽  
Liwen Zhang ◽  
Lianzhen Zhong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Nodes ◽  
Validation Cohort ◽  
Predictive Accuracy ◽  
Clinical Risk Factors ◽  
Node Metastasis ◽  
Clinical Risk

Abstract Background:This study aimed to evaluate the value of radiomic nomogram in predicting lymph node metastasis in T1-2 gastric cancer according to the No. 3 station lymph nodes.Methods:A total of 159 T1-2 gastric cancer (GC) patients who had undergone surgery with lymphadenectomy between March 2012 and November 2017 were retrospectively collected and divided into a primary cohort (n = 80) and a validation cohort (n = 79). Radiomic features were extracted from both tumor region and No. 3 station lymph nodes (LN) based on computed tomography (CT) images per patient. Then, key features were selected using minimum redundancy maximum relevance algorithm and fed into two radiomic signatures, respectively. Meanwhile, the predictive performance of clinical risk factors was studied. Finally, a nomogram was built by merging radiomic signatures and clinical risk factors and evaluated by the area under the receiver operator characteristic curve (AUC) as well as decision curve.Results: Two radiomic signatures, reflecting phenotypes of the tumor and LN respectively, were significantly associated with LN metastasis. A nomogram incorporating two radiomic signatures and CT-reported LN metastasis status showed good discrimination of LN metastasis in both the primary cohort (AUC: 0.915; 95% confidence interval [CI]: 0.832-0.998) and validation cohort (AUC: 0.908; 95%CI: 0.814-1.000). The decision curve also indicated its potential clinical usefulness.Conclusions:The nomogram received favorable predictive accuracy in predicting No.3 station LN metastasis in T1-2 GC, and could assist the choice of therapy.

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