Carcinoma of the breast.The prognostic significance of extranodal extension of axillary disease

Mambo, Nobby C.; Gallager, H. Stephen

doi:10.1002/1097-0142(197705)39:5<2280::aid-cncr2820390548>3.0.co;2-3

Cited by 71 publications

(29 citation statements)

References 8 publications

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“…There have been many reports of extranodal invasion, but few related to gastric cancer. It is well known that extranodal invasion is an important indicator of poor prognosis in cancers of the pharynx, larynx, thyroid, lung, and breast [17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Liver metastasis in gastric cancer with particular reference to lymphatic advancement

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Liver metastasis in gastric cancer with particular reference to lymphatic advancement

et al. 2001

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“…One hundred forty-three cases treated by one of the authors (W.L.D.) were identified as meeting the following criteria: (1) a minimum of 1 year follow-up after treatment, (2) no previous record of cancer (except skin carcinoma), (3) absence of systemic metastases at the time of initial treatment, (4) treatment with a unilateral modified radical mastectomy and a level I1 or I11 axillary lymph node dissection, and (5) available histologic slides with one or more involved axillary lymph nodes on routine sections.…”

Section: Methodsmentioning

confidence: 99%

Implications of extracapsular nodal metastases for treatment and prognosis of breast cancer

Donegan

Stine

Samter

1993

Cancer

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Background. Extracapsular extension of nodal metastases from cancer of the breast is a frequent histologic finding, but its significance for prognosis and treatment is unclear. Methods. One hundred forty‐three patients with breast cancer who had metastases to axillary lymph nodes were identified and divided into two groups: those with entirely intracapsular metastases (ICM), and those with extracapsular metastases (ECM). Results. ECM was found in 58.7% of patients. A direct correlation was found between ECM and both the number of metastases and their size. Overall survival was significantly lower in patients with ECM, but an influence on survival independent of node count could be demonstrated only in patients with one to three involved nodes. ECM did not influence the pattern (i.e., locoregional versus distant) of recurrence and was not associated with increased recurrence in the axilla. Radiation therapy reduced locoregional failures in both ICM and ECM groups, but it did not improve survival. Conclusions. It is concluded that ECM has limited influence on prognosis independent of the number of positive nodes and is not an indication for radiation therapy of the axilla after a complete axillary dissection.

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“…Previous studies demonstrated that assessment of extranodal extension (ENE) in patients who are node positive may provide prognostic information in certain human epithelial malignancies, including breast cancer (10,11), squamous cell carcinoma of the vulva (12,13), gastric carcinoma (14), and squamous carcinoma of the head and neck (15)(16)(17)(18)(19)(20)(21). Others refuted the significance of ENE (22)(23)(24)(25)(26). ENE is a frequent histologic finding in lymph nodes with prostate cancer, but its prognostic significance has not been established.…”

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confidence: 99%

Extranodal Extension in Lymph Node–Positive Prostate Cancer

et al. 2000

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Evaluation of extranodal tumor extension may provide prognostic information for patients with epithelial malignancies. However, its importance for the patient who has prostate cancer with regional lymph node metastasis requires further investigation and clarification. This study was performed to evaluate the prognostic significance of extranodal extension (ENE) in a large series of node-positive patients. The study group included 212 nodepositive patients who were treated by bilateral pelvic lymphadenectomy, radical retropubic prostatectomy, and androgen deprivation between 1987 and 1992 at the Mayo Clinic. ENE was defined as cancer perforating through the lymph node capsule into perinodal tissue. Nodal cancer volume was measured by the grid method. Univariate and multivariate risk ratios (RR) for distant metastasis-free and cancer-specific survival were estimated using the Cox proportional model. The mean follow-up was 6.3 years (median, 6.1 years). Distant metastasisfree and cancer-specific survival at 5 years for all patients was 91% and 95%, respectively. ENE was found in 126 of 212 patients (59%). The presence of ENE was not significantly associated with distant metastasis-free (RR ‫؍‬ 1.6; 95% confidence interval [CI], 0.7 to 3.9) or cancer-specific survival (RR ‫؍‬ 2.2; 95% CI, 0.7 to 6.8). Among 98 patients with a single positive node, there was no significant difference in distant metastasis or cancer-specific survival according to the presence of ENE (P ‫؍‬ .88 and P ‫؍‬ .36, respectively). After adjusting for Gleason score, DNA ploidy, and ENE, only nodal cancer volume was significantly associated with adverse distant metastasis-free (RR ‫؍‬ 1.9; 95% CI, 1.5 to 2.8) and cancer-specific survival (RR ‫؍‬ 1.4; 95% CI, 1.1 to 1.9). Our data indicate that the presence of ENE is not associated with unfavorable survival in patients with node-positive prostate cancer treated by radical retropubic prostatectomy, bilateral pelvic lymphadenectomy, and androgen deprivation therapy. In contrast, nodal cancer volume was predictive of distant metastasis-free survival and cancerspecific survival.

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Carcinoma of the breast.The prognostic significance of extranodal extension of axillary disease

Cited by 71 publications

References 8 publications

Liver metastasis in gastric cancer with particular reference to lymphatic advancement

Liver metastasis in gastric cancer with particular reference to lymphatic advancement

Implications of extracapsular nodal metastases for treatment and prognosis of breast cancer

Extranodal Extension in Lymph Node–Positive Prostate Cancer

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