Clinicopathological investigation of lymph node metastasis predictors in superficial esophageal squamous cell carcinoma with a focus on evaluation of lympho-vascular invasion

Mitobe, Jimi; Ikegami, Machiko; Urashima, Mitsuyoshi; Takahashi, Hiroyuki; Goda, Kenichi; Tajiri, Hisao

doi:10.3109/00365521.2013.832365

Cited by 34 publications

(35 citation statements)

References 23 publications

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“…This might be attributable to the small number of cancer‐related deaths and/or recurrences (especially in single‐institution cohorts) among patients with such small cancers. It is of note that five studies (Teramoto et al ., Nakagawa et al ., Landau et al ., Ito et al ., and Mitobe et al …”

Section: Discussionmentioning

confidence: 97%

Prognostic value of tumour budding in oesophageal cancer: a meta‐analysis

et al. 2015

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Recently, tumour budding (TB) has been suggested as a strong prognostic marker in oesophageal cancer. The aim of this systematic review is to test the prognostic value of TB in oesophageal cancer by a meta-analysis of previously published studies. We systematically reviewed the literature related to TB by using the bibliographic databases of Scopus, PubMed, and Web of Science. The search was limited to publications in the English language up to and including December 2014. There are 11 retrospective studies in which TB has been evaluated in oesophageal cancer. Two authors independently extracted the results from eligible studies. The meta-analysis of eligible studies revealed that TB is a significant prognosticator for overall survival in oesophageal cancer, with a risk ratio (RR) of 2.97 [95% confidence interval (CI) 1.81-4.85; P = 0.0023] in univariate analysis, and with an RR of 2.07 (95% CI 1.22-3.52; P = 0.017) in multivariate analysis. We conclude that a high TB score is a promising prognostic marker of poor survival in oesophageal cancer. Because of its simplicity, reproducibility and high predictive power, TB is strongly recommended to be included in the routine pathology report of oesophageal cancer.

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Section: Discussionmentioning

confidence: 97%

Prognostic value of tumour budding in oesophageal cancer: a meta‐analysis

et al. 2015

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“…Other features have been found to be prognostic assessment of patients with ESCC. In this regard, the presence of tumor size, differentiation, location, performance status of patient, tumor infiltration depth, lymph node status and distant metastasis have a major role, and are extensively utilized in clinical setting [4], [10]–[11], [14], [17]–[23].…”

Section: Discussionmentioning

confidence: 99%

“…In a more recent study, Kitagawa et al investigated the prognostic value of epidermal growth factor receptor (EGFR) gene amplification in patients with ESCC and found that vascular invasion was proved to retain independent prognostic value [12]. Importantly, vascular invasion in superficial ESCC is also found to be a strong independent predictor of lymph node metastasis with an odds ratio of 12.01 [14]. Notably other published reports show no significantly prognostic value for vascular invasion to predict the outcome in patients with ESCC [15]–[16].…”

Section: Discussionmentioning

confidence: 99%

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Prognostic Significance of the pN Classification Supplemented by Vascular Invasion for Esophageal Squamous Cell Carcinoma

Zhu

Ling

et al. 2014

PLoS ONE

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BackgroundThe biological behavior and clinical outcome of esophageal squamous cell carcinoma (ESCC) are difficult to predict.Methodology/Principal FindingsWe investigate the prognostic impact of vascular invasion to establish a risk stratification model to predict recurrence and overall survival. We retrospectively evaluated the vascular invasion of 433 patients with ESCC treated with surgery between 2000 and 2007 at a single academic center. Those patients were assigned to a testing cohort and a validation cohort by random number generated in computer. The presence of vascular invasion was observed in 113 of 216 (52.3%) and 96 of 217 (44.2%) of ESCC in the training and validation cohorts, respectively. Further correlation analysis demonstrated that vascular invasion in ESCC was significantly correlated with more advanced pN classification and stage in both cohorts (P<0.05). Additionally, presence of vascular invasion in ESCC patients was associated closely with poor overall and recurrence-free survival as evidenced by univariate and multivariate analysis in both cohorts (P<0.05). In the subset of ESCC patients without lymph node metastasis, vascular invasion was evaluated as a prognostic predictor as well (P<0.05). More importantly, the combined prognostic model with pN classification supplemented by vascular invasion can significantly stratify the risk (low, intermediate and high) for overall survival and recurrence-free survival in both cohorts (P<0.05). The C-index to the combined model showed improved predictive ability when compared to the pN classification (0.785 vs 0.739 and 0.689 vs 0.650 for the training and validation cohorts, respectively; P<0.05).Conclusions/SignificanceThe examination of vascular invasion could be used as an additional effective instrument in identifying those ESCC patients at increased risk of tumor progression. The proposed new prognostic model with the pN classification supplemented by vascular invasion might improve the ability to discriminate ESCC patients’ outcome.

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“…It is not defined either dominant histopathological grade or the highest grade should be adopted. Although I admit that histopathological grading surely has close relation to the probability of lymph node involvement in T1a-MM and T1b tumors, more detailed discussion is necessary on this issue (20)(21)(22). Though this grouping would have been defined so that the prognoses can be properly stratified, it should be database-restricted, and i.e., therapeutic measurerestricted.…”

Section: Pathological Prognostic Groupmentioning

confidence: 99%

Comparison of two major staging systems of esophageal cancer—toward more practical common scale for tumor staging

Udagawa¹,

Ueno²

2018

Ann. Transl. Med.

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The latest 8th edition of TNM Classification of Malignant Tumours by Union for InternationalCancer Control (UICC) and 11th edition of Japanese Classification of Esophageal Cancer by Japan Esophageal Society (JES) are the two major classifications widely accepted as tools for clinical staging of esophageal cancer. Both systems consist of three main categories, i.e., T, N, and M, but large difference exists between the two. JES system has more detailed sub-classification of T1 tumors reflecting meticulous work by Japanese investigators on superficial esophageal cancer. N-category shows the largest difference. UICC defines the N-category according to only the number of the metastatic regional lymph nodes. The definition of regional nodes in UICC system is static and uniform, and supraclavicular nodes are definitely excluded. In JES system, regional nodes are subgrouped into five different patterns according to the main tumor location, and the supraclavicular nodes are always regional nodes for thoracic esophageal cancer. Japanese surgeons have described the evidence that regional nodes should be dynamically defined according to tumor location and supraclavicular nodes should be included in regional nodes. Compared to the simplified N-category, the staging matrix of UICC system is somewhat complicated. The clinical stage and pathological stage of UICC system are not identical and difference exists also between squamous cell carcinoma (SCC) and adenocarcinoma. It has another system of pathological prognostic grouping. We can imagine several reasons for the difference occurred between the two systems. One is the difference of major pathology. Another reason is the difference of basic concept of cancer treatment. The relative "dependence" on radical surgery in Japan has required the detailed definition of each lymph node station and the evaluation of "efficacy index" of each station. The strict and detailed definition of lymph node stations has been regarded as an obstacle to those who are not familiar with it. Some simplification can be done but maintaining dynamic definition of regional lymph nodes linked to tumor location. If UICC system can accept this concept, I think the two systems can be unified to realize more practical and useful staging system as an international common language.

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Clinicopathological investigation of lymph node metastasis predictors in superficial esophageal squamous cell carcinoma with a focus on evaluation of lympho-vascular invasion

Cited by 34 publications

References 23 publications

Prognostic value of tumour budding in oesophageal cancer: a meta‐analysis

Prognostic value of tumour budding in oesophageal cancer: a meta‐analysis

Prognostic Significance of the pN Classification Supplemented by Vascular Invasion for Esophageal Squamous Cell Carcinoma

Comparison of two major staging systems of esophageal cancer—toward more practical common scale for tumor staging

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