Liver metastasis in gastric cancer with particular reference to lymphatic advancement

Kumagai, Koshi; Tanaka, Takayuki; Yamagata, Kensuke; Yokoyama, Noboru; Shimizu, Katsuyoshi

doi:10.1007/pl00011738

Cited by 39 publications

(32 citation statements)

References 18 publications

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“…One year later the same authors showed that extranodal invasion is also a significant risk factor for liver metastasis in patients with gastric cancer. 22 In accordance to these findings, a significant correlation of extracapsular lymph node involvement and distant metastasis also could be demonstrated in our study (Table 1).…”

Section: Discussionsupporting

confidence: 91%

“…But up to this time, only a few studies have reported on extracapsular lymph node involvement in relation to gastric cancer. 13,[21][22][23][24][25] In 2000, Tanaka et al compared clinicopathological features of 56 gastric cancer patients with peritoneal metastasis to those of 61 gastric cancer patients without peritoneal metastasis in reference to extranodal invasion of the resected lymph nodes. 21 In this study, a highly significant relationship between extranodal invasion and peritoneal metastasis was observed.…”

Section: Discussionmentioning

confidence: 99%

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Extracapsular lymph node spread

Alakus

Hölscher

Grass

et al. 2009

Cancer

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BACKGROUND: Lymphatic spread is 1 of the most relevant prognostic factors for gastric carcinoma. The current International Union Against Cancer (UICC) pN staging system is based on the number of metastatic lymph nodes and does not take into consideration the characteristics of the metastatic lymph nodes itself. The aim of the current study was to examine the prognostic value of extracapsular lymph node involvement in gastric cancer and to find correlations with clinicopathological parameters. METHODS: Tissue samples were obtained from 159 gastric cancer patients who underwent gastrectomy with D2-lymphadenectomy in 142 (89.3%) cases and subtotal gastrectomy with D2-lymphadenectomy in 17 (10.7%) cases. The number of resected lymph nodes, number of metastatic lymph nodes, and number of metastatic lymph nodes with extracapsular lymph node involvement were determined. Extracapsular spread was defined as infiltration of cancer cells beyond the capsule of the metastatic lymph node. RESULTS: Ninetysix (60.4%) patients had lymph node metastasis. In 57 (35.8%) cases, extracapsular lymph node involvement was also detected. Extracapsular lymph node involvement was significantly associated with higher pN-category (P < .001), higher pM category (P ¼ .048), and higher UICC stages (P ¼ .001). According to the Kaplan-Meier log-rank statistical method, extracapsular lymph node involvement was significantly associated with poor survival (P ¼ .001). In the multivariate analysis besides pT (P < .001) and R-category (P ¼ .009), extracapsular lymph node involvement also remained as an independent prognostic factor (P ¼ .003), whereas the UICC pN-category (P ¼ .822) lost its prognostic value. CONCLUSIONS: Extracapsular lymph node involvement is associated with higher tumor stages and is an independent negative prognostic factor in gastric cancer. In future staging systems for gastric cancer, extracapsular lymph node involvement should be considered. Cancer 2010;116:309-15.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Extracapsular lymph node spread

Alakus

Hölscher

Grass

et al. 2009

Cancer

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“…Tumor metastasis is promoted by communication between tumor and immune cells through the vasculature including lymphatic vessels [19]. Lymphatic spread is closely related to peritoneal dissemination and liver metastasis of gastric cancer [20,21]. These reports indicate that cancer cells that lead to liver metastasis and peritoneal dissemination might have the strong ability to escape from anti-tumor immunity.…”

Section: Discussionmentioning

confidence: 99%

Differential Impact of the Neutrophil-Lymphocyte Ratio on the Survival of Patients with Stage IV Gastric Cancer

et al. 2014

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Background and Aim: The neutrophil to lymphocyte ratio (NLR) may be related to progression in several cancers. The aim of this study was to investigate the impact of pretreatment NLR in advanced gastric cancer on the prognosis of the patients stratified by metastatic pattern. Methods: We retrospectively investigated clinical data from 191 patients with stage IV gastric cancer who had undergone surgery for primary gastric cancer between 1997 and 2010 at the Department of Surgical Oncology of Osaka City University. Results: All patients had unresectable metastatic factors including peritoneal metastasis (P) and liver metastasis (H). Sixty-one (32%) patients had more than two unresectable factors. We determined a cutoff value of 2.5 for the NLR to be optimal to discriminate the patient's characteristics and divided patients into low (<2.5) and high (>2.5) NLR group for subsequent analysis. In the low NLR group, long survival was found in patients with H, P, or multiple site metastases. Conclusion: Our results suggest that NLR well reflects the progression of critical metastasis and surgical resection might improve prognosis for patients with low NLR. In conclusion, NLR might be used as a predictive marker to decide on surgical therapy for patients with Stage IV gastric cancer. i 2014 S. Karger AG, Basel

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“…In particular, the prognosis seems to be significantly worsened by greater extent of hepatic involvement (H3) or macroscopic peritoneal dissemination (P1) detected at surgical exploration, by greater number (>1) and size of hepatic metastases in H1-2 and P0 patients [61,62,95,96], by greater tumor size (T4), nodal involvement (N+ independently by the extension of the metastatic spread) or higher grading (G3) [63,80,97], and the timing of liver metastases diagnosis if metachronous to the primary tumor diagnosis [68,70,91]. Therefore, these factors should be considered as possible confounding factors in the future studies.…”

Section: Liver Metastases From Gastric Cancermentioning

confidence: 99%

Surgical Indications, Timing, and Strategy in Non-colorectal Liver Metastases

Uzzau¹,

Bertozzi²,

Londero³

et al. 2015

Recent Advances in Liver Diseases and Surgery

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Taking into consideration all primary solid tumors, the liver represents the most common site involved in distant metastasization, also due to its important blood reception from the majority of digestive organs. Despite the abundant literature and guidelines about colorectal liver metastases, there is still great debate about the treatment strategy in the case of non-colorectal ones. Therefore, in this chapter, we reviewed the treatment strategy and surgical indications for the most frequent non-colorectal liver metastases. In the case of neuroendocrine hepatic secondaries, the literature suggests that surgery should be always considered for patients with resectable hepatic disease, as this treatment results more likely to offer the best long-term outcome. For what concerns liver metastases from gastric cancer, surgical approach should always be undertaken if indications are appropriate, after a multidisciplinary discussion to plan an adequate multidisciplinary adjuvant treatment, a proper patient selection, and the exclusion of additional secondary tumors or extrahepatic metastases. Taking into consideration liver secondaries from breast cancer and their chemosensitivity, in the absence of brain and lung lesions, it can be considered a space for liver surgery, especially in the case of single lesions or a maximum of two lesions with dimensions within 3 cm. However, as the number of cancer survivors is progressively increasing and, with it, the number of patients affected by non-colorectal liver metastases, further randomized controlled trials are required in order to better define the benefit of hepatic surgery in these kinds of patients.

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Liver metastasis in gastric cancer with particular reference to lymphatic advancement

Cited by 39 publications

References 18 publications

Extracapsular lymph node spread

Extracapsular lymph node spread

Differential Impact of the Neutrophil-Lymphocyte Ratio on the Survival of Patients with Stage IV Gastric Cancer

Surgical Indications, Timing, and Strategy in Non-colorectal Liver Metastases

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