Lymph node examination among patients with gastric cancer: Variation between departments of pathology and prognostic impact of lymph node ratio

Lemmens, Valery; Dassen, Anneriet E.; Wurff, A.A.M. van der; Coebergh, Jan Willem; Bosscha, K.

doi:10.1016/j.ejso.2011.03.005

Cited by 28 publications

(18 citation statements)

References 30 publications

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“…Furthermore, various factors such as different surgical techniques and pathological assessments have made standardized lymph node staging difficult. To overcome these problems, some investigators have proposed the metastatic lymph node rate (Katai et al, 2004;Marchet et al, 2007;Xu, 2010;Lemmens et al, 2011). In line with previous studies, it was showed that higher rate of lymph node metastasis was related to poor prognosis.…”

Section: Discussionmentioning

confidence: 70%

Validity and Necessity of Sub-classification of N3 in the 7^thUICC TNM Stage of Gastric Cancer

Zhang

Liang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: The 7 th TNM staging is the first authoritative standard for evaluation of effectiveness of treatment of gastric cancer worldwide. However, revision of pN classification within TNM needs to be discussed. In particular, the N3 sub-stage is becoming more conspicuous. Methods: Clinical data of 302 pN3M0 stage gastric cancer patients who received radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital from January 2001 to May 2006 were retrospectively analyzed. Results: Location of tumor, depth of invasion, extranodal metastasis, gastric resection, combined organs resection, lymph node metastasis, rate of lymph node metastasis, negative lymph nodes count were important prognostic factors of pN3M0 stage gastric cancers. TNM stage was also associated with prognosis. Patients at T2N3M0 stage had a better prognosis than other sub-classification. T3N3M0 and T4aN3aM0 patients had equal prognosis which followed the T2N3M0. T4aN3bM0 and T4bN3aM0 had lower survival rate than the formers. T4bN3bM0 had worst prognosis. In multivariate analysis, TNM stage group and rate of lymph node metastasis were independent prognostic factors. Conclusions: The sub-stage of N3 may be useful for more accurate prediction of prognosis; it should therefore be applied in the TNM stage system.

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Section: Discussionmentioning

confidence: 70%

Validity and Necessity of Sub-classification of N3 in the 7^thUICC TNM Stage of Gastric Cancer

Zhang

Liang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Other studies demonstrated that the prognosis of the patients was associated with the absolute number of positive lymph nodes when the lymph node sampling was sufficient (16 required by TNM, AJCC 7th edition); however, the metastatic lymph node ratio and log odds of positive lymph nodes may be used to better assess prognosis when lymph node sampling was inadequate (31,32). In addition to the status of lymph node metastasis, the factors affecting the prognosis of gastric cancer also included TNM stage, depth of tumor infiltration, vascular invasion and nerve invasion (33,34).…”

Section: Discussionmentioning

confidence: 99%

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Luo

Zhang

Zhao

et al. 2016

Molecular and Clinical Oncology

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Abstract. In order to investigate the clinical value of different chemotherapies, the efficacy of intensity-modulated radiation therapy with concurrent chemotherapy following D2 radical surgery for gastric carcinoma was evaluated in this study. A total of 102 patients who underwent D2 radical surgery for gastric carcinoma followed by concurrent chemoradiotherapy (CRT) between January, 2008 and March, 2012, were selected. The 5/7 field intensity-modulated radiation therapy was used, with a planning target volume dose of 45 Gy in 25 fractions over 5 weeks. Among these patients, 45 were administered 400 mg̸m 2 ̸day fluorouracil and 20 mg̸m 2 ̸day tetrahydrofurfuryl alcohol through intravenous infusion 4 days before and 3 days after the radiotherapy (F-CRT group), while 57 patients received 825 mg/m 2 capecitabine orally twice a day (C-CRT group). The 3-year overall and the disease-free survival rates were 75.5 and 70.5%, respectively. The overall 3-year survival rates of the F-CRT and C-CRT groups were 72.2 and 78.5% (P>0.05), respectively, and the 3-year disease-free survival rates were 67.7 and 72.8% (P>0.05), respectively. No significant differences were observed between the two groups. However, during the concurrent CRT, significant differences were found in the incidence of grade 1-2 haematological toxicity between the F-CRT and C-CRT groups (73.3 vs. 50.9%, respectively; χ 2 =5.320, P= 0.021). Significant differences were also found in the incidence of grade 1-2 gastrointestinal reactions between the two groups (77.8 vs. 57.9%, respectively; χ 2 = 4.474, P= 0.034). Therefore, intensity-modulated radiation therapy combined with concurrent chemotherapy following D2 radical surgery for gastric cancer was found to be safe and effective.In addition, radiotherapy was better tolerated and more likely to be completed using C-CRT rather than F-CRT.

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“…2,6,8,9,[14][15][16][17][18][19][20][21] Few authors have specifically evaluated the value of LNR in patients with less than 15 nodes included in the surgical specimen. 12,13,22 Sun et al examined 2,159 patients to detect how the number of retrieved lymph nodes influences survival both in pN and LNR staging system. They found that compared with patients with more than 30 retrieved nodes, OS was significantly decreased for pN1 patients with less than 15 nodes, pN2 with less than 20 nodes, and pN3 with less than 25 nodes.…”

Section: Commentsmentioning

confidence: 99%

Does lymph node ratio affect prognosis in gastroesophageal cancer?

Melis

Masi

Pinna

et al. 2015

The American Journal of Surgery

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Lymph node examination among patients with gastric cancer: Variation between departments of pathology and prognostic impact of lymph node ratio

Cited by 28 publications

References 30 publications

Validity and Necessity of Sub-classification of N3 in the 7^thUICC TNM Stage of Gastric Cancer

Validity and Necessity of Sub-classification of N3 in the 7^thUICC TNM Stage of Gastric Cancer

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Does lymph node ratio affect prognosis in gastroesophageal cancer?

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Lymph node examination among patients with gastric cancer: Variation between departments of pathology and prognostic impact of lymph node ratio

Cited by 28 publications

References 30 publications

Validity and Necessity of Sub-classification of N3 in the 7thUICC TNM Stage of Gastric Cancer

Validity and Necessity of Sub-classification of N3 in the 7thUICC TNM Stage of Gastric Cancer

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Does lymph node ratio affect prognosis in gastroesophageal cancer?

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Validity and Necessity of Sub-classification of N3 in the 7^thUICC TNM Stage of Gastric Cancer

Validity and Necessity of Sub-classification of N3 in the 7^thUICC TNM Stage of Gastric Cancer