Prognostic Value of Immunohistochemically Identifiable Tumor Cells in Lymph Nodes of Patients with Completely Resected Esophageal Cancer

Izbicki, Jakob R.; Hosch, Stefan B.; Pichlmeier, Uwe; Rehders, Alexander; Busch, Christoph; Niendorf, Axel; Passlick, Bernward; Broelsch, Christoph E.; Pantel, Klaus

doi:10.1056/nejm199710233371702

Cited by 340 publications

(264 citation statements)

References 25 publications

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“…There is a strong body of evidence suggesting that immunohistochemically detected micrometastatic deposits in oesophageal cancer are associated with reduced survival and increased risk of disease recurrence [55][56][57][58][59][60][61][62][63][64][65]. Several studies have identified micrometastatic spread to be an independent prognostic indicator in oesophageal adenocarcinoma [35,39,41,43,66] and it has been postulated that these micrometastatic deposits may help to explain why up to 50% of histologically nodenegative oesophageal cancer patients develop recurrence, despite a curative resection of the primary tumour [67,68].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…These micrometastatic deposits can be detected with immunohistochemical analysis using monoclonal antibodies to stain tumour-specific antigens or using Polymerase Chain reaction (PCR) at the molecular level [37][38][39][40][41][42][43][44]. It is unclear whether these nodal micrometastases represent tumour cells with metastatic potential or just shredded cells, which will be cleared by the immune system or remain dormant in a non-proliferating phase [39,45].…”

Section: Micrometastases In Lymph Nodesmentioning

confidence: 99%

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Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Kayani

Zacharakis

Ahmed

et al. 2011

European Journal of Surgical Oncology (EJSO)

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Oesophageal cancer is the seventh most common cause of cancer-related death in the developed world and the incidence of oesophageal adenocarcinoma is now the fastest growing of any gastrointestinal cancer. Lymph node involvement is the single most important prognostic factor in oesophageal cancer. Imaging to determine the extent of lymph node involvement and plan treatment often requires a combination of modalities to avoid under-staging. The seventh edition of the staging system released by the International Union Against Cancer (IUCC) has stratified lymph node involvement according to the number of lymph nodes involved and redefined its groupings for location of metastatic lymph node involvement. This review discusses the prognostic and treatment implications of these modifications and explores micrometastatic lymph node involvement, capsular infiltration and lymph node ratio as possible additions to the staging system.

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Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Section: Micrometastases In Lymph Nodesmentioning

confidence: 99%

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Kayani

Zacharakis

Ahmed

et al. 2011

European Journal of Surgical Oncology (EJSO)

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“…Glickman et al 21 did not ®nd a correlation between the presence of occult lymph node metastasis and poor survival for patients with oesophageal cancer. In contrast, Izbicki et al 8 and Natsugoe et al 9 have found nodal micrometastases to be a signi®cant indicator of a poorer prognosis after oesophagectomy. The authors' previous study was consistent with the ®ndings of the latter authors 7 .…”

Section: Discussionmentioning

confidence: 90%

Significance of immunohistochemical nodal micrometastasis as a prognostic indicator in potentially curable oesophageal carcinoma

Komukai

Nishimaki

Suzuki

et al. 2002

British Journal of Surgery

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Background: The number of positive lymph nodes is an important prognostic predictor in patients with oesophageal cancer. However, the signi®cance of nodal micrometastasis in patients with overt nodal metastasis is unknown. The aim of this study was to clarify the clinical implications of nodal micrometastasis in patients undergoing curative oesophagectomy for oesophageal cancer.Methods: Cervical, mediastinal and abdominal lymph nodes systematically removed from 104 patients with oesophageal cancer were examined immunohistochemically to detect cells that stained positively for cytokeratins with the monoclonal antibody cocktail AE1/AE3. The postoperative course and survival rates were compared among patients with and without micrometastases, after numerical classi®cation of overt metastatic nodes (none, between one and four, ®ve or more).Results: Univariate analysis showed T stage, nodal micrometastasis and number of overt nodal metastases to be signi®cant prognostic factors after oesophagectomy. Multivariate analysis revealed nodal micrometastasis and number of overt nodal metastases to be independent prognostic factors. The presence of micrometastases had a signi®cant adverse effect on postoperative survival in patients with no overt metastasis and in patients with one to four overt metastatic nodes, but no such impact in patients with ®ve or more overt metastatic nodes.Conclusion: Assessment of nodal status by both histological examination for overt metastases and immunohistochemical examination for micrometastases is useful in stratifying patients undergoing curative oesophagectomy.

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“…Da mesma forma, Komukai et al 14 , encontraram maior índice de recorrência em pacientes com câncer de esôfago e micrometástases em linfonodos, além de menor sobrevida, em comparação a pacientes sem doença micrometastática. Por outro lado, Glickman et al e Nakamura et al 5,10,22 , não encontraram relação entre micrometástases e prognóstico no câncer de esôfago. Um importante ponto de discussão no estudo das micrometástases é a metodologia de detecção.…”

Section: Considerações Finaisunclassified

Novas perspectivas no estadiamento e tratamento do câncer de esôfago

Fonseca

Furlan

Ferranti

et al. 2007

ABCD, arq. bras. cir. dig.

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InTRODUÇÃOO câncer de esôfago apresenta-se como uma das neoplasias mais freqüentes e letais. Nas últimas décadas sua incidência vem aumentando consideravelmente com altas taxas de mortalidade em vários países. A doença predomina em faixas etárias avançadas, com maior ocorrência entre a sexta e sétima década de vida, e no sexo masculino, com razão de 4:1 em relação ao minino .Sua incidência varia geograficamente. É alta sobretudo em países como a China, Japão, Turquia, Cingapura A taxa de sobrevida geral após cinco anos é de aproximadamente 10% nas populações ocidentais, em contraste com a de 4% observada na década de 1970 . Apesar desta melhora na sobrevida, seu prognóstico continua insatisfatório e seu tratamento merece novos estudos na busca de melhores resultados.A classificação TNM é utilizada para determinar o grau de disseminação da doença e auxiliar na estimativa do prognóstico, levando em consideração principalmente o número de linfonodos acometidos. Kunisaki et al. 15 , através de 113 esofagectomias, compararam 5 métodos de estadiamento diferentes, observando que os que consideravam o número de linfonodos acometidos ao invés dos padrões de distribuição anatômica das metástases linfonodais, obtiveram melhor relação entre estadiamento e prognóstico. A presença de metástases linfonodais é vista, em muitos estudos, como um fator prognóstico independente. Estes estudos ressaltam a grande importância da realização de estadiamento linfonodal o mais acurado possível.Os métodos atualmente utilizados para ele no pré-operatório são o ultrassom endoscópico, tomografia computadorizada helicoidal e a tomografia com emissão de pósitrons. Ainda assim, estes métodos apresentam baixa

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Prognostic Value of Immunohistochemically Identifiable Tumor Cells in Lymph Nodes of Patients with Completely Resected Esophageal Cancer

Abstract: Immunohistochemical examination of lymph nodes may improve the pathological staging of esophageal cancer.

Cited by 340 publications

References 25 publications

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Significance of immunohistochemical nodal micrometastasis as a prognostic indicator in potentially curable oesophageal carcinoma

Novas perspectivas no estadiamento e tratamento do câncer de esôfago

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