Significance of lymph node micrometastasis in pN0 hilar bile duct carcinoma

Taniguchi, Koichi; Tabata, Masami; Iida, Takuya; Hori, T.; Yagi, Shintaro; Üemoto, Shinji

doi:10.1016/j.ejso.2005.11.006

Cited by 13 publications

(15 citation statements)

References 23 publications

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“…And MM was significantly associated with tumor size and lymphatic invasion. Many studies have proved that there are two types micrometastases in lymph nodes: single-cell type and clustered-cell type [13,14]. This can be explained by invoking the concept of tumor cell dormancy [15].…”

Section: Discussionmentioning

confidence: 99%

Adverse prognosis of clustered‐cell versus single‐cell micrometastases in pN0 early gastric cancer

Cao

Zhang

et al. 2010

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Adverse prognosis of clustered‐cell versus single‐cell micrometastases in pN0 early gastric cancer

Cao

Zhang

et al. 2010

Journal of Surgical Oncology

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“…They identified para-aortic, but not regional lymph node micrometastasis in 1 patient. Taniguchi et al [16] detected micrometastasis in 11 (39.2%) of 28 patients and in 14 (3.3%) of 423 lymph nodes obtained from pN0 hilar bile duct carcinoma. Among the 11 patients with lymph node micrometastasis, 10 included the regional lymph nodes, and 1 included regional and para-aortic lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical significance of immunohistochemically detected lymph node micrometastasis for cancers of the breast [1,2], lung [3,4,5], esophagus [6,7], stomach [8,9] and colon [10,11,12] has been evaluated, whereas little has been published regarding biliary cancer [13], including hilar bile duct [14,15,16], gallbladder [17,18,19,20] and ampullary [21] carcinoma. However, whether or not the presence of lymph node micrometastasis relates to prognosis is controversial.…”

Section: Introductionmentioning

confidence: 99%

Para-Aortic Lymph Node Micrometastasis in Patients with Node-Negative Biliary Cancer

et al. 2011

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Background/Aims: The presence of para-aortic lymph node metastasis in biliary cancer negatively impacts prognosis. The present study aims to immunohistochemically identify and evaluate the clinical significance of para-aortic lymph node micrometastases in 66 patients who had undergone curative resection of biliary cancer. Methods: We used an antibody against cytokeratins 7 and 8 (CAM5.2) to immunostain 529 para-aortic lymph nodes that were negative according to conventional analysis from 66 patients with biliary cancer. Results: We detected CAM5.2-positive occult carcinoma cells in para-aortic lymph nodes from 3 (5%) of the 66 patients and in 3 (0.6%) of the 529 para-aortic lymph nodes. One of the 3 patients also had micrometastasis in the regional lymph nodes. All 3 patients with para-aortic lymph node micrometastasis are alive at 45, 48 and 90 months after surgery despite having locally advanced cancer. Conclusions: Occult cancer cells were identified in para-aortic lymph nodes from 5% of patients with node-negative biliary cancer, yet these patients have survived over the long term. The presence of para-aortic nodal micrometastasis might not have an influence on survival. However, further studies using a greater number of patients are required to support this notion.

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“…The possible reason for the poor outcome is existence of occult lymph node metastasis that cannot be detected by conventional hematoxylin and eosin staining at surgical resection [24,25] . Recently, immunohistochemical and molecular techniques have made it possible to identify lymph node micrometastasis missed by traditional methods, and Taniguchi et al [24,25] clearly demonstrated that occult lymph node metastasis is crucial for the prognosis of bile duct carcinomas including GB cancer. At present, we are still troubled about the additional treatment for occult T2 GB carcinoma after cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

“…At present, we are still troubled about the additional treatment for occult T2 GB carcinoma after cholecystectomy. For the time being, we will recommend the radical surgery including systematic lymph node dissection for this cancer, because of the excellent prognosis after additional radical surgery [1,2,13,15,16] and the possibility of lymph node micrometastasis [24,25] . This is the first case of spontaneous necrosis of solid GB adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous necrosis of solid gallbladder adenocarcinoma accompanied with pancreaticobiliary maljunction

Hori¹,

Wagata²,

Takemoto³

et al. 2008

WJG

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A 71-year-old Japanese man with acute cholecystitis and an incarcerated gallbladder (GB) stone was admitted. Plain ultrasonography (US) incidentally detected a mass-like lesion in the fundus. Doppler US revealed that this elevated lesion had no blood flow. Computed tomography showed a relatively low-density mass, measuring 5 cm x 4 cm in diameter, with no positive enhancement. Magnetic resonance imaging showed a mass in the fundus with a slightly low intensity on T1-weighted images and a slightly high intensity on T2-weighted images. We were agonized in making the qualitative diagnosis of mass-like lesions of the fundus, such as a benign tumor, cancer, or debris. We performed laparoscopic cholecystectomy, because the incarcerated GB stone clearly caused acute cholecystitis. Intra-operative cholangiography clearly revealed pancreaticobiliary maljunction. Amylase levels in the common bile duct and gallbladder were quite high. The elevated lesion in the fundus clearly showed severe necrosis. Although this necrotic nodule included non-viable adenocarcinoma cells, viable cancer cell nests were located in the muscularis propria and subcutaneous layer. Histopathological examination confirmed a solid adenocarcinoma. Thus, we diagnosed it as a gallbladder cancer, based on histopathological analysis of the resected specimen. We therefore undertook radical surgery, including wedge resection of the liver, radical dissection of regional lymph nodes, and resection of the extrahepatic bile duct. Histopathological findings revealed no cancer, hyperplasia or dysplasia in the additionally resected specimens. The patient was finally staged as T2, N0, H0, P0, M(-), stage Ⅱ. We present the first case of spontaneous necrosis of solid gallbladder adenocarcinoma, with a review of previous studies.

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Significance of lymph node micrometastasis in pN0 hilar bile duct carcinoma

Cited by 13 publications

References 23 publications

Adverse prognosis of clustered‐cell versus single‐cell micrometastases in pN0 early gastric cancer

Adverse prognosis of clustered‐cell versus single‐cell micrometastases in pN0 early gastric cancer

Para-Aortic Lymph Node Micrometastasis in Patients with Node-Negative Biliary Cancer

Spontaneous necrosis of solid gallbladder adenocarcinoma accompanied with pancreaticobiliary maljunction

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