The impact of the largest metastasis size on nodal tumor burden in colorectal carcinomas: implications for the sentinel lymph node theory in cancers of the large intestine

Vinh-Hung, Vincent; Vajda, Kornél; Svébis, Mihály

doi:10.1002/jso.20725

Cited by 1 publication

(1 citation statement)

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“…This overdispersion of involved ALNs was described by Guern and colleagues and is known as "infectivity", that is, the more involved ALNs a person has, the greater the risk that the same person will subsequently have more involved ALNs 23 . Bori and colleagues also described this phenomenon in colorectal cancer 25 . A cascade process, which we believe is more appropriate than an infection-type process, is easy to understand because lymph nodes are not isolated organs but are interconnected through a complete lymphatic network.…”

Section: Discussionmentioning

confidence: 87%

A negative binomial regression model for risk estimation of 0–2 axillary lymph node metastases in breast cancer patients

Zeng

Lin

Zhang

et al. 2020

Sci Rep

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Extensive clinical trials indicate that patients with negative sentinel lymph node biopsy do not need axillary lymph node dissection (ALND). However, the ACOSOG Z0011 trial indicates that patients with clinically negative axillary lymph nodes (ALNs) and 1–2 positive sentinel lymph nodes having breast conserving surgery with whole breast radiotherapy do not benefit from ALND. The aim of this study is therefore to identify those patients with 0–2 positive nodes who might avoid ALND. A total of 486 patients were eligible for the study with 212 patients in the modeling group and 274 patients in the validation group, respectively. Clinical lymph node status, histologic grade, estrogen receptor status, and human epidermal growth factor receptor 2 status were found to be significantly associated with ALN metastasis. A negative binomial regression (NBR) model was developed to predict the probability of having 0–2 ALN metastases with the area under the curve of 0.881 (95% confidence interval 0.829–0.921, P < 0.001) in the modeling group and 0.758 (95% confidence interval 0.702–0.807, P < 0.001) in the validation group. Decision curve analysis demonstrated that the model was clinically useful. The NBR model demonstrated adequate discriminative ability and clinical utility for predicting 0–2 ALN metastases.

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Section: Discussionmentioning

confidence: 87%