The presence of metastases in regional lymph nodes is associated with tumor size and depth of invasion in sporadic gastric adenocarcinoma

Abstract

BackgroundGastric adenocarcinoma is more often found in men over 50 years in the form of an antral lesion. The tumor has heterogeneous histopathologic features and a poor prognosis (median survival of 15% in five years).AimTo estimate the relationship between the presence of nodal metastasis and other prognostic factors in sporadic gastric adenocarcinoma.MethodWere evaluated 164 consecutive cases of gastric adenocarcinoma previously undergone gastrectomy (partial or total), without clinical evidence of distant metastasis, and determined the following variables: topography of the lesion, tumor size, Borrmann macroscopic configuration, histological grade, early or advanced lesions, Lauren histological subtype, presence of signet ring cell, degree of invasion, perigastric lymph node status, angiolymphatic/perineural invasion, and staging.ResultsWere found 21 early lesions (12.8%) and 143 advanced lesions (87.2%), with a predominance of lesions classified as T3 (n=99/60, 4%) and N1 (n=62/37, 8%). The nodal status was associated with depth of invasion (p<0.001) and tumor size (p<0.001). The staging was related to age (p=0.048), histological grade (p=0.003), and presence of signet ring cells (p = 0.007), angiolymphatic invasion (p = 0.001), and perineural invasion (p=0.003).ConclusionIn gastric cancer, lymph node involvement, tumor size and depth of invasion are histopathological data associated with the pattern of growth/tumor spread, suggesting that a wide dissection of perigastric lymph nodes is a fundamental step in the surgical treatment of these patients.

Breast Cancer Metastasis in the Stomach: When the Gastrectomy Is Indicated ?

“…The most common aspect of presentation of these metastases in the stomach is linitis, affecting muscle layer and submucosae at maximum rate of 73% of cases 1 , 3 , 4 , 5 , 7 .…”

“…Subsidiary examinations like upper endoscopy, computerized tomography scans or positron emission tomography must be part of the diagnostic effort. However, they have lower specificity 6 , 7 , 8 , 9 , 15 , 20 .…”

“…It suggests breast cancer metastasis considering that only 50-64% of adenocarcinomas of the stomach present this molecule 8 , 10 , 11 . On the other hand, CK20 antibody presence favors the diagnoses of primary cancers from stomach, large bowel and pancreas 7 , 10 , 13 , 15 , 19 . In this study, was verified an endorsement of this immunohistochemistry profile that means positivity for estrogen receptor, progesterone receptor and CK7 antibody and negativity for CK20 antibody.…”

“…However, metastases to the stomach are very unusual and there are a few studies on this subject 2 , 6 , 8 , 9 , 11 , 12 , 13 , 17 , 20 . When these metastases occur, diagnostic confirmation based on immunohistochemistry is needed 2 , 3 , 5 , 7 , 11 , 14 , 16 , 20 .…”

Assessment of lymphovascular invasion in gastric carcinoma; do they always indicate lymph node metastasis?

“…• macroscopic configuration of advanced lesions according to Borrmann's classification. 10 The paraffin blocks of each case were retrieved from store room. Standard pathological procedure was followed for all blocks.…”