Tumor infiltration pattern into the surrounding tissue has prognostic significance in advanced gastric cancer

Saito, Hiroaki; Miyatani, Kozo; Takaya, Seigo; Kuroda, Hirohiko; Matsunaga, Tomoyuki; Osaki, Tomohiro; Ikeguchi, Masahide

doi:10.1007/s00428-015-1811-y

Cited by 15 publications

(18 citation statements)

References 17 publications

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“…INF can be easily determined using only hematoxylin and eosin‐stained sections . However, there have been a few recent studies focusing on the clinical significance of INF in gastric cancer . In the present study, we revalidated the impact of pathological INF on prognosis and recurrence patterns after curative gastrectomy in patients with stage II/III gastric cancer using a large multicenter dataset.…”

Section: Discussioncontrasting

confidence: 67%

“…Our findings suggest that INF‐c type gastric cancer tends to grow out of the stomach wall directly by skipping the lymphatic and blood vascular systems, and that INF‐a/b type gastric cancer causes lymphatic involvement and vascular invasion in parallel with growth outside the stomach wall. It has been reported that INF‐c is closely linked to other risk factors for peritoneal metastasis such as Borrmann type 4 tumors, poorly differentiated tumors, and serosal invasion . However, our multivariate analysis revealed that INF‐c was an independent risk factor for peritoneal recurrences.…”

Section: Discussioncontrasting

confidence: 67%

“…In East Asia, pathological INF has long been routinely evaluated in surgically resected specimens . INF can be easily determined using only hematoxylin and eosin‐stained sections .…”

Section: Discussionmentioning

confidence: 99%

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Pathological tumor infiltrative pattern and sites of initial recurrence in stage II/III gastric cancer: Propensity score matching analysis of a multi‐institutional dataset

et al. 2018

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BackgroundAdvanced gastric cancer frequently recurs even after radical resection followed by adjuvant chemotherapy. The aim of this study was to evaluate the relationship between pathological infiltrative pattern (INF) and initial recurrence patterns in patients with stage II/III gastric cancer using a large multicenter database.MethodsWe retrospectively analyzed 1098 eligible patients who underwent curative gastrectomy for stage II/III gastric cancer at nine institutions between 2010 and 2014. Patients were categorized into the INF‐a/b and INF‐c groups and adjusted using propensity score matching.ResultsAfter propensity score matching, 686 patients (343 for each) were classified in the INF‐a/b and INF‐c groups. There were no significant differences in overall and disease‐free survival between the two groups. In the INF‐a/b group, frequencies of recurrence at the peritoneum, lymph node, and liver were equivalent. In contrast, the peritoneum was the most frequent site and accounted for 60% of the total recurrences in the INF‐c group. The cumulative peritoneal recurrence rate was significantly higher in the INF‐c group than in the INF‐a/b group (hazard ratio 2.47). INF‐c was a significant risk factor for peritoneal recurrences in most subgroups including age, sex, macroscopic type, tumor differentiation, and disease stage, and whether the postoperative treatment was given. Multivariate analysis identified INF‐c as an independent risk factor for peritoneal recurrences. The cumulative liver recurrence rate was significantly higher in the INF‐a/b group than in the INF‐c group (hazard ratio 3.44).ConclusionsINF may represent an important predictor of recurrence patterns after curative resection of stage II/III gastric cancer.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussioncontrasting

confidence: 67%

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Pathological tumor infiltrative pattern and sites of initial recurrence in stage II/III gastric cancer: Propensity score matching analysis of a multi‐institutional dataset

et al. 2018

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“…This correlates well with the absence of corresponding markers of cytotoxicity, such as perforin and granzyme B. We are prone to believe that this immunosuppressive activity is performed by SRC cells through the selective release of cytokines, which by a paracrine action inhibit the recruitment of T-killer or N-killer lymphocytes, potentially active against the neoplastic elements [7]. This equally takes place in the lymphatic structures of the gastric wall and of the metastatic lymph nodes.…”

Section: Resultssupporting

confidence: 54%

Deep inside of gastric signet-ring cell carcinoma

Roncati¹,

Manenti²,

Barbolini³

et al. 2018

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The histology of signet-ring cell carcinoma (SRC) of the stomach has been revisited with the support of current immuno- histochemical techniques in order to explain particular features of this tumor; its great capacity of local diffusion and lymph node metastasis, also through a neo-lymphoangiogenesis. An observational retrospective study on 50 cases of SRC in stage II and III has been performed with the addition of histochemical (Alcian Blue, DDD-Fast Blue B, Mercury Orange) and immunohistochemical (cytocheratin, CD3, CD4, CD8, CD10, CD56, CD68, perforin, granzyme B, podoplanin, collagen type IV) investigations for each case. The signet ring cells, typical for this tumor, show abundant content of electro-negative sialomucins and demonstrate a great capacity of diffusion through the gastric wall. They evoke production and deposition of collagen type IV in the sub-mucosa layer through the local action of fibroblasts. The immunological response to this tumor in the gastric wall and in the metastatic lymph nodes is represented by an increase of B and T-helper lymphocytes, but not of T-killers or natural killers. The neoplastic cells are curiously able to avoid these newly formed 'lymph nodules'. An extended neo-lymphangiogenesis has been observed around the primary tumor and in metastatic lymph nodes. A careful immunohistochemical characterization has allowed a better knowledge of SRC, regarding especially the peculiar behavior of local diffusion of its cells, the associated neo-lymph angiogenesis, and poor immunological reaction.

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“…Song et al reported that this pattern type was associated with the poorer prognosis in patients with T3 gastric cancer (17). Saito et al reported that lymph node involvement, but not the pattern type, is a prognostic factor in T3 gastric cancer (18). The report by Soga et al is the only recent study of the horizontal width of tumor invasion into the subserosal layer in T3 gastric cancer (11).…”

Section: Discussionmentioning

confidence: 99%

inical Implication of the Width of Subserosal Invasion in T3N0 Gastric Cancer

Nakamura

Tomioku

Nabeshima

et al. 2017

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Abstract. Background: The aim of this study was to clarify the impact of the horizontal width of tumor invasion into the subserosal layer on prognosis in patients withIn Japan, gastric cancer is treated according to the Japanese gastric cancer treatment guidelines 2014 (1). According to the guidelines, the standard treatment for curatively resectable advanced gastric cancer with invasion of the subserosa (T3) and no lymph node metastasis (N0) is surgery alone. However, a certain proportion of these patients develop recurrence, and nearly all patients with recurrence die of their disease. Therefore, it is considered to be of crucial clinical importance to identify the subset of patients with poor prognosis in this group.Tumor diameter, lymphatic invasion, venous invasion, etc., have been considered as prognostic factors in patients with T3N0 gastric cancer (2-6). Opinions regarding the prognostic factors are divided, and no consensus has been reached. Therefore, in this study, we paid attention to the status of tumor invasion at the invasive front. Many studies of the status of tumor invasion at the invasive front have investigated changes in the serosal surface in patients with gastric cancer invading the serosa (7-10). However, there have been few studies investigating the status of tumor invasion into the subserosal layer in gastric cancer with invasion of the subserosa (11). Therefore, in the present study, we assessed the status of tumor invasion into the subserosal layer in T3N0 gastric cancer and investigated the possibility of its being a prognostic factor. Patients and MethodsPatients. Between January 2006 and December 2015, 884 consecutive patients with gastric cancer underwent curative gastrectomy at the Department of Gastroenterological Surgery of Tokai University School of Medicine. Of these patients, the data of 72 in whom the histological examination revealed pT3N0 were analyzed in this retrospective study. The gross classification and histopathological classification were based on the Japanese Classification of Gastric Carcinoma published by the Japanese Gastric Cancer Association (JCGC) (12). Staging was performed according to the American Joint Committee on Cancer staging manual seventh edition (13). Patients were mainly followed-up on an outpatient basis at our hospital; however, those who had moved to other institutions were asked relevant questions by telephone. Follow-up was continued until June 2016, with a median duration of follow-up of 1574 days (range=82-4373 days). Diagnosis of tumor recurrence was based on clinical grounds. In patients with suspected recurrence, further investigations were performed. In some patients, the initial recurrence was diagnosed at two or more sites, and in such patients, all of the sites were counted as sites of initial recurrence.Definition of width of subserosal invasion and clinicopathological parameters. The resected stomach was opened and placed on a flat board with the mucosal side up, and fixed in 10% formalin. After 409

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Tumor infiltration pattern into the surrounding tissue has prognostic significance in advanced gastric cancer

Cited by 15 publications

References 17 publications

Pathological tumor infiltrative pattern and sites of initial recurrence in stage II/III gastric cancer: Propensity score matching analysis of a multi‐institutional dataset

Pathological tumor infiltrative pattern and sites of initial recurrence in stage II/III gastric cancer: Propensity score matching analysis of a multi‐institutional dataset

Deep inside of gastric signet-ring cell carcinoma

inical Implication of the Width of Subserosal Invasion in T3N0 Gastric Cancer

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