Value of MRI morphologic features with pT1‐2 rectal cancer in determining lymph node metastasis

Tang, Yanlin; Rao, Sheng-Xiang; Yang, Chun; Hu, Yabin; Sheng, Ruofan; Zeng, Mengsu

doi:10.1002/jso.25173

Cited by 11 publications

(6 citation statements)

References 27 publications

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“…A maximum ILN diameter of > 1.0 cm is usually considered abnormal, while a diameter > 1.5 cm, with a relatively hard texture, strongly indicates tumor metastasis [16]. The present study suggested that the largest diameter of the enlarged ILNs was an independent risk factor, corroborating studies by Tang et al [17] and Zhou et al [6]. However, in another study, 50% of enlarged ILNs were in amed or reactive, rather than metastatic [14], indicating that ILN metastasis cannot be reliably detected using imaging or clinical evaluation.…”

Section: Discussionsupporting

confidence: 89%

Analysis of the related risk factors of inguinal lymph node metastasis in patients with penile cancer: A cross-sectional study

et al. 2022

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Background: To determine independent predictors of inguinal lymph node(ILN) metastasis in patients with penile-cancer.Patients and methods: We retrospectively analyzed all patients with penile-cancer undergoing surgery at our medical center in ten years(N=157). Using univariate and multivariate logistic-regression models, we assessed associations between the following factors: age, medical-history, phimosis, onset-time, number and maximum diameter of involved ILNs, pathological T stage, degree of tumor differentiation and/or corni cation, lymphatic vascular in ltration(LVI), nerve in ltration, and ILN metastases. Interaction and strati ed analyses were then used to assess age, phimosis, onset-time, number of ILNs, corni cation, and nerve in ltration.Results: Ultimately, 110 patients were included. Multiple logistic-regression analysis showed that the following factors were signi cantly correlated with ILN metastasis: maximum diameter of enlarged ILNs, T stage, pathological differentiation, and LVI. Among patients with a maximum ILN diameter of ≥1.5 cm, 50%(19/38) had LNM(HR=2.3, 95%CI: 1.0-5.1), whereas only 30.6%(22/72) of patients with a maximum ILN diameter <1.5 cm showed LNM. Among 44 patients with stage Ta/T1, 10(22.7%) showed ILN metastases, while 31 of 66(47.0%) patients with stage T2 showed ILN metastases(HR=3.0, 95%CI: 1.3-7.1). Among 40 patients with highly differentiated penile-cancer, eight(20%) showed ILN metastasis, while 33 of 70(47.1%) patients with low-to-middle differentiation showed ILN metastases(HR=3.6, 95%CI: 1.4-8.8). In the LVI-free group, the rate of LNM was 33.3%(32/96), whereas it was 64.3%(9/14) in the LVI group(HR=3.6, 95%CI: 1.1-11.6).Conclusion: Our single-center results suggested that maximum ILN diameter, pathological T stage, pathological differentiation, and LVI were independent risk factors for ILN metastases.

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Section: Discussionsupporting

confidence: 89%

Analysis of the related risk factors of inguinal lymph node metastasis in patients with penile cancer: A cross-sectional study

et al. 2022

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“…Therefore, we incorporated the imaging parameters of the largest ILN into the nomogram. Our multivariate logistic regression analysis showed that only SD of the largest ILN was an independent risk factor of ILNM, which is supported by the study of Tang et al (19). Merely imaging examination by CT or MRI cannot detect tumor metastasis in palpable ILNs accurately, but imaging parameters combined with pathologic findings of primary tumor can predict ILNM more accurately.…”

Section: Discussionsupporting

confidence: 85%

“…Our nomograms suggested that tumor grade and LVI were associated with ILNM in PC patients with clinically positive nodes, which is supported by the researches of Peak et al (17) and Bhagat et al (18). Large size, round or irregular shape, heterogeneous signal and irregular border of the nodes were also associated with the tumor metastasis in LNs (19,20). Therefore, we incorporated the imaging parameters of the largest ILN into the nomogram.…”

Section: Discussionmentioning

confidence: 99%

Nomograms to predict the presence and extent of inguinal lymph node metastasis in penile cancer patients with clinically positive lymph nodes

et al. 2020

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Background: We developed two nomograms to predict the presence of inguinal lymph node metastasis (ILNM) and two or more histologically positive inguinal lymph nodes (ILNs) or one ILN with extranodal extension (ENE) in penile cancer patients with clinically positive inguinal lymph nodes (ILNs).Methods: This study enrolled 75 penile squamous cell carcinoma (PSCC) patients with clinically positive ILNs. A binary logistic regression model was taken to screen out the risk factors for the presence of ILNM and two or more positive ILNs or one node with ENE in one side. Nomograms were plotted based on the results of multivariate logistic regression analysis.Results: Our multivariate analysis demonstrated that the pathological grade, lymphovascular invasion (LVI), and short diameter (SD) of the largest ILN were independent risks. The bootstrap-corrected concordance index of the nomogram for the presence of ILNM was 0.948, and 0.878 for two or more histologically positive ILNs or one ILN with ENE on one side.Conclusions: By incorporating tumor pathological grade, LVI and SD of the largest ILN, our nomograms can efficiently predict the ILNM in penile cancer patients with clinically positive nodes.

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“…However, MRI is less accurate for estimating lymph node status, although certain findings (heterogeneous signal intensity and irregular margins) are usually indicative of lymph node involvement with tumor [10]. Tang et al demonstrated that other MRI findings, namely, the diameter of the largest lymph node and the tumor percent enhancement on the arterial phase were independent risk factors of lymph node positivity in early rectal cancer patients (p = 0.005 vs 0.021, respectively) [11]. Hopefully with improvements in radiographic assessment of mesorectal lymph node status and the involvement of dedicated radiologists who review all rectal cancer MRIs and participate in multidisciplinary tumor discussions, the decision-making process for patients with clinically early stage rectal cancer will be more refined.…”

Section: Patient Selectionmentioning

confidence: 99%

Rectal Cancer: Local Excision

Monson

Hoedema

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Concepts• Local excision of biopsy-proven rectal cancer requires en bloc full-thickness dissection. • Predictors of lymph node metastases include tumor depth, lymphovascular invasion, poor differentiation, and tumor budding. • Local recurrence rates for T2 rectal cancers treated with neoadjuvant therapy and local excision appear similar to those of T1 cancers treated with local excision alone. • Transanal endoscopic surgery techniques including transanal endoscopic microsurgery (TEM) and transanal minimally invasive surgery (TAMIS) may improve surgical outcomes as compared to standard transanal excision techniques.

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Value of MRI morphologic features with pT1‐2 rectal cancer in determining lymph node metastasis

Abstract: The largest lymph node's diameter and the tumor percent enhancement of arterial phase on MRI were helpful in determining LNM in pT1-2 rectal cancer.

Cited by 11 publications

References 27 publications

Analysis of the related risk factors of inguinal lymph node metastasis in patients with penile cancer: A cross-sectional study

Analysis of the related risk factors of inguinal lymph node metastasis in patients with penile cancer: A cross-sectional study

Nomograms to predict the presence and extent of inguinal lymph node metastasis in penile cancer patients with clinically positive lymph nodes

Rectal Cancer: Local Excision

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