Discrepancy between clinical and pathological lymph node evaluation in Epstein-Barr virus-associated gastric cancers.

H Ojima; T Fukuda; T Nakajima; S Takenoshita; Y Nagamachi

PubMed · 8920771

Discrepancy between clinical and pathological lymph node evaluation in Epstein-Barr virus-associated gastric cancers.

H Ojima·T Fukuda·T Nakajima·S Takenoshita·Y Nagamachi

Abstract

We investigated the clinicopathological characteristics of EBV-associated gastric cancers among poorly differentiated gastric adenocarcinomas. A total of 412 patients with poorly differentiated gastric adenocarcinoma were studied for Epstein-Barr virus (EBV) infection by in situ hybridization for EBV-encoded small RNA. EBV genomes were detected in the tumor cell nuclei of 83 gastric cancers (20.1%). Of these EBV-positive cancers, 60 were histologically classified as gastric carcinoma with lymphoid stroma. Comparing various clinicopathological data with EBV status in gastric cancers revealed a significantly large discrepancy between the clinical and pathological lymph node evaluation of the EBV-positive cancers as compared with that of EBV-negative cancers. These results indicated that a strong host immune reaction occurs in the regional lymph nodes of EBV-associated gastric cancers, and that surgeons should be warned against clinically overestimating the stage of EBV-associated gastric cancer.

Explore related subjects

Adenocarcinoma Adult Aged Aged, 80 and over Female Herpesviridae Infections Herpesvirus 4, Human Humans In Situ Hybridization Lymph Nodes Male Middle Aged Neoplasm Invasiveness Sex Distribution Stomach Neoplasms Tumor Virus Infections Journal Article

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

H Ojima, T Fukuda, T Nakajima, S Takenoshita, Y Nagamachi. Discrepancy between clinical and pathological lymph node evaluation in Epstein-Barr virus-associated gastric cancers.. https://pubmed.ncbi.nlm.nih.gov/8920771/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

The case for routine use of adjuvant therapy in pancreatic cancer.

Pancreatic cancer is a devastating disease with a poor prognosis for most patients. Surgical resection remains the cornerstone of treatment, providing the only realistic hope of long-term survival. Even with optimal surgical management, 5-year survival averages 15% to 20% for resectable disease. Progress is being made, however. Currently, the benefits of postoperative therapy for resected pancreatic ductal adenocarcinoma appear clear, and recommendations for such therapy appear to us to be well justified. Additional benefit to patients awaits the development of new agents, molecular targeted drugs, and novel approaches such as immunotherapy.

Adenocarcinoma↗

PubMed2007

Proposal for a new definition of true cardia carcinoma.

BACKGROUND AND OBJECTIVES: It remains controversial whether cardia carcinoma should be categorized and treated as esophageal cancer or gastric cancer. The purpose of this study was to develop a reasonable definition of cardia carcinoma. METHODS: Patients with Siewert type II carcinomas were divided into two subgroups: 25 patients with a tumor center within 1 cm of the esophagogastric junction (EGJ) (type IIA) and 22 patients with tumor center 1-2 cm aboral of the EGJ (type IIB). Patients with subcardia carcinomas, 40 with invasion to the EGJ (type III) and 110 without (type IIIe-), were used as controls. RESULTS: The patients with type IIB carcinomas showed no different characteristics from those with type III or type IIIe- carcinomas, except for the stage of the disease. On the other hand, those with type IIA carcinomas were associated with a higher male/female ratio, higher incidences of elevated appearance, differentiated histology, and mediastinal node metastasis, and a significantly lower survival rate as compared with patients with subcardia carcinomas. Multivariate survival analysis revealed that type IIA is a significant prognostic determinant, but that type IIB is not. CONCLUSION: Type IIA carcinomas should be treated as true cardia carcinoma; type IIB as subcardia carcinoma. Our results should be confirmed by a prospective study.

Adenocarcinoma↗

PubMed2007

Favorable indications for hepatectomy in patients with liver metastasis from gastric cancer.

BACKGROUND: The prognosis of patients with liver metastasis from gastric cancer (LMGC) is dismal. The purpose of this study was to review our recent outcomes of hepatectomy for LMGC and to determine the suitable candidates for surgery. STUDY DESIGN: The outcomes of 37 patients with LMGC who underwent hepatectomy between 1990 and 2005 were assessed. No extrahepatic distant metastasis and feasibility of macroscopic curative resection were requisite indications for surgery. The prognostic values of clinicopathological factors were assessed by univariate and multivariate analyses. RESULTS: There was no in-hospital mortality. The median survival time and overall 5-year survival rate after hepatectomy of the patients with LMGC were 31 months and 11%, respectively. Intrahepatic recurrence following hepatectomy was found in 23 patients (62%). Variables independently associated with poor survival were bilobar metastasis (P = 0.002, CI = 1.9-16.3) and a maximum tumor diameter of >or= 4 cm (P = 0.006, CI = 1.4-7.7). The depth of the primary tumor and the timing of metastasis were not associated with survival. CONCLUSIONS: Surgical resection for LMGC may be indicated in patients with unilobar metastasis and/or tumors less than 4 cm in diameter. Synchronous metastasis is not a contraindication for hepatectomy.

Adenocarcinoma↗