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Results for “lymph node metastasis”

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PubMed1996

Pelvic lymph node metastasis in endometrial cancer with no myometrial invasion.

OBJECTIVE: To analyze the incidence of pelvic lymph node metastasis in endometrial carcinoma with no myometrial invasion. METHODS: Between 1971 and 1995, 684 women with stage I endometrial carcinoma underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph-adenectomy. The incidence of pelvic lymph node metastases in 100 cases without myometrial invasion was examined. RESULTS: Histologic examination of the surgical specimens revealed a single pelvic lymph node metastasis in each of four cases. The incidence of pelvic lymph node metastasis was four of 83 in grade 1, zero of 13 in grade 2, and zero of four in grade 3 tumors. CONCLUSION: Pelvic lymph node metastasis in endometrial cancer with no myometrial invasion is not rare, even with grade 1 tumors. Lymphadenectomies may be necessary in all patients with endometrial cancer, except when clinical or operative factors increase the procedure's risk of morbidity.

Adenocarcinoma↗

PubMed1991

[Immunohistochemical study of the extracellular matrix in non-small cell lung cancer: relation to lymph node metastasis and prognosis].

The distribution of type IV collagen and laminin in the basement membrane (BM), and fibronectin in the peritumoral stroma of 112 lung cancers (62 adenocarcinomas, 50 squamous cell carcinomas) was studied using immunohistochemical techniques to compare with tumor size, lymph node metastasis and prognosis. In normal lung tissues, type IV collagen and laminin stainings were continuously linear in bronchial BM, blood vessel BM, around bronchial gland and along alveolar septa. Immunoreactivity of fibronectin was shown in BM and stroma. In lung cancers, type IV collagen and laminin stainings were observed in continuous or discontinuous pattern around carcinoma cells, and partially unrecognizable. Staining patterns were divided into continuous (C) and discontinuous (D). And fibronectin patterns were divided into weakly and strongly positive. In relation between staining pattern and lymph node metastasis, in adenocarcinomas, C pattern of type IV collagen staining without lymph node metastasis occurred in 73.9% and with metastasis in 26.1%, on the other hand, D pattern without lymph node metastasis occurred in 25.6% and with metastasis in 74.4%. The correlation was statistically significant (p less than 0.01). And also, in squamous cell carcinomas, C pattern without lymph node metastasis seen in 71.4% and with metastasis in 28.6%, on the other hand, D pattern without lymph node metastasis seen in 27.6% and with metastasis in 72.4%. The correlation was statistically significant (p less than 0.01). But staining pattern of fibronectin didn't correlate to lymph node metastasis. In comparison between C and D patterns, C pattern was associated with longer survival than D pattern (p less than 0.01). In lung cancers without lymph node metastasis, C pattern tended to be higher in 5-year-survival than D pattern, but not significant. These findings suggest that staining pattern of type IV collagen and laminin might be correlated to cancer metastasis and useful to estimate the prognosis.

Adenocarcinoma↗

PubMed2006

Intrapulmonary lymph node metastasis and renal cell carcinoma.

Intrapulmonary lymph node metastasis occuring after nephrectomy for renal cell carcinoma is a particular recurrence modality. Authors report two male patients presenting with this recurrence 2 and 4 years after treatment of the primary and who underwent surgery. Surgery confirmed the diagnosis and demonstrated station 7 minimal metastases and positive pleural lavage cytology in both patients. The first patient survived 2 years and the second was alive disease free at 33 months follow-up. Such metastases probably originate from the thoracic duct. Resection confirms the diagnosis and may be part of the treatment.

Adult↗

PubMed1999

Assessment of cervical lymph node metastasis in esophageal carcinoma using ultrasonography.

OBJECTIVE: To evaluate the efficacy of ultrasonography for the diagnosis of cervical lymph node metastasis in esophageal carcinoma. SUMMARY BACKGROUND DATA: Ultrasound (US) examination is useful for diagnosing lymph node metastasis. However, few reports have examined its role in the decision to perform cervical lymph node dissection in esophageal carcinoma. METHODS: Ultrasound examination was performed to evaluate cervical lymph node metastasis in 519 patients with esophageal carcinoma. The patients were divided into 5 groups according to treatment received: group 1, 153 patients who underwent curative resection of primary tumor by right thoracotomy and complete bilateral cervical lymphadenectomy; group 2, 112 patients who underwent curative resection of primary tumor by right thoracotomy but without cervical lymphadenectomy; group 3, 78 patients who underwent esophagectomy by left thoracotomy or blunt dissection with or without removal of cervical lymph nodes; group 4, 76 patients with palliative resection without cervical lymphadenectomy; and group 5, 100 patients without any surgical treatment. US diagnosis was compared with histologic findings or cervical lymph node recurrence. RESULTS: Lymph node metastasis was detected in 30.8% of patients (160/519). The sensitivity, specificity, and accuracy of US diagnosis in group 1 were 74.5%, 94.1%, and 87.6%, respectively. Cervical lymph node recurrence was seen in 7 patients (4.6%) in group 1, in 4 patients (3.6%) in group 2, and 3 patients (3.8%) in group 3. Although the incidence of cervical lymph node metastasis as determined by US examination was high in groups 4 and 5, almost none of the patients died of cervical lymph node metastasis. CONCLUSIONS: Ultrasound examination plays a useful role in the decision to perform cervical lymph node dissection in patients with esophageal carcinoma, particularly in those with potentially curative dissection.

Esophageal Neoplasms↗

PubMed2001

Lymph node metastasis in cancer of the middle-third stomach: criteria for treatment with a pylorus-preserving gastrectomy.

A retrospective study was conducted to establish the criteria for performing a pylorus-preserving gastrectomy. This study was performed on 491 patients who had cancer of the middle-third stomach and had been curatively treated with a distal gastrectomy. The incidence of node metastasis for each lymph node station (the group of regional lymph nodes which have been anatomically defined and classified by the Japanese Classification of Gastric Carcinoma) was evaluated with reference to the depth of invasion, tumor size, and circumferential location, to show any significant correlations with an increase in tumor diameter or in the depth of tumor invasion. The benefits of resecting each station was then evaluated based on the incidence of metastasis to each station and the rate of long-term survivors among those with metastasis to each station. The benefit was substantial for the lymph nodes along the lesser curvature, along the right gastroepiploic artery, and at the base of the left gastric artery, while the advantages were almost negligible for the suprapyloric nodes and right paracardial nodes. In conclusion, carcinoma that fulfills either of the following conditions may thus be indicated to undergo a pylorus-preserving gastrectomy: (i) restricted to a depth of m or sml, (ii) a depth of sm2 or mp with a diameter of less than 2cm, (ii) a depth of sm2 or mp and located in the greater curvature.

Adult↗

PubMed1999

A human seminoma xenograft model with regional lymph node metastasis.

PURPOSE: To establish a seminoma orthotopic model with lymph node metastasis to investigate the factors related to the lymphophilic behavior of seminoma cells. MATERIALS AND METHODS: Testicular seminoma xenografts were established by the inoculation of small fragments from subcutaneous (s.c.) xenografts that had previously been established in severe combined immunodeficient (SCID) mice with a supraclavicular lymph node metastasis from a human seminoma. Hematologic dissemination of tumor cells was analyzed by polymerase chain reaction (PCR) amplification of the human beta-globin gene. Xenograft messenger RNA levels of metastasis-related genes were examined by reverse transcription (RT)-PCR. RESULTS: Testicular seminoma xenografts grew in 32/32 (100%) of the inoculated mice, of which 15 mice (47%) developed macroscopic metastasis to the renal hilar lymph node. Circulating tumor cells and tumor cell shedding in the lung and liver were detectable by PCR assay in 25/32 (78%), 32/32 (100%), and 27/32 (84%) mice, respectively, although metastatic foci were not histologically evident in these organs. Increased expression of matrix metalloproteinase-2 (MMP-2), membrane-type 3 matrix metalloproteinase (MT3-MMP) and vascular endothelial growth factor (VEGF), and reduction in expression of plasminogen activator inhibitor-2 (PAI-2) were demonstrated by RT-PCR assay in the testicular xenografts as compared with the s.c. xenografts. CONCLUSIONS: This model mimics the lymphophilic behavior of seminoma and may help in elucidating the molecular mechanism of tumor spread via the lymphatics.

Animals↗

PubMed2004

Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma.

AIM: The prognosis of early gastric carcinoma (EGC) is generally excellent after surgery. The presence or absence of lymph node metastasis in EGC is an important prognostic factor. The survival and recurrence rates of node-negative EGC are much better than those of node-positive EGC. This study examined the factors related to lymph node metastasis in EGC to determine the appropriate treatment for EGC. METHODS: We investigated 748 patients with EGC who underwent surgery between January 1985 and December 1999 at the Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hospital. Several clinicopathologic factors were investigated to analyze their relationship to lymph node metastasis: age, sex, tumor location, tumor size, gross type, histologic type, depth of invasion, extent of lymph node dissection, type of operation, and DNA ploidy. RESULTS: Lymph node metastases were found in 75 patients (10.0%). Univariate analysis showed that male sex, tumor size larger than 2.0 cm, submucosal invasion of tumor, histologic differentiation, and DNA ploidy pattern were risk factors for regional lymph node metastasis in EGC patients. However, a multivariate analysis showed that three risk factors were associated with lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion. No statistical relationship was found for age, sex, tumor location, gross type, or DNA ploidy in multivariate analysis. The 5-year survival rate was 94.2% for those without lymph node metastasis and 87.3% for those with lymph node metastasis, and the difference was significant (P<0.05). CONCLUSION: In patients with EGC, the survival rate of patients with positive lymph nodes is significantly worse than that of patients with no lymph node metastasis. Therefore, a standard D2 lymphadenectomy should be performed in patients at high risk of lymph node metastasis: large tumor size, undifferentiated histologic type and submucosal invasion.

Adult↗

PubMedDate not supplied

Lymph node metastasis in early gastric cancer: a clinicopathological analysis.

BACKGROUND/AIMS: Endoscopic mucosal resection and laparoscopic wedge resection have become more common in the treatment of early gastric cancer. However, lymph node metastasis is a major poor prognostic factor influencing tumor recurrence and survival. To predict the risk of lymph node metastasis in early gastric cancer, the authors conducted a study to investigate the clinicopathologic characteristics of early gastric cancer with lymph node metastasis. METHODOLOGY: From 1982 to 1998, 181 patients of early gastric cancer underwent primary surgery and were included in the study. Patient data was postoperatively reviewed regarding age, gender, tumor size, depth of invasion, histologic differentiation, macroscopic classification and anatomic level of lymph node metastasis. The chi 2 test or Student's t test was used for statistical analysis. Logistic regression analysis was used to evaluate the independent risk factors for lymph node metastasis. RESULTS: Lymph node metastasis was observed in 19 cases (11%). Early gastric cancer with size larger than 4 cm (P < 0.05), with submucosal invasion (P < 0.01), and with poor differentiation (P < 0.05) was associated with higher risk of lymph node metastasis. The macroscopic classification had no predictive value. Multivariate analysis showed that submucosal invasion correlated best with lymph node spread (OR 10.25, 95% CI: 2.10-49.96), followed by tumor size larger than 4 cm (OR 4.99, 95% CI: 1.46-17.05), and poorly differentiated histological subtype (OR 3.31, 95% CI: 1.16-9.45). CONCLUSIONS: Poor differentiation, submucosal invasion and large tumor size were independent risk factors for lymph node metastasis in early gastric cancer. Macroscopic classification was not correlated with lymph node metastasis.

Adult↗

PubMed2005

[Prediction of lymph node metastasis with binary logistic regression in gastric carcinoma].

OBJECTIVE: To investigate more specific markers to predict the lymph node metastasis in gastric carcinoma. METHODS: The expression of heparanase mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR) in 43 cases with gastric cancer. The expressions of CD44V6, MMP-7, nm23 and syndecan-1 protein were examined by streptavidin-peroxidase (SP) two-step method. Clinicopathological features influencing lymphatic metastasis such as age,sex,tumor size,tumor location, Borrmann classification, histological type, differentiation and serosal infiltration were also analyzed. RESULTS: Twenty-seven cases (62.8%) in 43 gastric cancer patients had lymphatic metastasis. The incidence of metastatic lymph nodes was(36.3 +/- 30.8)%. The median incidence was 19%. Univariate analysis showed that tumor size, serosal infiltration, expressions of heparanase mRNA, CD44V6, nm23 and syndecan-1 protein were risk factors for lymph node metastasis in gastric carcinoma. Multivariate analysis showed expressions of nm23 and syndecan-1 protein, serosal infiltration were independent factors for lymph node metastasis. CONCLUSION: Gastric cancer with serosal infiltration, positive expressions of nm23 and syndecan-1 has greater possibility of lymph node metastasis.

Biomarkers, Tumor↗

PubMed2004

Analysis of pathological risk factors for lymph node metastasis of submucosal invasive colon cancer.

There are currently no universally accepted indications and criteria for additional surgical resection of the colorectum after endoscopic resection of the submucosal invasive cancer. The purpose of the present study is to establish accurate indications and criteria for additional surgical resection of the colorectum, based on the prediction of lymph node metastasis, after endoscopic resection of the submucosal invasive cancer. We investigated 140 submucosal invasive colorectal cancers and analyzed the pathologic factors of lymph node metastasis. The tumors were evaluated for pathologic factors in the invasive area of the submucosal carcinoma and were compared between the cases with lymph node metastasis and those without lymph node metastasis. Lymph node metastasis was observed in 13 cases (9%). Univariate logistic regression analysis showed that the depth of invasion, cribriform-type structural atypia, absence of lymphoid infiltration, lymphatic permeation, and venous permeation were statistically significant as risk factors for lymph node metastasis. Multivariate logistic regression analysis showed that the important risk factors included, in decreasing order, lymphatic permeation, absence of lymphoid infiltration, cribriform-type structural atypia, venous permeation, and depth of invasion. Submucosal invasion of 2 mm or more, and/or, depth of lymphatic permeation of 2 mm or more are risk factors for lymph node metastasis. The pathologic criteria based on our results for additional colectomy enables greater accuracy selection of patients who will undergo further surgical treatment after endoscopic resection.

Algorithms↗

PubMed1998

Distribution of lymph node metastasis and level of inferior mesenteric artery ligation in colorectal cancer.

To investigate the distribution of lymph node metastasis along the inferior mesenteric artery (IMA) and clarify whether high ligation of the IMA is important or not, we examined the surgical results of 172 patients with cancer of the sigmoid colon and rectum. Histologically, lymph node metastasis was absent in 108 (63%) patients and present in 64 (37%) patients. The distribution was adjacent to the wall of the rectum (35.5%) and sigmoid colon (10.5%), along the IMA (7.7%) and sigmoid colic artery (6.3%), and at the root of the IMA (0.7%, 1 of 135 patients). The presence of lymph node metastasis was predicted by the operative findings of lymph node metastasis (p < 0.01) and serosal invasion (p < 0.05) and by the histologic type of tumor (p < 0.05). These results indicate that lymph node metastasis at the root of the IMA is rare, and complete removal of the pericolic and intermediate nodes (D2 dissection) without high ligation of the IMA is feasible for cancer of the sigmoid colon and rectum.

Adenocarcinoma↗

PubMed2002

Risk of lymph node metastasis in T1 carcinoma of the colon and rectum.

PURPOSE: Several recent reports of high local recurrence and lymph node metastasis in T1 carcinoma of the rectum prompted us to study the risk factors for lymph node metastasis in these lesions. METHODS: We reviewed the clinical records of 7,543 patients who underwent operative treatment for carcinoma of the colon and rectum from 1979 to 1995. Only patients with sessile T1 lesions who underwent colorectal resection were included in the study, yielding an analysis cohort of 353 patients. The following carcinoma-related variables were assessed: size, mucinous subtype, carcinomatous component, grade, site in colon and rectum, lymphovascular invasion, and depth of submucosal invasion. For the depth, the submucosa was divided into upper third (sm1), middle third (sm2), and lower third (sm3). Chi-squared tests and logistic regression were used to evaluate the variables as potential risk factors for lymph node metastasis. RESULTS: The incidence of T1 lesions was 8.6 percent. In the analysis cohort, the lymph node metastasis rate was 13 percent. Significant predictors of lymph node metastasis both univariately and multivariately were sm3 (P = 0.001), lymphovascular invasion (P = 0.005), and lesions in the lower third of the rectum (P = 0.007). Poorly differentiated carcinoma was significant univariately (P = 0.001) but not in the multivariate model. No other parameter was associated with a significant risk. CONCLUSIONS: T1 colorectal carcinomas with lymphovascular invasion, sm3 depth of invasion, and location in the lower third of the rectum have a high risk of lymph node metastasis. These lesions should have an oncologic resection. In a case of the lesion in the lower third of the rectum, local excision plus adjuvant chemoradiation may be an alternative.

Adenocarcinoma↗

PubMed1979

Enhancing effect of clamping of the portal vein on the effectiveness of antitumor agents against lymph node metastasis.

An experimental study was made on the suppressive effect on lymph node metastasis of an antitumor agent administered during the clamping of the portal vein. When mitomyaneously clamped, a higher concentration of the drug was detected in the mesenteric lymph nodes compared to the conventional intravenous administration. The growth of mesenteric lymph node metastasis was markedly suppressed by the combined use of mitomycin-C and portal vein clamping. These results suggest that the procedure applied in the present study directs a high concentration of antitumor preparations to the lymph nodes in the portal vein region, and thus is a good method for the suppression of lymph node metastasis.

Animals↗

PubMed2000

Histopathologic findings predicting lymph node metastasis and prognosis of patients with superficial esophageal carcinoma: analysis of 240 surgically resected tumors.

BACKGROUND: If it were possible to elucidate the histopathologic findings predicting lymph node metastasis and prognosis in superficial squamous cell carcinoma of the esophagus (SSCCE), they could be used as markers to identify patients who do not require additional surgical resection after endoscopic mucosal resection (EMR). METHODS: Two hundred forty surgically resected SSCCEs were examined histopathologically. Histopathologic factors including vertical tumor invasion depth in the submucosal layer (VTIDsm), degree of nuclear atypia (low, one point; high, two points), growth pattern (expansive, one point; infiltrative, two points), and histologic grade (calculated by adding the latter two scores to obtain Grade 1, two points; Grade 2, three points; and Grade 3, four points) were evaluated to investigate the associations among these factors, lymph node metastasis, and prognosis. RESULTS: No lymph node metastasis was found in 54 patients with carcinoma limited to the lamina propria. Their 5-year survival rate was 100%. Multivariate analysis of 186 carcinomas invading beyond the lamina propria showed that lymphatic permeation correlated with lymph node metastasis (P<0.0001) and the presence of lymph node metastasis and a high histologic grade were independent factors indicating a poor prognosis (P = 0.0061 and 0.023, respectively). In 53 patients whose tumors had invaded the lamina muscularis or slightly invaded the submucosa (VTIDsm <500 microm), no lymph node metastasis was found in the lymphatic permeation negative and blood vessel permeation negative patients with VTIDsm values <200 microm and histologic Grades 1 or 2. CONCLUSIONS: Lymphatic permeation is a good predictor of lymph node metastasis in patients with SSCCE. Lymph node metastasis and the histologic grade are independent prognostic factors. Vessel permeation, VTIDsm, and histologic grade were found to be important factors for identifying patients who did not require additional surgical treatment after EMR.

Biomarkers, Tumor↗

PubMed1994

[A clinical study on lymph node metastasis of renal pelvic and ureteral cancers].

A clinical study was performed on 38 patients with renal pelvic and ureteral cancers who were treated in our hospital between 1977 and 1992. Nine patients (23.7%) had lymph node metastasis. The risk factors of lymph node metastasis were high grade, high stage and class IV or V or urine cytology. None of the patients with G1 or under pT1 had lymph node metastasis. The 5-year survival rate of the patients without [lymph node metastasis was 76.7% and that of the patients with lymph node metastasis was 11.1%. Although 6 of the 9 patients with G1 or G2 and under pT1 did not have adjuvant therapy, none of them died of the cancer. We concluded that lymph node metastasis in renal pelvic and ureteral cancers was the most important prognostic factor and that regional lymphadenectomy might be useful for the decision of adjuvant therapy.

Adult↗

PubMed1999

[Diagnostic value of ultrasonography in cervical lymph node metastasis].

OBJECTIVE: To research the accuracy of ultrasonography in the diagnosis of cervical lymph node metastasis and the value of that of cervical lymph node occult metastasis. METHOD: Fifty-five patients(61 sides) operated by neck dissection were double-blindedly studied by preoperation palpation and ultrasonography comparing with postoperating pathological examination. RESULT: Fifty-two sides were confirmed to be pathology lymph node metastasis from 61 sides. 40 and 48 sides were checked out by palpation and ultrasonography, respectively. The sensitivity, specificity and accuracy of palpation and ultrasonography were 76.9% and 92.3% (P < 0.05), 77.8% and 88.9%(P > 0.05) and 77.0% and 91.8%(P < 0.05), respectively. Six sides were checked out by ultrasonography (occult metastasis) in 12 sides of palpation negative. CONCLUSION: The accuracy of ultrasonography was prior to that of palpation in examining cervical lymph node metastsis. Ultrasonography could check out about half occult metastasis and should be regarded as a routine examining items in diagnosing cervical lymph node metastasis.

Adult↗

PubMed1988

Detection of the mediastinal lymph nodes metastasis in lung cancer by endoscopic ultrasonography.

Mediastinal lymph nodes metastasis of lung cancer was analysed by endoscopic ultrasonography in 96 patients in whom histological diagnosis of the lymph nodes could be proven by thoracotomy. A Receiver Operating Characteristic (ROC) curve was drawn up for determining the criteria for metastatic lymph nodes by endoscopic ultrasonography. The ROC curve was evaluated by using four parameters: The long diameter, the short diameter, the long diameter plus the short diameter, and the product of the long diameter times the short diameter. The long plus short diameter and the long-times-short diameter showed the highest detectability of the metastasis of all histological types on the ROC curve. The reasonable criteria levels were found to be 18 mm and 75 mm2 by means of a moderate threshold. In this level, sensitivity were 77%, 76%; specificity 84%, 84%; and accuracy 82%, 82%, respectively. When examinations were done by histological types, the criteria level for the epidermoid carcinoma should be increased to more than that for the adenocarcinoma. And, sensitivity and specificity were better in the epidermoid carcinoma. Thus, these results suggest that endoscopic ultrasonography is clinically useful for the detection of lymph nodes metastasis in lung cancer.

Adenocarcinoma↗

PubMed2006

A combination of molecular markers accurately detects lymph node metastasis in non-small cell lung cancer patients.

Occult lymph node metastasis (micrometastasis) is a good prognostic indicator in non-small cell lung cancer (NSCLC) and could be used to direct adjuvant chemotherapy in stage I patients. This study was designed to evaluate molecular markers for detection of occult lymph node metastasis in NSCLC, define the best marker or marker combination to distinguish positive from benign lymph nodes, and evaluate these markers in lymph nodes from pathologically node-negative (pN(0)) NSCLC patients. Potential markers were identified through literature and database searches and all markers were analyzed by quantitative reverse transcription-PCR in a primary screen of six NSCLC specimens and 10 benign nodes. Selected markers were further evaluated on 21 primary NSCLC specimens, 21 positive nodes, and 21 benign nodes, and the best individual markers and combinations were identified. A combination of three markers was further validated on an independent set of 32 benign lymph nodes, 38 histologically positive lymph nodes, and 462 lymph nodes from 68 pN(0) NSCLC patients. Forty-two markers were evaluated in the primary screen and eight promising markers were selected for further analysis. A combination of three markers (SFTPB, TACSTD1, and PVA) was identified that provided perfect classification of benign and positive nodes in all sample sets. PVA and SFTPB are particularly powerful in tumors of squamous and adenocarcinoma histologies, respectively, whereas TACSTD1 is a good general marker for NSCLC metastasis. The combination of these genes identified 32 of 462 (7%) lymph nodes from 20 of 68 (29%) patients as potentially positive for occult metastasis. Long-term follow-up will determine the clinical relevance of these findings.

Antigens, Neoplasm↗