Extra-perigastric Extranodal Metastasis is a Significant Prognostic Factor in Node-Positive Gastric Cancer
Background Extranodal metastasis is an isolated tumor nodule without a residual lymph node structure and has been reported as a poor prognostic factor in gastric cancer. The aim of this study is to assess the prognostic value of extranodal metastasis, especially from the viewpoint of its anatomical...
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| Veröffentlicht in: | World journal of surgery 2019-10, Vol.43 (10), p.2499-2505 |
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| creator | Tonouchi, Akiko Sugano, Masato Tokunaga, Masanori Sugita, Shizuki Watanabe, Masahiro Sato, Reo Kaito, Akio Akimoto, Tetsuo Ochiai, Atsushi Kinoshita, Takahiro Kuwata, Takeshi |
| description | Background
Extranodal metastasis is an isolated tumor nodule without a residual lymph node structure and has been reported as a poor prognostic factor in gastric cancer. The aim of this study is to assess the prognostic value of extranodal metastasis, especially from the viewpoint of its anatomical distribution.
Methods
A total of 139 consecutive gastric cancer patients who underwent curative surgery with lymph node metastasis between 2008 and 2009 were included. Clinicopathological features and patient survival outcomes were retrospectively assessed. Patients with extranodal metastasis were subdivided into two groups: perigastric extranodal metastasis, located near the perigastric area (#1–#7 according to the Japanese classification of gastric carcinoma 15th edition), and extra-perigastric extranodal metastasis, located alongside the major vessels (#8–#12).
Results
Extranodal metastasis was found in 51 patients (37%), and it was more frequent in those with bulky, ≥pT3, and pStage III tumors. All patients with extra-perigastric extranodal metastasis had recurrence, resulting in a 0% 5-year overall survival rate, which was significantly worse than that of patients with perigastric extranodal metastasis (59%), or those without extranodal metastasis (84%;
P
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| doi_str_mv | 10.1007/s00268-019-05076-x |
| format | Article |
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Extranodal metastasis is an isolated tumor nodule without a residual lymph node structure and has been reported as a poor prognostic factor in gastric cancer. The aim of this study is to assess the prognostic value of extranodal metastasis, especially from the viewpoint of its anatomical distribution.
Methods
A total of 139 consecutive gastric cancer patients who underwent curative surgery with lymph node metastasis between 2008 and 2009 were included. Clinicopathological features and patient survival outcomes were retrospectively assessed. Patients with extranodal metastasis were subdivided into two groups: perigastric extranodal metastasis, located near the perigastric area (#1–#7 according to the Japanese classification of gastric carcinoma 15th edition), and extra-perigastric extranodal metastasis, located alongside the major vessels (#8–#12).
Results
Extranodal metastasis was found in 51 patients (37%), and it was more frequent in those with bulky, ≥pT3, and pStage III tumors. All patients with extra-perigastric extranodal metastasis had recurrence, resulting in a 0% 5-year overall survival rate, which was significantly worse than that of patients with perigastric extranodal metastasis (59%), or those without extranodal metastasis (84%;
P
< 0.001). Multivariable analysis identified the presence of extra-perigastric extranodal metastasis as an independent poor prognostic factor.
Conclusions
Extranodal metastasis, especially extra-perigastric extranodal metastasis, was a pivotal poor prognostic factor in node-positive gastric cancer. Recognizing extra-perigastric extranodal metastasis would help provide optimal therapeutic options to these high-risk patients.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-019-05076-x</identifier><identifier>PMID: 31312947</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Blood vessels ; Cancer ; Cardiac Surgery ; Female ; Gastrectomy ; Gastric cancer ; General Surgery ; Humans ; Kaplan-Meier Estimate ; Lymph nodes ; Lymph Nodes - pathology ; Lymphatic Metastasis ; Lymphatic system ; Male ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - mortality ; Nodes ; Original Scientific Report ; Prognosis ; Recurrence ; Retrospective Studies ; Risk groups ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgery ; Survival ; Survival Rate ; Thoracic Surgery ; Treatment Outcome ; Tumors ; Vascular Surgery</subject><ispartof>World journal of surgery, 2019-10, Vol.43 (10), p.2499-2505</ispartof><rights>Société Internationale de Chirurgie 2019</rights><rights>2019 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5654-8c8c0e17f0e2dbbc1e9e731aa282e9904ac5003a408ac499cbf28606ff6467373</citedby><cites>FETCH-LOGICAL-c5654-8c8c0e17f0e2dbbc1e9e731aa282e9904ac5003a408ac499cbf28606ff6467373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-019-05076-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-019-05076-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31312947$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tonouchi, Akiko</creatorcontrib><creatorcontrib>Sugano, Masato</creatorcontrib><creatorcontrib>Tokunaga, Masanori</creatorcontrib><creatorcontrib>Sugita, Shizuki</creatorcontrib><creatorcontrib>Watanabe, Masahiro</creatorcontrib><creatorcontrib>Sato, Reo</creatorcontrib><creatorcontrib>Kaito, Akio</creatorcontrib><creatorcontrib>Akimoto, Tetsuo</creatorcontrib><creatorcontrib>Ochiai, Atsushi</creatorcontrib><creatorcontrib>Kinoshita, Takahiro</creatorcontrib><creatorcontrib>Kuwata, Takeshi</creatorcontrib><title>Extra-perigastric Extranodal Metastasis is a Significant Prognostic Factor in Node-Positive Gastric Cancer</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
Extranodal metastasis is an isolated tumor nodule without a residual lymph node structure and has been reported as a poor prognostic factor in gastric cancer. The aim of this study is to assess the prognostic value of extranodal metastasis, especially from the viewpoint of its anatomical distribution.
Methods
A total of 139 consecutive gastric cancer patients who underwent curative surgery with lymph node metastasis between 2008 and 2009 were included. Clinicopathological features and patient survival outcomes were retrospectively assessed. Patients with extranodal metastasis were subdivided into two groups: perigastric extranodal metastasis, located near the perigastric area (#1–#7 according to the Japanese classification of gastric carcinoma 15th edition), and extra-perigastric extranodal metastasis, located alongside the major vessels (#8–#12).
Results
Extranodal metastasis was found in 51 patients (37%), and it was more frequent in those with bulky, ≥pT3, and pStage III tumors. All patients with extra-perigastric extranodal metastasis had recurrence, resulting in a 0% 5-year overall survival rate, which was significantly worse than that of patients with perigastric extranodal metastasis (59%), or those without extranodal metastasis (84%;
P
< 0.001). Multivariable analysis identified the presence of extra-perigastric extranodal metastasis as an independent poor prognostic factor.
Conclusions
Extranodal metastasis, especially extra-perigastric extranodal metastasis, was a pivotal poor prognostic factor in node-positive gastric cancer. Recognizing extra-perigastric extranodal metastasis would help provide optimal therapeutic options to these high-risk patients.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Blood vessels</subject><subject>Cancer</subject><subject>Cardiac Surgery</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastric cancer</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Nodes</subject><subject>Original Scientific Report</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk groups</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkEtLAzEUhYMotj7-gAsZcB29ecxkxp2WtipVC1VchkyaKSl1UpOp1n9vdKruRAgkHM537s1B6IjAKQEQZwGAZjkGUmBIQWR4vYW6hDOKKaNsG3WBZTy-CeugvRDmAERkkO2iTpQILbjoonl_3XiFl8bbmQqNtzr5Umo3VYvk1jRRVMGGJB6VTOystpXVqm6SsXez2oUmEgOlG-cTWyd3bmrw2AXb2FeTDDeJPVVr4w_QTqUWwRxu7n30OOg_9K7w6H543bsYYZ1mKce5zjUYIiowdFqWmpjCCEaUojk1RQFc6RSAKQ650rwodFnRPH6rqjKeCSbYPjppc5fevaxMaOTcrXwdR0pK05wLTvJPF21d2rsQvKnk0ttn5d8lAflZr2zrlbFe-VWvXEfoeBO9Kp_N9Af57jMazlvDm12Y939EyqebyeUAAAoeYdbCIXL1zPjfxf_Y6QNJQ5f0</recordid><startdate>20191015</startdate><enddate>20191015</enddate><creator>Tonouchi, Akiko</creator><creator>Sugano, Masato</creator><creator>Tokunaga, Masanori</creator><creator>Sugita, Shizuki</creator><creator>Watanabe, Masahiro</creator><creator>Sato, Reo</creator><creator>Kaito, Akio</creator><creator>Akimoto, Tetsuo</creator><creator>Ochiai, Atsushi</creator><creator>Kinoshita, Takahiro</creator><creator>Kuwata, Takeshi</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20191015</creationdate><title>Extra-perigastric Extranodal Metastasis is a Significant Prognostic Factor in Node-Positive Gastric Cancer</title><author>Tonouchi, Akiko ; Sugano, Masato ; Tokunaga, Masanori ; Sugita, Shizuki ; Watanabe, Masahiro ; Sato, Reo ; Kaito, Akio ; Akimoto, Tetsuo ; Ochiai, Atsushi ; Kinoshita, Takahiro ; Kuwata, Takeshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5654-8c8c0e17f0e2dbbc1e9e731aa282e9904ac5003a408ac499cbf28606ff6467373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>Blood vessels</topic><topic>Cancer</topic><topic>Cardiac Surgery</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastric cancer</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Nodes</topic><topic>Original Scientific Report</topic><topic>Prognosis</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk groups</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tonouchi, Akiko</creatorcontrib><creatorcontrib>Sugano, Masato</creatorcontrib><creatorcontrib>Tokunaga, Masanori</creatorcontrib><creatorcontrib>Sugita, Shizuki</creatorcontrib><creatorcontrib>Watanabe, Masahiro</creatorcontrib><creatorcontrib>Sato, Reo</creatorcontrib><creatorcontrib>Kaito, Akio</creatorcontrib><creatorcontrib>Akimoto, Tetsuo</creatorcontrib><creatorcontrib>Ochiai, Atsushi</creatorcontrib><creatorcontrib>Kinoshita, Takahiro</creatorcontrib><creatorcontrib>Kuwata, Takeshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tonouchi, Akiko</au><au>Sugano, Masato</au><au>Tokunaga, Masanori</au><au>Sugita, Shizuki</au><au>Watanabe, Masahiro</au><au>Sato, Reo</au><au>Kaito, Akio</au><au>Akimoto, Tetsuo</au><au>Ochiai, Atsushi</au><au>Kinoshita, Takahiro</au><au>Kuwata, Takeshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extra-perigastric Extranodal Metastasis is a Significant Prognostic Factor in Node-Positive Gastric Cancer</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2019-10-15</date><risdate>2019</risdate><volume>43</volume><issue>10</issue><spage>2499</spage><epage>2505</epage><pages>2499-2505</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
Extranodal metastasis is an isolated tumor nodule without a residual lymph node structure and has been reported as a poor prognostic factor in gastric cancer. The aim of this study is to assess the prognostic value of extranodal metastasis, especially from the viewpoint of its anatomical distribution.
Methods
A total of 139 consecutive gastric cancer patients who underwent curative surgery with lymph node metastasis between 2008 and 2009 were included. Clinicopathological features and patient survival outcomes were retrospectively assessed. Patients with extranodal metastasis were subdivided into two groups: perigastric extranodal metastasis, located near the perigastric area (#1–#7 according to the Japanese classification of gastric carcinoma 15th edition), and extra-perigastric extranodal metastasis, located alongside the major vessels (#8–#12).
Results
Extranodal metastasis was found in 51 patients (37%), and it was more frequent in those with bulky, ≥pT3, and pStage III tumors. All patients with extra-perigastric extranodal metastasis had recurrence, resulting in a 0% 5-year overall survival rate, which was significantly worse than that of patients with perigastric extranodal metastasis (59%), or those without extranodal metastasis (84%;
P
< 0.001). Multivariable analysis identified the presence of extra-perigastric extranodal metastasis as an independent poor prognostic factor.
Conclusions
Extranodal metastasis, especially extra-perigastric extranodal metastasis, was a pivotal poor prognostic factor in node-positive gastric cancer. Recognizing extra-perigastric extranodal metastasis would help provide optimal therapeutic options to these high-risk patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31312947</pmid><doi>10.1007/s00268-019-05076-x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdominal Surgery Adult Aged Aged, 80 and over Analysis of Variance Blood vessels Cancer Cardiac Surgery Female Gastrectomy Gastric cancer General Surgery Humans Kaplan-Meier Estimate Lymph nodes Lymph Nodes - pathology Lymphatic Metastasis Lymphatic system Male Medicine Medicine & Public Health Metastases Metastasis Middle Aged Multivariate Analysis Neoplasm Invasiveness Neoplasm Recurrence, Local - mortality Nodes Original Scientific Report Prognosis Recurrence Retrospective Studies Risk groups Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgery Survival Survival Rate Thoracic Surgery Treatment Outcome Tumors Vascular Surgery |
| title | Extra-perigastric Extranodal Metastasis is a Significant Prognostic Factor in Node-Positive Gastric Cancer |
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