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1.
Yu-Long Wang Shou-Hao Feng Ji Zhu Guo-Pei Zhu Duan-Shu Li Yu Wang Yong-Xue Zhu Guo-Hua Sun Qing-Hai Ji 《PloS one》2013,8(2)
Objective
To analyze the impact of the lymph node ratio (LNR, ratio of metastatic to examined nodes) on the prognosis of hypopharyngeal cancer patients.Methods
SEER (Surveillance, Epidemiology and End Results)-registered hypopharyngeal cancer patients with lymph node metastasis were evaluated using multivariate Cox regression analysis to identify the prognostic role of the LNR. The categorical LNR was compared with the continuous LNR and pN classifications to predict cause-specific survival (CSS) and overall survival (OS) rates of hypopharyngeal cancer patients.Results
Multivariate analysis of 916 pN+ hypopharyngeal cancer cases identified race, primary site, radiation sequence, T classification, N classification, M classification, the number of regional lymph nodes examined, the continuous LNR (Hazard ratio 2.415, 95% CI 1.707–3.416, P<0.001) and age as prognostic variables that were associated with CSS in hypopharyngeal cancer. The categorical LNR showed a higher C-index and lower Akaike information criterion (AIC) value than the continuous LNR. When patients (n = 1152) were classified into four risk groups according to LNR, R0 (LNR = 0), R1 (LNR ≤0.05), R2 (LNR 0.05–0.30) and R3 (LNR >0.30), the Cox regression model for CSS and OS using the R classification had a higher C-index value and lower AIC value than the model using the pN classification. Significant improvements in both CSS and OS were found for R2 and R3 patients with postoperative radiotherapy.Conclusions
LNR is a significant prognostic factor for the survival of hypopharyngeal cancer patients. Using the cutoff points 0.05/0.30, the R classification was more accurate than the pN classification in predicting survival and can be used to select high risk patients for postoperative treatment. 相似文献2.
Background
Lymph node metastasis has a significant impact on laryngeal cancer prognosis. The role of lymph node ratio (LNR, ratio of metastatic to examined nodes) in the staging of laryngeal cancer was not reported.Patients and Methods
Records of laryngeal cancer patients with lymph node involvement from Surveillance, Epidemiology, and End Results database (SEER, training set, N = 1963) and Fudan University Shanghai Cancer Center (FDSCC, validating set, N = 27) were analyzed for the prognostic value of LNR. Kaplan–Meier survival estimates, the Log-rank χ2 test and Cox proportional hazards model were used for univariate and multivariate analysis. Optimal LNR cutoff points were identified by X-tile.Results
Optimal LNR cutoff points classified patients into three risk groups R1 (≤0.09), R2 (0.09–0.20) and R3 (>0.20), corresponding to 5-year cause-specific survival and overall survival in SEER patients of 55.1%, 40.2%, 28.8% and 43.1%, 31.5%, 21.8%, 2-year disease free survival and disease specific survival in FDSCC patients of 74.1%, 62.5%, 50.0%, and 67.7%, 43.2%, 25.0%, respectively. R3 stratified more high risk patients than N3 with the same survival rate, and R classification clearly separated N2 patients to 3 risk groups and N1 patients to 2 risk groups (R1–2 and R3).Conclusions
R classification is a significant prognostic factor of laryngeal cancer and should be used as a complementary staging system of N classification. 相似文献3.
目的:探讨胸段食管癌术后淋巴结转移情况及其对患者5年生存期的影响。方法:对125例胸段食管癌患者的病例资料进行回顾性研究,统计其淋巴结转移情况以及转移度、转移数、转移域数等相关数据资料,并分析各种淋巴结转移情况对患者5年生存期的影响,再对基于不同淋巴结转移情况"手术组"与"手术+放疗组"的5年生存率进行比较。结果:有无淋巴结转移、淋巴结转移度、淋巴结转移数以及淋巴结转移域数均对胸段食管癌患者的5年生存率有显著影响(P0.01);有淋巴结转移患者手术组的5年生存率显著低于手术+放疗组(P0.01),同时术后加行放疗治疗对转移度0、≤20%及转移数≥2枚的患者的5年生存率有显著影响(P0.01)。结论:淋巴结转移是胸段食管癌患者术后效果的重要影响因素,淋巴结转移数0、1、及≥2枚的三级别分类或可更准确地反应胸段食管癌患者淋巴结转移数与5年生存率的关系;术后预防性放疗能提高有淋巴结转移、转移0、≤20%及转移数≥2枚的患者的5年生存率。 相似文献
4.
Objective
To date, there is no consensus to evaluate the most appropriate category of the nodal metastasis for precise predication the prognosis of gastric cancer patients with positive node metastasis after curative surgery.Methods
We retrospectively analyzed the clinicopathologic characteristics and overall survival (OS) of 299 gastric cancer patients with positive node metastasis after curative surgery for evaluation the optimal category of the nodal metastasis.Results
With the univariate and multivariate survival analyses, the depth of primary tumor invasion was identified as the independent predicators with the OS of 299 gastric cancer patients with nodal metastasis postoperatively, as were the number of positive lymph nodes (PLNs), the number of negative lymph nodes (NLNs), and the ratio between negative and positive lymph nodes (RNPL). The RNPL was identified to be more suitable for predication the OS of gastric cancer patients with positive node metastasis than the ratio between positive and dissected lymph nodes (RPDL) by using the stratum procedure of survival analysis. Besides, we found both PLNs and NLNs were independently correlated with OS of gastric cancer patients with nodal metastasis when RNPL, instead of RPDL, was controlled in the partial correlation model.Conclusions
RNPL, a new category of the nodal metastasis, was suitable for predication the OS of gastric cancer patients with nodal metastasis after curative resection, as were the PLNs, and NLNs. 相似文献5.
Tian-Tian Wang Qing-Hua Cao Ming-Yuan Chen Qing Xia Xin-Juan Fan Xiao-Kun Ma Qu Lin Chang-Chang Jia Min Dong Dan-Yun Ruan Ze-Xiao Lin Jing-Yun Wen Li Wei Xing Li Zhan-Hong Chen Lei Wang Xiang-Yuan Wu Xiang-Bo Wan 《PloS one》2013,8(11)
Autophagy can be tumor suppressive as well as promotive in regulation of tumorigenesis and disease progression. Accordingly, the prognostic significance of autophagy key regulator Beclin 1 was varied among different tumors. Here, we detected the clinicopathological and prognostic effect of Beclin 1 in the subtypes of intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC). Beclin 1 expression level was detected by immunohistochemistry staining in 106 ICC and 74 ECC patients. We found that Beclin 1 was lowly expressed in 126 (70%) cholangiocarcinoma patients, consist of 72 ICC and 54 ECC. Moreover, the cholangiocarcinoma patients with lymph node metastasis (N1) had a lower Beclin 1 level than that of N0 subgroup (P=0.012). However, we did not detect any correlations between Beclin 1 and other clinicopathological features, including tumor subtypes, vascular invasion, HBV infection, liver cirrhosis, cholecystolithiasis and TNM stage. Survival analysis showed that, compared with the high expression subset, Beclin 1 low expression was correlated with a poorer 3-year progression-free survival (PFS, 69.1% VS 46.8%, P=041) for cholangiocarcinoma. Importantly, our stratified univariate and multivariate analysis confirmed that Beclin 1 lowly expressed ICC had an inferior PFS as well as overall survival than ECC, particularly than that of Beclin 1 highly expressed ECC patients. Thus, our study demonstrated that Beclin 1low expression, correlated with lymph node metastasis, and might be a negative prognostic biomarker for cholangiocarcinoma. Combined Beclin 1 level with the anatomical location might lead to refined prognosis for the subtypes of ICC and ECC. 相似文献
6.
Fabien Reyal Catherine Belichard Roman Rouzier Emmanuel de Gournay Claire Senechal Francois-Clement Bidard Jean-Yves Pierga Paul Cottu Florence Lerebours Youlia Kirova Jean-Guillaume Feron Virginie Fourchotte Anne Vincent-Salomon Jean-Marc Guinebretiere Brigitte Sigal-Zafrani Xavier Sastre-Garau Yann De Rycke Charles Coutant 《PloS one》2012,7(10)
Introduction
To decipher the interaction between the molecular subtype classification and the probability of a non-sentinel node metastasis in breast cancer patients with a metastatic sentinel lymph-node, we applied two validated predictors (Tenon Score and MSKCC Nomogram) on two large independent datasets.Materials and Methods
Our datasets consisted of 656 and 574 early-stage breast cancer patients with a metastatic sentinel lymph-node biopsy treated at first by surgery. We applied both predictors on the whole dataset and on each molecular immune-phenotype subgroups. The performances of the two predictors were analyzed in terms of discrimination and calibration. Probability of non-sentinel lymph node metastasis was detailed for each molecular subtype.Results
Similar results were obtained with both predictors. We showed that the performance in terms of discrimination was as expected in ER Positive HER2 negative subgroup in both datasets (MSKCC AUC Dataset 1 = 0.73 [0.69–0.78], MSKCC AUC Dataset 2 = 0.71 (0.65–0.76), Tenon Score AUC Dataset 1 = 0.7 (0.65–0.75), Tenon Score AUC Dataset 2 = 0.72 (0.66–0.76)). Probability of non-sentinel node metastatic involvement was slightly under-estimated. Contradictory results were obtained in other subgroups (ER negative HER2 negative, HER2 positive subgroups) in both datasets probably due to a small sample size issue. We showed that merging the two datasets shifted the performance close to the ER positive HER2 negative subgroup.Discussion
We showed that validated predictors like the Tenon Score or the MSKCC nomogram built on heterogeneous population of breast cancer performed equally on the different subgroups analyzed. Our present study re-enforce the idea that performing subgroup analysis of such predictors within less than 200 samples subgroup is at major risk of misleading conclusions. 相似文献7.
Ling-Long Tang Rui Guo Guanqun Zhou Ying Sun Li-Zhi Liu Ai-Hua Lin Haiqiang Mai Jianyong Shao Li Li Jun Ma 《PloS one》2014,9(10)
Background
The development of intensity-modulated radiotherapy (IMRT) has revolutionized the management of nasopharyngeal carcinoma (NPC). The purpose of this study was to evaluate the prognostic value and classification of TNM stage system for retropharyngeal lymph node (RLN) metastasis in NPC in the IMRT era.Material and Methods
We retrospectively reviewed data from 749 patients with biopsy-proven, non-metastatic NPC. All patients received IMRT as the primary treatment. Chemotherapy was administered to 86.2% (424/492) of the patients with stage III or IV disease.Results
The incidence of RLN metastasis was 64.2% (481/749). Significant differences were observed in the 5-year disease-free survival (DFS; 70.6% vs. 85.4%, P<0.001) and distant metastasis-free survival (DMFS; 79.2% vs. 90.1%, P<0.001) rates of patients with and without RLN metastasis. In multivariate analysis, RLN metastasis was an independent prognostic factor for disease failure and distant failure (P = 0.005 and P = 0.026, respectively), but not for locoregional recurrence. Necrotic RLN metastases have a negative effect on disease failure, distant failure and locoregional recurrence in NPC with RLN metastasis (P = 0.003, P = 0.018 and P = 0.005, respectively). Survival curves demonstrated a significant difference in DFS between patients with N0 disease and N1 disease with only RLN metastasis (P = 0.020), and marginally statistically significant differences in DMFS and DFS between N1 disease with only RLN metastasis and other N1 disease (P = 0.058 and P = 0.091, respectively). In N1 disease, no significant differences in DFS were observed between unilateral and bilateral RLN metastasis (P = 0.994).Conclusions
In the IMRT era, RLN metastasis remains an independent prognostic factor for DFS and DMFS in NPC. It is still reasonable for RLN metastasis to be classified in the N1 disease, regardless of laterality. However, there is a need to investigate the feasibility of classifying RLN metastasis as N1a disease in future by a larger cohort study. 相似文献8.
目的:探讨进展期胃癌脾门淋巴结(10组)转移的相关临床病理因素.方法:回顾分析了(2008-2011年)75例胃癌根治术伴10组淋巴结切除的进展期胃癌病例.分析了临床病理学因素和10组淋巴结转移的相关性.结果:本研究结果提示10组淋巴结转移的阳性率为52%.胃下部癌的转移率(20%)相对较低(P=0.000),大弯侧肿瘤的转移率高达76.2%.病灶的侵润深度及病理TNM分期与10组淋巴结阳性率密切相关,组织学类型或分化程度与10组淋巴结转移无统计学相关.病灶小于3 cm病例的10组淋巴结转移的阳性率为0%,而大于9 cm或Borrmann-Ⅳ的肿瘤患者的10组淋巴结转移的阳性率为100%.结论:10组淋巴结转移的高危因素包括:1.中上部胃癌;2.肿瘤位于胃大弯侧;3.大于3 cm; 4.侵达胃壁浆膜层.含以上高危因素的进展期胃癌根治手术中,建议常规行术中快速冰冻检查10组淋巴结是否存在转移;含2个以上高危因素的进展期胃癌建议行脾切除术,或如果技术条件具备应行保留脾的10组淋巴结清扫术以便最终获得R0切除. 相似文献
9.
Cai Shirong Chen Jianhui Chen Chuangqi Wu Kaiming Zhang Xinhua Song Wu He Yulong 《PloS one》2015,10(3)
Background and Aims
There is a discrepancy between the American Joint Committee on Cancer (AJCC) guidelines (7th edition) and the Japanese treatment guidelines (3rd edition) with regard to the extent of D2 lymphadenectomy for gastric cancer. In the AJCC, hepatic artery station (No.12a) lymph node (LN) metastasis is classified as distant metastasis, whereas in the Japanese guidelines, this classified is regional metastasis. This study aimed to evaluate whether it is appropriate to reclassify No.12a LN metastasis as distant metastasis in consideration of survival outcome.Methods
In this retrospective analysis, data from patients with gastric cancer who underwent regular D2 or greater lymphadenectomy between 1996 and 2006 were evaluated to determine any association between the clinicopathological features of hepatic artery LNs and survival prognosis.Results
Among the 247 patients with gastric cancer who underwent No.12 LN harvest, 45 (18.2%) were positive for No.12a LN metastasis. No.12a LN metastasis was significantly associated with poor clinicopathological features, advanced tumor stage, and poor overall survival. The 5-year survival rate of patients with No.12a LN metastasis was significantly better than that of patients with distant metastasis (P < 0.05), but was similar to that of patients with LN involvement in the D2 lymphadenectomy region (P > 0.05). No.12a LN metastasis was shown to significantly influence survival outcome in univariate analysis, but was not identified as a significant independent predictor in multivariate analysis. In logistic multivariate regression analysis, T stage, N stage, and station No.3, 5, and 6 LN metastasis were independent predictors of No.12a LN involvement.Conclusions
It is inappropriate to reclassify No.12a LN metastasis as distant metastasis. We propose that this be considered as regional metastasis and be included in the extent of D2 lymphadenectomy to improve survival outcomes in patients with gastric cancer. 相似文献10.
目的:探讨CT扫描对食管癌淋巴结转移诊断的准确率及CT扫描对预测淋巴结转移患者预后的价值.方法:选择我院收入的行食管癌根治术患者共146例,患者均行CT及腹部彩超,检查者CT及腹部彩超对食管癌淋巴结转移检测的准确率及漏诊率,检测CT淋巴结转移数、CT三分区转移情况及CT最大病变直径等CT检测与食管癌淋巴结转移相关因素.结果:CT淋巴结总检出率显著高于彩超检出率,两组对比差异有统计学意义,P<0.05.CT检测中胸上段、胸中段总检出率显著高于彩超检出率,结果对比差异有统计学意义,P<0.05.所有患者自手术日起计算术后1、3年生存率分别为73.3%(107/146)、47.9%( 70/146),CT 转移数≥2枚、CT三分区转移<2区、CT最大病变直径≤3cm患者术后生存率较高,结果对比差异有统计学意义,P<0.05.结论:CT对食管癌淋巴结转移诊断率较高,CT转移数、CT三分区转移及CT最大病变直径检测可用于评估患者术后生存率情况. 相似文献
11.
Jian-Hong Zhong Bang-De Xiang Wen-Feng Gong Yang Ke Qin-Guo Mo Liang Ma Xing Liu Le-Qun Li 《PloS one》2013,8(7)
Background and Aims
Treatment of patients with Barcelona Clinic Liver Cancer Stage B hepatocellular carcinoma (BCLC-B HCC) is controversial. This study compared the long-term survival of patients with BCLC-B HCC who received liver resection (LR) or transarterial chemoembolization (TACE).Methods
A total of 257 and 135 BCLC-B HCC patients undergoing LR and TACE, respectively, were retrospectively evaluated. Kaplan–Meier method was used for long-term survival analysis. Independent prognostic predictors were determined by the Cox proportional hazards model.Results
The hospital mortality rate was similar between groups (3.1% vs. 3.7%; P = 0.76). However, the LR group showed a significantly higher postoperative complication rate than the TACE group (28 vs. 18.5%; P = 0.04). At the same time, the LR group showed significantly higher overall survival rates (1 year, 84 vs. 69%; 3 years, 59 vs. 29%; 5 years, 37 vs. 14%; P<0.001). Moreover, similar results were observed in the propensity score model. Three independent prognostic factors were associated with worse overall survival: serum AFP level (≥400 ng/ml), serum ALT level, and TACE.Conclusions
LR appears to be as safe as TACE for patients with BCLC-B HCC, and it provides better long-term overall survival. However, prospective studies are needed to disclose if LR may be regarded as the preferred treatment for these patients as long as liver function is preserved. 相似文献12.
Purpose
To investigate the correlated factors for lymph node metastasis and prognosis for patients with T2 gastric cancer.Methods
A total of 442 patients with T2 gastric cancer who underwent gastrectomy from January 1996 to December 2009 were evaluated. The clinicopathological parameters were analyzed for lymph node metastasis and prognosis, including gender, age, tumor size, tumor location, histological type, depth of invasion, vascular tumor emboli, nervous invasion, resection type, and pathological stage.Results
The rate of lymph node metastasis was 45.9%. Univariate analysis showed that depth of invasion, tumor size, and vascular tumor emboli were associated with lymph node metastasis. Logistic regression demonstrated that depth of invasion, tumor size, and vascular tumor emboli were independently predictive factors for lymph node metastasis. The 5-year survival rate was 64.0%. Multivariate analysis showed that tumor size, tumor location, resection type, and pathological stage were independent prognostic factors. Based on tumor size, there were significant differences of 5-year survival between small size tumor (<6 cm) and large size tumor (≥6 cm) according to stage IIA (P = 0.006). Based on tumor location, there were significant differences of 5-year survival among different tumor location according to stage IB. Based on resection type, there were significant differences of overall 5-year survival between curative surgery and palliative surgery according to stage IIB (P = 0.015) and IIIA (P = 0.001).Conclusion
Depth of invasion, tumor size, and vascular tumor emboli were independently predictive factors for lymph node metastasis. Tumor size, tumor location, resection type, and pathological stage were independent prognostic factors. 相似文献13.
目的:观察多品系小鼠多部位接种H22腹水癌能否引发淋巴结转移,以及它们的差异。方法:选择KM小鼠、BALB/c小鼠、C57BL/6小鼠,分别在腋下、股部内侧和脚垫接种H22腹水癌细胞,观察腋下和腹股沟淋巴结的变化。结果:腋下、股部内侧和脚垫接种组50d动物死亡率分别是:KM小鼠为100%、60%乘0%;BALB/c小鼠为80%、60%和0%;C57BL/6小鼠为100%、50%和0%。试验组动物的淋巴结重量普遍大于空白对照,尤其是KM小鼠和BALB/c小鼠脚垫接种组,病理检查显示,右腹股沟淋巴结可见大量癌细胞淋巴结的正常结构完全被破坏,甚至消失;C57BL,/6小鼠脚垫接种组淋巴结病理检查未发现癌细胞,淋巴结结构完整。结论:KM小鼠、BALB/c小鼠脚垫接种H22腹水癌细胞能够复制存活时间在50d以上,癌细胞发生淋巴结转移的动物模型。 相似文献
14.
目的:探讨合并桥本甲状腺炎的甲状腺微小乳头状癌淋巴结转移的特点,分析血清甲状腺过氧化物酶抗体(Thyroid peroxidase-antibody,TPO-Ab)滴度对该组病例淋巴结转移的影响。方法:回顾性分析武汉同济医院甲状腺乳腺外科2012年1月至2014年5月收治的甲状腺微小癌伴桥本甲状腺炎的病例,运用卡方检验、阈值效应分析、多因素logistic回归方法分析该组病例血清TPO-Ab滴度对淋巴结转移的影响。结果:共收集75例合并桥本甲状腺炎的微小乳头状癌病例,血清TPO-Ab滴度与淋巴结转移相关:抗体滴度对淋巴结转移的影响存在分段特征,有阈值效应,该组病例以212 IU/m L为阈值;多因素logistic回归显示,随着血清TPO-Ab水平升高,淋巴结转移率下降(OR=0.993,95%CL=0.987,0.999,P=0.018)。结论:合并桥本甲状腺炎的甲状腺微小乳头状癌病例,血清TPO-Ab滴度对淋巴结转移的影响可能存在阈值效应,值得深入分析;且高血清TPO-Ab滴度可能是淋巴结转移的保护因素,但两者的相互关系尚需进一步探讨。 相似文献
15.
《Endocrine practice》2021,27(12):1175-1182
ObjectiveTo develop and validate an individualized risk prediction model for the need for central cervical lymph node dissection in patients with clinical N0 papillary thyroid carcinoma (PTC) diagnosed using ultrasound.MethodsUpon retrospective review, derivation and internal validation cohorts comprised 1585 consecutive patients with PTC treated from January 2017 to December 2019 at hospital A. The external validation cohort consisted of 406 consecutive patients treated at hospital B from January 2016 to June 2020. Independent risk factors for central cervical lymph node metastasis (CLNM) were determined through univariable and multivariable logistic regression analysis. An individualized risk prediction model was constructed and illustrated as a nomogram, which was internally and externally validated.ResultsThe following risk factors of CLNM were established: a solitary primary thyroid nodule’s diameter, shape, calcification, and capsular abutment-to-lesion perimeter ratio. The areas under the receiver operating characteristic curves of the risk prediction model for the internal and external validation cohorts were 0.921 and 0.923, respectively. The calibration curve showed good agreement between the nomogram-estimated probability of CLNM and the actual CLNM rates in the 3 cohorts. The decision curve analysis confirmed the clinical usefulness of the nomogram.ConclusionThis study developed and validated a model for predicting the risk of CLNM in individual patients with clinical N0 PTC, which should be an efficient tool for guiding clinical treatment. 相似文献
16.
Jing-Ren Tseng Tsung-Ying Ho Chien-Yu Lin Li-Yu Lee Hung-Ming Wang Chun-Ta Liao Tzu-Chen Yen 《PloS one》2013,8(11)
Purpose
Retropharyngeal lymph node (RPLN) metastasis is an uncommon finding in patients with oral cavity squamous carcinoma (OSCC). We sought to investigate the clinical outcomes, clinicopathological characteristics, and the priority of treatment with curative intent in OSCC patients with RPLN involvement.Methods and Materials
Between January 2007 and January 2011, we identified 36 patients with primary RPLN metastases (n = 10) or RPLN relapse (n = 26). The follow-up continued until June 2013. Disease-specific survival (DSS), disease-free survival (DFS), and the potential benefits of salvage therapy served as the main outcome measures.Results
The 2-year DSS and DFS rates of untreated patients with RPLN involvement were 20% and 24%, respectively. Level IV/V neck lymph node involvement was an adverse prognostic factor for DSS (P = 0.048) and DFS (P = 0.018). All of the patients presenting with neck lymph node involvement at level IV/V died within 6 months. Among patients who were treated for RPLN relapse, the 2-year DSS and DFS rates from the relapse day were 12.8% and 9.6%, respectively. Concomitant contralateral neck lymph node metastases (N2c) were associated with lower 2-year DSS (P = 0.005) and DFS (P = 0.011) rates. Moreover, five (55%) of the nine patients with recurrent disease in the contralateral RPLN had distant metastases within 6 months. Salvage therapy yielded the maximum survival benefit in patients without N2c disease and ipsilateral RPLN involvement alone (P = 0.005).Conclusion
OSCC patients with RPLN involvement have poor outcomes. The risk factor for definitive treatment in OSCC patients with FDG PET/CT defined RPLN disease in primary disease was neck lymph node involvement at level IV/V and N2c and/or contralateral RPLN disease in recurrent disease. Treatment efforts with curative intent should be tailored according to individual risk factors. 相似文献17.
Ji-hoon Jung Choon-Young Kim Seung Hyun Son Do-Hoon Kim Shin Young Jeong Sang-Woo Lee Jaetae Lee Byeong-Cheol Ahn 《PloS one》2015,10(12)
Objectives
The aim of the current study was to evaluate the value of preoperative 18F-FDG (FDG) PET/CT in predicting cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC).Methods
One hundred and ninety-three newly diagnosed PTC patients (M: F = 25:168, age = 46.8 ± 12.2) who had undergone pretreatment FDG PET/CT and had neck node dissection were included in this study. The FDG avidity of the primary tumor and the SUVmax of the primary tumor (pSUVmax) were analyzed for prediction of LN metastasis. Detectability by ultrasonography (US) and FDG PET/CT for cervical LN metastasis were also assessed and compared with the pSUVmax.Results
The FDG avidity of the primary tumor was identified in 118 patients (FDG avid group: 61.0%, M: F = 16:102, age 47.0 ± 12.7 years) and pSUVmax ranged from 1.3 to 35.6 (median 4.6) in the FDG avid group. The tumor size in the FDG avid group was bigger and there was a higher incidence of LN metastasis compared to the FDG non-avid group (0.93 vs. 0.59 cm, p <0.001 and 49.2 vs. 33.3%, p <0.05). In the FDG avid group, patients with LN metastasis had higher pSUVmax than patients without LN metastasis (8.7 ± 8.3 vs. 5.7 ± 5.1, p <0.001). The incidence of central LN metastasis in patients with a pSUVmax >4.6 was 54%; however, the detectability of central LN metastasis by US and FDG PET/CT were 10.3% and 3.6%, respectively.Conclusion
A high FDG avidity of the primary tumor was related to LN metastasis in PTC patients. Therefore, patients with a high pSUVmax should be cautiously assessed for LN metastasis and might need a more comprehensive surgical approach. 相似文献18.
Hiroaki Kuroda Yukinori Sakao Mingyon Mun Hirofumi Uehara Masayuki Nakao Yousuke Matsuura Tetsuya Mizuno Noriaki Sakakura Noriko Motoi Yuichi Ishikawa Yasushi Yatabe Ken Nakagawa Sakae Okumura 《PloS one》2015,10(8)
Background
Left upper division segmentectomy is one of the major pulmonary procedures; however, it is sometimes difficult to completely dissect interlobar lymph nodes. We attempted to clarify the prognostic importance of hilar and mediastinal nodes, especially of interlobar lymph nodes, in patients with primary non-small cell lung cancer (NSCLC) located in the left upper division.Methods
We retrospectively studied patients with primary left upper lobe NSCLC undergoing surgical pulmonary resection (at least lobectomy) with radical lymphadenectomy. The representative evaluation of therapeutic value from the lymph node dissection was determined using Sasako’s method. This analysis was calculated by multiplying the frequency of metastasis to the station and the 5-year survival rate of the patients with metastasis to the station.Results
We enrolled 417 patients (237 men, 180 women). Tumors were located in the lingular lobe and at the upper division of left upper lobe in 69 and 348 patients, respectively. The pathological nodal statuses were pN0 in 263 patients, pN1 in 70 patients, and pN2 in 84 patients. Lymph nodes #11 and #7 were significantly correlated with differences in node involvement in patients with left upper lobe NSCLC. Among those with left upper division NSCLC, the 5-year overall survival in pN1 was 31.5% for #10, 39.3% for #11, and 50.4% for #12U. The involvement of node #11 was 1.89-fold higher in the anterior segment than that in the apicoposterior segment. The therapeutic index of estimated benefit from lymph node dissection for #11 was 3.38, #4L was 1.93, and the aortopulmonary window was 4.86 in primary left upper division NSCLC.Conclusions
Interlobar node involvement is not rare in left upper division NSCLC, occurring in >20% cases. Furthermore, dissection of interlobar nodes was found to be beneficial in patients with left upper division NSCLC. 相似文献19.
Been-Ren Lin Yu-Lin Lin Hong-Shiee Lai Po-Huang Lee King-Jen Chang Jin-Tung Liang 《PloS one》2015,10(9)
Background
This study identified predictors of favorable overall survival (OS) for stage III colon cancer patients who had only one lymph node (LN) metastasis (N1a).Methods
Variables, including preoperative carcinoembryonic antigen (CEA) level, LN sampling status, and the choices of postoperative adjuvant chemotherapy, were recorded. Prognostic significance was determined using the log-rank test and multivariate Cox regression analysis.Results
The median 42-month follow-up period included 363 eligible patients. Among them, 230 (63.3%) received only 5-flurouracil (5-FU) adjuvant chemotherapy; 76 (20.9%) underwent oxaliplatin-based regimens; and 57 (15.7%) chose surgery alone. The 5-year survival rate of these evaluated patients was 75%, 63%, and 77%, respectively (P = 0.823). Multivariate analysis revealed that normal preoperative CEA level (≦5 ng/mL) and adequate LN sampling (LN ≧ 12) were significant predictors for higher 5-year OS (P < 0.001; P = 0.007, respectively). However, the use of postoperative adjuvant chemotherapy in these N1a colon cancer patients did not significantly affect their 5-year OS.Conclusions
A preoperative CEA level of less than or equal to 5 ng/mL, and curative surgery with an adequate lymphadenectomy determined a favorable OS outcome in stage III colon cancer with only one LN metastasis. 相似文献20.
Ja Hyeon Ku Myong Kim Seok-Soo Byun Hyeon Jeong Cheol Kwak Hyeon Hoe Kim Sang Eun Lee 《PloS one》2015,10(10)