• Journal of Gastric Cancer
• /
• 제21권3호
• /
• pp.236-245
• /
• 2021

Purpose: The numeric N stage has replaced the topographic N stage in the current tumor node metastasis (TNM) staging in gastric carcinoma. However, the usefulness of the topographic N stage in the current TNM staging system is uncertain. We aimed to investigate the prognostic value of the topographic N stage in the current TNM staging system. Materials and Methods: We reviewed the data of 3350 patients with gastric cancer who underwent curative gastrectomy. The anatomic regions of the metastatic lymph nodes (MLNs) were classified into 2 groups: perigastric and extra-perigastric. The prognostic value of the anatomic region was analyzed using a multivariate prognostic model with adjustments for the TNM stage. Results: In patients with lymph node metastasis, extra-perigastric metastasis demonstrated significantly worse survival than perigastric metastasis alone (5-year survival rate, 39.6% vs. 73.1%, respectively, P<0.001). Extra-perigastric metastasis demonstrated significantly worse survival within the same pN stage; the multivariate analysis indicated that extra-perigastric metastasis was an independent poor prognostic factor (hazard ratio=1.33; 95% confidence interval=1.01-1.75). The anatomic region of the MLNs improved the goodness-of-fit (likelihood ratio statistics, 4.57; P=0.033) of the prognostic model using the TNM stage. Conclusions: The anatomic region of MLNs has an independent prognostic value in the numeric N stage in the current TNM staging of gastric carcinoma.

• Korean Journal of Head & Neck Oncology
• /
• 제31권2호
• /
• pp.86-90
• /
• 2015

Cystic lymph node metastasis of head and neck squamous cell carcinoma(HNSCC) which presumed to be mainly originated from oropharynx including Waldeyer's ring may present as a benign cystic mass on lateral neck such as branchial cleft cyst. Branchial cleft cyst is one of the most common lateral neck cystic mass which may result in regional infection or lymph adenopathy. Many of previously reported literatures showed the incidence of cystic lymph node metastasis from oropharynx including Waldeyer's ring. Preoperative imaging studies and fine needle aspiration cytology cannot provide the accurate results until excision of cystic mass for the diagnostic or therapeutic purpose. Recently, we experienced the rare case of cystic lymph node metastasis from ipsilateral tonsil, which mimicked infected 2nd branchial cleft cyst. Thus, we reported our experience with presentation of case and review of literatures.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제35권5호
• /
• pp.376-379
• /
• 2009

Likely to be the most common oral cancer, squamous cell carcinoma(SCC) of the tongue accounts for about 20% of all oral and pharyngeal cancers. SCC of the tongue frequently arises in the lateral border, and if it metastasize, it occurs on submandibular gland and neck lymph nodes. Location of the primary lesions and neck lymph node metastasis affect the prognosis and decrease survival rate of patients with carcinoma of the tongue. The authors experienced the patient with contralateral neck lymph node metastasis of SCC of the tongue. The patient came to our department with chief complaint of elevated lesion on left lateral border of the tongue. The mass was diagnosed as $T_2N_0M_0$, Stage II invasive SCC of oral tongue. Computed tomography(CT) & magnetic resonance imaging(MRI) which were taken before the operation showed no significant finding of metastasis. Surgical mass removal and preventive neck dissection on the left side were done. While follow up PET/CT, contralateral neck lymph node metastasis(right side, level II) was detected, and re-operation(Rt. side RND) was done. There are few studies concerning the contralateral neck lymph node metastasis related with SCC of the tongue. The purpose of this report is to introduce the uncommon case of contralateral neck lymph node metastasis occurred in the $T_2$-stage of SCC of the tongue treated by surgical resection.

• Journal of Chest Surgery
• /
• 제37권8호
• /
• pp.665-671
• /
• 2004

Background: Lymph node metastasis is commonly reported in thoracic esophageal cancer, even in the early esophageal cancer which may be localized only in the mucosa or within the submucosal layer. Although lymph node metastasis greatly influence long-term outcome and cure of the disease, endoscopic mucosal resection or photodynamic therapy without lymph node dissection is widely attempted. The investigation of the pattern of lymph node metastasis and results of surgical resection of superficial esophageal cancer is needed. Material and Method: Pattern of lymph node metastsis and depth of tumor invasion were studied retrospectively from 44 patients with early esophageal cancer who underwent radical resection of the tumor from December, 1995 to August, 2001. Result: Lymph node metastasis was found in 10 patients (22.7%) out of total of 44 patients. Lymph node metastasis was found in 0% (0 of 3), 0% (0 of 4), 50% (2 of 4), and 24.24% (8 of 33) of tumors that invaded the intraepitherium, lamina propria, muscularis mucosa, and submucosa respectively. Anatomically distant lymph node metastases were found more frequently in recurrent laryngeal nerve node(5 cases of 10 patients) and in intraperitoneal node (8 cases of 10). than intrathoracic node (3 cases of 10). There was no operative mortality, however, there were 1 hospital death in patient with lamina propria cancer, 1 late death in patient with submucosal cancer. Three-year survival rates (except hospital death) were 100% in mucosal cancer and 97.0% in submucosal cancer (p>0.05), and 100% in the node negative group and 90.0% in the node positive group (p>0.05). Conclusion: The survival rate of superficial esophageal cancer patient who was recieved operative resection was excellent. But, lymph node metastasis were found in superficial esophageal cancer, even in esophageal cancer limited to the muscularis mucosa. Systemic lymph node dissection which includes recurrent laryngeal nerve nodes and intraperitoneal nodes was recommended for favorable outcome in superficial esophageal cancer.

• Journal of Gastric Cancer
• /
• 제1권3호
• /
• pp.155-160
• /
• 2001

Purpose: Submucosal gastric carcinomas metastasize to lymph nodes more often than the intramucosal gastric carcinomas. The objectives of this study are to clarify the characteristics of submucosal gastric carcinomas, especially in reference to the status of lymph node metastasis, and to explore the possibility of a minimally invasive operation. Materials and Methods: The clinicopathologic features of 88 patients with submucosal gastric carcinoma, all of whom were treated with a $D_{2}+\alpha$ gastrectomy between January 1994 and December 1999, were examined retrospectively with respect to the status of lymph nodes. The size, depth of submucosal invasion, histologic differentiation, location,and macroscopic finding of the tumor were investigated in association with the presence or the absence of lymph node metastasis. Results: Among the 88 patients, 15 ($17.05\%$) had lymph node metastasis, and the status of metastasis was significantly correlated with tumor size and depth of submucosal invasion. The frequency of metastasis was $0\%$ (0/7) of up to 1.0 cm and $18.5\%$ (15/81) over 1.0 cm in size (p=0.034) and $6.1\%$ (2/33) of up to 1.0mm and $23.6\%$ (13/55) over 1.0 mm in depth of submucosal invasion (p=0.042). Conclusion: The tumor size and depth of submucosal invasion are useful indicators of lymph node metastasis in submucosal gastric carcinoma. A minimally invasive operation can be applied for submucosal gastric carcinoma up to 1.0 cm in size Further studies are needed to limited surgery for depth of submucosal invasion.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권1호
• /
• pp.27-31
• /
• 2012

Objectives: Expression of vascular endothelial growth factor C (VEGF-C)and vascular endothelial growth factor feceptor-3 (VEGFR-3) in laryngeal squamous carcinoma and its relationship to lymph node metastasis were investigated. Methods: VEGF-C and VEGFR-3 gene expression in 30 cases of normal laryngeal mucosa tissue (NLM), primary laryngeal carcinoma cell carcinomas (PLC) and cervical lymph nodes (CLN) was examined by reverse transcription polymerase chain reaction (RT-PCR). Protein levels of VEGF-C expression were determined by immunohistochemical staining in 60 cases of PLC. Results: Expression of VEGF-C and VEGFR-3 different among NLM, PLC and CLN in the same patient. In PLC, expression was significantly higher in lymph node positive group than in the lymph node negative group and associated with histological grade of differentiation; Expression of VEGF-C and VEGFR-3 was not linked with age, sex, site or T stage. Conclusions: A close correlation was found between VEGF-C/VEGFR-3 expression and lymph node metastasis in PLC, suggesting a role in metastasis of laryngeal carcinomas.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권17호
• /
• pp.7425-7432
• /
• 2014

Aim: To investigate the expression of protein kinase $CK2{\alpha}$ ($CK2{\alpha}$) in human thyroid disease and its relationship with thyroid cancer metastasis. Materials and Methods: Using immunohistochemistry we measured the expression of $CK2{\alpha}$ in 76 benign and malignant human thyroid cancer tissues, including 10 pairs of papillary carcinoma tissues with or without lymph node cancerous metastasis and similarly 10 pairs of lymph nodes. Results: The expression of $CK2{\alpha}$ was found to be higher in thyroid carcinoma cases (papillary carcinoma, follicular carcinoma, anaplastic carcinoma and medullary carcinoma) than in ones such as chronic lymphocytic thyroiditis, nodular goiter and adenoma. These findings were also confirmed by RT-PCR and Western blotting. More strikingly, elevated expression of $CK2{\alpha}$ in thyroid papillary carcinoma tissues was not only significantly associated with lymph node cancerous metastasis and clinical stage of thyroid cancers; but also correlated with epithelial-mesenchymal transition (EMT) and high tenascin C (TNC) expression. In addition, EMT and high TNC expression in thyroid carcinoma tissues was significantly associated with lymph node cancerous metastasis. Conclusions: Elevated expression of nuclear $CK2{\alpha}$ is a poor prognosis indicator in lymph node cancerous metastasis of human thyroid cancers.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제28권3호
• /
• pp.182-187
• /
• 2002

Matrix metalloproteinase(MMP) is the proteolytic enzyme of the extracellular matrix. MMPs play a role in the invasion and metastasis of malignant tumor, but it is not known whether the expression of MMPs in squamous cell carcinoma of the tongue is related to the prognostic factors of this tumor. In this study, 32 paraffin-embedded tumor specimens were examined immunohistochemically using monoclonal antibodies of MMP-2, MMP-3, MMP-10 and MMP-13. The possible relationships between the expressions of the MMPs and TNM staging, the differentiation of tumor cells, size of tumor mass and lymph node metastasis were anlaysed statistically. The results were as follows. 1. The expression of MMP-2 increased according to TNM staging (P<0.05) and lymph node metastasis (P<0.05) and the expression of MMP-2 was not affected by the differentiation of tumor cells or tumor size. 2. The expression of MMP-3 increased with increasing tumor size (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. 3. The expression of MMP-10 was unrelated to TNM staging, differentiation of tumor cells, lymph node metastasis or tumor size. 4. The expression of MMP-13 increased as tumor size increased (P<0.05). However it was not related to TNM staging, the differentiation of tumor cells or lymph node metastasis. We concluded that the expression patterns of MMP-2, MMP-3, and MMP-13 may play a role in the diagnosis, treatment plan and prognostic evaluation of malignant tumors of the tongue.

• Journal of Gastric Cancer
• /
• 제24권2호
• /
• pp.185-198
• /
• 2024

Purpose: Peritoneal washing cytology (PWC) is a widely used diagnostic tool for detecting peritoneal metastasis of advanced gastric cancer. However, the prognosis of patients with positive PWC remains poor even after gastrectomy, and treatments vary among institutions and eras. In this study, we identified the clinical factors that can help predict cytology-positive (CY(+)) gastric cancer. Materials and Methods: We retrospectively reviewed the national data of patients with gastric cancer from 2019, as provided by the Information Committee of the Korean Gastric Cancer Association. Of the 13,447 patients with gastric cancer, 3,672 underwent PWC. Based on cytology results, we analyzed the clinicopathological characteristics and assessed the possibility of CY(+) outcomes in relation to T and N stages. Results: Of the 3,270 patients who underwent PWC without preoperative chemotherapy, 325 were CY(+), whereas 2,945 were negative. CY(+) was more commonly observed in patients with Borrmann type IV gastric cancer, an undifferentiated histological type, and advanced pathological stages. Multivariate analysis revealed Borrmann type IV (odds ratio [OR], 1.821), tumor invasion to T3-4 (OR, 2.041), and lymph node metastasis (OR, 3.155) as independent predictors of CY(+). Furthermore, for circular tumor location, the N stage emerged as a significant risk factor for CY(+), particularly when the tumor was located on the posterior wall (PW) side. Conclusions: Lymph node metastasis significantly affects CY(+) outcomes, particularly when the tumor is located on the PW side. Therefore, PWC should be considered not only in suspected serosal exposure cases but also in cases of lymph node metastasis.

• Archives of Plastic Surgery
• /
• 제47권1호
• /
• pp.42-48
• /
• 2020

Background Methods for identifying local lymph node metastasis in malignant melanoma include sentinel lymph node biopsy (SLNB) and lymph node dissection (LND). In particular, SLNB has been widely used in recent years. This study aimed to retrospectively confirm the adequacy of the current indication criteria for SLNB by applying those criteria to a mixed group of patients who previously received SLNB and LND. Methods This study included 77 patients with malignant melanoma of the extremities and trunk who were monitored for >24 months. The patients were classified according to whether the current indication criteria for SLNB were applicable. The sentinel lymph nodes were evaluated for each group. Patients for whom the indication criteria for SLNB and LND were applicable were analyzed according to whether SLNB or LND was performed. Finally, the outpatient records of these patients were reviewed to evaluate recurrence, metastasis, and prognosis. Results Of the 77 patients, SLNB was indicated according to the current criteria in 60 cases. Among the 60 patients for whom SLNB was indicated, 35 survived the follow-up period disease-free, 21 died during the follow-up period, and four experienced metastasis. The 17 patients for whom SLNB was not indicated had no recurrence or metastasis. Conclusions Patients for whom SLNB was not indicated had no recurrence or metastasis. In cases where SLNB is indicated, the possibility of metastasis and recurrence may be high even if SLNB is negative or LND is performed, so more aggressive treatment and careful follow-up are crucial.