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The article presents a study which investigated the clinicopathological significance of fibrous tissue around a recurrent rectal tumour in the pelvis. Results showed that the overall survival of patients with circumferential fibrosis was better than that in patients with no fibrosis. The author concluded that outcome of patients with locally recurrent rectal cancer after total pelvic exenteration with distal sacrectomy appears to be better when circumferential fibrosis is present.

Background: The aim of this study was to evaluate the clinicopathological significance of microscopic abscess formation (MAF) at the invasive front of advanced low rectal cancer. Methods: The clinicopathological features of 226 consecutive patients with low rectal cancer, who underwent curative resection between May 1997 and December 2002, were analysed. Results: Fifty-seven (25·2 per cent) of the 226 tumours had MAF and 169 (74·8 per cent) did not. Patients with tumours showing MAF were more likely to have extended surgery than those without MAF: 47 versus 31·4 per cent respectively underwent non-sphincter-preserving surgery ( P = 0·029) and 82 versus 60·9 per cent underwent lateral lymph node dissection ( P = 0·003). The incidence of lymph node metastases was lower in patients with MAF (30 versus 53·3 per cent; P = 0·002). Univariable analysis of disease-free survival revealed that depth of invasion ( P < 0·001), lymph node status ( P < 0·001), histological type ( P = 0·035), lymphatic invasion ( P < 0·001), venous invasion ( P < 0·001), perineural invasion ( P < 0·001), focal dedifferentiation ( P < 0·001) and MAF ( P < 0·001) were significant prognostic factors. Multivariable analysis showed that lymph node status ( P < 0·001), perineural invasion ( P = 0·002), venous invasion ( P = 0·033) and MAF ( P = 0·012) remained independent prognostic factors. Conclusion: MAF may reflect indolent tumour behaviour and a more favourable outcome in patients with advanced low rectal cancer. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article offers information on treatment methodology after non curative endoscopoc resection of early gastric cancer who have a negligible risk of lymph node metastasis (LNM). It is revealed that despite of possible risk of LNM, surgery remains the most efficient treatment after non-curative ER in patients.

The article discusses the results of a study designed to determine the clinical significance and prognostic impact of extranodal metastasis (EM) in gastric carcinoma. A description of the study's methods is provided. The study showed that the incidence of EM was higher in patients with tumors that were large, infiltrative and deeply invading or undifferentiated and in those with lymph node, peritoneal or liver metastases or lymphatic or vascular involvement. The study concludes that EM is an independent prognostic factors.

Studies surgery for clinical T3 carcinomas of the upper thoracic esophagus. Resection of primary tumor and metastatic nodes; Penetration of the esophagus wall; Absence of preoperative adjuvant treatment.

Summary Background When cancer cells are found in the submucosal layer of an endoscopically resected specimen, patients are recommended to undergo gastrectomy with lymph node dissection. If it were possible to identify those patients in whom the risk of lymph node metastasis was negligible, it might be possible to avoid surgery. Methods Among those who underwent gastrectomy for gastric cancer from 1980 to 1999, 1091 patients with a cancer invading the submucosa were studied. Clinicopathological factors (sex, age, tumour location, macroscopic type, size, ulceration, histological type, lymphatic–vascular involvement and degree of submucosal penetration) were investigated for their possible association with lymph node metastasis. Results Lymph node metastases were found in 222 patients (20·3 per cent). Univariate analysis showed that larger tumour size (more than 30 mm), undifferentiated histological type, lymphatic–vascular involvement and massive submucosal penetration had a significant association with lymph node metastasis. Tumour size, histological type and lymphatic–vascular involvement were independent risk factors for lymph node metastasis. By combining these three factors with submucosal penetration of less than 500 μm, 117 patients could be selected as having a minimal risk of lymph node metastasis (95 per cent confidence interval 0–3·1 per cent). Conclusion Lymphadenectomy may not be necessary for patients with gastric cancer invading the submucosa who fulfil the above conditions. [ABSTRACT FROM AUTHOR]