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Significance of isolated tumor cells in lymph nodes among gastric cancer patients
- Source :
- Journal of Cancer Research and Clinical Oncology. 130:733-740
- Publication Year :
- 2004
- Publisher :
- Springer Science and Business Media LLC, 2004.
-
Abstract
- To determine the frequency and prognostic impact of isolated tumor cells (ITC) in regional lymph nodes judged to be tumor free in conventional histopathology among gastric cancer patients.Among 161 patients who underwent gastrectomy and D2-lymphadenectomy, 56 were staged pN0(35%). Archival paraffin blocks of 1148 resected regional lymph nodes of those pN0 patients were reevaluated for ITC using monoclonal antibody Ber-EP4. Patients with and without ITC were compared with regard to the distribution of various clinicopathological factors. Prognostic impact of ITC was tested in uni- and multivariate analysis.Of 56 pN0 patients, 33 (59%) exhibited single Ber-Ep4 immunoreactive cells or small cell clusters in at least one lymph node. The occurrence of ITC was not dependent on other clinicopathological factors. ITC impaired patients' prognoses significantly in uni- as well as multivariate analyses [estimated 5-year survival rate: 82% for pN0((i-))vs 58% for pN0((i+))(p = 0.059) and 15% for pN1/2 (p = 0.0005 and p0.0001, respectively)].ITC are a frequent event in apparently tumor-free lymph nodes of gastric cancer patients and are overlooked by conventional histopathology. They are encountered even in limited stages of disease and impair patients' prognoses. This should be borne in mind when advocating local resection for early gastric cancer.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Pathology
Ki-1 Antigen
Gastroenterology
Stomach Neoplasms
Internal medicine
medicine
Humans
Stomach cancer
Lymph node
Survival rate
Aged
business.industry
Cancer
General Medicine
Middle Aged
Prognosis
medicine.disease
Immunohistochemistry
Early Gastric Cancer
Survival Rate
Isolated Tumor Cells
medicine.anatomical_structure
Oncology
Multivariate Analysis
Lymph Node Excision
Female
Histopathology
Lymph Nodes
Lymph
business
Subjects
Details
- ISSN :
- 14321335 and 01715216
- Volume :
- 130
- Database :
- OpenAIRE
- Journal :
- Journal of Cancer Research and Clinical Oncology
- Accession number :
- edsair.doi.dedup.....7c8e19977ce3918abbaf5d18122499d7