Perigastric Tumor Deposits in Primary Gastric Cancer: Implications for Patient Prognosis and Staging View Full Text


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Article Info

DATE

2013-05

AUTHORS

Hye Seung Lee, Hee Eun Lee, Han-Kwang Yang, Woo Ho Kim

ABSTRACT

BACKGROUND: Metastatic nodules in perigastric adipose tissue without evidence of lymph node tissue have been reported in gastric cancers. However, the morphological features and clinical significance of perigastric tumor deposits (TD) have not been clarified in gastric cancers. METHODS: To demonstrate the clinical implication of perigastric TD, 653 consecutive gastric cancer patients were enrolled and all of their slides were reviewed. Separate tumor nodules in the perigastric fat were classified as perigastric TD and correlated with clinicopathologic features and patient survival. RESULTS: Perigastric TD were observed in 156 (23.9 %) of 653 patients. Perigastric TD were associated with synchronous distant metastasis (p < 0.001), independently of depth and venous invasion. There was a significant difference between the overall survival of those with and without TD by univariate (p < 0.001) and multivariate (p = 0.001) survival analyses. However, distant metastasis or patient prognosis could not be predicted by the morphologic patterns of the TD (p > 0.05). When TD without lymph node tissue and lymph node metastasis were recorded separately, TD were observed in 13 node-negative patients. The overall survival of node-negative patients with TD was significantly worse than that of node-negative patients without TD (p < 0.001). CONCLUSIONS: Perigastric TD significantly correlated with distant metastasis and satisfactorily predicted patient outcomes independently of invasion depth, lymph node metastasis, and other clinicopathologic factors. Our findings suggest that perigastric TD should be included in the staging of patients with gastric cancer. More... »

PAGES

1604-1613

References to SciGraph publications

  • 2009-02. Positive Lymph Node Ratio Is an Independent Prognostic Factor in Gastric Cancer After D2 Resection Regardless of the Examined Number of Lymph Nodes in ANNALS OF SURGICAL ONCOLOGY
  • 1998-01. Prognostic significance of extranodal microscopic foci discontinuous with primary lesion in rectal cancer in DISEASES OF THE COLON & RECTUM
  • 2010-08. The prognostic significance of isolated tumor cells in the lymph nodes of gastric cancer patients in GASTRIC CANCER
  • 2008-11. Prognostic implications of type and density of tumour-infiltrating lymphocytes in gastric cancer in BRITISH JOURNAL OF CANCER
  • 1998-12. Japanese Classification of Gastric Carcinoma – 2nd English Edition – in GASTRIC CANCER
  • 2009-03. Tumor deposits are encountered in advanced colorectal cancer and other adenocarcinomas: an expanded classification with implications for colorectal cancer staging system including a unifying concept of in-transit metastases in MODERN PATHOLOGY
  • 2009-03. The Prognostic Impact of Isolated Tumor Cells in Lymph Nodes of T2N0 Gastric Cancer: Comparison of American and Japanese Gastric Cancer Patients in ANNALS OF SURGICAL ONCOLOGY
  • 2011-06. Japanese classification of gastric carcinoma: 3rd English edition in GASTRIC CANCER
  • 2007-08. Pathological assessment of pericolonic tumor deposits in advanced colonic carcinoma: relevance to prognosis and tumor staging in MODERN PATHOLOGY
  • 2003-11. Impact of Microscopic Extranodal Tumor Deposits on the Outcome of Patients With Rectal Cancer in DISEASES OF THE COLON & RECTUM
  • 2005-05. A Clinicopathological Investigation of “Tumor Nodules” in Colorectal Cancer in SURGERY TODAY
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    http://scigraph.springernature.com/pub.10.1245/s10434-012-2692-9

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    http://dx.doi.org/10.1245/s10434-012-2692-9

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/23184289


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    53 schema:description BACKGROUND: Metastatic nodules in perigastric adipose tissue without evidence of lymph node tissue have been reported in gastric cancers. However, the morphological features and clinical significance of perigastric tumor deposits (TD) have not been clarified in gastric cancers. METHODS: To demonstrate the clinical implication of perigastric TD, 653 consecutive gastric cancer patients were enrolled and all of their slides were reviewed. Separate tumor nodules in the perigastric fat were classified as perigastric TD and correlated with clinicopathologic features and patient survival. RESULTS: Perigastric TD were observed in 156 (23.9 %) of 653 patients. Perigastric TD were associated with synchronous distant metastasis (p < 0.001), independently of depth and venous invasion. There was a significant difference between the overall survival of those with and without TD by univariate (p < 0.001) and multivariate (p = 0.001) survival analyses. However, distant metastasis or patient prognosis could not be predicted by the morphologic patterns of the TD (p > 0.05). When TD without lymph node tissue and lymph node metastasis were recorded separately, TD were observed in 13 node-negative patients. The overall survival of node-negative patients with TD was significantly worse than that of node-negative patients without TD (p < 0.001). CONCLUSIONS: Perigastric TD significantly correlated with distant metastasis and satisfactorily predicted patient outcomes independently of invasion depth, lymph node metastasis, and other clinicopathologic factors. Our findings suggest that perigastric TD should be included in the staging of patients with gastric cancer.
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