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Staging of Head and Neck Cancer
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Lymph nodes are described as ipsilateral, bilateral, contralateral, or midline; they may be single or multiple and are measured by size, number, and anatomical location. Midline nodes are considered ipsilateral nodes, except with thyroid cancers. Direct extension of the primary tumour into lymph nodes is classified as lymph node metastasis.
Sentinel lymph node mapping in breast cancer
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
Angelena Crown, Mary L. Gemignani
At the time of Halsted’s radical mastectomy, complete ALND, including levels I–III, was routine, given the importance of nodal status for prognostication. The status of the axilla remains one of the most important prognostic factors today. Although valuable, clinical examination of the axilla is neither sensitive nor specific, and a negative clinical exam does not guarantee absence of metastatic disease. Multiple studies have shown that even in tumors <1 cm in size, lymph node metastasis may be present in >10% of patients and that the incidence of lymph node metastasis increases with larger tumor size.6
Primary adrenal malignancy
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Ayshea Hameeduddin, Anju Sahdev, Rodney H Reznek
Radical lymph node dissection (LND) is standard practice for most solid malignancies. In ACCs, LND is incompletely defined. The presence of metastatic regional lymph node metastasis occurs in up to 20% and has a negative correlation with survival. En bloc resection of surrounding structures includes adequate lymph nodes for staging, but this is not currently deemed standard of care, and the definition of LND has not been set. Limited literature suggests LND confers a reduced risk of tumour recurrence as well as a reduced risk of disease-related death (41).
Influence of Preoperative Nutritional Status on Patients Who Undergo Upfront Surgery for Esophageal Squamous Cell Carcinoma
Published in Nutrition and Cancer, 2022
Jin Hee Noh, Hee Kyong Na, Yong-Hee Kim, Ho June Song, Hyeong Ryul Kim, Kee Don Choi, Gin Hyug Lee, Hwoon-Yong Jung
The clinical characteristics of patients and tumors are summarized in Table 1. The median age was 63 years (IQR, 58–70) and 94.5% (259/274) of patients were male. No patient complained of obstructive symptoms or required nutritional support with enteral tube feedings. The median preoperative PNI score was 48.6 (IQR, 45.1–51.6) and the results showed that 23.0% (63/274) of esophageal cancer patients (low PNI < 45) were malnourished. We also evaluated the NRS 2002 scores and 12.8% (35/274) of patients (high NRS 2002 ≥ 3) were classified as requiring nutritional intervention. The median CONUT score was 1.0 (0.0–2.0), and the high CONUT (≥3) group constituted 15.7% (43/274). In 13 patients (4.7%), the tumor invaded the muscularis propria. In 63 patients (22.9%) lymph node metastasis in resected specimens was observed. The pathological stages were Stage I—204 (74.5%), Stage II—56 (20.4%), and Stage III—14 (5.1%). Additionally, 58 patients (21.2%) underwent additional therapy after surgery. Postoperative complications occurred in a total of 49 patients, followed by wound complications (18, 6.6%), pneumonia (17, 6.2%), anastomosis site leakage (8, 2.9%), bleeding (2, 0.7%), and other issues (4, 1.5%). Complications included gastrotracheal fistula and a sustained JP drain. The median postoperative hospitalization was 14 day (IQR, 12–19), and the median follow-up period was 55 mo, (IQR, 40–69).
A clearer view on ovarian clear cell carcinoma
Published in Acta Clinica Belgica, 2022
Aglaja De Pauw, Eline Naert, Koen Van de Vijver, Tummers Philippe, Katrien Vandecasteele, Hannelore Denys
Similar to the EOC, prognosis is mainly determined by FIGO stage at diagnosis [2,3,8,13]. Adjusted for stage, the 5-year disease-specific survival of patients with OCCC is worse compared to patients with serous carcinoma, translating into a significant difference (p < 0001) for each stage: 85.3% vs. 86.4% for stage I, 60.3% vs. 66.4% for stage II, 31.5% vs. 35.0% stage III, and 17.5% vs. 22.2% stage IV, respectively [4]. A pooled analysis with 544 patients based on 12 existing prospective randomized Gynecological Oncology Group (GOG) protocols demonstrated a better survival of OCCC in early stage but a worse survival in advanced stages compared to EOC [13]. The poor survival of advanced OCCC was confirmed in a meta-analysis by the Gynecologic Cancer Intergroup. The median overall survival for stage III/IV OCCC in this analysis was only 21.3 months [15]. The risk of relapse increases with a more severe stage at diagnosis. The proportion of OCCC patients who relapse is 29%, 30%, 62% and 73% at stage I, II, III and IV, respectively [11]. The presence of lymph node metastasis is an independent prognostic factor for survival [16]. A recent retrospective cohort study with 209 OCCC patients showed a high proportion (25.8%) of patient with a second primary malignancy, both synchronous and metachronous, in some cases in several organ systems [17].
A Nomogram for Predicting Lymph Nodal Metastases in Patients with Appendiceal Cancers: An Analysis of SEER Database
Published in Journal of Investigative Surgery, 2021
Dan Wang, Chongshun Liu, Tingyu Yan, Chenglong Li, Cenap Güngör, Qionghui Yang, Yang Xu, Lilan Zhao, Qian Pei, Fengbo Tan, Yuqiang Li
In this study, the potential risk of LN metastasis had a bearing on age, tumor grade, tumor histology, T stage, M stage and tumor size in appendiceal cancer patients. Among them, tumor grade was the most principal hazard factor of LN metastasis in this nomogram. Patients of undifferentiated appendiceal cancer owned the highest risk of LN metastasis which were consistent with most previous studies [24–27]. Moreover, T stage could also be used as an important predictive factors of LN metastasis for appendiceal cancer, which was confirmed by these research of Ryan W. Day and Partelli S [22,28]. The study of Mosquera C et al displayed that tumor size was associated with lymph node metastasis of appendicoma [23]. This study verified that patients with tumors ≥2 cm suffered a higher risk of LN metastasis than those <2 cm. Interestingly, the risk of lymph node metastasis did not increase completely with age. In fact, patients over 80-year old suffered the highest risk of lymph node metastasis but those less than 50 years old not the lowest. Moreover, this study found that lymph node metastasis related to distant metastasis closely. Previous studies also reported that patients' age and distant metastasis were related with LN metastasis in patients with appendiceal cancer [22,23].