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Urothelial and Urethral Cancer
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Ibrahim Jubber, Karl H. Pang, James W.F. Catto
Lymphovascular invasion:Can lead to metastases.Present in ~25% of MIBC.Poor prognostic sign − 40% risk of nodal disease.Independent predictor of survival.
Gynaecological cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Microscopically, the distinction between a benign mole and choriocarcinoma is made by the absence of villi in the choriocarcinoma with areas of necrosis and haemorrhage. The cells of the trophoblast have malignant features with many mitoses and pleomorphic cells with multiple nucleoli. Lymphovascular invasion is common.
The respiratory system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
This is a rapidly growing and aggressive tumour, which may present with metastases without any visible primary tumour. It arises more commonly in the hilum with extension into lymph nodes (Figure 8.21) and, in advanced cases, with bronchial obstruction by extrinsic compression. Some tumours, however, arise in the periphery of the lung. The tumour is soft and white, and shows extensive necrosis. In classic small cell carcinomas there are sheets of small, hyperchromatic nuclei with nuclear moulding and little cytoplasm (Figure 8.33). There is a high mitotic rate, apoptosis, and necrosis. This tumour stains positively with neuroendocrine markers NCAM (neural cell adhesion molecule, CD56), synaptophysin, chromogranin, and thyroid transcription factor 1 (TTF-1). The term combined small cell carcinoma refers to a tumour with this pattern combined with an adenocarcinoma, or squamous or large-cell carcinoma component. Lymphovascular invasion occurs early and distant metastases are common. These are seen in bone marrow, liver, kidney, adrenals, cerebrum, cerebellum, meninges, and regional and cervical lymph nodes. This tumour is extremely responsive to chemotherapy, at least initially, and this is the main modality of treatment. However, recurrence is common and the 5-year survival rate is about 5%. SCLC frequently shows loss of tumour suppressor genes p53 and Rb, and myc amplification is common.
The prognostic significance of skin involvement in breast cancer patients with chest wall recurrence
Published in Annals of Medicine, 2023
Danyang Zhou, Mei Li, Fei Xu, Qiufan Zheng, Qianyi Lu, Ruoxi Hong, Shusen Wang
We reviewed, collected and organized all eligible cases between February and June 2021. A total of 25,272 female breast cancer patients visited Sun Yat-sen University Cancer Center between January 2000 and April 2020, and 476 (1.9%) of them met the inclusion criteria and were enrolled in this retrospective study (Figure 1). The clinicopathological characteristics of the 476 patients are summarized in Table 1. All the patients underwent radical resection of the primary lesions. Twenty-six patients had a previous lumpectomy with surgical axillary staging, and the remaining patients had undergone total mastectomy with surgical axillary staging ± reconstruction. The postoperative pathological reports of all the patients showed a negative margin ≥1 mm. Invasive ductal carcinoma (IDC) was the main pathological subtype of the primary site in these patients. Almost half of the patients were T1–2 or N positive according to the TNM stage. A total of 24.2% of patients had lymphovascular invasion of the primary tumour. Compared with the primary lesion, the proportion of Ki-67 ≥ 15% increased significantly in recurrent lesions, while the positive proportion of oestrogen receptor (ER), progesterone receptor (PR) and HER2 did not change significantly (Supplementary Table). The median intervals between primary treatment and CWR and OS after CWR were 26.15 and 103.76 months, respectively. The median follow-up time after the initial breast cancer diagnosis was 63.7 months, and the median follow-up time after the CWR diagnosis was 37.4 months.
Predicting response to neoadjuvant chemotherapy in patients with oesophageal adenocarcinoma
Published in Acta Oncologica, 2021
Rebecca K. Bott, Gincy George, Ricardo McEwen, Janine Zylstra, William R. C. Knight, Cara R. Baker, Mark Kelly, Nyree Griffin, Naami McAddy, Nick Maisey, Mieke Van Hemelrijck, James A. Gossage, Jesper Lagergren, Andrew R. Davies
In this study, lymphovascular invasion was associated with non-responder status. Although lymphovascular invasion is not standardly available prior to surgical resection, it can be identified in patients with early stage tumours, from endoscopic mucosal resection or dissection specimens. There have also been recent studies, in other cancer types, which suggest that accurate prediction of lymphovascular invasion prior to surgery can be achieved using a variety of different techniques. One study demonstrated the use of pre-operative CT in predicting lymphovascular invasion in early rectal cancer by measuring the diameter of the superior haemorrhoidal vein [34]. The prediction of lymphovascular invasion in breast cancer has been demonstrated using magnetic-resonance imaging and specifically the tumour apparent diffusion coefficient [35]. More recently, another study demonstrated that a specific candidate gene can be used as a potential biomarker for predicting lymphovascular invasion in endometrial cancer [36]. These encouraging results highlight the potential for future work where accurate prediction of lymphovascular invasion may have a role alongside other factors in determining response to neoadjuvant chemotherapy in oesophageal adenocarcinoma.
Comparison of Right-side and Left-side Colon Cancers Following Laparoscopic Radical Lymphadenectomy
Published in Journal of Investigative Surgery, 2021
Han Deok Kwak, Jae Kyun Ju, Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
Vascular, lymphatic, or lymphovascular invasion (LVI) refers to entry into the blood vessels or lymph channels by cancer cells. LVI has powerful prognostic significance. The presence of LVI in colon cancer patients is an independent predictor of adverse disease-free survival (p = 0.02) [11], and has been confirmed in early colon cancers; a meta-analysis including 19 studies on 9,881 patients in stages I and II showed LVI is significantly associated with poor prognosis in overall survival (hazard ratio [HR] = 2.15, 95% confidence interval [CI] = 1.72–2.68, p < 0.01) and disease-free survival (HR = 1.73, 95% CI = 1.50–1.99, p < 0.01) [12]. We analyzed vascular and lymphatic invasion separately in this study; lymphatic invasion includes capillary invasion and involvement of small vessels in general, while large vessel involvement indicates venous invasion [13]. Vascular invasion can be understood as the first entry of tumor cells into vessels, which may result in micro-metastasis and eventually macroscopic tumor growth at another site [14]. The pathologic data in this study clearly distinguished between lymphatic channel and venous involvement; therefore, these were analyzed separately. However, venous invasion, especially in an extramural location (EMVI), is a strong prognostic factor in colorectal cancers, while the prognostic significance of intramural venous invasion (IMVI) remains unclear [15].