AIMS: The impact of extracapsular lymph node involvement (LNI) has been studied for several malignancies, including gastrointestinal malignancies. Aim of this study was to assess the current evidence on extracapsular LNI as a prognostic factor for recurrence in gastrointestinal malignancies. METHODS: The Cochrane Database of systematic reviews, the Cochrane central register of controlled trials, and MEDLINE databases were searched using a combination of keywords relating to extracapsular LNI in gastrointestinal malignancies. Primary outcome parameters were incidence of extracapsular LNI and overall five-year survival rates. FINDINGS: Fourteen manuscripts were included, concerning seven oesophageal, three gastric, one colorectal, and three rectal cancer series with a total of 1528 node positive patients. The pooled incidence of extracapsular LNI was 57% (95% CI: 53-61%) for oesophageal cancer, 41% (95% CI: 36-47%) for gastric cancer, and 35% (95% CI: 31-40%) for rectal cancer. In nine of the 14 studies a multivariate analysis was performed. In eight of these nine studies extracapsular LNI was identified as an independent risk factor for recurrence. CONCLUSION: Extracapsular LNI is a common phenomenon in patients with gastrointestinal malignancies. It identifies a subgroup of patients with a significantly worse long-term survival. This systematic review highlights the importance of assessing extracapsular LNI as a valuable prognostic factor. Pathologists and clinicians should be aware of this important feature.
AIMS: The impact of extracapsular lymph node involvement (LNI) has been studied for several malignancies, including gastrointestinal malignancies. Aim of this study was to assess the current evidence on extracapsular LNI as a prognostic factor for recurrence in gastrointestinal malignancies. METHODS: The Cochrane Database of systematic reviews, the Cochrane central register of controlled trials, and MEDLINE databases were searched using a combination of keywords relating to extracapsular LNI in gastrointestinal malignancies. Primary outcome parameters were incidence of extracapsular LNI and overall five-year survival rates. FINDINGS: Fourteen manuscripts were included, concerning seven oesophageal, three gastric, one colorectal, and three rectal cancer series with a total of 1528 node positive patients. The pooled incidence of extracapsular LNI was 57% (95% CI: 53-61%) for oesophageal cancer, 41% (95% CI: 36-47%) for gastric cancer, and 35% (95% CI: 31-40%) for rectal cancer. In nine of the 14 studies a multivariate analysis was performed. In eight of these nine studies extracapsular LNI was identified as an independent risk factor for recurrence. CONCLUSION: Extracapsular LNI is a common phenomenon in patients with gastrointestinal malignancies. It identifies a subgroup of patients with a significantly worse long-term survival. This systematic review highlights the importance of assessing extracapsular LNI as a valuable prognostic factor. Pathologists and clinicians should be aware of this important feature.
Authors: J Brabender; E Bollschweiler; A H Hölscher; K Strobel; C Gutschow; K Prenzel; P Grimminger; U Drebber; W Schröder; R Metzger; D Vallböhmer Journal: Oncol Lett Date: 2012-01-16 Impact factor: 2.967
Authors: Nicola Veronese; Matteo Fassan; Laura D Wood; Brendon Stubbs; Marco Solmi; Paola Capelli; Antonio Pea; Alessia Nottegar; Giuseppe Sergi; Enzo Manzato; Sara Carraro; Marco Maruzzo; Ivana Cataldo; Fabio Bagante; Mattia Barbareschi; Liang Cheng; Maria Bencivenga; Giovanni de Manzoni; Claudio Luchini Journal: J Gastrointest Surg Date: 2016-07-13 Impact factor: 3.452
Authors: Bobby V M Dasari; Sandro Pasquali; Ravinder S Vohra; Andrew M Smith; Mark A Taylor; Robert P Sutcliffe; Paolo Muiesan; Keith J Roberts; John Isaac; Darius F Mirza Journal: J Gastrointest Surg Date: 2015-06-09 Impact factor: 3.452
Authors: Ralf Metzger; Elfriede Bollschweiler; Uta Drebber; Stefan P Mönig; Wolfgang Schröder; Hakan Alakus; Martin Kocher; Stephan E Baldus; Arnulf H Hölscher Journal: World J Gastroenterol Date: 2010-04-28 Impact factor: 5.742