Nicola Veronese1, Matteo Fassan1, Laura D Wood2, Brendon Stubbs3, Marco Solmi4, Paola Capelli5, Antonio Pea6, Alessia Nottegar5, Giuseppe Sergi1, Enzo Manzato1, Sara Carraro1, Marco Maruzzo7, Ivana Cataldo5, Fabio Bagante6, Mattia Barbareschi8, Liang Cheng9, Maria Bencivenga10, Giovanni de Manzoni10, Claudio Luchini11,12,13. 1. Department of Medicine, DIMED, University of Padua, Padua, Italy. 2. Department of Pathology, The Johns Hopkins University, Baltimore, MD, USA. 3. Health Service and Population Research Department, King's College London, De Crespigny Park, London, UK. 4. Department of Neuroscience, University of Padua, Padua, Italy. 5. Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy. 6. Department of Surgery, University and Hospital trust of Verona, Verona, Italy. 7. Medical Oncology Unit, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto IOV-IRCCS, Padova, Italy. 8. Department of Pathology, Santa Chiara Hospital, Trento, Italy. 9. Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. 10. Division of General and Upper GI Surgery, Department of Surgery, University and Hospital trust of Verona, Verona, Italy. 11. Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Piazzale Scuro, 10, 37134, Verona, Italy. claudio.luchini@katamail.com. 12. Department of Pathology, Santa Chiara Hospital, Trento, Italy. claudio.luchini@katamail.com. 13. ARC-NET Research Center, University and Hospital Trust of Verona, Verona, Italy. claudio.luchini@katamail.com.
Abstract
INTRODUCTION: The extranodal extension (ENE) of nodal metastases (the extension of neoplastic cells through the nodal capsule into the perinodal soft tissue) is a histological feature that has been considered a prognostic factor in several cancers, but the role in gastric cancer was not yet investigated. We aimed to investigate the prognostic role of ENE in patients affected by gastric cancer through a systematic review and meta-analysis. MATERIAL AND METHODS: Two independent authors searched major databases until 09/30/2015 to identify studies providing data on gastric cancer patients' prognostic parameters and comparing patients with ENE (ENE+) vs intra-nodal extension (ENE-). The data were summarized using risk ratios (RRs) for the number of deaths/recurrences and hazard ratios (HRs) with 95 % confidence intervals (CI), adjusted for potential confounders. RESULTS: Nine studies followed up 3250 patients with gastric cancer (1064 ENE+ and 2186 ENE-). ENE+ was associated with a significantly higher risk of all-cause mortality (RR = 1.70; 95 % CI: 1.43-2.03, I (2) = 66 %; HR = 2.14; 95 % CI: 1.66-2.75, I (2) = 0 %), cancer-specific mortality (RR = 1.59; 95 % CI: 1.42-1.79; HR = 1.52; 95 % CI: 1.19-1.96), and disease recurrence (RR = 3.43, 95 % CI: 1.80-6.54, I (2) = 0 %). DISCUSSION: Judging from our results, ENE in gastric cancer patients should be considered for prognostic purposes from the gross sample to the pathology report.
INTRODUCTION: The extranodal extension (ENE) of nodal metastases (the extension of neoplastic cells through the nodal capsule into the perinodal soft tissue) is a histological feature that has been considered a prognostic factor in several cancers, but the role in gastric cancer was not yet investigated. We aimed to investigate the prognostic role of ENE in patients affected by gastric cancer through a systematic review and meta-analysis. MATERIAL AND METHODS: Two independent authors searched major databases until 09/30/2015 to identify studies providing data on gastric cancerpatients' prognostic parameters and comparing patients with ENE (ENE+) vs intra-nodal extension (ENE-). The data were summarized using risk ratios (RRs) for the number of deaths/recurrences and hazard ratios (HRs) with 95 % confidence intervals (CI), adjusted for potential confounders. RESULTS: Nine studies followed up 3250 patients with gastric cancer (1064 ENE+ and 2186 ENE-). ENE+ was associated with a significantly higher risk of all-cause mortality (RR = 1.70; 95 % CI: 1.43-2.03, I (2) = 66 %; HR = 2.14; 95 % CI: 1.66-2.75, I (2) = 0 %), cancer-specific mortality (RR = 1.59; 95 % CI: 1.42-1.79; HR = 1.52; 95 % CI: 1.19-1.96), and disease recurrence (RR = 3.43, 95 % CI: 1.80-6.54, I (2) = 0 %). DISCUSSION: Judging from our results, ENE in gastric cancerpatients should be considered for prognostic purposes from the gross sample to the pathology report.
Authors: J Wind; S M Lagarde; F J W Ten Kate; D T Ubbink; W A Bemelman; J J B van Lanschot Journal: Eur J Surg Oncol Date: 2006-12-15 Impact factor: 4.424
Authors: Helena Link; Martin Angele; Miriam Schüller; Petra Ganschow; Lena Machetanz; Markus Guba; Jens Werner; Thomas Kirchner; Jens Neumann Journal: BMC Cancer Date: 2018-04-27 Impact factor: 4.430