Sample records for cancer axillary lymph

  1. Axillary lymph node metastasis in lung cancer

    Microsoft Academic Search

    Hiroaki Satoh; Hiroichi Ishikawa; Katsunori Kagohashi; Koichi Kurishima; Kiyohisa Sekizawa

    2009-01-01

    Study objectives Axillary lymph node metastasis (ALNM) from lung cancer is rare. Its prognosis and effective treatments remain unknown. To\\u000a evaluate clinicopatholgical characteristics of such lung cancer patients, we performed a retrospective study of them, who\\u000a had ALNM at the time of initial presentation or developed ALNM in their clinical courses. Methods We reviewed the medical records and pathological reports

  2. Determinants of axillary recurrence after axillary lymph node dissection for invasive breast cancer

    Microsoft Academic Search

    A. C. Voogd; R. de Boer; M. J. C. van der Sangen; R. M. H. Roumen; H. J. T. Rutten; J. W. W. Coebergh

    2001-01-01

    Aim This study was undertaken to gain insight into the risk factors for axillary recurrence among patients with invasive breast cancer who underwent breast-conserving treatment or mastectomy and axillary lymph node dissection. Methods In a matched case–control design, 59 patients with axillary recurrence and 295 randomly selected control patients without axillary recurrence were compared. Matching factors included age, year of

  3. Sentinel lymph node biopsy alone without axillary lymph node dissection – follow up of sentinel lymph node negative breast cancer patients

    Microsoft Academic Search

    R Reitsamer; F Peintinger; E Prokop; C Menzel; W Cimpoca; L Rettenbacher

    2003-01-01

    Aims: To evaluate the rate of axillary recurrences in sentinel lymph node (SLN) negative breast cancer patients after sentinel lymph node biopsy (SLNB) alone without further axillary lymph node dissection (ALND).Methods: Between May 1999 and February 2001 all patients who had primary invasive breast cancer and were SLN negative were eligible for this prospective study. SLNB was performed by using

  4. Sentinel lymph-node biopsy compared to axillary lymph-node dissection for axillary staging in breast cancer patients

    Microsoft Academic Search

    P Schrenk; A Shamiyeh; W Wayand

    2001-01-01

    Aims The purpose of this study was to evaluate the feasibility of sentinel lymph-node biopsy in breast cancer patients at our institution and to compare the results of sentinel node (SN) biopsy to standard axillary lymph-node dissection (ALND). Methods In a retrospective study the percentage of lymph-node positive patients and the number of micrometastases in 165 breast cancer patients following

  5. Sentinel lymph-node biopsy compared to axillary lymph-node dissection for axillary staging in breast cancer patients

    Microsoft Academic Search

    P. Schrenk; A. Shamiyeh; W. Wayand

    Aims: The purpose of this study was to evaluate the feasibility of sentinel lymph-node biopsy in breast cancer patients at our institution and to compare the results of sentinel node (SN) biopsy to standard axillary lymph-node dissection (ALND). Methods: In a retrospective study the percentage of lymph-node positive patients and the number of micrometastases in 165 breast cancer patients following

  6. The role of axillary lymph node dissection in breast cancer patients with sentinel lymph node micrometastases

    Microsoft Academic Search

    M. Gipponi; G. Canavese; R. Lionetto; A. Catturich; C. Vecchio; A. Sapino; D. Friedman; F. Cafiero

    2006-01-01

    AimTo identify by means of clinical and histopathological features a subset of breast cancer patients with sentinel lymph-node (sN) micrometastases and metastatic disease confined only to the sN in order to spare them an unnecessary axillary lymph node dissection (ALND).

  7. Axillary lymph node dissection in early-stage invasive breast cancer: is it still standard today?

    Microsoft Academic Search

    Bernd Gerber; Kristin Heintze; Johannes Stubert; Max Dieterich; Steffi Hartmann; Angrit Stachs; Toralf Reimer

    2011-01-01

    Evaluation of axillary lymph node status by sentinel lymph node biopsy (SLNB) and complete axillary lymph node dissection\\u000a (ALND) are an inherent part of breast cancer treatment. Increased understanding of tumor biology has changed the prognostic\\u000a and therapeutic impact of lymph node status. Non-invasive imaging techniques like axillary ultrasound, FDG-PET, or MRI revealed\\u000a moderate sensitivity and high specificity in evaluation

  8. Minimal risk of macrometastases in the non-sentinel axillary lymph nodes in breast cancer patients with micrometastatic sentinel lymph nodes and preoperatively ultrasonically uninvolved axillary lymph nodes

    Microsoft Academic Search

    Janez Zgajnar; Nikola Besic; Maja Podkrajsek; Kristijana Hertl; Snjezana Frkovic-Grazio; Marko Hocevar

    2005-01-01

    Micrometastases in the sentinel lymph node (SLN) carry a considerable risk of macrometastases in the non-sentinel lymph nodes (NSLN), resulting in axillary lymph node dissection (ALND). Preoperative ultrasound (US) examination of the axillary lymph nodes combined with a fine-needle aspiration biopsy (FNAB) has been proved to discover metastases in the axillary lymph nodes. The aim of our study was to

  9. Quantitative evaluation of metastases in axillary lymph nodes of breast cancer

    Microsoft Academic Search

    M Inokuchi; I Ninomiya; K Tsugawa; I Terada; K Miwa

    2003-01-01

    We have established a highly sensitive and quantitative reverse transcriptase–polymerase chain reaction (RT–PCR) method to detect axillary lymph node metastases of breast cancer. Amplifying cytokeratin 19 (CK19) mRNA transcripts using real-time TaqMan PCR made it possible to quantify axillary metastatic burden. Metastases in 358 axillary lymph nodes obtained from 23 breast cancers of 22 patients were investigated by conventional haematoxylin

  10. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer

    Microsoft Academic Search

    Karen K. Swenson; Mary J. Nissen; Carolyn Ceronsky; Lindsey Swenson; Martin W. Lee; Todd M. Tuttle

    2002-01-01

    Background  Axillary lymph node dissection (ALND) is often associated with permanent arm side effects. Side effects after sentinel lymph\\u000a node dissection (SLND) should be less common, because the surgery is less extensive.\\u000a \\u000a \\u000a \\u000a Methods  The study compared side effects and interference with daily life between 169 women who underwent an SLND and 78 who underwent\\u000a an ALND for breast cancer. Patients rated symptom

  11. Intraoperative Pathologic Evaluation of a Breast Cancer Sentinel Lymph Node Biopsy as a Determinant for Synchronous Axillary Lymph Node Dissection

    Microsoft Academic Search

    John M. Kane III; Stephen B. Edge; Janet S. Winston; Nancy Watroba; Thelma C. Hurd

    2001-01-01

    Background: Intraoperative pathologic evaluation of a breast cancer sentinel lymph node (SLN) biopsy permits synchronous axillary lymph node dissection (ALND), but frozen section is time consuming and potentially inaccurate. This study evaluated intraoperative gross examination and touch prep analysis (TPA) of a breast cancer SLN biopsy as determinants for synchronous ALND. Methods: Intraoperative gross examination\\/TPA were performed on the SLN

  12. Predictors of positive axillary lymph nodes in breast cancer patients with metastatic sentinel lymph node

    Microsoft Academic Search

    Isabel Peixoto Callejo; José Américo Brito; José Wheinholtz Bivar; Fernando Jesus Fernandes; João Leal Faria; María Saudade André; Carlos Santos Costa; M. Odette Almelda; J. Menesese Sousa

    2005-01-01

    Introduction  Breast cancer with metastatic sentinel lymph nodes (SLN) may have clinico-pathologic factors associated with the presence\\u000a of positive nonsentinel axillary nodes (NSLN). The aim of the present study was to determine factors that predict in-volvement\\u000a of NSLN in breast cancer patients with positive SLN.\\u000a \\u000a \\u000a \\u000a Material and methods  A prospective database search identified 80 patients who underwent SLN biopsy for invasive breast

  13. Five cases of axillary lymph node metastatic breast cancer on contrast-enhanced sonography.

    PubMed

    Ohta, Tomoyuki; Nishioka, Makiko; Nakata, Norio; Fukuda, Kunihiko; Kato, Kumiko

    2015-06-01

    This study was performed to determine the importance of contrast-enhanced sonography for axillary lymph node metastatic breast cancer. Contrast-enhanced sonographic findings in 5 patients with breast cancer and axillary lymph node metastasis are discussed, and imaging-pathologic correlations are also presented in 3 cases. In all 5 cases, lymph nodes showed a perfusion defect in the late phase. Rapid arterial enhancement and wash-out were observed in 2 cases in which we performed second injections. Contrast-enhanced sonography may be effective for identifying metastatic lesions in lymph nodes, especially in the early stages. PMID:26014334

  14. Comparative efficacy of positron emission tomography and ultrasonography in preoperative evaluation of axillary lymph node metastases in breast cancer

    Microsoft Academic Search

    Masatoshi Ohta; Yutaka Tokuda; Yuki Saitoh; Yasuhiro Suzuki; Akira Okumura; Mitsuhiro Kubota; Hiroyasu Makuuchi; Tomoo Tajima; Seiei Yasuda; Akira Shohtsu

    2000-01-01

    Purpose  In primary breast cancer, axillary nodal status is the most powerful predictive factor of recurrence. However, axillary lymph\\u000a node dissection may cause surgical complications. If preoperative evaluation of axillary lymph node metastases is possible,\\u000a unnecessary axillary lymph node dissections can be avoided. The purpose of this study was to evaluate the efficacy of positron\\u000a emission tomography (PET) on detection of

  15. Axillary lymph node ratio and total number of removed lymph nodes: predictors of survival in stage I and II breast cancer

    Microsoft Academic Search

    B. C. H van der Wal; R. M. J. M Butzelaar; S van der Meij; M. A Boermeester

    2002-01-01

    Aims: Presence of axillary lymph node metastases is considered the most important prognostic factor for breast cancer survival. In a period of increasing popularity for the sentinel node procedure, clarity about the possible relation between axillary dissection and survival is essential. This study investigated whether the total number of removed lymph nodes and the ratio of invaded\\/removed lymph nodes (lymph

  16. In vitro diagnosis of axillary lymph node metastases in breast cancer by spectrum analysis of radio frequency echo signals

    Microsoft Academic Search

    Tsutomu Tateishi; Junji Machi; Ernest J. Feleppa; Robert Oishi; Jerry Jucha; Eugene Yanagihara; Laurence J. McCarthy; Tomoaki Noritomi; Kazuo Shirouzu

    1998-01-01

    Axillary lymph node status is of particular importance for staging and managing breast cancer. Currently, axillary lymph node dissection is performed routinely in cases of invasive breast cancer because of the lack of accurate noninvasive methods for diagnosing lymph node metastasis. We investigated the diagnostic ability of ultrasonic tissue characterization based on spectrum analysis of backscattered echo signals to detect

  17. Axillary sparganosis which was misunderstood lymph node metastasis during neoadjuvant chemotheraphy in a breast cancer patient.

    PubMed

    Lee, Eun Kyoung; Yoo, Young Bum

    2014-12-01

    Sparganosis of the breast is an uncommon disease, but should be considered in the differential diagnosis of unusual and suspicious breast masses. A history of ingesting contaminated water and direct ingestion of snakes and frogs may help in differential diagnosis of the mass. Complete surgical removal is the treatment of choice and provides a definite diagnosis. We report a case of multiple axillary lymph node sparganosis. It was first considered as an axillary metastasis of breast cancer because a newly axillary mass appeared in follow-up radiologic study after neoadjuvant chemotherapy. We performed curative breast cancer surgery and sparganosis was confirmed by extracting the worm during axillary dissection. PMID:25485243

  18. Sentinel lymph node biopsy results in less postoperative morbidity compared with axillary lymph node dissection for breast cancer

    Microsoft Academic Search

    William E Burak; Scott T Hollenbeck; Emmanuel E Zervos; Karen L Hock; Lisa C Kemp; Donn C Young

    2002-01-01

    Background: This study was designed to compare the postoperative morbidity and socioeconomic impact of sentinel lymph node biopsy (SLNB) with axillary lymph node dissection (ALND) in patients with early stage breast cancer.Methods: A prospective, nonrandomized, controlled study was designed to include patients who underwent breast conservation surgery and SLNB ± ALND. Group A consisted of patients who had a negative

  19. FDG-PET for axillary lymph node staging in primary breast cancer

    Microsoft Academic Search

    Flavio Crippa; Alberto Gerali; Alessandra Alessi; Roberto Agresti; Emilio Bombardieri

    2004-01-01

    Management of the axilla in patients with operable breast cancer is still one of the most controversial areas in clinical oncology. The best procedure to examine the lymph nodes is still standard axillary lymph node dissection; nevertheless, the morbidity associated with this procedure is well known. Based on these considerations, it is important for progress in the treatment of operable

  20. Sentinel lymph node biopsy compared with axillary lymph node dissection in early breast cancer: a meta-analysis

    Microsoft Academic Search

    Zhen Wang; Liu-Cheng Wu; Jun-Qiang Chen

    Sentinel lymph node biopsy (SLNB) has been recommended as the standard performance for negative sentinel lymph node (SLN)\\u000a patients without axillary lymph node dissection (ALND) in the surgical management of early breast cancer; however, the efficiency\\u000a of SLNB for patients with positive SLNs is still unclear. We performed this meta-analysis to compare the effectiveness and\\u000a safety of SLNB with ALND.

  1. S-Classification of Sentinel Lymph Node Predicts Axillary Nonsentinel Lymph Node Status in Patients with Breast Cancer

    Microsoft Academic Search

    Astrid Maria Fink; Harald Lass; Helmut Hartleb; Wolfgang Jurecka; Heinrich Salzer; Andreas Steiner

    2008-01-01

    Background  One-half of breast cancer patients with positive sentinel lymph node (SN) have no further metastases in the axillary lymph\\u000a node basin. The aim of the present study was to identify patients with positive SN who are unlikely to have further metastases\\u000a in the axillary lymph node basin, using a new classification of SN, namely the S-classification.\\u000a \\u000a \\u000a \\u000a Methods  Specimens of positive SN

  2. The evolving role of axillary lymph node dissection in the modern era of breast cancer management

    Microsoft Academic Search

    J. M. Barry; W. P. Weber; V. Sacchini

    The standard of practice in breast cancer surgery is that all patients with a positive sentinel node mandate an axillary lymph node dissection (ALND). Recently, this dogma has been challenged by a trial from ACOSOG (American College Of Surgeons Oncology Group) (Trial Z0011) which demonstrated that patients (without clinically\\/radiologically apparent axillary metastases) undergoing breast conserving surgery (i.e lumpectomy followed by

  3. Role of axillary lymph node dissection after tumor downstaging with induction chemotherapy for locally advanced breast cancer

    Microsoft Academic Search

    Henry M. Kuerer; Lisa A. Newman; Bruno D. Fornage; Kapil Dhingra; Kelly K. Hunt; Aman U. Buzdar; Fred C. Ames; Merrick I. Ross; Barry W. Feig; Gabriel N. Hortobagyi; S. Eva Singletary

    1998-01-01

    Background: Induction chemotherapy has become the standard of care for patients with locally advanced breast cancer (LABC) and currently is being evaluated in prospective clinical trials in patients with earlier-stage disease. To better gauge the role of axillary lymph node dissection in patients with LABC this study was performed to assess initial axillary status on physical and ultrasound examination, axillary

  4. Interoperative detection of cancer metastasis to the axillary lymph nodes

    NASA Astrophysics Data System (ADS)

    Derakhshan, Jamal

    2002-03-01

    Sentinel lymph node biopsy utilizing Technetium-99m-labeled sulfur colloid is becoming a standard part of the surgical treatment of breast cancer. However, the non-tumor-specific nature of colloids necessitates removal of the node(s) for analysis. Tumor-specific radiotracers, such as positron-emitting Fluorine-18-labeled Fluorodeoxyglucose (FDG), are used with positron emission tomography (PET) to successfully stage breast cancer. Thus, the use of FDG with a handheld probe optimized for detection of beta particles could perhaps identify cancer-infiltrated nodes. In this study the ability of a new solid-state beta-sensitive probe to identify tumor-infiltrated lymph nodes was investigated in a phantom study. A PET image of the phantom was also acquired. The results demonstrated that the probe was capable of identifying nodes containing as little as 10ml of tumor, an amount too small to be detected by the PET scanner. This method, therefore, may be useful in intraoperatively identifying some tumor-infiltrated lymph nodes not detected with PET.

  5. A Prospective Evaluation of Positron Emission Tomography Scanning, Sentinel Lymph Node Biopsy, and Standard Axillary Dissection for Axillary Staging in Patients with Early Stage Breast Cancer

    Microsoft Academic Search

    Peter J. Lovrics; Vicky Chen; Geoff Coates; Sylvie D. Cornacchi; Charlie H. Goldsmith; Calvin Law; Mark N. Levine; Ken Sanders; Ved R. Tandan

    2004-01-01

    Background: Positron emission tomography (PET) is a noninvasive imaging modality that can detect malignant lymph nodes. This study determined the sensitivity, specificity, predictive values, and likelihood ratios of PET scanning compared with standard axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) in staging the axilla in women with early stage breast cancer.Methods: Women with clinical stage I

  6. Eighteen Sensations After Breast Cancer Surgery: A 5Year Comparison of Sentinel Lymph Node Biopsy and Axillary Lymph Node Dissection

    Microsoft Academic Search

    Roberta H. Baron; Jane V. Fey; Patrick I. Borgen; Michelle M. Stempel; Kathleen R. Hardick; Kimberly J. Van Zee

    2007-01-01

    Background  The aim of this study is to evaluate prevalence, severity, and level of distress of 18 sensations at baseline (3–15 days)\\u000a and 5 years after breast cancer surgery, and compare sensations after sentinel lymph node biopsy (SLNB) with those after SLNB\\u000a plus immediate or delayed axillary lymph node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Methods  A total of 187 patients with breast cancer completed the

  7. Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up

    Microsoft Academic Search

    Patty H Spruit; Sabine Siesling; Marloes AG Elferink; Ernest JA Vonk; Carel JM Hoekstra

    2007-01-01

    BACKGROUND: The standard treatment of the axilla in breast cancer used to be an axillary lymph node dissection. An axillary lymph node dissection is known to give substantial risks of morbidity. In recent years the sentinel node biopsy has become common practice. Future randomized study results will determine whether the expected decrease in morbidity can be proven. METHODS: Before the

  8. [Statistical distribution of involved axillary lymph nodes in breast cancer].

    PubMed

    Guern, Anne-Sophie; Vinh-Hung, Vincent

    2008-04-01

    Our aim is to characterize the statistical distribution of the number of involved lymph nodes in breast cancer. The material uses a sample of 109618 women from the US SEER (Surveillance, Epidemiology, and End Results). In a first analysis, we observed a log-concave distribution with overdispersion which excluded a Poisson stochastic process. A Negative Binomial (NB) provided an acceptable fit. Overdispersion implies that there are patients who are more at risk than expected, and/or cascade processes in which the variability increases when there are more involved lymph nodes. In a second series of analyses, we applied predictive models taking into account or not the NB. Logistic models, commonly used, allow only the prediction of nodal status, and we found a poor predictive value. A NB generalized linear regression (NBGLR) allowed us to model the number of involved nodes. We argued that the approach of modeling the number of nodes, and not merely the nodal status, allows a grading of nodal involvement risk and might identify patients for whom neoadjuvant treatment would be justified. Incidentally, the NBGLR found in our sample a seasonal factor affecting the numbers of nodes, suggesting the variability of medical practice, which might warrant further investigation. PMID:18495575

  9. Touch Imprint Cytology of the Sentinel Lymph Nodes Might Not Be Indicated in Early Breast Cancer Patients with Ultrasonically Uninvolved Axillary Lymph Nodes

    Microsoft Academic Search

    Andraž Perhavec; Nikola Besi?; Marko Ho?evar; Janez Žgajnar

    2008-01-01

    Background  Touch imprint cytology (TIC) is a fast, cheap and specific intraoperative examination of the sentinel lymph nodes (SLNs) in\\u000a early breast cancer patients. The results of TIC in patients with ultrasonically (US) uninvolved axillary lymph nodes are\\u000a not known. The objective of our study was to compare the results of TIC in the patients with US uninvolved axillary lymph\\u000a nodes

  10. The prognostic significance of total lymph node number in patients with axillary lymph node-negative breast cancer

    Microsoft Academic Search

    H Mersin; E Y?ld?r?m; H Bulut; U Berbero?lu

    2003-01-01

    Aim: In node-negative breast cancer patients, several factors for survival have been evaluated and currently, some of them are accepted for their prognostic and\\/or predictive values after validation in the separate data sets. The prognostic significance of increases in the number of pathologically detectable axillary lymph nodes in the node-negative patients could not been established clearly. To address this question,

  11. Patients with Breast Cancer and Negative Sentinel Lymph Node Biopsy without Additional Axillary Lymph Node Dissection: A Follow-Up Study of up to 5 Years

    Microsoft Academic Search

    Anna Domènech; Ana Benitez; María Teresa Bajén; María Jesús Pla; Miguel Gil; Josep Martín-Comín

    2007-01-01

    Objective: To analyze the rate of axillary recurrences and survival in patients operated on for breast cancer who had not undergone an axillary lymph node dissection (ALND) because of a negative sentinel node biopsy. Methods: The study includes 97 patients operated on for breast cancer and selective node biopsy from June 2000 to December 2001 who had a negative sentinel

  12. 18F-FDG PET complemented with sentinel lymph node biopsy in the detection of axillary involvement in breast cancer

    Microsoft Academic Search

    G. Zornoza; M. J. Garcia-Velloso; J. Sola; F. M. Regueira; L. Pina; C. Beorlegui

    2004-01-01

    Aim. The presence of axillary involvement is the most important prognostic factor in breast cancer. This study analysis the value of 18F-FDG PET in the detection of the lymph node status.Methods. This study includes 200 breast cancer patients. The PET scans were obtained after the injection of 370MBq of 18F-FDG; the breast areas, axillary, supraclavicular and internal mammary lymph node

  13. Breast Cancer Metastasis Alters Acetylcholinesterase Activity and the Composition of Enzyme Forms in Axillary Lymph Nodes

    Microsoft Academic Search

    Francisco Ruiz-Espejo; Juan Cabezas-Herrera; Julián Illana; Francisco J. Campoy; Encarnación Muñoz-Delgado; Cecilio J. Vidal

    2003-01-01

    Because of the probable involvement of cholinesterases (ChEs) in tumorigenesis, this research was addressed to ascertaining whether breast cancer metastasis alters the content of acetylcholinesterase (AChE) and\\/or butyrylcholinesterase (BuChE) in axillary lymph nodes (LN). ChE activity was assayed in nine normal (NLN) and seven metastasis-bearing nodes (MLN) from women. AChE and BuChE forms were characterised by sedimentation analyses, hydrophobic chromatography

  14. Morbidity comparison of sentinel lymph node biopsy versus conventional axillary lymph node dissection for breast cancer patients: Results of the sentinella–GIVOM Italian randomised clinical trial

    Microsoft Academic Search

    P. Del Bianco; G. Zavagno; P. Burelli; G. Scalco; L. Barutta; P. Carraro; P. Pietrarota; G. Meneghini; T. Morbin; G. Tacchetti; P. Pecoraro; V. Belardinelli; G. L. De Salvo

    2008-01-01

    AimsTo compare physical morbidity and health-related quality of life (HRQOL) in breast cancer patients who received standard axillary dissection (ALND) or sentinel lymph node biopsy (SLNB), followed by axillary dissection only in the case of sentinel-node positivity, within a randomised clinical trial.

  15. Herpes Zoster Mimicking Breast Cancer With Axillary Lymph Node Metastasis on PET/CT.

    PubMed

    Choi, Eun Kyoung; Oh, Jin Kyoung; Chung, Yong-An

    2015-07-01

    Herpes zoster is a reactivated varicella-zoster virus infection and demonstrates typical dermatomal distribution. We herein describe a case of a 41-year-old woman with a history of ovarian cancer. Intense hot uptake in the left breast and enlarged ipsilateral axillary lymph nodes were noted on F-FDG PET/CT for adjuvant chemotherapy response evaluation. Blinded to the patient's clinical information, these lesions were interpreted as incidental breast cancer with axillary nodal metastasis. However, clinically she presented with vesicles along the T4 dermatome and palpable enlarged nodes in the left axilla. On 3-month follow-up PET/CT after antiviral treatment, these intense hot uptake areas were no longer visualized. PMID:26018707

  16. A mathematical model of axillary lymph node involvement considering lymph node size in patients with breast cancer

    Microsoft Academic Search

    Takaomi Suzuma; Takeo Sakurai; Goro Yoshimura; Teiji Umemura; Takeshi Tamaki; Yasuaki Naito

    2001-01-01

    Background  Surgical sampling for assessing axillary status has not been considered as a well defined surgical procedure. We have reported\\u000a that MRI is a good instrument for assessing lymph node size and identifying lymph node position. We also developed a mathematical\\u000a model that takes into consideration the size of axillary lymph nodes, and retrospectively determined the number and size of\\u000a the

  17. Variability of the depth of supraclavicular and axillary lymph nodes in patients with breast cancer: is a posterior axillary boost field necessary?

    Microsoft Academic Search

    Gunilla C Bentel; Lawrence B Marks; Patricia H Hardenbergh; Leonard R Prosnitz

    2000-01-01

    Purpose: To determine the variability of the depth of supraclavicular (SC) and axillary (AX) lymph nodes in patients undergoing radiation therapy for breast cancer and to relate this variability with the patient’s anterior\\/posterior (A\\/P) diameter. The dosimetric consequences of the variability in depth are explored and related to the need for a posterior axillary boost field.Method and Materials: In 49

  18. Morbidity of Sentinel Lymph Node Biopsy (SLN) Alone Versus SLN and Completion Axillary Lymph Node Dissection After Breast Cancer Surgery A Prospective Swiss Multicenter Study on 659 Patients

    Microsoft Academic Search

    Igor Langer; Ulrich Guller; Gilles Berclaz; Ossi R. Koechli; Gabriel Schaer; Mathias K. Fehr; Thomas Hess; Daniel Oertli; Lucio Bronz; Beate Schnarwyler; Edward Wight; Urs Uehlinger; Eduard Infanger; Daniel Burger; Markus Zuber

    Objective: To assess the morbidity after sentinel lymph node (SLN) biopsy compared with SLN and completion level I and II axillary lymph node dissection (ALND) in a prospective multicenter study. Summary Background Data: ALND after breast cancer surgery is associated with considerable morbidity. We hypothesized: 1) that the morbidity in patients undergoing SLN biopsy only is signifi- cantly lower compared

  19. Predictors of positive axillary lymph nodes after sentinel lymph node biopsy in breast cancer

    Microsoft Academic Search

    Shahab F Abdessalam; Emmanuel E Zervos; Manju Prasad; William B Farrar; Lisa D Yee; Michael J Walker; William B Carson; William E Burak

    2001-01-01

    Objective: The purpose of this study was to determine the factors that predict the presence of metastasis in nonsentinel lymph nodes (SLN) when the SLN is positive.Methods: A prospective database was analyzed and included patients who underwent SLN biopsy for invasive breast cancer from July 1997 to August 2000 (n = 442). One hundred (22.6%) patients had one or more

  20. Diagnostic value of full-dose FDG PET\\/CT for axillary lymph node staging in breast cancer patients

    Microsoft Academic Search

    Till A. Heusner; Sherko Kuemmel; Steffen Hahn; Angela Koeninger; Friedrich Otterbach; Monia E. Hamami; Klaus R. Kimmig; Michael Forsting; Andreas Bockisch; Gerald Antoch; Alexander Stahl

    2009-01-01

    Purpose  The aims of this study were (1) to evaluate FDG PET\\/CT and CT for the detection of axillary lymph node metastases in breast\\u000a cancer (BC) patients and (2) to evaluate FDG PET\\/CT as a pre-test for the triage to sentinel lymph node biopsy (SLNB) versus\\u000a axillary lymph node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Methods  The sensitivity, specificity, positive and negative predictive value (PPV, NPV),

  1. A Longitudinal Comparison of Arm Morbidity in Stage I–II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection

    Microsoft Academic Search

    Jan J. Kootstra; Josette E. H. M. Hoekstra-Weebers; Johan S. Rietman; Jakob de Vries; Peter C. Baas; Jan H. B. Geertzen; Harald J. Hoekstra

    2010-01-01

    Background  Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary\\u000a lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared\\u000a outcomes after SLNB, SLNB + CLND, and ALND in stage I\\/II breast cancer patients.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  Breast cancer patients who had SLNB (n = 51), SLNB + CLND (n = 55), and ALND (n = 65)

  2. Axillary and internal mammary sentinel lymph node biopsy in male breast cancer patients: case series and review

    PubMed Central

    Cao, Xiaoshan; Wang, Chunjian; Liu, Yanbing; Qiu, Pengfei; Cong, Binbin; Wang, Yongsheng

    2015-01-01

    Male breast cancer (MBC) is considered as a rare disease that accounts for less than 1% of all breast cancers, and its treatment has been based on the evidence available from female breast cancer. Axillary sentinel lymph node biopsy (SLNB) is now regarded as the standard of care for both female and male patients without clinical and imaging evidence of axillary lymph node metastases, while internal mammary SLNB has rarely been performed. Internal mammary chain metastasis is an independent prognostic predictor. Internal mammary SLNB should be performed to complete nodal staging and guide adjuvant therapy in MBC patients with preoperative lymphoscintigraphic internal mammary chain drainage. We report both axillary and internal mammary SLNB in two cases with MBC. Internal mammary sentinel lymph node did contain metastasis in one case. PMID:26124669

  3. Discordance of Intraoperative Frozen Section Analysis with Definitive Histology of Sentinel Lymph Nodes in Breast Cancer Surgery: Complementary Axillary Lymph Node Dissection is Irrelevant for Subsequent Systemic Therapy

    Microsoft Academic Search

    D. Geertsema; P. D. Gobardhan; E. V. E. Madsen; M. Albregts; J. van Gorp; P. de Hooge; Th. van Dalen

    2010-01-01

    Background  In breast cancer surgery, intraoperative frozen section (FS) analysis of sentinel lymph nodes (SLNs) enables axillary lymph\\u000a node dissection (ALND) during the same operative procedure. In case of discordance between a “negative” FS analysis and definitive\\u000a histology, an ALND as a second operation is advocated since additional lymph node metastases may be present. The clinical\\u000a implications of the subsequent ALND

  4. Immunohistochemical detection of axillary lymph node micrometastases in node negative breast cancer patients using cytokeratin and epithelial membrane antigen

    PubMed Central

    Choudhury, Monisha; Agrawal, Sapna; Pujani, Mukta; Thomas, Shaji; Pujani, Meenu

    2015-01-01

    Background and Objective: The study was conducted to detect occult metastases in lymph node negative breast cancer patients using cytokeratin (CK) and epithelial membrane antigen (EMA) immunohistochemistry (IHC) and correlate this with primary tumor size and grade. Materials and Methods: A total of 32 cases including 12 prospective and 20 retrospective cases of axillary lymph node negative breast cancer were studied. CK and EMA IHC were performed to detect micrometastases. Results: Axillary lymph node metastases were detected in 18.75% of previously node negative cases using CK and EMA IHC. CK was found to be more sensitive for detection of metastases compared to EMA. A highly significant correlation was observed between tumor grade and axillary lymph node metastases detected by CK and EMA. However, no significant correlation was found between tumor size and axillary lymph node metastases detected by IHC. Conclusion: In the present study, there was an increase of 18.75% in the occult metastases detection rate using CK and EMA. To conclude, IHC detection of occult metastases should be done using CK in all axillary node negative cases, especially in T1 and T2 stage tumors. PMID:25839017

  5. 200 Sentinel lymph node biopsies without axillary lymph node dissection – no axillary recurrences after a 3-year follow-up

    Microsoft Academic Search

    R Reitsamer; F Peintinger; E Prokop; L Rettenbacher; C Menzel

    2004-01-01

    The aim of this study is to evaluate the rate of axillary recurrences in sentinel lymph node (SLN)-negative breast cancer patients after sentinel lymph node biopsy (SLNB) alone without further axillary lymph node dissection (ALND). Between May 1999 and February 2002, 333 consecutive patients with primary invasive breast cancer up to 4 cm and clinically negative axillae were entered into

  6. Breast Cancer Regional Radiation Fields for Supraclavicular and Axillary Lymph Node Treatment: Is a Posterior Axillary Boost Field Technique Optimal?

    SciTech Connect

    Wang Xiaochun [Department of Radiation Physics, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: xiaochunw@mdanderson.org; Yu, T.K. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Salehpour, Mohammad; Zhang, Sean X.; Sun, T.L. [Department of Radiation Physics, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas, M. D. Anderson Cancer Center, Houston, TX (United States)

    2009-05-01

    Purpose: To assess whether using an anterior oblique supraclavicular (SCV) field with a posterior axillary boost (PAB) field is an optimal technique for targeting axillary (AX) lymph nodes compared with two computed tomography (CT)-based techniques: (1) an SCV field with an anterior boost field and (2) intensity-modulated radiotherapy (IMRT). Methods and Materials: Ten patients with CT simulation data treated with postmastectomy radiation that included an SCV field were selected for the study. Supraclavicular nodes and AX Level I-III nodes within the SCV field were contoured and defined as the treatment target. Plans using the three techniques were generated and evaluated for each patient. Results: The anterior axillary boost field and IMRT resulted in superior dose coverage compared with PAB. Namely, treatment volumes that received 105%, 80%, and 30% of prescribed dose for IMRT plans were significantly less than those for the anterior axillary boost plans, which were significantly less than PAB. For PAB and anterior axillary boost plans, there was a linear correlation between treatment volume receiving 105% of prescribed dose and maximum target depth. Furthermore, the IMRT technique resulted in better lung sparing and dose conformity to the target than anterior axillary boost, which again was significantly better than PAB. The maximum cord dose for IMRT was small, but higher than for the other two techniques. More monitor units were required to deliver the IMRT plan than the PAB plan, which was more than the anterior axillary boost plan. Conclusions: The PAB technique is not optimal for treatment of AX lymph nodes in an SCV field. We conclude that CT treatment planning with dose optimization around delineated target volumes should become standard for radiation treatments of supraclavicular and AX lymph nodes.

  7. Can Axillary Lymph Node Dissection Be Safely Omitted for Early-Stage Breast Cancer Patients with Sentinel Lymph Node Micrometastasis?

    Microsoft Academic Search

    Sameer Damle; Christine B. Teal

    2009-01-01

    This study presents data that we have been anxiously awaiting. It adds to a slowly growing body of evidence that axillary lymph node dissection (ALND) may be omitted in select groups of node-positive patients. Many of us prefer not to perform ALND when only micrometastases are identified in sentinel lymph nodes (SLNs), especially when it often involves returning to the

  8. Can Axillary Lymph Node Dissection Be Safely Omitted for Early-Stage Breast Cancer Patients with Sentinel Lymph Node Micrometastasis?

    Microsoft Academic Search

    Sameer Damle; Christine B. Teal

    2010-01-01

    This study presents data that we have been anxiously awaiting. It adds to a slowly growing body of evidence that axillary lymph node dissection (ALND) may be omitted in select groups of node-positive patients. Many of us prefer not to perform ALND when only micrometastases are identified in sentinel lymph nodes (SLNs), especially when it often involves returning to the

  9. Probability of axillary lymph node metastasis when sentinel lymph node biopsy is negative in women with clinically node negative breast cancer: a bayesian approach

    Microsoft Academic Search

    Takahiro Okamoto; Kiyomi Yamazaki; Masako Kanbe; Hitomi Kodama; Yoko Omi; Akiko Kawamata; Rumi Suzuki; Yuka Igari; Reiko Tanaka; Masatoshi lihara; Yukio Ito; Tatsuo Sawada; Toshio Nishikawa; Masako Maki; Kiyoko Kusakabe; Norio Mitsuhashi; Takao Obara

    2005-01-01

    Background  Although sentinel lymph node biopsy (SLNB) is highly accurate in predicting axillary nodal status in patients with breast\\u000a cancer, it has been shown that the procedure is associated with a few false negative results. The risk of leaving metastatic\\u000a nodes behind in the axillary basin when SLNB is negative should be estimated for an individual patient if SLNB is performed

  10. Sentinel lymph node biopsy as an indicator for axillary dissection in early breast cancer

    Microsoft Academic Search

    U Veronesi; V Galimberti; S Zurrida; F Pigatto; P Veronesi; C Robertson; G Paganelli; V Sciascia; G Viale

    2001-01-01

    Sentinel node biopsy (SNB) is a new component of the surgical treatment of breast cancer that accurately predicts axillary status. Although the procedure is still mainly investigational, many patients are requesting SNB to avoid axillary dissection if the sentinel node (SN) is negative. From March 1996 to December 1999, 373 patients with breast carcinoma and clinically negative axillary nodes underwent

  11. Isolated retromammary lymph node metastasis of breast cancer without axillary lymph node involvement: a case report with a false-negative sentinel lymph node biopsy

    Microsoft Academic Search

    Nana Rokutanda; Jun Horiguchi; Yukio Koibuchi; Rin Nagaoka; Ayako Sato; Hiroki Odawara; Hideaki Tokiniwa; Yuichi Iino; Junko Hirato; Izumi Takeyoshi

    2009-01-01

    A 54-year-old woman visited our hospital with a palpable tumor in her left breast, which was diagnosed as invasive ductal\\u000a carcinoma. Breast-conserving surgery was performed, in association with a sentinel lymph node (SLN) biopsy and back-up dissection\\u000a of the axillary lymph nodes. One dyed axillary lymph node with high radioactivity was defined as an SLN, and intraoperative\\u000a frozen-section analysis of

  12. Sentinel lymph node biopsy is associated with improved survival compared to level I & II axillary lymph node dissection in node negative breast cancer patients

    Microsoft Academic Search

    I. Langer; U. Guller; S. F. Hsu-Schmitz; A. Ladewig; C. T. Viehl; H. Moch; E. Wight; F. Harder; D. Oertli; M. Zuber

    2009-01-01

    ObjectiveThe few long-term follow-up data for sentinel lymph node (SLN) negative breast cancer patients demonstrate a 5-year disease-free survival of 96–98%. It remains to be elucidated whether the more accurate SLN staging defines a more selective node negative patient group and whether this is associated with better overall and disease-free survival compared with level I & II axillary lymph node

  13. Treatment-Related Upper Limb Morbidity 1 Year after Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection for Stage I or II Breast Cancer

    Microsoft Academic Search

    J. S. Rietman; P. U. Dijkstra; J. H. B. Geertzen; P. Baas; J. de Vries; W. V. Dolsma; J. W. Groothoff; W. H. Eisma; H. J. Hoekstra

    2004-01-01

    Background: In a prospective study, upper limb morbidity and perceived disability\\/activities of daily life (ADLs) were assessed before and 1 year after sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND).Methods: A total of 204 patients with stage I\\/II breast cancer (mean age, 55.6 years; SD, 11.6 years) entered the study, and 189 patients (93%) could be evaluated

  14. Arm morbidity following sentinel lymph node biopsy or axillary lymph node dissection: A study from the Danish Breast Cancer Cooperative Group

    Microsoft Academic Search

    Anders Husted Madsen; Karen Haugaard; Jan Soerensen; Susanne Bokmand; Esbern Friis; Helle Holtveg; Jens Peter Garne; John Horby; Peer Christiansen

    2008-01-01

    BackgroundSentinel lymph node biopsy was implemented in the treatment of early breast cancer with the aim of reducing shoulder and arm morbidity. Relatively few prospective studies have been published where the morbidity was assessed by clinical examination. Very few studies have examined the impact on shoulder mobility of node positive patients having a secondary axillary dissection because of the findings

  15. Management strategy of early-stage breast cancer patients with a positive sentinel lymph node: With or without axillary lymph node dissection

    Microsoft Academic Search

    Jia-Jian Chen; Jiong Wu

    2011-01-01

    Sentinel lymph node biopsy (SLNB) has been generally adopted as an alternative procedure to axillary lymph node dissection (ALND) for node staging. ALND remains the standard management of the axilla when a tumor-positive sentinel lymph node (SLN) is identified. However, further analysis has demonstrated that in 40–70% of cases with metastasis to the axillary lymph nodes, the SLN is the

  16. Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients

    Microsoft Academic Search

    F Peintinger; R Reitsamer; H Stranzl; G Ralph

    2003-01-01

    The sentinel lymph node biopsy (SLNB) represents a minimal invasive surgical method for axillary staging in patients with primary breast cancer. In a prospective study, evaluation of quality of life (QOL) and arm morbidity was performed before surgery on a total of 56 breast cancer patients. The EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires were used for QOL assessment. Assessment of

  17. Six Cases of Chylous Leakage after Axillary Lymph Node Dissection

    Microsoft Academic Search

    Ming-hua Cong; Qi Liu; Wen-hong Zhou; Jian Zhu; Chen-xin Song; Xing-song Tian

    2008-01-01

    Summary Background: Chylous leakage has been described after several surgical procedures, especially in the region of the neck and thorax. However, it has rarely been reported after axillary lymph node dissection. Patients and Methods: We encountered 6 cases of chylous leakage after axillary lymph node dissection out of a total of 882 breast cancer patients between July 2005 and June

  18. Spontaneous regression of breast cancer with axillary lymph node metastasis: a case report and review of literature.

    PubMed

    Tokunaga, Eriko; Okano, Shinji; Nakashima, Yuichiro; Yamashita, Nami; Tanaka, Kimihiro; Akiyoshi, Sauri; Taketani, Kenji; Shirouzu, Mitsunori; Yamamoto, Hidetaka; Morita, Masaru; Maehara, Yoshihiko

    2014-01-01

    Spontaneous regression (SR) of cancer is a rare but well-documented biological phenomenon. However, the mechanism remains to be elucidated. We herein report a case of the SR of breast cancer at both the primary site and metastatic axillary lymph node with spontaneously-induced T cell-mediated immunological responses. A 52-year-old female with a lump in the left axilla was diagnosed to have a small breast carcinoma with a distinct axillary lymph node metastasis. During the preoperative systemic examination, she was diagnosed to have severe type 2 diabetes mellitus, was treated with insulin, and the hyperglycemia was normalized after one month. Surgery for left breast cancer was then performed. The postoperative histopathological examination revealed the SR of breast cancer at both the primary site and metastatic axillary lymph node. Immunohistochemical studies revealed that estrogen receptor positive, AE1/AE3-positive ductal carcinoma completely underwent necrosis associated with extensive infiltration of CD3-positive T cells in the tumor nodule in the lymph node. In addition, primary ductal carcinoma cells also underwent single cell necrosis with infiltration of T cells with lymph follicle-like organization of B cells in the mammary gland. The features were suggestive that the tumor eradication in the metastatic lymph node and regression of the primary ductal carcinoma could be due to host T cell response to the ductal carcinoma. As far as we know it is the first report that shows the spontaneous regression of breast cancer, probably due to the spontaneously-induced T cell response. PMID:25120822

  19. Volume-controlled vs no\\/short-term drainage after axillary lymph node dissection in breast cancer surgery: A meta-analysis

    Microsoft Academic Search

    R. A. Droeser; D. M. Frey; D. Oertli; D. Kopelman; M. J. Baas-Vrancken Peeters; A. E. Giuliano; K. Dalberg; R. Kallam; A. Nordmann

    2009-01-01

    It is unknown whether there are any clinically relevant differences between volume-controlled (<30–50ml\\/24h across trials) vs no\\/short-term drainage after axillary lymph node dissection in breast cancer surgery on outcomes such as seroma formation, wound infection or length of hospital stay.Randomised controlled trials comparing volume-controlled drainage vs no or short-term drainage after axillary lymph node dissection in breast cancer surgery were

  20. Axillary lymph node dissection can be avoided in women with breast cancer with intraoperative, false-negative sentinel lymph node biopsies

    Microsoft Academic Search

    Hiroyuki Takei; Masafumi Kurosumi; Takashi Yoshida; Yuko Ishikawa; Yuji Hayashi; Jun Ninomiya; Katsunori Tozuka; Hanako Oba; Kenichi Inoue; Shigenori Nagai; Yoshihiro Saito; Tomoko Kazumoto; Jun-ichi Saitoh; Toshio Tabei

    2010-01-01

    Background  It is currently unclear which patients with breast cancer with sentinel lymph node (SLN) metastases do not need axillary lymph\\u000a node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Patients and methods  A cohort of 1,132 women who had unilateral invasive breast cancer with clinically negative nodes or nodes suspicious for metastasis,\\u000a were intraoperatively diagnosed as having negative SLNs, and did not undergo an immediate ALND. Our

  1. Quality of Life After Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection in Stage I\\/II Breast Cancer Patients: A Prospective Longitudinal Study

    Microsoft Academic Search

    Jan Kootstra; Josette E. H. M. Hoekstra-Weebers; Hans Rietman; Jaap de Vries; Peter Baas; Jan H. B. Geertzen; Harald J. Hoekstra

    2008-01-01

    Background  Breast cancer patients’ quality of life (QoL) after surgery has been reported to improve significantly over time. Little is\\u000a known about QoL recovery after sentinel lymph node biopsy (SLNB) in comparison to axillary lymph node dissection (ALND).\\u000a \\u000a \\u000a \\u000a Methods  175 of 195 stage I\\/II breast cancer patients completed the EORTC QLQ-C30: one day before surgery (T0) and after 6 (T1), 26\\u000a (T2),

  2. Predictors of Completion Axillary Lymph Node Dissection in Patients With Immunohistochemical Metastases to the Sentinel Lymph Node in Breast Cancer

    Microsoft Academic Search

    Matthew S. Pugliese; Amer K. Karam; Meier Hsu; Michelle M. Stempel; Sujata M. Patil; Alice Y. Ho; Tiffany A. Traina; Kimberly J. Van Zee; Hiram S. Cody III; Monica Morrow; Mary L. Gemignani

    2010-01-01

    Background  Axillary lymph node dissection (ALND) in patients with immunohistochemistry (IHC)-determined metastases to the sentinel lymph\\u000a node (SLN) is controversial. The goal of this study was to examine factors associated with ALND in IHC-only patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Retrospective review of an institutional SLN database from July 1997 to July 2003 was performed. We compared sociodemographic,\\u000a pathologic, and therapeutic variables between IHC-only patients who

  3. The use of Raman spectroscopy for the intra-operative assessment of axillary lymph nodes in breast cancer

    NASA Astrophysics Data System (ADS)

    Horsnell, Jonathan

    Breast cancer remains a significant cause of morbidity and mortality. Assessment of the axillary lymph nodes is part of the staging of the disease. Advances in surgical management of breast cancer have seen a move towards intra-operative lymph node assessment that facilitates an immediate axillary clearance if it is indicated. Raman spectroscopy, a technique based on the inelastic scattering of light, has previously been shown to be capable of differentiating between normal and malignant tissue. These results, based on the biochemical composition of the tissue, potentially allow for this technique to be utilised in this clinical context. The aim of this study was to evaluate the facility of Raman spectroscopy to both assess axillary lymph node tissue within the theatre setting and to achieve results that were comparable to other intra-operative techniques within a clinically relevant time frame. Initial experiments demonstrated that these aims were feasible within the context of both the theatre environment and current surgical techniques. A laboratory based feasibility study involving 17 patients and 38 lymph node samples achieved sensivities and specificities of >90% in unsupervised testing. 339 lymph node samples from 66 patients were subsequently assessed within the theatre environment. Chemometric analysis of this data demonstrated sensitivities of up to 94% and specificities of up to 99% in unsupervised testing. The best results were achieved when comparing negative nodes from N0 patients and nodes containing macrometastases. Spectral analysis revealed increased levels of lipid in the negative nodes and increased DNA and protein levels in the positive nodes. Further studies highlighted the reproducibility of these results using different equipment, users and time from excision. This study uses Raman spectroscopy for the first time in an operating theatre and demonstrates that the results obtained, in real-time, are comparable, if not superior, to current intra-operative techniques of lymph nodes assessment.

  4. Optical characterization of ex-vivo axillary lymph nodes of breast-cancer patients using a custom-built spectrophotometer

    NASA Astrophysics Data System (ADS)

    Sampathkumar, Ashwin; Saegusa-Beecroft, Emi; Mamou, Jonathan; Chitnis, Parag V.; Machi, Junji; Feleppa, Ernest J.

    2014-03-01

    Quantitative photoacoustics is emerging as a new hybrid modality to investigate diseases and cells in human pathology and cytology studies. Optical absorption of light is the predominant mechanism behind the photoacoustic effect. Therefore, a need exits to characterize the optical properties of specimens and to identify the relevant operating wavelengths for photoacoustic imaging. We have developed a custom low-cost spectrophotometer to measure the optical properties of human axillary lymph nodes dissected for breast-cancer staging. Optical extinction curves of positive and negative nodes were determined in the spectral range of 400 to 1000 nm. We have developed a model to estimate tissue optical properties, taking into account the role of fat and saline. Our results enabled us to select the optimal optical wavelengths for maximizing the imaging contrast between metastatic and noncancerous tissue in axillary lymph nodes.

  5. Use of tomographic nuclear medicine procedures, SPECT and pinhole SPECT, with cationic lipophilic radiotracers for the evaluation of axillary lymph node status in breast cancer patients

    Microsoft Academic Search

    Giuseppe Madeddu; Angela Spanu

    2004-01-01

    Scintimammography with the cationic lipophilic 99mTc-tetrofosmin and 99mTc-methoxyisobutylisonitrile (MIBI) is one of the most widely available non-invasive imaging methods employed in the preoperative evaluation of breast cancer axillary lymph node status, for which, at present, axillary lymph node dissection (ALND) is still considered the method of choice. Comparative studies have demonstrated that single-photon emission computed tomography (SPECT) acquisition significantly improves

  6. The detection of axillary lymph node metastases from breast cancer by radiolabelled monoclonal antibodies: a prospective study.

    PubMed

    Tjandra, J J; Sacks, N P; Thompson, C H; Leyden, M J; Stacker, S A; Lichtenstein, M; Russell, I S; Collins, J P; Andrews, J T; Pietersz, G A

    1989-02-01

    In a prospective study to assess the accuracy of monoclonal immunoscintigraphy for the detection of axillary lymph node metastases in breast cancer, two murine monoclonal antibodies that react with human breast cancer (3E1.2 and RCC-1) were labelled with 131iodine, and the radiolabelled antibody was injected subcutaneously into the interdigital spaces of both hands of 40 patients, 36 of whom had breast cancer and the remaining four of whom had fibroadenoma (the normal, contralateral axilla was used as a control). Of the patients with breast cancer, the findings from the scintigraphy images were correlated with histopathology or cytology of the axillary lymph nodes; images were regarded as positive and hence indicative of lymph node metastases if the amount of background-subtracted radioactive count in axilla on the side of breast cancer exceeded the contralateral normal side by a ratio greater than or equal to 1.5:1.0 as assessed by computer analysis. Using this method, immunoscintigraphy had an overall sensitivity of 33% (23% with 131I-3E1.2 and 50% with 131I-RCC-1) for the detection of lymph node metastases and a specificity of 63% (67% with 131I-3E1.2 and 60% with 131I-RCC-1) with problems of non-specific uptake by presumably normal lymph nodes. The results of immunoscintigraphy obtained with 131I-RCC-1 (IgG) were superior to 131I-3E1.2 (IgM) although the accuracy of immunoscintigraphy using 131I-RCC-1 (56%) was not much better than preoperative clinical assessment (50%). However, there were cases when immunoscintigraphy using radiolabelled antibody (IgM or IgG) detected axillary lymph node metastases not suspected by clinical examination. Thus it appears that while immunoscintigraphy may be a useful adjunct to preoperative clinical assessment and is simple and safe, a major improvement in its accuracy is needed before it can replace axillary dissection and histological examination in the accurate staging of axilla in breast cancer. PMID:2930695

  7. Implications of a Postoperative Rehabilitation Program on Quality of Life in Women with Primary Breast Cancer Treated with Sentinel Lymph Node Biopsy or Complete Axillary Lymph Node Dissection

    Microsoft Academic Search

    Marcela Ponzio Pinto e Silva; Luis Otávio Sarian; Sirlei Siani Morais; Maria Teresa Pace do Amaral; Mariana Maia Freire de Oliveira; Sophie Derchain

    2008-01-01

    Background  The aim of this clinical study was to evaluate quality of life (QoL) in early-stage breast cancer patients and to investigate\\u000a the effects of a comprehensive rehabilitation program comparing women undergoing sentinel node biopsy (SNB) versus complete\\u000a axillary lymph node dissection (ALND). QoL was assessed with the Functional Assessment of Cancer Therapy—General and Functional\\u000a Assessment of Cancer Therapy—Breast (FACT-B) questionnaire.

  8. Predictors of tumour involvement in remaining axillary lymph nodes of breast cancer patients with positive sentinel lymph node

    Microsoft Academic Search

    N. Wada; S. Imoto; C. Yamauchi; T. Hasebe; A. Ochiai

    2006-01-01

    AimsTo characterize the various clinicopathologic features in cases of breast cancer with positive sentinel lymph nodes (SLNs), in order to determine factors that might help in predicting the involvement of the non-SLNs.

  9. Tattoo pigment in axillary lymph node mimicking calcification of breast cancer.

    PubMed

    Matsika, Admire; Srinivasan, Bhuvana; Gray, Janet Meryl; Galbraith, Christine Ruth

    2013-01-01

    A tattoo is defined as the intentional or accidental deposit of pigment into the skin. The phenomenon of skin tattooing is on the rise worldwide and complications of tattooing are increasingly being recognised in diagnostic and clinical medicine. We describe a case of calcification-like changes on mammography resembling that of breast malignancy as a result of tattoo pigment deposition in an axillary lymph node. Recognition of such changes in routine breast screening is crucial to avoid further unnecessary invasive investigations and surgery in such patients. PMID:23929611

  10. Evaluation of Fluorodeoxyglucose Positron Emission Tomography in the Detection of Axillary Lymph Node Metastases in Patients With Early-Stage Breast Cancer

    Microsoft Academic Search

    Emmanuel Barranger; Dany Grahek; Martine Antoine; Françoise Montravers; Jean-Noel Talbot; Serge Uzan

    2003-01-01

    Background: The aim of this study was to assess the capacity of positron emission tomography (PET) with fluorodeoxyglucose (FDG) to determine\\u000a axillary lymph node status in patients with breast cancer undergoing sentinel node (SN) biopsy.\\u000a \\u000a \\u000a Methods: Thirty-two patients with breast cancer and clinically negative axillary nodes were recruited. All patients underwent FDG-PET\\u000a before SN biopsy. After SN biopsy, all patients

  11. The Role of FDG-PET for Axillary Lymph Node Staging in Primary Breast Cancer

    Microsoft Academic Search

    Flavio Crippa; Alberto Gerali; Alessandra Alessi; Roberto Agresti; Emilio Bombardieri

    PET and PET\\/CT have revealed a good diagnostic accuracy in visualizing both primary cancer and metastatic lesions, and many\\u000a clinical studies demonstrate that they can compete with the morphological conventional diagnostic modalities mainly in staging,\\u000a detecting tumor relapses, evaluating tumor response to therapy and giving useful prognostic indications. Data about the usefulness\\u000a of PET to stage axillary nodes in breast

  12. Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer

    PubMed Central

    Gherghe, M; Bordea, C; Blidaru, A

    2015-01-01

    The identification and biopsy of the sentinel lymph node has become a standard method of treatment for stage I and II breast cancer in the last decades, taking into account the fact that the management of the axilla in patients with breast cancer has evolved from the routine lymphadenectomy to a selective attitude, based on the histopathological evaluation of the sentinel lymph node, as well as on the tumor and on the patients’ characteristics. Since the introduction of the method into clinical practice, in 1994, different methods of identification have been used (radioisotope injection, vital blue dye, or, more recently, lipophilic contrast agent for ultrasound visualization or paramagnetic nanoparticles (NPs) or the method of indocyanine green fluorescence), each presenting certain limits, but the radioisotopic method proving the most accurate. Moreover, during the development of the method, beside the standard indications specific for T1 or T2 breast tumor, without clinical or imagistic axillary adenopathies, their extension to a series of other particular situations such as the following, has been tried: ductal carcinoma in situ, multicentre tumors, after excisional biopsy or tumors preoperatively treated by neoadjuvant chemotherapy. The aim of the paper is to present the progress made regarding the current stage in the use of sentinel lymph node technique in breast cancer, while mentioning the established indications, as well as the ones that are still debating and need further studies. Likewise, the cases in which the axillary lymph node dissection remains the major indication for treatment of the axilla, in patients with early stage breast cancer, will be discussed. PMID:25866575

  13. Sentinel lymph node biopsy (SLNB) vs. axillary lymph node dissection (ALND) in the current surgical treatment of early stage breast cancer.

    PubMed

    Gherghe, M; Bordea, C; Blidaru, A

    2015-01-01

    The identification and biopsy of the sentinel lymph node has become a standard method of treatment for stage I and II breast cancer in the last decades, taking into account the fact that the management of the axilla in patients with breast cancer has evolved from the routine lymphadenectomy to a selective attitude, based on the histopathological evaluation of the sentinel lymph node, as well as on the tumor and on the patients' characteristics. Since the introduction of the method into clinical practice, in 1994, different methods of identification have been used (radioisotope injection, vital blue dye, or, more recently, lipophilic contrast agent for ultrasound visualization or paramagnetic nanoparticles (NPs) or the method of indocyanine green fluorescence), each presenting certain limits, but the radioisotopic method proving the most accurate. Moreover, during the development of the method, beside the standard indications specific for T1 or T2 breast tumor, without clinical or imagistic axillary adenopathies, their extension to a series of other particular situations such as the following, has been tried: ductal carcinoma in situ, multicentre tumors, after excisional biopsy or tumors preoperatively treated by neoadjuvant chemotherapy. The aim of the paper is to present the progress made regarding the current stage in the use of sentinel lymph node technique in breast cancer, while mentioning the established indications, as well as the ones that are still debating and need further studies. Likewise, the cases in which the axillary lymph node dissection remains the major indication for treatment of the axilla, in patients with early stage breast cancer, will be discussed. PMID:25866575

  14. Axillary reverse mapping for preventing lymphedema in axillary lymph node dissection and\\/or sentinel lymph node biopsy

    Microsoft Academic Search

    Masakuni Noguchi

    2010-01-01

    The Japanese Breast Cancer Society 2009 Axillary lymph node dissection (ALND) is a standard surgical treatment in patients with involved axillary lymph nodes. Unfortunately, arm lymphedema develops in 2.7– 5.0% of patients treated by partial ALND (level I and II), in 3.1–9.6% of those undergoing total ALND, and in 26– 38% of patients treated with ALND and radiotherapy [1]. The

  15. Recurrence after sentinel lymph node biopsy with or without axillary lymph node dissection in patients with breast cancer

    Microsoft Academic Search

    Hiroyuki Takei; Kimito Suemasu; Masafumi Kurosumi; Yoshio Horii; Takashi Yoshida; Jun Ninomiya; Miho Yoshida; Yasutaka Hagiwara; Mari Kamimura; Yuji Hayashi; Kenichi Inoue; Toshio Tabei

    2007-01-01

    Background  A regional nodal recurrence is a major concern after a sentinel lymph node biopsy (SLNB) alone in patients with breast cancer.\\u000a In this study we investigated patterns and risk factors of regional nodal recurrence after SLNB alone.\\u000a \\u000a \\u000a \\u000a Patients and Methods  Between January 1999 and March 2005, a series of 1,704 consecutive breast cancer cases in 1,670 patients (34 bilateral breast\\u000a cancer

  16. Sentinel Lymph Node Metastases Detected by Immunohistochemistry Only Do Not Mandate Complete Axillary Lymph Node Dissection in Breast Cancer

    Microsoft Academic Search

    Richard J. Gray; Barbara A. Pockaj; Christopher R. Conley

    2004-01-01

    Background: The significance of breast cancer sentinel lymph node (SLN) metastases detected only by immunohistochemistry staining (IHC)\\u000a remains poorly understood. This study attempted to quantify the risk of non-SLN metastases.\\u000a \\u000a \\u000a Methods: A prospectively collected database of 750 consecutive SLN biopsy procedures in breast cancer patients was reviewed. Medical\\u000a records were reviewed to supplement the database.\\u000a \\u000a \\u000a \\u000a \\u000a Results: SLNs were identified in

  17. Axillary lymph node dose with tangential breast irradiation

    SciTech Connect

    Reed, Daniel R. [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States)]. E-mail: drreed@u.washington.edu; Lindsley, Skyler Karen [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Mann, Gary N. [Department of Surgery, University of Washington Medical Center, Seattle, WA (United States); Austin-Seymour, Mary [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Korssjoen, Tammy [Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States); Anderson, Benjamin O. [Department of Surgery, University of Washington Medical Center, Seattle, WA (United States); Moe, Roger [Department of Surgery, University of Washington Medical Center, Seattle, WA (United States)

    2005-02-01

    Purpose: The advent of sentinel lymph node mapping and biopsy in the staging of breast cancer has resulted in a significant decrease in the extent of axillary nodal surgery. As the extent of axillary surgery decreases, the radiation dose and distribution within the axilla becomes increasingly important for current therapy planning and future analysis of results. This analysis examined the radiation dose distribution delivered to the anatomically defined axillary level I and II lymph node volume and surgically placed axillary clips with conventional tangential breast fields and CT-based three-dimensional (3D) planning. Methods and materials: Fifty consecutive patients with early-stage breast cancer undergoing breast conservation therapy were evaluated. All patients underwent 3D CT-based planning with conventional breast tangential fields designed to encompass the entire breast parenchyma. Using CT-based 3D planning, the dose distribution of the standard tangential breast irradiation fields was examined in relationship to the axillary level I and II lymph node volumes. Axillary level I and II lymph node anatomic volumes were defined by CT and surgical clips placed during complete level I-II lymph node dissection. Axillary level I-II lymph node volume doses were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: All defined breast volumes received {>=}95% of the prescribed dose. By contrast, the 95% isodose line encompassed only an average of 55% (range, 23-87%) of the axillary level I-II lymph node anatomic volume. No patient had complete coverage of the axillary level I-II lymph node region by the 95% isodose line. The mean anatomic axillary level I-II volume was 146.3 cm{sup 3} (range, 83.1-313.0 cm{sup 3}). The mean anatomic axillary level I-II volume encompassed by the 95% isodose line was 84.9 cm{sup 3} (range, 25.1-219.0 cm{sup 3}). The mean 95% isodose coverage of the surgical clip volume was 80%, and the median value was 81% (range, 58-98%). The mean volume deficit between the axillary level I-II volume and the surgical clip volume was 41.7 cm{sup 3} (median, 30.0 cc). Conclusion: In this study, standard tangential breast radiation fields failed to deliver a therapeutic dose adequately to the axillary level I-II lymph node anatomic volume. No patient received complete coverage of the axillary level I-II lymph node volume. Surgically placed axillary clips also failed to delineate the level I-II axilla adequately. Definitive irradiation of the level I and II axillary lymph node region requires significant modification of standard tangential fields, best accomplished with 3D treatment planning, with specific targeting of anatomically defined axillary lymph node volumes as described, in addition to the breast parenchymal volumes.

  18. Assessment of Axillary Lymph Node Involvement in Breast Cancer Patients With Positron Emission Tomography Using Radiolabeled 2-(Fluorine18)- fluoro-2-deoxy-D-glucose

    Microsoft Academic Search

    Norbert Avril; Jorg Dose; Fritz Jdnicke; Sibylle Ziegler; Wolfgang Romer; Wolfgang Weber; Michael Herz; Walter Nathrath; Henner Graejf; Markus Schwaiger

    Background: The presence of metastatic tumor cells in the axillary lymph nodes is an important factor when deciding whether or not to treat breast cancer patients with adjuvant therapy. Positron emission tomography (PET) imaging with the radiolabeled glucose analogue 2-(fluorine-18)-fluoro-2- deoxy-D-glucose (F-18 FDG) has been used to visualize primary breast tumors as well as bone and soft-tissue metas- tases. Purpose:

  19. Axillary Lymph Node Echo-Guided Fine-Needle Aspiration Cytology Enables Breast Cancer Patients to Avoid a Sentinel Lymph Node Biopsy. Preliminary Experience and a Review of the Literature

    Microsoft Academic Search

    Vittorio Altomare; Gabriella Guerriero; Rita Carino; Cleonice Battista; Angelo Primavera; Annamaria Altomare; Donata Vaccaro; Alessandro Esposito; Anna Maria Ferri; Carla Rabitti

    2007-01-01

    Purpose  For many years, the status of the axillary lymph nodes has been determined by an axillary lymphadenectomy. However, a sentinel\\u000a lymph node biopsy has been shown to effectively replace the need for an axillary lymphadenectomy in order to determine the\\u000a axillary staging. This study presents the preliminary results regarding the efficacy of fine-needle aspiration cytology (FNAC)\\u000a to identify metastatic axillary

  20. Feasibility of FDG PET\\/CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patients

    Microsoft Academic Search

    Marieke E. Straver; Tjeerd S. Aukema; Renato A. Valdes Olmos; Emiel J. T. Rutgers; Kenneth G. A. Gilhuijs; Margaret E. Schot; Wouter V. Vogel; Marie-Jeanne T. F. D. Vrancken Peeters

    2010-01-01

    Purpose  The aim of this study was to assess the accuracy of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)\\/CT to visualize lymph node metastases before the start of neoadjuvant\\u000a chemotherapy and to determine how often the visualization is sufficiently prominent to allow monitoring of the axillary response.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Thirty-eight patients with invasive breast cancer of >3 cm and\\/or lymph node metastasis underwent FDG PET\\/CT

  1. Efficiency of Ultrasound and Ultrasound-Guided Fine Needle Aspiration Cytology in Preoperative Assessment of Axillary Lymph Node Metastases in Breast Cancer

    PubMed Central

    Demirkazik, Figen Basaran; Akpinar, Meltem Gulsun; Soygur, Is?l; Baykal, Atac; Onder, Sevgen Celik; Uner, Aysegul

    2012-01-01

    Purpose We performed this study to detect preoperative axillary metastases with ultrasound (US)-guided fine needle aspiration biopsy (FNAB), to eliminate the need for time-consuming and costly sentinel lymph node (SLN) scintigraphy and biopsy steps in the treatment of breast cancer patients, and in that of with suspicious US findings, and to evaluate the accuracy of preoperative US-guided FNAB for patients with suspicious lymph node metastases on US. Methods Patients with a suspicious breast lump or histopathologically proven breast cancer underwent breast-axillary US. Increase in lymph node size, cortical thickening, non-hilar cortical flow, and hilar changes were evaluated with gray scale-color Doppler US. FNAB was performed if US results were suspicious for malignancy. Results Thirty-eight axillary lymph nodes (ALN) underwent FNAB. ALN dissection, SLN scintigraphy, and biopsy steps were bypassed in 23 axillas with positive ALN FNAB (60.5%). The sensitivity of ALN FNAB was 88.46%; specificity and positive predictive value were 100%; and negative predictive value was 66.6% (inadequate cytology included; 76.7%, 100%, 100%, 53.3%, respectively). Asymmetrical cortical thickening, non-hilar cortical flow, and increase in hypoechogenity were only detected in metastatic nodes. Cortical thickening, and lymph node and breast mass size was higher in the metastatic group. Conclusion By performing FNAB on suspicious lymph nodes, the routine, high-cost SLN scintigraphy and intraoperative gamma probe steps may be skipped, and axilla dissection can be performed directly. This leads to the elimination of the need for SLN investigation in more than half of the patients. The assessment of ALN metastases with preoperative US-guided FNAB is a cost-effective method with high specificity, that eliminates the need for costly and time-consuming SLN scintigraphy and biopsy steps, and helps in preoperative staging. PMID:22807939

  2. Axillary lymph node dissection for sentinel lymph node micrometastases may be safely omitted in early-stage breast cancer patients: long-term outcomes of a prospective study

    Microsoft Academic Search

    Igor Langer; Ulrich Guller; Carsten T. Viehl; Holger Moch; Edward Wight; Felix Harder; Daniel Oertli; Markus Zuber

    2010-01-01

    Objectives  To evaluate the long-term disease-free and overall survival of patients with sentinel lymph node (SLN) micrometastases, in\\u000a whom a completion axillary lymph node dissection (ALND) was systematically omitted.\\u000a \\u000a \\u000a \\u000a \\u000a Background  The use of step sectioning and immunohistochemistry for SLN analysis results in a more accurate histopathologic examination\\u000a and a higher detection rate of micrometastases. However, the clinical relevance and therapeutic implications of

  3. Axillary Lymph Node Dissection for Sentinel Lymph Node Micrometastases May Be Safely Omitted in Early-Stage Breast Cancer Patients: Long-Term Outcomes of a Prospective Study

    Microsoft Academic Search

    Igor Langer; Ulrich Guller; Carsten T. Viehl; Holger Moch; Edward Wight; Felix Harder; Daniel Oertli; Markus Zuber

    2009-01-01

    Objectives  To evaluate the long-term disease-free and overall survival of patients with sentinel lymph node (SLN) micrometastases, in\\u000a whom a completion axillary lymph node dissection (ALND) was systematically omitted.\\u000a \\u000a \\u000a \\u000a \\u000a Background  The use of step sectioning and immunohistochemistry for SLN analysis results in a more accurate histopathologic examination\\u000a and a higher detection rate of micrometastases. However, the clinical relevance and therapeutic implications of

  4. Molecular Detection of Micrometastatic Breast Cancer in Histopathology—Negative Axillary Lymph Nodes Fails to Predict Breast Cancer Recurrence: A Final Analysis of a Prospective Multi-Institutional Cohort Study

    Microsoft Academic Search

    Carla Suzanne Fisher; David J. Cole; Michael Mitas; Elizabeth Garrett-Meyer; John S. Metcalf; William E. Gillanders; Kaidi Mikhitarian; Marshall M. Urist; G. Bruce Mann; Gerard Doherty; Virginia M. Herrmann; Arnold D. Hill; Oleg Eremin; Mohamed El-Sheemy; Richard K. Orr; Alvaro A. Valle; Michael A. Henderson; Robert L. Dewitty; Sonia L. Sugg; Eric Frykberg; Karen Yeh; Richard M. Bell; Megan K. Baker

    2010-01-01

    Background  To address the clinical relevance of molecular detection of occult breast cancer in sentinel lymph nodes and nonsentinel axillary\\u000a lymph nodes (ALN), we initiated the Minimally Invasive Molecular Staging of Breast Cancer (MIMS) trial, a multi-institutional\\u000a prospective cohort study. This trial represents the first prospective cohort study in which a multimarker, real-time reverse\\u000a transcription polymerase chain reaction (RT-PCR) analysis was

  5. Diagnostic performance of fluorodeoxyglucose-positron emission tomography\\/computed tomography of breast cancer in detecting axillary lymph node metastasis: comparison with ultrasonography and contrast-enhanced CT

    Microsoft Academic Search

    Shuichi Monzawa; Shuji Adachi; Kayo Suzuki; Koichi Hirokaga; Shintaro Takao; Toshiko Sakuma; Keisuke Hanioka

    2009-01-01

    Purpose  The purpose of this retrospective study was to evaluate the diagnostic performance of positron emission tomography\\/computed\\u000a tomography (PET\\/CT) with fluorine-18–labeled 2-fluoro-2-deoxy-d-glucose (FDG) in comparison with that of ultrasonography and contrast-enhanced computed tomography (CT) in detecting axillary\\u000a lymph node metastasis in patients with breast cancer.\\u000a \\u000a \\u000a \\u000a Materials and methods  Fifty patients with invasive breast cancer were recruited. They had received no neoadjuvant chemotherapy

  6. Development of Web tools to predict axillary lymph node metastasis and pathological response to neoadjuvant chemotherapy in breast cancer patients.

    PubMed

    Sugimoto, Masahiro; Takada, Masahiro; Toi, Masakazu

    2014-01-01

    Nomograms are a standard computational tool to predict the likelihood of an outcome using multiple available patient features. We have developed a more powerful data mining methodology, to predict axillary lymph node (AxLN) metastasis and response to neoadjuvant chemotherapy (NAC) in primary breast cancer patients. We developed websites to use these tools. The tools calculate the probability of AxLN metastasis (AxLN model) and pathological complete response to NAC (NAC model). As a calculation algorithm, we employed a decision tree-based prediction model known as the alternative decision tree (ADTree), which is an analog development of if-then type decision trees. An ensemble technique was used to combine multiple ADTree predictions, resulting in higher generalization abilities and robustness against missing values. The AxLN model was developed with training datasets (n=148) and test datasets (n=143), and validated using an independent cohort (n=174), yielding an area under the receiver operating characteristic curve (AUC) of 0.768. The NAC model was developed and validated with n=150 and n=173 datasets from a randomized controlled trial, yielding an AUC of 0.787. AxLN and NAC models require users to input up to 17 and 16 variables, respectively. These include pathological features, including human epidermal growth factor receptor 2 (HER2) status and imaging findings. Each input variable has an option of "unknown," to facilitate prediction for cases with missing values. The websites developed facilitate the use of these tools, and serve as a database for accumulating new datasets. PMID:25096734

  7. Breast imaging. Preoperative breast cancer staging: comparison of USPIO-enhanced MR imaging and 18F-fluorodeoxyglucose (FDC) positron emission tomography (PET) imaging for axillary lymph node staging—initial findings

    Microsoft Academic Search

    Tadeusz W. Stadnik; Hendrik Everaert; Smitha Makkat; Robert Sacré; Jan Lamote; Claire Bourgain

    2006-01-01

    Magnetic resonance (MR) imaging after ultra-small super paramagnetic iron oxide (USPIO) injection and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for preoperative axillary lymph node staging in patients with breast cancer were evaluated using histopathologic findings as the reference standard. USPIO-enhanced MR and FDG-PET were performed in ten patients with breast cancer who were scheduled for surgery and axillary node resection. T2-weighted

  8. Quantum dots in axillary lymph node mapping: Biodistribution study in healthy mice

    Microsoft Academic Search

    Anne Robe; Emilie Pic; Henri-Pierre Lassalle; Lina Bezdetnaya; François Guillemin; Frédéric Marchal

    2008-01-01

    BACKGROUND: Breast cancer is the first cause of cancer death among women and its incidence doubled in the last two decades. Several approaches for the treatment of these cancers have been developed. The axillary lymph node dissection (ALND) leads to numerous morbidity complications and is now advantageously replaced by the dissection and the biopsy of the sentinel lymph node. Although

  9. Women with Breast Cancer Micrometastases in Their Sentinel Lymph Nodes May Not Need Axillary Dissection

    MedlinePLUS

    ... doctors,” said Jo Anne Zujewski, MD, head of breast cancer therapeutics at NCI. “Some patients, especially those for whom radiation therapy plus chemotherapy and/or hormonal therapy is planned, ...

  10. Comparison of Mastoscopic and Conventional Axillary Lymph Node Dissection in Breast Cancer: Long-term Results From a Randomized, Multicenter Trial

    PubMed Central

    Luo, Chengyu; Guo, Wenbin; Yang, Jie; Sun, Qiuru; Wei, Wei; Wu, Suhua; Fang, Shubing; Zeng, Qingliang; Zhao, Zhensheng; Meng, Fanjie; Huang, Xuandong; Zhang, Xianlan; Li, Ruihua; Ma, Xiufeng; Luo, Chaoying; Yang, Yun

    2012-01-01

    Objective To compare the long-term results of mastoscopic axillary lymph node dissection (MALND) and conventional axillary lymph node dissection (CALND). Patients and Methods From January 1, 2003, through December 31, 2005, a group of 1027 consecutive patients with operable breast cancer were randomly assigned to 1 of 2 study groups: MALND and CALND. The median follow-up was 63 months. The primary end points of the study were operative outcomes, complication reduction, function conservation, and cosmetics. The secondary end points were disease-free and overall survival. Results The mean operative blood loss in the MALND group was less than in the CALND group (P<.001). The patients who underwent MALND had less axillary pain, numbness or paresthesias, and arm swelling (P<.001). The aesthetic appearance of the axilla in the MALND group was much better than that in the CALND group (P=.001 at 6 months and P=.002 at 24 months). A significant difference was found between the 2 groups in distant metastasis (P=.04). The disease-free survival rate was 64.5% in the MALND group and 60.8% in the CALND group (P=.88). The overall survival rate was 81.7% in the MALND group and 78.6% in the CALND group (P=.95). Conclusion Compared with CALND, MALND has advantages in operative outcomes, complication reduction, function conservation, and cosmetics. PMID:23146657

  11. Axillary and Extra-axillary Lymph Node Recurrences after a Tumor-Negative Sentinel Node Biopsy for Breast Cancer Using Intralesional Tracer Administration

    Microsoft Academic Search

    Iris M. C. van der Ploeg; Bin B. R. Kroon; Ninja Antonini; Renato A. Valdés Olmos; Emiel J. T. Rutgers; Omgo E. Nieweg

    2008-01-01

    Background  At our institution, tracer fluids are administered in the primary breast cancer and, in addition to the ones in the axilla,\\u000a sentinel nodes outside the axilla are rigorously pursued. The objective of the present study of sentinel node-negative breast\\u000a cancer patients was to determine the lymph node recurrence rates in the axilla and elsewhere, the false-negative rates, and\\u000a the survival.

  12. Sentinel Node Biopsy Before Neoadjuvant Chemotherapy Spares Breast Cancer Patients Axillary Lymph Node Dissection

    Microsoft Academic Search

    Maartje C. van Rijk; Omgo E. Nieweg; Emiel J. T. Rutgers; Hester S. A. Oldenburg; Renato Valdés Olmos; Cornelis A. Hoefnagel; Bin B. R. Kroon

    2006-01-01

    Background  Neoadjuvant chemotherapy in breast cancer patients is a valuable method to determine the efficacy of chemotherapy and potentially\\u000a downsize the primary tumor, which facilitates breast-conserving therapy. In 18 studies published about sentinel node biopsy\\u000a after neoadjuvant chemotherapy, the sentinel node was identified in on average 89%, and the false-negative rate was on average\\u000a 10%. Because of these mediocre results, no

  13. [Prophylactic axillary radiotherapy for breast cancer].

    PubMed

    Rivera, S; Louvel, G; Rivin Del Campo, E; Boros, A; Oueslati, H; Deutsch, É

    2015-06-01

    Adjuvant radiotherapy, after breast conserving surgery or mastectomy for breast cancer, improves overall survival while decreasing the risk of recurrence. However, prophylactic postoperative radiotherapy of locoregional lymph nodes for breast cancer, particularly of the axillary region, is still controversial since the benefits and the risks due to axillary irradiation have not been well defined. To begin with, when performing conformal radiotherapy, volume definition is crucial for the analysis of the risk-benefit balance of any radiation treatment. Definition and contouring of the axillary lymph node region is discussed in this work, as per the recommendations of the European Society for Radiotherapy and Oncology (ESTRO). Axillary recurrences are rare, and the recent trend leads toward less aggressive surgery with regard to the axilla. In this literature review we present the data that lead us to avoid adjuvant axillary radiotherapy in pN0, pN0i+ and pN1mi patients even without axillary clearance and to perform it in some other situations. Finally, we propose an update about the potential toxicity of adjuvant axillary irradiation, which is essential for therapeutic decision-making based on current evidence, and to guide us in the evolution of our techniques and indications of axillary radiotherapy. PMID:26044178

  14. Predictors of Completion Axillary Lymph Node Dissection in Patients with Positive Sentinel Lymph Nodes

    Microsoft Academic Search

    Amer K. Karam; Meier Hsu; Sujata Patil; Michelle Stempel; Tiffany A. Traina; Alice Y. Ho; Hiram S. Cody; Elisa R. Port; Monica Morrow; Mary L. Gemignani

    2009-01-01

    Background  Completion axillary lymph node dissection (CALND) is routinely performed in breast cancer patients with positive sentinel\\u000a lymph nodes (SLN). We sought to determine the sociodemographic, pathologic, and therapeutic variables that were associated\\u000a with CALND.\\u000a \\u000a \\u000a \\u000a Methods  From 7\\/1997 to 7\\/2003, 1,470 patients with invasive breast cancer were SLN positive by intraoperative frozen section or final\\u000a pathologic exam by hematoxylin–eosin and\\/or immunohistochemistry (IHC).

  15. A standardized surgical technique for mastoscopic axillary lymph node dissection.

    PubMed

    Chengyu, Luo; Yongqiao, Zhou; Hua, Lin; Xiaoxin, Ji; Chen, Guan; Jing, Li; Jian, Zhang

    2005-06-01

    To standardize the surgical technique for mastoscopic axillary lymph node dissection (MALND). Mastoscopic lymph node dissection was performed consistently by a group of surgeons in 316 cases of breast cancer. The mean operation time was 46.7 minutes with minimal bleeding, and the median number of lymph nodes dissected at each operation was 17.0. There were no operative complications in any case, nor did trocar implantation or tumor diffusion occurring during the mean follow-up time of 15.1 months. MALND is distinctive and practicable in operative anatomy as well as safe and convenient. The location of critical anatomy such as the intercostobrachial nerve, lateral thoracic artery, medial thoracic nerve, and thoracoepigastric vein should be clearly identified to avoid damage to them, so that is the great advantage of MALND. PMID:15956900

  16. Reoperative sentinel lymph node biopsy for ipsilateral breast tumor recurrence after previous axillary lymph node dissection: Report of a case

    Microsoft Academic Search

    Masaya Hattori; Seiichiro Nishimura; Keiichiro Tada; Masamichi Koyama; Futoshi Akiyama; Yoshinori Ito; Takuji Iwase

    2011-01-01

    Sentinel lymph node biopsy has become a standard component of the evaluation of early-stage breast cancer, with a gradually\\u000a increasing number of indications in this patient population. This report presents the case of a patient who underwent reoperative\\u000a sentinel lymph node biopsy as part of an evaluation of ipsilateral breast tumor recurrence; she had previously undergone axillary\\u000a lymph node dissection.

  17. Contribution of Kinetic Characteristics of Axillary Lymph Nodes to the Diagnosis in Breast Magnetic Resonance Imaging

    PubMed Central

    Örgüç, ?ebnem; Ba?ara, I??l; Pekindil, Gökhan; Co?kun, Teoman

    2012-01-01

    Objective: To assess the contribution of kinetic characteristics in the discrimination of malignant-benign axillary lymph nodes. Material and Methods: One hundred fifty-five female patients were included in the study. Following magnetic resonance imaging (MRI) examinations postprocessing applications were applied, dynamic curves were obtained from subtracted images. Types of dynamic curves were correlated with histopathological results in malignant cases or final clinical results in patients with no evidence of malignancy. Sensitivity, specificity, positive likehood ratio (+LHR), negative (?LHR) of dynamic curves characterizing the axillary lymph nodes were calculated. Results: A total of 178 lymph nodes greater than 8 mm were evaluated in 113 patients. Forty-six lymph nodes in 24 cases had malignant axillary involvement. 132 lymph nodes in 89 patients with benign diagnosis were included in the study. The sensitivity of type 3 curve as an indicator of malignancy was calculated as 89%. However the specificity, +LHR, ?LHR were calculated as 14%, 1.04, 0.76 respectively. Conclusion: Since kinetic analysis of both benign and malignant axillary lymph nodes, rapid enhancement and washout (type 3) they cannot be used as a discriminator, unlike breast lesions. MRI, depending on the kinetic features of the axillary lymph nodes, is not high enough to be used in the clinical management of breast cancer patients. PMID:25207016

  18. Intercostobrachial Nerves as a Novel Anatomic Landmark for Dividing the Axillary Space in Lymph Node Dissection

    PubMed Central

    Li, Jianyi; Zhang, Yang; Zhang, Wenhai; Jia, Shi; Gu, Xi; Ma, Yan; Li, Dan

    2013-01-01

    Purpose. Our aim was to assess the feasibility of using the intercostobrachial nerves (ICBNs) as a possible new anatomic landmark for axillaries lymph node dissection in breast cancer patients. Background Data Summary. The preservation of ICBN is now an accepted procedure in this type of dissection; however, it could be improved further to reduce the number of postoperative complications. The axillary space is divided into lower and upper parts by the ICBN—a thorough investigation of the metastasis patterns in lymph nodes found in this area could supply new information leading to such improvements. Methods. Seventy-two breast cancer patients, all about to undergo lymph node dissection and with sentinel lymph nodes identified, were included in this trial. The lymph nodes were collected in two groups, from lower and upper axillary spaces, relative to the intercostobrachial nerves. The first group was further subdivided into sentinel (SLN) and nonsentinel (non-SLN) nodes. All lymph nodes were tested to detect macro- and micrometastasis. Results. All the sentinel lymph nodes were found under the intercostobrachial nerves; more than 10 lymph nodes were located in that space. Moreover, when lymph nodes macrometastasize or micrometastasize above the intercostobrachial nerves, we also observe metastasis-positive nodes under the nerves; when the lower group nodes show no metastasis, the upper group is also metastasis free. Conclusions. Our results show that the intercostobrachial nerves are good candidates for a new anatomic landmark to be used in lymph node dissection procedure. PMID:23401796

  19. Intradermal administration of fluorescent contrast agents for delivery to axillary lymph nodes

    NASA Astrophysics Data System (ADS)

    Rasmussen, John C.; Meric-Berstam, Funda; Krishnamurthy, Savitri; Tan, I.-Chih; Zhu, Banghe; Wagner, Jamie L.; Babiera, Gildy V.; Mittendorf, Elizabeth A.; Sevick-Muraca, Eva M.

    2014-05-01

    In this proof-of-concept study we seek to demonstrate the delivery of fluorescent contrast agent to the tumor-draining lymph node basin following intraparenchymal breast injections and intradermal arm injection of micrograms of indocyanine green in 20 breast cancer patients undergoing complete axillary lymph node dissection. Individual lymph nodes were assessed ex vivo for presence of fluorescent signal. In all, 88% of tumor-negative lymph nodes and 81% of tumor-positive lymph nodes were fluorescent. These results indicate that future studies utilizing targeted fluorescent contrast agents may demonstrate improved surgical and therapeutic intervention.

  20. Efficiency of a Preoperative Axillary Ultrasound and Fine-Needle Aspiration Cytology to Detect Patients with Extensive Axillary Lymph Node Involvement

    PubMed Central

    Castellano, Isabella; Deambrogio, Cristina; Muscarà, Francesca; Chiusa, Luigi; Mariscotti, Giovanna; Bussone, Riccardo; Gazzetta, Guglielmo; Macrì, Luigia; Cassoni, Paola; Sapino, Anna

    2014-01-01

    Background Recent studies have demonstrated that axillary lymph node dissection (ALND) does not affect patient survival, even in those with one or two positive sentinel lymph nodes (SLNs). On the other hand, patients with 3 or more metastatic lymph nodes are eligible for chemotherapy. Therefore, it is crucial to identify a priori patients at risk of having a high number of metastatic axillary lymph nodes for their surgical and/or clinical management. Ultrasound (US) guided Fine-Needle Aspiration (FNA) has been proven to be a useful and highly specific method for detecting metastatic axillary lymph nodes. However, only one recent study has evaluated the efficiency of this method in identifying patients with high metastatic nodal involvement. Our aim was to validate US-guided FNA as a reliable method to discriminate a priori patients with >3 metastatic lymph nodes. Methods A retrospective series of 1287 breast cancer patients who underwent a simultaneous preoperative breast and axillary US to stage their axilla was collected. A total of 365 patients, with either positive SLNs (278) or positive axillary lymph nodes detected via US-guided FNA (87), underwent ALND. In these two subgroups, we compared the number of metastatic lymph nodes in the axilla. Results The number of metastatic axillary lymph nodes in patients who underwent US-guided FNA was significantly higher (63% had >3 metastatic lymph nodes) than that in patients with SLNs positive for micro- or macrometastases (3% and 27%, respectively) (P<0.001, ?2?=?117.897). Conclusions Preoperative axillary US-guided FNA could act as a reliable tool in identifying breast cancer patients with extensive nodal involvement. PMID:25207643

  1. Subareolar blue dye only injection sentinel lymph node biopsy could reduce the numbers of standard axillary lymph node dissection in environments without access to nuclear medicine

    Microsoft Academic Search

    Andreas Kavallaris; Oumar Camara; Ingo B. Runnebaum

    2008-01-01

    Purpose  The gold standard of axillary sentinel lymph node biopsy (SLNB) in breast cancer is the combination of radioactive colloid\\u000a and blue dye injection. Worldwide, numerous hospitals without access to radioactive tracers still perform a routine complete\\u000a axillary lymph node dissection (ALND). We retrospectively analyzed the false negative rate and identification rate of SLNB\\u000a with injection of blue dye in the

  2. Does Fibrin Glue Improve Drainage after Axillary Lymph Node Dissection? Prospective and Randomized Study in Humans

    Microsoft Academic Search

    F. Vaxman; A. Kolbe; F. Stricher; D. Zund; P. Volkmar; D. Gros; J. F. Grenier

    1995-01-01

    The aim of this prospective and randomized study was to establish whether the use of fibrin glue was beneficial after axillary lymph node dissection. From January 1990 to January 1991, 40 women were randomized before surgery for breast cancer: 20 patients (group A) underwent vaporization of fibrin glue (Tissucol®, 5 ml of 500 IU thrombin) only in the area of

  3. Trends in and Outcomes from Sentinel Lymph Node Biopsy (SLNB) Alone vs. SLNB with Axillary Lymph Node Dissection for Node-Positive Breast Cancer Patients: Experience from the SEER Database

    Microsoft Academic Search

    Min Yi; Sharon Hermes Giordano; Funda Meric-Bernstam; Elizabeth A. Mittendorf; Henry M. Kuerer; Rosa F. Hwang; Isabelle Bedrosian; Loren Rourke; Kelly K. Hunt

    2010-01-01

    Background  Complete axillary lymph node dissection (ALND) after a positive sentinel lymph node biopsy (SLNB) remains the standard practice.\\u000a As nodal surgery has long been considered a staging procedure without a clear survival benefit, the need for ALND in all patients\\u000a is debatable. The purpose of this study was to examine differences in survival for patients undergoing SLNB alone versus SLNB

  4. Epitrochlear and axillary lymph node visualization on FDG-PET\\/CT imaging in a patient with rheumatoid arthritis

    Microsoft Academic Search

    P. Ozcan Kara; B. Kaya; G. Kara Gedik; O. Sari

    2011-01-01

    An 38 year-old female with oral tongue cancer was referred for FDG-PET\\/CT scan for evaluating axillary lymph nodes and restaging malignancy. Bilateral uptake of axillary and epitrochlear lymph nodes were observed on PET\\/CT imaging. The uptake pattern was unexpected for the patient with this malignancy and she had a history of rheumatoid arthritis. Additionally, the wrists were included in the

  5. Sentinel Lymph Node Biopsy in Patients with Previous Ipsilateral Complete Axillary Lymph Node Dissection

    Microsoft Academic Search

    Paramjeet Kaur; John V. Kiluk; Tammi Meade; Daniel Ramos; William Koeppel; Julia Jara; Jeff King; Charles E. Cox

    2011-01-01

    Background  Prior ipsilateral completion axillary lymph node dissection (CALND) may be considered a contraindication to performing a sentinel\\u000a lymph node (SLN) mapping in a patient with recurrent breast carcinoma. However, reoperative SLN biopsy following axillary\\u000a dissection would determine if alternative lymphatic drainage pathways exist. If nodes were found to contain metastatic disease,\\u000a staging and locoregional control of the disease could be

  6. Fine-Needle Aspirate CYFRA 21-1, an Innovative New Marker for Diagnosis of Axillary Lymph Node Metastasis in Breast Cancer Patients.

    PubMed

    Choi, Ji Soo; Han, Kyung Hwa; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung

    2015-05-01

    To compare the value of cytokeratin fragment 21-1 (CYFRA 21-1) concentration in the fine-needle biopsy aspirates (fine needle aspirate [FNA] CYFRA 21-1) with cytopathology of fine-needle aspiration biopsy (FNA cytology) and to assess whether CYFRA 21-1 concentrations from ultrasound-guided fine-needle aspiration biopsy (US-FNAB) specimens (FNA CYFRA 21-1) is not inferior to FNA cytology in the diagnosis of axillary lymph node (ALN) metastasis of breast cancer patients.This study received institutional review board approval, and written informed consent was obtained from all patients. US-FNAB was performed in 373 ALNs from 358 patients with invasive breast cancer. Concentrations of CYFRA 21-1 were measured from washouts of the syringe used during US-FNAB (FNA CYFRA 21-1), and ALN metastasis was determined using a cutoff value of 1.93?ng/mL. FNA cytology, intraoperative sentinel lymph node biopsy, and surgical pathology results were reviewed and analyzed. The noninferiority margin for the difference in accuracies between FNA cytology and FNA CYFRA 21-1 was set as 5%.Among 373 ALNs, 136 (36.5%) were benign, and 237 (63.5%) were metastatic. The mean FNA CYFRA 21-1 was significantly higher in metastatic ALNs compared to that in benign ALNs (P?=?0.001). For the diagnosis of ALN metastasis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA CYFRA 21-1 (cutoff value 1.93?ng/mL) were not significantly different from those of FNA cytology (P?>?0.05). FNA CYFRA 21-1 reached statistical noninferiority to FNA cytology in terms of diagnostic accuracy for ALN metastasis. Of the 20 ALNs (8 metastasis, 12 benign) that showed insufficient results on FNA cytology, FNA CYFRA 21-1 accurately diagnosed 15 ALNs (4 metastasis, 11 benign).The diagnostic performance of FNA CYFRA 21-1 is comparable with that of FNA cytology for breast cancer ALN metastasis. Our results indicate that FNA CYFRA 21-1, using an US-FNAB specimen, can be a useful method equal to FNA cytology in terms of diagnostic accuracy. PMID:25984666

  7. Axillary lymphadenectomy for breast cancer – the influence of shoulder mobilisation on lymphatic drainage

    Microsoft Academic Search

    M. Christodoulakis; E. Sanidas; E. de Bree; J. Michalakis; E. Volakakis; D. Tsiftsis

    2003-01-01

    Aim: The purpose of the present study was to study the influence of external axillary compression dressing with immobilisation of the ipsilateral shoulder after axillary lymph node dissection (ALND) on postoperative axillary drainage.Methods: One hundred consecutive women with breast cancer undergoing ALND were enrolled in this study. They were allowed free shoulder movement and were compared with a matched historical

  8. Epitrochlear and axillary lymph node visualization on FDG-PET/CT imaging in a patient with rheumatoid arthritis.

    PubMed

    Ozcan Kara, P; Kaya, B; Kara Gedik, G; Sari, O

    2011-01-01

    An 38 year-old female with oral tongue cancer was referred for FDG-PET/CT scan for evaluating axillary lymph nodes and restaging malignancy. Bilateral uptake of axillary and epitrochlear lymph nodes were observed on PET/CT imaging. The uptake pattern was unexpected for the patient with this malignancy and she had a history of rheumatoid arthritis. Additionally, the wrists were included in the field of view and showed elevated FDG uptake. In this case report, we report benign axillary and epitrochlear tracer uptake on FDG-PET/CT scan in a patient with a history of rheumatoid arthritis. PMID:20570414

  9. Locoregional failure of postmastectomy patients with 1–3 positive axillary lymph nodes without adjuvant radiotherapy

    Microsoft Academic Search

    Jason Chia-Hsien Cheng; Chii-Ming Chen; Mei-Ching Liu; Mei-Hua Tsou; Po-Sheng Yang; James Jer-Min Jian; Skye Hongiun Cheng; Stella Y. Tsai; Szu-Yun Leu; Andrew T. Huang

    2002-01-01

    Purpose: To analyze the incidence and risk factors for locoregional recurrence (LRR) in patients with breast cancer who had T1 or T2 primary tumor and 1–3 histologically involved axillary lymph nodes treated with modified radical mastectomy without adjuvant radiotherapy (RT).Methods and Materials: Between April 1991 and December 1998, 125 patients with invasive breast cancer were treated with modified radical mastectomy

  10. Endoscopic axillary lymph node dissection: an experimental study in human cadavers

    Microsoft Academic Search

    L. Michael Brunt; Daniel B. Jones; Justin S. Wu; Elizabeth M. Brunt; Diane M. Radford

    1998-01-01

    Background: The role of axillary lymph node dissection in the staging of patients with breast carcinoma is currently under evaluation. As a result of recent advances in minimally invasive techniques, an endoscopic approach to axillary lymph node dissection may be an attractive alternative to lymphadenectomy performed via a standard “open” axillary incision. The purpose of the present study was to

  11. Axillary Lymph Node-to-Primary Tumor Standard Uptake Value Ratio on Preoperative 18F-FDG PET/CT: A Prognostic Factor for Invasive Ductal Breast Cancer

    PubMed Central

    Kim, Young Hwan; Yoon, Hai-Jeon; Kim, Yemi

    2015-01-01

    Purpose This study assessed the axillary lymph node (ALN)-to-primary tumor maximum standard uptake value (SUVmax) ratio (ALN/T SUV ratio) in invasive ductal breast cancer (IDC) on preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) to determine the effectiveness in predicting recurrence-free survival (RFS). Methods One hundred nineteen IDC patients (mean age, 50.5±10.5 years) with pathologically proven ALN involvement without distant metastasis and preoperative FDG PET/CT were enrolled in the study. SUVmax values of the ALN and primary tumor were obtained on FDG PET/CT, and ALN/T SUV ratio was calculated. Several factors were evaluated for their effectiveness in predicting RFS. These included several parameters on FDG PET/CT as well as several clinicopathological parameters: pathologic tumor/node stage; nuclear and histological grade; hormonal state; status with respect to human epidermal growth factor receptor 2, mindbomb E3 ubiquitin protein ligase 1 (MIB-1), and p53; primary tumor size; and ALN size. Results Among 119 patients with breast cancer, 17 patients (14.3%) experienced relapse during follow-up (mean follow-up, 28.4 months). The ALN/T SUV ratio of the group with disease recurrence was higher than that of the group without recurrence (0.97±1.60 and 0.45±0.40, respectively, p=0.005). Univariate analysis showed that the primary tumor SUVmax, ALN SUVmax, ALN/T SUV ratio, ALN status, nuclear and histological grade, estrogen receptor (ER) status, and MIB-1 status were predictors for RFS. Among these variables, ALN/T SUV ratio with hazard ratio of 4.20 (95% confidence interval [CI], 1.74-10.13) and ER status with hazard ratio of 4.33 (95% CI, 1.06-17.71) were predictors for RFS according to multivariate analysis (p=0.002 and p=0.042, respectively). Conclusion Our study demonstrated that ALN/T SUV ratio together with ER status was an independent factor for predicting relapse in IDC with metastatic ALN. ALN/T SUV ratio on preoperative FDG PET/CT may be a useful marker for selecting IDC patients that need adjunct treatment to prevent recurrence. PMID:26155294

  12. Predicting axillary lymph node metastasis from kinetic statistics of DCE-MRI breast images

    NASA Astrophysics Data System (ADS)

    Ashraf, Ahmed B.; Lin, Lilie; Gavenonis, Sara C.; Mies, Carolyn; Xanthopoulos, Eric; Kontos, Despina

    2012-03-01

    The presence of axillary lymph node metastases is the most important prognostic factor in breast cancer and can influence the selection of adjuvant therapy, both chemotherapy and radiotherapy. In this work we present a set of kinetic statistics derived from DCE-MRI for predicting axillary node status. Breast DCE-MRI images from 69 women with known nodal status were analyzed retrospectively under HIPAA and IRB approval. Axillary lymph nodes were positive in 12 patients while 57 patients had no axillary lymph node involvement. Kinetic curves for each pixel were computed and a pixel-wise map of time-to-peak (TTP) was obtained. Pixels were first partitioned according to the similarity of their kinetic behavior, based on TTP values. For every kinetic curve, the following pixel-wise features were computed: peak enhancement (PE), wash-in-slope (WIS), wash-out-slope (WOS). Partition-wise statistics for every feature map were calculated, resulting in a total of 21 kinetic statistic features. ANOVA analysis was done to select features that differ significantly between node positive and node negative women. Using the computed kinetic statistic features a leave-one-out SVM classifier was learned that performs with AUC=0.77 under the ROC curve, outperforming the conventional kinetic measures, including maximum peak enhancement (MPE) and signal enhancement ratio (SER), (AUCs of 0.61 and 0.57 respectively). These findings suggest that our DCE-MRI kinetic statistic features can be used to improve the prediction of axillary node status in breast cancer patients. Such features could ultimately be used as imaging biomarkers to guide personalized treatment choices for women diagnosed with breast cancer.

  13. Axillary reverse mapping for breast cancer

    Microsoft Academic Search

    Masakuni Noguchi

    2010-01-01

    The axillary reverse mapping (ARM) technique has been developed to map and preserve arm lymphatic drainage during axillary\\u000a lymph node dissection (ALND) and\\/or sentinel lymph node (SLN) biopsy, thereby minimizing arm lymphedema. However, several\\u000a problems remain to be resolved in the practical application of this technique. This article presents a review of current knowledge\\u000a regarding ARM and discusses the practical

  14. Pathology Case Study: Enlarged Right Axillary Lymph Node

    NSDL National Science Digital Library

    Fung, Mark

    This is a case study presented by the University of Pittsburgh Department of Pathology in which a 40-year-old man was found to have an enlarged right axillary lymph node. Visitors are given the patient history, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pathology and clinical immunology.

  15. Factors associated with involvement of four or more axillary nodes for sentinel lymph node-positive patients

    SciTech Connect

    Katz, Angela [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)]. E-mail: abkatz@partners.org; Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Gage, Irene [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Evans, Sheila [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Shaffer, Margaret [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Smith, Frederick P. [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States); Taghian, Alphonse [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Magnant, Colette [Breast Cancer Treatment Group, Sibley Memorial Hospital, Washington, DC (United States)

    2006-05-01

    Purpose: Sentinel lymph node-positive (SLN+) patients who are unlikely to have 4 or more involved axillary nodes might be treated with less extensive regional nodal radiation. The purpose of this study was to define possible predictors of having 4 or more involved axillary nodes. Methods and Materials: The records of 224 patients with breast cancer and 1 to 3 involved SLNs, who underwent completion axillary dissection without neoadjuvant chemotherapy or hormonal therapy were reviewed. Factors associated with the presence of 4 or more involved axillary nodes (SLNs plus non-SLNs) were evaluated by Pearson chi-square test of association and by simple and multiple logistic-regression analysis. Results: Of 224 patients, 42 had involvement of 4 or more axillary nodes. On univariate analysis, the presence of 4 or more involved axillary nodes was positively associated with increased tumor size, lobular histology, lymphovascular space invasion (LVSI), increased number of involved SLNs, decreased number of uninvolved SLNs, and increased size of SLN metastasis. On multivariate analysis, the presence of 4 or more involved axillary nodes was associated with LVSI, increased number of involved SLNs, increased size of SLN metastasis, and lobular histology. Conclusions: Patients with 1 or more involved SLN, LVSI, or SLN macrometastasis should be treated to the supraclavicular fossa/axillary apex if they do not undergo completion axillary dissection. Other SLN+ patients might be adequately treated with less extensive radiation fields.

  16. Impact of Omission of Axillary Lymph Node Dissection After Negative Sentinel Lymph Node Biopsy: 70Month Follow-up

    Microsoft Academic Search

    Hee Jeong Kim; Byung Ho Son; Woo Sung Lim; Jin Yong Seo; Beom Seok Koh; Jong Won Lee; Gyung Yup Gong; Sei Hyun Ahn

    2010-01-01

    Background  The objective of this study is to assess the oncologic safety of sentinel lymph node biopsy (SLNB), especially with regard\\u000a to the axillary recurrence (AR) rate, and to determine the risk factors for AR and disease-free survival (DFS) and overall\\u000a survival (OS) after negative SLNB.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  Between 2003 and 2006, a total of 1626 patients with invasive breast cancer

  17. Intramammary lymph nodes and breast cancer: a marker for disease severity, or just another lymph node?

    Microsoft Academic Search

    Amber A. Guth; Cecilia Mercado; Daniel F. Roses; Karen Hiotis; Kristin Skinner; Thomas Diflo; Joan Cangiarella

    2006-01-01

    BackgroundAxillary lymph node status is still considered the most significant prognostic factor for breast cancer outcome, and treatment decisions are based on the presence or absence of nodal disease. Intramammary lymph nodes (IMLNs) can be a site of regional spread. Is this a marker for more aggressive disease?

  18. Sentinel lymphadenectomy in breast cancer: identification of sentinel lymph node and detection of metastases

    Microsoft Academic Search

    Masakuni Noguchi; Koichiro Tsugawa; Etsuro Bando; Futoshi Kawahara; Koichi Miwa; Kunihiko Yokoyama; Ken-ichi Nakajima; Norihisa Tonami

    1999-01-01

    Sentinel lymphadenectomy is a useful way of assessing axillary status and obviating axillary dissection in patients with node-negative breast cancer. However, controversies remain concerning the optimal method to identify the sentinel lymph node (SLN) and detect micrometastases in this lymph node. We reviewed the literature concerning sentinel lymphadenectomy in breast cancer and reached the following conclusions: (a) A combination of

  19. Toward nodal staging of axillary lymph node basins through intradermal administration of fluorescent imaging agents

    PubMed Central

    Meric-Bernstam, Funda; Rasmussen, John C.; Krishnamurthy, Savitri; Tan, I-Chih; Zhu, Banghe; Wagner, Jamie L.; Babiera, Gildy V.; Mittendorf, Elizabeth A.; Sevick-Muraca, Eva M.

    2013-01-01

    As part of a proof-of-concept study for future delivery of targeted near-infrared fluorescent (NIRF) tracers, we sought to assess the delivery of micrograms of indocyanine green to all the axillary lymph nodes following intraparenchymal breast injections and intradermal arm injections in 20 subjects with advanced breast carcinoma and undergoing complete axillary lymph node dissection. Lymphatic vessels and nodes were assessed in vivo. Ex vivo images demonstrated that 87% of excised lymph nodes, including 81% of tumor-positive lymph nodes, were fluorescent. Future clinical studies using microdose amounts of tumor-targeting NIRF contrast agents may demonstrate improved surgical intervention with reduced morbidity. PMID:24466486

  20. Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?

    PubMed Central

    2011-01-01

    Background We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR) rate, distant metastasis (DM) rate, disease free survival (DFS) and overall survival (OS) in a group of breast cancer (BC) patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes) treated with or without postmastectomy radiotherapy (PMRT) following modified radical mastectomy (MRM). Methods Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66) or without (n = 24) PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes) and treatment-related factors (PMRT, chemotherapy and hormonal therapy) were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed. Results Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3%vs 17%, p = 0.038), DM rate (12% vs 42%, p = 0.004), 5 year DFS (82.4% vs 52.4%, p = 0.034), 5 year OS (90,2% vs 61,9%, p = 0.087). In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS. Conclusion PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval. PMID:21450076

  1. Combined ipsilateral neck and axillary lymphadenectomy for metastatic skin cancers: a case series and surgical tips.

    PubMed

    Goodenough, J; Martin, H; Shaaban, H

    2013-08-01

    In the absence of distant disease simultaneous skin cancer metastasis to neck and axillary lymph nodes necessitates both an axillary and neck en block lymphadenectomy. A combined ipsilateral neck and axillary lymph node dissection should involve an in-continuity dissection through the cervicoaxillary canal for optimal lymphatic and oncological clearance. Review of the literature reveals little published instruction on the procedure since the radical surgery performed by Bowden over 50 years ago. We present 4 cases where ipsilateral axillary and neck lymph node dissections were performed for metastatic melanoma and a case of apical axillary node dissection via a neck incision approach. Our surgical tips include performing apical axillary node dissection via the neck incision and consideration of clavicular osteotomy or clavicular excision. A transclavicular approach was taken in one patient who had an excellent functional outcome after a plate and screw fixation. One elderly patient required a middle third claviculectomy which reduced shoulder elevation but was not associated with functional impairment. We conclude the surgery is safe and associated with the usual morbidity ascribed with either an axillary or neck dissection undertaken in isolation. However, patients have a significant risk of disease relapse as would be expected due to the duel metastatic sites, multiple lymph node and neck involvement which are known to be independent poor prognostic factors on melanoma survival and relapse. PMID:23664381

  2. Solitary positive sentinel lymph node accompanied by negative sentinel lymph node(s) is predictive of a negative completion axillary lymph node dissection

    Microsoft Academic Search

    Weesam Alkhatib; Carol Connor; Fan Fang

    2007-01-01

    BackgroundMany patients with a positive sentinel lymph node (SLN) have a negative axillary lymph node dissection (ALND). We hypothesized that a solitary positive SLN associated with at least 1 negative SLN is predictive of a negative completion ALND. Omission of ALND may be possible in these patients.

  3. A calibration phantom for direct, in vivo measurement of 241Am in the axillary lymph nodes.

    PubMed

    Zeman, Rachel; Lobaugh, Megan; Spitz, Henry; Glover, Samuel; Hickman, David

    2009-09-01

    A calibration phantom was developed at the University of Cincinnati (UC) to determine detection efficiency and estimate the quantity of activity deposited in the axillary lymph nodes of a worker who had unknowingly sustained a wound contaminated with 241Am at some distant time in the past. This paper describes how the Livermore Torso Phantom was modified for calibrating direct, in vivo measurements of 241Am deposited in the axillary lymph nodes. Modifications involved milling a pair of parallel, flat bottom, cylindrical holes into the left and right shoulders (below the humeral head) of the Livermore Torso Phantom in which solid, 1.40-cm-diameter cylindrical rods were inserted. Each rod was fabricated using a muscle tissue substitute. One end of each rod contained a precisely known quantity of Am sealed in a 1-cm-diameter, 2.54-cm-deep well to simulate the axillary lymph nodes when inserted into the modified Livermore Torso Phantom. The fixed locations for the axillary lymph nodes in the phantom were determined according to the position of the Level I and the combined Level II + III axillary lymph nodes reported in the literature. Discrete calibration measurements for 241Am in the simulated axillary lymph nodes located in the right and left sides of the thorax were performed using pairs of high-resolution germanium detectors at UC and Lawrence Livermore National Laboratory. The percent efficiency for measuring the 59.5 keV photon from Am deposited in the right and left axillary lymph nodes using a pair of 3,000 mm2 detectors is 2.60 +/- 0.03 counts gamma-1 and 5.45 +/- 0.07 counts gamma-1, respectively. Activity deposited in the right and left axillary lymph nodes was found to contribute 12.5% and 19.7%, respectively, to a lung measurement and 1.2% and 0.2%, respectively, to a liver measurement. Thus, radioactive material mobilized from a wound in a finger or hand and deposited in the axillary lymph nodes has been shown to confound results of a direct, in vivo measurement of the lungs. PMID:19667805

  4. Sentinel lymph node biopsy in early-stage breast cancer

    Microsoft Academic Search

    Amit Goyal; Robert E. Mansel

    Sentinel lymph node biopsy (SLNB) is the current standard of care for nodal staging in early-stage breast cancer patients\\u000a who are clinically nodenegative. Data from three randomised controlled trials conclusively demonstrates that SLNB is associated\\u000a with less arm morbidity and better quality of life than axillary lymph node dissection (ALND). Large observational studies\\u000a have shown that SLNB is associated with

  5. Prognostic, predictive abilities and concordance of BCL2 and TP53 protein expression in primary breast cancers and axillary lymph-nodes: a retrospective analysis of the Belgian three arm study evaluating anthracycline vs CMF adjuvant chemotherapy.

    PubMed

    Bozovic-Spasojevic, Ivana; Ameye, Lieveke; Paesmans, Marianne; Larsimont, Denis; Di Leo, Angelo; Dolci, Stella; Piccart, Martine; de Azambuja, Evandro; Loi, Sherene

    2014-08-01

    Given recent data on genetic heterogeneity within and individual's tumor, we investigated if there were differences in the prognostic and predictive abilities of BCL2 and TP53 protein expression in primary breast cancer (TU) and corresponding axillary lymph-nodes (LN). We used patient samples from the adjuvant Belgian three-arm study which randomized between anthracycline containing regimens and traditional CMF. The endpoints analyzed were overall survival (OS), event-free survival (EFS) and interactions between chemotherapy regimens. At a median follow-up of 15.6 years, BCL2 and TP53 (in both TU and LN) were significantly associated with OS but only in the first 5 years. Likewise, BCL2 and TP53 (in both TU and LN) were associated with EFS in the first 2 years after randomization, with no association after 2 years. BCL2 and TP53 remained statistically significant after adjustment for the standard clinical-pathological characteristics in regard to OS and EFS in the respective first years after randomization, (p value < 0.001 for both markers). Furthermore, an interaction was found between high BCL2 expression in the TU (but not in LN) and benefit to CMF over anthracycline-based chemotherapy (interaction p value EFS: 0.042; OS = 0.01). No interaction was found for TP53 expression neither in TU nor in LN. We conclude that BCL2 and TP53 were predictive biomarkers for better and worse survival respectively, but only in the first two to five years after diagnosis. BCL2 expression in the TU but not in the LN was predictive of increased benefit to CMF vs anthracycline-based chemotherapy. PMID:24768477

  6. Chemoendocrine Therapy for Premenopausal Women With Axillary Lymph Node-Positive, Steroid Hormone Receptor-Positive Breast Cancer: Results From INT 0101 (E5188)

    Microsoft Academic Search

    Nancy E. Davidson; Anne M. O'Neill; Allen M. Vukov; C. Kent Osborne; Silvana Martino; Douglas R. White; Martin D. Abeloff

    Purpose Chemotherapy, tamoxifen, and ovarian ablation\\/suppression (OA\\/OS) are effective adjuvant approaches for premenopausal, steroid hormone receptor-positive breast cancer. The value of combined therapy has not been clearly established.

  7. Completion axillary lymph node dissection minimizes the likelihood of false negatives for patients with invasive breast carcinoma and cytokeratin positive only sentinel lymph nodes

    Microsoft Academic Search

    James W Jakub; Nils M Diaz; Mark D Ebert; Alan Cantor; Douglas S Reintgen; Elisabeth L Dupont; Alan R Shons; Charles E Cox

    2002-01-01

    Objective: To document the incidence of metastatic disease in complete axillary lymph node dissections (CALND) of patients with invasive carcinoma after a sentinel lymph node (SLN) biopsy, positive only by immunohistochemical staining for cytokeratin (CK-IHC).Methods: Sections of all SLNs, negative by routine histology, were immunostained and examined for cytokeratin positive cells. Sections of lymph nodes from CALND specimens were interpreted

  8. Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma

    Microsoft Academic Search

    Johan S. Rietman; Pieter U. Dijkstra; Jan H. B. Geertzen; Peter Baas; Jaap de Vries; Wil Dolsma; Johan W. Groothoff; Willem H. Eisma; Harald J. Hoekstra

    2003-01-01

    BACKGROUND. The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment-related upper-limb morbidity. In the current prospec- tive study, short-term upper-limb morbidity was assessed after SLNB and\\/or ALND. METHODS. The study comprised 204 patients with Stage I\\/II breast carcinoma. Mean patient age was 55.6 years (standard

  9. Optical Coherence uring breast-conserving surgeries, axillary lymph

    E-print Network

    Boppart, Stephen

    to lung cancer) has started to decrease over the last few years, largely attributed to the effectiveness-node involvement and cancer metastasis. The management and treatment of breast cancer has continued to improve-time microscopic optical-imaging technique previously used to image breast cancer tumor margins intraoperatively

  10. Immunohistochemical detection and significance of axillary lymph node micrometastases in breast carcinoma. A study of 97 cases.

    PubMed

    Elson, C E; Kufe, D; Johnston, W W

    1993-06-01

    Paraffin blocks of all axillary lymph nodes from 97 patients with an initial histologic diagnosis of infiltrating ductal carcinoma and negative axillary nodes were recut and stained with two monoclonal antibodies, AE/AE3 (antikeratin) and DF3 (developed against breast cancer cells and reactive with a glycoprotein tumor-associated antigen). Immunohistochemical staining detected occult micrometastases in 20 patients (20.6%). No patient had more than three lymph nodes involved by tumor. Review of the original hematoxylin and eosin-stained sections revealed that foci of tumor were initially overlooked in nine of these cases (9.3%). In the remaining 11 cases (11.3%) the metastatic foci were encountered in the process of recutting the paraffin blocks for immunohistochemical studies. AE1/AE3 proved to be the more effective of the two antibodies in staining micrometastases. After a mean follow-up period of 5.7 years, no significant decrease in survival or increase in tumor recurrence was detected for patients with occult micrometastases as compared to those patients without micrometastases. PMID:7688511

  11. Impact of Clinicopathological Factors on Sensitivity of Axillary Ultrasonography in the Detection of Axillary Nodal Metastases in Patients With Breast Cancer

    Microsoft Academic Search

    Isabelle Bedrosian; Deepak Bedi; Henry M. Kuerer; Bruno D. Fornage; Lori Harker; Merrick I. Ross; Frederick C. Ames; Savitri Krishnamurthy; Beth S. Edeiken-Monroe; Funda Meric; Barry W. Feig; Jeri Akins; S. Eva Singletary; Nadeem Q. Mirza; Kelly K. Hunt

    2003-01-01

    Background: Ultrasonography and fine-needle aspiration (FNA) are used to evaluate the breast and regional nodes in breast cancer patients.\\u000a We sought to identify factors influencing the sensitivity of ultrasonography for detection of nodal metastasis.\\u000a \\u000a \\u000a Methods: Patients with a clinically negative axilla who underwent axillary ultrasonography and sentinel lymph node biopsy were included.\\u000a \\u000a \\u000a \\u000a \\u000a Results: Of 208 patients, axillary ultrasonography was negative

  12. [Lung cancer and lymph drainage].

    PubMed

    Riquet, M

    2007-01-01

    Lung cancer is lymphophile and may involve lymph nodes (LN) belonging to lung lymph drainage. LN metastases are figured within stations numbered 1 to 14. These stations are located along lymph vessels. The lymph vessels and the LN are forming together anatomical chains. Lymph vessels are valved and pulsatile and travel to the cervical venous confluence where they pour the lung lymph into the blood circulation. They may be totally or partly nodeless along their travel, anastomose with each other around the trachea, and connect with the thoracic duct within the mediastinum. Within the anatomical LN chains, LN are variable in number and in size from one individual to another. They may be absent from one or several stations of the international mapping. Stations are located along the anatomical chains: pulmonary ligament (9), tracheal bifurcation(8 and 7), right paratracheal (4R, 2R and 1), preaortic (5 and 6), left paratracheal (4L, 2L and 1). Station 3 is located on 2 differents chains (phrenic and right esophagotracheal). Station 10 are located at the beginning of the mediastinal lymph nodes chains. Each chain connects with the blood circulation, anastomoses with he neighbouring chains and behave as an own entity whatever the number of its LN. International station mapping misknowns this anatomy and occults the true pronostic value of lung lymph drainage. PMID:16928459

  13. A comparison of axillary node status between cancers detected at the prevalence and first incidence breast screening rounds.

    PubMed Central

    Holland, P. A.; Walls, J.; Boggis, C. R.; Knox, F.; Baildam, A. D.; Bundred, N. J.

    1996-01-01

    Screen-detected breast cancers are smaller than those detected in symptomatic populations and, for any given size, they are associated with fewer lymph node metastases. The management of axillary lymph nodes in patients with screen-detected breast cancer remains controversial. We have previously reported that prevalence (initial screen)-detected cancers are associated with nodal metastases in 17.4% of cases overall. Cancers < or = 10 mm, of any grade, are associated with metastases in only 5% of cases, and grade I cancers <30 mm are not associated with metastases. This led to our recommendation that axillary surgery is unnecessary for these groups of women. The present study compared the nodal status of cancers detected at the prevalence and first incidence (second) screens in order to determine whether our recommendation is appropriate for cancers detected at the first incidence screen. Overall, 30.1% of cancers detected in the first incidence screen presented axillary nodal metastases. At all size ranges, cancers detected at the first incidence screen were associated with significantly more lymph node metastases than prevalence-detected cancers. In particular, cancers < or = 10 mm were associated with metastases in 14.3% of cases. With the possible exception of grade I cancers, we believe that surgical staging of the axilla is essential for cancers detected at the first incidence screen, irrespective of size. PMID:8932348

  14. [Loss of appetite, night sweats, eczema, and axillary and inguinal lymph node swelling in a 28-year-old man].

    PubMed

    Wahl, U; Stranzenbach, R; Tischoff, I; Tannapfel, A; Stadler, R; Ernst, F

    2014-03-01

    A 28-year-old man presented with loss of appetite, night sweats, eczema, and axillary and inguinal lymph node swelling. The tentative diagnosis of malignant lymphoma was made. To confirm the diagnosis, extirpation of a lymph node and a skin biopsy were performed. Systemic treatment with methylprednisolone resulted in an improvement of eczema and lymph node swelling. Because of the histological findings and clinical course, we diagnosed dermatopathic lymphadenopathy, also known as Pautrier-Woringer syndrome. PMID:24522559

  15. In-vivo detection of tumor-infiltrated axillary lymph nodes with a handheld beta-sensitive probe: a phantom study

    NASA Astrophysics Data System (ADS)

    Raylman, Raymond R.; Derakhshan, Jamal

    2001-05-01

    Sentinel node biopsy utilizing Technetium-99m-labeled sulfur colloid is rapidly becoming a standard part of the surgical treatment of breast cancer. Although this method is effective in identifying sentinel lymph node(s) in the axilla, the non-tumor-specific nature of colloids necessitates removal of the node(s) for subsequent analysis. Tumor-specific radiotracers, such as positron-emitting Fluorine-18-labeled Fluorodeoxyglucose (FDG), have been used with positron emission tomography (PET) to successfully stage breast cancer. Thus, the use of FDG with a handheld probe optimized for detection of beta particles could perhaps help identify cancer-infiltrated nodes during axillary dissection. In this study the ability of a new solid-state beta-sensitive probe to identify tumor- infiltrated lymph nodes was investigated in a phantom study. The axilla and tumor-infiltrated lymph nodes were simulated with gelatin phantoms containing FDG concentrations commonly reported from PET studies. FDG uptake in the organs of a patient was simulated with an anthropomorphic torso phantom. Following examination by the handheld probe, a PET image of the phantom was acquired. The results demonstrated that the probe was capable of identifying lymph nodes containing as little as 10 (mu) l of tumor. This amount of simulated tumor was too small to be detected by the PET scanner. This method, therefore, may be useful in intraoperatively identifying some tumor-infiltrated axillary lymph nodes not detected with PET; potentially increasing the efficiency of axillary dissection. Future clinical trials must be performed to assess the utility of this new technique.

  16. A rare case of secretory breast carcinoma in a male adult with axillary lymph node metastasis

    PubMed Central

    Ding, Jinhua; Jiang, Li; Gan, Yongli; Wu, Weizhu

    2015-01-01

    Secretory breast carcinoma is a rare tumor originally described in children but occurring equally in adult population, especially in women. This unusual subtype has a generally favorable prognosis, although several cases have been described in adults with increased aggressiveness and a risk of metastases even death. So far, merely ten cases of secretory breast carcinoma with metastatic axillary lymph node in male were reported. Here, we describe the eleventh case, a 24-years-old male who presented with a painless mass in the right breast was diagnosed to be “secretary breast carcinoma”, and subsequently underwent modified radical mastectomy and adjuvant chemotherapy. PMID:26045861

  17. Axillary skin malignancy: a rare breast cancer presentation.

    PubMed

    Miranda, Benjamin H; Malahias, Marco; El-Said, Tarek F A; Fahmy, Fahmy S

    2014-05-01

    A rise in incidence and decrease in mortality rates from breast cancer have lead to an increase in prevalence within developed countries. Presentation is classically with a palpable breast tissue mass that may metastasize to bone, lung, liver, brain, lymph nodes, and skin. We describe a delayed diagnosis, in an 80-year-old female patient, where, on 2 occasions, the primary initial presentation was with a cutaneous squamous cell carcinoma in the right axilla. It was not until the third referral, with an ipsilateral breast lump, that breast cancer was clinically diagnosed. This was histologically identified as the primary malignancy, most likely in-keeping with squamous cell carcinoma of the breast. This unique atypical presentation represents a diagnostic challenge and highlights a clinically relevant learning point that may avoid subsequent diagnostic delay. Cutaneous axillary lesions should be treated with a high index of suspicion, necessitating the requirement for chest examination because of the possible presence of an associated primary breast carcinoma. PMID:23241794

  18. Impact of breast MRI on surgical treatment, axillary approach, and systemic therapy for breast cancer.

    PubMed

    Mameri, Claudia S; Kemp, Claudio; Goldman, Suzan M; Sobral, Luiz A; Ajzen, Sergio

    2008-01-01

    The purpose of this study is to determine how often breast magnetic resonance imaging (MRI) brings additional information that influences management of patients with breast cancer concerning surgical treatment, axillary lymph node approach, and systemic therapy. From July 2004 to July 2005, 99 patients recently diagnosed with breast cancer in clinical stages 0, I, and II were prospectively evaluated about their therapeutic plans, at first based on usual protocol (physical examination, mammography and ultrasound) and next going through bilateral breast MR. Examinations were carried out at 1.5 T on five sequences of FSPGR 3D for 90 seconds (four post-gadolinium diethylenetriaminepenta acetic acid 0.16 mM/Kg). Parameters analyzed on MRI were extension of primary lesion; detection of multifocality, multicentricity, or contra lateral lesion; muscular or skin involvement; and presence of lymph node involvement. Pathologic confirmation of additional lesions was achieved by core or excisional biopsy. MRI made 69 additional findings in 53 patients. Fifty-one findings were true-positives (51/69 = 73.9%) including 16 larger single lesions; 18 cases of multifocality; 7 cases of multicentricity; 3 cases of contra lateral lesion; 5 cases of lymph node involvement (one of them involved medial thoracic chain); 1 with muscular involvement; 1 with skin involvement. MRI has changed previous management plans in 44.4% of 99 patients. We observed increase in mastectomies (26.8%) on axillary lymph node dissection (25%) and changes on systemic therapy (20.2%), all because of additional MRI true-positive findings. Breast MRI alters significantly the rate of mastectomy, the approach of axillary chain for staging, and the use of systemic therapy because of its accuracy in evaluating breast cancer local extent. PMID:18476882

  19. Multifocality and multicentricity are not contraindications for sentinel lymph node biopsy in breast cancer surgery

    Microsoft Academic Search

    Alberta Ferrari; Paolo Dionigi; Francesca Rovera; Luigi Boni; Giorgio Limonta; Silvana Garancini; Diego De Palma; Gianlorenzo Dionigi; Cristiana Vanoli; Mario Diurni; Giulio Carcano; Renzo Dionigi

    2006-01-01

    BACKGROUND: After the availability of the results of validation studies, the sentinel lymph node biopsy (SLNB) has replaced routine axillary dissection (AD) as the new standard of care in early unifocal breast cancers. Multifocal (MF) and multicentric (MC) tumors have been considered a contraindication for this technique due to the possible incidence of a higher false-negative rate. This prospective study

  20. Consensus on the regional lymph nodes irradiation in breast cancer.

    PubMed

    Bayo, E; Herruzo, I; Arenas, M; Algara, M

    2013-10-01

    Standard locoregional treatment of early-stage breast cancer currently consists of the conservative surgery and sentinel lymph node biopsy. In the event of positive sentinel node biopsy, an axillary level I-II lymphadenectomy should be carried out. However, recent publications have increasingly supported a tendency not to apply the surgical lymphadenectomy, but simultaneously, it has been developed a new role of regional radiotherapy, even if there is only 1-3 axillary lymph nodes involved. Given these new trends, radiation oncologists are facing the dilemma with regard to deciding about regional irradiation of breast cancer. For such purpose, The Spanish Group of Breast Cancer Radiation Oncology (GEORM as per its Spanish acronym) decided to reach a consensus to issue the respective guidelines for such types of cases. GEORM Managing Commission, gathering 13 members of different Spanish regional communities, issued a questionnaire including different clinical situations. These questions were set as key questions seeking responses, which were answered by 66 % out of the 75 members of the group. Following the response, the guidelines were drafted based on the replies to the mentioned questionnaire. All the respective issues were discussed by means of a virtual platform. In this article, we show the levels of consensus for different clinical situations, depending on the number of nodes involved and the type of surgical procedure performed on the axillary lymph nodes. The ongoing evolution of the oncological treatments obliges the radiation oncologists to take decisions without any existing clarifying evidence, and therefore, the consensus is necessary, which can assist in the decision-making process by the practitioners in such kinds of clinical situations. PMID:23519538

  1. Lymph node staging in prostate cancer.

    PubMed

    Sankineni, Sandeep; Brown, Anna M; Fascelli, Michele; Law, Yan Mee; Pinto, Peter A; Choyke, Peter L; Turkbey, Baris

    2015-05-01

    Nodal staging is important in prostate cancer treatment. While surgical lymph node dissection is the classic method of determining whether lymph nodes harbor malignancy, this is a very invasive technique. Current noninvasive approaches to identifying malignant lymph nodes are limited. Conventional imaging methods rely on size and morphology of lymph nodes and have notoriously low sensitivity for detecting malignant nodes. New imaging techniques such as targeted positron emission tomography (PET) imaging and magnetic resonance lymphography (MRL) with iron oxide particles are promising for nodal staging of prostate cancer. In this review, the strengths and limitations of imaging techniques for lymph node staging of prostate cancer are discussed. PMID:25773350

  2. Unusual lymph node metastases of prostate cancer detected by 18F-fluorocholine PET/CT.

    PubMed

    Pinaquy, J B; Allard, J B; Cornelis, F; Pasticier, G; De Clermont, H

    2015-04-01

    A 65-year-old patient with prostate adenocarcinoma was explored by 18F-fluorocholine (FCH) PET/CT for pretreatment staging because of a high risk of prostate cancer. Images showed multiple foci with increased uptake of 18F-FCH within some pelvic and retroperitoneal lymph nodes, osseous foci (iliac bones and sacrum), and much more unusual, increased uptake foci within some left supraclavicular and left axillary lymph nodes. Owing to the rarity of spread to supraclavicular lymph nodes, surgical removal was performed and revealed prostate cancer metastases. PMID:25674860

  3. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients

    Microsoft Academic Search

    Holbrook E Kohrt; Richard A Olshen; Honnie R Bermas; William H Goodson; Douglas J Wood; Solomon Henry; Robert V Rouse; Lisa Bailey; Vicki J Philben; Frederick M Dirbas; Jocelyn J Dunn; Denise L Johnson; Irene L Wapnir; Robert W Carlson; Frank E Stockdale; Nora M Hansen; Stefanie S Jeffrey

    2008-01-01

    BACKGROUND: Current practice is to perform a completion axillary lymph node dissection (ALND) for breast cancer patients with tumor-involved sentinel lymph nodes (SLNs), although fewer than half will have non-sentinel node (NSLN) metastasis. Our goal was to develop new models to quantify the risk of NSLN metastasis in SLN-positive patients and to compare predictive capabilities to another widely used model.

  4. Clinical significance of aromatase protein expression in axillary node negative breast cancer

    Microsoft Academic Search

    Jingsong Lu; Hecheng Li; Daocheng Cao; Genhong Di; Jiong Wu; Kunwei Sheng; Qixia Han; Zhenzhou Shen; Zhiming Shao

    2007-01-01

    Purpose  Aromatase catalyzes the conversion of androgens to estrogens; its high expression in breast cancers may be responsible for\\u000a the local high levels of estrogen and may promote tumor growth and progression; however, the clinical importance of aromatase\\u000a remains unclear and needs to be further researched.\\u000a \\u000a \\u000a \\u000a Methods  By immunochemistry, we detected aromatase, MMP2 and MMP9 immunoreactivity in 244 axillary lymph node negative

  5. Volume-Based Parameters of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Improve Disease Recurrence Prediction in Postmastectomy Breast Cancer Patients With 1 to 3 Positive Axillary Lymph Nodes

    SciTech Connect

    Nakajima, Naomi, E-mail: haruhi0321@gmail.com [Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Department of Radiology, Ehime University, Ehime (Japan); Kataoka, Masaaki [Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Sugawara, Yoshifumi [Department of Diagnostic Radiology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Ochi, Takashi [Department of Radiology, Ehime University, Ehime (Japan); Kiyoto, Sachiko; Ohsumi, Shozo [Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Ehime (Japan); Mochizuki, Teruhito [Department of Radiology, Ehime University, Ehime (Japan)

    2013-11-15

    Purpose: To determine whether volume-based parameters on pretreatment {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography in breast cancer patients treated with mastectomy without adjuvant radiation therapy are predictive of recurrence. Methods and Materials: We retrospectively analyzed 93 patients with 1 to 3 positive axillary nodes after surgery, who were studied with {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography for initial staging. We evaluated the relationship between positron emission tomography parameters, including the maximum standardized uptake value, metabolic tumor volume (MTV), and total lesion glycolysis (TLG), and clinical outcomes. Results: The median follow-up duration was 45 months. Recurrence was observed in 11 patients. Metabolic tumor volume and TLG were significantly related to tumor size, number of involved nodes, nodal ratio, nuclear grade, estrogen receptor (ER) status, and triple negativity (TN) (all P values were <.05). In receiver operating characteristic curve analysis, MTV and TLG showed better predictive performance than tumor size, ER status, or TN (area under the curve: 0.85, 0.86, 0.79, 0.74, and 0.74, respectively). On multivariate analysis, MTV was an independent prognostic factor of locoregional recurrence-free survival (hazard ratio 34.42, 95% confidence interval 3.94-882.71, P=.0008) and disease-free survival (DFS) (hazard ratio 13.92, 95% confidence interval 2.65-103.78, P=.0018). The 3-year DFS rate was 93.8% for the lower MTV group (<53.1; n=85) and 25.0% for the higher MTV group (?53.1; n=8; P<.0001, log–rank test). The 3-year DFS rate for patients with both ER-positive status and MTV <53.1 was 98.2%; and for those with ER-negative status and MTV ?53.1 it was 25.0% (P<.0001). Conclusions: Volume-based parameters improve recurrence prediction in postmastectomy breast cancer patients with 1 to 3 positive nodes. The addition of MTV to ER status or TN has potential benefits to identify a subgroup at higher risk for recurrence.

  6. Sentinel Lymph Node in Nonmelanoma Skin Cancer

    Microsoft Academic Search

    I. Salguero-Fernández; L. Rios-Buceta; P. Jaén-Olasolo

    Sentinel lymph node biopsy is performed routinely in melanoma because lymph node progression has been shown to be the strongest predictor of survival. Given the proven relevance of biopsy findings in this type of skin cancer, the procedure has been extended to other skin tumors. Experience in nonmelanoma cancer is much more limited and the prognostic usefulness of biopsy results

  7. The risk of nodal metastases in breast cancer patients with clinically negative lymph nodes: a population-based analysis

    Microsoft Academic Search

    Adri C. Voogd; Jan-Willem W. Coebergh; Ocker J. Repelaer van Driel; Rudi M. H. Roumen; Mike W. P. M. van Beek; Art Vreugdenhil; Mariad A. Crommelin

    2000-01-01

    A population-based study was performed to assess the likelihood of axillary lymph node metastases in patients with clinically negative lymph nodes, according to patient age, tumor size and site, estrogen receptor status, histologic type and mode of detection. Data were obtained from the population-based Eindhoven Cancer Registry. During the period 1984–1997, 7680 patients with invasive breast cancer were documented, 6663

  8. Multi-modality computer-aided diagnosis system for axillary lymph node (ALN) staging: segmentation of ALN on ultrasound images

    NASA Astrophysics Data System (ADS)

    Arbash Meinel, Lina; Bergtholdt, Martin; Abe, Hiroyuki; Huo, D.; Buelow, Thomas; Carlsen, Ingwer; Newstead, Gillian

    2009-02-01

    Our goal was to develop and evaluate a reliable segmentation method to delineate axillary lymph node (ALN) from surrounding tissues on US images as the first step of building a multi-modality CADx system for staging ALN. Ultrasound images of 24 ALN from 18 breast cancer patients were used. An elliptical model algorithm was used to fit ALNs boundaries using the following steps: reduce image noise, extract image edges using the Canny edge detector, select edge pixels and fit an ellipse by minimizing the quadratic error, Find the best fitting ellipse based on RANSAC. The segmentation was qualitatively evaluated by 3 expert readers using 4 aspects: Orientation of long axis (OLA): within +- 45 degrees, or off by +-45 degrees, overlap (OV): the fitted ellipse completely included ALN, partially included ALN, or missed the ALN, size (SZ): too small, good within 20% error margin, or too large, and aspect ratio (AR): correct or wrong. Nightly six % of ALNs were correctly evaluated by all readers in terms of OLA and AR, 90.2% in terms of OV and 86.11 in terms of SZ. Readers agreed that the segmentation was correct in 70% of the cases in all aspects. Due to small sample size and small variation among readers, we don't have power to show the accuracy of them is different.

  9. Appropriate lymph node dissection for early gastric cancer based on lymph node metastases

    Microsoft Academic Search

    Chikara Kunisaki; Hiroshi Shimada; Masato Nomura; Hirotoshi Akiyama

    2001-01-01

    Background. Lymph node dissection in patients with early gastric cancer is controversial because lymph node metastases are much less common than in advanced cancer. Therefore, routine extensive lymph node dissection with wide resection of the stomach may be excessive, and an appropriate lymph node dissection procedure in patients with early gastric cancer should be established. Methods. Retrospectively, 588 consecutive patients

  10. Axillary dissection in primary breast cancer: variations of the surgical technique and influence on morbidity.

    PubMed

    Wojcinski, Sebastian; Nuengsri, Sirin; Hillemanns, Peter; Schmidt, Werner; Deryal, Mustafa; Ertan, Kubilay; Degenhardt, Friedrich

    2012-01-01

    Lymphedema of the arm is the most common and impairing complication after breast cancer surgery with axillary lymph node dissection (ALND). Our prospective study evaluated the effect of two different surgical techniques for ALND on postoperative morbidity. Patients were scheduled to undergo ALND. Patients in group 1 (n = 17) underwent the most common and standard technique of ALND, which uses sharp dissection of the tissue and subsequent electro-coagulation of bleedings. Patients in group 2 (n = 17) underwent a modified standard technique of ALND with clamping and ligatures of all resection margins. Postoperative wound secretion was quantified and patients were followed up for 6 months to assess long-term morbidity. The variations in surgical technique had no significant influence on the outcome variables. However, patients in group 2 showed a tendency to less wound secretion (713 versus 802 mL; P = nonsignificant), a decreased rate of immediate postoperative seromas (11.8 versus 23.5%; P = nonsignificant) and less lymphedema after 3 months (29.4 versus 41.2%; P = nonsignificant). Moreover, the number of resected lymph nodes correlated with the total amount of drained fluid (P = 0.006), the duration of the drain (P = 0.015), and the risk for the development of lymphedema after 3 months (P = 0.016). The described variations in surgical technique had no influence on the outcomes of the patients. The number of resected axillary lymph nodes remains the most important risk factor for treatment-related morbidity. Therefore, a well-balanced choice of the extent of the axillary dissection should be the surgeon's main concern. PMID:22570566

  11. Sentinel lymph node mapping with GI cancer

    Microsoft Academic Search

    Takashi Aikou; Yuko Kitagawa; Masaki Kitajima; Yoshikazu Uenosono; Anton J. Bilchik; Steve R. Martinez; Sukamal Saha

    2006-01-01

    Precise evaluation of lymph node status is one of the most important factors in determining clinical outcome in treating gastro-intestinal\\u000a (GI) cancer. Sentinel lymph node (SLN) mapping clearly has become highly feasible and accurate in staging GI cancer. The lunchtime\\u000a symposium focused on the present status of SLN mapping for GI cancer. Dr. Kitigawa proposed a new strategy using sentinel

  12. Familial Blood and Lymph Node Cancers Study

    Cancer.gov

    A study of a group of familial blood and lymph node cancers (also called "lymphoproliferative disorders"), including: chronic lymphocytic leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, Waldenström's macroglobulinemia, and multiple myeloma

  13. Collision metastasis of breast and ovarian adenocarcinoma in axillary lymph nodes: a case report and review of the literature.

    PubMed

    Sughayer, Maher A; Zakarneh, Lama; Abu-Shakra, Raffat

    2009-09-01

    Despite their accepted clinical and genetic association, the incidence of synchronous breast and ovarian carcinoma is rare. Moreover, collision metastasis from both breast and ovarian carcinomas to the same lymph node, to our knowledge has never been reported. Review of the literature revealed eleven cases of metastatic malignant tumors colliding in the same lymph node, none of which had both ovarian and breast carcinoma. Our case was that of a 63 year old woman presenting with a breast lump that was diagnosed as infiltrating ductal carcinoma after a needle biopsy. One month later the patient was found to have malignant ascites, omental carcinomatosis and an ovarian mass. Histology and immunohistochemistry revealed high grade serous papillary adenocarcinoma. When surgery was done to treat the breast tumor some of the axillary lymph nodes revealed metastases from the breast primary, others metastases from the ovarian primary and one had both tumors in a collision phenomenon. Immunohistochemistry was used to confirm this finding. PMID:19067238

  14. Treatment and prognosis for retrograde cervical lymph node metastases in breast cancer

    PubMed Central

    Qin, Rong; Zhang, Qiaoyu; Weng, Jianfeng; Liu, Weiping; Zhang, Bo; Lv, Gang; Wang, Yi; Wu, Youjun

    2015-01-01

    Metastasis in axillary and supraclavicular lymph nodes has been frequently observed in patients with breast cancer. The clinical staging and therapeutic principle determined according to the situation of lymph node metastasis are clear. One patient with infiltrating ductal carcinoma of the left breast was reported to undergo modified radical mastectomy. One and a half years later, lymphadenectasis was observed in area II, III, IV, V and VI of the left neck; therefore, cervical lymphadenectomy was performed under cervical plexus anesthesia, indicating lymph node metastatic adenocarcinoma (21/26). The patient took 10 mg tamoxifen twice per day for five years after lymphadenectomy and the review showed negative results in liver, lungs, mediastinum, neck and contralateral breast. This suggested that although breast cancer complicated with retrograde cervical lymph node metastases is rare, timely surgery is required even if the patient is in a good general condition, to avoid „delayed therapy” due to misjudgment of illness simply according to disease staging. PMID:26034395

  15. Sentinel lymph node detection ex vivo using

    E-print Network

    Wang, Lihong

    - tinel lymph nodes in breast cancer staging in vivo. © 2008 Society of Photo-Optical Instrumentation biopsy; breast cancer; axillary lymph node dissection; speckle contrast; acoustic bursts. Paper 07492LRSentinel lymph node detection ex vivo using ultrasound-modulated optical tomography Chulhong Kim

  16. Evaluation of a Single-Isocenter Technique for Axillary Radiotherapy in Breast Cancer

    SciTech Connect

    Beek, Suzanne van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands)], E-mail: s.v.beek@nki.nl; Jaeger, Katrien de [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands); Mijnheer, Ben [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands)]|[INHOLLAND University of Professional Training, Haarlem (Netherlands); Vliet-Vroegindeweij, Corine van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands)

    2008-10-01

    The aim of this study was to develop a technique for axillary radiotherapy that minimizes the risk of radiation-induced damage to the surrounding normal tissue (i.e., arm, shoulder, lung, esophagus, and spinal cord) while keeping the risk of a nodal recurrence to a minimum. A planning study was performed in 20 breast cancer patients. The target volume of the axillary treatment encompassed the periclavicular and axillary lymph node areas. The 3-dimensional (3D) computed tomography (CT) information in this study was used to outline the lymph node areas and the organs at risk (i.e., the esophagus, spinal cord, brachial plexus, and lung). A conventional AP-PA technique (with a transmission plate placed in the AP beam) was evaluated. In addition, a new single-isocenter technique consisting of AP/PA fields using a gantry rotation of {+-}20 deg. and a medial AP segment was developed. Both techniques were compared by evaluation of the calculated dose distributions and the dose-volume histograms of the target volume and surrounding organs at risk. The field borders and humeral shielding were redefined based on the 3D anatomical references. Adapting the humeral shielding reduced the irradiated volume by 19% and might contribute to a reduction of the incidence of arm edema and impairment of shoulder function. The maximum radiation dose in the esophagus and spinal cord was reduced by more than 50% using the single-isocenter technique. The difference between both techniques with respect to the mean doses in the target volume and lung, and the maximum dose in brachial plexus, was not statistically significant. Moreover, the single-isocenter technique allowed a fast and easy treatment preparation and reduced the execution time considerably (with approximately 10 minutes per fraction)

  17. Optimization of a gamma imaging probe for axillary sentinel lymph mapping

    NASA Astrophysics Data System (ADS)

    Georgiou, M.; Loudos, G.; Stratos, D.; Papadimitroulas, P.; Liakou, P.; Georgoulias, P.

    2012-09-01

    Sentinel lymph node (SLN) mapping is a technique for assessing whether early-stage invasive breast cancer has metastasized, thus determining prognosis and treatment options. SLN identification is achieved using the blue-dye and radioactive colloids techniques, which are sometimes combined with lymphoscintigraphy. Furthermore, intra-operative gamma acoustic probes, as well as gamma imaging probes are used during surgery. The purpose of this study is the construction of a gamma probe for sentinel lymph node imaging and its optimization in terms of sensitivity with respect to spatial resolution. The reference probe has small field of view (2.5 × 2.5 cm2) and is based on a position sensitive photomultiplier tube (PSPMT) coupled to a pixellated CsI(Tl) scintillator. Following experimental validation, we simulated the system using the GATE Monte Carlo toolkit (GATE v6.1) and modeled various collimator geometries, in order to evaluate their performance and propose the optimal configuration. The constraints of the proposed gamma imaging probe are i) sensitivity close to 2 cps/kBq and ii) spatial resolution equal to 6 mm at 2 cm source-to-collimator distance and ~ 10 mm at 5 cm. An integrated structure that achieves those requirements is a tungsten collimator with 2 × 2 mm2square holes, 16 mm thickness, 0.15 mm septa, where each CsI(Tl) 2 × 2 × 5 mm3 crystal pixel is placed inside the collimator.

  18. Which prediction models best identify additional axillary disease after a positive sentinel node biopsy for breast cancer?

    PubMed

    Berrang, Tanya S; Lesperance, Mary; Truong, Pauline T; Walter, Caroline; Hayashi, Allen H; Olivotto, Ivo A

    2012-06-01

    To determine which web-based model best identifies women at low risk of further axillary disease after a positive sentinel lymph node (SLN+) biopsy. 673 women with T1-2cN0M0 SNB+ breast cancer who underwent completion axillary dissection (AxD) were identified. A subgroup not eligible to avoid AxD as part of the Z0011 study was defined (Z0011 exclusion group). Predicted risk of further axillary disease was generated using seven web-based models. "Low risk" was defined as a ?10% risk of further axillary disease. False negative ("low risk" prediction but AxD+) rates (FNRs), area under the receiver operating characteristic curve (AUC), and Brier score were determined for each model. 6 of 7 models identified "low risk" patients but FNRs ranged from 14 to 30%. The Stanford and Memorial Sloan-Kettering (MSKCC) models had the best FNRs. FNRs were lower with SLN micrometastasis (7-15%) and higher in the Z0011 exclusion group (21-41%). All models under-predicted further nodal disease in low risk patients and over-predicted in higher-risk patients. The Stanford and MSKCC models were able to identify women with SLN micrometastasis with a ?10% FNR. Models were not able to accurately identify low risk women from a cohort that would have been excluded from Z0011. PMID:22367621

  19. Methylation signature of lymph node metastases in breast cancer patients

    PubMed Central

    2012-01-01

    Background Invasion and metastasis are two important hallmarks of malignant tumors caused by complex genetic and epigenetic alterations. The present study investigated the contribution of aberrant methylation profiles of cancer related genes, APC, BIN1, BMP6, BRCA1, CST6, ESR-b, GSTP1, P14 (ARF), P16 (CDKN2A), P21 (CDKN1A), PTEN, and TIMP3, in the matched axillary lymph node metastasis in comparison to the primary tumor tissue and the adjacent normal tissue from the same breast cancer patients to identify the potential of candidate genes methylation as metastatic markers. Methods The quantitative methylation analysis was performed using the SEQUENOM’s EpiTYPER™ assay which relies on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results The quantitative DNA methylation analysis of the candidate genes showed higher methylation proportion in the primary tumor tissue than that of the matched normal tissue and the differences were significant for the APC, BIN1, BMP6, BRCA1, CST6, ESR-b, P16, PTEN and TIMP3 promoter regions (P<0.05). Among those candidate methylated genes, APC, BMP6, BRCA1 and P16 displayed higher methylation proportion in the matched lymph node metastasis than that found in the normal tissue (P<0.05). The pathway analysis revealed that BMP6, BRCA1 and P16 have a role in prevention of neoplasm metastasis. Conclusions The results of the present study showed methylation heterogeneity between primary tumors and metastatic lesion. The contribution of aberrant methylation alterations of BMP6, BRCA1 and P16 genes in lymph node metastasis might provide a further clue to establish useful biomarkers for screening metastasis. PMID:22695536

  20. [Breast cancer and axillary area: state of the art and perspectives].

    PubMed

    Houvenaeghel, Gilles; Cohen, Monique; Chereau Ewald, Elisabeth; Bannier, Marie; Buttarelli, Max; Jauffret, Camille; Lambaudie, Eric

    2013-12-01

    A therapeutic surgical de-escalation has been observed since many years with an actual prolongation for axillary lymph node area treatment. Axillary lymph node dissection (ALND) omission has been studied before and after validation of sentinel node (SN) biopsy procedure. A non-inferiority of ALND omission has been reported in case of non-involved SN. ALND omission has been studied in case of SN involvement without consensus in relation with scientific level of proof and with selective indications. The purpose of this work is to make a synthesis of the experiences on this subject then to envisage the current and future perspectives. PMID:24316763

  1. Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

    E-print Network

    Wang, Lihong

    lymph nodes for cancer staging and metastasis detection in humans. © 2010 Society of Photo cancer, replacing axillary lymph node dissection. Biopsy of the lymph nodes directly draining the tumorHandheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes Chulhong

  2. Non-sentinel lymph node metastases associated with isolated breast cancer cells in the sentinel node

    Microsoft Academic Search

    Carolien H. M. van Deurzen; M. de Boer; E. M. Monninkhof; P. Bult; E. van der Wall; V. C. Tjan-Heijnen; P. J. van Diest

    2008-01-01

    There are many reports on the frequency of non-sentinel lymph node involvement when isolated tumor cells are found in the sentinel node, but results and recommendations for the use of an axillary lymph node dissection differ among studies. This systematic review was conducted to give an overview of this issue and to provide recommendations for the use of an axillary

  3. Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

    PubMed Central

    Kay?l?o?lu, Selami Ilgaz; Akyol, Cihangir; Esen, Ebru; Cans?z-Ersöz, Cevriye; Kocaay, Ak?n F?rat; Genç, Volkan; Kepenekçi, ?lknur; Demirer, Seher

    2014-01-01

    Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis. PMID:25574403

  4. Sentinel Lymph Node Biopsy for Breast Cancer: Impact of the Number of Sentinel Nodes Removed on the False-Negative Rate

    Microsoft Academic Search

    Sandra L Wong; Michael J Edwards; Celia Chao; Todd M Tuttle; R Dirk Noyes; David J Carlson; Patricia B Cerrito; Kelly M McMasters

    BACKGROUND: Numerous studies have demonstrated that sentinel lymph node (SLN) biopsy can accurately determine axillary nodal status for breast cancer, but unacceptably high false negative rates have also been reported. Attention has been focused on factors associated with improved accuracy. We have previously shown that injection of blue dye in combination with radioactive colloid reduces the false negative rate compared

  5. Risk Factors for Regional Nodal Relapse in Breast Cancer Patients With One to Three Positive Axillary Nodes

    SciTech Connect

    Yates, Lucy, E-mail: lucy.yates@gstt.nhs.uk [Guy's, King's, St Thomas' Cancer Centre, Guy's Hospital, London (United Kingdom); Kirby, Anna [Guy's, King's, St Thomas' Cancer Centre, Guy's Hospital, London (United Kingdom); Department of Clinical Oncology, Royal Marsden Hospital, Sutton (United Kingdom); Crichton, Siobhan [Department of Statistics, Kings College London (United Kingdom); Gillett, Cheryl [Breast Pathology, Kings College London (United Kingdom); Cane, Paul [Department of Histopathology, Guy's and St Thomas' Foundation Trust, London (United Kingdom); Fentiman, Ian; Sawyer, Elinor [Guy's, King's, St Thomas' Cancer Centre, Guy's Hospital, London (United Kingdom)

    2012-04-01

    Purpose: In many centers, supraclavicular fossa radiotherapy (SCF RT) is not routinely offered to breast cancer patients with one to three positive lymph nodes. We aimed to identify a subgroup of these patients who are at high risk of supra or infraclavicular fossa relapse (SCFR) such that they can be offered SCFRT at the time of diagnosis to improve long term locoregional control. Methods and Materials: We performed a retrospective analysis of the pathological features of 1,065 cases of invasive breast cancer with one to three positive axillary lymph nodes. Patients underwent radical breast conserving surgery or mastectomy. A total of 45% of patients received adjuvant chest wall/breast RT. No patients received adjuvant SCFRT. The primary outcome was SCFR. Secondary outcomes were chest wall/breast recurrence, distant metastasis, all death, and breast-cancer specific death. Kaplan-Meier estimates were used to calculate actuarial event rates and survival functions compared using log-rank tests. Multivariate analyses (MVA) of factors associated with outcome were conducted using Cox proportional hazards models. Results: Median follow-up was 9.7 years. SCFR rate was 9.2%. Median time from primary diagnosis to SCFR was 3.4 years (range, 0.7-14.4 years). SCFR was associated with significantly lower 10-year survival (18% vs. 65%; p < 0.001). Higher grade and number of positive lymph nodes were the most significant predictors of SCFR on MVA (p < 0.001). 10 year SCFR rates were less than 1% in all patients with Grade 1 cancers compared with 30% in those having Grade 3 cancers with three positive lymph nodes. Additional factors associated with SCFR on univariate analysis but not on MVA included larger nodal deposits (p = 0.002) and proportion of positive nodes (p = 0.003). Conclusions: Breast cancer patients with one to three positive lymph nodes have a heterogenous risk of SCFR. Patients with two to three positive axillary nodes and/or high-grade disease may warrant consideration of SCFRT.

  6. Sentinel Lymph Node Biopsy in Colon Cancer

    PubMed Central

    Bembenek, Andreas E.; Rosenberg, Robert; Wagler, Elke; Gretschel, Stephan; Sendler, Andreas; Siewert, Joerg-Ruediger; Nährig, Jörg; Witzigmann, Helmut; Hauss, Johann; Knorr, Christian; Dimmler, Arno; Gröne, Jörn; Buhr, Heinz-Johannes; Haier, Jörg; Herbst, Hermann; Tepel, Juergen; Siphos, Bence; Kleespies, Axel; Koenigsrainer, Alfred; Stoecklein, Nikolas H.; Horstmann, Olaf; Grützmann, Robert; Imdahl, Andreas; Svoboda, Daniel; Wittekind, Christian; Schneider, Wolfgang; Wernecke, Klaus-Dieter; Schlag, Peter M.

    2007-01-01

    Introduction: The clinical impact of sentinel lymph node biopsy (SLNB) in colon cancer is still controversial. The purpose of this prospective multicenter trial was to evaluate its clinical value to predict the nodal status and identify factors that influence these results. Methods: Colon cancer patients without prior colorectal surgery or irradiation were eligible. The sentinel lymph node (SLN) was identified intraoperatively by subserosal blue dye injection around the tumor. The SLN underwent step sections and immunohistochemistry (IHC), if classified free of metastases after routine hematoxylin and eosin examination. Results: At least one SLN (median, n = 2) was identified in 268 of 315 enrolled patients (detection rate, 85%). Center experience, lymphovascular invasion, body mass index (BMI), and learning curve were positively associated with the detection rate. The false-negative rate to identify pN+ patients by SLNB was 46% (38 of 82). BMI showed a significant association to the false-negative rate (P < 0.0001), the number of tumor-involved lymph nodes was inversely associated. If only slim patients (BMI ?24) were investigated in experienced centers (>22 patients enrolled), the sensitivity increased to 88% (14 of 16). Moreover, 21% (30 of 141) of the patients, classified as pN0 by routine histopathology, revealed micrometastases or isolated tumor cells (MM/ITC) in the SLN. Conclusions: The contribution of SLNB to conventional nodal staging of colon cancer patients is still unspecified. Technical problems have to be resolved before a definite conclusion can be drawn in this regard. However, SLNB identifies about one fourth of stage II patients to reveal MM/ITC in lymph nodes. Further studies must clarify the clinical impact of these findings in terms of prognosis and the indication of adjuvant therapy. PMID:17522509

  7. Observational study of axilla treatment for breast cancer patients with 1-3 positive micrometastases or macrometastases in sentinel lymph nodes.

    PubMed

    Oba, Mari S; Imoto, Shigeru; Toh, Uhi; Wada, Noriaki; Kawada, Masaya; Kitada, Masahiro; Masuda, Norikazu; Taguchi, Tetsuya; Minami, Shigeki; Jinno, Hiromitsu; Sakamoto, Junichi; Morita, Satoshi

    2014-09-01

    Sentinel node biopsy is a standard procedure in clinically node-negative breast cancer patients. It has eliminated unnecessary axillary lymph node dissection in more than half of the early breast cancers. However, one of the unresolved issues in sentinel node biopsy is how to manage axilla surgery for sentinel node-positive patients and clinically node-negative patients. To evaluate the outcome of no axillary lymph node dissection in sentinel node-positive breast cancer, a prospective cohort study registering early breast cancer patients with positive sentinel nodes has been conducted (UMIN 000011782). Patients with 1-3 positive micrometastases or macrometastases in sentinel lymph nodes are eligible for the study. The primary endpoint is the recurrence rate of regional lymph nodes in patients treated with sentinel node biopsy. Patients treated with sentinel node biopsy followed by axillary lymph node dissection are also registered simultaneously to compare the prognosis. The propensity score matching is used to make the distributions of baseline risk factors comparable. PMID:25030214

  8. Some Women May Not Need More Extensive Lymph Node Surgery for Breast Cancer

    Cancer.gov

    Results from a randomized clinical trial published February 9, 2011, in the Journal of the American Medical Association demonstrate that axillary lymph node dissection provided no additional survival benefit when compared with sentinel lymph node biopsy in women with small breast tumors and minimal lymph node metastasis who were treated with lumpectomy, whole-breast radiotherapy, and adjuvant systemic therapy.

  9. Micrometastatic Breast Cancer Cells in Bone Marrow at Primary Surgery: Prognostic Value in Comparison With Nodal Status

    Microsoft Academic Search

    Ingo J. Diel; Manfred Kaufmann; Serban D. Costa; Erich F. Solomayer; Sepp Kaul; Gunther Bastert

    Background: Approximately 30% of the patients with primary breast cancer who have no axillary lymph node in- volvement (i.e., lymph node negative) at the time of surgery will relapse within 10 years; 10% -20% of the patients with distant metastases will be lymph node negative at surgery. Axillary lymph node dissection, as a surgical procedure, is associated with frequent complications.

  10. Lymph node dissection for lung cancer: past, present, and future.

    PubMed

    Watanabe, Shun-ichi

    2014-07-01

    In 1978, Naruke et al. proposed an anatomical map that included numbered lymph node stations, which then became widely used for nodal dissection. In 1997, Mountain and Dresler published a new map, which is now favored by the American Thoracic Society and the European Respiratory Society. Using these maps, regional nodal dissection has been universally performed in lung cancer surgery. Clear evidence regarding the survival benefit of lymph node dissection for lung cancer is lacking. However, lobectomy with lymph node dissection continues to be a standard surgical procedure for lung cancer because lymph node dissection is an important investigative process in staging patients. Over the last decade, the extent of nodal dissection for lung cancer has changed due to the increasing number of early detected lung cancers made possible by the recent development of the CT scanner. This manuscript describes the history, present strategy, and future perspectives of lymph node dissection for lung cancer. PMID:24823489

  11. Clinicopathologic subtypes and compromise of lymph nodes in patients with breast cancer

    PubMed Central

    Jaime Jans, B; Nicolás Escudero, M; Dahiana Pulgar, B; Francisco Acevedo, C; César Sánchez, R; Camus, A Mauricio

    2014-01-01

    Breast cancer (BC) is currently a heterogeneous disease with variations in clinical behaviour. Classification according to subtypes has allowed progress in the individualisation of treatment. The objective of this study is to evaluate the risk of axillary node compromise in patients with BC, according to clinicopathologic subtypes. Materials and methods are a retrospective, descriptive-analytical study. All patients that had undergone surgery for invasive BC were included, with the study of sentinel lymph nodes (SLNs) at Hospital Clínico de la Pontificia Universidad Católica, between May 1999 and December 2012. The results showed 632 patients fulfilled the inclusion criteria, with the median age being 55 years (range: 28–95), and 559 (88.4%) patients presented with estrogen receptor and/or progesterone receptor positive tumours. Luminal A: 246 patients (38.9%), luminal B: 243 (38.4%), luminal not otherwise specified: 70 (11.1%) triple negative (TN): 60 (9.5%) and over expression of epidermal growth factor type 2 receptor (HER2 positive): 13 (2.1%). Luminal tumours displayed a greater risk of metastasis in the SLNs, but this difference was not statistically significant (p = 0.67). TN and HER2 positive tumours presented the greatest proportion of metastatic compromise in non-sentinel lymph nodes (non-SLNs) (57.1% and 50%, respectively). The presence of macrometastasis (MAM) in the SLN was associated with a greater risk of compromise of the non-SLN. Conclusions: Luminal tumours are the most frequent and present a greater proportion of axillary lymph node compromise, without being statistically significant. TN and HER2 positive tumours tend to have a higher axillary compromise; however, this was not statistically significant in either. Only the presence of MAM in SLNs displayed a statistically significantly association in the compromise of non-SLNs. PMID:25114720

  12. Elastic scattering spectroscopy for intraoperative determination of sentinel lymph node status in the breast

    E-print Network

    Bigio, Irving J.

    depends on establishing whether or not the cancer has spread to the lymph nodes under the arm incidence of up to 1 in 8 women. The presence or absence of metastatic cancer in the axillary lymph nodesElastic scattering spectroscopy for intraoperative determination of sentinel lymph node status

  13. Importance of Nuclear Morphology in Breast Cancer Prognosis William H. Wolberg,1

    E-print Network

    Street, Nick

    with invasive breast cancer. Tumor size and lymph node status were determined at the time of surgery. Median to replace axillary lymph node status for staging of breast cancer. If confirmed by others, axillary is to define prognostic rela- tionships between computer-derived nuclear morphological features, lymph node

  14. A Randomized Comparison of Sentinel-Node Biopsy with Routine Axillary Dissection in Breast Cancer

    Microsoft Academic Search

    Umberto Veronesi; Giovanni Paganelli; Giuseppe Viale; Alberto Luini; Stefano Zurrida; Viviana Galimberti; Mattia Intra; Paolo Veronesi; Chris Robertson; Patrick Maisonneuve; Giuseppe Renne; Concetta De Cicco; Francesca De Lucia; Roberto Gennari

    2010-01-01

    background Although numerous studies have shown that the status of the sentinel node is an accu- rate predictor of the status of the axillary nodes in breast cancer, the efficacy and safety of sentinel-node biopsy require validation. methods From March 1998 to December 1999, we randomly assigned 516 patients with primary breast cancer in whom the tumor was less than

  15. Primary Tumor Response to Induction Chemotherapy as a Predictor of Histological Status of Axillary Nodes in Operable Breast Cancer Patients

    Microsoft Academic Search

    Jeffrey T. Lenert; Georges Vlastos; Nadem Q. Mirza; David J. Winchester; Susanne M. Binkley; Fred C. Ames; Merrick I. Ross; Barry W. Feig; Kelly K. Hunt; Eric Strom; Aman U. Buzdar; Gabriel N. Hortobagyi; S. Eva Singletary

    1999-01-01

    Background: Routine use of axillary lymph node dissection is being questioned, especially in clinically N0 patients. The goal of this study was to determine whether primary tumor response to induction chemotherapy (IC) can predict the histological volume of residual axillary disease in patients who were candidates for breast conservation surgery after IC.Methods: Forty-seven patients with stage II or IIIA breast

  16. Tangential Radiotherapy Without Axillary Surgery in Early-Stage Breast Cancer: Results of a Prospective Trial

    SciTech Connect

    Wong, Julia S. [Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States)], E-mail: jwong@lroc.harvard.edu; Taghian, Alphonse G. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Bellon, Jennifer R. [Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States); Keshaviah, Aparna [Department of Biostatistics and Computational Biology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States); Smith, Barbara L. [Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Winer, Eric P. [Department of Medical Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States); Silver, Barbara; Harris, Jay R. [Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA (United States)

    2008-11-01

    Purpose: To determine the risk of regional-nodal recurrence in patients with early-stage, invasive breast cancer, with clinically negative axillary nodes, who were treated with breast-conserving surgery, 'high tangential' breast radiotherapy, and hormonal therapy, without axillary surgery or the use of a separate nodal radiation field. Methods and Materials: Between September 1998 and November 2003, 74 patients who were {>=}55 years of age with Stage I-II clinically node-negative, hormone-receptor-positive breast cancer underwent tumor excision to negative margins without axillary surgery as a part of a multi-institutional prospective study. Postoperatively, all underwent high-tangential, whole-breast radiotherapy with a boost to the tumor bed, followed by 5 years of hormonal therapy. Results: For the 74 patients enrolled, the median age was 74.5 years, and the median pathologic tumor size was 1.2 cm. Lymphatic vessel invasion was present in 5 patients (7%). At a median follow-up of 52 months, no regional-nodal failures or ipsilateral breast recurrences had been identified (95% confidence interval, 0-4%). Eight patients died, one of metastatic disease and seven of other causes. Conclusion: In this select group of mainly older patients with early-stage hormone-responsive breast cancer and clinically negative axillary nodes, treatment with high-tangential breast radiotherapy and hormonal therapy, without axillary surgery, yielded a low regional recurrence rate. Such patients might be spared more extensive axillary treatment (axillary surgery, including sentinel node biopsy, or a separate nodal radiation field), with its associated time, expense, and morbidity.

  17. Radioguided Sentinel Lymph Node Biopsy in Breast Cancer Surgery

    Microsoft Academic Search

    Giuliano Mariani; Luciano Moresco; Giuseppe Viale; Giuseppe Villa; Marcello Bagnasco; Giuseppe Canavese; John Buscombe; H. William Strauss; Giovanni Paganelli

    The concept of sentinel lymph node biopsy in breast cancer surgery relates to the fact that the tumor drains in a logical way through the lymphatic system, from the first to upper levels. Therefore, the first lymph node met (the sentinel node) will most likely be the first to be affected by metastasis, and a negative sentinel node makes it

  18. Significance of Lymph Node Micrometastasis in Pancreatic Cancer Patients

    Microsoft Academic Search

    J. Bober

    2012-01-01

    Background \\/Aims: The present study deals with the significance of lymph node micrometastasis in the survival rate for pancreatic cancer patients. Methods: Between January 2006 and December 2010 at the First Department of Surgery in Košice, a prospective trial was done in which we investigated the survival rate after radical pancreatic resection. All negative lymph nodes removed during standard radical

  19. Genetic diagnosis of lymph-node metastasis in colorectal cancer

    Microsoft Academic Search

    N. Hayashi; I. Ito; Y. Nakamura; A. Yanagisawa; Y. Kato; S. Nakamori; S. Imaoka; H. Watanabe; M. Ogawa

    1995-01-01

    If a regional lymph node taken during surgery for colorectal cancer is found to be free of tumour on histological examination this is taken to be a good sign. However, conventional staining may not be sensitive enough. Mutant-allele-specific amplification (MASA) is a technique that can detect, at the level of an individual cell, micrometastases to lymph nodes that are histologically

  20. Nodal lymph flow quantified with afferent vessel input function allows differentiation between normal and cancer-bearing nodes.

    PubMed

    DSouza, Alisha V; Elliott, Jonathan T; Gunn, Jason R; Barth, Richard J; Samkoe, Kimberley S; Tichauer, Kenneth M; Pogue, Brian W

    2015-04-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy could ideally be improved using node assay techniques that are non-invasive. While visible blue dyes are often used to locate the sentinel lymph nodes from draining lymphatic vessels near a tumor, they do not provide an in situ metric to evaluate presence of cancer. In this study, the transport kinetics of methylene blue were analyzed to determine the potential for better in situ information about metastatic involvement in the nodes. A rat model with cancer cells in the axillary lymph nodes was used, with methylene blue injection to image the fluorescence kinetics. The lymphatic flow from injection sites to nodes was imaged and the relative kinetics from feeding lymphatic ducts relative to lymph nodes was quantified. Large variability existed in raw fluorescence and transport patterns within each cohort resulting in no systematic difference between average nodal uptake in normal, sham control and cancer-bearing nodes. However, when the signal from the afferent lymph vessel fluorescence was used to normalize the signal of the lymph nodes, the high signal heterogeneity was reduced. Using a model, the lymph flow through the nodes [Formula: see text] was estimated to be 1.49 ± 0.64 ml/g/min in normal nodes, 1.53 ± 0.45 ml/g/min in sham control nodes, and reduced to 0.50 ± 0.24 ml/g/min in cancer-cell injected nodes. This summarizes the significant difference (p = 0.0002) between cancer-free and cancer-bearing nodes in normalized flow. This process of normalized flow imaging could be used as an in situ tool to detect metastatic involvement in nodes. PMID:25909014

  1. Nodal lymph flow quantified with afferent vessel input function allows differentiation between normal and cancer-bearing nodes

    PubMed Central

    DSouza, Alisha V.; Elliott, Jonathan T.; Gunn, Jason R.; Barth, Richard J.; Samkoe, Kimberley S.; Tichauer, Kenneth M.; Pogue, Brian W.

    2015-01-01

    Morbidity and complexity involved in lymph node staging via surgical resection and biopsy could ideally be improved using node assay techniques that are non-invasive. While visible blue dyes are often used to locate the sentinel lymph nodes from draining lymphatic vessels near a tumor, they do not provide an in situ metric to evaluate presence of cancer. In this study, the transport kinetics of methylene blue were analyzed to determine the potential for better in situ information about metastatic involvement in the nodes. A rat model with cancer cells in the axillary lymph nodes was used, with methylene blue injection to image the fluorescence kinetics. The lymphatic flow from injection sites to nodes was imaged and the relative kinetics from feeding lymphatic ducts relative to lymph nodes was quantified. Large variability existed in raw fluorescence and transport patterns within each cohort resulting in no systematic difference between average nodal uptake in normal, sham control and cancer-bearing nodes. However, when the signal from the afferent lymph vessel fluorescence was used to normalize the signal of the lymph nodes, the high signal heterogeneity was reduced. Using a model, the lymph flow through the nodes (FLN) was estimated to be 1.49 ± 0.64 ml/g/min in normal nodes, 1.53 ± 0.45 ml/g/min in sham control nodes, and reduced to 0.50 ± 0.24 ml/g/min in cancer-cell injected nodes. This summarizes the significant difference (p = 0.0002) between cancer-free and cancer-bearing nodes in normalized flow. This process of normalized flow imaging could be used as an in situ tool to detect metastatic involvement in nodes. PMID:25909014

  2. Lymph node size does not correlate with the presence of prostate cancer metastasis

    Microsoft Academic Search

    Rabi Tiguert; Edward L Gheiler; Marcos V Tefilli; Peter Oskanian; Mousumi Banerjee; David J Grignon; Wael Sakr; J. Edson Pontes; David P Wood

    1999-01-01

    Objectives. To determine whether lymph node size is a surrogate marker for lymph node metastasis.Methods. We reviewed 980 patients who underwent radical retropubic prostatectomy with bilateral pelvic lymph node dissection for clinically localized prostate cancer, of whom 63 had lymph node metastases. A comparable group of patients with prostate cancer undergoing radical prostatectomy who did not have lymph node involvement

  3. Whole Genome Sequence Analysis Suggests Intratumoral Heterogeneity in Dissemination of Breast Cancer to Lymph Nodes

    PubMed Central

    Blighe, Kevin; Kenny, Laura; Patel, Naina; Guttery, David S.; Page, Karen; Gronau, Julian H.; Golshani, Cyrus; Stebbing, Justin; Coombes, R. Charles; Shaw, Jacqueline A.

    2014-01-01

    Background Intratumoral heterogeneity may help drive resistance to targeted therapies in cancer. In breast cancer, the presence of nodal metastases is a key indicator of poorer overall survival. The aim of this study was to identify somatic genetic alterations in early dissemination of breast cancer by whole genome next generation sequencing (NGS) of a primary breast tumor, a matched locally-involved axillary lymph node and healthy normal DNA from blood. Methods Whole genome NGS was performed on 12 µg (range 11.1–13.3 µg) of DNA isolated from fresh-frozen primary breast tumor, axillary lymph node and peripheral blood following the DNA nanoball sequencing protocol. Single nucleotide variants, insertions, deletions, and substitutions were identified through a bioinformatic pipeline and compared to CIN25, a key set of genes associated with tumor metastasis. Results Whole genome sequencing revealed overlapping variants between the tumor and node, but also variants that were unique to each. Novel mutations unique to the node included those found in two CIN25 targets, TGIF2 and CCNB2, which are related to transcription cyclin activity and chromosomal stability, respectively, and a unique frameshift in PDS5B, which is required for accurate sister chromatid segregation during cell division. We also identified dominant clonal variants that progressed from tumor to node, including SNVs in TP53 and ARAP3, which mediates rearrangements to the cytoskeleton and cell shape, and an insertion in TOP2A, the expression of which is significantly associated with tumor proliferation and can segregate breast cancers by outcome. Conclusion This case study provides preliminary evidence that primary tumor and early nodal metastasis have largely overlapping somatic genetic alterations. There were very few mutations unique to the involved node. However, significant conclusions regarding early dissemination needs analysis of a larger number of patient samples. PMID:25546409

  4. Breast cancer with cartilaginous and/or osseous metaplasia diagnosed by lymph nodal metastasis: a case report.

    PubMed

    Tsukuda, Kazunori; Tsuji, Hisashi; Kunitomo, Tadayoshi; Aokage, Keiju; Miyake, Takayoshi; Nakahara, Saki; Masuda, Hiroko

    2009-12-01

    Breast cancer with cartilaginous and/or osseous metaplasia is a type of metaplastic carcinomas and is a rare disease. We report the case of a 49 year-old female who underwent right mastectomy for a large breast tumor. Histological examinations revealed a mixed tumor with both stromal and epithelial elements;the stroma showed poor differentiated spindle-shape and multiform cells with a massive osseous matrix, and atypical epithelial cells, which mainly existed on the surface of the cysts, showed nucleic atypia. The tumor was diagnosed as a malignant phyllodes tumor with osteosarcomatous differentiation;it was not identified as a metaplastic carcinoma because of the lack of proof of a cancerous component. Two years after a mastectomy, swelling of the axillary lymph nodes was found and a biopsy was performed. Histological findings for the lymph node indicated a metastasis of the invasive ductal carcinoma. The primary tumor was re-examined and was considered to be the origin of the lymph nodal metastasis. Lymph nodal metastasis of cancer proved that the primary tumor had cancerous potential, and the pathological diagnosis was altered to a breast cancer with cartilaginous and/or osseous metaplasia. PMID:20035293

  5. Lymphoscintigraphy in Differentiated Thyroid Cancer.

    PubMed

    Boschin, Isabella Merante; Pelizzo, Maria Rosa; Giammarile, Francesco; Rubello, Domenico; Colletti, Patrick M

    2015-07-01

    There is considerable variability in the surgical approach to differentiated thyroid cancer regarding the decision to explore and remove central or central and lateral compartment lymph nodes. Much as sentinel lymph node sampling has improved the decision to remove axillary nodes for breast cancer, vital dye and lymphoscintigraphy with lymph node sampling may direct the surgical approach to differentiated thyroid cancer. PMID:26018703

  6. Lymphoscintigraphy and Radioguided Biopsy of the Sentinel Axillary Node in Breast Cancer

    Microsoft Academic Search

    Concetta De Cicco; Marta Cremonesi; Alberto Luini; Mirco Bartolomei; Chiara Grana; Gennaro Prisco; Viviana Galimberti; Paolo Calza; Giuseppe Viale; Umberto Veronesi; Giovanni Paganelli

    Lymphoscintigraphy associated with radioguided biopsy of the sentinel node (SN) is well established in clinical practice for mela noma. In breast cancer, the SN concept is similarly valid, and lymphoscintigraphy is a useful method for localizing the axillary SN. The aim of this study was to optimize the lymphoscintigraphy technique in association with a gamma ray detecting probe (GDP) for

  7. Pathological lymph node involvement at surgery is a significant predictive factor of recurrence in locally advanced breast cancer treated with concomitant epirubicin–docetaxel neoadjuvant chemotherapy: a cohort study

    Microsoft Academic Search

    Kazuharu Kai; Nobuyuki Arima; Haruhiko Miyayama; Yutaka Yamamoto; Hirotaka Iwase; Reiki Nishimura

    2009-01-01

    Background  Neoadjuvant chemotherapy (NAC) is the standard therapy for locally advanced breast cancer. Recently, several studies have\\u000a revealed that clearance of axillary lymph node involvement is an independent factor for survival irrespective of the response\\u000a of the primary lesion. However, in daily practice, it is difficult to fully examine every lymph node that has been surgically\\u000a sampled, in view of pathology

  8. Anthracycline-based induction chemotherapy followed by concurrent cyclophosphamide, methotrexate and 5-fluorouracil and radiation therapy in surgically resected axillary node-positive breast cancer.

    PubMed

    Recchia, Francesco; Candeloro, Giampiero; Cesta, Alisia; DI Staso, Mario; Bonfili, Pierluigi; Gravina, Giovanni Luca; DI Cesare, Ernesto; Necozione, Stefano; Rea, Silvio

    2014-05-01

    The present study aimed to determine the toxicity and efficacy of 4 courses of anthracyclines-taxane (AT) chemotherapy followed by radiation therapy (XRT) concurrent with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in surgically resected axillary node-positive (N+) breast cancer. A total of 200 women with N+ breast cancer were treated with adriamycin and docetaxel followed by XRT concurrent with six courses of CMF. Two courses of dose-dense chemotherapy with ifosfamide, carboplatin and etoposide, supported by pegfilgrastim, were administered to patients with >5 histologically confirmed axillary lymph node metastases and patients with triple-negative disease. Additional treatments included 1 year of trastuzumab in human epidermal growth factor receptor 2-positive patients, 5 years of a luteinizing hormone-releasing hormone analogue in premenopausal women and 5 years of an aromatase inhibitor (AI) in estrogen receptor-positive (ER+) patients. The mean number of positive axillary lymph nodes was 4.4 (range, 2-37), 52% of the patients were premenopausal, 74% were ER+ and 26% had triple-negative disease. After a median follow-up of 73 months, grade 2 and 3 hematological toxicity was observed in 20% of the patients. The 10-year disease-free survival (DFS) and overall survival (OS) rates were 73 and 77%, respectively. There was no significant difference in DFS between ER+ and estrogen receptor-negative (ER-) patients (P>0.05), whereas the OS was better in ER+ vs. ER- patients (P<0.05) and in premenopausal vs. postmenopausal patients (P<0.005). In conclusion, induction AT concurrent CMF and XRT and dose-dense chemotherapy followed by AI in N+ high-risk breast cancer was associated with a low level of systemic and late cardiac toxicity and excellent local control, DFS and OS. PMID:24772320

  9. Anthracycline-based induction chemotherapy followed by concurrent cyclophosphamide, methotrexate and 5-fluorouracil and radiation therapy in surgically resected axillary node-positive breast cancer

    PubMed Central

    RECCHIA, FRANCESCO; CANDELORO, GIAMPIERO; CESTA, ALISIA; DI STASO, MARIO; BONFILI, PIERLUIGI; GRAVINA, GIOVANNI LUCA; DI CESARE, ERNESTO; NECOZIONE, STEFANO; REA, SILVIO

    2014-01-01

    The present study aimed to determine the toxicity and efficacy of 4 courses of anthracyclines-taxane (AT) chemotherapy followed by radiation therapy (XRT) concurrent with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in surgically resected axillary node-positive (N+) breast cancer. A total of 200 women with N+ breast cancer were treated with adriamycin and docetaxel followed by XRT concurrent with six courses of CMF. Two courses of dose-dense chemotherapy with ifosfamide, carboplatin and etoposide, supported by pegfilgrastim, were administered to patients with >5 histologically confirmed axillary lymph node metastases and patients with triple-negative disease. Additional treatments included 1 year of trastuzumab in human epidermal growth factor receptor 2-positive patients, 5 years of a luteinizing hormone-releasing hormone analogue in premenopausal women and 5 years of an aromatase inhibitor (AI) in estrogen receptor-positive (ER+) patients. The mean number of positive axillary lymph nodes was 4.4 (range, 2–37), 52% of the patients were premenopausal, 74% were ER+ and 26% had triple-negative disease. After a median follow-up of 73 months, grade 2 and 3 hematological toxicity was observed in 20% of the patients. The 10-year disease-free survival (DFS) and overall survival (OS) rates were 73 and 77%, respectively. There was no significant difference in DFS between ER+ and estrogen receptor-negative (ER?) patients (P>0.05), whereas the OS was better in ER+ vs. ER? patients (P<0.05) and in premenopausal vs. postmenopausal patients (P<0.005). In conclusion, induction AT concurrent CMF and XRT and dose-dense chemotherapy followed by AI in N+ high-risk breast cancer was associated with a low level of systemic and late cardiac toxicity and excellent local control, DFS and OS. PMID:24772320

  10. Treatment Outcome of Breast Cancer with Pathologically Proven Synchronous Ipsilateral Supraclavicular Lymph Node Metastases

    PubMed Central

    Jung, Jinhong; Ahn, Seung Do; Lee, Sang-wook; Ahn, Sei-Hyun; Son, Byung Ho; Lee, Jong Won; Choi, Eun Kyung

    2015-01-01

    Purpose The aim of this study was to investigate the prognosis, patterns of failure, and prognostic factors for breast cancer patients with pathologically proven synchronous ipsilateral supraclavicular lymph node (ISCLN) metastases. Methods We reviewed the records of breast cancer patients with pathologically proven ISCLN metastases. Local aggressive treatment was defined as treatment including surgery, axillary lymph node dissection (ALND), ISCLN excision, radiotherapy (RT), and chemotherapy. Results A total of 111 patients were included. The 5-year overall survival (OS) and disease-free survival (DFS) rates were 64.2% and 56.2%, respectively. On univariate analysis, RT, ALND, trastuzumab treatment, hormone receptor (HR) status, and local aggressive treatment were identified as significant factors for OS. The 5-year OS for 73 patients who received local aggressive treatment was superior to that of 38 patients who received nonaggressive treatment (70.9% vs. 49.3%, p=0.036). Multivariate analysis showed that RT, HR status, and trastuzumab were significant variables for the 5-year OS and DFS. Conclusion Multimodality treatment with surgery, taxane-based chemotherapy, hormone therapy, and RT is strongly recommended for breast cancer patients with synchronous ISCLN metastases.

  11. Metastasis of Right Upper Para-Esophageal Lymph Nodes in Central Compartment Lymph Node Dissection of Papillary Thyroid Cancer

    Microsoft Academic Search

    Byung-Joo Lee; Jin-Choon Lee; Soo-Geun Wang; Yong-Ki Kim; In-Ju Kim; Seok-Man Son

    2009-01-01

    Background  Although some lymph nodes (upper para-esophageal lymph nodes) that exist between the right recurrent laryngeal nerve and the\\u000a esophagus should be involved in central-compartment lymph node dissection (CLND) in patients with papillary thyroid cancer,\\u000a the procedure can cause some injury to the nerve. We set out to assess the incidence of right upper para-esophageal lymph\\u000a node metastasis after routine CLND.

  12. Sentinel lymph node detection by intranipple injection of patent blue dye in breast cancer: a preliminary report of a feasibility study.

    PubMed

    Zervoudis, S; Iatrakis, G; Paschopoulos, M; Dousias, V; Geahchan, N; Stefos, T; Pechlivani, F; Navrozoglou, I

    2012-01-01

    Sentinel lymph node (SLN) biopsy is a well established option for assessing axillary lymph node status in breast cancer. Several techniques have been applied so far (superficial or deeper ones). Based on anatomical features of the lymphatic drainage in the breast, we assessed the feasibility of an intranipple approach for SLN mapping. Our data support the feasibility of SLN detection by our technique, with a high rate of SLN identification, which could be used in clinical practice as an alternative to the peri-areolar approach. PMID:22873105

  13. Epitrochlear lymph node metastases from invasive ductal breast cancer.

    PubMed

    Kumar, Pavan; Singh, Shalini; Datta, N R; Tandon, Ashwani

    2009-01-01

    Metastasis to an epitrochlear lymph node from a primary invasive breast cancer has not been reported earlier. We report a case of epitrochlear lymph node metastasis that presented 10 years after the primary breast malignancy had been treated with radiotherapy, chemotherapy, and hormonal therapy. The patient was successfully treated and continues to remain asymptomatic more than 2 years after she presented with the metastasis. PMID:19841563

  14. Sarcoid Reactions in Regional Lymph Nodes of Primary Lung Cancer

    Microsoft Academic Search

    Kenji Sugio; Takashi Inoue; Hideki Yokoyama; Teruyoshi Ishida; Shuji Nakano; Keizo Sugimachi

    1993-01-01

    A 66-year-old woman diagnosed as having primary lung cancer with an enlargement of the mediastinal, subcarinal and bilateral hilar lymph nodes underwent a thoracotomy after preoperative chemotherapy. The histological examination showed a moderately differentiated papillary adenocarcinoma in the left upper lobe without any metastases to the regional lymph nodes; however, non-caseous epithelioid granulomas without necrosis were observed in the nodes.

  15. Cytokeratin Deposits in Lymph Nodes Show Distinct Clinical Significance from Lymph Node Micrometastasis in Human Esophageal Cancers

    Microsoft Academic Search

    Yuichiro Doki; Osamu Ishikawa; Masayuki Mano; Masahiro Hiratsuka; Yo Sasaki; Masao Kameyama; Hiroaki Ohigashi; Kohei Murata; Terumasa Yamada; Isao Miyashiro; Shigekazu Yokoyama; Shingo Ishiguro; Shingi Imaoka

    2002-01-01

    Background. Cytokeratin immunostaining is the most common method used to identify micrometastatic cancer cells from the lymph nodes. However, contamination with hyalinized cytokeratin particles, frequently observed in the lymph nodes of esophageal cancer patients, can lead to misinterpretation of cytokeratin immunostaining.Materials and methods. Cytokeratin immunostaining (AE1\\/AE3) of surgically removed lymph nodes was performed for 41 cases of node-negative, but locally

  16. Pathologic examination of sentinel lymph nodes in breast cancer.

    PubMed

    Ku, N N

    1999-07-01

    Lymphatic mapping with selective sentinel lymphadenectomy allows accurate pathologic examination of the nodes most likely to contain macro- or micrometastastic disease for staging and proper adjuvant chemotherapy. The hypothesis of SLN biopsies was histopathologically validated by Turner et al that if the node is tumor free by H&E and immunohistochemistry, the probability of non-SLN involvement is less than 0.1%. Giuliano et al and Veronesi et al reported that detection of metastases in SLNs by frozen section technique is 89% and 64%, respectively. At MCC, frozen section evaluation of SLN is not performed because of its potential loss of micrometastasis in the cryostat, freezing artifacts, sampling error, and perhaps radioactive contamination. Intraoperative detection of macro- or micrometastasis is critical because it enables conversion of patients with positive SLN to CLND in one surgical setting more cost-effectively. IIC of the lymph nodes has been used routinely in the diagnosis of hematologic malignancies and also in breast cancer as a useful method in many series. In the author's experience, IIC by Diff-Quik stain converted 100% of grossly positive and suspicious SLNs and 22% of grossly negative SLNs. The significance of detecting micrometastases in axillary lymph nodes using immunohistochemical techniques has been reported in many series. At the MCC, routine use of CKI on paraffin sections of grossly negative SLNs enabled the upstaging of 10.6% of patients from N0 to N1. Recent addition of intraoperative rapid CKI as an adjunct to complement Diff-Quik stain has proven to be more sensitive in detecting micrometastases than using Diff-Quik stain alone. IIC technique using either Diff-Quik stain or CKI requires intensive training and experience to avoid potential pitfalls and errors in interpretation. Evaluation of SLN should use methods that enhance the ability to detect micrometastasis, however, in a cost-effective manner. The cost-effectiveness of IIC by Diff-Quik stain is incomparable with frozen section evaluation. The added cost of routine immunohistochemical stain and perhaps multiple levels of H&E stain should be offset by the decreased costs of IIC and clinically by treating most patients in the outpatient settings. In summary, IIC by Diff-Quik stain is simple, rapid, and has excellent diagnostic accuracy in grossly positive and suspicious SLNs allowing cost-effective, immediate CLND. IIC by CKI is an extremely useful ancillary technique that complements Diff-Quik stain in detecting micrometastases particularly in low grade ductal or lobular carcinoma and low tumor cell volume. Appropriate combined use of both stains may lead to intraoperative nodal staging and cost-effective CLND. SLN mapping technology at MCC using IIC in conjunction with serial sections, entire tissue submission, routine use of CKI, and multiple levels of the SLN have led us to uncover micrometastasis in high-risk, traditionally node-negative patients. These results have encouraged investigators to pursue even more sensitive techniques to detect micrometastases, including molecular biology techniques such as RT-PCR. Experienced cytopathologists and active cytopathology services are required to avoid potential pitfalls in performing and interpreting IIC. More long-term follow-up and prospective trials are needed to determine the prognostic significance of upstaging by ancillary techniques, which may lead to a revision of the current TNM staging system. PMID:10448690

  17. A false-positive finding in therapeutic evaluation: hypermetabolic axillary lymph node in a lymphoma patient following FDG extravasation.

    PubMed

    Wagner, Thomas; Brucher, Nicolas; Julian, Anne; Hitzel, Anne

    2011-01-01

    We report a case of a false-positive finding in FDG PET/CT following radiotracer extravasation. A 15-year-old male patient was referred for therapeutic evaluation status post-chemotherapy for a lymphoblastic lymphoma. FDG PET/CT showed discordant findings with a marked decrease in a liver/hepatic hilum uptake, disappearance of a subcutaneous left supraclavicular uptake, and appearance of intense right axillary nodal uptake. Extravasation in the right superior limb was noted. Comparison with the previous scan showed that the axillary nodes were present, measured less than 1 cm in their short axis, had not increased in size, and had a fatty hilum. We concluded that FDG uptake was caused by a migration in lymphatic vessels. PMID:22219152

  18. Evolution of sentinel lymph node biopsy in breast cancer, in and out of vogue?

    PubMed

    Jaffer, Shabnam; Bleiweiss, Ira J

    2014-11-01

    Sentinel lymph node biopsy (SLNB) was introduced 2 decades ago and thereafter validated for routine surgical management of breast cancer, including cases treated with neoadjuvant chemotherapy. As the number of lymph nodes for staging has decreased, pathologists have scrutinized SLN with a combination of standard hematoxylin and eosin, levels, immunohistochemistry (IHC), and molecular methods. An epidemic of small-volume metastases thereby arose, leading to modifications in the American Joint Committee on Cancer staging to accommodate findings such as isolated tumor cells (ITC) and micrometastases. With the goal of determining the significance of these findings, retrospective followed by prospective trials were performed, showing mixed results. The ACOSOG Z10 and NSABP B-32 trials both independently showed that ITC and micrometastases were not significant and thus discouraged the use of levels and IHC for detecting them. However, the Surveillance Epidemiology and End Results database showed that patients with micrometastases had an overall decreased survival. In addition, the MIRROR (Micrometastases and ITC: Relevant and Robust or Rubbish?) trial, showed that patients with ITC and micrometastases treated with adjuvant therapy had lower hazard ratios compared with untreated patients. Subsequently, the ACOSOG Z0011 trial randomized patients with up to 2 positive SLN to axillary lymph node dissection (ALND) or not, all treated with radiation and chemotherapy, showing no difference in survival or recurrence rates between the 2 groups and causing a shift from ALND. As the rate of ALND has declined, the necessity of performing levels, IHC, frozen section, and molecular studies on SLN needs to be revisited. PMID:25299312

  19. Omission of Mediastinal Lymph Node Dissection in Lung Cancer: Its Techniques and Diagnostic Procedures

    Microsoft Academic Search

    Hiroaki Nomori; Kazunori Iwatani; Hironori Kobayashi; Atsushi Mori; Shouichi Yoshioka

    To reduce or omit a mediastinal lymph node dissection in the patients with clinical stage I non-small cell lung cancer (NSCLC), several authors examined the prevalence of metastatic sites of lymph nodes. Because lymphatic drainage usually heads for the upper mediastinum in upper lobe cancer and for the lower mediastinum in lower lobe cancer, upper and lower mediastinal lymph node

  20. Predictive Factors for Non-Sentinel Lymph Node Metastasis in the Case of Positive Sentinel Lymph Node Metastasis in Two or Fewer Nodes in Breast Cancer

    PubMed Central

    Toshikawa, Chie; Koyama, Yu; Nagahashi, Masayuki; Tatsuda, Kumiko; Moro, Kazuki; Tsuchida, Junko; Hasegawa, Miki; Niwano, Toshiyuki; Manba, Naoko; Ikarashi, Mayuko; Kameyama, Hitoshi; Kobayashi, Takashi; Kosugi, Shin-ichi; Wakai, Toshifumi

    2015-01-01

    Background In breast cancer, recent clinical trials have shown that sentinel lymph node biopsy (SLNB) alone without axillary lymph node dissection results in excellent prognosis if there is sentinel lymph node (SLN) metastasis in two or fewer nodes. The aim of the present study was to investigate the association between non-SLN metastasis and clinicopathological factors in case of SLN metastasis in two or fewer nodes in breast cancer. Methods Patients who underwent SLNB for invasive breast cancer and were found to have positive SLN in two or fewer nodes were evaluated. The associations between non-SLN metastasis and clinicopahological factors were examined. Statistical analyses were performed using the Mann-Whitney and Chi-square tests, with statistical significance set at P < 0.05. Results A total of 358 patients were enrolled during the study period and all of these patients were female and 54 patients had SLN metastasis (15%). Positive SLN in two or fewer nodes was identified in 44 patients (81.5%). Among these patients, 17 (38.6%) were found to have non-SLN metastasis. Non-SLN metastasis was associated with invasive tumor size (P = 0.015) and lymphatic involvement (P = 0.035). Multivariate analysis showed that tumor size (P = 0.011) and lymphatic involvement (P = 0.019) remained significant independent predictors of non-SLN metastasis, and that an invasive tumor size cut-off point of 28 mm was useful for dividing patients with positive SLN in two or fewer nodes into non-SLN-positive and non-SLN-negative groups. Conclusions Non-SLN metastasis was found in more than 30% of patients with SLN metastasis present in two or fewer nodes. Large tumor size and the presence of lymphatic involvement were significantly associated with non-SLN metastasis.

  1. Collision Metastasis of Breast and Ovarian Adenocarcinoma in Axillary Lymph Nodes: A Case Report and Review of the Literature

    Microsoft Academic Search

    Maher A. Sughayer; Lama Zakarneh; Raffat Abu-Shakra

    2009-01-01

    Despite their accepted clinical and genetic association, the incidence of synchronous breast and ovarian carcinoma is rare.\\u000a Moreover, collision metastasis from both breast and ovarian carcinomas to the same lymph node, to our knowledge has never\\u000a been reported. Review of the literature revealed eleven cases of metastatic malignant tumors colliding in the same lymph node,\\u000a none of which had both

  2. The impact of lymph node metastases on the survival of breast cancer patients with ten or more positive lymph nodes

    Microsoft Academic Search

    Atsuo Tsuchiya; Masahiko Kanno; Rikiya Abe

    1997-01-01

    To investigate the impact of the number of involved lymph nodes on survival, we retrospectively reviewed the data for 37 patients\\u000a with breast cancer and metastases of ten or more lymph nodes who underwent treatment between 1987 and 1995. Based on the number\\u000a of positive lymph nodes, the patients were allocated to one of three groups. The 5-year disease-free and

  3. Immunomorphologic study of regional lymph nodes in cancer: Response of regional lymph node cells from gastric and colorectal cancer to PHA stimulation

    Microsoft Academic Search

    Osamu Kojima; Yoshihiro Fujita; Akimune Oh; Masakazu Sakita; Bunzo Nishioka; Susumu Majima

    1980-01-01

    To obtain information regarding the immunologic capacity of uninvolved regional lymph nodes (RLNs) draining tumor, the in\\u000a vitro response of regional lymph node cells (RLNCs) to PHA was investigated in lymph nodes from 55 patients with gastric or\\u000a colorectal cancer, and gastric ulcer. Evaluation of data relative to cancer progress demonstrated that, in gastric cancer\\u000a patients, the response of stimulated

  4. Detection of Lymph Node Micrometastases and Isolated Tumor Cells in Sentinel and Nonsentinel Lymph Nodes of Colon Cancer Patients

    Microsoft Academic Search

    Andreas Bembenek; Ulrike Schneider; Stephan Gretschel; Joerg Fischer; Peter M. Schlag

    2005-01-01

    About 20% to 30% of colon cancer patients classified as node negative by routine hematoxylin-eosin (H&E) staining are found to have micrometastases (MM) or isolated tumor cells (ITC) in sentinel lymph nodes (SLNs) if analyzed by step sections and immunohistochemistry (IHC). Whether SLNs are in this respect representative for all lymph nodes was addressed in this study. SLNs were identified

  5. Long-term outcomes in breast cancer patients with ten or more positive axillary nodes treated with combined-modality therapy: The importance of radiation field selection

    SciTech Connect

    Chang, Daniel T. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Feigenberg, Steven J. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Lightsey, Judith [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Grobmyer, Stephen R. [Department of Surgery, University of Florida College of Medicine, Gainesville, FL (United States); Copeland, Edward M. [Department of Surgery, University of Florida College of Medicine, Gainesville, FL (United States); Mendenhall, Nancy P. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)]. E-mail: mendenan@shands.ufl.edu

    2007-03-15

    Purpose: To determine the long-term outcome of a consistent treatment approach with electron beam postmastectomy radiation therapy (PMRT) in breast cancer patients with {>=}10 positive nodes treated with combined-modality therapy. Methods and Materials: TSixty-three breast cancer patients with {>=}10 positive lymph nodes were treated with combined-modality therapy using an electron beam en face technique for PMRT at University of Florida. Patterns of recurrence were studied for correlation with radiation fields. Potential clinical and treatment variables were tested for possible association with local-regional control (LRC), disease-free survival (DFS), and overall survival (OS). Results: TAt 5, 10, and 15 years, OS rates were 57%, 36%, and 27%, respectively; DFS rates were 46%, 37%, and 34%; and LRC rates were 87%, 87%, and 87%. No clinical or treatment variables were associated with OS or DFS. The use of supplemental axillary radiation (SART) (p = 0.012) and pathologic N stage (p = 0.053) were associated with improved LRC. Patients who received SART had a higher rate of LRC than those who did not. Moderate to severe arm edema developed in 17% of patients receiving SART compared with 7% in patients not treated with SART (p = 0.28). Conclusions: TA substantial percentage of patients with {>=}10 positive lymph nodes survive breast cancer. The 10-year overall survival in these patients was 36%. The addition of SART was associated with better LRC.

  6. Staging lymph node metastases from lung cancer in the mediastinum

    PubMed Central

    Terán, Mario D.

    2014-01-01

    Background The presence of tumor metastases in the mediastinum is one of the most important elements in determining the optimal treatment strategy in patients with non-small cell lung cancer. This review is aimed at examining the current strategies for investigating lymph node metastases corresponding to an “N2” classification delineated by The International Staging Committee of the International Association for the Study of Lung Cancer (IASLC). Methods Extensive review of the existing scientific literature related to the investigation of mediastinal lymph node metastases was undertaken in order to summarize and report current best practices. Conclusions N2 disease is very heterogeneous requiring multiple modalities for thorough investigation. New research is now focusing on better identifying, defining, and classifying lymph node metastases in the mediastinum. Molecular staging and sub-classifying mediastinal lymph node metastases are being actively researched in order to provide better prognostic value and to optimize treatment strategies. Non-invasive imaging, such as PET/CT and minimally invasive techniques such as endobronchial and endoscopic ultrasound guided biopsy, are now the lead investigative methods in evaluating the mediastinum for metastatic presence. PMID:24624287

  7. Near infrared photoacoustic detection of sentinel lymph nodes with gold nanobeacons

    Microsoft Academic Search

    Dipanjan Pan; Manojit Pramanik; Angana Senpan; Soumojit Ghosh; Samuel A. Wickline; Lihong V. Wang; Gregory M. Lanza

    2010-01-01

    Detection of sentinel lymph node (SLN) using photoacoustic imaging is an emerging technique for noninvasive axillary staging of breast cancer. Due to the absence of intrinsic contrast inside the lymph nodes, exogenous contrast agents are used for photoacoustic detection. In this work, we have demonstrated near infrared detection of SLN with gold nanobeacons (GNBs) providing the photoacoustic contrast in a

  8. GENE EXPRESSION PREDICTORS OF BREAST CANCER OUTCOMES Erich Huang2

    E-print Network

    West, Mike

    to lymph node metastasis and cancer recurrence. Findings We identify aggregate patterns of gene expression's prognosis is central to effective oncologic treatment. In breast cancer, invasion into axillary lymph nodes (metagenes) that associate with lymph node status and recurrence, and that are capable of honestly predicting

  9. Site-specific cancer deaths in cancer of unknown primary diagnosed with lymph node metastasis may reveal hidden

    E-print Network

    Hemminki, Akseli

    Site-specific cancer deaths in cancer of unknown primary diagnosed with lymph node metastasis may to lymph nodes in some patients. Cause-specific survival data could guide the search for hidden primary Registry between 1987 and 2008; 1,444 patients had only lymph node metastasis of defined histology

  10. A Long-Term Study of Radiation Therapy in T1-2 Node-Negative Breast Cancer Patients in Relation to the Number of Axillary Nodes Examined

    SciTech Connect

    Tai, Patricia [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan (Canada)], E-mail: ptai2@yahoo.com; Yu, Edward [Radiation Oncology Division, Department of Oncology, University of Western Ontario (Canada); Sadikov, Evgeny [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan (Canada); Joseph, Kurian [Department of Radiation Oncology, Cross Cancer Institute, University of Alberta (Canada)

    2009-06-01

    Purpose: The optimal number of axillary nodes to be resected is controversial. This large series investigated the effect of surgery with or without adjuvant radiotherapy among node-negative breast cancer patients in relation to the number of nodes examined. Methods and Materials: Node-negative patients from the Saskatchewan registry of 1981-1995 were studied. Because nodal status may be more reliable with more number of nodes examined, we analyzed T1-2 age < 90 patients with < 10 nodes examined treated with surgery alone (Group A{sub S}, n = 509) vs. surgery and adjuvant radiotherapy (Group A{sub S}+R, n = 342); and T1-2 age < 90 patients with {>=} 10 nodes examined treated with surgery alone (Group B{sub S}, n = 902) vs. surgery and adjuvant radiotherapy (Group B{sub S}+R, n = 596). Results: For the two radiotherapy groups, patients with < 10 nodes (Group A{sub S}+R) vs. {>=} 10 nodes (Group B{sub S}+R), there was no difference in overall survival (p = 0.14). In the two nonradiotherapy groups (A{sub S} and B{sub S}), there is a statistically significant decrease in overall survival for patients with < 10 nodes removed (p < 0.001, log-rank test). The optimal number of axillary nodes examined could be 8 nodes with adjuvant radiotherapy (p = 0.05, logrank test) and 12 nodes without adjuvant radiotherapy (p = 0.02, log-rank test). Conclusions: The poorer prognosis of a lesser number of nodes resected was overcome partly by the use of radiotherapy, raising the possibility of micrometastases in lymph nodes not removed. The optimal number of axillary nodes examined could be 8 nodes with adjuvant radiotherapy and 12 nodes without adjuvant radiotherapy.

  11. Sentinel lymph node navigation surgery for early stage gastric cancer

    PubMed Central

    Mitsumori, Norio; Nimura, Hiroshi; Takahashi, Naoto; Kawamura, Masahiko; Aoki, Hiroaki; Shida, Atsuo; Omura, Nobuo; Yanaga, Katsuhiko

    2014-01-01

    We attempted to evaluate the history of sentinel node navigation surgery (SNNS), technical aspects, tracers, and clinical applications of SNNS using Infrared Ray Electronic Endoscopes (IREE) combined with Indocyanine Green (ICG). The sentinel lymph node (SLN) is defined as a first lymph node (LN) which receives cancer cells from a primary tumor. Reports on clinical application of SNNS for gastric cancers started to appear since early 2000s. Two prospective multicenter trials of SNNS for gastric cancer have also been accomplished in Japan. Kitagawa et al reported that the endoscopic dual (dye and radioisotope) tracer method for SN biopsy was confirmed acceptable and effective when applied to the early-stage gastric cancer (EGC). We have previously reported the usefulness of SNNS in gastrointestinal cancer using ICG as a tracer, combined with IREE (Olympus Optical, Tokyo, Japan) to detect SLN. LN metastasis rate of EGC is low. Hence, clinical application of SNNS for EGC might lead us to avoid unnecessary LN dissection, which could preserve the patient’s quality of life after operation. The most ideal method of SNNS should allow secure and accurate detection of SLN, and real time observation of lymphatic flow during operation. PMID:24914329

  12. Human papillomavirus DNA in genital cancers, metastases, and lymph nodes.

    PubMed

    Beyer-Finkler, E; Girardi, F; Sillem, M; Pfister, H

    1995-01-01

    To evaluate the utility of human papillomavirus (HPV) DNA as molecular marker for diagnostic screening of lymph nodes for cancer metastases, we examined 16 involved and 124 histologically cancer-free nodes of 34 patients with cervical, vulval, or vaginal carcinomas associated with HPV 6, 16, 18, 31, 33, 45, or X. All metastases of HPV-positive tumors contained viral DNA of the same type as the primary cancer but in one case the copy number of viral genomes was dramatically reduced. In a varying proportion of histologically normal nodes of 7 of 23 patients with HPV 16-positive cancers HPV 16 DNA was revealed by Southern blot hybridization and/or PCR. Histologic reevaluation showed a metastasis in one case. Three examples of tumor heterogeneity regarding physical state or copy number of viral DNA are presented. Tumor heterogeneity is discussed as possible explanation for apparently inconsistent results such as HPV-negative metastases of HPV-positive tumors. PMID:8682613

  13. Detection of isolated ipsilateral regional lymph node recurrences by F18-fluorodeoxyglucose positron emission tomography-CT in follow-up of postoperative breast cancer patients.

    PubMed

    Ohsumi, Shozo; Inoue, Takeshi; Kiyoto, Sachiko; Hara, Fumikata; Takahashi, Mina; Takabatake, Daisuke; Takashima, Seiki; Aogi, Kenjiro; Takashima, Shigemitsu

    2011-11-01

    Imaging diagnostic methods except for mammograms are not recommended for follow-up of postoperative breast cancer patients in order to detect small recurrences because of the poor survival improvement in earlier randomized trials. However, the use of new imaging modalities may improve survival by detection of small isolated regional lymph node recurrences which are potentially curable. Between April 2006 and December 2008, we used PET-CT to find small recurrences in follow-up of 1,907 postoperative breast cancer patients. A total of 3,280 PET-CT imagings were performed. The median age at PET-CT imaging was 58 years, with a median 48-month interval from definitive surgery to the PET-CT imaging. Twenty-two patients were found to have isolated ipsilateral regional recurrences only by PET-CT (axillary node recurrences in 6, infraclavicular node recurrences in 5, supraclavicular node recurrences in 6, and parasternal node recurrences in 5). All of those recurrences were missed by palpation or were nonpalpable. The pathological lymph node status at the definitive surgery for the primary breast cancer of 22 patients with the isolated ipsilateral regional lymph node recurrences was positive in 17 patients. If patients are limited to those who had pathologically positive node(s) at definitive surgery, the incidence of patients with isolated regional lymph node recurrences found only by PET-CT would be 2.6% (17/663 patients). Seventeen other asymptomatic cancers including contralateral breast cancers were found only by PET-CT. Early detection of isolated loco-regional recurrences of breast cancer is suggested to result in improved survival. Therefore, the use of PET-CT in follow-up of postoperative node-positive breast cancer patients may improve their survival because of early detection of isolated regional lymph node recurrences which are still potentially curable, and screening of other asymptomatic cancers. PMID:21590272

  14. Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes

    E-print Network

    Bigio, Irving J.

    Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes of Medicine London, United Kingdom Abstract. A novel method for rapidly detecting metastatic breast cancer; breast cancer; sentinel lymph node biopsy. Paper 09556RR received Dec. 15, 2009; revised manuscript

  15. Rationale for Central and Bilateral Lymph Node Dissection in Sporadic and Hereditary Medullary Thyroid Cancer

    Microsoft Academic Search

    CLAUDIA SCOLLO; ERIC BAUDIN; JEAN-PAUL TRAVAGLI; BERNARD CAILLOU; NICOLAS BELLON; SOPHIE LEBOULLEUX; MARTIN SCHLUMBERGER

    A retrospective study was performed on 101 consecutive med- ullary thyroid cancer (MTC) patients who underwent at In- stitut Gustave-Roussy (IGR) total thyroidectomy with central and bilateral lymph node dissection. At histology, lymph node metastases were found in 55% of patients. In sporadic MTC, lymph node metastases were observed in the central compart- ment in 50% of patients, in the

  16. In Vitro Investigation of Lymph Node Metastasis of Colorectal Cancer Using Ultrasonic Spectral Parameters

    Microsoft Academic Search

    Tomoaki Noritomi; Junji Machi; Ernest J Feleppa; Eugene Yanagihara; Kazuo Shirouzu

    1998-01-01

    Lymph node involvement is one of the major factors affecting the prognosis of colorectal cancer. Various imaging methods, including ultrasound and computed tomography, are not sufficiently sensitive or specific for reliably determining lymph node involvement. We investigated the feasibility of using ultrasonic tissue characterization (UTC) based on spectrum analysis of backscattered echo signals for diagnosing lymph node metastasis of colorectal

  17. Current Status and Scope of Lymph Node Micrometastasis in Gastric Cancer

    PubMed Central

    Lee, Chang Min; Park, Sung-Soo

    2015-01-01

    Recently, lymph node micrometastasis has been evaluated for its prognostic value in gastric cancer. Lymph node micrometastasis cannot be detected via a usual pathologic examination, but it can be detected by using some other techniques including immunohistochemistry and reverse transcription-polymerase chain reaction assay. With the development of such diagnostic techniques, the detection rate of lymph node micrometastasis is constantly increasing. Although the prognostic value of lymph node micrometastasis remains debatable, its clinical impact is apparently remarkable in both early and advanced gastric cancer. At present, studies on the prognostic value of lymph node micrometastasis are evolving to overcome its current limitations and extend the scope of its application. PMID:25861517

  18. Exploring molecular links between lymph node invasion and cancer prognosis in human breast cancer

    PubMed Central

    2011-01-01

    Background Lymph node invasion is one of the most powerful clinical factors in cancer prognosis. However, molecular level signatures of their correlation are remaining poorly understood. Here, we propose a new approach, monotonically expressed gene analysis (MEGA), to correlate transcriptional patterns of lymph node invasion related genes with clinical outcome of breast cancer patients. Results Using MEGA, we scored all genes with their transcriptional patterns over progression levels of lymph node invasion from 278 non-metastatic breast cancer samples. Applied on 65 independent test data, our gene sets of top 20 scores (positive and negative correlations) showed significant associations with prognostic measures such as cancer metastasis, relapse and survival. Our method showed better accuracy than conventional two class comparison methods. We could also find that expression patterns of some genes are strongly associated with stage transition of pathological T and N at specific time. Additionally, some pathways including T-cell immune response and wound healing serum response are expected to be related with cancer progression from pathway enrichment and common motif binding site analyses of the inferred gene sets. Conclusions By applying MEGA, we can find possible molecular links between lymph node invasion and cancer prognosis in human breast cancer, supported by evidences of feasible gene expression patterns and significant results of meta-analysis tests. PMID:22784575

  19. A clinicopathological study of mediastinal lymph node metastasis of lung cancer

    Microsoft Academic Search

    Jin-liang Xu; Qing-kai Yu; Sen Wu; Zong-ren Gao; Zhi-qiang Long; Si-jie Qiao

    2000-01-01

    Objective: To investigate pathologically the characteristics of lung cancer metastasis by mediastinal lymph node ways (N2). Methods: Of 398 lung cancer patients who underwent radical pulmonectomy and extensive lymph node dissection, 160 patients\\u000a were diagnosed as with N2 metastasis, their 352 groups of mediastinal lymph nodes invaded were subject to the pathological\\u000a study. Results: Evidences showed that the N2 metastasis

  20. Curative use of forequarter amputation for recurrent breast cancer over an axillary area: a case report and literature review.

    PubMed

    Tsai, Chun-Hao; Tzeng, Huey-En; Juang, Wei-Kae; Chu, Pei-Guo; Fann, Patricia; Fong, Yi-Chin; Hsu, Horng-Chaung; Yen, Yun

    2014-01-01

    Axillary recurrence of breast cancer that involves the brachial neurovascular bundle is uncommon. However, for many patients with such recurrence, forequarter amputation can play a palliative role in relieving excruciating pain and paralysis of the upper limb. Further, for those patients who do not have distant metastasis or other local-regional recurrence, forequarter amputation provides a chance for a cure. Only a few case reports of curative amputations for recurrent breast cancer are present in the literature. Here, we report a case of forequarter amputation for curative treatment of axillary recurrent breast cancer, together with a literature review. To date, we have followed the patient for three years after amputation, during which there has been no evidence of recurrence or metastasis. Although radical resection is feasible, it can be accompanied by surgical wound complications and psychosocial stress. Therefore, an organized multidisciplinary approach is needed to ensure the success of radical resection. PMID:25407045

  1. Imprint Cytology for Detecting Metastasis of Lung Cancer in Mediastinal Lymph Nodes

    Microsoft Academic Search

    Kenichi Okubo; Tatsuo Kato; Akira Hara; Naoki Yoshimi; Keiichi Takeda; Fumihiko Iwao

    2004-01-01

    BackgroundLymph node metastasis of lung cancer has been evaluated with histologic examination. We studied the usefulness of cytologic diagnosis for detecting metastasis of lung cancer in mediastinal nodes.

  2. Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Maslov, Konstantin; Jankovic, Ladislav; Akers, Walter J.; Song, Liang; Achilefu, Samuel; Margenthaler, Julie A.; Pashley, Michael D.; Wang, Lihong V.

    2010-07-01

    By modifying a clinical ultrasound array system, we develop a novel handheld photoacoustic probe for image-guided needle biopsy. The integration of optical fiber bundles for pulsed laser light delivery enables photoacoustic image-guided insertion of a needle into rat axillary lymph nodes with accumulated indocyanine green (ICG). Strong photoacoustic contrast of the needle is achieved. After subcutaneous injection of the dye in the left forepaw, sentinel lymph nodes are easily detected, in vivo and in real time, beneath 2-cm-thick chicken breast overlaying the axillary region. ICG uptake in axillary lymph nodes is confirmed with fluorescence imaging both in vivo and ex vivo. These results demonstrate the clinical potential of this handheld photoacoustic system for facile identification and needle biopsy of sentinel lymph nodes for cancer staging and metastasis detection in humans.

  3. Molecular and Functional Imaging for Detection of Lymph Node Metastases in Prostate Cancer

    PubMed Central

    Fortuin, Ansje; de Rooij, Maarten; Zamecnik, Patrik; Haberkorn, Uwe; Barentsz, Jelle

    2013-01-01

    Knowledge on lymph node metastases is crucial for the prognosis and treatment of prostate cancer patients. Conventional anatomic imaging often fails to differentiate benign from metastatic lymph nodes. Pelvic lymph node dissection is an invasive technique and underestimates the extent of lymph node metastases. Therefore, there is a need for more accurate non-invasive diagnostic techniques. Molecular and functional imaging has been subject of research for the last decades, in this respect. Therefore, in this article the value of imaging techniques to detect lymph node metastases is reviewed. These techniques include scintigraphy, sentinel node imaging, positron emission tomography/computed tomography (PET/CT), diffusion weighted magnetic resonance imaging (DWI MRI) and magnetic resonance lymphography (MRL). Knowledge on pathway and size of lymph node metastases has increased with molecular and functional imaging. Furthermore, improved detection and localization of lymph node metastases will enable (focal) treatment of the positive nodes only. PMID:23823804

  4. The Influence of Serial Sections, Immunohistochemistry, and Extension of Pelvic Lymph Node Dissection on the Lymph Node Status in Clinically Localized Prostate Cancer

    Microsoft Academic Search

    Friedhelm Wawroschek; Theodor Wagner; Michael Hamm; Dorothea Weckermann; Harry Vogt; Bruno Märkl; Ronald Gordijn; Rolf Harzmann

    2003-01-01

    Objectives: Pelvic lymph node metastases indicate a poor prognosis for patients with clinically localized prostate cancer. The aim of the study was to investigate the value of extended histopathological techniques considering the extent of pelvic lymphadenectomy and preoperative risk factors.Methods: Total of 194 patients with prostate cancer were examined. At first all patients had a sampling of the sentinel lymph

  5. Real-time rapid reverse transcriptase-polymerase chain reaction for intraoperative diagnosis of lymph node micrometastasis: Clinical application for cervical lymph node dissection in esophageal cancers

    Microsoft Academic Search

    Setsuko Yoshioka; Yoshiyuki Fujiwara; Yurika Sugita; Yoshihiro Okada; Masahiko Yano; Shigeyuki Tamura; Takushi Yasuda; Shuji Takiguchi; Hitoshi Shiozaki; Morito Monden

    2002-01-01

    Background. New molecular techniques have been designed to detect cancer micrometastases that are otherwise missed by conventional histologic examination. The aim of this study was to establish a sensitive and rapid genetic assay to detect lymph node micrometastasis and to assess its usefulness clinically for cervical lymphadenectomy in esophageal cancer. We have recently shown that metastasis in the lymph node

  6. Epigenetic variations in breast cancer progression to lymph node metastasis.

    PubMed

    Urrutia, Guillermo; Laurito, Sergio; Marzese, Diego M; Gago, Francisco; Orozco, Javier; Tello, Olga; Branham, Teresita; Campoy, Emanuel M; Roqué, María

    2015-02-01

    Breast cancer is a heterogeneous disease characterized by the accumulation of genetic and epigenetic alterations that contribute to the development of regional and distant metastases. Lymph node metastasis (LNM) status is the single most important prognostic factor. Metastatic cancer cells share common molecular alterations with those of the primary tumor, but in addition, they develop distinct changes that allow the cancer to progress. There is an urgent need for molecular studies which focus on identifying genomic and epigenomic markers that can predict the progression to metastasis. The objective of this study was to identify epigenetic similarities and differences between paired primary breast tumor (PBT) and LNM. We employed Methylation-Specific-MLPA (Multiplex ligation-dependent probe amplification) to assess the methylation status of 33 cancer-related genes in a cohort of 50 paired PBT and LNM specimens. We found that the methylation index, which represents the degree of aberrantly methylated genes in a specimen, was maintained during the progression to LNM. However, some genes presented differential methylation profiles. Interestingly, PAX6 presented a significant negative correlation between paired PBT and LNM (p = 0.03), which indicated a switch from methylated to unmethylated status in the progression from PBT to LNM. We further identified that the methylation status of PAX6 on the identified CpG site functionally affected the expression of PAX6 at the mRNA level. Our study unraveled significant epigenetic changes during the progression from PBT to LNM, which may contribute to improved prognosis, prediction and therapeutic management of metastatic breast cancer patients. PMID:25628026

  7. Lymph Node Micrometastases in Early Gastric Cancer and Their Impact on Prognosis

    Microsoft Academic Search

    Paolo Morgagni; Luca Saragoni; Emanuela Scarpi; Pier Sante Zattini; Alberto Zaccaroni; Diana Morgagni; Francesca Bazzocchi

    2003-01-01

      Abstract\\u000a \\u000a While the presence of lymph node metastases in early gastric cancer (EGC) is the most significant prognostic factor, the relevance\\u000a of lymph node micrometastases remains uncertain. The authors studied 5400 lymph nodes dissected from 300 patients treated\\u000a surgically for EGC between 1976 and 1999, all of whom were histologically pN0. Micrometastases were defined as single or small\\u000a clusters of

  8. A preliminary study on sentinel lymph node biopsy: feasibility and predictive ability in oral cavity cancer

    Microsoft Academic Search

    Kazuaki Chikamatsu; Hideo Kamada; Hiroshi Ninomiya; Katsumasa Takahashi; Tsutomu Sakurai; Noboru Oriuchi; Nobuhiko Furuya

    2004-01-01

    The main factor that affects the prognosis of patients with head and neck cancer (HNC) is regional lymph node metastases.\\u000a For this reason, the accurate evaluation of neck metastases is required for neck management. This study investigates the sentinel\\u000a lymph node identification and the accuracy of the histopathology of the sentinel lymph node in patients with HNC. Eleven patients\\u000a with

  9. Sentinel lymph node biopsy progress in surgical treatment of cancer

    Microsoft Academic Search

    T. Schulze; A. Bembenek; P. M. Schlag

    2004-01-01

    Background Forty-three years after the first description of the sentinel lymph node technique in malignant tumours of the parotid by Gould, sentinel lymph node biopsy (SNLB) has become a precious tool in the treatment of solid tumours. Methods In the following review we give a synopsis of the fundamentals of the sentinel lymph node concept and then proceed to an

  10. Extended Lymph Node Dissection for Rectal Cancer with Radiologically Diagnosed Extramesenteric Lymph Node Metastasis

    Microsoft Academic Search

    Byung Soh Min; Jin Soo Kim; Nam Kyu Kim; Joon-Seok Lim; Kang Young Lee; Chang Hwan Cho; Seung Kook Sohn

    2009-01-01

    Background  The purpose of this study is to review the clinical outcomes of patients who received extended lymph node dissection for radiologically\\u000a diagnosed extramesenteric lymph node metastasis.\\u000a \\u000a \\u000a \\u000a \\u000a Patients and Methods  The authors reviewed clinical characteristics, short-term operative outcomes, and long-term oncologic outcomes of 151 patients\\u000a who had received total mesorectal excision plus extended lymph node dissection for the treatment of radiologically diagnosed

  11. Metastatic breast cancer cells in lymph nodes increase nodal collagen density.

    PubMed

    Rizwan, Asif; Bulte, Camille; Kalaichelvan, Anusha; Cheng, Menglin; Krishnamachary, Balaji; Bhujwalla, Zaver M; Jiang, Lu; Glunde, Kristine

    2015-01-01

    The most life-threatening aspect of breast cancer is the occurrence of metastatic disease. The tumor draining lymph nodes typically are the first sites of metastasis in breast cancer. Collagen I fibers and the extracellular matrix have been implicated in breast cancer to form avenues for metastasis. In this study, we have investigated extracellular matrix molecules such as collagen I fibers in the lymph nodes of mice bearing orthotopic human breast cancer xenografts. The lymph nodes in mice with metastatic MDA-MB-231 and SUM159 tumor xenografts and tumor xenografts grown from circulating tumor cell lines displayed an increased collagen I density compared to mice with no tumor and mice with non-metastatic T-47D and MCF-7 tumor xenografts. These results suggest that cancer cells that have metastasized to the lymph nodes can modify the extracellular matrix components of these lymph nodes. Clinically, collagen density in the lymph nodes may be a good marker for identifying lymph nodes that have been invaded by breast cancer cells. PMID:25950608

  12. Sentinel lymph node biopsy in breast cancer: an analysis of the maximum number of nodes requiring excision.

    PubMed

    Gill, Jasper; Lovegrove, Richard; Naessens, Katrien; Pursell, Roslyn; Cominos, Timothy; McCormick, Colin; Umeh, Hilary; Courtney, Stephen; Smith, Brendan

    2011-01-01

    Sentinel lymph node biopsy (SNB) is now the standard of care in assessment of patients with clinically staged T1-2, N0 breast cancers. This study investigates whether there is a maximum number of sentinel lymph nodes (SLN) that need to be excised without compromising the false-negative (FN) rate of this procedure. Data were prospectively collected for 319 patients undergoing SNB between February 2001 and December 2006 at our institution. This data were analysed, both in terms of the order of SLN retrieval and relative isotope counts of the SLNs, in order to determine the maximum number of SLNs that need to be retrieved without increasing the FN rate. Furthermore, we investigated the relationship between SLN blue dye concentration and the presence of SLN metastases. The SLN identification rate was 97% with no false-negative cases amongst patients undergoing simultaneous axillary clearance historically during technique validation. In patients with SLN metastases, excision of the first 4 SLNs encountered results in the identification of a metastatic SLN in all cases. Although the majority (86%) of SNB metastases are in the hottest node, the SLN containing the metastasis is in the first 4 hottest nodes in 99% of patients with nodal metastases. The remaining 1% of SLN metastases were identified by blue dye. There was no statistically significant association between the SLN blue dye concentration and the presence of SLN metastases. A policy to remove a maximum of four blue and/or hot SLNs along with any palpably abnormal lymph nodes does not result in an increased false-negative rate of detection of SLN metastases. PMID:21129088

  13. Are lymph node micrometastases of any clinical significance in dukes stages A and B colorectal cancer?

    Microsoft Academic Search

    Åke Öberg; Roger Stenling; Björn Tavelin; Gudrun Lindmark

    1998-01-01

    PURPOSE: The aim was to investigate the significance of lymph node micrometastases in Dukes Stages A and B colorectal cancer. METHODS: Archival specimens were examined from 147 patients (96 colon, 51 rectum; 44 Stage A, 103 Stage B) who had surgery between 1987 and 1994. One lymph node section from each node (colon, 1–11; median, 4; rectum, 1–15; median, 3)

  14. Selection and Delineation of Lymph Node Target Volume for Lung Cancer Conformal Radiotherapy

    Microsoft Academic Search

    Ion Christian Kiricuta

    2001-01-01

    Purpose: To select and delineate the target volumes for definitive or postoperative radiotherapy for lung cancer. Methods and Materials: The lymphatics of the lung and the dissemination of tumor cells to the intra- and extrathoracic lymph nodes are described. The incidence of involvement of the different lymph node sites in the chest is analyzed. The involvement of the contralateral hilar

  15. Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer - preliminary experience

    Microsoft Academic Search

    Marius G Bredell

    2010-01-01

    BACKGROUND: Sentinel lymph node (SLN) detection and biopsy is gaining popularity in the treatment of Head and Neck cancer. Various methods in this regard have been described, each with their respective advantages and disadvantages. The aim of this paper was to evaluate the potential application of Indocyanin Green (ICG) in the mapping and detection of sentinel lymph nodes (SLN) in

  16. Occult Lymph Node Metastases Detected by Cytokeratin Immunohistochemistry Predict Recurrence in Node-Negative Endometrial Cancer

    Microsoft Academic Search

    Hiromitsu Yabushita; Mitsuma Shimazu; Hidefumi Yamada; Keizo Sawaguchi; Masayoshi Noguchi; Masami Nakanishi; Michiyasu Kawai

    2001-01-01

    Objective. Even after curative resection of early endometrial cancer, some patients die as a result of recurrence. We believe that these patients likely had occult lymph node metastases at the time of diagnosis. In an attempt to identify the responsible occult metastases, the clinicopathological significance of cytokeratin expression in lymph nodes with unconfirmed metastasis was evaluated retrospectively in patients with

  17. Regional lymph node radiotherapy in breast cancer: single anterior supraclavicular field vs. two anterior and posterior opposed supraclavicular fields

    PubMed Central

    Houshyari, Mohammad; Kashi, Amir Shahram Yousefi; Varaki, Sakineh Soleimani; Rakhsha, Afshin; Blookat, Eftekhar Rajab

    2015-01-01

    Background: The treatment of lymph nodes engaged in breast cancer with radiotherapy leads to improved locoregional control and enhanced survival rates in patients after surgery. The aim of this study was to compare two treatment techniques, namely single anterior posterior (AP) supraclavicular field with plan depth and two anterior and posterior opposed (AP/PA) supraclavicular fields. In the study, we also examined the relationships between the depth of supraclavicular lymph nodes (SCLNs) and the diameter of the wall of the chest and body mass index (BMI). Methods: Forty patients with breast cancer were analyzed using computed tomography (CT) scans. In planning target volume (PTV), the SCLNs and axillary lymph nodes (AXLNs) were contoured, and, with the attention to PTV, supraclavicular (SC) depth was measured. The dosage that reached the aforementioned lymph nodes and the level of hot spots were investigated using two treatment methods, i.e., 1) AP/PA and 2) AP with three-dimensional (3D) planning. Each of these methods was analyzed using the program Isogray for the 6 MV compact accelerator, and the diameter of the wall of the chest was measured using the CT scan at the center of the SC field. Results: Placing the plan such that 95% of the target volume with 95% or greater of the prescribed dose of 50 Gy (V95) had ?95% concordance in both treatment techniques. According to the PTV, the depth of SCLNs and the diameter of the wall of the chest were 3–7 and 12–21cm, respectively. Regression analysis showed that the mean SC depth (the mean Plan depth) and the mean diameter of the wall of the chest were related directly to BMI (p<0.0001, adjusted R2=0.67) and (p<0.0001, adjusted R2=0.71), respectively. Conclusion: The AP/PA treatment technique was a more suitable choice of treatment than the AP field, especially for overweight and obese breast cancer patients. However, in the AP/PA technique, the use of a single-photon, low energy (6 MV) caused more hot spots than usual. PMID:26120411

  18. New models and online calculator for predicting non-sentinel lymph node status in sentinel lymph node positive breast cancer patients

    PubMed Central

    Kohrt, Holbrook E; Olshen, Richard A; Bermas, Honnie R; Goodson, William H; Wood, Douglas J; Henry, Solomon; Rouse, Robert V; Bailey, Lisa; Philben, Vicki J; Dirbas, Frederick M; Dunn, Jocelyn J; Johnson, Denise L; Wapnir, Irene L; Carlson, Robert W; Stockdale, Frank E; Hansen, Nora M; Jeffrey, Stefanie S

    2008-01-01

    Background Current practice is to perform a completion axillary lymph node dissection (ALND) for breast cancer patients with tumor-involved sentinel lymph nodes (SLNs), although fewer than half will have non-sentinel node (NSLN) metastasis. Our goal was to develop new models to quantify the risk of NSLN metastasis in SLN-positive patients and to compare predictive capabilities to another widely used model. Methods We constructed three models to predict NSLN status: recursive partitioning with receiver operating characteristic curves (RP-ROC), boosted Classification and Regression Trees (CART), and multivariate logistic regression (MLR) informed by CART. Data were compiled from a multicenter Northern California and Oregon database of 784 patients who prospectively underwent SLN biopsy and completion ALND. We compared the predictive abilities of our best model and the Memorial Sloan-Kettering Breast Cancer Nomogram (Nomogram) in our dataset and an independent dataset from Northwestern University. Results 285 patients had positive SLNs, of which 213 had known angiolymphatic invasion status and 171 had complete pathologic data including hormone receptor status. 264 (93%) patients had limited SLN disease (micrometastasis, 70%, or isolated tumor cells, 23%). 101 (35%) of all SLN-positive patients had tumor-involved NSLNs. Three variables (tumor size, angiolymphatic invasion, and SLN metastasis size) predicted risk in all our models. RP-ROC and boosted CART stratified patients into four risk levels. MLR informed by CART was most accurate. Using two composite predictors calculated from three variables, MLR informed by CART was more accurate than the Nomogram computed using eight predictors. In our dataset, area under ROC curve (AUC) was 0.83/0.85 for MLR (n = 213/n = 171) and 0.77 for Nomogram (n = 171). When applied to an independent dataset (n = 77), AUC was 0.74 for our model and 0.62 for Nomogram. The composite predictors in our model were the product of angiolymphatic invasion and size of SLN metastasis, and the product of tumor size and square of SLN metastasis size. Conclusion We present a new model developed from a community-based SLN database that uses only three rather than eight variables to achieve higher accuracy than the Nomogram for predicting NSLN status in two different datasets. PMID:18315887

  19. Axillary sampling in the definitive treatment of breast cancer by radiation therapy and lumpectomy

    Microsoft Academic Search

    C. M. Rose; L. E. Botnick; M. Weinstein; J. R. Harris; C. Koufman; W. Silen; S. Hellman

    1983-01-01

    Between January, 1967 and July, 1980, 176 women who were referred to the Joint Center for Radiation Therapy (JCRT) for definitive breast irradiation underwent low axillary dissection. A typical operative technique is described. The dissection stops short of the axillary vein although the vein is usually visualized. One hundred thirty-two axillae were thought to be Nâ or N\\/sub 1a\\/. Forty-six

  20. Combination of Ex Vivo Sentinel Lymph Node Mapping and Methylene Blue-Assisted Lymph Node Dissection in Gastric Cancer: A Prospective and Randomized Study

    Microsoft Academic Search

    Bruno Märkl; Alexandra I. Moldovan; Hendrik Jähnig; Claudio Cacchi; Hanno Spatz; Matthias Anthuber; Daniel V. Oruzio; Hallie Kretsinger; Hans M. Arnholdt

    2011-01-01

    Background  Exact lymph node (LN) staging is crucial for prognosis estimation and treatment stratification in gastric cancer. Recently,\\u000a a new concept for improving LN harvest and the accuracy of LN staging was introduced. It combines methylene blue-assisted\\u000a lymph node dissection (MBLND) with a new ex vivo sentinel lymph node (evSLN) mapping technique. The purpose of this study\\u000a was to investigate these

  1. [A new approach to the axilla: functional axillary lymphadenectomy and padding].

    PubMed

    Garnier, J M; Hamy, A; Classe, J M; Laborde, O; Sagot, P; Lopes, P; Boog, G; Drianno, J C; Guillard, Y

    1993-01-01

    Axillary lymph node dissection, which is now mandatory in the conservative breast cancer surgery and classically involves Berg's two lower levels, is burdened with numerous complications. In 1988 and 1989, two technical modifications were introduced and are described here: padding of the axilla as preventive treatment of postoperative lymphocele and, more recently, functional axillary lymphadenectomy (FAL) in which the medial cutaneous nerve of the arm, the two perforating intercostal nerves and above all the lateral thoracic pedicle (external mammary artery and vein) are spared. These two technical innovations, more respectful of anatomy, are aimed at reducing the morbidity of conservative breast cancer at a time when detection enables breast cancers to be treated at an increasingly early stage, which results in a increase of negative axillary dissections. The postoperative period is simplified (no drainage, immediate mobilization), and the hospital stay is reduced to 2 days. Complementary treatments can thus be started early on, without any functional or cosmetic damage while the number of lymph nodes removes remains the same as in the conventional axillary dissection technique. The authors describe the operative procedures and analyse the 100 cases of conservative breast cancer they have treated with padding and FAL. These two technical modifications are now systematically used by them in the management of breast cancers. PMID:8345145

  2. Factors affecting sentinel lymph node identification rate after neoadjuvant chemotherapy for breast cancer patients enrolled in ACOSOG Z1071 (Alliance)

    PubMed Central

    Boughey, Judy C.; Suman, Vera J.; Mittendorf, Elizabeth A.; Ahrendt, Gretchen M.; Wilke, Lee G.; Taback, Bret; Leitch, A. Marilyn; Flippo-Morton, Teresa S.; Kuerer, Henry M.; Bowling, Monet; Hunt, Kelly K.

    2014-01-01

    Objective To evaluate factors affecting sentinel lymph node (SLN) identification after neoadjuvant chemotherapy (NAC) in patients with initial node-positive breast cancer. Summary Background Data SLN surgery is increasingly used for nodal staging after NAC and optimal technique for SLN identification is important. Methods The American College of Surgeons Oncology Group Z1071 prospective trial enrolled clinical T0-4,N1-2,M0 breast cancer patients. Following NAC, SLN surgery and axillary lymph node dissection (ALND) were planned. Multivariate logistic regression modeling assessing factors influencing SLN identification was performed. Results Of 756 patients enrolled, 34 women withdrew, 21 were ineligible, 12 underwent ALND only, and 689 had SLN surgery attempted. At least one SLN was identified in 639 patients (92.7%: 95%CI: 90.5–94.6%). Among factors evaluated, mapping technique was the only factor found to impact SLN identification; with use of blue dye alone increasing the likelihood of failure to identify the SLN relative to using radiolabelled colloid +/? blue dye (p=0.006; OR=3.82 95%CI: 1.47-9.92). The SLN identification rate was 78.6% with blue dye alone; 91.4% with radiolabelled colloid and 93.8% with dual mapping agents. Patient factors (age, BMI), tumor factors (clinical T or N stage), pathologic nodal response to chemotherapy, site of tracer injection and length of chemotherapy treatment did not significantly affect the SLN identification rate. Conclusions The SLN identification rate after NAC was higher when mapping was performed using radiolabelled colloid alone or with blue dye compared to blue dye alone. Optimal tracer use is important to ensure successful identification of SLN(s) after NAC. PMID:25664534

  3. Non-invasive and minimally invasive staging of regional lymph nodes in penile cancer

    Microsoft Academic Search

    Ben Hughes; Joost Leijte; Majid Shabbir; Nick Watkin; Simon Horenblas

    2009-01-01

    Introduction  The management of the regional lymph nodes in penile cancer patients, particularly when these lymph nodes are impalpable,\\u000a remains controversial. Prophylactic bilateral inguinal lymphadenectomy is associated with high morbidity and is often unnecessary.\\u000a However, there is no non-invasive or minimally invasive staging technique that can determine the lymph node status of penile\\u000a cancer patients with 100% accuracy.\\u000a \\u000a \\u000a \\u000a Methods  We reviewed the

  4. Clinicopathologic factors correlated with number of metastatic lymph nodes in oesophageal cancer

    Microsoft Academic Search

    M. Tachibana; H. Yoshimura; S. Kinugasa; D. K. Ohar; M. Shibakita; S. Ohno; S. Ueda; T. Fujii; N. Nagasue

    2001-01-01

    Background. The number of metastatic lymph nodes is applied to the staging system of gastric cancer and colorectal cancer. However, it has not been evaluated in oesophageal cancer.Patients and Methods. Of 258 patients with primary squamous cell carcinoma of the thoracic oesophagus between February 1981 and December 1999, 160 underwent three-field oesophagectomy with a curative intent. Clinicopathologic characteristics of those

  5. Intramammary lymph node metastasis in a patient with ovarian carcinoma and a brief review of the literature

    PubMed Central

    Erten, Cigdem; Yigit, Seyran Ceri; Can, Alper; Dirican, Ahmet; Bayoglu, Vedat; Kucukzeybek, Yuksel; Somali, Isil; Tarhan, M Oktay

    2012-01-01

    Metastasis from serous carcinoma of the ovary usually occurs in the subdiaphragmatic region. Metastasis to the breast and/or axillary-intramammary lymph node is very rare. It usually occurs in advanced disease, and it is important to distinguish a primary breast cancer from an ovarian cancer metastasis since the management of these two entities is totally different. Here we present a patient with metastasis to the breast and intramammary lymph nodes from ovarian serous carcinoma 25 months after diagnosis. PMID:23788864

  6. Thyroid Gland Removal With or Without Central Lymph Node Dissection in Treating Patients With Node Negative Thyroid Cancer | Division of Cancer Prevention

    Cancer.gov

    This randomized phase II trial studies how well thyroid gland removal with or without central lymph node dissection works in treating patients with thyroid cancer or suspected thyroid cancer that has not spread to the lymph nodes. Currently, the standard treatment for thyroid cancer is total thyroidectomy, or complete removal of the thyroid. Sometimes, the lymph nodes in the central part of the neck may also be surgically removed, called central lymph node dissection.

  7. Assessment of the performance of the Stanford Online Calculator for the prediction of nonsentinel lymph node metastasis in sentinel lymph node-positive breast cancer patients

    Microsoft Academic Search

    Jeffrey S. Scow; Amy C. Degnim; Tanya L. Hoskin; Carol Reynolds; Judy C. Boughey

    2009-01-01

    BACKGROUND: Several models for the prediction of nonsentinel lymph node (NSLN) metastasis in sentinel lymph node (SLN)-positive breast cancer patients have been proposed. In this study, the authors evaluate the Stanford Online Calculator (SOC), which was designed to predict the likelihood of NSLN metastasis using only 3 variables: primary tumor size, SLN metastasis size, and angiolymphatic invasion status. They compared

  8. Computed tomography and magnetic resonance imaging evaluation of lymph node metastasis in early colorectal cancer

    PubMed Central

    Choi, Joonsung; Oh, Soon Nam; Yeo, Dong-Myung; Kang, Won Kyung; Jung, Chan-Kwon; Kim, Sang Woo; Park, Michael Yong

    2015-01-01

    AIM: To assess the role of computed tomography (CT) and magnetic resonance imaging (MRI) and establish imaging criteria of lymph node metastasis in early colorectal cancer. METHODS: One hundred and sixty patients with early colorectal cancer were evaluated for tumor location, clinical history of polypectomy, depth of tumor invasion, and lymph node metastasis. Two radiologists assessed preoperative CT and/or MRI for the primary tumor site detectability, the presence or absence of regional lymph node, and the size of the largest lymph node. Demographic, imaging, and pathologic findings were compared between the two groups of patients based on pathologic lymph node metastasis and optimal size criterion was obtained. RESULTS: The locations of tumor were ascending, transverse, descending, sigmoid colon, and rectum. One hundred and sixty early colorectal cancers were classified into 3 groups based on the pathological depth of tumor invasion; mucosa, submucosa, and depth unavailable. A total of 20 (12.5%) cancers with submucosal invasion showed lymph node metastasis. Lymph nodes were detected on CT or MRI in 53 patients. The detection rate and size of lymph nodes were significantly higher (P = 0.000, P = 0.044, respectively) in patients with pathologic nodal metastasis than in patients without nodal metastasis. Receiver operating curve analysis showed that a cut-off value of 4.1 mm is optimal with a sensitivity of 78.6% and specificity of 75%. CONCLUSION: The short diameter size criterion of ? 4.1 mm for metastatic lymph nodes was optimal for nodal staging in early colorectal cancer. PMID:25593474

  9. A New Formula for Prostate Cancer Lymph Node Risk

    SciTech Connect

    Yu, James B., E-mail: james.b.yu@yale.ed [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT (United States); Yale Cancer Center, New Haven, CT (United States); Makarov, Danil V. [Robert Wood Johnson Clinical Scholars Program, Yale School of Medicine, New Haven, CT (United States); Section of Urology, Yale School of Medicine, New Haven, CT (United States); Department of Veterans Affairs Connecticut Healthcare System, West Haven, CT (United States); Gross, Cary [Robert Wood Johnson Clinical Scholars Program, Yale School of Medicine, New Haven, CT (United States); Department of Internal Medicine, Yale School of Medicine, New Haven, CT (United States)

    2011-05-01

    Introduction: The successful treatment of prostate cancer depends on the accurate estimation of the risk of regional lymph node (LN) involvement. The Roach formula (RF) has been criticized as overestimating LN risk. A modification of the RF has been attempted by other investigators using simplified adjustment ratios: the Nguyen formula (NF). Methods and Materials: The National Cancer Institute Surveillance, Epidemiology, and End Results database was investigated for patients treated in 2004 through 2006 for whom at least 10 LN were examined at radical prostatectomy, cT1c or cT2 disease, and prostate-specific antigen (PSA) <26 ng/ml (N = 2,930). The Yale formula (YF) was derived from half of the sample (n = 1,460), and validated in the other half (n = 1,470). Results: We identified 2,930 patients. Only 4.6% of patients had LN+, and 72.6% had cT1c disease. Gleason (GS) 8-10 histology was found in 14.4% of patients. The YF for prediction of %LN+ risk is [GS - 5]x [PSA/3 + 1.5 x T], where T = 0, 1, and 2 for cT1c, cT2a, and cT2b/cT2c. Within each strata of predicted %LN+ risk, the actual %LN+ was closest to the YF. Using a >15% risk as an indicator of high-risk disease, the YF had increased sensitivity (39.0% vs. 13.6%) compared with the NF, without a significant reduction in specificity (94.9% vs. 98.8%). The NF was overly restrictive of the high-risk group, with only 2% of patients having a >15% risk of LN+ by that formula. Conclusion: The YF performed better than the RF and NF and was best at differentiating patients at high risk for LN+ disease.

  10. Sentinel node biopsy in breast cancer: early results in 953 patients with negative sentinel node biopsy and no axillary dissection

    Microsoft Academic Search

    Umberto Veronesi; Viviana Galimberti; Luigi Mariani; Giovanna Gatti; Giovanni Paganelli; Giuseppe Viale; Stefano Zurrida; Paolo Veronesi; Mattia Intra; Roberto Gennari; Anna Rita Vento; Alberto Luini; Marco Tullii; Guillermo Bassani; Nicole Rotmensz

    2005-01-01

    Sentinel node biopsy in patients with breast carcinoma accurately predicts the axillary nodal status. However, in some 6% of patients with negative sentinel nodes the remaining axillary nodes harbour metastases. Our purpose was to observe a large number of patients who did not undergo an axillary dissection after a negative sentinel node biopsy for the appearance of overt axillary metastases.

  11. Magnetic Resonance Lymphography-Guided Selective High-Dose Lymph Node Irradiation in Prostate Cancer

    SciTech Connect

    Meijer, Hanneke J.M., E-mail: H.Meijer@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Debats, Oscar A. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kunze-Busch, Martina; Kollenburg, Peter van; Leer, Jan Willem [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Witjes, J. Alfred [Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kaanders, Johannes H.A.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Barentsz, Jelle O. [Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Lin, Emile N.J.Th. van [Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)

    2012-01-01

    Purpose: To demonstrate the feasibility of magnetic resonance lymphography (MRL) -guided delineation of a boost volume and an elective target volume for pelvic lymph node irradiation in patients with prostate cancer. The feasibility of irradiating these volumes with a high-dose boost to the MRL-positive lymph nodes in conjunction with irradiation of the prostate using intensity-modulated radiotherapy (IMRT) was also investigated. Methods and Materials: In 4 prostate cancer patients with a high risk of lymph node involvement but no enlarged lymph nodes on CT and/or MRI, MRL detected pathological lymph nodes in the pelvis. These lymph nodes were identified and delineated on a radiotherapy planning CT to create a boost volume. Based on the location of the MRL-positive lymph nodes, the standard elective pelvic target volume was individualized. An IMRT plan with a simultaneous integrated boost (SIB) was created with dose prescriptions of 42 Gy to the pelvic target volume, a boost to 60 Gy to the MRL-positive lymph nodes, and 72 Gy to the prostate. Results: All MRL-positive lymph nodes could be identified on the planning CT. This information could be used to delineate a boost volume and to individualize the pelvic target volume for elective irradiation. IMRT planning delivered highly acceptable radiotherapy plans with regard to the prescribed dose levels and the dose to the organs at risk (OARs). Conclusion: MRL can be used to select patients with limited lymph node involvement for pelvic radiotherapy. MRL-guided delineation of a boost volume and an elective pelvic target volume for selective high-dose lymph node irradiation with IMRT is feasible. Whether this approach will result in improved outcome for these patients needs to be investigated in further clinical studies.

  12. A Model to Estimate the Risk of Breast Cancer-Related Lymphedema: Combinations of Treatment-Related Factors of the Number of Dissected Axillary Nodes, Adjuvant Chemotherapy, and Radiation Therapy

    SciTech Connect

    Kim, Myungsoo; Kim, Seok Won; Lee, Sung Uk; Lee, Nam Kwon; Jung, So-Youn; Kim, Tae Hyun; Lee, Eun Sook; Kang, Han-Sung [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)] [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Shin, Kyung Hwan, E-mail: shin.kyunghwan@gmail.com [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2013-07-01

    Purpose: The development of breast cancer-related lymphedema (LE) is closely related to the number of dissected axillary lymph nodes (N-ALNs), chemotherapy, and radiation therapy. In this study, we attempted to estimate the risk of LE based on combinations of these treatment-related factors. Methods and Materials: A total of 772 patients with breast cancer, who underwent primary surgery with axillary lymph node dissection from 2004 to 2009, were retrospectively analyzed. Adjuvant chemotherapy (ACT) was performed in 677 patients (88%). Among patients who received radiation therapy (n=675), 274 (35%) received supraclavicular radiation therapy (SCRT). Results: At a median follow-up of 5.1 years (range, 3.0-8.3 years), 127 patients had developed LE. The overall 5-year cumulative incidence of LE was 17%. Among the 127 affected patients, LE occurred within 2 years after surgery in 97 (76%) and within 3 years in 115 (91%) patients. Multivariate analysis showed that N-ALN (hazard ratio [HR], 2.81; P<.001), ACT (HR, 4.14; P=.048), and SCRT (HR, 3.24; P<.001) were independent risk factors for LE. The total number of risk factors correlated well with the incidence of LE. Patients with no risk or 1 risk factor showed a significantly lower 5-year probability of LE (3%) than patients with 2 (19%) or 3 risk factors (38%) (P<.001). Conclusions: The risk factors associated with LE were N-ALN, ACT, and SCRT. A simple model using combinations of these factors may help clinicians predict the risk of LE.

  13. Local Treatment of the Axilla in Early Breast Cancer: Concepts from the National Surgical Adjuvant Breast and Bowel Project B-04 to the Planned Intergroup Sentinel Mamma Trial

    PubMed Central

    Reimer, Toralf; Hartmann, Steffi; Stachs, Angrit; Gerber, Bernd

    2014-01-01

    Summary Local treatment of the axilla in clinically node-negative, early-stage breast cancer patients has been hotly debated after the release of the American College of Surgeons Oncology Group (ACOSOG) Z0011 findings. However, this review does not focus on the ‘Z0011-eligible’ patients alone, because this subgroup represents a minority of our patients undergoing breast-conserving surgery (BCS) and sentinel lymph node biopsy (SLNB). The following topics are discussed: axillary diagnostics, timing of axillary procedures in the neoadjuvant setting, long-term follow-up of SLNB trials, omission of axillary surgery in randomized trials, management of the involved axilla with low tumor volume, positive sentinel lymph nodes and BCS, involved sentinel lymph nodes and mastectomy, and axillary radiotherapy. Finally, the current innovative study concepts (i.e. Sentinel Node versus Observation after Axillary Ultrasound (SOUND) and Intergroup Sentinel Mamma (INSEMA)) including patients with axillary observation alone in clinically node-negative women are presented. PMID:24944550

  14. Radical resection with autonomic nerve preservation and lymph node dissection techniques in lower rectal cancer surgery and its results: the impact of lateral lymph node dissection

    Microsoft Academic Search

    T. Mori; K. Takahashi; M. Yasuno

    1998-01-01

    Lateral lymph node metastases occur in 9% of rectal cancer patients. For cancers localized in the lower rectum below peritoneal\\u000a reflection, the frequency increases to 13% of all cases and to 25.5% in those of Dukes' stage C. The most important technique\\u000a in colorectal surgery for decreasing local failure in the pelvis is lateral lymph node dissection. Today, however, it

  15. Enhancement of pleural dissemination and lymph node metastasis of intrathoracic lung cancer cells by vascular endothelial growth factors (VEGFs)

    Microsoft Academic Search

    Haruhiko Ishii; Takuya Yazawa; Hanako Sato; Takehisa Suzuki; Masaichi Ikeda; Yasufumi Hayashi; Yoshinori Takanashi; Hitoshi Kitamura

    2004-01-01

    The expression of vascular endothelial growth factors (VEGFs) in tumors including lung cancer is considered to be associated with tumor development via capillary and lymph vessel neogenesis. Dissemination of the tumor cells to the pleura or regional lymph nodes is a critical poor prognostic factor for lung cancer patients. To investigate how VEGFs expressed in the intrathoracic infiltrating lung cancer

  16. Cranial location of level II lymph nodes in laryngeal cancer: Implications for elective nodal target volume delineation

    Microsoft Academic Search

    Petra M.. Braam; Cornelis P. J. Raaijmakers; Chris H. J. Terhaard

    2007-01-01

    Purpose: To analyze the cranial distribution of level II lymph nodes in patients with laryngeal cancer to optimize the elective radiation nodal target volume delineation. Methods and Materials: The most cranially located metastatic lymph node was delineated in 67 diagnostic CT data sets. The minimum distance from the base of the skull (BOS) to the lymph node was determined. Results:

  17. Molecular Changes in Pre-Metastatic Lymph Nodes of Esophageal Cancer Patients

    PubMed Central

    Otto, Benjamin; Koenig, Alexandra M.; Tolstonog, Genrich V.; Jeschke, Anke; Klaetschke, Kristin; Vashist, Yogesh K.; Wicklein, Daniel; Wagener, Christoph; Izbicki, Jakob R.; Streichert, Thomas

    2014-01-01

    Lymph node metastasis indicates poor prognosis in esophageal cancer. To understand the underlying mechanisms, most studies so far focused on investigating the tumors themselves and/or invaded lymph nodes. However they neglected the potential events within the metastatic niche, which precede invasion. Here we report the first description of these regulations in patients on transcription level. We determined transcriptomic profiles of still metastasis-free regional lymph nodes for two patient groups: patients classified as pN1 (n?=?9, metastatic nodes exist) or pN0 (n?=?5, no metastatic nodes exist). All investigated lymph nodes, also those from pN1 patients, were still metastasis-free. The results show that regional lymph nodes of pN1 patients differ decisively from those of pN0 patients – even before metastasis has taken place. In the pN0 group distinct immune response patterns were observed. In contrast, lymph nodes of the pN1 group exhibited a clear profile of reduced immune response and reduced proliferation, but increased apoptosis, enhanced hypoplasia and morphological conversion processes. DKK1 was the most significant gene associated with the molecular mechanisms taking place in lymph nodes of patients suffering from metastasis (pN1). We assume that the two molecular profiles observed constitute different stages of a progressive disease. Finally we suggest that DKK1 might play an important role within the mechanisms leading to lymph node metastasis. PMID:25048826

  18. Helical Tomotherapy Planning for Left-Sided Breast Cancer Patients With Positive Lymph Nodes: Comparison to Conventional Multiport Breast Technique

    SciTech Connect

    Goddu, S. Murty [Washington University School of Medicine, St. Louis, MO (United States)], E-mail: sgoddu@radonc.wustl.edu; Chaudhari, Summer; Mamalui-Hunter, Maria; Pechenaya, Olga L.; Pratt, David; Mutic, Sasa; Zoberi, Imran [Washington University School of Medicine, St. Louis, MO (United States); Jeswani, Sam [Tomotherapy Inc., Madison, WI (United States); Powell, Simon N. [Washington University School of Medicine, St. Louis, MO (United States); Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Low, Daniel A. [Washington University School of Medicine, St. Louis, MO (United States)

    2009-03-15

    Purpose: To evaluate the feasibility of using helical tomotherapy for locally advanced left-sided breast cancer. Methods and Materials: Treatment plans were generated for 10 left-sided breast cancer patients with positive lymph nodes comparing a multiport breast (three-dimensional) technique with the tomotherapy treatment planning system. The planning target volumes, including the chest wall/breast, supraclavicular, axillary, and internal mammary lymph nodes, were contoured. The treatment plans were generated on the tomotherapy treatment planning system to deliver 50.4 Gy to the planning target volume. To spare the contralateral tissues, directional blocking was applied to the right breast and right lung. The optimization goals were to protect the lungs, heart, and right breast. Results: The tomotherapy plans increased the minimal dose to the planning target volume (minimal dose received by 99% of target volume = 46.2 {+-} 1.3 Gy vs. 27.9 {+-} 17.1 Gy) while improving the dose homogeneity (dose difference between the minimal dose received by 5% and 95% of the planning target volume = 7.5 {+-} 1.8 Gy vs. 37.5 {+-} 26.9 Gy). The mean percentage of the left lung volume receiving {>=}20 Gy in the tomotherapy plans decreased from 32.6% {+-} 4.1% to 17.6% {+-} 3.5%, while restricting the right-lung mean dose to <5 Gy. However, the mean percentage of volume receiving {>=}5 Gy for the total lung increased from 25.2% {+-} 4.2% for the three-dimensional technique to 46.9% {+-} 8.4% for the tomotherapy plan. The mean volume receiving {>=}35 Gy for the heart decreased from 5.6% {+-} 4.8% to 2.2% {+-} 1.5% in the tomotherapy plans. However, the mean heart dose for tomotherapy delivery increased from 7.5 {+-} 3.4 Gy to 12.2 {+-} 1.8 Gy. Conclusion: The tomotherapy plans provided better dose conformity and homogeneity than did the three-dimensional plans for treatment of left-sided breast tumors with regional lymph node involvement, while allowing greater sparing of the heart and left lung from doses associated with increased complications.

  19. Estrogen Insensitivity in a Model of Estrogen Receptor-Positive Breast Cancer Lymph Node Metastasis

    Microsoft Academic Search

    Joshua Chuck Harrell; Wendy W. Dye; Djuana M. E. Harvell; Mauricio Pinto; Paul Jedlicka; Carol A. Sartorius; Kathryn B. Horwitz

    2007-01-01

    The lymphatic system is a common avenue for the spread of breast cancer cells and dissemination through it occurs at least as frequently as hematogenous metastasis. Approximate- ly 75% of primary breast cancers are estrogen receptor (ER) positive and the majority of these maintain receptor expres- sion as lymph node (LN) metastases. However, it is unknown if ERfunction is equivalent

  20. Adjacent thoracic lymph node metastases originating from two separate primary cancers: case report

    PubMed Central

    El-Gendy, Khalid A; Atkin, Gary K; Brightwell, Robert E; Richman, Paul; Livingstone, Jeremy I

    2008-01-01

    Reported is an unusual case of adjacent thoracic lymph nodes demonstrating metastases from two different primary malignancies. A 51 year-old woman with a previous history of bilateral breast cancer underwent a radical gastro-oesophagectomy for adenocarcinoma of the lower third of the oesophagus. The resection specimen demonstrated breast and oesophageal metastases in adjacent thoracic lymph nodes. Mechanisms for this phenomenon, including the known local immune suppression on lymphoid cells by oesophageal carcinoma cells, are discussed. PMID:18831741

  1. Preoperative diagnosis of lymph node metastases in gastric cancer by magnetic resonance imaging with ferumoxtran-10

    Microsoft Academic Search

    Yoshiaki Tatsumi; Nobuhiko Tanigawa; Haruto Nishimura; Eiji Nomura; Hideaki Mabuchi; Mitsuru Matsuki; Isamu Narabayashi

    2006-01-01

    Background  Knowledge regarding the presence and location of lymph node metastasis in gastric cancer is essential in deciding on the operative\\u000a approach. Lymph node metastases have been diagnosed with imaging tests such as computed tomography (CT) and ultrasonography\\u000a (US); however, the accuracy of such diagnoses, based on size and shape criteria, has not been adequate. Ferumoxtran-10 (Combidex;\\u000a Advanced Magnetics) is a

  2. Epitrochlear Lymph Node Dissection

    Microsoft Academic Search

    Steven N. Hochwald; Nicole Kissane; Stephen R. Grobmyer; James Lopes

    2011-01-01

    Epitrochlear node involvement occurs in a small minority of patients with forearm or hand melanoma. Although in-transit sentinel\\u000a lymph nodes are identified infrequently, they contain metastatic disease at nearly the same frequency as sentinel lymph nodes\\u000a in cervical, axillary, and inguinal nodal basins. Positive in-transit sentinel lymph nodes are likely to be the only site\\u000a of nodal metastasis. Therefore, detailed

  3. Dose-dense paclitaxel versus docetaxel following FEC as adjuvant chemotherapy in axillary node-positive early breast cancer: a multicenter randomized study of the Hellenic Oncology Research Group (HORG).

    PubMed

    Saloustros, Emmanouil; Malamos, Nikolaos; Boukovinas, Ioannis; Kakolyris, Stylianos; Kouroussis, Charalampos; Athanasiadis, Athanasios; Ziras, Nikolaos; Kentepozidis, Nikolaos; Makrantonakis, Parisis; Polyzos, Aristidis; Christophyllakis, Charalampos; Georgoulias, Vassilios; Mavroudis, Dimitrios

    2014-12-01

    Adding a taxane to anthracycline-based adjuvant chemotherapy prolongs survival in node-positive early breast cancer. However, which is the preferable taxane in a dose-dense regimen remains unknown. We conducted a randomized study to compare the efficacy of dose-dense paclitaxel versus docetaxel following 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) as adjuvant chemotherapy in women with node-positive early breast cancer. Following surgery women with HER2-negative breast cancer and at least one infiltrated axillary lymph node were randomized to receive four cycles of FEC (700/75/700 mg/m(2)) followed by four cycles of either paclitaxel (175 mg/m(2)) or docetaxel (75 mg/m(2)). All cycles were administered every 14 days with G-CSF support. The primary endpoint was disease-free survival (DFS) at 3 years. Between 2004 and 2007, 481 women were randomized to paclitaxel (n = 241) and docetaxel (n = 240). After a median follow-up of 6 years, 51 (21%) and 48 (20%) women experienced disease relapse (p = 0.753) and there was no significant difference in DFS between the paclitaxel- and docetaxel-treated groups (3-year DFS 87.4 vs. 88.3%, respectively; median DFS not reached; p = 0.633). Toxicities were manageable, with grade 2-4 neutropenia in 21 versus 31% (p = 0.01), thrombocytopenia 0.8 versus 3.4% (p = 0.06), any grade neurotoxicity 17 versus 7.5% (p = 0.35) and onycholysis 4.9 versus 12.1% (p = 0.03) for patients receiving paclitaxel and docetaxel, respectively. There were no toxic deaths. Dose-dense paclitaxel versus docetaxel after FEC as adjuvant chemotherapy results in a similar 3-year DFS rate in women with axillary node-positive early breast cancer. Due to its more favorable toxicity profile, paclitaxel is the taxane of choice in this setting. PMID:25399229

  4. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized Dutch gastric cancer group trial

    Microsoft Academic Search

    H. H. Hartgrink; Velde van de C. J. H; H. Putter; J. J. Bonenkamp; E. Meershoek-Klein Kranenbarg; I. Songun; K. Welvaart; S. Meijer; J. T. M. Plukker; P. J. van Elk; H. Obertop; D. J. Gouma; J. J. B. van Lanschot; C. W. Taat; P. W. de Graaf; M. F. von Meyenfeldt; H. W. Tilanus; M. Sasako

    2004-01-01

    PURPOSE: The extent of lymph node dissection appropriate for gastric cancer is still under debate. We have conducted a randomized trial to compare the results of a limited (D1) and extended (D2) lymph node dissection in terms of morbidity, mortality, long-term survival and cumulative risk of relapse. We have reviewed the results of our trial after follow-up of more than

  5. Support vector machine model for diagnosis of lymph node metastasis in gastric cancer with multidetector computed tomography: a preliminary study

    Microsoft Academic Search

    Xiao-Peng Zhang; Zhi-Long Wang; Lei Tang; Ying-Shi Sun; Kun Cao; Yun Gao

    2011-01-01

    BACKGROUND: Lymph node metastasis (LNM) of gastric cancer is an important prognostic factor regarding long-term survival. But several imaging techniques which are commonly used in stomach cannot satisfactorily assess the gastric cancer lymph node status. They can not achieve both high sensitivity and specificity. As a kind of machine-learning methods, Support Vector Machine has the potential to solve this complex

  6. Sentinel lymph node biopsy in breast cancer: results of intradermal periareolar tracer injection and follow-up of sentinel lymph node-negative patients

    Microsoft Academic Search

    K. J. P. van Wessem; W. S. Meijer

    2004-01-01

    Several methods are in use for identification of the sentinel lymph node (SLN) in breast cancer. We set up the hypothesis that intradermal (i.d.) infra-areolar injection of technetium-99m in combination with i.d. injection of patent blue dye lateral to the areola can identify the same lymph node as peritumoral injection, regardless of the location of the tumour. Each of 50

  7. In vivo identification of sentinel lymph nodes for clinical stage I non-small cell lung cancer for abbreviation of mediastinal lymph node dissection

    Microsoft Academic Search

    Hiroaki Nomori; Kenichi Watanabe; Takashi Ohtsuka; Tsuguo Naruke; Keiichi Suemasu

    2004-01-01

    Background: We previously reported that an identification of sentinel lymph node (SN) with a techenetium-99m (99mTc) tin colloid by ex vivo counting, i.e. the radio-activity of dissected lymph nodes, was a reliable method of establishing the first site of nodal metastasis in non-small cell lung cancer [J. Thorac. Cardiovasc. Surg. 124(2002)486]. However, for SN navigation surgery, SN should be identified

  8. Lymph Node Evaluation for Colon Cancer in an Era of Quality Guidelines: Who Improves?

    PubMed Central

    Parsons, Helen M.; Begun, James W.; Kuntz, Karen M.; Tuttle, Todd M.; McGovern, Patricia M.; Virnig, Beth A.

    2013-01-01

    Introduction: In the 1990s, several organizations began recommending evaluation of > 12 lymph nodes during colon resection because of its association with improved survival. We examined practice implications of multispecialty quality guidelines over the past 20 years recommending evaluation of ? 12 lymph nodes during colon resection for adequate staging. Materials and Methods: We used the 1988 to 2009 Surveillance, Epidemiology, and End Results program to conduct a retrospective observational cohort study of 90,203 surgically treated patients with colon cancer. We used Cochran-Armitage tests to examine trends in lymph node examination over time and multivariate logistic regression to identify patient characteristics associated with guideline-recommended lymph node evaluation. Results: The introduction of practice guidelines was associated with gradual increases in guideline-recommended lymph node evaluation. From 1988 to 1990, 34% of patients had > 12 lymph nodes evaluated, increasing to 38% in 1994 to 1996 and to > 75% from 2006 to 2009. Younger, white patients and those with more-extensive bowel penetration (T3/4 nonmetastatic) and high tumor grade saw more-rapid increases in lymph node evaluation (P < .001). Multivariate analyses demonstrated a significant interaction between year of diagnosis and both T stage and grade, indicating that those with higher T stage and higher grade were more likely to receive guideline-recommended care earlier. Conclusion: The implementation of lymph node evaluation guidelines was accepted gradually into practice but adopted more quickly among higher risk patients. By identifying patients who are least likely to receive guideline-recommended care, these findings present a starting point for promoting targeted improvements in cancer care and further understanding underlying contributors to these disparities. PMID:23942934

  9. Gene Expression Profiling in Lymph Node-Positive and Lymph Node-Negative Colorectal Cancer

    Microsoft Academic Search

    Hyuk-Chan Kwon; Sung-Hyun Kim; Mee-Sook Roh; Jae-Seok Kim; Hyung-Sik Lee; Hong-Jo Choi; Jin-Sook Jeong; Hyo-Jin Kim; Tae-Ho Hwang

    2004-01-01

    PURPOSE: To identify the genes involved in the carcinogenesis and progression of colorectal cancer, we analyzed the gene-expression profiles of colorectal cancer cells from 12 tumors with corresponding noncancerous colonic epithelia using a cDNA microarray representing 4,08 genes. METHODS: We classified both samples and genes by using a twoway clustering analysis and identified genes that were differentially expressed in the

  10. The effect of preoperative chemoradiotherapy on lymph nodes harvested in TME for rectal cancer

    PubMed Central

    2013-01-01

    Background Adequate lymph nodes resection in rectal cancer is important for staging and local control. This retrospective analysis single center study evaluated the effect of neoadjuvant chemoradiation on the number of lymph nodes in rectal carcinoma, considering some clinicopathological parameters. Methods A total of 111 patients undergone total mesorectal excision for rectal adenocarcinoma from July 2005 to May 2012 in our center were included. No patient underwent any prior pelvic surgery or radiotherapy. Chemoradiotherapy was indicated in patients with rectal cancer stage II or III before chemoradiation. Results One-hundred and eleven patients were considered. The mean age was 67.6 yrs (range 36 – 84, SD 10.8). Fifty (45.0%) received neoadjuvant therapy before resection. The mean number of removed lymph nodes was 13.6 (range 0–39, SD 7.3). In the patients who received neoadjuvant therapy the number of nodes detected was lower (11.5, SD 6.5 vs. 15.3, SD 7.5, p?=?0.006). 37.4% of patients with preoperative chemoradiotherapy had 12 or more lymph nodes in the specimen compared to the 63.6% of those who had surgery at the first step (p: 0.006). Other factors associated in univariate analysis with lower lymph nodes yield included stage (p 0.005) and grade (p 0.0003) of the tumour. Age, sex, tumor site, type of operation, surgeons and pathologists did not weight upon the number of the removed lymph nodes. Conclusion In TME surgery for rectal cancer, preoperative CRT results into a reduction of lymph nodes yield in univariate analisys and linear regression. PMID:24246069

  11. What next? Managing lymph nodes in men with penile cancer

    PubMed Central

    Leveridge, Michael; Siemens, D. Robert; Morash, Christopher

    2008-01-01

    The management of patients with squamous cell carcinoma of the penis is often daunting given its rarity and subsequent lack of high-level evidence to support our decision-making. This culminates in the complex surgical issues involving the management of the regional lymph nodes, which is of critical importance to both quantity and quality of life for these patients. This review aims to highlight the decisive issues surrounding the management of the pelvic and inguinal lymph nodes in the setting of squamous cell carcinoma of the penis, and to spotlight recently published information that adds credence to accepted management strategies of both the clinically positive and negative groin after successful management of the primary lesion. PMID:18953451

  12. [Curative dissection of paraaortic lymph node metastases after operation for ascending colon cancer].

    PubMed

    Yoshino, Jun; Fukunari, Hiroyuki; Kato, Tomotaka; Nakajima, Yutaka; Okajima, Chisato; Shitara, Kenji; Hayashi, Tetsuji

    2014-11-01

    In October 2007, a 69-year-old woman underwent right hemicolectomy and D3 lymph node dissection for the treatment of adenocarcinoma (type 2, por2]tub2, pSS, pN3, fStage IIIb). Serum carcinoembryonic antigen (CEA) concentration was 152.8 ng/mL preoperation, but returned to normal after the operation. Adjuvant chemotherapy using 450 mg/day UFT-E was added. Computed tomography (CT) examination revealed a swollen paraaortic lymph node 3 months after the operation, while serum CEA concentration had increased to 92.7 ng/mL. After the chemotherapy was changed to FOLFOX, the paraaortic lymph node shrank and serum CEA concentration decreased. However, after 6 courses, serum CEA concentration increased again and bevacizumab-FOLFIRI therapy was initiated. After 3 courses of bevacizumab-FOLFIRI were not effective, paraaortic lymph node dissection was performed in February 2009. Pathological examination of the resected specimen showed metastatic adenocarcinoma. At present, the patient is alive without any signs of recurrence. Although the effectiveness of chemotherapy for paraaortic lymph node metastasis of colorectal cancer has been described, complete cure has not been reported. Thus, surgical resection has the potential to cure solitary recurrence of paraaortic lymph node metastasis, and therefore, should be considered in the treatment of such cases. PMID:25731270

  13. Preoperative Staging of Pelvic Lymph Nodes in Prostate Cancer by 11C-Choline PET

    Microsoft Academic Search

    Igle J. de Jong; Jan Pruim; Philip H. Elsinga; Willem Vaalburg; Han J. Mensink

    Prostate cancer is known for its difficulties in preoperative stag- ing of pelvic lymph nodes by conventional imaging techniques. Thus, a histopathologic examination of the pelvic lymphadenec- tomy specimen is mandatory for patients at risk for metastatic disease. The aim of this study was to evaluate the strength and accuracy of 11C-choline PET in preoperative noninvasive stag- ing of pelvic

  14. Single-port laparoscopic pelvic lymph node dissection with modified radical vaginal hysterectomy in cervical cancer.

    PubMed

    Hahn, Ho-Suap; Kim, Yong-Wook

    2010-11-01

    There is no doubt that laparoscopic surgeries have replaced open surgeries in many gynecologic operations and have led to the development of novel techniques such as single-port laparoscopic surgery. Single-port surgery has been performed mainly for hysterectomy or adnexectomy recently, and it has also been carefully considered for other possible single-port surgeries such as cancer operations. Although pelvic lymph node dissection is a common procedure in gynecologic cancer operations, it has been rarely performed with single-port laparoscopic access because of technical difficulties. In this report, we present a detailed description of single-port laparoscopic pelvic lymph node dissection with modified radical vaginal hysterectomy in 2 patients with cervical cancer, stage IA2. Combining either classic or modified Schauta radical vaginal hysterectomy with single-port laparoscopic technique could be a good option for the management of patients with cervical cancer. PMID:21051989

  15. [Extended salvage pelvic and retroperitoneal lymph node dissection due to prostate cancer relapse].

    PubMed

    Osmonov, D K; Aksenov, A V; Jünemann, K-P

    2013-01-01

    Treatment of a biochemical prostate cancer relapse represents a difficult clinical dilemma, which has remained without a definitive solution so far. Based on clinical studies, we combine radical prostatectomy with extended pelvic lymph node dissection in intermediate and high risk patients as a routine procedure at our clinic. In this paper, we report on a case of extended salvage lymphadenectomy performed due to biochemical prostate cancer recurrence. The 56-year-old patient came to our clinic in April 2012 with a finding of lymph node metastasis according to PET-CT imaging. Laparoscopic radical retropubic prostatectomy with lymphadenectomy had been performed in 2008 [pT3a, N0 (0/4), M0, R0, GS 5+4=9, iPSA 26.67 ng/mL], and followed by radiotherapy as of September 2009. The extended salvage lymphadenectomy was performed in April 2012 due to a PSA-level rise up to 24 ng/mL and the aforementioned PET-CT findings. A total of 22 lymph nodes were removed, among them 3 lymph nodes with metastases. In the fossa obturatoria on the right we identified a walnut-size lymph node relapse with tumour necrosis, which fully corresponded to the PET-CT scan. The PSA level subsequently dropped to 0.4 ng/mL postoperatively, and further to the current value of 0.02 ng/mL (August 2012). PMID:23325670

  16. Intraoperative sentinel lymph node mapping guides laparoscopic-assisted distal gastrectomy for distal gastric cancer

    PubMed Central

    Liu, Naiqing; Niu, Zhengchuan; Niu, Wei; Peng, Cheng; Zou, Xueqing; Sun, Shuxiang; Shinichi, Obo; Shahbaz, Muhammad; Sun, Qinli; Jun, Niu

    2015-01-01

    Aims: The aim of this retrospective study is to explore the effects of sentinel lymph node (SLN) mapping guided laparoscopic-assisted distal gastrectomy (LADG) for distal gastric cancer. Methods: Two hundred patients were enrolled in this study. One hundred and one patients undergoing SLN guided LADG were designated as the SLN group. Ninety-nine patients having conventional LADG with D1 or D2 lymph node dissection were designated as the control group. Intraoperative and postoperative indicators such as the number of lymph nodes dissected, intraoperative and postoperative conditions, flow cytometry analysis of T lymphocyte subsets and natural killer (NK) cells, survival rates, recurrence rates and postoperative complications were investigated between these two groups. Results: The number of lymph nodes dissected in the SLN group was significantly lesser than that in the control group. Furthermore, in the SLN group, the patients achieved better immunization status, improved intraoperative and postoperative conditions and decreased postoperative complications. There were no significant differences were found in the positive lymph nodes detected, the distance between proximal and distal cutting edge, postoperative survival or recurrence rates. Conclusions: SLN guided LADG for gastric cancer is a safe and effective method and could achieve an equal clinical effect as traditional laparoscopic D1 or D2 radical operation with less operation trauma and better recovery.

  17. ZEB1 Expression in Endometrial Biopsy Predicts Lymph Node Metastases in Patient with Endometrial Cancer

    PubMed Central

    Feng, Gang; Wang, Xiangming; Cao, Xiaozhi; Shen, Lijuan; Zhu, Jiansheng

    2014-01-01

    Purpose. The purpose of this study was to analyze the expression of zinc-finger E-box-binding homeobox 1 (ZEB1) in endometrial biopsy and its correlation with preoperative characteristics, including lymph node metastases in patient with endometrial cancer. Methods. Using quantitative RT-PCR, ZEB1 expressions in endometrial biopsy from 452 patients were measured. The relationship between ZEB1 expression and preoperative characteristics was analyzed. Results. ZEB1 expressions were significantly associated with subtype, grade, myometrial invasion, and lymph node metastases. Lymph node metastases could be identified with a sensitivity of 57.8% at specificity of 74.1% by ZEB1 expression in endometrial biopsy. Based on combination of preoperative characteristics and ZEB1 expression, lymph node metastases could be identified with a sensitivity of 62.1% at specificity of 96.2% prior to hysterectomy. Conclusion. ZEB1 expression in endometrial biopsy could help physicians to better predict the lymph node metastasis in patients with endometrial cancer prior to hysterectomy. PMID:25544793

  18. Promoter hypermethylation in sentinel lymph nodes as a marker for breast cancer recurrence

    Microsoft Academic Search

    Hetty E. Carraway; Shelun Wang; Amanda Blackford; Mingzho Guo; Penny Powers; Stacie Jeter; Nancy E. Davidson; Pedram Argani; Kyle Terrell; James G. Herman; Julie R. Lange

    2009-01-01

    Purpose Promoter methylation of tumor suppressor genes in histologically negative sentinel lymph nodes (HNSN) of early stage breast\\u000a cancer patients has not been extensively studied. This study evaluates the methylation frequency and pattern in HNSN to determine\\u000a if detection of hypermethylation of one or more genes is associated with an increased recurrence risk in node negative breast\\u000a cancer. Experimental design

  19. COX2 expression is correlated with VEGF-C, lymphangiogenesis and lymph node metastasis in human cervical cancer

    Microsoft Academic Search

    Huidong Liu; Jianbing Xiao; Yanmei Yang; Yan Liu; Ruijin Ma; Yuhang Li; Fengchun Deng; Yafang Zhang

    Lymphangiogenesis has been shown to promote lymph node metastasis in cancers, making it an important target in cancer therapy. Vascular endothelial growth factor (VEGF)-C is upregulated in various tumors\\/cancers and is one of the most potent growth factors for inducing lymphangiogenesis and promoting lymph node metastasis (LNM). Likewise, cyclooxygenase (COX)-2 plays major roles in carcinogenesis, tumor growth and metastasis via

  20. Diagnostic accuracy of preoperative tests for lymph node status in endometrial cancer: a systematic review

    PubMed Central

    Trum, J.W.; Bakers, F.C.H.; Beets-Tan, R.G.H.; Smits, L.J.M.; Kruitwagen, R.F.P.M.

    2013-01-01

    Abstract Background: Approximately 72% of endometrial cancers are FIGO stage I at diagnosis and about 10% have lymph node metastases. An ideal diagnostic test for nodal disease would be able to prevent both overtreatment (i.e. unnecessary lymphadenectomy) and undertreatment (i.e. withholding lymphadenectomy or adjuvant postoperative treatment to patients with lymph node metastases). Objectives: In this review we compare the accuracy of preoperative tests (computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography, CA-125 serum levels, and ultrasonography) for the detection of lymph node metastases in endometrial cancers with the final histopathologic diagnosis after complete pelvic and para-aortic lymphadenectomy as the gold standard. Method: A systematic search in MEDLINE (using PubMed), Embase and The Cochrane Library was performed up to 23 July 2012. Results: We found one article that met our inclusion criteria for computed tomography, none for magnetic resonance imaging, 2 for positron emission tomography/computed tomography), 2 for CA-125 and none for ultrasonography. Conclusions: Due to the lack of high-quality articles on a preoperative test for lymph node status in endometrial cancer, no proper comparison between these modalities can be made. PMID:23876490

  1. Current advances in diagnosis and surgical treatment of lymph node metastasis in head and neck cancer

    PubMed Central

    Teymoortash, A.; Werner, J. A.

    2012-01-01

    Still today, the status of the cervical lymph nodes is the most important prognostic factor for head and neck cancer. So the individual treatment concept of the lymphatic drainage depends on the treatment of the primary tumor as well as on the presence or absence of suspect lymph nodes in the imaging diagnosis. Neck dissection may have either a therapeutic objective or a diagnostic one. The selective neck dissection is currently the method of choice for the treatment of patients with advanced head and neck cancers and clinical N0 neck. For oncologic reasons, this procedure is generally recommended with acceptable functional and aesthetic results, especially under the aspect of the mentioned staging procedure. In this review article, current aspects on pre- and posttherapeutic staging of the cervical lymph nodes are described and the indication and the necessary extent of neck dissection for head and neck cancer is discussed. Additionally the critical question is discussed if the lymph node metastasis bears an intrinsic risk of metastatic development and thus its removal in a most possible early stage plays an important role. PMID:23320056

  2. The use of high-dose cyclophosphamide, carmustine, and thiotepa plus autologous hematopoietic stem cell transplantation as consolidation therapy for high-risk primary breast cancer after primary surgery or neoadjuvant chemotherapy

    Microsoft Academic Search

    Yee Chung Cheng; Gabriela Rondón; Ying Yang; Terry L. Smith; James L. Gajewski; Michele L. Donato; Elizabeth J. Shpall; Roy Jones; Gabriel N. Hortobagyi; Richard E. Champlin; Naoto T. Ueno

    2004-01-01

    We assessed the 5-year results of a high-dose cyclophosphamide, carmustine, and thiotepa (CBT) regimen plus autologous hematopoietic stem cell transplantation (AHST) as an adjuvant consolidation therapy for high-risk primary breast cancer patients with ?10 positive axillary lymph nodes after primary surgery or ?4 positive axillary lymph nodes after neoadjuvant chemotherapy and surgery. The associations of various potential prognostic factors with

  3. Collagen I fiber density increases in lymph node positive breast cancers: pilot study.

    PubMed

    Kakkad, Samata M; Solaiyappan, Meiyappan; Argani, Pedram; Sukumar, Saraswati; Jacobs, Lisa K; Leibfritz, Dieter; Bhujwalla, Zaver M; Glunde, Kristine

    2012-11-01

    Collagen I (Col1) fibers are a major structural component in the extracellular matrix of human breast cancers. In a preliminary pilot study, we explored the link between Col1 fiber density in primary human breast cancers and the occurrence of lymph node metastasis. Col1 fibers were detected by second harmonic generation (SHG) microscopy in primary human breast cancers from patients presenting with lymph node metastasis (LN+) versus those without lymph node metastasis (LN-). Col1 fiber density, which was quantified using our in-house SHG image analysis software, was significantly higher in the primary human breast cancers of LN+ (fiber volume=29.22%±4.72%, inter-fiber distance=2.25±0.45???m) versus LN- (fiber volume=20.33%±5.56%, inter-fiber distance=2.88±1.07???m) patients. Texture analysis by evaluating the co-occurrence matrix and the Fourier transform of the Col1 fibers proved to be significantly different for the parameters of co-relation and energy, as well as aspect ratio and eccentricity, for LN+ versus LN- cases. We also demonstrated that tissue fixation and paraffin embedding had negligible effect on SHG Col1 fiber detection and quantification. High Col1 fiber density in primary breast tumors is associated with breast cancer metastasis and may serve as an imaging biomarker of metastasis. PMID:23117811

  4. Collagen I fiber density increases in lymph node positive breast cancers: pilot study

    PubMed Central

    Kakkad, Samata M.; Solaiyappan, Meiyappan; Argani, Pedram; Sukumar, Saraswati; Jacobs, Lisa K.; Leibfritz, Dieter; Bhujwalla, Zaver M.; Glunde, Kristine

    2012-01-01

    Abstract. Collagen I (Col1) fibers are a major structural component in the extracellular matrix of human breast cancers. In a preliminary pilot study, we explored the link between Col1 fiber density in primary human breast cancers and the occurrence of lymph node metastasis. Col1 fibers were detected by second harmonic generation (SHG) microscopy in primary human breast cancers from patients presenting with lymph node metastasis (LN+) versus those without lymph node metastasis (LN?). Col1 fiber density, which was quantified using our in-house SHG image analysis software, was significantly higher in the primary human breast cancers of LN+ (fiber volume=29.22%±4.72%, inter-fiber distance=2.25±0.45???m) versus LN? (fiber volume=20.33%±5.56%, inter-fiber distance=2.88±1.07???m) patients. Texture analysis by evaluating the co-occurrence matrix and the Fourier transform of the Col1 fibers proved to be significantly different for the parameters of co-relation and energy, as well as aspect ratio and eccentricity, for LN+ versus LN? cases. We also demonstrated that tissue fixation and paraffin embedding had negligible effect on SHG Col1 fiber detection and quantification. High Col1 fiber density in primary breast tumors is associated with breast cancer metastasis and may serve as an imaging biomarker of metastasis. PMID:23117811

  5. Near infrared imaging to identify sentinel lymph nodes in invasive urinary bladder cancer

    NASA Astrophysics Data System (ADS)

    Knapp, Deborah W.; Adams, Larry G.; Niles, Jacqueline D.; Lucroy, Michael D.; Ramos-Vara, Jose; Bonney, Patty L.; deGortari, Amalia E.; Frangioni, John V.

    2006-02-01

    Approximately 12,000 people are diagnosed with invasive transitional cell carcinoma of the urinary bladder (InvTCC) each year in the United States. Surgical removal of the bladder (cystectomy) and regional lymph node dissection are considered frontline therapy. Cystectomy causes extensive acute morbidity, and 50% of patients with InvTCC have occult metastases at the time of diagnosis. Better staging procedures for InvTCC are greatly needed. This study was performed to evaluate an intra-operative near infrared fluorescence imaging (NIRF) system (Frangioni laboratory) for identifying sentinel lymph nodes draining InvTCC. NIRF imaging was used to map lymph node drainage from specific quadrants of the urinary bladder in normal dogs and pigs, and to map lymph node drainage from naturally-occurring InvTCC in pet dogs where the disease closely mimics the human condition. Briefly, during surgery NIR fluorophores (human serum albumen-fluorophore complex, or quantum dots) were injected directly into the bladder wall, and fluorescence observed in lymphatics and regional nodes. Conditions studied to optimize the procedure including: type of fluorophore, depth of injection, volume of fluorophore injected, and degree of bladder distention at the time of injection. Optimal imaging occurred with very superficial injection of the fluorophore in the serosal surface of the moderately distended bladder. Considerable variability was noted from dog to dog in the pattern of lymph node drainage. NIR fluorescence was noted in lymph nodes with metastases in dogs with InvTCC. In conclusion, intra-operative NIRF imaging is a promising approach to improve sentinel lymph node mapping in invasive urinary bladder cancer.

  6. Effect of lymph node metastasis size on breast cancer-specific and overall survival in women with node-positive breast cancer.

    PubMed

    Rose, Brent S; Jiang, Wei; Punglia, Rinaa S

    2015-07-01

    We investigated whether increasing size of lymph nodes (LN) metastases is associated with lower breast cancer-specific survival (BCSS) and overall survival (OS) independent of the number of positive LNs. Using Surveillance, Epidemiology, and End Results registry data, we identified 8791 women diagnosed between 1990 and 2003 with node-positive, non-metastatic invasive breast cancer treated with surgery and axillary LN dissection. Size of the largest involved LN metastasis was categorized as ?2 mm, >2 mm to <2 cm, and ?2 cm. BCSS and OS were estimated using the Kaplan-Meier method and compared using log-rank statistics. Adjusted hazard ratios (HR) were calculated using Cox proportional hazards models. Median follow-up was 109 months. Largest LN size was ?2 mm, >2 mm to <2 cm, and ?2 cm in 2219 (25.2 %), 5047 (57.4 %), and 1525 (17.3 %) women, respectively. The 10-year BCSS for women with LNs ?2 mm, >2 mm to <2 cm, and ?2 cm was 82.9, 75.5, 64.8 %, respectively (p < 0.001). On multivariable analysis, large (?2 cm) LN size was significantly associated with worsened BCSS (HR: 1.169; p = 0.026) and OS (HR: 1.169; p = 0.006) in addition to age, race, grade, PR status, adjuvant radiation, T-stage, and number of positive LNs. Large (?2 cm) LNs metastases were associated with lower BCSS and OS after controlling for other known prognostic factors including number of positive LNs. LN size could be useful to risk-stratify patients for adjuvant therapy if these results are validated in future prospective studies. PMID:26041688

  7. Detection of Occult Tumor Cells in Lymph Nodes from Bladder Cancer Patients by MUC7 Nested RT-PCR

    Microsoft Academic Search

    Margitta Retz; Jan Lehmann; Celine Szysnik; Stephanie Zwank; Thorsten Venzke; Christian Röder; Holger Kalthoff; Carol Basbaum; Michael Stöckle

    2004-01-01

    Objective: Systemic progression is the prevalent form of bladder tumor recurrence after radical cystectomy. The detection of occult bladder tumor cells in histopathologically normal lymph nodes could be of prognostic value. We examined the possibility that mucin 7 (MUC7) RNA might reflect the presence of occult tumor cells in lymph nodes from bladder cancer patients. We used the polymerase chain

  8. Quality control of lymph node dissection in the Dutch randomized trial of D1 and D2 lymph node dissection for gastric cancer

    Microsoft Academic Search

    J. J Bonenkamp; J. Hermans; M. Sasako

    1998-01-01

    Background.   Variability among surgeons and reduced protocol adherence threaten the conduct and outcome of surgical multicenter trials.\\u000a We introduced, in the Dutch Gastric Cancer Trial of D1 and D2 (extended) lymph node dissection for gastric cancer, a novel\\u000a way of managing instruction, quality control, and evaluation of protocol adherence.\\u000a \\u000a \\u000a Methods. Of 1078 patients entered in the Dutch trial, 711 patients

  9. How many cases are enough for accreditation in sentinel lymph node biopsy in breast cancer?

    Microsoft Academic Search

    Elias E Sanidas; Eelco de Bree; Dimitris D Tsiftsis

    2003-01-01

    BackgroundThere is considerable argument concerning the number of sentinel node biopsy cases with axillary dissection that surgeons should perform before they are eligible on abandoning axillary dissection in negative sentinel node patients.

  10. Breast Cancer Subtype as a Predictor of Lymph Node Metastasis according to the SEER Registry

    PubMed Central

    Bhatia, Jay K.; Metzger, Daniel; Ashamalla, Hani; Katsoulakis, Evangelia

    2015-01-01

    Purpose Breast cancer subtype correlates with response to systemic therapy and overall survival (OS), but its impact on lymphatic spread is incompletely understood. In this study, we used the Surveillance, Epidemiology, and End Results registry to assess whether the subtype can predict the presence of nodal metastasis or advanced nodal stage in breast cancer. Methods A total of 7,274 eligible patients diagnosed with T1-3 infiltrating ductal carcinoma with known estrogen or progesterone hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status, who underwent surgical excision of the primary tumor and pathologic lymph node evaluation, were included in this analysis. Patients were categorized into four breast cancer subtypes: HR+/HER2-; HR+/HER2+; HR-/HER2+; and HR-/HER2-. Binary logistic regression analysis was used to determine whether breast cancer subtype, tumor size, tumor grade, patient race, and patient age at diagnosis are independently predictive of lymph node positivity or advanced nodal stage. The Pearson chi-square test was used to determine whether progesterone receptor (PR) status had an impact on the incidence of lymph node positivity in estrogen receptor (ER) positive patients. Results Independent predictors of nodal positivity included breast cancer subtype (p=0.040), tumor size (p<0.001), tumor grade (p<0.001), and patient age (p<0.001), whereas only tumor size (p<0.001), grade (p=0.001), and patient age (p=0.005) predicted advanced nodal stage. Triple-negative cancers had a significantly lower risk of nodal positivity than the HR+/HER2- subtype (odds ratio, 0.686; p=0.004), but no other significant differences between subtypes were observed. There was also no difference in lymph node positivity between PR+ and PR- tumors amongst ER+/HER2- (p=0.228) or ER+/HER2+ tumors (p=0.713). Conclusion The HR+/HER2-breast cancer subtype has a higher rate of lymph node involvement at diagnosis than the triple-negative subtype. These findings may play a role in guiding regional management considerations if confirmed in further studies. PMID:26155290

  11. Cranial location of level II lymph nodes in laryngeal cancer: Implications for elective nodal target volume delineation

    SciTech Connect

    Braam, Petra M. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands)]. E-mail: P.M.Braam@umcutrecht.nl; Raaijmakers, Cornelis P.J. [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands); Terhaard, Chris [Department of Radiotherapy, University Medical Center Utrecht, Utrecht (Netherlands)

    2007-02-01

    Purpose: To analyze the cranial distribution of level II lymph nodes in patients with laryngeal cancer to optimize the elective radiation nodal target volume delineation. Methods and Materials: The most cranially located metastatic lymph node was delineated in 67 diagnostic CT data sets. The minimum distance from the base of the skull (BOS) to the lymph node was determined. Results: A total of 98 lymph nodes were delineated including 62 ipsilateral and 36 contralateral lymph nodes. The mean ipsilateral and contralateral distance from the top of the most cranial metastatic lymph node to the BOS was 36 mm (range, -9-120; standard deviation [SD], 17.9) and 35 mm (range, 14-78; SD 15.0), respectively. Only 5% and 12% of the ipsilateral and 3% and 9% of the contralateral metastatic lymph nodes were located within 15 mm and 20 mm below the BOS, respectively. No significant differences were found between patients with only ipsilateral metastatic lymph nodes and patients with bilateral metastatic lymph nodes. Between tumors that do cross the midline and those that do not, no significant difference was found in the distance of the most cranial lymph node to the BOS and the occurrence ipsilateral or contralateral. Conclusions: Setting the cranial border of the nodal target volume 1.5 cm below the base of the skull covers 95% of the lymph nodes and should be considered in elective nodal irradiation for laryngeal cancer. Bilateral neck irradiation is mandatory, including patients with unilateral laryngeal cancer, when elective irradiation is advised.

  12. 18F-FDG Uptake in Reactive Neck Lymph Nodes of Oral Cancer: Relationship to Lymphoid Follicles

    Microsoft Academic Search

    Tassei Nakagawa; Masatoshi Yamada; Yoshio Suzuki

    PET using 18F-FDG is acceptable as a preoperative diagnostic tool for head and neck cancer. PET combined with CT provides precise localization of neck lymph nodes. Reactive lymphade- nopathy is well known as a principal cause of false-positive find- ings on PET\\/CT for nodal staging. We investigated the reactive lymph nodes of oral cancer to elucidate the 18F-FDG-avid area in

  13. Nonpalpable Supraclavicular Lymph Nodes in Lung Cancer Patients: Preoperative Characterization with 18F-FDG PET\\/CT

    Microsoft Academic Search

    Yon Mi Sung; Kyung Soo Lee; Byung-Tae Kim; Seonwoo Kim; O Jung Kwon; Joon Young Choi; Seoung-Oh Yang

    OBJECTIVE. Our purpose was to evaluate the usefulness of integrated 18F-FDG PET\\/CT in the detection and characterization of nonpalpable supraclavicular lymph node metastasis in patients with the initial diagnosis of lung cancer. SuBJECTS AND METHODS. This study was conducted from May 2005 to May 2006 and included 32 consecutively registered lung cancer patients in whom supraclavicular lymph nodes were not

  14. ARTICLES Prospective Analysis of Prostate-Specific Markers in Pelvic Lymph Nodes of Patients With High-Risk Prostate Cancer

    Microsoft Academic Search

    Anna C. Ferrari; Nelson N. Stone; Jason N. Eyler; Min Gao; John Mandeli; Pamela Unger; Robert E. Gallagher; Richard Stock

    Background: Pathologic evidence of pelvic lymph node in- volvement is obtained in 12%-20% of patients with localized prostate cancer that exhibits high-risk features (defined on the basis of tumor size, serum prostate-specific antigen (PSA) level, or Gleason score). The rate of systemic failure (i.e., relapse) in patients with this type of prostate cancer and no pathologic evidence of regional lymph

  15. Impact of boost irradiation on pelvic lymph node control in patients with cervical cancer

    PubMed Central

    Wakatsuki, Masaru; Ohno, Tatsuya; Kato, Shingo; Ando, Ken; Noda, Shin-ei; Kiyohara, Hiroki; Shibuya, Kei; Karasawa, Kumiko; Kamada, Tadashi; Nakano, Takashi

    2014-01-01

    Radiation therapy (RT) for metastatic pelvic lymph nodes (PLNs) is not well established in cervical cancer. In this study the correlation between size of lymph nodes and control doses of RT was analyzed. Between January 2002 and December 2007, 245 patients with squamous cell carcinoma of the cervix treated with a combination of external beam irradiation with or without boost irradiation and high-dose rate brachytherapy were investigated. Size of lymph node was measured by computed tomography before RT and just after 50 Gy RT. Of the 245 patients, 78 had PLN metastases, and a total of 129 had enlarged PLNs diagnosed as metastases; 22 patients had PLN failure. The PLN control rate at 5 years was 79.5% for positive cases and 95.8% for negative cases. In cases with positive PLNs, 12 of 129 nodes (9.3%) developed recurrences. There was significant correlation between PLN control rate and size of PLN after 50 Gy (<10 mm: 96.7%, ? 10 mm: 75.7 % (P<0.001)). In addition, the recurrence in these poor-response nodes was significantly correlated with dose of RT. Nine of 16 nodes receiving ? 58 Gy had recurrence, but none of 21 nodes receiving > 58 Gy had recurrence (P = 0.0003). These results suggested that the response of lymph nodes after RT was a more significant predictive factor for recurrence than size of lymph node before RT, and poor-response lymph nodes might require boost irradiation at a total dose of > 58 Gy. PMID:23912599

  16. Prognosis of Minimal Residual Disease in Bone Marrow, Blood and Lymph Nodes in Breast Cancer

    Microsoft Academic Search

    Debra Hawes; A. Munro Neville; Richard J. Cote

    The most important factor affecting the outcome of patients with invasive cancers is whether the tumor has spread, either\\u000a regionally (to regional lymph nodes) or systemically (to the bone marrow). However, a proportion of patients with no evidence\\u000a of systemic dissemination will develop recurrent disease after primary therapy. Clearly, these patients had occult systemic\\u000a spread of disease that was undetectable

  17. Detection of Telomerase Expression in Mediastinal Lymph Nodes of Patients with Lung Cancer

    Microsoft Academic Search

    Michael B. Wallace; Mark Block; Brenda J. Hoffman; Robert H. Hawes; Gerard Silvestri; Carolyn E. Reed; Michael Mitas; James Ravenel; Mostafa Fraig; Scott Miller; Edward T. Jones; Alice Boylan

    Mediastinal lymph nodes are the most common site of tumor spread nodes by a transesophageal approach by fine-needle aspiration in non-small cell lung cancer (NSCLC). We hypothesized that micro- and can be performed under conscious sedation on an outpa- metastatic disease could be detected by reverse transcription-poly- tient basis. Others and we have shown that EUS-guided fine- merase chain reaction

  18. Solid lipid nanoparticles of mitoxantrone for local injection against breast cancer and its lymph node metastases

    Microsoft Academic Search

    Bin Lu; Su-Bin Xiong; Hong Yang; Xiao-Dong Yin; Ruo-Bing Chao

    2006-01-01

    In an attempt to improve the therapeutic effect of mitoxantrone (MTO) against breast cancer and its lymph node metastases, solid lipid nanoparticles (SLN) of MTO were prepared, characterized and evaluated on mice. Film dispersion–ultrasonication method was used to prepare MTO-SLN, optimized by central composite design. MTO-SLN were prepared with a mean size of 61nm, drug content (DC) of 4.18±0.10% and

  19. FDG-PET staging and importance of lymph node SUV in head and neck cancer

    PubMed Central

    2010-01-01

    Objectives The role of positron emission tomography (PET) with fluoro-deoxy-glucose (FDG) in the staging of head and neck cancer (HNC) is unclear. The NCCN guidelines do not recommend FDG-PET as a part of standard workup. The purpose of this report is to examine the role of FDG-PET imaging in altering management and providing prognostic information for HNC. Methods Retrospective review of HNC patients who had a staging FDG-PET scan performed at either Thomas Jefferson University or University of Kansas Medical Center between the years 2001 and 2007. A total of 212 PET scans were performed in patients who went on to receive radiotherapy. Results The median follow-up time for all patients was 469 days. The PPV and NPV of PET imaging to correctly identify lymph node status was 94% and 89% respectively. Lymph nodes with extracapsular extension (ECE) had higher SUVs than nodes without ECE, 11.0 vs. 5.0 (p < 0.0007). Maximum SUV for the primary tumor > 8.0 was predictive of worse overall survival (p < 0.045), while the SUV of the lymph nodes was predictive for distant recurrence at one year--with a mean SUV value of 10.4 for patients with distant failure vs. 7.0 without (p < 0.05). Conclusions FDG-PET staging in head and neck cancer has good positive and negative predictive values in determining lymph node status. The maximum SUV of the primary tumor is predictive of overall survival. This is the first report to find that the SUV of a lymph node is predictive for ECE and also for distant recurrence. PMID:20637102

  20. Cost-analysis of staging methods for lymph nodes in patients with prostate cancer: MRI with a lymph node-specific contrast agent compared to pelvic lymph node dissection or CT

    Microsoft Academic Search

    Anke M. Hövels; Roel A. M. Heesakkers; Eddy M. Adang; Gerrit J. Jager; Jelle O. Barentsz

    2004-01-01

    The aim of this study was to compare the costs of three strategies in patients with prostate cancer in a specific setting: firstly, a strategy including MR lymphography (MRL) in which pelvic lymph node dissection (PLND) is foregone in case of a negative result. The second strategy involves computed tomography (CT) followed by a biopsy or PLND. The third strategy

  1. Podocalyxin-like protein expression in primary colorectal cancer and synchronous lymph node metastases

    PubMed Central

    2013-01-01

    Aims Previous studies have shown that membranous expression of podocalyxin-like protein (PODXL) is associated with poor prognosis in colorectal cancer (CRC). In this study, we compared PODXL expression in primary CRC and synchronous lymph node metastases. We further analyzed whether its expression changed in rectal tumours after neoadjuvant radiation therapy. Methods and results The studied cohort consists of 73 consecutive patients from the South-Swedish Colorectal Cancer Biobank. Immunohistochemical PODXL expression was examined on full-face sections from all primary tumours and all 140 available lymph node metastases from 31 cases. Membranous PODXL expression was denoted in 18/73 (24,7%) primary tumours, with a high concordance between primary and metastatic lesions. While all negative primary tumours had negative metastases, some PODXL positive primaries had a varying proportion of positive and negative metastatic lymph nodes. PODXL expression was also found to be mainly unaltered in pre- and post-irradiation surgically resected tumour specimens in rectal cancer patients (n=16). Conclusions The findings in this study suggest that analysis of PODXL expression in the primary tumour is sufficient for its use as a prognostic and treatment predictive biomarker in CRC, also in patients with metastatic disease. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9014177329634352 PMID:23819542

  2. Positive groin lymph nodes in superficial squamous cell vulvar cancer. A Gynecologic Oncology Group Study.

    PubMed

    Sedlis, A; Homesley, H; Bundy, B N; Marshall, R; Yordan, E; Hacker, N; Lee, J H; Whitney, C

    1987-05-01

    The term microinvasive carcinoma is inappropriate when applied to all vulvar cancers less than or equal to 5 mm thick because approximately 50% of vulvar carcinomas are no thicker than 5 mm and 20% of those superficial tumors metastasize to the lymph nodes. The significant predictors of groin node metastases in patients with superficial vulvar cancer are tumor thickness, histologic grade (proportion of undifferentiated tumor pattern), capillary-like space involvement with the tumor, clitoral or perineal location, and clinically suspicious nodes, according to the linear logistic model analysis of clinicopathologic data in 272 women. No lymph node metastases occurred in approximately one fourth of patients with a combination of low-risk factors: no clinically suspicious nodes, negative capillary-like space, and nonmidline vulvar cancers that were either grade 1 and 1 to 5 mm thick or grade 2 and 1 to 2 mm thick. In contrast, all 10 patients with clinically suspicious nodes and grade 4 tumors had positive groin nodes. The risk of lymph node metastases is best determined by simultaneous evaluation of all risk factors rather than a single factor such as tumor thickness. PMID:3578430

  3. Lymph Node Micrometastases in Early-Stage Cervical Cancer are Not Predictive of Survival.

    PubMed

    Stany, Michael P; Stone, Pamela J B; Felix, Juan C; Amezcua, Charles A; Groshen, Susan; Ye, Wei; Kyser, Kathy L; Howard, Robin S; Zahn, Chris M; Muderspach, Laila I; Lentz, Scott E; Chernofsky, Mildred R

    2015-07-01

    Although patients with early-stage cervical cancer have in general a favorable prognosis, 10% to 40% patients still recur depending on pathologic risk factors. The objective of this study was to evaluate if the presence of lymph node micrometastasis (LNmM) had an impact on patient's survival. We performed a multi-institutional retrospective review on patients with early-stage cervical cancer, with histologically negative lymph nodes, treated with radical hysterectomy and pelvic lymphadenectomy for the study period 1994 to 2004. Tissue blocks of lymph nodes from the patient's original surgery were recut and then evaluated for the presence of micrometastases. One hundred twenty-nine patients were identified who met inclusion criteria. LNmM were found in 26 patients (20%). In an average follow-up time of 70 mo, there were 11 recurrences (8.5%). Of the 11 recurrences, 2 (18%) patients had LNmM. Patients with LNmM were more likely to have received adjuvant radiation and chemotherapy. In stratified log-rank analysis, LNmM were not associated with any other high-risk clinical or pathologic variables. Survival data analysis did not demonstrate an association between the presence of LNmM and recurrence or overall survival. The presence of LNmM was not associated with an unfavorable prognosis nor was it associated with other high-risk clinical or pathologic variables predicting recurrence. Further study is warranted to understand the role of micrometastases in cervical cancer. PMID:26061072

  4. Lymph node ratio and pN staging in patients with node-positive breast cancer: a report from the Korean breast cancer society

    Microsoft Academic Search

    Sei Hyun Ahn; Hee Jeong Kim; Jong Won Lee; Gyung-Yub Gong; Dong-Yong Noh; Jung Hyun Yang; Sang Seol Jung; Ho Yong Park

    Patients with node-positive breast cancer are currently classified according to pN stage. Lymph node ratio (LNR), the ratio\\u000a of positive to total removed lymph nodes, maybe a more useful prognostic factor in these patients. We therefore compared LNR\\u000a and pN staging as prognostic factors in patients with node-positive breast cancer. Using two large prospective databases of\\u000a the Korean Breast Cancer

  5. Can CA-125 Predict Lymph Node Metastasis in Epithelial Ovarian Cancers in Turkish Population?

    PubMed Central

    Köro?lu, Nadiye; Y?ld?r?m, Gökhan; Ülker, Volkan; Gülk?l?k, Ahmet; Dansuk, Ramazan

    2014-01-01

    Objective. The role of single preoperative serum CA-125 levels in predicting pelvic or paraaortic lymph node metastasis in patients operated for epithelial ovarian cancer has been investigated. Methods. 176 patients diagnosed with epithelial ovarian carcinoma after staging laparotomy between January 2002 and May 2010 were evaluated retrospectively. Results. The mean, geometric mean, and median of preoperative serum CA-125 levels were 632,6, 200,29, and 191,5?U/mL, respectively. The cut-off value predicting lymph node metastases in the ROC curve was 71,92?U/mL, which is significant in logistic regression analysis (P = 0.005). The preoperative log CA-125 levels were also statistically significant in predicting lymph node metastasis in logistic regression analysis (P = 0.008). Conclusions. The tumor marker CA-125, which increases with grade independent of the effect of stage in EOC, is predictive of lymph node metastasis with a high rate of false positivity in Turkish population. The high false positive rate may obscure the predictive value of CA-125. PMID:24795494

  6. Radiation protection for the sentinel node procedure in breast cancer

    Microsoft Academic Search

    A. Y. de Kanter; P. P. A. M. Arends; A. M. M. Eggermont; T. Wiggers

    2003-01-01

    Aims: The purpose of our study was to determine the radiation dose for those who are involved in the sentinel node procedure in breast cancer patients and testing of a theoretical model.Methods: We studied 12 consecutive breast cancer patients undergoing breast surgery, and a sentinel node dissection including an axillary lymph node dissection (ALND). We performed measurements on the surgeon,

  7. Lung Cancer Lymph Node Micrometastasis Detection Using RT-PCR – Correlation with Vascular Endothelial Growth Factor (VEGF) expression

    PubMed Central

    Nwogu, Chukwumere E.; Yendamuri, Sai; Tan, Wei; Kannisto, Eric; Bogner, Paul; Morrison, Carl; Cheney, Richard; Dexter, Elisabeth; Picone, Anthony; Hennon, Mark; Hutson, Alan; Reid, Mary; Adjei, Alex; Demmy, Todd L.

    2013-01-01

    Objectives Lymph node (LN) staging provides critical information in non-small cell lung cancer (NSCLC) patients. Lymphangiogenesis may be an important contributor to the pathophysiology of lymphatic metastases. We hypothesized that the presence of lymph node micrometastases positively correlates with VEGF-A/C/D and VEGF-receptor-3 (lymphangiogenic factors) expression in lymph nodes. Methods Forty NSCLC patients had pre-operative PET-CT and mediastinoscopy. RT-PCR assays for mRNA expression of epithelial markers (CK-7, CEACAM-5 and PLUNC) were performed in selected fluorodeoxyglucose (FDG)-avid lymph nodes. VEGF-A/C/D and VEGF-receptor-3 expression levels were measured in primary tumors and lymph nodes. Wilcoxon rank sum test was run for the association between the RT-PCR epithelial marker levels and VEGF expression levels in the LNs. Results RT-PCR for CK-7, CEACAM5 or PLUNC indicated lymph node micrometastatic disease in 19 of 35 patients (54%). There was a high correlation between detection of micrometastases and VEGF-A/C/D or VEGF-receptor-3 expression levels in lymph nodes. Median follow-up was 12.6 months. Conclusions RT-PCR analysis of FDG-avid lymph nodes results in up-staging of patients. Micrometastases correlate with the expression of VEGF in lymph nodes in NSCLC patients. This may reflect the role of lymphangiogenesis in promoting metastases. PMID:23414988

  8. A comparative analysis of endoscopic thyroidectomy versus conventional thyroidectomy in clinically lymph node negative thyroid cancer

    PubMed Central

    Cho, Min Ji; Cho, Min Jeng; Yoo, Young Bum; Yang, Jung Hyun

    2015-01-01

    Purpose Differentiated thyroid cancer has a good prognosis and high incidence in young women. Since endoscopic techniques were first recorded in 1996, surgical indications of endoscopic thyroidectomy have broadened. Therefore, the aim of this study is to investigate the usefulness of endoscopic thyroidectomy in clinically lymph node negative (cN0) thyroid cancer patients, based on oncologic completeness and safety, considering cosmetic outcomes. Methods From July 2009 to June 2011, a total of 166 cases had undergone endoscopic thyroidectomy using the BABA (bilateral axillo-breast approach) method or conventional open thyroidectomy by one surgeon. Finally, excluding 72 patients, 94 patients with cN0 thyroid cancer were divided into two groups according to operative methods and analyzed to compare differences between the two methods retrospectively (endoscopic group, n = 49; conventional open group, n = 45). Results We practiced comparative analysis for clinicopathologic characteristics, surgical outcomes including postoperative complications, and recurred cases during follow-up periods of each group. The results showed there was a tendency for patients, young, women rather than men, and having small size of thyroid cancer, to prefer endoscopic surgery to open surgery. Meanwhile, in postoperative complications, there were no statistically significant differences. During short follow-up periods, no recurrence or mortality case was observed. Conclusion Endoscopic thyroidectomy is a feasible and safe method for the treatment of clinically lymph node negative (cN0) thyroid cancer. PMID:25692117

  9. Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update.

    PubMed

    Liss, Michael A; Noguchi, Jonathan; Lee, Hak J; Vera, David R; Kader, A Karim

    2015-01-01

    A sentinel lymph node (SLN) is the first lymph node to drain a solid tumor and likely the first place metastasis will travel. SLN biopsy has been well established as a staging tool for melanoma and breast cancer to guide lymph node dissection (LND); its utility in bladder cancer is debated. We performed a systematic search of PubMed for both human and animal studies that looked at SLN detection in cases of urothelial carcinoma of the bladder. We identified a total of nine studies that assessed a variety of imaging techniques to identify SLNs in patients with urothelial carcinoma of the bladder. Eight studies investigated human patients while one looked at animal (dog) models. Seven studies representing 156 patients noted the negative predictive value of the SLN to predict a metastasis free state was 92% (92/100). The SLN biopsy was less accurate in metastatic patients with a positive predictive value of only 77% (43/56) with a false negative range of in individual studies of 0-19%. Clinically, positive nodes routinely do not take up the pharmaceutical agent for SLN. Therefore, SLN biopsy is a promising concept with a 92% negative predictive value; however, the false negative rates are high which may be improved by standardizing populations and indications. Novel technologies are improving the detection of SLN and may provide the surgeon with an improved ability to detect micrometastasis, guide surgery, and reduce patient morbidity. PMID:26166959

  10. Sentinel lymph node biopsy in breast cancer patients with previous breast augmentation surgery.

    PubMed

    Nagao, Tomoya; Hojo, Takashi; Kurihara, Hiroaki; Tsuda, Hitoshi; Tanaka-Akashi, Sadako; Kinoshita, Takayuki

    2014-09-01

    The number of breast augmentation surgeries (BAS) has increased. Therefore, the number of breast cancer patients with history of BAS has also increased. In this paper, we present two cases of sentinel lymph node biopsy (SLNB) in patients with previous BAS who were diagnosed with breast cancer. The patients were augmented using different approach; the first case was augmented through transaxillary incision, whereas the second case was augmented through periareolar incision. Lymphoscintigraphy (LPG) was performed on the patients 1 day prior to operation, enabling confirmation of lymphatic flow and SLN in both patients. SLNB was successfully performed in both cases. In one patient, SLNB was performed using indocyanine green (ICG) fluorescence and the Photodynamic Eye (PDE) system. Regardless of history of BAS, ICG and PDE system showed lymphatic flow and SLN in real time. LPG and ICG fluorescence were useful methods for SLN detection in patients with previous BAS, being able to confirm lymph flow before operation. Biopsy methods using LPG and PDE system were considered useful for difficult confirmation of lymph flow after breast augmentation. This is the first report of SLNB using ICG and PDE system for patients with previous BAS. PMID:21671037

  11. Fluorescence diagnostics of metastatic lesion of regional lymph nodes upon surgical treatment of breast cancer

    NASA Astrophysics Data System (ADS)

    Filonenko, E. V.; Pak, D. D.; Yanikova, A. G.

    2013-06-01

    We have performed intraoperative fluorescence diagnostics of 60 patients for metastases of breast cancer to regional lymph nodes. All the patients were divided into two groups. The first group consisted of 50 patients, which were surgically treated at the first stage. The second group consisted of ten patients, which underwent combined treatment. At the first stage, they received from two to four courses of neoadjuvant chemotherapy, and, at the second stage, the surgical intervention was performed. The intraoperative fluorescence diagnostics was performed using the preparation alasens (precursor of protoporphyrin IX in the human organism). The occurrence of fluorescence of alasens-induced protoporphyrin IX was determined visually and using the local fluorescence spectroscopy method. Altogether, 498 lymph nodes were examined: 408 in the first group and 90 in the second one. For the first group, the sensitivity of the method was found to be 87.2%, and its specificity, 94.8%; in the second group, these parameters were determined to be 77 and 78%, respectively. The first experience of the application of the intraoperative fluorescence diagnostics of metastatic lesion of lymph nodes in patients with breast cancer has shown its high efficiency and application potential.

  12. Sentinel lymph node biopsy in bladder cancer: Systematic review and technology update

    PubMed Central

    Liss, Michael A.; Noguchi, Jonathan; Lee, Hak J.; Vera, David R.; Kader, A. Karim

    2015-01-01

    A sentinel lymph node (SLN) is the first lymph node to drain a solid tumor and likely the first place metastasis will travel. SLN biopsy has been well established as a staging tool for melanoma and breast cancer to guide lymph node dissection (LND); its utility in bladder cancer is debated. We performed a systematic search of PubMed for both human and animal studies that looked at SLN detection in cases of urothelial carcinoma of the bladder. We identified a total of nine studies that assessed a variety of imaging techniques to identify SLNs in patients with urothelial carcinoma of the bladder. Eight studies investigated human patients while one looked at animal (dog) models. Seven studies representing 156 patients noted the negative predictive value of the SLN to predict a metastasis free state was 92% (92/100). The SLN biopsy was less accurate in metastatic patients with a positive predictive value of only 77% (43/56) with a false negative range of in individual studies of 0-19%. Clinically, positive nodes routinely do not take up the pharmaceutical agent for SLN. Therefore, SLN biopsy is a promising concept with a 92% negative predictive value; however, the false negative rates are high which may be improved by standardizing populations and indications. Novel technologies are improving the detection of SLN and may provide the surgeon with an improved ability to detect micrometastasis, guide surgery, and reduce patient morbidity.

  13. Clinical significance of molecular diagnosis for gastric cancer lymph node micrometastasis

    PubMed Central

    Sonoda, Hiromichi; Tani, Tohru

    2014-01-01

    Advances in molecular diagnostic tools have allowed the identification of lymph node micrometastasis (LNM), including isolated tumor cells, in cancer patients. While immunohistochemistry and reverse transcription-polymerase chain reaction have been used to identify LNM in patients with gastric cancer, the clinical significance of this finding remains unclear. Recently, minimally invasive treatments, such as endoscopic submucosal dissection and laparoscopic surgery, are widely performed to help improve postsurgical quality of life (QOL). However, it is important to maintain the balance between QOL and curability when making treatments decision for patients with gastric cancer. If minimally invasive surgery based on accurate intraoperative LNM diagnosis was established, it could be performed safely. Therefore, we reviewed the clinical significance of LNM detected by molecular techniques as an important target for treatment decision making with gastric cancer patients. PMID:25320510

  14. Differential expression of angiogenesis associated genes in prostate cancer bone, liver and lymph node metastases.

    PubMed

    Morrissey, Colm; True, Lawrence D; Roudier, Martine P; Coleman, Ilsa M; Hawley, Sarah; Nelson, Peter S; Coleman, Roger; Wang, Ya-Chun; Corey, Eva; Lange, Paul H; Higano, Celestia S; Vessella, Robert L

    2008-01-01

    Our objective was to elucidate phenotypic differences between prostate cancer (PCa) liver, lymph node, and bone metastases. PCa metastases were obtained through a rapid tissue acquisition necropsy protocol. We grossly dissected metastatic foci from frozen samples and performed expression analyses using cDNA microarrays. Immunohistochemical analyses using a tissue microarray from thirty individuals with PCa metastases to lymph nodes, liver, and bone was used to confirm the gene expression changes associated with each metastatic site. Transcript alterations statistically-associated with bone metastases included increased expression of IBSP (Bone sialoprotein), F13A1 (factor XIII), and decreased expression of EFNA1 (ephrin-A1) and ANGPT2 (angiopoietin-2) when compared to liver and lymph node metastases. The metastasis-associated changes in proteins involved in coagulation and angiogenesis prompted further analysis of additional factors known to participate in the clotting cascade and blood vessel formation (angiopoitein-1, PAI-1, uPA, PAI-RBP-1 and hepsin). We also assessed tumor-associated microvessel density and distribution in liver, lymph node, and bone metastasis. Intense fibrin(ogen) and fibulin-1 staining was localized to epithelial cells at the periphery of metastatic tumors possibly to facilitate angiogenesis. The expression of hepsin, uPA, PAI-RBP1, PAI-1, and factor XIII may influence fibrinolysis and are regulated by the tumor microenvironment. The expression of angiopoietin-2 and apparent silencing of angiopoietin-1 in PCa bone, liver, and lymph node metastases may be critical for angiogenesis in this tumor type. In addition, the resulting tumor-associated microvessel density and distribution was significantly different between liver and bone metastasis possibly in response to the protein expression changes detailed above. PMID:17972146

  15. Subareolar injection of 99m Tc facilitates sentinel lymph node identification

    Microsoft Academic Search

    Todd M. Tuttle; Marybeth Colbert; Robert Christensen; Kevin J. Ose; Thomas Jones; Robert Wetherille; Joel Friedman; Karen Swenson; Kelly M. McMasters

    2002-01-01

    Background: Sentinel lymph node (SLN) biopsy with the standard intraparenchymal injection has been accepted as an alternative to routine\\u000a axillary dissection for patients with breast cancer. However, the identification and false-negative rates with this method\\u000a can vary widely from surgeon to surgeon. The subareolar location contains a rich lymphatic network and represents a potential\\u000a site of injection for SLN identification.

  16. Interleukin-24 is correlated with differentiation and lymph node numbers in rectal cancer

    PubMed Central

    Choi, Youngmin; Roh, Mee-Sook; Hong, Young-Seoub; Lee, Hyung-Sik; Hur, Won-Joo

    2011-01-01

    AIM: To assess the significance of interleukin (IL)-24 and vascular endothelial growth factor (VEGF) expression in lymph-node-positive rectal cancer. METHODS: Between 1998 and 2005, 90 rectal adenocarcinoma patients with lymph node involvement were enrolled. All patients received radical surgery and postoperative pelvic chemoradiotherapy of 50.4-54.0 Gy. Chemotherapy of 5-fluorouracil and leucovorin or levamisole was given intravenously during the first and last week of radiotherapy, and then monthly for about 6 mo. Expression of IL-24 and VEGF was evaluated by immunohistochemical staining of surgical specimens, and their relations with patient characteristics and survival were analyzed. The median follow-up of surviving patients was 73 mo (range: 52-122 mo). RESULTS: IL-24 expression was found in 81 out of 90 patients; 31 showed weak intensity and 50 showed strong intensity. VEGF expression was found in 64 out of 90 patients. Negative and weak intensities of IL-24 expression were classified as negative expression for analysis. IL-24 expression was significantly reduced in poorly differentiated tumors in comparison with well or moderately differentiated tumors (P = 0.004), N2b to earlier N stages (P = 0.016), and stage IIIc to stage IIIa or IIIb (P = 0.028). The number of involved lymph nodes was also significantly reduced in IL-24-positive patients in comparison with IL-24-negative ones.There was no correlation between VEGF expression and patient characteristics. Expression of IL-24 and VEGF was not correlated with survival, but N stage and stages were significantly correlated with survival. CONCLUSION: IL-24 expression was significantly correlated with histological differentiation, and inversely correlated with the degree of lymph node involvement in stage III rectal cancer. PMID:21448421

  17. What does absence of lymph node in resected specimen mean after neoadjuvant chemoradiation for rectal cancer

    PubMed Central

    2013-01-01

    Background The effect of insufficient node sampling in patients with rectal cancer managed by neoadjuvant chemoradiation followed by surgery has not been clearly determined. We evalulated the impact of insufficient sampling or even abscence of lymph nodes in the specimen on survival in patients at high-risk (T3, T4 or node positive) for rectal cancer. Methods We conducted a single institution, retrospective analysis of all patients who underwent surgical rectal resection following neoadjuvant chemoradiation for treatment of mid to lower rectal cancer between 1997 and 2009. ypNX was defined as the absence of lymph nodes retrieved in the resected specimen. Results A total of 132 patients underwent resection for treatment of rectal cancer following neoadjuvant chemoradiation. Ninety four patients (71.2%) were considered as having node-negative disease, including ypNx and ypN0. In 38 patients (28.8%), the primary tumor was associated with regional lymph node metastases (ypNpos). The mean number of retrieved nodes per specimen was 14.2, respectively. The five-year overall survival from initial operation for the ypNx group was 100%, respectively. The estimated five-year overall survival for ypN0 and ypNpos was 84.0% and 60.3%, respectively (P =0.001). No significant differences in overall survival were observed between the ypNx and ypN0 group (P =0.302). Conclusion Absence of recovered LN in resected specimens after neoadjuvant chemoradiation was observed in 7.6% of specimens. Absence of LN should not be regarded as a risk factor for poor survival or as a sign of less radical surgery. PMID:23957923

  18. Management of prostate cancer patients with lymph node involvement: A rapidly evolving paradigm

    PubMed Central

    Créhange, Gilles; Chen, Chien Peter; Hsu, Charles C.; Kased, Norbert; Coakley, Fergus V.; Kurhanewicz, John; Roach, Mack

    2013-01-01

    Although widespread PSA screening has inevitably led to increased diagnosis of lower risk prostate cancer, the number of patients with nodal involvement at baseline remains high (nearly 40% of high risk patients initially staged cN0). These rates probably do not reflect the true incidence of prostate cancer with lymph node involvement among patients selected for external beam radiotherapy (EBRT), as patients selected for surgery often have more favorable prognostic features. At many institutions, radical treatment directed only at the prostate is considered standard and patients known to have regional disease are often managed palliatively with androgen deprivation therapy (ADT) for presumed systemic disease. New imaging tools such as MR lymphangiography, choline-based PET imaging or combined SPECT/CT now allow surgeons and radiation oncologists to identify and target nodal metastasis and/or lymph nodes with a high risk of occult involvement. Recent advances in the field of surgery including the advent of extended nodal dissection and sentinel node procedures have suggested that cancer-specific survival might be improved for lymph-node positive patients with a low burden of nodal involvement when managed with aggressive interventions. These new imaging tools can provide radiation oncologists with maps to guide delivery of high dose conformal radiation to a target volume while minimizing radiation toxicity to non-target normal tissue. This review highlights advances in imaging and reports how they may help to define a new paradigm to manage node-positive prostate cancer patients with a curative-intent. PMID:22703831

  19. Ultrasonic Detection of Metastases in Dissected Lymph Nodes of Cancer Patients

    NASA Astrophysics Data System (ADS)

    Feleppa, E. J.; Mamou, J.; Machi, J.; Hata, M.; Coron, A.; Yanagihara, E.; Laugier, P.

    Current histological methods can miss micrometastases (< 2.0 mm) in dissected lymph nodes because nodes are cut into sections that are at least 2-mm thick for examination, and the entire node volume cannot be evaluated microscopically. In this study, high-frequency, quantitative ultrasound (HFU, QUS) methods were applied to freshly dissected lymph nodes to detect micrometastases based on their microstructural properties. 3-D ultrasound data were acquired from 40 nodes from 22, colorectal-cancer patients using a single-element, 25 MHz transducer. Significant cancer was detected subsequently in 7 of the 40 nodes. Node images were segmented semi-automatically in 3-D, and echo signals were processed to yield basic spectral parameters (slope, intercept, and midband) values plus QUS estimates associated with tissue microstructural properties (scatterer size and acoustic concentration). Images were formed by expressing local QUS estimates as color-encoded pixels and overlaying the color on conventional, gray-scale ultrasound images. Linear discriminant analysis classified nodes based on intercept, midband, size, and acoustic concentration. ROC methods assessed classification performance. 3-D QUS images interactively displayed spectral-parameter and QUS values. Linear-discriminant methods produced an area under the ROC curve of 1.000 based on size and intercept; interestingly, the areas for size alone and for intercept alone were 0.986. These initial results appear to validate spectrum-analysis-based QUS methods for distinguishing cancerous from non-cancerous tissue in lymph nodes. The Areas under the ROC curves suggest that this approach can be valuable clinically to identify nodal micrometastases that current histologic methods can miss.

  20. Anatomical Extent of Pelvic Lymph Node Dissection: Impact on Long-Term Cancer-Specific Outcomes in Men with Positive Lymph Nodes at Time of Radical Prostatectomy

    PubMed Central

    Bivalacqua, Trinity J.; Pierorazio, Phillip M.; Gorin, Michael A.; Allaf, Mohamad E.; Carter, H. Ballentine; Walsh, Patrick C.

    2013-01-01

    Objectives To evaluate the impact of an extended pelvic lymph node dissection (EPLND) on the oncologic outcomes of men with lymph node positive prostate cancer. Methods Between 1992 and 2003, two surgeons at one hospital performed 1,986 and 2,279 open radical prostatectomies. The first surgeon routinely performed a limited pelvic lymph node dissection (LPLND) while the second performed an EPLND. Men with positive lymph nodes (LNs) from each cohort were compared for differences in oncologic outcomes. Results In total, 94 (2.2%) men were found to have positive LNs, 21 (22.3%) from a LPLND and 73 (77.7%) an EPLND. On average, LPLND and EPLND yielded 11.4 and 14.6 nodes, respectively (p = 0.022). Between groups, there was no difference in the number of positive LNs (1.4 vs. 1.8, p = 0.223) or the proportion of patients with <15% positive nodes (57.1% vs. 69.9%, p = 0.300). At median follow-up of 10.5 years, EPLND patients had superior oncologic outcomes compared to the LPLND group: 5-year biochemical recurrence-free survival of 30.1% vs. 7.1% (p = 0.018); 10-year metastasis-free survival of 62.2% vs. 22.2% (p = 0.035); and 10-year cancer-specific survival of 83.6% vs. 52.6% (p = 0.199). This analysis demonstrated an augmented improvement in biochemical recurrence-free survival in men with <15% positive nodes. Conclusions In addition to affording valuable staging information, an EPLND may confer a therapeutic benefit to patients found to have positive lymph nodes at the time of radical prostatectomy. PMID:23987158

  1. Practical guidelines for optimal gamma probe detection of sentinel lymph nodes in breast cancer: Results of a multi-institutional study

    Microsoft Academic Search

    Robert C. G. Martin; Michael J. Edwards; Sandra L. Wong; Todd M. Tuttle; David J. Carlson; C. Matthew Brown; R. Dirk Noyes; Rebecca L. Glaser; Donald J. Vennekotter; Peter S. Turk; Peter S. Tate; Armando Sardi; Patricia B. Cerrito; Kelly M. McMasters

    2000-01-01

    Introduction:Multiple radioactive lymph nodes are often removed during the course of sentinel lymph node (SLN) biopsy for breast cancer when both blue dye and radioactive colloid injection are used. Some of the less radioactive lymph nodes are second echelon nodes, not true SLNs. The purpose of this analysis was to determine whether harvesting these less radioactive nodes, in addition to

  2. miRNA expression profile in primary gastric cancers and paired lymph node metastases indicates that miR-10a plays a role in metastasis from primary gastric cancer to lymph nodes.

    PubMed

    Chen, Weidong; Tang, Zhaoqing; Sun, Yihong; Zhang, Youyou; Wang, Xuefei; Shen, Zhenbin; Liu, Fenglin; Qin, Xinyu

    2012-02-01

    The aim of this study was to identify and evaluate microRNAs (miRNAs) in gastric cancer lymph node metastasis. A miRNA array was used to compare the expression of miRNAs in primary gastric cancer and paired lymph node metastases. miRNAs found to be differentially expressed were validated in a cohort of primary gastric cancer tissues, and the relationship between expression and the clinicopathological characteristics of the specimens was analyzed. The expression level of miR-10a in a gastric mucosal cell line and three gastric cancer cell lines was also detected using qPCR. Moreover, the target genes for miR-10a were predicted using bioinformatic methods. Based on the results, four differentially expressed miRNAs were detected by the miRNA array. Compared with primary gastric cancer, lymph node metastases displayed downregulated expression of miR-24-1(*), miR-510 and miR-1284, while the expression of miR-10a was upregulated. Consequently, analysis found that the expression of miR-10a was associated with lymph node metastasis (P=0.047), but was independent of the state of lymphatic invasion (P=0.169) in the cohort of primary gastric carcinoma. The expression of miR-10a was at least 10-fold higher in the three gastric cancer cell lines than in the gastric mucosal cell line. Two gastric cancer cell lines, which were established from lymph node metastasis, expressed higher miR-10a compared to the primary tumor origin cell line. Bioinformatic analysis demonstrated that the target genes of miR-10a are involved in multiple related pathways of tumorigenesis and metastasis. In conclusion, our study suggests that miR-10a is involved in the development of gastric cancer and lymph node metastasis, particularly in the latter process. PMID:22969895

  3. miRNA expression profile in primary gastric cancers and paired lymph node metastases indicates that miR-10a plays a role in metastasis from primary gastric cancer to lymph nodes

    PubMed Central

    CHEN, WEIDONG; TANG, ZHAOQING; SUN, YIHONG; ZHANG, YOUYOU; WANG, XUEFEI; SHEN, ZHENBIN; LIU, FENGLIN; QIN, XINYU

    2012-01-01

    The aim of this study was to identify and evaluate microRNAs (miRNAs) in gastric cancer lymph node metastasis. A miRNA array was used to compare the expression of miRNAs in primary gastric cancer and paired lymph node metastases. miRNAs found to be differentially expressed were validated in a cohort of primary gastric cancer tissues, and the relationship between expression and the clinicopathological characteristics of the specimens was analyzed. The expression level of miR-10a in a gastric mucosal cell line and three gastric cancer cell lines was also detected using qPCR. Moreover, the target genes for miR-10a were predicted using bioinformatic methods. Based on the results, four differentially expressed miRNAs were detected by the miRNA array. Compared with primary gastric cancer, lymph node metastases displayed downregulated expression of miR-24-1*, miR-510 and miR-1284, while the expression of miR-10a was upregulated. Consequently, analysis found that the expression of miR-10a was associated with lymph node metastasis (P=0.047), but was independent of the state of lymphatic invasion (P=0.169) in the cohort of primary gastric carcinoma. The expression of miR-10a was at least 10-fold higher in the three gastric cancer cell lines than in the gastric mucosal cell line. Two gastric cancer cell lines, which were established from lymph node metastasis, expressed higher miR-10a compared to the primary tumor origin cell line. Bioinformatic analysis demonstrated that the target genes of miR-10a are involved in multiple related pathways of tumorigenesis and metastasis. In conclusion, our study suggests that miR-10a is involved in the development of gastric cancer and lymph node metastasis, particularly in the latter process. PMID:22969895

  4. Sentinel lymph node biopsy in endometrial cancer: description of the technique and preliminary results

    PubMed Central

    Kuru, O?uzhan; Topuz, Samet; ?en, Serhat; ?yibozkurt, Cem; Berkman, Sinan

    2011-01-01

    Objective To measure the feasibility of sentinel lymph node technique in endometrial cancer. Material and Methods The study was designed as a prospective non-randomized case-control trial. Between 2010–2011, in Istanbul University, Istanbul Medical Faculty, Gynecologic Oncology department, 26 patients who were preoperatively evaluated as endometrial cancer enrolled in the study. Patients’ detailed informed consent and ethics committee approval were obtained. Sentinel lymph node (SLN) detection rate was determined as the primary outcome. Sensitivity, specificity, positive and negative predictive values and particularly false negative results were determined as secondary outcomes. As a technique of SLN, injection of methylene blue to the subserosal myometrium of the uterine fundus via 5 cc syringe following peritoneal aspiration cytology procedure was obtained. Surgery was made after injection for an average of 5 minutes due to the physiological spread of the blue dye. Then, the standard protocol of hysterectomy was performed and the retroperitoneum was opened to perform lymphadenectomy. The presence of lymph node regions, and presence of a sentinel node was recorded on the trial record form. Positive staining nodes were sent separately for pathological examination. In the course of the study due to insufficient rate of staining, the technique has been changed to cervical and multiple uterine injections. Results As the primary outcome, an SLN positivity rate of 23% in 6 patients with a total of 8 lymph nodes were found. The remarkable finding was that in the first technique, the rate was 1/16 (6%), while the second technique, 5/10 (50%), respectively. The difference is statistically significant (p=0.001). In endometrial cancer stage I and II, secondary outcomes for sensitivity, specificity, positive predictive value, negative predictive value were 23%, 0%, 100%, 43%, respectively. Because there were no metastatic lymph nodes found, false negative rate was 0%. Conclusion SLN approach is not valuable enough to eliminate the need for lymphadenectomy. On the other hand, it facilitates scanning micrometastases and ultrastaging, while its clinical value has not yet been established. However, according to the recent pilot studies, it provides a means for assessing micrometastases for the medium-risk group for local recurrence. PMID:24591995

  5. Thermochemoradiotherapy using superselective intra-arterial infusion for N3 cervical lymph node metastases of tongue cancer.

    PubMed

    Hiroaki, Nishiguchi; Kenji, Mitsudo; Noriyuki, Yamamoto; Iwai, Tohnai

    2013-01-01

    A case of squamous cell carcinoma of the tongue with advanced N3 cervical lymph node metastases in an 80-year-old female is reported. The patient was treated with a combination of radiotherapy (2 Gy/day, total 60 Gy), superselective intra-arterial chemotherapy via a superficial temporal artery and a femoral artery (docetaxel, total 124 mg; cisplatin, total 135 mg), and four sessions of hyperthermia for cervical lymph node metastases. The tumor responded well to therapy, and 18-fluorodeoxyglucose uptake in both primary and neck lesions disappeared on positron emission tomography-computed tomography. The patient has shown no clinical or radiological evidence of local recurrence or distant metastases 6 years after the end of treatment. Advanced oral cancer patients with N3 cervical lymph node metastases are particularly difficult to treat and have a poor prognosis. This method of thermochemoradiotherapy seems a promising modality for patients with N3 cervical lymph node metastases of oral cancer. PMID:24518725

  6. The International Association for the Study of Lung Cancer Lymph Node Map: A Radiologic Atlas and Review

    PubMed Central

    van Beek, Edwin JR; Murchison, John T; Marin, Aleksander; Mirsadraee, Saeed

    2015-01-01

    Accurate lymph node staging of lung cancer is crucial in determining optimal treatment plans and predicting patient outcome. Currently used lymph node maps have been reconciled to the internationally accepted International Association for the Study of Lung Cancer (IASLC) map published in the seventh edition of TNM classification system of malignant tumours. This article provides computed tomographic illustrations of the IASLC nodal map, to facilitate its application in day-to-day clinical practice in order to increase the appropriate classification in lung cancer staging. PMID:26175770

  7. Anthracosis mimicking mediastinal lymph node metastases with 18F-FCholine in high-risk prostate cancer.

    PubMed

    Pinaquy, Jean-Baptiste; Fernandez, Philippe; Pasticier, Gilles; Parrens, Marie; De Clermont, Henri

    2015-04-01

    A 62-year-old patient with prostate adenocarcinoma underwent PET with radiolabeled choline (18F-Fcholine) for pretreatment staging of a high-risk prostate cancer. Images showed a significant mediastinal lymph node uptake of 18F-Fcholine. Owing to the rarity of spread to supradiaphragmatic lymph nodes, a surgical removal was performed, revealing anthracosis and no malignant cells. Even if its specificity seems better than 18F-FDG, false positives have been reported and other pathologies could mimic lymph node metastases. Consequently, histology should be performed so that the appropriate treatment can be initiated. PMID:25674859

  8. A Preliminary Study of the Draining Lymph Node Basin in Advanced Lower Rectal Cancer Using a Radioactive Tracer

    Microsoft Academic Search

    Kimihiko Funahashi; Junichi Koike; Morio Shimada; Kosuke Okamoto; Tomohiko Goto; Tatsuo Teramoto

    2006-01-01

    \\u000a Purpose  This study was designed to examine the draining lymph node basin at highest risk of metastasis in lower rectal cancer using\\u000a 99 mTc-tin colloid.\\u000a \\u000a \\u000a \\u000a Methods  In 43 patients, the area with highest hot nodes density was defined as the draining lymph node basin using a gamma probe.\\u000a Metastatic states of all removed lymph nodes were examined histologically.\\u000a \\u000a \\u000a \\u000a Results  A total of 203 hot

  9. A prospective study of the significance of gene and chromosome alterations as prognostic indicators of breast cancer patients with lymph node metastases

    Microsoft Academic Search

    Hitoshi Tsuda; Chinami Sakamaki; Shoichiro Tsugane; Takashi Fukutomi; Setsuo Hirohashi

    1998-01-01

    In 150 surgically resected primary breast carcinomas that had axillary lymph-node metastases, we examined the incidence of loss of heterozygosity on chromosomes 16p, 16q, 17p, 17q, and 18q, point mutation of the p53 tumor-suppressor gene, nuclear immunoreaction of p53 protein, and amplifications of the c-erbB-2 and int-2 oncogenes by Southern blotting, single-strand conformation polymorphism analysis, and immunohistochemistry. We analyzed the

  10. The preoperative study of mediastinal lymph nodes metastasis in lung cancer by endoscopic ultrasonography (EUS) and helical computed tomography (CT)

    Microsoft Academic Search

    Jerzy Laudanski; Miroslaw Kozlowski; Jacek Nikli?ski; Lech Chyczewski

    2001-01-01

    Objective: Accurate staging of mediastinal lymph nodes in patients with lung cancer is fundamental for their treatment and prognosis. The aim of this study was to compare the value of EUS and CT staging in patients with non-small-cell lung cancer (NSCLC) with postsurgical stage. Methods: Ninety two patients with NSCLC underwent EUS and CT for preoperative detection of metastases to

  11. Survival after resection of gastric cancer and prognostic relevance of systematic lymph node dissection: Twenty years experience in Taiwan

    Microsoft Academic Search

    Wei-Jei Lee; Wen-Chung Lee; Shyh-Jinn Houng; Chia-Tung Shun; Ren-Long Houng; Po-Hung Lee; King-Jen Chang; Ta-Cheng Wei; Kai-Mo Chen

    1995-01-01

    A retrospective study of 954 resectable gastric cancers in a single institute of Taiwan from 1971 to 1990 was performed to evaluate improvements in gastric cancer surgery. The patients were divided into four time periods representing an overall experience of progressive implementation of aggressive resection and increased extent of systematic lymph node dissection. The clinicopathologic data and survival rates were

  12. EDITORIALS Micrometastasis of Prostate Cancer to Lymph Nodes: Detection by Means of Reverse Transcription Polymerase Chain Reaction

    Microsoft Academic Search

    Takashi Deguchi; Muzheng Yang; Yukimichi Kawada

    1997-01-01

    In the clinical management of patients with prostate cancer, recognition of metastatic spread is critical to determining thera- peutic options. Curative surgical procedures directed at the pri- mary tumor are used in patients with clinically localized disease. Among patients with cancer histologically confined to the organ and with no evidence of disease in regional lymph nodes, some will have distant

  13. Lymph Node Staging of Gastric Cancer Using 18F-FDG PET: A Comparison Study with CT

    Microsoft Academic Search

    Mijin Yun; Joon Seok Lim; Sung Hoon Noh; Woo Jin Hyung; Jae Ho Cheong; Jung Kyun Bong; Arthur Cho; Jong Doo Lee

    This study was performed to compare 18F-FDG PET with CT for the evaluation of primary tumors and lymph node metastases in gas- tric cancer. Methods: Eighty-one patients (28 women and 53 men; mean age, 56.6 y; age range; 32-82 y) who had undergone radical (n 74) or palliative (n 7) gastrectomy and lymph node dissec- tion for the management of

  14. The impact of the absolute number and ratio of positive lymph nodes on survival of endometrioid uterine cancer patients.

    PubMed

    Chan, J K; Kapp, D S; Cheung, M K; Osann, K; Shin, J Y; Cohn, D; Seid, P L

    2007-09-01

    The aim of the study was to determine the impact of the absolute number and ratio of positive lymph nodes on the survival in node-positive endometrioid uterine cancer. Data were obtained from the National Cancer Institute Registry from 1988 to 2001. Analyses were performed using Kaplan-Meier and Cox proportional hazard methods. A total of 1222 women were diagnosed with stage IIIC-IV node-positive endometrioid corpus cancer. The 5-year disease-specific survival of women with 1, 2-5, and >5 positive nodes were 68.1, 55.1, and 46.1%, respectively (P<0.001). Increasing lymph node ratio, expressed as a percentage of positive nodes to total nodes identified (10-50%), was associated with a decrease in survival from 77.3 to 60.7 to 40.9%, respectively (P<0.001). The absolute number of positive nodes and the lymph node ratio remained significant after adjusting for stage (IIIC vs IV) and the extent of lymphadenectomy (20 nodes). On multivariate analysis, the absolute number of positive nodes and lymph node ratio were significant independent prognostic factors for survival. Increasing absolute number of positive nodes and lymph node ratio are associated with a poorer survival in women with node-positive uterine cancers. The stratification of node-positive uterine cancer for prognostic and treatment purposes warrants further investigation. PMID:17667929

  15. Pre-treatment surgical para-aortic lymph node assessment in locally advanced cervical cancer

    PubMed Central

    Brockbank, Elly; Kokka, Fani; Bryant, Andrew; Pomel, Christophe; Reynolds, Karina

    2014-01-01

    Background Cervical cancer is the most common cause of death from gynaecological cancers worldwide. Locally advanced cervical cancer, FIGO stage equal or more than IB1 is treated with chemotherapy and external beam radiotherapy followed by brachytherapy. If there is metastatic para-aortic nodal disease radiotherapy is extended to additionally cover this area. Due to increased morbidity, ideally extended-field radiotherapy is given only when para-aortic nodal disease is proven. Therefore accurate assessment of the extent of the disease is very important for planning the most appropriate treatment. Objectives To evaluate the effectiveness and safety of pre-treatment surgical para-aortic lymph node assessment for woman with locally advanced cervical cancer (FIGO stage IB2 to IVA). Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE and EMBASE (up to January 2011). We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. Selection criteria Randomised controlled trials (RCTs) that compared surgical para-aortic lymph node assessment and dissection with radiological staging techniques, in adult women diagnosed with locally advanced cervical cancer. Data collection and analysis Two reviewers independently assessed whether potentially relevant trials met the inclusion criteria, abstracted data and assessed risk of bias. One RCT was identified so no meta-analyses were performed. Main results We found only one trial, which included 61 women, that met our inclusion criteria. This trial reported data on surgical versus clinical staging and an assessment of the two surgical staging techniques; laparoscopic (LAP) versus extraperitoneal (EXP) surgical staging. The clinical staging was either a contrast-enhanced CT scan or MRI scan of the abdomen and pelvis to determine nodal status. In this trial, clinical staging appeared to significantly prolong overall and progression-free survival compared to surgical staging. There was no statistically significant difference in the number of women who experienced severe (grade 3 or 4) toxicity. There was no statistically significant difference in the risk of death, disease recurrence or progression, blood loss, severe toxicity and the duration of the operational procedure between LAP and EXP surgical staging techniques. The strength of the evidence is weak in this review as it is based on one small trial which was at moderate risk of bias. Authors’ conclusions From the one available RCT we found insufficient evidence that pre-treatment surgical para-aortic lymph node assessment for locally advanced cervical cancer is beneficial, and it may actually have an adverse effect on survival. However this conclusion is based on analysis of a small single trial and therefore definitive guidance or recommendations for clinical practice cannot be made. Therefore the decision to offer surgical pre-treatment assessment of para-aortic lymph nodes in locally advanced cervical cancer needs to be individualised. The uncertainty regarding any impact on survival from pre-treatment para-aortic lymph node assessment should be discussed openly with the women. PMID:21491407

  16. Neurokinin-2 receptor polymorphism predicts lymph node metastasis in colorectal cancer patients

    PubMed Central

    FANG, WEIJIA; FU, CAIYUN; CHEN, XIAOGANG; MOU, XIAOZHOU; LIU, FANLONG; QIAN, JIONG; ZHAO, PENG; ZHENG, YULONG; ZHENG, YI; DENG, JING; YE, PINGJIANG; WANG, YIFEI; ZHENG, SHUSEN

    2015-01-01

    To analyze the single nucleotide polymorphisms (SNPs) of two subtypes of neurokinin (NK) receptors, NK1R and NK2R (also known as TAC1R and TAC2R), in colorectal cancer (CRC), peripheral blood samples were collected from 199 CRC patients. Direct-sequencing was performed to identify the NK1R rs10198644 and NK2R rs4644560 SNPs. Genotype results were correlated with clinical factors. The allele frequencies of NK1R rs10198644 GC, CC and GG were 52, 17 and 31%, respectively, while that of NK2R rs4644560 GC, CC, and GG were 36, 50 and 14%, respectively. Patients with NK2R rs4644560 GC exhibited more positive lymph nodes than those with CC (mean, 2.2 vs. 1.3; P=0.016). Further analysis highlighted that the number of positive lymph nodes was also increased in the NK2R rs4644560 GC/NK1R rs10198644 GG group compared with the NK2R rs4644560 GG/NK1R rs10198644 GG group (mean, 2.2 vs. 0.9; P=0.04). These data suggested that the NK2R rs4644560 GC polymorphism alone or combination with NK1R rs10198644 GG may be a promising prognostic marker of lymph node metastasis in CRC patients.

  17. Axillary lipogranuloma mimicking carcinoma metastasis after silicone breast implant rupture: a case report.

    PubMed

    Gundeslioglu, A Ozlem; Hakverdi, Sibel; Erdem, Ozlem; Ozen, E Cigdem; Inan, Irfan; Emlik, Dilek

    2013-03-01

    Silicone-gel-filled breast implants have been widely used for breast augmentation and reconstruction after mastectomy. However, silicone implants have some well-known complications, such as implant rupture, which requires surgical intervention. Dissemination of silicone particles out of the implant causes a granulomatous reaction, a phenomenon known as silicone granuloma, in breast parenchyma as well as axillary, breast and chest wall lymph nodes, which mimics breast cancer metastasis. However, lipogranuloma after silicone breast implant rupture has not been reported in the literature, although it is a common complication after mineral oil or liquid silicone injection. We present a case report of an axillary lymphadenopathy resulting from lipogranuloma after silicone-gel-filled implant rupture. Review of the literature suggests that this is the first report of a lipogranuloma resulting from implant rupture. PMID:23245917

  18. Quantitative photoacoustic assessment of ex-vivo lymph nodes of colorectal cancer patients

    NASA Astrophysics Data System (ADS)

    Sampathkumar, Ashwin; Mamou, Jonathan; Saegusa-Beercroft, Emi; Chitnis, Parag V.; Machi, Junji; Feleppa, Ernest J.

    2015-03-01

    Staging of cancers and selection of appropriate treatment requires histological examination of multiple dissected lymph nodes (LNs) per patient, so that a staggering number of nodes require histopathological examination, and the finite resources of pathology facilities create a severe processing bottleneck. Histologically examining the entire 3D volume of every dissected node is not feasible, and therefore, only the central region of each node is examined histologically, which results in severe sampling limitations. In this work, we assess the feasibility of using quantitative photoacoustics (QPA) to overcome the limitations imposed by current procedures and eliminate the resulting under sampling in node assessments. QPA is emerging as a new hybrid modality that assesses tissue properties and classifies tissue type based on multiple estimates derived from spectrum analysis of photoacoustic (PA) radiofrequency (RF) data and from statistical analysis of envelope-signal data derived from the RF signals. Our study seeks to use QPA to distinguish cancerous from non-cancerous regions of dissected LNs and hence serve as a reliable means of imaging and detecting small but clinically significant cancerous foci that would be missed by current methods. Dissected lymph nodes were placed in a water bath and PA signals were generated using a wavelength-tunable (680-950 nm) laser. A 26-MHz, f-2 transducer was used to sense the PA signals. We present an overview of our experimental setup; provide a statistical analysis of multi-wavelength classification parameters (mid-band fit, slope, intercept) obtained from the PA signal spectrum generated in the LNs; and compare QPA performance with our established quantitative ultrasound (QUS) techniques in distinguishing metastatic from non-cancerous tissue in dissected LNs. QPA-QUS methods offer a novel general means of tissue typing and evaluation in a broad range of disease-assessment applications, e.g., cardiac, intravascular, musculoskeletal, endocrine-gland, etc.

  19. A Prognostic Index for Predicting Lymph Node Metastasis in Minor Salivary Gland Cancer

    SciTech Connect

    Lloyd, Shane; Yu, James B. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Ross, Douglas A. [Department of Surgery, St. Vincent's Medical Center, Bridgeport, CT (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Decker, Roy H., E-mail: roy.decker@yale.ed [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States)

    2010-01-15

    Purpose: Large studies examining the clinical and pathological factors associated with nodal metastasis in minor salivary gland cancer are lacking in the literature. Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 2,667 minor salivary gland cancers with known lymph node status from 1988 to 2004. Univariate and multivariate analyses were conducted to identify factors associated with the use of neck dissection, the use of external beam radiation therapy, and the presence of cervical lymph node metastases. Results: Four hundred twenty-six (16.0%) patients had neck nodal involvement. Factors associated with neck nodal involvement on univariate analysis included increasing age, male sex, increasing tumor size, high tumor grade, T3-T4 stage, adenocarcinoma or mucoepidermoid carcinomas, and pharyngeal site of primary malignancy. On multivariate analysis, four statistically significant factors were identified, including male sex, T3-T4 stage, pharyngeal site of primary malignancy, and high-grade adenocarcinoma or high-grade mucoepidermoid carcinomas. The proportions (and 95% confidence intervals) of patients with lymph node involvement for those with 0, 1, 2, 3, and 4 of these prognostic factors were 0.02 (0.01-0.03), 0.09 (0.07-0.11), 0.17 (0.14-0.21), 0.41 (0.33-0.49), and 0.70 (0.54-0.85), respectively. Grade was a significant predictor of metastasis for adenocarcinoma and mucoepidermoid carcinoma but not for adenoid cystic carcinoma. Conclusions: A prognostic index using the four clinicopathological factors listed here can effectively differentiate patients into risk groups of nodal metastasis. The precision of this index is subject to the limitations of SEER data and should be validated in further clinical studies.

  20. Prospective preoperative mediastinal lymph node staging by integrated positron emission tomography–computerised tomography in patients with non-small-cell lung cancer

    Microsoft Academic Search

    Christian Perigaud; Boumédiène Bridji; Jean Christian Roussel; Christine Sagan; Antoine Mugniot; Daniel Duveau; Olivier Baron; Philippe Despins

    2009-01-01

    Objective: Mediastinal lymph node staging determines the treatment strategy for non-small-cell lung cancer. This study aims to evaluate prospectively the accuracy of preoperative integrated 18-fluoro-2-deoxy-d-glucose positron emission tomography–computerised tomography (18FDG PET-CT) for mediastinal lymph node staging. Methods: Preoperative integrated 18FDG PET-CT was used to analyse mediastinal lymph nodes in patients with non-small-cell lung cancer. Nodal stations were identified according to

  1. Comparative study of the immunohistochemical phenotype in breast cancer and its lymph node metastatic location.

    PubMed

    De la Haba-Rodríguez, Juan R; Ruiz Borrego, Manuel; Gómez España, Auxiliadora; Villar Pastor, Carlos; Japón, Miguel A; Travado, Paulino; Moreno Nogueira, José Andrés; López Rubio, Fernando; Aranda Aguilar, Enrique

    2004-01-01

    At present, an important part of prognostic information, together with particular treatment strategies in breast cancer, take into account the immunohistochemical phenotype of the primary tumor location. However, the changing heterogeneity intrinsic to neoplastic cells in general leads us to consider the possibility that the expression of these proteins is modified during tumoral development and dissemination. With this hypothesis as a starting point, 60 patients with breast cancer were studied with immunohistochemistry, the expression of estrogen and progestagenic receptors, proliferation through the Ki-67 expression, and the overexpression of HER-2 and p53 in both the primary location and the lymph node metastases. If we consider significant change to be loss (from positive to negative) or gain (negative to positive) of expression in some of the studied determinations, we find that this is produced in 60% of the tumors studied. These results demonstrate the modification of immunohistochemical expression of the proteins studied between the primary tumor location and the lymph node metastases. PMID:15199604

  2. Automatic FDG-PET-based tumor and metastatic lymph node segmentation in cervical cancer

    NASA Astrophysics Data System (ADS)

    Arbonès, Dídac R.; Jensen, Henrik G.; Loft, Annika; Munck af Rosenschöld, Per; Hansen, Anders Elias; Igel, Christian; Darkner, Sune

    2014-03-01

    Treatment of cervical cancer, one of the three most commonly diagnosed cancers worldwide, often relies on delineations of the tumour and metastases based on PET imaging using the contrast agent 18F-Fluorodeoxyglucose (FDG). We present a robust automatic algorithm for segmenting the gross tumour volume (GTV) and metastatic lymph nodes in such images. As the cervix is located next to the bladder and FDG is washed out through the urine, the PET-positive GTV and the bladder cannot be easily separated. Our processing pipeline starts with a histogram-based region of interest detection followed by level set segmentation. After that, morphological image operations combined with clustering, region growing, and nearest neighbour labelling allow to remove the bladder and to identify the tumour and metastatic lymph nodes. The proposed method was applied to 125 patients and no failure could be detected by visual inspection. We compared our segmentations with results from manual delineations of corresponding MR and CT images, showing that the detected GTV lays at least 97.5% within the MR/CT delineations. We conclude that the algorithm has a very high potential for substituting the tedious manual delineation of PET positive areas.

  3. Effectiveness of prophylactic retropharyngeal lymph node irradiation in patients with locally advanced head and neck cancer

    PubMed Central

    2012-01-01

    Background The aim of the study is to assess the effectiveness of intensity-modulated radiotherapy (IMRT) or image-guided radiotherapy (IGRT) for the prevention of retropharyngeal nodal recurrences in locally advanced head and neck cancer. Methods A retrospective review of 76 patients with head and neck cancer undergoing concurrent chemoradiation or postoperative radiotherapy with IMRT or IGRT who were at risk for retropharyngeal nodal recurrences because of anatomic site (hypopharynx, nasopharynx, oropharynx) and/or the presence of nodal metastases was undertaken. The prevalence of retropharyngeal nodal recurrences was assessed on follow-up positron emission tomography (PET)-CT scans. Results At a median follow-up of 22?months (4–53?months), no patient developed retropharyngeal nodal recurrences. Conclusion Prophylactic irradiation of retropharyngeal lymph nodes with IMRT or IGRT provides effective regional control for individuals at risk for recurrence in these nodes. PMID:22708791

  4. CDO1 Promoter Methylation is a Biomarker for Outcome Prediction of Anthracycline Treated, Estrogen Receptor-Positive, Lymph Node-Positive Breast Cancer Patients

    Microsoft Academic Search

    Dimo Dietrich; Manuel Krispin; Jörn Dietrich; Anne Fassbender; Jörn Lewin; Nadia Harbeck; Manfred Schmitt; Serenella Eppenberger-Castori; Vincent Vuaroqueaux; Frédérique Spyratos; John A Foekens; Ralf Lesche; John WM Martens

    2010-01-01

    BACKGROUND: Various biomarkers for prediction of distant metastasis in lymph-node negative breast cancer have been described; however, predictive biomarkers for patients with lymph-node positive (LNP) disease in the context of distinct systemic therapies are still very much needed. DNA methylation is aberrant in breast cancer and is likely to play a major role in disease progression. In this study, the

  5. The utility of EUS and EUS-guided fine needle aspiration in detecting celiac lymph node metastasis in patients with esophageal cancer: A single-center experience

    Microsoft Academic Search

    Mohamad A. Eloubeidi; Michael B. Wallace; Carolyn E. Reed; Neven Hadzijahic; David N. Lewin; Annette Van Velse; Margaret B. Leveen; Babak Etemad; Koji Matsuda; Rig S. Patel; Robert H. Hawes; Brenda J. Hoffman

    2001-01-01

    Background: The aims of this study were to determine the utility of EUS and EUS-guided fine needle aspiration (EUS-FNA) in the detection and confirmation of celiac lymph node metastasis in patients with esophageal cancer and to define EUS features predictive of celiac lymph node metastasis in these patients. Methods: The records of 211 patients with esophageal cancer who underwent EUS

  6. Pathology Case Study: Enlarged Axillary Lymph Node

    NSDL National Science Digital Library

    Contis, Lydia C.

    This is a case study presented by the University of Pittsburgh Department of Pathology, which describes a 73 year old female who had a history of thyroidectomy for benign nodules who presented with a lump in her thyroidectomy scar. Visitors are given a patient history, microscopic description, and immunohistochemistry, including images. They are also given an opportunity to diagnose the patient before clicking on the "Final Diagnosis" section, which provides a discussion of the findings as well as references. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in hematopatholgy.

  7. Role of FDG PET-CT in evaluation of locoregional nodal disease for initial staging of breast cancer

    PubMed Central

    Liu, Yiyan

    2014-01-01

    Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is not indicated or recommended in the initial staging of early breast cancer. Although it is valuable for detecting distant metastasis, providing prognostic information, identifying recurrence and evaluating response to chemotherapy, the role of FDG PET/CT in evaluating locoregional nodal status for initial staging of breast cancer has not yet been well-defined in clinical practice. FDG PET/CT has high specificity but compromised sensitivity for identifying axillary nodal disease in breast cancer. Positive axillary FDG PET/CT is a good predictor of axillary disease and correlates well with sentinel lymph node biopsy (SLNB). FDG PET/CT may help to identify patients with high axillary lymph node burden who could then move directly to axillary lymph node dissection (ALND) and would not require the additional step of SLNB. However, FDG PET/CT cannot replace SLNB or ALND due to unsatisfactory sensitivity. The spatial resolution of PET instruments precludes the detection of small nodal metastases. Although there is still disagreement regarding the management of internal mammary node (IMN) disease in breast cancer, it is known that IMN involvement is of prognostic significance, and IMN metastasis has been associated with higher rates of distant metastasis and lower overall survival rates. Limited clinical observations suggested that FDG PET/CT has advantages over conventional modalities in detecting and uncovering occult extra-axillary especially IMN lesions with upstaging the disease and an impact on the adjuvant management. PMID:25493234

  8. Three-dimensional quantitative ultrasound for detecting lymph node metastases

    E-print Network

    Illinois at Urbana-Champaign, University of

    -frequency ultrasound Lymph node metastases Lymph node micrometastases Breast cancer Colorectal cancer Gastric cancerThree-dimensional quantitative ultrasound for detecting lymph node metastases Emi Saegusa nodes (LNs) is critical for cancer management. Conventional histological methods may miss metastatic

  9. [PET/CT for monitoring the therapeutic response in a patient with abdominal lymph node tuberculosis after colon cancer resection].

    PubMed

    Shimizu, Yasuo; Hashizume, Yutaka

    2012-11-01

    In February 2007, a 76-year-old man underwent endoscopic mucosal resection (EMR) for sigmoid colon cancer. Histological examination of the EMR specimen revealed adenocarcinoma in adenoma that was confined to the mucosal layer, and pathological complete resection was achieved. Since then, the patient has been followed up every year with endoscopic examination of the colon, with normal results except for hemorrhoids. In June 2011, a positive result for occult blood was obtained on examination of a stool sample. In July 2011, enhanced computed tomography of the chest and abdomen was performed, and the left supraclavicular, paraaortic, and left common iliac artery lymph nodes were found to be enlarged. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) identified accumulation of 18F-FDG in the enlarged lymph nodes. Histopathological examination of a biopsy specimen from the left supraclavicular lymph node revealed tuberculous changes; therefore, the patient was administered anti-tuberculosis therapy. The culture isolate of the above lymphatic tissue specimen was identified as Mycobacterium tuberculosis by immunochromatographic assay with MPB64 protein (Capilia TB). Laparoscopic examination of abdominal lymph nodes was not performed because the patient's consent could not be obtained. After the anti-tuberculosis therapy, the size of the abdominal lymph nodes was reduced, and subsequently, 18F-FDG accumulation decreased. It is considered that mucosal colon cancer did not spread to the lymph nodes after it was removed completely. For the definitive diagnosis of abdominal lymph node swelling, it would have been necessary to perform laparoscopic examination, which was impossible in this case. When it is difficult to perform invasive examinations, such as laparoscopy in case of swelling of the abdominal lymph node, 18F-FDG PET/CT can be useful for monitoring the therapeutic response of abdominal tuberculosis. PMID:23367829

  10. Frequent genetic differences between matched primary and metastatic breast cancer provide an approach to identification of biomarkers for disease progression

    Microsoft Academic Search

    Andrzej B Pop?awski; Micha? Jankowski; Stephen W Erickson; Teresita Díaz de Ståhl; E Christopher Partridge; Chiquito Crasto; Jingyu Guo; John Gibson; Uwe Menzel; Carl EG Bruder; Aneta Kaczmarczyk; Magdalena Benetkiewicz; Robin Andersson; Johanna Sandgren; Barbara Zegarska; Dariusz Ba?a; Ewa ?rutek; David B Allison; Arkadiusz Piotrowski; Wojciech Zegarski; Jan P Dumanski

    2010-01-01

    Breast cancer is a major cause of morbidity and mortality in women and its metastatic spread is the principal reason behind the fatal outcome. Metastasis-related research of breast cancer is however underdeveloped when compared with the abundant literature on primary tumors. We applied an unexplored approach comparing at high resolution the genomic profiles of primary tumors and synchronous axillary lymph

  11. Coincidental detection of T-cell rich B-cell lymphoma in the paraaortic lymph nodes of a woman undergoing lymph node dissection for cervical cancer.

    PubMed

    Abali, H; Eren, O O; Erman, M; Uner, A H; Kose, F; Guler, N

    2003-01-01

    The diagnosis of cervical squamous cell carcinoma with concurrent T-cell rich B-cell lymphoma in dissected lymph nodes has not been reported to our knowledge. We report such a case. The biopsy of an exophytic lesion at the uterine cervix showed squamous cell carcinoma in a 50-year-old woman presenting with postcoital bleeding. Type III hysterectomy, bilateral salpingo-oophorectemy, bilateral pelvic, paraaortic lymph node dissections were performed. Pathologic examination revealed a T-cell rich B-cell lymphoma in some lymph nodes beside squamous cell carcinoma in several of others. ELISA for human immuno-deficiency virus (HIV) was negative. The cervical carcinoma was staged as FIGO clinical stage IB1 and the lymphoma as Ann Arbor IIA. Six cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisone) chemotherapy for the lymphoma and concomitant pelvic chemo-radiotherapy with cisplatin for cervical cancer were given. In this rare coincidence; the best available therapy for each of the diseases should be considered individually. We also suggest that HIV screening test be carried out, because both diseases may be related to human immuno-deficiency virus, although our patient was HIV-negative. PMID:12911737

  12. Combined expression of ezrin and E-cadherin is associated with lymph node metastasis and poor prognosis in breast cancer.

    PubMed

    Yu, Zhaojin; Sun, Mingli; Jin, Feng; Xiao, Qinghuan; He, Miao; Wu, Huizhe; Ren, Jie; Zhao, Lin; Zhao, Haishan; Yao, Weifan; Shan, Fengping; Cao, Yaming; Wei, Minjie

    2015-07-01

    Ezrin and E-cadherin have been known to play a role in tumor metastasis. However, the association between the expression of ezrin and E-cadherin in breast cancer patients remains unclear. In the present study, we investigated the expression of ezrin and E-cadherin in 275 breast cancer and 80 control patients with benign hyperplasia, using tissue microarray?based immunohistochemistry (IHC). Ezrin expression was higher, while that of E-cadherin was lower in breast cancer than in control samples. Ezrin expression was negatively correlated with E-cadherin expression in a subpopulation of breast cancer patients with a high expression of ezrin [ezrin(high)] and a low expression of E-cadherin [E-cad(low)]. The cytoplasmic expression of E-cadherin [E-cad(c)] occurred significantly more frequently in ezrin(high) breast cancer than in ezrin(low) breast cancer. The expression level of ezrin was significantly higher in breast cancer with E-cad(c) than that with a membrane expression of E-cadherin [E-cad(m)]. Ezrin(high) or E-cad(low) expression was more associated with lymph node metastasis, and shorter overall survival (OS) and disease-free survival (DFS) in breast cancer patients. E-cad(c) was more associated with lymph node metastasis and shorter OS and DFS compared with E-cad(m). The combined expression of ezrin(high) and E-cad(low) or ezrin(high) and ezrin(c) was more associated with lymph node metastasis and poor prognosis. In addition, the multivariate Cox regression analysis revealed that lymph node metastasis and ezrin(high) expression were independent prognostic factors for shorter OS and DFS in breast cancer patients. The results of the present study suggested that ezrin promotes breast cancer metastasis via the regulation of E-cadherin expression. PMID:25955302

  13. Lymph Node–Positive Bladder Cancer Treated With Radical Cystectomy and Lymphadenectomy: Effect of the Level of Node Positivity

    PubMed Central

    Tarin, Tatum V.; Power, Nicholas E.; Ehdaie, Behfar; Sfakianos, John P.; Silberstein, Jonathan L.; Savage, Caroline J.; Sjoberg, Daniel; Dalbagni, Guido; Bochner, Bernard H.

    2014-01-01

    Background The extent of lymphadenectomy needed to optimize oncologic outcomes after radical cystectomy (RC) for patients with regionally advanced bladder cancer (BCa) is unclear. Objective Evaluate the effect of the location of lymph node metastasis on recurrence-free survival (RFS) and cancer-specific survival (CSS) for patients undergoing RC with a mapping pelvic lymph node dissection (PLND). Design, setting, and participants A study of 591 patients undergoing RC with mapping PLND was completed between 2000 and 2010. Median follow-up was 30 mo. Intervention RC with mapping PLND. Measurements We evaluated the impact of lymph node involvement by location on disease outcomes using the 2010 TNM staging system. Survival estimates were described using Kaplan-Meier methods. Gender, age, pathologic stage, histology, number of positive nodes, node density, use of perioperative chemotherapy, and grade were evaluated as predictors of RFS and CSS using multivariate Cox proportional hazard regression. Results and limitations Overall, 114 patients (19%) had lymph node involvement, and 42 patients (7%) had pN3 disease. On multivariate analysis, the number of positive lymph nodes (one or two or more) was significantly associated with increased risk of cancer-specific death (hazard ratio [HR]: 1.9 [95% confidence interval (CI), 1.04–3.46], p = 0.036; versus HR: 4.3 [95% CI, 2.25–8.34], p < 0.0005). Positive lymph node location was not an independent predictor of RFS or CSS. Five-year RFS for pN3 patients undergoing RC with PLND was 25% (95% CI, 22–54). This finding was not statistically different from our pN1 and pN2 patients (38% [95% CI, 22–54] and 35% [95% CI, 11–60], respectively). This study is limited by the lack of prospective randomization and a control group. Conclusions The outcome for patients with involved common iliac lymph nodes was similar to the outcome for patients with primary nodal basin disease. These data support inclusion of the common iliac lymph nodes (pN3) in the nodal staging system for BCa. Lymph node location was not an independent predictor of outcome, whereas the number of positive lymph nodes was an independent predictor of worse oncologic outcome (pN1, pN2). Further refinements of the TNM system to provide improved prognostication are warranted. PMID:22342773

  14. Predicting Pelvic Lymph Node Involvement in Current-Era Prostate Cancer

    SciTech Connect

    Rahman, Sophia, E-mail: sophs1578@yahoo.com [Kaiser Permanente Medical Center, Department of Radiation Oncology, Los Angeles, CA (United States); Cosmatos, Harry [Kaiser Permanente Medical Center, Department of Radiation Oncology, Los Angeles, CA (United States); Dave, Giatri [Kaiser Permanente Medical Center, Department of Radiation Oncology, Fresno, CA (United States); Williams, Stephen [Kaiser Permanente Medical Center, Department of Urology, Los Angeles, CA (United States); Tome, Michael [Kaiser Permanente Medical Center, Department of Radiation Oncology, Los Angeles, CA (United States)

    2012-02-01

    Purpose: The Roach formula [2/3 Multiplication-Sign prostate-specific antigen + (Gleason score - 6) Multiplication-Sign 10], derived in 1993 during the early prostate specific antigen (PSA) screening era, has been used to predict the risk of pelvic lymph node involvement in patients with prostate cancer. In the current era of widespread PSA screening with a shift to earlier disease stages, there is evidence to suggest that the Roach score overestimates risk of nodal metastasis. This study retrospectively reviews the validity of this formula as a prediction tool. Methods and Materials: We conducted a retrospective institutional review including men with clinical T1c-T3 prostate cancer, with baseline PSA levels and biopsy-obtained Gleason scores who underwent radical prostatectomy with pelvic node dissection from 2001 through 2009 (N = 1,022). The predicted risk of nodal involvement was calculated for each patient using the Roach formula and then compared with actual rates following surgery. Results: The study included 1,022 patients; 99.6% had clinical T1c/T2 disease, with a mean of 10.3 lymph nodes surgically evaluated. Overall, 42 patients (4.1%) had nodal metastasis. For every range of scores, the Roach formula overestimates the risk of nodal involvement. Observed nodal positivity was 1%, 6.3%, 10%, 15.2%, and 16.7% for Roach scores {<=}10%, >10%-20%, >20%-30%, >30%-40%, and >40%, respectively. The Roach score overestimates the risk by approximately 4.5-fold in patients with scores {<=}10%, by 2.5-fold for all scores between 10% and 40%, and by 4-fold for scores >40%. Conclusion: The Roach formula overpredicts the risk of pelvic nodal involvement in current-era prostate cancer patients undergoing regular PSA screening and with mainly T1c/T2 disease. Contemporary patients are much less likely to have nodal involvement for a given PSA and Gleason score.

  15. Ten-Year Locoregional Recurrence Risks in Women With Nodal Micrometastatic Breast Cancer Staged With Axillary Dissection

    SciTech Connect

    Lupe, Krystine [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Island Centre, Victoria, BC (Canada); Truong, Pauline T., E-mail: ptruong@bccancer.bc.ca [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Island Centre, Victoria, BC (Canada); Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, Victoria, BC (Canada); University of British Columbia, Victoria, BC (Canada); Alexander, Cheryl; Speers, Caroline [Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, Victoria, BC (Canada); Tyldesley, Scott [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Island Centre, Victoria, BC (Canada); Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, Victoria, BC (Canada); University of British Columbia, Victoria, BC (Canada)

    2011-12-01

    Purpose: To compare the locoregional recurrence (LRR) rates in patients with nodal mirometastases (pNmic) with those in patients with node-negative (pN0) and macroscopic node-positive (pNmac) breast cancer; and to evaluate the LRR rates according to locoregional treatment of pNmic disease. Methods and Materials: The subjects were 9,616 women diagnosed between 1989 and 1999 with Stage pT1-T2, pN0, pNmic, or pNmac, M0 breast cancer. All women had undergone axillary dissection. The Kaplan-Meier local recurrence, regional recurrence, and LRR rates were compared among those with pN0 (n = 7,977), pNmic (n = 490) and pNmac (n = 1,149) and according to locoregional treatment. Multivariate analysis was performed to identify the significant factors associated with LRR. Results: The median follow-up was 11 years. The 10-year Kaplan-Meier recurrence rate in the pN0, pNmic, and pNmac cohorts was 6.1%, 6.8%, and 8.7% for local recurrence; 3.1%, 6.2%, and 10.3% for regional recurrence; and 8.0%, 11.6%, and 15.2% for LRR, respectively (all p < .001). In the pNmic patients, the 10-year regional recurrence rate was 6.4% with breast-conserving surgery plus breast radiotherapy (RT), 5.4% with breast-conserving surgery plus locoregional RT, 4.6% with mastectomy alone, 11.1% with mastectomy plus chest wall RT, and 10.7% with mastectomy plus locoregional RT. In patients with pNmic disease and age <45 years, Grade 3 histologic features, lymphovascular invasion, nodal ratio >0.25, and estrogen receptor-negative disease, the 10-year LRR rates were 15-20%. On multivariate analysis of the entire cohort, pNmic was associated with greater LRR than Stage pN0 (hazard ratio [HR], 1.6; p = .002). On multivariate analysis of pNmic patients only, age <45 years was associated with significantly greater LRR (HR, 1.9; p = .03), and trends for greater LRR were observed with a nodal ratio >0.25 (HR, 2.0; p = .07) and lymphovascular invasion (HR, 1.7; p = .07). Conclusion: Women with pNmic had a greater risk of LRR than those with pN0 disease. Patients with pNmic in association with young age, Grade 3 histologic features, lymphovascular invasion, nodal ratio >0.25, and estrogen receptor-negative disease experienced 10-year LRR rates of {approx}15-20%, warranting consideration of locoregional RT.

  16. Colorectal cancer and lymph nodes: The obsession with the number 12

    PubMed Central

    Li Destri, Giovanni; Di Carlo, Isidoro; Scilletta, Roberto; Scilletta, Beniamino; Puleo, Stefano

    2014-01-01

    Lymphadenectomy of colorectal cancer is a decisive factor for the prognostic and therapeutic staging of the patient. For over 15 years, we have asked ourselves if the minimum number of 12 examined lymph nodes (LNs) was sufficient for the prevention of understaging. The debate is certainly still open if we consider that a limit of 12 LNs is still not the gold standard mainly because the research methodology of the first studies has been criticized. Moreover many authors report that to date both in the United States and Europe the number “12” target is uncommon, not adequate, or accessible only in highly specialised centres. It should however be noted that both the pressing nature of the debate and the dissemination of guidelines have been responsible for a trend that has allowed for a general increase in the number of LNs examined. There are different variables that can affect the retrieval of LNs. Some, like the surgeon, the surgery, and the pathology exam, are without question modifiable; however, other both patient and disease-related variables are non-modifiable and pose the question of whether the minimum number of examined LNs must be individually assigned. The lymph nodal ratio, the sentinel LNs and the study of the biological aspects of the tumor could find valid application in this field in the near future. PMID:24587671

  17. [Lymphatic spread of lung cancer: anatomical lymph node chains unchained in zones].

    PubMed

    Riquet, M; Rivera, C; Gibault, L; Pricopi, C; Mordant, P; Badia, A; Arame, A; Le Pimpec Barthes, F

    2014-01-01

    Lung cancer is characterized by its lymphophilia. Its metastatic spread mainly occurs by tumor cells lymphatic drainage into the blood circulation. Initially, the lymph node TNM classification was based on clinical and therapeutic considerations, particularly concerning N2 involvement. The goals were to avoid futile exploratory thoracotomies without lung resection, to provide more accurate data from mediastinoscopy, and to take into account the radiation therapy fields. Since 1997, the international lymph node classification was more used to analyse the disparities within N1 and N2 groups. However, this attempt did not succeed in clarifying the lymphatic metastazing process, and was not progressing any more. Anatomy not being considered, it did not permit to grasp the anatomical and physiological significances of N2 and N3 involvement. In effect, this classification is now confined in zones and is lacking the anatomical and physiological descriptions that characterise the lymphatic pathways draining the lungs and their tumoral pathology. The stations proposed in numbers in cartographies should have gained in accuracy and in prognostic value if they had been expressed in their anatomical counterparts. PMID:24566031

  18. Sentinel lymph node metastases in cancer: causes, detection and their role in disease progression.

    PubMed

    Nathanson, S D; Shah, R; Rosso, K

    2015-02-01

    Malignant tumors of ectodermal or endodermal origin may metastasize to the sentinel lymph node, the first lymph node encountered by tumor cells that enter lymphatics in the organ of origin. This pathway is enabled by the anatomy of the disease and the causes of metastasis are the result of complex interactions that include mechanical forces within the tumor and host tissues, and molecular factors initiated by tumor cell proliferation, elaboration of cytokines and changes in the tumor microenvironment. Mechanical stresses may influence complex biochemical, genetic and other molecular events and enhance the likelihood of metastasis. This paper summarizes our understanding of interacting molecular, anatomical and mechanical processes which facilitate metastasis to SLNs. Our understanding of these interacting events is based on a combination of clinical and basic science research, in vitro and in vivo, including studies in lymphatic embryology, anatomy, micro-anatomy, pathology, physiology, molecular biology and mechanobiology. The presence of metastatic tumor in the SLN is now more accurately identifiable and, based upon prospective clinical trials, paradigm-changing SLN biopsy has become the standard of clinical practice in breast cancer and melanoma. PMID:25444847

  19. Effects of phase I complex decongestive physiotherapy on physical functions and depression levels in breast cancer related lymph edema

    PubMed Central

    Atalay, Orçin Telli; Özkir, An?l; Çalik, Bilge Ba?akçi; Baskan, Emre; Ta?kin, Harun

    2015-01-01

    [Purpose] Breast cancer-related upper extremity lymph edema is known to cause physical, functional and psychological impairments in women after modified radical mastectomy. The aim of this study was to investigate the effects of phase I Complex Decongestive Physiotherapy (CDP) on physical functions and depression levels in women with breast cancer-related upper extremity lymph edema. [Subjects and Methods] Fifty-eight subjects with breast cancer-related upper extremity lymph edema were the subjects of this study. The arm circumference, shoulder range of motion (ROM), muscle strength and depression levels of the subjects were assessed before and after phase I CDP treatment. [Results] After phase I CDP, there was a statistically significant reduction in circumference measurements at all levels of the affected arm. There was not any statistically significant difference in muscle strength after CDP. The shoulder ROM improved after treatment. There was a significant reduction in the Beck Depression Inventory score. A significant positive correlation was found between depression levels and circumference measurement. [Conclusion] Based on the results we suggest that by reducing limb volume, beside improving physical functions, phase I CDP can affect psychological status, especially depression which is very common in women with breast cancer-related upper extremity lymph edema. PMID:25931748

  20. Should a Sentinel Node Biopsy Be Performed in Patients with High-Risk Breast Cancer?

    PubMed Central

    Westover, Kenneth D.; Westover, M. Brandon; Winer, Eric P.; Richardson, Andrea L.; Iglehart, J. Dirk; Punglia, Rinaa S.

    2011-01-01

    A negative sentinel lymph node (SLN) biopsy spares many breast cancer patients the complications associated with lymph node irradiation or additional surgery. However, patients at high risk for nodal involvement based on clinical characteristics may remain at unacceptably high risk of axillary disease even after a negative SLN biopsy result. A Bayesian nomogram was designed to combine the probability of axillary disease prior to nodal biopsy with customized test characteristics for an SLN biopsy and provides the probability of axillary disease despite a negative SLN biopsy. Users may individualize the sensitivity of an SLN biopsy based on factors known to modify the sensitivity of the procedure. This tool may be useful in identifying patients who should have expanded upfront exploration of the axilla or comprehensive axillary irradiation. PMID:22295240

  1. Does skip metastasis or other lymph node parameters have additional effects on survival of patients undergoing radical cystectomy for bladder cancer?

    PubMed Central

    Baltaci, Sumer; Aslan, Guven; Can, Cavit; Cal, Cag; Elhan, Atilla; Turkeri, Levent; Mungan, Aydin

    2015-01-01

    Purpose To investigate the effects of lymph node metastasis, skip metastasis, and other factors related to lymph node status on survival in patients who underwent radical cystectomy (RC) and extended lymph node dissection (eLND). Materials and Methods RC and eLND were performed in 85 patients with a diagnosis of bladder cancer. Disease-free survival (DFS) and overall survival (OS) were determined by using a Cox proportional hazards model that included the number of excised lymph nodes, the presence of pathological lymph node metastasis, the anatomical level of positive nodes, the number of positive lymph nodes, lymph node density, and the presence of skip metastasis. Results The mean number of lymph nodes removed per patient was 29.4±9.3. Lymph node positivity was detected in 85 patients (34.1%). The mean follow-up duration was 44.9±27.4 months (2-93 months). Five-year estimated OS and DFS for the 85 patients were 62.6% and 57%, respectively. Three of 29 lymph node-positive patients (10.3%) had skip metastasis. Only lymph node positivity had a significant effect on 5-year OS and DFS (p<0.001). No difference in OS and DFS was found between the three patients with skip metastasis and other lymph node-positive patients. Other factors related to lymph node status had no significant effect on 5-year OS and DFS. Conclusions No factors related to lymph node status predict DFS and OS, except for lymph node positivity. OS and DFS were comparable between patients with skip metastasis and other lymph node-positive patients. PMID:25964836

  2. Size analysis of lymph node metastasis in esophageal cancer: diameter distribution and assessment of accuracy of preoperative diagnosis

    Microsoft Academic Search

    Yoshiaki Kajiyama; Yoshimi Iwanuma; Natsumi Tomita; Takayuki Amano; Fuyumi Isayama; Toshiharu Matsumoto; Masahiko Tsurumaru

    2006-01-01

    Background  In esophageal cancer, lymphatic spread occurs more frequently and at an earlier stage than in other gastrointestinal cancers,\\u000a and both preoperative and intraoperative diagnoses of lymph nodes metastases are sometimes incorrect. Our objective was to\\u000a measure the sizes of lymphatic metastases and to examine the accuracy of clinical diagnosis of lymphatic spread in patients\\u000a with squamous cell carcinoma of the

  3. Adjuvant Therapy in Lymph Node–Positive Vulvar Cancer: The AGO-CaRE-1 Study

    PubMed Central

    Jueckstock, Julia; Hilpert, Felix; Neuser, Petra; Harter, Philipp; de Gregorio, Nikolaus; Hasenburg, Annette; Sehouli, Jalid; Habermann, Annika; Hillemanns, Peter; Fuerst, Sophie; Strauss, Hans-Georg; Baumann, Klaus; Thiel, Falk; Mustea, Alexander; Meier, Werner; du Bois, Andreas; Griebel, Lis-Femke; Woelber, Linn

    2015-01-01

    Background: Women with node-positive vulvar cancer have a high risk for disease recurrence. Indication criteria for adjuvant radiotherapy are controversial. This study was designed to further understand the role of adjuvant therapy in node-positive disease. Methods: Patients with primary squamous-cell vulvar cancer treated at 29 gynecologic cancer centers in Germany from 1998 through 2008 were included in this retrospective exploratory multicenter cohort study. Of 1618 documented patients, 1249 had surgical groin staging and known lymph node status and were further analyzed. All statistical tests were two-sided. Results: Four hundred forty-seven of 1249 patients (35.8%) had lymph node metastases (N+). The majority of N+ patients had one (172 [38.5%]) or two (102 [22.8%]) positive nodes. The three-year progression-free survival (PFS) rate of N+ patients was 35.2%, and the overall survival (OS) rate 56.2% compared with 75.2% and 90.2% in node-negative patients (N-). Two hundred forty-four (54.6%) N+ patients had adjuvant therapy, of which 183 (40.9%) had radiotherapy directed at the groins (+/-other fields). Three-year PFS and OS rates in these patients were better compared with N+ patients without adjuvant treatment (PFS: 39.6% vs 25.9%, hazard ratio [HR] = 0.67, 95% confidence interval [CI[= 0.51 to 0.88, P = .004; OS: 57.7% vs 51.4%, HR = 0.79, 95% CI = 0.56 to 1.11, P = .17). This effect was statistically significant in multivariable analysis adjusted for age, Eastern Cooperative Oncology Group, Union internationale contre le cancer stage, grade, invasion depth, and number of positive nodes (PFS: HR = 0.58, 95% CI = 0.43 to 0.78, P < .001; OS: HR = 0.63, 95% CI = 0.43 to 0.91, P = .01). Conclusion: This large multicenter study in vulvar cancer observed that adjuvant radiotherapy was associated with improved prognosis in node-positive patients and will hopefully help to overcome concerns regarding adjuvant treatment. However, outcome after adjuvant radiotherapy remains poor compared with node-negative patients. Adjuvant chemoradiation could be a possible strategy to improve therapy because it is superior to radiotherapy alone in other squamous cell carcinomas. PMID:25618900

  4. Intensity-Modulated Radiotherapy for Cervical Lymph Node Metastases From Unknown Primary Cancer

    SciTech Connect

    Madani, Indira [Department of Radiotherapy, Ghent University Hospital, Ghent (Belgium)], E-mail: indira@krtkg1.ugent.be; Vakaet, Luc [Department of Radiotherapy, Ghent University Hospital, Ghent (Belgium); Bonte, Katrien [Division of Head and Neck Surgery, Ghent University Hospital, Ghent (Belgium); Boterberg, Tom; Neve, Wilfried de [Department of Radiotherapy, Ghent University Hospital, Ghent (Belgium)

    2008-07-15

    Purpose: To compare the effectiveness of intensity-modulated radiotherapy (IMRT) and conventional (two-dimensional) radiotherapy in the treatment of cervical lymph node metastases from unknown primary cancer (UPC). Methods and Materials: Between February 2003 and September 2006, 23 patients with UPC of squamous cell carcinoma were treated with IMRT. Extended putative mucosal and bilateral nodal sites were irradiated to a median dose of 66 Gy. In 19 patients, IMRT was performed after lymph node dissection, and in 4 patients primary radiotherapy was given. The conventional radiotherapy group (historical control group) comprised 18 patients treated to a median dose of 66 Gy between August 1994 and October 2003. Results: Twenty patients completed treatment. As compared with conventional radiotherapy, the incidence of Grade 3 acute dysphagia was significantly lower in the IMRT group (4.5% vs. 50%, p = 0.003). By 6 months, Grade 3 xerostomia was detected in 11.8% patients in the IMRT group vs. 53.4% in the historical control group (p = 0.03). No Grade 3 dysphagia or skin fibrosis was observed after IMRT but these were noted after conventional radiotherapy (26.7%, p = 0.01) and 26.7%, p = 0.03) respectively). With median follow-up of living patients of 17 months, there was no emergence of primary cancer. One patient had persistent nodal disease and another had nodal relapse at 5 months. Distant metastases were detected in 4 patients. The 2-year overall survival and distant disease-free probability after IMRT did not differ significantly from those for conventional radiotherapy (74.8% vs. 61.1% and 76.3% vs. 68.4%, respectively). Conclusions: Use of IMRT for UPC resulted in lower toxicity than conventional radiotherapy, and was similar in efficacy.

  5. Epitrochlear sentinel lymph nodes in melanoma: interval or independent?

    PubMed

    Kidner, Travis B; Yoon, Jeong L; Faries, Mark B; Morton, Donald L

    2012-06-01

    Most primary melanomas on the distal upper extremity metastasize to a sentinel lymph node (SLN) in the axillary basin, but occasionally a primary melanoma will drain to the epitrochlear basin. The relationship between tumor-draining axillary and epitrochlear SLNs is unclear. We hypothesize that the epitrochlear SLN functions in an interval manner with the axillary lymph node basin. We queried our melanoma database to identify patients who underwent SLN biopsy for a distal upper-extremity melanoma. Patient demographics, tumor characteristics, patterns of nodal drainage, and incidence of SLN metastasis were analyzed. Of 255 patients identified, 38 (14.9%) had an epitrochlear SLN. Mean Breslow thickness was 2.26 mm. All patients with epitrochlear drainage had concurrent axillary drainage and underwent axillary and epitrochlear SLN biopsies. Of these 38 patients, two (5.2%) had epitrochlear and axillary SLN metastasis, four (10.5%) had epitrochlear metastasis only, four (10.5%) had axillary metastasis only, and the remaining 28 (73.7%) had tumor-free SLNs. The invariable association of epitrochlear and axillary drainage in this study suggests that epitrochlear nodes function in an interval role with the axillary lymph node basin. Therefore we recommend that all patients with a positive epitrochlear SLN undergo completion axillary dissection. PMID:22643268

  6. Epitrochlear Sentinel Lymph Nodes in Melanoma: Interval or Independent?

    PubMed Central

    Kidner, Travis; Yoon, Jeong; Faries, Mark; Morton, Donald

    2012-01-01

    Most primary melanomas on the distal upper extremity metastasize to a sentinel lymph node (SLN) in the axillary basin, but occasionally a primary melanoma will drain to the epitrochlear basin. The relationship between tumor-draining axillary and epitrochlear SLNs is unclear. We hypothesize that the epitrochlear SLN functions in an interval manner with the axillary lymph node basin. We queried our melanoma database to identify patients who underwent SLN biopsy for a distal upper-extremity melanoma. Patient demographics, tumor characteristics, patterns of nodal drainage and incidence of SLN metastasis were analyzed. Of 255 patients identified, 38 (14.9%) had an epitrochlear SLN. Mean Breslow thickness was 2.26 mm. All patients with epitrochlear drainage had concurrent axillary drainage and underwent axillary and epitrochlear SLN biopsies. Of these 38 patients, two (5.2%) had epitrochlear and axillary SLN metastasis, four (10.5%) had epitrochlear metastasis only, four (10.5%) had axillary metastasis only, and the remaining 28 (73.7%) had tumor-free SLNs. The invariable association of epitrochlear and axillary drainage in this study suggests that epitrochlear nodes function in an interval role with the axillary lymph node basin. Therefore we recommend that all patients with a positive epitrochlear SLN undergo completion axillary dissection. PMID:22643268

  7. Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes.

    PubMed

    Austwick, Martin R; Clark, Benjamin; Mosse, Charles A; Johnson, Kristie; Chicken, D Wayne; Somasundaram, Santosh K; Calabro, Katherine W; Zhu, Ying; Falzon, Mary; Kocjan, Gabrijela; Fearn, Tom; Bown, Stephen G; Bigio, Irving J; Keshtgar, Mohammed R S

    2010-01-01

    A novel method for rapidly detecting metastatic breast cancer within excised sentinel lymph node(s) of the axilla is presented. Elastic scattering spectroscopy (ESS) is a point-contact technique that collects broadband optical spectra sensitive to absorption and scattering within the tissue. A statistical discrimination algorithm was generated from a training set of nearly 3000 clinical spectra and used to test clinical spectra collected from an independent set of nodes. Freshly excised nodes were bivalved and mounted under a fiber-optic plate. Stepper motors raster-scanned a fiber-optic probe over the plate to interrogate the node's cut surface, creating a 20x20 grid of spectra. These spectra were analyzed to create a map of cancer risk across the node surface. Rules were developed to convert these maps to a prediction for the presence of cancer in the node. Using these analyses, a leave-one-out cross-validation to optimize discrimination parameters on 128 scanned nodes gave a sensitivity of 69% for detection of clinically relevant metastases (71% for macrometastases) and a specificity of 96%, comparable to literature results for touch imprint cytology, a standard technique for intraoperative diagnosis. ESS has the advantage of not requiring a pathologist to review the tissue sample. PMID:20799832

  8. Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes

    PubMed Central

    Austwick, Martin R.; Clark, Benjamin; Mosse, Charles A.; Johnson, Kristie; Chicken, D. Wayne; Somasundaram, Santosh K.; Calabro, Katherine W.; Zhu, Ying; Falzon, Mary; Kocjan, Gabrijela; Fearn, Tom; Bown, Stephen G.; Bigio, Irving J.; Keshtgar, Mohammed R.S.

    2010-01-01

    A novel method for rapidly detecting metastatic breast cancer within excised sentinel lymph node(s) of the axilla is presented. Elastic scattering spectroscopy (ESS) is a point-contact technique that collects broadband optical spectra sensitive to absorption and scattering within the tissue. A statistical discrimination algorithm was generated from a training set of nearly 3000 clinical spectra and used to test clinical spectra collected from an independent set of nodes. Freshly excised nodes were bivalved and mounted under a fiber-optic plate. Stepper motors raster-scanned a fiber-optic probe over the plate to interrogate the node’s cut surface, creating a 20×20 grid of spectra. These spectra were analyzed to create a map of cancer risk across the node surface. Rules were developed to convert these maps to a prediction for the presence of cancer in the node. Using these analyses, a leave-one-out cross-validation to optimize discrimination parameters on 128 scanned nodes gave a sensitivity of 69% for detection of clinically relevant metastases (71% for macrometastases) and a specificity of 96%, comparable to literature results for touch imprint cytology, a standard technique for intraoperative diagnosis. ESS has the advantage of not requiring a pathologist to review the tissue sample. PMID:20799832

  9. Scanning elastic scattering spectroscopy detects metastatic breast cancer in sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Austwick, Martin R.; Clark, Benjamin; Mosse, Charles A.; Johnson, Kristie; Chicken, D. Wayne; Somasundaram, Santosh K.; Calabro, Katherine W.; Zhu, Ying; Falzon, Mary; Kocjan, Gabrijela; Fearn, Tom; Bown, Stephen G.; Bigio, Irving J.; Keshtgar, Mohammed R. S.

    2010-07-01

    A novel method for rapidly detecting metastatic breast cancer within excised sentinel lymph node(s) of the axilla is presented. Elastic scattering spectroscopy (ESS) is a point-contact technique that collects broadband optical spectra sensitive to absorption and scattering within the tissue. A statistical discrimination algorithm was generated from a training set of nearly 3000 clinical spectra and used to test clinical spectra collected from an independent set of nodes. Freshly excised nodes were bivalved and mounted under a fiber-optic plate. Stepper motors raster-scanned a fiber-optic probe over the plate to interrogate the node's cut surface, creating a 20×20 grid of spectra. These spectra were analyzed to create a map of cancer risk across the node surface. Rules were developed to convert these maps to a prediction for the presence of cancer in the node. Using these analyses, a leave-one-out cross-validation to optimize discrimination parameters on 128 scanned nodes gave a sensitivity of 69% for detection of clinically relevant metastases (71% for macrometastases) and a specificity of 96%, comparable to literature results for touch imprint cytology, a standard technique for intraoperative diagnosis. ESS has the advantage of not requiring a pathologist to review the tissue sample.

  10. Evaluation of Breast Sentinel Lymph Node Coverage by Standard Radiation Therapy Fields

    SciTech Connect

    Rabinovitch, Rachel [Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, CO (United States)], E-mail: Rachel.rabinovitch@uchsc.edu; Ballonoff, Ari; Newman, Francis M.S. [Department of Radiation Oncology, University of Colorado Cancer Center, Aurora, CO (United States); Finlayson, Christina [Department of GI, Tumor, and Endocrine Surgery, University of Colorado Cancer Center, Aurora, CO (United States)

    2008-04-01

    Background: Biopsy of the breast sentinel lymph node (SLN) is now a standard staging procedure for early-stage invasive breast cancer. The anatomic location of the breast SLN and its relationship to standard radiation fields has not been described. Methods and Materials: A retrospective review of radiotherapy treatment planning data sets was performed in patients with breast cancer who had undergone SLN biopsy, and those with a surgical clip at the SLN biopsy site were identified. The location of the clip was evaluated relative to vertebral body level on an anterior-posterior digitally reconstructed radiograph, treated whole-breast tangential radiation fields, and standard axillary fields in 106 data sets meeting these criteria. Results: The breast SLN varied in vertebral body level position, ranging from T2 to T7 but most commonly opposite T4. The SLN clip was located below the base of the clavicle in 90%, and hence would be excluded from standard axillary radiotherapy fields where the inferior border is placed at this level. The clip was within the irradiated whole-breast tangent fields in 78%, beneath the superior-posterior corner multileaf collimators in 12%, and outside the tangent field borders in 10%. Conclusions: Standard axillary fields do not encompass the lymph nodes at highest risk of containing tumor in breast cancer patients. Elimination of the superior-posterior corner MLCs from the tangent field design would result in inclusion of the breast SLN in 90% of patients treated with standard whole-breast irradiation.

  11. Near-infrared fluorescence sentinel lymph node mapping in breast cancer: a multicenter experience

    PubMed Central

    Verbeek, Floris P.R.; Troyan, Susan L.; Mieog, J. Sven D.; Liefers, Gerrit-Jan; Moffitt, Lorissa A.; Rosenberg, Mireille; Hirshfield-Bartek, Judith; Gioux, Sylvain; van de Velde, Cornelis J.H.; Vahrmeijer, Alexander L.; Frangioni, John V.

    2014-01-01

    NIR fluorescence imaging using indocyanine green (ICG) has the potential to improve the SLN procedure by facilitating percutaneous and intraoperative identification of lymphatic channels and SLNs. Previous studies suggested that a dose of 0.62 mg (1.6 ml of 0.5 mM) ICG is optimal for SLN mapping in breast cancer. The aim of this study was to evaluate the diagnostic accuracy of near-infrared (NIR) fluorescence for sentinel lymph node (SLN) mapping in breast cancer patients when used in conjunction with conventional techniques. Study subjects were 95 breast cancer patients planning to undergo SLN procedure at either the Dana-Farber/Harvard Cancer Center (Boston, MA, USA) or the Leiden University Medical Center (Leiden, the Netherlands) between July 2010 and January 2013. Subjects underwent the standard-of-care SLN procedure at each institution using 99Technetium-colloid in all subjects and patent blue in 27 (28%) of the subjects. NIR fluorescence-guided SLN detection was performed using the Mini-FLARE imaging system. SLN identification was successful in 94 of 95 subjects (99%) using NIR fluorescence imaging or a combination of both NIR fluorescence imaging and radioactive guidance. In 2 of 95 subjects, radioactive guidance was necessary for initial in vivo identification of SLNs. In 1 of 95 subjects, NIR fluorescence was necessary for initial in vivo identification of SLNs. A total of 177 SLNs (mean = 1.9, range = 1–5) were resected: 100% NIR fluorescent, 88% radioactive, and 78% (of 40 nodes) blue. In 2 of 95 subjects (2.1%), SLNs containing macrometastases were found only by NIR fluorescence, and in 1 patient this led to upstaging to N1. This study demonstrates the safe and accurate application of NIR fluorescence imaging for the identification of SLNs in breast cancer patients, but calls into question what technique should be used as the gold standard in future studies. PMID:24337507

  12. A lymph node ratio of 10% is predictive of survival in stage III colon cancer: a French regional study.

    PubMed

    Sabbagh, Charles; Mauvais, François; Cosse, Cyril; Rebibo, Lionel; Joly, Jean-Paul; Dromer, Didier; Aubert, Christine; Carton, Sophie; Dron, Bernard; Dadamessi, Innocenti; Maes, Bernard; Perrier, Guillaume; Manaouil, David; Fontaine, Jean-François; Gozy, Michel; Panis, Xavier; Foncelle, Pierre Henri; de Fresnoy, Hugues; Leroux, Fabien; Vaneslander, Pierre; Ghighi, Caroline; Regimbeau, Jean-Marc

    2014-01-01

    Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between "good prognosis" and "poor prognosis" colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P=0.06) and a significant correlation between the LNR group and 3-year DFS (P=0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P=0.02) and DFS (P=0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff. PMID:25058763

  13. A Lymph Node Ratio of 10% Is Predictive of Survival in Stage III Colon Cancer: A French Regional Study

    PubMed Central

    Sabbagh, Charles; Mauvais, François; Cosse, Cyril; Rebibo, Lionel; Joly, Jean-Paul; Dromer, Didier; Aubert, Christine; Carton, Sophie; Dron, Bernard; Dadamessi, Innocenti; Maes, Bernard; Perrier, Guillaume; Manaouil, David; Fontaine, Jean-François; Gozy, Michel; Panis, Xavier; Foncelle, Pierre Henri; de Fresnoy, Hugues; Leroux, Fabien; Vaneslander, Pierre; Ghighi, Caroline; Regimbeau, Jean-Marc

    2014-01-01

    Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between “good prognosis” and “poor prognosis” colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P = 0.06) and a significant correlation between the LNR group and 3-year DFS (P = 0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P = 0.02) and DFS (P = 0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff. PMID:25058763

  14. Axillary lump: an unusual presentation of fat necrosis in the breast.

    PubMed

    Donuru, A; Obaid, H; Al Attar, M; Kandula, V; Purnell, D

    2007-10-01

    The clinical presentation of an axillary lump, in majority of cases, raises suspicion of an enlarged lymph node due to malignant causes. In this case report, we established a diagnosis of an axillary lump caused by fat necrosis. We present this case report with review of the literature to familiarize clinicians with this condition. PMID:17875154

  15. Mitotic centromere-associated kinesin is a novel marker for prognosis and lymph node metastasis in colorectal cancer

    PubMed Central

    Ishikawa, K; Kamohara, Y; Tanaka, F; Haraguchi, N; Mimori, K; Inoue, H; Mori, M

    2008-01-01

    Mitotic centromere-associated kinesin (MCAK) is a microtubule depolymerase that is essential for proper kinetochore–microtubule attachment during spindle formation. Overexpression of MCAK has been correlated with aggressive forms of carcinoma, resulting in poor prognosis of colorectal cancer. The purpose of this study was to quantify MCAK expression in malignant and benign colorectal tissues and to determine if MCAK expression levels correlate with clinicopathologic factors and prognosis in colorectal cancer patients. Paired colorectal tissue samples from tumours and the corresponding normal tissues were obtained from 120 patients with colorectal cancer who underwent surgical resection. The real-time reverse transcriptase-PCR and immunohistochemistry were used to analyse mRNA and protein expression status with respect to various clinicopathological factors. MCAK expression was higher in colorectal cancer tissue (P<0.01) than in corresponding normal tissue, and this elevated expression level was markedly associated with factors such as lymph node metastasis (P=0.0023), venous invasion (P=0.019), peritoneal dissemination (P=0.021) and Dukes' classification (P=0.0023). Patients with high MCAK mRNA expression also showed a far poorer survival rate than those with low MCAK mRNA expression (P<0.01). Elevated MCAK expression was an independent predictor of overall survival and lymph node metastasis. These data suggest that MCAK expression may serve as a good marker of prognosis and lymph node metastasis in colorectal cancer. PMID:18506187

  16. MRI with a lymph-node-specific contrast agent as an alternative to CT scan and lymph-node dissection in patients with prostate cancer: a prospective multicohort study

    Microsoft Academic Search

    Roel AM Heesakkers; Anke M Hövels; Gerrit J Jager; Harrie CM van den Bosch; J Alfred Witjes; Hein PJ Raat; Johan L Severens; Eddy MM Adang; Christina Hulsbergen van der Kaa; Jurgen J Fütterer; Jelle Barentsz

    2008-01-01

    BACKGROUND: In patients with prostate cancer who are deemed to be at intermediate or high risk of having nodal metastases, invasive diagnostic pelvic lymph-node dissection (PLND) is the gold standard for the detection of nodal disease. However, a new lymph-node-specific MR-contrast agent ferumoxtran-10 can detect metastases in normal-sized nodes (ie, <8 mm in size) by use of MR lymphoangiography (MRL).

  17. Photoacoustic image-guided needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Akers, Walter J.; Maslov, Konstantin; Song, Liang; Jankovic, Ladislav; Margenthaler, Julie A.; Achilefu, Samuel; Wang, Lihong V.

    2011-03-01

    We have implemented a hand-held photoacoustic and ultrasound probe for image-guided needle biopsy using a modified clinical ultrasound array system. Pulsed laser light was delivered via bifurcated optical fiber bundles integrated with the hand-held ultrasound probe. We photoacoustically guided needle insertion into rat sentinel lymph nodes (SLNs) following accumulation of indocyanine green (ICG). Strong photoacoustic image contrast of the needle was achieved. After intradermal injection of ICG in the left forepaw, deeply positioned SLNs (beneath 2-cm thick chicken breast) were easily indentified in vivo and in real time. Further, we confirmed ICG uptake in axillary lymph nodes with in vivo and ex vivo fluorescence imaging. These results demonstrate the clinical potential of this hand-held photoacoustic system for facile identification and needle biopsy of SLNs for cancer staging and metastasis detection in humans.

  18. Concerning the article “The association of lymph node volume with cervical metastatic lesions in head and neck cancer patients” by Liang et al

    Microsoft Academic Search

    Ohad Hilly; Michal Preis; Jacob Shvero

    2010-01-01

    Sir, Preoperative assessment for the presence of metastatic cervical lymph nodes is an important step in the initial evaluation of patients with head and neck cancer. Unfortunately, clinical assessment by palpation is inaccurate, therefore, many researchers attempted to establish imaging criteria that predicts regional spread to cervical lymph nodes. We read with interest the study by Liang et al. “The

  19. Tracking nonpalpable breast cancer for breast-conserving surgery with carbon nanoparticles: implication in tumor location and lymph node dissection.

    PubMed

    Jiang, Yanyan; Lin, Nan; Huang, Sheng; Lin, Chongping; Jin, Na; Zhang, Zaizhong; Ke, Jun; Yu, Yinghao; Zhu, Jianping; Wang, Yu

    2015-03-01

    To examine the feasibility of using carbon nanoparticles to track nonpalpable breast cancer for breast-conserving surgery. During breast-conserving surgery, it is often very challenging to determine the boundary of tumor and identify involved lymph nodes. Currently used methods are useful in identifying tumor location, but do not provide direct visual guidance for resection margin during surgery. The study was approved by the Institutional Review Board of the Fuzhou General Hospital (Fuzhou, China). The current retrospective analysis included 16 patients with nonpalpable breast cancer receiving breast-conserving surgery under the guidance of preoperative marking using a carbon nanoparticle, as well as 3 patients receiving carbon nanoparticle marking followed by neoadjuvant treatment and then breast-conserving surgery. The Tumor Node Metastasis stage in the 16 cases included: T1N0M0 in 7, T1N1M0 in 2, T2N0M0 in 4, and T2N1M0 in the remaining 3 cases. The nanoparticle was injected at 12 sites at 0.5?cm away from the apparent edge under colored ultrasonography along 6 tracks separated by 60 degrees (2 sites every track). Lymph node status was also examined. The resection edge was free from cancer cells in all 16 cases (and the 3 cases with neoadjuvant treatment). Cancer cells were identified in majority of stained lymph nodes, but not in any of the unstained lymph nodes. No recurrence or metastasis was noticed after the surgery (2 to 22-month follow-up; median: 6 months). Tracking nonpalpable breast cancer with carbon nanoparticle could guide breast-conserving surgery. PMID:25761181

  20. L1 Cell Adhesion Molecule Expression Is Associated With Pelvic Lymph Node Metastasis and Advanced Stage in Diabetic Patients With Endometrial Cancer: A Matched Case Control Study

    PubMed Central

    Suh, Dong Hoon; Kim, Min A; Kim, Hee Seung; Chung, Hyun Hoon; Park, Noh Hyun; Song, Yong Sang; Kang, Soon-Beom

    2014-01-01

    Background: Diabetic patients with endometrial cancer had more lymph node metastasis than non-diabetic patients with endometrial cancer. L1 cell adhesion molecule (L1CAM) could be possibly associated with lymph node metastasis in diabetic patients with endometrial cancer via epithelial-mesenchymal transition. We aimed to investigate the association between L1CAM expression and lymph node metastasis in diabetic patients with endometrial cancer. Methods: We conducted a matched case control study of 68 endometrial cancer patients who comprise each 34 diabetic and non-diabetic patients. L1CAM expression was evaluated by immunohistochemistry using fresh formalin-fixed paraffin-embedded tissue block of the patients. The association between L1CAM expression and pelvic lymph node metastasis was assessed according to the presence of diabetes. Results: Of the 68 patients, 13 (19.1%) were positive for L1CAM immunostaining. Positive rate of L1CAM expression in diabetic endometrial cancer patients was similar to that in non-diabetic endometrial cancer patients (14.7% vs. 23.5%, P = 0.355). Tumor recurred more frequently in patients with positive L1CAM expression than those with negative L1CAM expression (33.3% vs. 1.6%, P = 0.019). However, we failed to find any significant association between L1CAM expression and lymph node metastasis. Only for the diabetic patients (n = 34), patients with pelvic lymph node metastasis had more L1CAM expression than those without lymph node metastasis (50.0% vs. 3.6%, P = 0.035). Advanced stage was the only risk factor for recurrence that showed a significant association with L1CAM expression for the diabetic endometrial cancer patients (P = 0.006), as well as all the enrolled patients (P = 0.014). Conclusion: L1CAM expression is associated with pelvic lymph node metastasis and advanced stage in diabetic patients with endometrial cancer. PMID:25337593

  1. Tattoo Pigment Mimics Positive Sentinel Lymph Node in Melanoma

    Microsoft Academic Search

    M. Moehrle; H. J. Blaheta; P. Ruck

    2001-01-01

    A 42-year-old man with metastasizing melanoma from an unknown primary is presented. Initially a subcutaneous metastasis in the scapular region and a single lung metastasis were resected. Thorough examinations did not show any evidence of a primary tumour. From the site of the metastasis on the right scapular region, lymphoscintigraphy with axillary sentinel lymph node biopsy was performed. One axillary

  2. New therapeutic possibilities in primary invasive breast cancer.

    PubMed Central

    Cady, B; Stone, M D; Wayne, J

    1993-01-01

    OBJECTIVE: Current therapy for small invasive breast cancer, particularly when discovered mammographically, was re-examined. Axillary dissection may be avoided when lymph node metastases incidence is low (< 10%) or when primary cancer features determine adjuvant therapy. Radiation therapy may be avoided when risk of recurrence is very low. SUMMARY BACKGROUND DATA: Recent studies by the Surveillance, Epidemiology, and End Results program (SEER) have shown increases in small invasive breast cancers (< 1 cm) attributable to mammographic screening. The incidence of axillary metastases in mammographically discovered small cancers (< 1 cm) may be less than 10%. Follow-up data from the Breast Cancer Detection Demonstration Project (BCDDP) indicate a disease-free survival rate exceeding 95% at 8 years if the cancer was discovered mammographically. METHODS: Maximum diameter and lymph node metastases of invasive breast cancer diagnosed between 1969 and 1988 were analyzed and compared to cases diagnosed between 1929 and 1968. One hundred thirty patients have been treated without either axillary dissection or radiation therapy since 1980. RESULTS: The mean and median diameters of invasive breast cancers decreased to 2.31 and 2.0 cm, respectively, between 1984 and 1988; 13% were less than 1 cm in diameter. Only 13% of patients had axillary metastases if the primary cancer was 1 cm or less in diameter in the last 10 years; 71% had only 1 or 2 nodes involved. Isolated local recurrence, total local recurrence, and distant metastases were unchanged when radiated and nonirradiated patients were compared. Axillary nodal recurrence was decreased in irradiated patients because the lower half of the axilla was treated. CONCLUSION: In selected patients with very small invasive breast cancers detected by mammography, breast conservation without axillary dissection or radiation therapy may be used. Entirely outpatient treatment markedly reduces morbidity and cost, and furthers the gains from screening programs. PMID:8373276

  3. Risk Factors for Lymph Node Metastases and their Prognostic Significance in Early Gastric Cancer (EGC) for the Italian Research Group for Gastric Cancer (IRGGC)

    Microsoft Academic Search

    Secondo Folli; Paolo Morgagni; Franco Roviello; G iovanni De Manzoni; Daniele Marrelli; Luca Saragoni; Michele Gaudio; Oriana Nanni; Claudio Cordiano; Davide Dell' Amore; Antonio Vio

    2001-01-01

    Background: Lymph node metastases are present in only about 15% of patients with early gastric cancer (EGC) and for this reason, the majority of these patients do not require lym- phadenectomy. In Japan, EGC patients undergo less invasive treatment (endoscopic mucosal resection, wedge resection, laparoscopy). However, the indications for and results of these types of treatment are still uncertain. Methods:

  4. Detecting Metastatic Pelvic Lymph Nodes by 18F-2Deoxyglucose Positron Emission Tomography in Patients with Prostate-Specific Antigen Relapse after Treatment for Localized Prostate Cancer

    Microsoft Academic Search

    Chao-Hsiang Chang; His-Chin Wu; Jeffery J. P. Tsai; Yeh-You Shen; Sheng-Pin Changlai; Albert Kao

    2003-01-01

    Aim: To evaluate whether positron emission tomography (PET) with 18F-2-deoxyglucose (FDG) can detect pelvic lymph node metastases in prostate cancer patients who had elevated serum prostate-specific antigen (PSA) levels after treatment. Methods: Twenty-four patients with a rising serum PSA level after treatment for localized prostate cancer were examined with FDG-PET before pelvic lymph node dissection. All patients had negative findings

  5. Prediction of lymph node involvement in breast cancer from primary tumor tissue using gene expression profiling and miRNAs

    Microsoft Academic Search

    A. Smeets; A. Daemen; I. Vanden Bempt; O. Gevaert; B. Claes; H. Wildiers; R. Drijkoningen; P. Van Hummelen; D. Lambrechts; B. De Moor; P. Neven; C. Sotiriou; T. Vandorpe; R. Paridaens; M. R. Christiaens

    The aim of this study was to investigate whether lymph node involvement in breast cancer is influenced by gene or miRNA expression\\u000a of the primary tumor. For this purpose, we selected a very homogeneous patient population to minimize heterogeneity in other\\u000a tumor and patient characteristics. First, we compared gene expression profiles of primary tumor tissue from a group of 96

  6. Lymph node staging in non-small cell lung cancer: evaluation by [18F]FDG positron emission tomography (PET)

    Microsoft Academic Search

    A. Guhlmann; M. Storck; J. Kotzerke; F. Moog; L. Sunder-Plassmann; S. N. Reske

    1997-01-01

    BACKGROUND: A study was undertaken to investigate the accuracy of positron emission tomography (PET) with 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) in the thoracic lymph node staging of non-small cell lung cancer (NSCLC). METHODS: Forty six patients with focal pulmonary tumours who underwent preoperative computed tomographic (CT) and FDG-PET scanning were evaluated retrospectively. Thirty two patients had NSCLC and 14 patients had a benign

  7. Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer

    Microsoft Academic Search

    Noriaki Sakuragi

    2007-01-01

    Lymph node metastasis (LNM), together with parametrial infiltration and positive surgical margins, is an important prognostic\\u000a factor in cervical cancer. The incidence of LNM increases with International Federation of Gynecology and Obstetrics (FIGO)\\u000a stage, with rates being 12%–22% in stage Ib, 10%–27% in stage IIa, and 34%–43% in stage IIb. Radical hysterectomy and pelvic\\u000a lymphadenectomy are widely used treatments for

  8. Radioguided lymph node biopsy of a chemoresistant lymph node detected on interim FDG PET-CT in Hodgkin lymphoma

    Microsoft Academic Search

    Tamás Györke; Attila Kollár; Gyula Bottlik; Ágota Szepesi; Imre Bodó; Tamás Masszi; Viktor Bérczi; Ildikó Garai

    2011-01-01

    A 32-year-old male patient was diagnosed with nodular lymphocyte-predominant Hodgkin lymphoma. Staging FDG PET-CT detected\\u000a a large right axillary lymph node conglomerate and splenic manifestation. Interim PET-CT following two cycles of ABVD chemotherapy\\u000a revealed good metabolic response with the exception of a single axillary lymph node. A second “interim” PET-CT after two further\\u000a cycles showed a similar result. A biopsy

  9. Curative Chemoradiotherapy in Patients With Stage IVB Cervical Cancer Presenting With Paraortic and Left Supraclavicular Lymph Node Metastases

    SciTech Connect

    Kim, Ji-Yoon [Department of Radiation Oncology, Catholic University of Korea, College of Medicine, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Catholic University of Korea, College of Medicine, Seoul (Korea, Republic of); Kim, Joo-Young [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)] [Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)] [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Yoon, Mee Sun [Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do (Korea, Republic of)] [Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do (Korea, Republic of); Kim, Juree [Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of)] [Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Kim, Young Seok, E-mail: ysk@amc.seoul.kr [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

    2012-11-01

    Purpose: To evaluate the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with curative intent in patients with stage IVB cervical cancer initially presenting with paraortic and left supraclavicular lymph node metastases. Methods and Materials: The medical records of 25 patients with both paraortic and left supraclavicular lymph nodal metastases (group I) were reviewed and compared with those of 101 women with paraortic lymph node metastases alone (group II). Group I received a mean 59.4 Gy to the paraortic and left supraclavicular areas and 50.4 Gy to the pelvis, followed by 30 Gy of high-dose-rate brachytherapy in 6 fractions. Group II received the same dose to the paraortic area and pelvis followed by intracavitary brachytherapy. All patients received platinum-based chemotherapy simultaneously. Results: Of the 25 patients in group I, 16 (64%) experienced acute grade 3-4 hematologic toxicities, and 1 had a late grade 3 genitourinary toxicity. Complete responses, including the primary mass and pelvic, paraortic, and left supraclavicular lymph nodes, were observed in 13 patients (52%). At a median follow-up of 32 months for surviving patients, 3 experienced in-field failure, 6 showed distant failure, and 9 showed both. The 3-year overall and disease-free survival rates were 49% and 33%, respectively. In comparison, of the 101 patients in group II, 16 showed in-field failure, 14 experienced distant failure, and 11 showed both. The 3-year overall and disease-free survival rates were 69% and 57%, respectively. Conclusions: Curative CCRT is feasible in patients with stage IVB cervical cancer presenting with paraortic and left supraclavicular lymph nodal metastases, with acceptable late toxicity and high response rates, despite high rates of acute hematologic toxicity.

  10. Diagnostic Performance of 18 F-FDG PET\\/CT for Lymph Node Staging in Patients with Operable Non-small-cell Lung Cancer and Inflammatory Lung Disease

    Microsoft Academic Search

    Young-Sil An; Joo Sung Sun; Kyung Joo Park; Sung Chul Hwang; Kwang Joo Park; Seung Soo Sheen; Sungsoo Lee; Kyi Beom Lee; Joon-Kee Yoon

    2008-01-01

    As 18F-fluorodeoxyglucose (FDG) is taken up by inflammatory lymph nodes, it could be falsely interpreted as metastasis. Therefore,\\u000a we evaluated the diagnostic ability of positron emission tomography\\/computed tomography (PET\\/CT) for lymph node staging of\\u000a lung cancer when inflammatory lung disease coexisted. Patients with operable non-small-cell lung cancer and FDG-avid lymph\\u000a nodes were retrospectively classified into two groups; those with inflammatory

  11. Activin type IB receptor signaling in prostate cancer cells promotes lymph node metastasis in a xenograft model

    SciTech Connect

    Nomura, Masatoshi, E-mail: nomura@med.kyushu-u.ac.jp [Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)] [Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan); Tanaka, Kimitaka; Wang, Lixiang; Goto, Yutaka; Mukasa, Chizu; Ashida, Kenji; Takayanagi, Ryoichi [Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)] [Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 (Japan)

    2013-01-04

    Highlights: Black-Right-Pointing-Pointer ActRIB signaling induces Snail and S100A4 expressions in prostate cancer cells. Black-Right-Pointing-Pointer The prostate cancer cell lines expressing an active form of ActRIB were established. Black-Right-Pointing-Pointer ActRIB signaling promotes EMT and lymph node metastasis in xenograft model. -- Abstract: Activin, a member of the transforming growth factor-{beta} family, has been known to be a growth and differentiating factor. Despite its pluripotent effects, the roles of activin signaling in prostate cancer pathogenesis are still unclear. In this study, we established several cell lines that express a constitutive active form of activin type IB receptor (ActRIBCA) in human prostate cancer cells, ALVA41 (ALVA-ActRIBCA). There was no apparent change in the proliferation of ALVA-ActRIBCA cells in vitro; however, their migratory ability was significantly enhanced. In a xenograft model, histological analysis revealed that the expression of Snail, a cell-adhesion-suppressing transcription factor, was dramatically increased in ALVA-ActRIBCA tumors, indicating epithelial mesenchymal transition (EMT). Finally, mice bearing ALVA-ActRIBCA cells developed multiple lymph node metastases. In this study, we demonstrated that ActRIBCA signaling can promote cell migration in prostate cancer cells via a network of signaling molecules that work together to trigger the process of EMT, and thereby aid in the aggressiveness and progression of prostate cancers.

  12. The microRNA-218~Survivin axis regulates migration, invasion, and lymph node metastasis in cervical cancer

    PubMed Central

    Kogo, Ryunosuke; How, Christine; Chaudary, Naz; Bruce, Jeff; Shi, Wei; Hill, Richard P.; Zahedi, Payam; Yip, Kenneth W.; Liu, Fei-Fei

    2015-01-01

    Cervical cancer is the third most common cancer in women worldwide. In the present study, global microRNA profiling for 79 cervical cancer patient samples led to the identification of miR-218 down-regulation in cervical cancer tissues compared to normal cervical tissues. Lower miR-218 expression was associated significantly with worse overall survival (OS), disease-free survival (DFS), and pelvic/aortic lymph node recurrence. In vitro, miR-218 over-expression decreased clonogenicity, migration, and invasion. Survivin (BIRC5) was subsequently identified as an important cervical cancer target of miR-218 using in silico prediction, mRNA profiling, and quantitative real-time PCR (qRT-PCR). Concordant with miR-218 over-expression, survivin knockdown by siRNA decreased clonogenicity, migration, and invasion. YM155, a small molecule survivin inhibitor, significantly suppressed tumor growth and lymph node metastasis in vivo. Our findings demonstrate that the miR-218~survivin axis inhibits cervical cancer progression by regulating clonogenicity, migration, and invasion, and suggest that the inhibition of survivin could be a potential therapeutic strategy to improve outcome in this disease. PMID:25473903

  13. Elevated IGFIR expression regulating VEGF and VEGF-C predicts lymph node metastasis in human colorectal cancer

    PubMed Central

    2010-01-01

    Background Insulin-like growth factor-I receptor (IGFIR) has been shown to regulate the tumor development. The objective of the current study is to determine the association of IGFIR with lymph node metastasis and to explore the related mechanism in human colorectal cancer in clinic. Methods In a random series of 98 colorectal cancer patients, the expressions of IGFIR, vascular endothelial growth factor (VEGF) and VEGF-C were investigated by immunohistochemistry, and the association of these expressions with lymph node metastasis was statistically analyzed. The expressions of VEGF and VEGF-C in colorectal cancer cells stimulated with IGF-I were also examined by real-time quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay. Results Higher rates of IGFIR (46%), VEGF (53%), and VEGF-C (46%) expression were found in colorectal cancer tissues than in normal and colorectal adenoma tissues. These expressions were significantly associated with clinicopathologic factors and lymph node status. We also found the concomitant high expressions of IGFIR/VEGF (P < 0.001) and IGFIR/VEGF-C (P = 0.001) had a stronger correlation with lymph node metastasis than did each alone or both low expressions. In addition, IGF-I could effectively induce the VEGF and VEGF-C mRNA expression and protein secretion in colorectal cancer cells expressing IGFIR molecules. Moreover, Patients who had strong staining for IGFIR, VEGF and VEGF-C showed significantly less favorable survival rates compared with patients who had low staining for these molecules (P < 0.001). The survival rates of patients who were both high expression of IGFIR/VEGF and IGFIR/VEGF-C also were significantly lower compared with patients who were negative or one of high expression of these molecules (P < 0.001). Conclusions Together the findings indicated for the first time that simultaneous examination of the expressions of IGFIR, VEGF and VEGF-C will benefit the diagnosis of lymph node metastasis in order to assay the prognosis and determine the treatment strategy in patients with colorectal cancer undergoing surgery. PMID:20459642

  14. Computed tomography–based distribution of involved lymph nodes in patients with upper esophageal cancer

    PubMed Central

    Li, M.; Liu, Y.; Xu, L.; Huang, Y.; Li, W.; Yu, J.; Kong, L.

    2015-01-01

    Background Delineating the nodal clinical target volume (ctvn) remains a challenging task in patients with cervical or upper thoracic esophageal carcinoma (ec). In particular, the extent of the lymph area that should be included in the irradiation field remains controversial. In the present study, the extent of the ctvn was determined based on the incidence of lymph node involvement mapped by computed tomography (ct) imaging. Methods Our study included 468 patients who were diagnosed with cervical and upper thoracic ec and who received staging information between June 2005 and April 2011. The anatomic distribution of metastatic regional lymph nodes was mapped using ct images and grouped using the levels established by the Radiation Therapy Oncology Group. The probability of the various groups being involved was examined. If a lymph node group had a probability of 10% or more of being involved, it was considered at high risk for metastasis, and elective treatment as part of the ctvn was recommended. Results Lymph node involvement was mapped by ct in 256 patients (54.7%). Not all lymph node groups should be included in the ctvn. For cervical lesions, the involved lymph nodes were located mainly between the hyoid bone and the arcus aortae; the recommended ctvn should consist of the neck lymph nodes at levels iii and iv (supraclavicular group) and thoracic groups 2 and 3P. In upper thoracic ec patients, most of the involved lymph nodes were distributed between the cricoid cartilage and the subcarinal area; the ctvn should cover the supraclavicular group and thoracic nodal groups 2, 3P, 4, 5, and 7. Conclusions Our ct-based study indicates a specific distribution and incidence of metastatic lymph node groups in patients with cervical and upper thoracic ec. The results suggest that regional lymph node groups should be electively included in the ctvn for precise radiation administration.

  15. Sentinel lymphadenectomy after neoadjuvant chemotherapy for breast cancer may reliably represent the axilla except for inflammatory breast cancer

    Microsoft Academic Search

    Vered Stearns; C. Alexander Ewing; Rebecca Slack; Marie F. Penannen; Daniel F. Hayes; Theodore N. Tsangaris

    2002-01-01

    Background  After neoadjuvant chemotherapy, women with locally advanced breast cancer (LABC) undergo a modified radical mastectomy or\\u000a lumpectomy with axillary lymph node dissection (ALND) and radiotherapy. Sentinel lymphadenectomy (SL) is accepted for axillary\\u000a evaluation in early breast cancer. We assessed the feasibility and predictive value of SL after neoadjuvant chemotherapy.\\u000a \\u000a \\u000a \\u000a Methods  Eligible women received neoadjuvant therapy for LABC and were scheduled to

  16. Atypical Anaphylactic Reaction to Patent Blue During Sentinel Lymph Node Biopsy for Breast Cancer

    PubMed Central

    Lanitis, Sophocles; Filippakis, George; Sidhu, Virinder; Mufti, Ragheed AL; Lee, Tak H; Hadjiminas, Dimitri J

    2008-01-01

    INTRODUCTION We present an unusual case of severe anaphylaxis to Patent Blue dye with atypical clinical features during sentinel lymph node biopsy (SLNB). The medical personnel involved with sentinel node biopsies should be alert, and familiar with this unusual entity. We also present current data from the literature. CASE REPORT During a wide local excision for primary breast cancer and SLNB, and early during the operation, the patient became severely tachycardic and hypotensive without any signs of urticaria, rash, oedema, or bronchospasm. Resuscitation required the addition of noradrenaline infusion followed by an overnight admission to the intensive care unit. Raised serum tryptase levels supported the diagnosis of anaphylactic shock while skin tests showed a severe reaction to Patent Blue dye. CONCLUSIONS Severe, life-threatening anaphylaxis to Patent Blue dye may present without obvious previous exposure to the dye and without the cardinal signs of oedema, urticaria and bronchospasm making the diagnosis and management of such cases challenging. Correct diagnosis and identification of the causative factor is important and requires a specific set of laboratory tests that are not commonly requested in every-day medical practice. It is not clear from the literature whether the condition is common enough to justify pre-operative prophylactic or diagnostic measures. PMID:18492403

  17. Extended salvage pelvic lymph node dissection in patients with recurrent prostate cancer.

    PubMed

    Osmonov, Daniar K; Aksenov, Alexey V; Boller, Annkathrin; Kalz, Almut; Heimann, Diana; Janssen, Isa; Jünemann, Klaus-Peter

    2014-01-01

    Background. Treatment of patients with a biochemical recurrence (BCR) of prostate cancer (PCa) is generally difficult and without valid treatment options. Since 2004 we have been developing therapeutic possibilities for these patients. Methods. We retrospectively analyzed a cohort of 41 patients with a BCR of PCa and a mean followup of 40.3 ± 20.8 months. Group 1 (n = 10): salvage radical prostatectomy (sRP) with SePLND (salvage extended pelvic lymph nodes dissection) (initial treatment: combined brachytherapy). Group 2 (n = 22): SePLND (initial treatment: radical prostatectomy (RP)). Group 3 (n = 9): SePLND (initial treatment: RP and adjuvant radiation therapy (RT)). We observed PSA, PSA-velocity, localization of LNs and LNs+, BCR-free period, and BR (biochemical response). Results. Group 1: 60% with BCR-freedom (mean 27.2 months). Group 2: 63.6% with BCR-freedom (mean 17.5 months). Group 3: 33.3% with BCR-freedom (mean 17.6 months). In total, BCR-freedom was observed in 23 of 41 patients (56.1%) after salvage surgery. 75.6% of all patients showed a BR. 765?LNs were removed and 14.8% of these were LN+. Conclusions. The BCR-free period and BR are comparable in all three groups. Sensibility to ADT can be reestablished and prolonged as a result of SePLND. Multicenter studies are needed for a reliable output. PMID:24688536

  18. Extended Salvage Pelvic Lymph Node Dissection in Patients with Recurrent Prostate Cancer

    PubMed Central

    Osmonov, Daniar K.; Aksenov, Alexey V.; Boller, Annkathrin; Kalz, Almut; Heimann, Diana; Janssen, Isa; Jünemann, Klaus-Peter

    2014-01-01

    Background. Treatment of patients with a biochemical recurrence (BCR) of prostate cancer (PCa) is generally difficult and without valid treatment options. Since 2004 we have been developing therapeutic possibilities for these patients. Methods. We retrospectively analyzed a cohort of 41 patients with a BCR of PCa and a mean followup of 40.3 ± 20.8 months. Group 1 (n = 10): salvage radical prostatectomy (sRP) with SePLND (salvage extended pelvic lymph nodes dissection) (initial treatment: combined brachytherapy). Group 2 (n = 22): SePLND (initial treatment: radical prostatectomy (RP)). Group 3 (n = 9): SePLND (initial treatment: RP and adjuvant radiation therapy (RT)). We observed PSA, PSA-velocity, localization of LNs and LNs+, BCR-free period, and BR (biochemical response). Results. Group 1: 60% with BCR-freedom (mean 27.2 months). Group 2: 63.6% with BCR-freedom (mean 17.5 months). Group 3: 33.3% with BCR-freedom (mean 17.6 months). In total, BCR-freedom was observed in 23 of 41 patients (56.1%) after salvage surgery. 75.6% of all patients showed a BR. 765?LNs were removed and 14.8% of these were LN+. Conclusions. The BCR-free period and BR are comparable in all three groups. Sensibility to ADT can be reestablished and prolonged as a result of SePLND. Multicenter studies are needed for a reliable output. PMID:24688536

  19. Alteration of CD4 T cell subsets in metastatic lymph nodes of human gastric cancer.

    PubMed

    Okita, Yoshihiro; Ohira, Masaichi; Tanaka, Hiroaki; Tokumoto, Mao; Go, Yukie; Sakurai, Katsunobu; Toyokawa, Takahiro; Kubo, Naoshi; Muguruma, Kazuya; Sawada, Tetsuji; Maeda, Kiyoshi; Hirakawa, Kosei

    2015-08-01

    Studies of tumor-infiltrating immune cells have revealed that immune escape plays an important role in tumor growth. The aim of the present study was to investigate the impact of metastasis affecting CD4+ T cell subsets in human clinical samples. Single-cell suspensions derived from tumor-draining lymph node (TDLN) and primary cancer specimens were assessed by flow cytometry, qRT-PCR and immunohistochemistry. In the CD4+ T cell subsets detected in TDLN, effector T cells (TE) in metastatic TDLN (mTDLN) was significantly lower than that in metastatic-free TDLN (mfTDLN). TE in mfTDLN were increased compared with normal controls. Similarly, effector memory T cells (TEM) in mTDLN was significantly lower than in control and mfTDLN. There was a significantly positive correlation between the proportion of TEM in TDLN and number of tumor-infiltrating CD4+ and CD8+ T cells. Th1 to Th2 ratio was lower in mTDLN, and Treg in mTDLN was significantly higher than in mfTDLN. CD4+ T cell and TE subsets in TDLN were significantly affected by metastasis. Immunosuppressive cells exhibit increased migration to TDLN, in which a subset of CD4+ TE is skewed towards immune tolerance in the tumor microenvironment. PMID:26081040

  20. Salvage Pelvic Lymph Node Dissection in Recurrent Prostate Cancer: Surgical and Early Oncological Outcome

    PubMed Central

    Van Praet, Charles; Lumen, Nicolaas; Ost, Piet; Fonteyne, Valérie; De Meerleer, Gert; Lambert, Bieke; Delrue, Louke; De Visschere, Pieter; Villeirs, Geert; Decaestecker, Karel

    2015-01-01

    Methodology. Seventeen patients with prostate-specific antigen (PSA) rise following local treatment for prostate cancer with curative intent underwent open or minimally invasive salvage pelvic lymph node dissection (SLND) for oligometastatic disease (<4 synchronous metastases) or as staging prior to salvage radiotherapy. Biochemical recurrence after complete biochemical response (cBR) was defined as 2 consecutive PSA increases >0,2?ng/mL; and after incomplete biochemical response as 2 consecutive PSA rises. Newly found metastasis on imaging defined clinical progression (CP). Palliative androgen deprivation therapy (ADT) was initiated if >3 metastases were detected or if patients became symptomatic. Kaplan-Meier statistics were applied. Results. Clavien-Dindo grade 1, 2, 3a, and 3b complications were seen in 6, 1, 1, and 2 patients, respectively. Median follow-up time was 22 months. Among 13 patients treated for oligometastatic disease, 8 (67%) had a PSA decline, with 3 patients showing cBR. Median PSA progression-free survival (FS) was 4.1 months and median CP-FS 7 months. Three patients started ADT, resulting in a 2-year ADT-FS rate of 79.5%. Conclusion. SLND is feasible, but postoperative complication rate seems higher than that for primary LND. Biochemical and clinical response duration is limited, but as part of an oligometastatic treatment regime it can defer palliative ADT. PMID:25695051

  1. Breast cancer subpopulation with high risk of internal mammary lymph nodes metastasis: analysis of 2,269 Chinese breast cancer patients treated with extended radical mastectomy

    Microsoft Academic Search

    Ou Huang; Liping Wang; Kunwei Shen; Hong Lin; Zhen Hu; Guangyu Liu; Jiong Wu; Jinsong Lu; Zhiming Shao; Qixia Han; Zhenzhou Shen

    2008-01-01

    Purpose  The selective treatment of internal mammary lymph nodes (IMNs) in breast cancer is controversial. The purpose of this research\\u000a was to determine the subpopulation patients with high risk of internal mammary lymph nodes metastasis who received extended\\u000a radical mastectomy without any preoperative treatment from 1956 to 2003 in China.\\u000a \\u000a \\u000a \\u000a Patients and methods  1,679 Chinese patients were underwent extended radical mastectomy (ERM)

  2. In vivo photoacoustic and ultrasonic mapping of rat sentinel lymph nodes with a modified commercial ultrasound imaging system

    NASA Astrophysics Data System (ADS)

    Erpelding, Todd N.; Kim, Chulhong; Pramanik, Manojit; Guo, Zijian; Dean, John; Jankovic, Ladislav; Maslov, Konstantin; Wang, Lihong V.

    2010-02-01

    Sentinel lymph node biopsy (SLNB) has become the standard method for axillary staging in breast cancer patients, relying on invasive identification of sentinel lymph nodes (SLNs) following injection of blue dye and radioactive tracers. While SLNB achieves a low false negative rate (5-10%), it is an invasive procedure requiring ionizing radiation. As an alternative to SLNB, ultrasound-guided fine needle aspiration biopsy has been tested clinically. However, ultrasound alone is unable to accurately identify which lymph nodes are sentinel. Therefore, a non-ionizing and noninvasive detection method for accurate SLN mapping is needed. In this study, we successfully imaged methylene blue dye accumulation in vivo in rat axillary lymph nodes using a Phillips iU22 ultrasound imaging system adapted for photoacoustic imaging with an Nd:YAG pumped, tunable dye laser. Photoacoustic images of rat SLNs clearly identify methylene blue dye accumulation within minutes following intradermal dye injection and co-registered photoacoustic/ultrasound images illustrate lymph node position relative to surrounding anatomy. To investigate clinical translation, the imaging depth was extended up to 2.5 cm by adding chicken breast tissue on top of the rat skin surface. These results raise confidence that photoacoustic imaging can be used clinically for accurate, noninvasive SLN mapping.

  3. Fluoroscopically Guided Skinny-Needle Aspirative Biopsy in Normal and Suspected Lymph Nodes in Urologic Cancer

    Microsoft Academic Search

    V. F. Nadalini; C. Giglio; G. P. Bruttini; M. Medica; M. Piccardo; C. Ruggeri

    1983-01-01

    The authors present their experience with transperitoneal thin-needle biopsy of the retroperitoneal lymph nodes. This method is a means of improving lymphographic diagnosis in suspected lymph node metastases, the small contrast defects serving as a sign. The high rate of false-negative results makes its use unadvisable in patients with negative lymphography where the sample cannot be aimed at but is

  4. Relationship between maximum standardized uptake value (SUVmax) of lung cancer and lymph node metastasis on FDG-PET

    Microsoft Academic Search

    Atsushi Nambu; Satoshi Kato; Yoko Sato; Hideto Okuwaki; Keiichi Nishikawa; Akitoshi Saito; Keiko Matsumoto; Tomoaki Ichikawa; Tsutomu Araki

    2009-01-01

    Purpose  To evaluate the relationship between SUVmax of primary lung cancers on FDG-PET and lymph node metastasis.\\u000a \\u000a \\u000a \\u000a Method and materials  The subjects were a total of consecutive 66 patients with lung cancer who were examined by FDG-PET and subsequently underwent\\u000a surgery between October 2004 and January 2008. There were 41 males and 25 females, ranging in age from 45 to 83 years with

  5. Proteomic biomarkers predicting lymph node involvement in serum of cervical cancer patients. Limitations of SELDI-TOF MS

    PubMed Central

    2012-01-01

    Background Lymph node status is not part of the staging system for cervical cancer, but provides important information for prognosis and treatment. We investigated whether lymph node status can be predicted with proteomic profiling. Material & methods Serum samples of 60 cervical cancer patients (FIGO I/II) were obtained before primary treatment. Samples were run through a HPLC depletion column, eliminating the 14 most abundant proteins ubiquitously present in serum. Unbound fractions were concentrated with spin filters. Fractions were spotted onto CM10 and IMAC30 surfaces and analyzed with surface-enhanced laser desorption time of flight (SELDI-TOF) mass spectrometry (MS). Unsupervised peak detection and peak clustering was performed using MASDA software. Leave-one-out (LOO) validation for weighted Least Squares Support Vector Machines (LSSVM) was used for prediction of lymph node involvement. Other outcomes were histological type, lymphvascular space involvement (LVSI) and recurrent disease. Results LSSVM models were able to determine LN status with a LOO area under the receiver operating characteristics curve (AUC) of 0.95, based on peaks with m/z values 2,698.9, 3,953.2, and 15,254.8. Furthermore, we were able to predict LVSI (AUC 0.81), to predict recurrence (AUC 0.92), and to differentiate between squamous carcinomas and adenocarcinomas (AUC 0.88), between squamous and adenosquamous carcinomas (AUC 0.85), and between adenocarcinomas and adenosquamous carcinomas (AUC 0.94). Conclusions Potential markers related with lymph node involvement were detected, and protein/peptide profiling support differentiation between various subtypes of cervical cancer. However, identification of the potential biomarkers was hampered by the technical limitations of SELDI-TOF MS. PMID:22694804

  6. Axillary Metastasis from an Occult Tubal Serous Carcinoma in a Patient with Ipsilateral Breast Carcinoma: A Potential Diagnostic Pitfall

    PubMed Central

    Altinel, Gulbeyaz; Arseneau, Jocelyne; Omeroglu, Atilla

    2014-01-01

    Axillary nodal metastasis from a nonmammary neoplasia is much rarer than diseases associated with a primary breast carcinoma. However, this has to be considered in the differential diagnosis of nodal disease in patients with a history of breast cancer. Here, we report the case of a 73-year-old female with a past medical history of breast cancer, presenting with an ipsilateral axillary metastatic carcinoma. The immunohistochemical profile of the metastatic lesion was consistent with a high grade serous carcinoma. After undergoing a total abdominal hysterectomy and salpingo-oophorectomy, thorough pathological examination revealed two microscopic foci of serous carcinoma in the right fallopian tube, not detectable by preoperative magnetic resonance imaging. In this context, the poorly differentiated appearance of the metastatic tumor and positive staining for estrogen receptor, might lead to a misdiagnosis of metastatic breast carcinoma. As the therapeutic implications differ, it is important for the pathologist to critically assess axillary lymph node metastases, even in patients with a past history of ipsilateral breast carcinoma and no other known primary tumors. PMID:25110596

  7. Predictive risk factors for lymph node metastasis in patients with small size non-small cell lung cancer

    PubMed Central

    Bao, Feichao; Yuan, Ping; Yuan, Xiaoshuai; Lv, Xiayi; Wang, Zhitian

    2014-01-01

    Background Accurate clinical staging of non-small cell lung cancer (NSCLC) is essential for developing an optimal treatment strategy. This study aimed to determine the predictive risk factors for lymph node metastasis, including both N1 and N2 metastases, in clinical T1aN0 NSCLC patients. Methods We retrospectively evaluated clinical T1aN0M0 NSCLC patients who showed no radiologic evidence of lymph node metastasis, and who had undergone surgical pulmonary resection with systematic mediastinal node dissection or sampling at the First Affiliated Hospital of Zhejiang University between January 2011 and June 2013. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for node metastasis. Results Pathologically positive lymph nodes were found in 16.2% (51/315) of the patients. Positive N1 nodes were found in 12.4% (39/315) of the patients, and positive N2 nodes were identified in 13.0% (41/315) of the patients. Some 9.2% (29/315) of the patients had both positive N1 and N2 nodes, and 3.8% (12/315) of the patients had nodal skip metastasis. Variables of preoperative radiographic tumor size, non-upper lobe located tumors, high carcinoembryonic antigen (CEA) levels and micropapillary predominant adenocarcinoma (AC) were identified as predictors for positive N1 or N2 node multivariate analysis. Conclusions Pathologically positive lymph nodes were common in small size NSCLC patients with clinical negative lymph nodes. Therefore, preoperative staging should be performed more thoroughly to increase accuracy, especially for patients who have the larger size, non-upper lobe located, high CEA level or micropapillary predominant ACs. PMID:25589962

  8. Molecular Staging of Prostatic Cancer with RT-PCR Assay for Prostate-Specific Antigen in Peripheral Blood and Lymph Nodes: Comparison with Standard Histological Staging and Immunohistochemical Assessment of Occult Regional Lymph Node Metastases

    Microsoft Academic Search

    Luis Mart??nez-Piñeiro; Emilio Rios; Montserrat Mart??nez-Gomariz; Teresa Pastor; Mónica de Cabo; Mar??a L. Picazo; José Palacios; Rosario Perona

    2003-01-01

    Background: About 30–40% of men with localized prostate cancer undergoing radical prostatectomy will have cancer recurrence. It is estimated that one third recur locally and two thirds develop distant metastases with or without local recurrence.Methods: In the present study we investigate the detection of prostate-specific antigen (PSA) mRNA in peripheral blood samples (n=200 patients) and pelvic lymph nodes (n=154 patients)

  9. The Assessment of the Oncological Safety Margin of Insufficient Lymph Node Dissection in pT2 (pm) Gastric Cancer

    PubMed Central

    Choi, Yoon Young; An, Ji Yeong; Cho, In; Kwon, In Gyu; Kang, Dae Ryong; Hyung, Woo Jin

    2014-01-01

    Purpose To identify the effect of insufficient lymph node dissection (LND) on the survival of patients with pT2 gastric cancer. Materials and Methods A total of 340 patients (120 patients with insufficient LND and others with D2 LND) who underwent gastrectomy for pT2 gastric cancer between January 2008 and December 2010 were included. Results The incidence of preoperatively diagnosed early gastric cancer was higher and there were fewer metastatic lymph nodes (LNs) in the insufficient LND group than the D2 group, but there was no survival difference between two groups (p=0.365). Among the 89 patients with metastatic LNs after D2 LND, 13 patients (14.6%) had metastatic LNs at selected N2 stations (#10, 11, or 12a), but none of these patients were in the pN1 category. One patient had five metastatic LNs at station #11p with no metastatic LNs at any other stations. The number of metastatic LNs was identified as the only risk factor for LN metastasis at selected N2 stations by logistic regression. Conclusion If a patient has pN0 or pN1 category after insufficient LND for pT2 gastric cancer, the surgery can be regarded as secure. However, for patients with pN2 or pN3 category, more careful examination is required. PMID:24339288

  10. Expression of aquaporin 5 in primary carcinoma and lymph node metastatic carcinoma of non-small cell lung cancer

    PubMed Central

    SONG, TIANHE; YANG, HONG; HO, JAMES CHUNG MAN; TANG, SYDNEY CHI WAI; SZE, STEPHEN CHO WING; LAO, LIXING; WANG, YING; ZHANG, KALIN YANBO

    2015-01-01

    Aquaporin 5 (AQP5), a water channel protein, is highly expressed in non-small cell lung cancer (NSCLC) tissues compared with adjacent normal tissues. AQP5 expression in lung cancer tissues is associated with a poor prognosis. The present study aimed to analyze the expression of AQP5 and investigate its role in primary and lymph node metastatic NSCLCs. An immunohistochemical labeled streptavidin-biotin method was used to determine the expression of AQP5 in 94 cases of NSCLC primary carcinoma, which included 51 cases accompanied by lymph node metastasis. The results revealed that the expression of AQP5 was significantly higher in adenocarcinomas compared with squamous cell carcinomas (P=0.002). In addition, the percentage of AQP5 expression in the primary carcinomas with lymph node metastasis was significantly higher compared with those without lymph node metastasis (P=0.024). However, no statistically significant difference in the percentage of AQP5 expression was observed between the metastatic and the primary carcinomas (P=0.377). The expression of AQP5 exhibited a correlation with the tumor-node-metastasis staging of NSCLC (P=0.027). The percentage of AQP5 expression in stage III and IV tumors was higher than that in stage I and II tumors. In addition, AQP5 expression was correlated with the survival rate of NSCLC patients (P=0.051). In conclusion, the results of the present study provide evidence for the AQP5-facilitated incidence, progression and metastasis of NSCLC. Therefore, AQP5 may be used as a potential target to investigate the incidence, progression and metastasis of NSCLC. PMID:26137150

  11. Lymph node density in oral cavity cancer: results of the International Consortium for Outcomes Research

    PubMed Central

    Patel, S G; Amit, M; Yen, T C; Liao, C T; Chaturvedi, P; Agarwal, J P; Kowalski, L P; Ebrahimi, A; Clark, J R; Cernea, C R; Brandao, S J; Kreppel, M; Zöller, J; Fliss, D; Fridman, E; Bachar, G; Shpitzer, T; Bolzoni, V A; Patel, P R; Jonnalagadda, S; Robbins, K T; Shah, J P; Gil, Z

    2013-01-01

    Background: Lymph node density (LND) has previously been reported to reliably predict recurrence risk and survival in oral cavity squamous cell carcinoma (OSCC). This multicenter international study was designed to validate the concept of LND in OSCC. Methods: The study included 4254 patients diagnosed as having OSCC. The median follow-up was 41 months. Five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), locoregional control and distant metastasis rates were calculated using the Kaplan–Meier method. Lymph node density (number of positive lymph nodes/total number of excised lymph nodes) was subjected to multivariate analysis. Results: The OS was 49% for patients with LND?0.07 compared with 35% for patients with LND>0.07 (P<0.001). Similarly, the DSS was 60% for patients with LND?0.07 compared with 41% for those with LND>0.07 (P<0.001). Lymph node density reliably stratified patients according to their risk of failure within the individual N subgroups (P=0.03). A modified TNM staging system based on LND ratio was consistently superior to the traditional system in estimating survival measures. Conclusion: This multi-institutional study validates the reliability and applicability of LND as a predictor of outcomes in OSCC. Lymph node density can potentially assist in identifying patients with poor outcomes and therefore for whom more aggressive adjuvant treatment is needed. PMID:24064974

  12. High Occurrence of Aberrant Lymph Node Spread on Magnetic Resonance Lymphography in Prostate Cancer Patients With a Biochemical Recurrence After Radical Prostatectomy

    SciTech Connect

    Meijer, Hanneke J.M., E-mail: H.Meijer@rther.umcn.nl [Department of Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Lin, Emile N. van [Department of Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Debats, Oscar A. [Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Witjes, J. Alfred [Department of Urology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Span, Paul N.; Kaanders, Johannes H.A.M. [Department of Radiation Oncology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands); Barentsz, Jelle O. [Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen (Netherlands)

    2012-03-15

    Purpose: To investigate the pattern of lymph node spread in prostate cancer patients with a biochemical recurrence after radical prostatectomy, eligible for salvage radiotherapy; and to determine whether the clinical target volume (CTV) for elective pelvic irradiation in the primary setting can be applied in the salvage setting for patients with (a high risk of) lymph node metastases. Methods and Materials: The charts of 47 prostate cancer patients with PSA recurrence after prostatectomy who had positive lymph nodes on magnetic resonance lymphography (MRL) were reviewed. Positive lymph nodes were assigned to a lymph node region according to the guidelines of the Radiation Therapy Oncology Group (RTOG) for delineation of the CTV for pelvic irradiation (RTOG-CTV). We defined four lymph node regions for positive nodes outside this RTOG-CTV: the para-aortal, proximal common iliac, pararectal, and paravesical regions. They were referred to as aberrant lymph node regions. For each patient, clinical and pathologic features were recorded, and their association with aberrant lymph drainage was investigated. The distribution of positive lymph nodes was analyzed separately for patients with a prostate-specific antigen (PSA) <1.0 ng/mL. Results: MRL detected positive aberrant lymph nodes in 37 patients (79%). In 20 patients (43%) a positive lymph node was found in the pararectal region. Higher PSA at the time of MRL was associated with the presence of positive lymph nodes in the para-aortic region (2.49 vs. 0.82 ng/mL; p = 0.007) and in the proximal common iliac region (1.95 vs. 0.59 ng/mL; p = 0.009). There were 18 patients with a PSA <1.0 ng/mL. Ten of these patients (61%) had at least one aberrant positive lymph node. Conclusion: Seventy-nine percent of the PSA-recurrent patients had at least one aberrant positive lymph node. Application of the standard RTOG-CTV for pelvic irradiation in the salvage setting therefore seems to be inappropriate.

  13. Lymph node spread of gallbladder cancer from the perspective of embryologically-based anatomy and significance of the lymphatic basin along the embryonic right hepatic artery

    PubMed Central

    NAKAGAWARA, HISATOSHI; TAJIMA, HIDEHIRO; MIYASHITA, TOMOHARU; KITAGAWA, HIROHISA; MAKINO, ISAMU; SAKAI, SEISHO; HAYASHI, HIRONORI; NAKANUMA, SHINICHI; OYAMA, KATSUNOBU; TAKAMURA, HIROYUKI; FUSHIDA, SACHIO; FUJIMURA, TAKASHI; OHTA, TETSUO

    2014-01-01

    Lymph node metastasis from gallbladder cancer is often found in the pericholedochal area; however, these regional lymph nodes are not typically accompanied by arteries. We hypothesized that the artery accompanying pericholedochal lymph nodes was either the regressed embryonic right hepatic artery (eRHA) or an aberrant right hepatic artery (aRHA) remaining without regression. This study aimed to determine the artery supplying pericholedochal lymph nodes. We obtained serial tissue sections of resected specimens from 10 patients who underwent pancreaticoduodenectomy with combined resection of the superior mesenteric artery and vein and investigated the association between the distribution of enlarged lymph nodes and the course of blood vessels in each section. In 2 cases with aRHA, enlarged lymph nodes were distributed in the posterosuperior area, pancreaticoduodenal region and retroportal area along this artery. By contrast, no blood vessels accompanied enlarged lymph nodes in 8 patients exhibiting a normal hepatic artery branching pattern, although these nodes exhibited a distribution pattern similar to that of patients with the aRHA. Thus, the artery supplying pericholedochal lymph nodes appears to be either the regressed eRHA or an aRHA persisting without regression. PMID:25279182

  14. Expression and Clinical Significance of Matrix Metalloproteinase-9 in Lymphatic Invasiveness and Metastasis of Breast Cancer

    PubMed Central

    Huang, Yu-Fan; She, Hong-Qiang; Liang, Jing; Yang, Qiao-Lu; Zhang, Zhi-Ming

    2014-01-01

    Background Matrix metalloproteinase 9 (MMP-9) is a type-IV collagenase that is highly expressed in breast cancer, but its exact role in tumor progression and metastasis is unclear. Methods MMP-9 mRNA and protein expression was examined by real-time reverse transcriptase PCR and immunohistochemical staining, respectively, in 41 breast cancer specimens with matched peritumoral benign breast epithelial tissue and suspicious metastatic axillary lymph nodes. Lymph vessels were labeled with D2-40 and lymphatic microvessel density (LMVD) was calculated. Correlation of MMP-9 protein expression with clinicopathological parameters and LMVD was also evaluated. Results MMP-9+ staining in breast cancer specimens (35/41, 85.4%) was higher than in matched epithelium (21/41, 51.2%; P<0.05) and lymph nodes (13/41, 31.7%; P<0.001). Higher MMP-9 mRNA expression was also detected in tumor specimens compared with matched epithelial tissues and lymph nodes (P<0.05). Elevated MMP-9 expression was correlated with lymph node metastasis and LMVD (P<0.05). Conclusion MMP-9 was overexpressed in breast cancer specimens compared with peritumoral benign breast epithelium and lymph nodes. Moreover, its expression in the matched epithelium and lymph nodes was positively associated with lymph node metastasis, and its expression in lymph nodes was positively associated with lymphangiogenesis in breast cancer. Thus, MMP-9 is a potential marker for breast cancer progression. PMID:24845596

  15. The Usefulness of MRI and PET Imaging for the Detection of Parametrial Involvement and Lymph Node Metastasis in Patients with Cervical Cancer

    Microsoft Academic Search

    Won Park; Young Je Park; Seung Jae Huh; Byoung Gie Kim; Duk Soo Bae; Jeho Lee; Bo Hyun Kim; Joon Young Choi; Yong Chan Ahn

    2005-01-01

    (MRI) and positron emission tomography (PET) for the detection of parametrial involvement and lymph node metastasis in patients with cervical cancer. Methods: Thirty-six patients with cervical cancer were retrospectively enrolled. MRI and PET scans were performed for all patients within a week before radical surgery. The criterion for malignancy on MRI was >1 cm short axis diameter of the suspected

  16. Selective Changes in the Immune Profile of Tumor-Draining Lymph Nodes After Different Neoadjuvant Chemoradiation Regimens for Locally Advanced Cervical Cancer

    Microsoft Academic Search

    Alessandra Battaglia; Alexia Buzzonetti; Enrica Martinelli; Mara Fanelli; Marco Petrillo; Gabriella Ferrandina; Giovanni Scambia; Andrea Fattorossi

    2010-01-01

    Purpose: To assess how neoadjuvant chemoradiation regimens modulate the immune system state in tumor-draining lymph nodes (TDLN), in the setting of advanced cervical cancer. Methods and Materials: Tumor-draining lymph nodes of patients undergoing chemotherapy only (nonirradiated, NI-TDLN) and chemoradiation with lower-dose (39.6 Gy, LD-TDLN) and higher-dose radiation (50 Gy, HD-TDLN) were analyzed by multicolor flow cytometry. Results: Enlarging our previous

  17. Mediastinal Lymph Node Staging by FDG-PET in Patients with Non-Small Cell Lung Cancer: Analysis of False-Positive FDG-PET Findings

    Microsoft Academic Search

    Jun Konishi; Koichi Yamazaki; Eriko Tsukamoto; Nagara Tamaki; Yuya Onodera; Toshiyuki Otake; Toshiaki Morikawa; Ichiro Kinoshita; Hirotoshi Dosaka-Akita; Masaharu Nishimura

    2003-01-01

    Background: Accurate staging of mediastinal and hilar lymph nodes is a critical factor determining operability in patients with non-small cell lung cancer (NSCLC). Positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose as a tracer (FDG-PET) has recently been reported to be more effective in detecting tumor involvement in mediastinal and hilar lymph nodes than computed tomography (CT). Objective: In this study, we

  18. Correlation of polymorphism of IL-8 and MMP-7 with occurrence and lymph node metastasis of early stage cervical cancer.

    PubMed

    Wu, Suhui; Lu, Shi; Tao, Huijuan; Zhang, Li; Lin, Weifeng; Shang, Haixia; Xie, Jun

    2011-02-01

    The IL-8 and MMP-7 genes participate in the carcinogenesis of many malignancies, but the role of both genes in cervical cancer is not fully elucidated. The aim of this study was to determine the frequency of IL-8 and MMP-7 gene mutations and to assess their effects on the risk of early stage cervical cancer and lymph node metastasis. The clinical stage and histological grade of cervical cancer were also studied. The peripheral blood from the patients with early stage cervical cancers and normal controls was collected and the DNA was extracted. The incidence of IL-8 and MMP-7 gene mutations was assessed by using tetra-primer amplification refractory mutation system polymerase chain reaction (ARMS PCR) and restriction fragment length polymorphism (RFLP). The data were statistically analyzed by x2 test. The results showed that: (1) The genotype frequency of IL-8 -251AT and TT was significantly higher in the cervical cancer group than in the normal control group (OR=2.290 and 2.619 respectively, P=0.001), and it was also higher in the lymphatic metastasis group than that without metastasis (OR=2.917, P=0.035); (2) The frequency of MMP-7 -181G/G genotype was significantly higher in the cervical cancer group and in the lymphatic metastasis group (P<0.05); (3) The incidence of IL-8 mutation was two times higher in IIa cervical cancer group than in Ib1 and Ib2 cervical cancer group (P=0.006). For the MMP-7 gene, there was statistically significant difference in the incidence of mutation between the Ib1, Ib2 and the IIa (P=0.000); (4) Different histological types and different grades of cervical cancer had different incidence of mutations, statistically. It was suggested that there was significant difference in the genotype of IL-8 -251TT and MMP-7 -181GG polymorphism between the cervical cancer group and the lymph node metastasis group. Moreover, individuals with IL-8 T allele or MMP-7 G allele carriers were at significantly higher risk of cervical cancer, particularly the early (IIa) and medium, poorly differentiated cervical cancer (G2+G3). PMID:21336735

  19. Disease-Free Survival and Prognostic Significance of Metastatic Lymph Node Ratio in T1-T2 N Positive Breast Cancer Patients. A Population Registry-Based Study in a European Country

    Microsoft Academic Search

    David Martinez-Ramos; Javier Escrig-Sos; Miguel Alcalde-Sanchez; Ana Torrella-Ramos; Jose Luis Salvador-Sanchis

    2009-01-01

    Background  The ratio of positive lymph nodes between the total number of harvested lymph nodes (metastatic lymph node ratio, MLNR) has\\u000a been proposed as an alternative to the total number of lymph nodes alone in predicting outcomes for patients with breast cancer.\\u000a Because there can be differences between European and non-European populations, the authors present the first study analyzing\\u000a MLNR influence

  20. Muscular Variations During Axillary Dissection: A Clinical Study in Fifty Patients

    PubMed Central

    Upasna; Kumar, Ashwani; Singh, Bimaljot; Kaushal, Subhash

    2015-01-01

    Aim: The present study was conducted to detect the musculature variations during axillary dissection for breast cancer surgery. Methods: The anatomy of axilla regarding muscular variations was studied in 50 patients who had an axillary dissection for the staging and treatment of invasive primary breast cancer over one year. Results: In a period of one year, two patients (4%) with axillary arch and one patient (2%) with absent pectoralis major and minor muscles among fifty patients undergoing axillary surgery for breast cancer were identified. Conclusions: Axillary arch when present should always be identified and formally divided to allow adequate exposure of axillary contents, in order to achieve a complete lymphatic dissection. Complete absence of pectoralis major and minor muscles precludes the insertion of breast implants and worsens the prognosis of breast cancer. PMID:25838770

  1. Whole-Pelvis or Bladder-Only Chemoradiation for Lymph Node-Negative Invasive Bladder Cancer: Single-Institution Experience

    SciTech Connect

    Tunio, Mutahir A., E-mail: drmutahirtonio@hotmail.com [Department of Radiation Oncology, Sindh Institute of Urology and Transplantation, Karachi (Pakistan); Hashmi, Altaf [Department of Urology, Sindh Institute of Urology and Transplantation, Karachi (Pakistan); Qayyum, Abdul [Department of Medical Oncology, Sindh Institute of Urology and Transplantation, Karachi (Pakistan); Mohsin, Rehan [Department of Urology, Sindh Institute of Urology and Transplantation, Karachi (Pakistan); Zaeem, Ahmed [Department of Medical Physics, Sindh Institute of Urology and Transplantation, Karachi (Pakistan)

    2012-03-01

    Purpose: Whole-pelvis (WP) concurrent chemoradiation (CCRT) is the standard bladder preserving option for patients with invasive bladder cancer. The standard practice is to treat elective pelvic lymph nodes, so our aim was to evaluate whether bladder-only (BO) CCRT leads to results similar to those obtained by standard WP-CCRT. Methods and Materials: Patient eligibility included histopathologically proven muscle-invasive bladder cancer, lymph nodes negative (T2-T4, N-) by radiology, and maximal transurethral resection of bladder tumor with normal hematologic, renal, and liver functions. Between March 2005 and May 2006, 230 patients were accrued. Patients were randomly assigned to WP-CCRT (120 patients) and BO-CCRT (110 patients). Data regarding the toxicity profile, compliance, initial complete response rates at 3 months, and occurrence of locoregional or distant failure were recorded. Results: With a median follow-up time of 5 years (range, 3-6), WP-CCRT was associated with a 5-year disease-free survival of 47.1% compared with 46.9% in patients treated with BO-CCRT (p = 0.5). The bladder preservation rates were 58.9% and 57.1% in WP-CCRT and BO-CCRT, respectively (p = 0.8), and the 5-year overall survival rates were 52.9% for WP-CCRT and 51% for BO-CCRT (p = 0.8). Conclusion: BO-CCRT showed similar rates of bladder preservation, disease-free survival, and overall survival rates as those of WP-CCRT. Smaller field sizes including bladder with 2-cm margins can be used as bladder preservation protocol for patients with muscle-invasive lymph node-negative bladder cancer to minimize the side effects of CCRT.

  2. Newer Imaging Modalities to Assist With Target Localization in the Radiation Treatment of Prostate Cancer and Possible Lymph Node Metastases

    SciTech Connect

    John, Subhash S. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)], E-mail: subhashjohn@hotmail.com; Zietman, Anthony L.; Shipley, William U. [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Harisinghani, Mukesh G. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2008-05-01

    Precise localization of prostate cancer and the drainage lymph nodes is mandatory to define an accurate clinical target volume for conformal radiotherapy. Better target definition and delineation on a daily basis is surely important in quality assurance for fractionated radiation therapy. This article reviews the evidence for major emerging techniques that show promise in better identifying the clinical target volume. Partial prostate boost by brachytherapy, intensity-modulated radiation therapy, or protons has become possible not only with standard imaging techniques but also with the availability of metabolic images obtained by magnetic resonance spectroscopy. Even though fluorine-18 fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography has not been found to be useful, novel radiolabeled tracers may eventually prove of value in the diagnosis and treatment planning of prostate cancer. For the metastatic lymph nodes, lymphotropic nanoparticle-enhanced magnetic resonance imaging using ultra-small superparamagnetic iron oxide particles has greater accuracy as compared with conventional techniques and has been instrumental in delineating the lymphatic drainage of the prostate gland. These novel investigational techniques could further help in optimizing conformal radiotherapy for patients with prostate cancer. The concepts of biologic target volume, real target volume, and multidimensional conformal radiotherapy are being explored.

  3. Impact of preoperative radiation for rectal cancer on subsequent lymph node evaluation: A population-based analysis

    SciTech Connect

    Baxter, Nancy N. [Department of Surgery, University of Minnesota, Minneapolis, MN (United States)]. E-mail: baxte025@umn.edu; Morris, Arden M. [Department of Surgery, University of Michigan, Ann Arbor, MI (United States); Rothenberger, David A. [Department of Surgery, University of Minnesota, Minneapolis, MN (United States); Tepper, Joel E. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC (United States)

    2005-02-01

    Purpose: To determine the impact of preoperative radiotherapy (RT) on the accuracy of lymph node staging (LNS). Preoperative RT is a well-established component of rectal cancer treatment but its impact on LNS is unknown. Methods and materials: The Surveillance, Epidemiology and End Results (SEER) registry, representing 14% of the U.S. population, was used to assess the impact of preoperative RT on LNS. Our study population consisted of adults with rectal cancer between 1998 and 2000 who underwent radical resection. Results: In our 3-year study period, 5647 patients met the selection criteria and 1034 (19.5%) underwent preoperative RT. The preoperative RT group was younger (average age, 61 years) than those who did not undergo preoperative RT (average age, 69 years) and more likely to be male (22% of men vs. 16% of women). On average, fewer nodes were examined in patients who underwent preoperative RT (7 nodes) vs. those who did not (10 nodes); this difference was statistically significant, controlling for potential confounders (p {<=} 0.0001). In 16% of the preoperative RT patients (vs. 7.5% without), no nodes were identified (p {<=} 0.0001). If one used a minimum of 12 nodes as the standard, only 20% of patients who underwent preoperative RT underwent adequate LNS. Conclusion: Lymph node staging in patients who undergo preoperative RT must be interpreted with caution. Studies are needed to evaluate the clinical relevance of node number and pathologic staging after preoperative RT for rectal cancer.

  4. Transcriptional profile of fibroblasts obtained from the primary site, lymph node and bone marrow of breast cancer patients

    PubMed Central

    Del Valle, Paulo Roberto; Milani, Cintia; Brentani, Maria Mitzi; Katayama, Maria Lucia Hirata; de Lyra, Eduardo Carneiro; Carraro, Dirce Maria; Brentani, Helena; Puga, Renato; Lima, Leandro A.; Rozenchan, Patricia Bortman; Nunes, Bárbara dos Santos; Góes, João Carlos Guedes Sampaio; Azevedo Koike Folgueira, Maria Aparecida

    2014-01-01

    Cancer-associated fibroblasts (CAF) influence tumor development at primary as well as in metastatic sites, but there have been no direct comparisons of the transcriptional profiles of stromal cells from different tumor sites. In this study, we used customized cDNA microarrays to compare the gene expression profile of stromal cells from primary tumor (CAF, n = 4), lymph node metastasis (N+, n = 3) and bone marrow (BM, n = 4) obtained from breast cancer patients. Biological validation was done in another 16 samples by RT-qPCR. Differences between CAF vs N+, CAF vs BM and N+ vs BM were represented by 20, 235 and 245 genes, respectively (SAM test, FDR < 0.01). Functional analysis revealed that genes related to development and morphogenesis were overrepresented. In a biological validation set, NOTCH2 was confirmed to be more expressed in N+ (vs CAF) and ADCY2, HECTD1, HNMT, LOX, MACF1, SLC1A3 and USP16 more expressed in BM (vs CAF). Only small differences were observed in the transcriptional profiles of fibroblasts from the primary tumor and lymph node of breast cancer patients, whereas greater differences were observed between bone marrow stromal cells and the other two sites. These differences may reflect the activities of distinct differentiation programs. PMID:25249769

  5. Paratracheal lymph node dissection in cancer of the larynx, hypopharynx, and cervical esophagus: the need for guidelines.

    PubMed

    de Bree, Remco; Leemans, C René; Silver, Carl E; Robbins, K Thomas; Rodrigo, Juan P; Rinaldo, Alessandra; Takes, Robert P; Shaha, Ashok R; Medina, Jesus E; Suárez, Carlos; Ferlito, Alfio

    2011-06-01

    In laryngeal, hypopharyngeal, and cervical esophageal carcinomas, the paratracheal lymph nodes (PTLN) may be at risk for lymph node metastasis. The presence of PTLN metastasis is an important prognostic factor for the development of mediastinal and distant metastases, stomal recurrence, and disease-free and overall survival. Studies on PTLN metastasis are scarce. In most studies, PTLN dissection has not been routinely performed, and selection criteria for PTLN dissection are usually not well defined. Therefore, in most reported studies, selection bias is present and results are difficult to compare. The reported prevalence of PTLN metastases varies according to the site and stage of the primary tumor: subglottic cancer, transglottic cancer, and glottic cancer with subglottic extension have a higher risk of PTLN metastases. Diagnostic imaging is not sufficiently reliable to detect occult PTLN metastases and avoid unnecessary PTLN dissections. PTLN dissection is associated with limited morbidity, but damage to major vessels may occur, and because of exposure of these vessels PTLN may increase the morbidity of fistulae that can occur after total laryngectomy. The dissection may produce hypocalcemia, if performed bilaterally. Nevertheless, the limited morbidity and high rate of metastasis in specific laryngeal, hypopharyngeal, and cervical esophageal carcinomas argue in favor of routine elective PTLN treatment for these tumors. Large prospective studies are needed to identify the patients at risk with primary tumors in more detail. Moreover, improved diagnostic imaging is needed to detect (occult) PTLN metastases more reliably. Based on future studies, clinical guidelines have to be developed to avoid undertreatment and overtreatment. PMID:20652978

  6. Oncologic Results of Laparoscopic D3 Lymphadenectomy for Male Sigmoid and Upper Rectal Cancer with Clinically Positive Lymph Nodes

    Microsoft Academic Search

    Jin-Tung Liang; Kuo-Chin Huang; Hong-Shiee Lai; Po-Huang Lee; Chia-Tung Sun

    2007-01-01

    Background  Many Japanese surgeons routinely perform extended D3 lymph node dissection for the treatment of advanced rectosigmoid cancer\\u000a with a view to achieving better tumor control. However, the application of a laparoscopic approach to perform D3 lymphadenectomy\\u000a has been challenging. This phase 2 prospective study aimed to explore the oncologic results of this surgical approach.\\u000a \\u000a \\u000a \\u000a Methods  The study was conducted during a

  7. Predictive factors of non-sentinel lymph node involvement in patients with invasive breast cancer and sentinel node micrometastases.

    PubMed

    Friedman, Daniele; Gipponi, Marco; Murelli, Federica; Meszaros, Paolo; Solari, Nicola; Massa, Michela; Depaoli, Francesca; Baccini, Paola; Carli, Franca; Gallo, Maurizio; Cafiero, Ferdinando

    2013-10-01

    Patient-related, tumor-related, and sentinel node (SN)-related factors have been identified with the aim of predicting non-SN status in patients with SN micrometastases. According to our previous experience, primary tumor size (p=0.005) and the presence of lymphovascular invasion (LVI) (p=0.000) significantly predicted non-SN status in patients with SN micrometastasis; moreover, non-SN metastases were never detected in patients with pT1a-1b, G1, and no LVI. A prospective assessment was undertaken in a validation set of 126 patients to confirm these findings. Univariate analysis indicated that primary tumor size (p=0.05), Scarff-Bloom-Richardson (SBR) grade (p=0.008), LVI (p=0.001), and the number of mitoses/mm(2) (p=0.01) were significant predictors of non-SN status. By logistic regression analysis, tumor size (p=0.03), LVI (p=0.001), grade (p=0.003) and the number of mitoses/mm(2) (p=0.01) were the only variables remaining in the model. Three subsets of patients were identified: i) 18.3% of patients (pT1, G1, and no LVI) had tumor-negative non-SN (no risk group); ii) 37.3% of patients (number of mitoses/mm(2) <10, SBR grade II-III) had a rate of tumor-positive non-SN <15% (intermediate risk); iii) 44.4% of patients had a mean rate of non-SN involvement of 46% (high risk). By these parameters, more than 50% of patients could be selectively spared unnecessary axillary lymph node dissection without staging or therapeutic benefit, especially in patients with well-differentiated pT1 tumors without LVI. PMID:24123023

  8. Differential roles of Bcl2L12 and its short variant in breast cancer lymph node metastasis.

    PubMed

    Chien, Shang-Tao; Yang, Tzu-Feng; Yang, Ming-Chang; Hsu, Ching-Mei; Hong, Yi-Ren; Lee, Tai-Min

    2015-08-01

    Bcl2L12 plays a role in post-mitochondrial apoptosis through multiple mechanisms involving p53, ?B-crystallin, caspase-3 and -7 in glioblastoma. Bcl2L12 is reported to be a good prognostic marker in breast cancer and correlated with ER and Bcl2 expression status. However, the mechanisms by which Bcl2L12 regulates apoptosis in breast cancer (BCa) remain unknown. Recent studies have shown that Bcl2L12 expression is a useful biomarker in other types of cancer. Thus, we examined whether Bcl2L12 and Bcl2L12A mRNA were associated with breast cancer progression or a specific subtype. In total, 106 paraffin-embedded, different stage breast cancer specimens were prepared and quantified for Bcl2L12 and Bcl2L12A expression by PCR. The correlation between Bcl2L12 and Bcl2L12A mRNA levels and clinicopathological characteristics was statistically analyzed. The results showed that Bcl2L12 and Bcl2L12A mRNA expression was not significantly different across the different stage, grade and TNM classification groups (P>0.005). Using linear regression, Bcl2L12 mRNA was associated with Bcl2L12A mRNA, grade 3 tumor and the triple-negative breast cancer (TNBC) subtype. In non-TNBC specimens, Bcl2L12 mRNA was only correlated with Bcl2L12A mRNA. Bcl2L12A mRNA was positively associated with Bcl2L12 mRNA and the number of lymph node metastases, but negatively correlated with staging in the non-TNBC group. Specifically, Bcl2L12, but not Bcl2L12A, mRNA was significantly higher in TNBC and grade 3 tumors, respectively. In non-TNBC, Bcl2L12A mRNA was significantly highly expressed in tumors with ?12 metastatic lymph nodes. Bcl2L12 and its variant mRNA were highly expressed in carcinoma in situ (CIS) samples. In addition, they were estimated to be correlated with the total sample and non-TNBC, but not the TNBC group. In summary, a high Bcl2L12 mRNA expression was associated with the high-grade BCa and TNBC subtype. In addition, the interplay between Bcl2L12 and its variant may be associated with high lymph node metastasis in non-TNBC tumors. PMID:26082034

  9. SERPINE2 is a possible candidate promotor for lymph node metastasis in testicular cancer

    SciTech Connect

    Nagahara, Akira; Nakayama, Masashi; Oka, Daizo; Tsuchiya, Mutsumi; Kawashima, Atsunari; Mukai, Masatoshi; Nakai, Yasutomo; Takayama, Hitoshi [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan)] [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan); Nishimura, Kazuo [Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamachi, Higashinari-ku, Osaka, 537-8511 (Japan)] [Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamachi, Higashinari-ku, Osaka, 537-8511 (Japan); Jo, Yoshimasa; Nagai, Atsushi [Department of Urology, Kawasaki Medical University, 577 Matsushima, Kurashiki-City, Okayama 701-0192 (Japan)] [Department of Urology, Kawasaki Medical University, 577 Matsushima, Kurashiki-City, Okayama 701-0192 (Japan); Okuyama, Akihiko [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan)] [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan); Nonomura, Norio, E-mail: nono@uro.med.osaka-u.ac.jp [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan)] [Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-City, Osaka 565-0871 (Japan)

    2010-01-22

    Testicular germ cell tumors (TGCTs) commonly metastasize to the lymph node or lung. However, it remains unclear which genes are associated with TGCT metastasis. The aim of this study was to identify gene(s) that promoted human TGCT metastasis. We intraperitoneally administered conditioned medium (CM) from JKT-1, a cell-line from a human testicular seminoma, or JKT-HM, a JKT-1 cell sub-line with high metastatic potential, into mice with JKT-1 xenografts. Administration of CM from JKT-HM significantly promoted lymph node metastasis. A cDNA microarray analysis showed that JKT-HM cells highly expressed the Serpine peptidase inhibitor, clade E, member 2 (SERPINE2), which encodes a secreted protein. Administration of CM from SERPINE2-silenced JKT-HM cells inhibited lymph node metastasis in the xenograft model, compared with administration of CM from JKT-HM cells. There was no significant difference in xenograft volume. Moreover, administration of CM from SERPINE2-over-expressing JKT-1 was likely to promote lymph node metastasis in the xenograft model. There was no difference in the in vitro proliferation or migration of JKT-1 cells cultured with CM from JKT-HM cells, compared to that with CM from JKT-1. There was no promotion of proliferation or lymphangiogenesis in the xenografts, as measured by Ki-67 and LYVE-1 immunohistochemistry, respectively. Although we could not clarify how SERPINE2 promoted lymph node metastasis, it may be a promoter in the development of lymph node metastasis in the human seminoma cells in a mouse xenograft model.

  10. Prognostic classifications of lymph node involvement in lung cancer and current International Association for the Study of Lung Cancer descriptive classification in zones.

    PubMed

    Riquet, Marc; Arame, Alex; Foucault, Christophe; Le Pimpec Barthes, Françoise

    2010-09-01

    The lymphatic drainage of solid organ tumors crosses through the lymph nodes (LNs) whose tumoral involvement may still be considered as local disease. Concerning lung cancer, LN involvement may be intrapulmonary (N1), and mediastinal and/or extra-thoracic. More than 30 years ago, mediastinal involved LNs were all considered as N2, and outside the scope of surgery. In 1978, Naruke presented an original article entitled 'Lymph node mapping and curability at various levels of metastasis in resected lung cancer', demonstrating that N2 was not a contraindication to surgery in all patients. The map permitted to localize the favorable N2 on the lung cancer ipsilateral side of the mediastinum. Several maps ensued aiming to discriminate between right and left involvement (1983), and to distinguish N2 (ipsilateral) and N3 (contralateral) mediastinal LN involvement (1983, 1986). The last map (1997 regional LN classification) was recently replaced by a descriptive classification in anatomical zones. This new LN map of the TNM classification for lung cancer is a step toward using anatomical view points which might be the best way to better understand lung cancer lymphatic spread. Nowadays, the LNs are easily identified by current radiological imaging, and their resectability may be anticipated. Each LN chain may be removed by en-bloc lymphadenectomy performed during radical lung resection, a safe procedure which seems to be more oncological based than sampling, and which avoids the source of discrepancies pointed out during the labeling of LN stations by surgeons. PMID:20573650

  11. Comparative Assessment of Lymph Node Micrometastasis in Cervical, Endometrial and Vulvar Cancer: Insights on the Real Time qRT-PCR Approach versus Immunohistochemistry, Employing Dual Molecular Markers

    PubMed Central

    Pappa, Kalliopi I.; Rodolakis, Alexandros; Christodoulou, Ioanna; Gazouli, Maria; Markaki, Sofia; Antsaklis, Aris; Anagnou, Nicholas P.

    2014-01-01

    To address the value of qRT-PCR and IHC in accurately detecting lymph node micrometastasis in gynecological cancer, we performed a systematic approach, using a set of dual molecular tumor-specific markers such as cytokeratin 19 (CK19) and carbonic anhydrase 9 (CA9), in a series of 46 patients (19 with cervical cancer, 18 with endometrial cancer, and 9 with vulvar cancer). A total of 1281 lymph nodes were analyzed and 28 were found positive by histopathology. Following this documentation, 82 lymph nodes, 11 positive and 71 negative, were randomly selected and further analyzed both by IHC and qRT-PCR for CK19 and CA9 expression. All 11 (100%) expressed CK19 by IHC, while only 6 (54.5%) expressed CA9. On the contrary, all the histologically negative for micrometastases lymph nodes were also negative by IHC analysis for both markers. The comparative diagnostic efficacy of the two markers using qRT-PCR, however, disclosed that the analysis of the same aliquots of the 82 lymph nodes led to 100% specificity for the CK19 biomarker, while, in contrast, CA9 failed to recapitulate a similar pattern. These data suggest that qRT-PCR exhibits a better diagnostic accuracy compared to IHC, while CK19 displays a consistent pattern of detection compared to CA9. PMID:24527437

  12. Spectral imaging as a potential tool for optical sentinel lymph node biopsies

    NASA Astrophysics Data System (ADS)

    O'Sullivan, Jack D.; Hoy, Paul R.; Rutt, Harvey N.

    2011-07-01

    Sentinel Lymph Node Biopsy (SLNB) is an increasingly standard procedure to help oncologists accurately stage cancers. It is performed as an alternative to full axillary lymph node dissection in breast cancer patients, reducing the risk of longterm health problems associated with lymph node removal. Intraoperative analysis is currently performed using touchprint cytology, which can introduce significant delay into the procedure. Spectral imaging is forming a multi-plane image where reflected intensities from a number of spectral bands are recorded at each pixel in the spatial plane. We investigate the possibility of using spectral imaging to assess sentinel lymph nodes of breast cancer patients with a view to eventually developing an optical technique that could significantly reduce the time required to perform this procedure. We investigate previously reported spectra of normal and metastatic tissue in the visible and near infrared region, using them as the basis of dummy spectral images. We analyse these images using the spectral angle map (SAM), a tool routinely used in other fields where spectral imaging is prevalent. We simulate random noise in these images in order to determine whether the SAM can discriminate between normal and metastatic pixels as the quality of the images deteriorates. We show that even in cases where noise levels are up to 20% of the maximum signal, the spectral angle map can distinguish healthy pixels from metastatic. We believe that this makes spectral imaging a good candidate for further study in the development of an optical SLNB.

  13. Design and development of a dedicated mammary and axillary region positron emission tomography system

    NASA Astrophysics Data System (ADS)

    Doshi, Niraj Kumar

    Breast cancer is the second leading cause of cancer death in women. Currently, mammography and physical breast examination, both non-invasive techniques, provide the two most effective methods available for screening potential breast cancer patients. During the management of patients, however, several invasive techniques such as axillary lymph node dissection, core biopsies and lumpectomies, are utilized to determine the stage or malignancy of the disease with significant cost and morbidity associated with them. Positron Emission Tomography (PET), using [F-18] fluorodeoxyglucose (FDG) tracer is a sensitive and non-invasive imaging modality that may be a cost-effective alternative to certain invasive procedures. In this project we have developed a low cost, high performance, dedicated PET camera (maxPET) for mammary and axillary region imaging. The system consists of two 15x15 cm2 planar scintillation detector arrays composed of modular detectors operating in coincidence. The modular detectors are comprised of a 9x9 array of 3x3x20 mm3 lutetiurn oxyorthosilicate (LSO) detector elements, read out by a 5x5 array of position- sensitive photomultiplier tubes. The average measured intrinsic spatial resolution of a detector module is 2.26 mm with a sensitivity of up to 40% for a central point source. The measured coincidence timing resolution for two modules is 2.4 ns. The average energy resolution measured across the entire two detector plates is 21.6%. The coincidence timing resolution for the entire system is 8.1 ns. A line bar phantom was imaged and images were reconstructed using the focal plane tomography algorithm. A 4 mm projection image resolution was measured based on profiles taken through the line bar phantom images. The goal of the maxPET system will be to aid in breast cancer patient management by assisting in imaging women with dense, fibro-glandular breasts, detecting axillary lymph node metastases without surgery, monitoring chemotherapy effectiveness and assisting in visualization of recurrence and tumoral boundaries.

  14. The role of growth patterns, according to Kodama's classification, and lymph node status, as important prognostic factors in early gastric cancer: analysis of 412 cases

    Microsoft Academic Search

    Luca Saragoni; Michele Gaudio; Paolo Morgagni; Secondo Folli; Antonio Vio; Emanuela Scarpi; Ariele Saragoni

    2000-01-01

      \\u000a \\u000a Background. During the 1970s, a special type of Gastric Cancer with excellent prognosis (early gastric cancer; EGC) was identified by\\u000a the Japanese Research Society for Gastric Cancer. EGC has been defined as a tumor which invades the mucosa and\\/or submucosa,\\u000a regardless of the lymph node status. Using this definition, we identified an initial phase of tumor development which could

  15. Validation of the sentinel lymph node biopsy technique in head and neck cancers of the oral cavity.

    PubMed

    Radkani, Pejman; Mesko, Thomas W; Paramo, Juan C

    2013-12-01

    The purpose of this study was to present our experience and validate the use of sentinel lymph node (SLN) mapping in patients with head and neck cancers. A retrospective review of a prospectively collected database of patients with a diagnosis of squamous cell carcinomas of the head and neck from 2008 to 2011 was done. The group consisted of a total of 20 patients. The first node(s) highlighted with blue, or identified as radioactive by Tc99-sulfur radioactive colloid, was (were) identified as the SLNs. In the first seven patients, formal modified neck dissection was performed. In the remaining 13 patients, only a SLN biopsy procedure was done. At least one SLN was identified in all 20 patients (100%). Only one patient (5%) had positive nodes. In this case, the SLN was also positive. In the remaining 19 cases, all lymph nodes were negative. After an average of 24 months of follow-up, there have been three local recurrences (15%) but no evidence of distant metastatic disease. SLN mapping in head and neck cancers is a feasible technique with a high identification rate and a low false-negative rate. Although the detection rate of regional metastatic disease compares favorably with published data as well as the disease-free and overall survival, further studies are warranted before considering this technique to be the "gold standard" in patients with oral squamous cell carcinoma and a negative neck by clinical examination and imaging studies. PMID:24351359

  16. Biomarker Identification for Prostate Cancer and Lymph Node Metastasis from Microarray Data and Protein Interaction Network Using Gene Prioritization Method

    PubMed Central

    Arias, Carlos Roberto; Yeh, Hsiang-Yuan; Soo, Von-Wun

    2012-01-01

    Finding a genetic disease-related gene is not a trivial task. Therefore, computational methods are needed to present clues to the biomedical community to explore genes that are more likely to be related to a specific disease as biomarker. We present biomarker identification problem using gene prioritization method called gene prioritization from microarray data based on shortest paths, extended with structural and biological properties and edge flux using voting scheme (GP-MIDAS-VXEF). The method is based on finding relevant interactions on protein interaction networks, then scoring the genes using shortest paths and topological analysis, integrating the results using a voting scheme and a biological boosting. We applied two experiments, one is prostate primary and normal samples and the other is prostate primary tumor with and without lymph nodes metastasis. We used 137 truly prostate cancer genes as benchmark. In the first experiment, GP-MIDAS-VXEF outperforms all the other state-of-the-art methods in the benchmark by retrieving the truest related genes from the candidate set in the top 50 scores found. We applied the same technique to infer the significant biomarkers in prostate cancer with lymph nodes metastasis which is not established well. PMID:22654636

  17. Lymph Node Metastasis from Tall-Cell Thyroid Cancer Negative on 18F-FDG PET/CT and Detected by 18F-Choline PET/CT.

    PubMed

    Piccardo, Arnoldo; Massollo, Michela; Bandelloni, Roberto; Arlandini, Anselmo; Foppiani, Luca

    2015-08-01

    A 77-year-old woman underwent thyroidectomy and I remnant ablation for tall-cell differentiated cancer (DTC) of the left lobe. Detectable Tg levels (4.1 ?g/L) under TSH suppression, with undetectable serum Tg-antibody levels, prompted neck ultrasonography, which revealed a lymph node in the left laterocervical region and in the right retroclavicular region. F-FDG PET/CT showed uptake by the left lymph node. F-choline PET/CT showed increased uptake by both lymph nodes. Histopathology revealed DTC solid metastasis in the left lymph node and solid and cystic metastasis in the right one. F-choline PET/CT can locate virulent DTC recurrence, thereby increasing F-FDG PET/CT information. PMID:26053727

  18. Doxorubicin Hydrochloride, Cyclophosphamide, and Paclitaxel With or Without Bevacizumab in Treating Patients With Lymph Node-Positive or High-Risk, Lymph Node-Negative Breast Cancer

    ClinicalTrials.gov

    2015-07-20

    Estrogen Receptor Negative; Estrogen Receptor Positive; HER2/Neu Negative; Male Breast Carcinoma; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage IIA Breast Cancer; Stage IIB Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer

  19. Treatment plan for breast cancer with sentinel node metastasis

    PubMed Central

    Abreu, Efrén Bolívar; Martinez, Pedro; Betancourt, Luis; Romero, Gabriel; Godoy, Ali; Bergamo, Laura

    2014-01-01

    Lymph node involvement is considered to be one of the most important independent prognostic factors in breast cancer. In patients without palpable lymphadenopathies, the method of choice for determining this involvement is the sentinel lymph node biopsy. In the presence of macrometastases, the current standard is to perform axillary lymph node dissection in spite of the knowledge that the involvement of non-sentinel lymph nodes is approximately 50%. When lymph node involvement is micrometastasic, the decision as to whether or not to proceed with lymphadenectomy remains in dispute. We set out, on the basis of the current scientific evidence and our own experience, to create guidelines that allow us to individualise each case and decide whether or not to perform a lymphadenectomy. We will discuss the arguments that support our position. PMID:24478806

  20. Noninvasive Photoacoustic and Fluorescence Sentinel Lymph Node

    E-print Network

    Wang, Lihong

    nodes and the blood- stream, leading to a wider spread of the cancer. The closest lymph node that drainsNoninvasive Photoacoustic and Fluorescence Sentinel Lymph Node Identification using Dye the lymphatic system. Cancer cells that migrate from the primary tumor may become lodged in the first lymph

  1. Fine-Needle Aspiration Cytology of the Sentinel Lymph Node in Head and Neck Cancer

    Microsoft Academic Search

    Steffen Hoft; Claus Muhle; Winfried Brenner; Ernst Sprenger; Steffen Maune

    In squamous cell carcinoma of the head and neck, staging of the neck cannot rule out occult metastatic disease. An improved staging is necessary to avoid elective neck dissection in pa- tients staged as N0. The study was performed to determine the feasibility of the detection of occult metastatic disease by ultra- sound-guided fine-needle aspiration cytology (USgFNAC) of sentinel lymph

  2. Near infrared imaging to identify sentinel lymph nodes in invasive urinary bladder cancer

    Microsoft Academic Search

    Deborah W. Knapp; Larry G. Adams; Jacqueline D. Niles; Michael D. Lucroy; Jose Ramos-Vara; Patty L. Bonney; Amalia E. deGortari; John V. Frangioni

    2006-01-01

    Approximately 12,000 people are diagnosed with invasive transitional cell carcinoma of the urinary bladder (InvTCC) each year in the United States. Surgical removal of the bladder (cystectomy) and regional lymph node dissection are considered frontline therapy. Cystectomy causes extensive acute morbidity, and 50% of patients with InvTCC have occult metastases at the time of diagnosis. Better staging procedures for InvTCC

  3. Regulation of activator protein-1 activity in the mediastinal lymph node metastasis of lung cancer

    Microsoft Academic Search

    Katsuyuki Ichiki; Noriyasu Mitani; Yoshinori Doki; Hiroiku Hara; Takuro Misaki; Ikuo Saiki

    2000-01-01

    Orthotopic implantation of a metastatic cell line of Lewis lung carcinoma (LLC-MLN), which was isolated by an in vivo selection method, resulted in greater metastatic growth in mediastinal lymph nodes as compared with that of the original\\u000a LLC cells. LLC-MLN cells also had increased invasive ability and activator protein-1 (AP-1) transcriptional activity as compared\\u000a with the original LLC cells. This

  4. Spatial organization of dendritic cells within tumor draining lymph nodes impacts clinical outcome in breast cancer patients

    PubMed Central

    2013-01-01

    Background Dendritic cells (DCs) are important mediators of anti-tumor immune responses. We hypothesized that an in-depth analysis of dendritic cells and their spatial relationships to each other as well as to other immune cells within tumor draining lymph nodes (TDLNs) could provide a better understanding of immune function and dysregulation in cancer. Methods We analyzed immune cells within TDLNs from 59 breast cancer patients with at least 5 years of clinical follow-up using immunohistochemical staining with a novel quantitative image analysis system. We developed algorithms to analyze spatial distribution patterns of immune cells in cancer versus healthy intra-mammary lymph nodes (HLNs) to derive information about possible mechanisms underlying immune-dysregulation in breast cancer. We used the non-parametric Mann–Whitney test for inter-group comparisons, Wilcoxon Matched-Pairs Signed Ranks test for intra-group comparisons and log-rank (Mantel-Cox) test for Kaplan Maier analyses. Results Degree of clustering of DCs (in terms of spatial proximity of the cells to each other) was reduced in TDLNs compared to HLNs. While there were more numerous DC clusters in TDLNs compared to HLNs,DC clusters within TDLNs tended to have fewer member DCs and also consisted of fewer cells displaying the DC maturity marker CD83. The average number of T cells within a standardized radius of a clustered DC was increased compared to that of an unclustered DC, suggesting that DC clustering was associated with T cell interaction. Furthermore, the number of T cells within the radius of a clustered DC was reduced in tumor-positive TDLNs compared to HLNs. Importantly, clinical outcome analysis revealed that DC clustering in tumor-positive TDLNs correlated with the duration of disease-free survival in breast cancer patients. Conclusions These findings are the first to describe the spatial organization of DCs within TDLNs and their association with survival outcome. In addition, we characterized specific changes in number, size, maturity, and T cell co-localization of such clusters. Strategies to enhance DC function in-vivo, including maturation and clustering, may provide additional tools for developing more efficacious DC cancer vaccines. PMID:24088396

  5. Clinical stage B non-seminomatous germ cell testis cancer: The Indiana University experience (1965–1989) using routine primary retroperitoneal lymph node dissection

    Microsoft Academic Search

    J. P. Donohue; J. A. Thornhill; R. S. Foster; R. G. Rowland; R. Bihrle

    1995-01-01

    Between 1965 and 1989, 1180 patients at Indiana University, U.S.A., underwent retroperitoneal lymph node dissection (RPLND) for non-seminomatous germ cell (NSGC) testis cancer of whom 638 cases had primary RPLND. A subset of 174 cases were considered clinical stage B (or II) before surgery (retroperitoneal nodal metastases by clinical staging). Surgery revealed that 23% (n = 41) had pathological stage

  6. IMRT dose escalation for positive para-aortic lymph nodes in patients with locally advanced cervical cancer while reducing dose to bone marrow and other organs at risk

    Microsoft Academic Search

    Raef S. Ahmed; Robert Y. Kim; Jun Duan; Streelatha Meleth; Jennifer F. De Los Santos; John B. Fiveash

    2004-01-01

    PurposeTo evaluate the feasibility of dose-escalated para-aortic lymph node (PALN) intensity modulated radiation therapy (IMRT) in reducing the dose to bone marrow, bowel, spinal cord, and kidneys, compared with conventional radiation techniques of PALNs in patients with locally advanced cervical cancer and PALN metastases.

  7. Diagnostic Value of EBUS-TBNA for Lung Cancer with Non-Enlarged Lymph Nodes: A Study in a Tuberculosis-Endemic Country

    Microsoft Academic Search

    Chih-Hsi Kuo; Hao-Cheng Chen; Fu-Tsai Chung; Yu-Lun Lo; Kang-Yun Lee; Chih-Wei Wang; Wen-Han Kuo; Tzu-Chen Yen; Han-Pin Kuo

    2011-01-01

    BackgroundIn tuberculosis (TB)-endemic areas, contrast-enhanced computed tomography (CT) and positron emission tomography (PET) findings of lung cancer patients with non-enlarged lymph nodes are frequently discrepant. Endobronchial ultrasound-guided transbronchial aspiration (EBUS-TBNA) enables real-time nodal sampling, and thereby improves nodal diagnosis accuracy. This study aimed to compare the accuracy of nodal diagnosis by using EBUS-TBNA, and PET.MethodsWe studied 43 lung cancer patients

  8. Additional value of MR\\/PET fusion compared with PET\\/CT in the detection of lymph node metastases in cervical cancer patients

    Microsoft Academic Search

    Seok-Ki Kim; Hyuck Jae Choi; Sang-Yoon Park; Ho-Young Lee; Sang-Soo Seo; Chong Woo Yoo; Dae Chul Jung; Sokbom Kang; Kyung-Sik Cho

    2009-01-01

    We evaluated the additional diagnostic value of magnetic resonance\\/positron emission tomography (MR\\/PET) fusion in the detection of metastatic lymph nodes in cervical cancer patients.Seventy nine patients with FIGO stage IB-IVA cervical cancer who had undergone both magnetic resonance imaging (MRI) and positron emission tomography\\/computed tomography (PET\\/CT) before lymphadenectomy were included in this study. Image analysis was first performed with PET\\/CT

  9. Regional Lymph Node Metastases, a Singular Manifestation of the Process of Clinical Metastases in Cancer: Contemporary Animal Research And Clinical Reports Suggest Unifying Concepts

    Microsoft Academic Search

    Blake Cady

    Extensive animal research into the process of metastatic development of cancers over recent years provides insight into clinical\\u000a findings in patients. Clinical research and reports provide strong support for the translation of these research conclusions\\u000a from the laboratory and animals to human cancers (1–6), particularly in understanding the role of lymph node metastases but\\u000a also more distant metastases in almost

  10. Automatic detection of axillary lymphadenopathy on CT scans of untreated chronic lymphocytic leukemia patients

    NASA Astrophysics Data System (ADS)

    Liu, Jiamin; Hua, Jeremy; Chellappa, Vivek; Petrick, Nicholas; Sahiner, Berkman; Farooqui, Mohammed; Marti, Gerald; Wiestner, Adrian; Summers, Ronald M.

    2012-03-01

    Patients with chronic lymphocytic leukemia (CLL) have an increased frequency of axillary lymphadenopathy. Pretreatment CT scans can be used to upstage patients at the time of presentation and post-treatment CT scans can reduce the number of complete responses. In the current clinical workflow, the detection and diagnosis of lymph nodes is usually performed manually by examining all slices of CT images, which can be time consuming and highly dependent on the observer's experience. A system for automatic lymph node detection and measurement is desired. We propose a computer aided detection (CAD) system for axillary lymph nodes on CT scans in CLL patients. The lung is first automatically segmented and the patient's body in lung region is extracted to set the search region for lymph nodes. Multi-scale Hessian based blob detection is then applied to detect potential lymph nodes within the search region. Next, the detected potential candidates are segmented by fast level set method. Finally, features are calculated from the segmented candidates and support vector machine (SVM) classification is utilized for false positive reduction. Two blobness features, Frangi's and Li's, are tested and their free-response receiver operating characteristic (FROC) curves are generated to assess system performance. We applied our detection system to 12 patients with 168 axillary lymph nodes measuring greater than 10 mm. All lymph nodes are manually labeled as ground truth. The system achieved sensitivities of 81% and 85% at 2 false positives per patient for Frangi's and Li's blobness, respectively.

  11. Judging the therapeutic value of lymph node dissections for melanoma> 2 1 >No competing interests declared. 2 2 Supported by NIH grant PO NCI CA 29605 and by funding from the Wrather Family Foundation, Los Angeles, CA. Dr Essner is a recipient of an American Cancer Society Career Development Award

    Microsoft Academic Search

    Arden D Chan; Richard Essner; Leslie A Wanek; Donald L Morton

    2000-01-01

    Background: The management of the regional lymph nodes remains controversial for early-stage melanoma and for those patients with lymph node metastases; American Joint Committee on Cancer stage III. This study examines the importance of quality of the surgical resection measured by the extent of lymph node dissection (quartile of the total number of lymph nodes removed) to determine if this

  12. Use of Indocyanine Green for Detecting the Sentinel Lymph Node in Breast Cancer Patients: From Preclinical Evaluation to Clinical Validation

    PubMed Central

    Chi, Chongwei; Ye, Jinzuo; Ding, Haolong; He, De; Huang, Wenhe; Zhang, Guo-Jun; Tian, Jie

    2013-01-01

    Assessment of the sentinel lymph node (SLN) in patients with early stage breast cancer is vital in selecting the appropriate surgical approach. However, the existing methods, including methylene blue and nuclides, possess low efficiency and effectiveness in mapping SLNs, and to a certain extent exert side effects during application. Indocyanine green (ICG), as a fluorescent dye, has been proved reliable usage in SLN detection by several other groups. In this paper, we introduce a novel surgical navigation system to detect SLN with ICG. This system contains two charge-coupled devices (CCD) to simultaneously capture real-time color and fluorescent video images through two different bands. During surgery, surgeons only need to follow the fluorescence display. In addition, the system saves data automatically during surgery enabling surgeons to find the registration point easily according to image recognition algorithms. To test our system, 5 mice and 10 rabbits were used for the preclinical setting and 22 breast cancer patients were utilized for the clinical evaluation in our experiments. The detection rate was 100% and an average of 2.7 SLNs was found in 22 patients. Our results show that the usage of our surgical navigation system with ICG to detect SLNs in breast cancer patients is technically feasible. PMID:24358319

  13. Nodal Ratios in Node-Positive Breast Cancer-Long-Term Study to Clarify Discrepancy of Role of Supraclavicular and Axillary Regional Radiotherapy

    SciTech Connect

    Tai, Patricia [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan, Regina, SK (Canada)]. E-mail: patricia.tai@scf.sk.ca; Joseph, Kurian [Department of Oncology, Cross Cancer Center, University of Alberta, Edmonton, AB (Canada); Sadikov, Evgeny [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan, Regina, SK (Canada); Mahmood, Shazia [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan, Regina, SK (Canada); Lien, Francis [Department of Oncology, Allan Blair Cancer Center, University of Saskatchewan, Regina, SK (Canada); Yu, Edward [Radiation Oncology Program, London Regional Cancer Center, University of Western Ontario, London, ON (Canada)

    2007-07-01

    Purpose: To study the absolute number of involved nodes/the number of nodes examined or the nodal ratio (NR) in breast cancer. The primary study endpoint was to evaluate the role of supraclavicular and axillary radiotherapy (SART) according to the NR. Methods and Materials: From the Saskatchewan provincial registry of 1981-1995, the charts of 5,996 consecutive patients were retrieved to collect detailed prognostic factors. Among these patients, 1,985 were node positive. Because the NRs are more reliable the greater the number of nodes examined, we analyzed 1,255 patients with {>=}10 nodes examined. Of these 1,255 patients, 667, 389, and 199 were categorized into three NR groups-low ({<=}25%), medium (>25% to {<=}75%), and high (>75%) nodal involvement, respectively. Results: The NR correlated significantly with the primary tumor size ({<=}2 cm, >2 to {<=}5 cm, and >5 cm; p = 2.2 x 10{sup -16}), clinical stage group (p = 5.5 x 10{sup -16}), pathologic stage group (p < 2.2 x 10{sup -16}), and the risk of any first recurrence (p = 5.0 x 10{sup -15}) using chi-square tests. For a low NR, the 10-year overall survival rate with and without SART was 57% and 58% (p 0.18), and the cause-specific survival rate was 68% and 71% (p = 0.32), respectively. For a medium NR, the 10-year overall survival rate with and without SART was 48% and 34% (p = 0.007), and the cause-specific survival rate was 57% and 43% (p = 0.002), respectively. For a high NR, the 10-year overall survival rate with and without SART was 19% and 10% (p = 0.005), and the cause-specific survival rate was 26% and 14% (p = 0.005), respectively. Conclusion: This is the first study demonstrating that for patients with {>=}10 nodes examined, SART significantly improved the survival for the median and high NR groups but not for the low NR group.

  14. Close correlation between restriction fragment length polymorphism of the L-MYC gene and metastasis of human lung cancer to the lymph nodes and other organs

    SciTech Connect

    Kawashima, Kazuko; Shikama, Hiroshi; Imoto, Kazuhiko; Izawa, Mitsuo; Nishimura, Susumu (National Cancer Center Research Institute, Tokyo (Japan)); Naruke, Tsuguo; Okabayashi, Kenzo (National Cancer Center Hospital, Tokyo (Japan))

    1988-04-01

    Restriction length fragment polymorphism of the L-MYC gene was examined in DNAs from lung cancer tissues and normal tissues of 51 Japanese patients with lung cancer. In individual patients, no difference was seen between the restriction length fragments of the two alleles of L-MYC (6-kilobase (kb)) and 10-kb fragments in EcoRI digests in lung cancer tissues and normal tissues. But a striking correlation was found between the restriction length fragment polymorphism pattern of L-MYC and the extent of metastasis, particularly to the lymph nodes at the time of surgery: Patients with only the L band (10 kb) had few lymph node metastatic lesions, whereas patients with either the S band (6 kb) or the S and L bands almost always had lymph node metastatic lesion. A similar correlation was found between the presence of the S band and metastases to other organs. This correlation was particularly marked in cases of adenocarcinoma. These results indicate a clear genetic influence on metastases and a consequent poor prognosis for certain patients of lung cancer; L-MYC restriction length fragment polymorphism is thus shown to be a useful marker for predicting the metastatic potential of human lung cancer.

  15. Incidental Pelvic and Para-aortic Lymph Node Lymphangioleiomyomatosis Detected During Surgical Staging of Pelvic Cancer in Women Without Symptomatic Pulmonary Lymphangioleiomyomatosis or Tuberous Sclerosis Complex.

    PubMed

    Rabban, Joseph T; Firetag, Brandie; Sangoi, Ankur R; Post, Miriam D; Zaloudek, Charles J

    2015-08-01

    Extrapulmonary lymphangioleiomyomatosis (LAM) is a rare neoplasm of spindle cells exhibiting melanocytic and myoid differentiation that arises as a mass in the mediastinum, retroperitoneum, uterine wall, and/or intraperitoneal lymph nodes. Many patients also have pulmonary LAM, tuberous sclerosis complex (TSC), and/or other neoplasms of the perivascular epithelioid cell tumor family. This study reports 26 patients with clinically occult LAM involving pelvic/para-aortic lymph nodes removed from women undergoing surgical staging of a uterine (17), ovarian (5), cervical (3), or urinary bladder (1) neoplasm. None of the patients exhibited symptoms of pulmonary LAM, and the median patient age (56 y) was older than what would be expected for patients presenting with pulmonary LAM. Only 2/26 patients had TSC. Four patients also had uterine LAM. One of these 4 had uterine perivascular epithelioid cell tumor, and 1 had vaginal angiomyolipoma. In all 26 patients the lymph node LAM was grossly occult, measured 3.5 mm on average (1 to 19 mm), and involved either a single lymph node (12/26) or multiple lymph nodes (14/26). HMB45 was positive in 24/25 cases, mostly in a focal or patchy distribution. Other melanocytic markers included MiTF (12/14) and MelanA (2/12). Myoid markers included smooth muscle actin (23/23) and desmin (15/16), mostly in a diffuse distribution. Estrogen receptor was positive in all cases tested, as was D240 expression in the lymphatic endothelium lining the spindle cell bundles. Concurrent findings in the involved lymph nodes included metastatic carcinoma (3/26), endosalpingiosis (3/26), and reactive lymphoid hyperplasia (13/26). This study demonstrates that clinically occult lymph node LAM can be detected during surgical staging of pelvic cancer and is not commonly associated with pulmonary LAM or TSC, although these patients should still be formally evaluated for both of these diseases. PMID:25786086

  16. Outcome Analysis of Patients With Oral Cavity Cancer and Extracapsular Spread in Neck Lymph Nodes

    SciTech Connect

    Liao, Chun-Ta, E-mail: liaoct@adm.cgmh.org.tw [Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Lee, Li-Yu [Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Huang, Shiang-Fu; Chen, I-How; Kang, Chung-Jan [Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Lin, Chien-Yu; Fan, Kang-Hsing [Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Radiation Oncology, Chang Gung Memorial Hospital and Graduate Institute of Clinical Medical Sciences of Chang Gung University, Taoyuan, Taiwan (China); Wang, Hung-Ming [Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Hema-Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Ng, Shu-Hang [Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Yen, Tzu-Chen, E-mail: yen1110@adm.cgmh.org.tw [Department of Head and Neck Oncology Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China); Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan (China)

    2011-11-15

    Purpose: Extracapsular spread (ECS) in neck lymph nodes is a major adverse prognostic factor in patients with oral cavity squamous cell carcinoma (OSCC). We conducted a retrospective analysis of prognostic factors in this patient group and tried to identify a subset of patients with a worse prognosis suitable for more aggressive therapeutic interventions. Methods and Materials: Enrolled in the study were 255 OSCC patients with ECS in neck nodes and without evidence of distant metastasis. All participants were followed-up for at least 2 years or censored at last follow-up. The 5-year rates of control, distant metastasis, and survival were the main outcome measures. Results: Level IV/V lymph node metastases and tumor depth {>=}12 mm were independent predictors of 5-year survival and identified three prognostic groups. In the low-risk group (no level IV/V metastases and tumor depth <12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 60%, 66%, and 50%, respectively. In the intermediate-risk group (no level IV/V metastases and tumor depth {>=}12 mm), the 5-year disease-free, disease-specific, and overall survival rates were 39%, 41%, and 28%, respectively. In the high-risk group (evidence of level IV/V metastases), the 5-year disease-free, disease-specific, and overall survival rates were 14%, 12%, and 10%, respectively. Conclusions: Among OSCC patients with ECS, those with level IV/V metastases appear to have the worst prognosis followed by without level IV/V metastases and tumor depth {>=}12 mm. An aggressive therapeutic approach may be suitable for intermediate- and high-risk patients.

  17. Tumor size and lymph node status determined by imaging are reliable factors for predicting advanced cervical cancer prognosis

    PubMed Central

    KYUNG, MIN SUN; KIM, HONG BAE; SEOUNG, JUNG YEOB; CHOI, IN YOUNG; JOO, YOUNG SOO; LEE, ME YEON; KANG, JUNG BAE; PARK, YOUNG HAN

    2015-01-01

    The aim of the present study was to investigate the prognostic role of a number of clinical factors in advanced cervical cancer patients. Patients (n=157) with stage IIA–IIB cervical cancer treated at four Hallym Medical Centers in South Korea (Hallym University Sacred Heart Hospital; Kangnam Sacred Heart Hospital; Chuncheon Sacred Heart Hospital; and Kangdong Sacred Heart Hospital) between 2006 and 2010 were retrospectively enrolled. Univariate analysis identified significant predictive values in the following eight factors: i) Cancer stage (P<0.0001); ii) tumor size (?4 vs. 4–6 cm, P=0.0147; and ?4 vs. >6 cm, P<0.0001); iii) serum squamous cell carcinoma antigen level (?2 vs. >15 ng/ml; P=0.0291); iv) lower third vaginal involvement (P<0.0001); v) hydronephrosis (P=0.0003); vi) bladder/rectum involvement (P=0.0015); vii) pelvic (P=0.0017) or para-aortic (P=0.0019) lymph node (LN) metastasis detected by imaging vs. no metastasis; and viii) pelvic LN metastasis identified by pathological analysis (P=0.0289). Furthermore, multivariate analysis determined that tumor size (?4 vs. 4–6 cm, P=0.0371; and ?4 vs. >6 cm, P=0.0024) and pelvic LN metastasis determined by imaging vs. no metastasis (P=0.0499) were independent predictive variables. Therefore, tumor size and pelvic LN metastasis measured by imaging were independent predictive factors for the prognosis of advanced cervical cancer. These factors may provide more clinically significant prognostic information compared with the currently used International Federation of Gynecology and Obstetrics staging system. PMID:26137044

  18. 18 F-FDG PET\\/CT in mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic country: consideration of lymph node calcification and distribution pattern to improve specificity

    Microsoft Academic Search

    Jeong Won Lee; Bom Sahn Kim; Dong Soo Lee; June-Key Chung; Myung Chul Lee; Soonhag Kim; Won Jun Kang

    2009-01-01

    Purpose  The aim of the study was to assess the accuracy of 18F-fluorodeoxyglucose (FDG) PET\\/CT in mediastinal lymph node staging of patients with non-small-cell lung cancer (NSCLC) in\\u000a a region with a high prevalence of granulomatous disease.\\u000a \\u000a \\u000a \\u000a Methods  Between March 2004 and February 2006, all patients with NSCLC underwent FDG PET\\/CT and contrast-enhanced thoracic CT, and\\u000a subsequent surgical resection. PET\\/CT and contrast-enhanced

  19. The Prognostic Role of Para-Aortic Lymph Nodes in Patients with Colorectal Cancer: Is It Regional or Distant Disease?

    PubMed Central

    Lu, Hsueh-Ju; Lin, Jen-Kou; Chen, Wei-Shone; Jiang, Jeng-Kai; Yang, Shung-Haur; Lan, Yuan-Tzu; Lin, Chun-Chi; Liu, Chien-An; Teng, Hao-Wei

    2015-01-01

    Introduction Visible para-aortic lymph nodes of ?2 mm in size are common metastatic patterns of colorectal cancer (CRC) seen on imaging. Their prognostic value, however, remains inconclusive. We aimed to assess the prognostic role of visible para-aortic lymph nodes (PALNs). Methods Patients with confirmed pathologic diagnosis of CRC were enrolled. Correlations among clinicopathologic variables were analyzed using the ?2 test. The Cox proportional hazards model was applied for univariate and multivariate analyses. Survival was estimated using the Kaplan-Meier method and log-rank test. A prognostic model for visible PALNs in CRC patients was established. Results In total, 4527 newly diagnosed CRC patients were enrolled. Patients with visible PALNs had inferior overall survival compared to those without visible PALNs (5-year overall survival, 67% vs. 76%, P = 0.015). Lymphovascular invasion (LVI) (hazard ratio = 1.865, P = 0.015); nodal disease (pN+) status (hazard ratio = 2.099, P = 0.006); elevated preoperative serum carcinoembryonic antigen (CEA) levels (hazard ratio = 2.263, P < 0.001); and visible PALNs ?10 mm (hazard ratio = 1.638, P = 0.031) were independent prognostic factors for patients with visible PALNs. If each prognostic factor scored one point, 5-year overall survival of lower- (prognostic score 0–1), intermediate- (prognostic score 2), and high- (prognostic score 3–4) risk groups were, 78%. 54%, and 25% respectively (P < 0.001). Conclusions The prognostic model, which included LVI, pN+ status, preoperative serum CEA level, and the size of visible PALNs, could effectively distinguish the outcome of patients with visible PALNs. PMID:26115511

  20. Radiation Therapy Field Extent for Adjuvant Treatment of Axillary Metastases From Malignant Melanoma

    SciTech Connect

    Beadle, Beth M. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)], E-mail: aguadagn@mdanderson.org; Ballo, Matthew T. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Lee, Jeffrey E.; Gershenwald, Jeffrey E.; Cormier, Janice N.; Mansfield, Paul F.; Ross, Merrick I. [Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Zagars, Gunar K. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

    2009-04-01

    Purpose: To compare treatment-related outcomes and toxicity for patients with axillary lymph node metastases from malignant melanoma treated with postoperative radiation therapy (RT) to either the axilla only or both the axilla and supraclavicular fossa (extended field [EF]). Methods and Materials: The medical records of 200 consecutive patients treated with postoperative RT for axillary lymph node metastases from malignant melanoma were retrospectively reviewed. All patients received postoperative hypofractionated RT for high-risk features; 95 patients (48%) received RT to the axilla only and 105 patients (52%) to the EF. Results: At a median follow-up of 59 months, 111 patients (56%) had sustained relapse, and 99 patients (50%) had died. The 5-year overall survival, disease-free survival, and distant metastasis-free survival rates were 51%, 43%, and 46%, respectively. The 5-year axillary control rate was 88%. There was no difference in axillary control rates on the basis of the treated field (89% for axilla only vs. 86% for EF; p = 0.4). Forty-seven patients (24%) developed treatment-related complications. On both univariate and multivariate analyses, only treatment with EF irradiation was significantly associated with increased treatment-related complications. Conclusions: Adjuvant hypofractionated RT to the axilla only for metastatic malignant melanoma with high-risk features is an effective method to control axillary disease. Limiting the radiation field to the axilla only produced equivalent axillary control rates to EF and resulted in lower treatment-related complication rates.

  1. [Management of axillary hyperhidrosis].

    PubMed

    Pomarède, N

    2009-05-01

    Hyperhidrosis is considered as an handicap which affects around of 2.8% of the population. It is linked to an extreme, permanent and symetric production of sweating because of an hyperactivity of sweat glands independant of thermo regulation process. The treatment by botulinum toxin has completely changed the treatment of axillary hyperhidrosis. It is an easy, quick, efficient treatment which improved quality of life of these patients. This treatment can also be used for palmar and plantar hyperhidrosis but it requires regional anesthetic technics, so it is done to the hospital. PMID:19576478

  2. [Lymph mobilization].

    PubMed

    Froneberg, W; Fabian, G

    1989-07-01

    Following a review of the literature lymph mobilization is described. Function and causalities of lymph mobilization and their interactions are explained giving examples and an evaluation of the experience available up to date. In many cases, manual neurotherapy may result in coordination and normalization of disorders which do not respond to other forms of therapy. PMID:2672664

  3. Sentinel lymph nodes detection with an imaging system using Patent Blue V dye as fluorescent tracer

    NASA Astrophysics Data System (ADS)

    Tellier, F.; Steibel, J.; Chabrier, R.; Rodier, J. F.; Pourroy, G.; Poulet, P.

    2013-03-01

    Sentinel lymph node biopsy is the gold standard to detect metastatic invasion from primary breast cancer. This method can help patients avoid full axillary chain dissection, thereby decreasing the risk of morbidity. We propose an alternative to the traditional isotopic method, to detect and map the sentinel lymph nodes. Indeed, Patent Blue V is the most widely used dye in clinical routine for the visual detection of sentinel lymph nodes. A Recent study has shown the possibility of increasing the fluorescence quantum yield of Patent Blue V, when it is bound to human serum albumin. In this study we present a preclinical fluorescence imaging system to detect sentinel lymph nodes labeled with this fluorescent tracer. The setup is composed of a black and white CCD camera and two laser sources. One excitation source with a laser emitting at 635 nm and a second laser at 785 nm to illuminate the region of interest. The prototype is operated via a laptop. Preliminary experiments permitted to determine the device sensitivity in the ?mol.L-1 range as regards the detection of PBV fluorescence signals. We also present a preclinical evaluation performed on Lewis rats, during which the fluorescence imaging setup detected the accumulation and fixation of the fluorescent dye on different nodes through the skin.

  4. The new TNM classification of lymph node metastasis minimises stage migration problems in gastric cancer patients

    Microsoft Academic Search

    G de Manzoni; G Verlato; F Roviello; P Morgagni; A Di Leo; L Saragoni; D Marrelli; H Kurihara; F Pasini

    2002-01-01

    The present study aimed at investigating whether in gastric cancer patients stage migration occurs with extension of lymphadenectomy, when node metastases are staged according to the new pN classification (UICC 1997). The investigation involved 921 patients, who underwent R0 gastric resection for gastric cancer between 1988 and 1998 in three different Italian centres: Verona (n=236), Forlì (n=409), Siena (n=276). The

  5. Coexistent Isolated Tumor Cell Clusters of Infiltrating Lobular Carcinoma and Benign Glandular Inclusions of Müllerian (Endosalpingiosis) Type in an Axillary Sentinel Node: Case Report and Review of the Literature.

    PubMed

    Groth, John V; Prabhu, Sanjiv; Wiley, Elizabeth

    2014-09-01

    The presence of benign epithelial inclusions in axillary lymph nodes coexistant with breast disease is a rare event; however, their presence makes the assessment of nodal disease diagnostically challenging. Broadly, these inclusions can be classified as glandular (müllerian type or nonmüllerian type), mixed glandular-squamous, and squamous. Among these the presence of benign müllerian-type glandular inclusions with concurrent breast parenchymal disease is an exceedingly rare event, with 10 previous cases reported in the literature, 2 coexisting with infiltrating ductal-type mammary carcinoma in axillary lymph nodes. Here, we report the first case of coexistent invasive lobular carcinoma and endosalpingiosis in an axillary lymph node. PMID:25203429

  6. The Impact of the Size of Nodal Metastases on Recurrence Risk in Breast Cancer Patients With 1-3 Positive Axillary Nodes After Mastectomy

    SciTech Connect

    Harris, Eleanor E.R., E-mail: Eleanor.harris@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Freilich, Jessica [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)] [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Lin, Hui-Yi [Biostatistics Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)] [Biostatistics Core, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Chuong, Michael [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)] [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Acs, Geza [Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)] [Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States)

    2013-03-01

    Purpose: Use of postmastectomy radiation therapy (PMRT) in breast cancer patients with 1-3 positive nodes is controversial. The objective of this study was to determine whether the size of nodal metastases in this subset could predict who would benefit from PMRT. Methods and Materials: We analyzed 250 breast cancer patients with 1-3 positive nodes after mastectomy treated with contemporary surgery and systemic therapy at our institution. Of these patients, 204 did not receive PMRT and 46 did receive PMRT. Local and regional recurrence risks were stratified by the size of the largest nodal metastasis measured as less than or equal to 5 mm or greater than 5 mm. Results: The median follow-up was 65.6 months. In the whole group, regional recurrences occurred in 2% of patients in whom the largest nodal metastasis measured 5 mm or less vs 6% for those with metastases measuring greater than 5 mm. For non-irradiated patients only, regional recurrence rates were 2% and 9%, respectively. Those with a maximal nodal size greater than 5 mm had a significantly higher cumulative incidence of regional recurrence (P=.013). The 5-year cumulative incidence of a regional recurrence in the non-irradiated group was 2.7% (95% confidence interval [CI], 0.7%-7.2%) for maximal metastasis size of 5 mm or less, 6.9% (95% CI, 1.7%-17.3%) for metastasis size greater than 5 mm, and 16% (95% CI, 3.4%-36.8%) for metastasis size greater than 10 mm. The impact of the maximal nodal size on regional recurrences became insignificant in the multivariable model. Conclusions: In patients with 1-3 positive lymph nodes undergoing mastectomy without radiation, nodal metastasis greater than 5 mm was associated with regional recurrence after mastectomy, but its effect was modified by other factors (such as tumor stage). The size of the largest nodal metastasis may be useful to identify high-risk patients who may benefit from radiation therapy after mastectomy.

  7. Alcohol fat clearing increases lymph node yield after surgery for colorectal cancer.

    PubMed

    Duldulao, Marjun; Booth, Cassie; Denham, Laura; Choi, Audrey; Friedman, Garrett; Kazanjian, Kevork

    2014-10-01

    Lymph node (LN) yield is associated with oncologic outcome in patients who undergo surgery for colorectal adenocarcinoma (CRC). Standards to maximize LN yield have been initiated to enhance treatment of patients with CRC. This study evaluates the impact of a simple alcohol-based preparation protocol on LN yield. Surgical specimens from patients with CRC were prepared using either the alcohol protocol or standard formalin fixation and LN yield was compared. In total, 80 consecutive patients (n = 40 formalin, n = 40 alcohol) were examined. Overall, median LN yield increased from 17 to 29 (P < 0.01) with the alcohol fat clearance protocol. For patients with rectal adenocarcinoma who underwent proctectomy after neoadjuvant chemoradiotherapy, LN yield increased from 15 to 23 (P = 0.02). The frequency of need for additional sampling to achieve a minimum 12 LN count was also reduced. Initiation of a standardized alcohol fat-clearing protocol increased LN yield after surgery for CRC. This simple, cost-effective measure may improve the efficiency of LN assessment and accurate staging, which may impact oncologic outcomes. PMID:25264659

  8. Time-dependence of hazard ratios for prognostic factors in primary breast cancer

    Microsoft Academic Search

    Susan G. Hilsenbeck; Peter M. Ravdin; Carl A. de Moor; Gary C. Chamness; C. Kent Osborne; Gary M. Clark

    1998-01-01

    Some prognostic factors, such as steroid receptors, appear strongly related to outcome in early studies with short follow-up, but as follow-up matures the relationships appear to weaken. We investigated this phenomenon for several factors (tumor size, axillary lymph nodes, S-phase fraction, estrogen receptor (ER) status, and adjuvant therapy) in a large sample of breast cancer cases (N=2,873) with up to

  9. The usefulness of FDG positron emission tomography for the detection of mediastinal lymph node metastases in patients with non-small cell lung cancer: a comparative study with X-ray computed tomography

    Microsoft Academic Search

    Masayuki Sasaki; Yuichi Ichiya; Yasuo Kuwabara; Yuko Akashi; Tsuyoshi Yoshida; Toshimitsu Fukumura; Sadayuki Murayama; Teruyoshi Ishida; Kenji Sugio; Kouji Masuda

    1996-01-01

    We evaluated the usefulness of fluorine-18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) in the detection of mediastinal lymph node metastases in patients with non-small cell lung cancer and then compared the findings with the results of X-ray CT by region based on the histological diagnoses. We examined 29 patients with non-small cell lung cancer. One hundred and thirty-two mediastinal lymph nodes

  10. Elevated serum epidermal growth factor receptor level is correlated with lymph node metastasis in lung cancer

    Microsoft Academic Search

    Hidefumi Sasaki; Haruhiro Yukiue; Kotaro Mizuno; Atsushi Sekimura; Akimitsu Konishi; Motoki Yano; Masahiro Kaji; Masanobu Kiriyama; Ichiro Fukai; Yosuke Yamakawa; Yoshitaka Fujii

    2003-01-01

    .  \\u000a \\u000a Background: Using an enzyme immunoassay for epidermal growth factor receptor (EGFR), we investigated whether serum EGFR levels could\\u000a be used as predictors of the development and extent of lung cancer.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: The study included 106 lung cancer patients and 16 patients with nonmalignant thoracic disease. Serum samples were collected\\u000a before clinical treatment.\\u000a \\u000a \\u000a \\u000a \\u000a Results: There was no difference between serum

  11. Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of second level lymph nodes: A longitudinal multicenter study

    Microsoft Academic Search

    Franco Roviello; Daniele Marrelli; Paolo Morgagni; Giovanni de Manzoni; Alberto di Leo; Carla Vindigni; Luca Saragoni; Anna Tomezzoli; Hayato Kurihara

    2002-01-01

    Background  The survival benefit of extended lymphadenectomy in the surgical treatment of gastric cancer is still being debated. The aim\\u000a of this longitudinal multicenter study was to evaluate long-term survival in a group of patients with involvement of second\\u000a level lymph nodes, which would not have been removed in the case of a limited lymphadenectomy. Results were compared with\\u000a those in

  12. Prospective comparison of 18 F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer

    Microsoft Academic Search

    Stefan Adams; Richard P Baum; Tankred Stuckensen; Klaus Bitter; Gustav Hör

    1998-01-01

    .   The aims of this study were to investigate the detection of cervical lymph node metastases of head and neck cancer by positron\\u000a emission tomographic (PET) imaging with fluorine-18 fluorodeoxyglucose (FDG) and to perform a prospective comparison with\\u000a computed tomography (CT), magnetic resonance imaging (MRI), sonographic and histopathological findings. Sixty patients with\\u000a histologically proven squamous cell carcinoma were studied by

  13. Preoperative intrathoracic lymph node staging in patients with non-small-cell lung cancer: accuracy of integrated positron emission tomography and computed tomography

    Microsoft Academic Search

    Andrea Billé; Ettore Pelosi; Andrea Skanjeti; Vincenzo Arena; Luca Errico; Piero Borasio; Maurizio Mancini; Francesco Ardissone

    2009-01-01

    Objective: To evaluate the accuracy of integrated positron emission tomography with 18F-fluoro-2-deoxy-d-glucose (FDG) and computed tomography (PET\\/CT) in preoperative intrathoracic lymph node staging in patients with non-small-cell lung cancer (NSCLC) and to ascertain the role of invasive staging in verifying positron emission tomography (PET)\\/computed tomography (CT) results. Methods: Retrospective, single institution study of consecutive patients with suspected or pathologically proven,

  14. Predictor of Intratumoral Lymphatic Vessel Invasion and Lymph Node Involvement in Non-Small Cell Lung Cancer: Analysis of a Multicenter Study

    Microsoft Academic Search

    Kotaro Higashi; Kengo Ito; Yoshinori Hiramatsu; Tsutomu Ishikawa; Tsutomu Sakuma; Ichiro Matsunari; Gencho Kuga; Katsuyuki Miura; Takahiro Higuchi; Hisao Tonami; Itaru Yamamoto

    Intratumoral lymphatic vessel invasion and lymph node involve- ment are important factors in the planning of therapeutic strat- egies, particularly limited surgical resection in patients with non-small cell lung cancer. 18F-FDG uptake within the primary lesion correlates with aggressiveness on PET studies. The more metabolically active the tumor, the more aggressive are the findings. The aim of this multicenter study

  15. Mediastinal Lymph Node Involvement in Non Small Cell Lung Cancer: Evaluation with 99mTc Tetrofosmin SPECT and Comparison with CT

    Microsoft Academic Search

    Orazio Schillaci; Angela Spanu; Francesco Scopinaro; Francesco Monteleone

    In patients with non-small cell lung cancer (NSCLC), surgical resection offers the best chance of cure. The preoperative as- sessment of mediastinal lymph node involvement is crucial to selecting those patients for whom surgery is indicated. Meth- ods: To evaluate the possible clinical role of 99mTc-tetrofosmin scintigraphy in the presurgical detection of mediastinal node metastases from NSCLC, we performed a

  16. Loss of has-miR-337-3p expression is associated with lymph node metastasis of human gastric cancer

    PubMed Central

    2013-01-01

    Background Metastasis is the major cause of cancer-related death in patients with gastric cancer, and aberrant expression of various microRNAs (miRNAs) is associated with cancer metastasis. Methods Profiling of differentially expressed miRNAs was performed in three cases of primary gastric cancer and the corresponding metastatic lymph node tissues. Then, the five most altered miRNAs were further verified in 16 paired samples. Two of these five miRNAs were further assessed for their effects on the regulation of gastric cancer cell growth and invasion. Results The miRNA profile data showed 151 upregulated miRNAs (? 1.5-fold) and 285 downregulated miRNAs (? 0.67-fold) in the metastatic tissues compared to the primary gastric cancer tissues. Among these five miRNAs (i.e., hsa-miR-508-5p, hsa-miR-30c, hsa-miR-337-3p, hsa-miR-483-5p, and hsa-miR-134), expression of hsa-miR-337-3p and hsa-miR-134 was significantly downregulated in these 16 lymph node metastatic tissues compared to their primary tumor tissues (P<0.05) and in nine gastric cancer cell lines compared to the nonmalignant GES cell line. Furthermore, induction of hsa-miR-134 or hsa-miR-337-3p expression did not dramatically affect gastric cancer cell proliferation, but transfection of the hsa-miR-337-3p mimic did reduce gastric cancer cell invasion capacity. Conclusions These findings indicate that hsa-miR-337-3p plays a role in the reduction of gastric cancer cell invasion capacity, and further studies on the mechanism of hsa-miR-337-3p in gastric cancer metastasis are warranted. PMID:24422944

  17. Introduction About 6070% of patients with lymph-node-negative

    E-print Network

    Tian, Qi

    Articles Introduction About 60­70% of patients with lymph-node-negative breast cancer are cured predictions on disease outcome for patients with lymph-node-negative breast cancer. Methods Patients' samples samples from patients with lymph-node- negative breast cancer who were treated during 1980­95, but who did

  18. Sentinel lymph node mapping in breast cancer using subareolar injection of blue dye

    Microsoft Academic Search

    Kenneth A Kern

    1999-01-01

    Background: Lymphatic mapping in breast cancer performed solely by intraparenchymal injections of blue dye remains an accepted method of identifying sentinel nodes, largely because of its simplicity. As currently practiced, the technique is associated with a marked learning curve, variable identification rates of sentinel nodes, and high false-negative rates. The purpose of this study is to improve dye-only lymphatic mapping

  19. Scintimammography with technetium-99m tetrofosmin in the diagnosis of breast cancer and lymph node metastases

    Microsoft Academic Search

    Luigi Mansi; Pier Francesco Rambaldil; Eugenio Procaccini; Fernando Di Gregorio; Adelina Laprovitera; Biagio Pecori; Walter Del Vecchio

    1996-01-01

    The aim of the study was to evaluate the possible role of scintimammography (SMM) with technetium-99m tetrofosmin in breast cancer. Thirty-three patients with breast disease and ten normal controls were included in the study. Planar scintigraphic images in supine anterior, prone lateral and lateral views, with the patient lying in lateral recumbency, were acquired. A qualitative analysis evaluating both breasts

  20. Staging of Regional Lymph Nodes in Melanoma: A Case for Including Nonsentinel Lymph Node Positivity in the American Joint Committee on Cancer (AJCC) Staging System

    PubMed Central

    Leung, Anna M.; Morton, Donald L; Ozao-Choy, Junko; Hari, Danielle M.; Shin-Sim, Myung; Difronzo, Andrew L.; Faries, Mark B.

    2013-01-01

    Importance Survival varies widely in Stage III melanoma. The existence of clinical significance for positive NSLN status would warrant consideration for incorporation into the AJCC staging system and better prediction of survival. Objective The objective of this study was to evaluate whether disease limited to the sentinel lymph node (SLN) represents different clinical significance than disease spread into nonsentinel lymph nodes (NSLN). Design, Setting, and Participants Our database was queried for all patients with positive SLN for cutaneous melanoma who subsequently underwent completion lymph node dissection. Main Outcome Measures Disease-free, melanoma-specific, and overall survival Results 4,223 patients underwent SLN biopsy from 1986–2012. 329 patients had a tumor positive SLN. 250 (76%) had no additional positive nodes. 79 (24%) had a positive NSLN. Factors predictive of NSLN positivity included older age (p=0.04), thicker breslow (p<0.0001), and ulceration (p<0.015). Median overall survival (OS) was 178 months for the SLN+ only group and 42.2 months for the NSLN+ group (5-yr OS, 72.3% and 46.4% respectively.) Median disease-specific survival (DSS) was not reached for the SLN+ only group and was 60 months for the NSLN+ group (5-yr DSS 77.8% and 49.5% respectively.) On multivariate analysis, NSLN positivity had a strong association with recurrence, {HR: 1.754 (1.228–2.505); p=0.002}, shorter OS {HR: 2.24 (1.476–3.404); p=0.0002} and shorter DSS {HR: 2.225 (1.456–3.072); p<0.0001}. To further control for the effects of total positive nodes, comparison was done for those with N2 disease only (2–3 total positive LN), this confirmed the independent effect of NSLN status (DSS; p=0.04). Conclusions NSLN positivity is one of the most significant prognostic factors in patients with Stage III melanoma. An AJCC sub classification of nodal stage based on NSLN positivity should be considered. PMID:23903435

  1. [Continuous dissection of the posterior mediastinal and abdominal lymph nodes using a laparoscopic transhiatal approach for esophageal cancer].

    PubMed

    Shiozaki, Atsushi; Fujiwara, Hitoshi; Konishi, Hirotaka; Morimura, Ryo; Murayama, Yasutoshi; Komatsu, Shuhei; Kuriu, Yoshiaki; Ikoma, Hisashi; Kubota, Takeshi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Okamoto, Kazuma; Sakakura, Chouhei; Otsuji, Eigo

    2014-11-01

    We began performing laparoscopic transhiatal esophagectomies in patients with esophageal cancer in 2009. By June 2014, 172 patients had undergone this procedure. The main advantage of this method was that the dissection of the posterior mediastinal and abdominal lymph nodes(LNs)could be performed continuously under a magnified videoscopic view. An abdominal wall sealing device was placed in the upper abdomen, and 4 ports were inserted. The esophageal hiatus was opened, and carbon dioxide was introduced into the mediastinum. The posterior plane of the pericardium was separated and extended, and the anterior side of each posterior mediastinal LN was separated. The thoracic aorta's adventitia was exposed, and the posterior sides of the LNs were then separated. While lifting the LNs like a membrane, they were resected along the border of the left mediastinal pleura. Subsequently, dissection of the posterior mediastinal LNs was extended towards the caudal side from the crural diaphragm to the celiac artery. Thus, the LNs along the celiac and left gastric artery were dissected en bloc from the left side. Our surgical procedure allowed good views during surgery, and the continuous dissection of the posterior mediastinal and abdominal LNs was performed safely. PMID:25731400

  2. Post-nephrectomy foreign-body granuloma in the retroperitoneum mimicking lymph node metastasis of renal cell cancer

    PubMed Central

    Luo, Jindan; Mao, Yeqing; Cai, Songliang; Shen, Xiaoyong; Chen, Shanwen; Xie, Liping

    2014-01-01

    Recently, iatrogenic foreign-body granuloma has been increasingly reported. The asymptomatic presentation and confusing appearance of granuloma can lead to misdiagnosis of a secondary malignancy, especially for a patient with a corresponding past medical history. Sometimes, surgical treatment is unavoidable, and the diagnosis relies upon the pathologic result. Herein, we report an unusual case of a 43-year-old man who underwent a nephrectomy for renal cell carcinoma (clear cell type) 5 years ago. A secondary granuloma was identified behind the inferior vena cava in the retroperitoneum 6 months after the surgery, but the radiologists had failed to identify it throughout the 4 years of routine examination. Later on, the lesion was identified by positron emission tomography, which classified it as a highly 18F-fluorodeoxyglucose-avid lesion. Considering no visible foreign-bodies identified on images, the lesion was arguably diagnosed as a lymph node metastasis of renal cancer. Finally, it was confirmed as a foreign-body granuloma encasing surgical suture and adipose tissue by the pathological analysis. PMID:25429231

  3. One-Step Nucleic Acid Amplification in Breast Cancer Sentinel Lymph Node: A Single Institutional Experience and a Short Review

    PubMed Central

    Brambilla, Tatiana; Fiamengo, Barbara; Tinterri, Corrado; Testori, Alberto; Grassi, Massimo Maria; Sciarra, Amedeo; Abbate, Tommaso; Gatzemeier, Wolfgang; Roncalli, Massimo; Di Tommaso, Luca

    2015-01-01

    Sentinel lymph node (SLN) examination is a standard in breast cancer patients, with several methods employed along its 20?years history, the last one represented by one-step nucleic acid amplification (OSNA). The latter is a intra-operative molecular assay searching for CK19 mRNA as a surrogate of metastatic cells. Our 3?years experience with OSNA (1122 patients) showed results overlapping those recorded in the same institution with a morphological evaluation (930 patients) of SLN. In detail, the data of OSNA were almost identical to those observed with standard post-operative procedure in terms of patients with positive SLN (30%) and micrometastatic/macrometastatic involvement of SLN (respectively, 38–45 and 62–55%). By contrast, when OSNA was compared to the standard intraoperatory procedure, it was superior in terms of accuracy, prompting the use of this molecular assay as a very valid, and reproducible for intra-operative evaluation of SLN. Further possibilities prompting the use of OSNA range from adhesion to quality control programs, saving of medical time, ability to predict, during surgery, additional nodal metastasis, and molecular bio-banking.

  4. Consideration of the Role of Radiotherapy for Abdominal Lymph Node Metastases in Patients With Recurrent Gastric Cancer

    SciTech Connect

    Sun Jing [Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai (China); Sun Yihong, E-mail: sun.yihong@zs-hospital.sh.c [Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai (China); Zeng Zhaochong, E-mail: zeng.zhaochong@zs-hospital.sh.c [Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai (China); Qin Xinyu [Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai (China); Zeng Mengsu [Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai (China); Chen Bing [Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai (China); Liu Tianshu [Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai (China); Zhang Jianying [Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai (China)

    2010-06-01

    Purpose: To evaluate the outcome of external beam radiotherapy for abdominal lymph node (LN) metastases in patients with recurrent gastric cancer. Methods and Materials: The clinical data of 79 patients with abdominal LN metastases developing after curative resection of gastric tumor were retrospectively analyzed. Of the 79 patients, 37 received radiation (40-60 Gy in fractions of 2.0 Gy daily, five times weekly; termed the radiation group), and 42 received chemotherapy or supportive care (the nonradiation group). The Kaplan-Meier method was used to evaluate survival, and a Cox regression model was used to identify predictors of prognosis. Results: After radiation, complete response and partial response were observed in 29.7% and 54.1% of patients, respectively. Clinical symptoms were relieved in 19 of 21 patients (90.5%) after completing radiation. Median survival time was 11.4 months in the radiation group and 4.8 months in the nonradiation group. Overall survival for patients with and without radiation was 43.2% and 19.0% at 1 year and 27.6% and 4.1% at 2 years, respectively (p = 0.002). Multivariate analysis showed that the relative risk of death in the radiation group from the time of diagnosis of LN metastases was 0.253 (p < 0.001). The most common adverse effect of radiation was gastrointestinal toxicity, but it was mild in most patients. Conclusions: Abdominal LN metastases from gastric cancer are sensitive to radiation. Delivery of 50 Gy is effective as palliative treatment and may prolong overall survival.

  5. Thermochemoradiation Therapy Using Superselective Intra-arterial Infusion via Superficial Temporal and Occipital Arteries for Oral Cancer With N3 Cervical Lymph Node Metastases

    SciTech Connect

    Mitsudo, Kenji, E-mail: mitsudo@yokohama-cu.ac.jp [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)] [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Koizumi, Toshiyuki; Iida, Masaki; Iwai, Toshinori; Oguri, Senri [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)] [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan); Yamamoto, Noriyuki [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan)] [Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine, Nagoya (Japan); Itoh, Yoshiyuki [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan)] [Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya (Japan); Kioi, Mitomu; Hirota, Makoto; Tohnai, Iwai [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)] [Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama (Japan)

    2012-08-01

    Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer. Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m{sup 2}; CDDP, total 100-150 mg/m{sup 2}) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks. Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971;1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively. Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3 metastatic lymph nodes experienced a high rate of distant metastases.

  6. FDG-PET staging and importance of lymph node SUV in head and neck cancer

    Microsoft Academic Search

    Gregory J Kubicek; Collin Champ; Shannon Fogh; Fen Wang; Eashwer Reddy; Charles Intenzo; Reginald W Dusing; Mitchell Machtay

    2010-01-01

    ABSTRACT: OBJECTIVES: The role of positron emission tomography (PET) with fluoro-deoxy-glucose (FDG) in the staging of head and neck cancer (HNC) is unclear. The NCCN guidelines do not recommend FDG-PET as a part of standard workup. The purpose of this report is to examine the role of FDG-PET imaging in altering management and providing prognostic information for HNC. METHODS: Retrospective

  7. Practical grouping of positive lymph nodes in pancreatic head cancer treated by an extended pancreatectomy

    Microsoft Academic Search

    Osamu Ishikawa; Hiroaki Ohigashi; Yo Sasaki; Toshiyuki Kabuto; Hiroshi Furukawa; Shoji Nakamori; Shingi Imaoka; Takeshi Iwanaga; Tsutomu Kasugai

    1997-01-01

    Background. Until recently long-term survival has not been expected when at least one positive node was detected at any site in pancreatic head cancer treated by conventional pancreatectomy. However, even when nodal involvement is seen, there has been an increasing number of long-term survivors after extended pancreatectomy in which a wide range of lymphatic and connective tissues were cleared.1 Thus

  8. Internal Mammary Lymph Node Irradiation Contributes to Heart Dose in Breast Cancer

    SciTech Connect

    Chargari, Cyrus [Department of Radiotherapy, Institut Gustave Roussy, Villejuif (France); Department of Radiotherapy and Medical Oncology, Hopital d'Instruction des Armees du Val-de-Grace, Paris (France); Castadot, Pierre [Department of Radio-Oncology, Institut Jules Bordet, Brussels (Belgium); MacDermed, Dhara [Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL (United States); Vandekerkhove, Christophe [Department of Medical Physics, Institut Jules Bordet, Brussels (Belgium); Bourgois, Nicolas; Van Houtte, Paul [Department of Radio-Oncology, Institut Jules Bordet, Brussels (Belgium); Magne, Nicolas, E-mail: nicolas.magne@igr.f [Department of Radiotherapy, Institut Gustave Roussy, Villejuif (France); Department of Radio-Oncology, Institut Jules Bordet, Brussels (Belgium)

    2010-10-01

    We assessed the impact of internal mammary chain radiotherapy (IMC RT) to the radiation dose received by the heart in terms of heart dose-volume histogram (DVH). Thirty-six consecutive breast cancer patients presenting with indications for IMC RT were enrolled in a prospective study. The IMC was treated by a standard conformal RT technique (50 Gy). For each patient, a cardiac DVH was generated by taking into account the sole contribution of IMC RT. Cardiac HDV were compared according to breast cancer laterality and the type of previous surgical procedure, simple mastectomy or breast conservative therapy (BCT). The contribution of IMC RT to the heart dose was significantly greater for patients with left-sided versus right-sided tumors (13.8% and 12.8% for left-sided tumors versus 3.9% and 4.2% for right-sided tumors in the BCT group and the mastectomy group, respectively; p < 0.0001). There was no statistically significant difference in IMC contribution depending on the initial surgical procedure. IMC RT contributes to cardiac dose for both left-sided and right-sided breast cancers, although the relative contribution is greater in patients with left-sided tumors.

  9. Paratracheal lymph node dissection in cancer of the larynx, hypopharynx, and cervical esophagus: the need for guidelines

    Microsoft Academic Search

    R. de Bree; C. R. Leemans; C. E. Silver; K. T. Robbins; J. P. Rodrigo; A. Rinaldo; R. P. Takes; A. R. Shaha; J. E. Medina; C. Suarez; A. Ferlito

    2011-01-01

    In laryngeal, hypopharyngeal, and cervical esophageal carcinomas, the paratracheal lymph nodes (PTLN) may be at risk for lymph node metastasis. The presence of PTLN metastasis is an important prognostic factor for the development of mediastinal and distant metastases, stomal recurrence, and disease-free and overall survival. Studies on PTLN metastasis are scarce. In most studies, PTLN dissection has not been routinely

  10. FDG-PET for Evaluation of Recurrent Lymph Node Metastases in Patients with Surgically Resected Breast Cancer: Adding Spot Images to Whole Body Images

    Microsoft Academic Search

    Tsuneo Tamaki; Akihiro Naito; Masami Nisbio; Katsuhiko Kawahara

    2004-01-01

    Background  To evaluate the role of18F-Fluorodeoxyglucose positron emission tomography (FDG-PET), spot images were added to whole-body FDG-PET images in a patient\\u000a with suspected lymph node recurrence of breast cancer.\\u000a \\u000a \\u000a \\u000a Methods  FDG-PET spot images were obtained of 44 patients who had undergone surgical resection of breast cancer as were whole-body\\u000a FDG-PET images. A total of 33 lesions in 19 patients (mean age, 59

  11. Lymph-node ratio is an independent prognostic factor in patients with stage III colorectal cancer: a retrospective study from the Middle East

    PubMed Central

    2012-01-01

    Background In this retrospective study, we evaluated the prognostic effect of positive lymph-node ratio (pLNR) on patients with stage III colorectal cancer (CRC). Our paper is the first analysis, to our knowledge, to deal with such data from the Middle East. Methods We analyzed the clinicopathological data of 535 patients diagnosed with colorectal cancer at our institution between 1983 and 2003. The 164 patients diagnosed with stage III disease were divided into two categories based on lymph-node ratio (LNR) being the ratio of positive lymph nodes over total lymph nodes dissected: LNR ?0.4 and LNR >0.4. We used Kaplan-Meier and Cox proportional hazard models to evaluate the prognostic effect of pLNR. Results The 10-year survival rate for the patients with stage IIIA, IIIB and IIIC cancers were 76%, 56% and 0% respectively (P?=?0.014). Using pLNR of 0.4 as the cutoff point was found to yield clinically and significant results, with a significant difference in the outcomes of patients with pLNR ?0.4 compared to those with pLNR >0.4 (hazard ratio?=?5.25, 95% confidence interval?=?1.2 to 22.1, P?=?0.02). Conclusion The ratio-based staging (pLNR) of CRC is a more accurate and clinically useful prognostic method than the number of positive LNs resected or the total number of LNs retrieved for predicting the course of patients with stage III CRC. PMID:22533518

  12. Relationship between the content of estrogen and progesterone receptors and the pathological characteristics in human breast cancer

    Microsoft Academic Search

    Reiki Nishimura; Atsunobu Misumi; Masaharu Kimura; Takao Tokunaga; Masanobu Akagi

    1982-01-01

    Assays of estrogen receptors (ER) and progesterone receptors (PgR) were performed by using the dextran-coated charcoal (DCC)\\u000a method in 124 cases of invasive breast cancer. The results were correlated with clinical and pathological characteristics.\\u000a There was no correlation between steroid hormone receptor contents and menopausal status, size of tumor, axillary lymph node\\u000a status, or histological type. The presences of ER

  13. The utility of hyperthermia for local recurrence of breast cancer

    PubMed Central

    2012-01-01

    Background Hyperthermia has long been used in combination with chemotherapy or radiation therapy for the treatment of superficial malignancies, in part due to its sensitizing capabilities. Patients who suffer from superficial recurrences of breast cancer have poor clinical outcomes. Skin metastases may particularly impair the quality of life due to the physical appearance, odor and bleeding. Case presentation A 66-year-old woman underwent mastectomy and axillary lymph node dissection for breast cancer. Nine years post-operatively, local metastases developed in the left axillary area (measuring 5 cm in diameter). Initially the tumor did not respond to radiation therapy and chemotherapy. Therefore, we added hyperthermia combined with them. Eight weeks later, the tumor became nearly flat and the patient noted improved activity in her daily life. Conclusion Hyperthermia may accelerate the antitumor effects of radiation therapy and chemotherapy. This treatment provides an alternative for unresectable breast cancer skin metastases. PMID:23017037

  14. Docetaxel, cisplatin and 5-fluorouracil adjuvant chemotherapy following three-field lymph node dissection for stage II/III N1, 2 esophageal cancer

    PubMed Central

    HASHIGUCHI, TADASUKE; NASU, MOTOMI; HASHIMOTO, TAKASHI; KUNIYASU, TETSUJI; INOUE, HIROHUMI; SAKAI, NORITAKA; OUCHI, KAZUTOMO; AMANO, TAKAYUKI; ISAYAMA, FUYUMI; TOMITA, NATSUMI; IWANUMA, YOSHIMI; TSURUMARU, MASAHIKO; KAJIYAMA, YOSHIAKI

    2014-01-01

    To determine the efficacy of postoperative adjuvant chemotherapy with docetaxel + cisplatin + 5-fluorouracil (DCF) in lymph node metastasis-positive esophageal cancer, we retrospectively analyzed 139 patients with stage II/III (non-T4) esophageal cancer with lymph node metastasis (1–6 nodes), who did not receive preoperative treatment and underwent three-field lymph node dissection in the Juntendo University Hospital between December, 2004 and December, 2009. The tumors were histologically diagnossed as squamous cell carcinoma. The patients were divided into two groups, a surgery alone group (S group, 88 patients) and a group that received postoperative DCF therapy (DCF group, 51 patients). The disease-free and overall survival were compared between the groups and a multivariate analysis of prognostic factors was performed. The same analysis was performed for cases classified as N1 and N2, according to the TNM classification. There were no significant differences between the S and DCF groups regarding clinicopathological factors other than intramural metastasis and main tumor location. The presence of intramural metastasis, blood vessel invasion and the number of lymph nodes were identified as prognostic factors. The 5-year disease-free and overall survival were 55.8 and 57.3%, respectively, in the S group and 52.8 and 63.0%, respectively, in the DCF group. These differences were not considered to be statistically significant (P=0.789 and 0.479 for disease-free and overall survival, respectively). Although there were no significant differences in disease-free and overall survival between the S and DCF groups in N1 cases, both disease-free and overall survival were found to be better in the DCF group (54.2 and 61.4%, respectively) compared to the S group (29.6 and 28.8%, respectively) in N2 cases (P=0.029 and 0.020 for disease-free and overall survival, respectively). Therefore, postoperative adjuvant chemotherapy with DCF was shown to improve disease-free and overall survival in moderate lymph node metastasis-positive cases (N2), suggesting that the DCF regimen may be effective as postoperative adjuvant chemotherapy for patients with lymph node metastasis from esophageal cancer. PMID:25054036

  15. Breast cancer with cartilaginous and/or osseous metaplasia.

    PubMed

    Yoichi, Takuya; Nagashima, Takeshi; Yagata, Hiroshi; Yoshida, Kazuya; Suzuki, Masato; Fujimori, Toshihiko; Sangai, Takafumi; Nakatani, Yukio; Miyazaki, Masaru

    2009-01-01

    We report a rare case of breast cancer with cartilaginous and/or osseous metaplasia. A 59-year-old woman had a large lump in her left breast, which had enlarged gradually over a period of 2 years. Mammography, ultrasonography and aspiration cytology suggested phyllodes tumor with carcinoma. She underwent wide excision and sentinel lymph node biopsy. Because of the existence metastatic tumor cells in the sentinel lymph node on frozen section, sequential axillary lymph node dissection was conducted consequently. Histologically, the tumor consisted of invasive ductal carcinoma and spindle-cell carcinoma, including cartilaginous metaplasia. Adjuvant chemotherapy and whole-breast irradiation were performed. However, she died of multiple metastases to the liver 2 years after surgery. Breast cancer with cartilaginous and/or osseous metaplasia belongs to a special type of invasive carcinoma, and the incidence is very low. We here present our case and a review of the literature. PMID:19184279

  16. Radiotherapy for Stage II and Stage III Breast Cancer Patients With Negative Lymph Nodes After Preoperative Chemotherapy and Mastectomy

    SciTech Connect

    Le Scodan, Romuald, E-mail: lescodan@crh1.org [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Selz, Jessica [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Stevens, Denise [Department of Biostatistics, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Bollet, Marc A.; Lande, Brigitte de la; Daveau, Caroline [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Lerebours, Florence [Department of Medical Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Labib, Alain [Department of Radiation Oncology, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France); Bruant, Sarah [Department of Biostatistics, Institut Curie-Hopital Rene Huguenin, Saint-Cloud (France)

    2012-01-01

    Purpose: To evaluate the effect of postmastectomy radiotherapy (PMRT) in Stage II-III breast cancer patients with negative lymph nodes (pN0) after neoadjuvant chemotherapy (NAC). Patients and Materials: Of 1,054 breast cancer patients treated with NAC at our institution between 1990 and 2004, 134 had pN0 status after NAC and mastectomy. The demographic data, tumor characteristics, metastatic sites, and treatments were prospectively recorded. The effect of PMRT on locoregional recurrence-free survival and overall survival (OS) was evaluated by multivariate analysis, including known prognostic factors. Results: Of the 134 eligible patients, 78 (58.2%) received PMRT and 56 (41.8%) did not. At a median follow-up time of 91.4 months, the 5-year locoregional recurrence-free survival and OS rate was 96.2% and 88.3% with PMRT and 92.5% and 94.3% without PMRT, respectively (p = NS). The corresponding values at 10 years were 96.2% and 77.2% with PMRT and 86.8% and 87.7% without PMRT (p = NS). On multivariate analysis, PMRT had no effect on either locoregional recurrence-free survival (hazard ratio, 0.37; 95% confidence interval, 0.09-1.61; p = .18) or OS (hazard ratio, 2.06; 95% confidence interval, 0.71-6; p = .18). This remained true in the subgroups of patients with clinical Stage II or Stage III disease at diagnosis. A trend was seen toward poorer OS among patients who had not had a pathologic complete in-breast tumor response after NAC (hazard ratio, 6.65; 95% confidence interval, 0.82-54.12; p = .076). Conclusions: The results from the present retrospective study showed no increase in the risk of distant metastasis, locoregional recurrence, or death when PMRT was omitted in breast cancer patients with pN0 status after NAC and mastectomy. Whether the omission of PMRT is acceptable for these patients should be addressed prospectively.

  17. The Influence of Radiation Modality and Lymph Node Dissection on Survival in Early-Stage Endometrial Cancer

    SciTech Connect

    Chino, Junzo P., E-mail: junzo.chino@duke.edu [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Jones, Ellen [Department of Radiation Oncology, University of North Caroline, Chapel Hill, NC (United States); Berchuck, Andrew; Secord, Angeles Alvarez; Havrilesky, Laura J. [Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC (United States)

    2012-04-01

    Background: The appropriate uses of lymph node dissection (LND) and adjuvant radiation therapy (RT) for Stage I endometrial cancer are controversial. We explored the impact of specific RT modalities (whole pelvic RT [WPRT], vaginal brachytherapy [VB]) and LND status on survival. Materials and Methods: The Surveillance Epidemiology and End Results dataset was queried for all surgically treated International Federation of Gynecology and Obstetrics (FIGO) Stage I endometrial cancers; subjects were stratified into low, intermediate and high risk cohorts using modifications of Gynecologic Oncology Group (GOG) protocol 99 and PORTEC (Postoperative Radiation Therapy in Endometrial Cancer) trial criteria. Five-year overall survival was estimated, and comparisons were performed via the log-rank test. Results: A total of 56,360 patients were identified: 70.4% low, 26.2% intermediate, and 3.4% high risk. A total of 41.6% underwent LND and 17.6% adjuvant RT. In low-risk disease, LND was associated with higher survival (93.7 LND vs. 92.7% no LND, p < 0.001), whereas RT was not (91.6% RT vs. 92.9% no RT, p = 0.23). In intermediate-risk disease, LND (82.1% LND vs. 76.5% no LND, p < 0.001) and RT (80.6% RT vs. 74.9% no RT, p < 0.001) were associated with higher survival without differences between RT modalities. In high-risk disease, LND (68.8% LND vs. 54.1% no LND, p < 0.001) and RT (66.9% RT vs. 57.2% no RT, p < 0.001) were associated with increased survival; if LND was not performed, VB alone was inferior to WPRT (p = 0.01). Conclusion: Both WPRT and VB alone are associated with increased survival in the intermediate-risk group. In the high-risk group, in the absence of LND, only WPRT is associated with increased survival. LND was also associated with increased survival.

  18. Redefining Stage I Endometrial Cancer: Incorporating Histology, a Binary Grading System, Myometrial Invasion, and Lymph Node Assessment

    PubMed Central

    Barlin, Joyce N.; Soslow, Robert A.; Lutz, Megan; Zhou, Qin C.; St Clair, Caryn M.; Leitao, Mario M.; Iasonos, Alexia; Hensley, Martee L.; Barakat, Richard R.; Matias-Guiu, Xavier; Abu-Rustum, Nadeem R.

    2015-01-01

    Objective We propose a new staging system for stage I endometrial cancer and compare its performance to the 1988 and 2009 International Federation of Gynecology and Obstetrics (FIGO) systems. Methods We analyzed patients with 1988 FIGO stage I endometrial cancer from January 1993 to August 2011. Low-grade carcinoma consisted of endometrioid grade 1 to grade 2 lesions. High-grade carcinoma consisted of endometrioid grade 3 or nonendometrioid carcinomas (serous, clear cell, and carcinosarcoma). The proposed system is as follows: IA Low-grade carcinoma with less than half myometrial invasion IA1 Negative nodes IA2 No nodes removed IB High-grade carcinoma with no myometrial invasion IB1 Negative nodes IB2 No nodes removed IC Low-grade carcinoma with half or greater myometrial invasion IC1 Negative nodes IC2 No nodes removed ID High-grade carcinoma with any myometrial invasion ID1 Negative nodes ID2 No nodes removed Results Data from 1843 patients were analyzed. When patients were restaged with our proposed system, the 5-year overall survival significantly differed (P < 0.001): IA1, 96.7%; IA2, 92.2%; IB1, 92.2%; IB2, 76.4%; IC1, 83.9%; IC2, 78.6%; ID1, 81.1%; and ID2, 68.8%. The bootstrap-corrected concordance probability estimate for the proposed system was 0.627 (95% confidence interval, 0.590–0.664) and was superior to the concordance probability estimate of 0.530 (95% confidence interval, 0.516–0.544) for the 2009 FIGO system. Conclusions By incorporating histological subtype, grade, myometrial invasion, and whether lymph nodes were removed, our proposed system for stage I endometrial cancer has a superior predictive ability over the 2009 FIGO staging system and provides a novel binary grading system (low-grade including endometrioid grade 1–2 lesions; high-grade carcinoma consisting of endometrioid grade 3 carcinomas and nonendometrioid carcinomas). PMID:24126219

  19. Robot-assisted laparoscopic retroperitoneal lymph node dissection for stage IIIb mixed germ cell testicular cancer after chemotherapy

    PubMed Central

    Lee, Sang Hyub; Kim, Dong Soo; Chang, Sung-Goo

    2015-01-01

    Laparoscopic retroperitoneal lymph node dissection, especially when performed with the da Vinci Surgical System (Intuitive Surgical), has shown excellent cosmetic results with similar oncologic outcomes to those of open surgery. In this study, we present a case of robot-assisted retroperitoneal lymph node dissection performed in an 18-year-old man who was diagnosed with a stage IIIb mixed germ cell tumor and who was initially treated with radical orchiectomy, followed by chemotherapy. This case shows that robot-assisted retroperitoneal lymph node dissection is technically feasible, safe, and cosmetically favorable, even when performed on patients with high-stage disease or after chemotherapy.

  20. CYTOPATHOLOGY Computer-Derived Nuclear Features Compared

    E-print Network

    Street, Nick

    172 CANCER CYTOPATHOLOGY Computer-Derived Nuclear Features Compared with Axillary Lymph Node Status of axillary lymph nodes and may obviate the need for routine axillary lymph node dissection. Cancer (Cancer for Breast Carcinoma Prognosis BACKGROUND. Both axillary lymph node involvement and tumor anaplasia, as