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Microscopic distance from tumor invasion front to serosa might be a useful predictive factor for peritoneal recurrence after curative resection of T3-gastric cancer.

ABSTRACT: BACKGROUND:Peritoneal recurrence is one of the most frequent recurrent diseases in gastric cancer. Although the exposure of cancer cells to the serosal surface is considered a common risk factor for peritoneal recurrence, there are some cases of peritoneal recurrence without infiltration to the serosal surface even after curative surgery. This study sought to clarify the risk factors of peritoneal recurrence in the absence of invasion to the serosal surface. MATERIALS AND METHODS:Ninety-six patients with gastric cancer who underwent curative surgery were enrolled. In all 96 cases, the depth of tumor invasion was subserosal (T3). The microscopic distance from the tumor invasion front to the serosa (DIFS) was measured using tissue slides by H&E staining and pan-cytokeratin staining. E-cadherin expression was evaluated by immunohistochemical staining. RESULTS:Among the 96 patients, 16 developed peritoneal recurrence after curative surgery. The DIFS of the tumors with peritoneal recurrence (156±220 ?m) was significantly shorter (p = 0.011) than that without peritoneal recurrence (360±478 ?m). Peritoneal recurrence was significantly correlated with DIFS ?234 ?m (p = 0.023), but not with E-cadherin expression. The prognosis of DIFS ?234 ?m was significantly poorer than that of DIFS >234 ?m (log rank, p = 0.007). A multivariate analysis of the patients' five-year overall survival revealed that DIFS ?234 ?m and lymph node metastasis were significantly correlated with survival (p = 0.005, p = 0.032, respectively). CONCLUSION:The measurement of the DIFS might be useful for the prediction of peritoneal recurrence in T3-gastric cancer patients after curative surgery.

SUBMITTER: Togano S

PROVIDER: S-EPMC6961828 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Microscopic distance from tumor invasion front to serosa might be a useful predictive factor for peritoneal recurrence after curative resection of T3-gastric cancer.

Togano Shingo S Yashiro Masakazu M Miki Yuichiro Y Yamamoto Yurie Y Sera Tomohiro T Kushitani Yukako Y Sugimoto Atsushi A Kushiyama Shuhei S Nishimura Sadaaki S Kuroda Kenji K Okuno Tomohisa T Yoshii Mami M Tamura Tatsuro T Toyokawa Takahiro T Tanaka Hiroaki H Muguruma Kazuya K Tanaka Sayaka S Ohira Masaichi M

PloS one 20200115 1

<h4>Background</h4>Peritoneal recurrence is one of the most frequent recurrent diseases in gastric cancer. Although the exposure of cancer cells to the serosal surface is considered a common risk factor for peritoneal recurrence, there are some cases of peritoneal recurrence without infiltration to the serosal surface even after curative surgery. This study sought to clarify the risk factors of peritoneal recurrence in the absence of invasion to the serosal surface.<h4>Materials and methods</h4> ...[more]

PMID: 31940352

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Project description:Adrenocortical carcinoma (ACC) is a rare but aggressive endocrine tumor, and the prognostic factors associated with long-term outcomes after surgical resection remain poorly defined.To define clinicopathological variables associated with recurrence-free survival (RFS) and overall survival (OS) after curative surgical resection of ACC and to propose nomograms for individual risk prediction.Nomograms to predict RFS and OS after surgical resection of ACC were proposed using a multi-institutional cohort of patients who underwent curative-intent surgery for ACC at 13 major institutions in the United States between March 17, 1994, and December 22, 2014. The dates of our study analysis were April 15, 2015, to May 12, 2015.The discriminative ability and calibration of the nomograms to predict RFS and OS were tested using C statistics, calibration plots, and Kaplan-Meier curves.In total, 148 patients who underwent surgery for ACC were included in the study. The median patient age was 53 years, and 65.5% (97 of 148) of the patients were female. One-third of the patients (35.1% [52 of 148]) had a functional tumor, and the median tumor size was 11.2 cm. Most patients (77.7% [115 of 148]) underwent R0 resection, and 8.8% (13 of 148) of the patients had N1 disease. Using backward stepwise selection of clinically important variables with the Akaike information criterion, the following variables were incorporated in the prediction of RFS: tumor size of at least 12 cm (hazard ratio [HR], 3.00; 95% CI, 1.63-5.70; P <?.001), positive nodal status (HR, 4.78; 95% CI, 1.47-15.50; P =?.01), stage III/IV (HR, 1.80; 95% CI, 0.95-3.39; P =?.07), cortisol-secreting tumor (HR, 2.38; 95% CI, 1.27-4.48; P =?.01), and capsular invasion (HR, 1.96; 95% CI, 1.02-3.74; P =?.04). Factors selected as predicting OS were tumor size of at least 12 cm (HR, 1.78; 95% CI, 1.00-3.17; P =?.05), positive nodal status (HR, 5.89; 95% CI, 2.05-16.87; P =?.001), and R1 margin (HR, 2.83; 95% CI, 1.51-5.30; P =?.001). The discriminative ability and calibration of the nomograms revealed good predictive ability as indicated by the C statistics (0.74 for RFS and 0.70 for OS).Independent predictors of survival and recurrence risk after curative-intent surgery for ACC were selected to create nomograms predicting RFS and OS. The nomograms were able to stratify patients into prognostic groups and performed well on internal validation.

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Microscopic distance from tumor invasion front to serosa might be a useful predictive factor for peritoneal recurrence after curative resection of T3-gastric cancer.

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Microscopic distance from tumor invasion front to serosa might be a useful predictive factor for peritoneal recurrence after curative resection of T3-gastric cancer.

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