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Journal of Cancer Research and Clinical Oncology

Erschienen in:

01.12.2004 | Original Paper

Significance of isolated tumor cells in lymph nodes among gastric cancer patients

verfasst von: Olaf Horstmann, Laszlo Füzesi, Peter M. Markus, Carola Werner, Heinz Becker

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 12/2004

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Abstract

Purpose

To determine the frequency and prognostic impact of isolated tumor cells (ITC) in regional lymph nodes judged to be tumor free in conventional histopathology among gastric cancer patients.

Methods

Among 161 patients who underwent gastrectomy and D2-lymphadenectomy, 56 were staged pN0(35%). Archival paraffin blocks of 1148 resected regional lymph nodes of those pN0 patients were reevaluated for ITC using monoclonal antibody Ber-EP4. Patients with and without ITC were compared with regard to the distribution of various clinicopathological factors. Prognostic impact of ITC was tested in uni- and multivariate analysis.

Results

Of 56 pN0 patients, 33 (59%) exhibited single Ber-Ep4 immunoreactive cells or small cell clusters in at least one lymph node. The occurrence of ITC was not dependent on other clinicopathological factors. ITC impaired patients’ prognoses significantly in uni- as well as multivariate analyses [estimated 5-year survival rate: 82% for pN0_(i−)vs 58% for pN0_(i+)(p=0.059) and 15% for pN1/2 (p=0.0005 and p<0.0001, respectively)].

Conclusion

ITC are a frequent event in apparently tumor-free lymph nodes of gastric cancer patients and are overlooked by conventional histopathology. They are encountered even in limited stages of disease and impair patients’ prognoses. This should be borne in mind when advocating local resection for early gastric cancer.

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Titel: Significance of isolated tumor cells in lymph nodes among gastric cancer patients
verfasst von: Olaf Horstmann
Laszlo Füzesi
Peter M. Markus
Carola Werner
Heinz Becker
Publikationsdatum: 01.12.2004
Verlag: Springer-Verlag
Erschienen in: Journal of Cancer Research and Clinical Oncology / Ausgabe 12/2004
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-004-0609-0

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