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01-01-2009 | Original Article

Occult disseminated tumor cells in lymph nodes of patients with gastric carcinoma. A critical appraisal of assessment and relevance

Authors: Peter Scheunemann, Nikolas H. Stoecklein, Kai Hermann, Alexander Rehders, Claus F. Eisenberger, Wolfram T. Knoefel, Stefan B. Hosch

Published in: Langenbeck's Archives of Surgery | Issue 1/2009

Abstract

Background and aims

In gastric cancer, regional lymph node metastasis verified by histopathological examination is the most important prognostic factor after complete surgical tumor resection (R0). However, the prognostic value of immunohistochemically identifiable disseminated tumor cells in lymph nodes without histopathological tumor burden in patients with gastric cancer is still controversially discussed. The aim of the study was to assess the frequency and prognostic impact of minimal tumor cell spread to lymph nodes in these patients.

Patients–methods

One hundred sixty lymph nodes judged as “tumor free” on routine histopathology obtained from 58 patients with gastric adenocarcinoma were analyzed immunohistochemically using the monoclonal anti-EpCAM antibody Ber-EP4 for occult disseminated tumor cells.

Results

Tumor cells in lymph nodes were detected in 62 (38.8%) of the 160 “tumor-free” lymph nodes obtained from 39 (67.2%) patients. Multivariate Cox regression analysis confirmed the presence of disseminated tumor cells in “tumor-free” lymph nodes as an independent prognostic factor for both a significantly reduced relapse-free survival (p = 0.008) and overall survival (p = 0.009).

Conclusions

The frequent occurrence and prognostic impact of minimal disseminated tumor cells in lymph nodes of patients with gastric carcinoma support the need for a refined staging system of excised lymph nodes, which should include immunohistochemical examination.

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Title: Occult disseminated tumor cells in lymph nodes of patients with gastric carcinoma. A critical appraisal of assessment and relevance
Authors: Peter Scheunemann
Nikolas H. Stoecklein
Kai Hermann
Alexander Rehders
Claus F. Eisenberger
Wolfram T. Knoefel
Stefan B. Hosch
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 1/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0369-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Occult disseminated tumor cells in lymph nodes of patients with gastric carcinoma. A critical appraisal of assessment and relevance

Abstract

Background and aims

Patients–methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aims

Patients–methods

Results

Conclusions

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