Significance of tumour regression in lymph node metastases of gastric and gastro‐oesophageal junction adenocarcinomas

The presence of lymph node (LN) metastases is one of the most important negative prognostic factors in upper gastrointestinal carcinomas. Tumour regression similar to that in primary tumours can be observed in LN metastases after neoadjuvant therapy. We evaluated the prognostic impact of histologica...

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Bibliographic Details
Published in:The journal of pathology. Clinical research 2020-10, Vol.6 (4), p.263-272
Main Authors: Reim, Daniel, Novotny, Alexander, Friess, Helmut, Slotta‐Huspenina, Julia, Weichert, Wilko, Ott, Katja, Dislich, Bastian, Lorenzen, Sylvie, Becker, Karen, Langer, Rupert
Format: Article
Language:English
Subjects:
Cancer therapies
Carcinoma
Chemotherapy
Classification
Endoscopy
Esophagus
Fibrosis
Gastric cancer
Lymph nodes
Lymphatic system
Medical prognosis
Metastases
Metastasis
Mucin
Multivariate analysis
neoadjuvant chemotherapy
Original
Prognosis
Signs
Statistical analysis
Surgery
Survival analysis
Tumors
tumour regression
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Summary:The presence of lymph node (LN) metastases is one of the most important negative prognostic factors in upper gastrointestinal carcinomas. Tumour regression similar to that in primary tumours can be observed in LN metastases after neoadjuvant therapy. We evaluated the prognostic impact of histological regression in LNs in 480 adenocarcinomas of the stomach and gastro‐oesophageal junction after neoadjuvant chemotherapy. Regressive changes in LNs (nodular and/or hyaline fibrosis, sheets of foamy histiocytes or acellular mucin) were assessed by histology. In total, regressive changes were observed in 128 of 480 patients. LNs were categorised according to the absence or presence of both residual tumour and regressive changes (LN−/+ and Reg−/+). 139 cases were LN−/Reg−, 28 cases without viable LN metastases revealed regressive changes (LN−/Reg+), 100 of 313 cases with LN metastases showed regressive changes (LN+/Reg+), and 213 of 313 metastatic LN had no signs of regression (LN+/Reg−). Overall, LN/Reg categorisation correlated with overall survival with the best prognosis for LN−/Reg− and the worst prognosis for LN+/Reg− (p
ISSN:2056-4538
2056-4538
DOI:10.1002/cjp2.169