接受根治性膀胱切除术和盆腔淋巴结切除术的膀胱癌患者淋巴结侵犯水平的预后影响。

IF 2.5 4区医学 Q3 ONCOLOGY

Oncology Letters Pub Date : 2024-08-29 DOI:10.3892/ol.2024.14650

Junichi Ikeda,Chisato Ohe,Takashi Yoshida,Takahiro Nakamoto,Ryoichi Saito,Koji Tsuta,Hidefumi Kinoshita

{"title":"接受根治性膀胱切除术和盆腔淋巴结切除术的膀胱癌患者淋巴结侵犯水平的预后影响。","authors":"Junichi Ikeda,Chisato Ohe,Takashi Yoshida,Takahiro Nakamoto,Ryoichi Saito,Koji Tsuta,Hidefumi Kinoshita","doi":"10.3892/ol.2024.14650","DOIUrl":null,"url":null,"abstract":"Extranodal extension in metastatic lymph nodes (LNs) is a poor prognostic factor in bladder cancer (BC). Furthermore, cancer invasion levels in sentinel LNs are associated with prognosis in melanoma. The present study aimed to evaluate the LN invasion level, defined as the extent of cancer invasion in anatomical and immunological LN substructures, and compare it with the pathological node (pN) stage of the tumor-node-metastasis staging system in BC. A total of 98 patients with BC who underwent radical cystectomy and pelvic lymphadenectomy were retrospectively assessed. The LN invasion level was classified as follows: Level 0, no cancer cell within the resected LNs; Level 1, cancer cells confined to intracapsular lymph vessels and subcapsular or transverse sinuses; Level 2, cancer cells infiltrating the cortex, paracortex or medulla; and Level 3, cancer cells infiltrating or beyond the LN capsule. The proportion of patients with Levels 0, 1, 2 and 3 was 70.4% (69/98), 8.2% (8/98), 14.3% (14/98) and 7.1% (7/98), respectively. Kaplan-Meier survival curves of recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) with LN invasion levels better stratified outcome patient when using Levels 1-3 compared with pN1-3. In addition, LN invasion levels better predicted RFS, CSS and OS, in comparison with the pN stage (c-index of 0.672 vs. 0.646, 0.688 vs. 0.665, and 0.702 vs. 0.661, respectively). Finally, multivariate analysis revealed that the predictive accuracy of the model integrating pathological tumor (pT) stage and LN invasion levels in RFS, CSS and OS was greater than that of the conventional model that included pT and pN stage (c-index of 0.723 vs. 0.703, 0.710 vs. 0.694, and 0.725 vs. 0.692, respectively). In conclusion, the model with LN invasion levels accurately predicted the prognosis of patients with BC after radical cystectomy and pelvic lymphadenectomy.","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"7 1","pages":"517"},"PeriodicalIF":2.5000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic impact of lymph node invasion levels in patients with bladder cancer undergoing radical cystectomy and pelvic lymphadenectomy.\",\"authors\":\"Junichi Ikeda,Chisato Ohe,Takashi Yoshida,Takahiro Nakamoto,Ryoichi Saito,Koji Tsuta,Hidefumi Kinoshita\",\"doi\":\"10.3892/ol.2024.14650\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Extranodal extension in metastatic lymph nodes (LNs) is a poor prognostic factor in bladder cancer (BC). Furthermore, cancer invasion levels in sentinel LNs are associated with prognosis in melanoma. The present study aimed to evaluate the LN invasion level, defined as the extent of cancer invasion in anatomical and immunological LN substructures, and compare it with the pathological node (pN) stage of the tumor-node-metastasis staging system in BC. A total of 98 patients with BC who underwent radical cystectomy and pelvic lymphadenectomy were retrospectively assessed. The LN invasion level was classified as follows: Level 0, no cancer cell within the resected LNs; Level 1, cancer cells confined to intracapsular lymph vessels and subcapsular or transverse sinuses; Level 2, cancer cells infiltrating the cortex, paracortex or medulla; and Level 3, cancer cells infiltrating or beyond the LN capsule. The proportion of patients with Levels 0, 1, 2 and 3 was 70.4% (69/98), 8.2% (8/98), 14.3% (14/98) and 7.1% (7/98), respectively. Kaplan-Meier survival curves of recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) with LN invasion levels better stratified outcome patient when using Levels 1-3 compared with pN1-3. In addition, LN invasion levels better predicted RFS, CSS and OS, in comparison with the pN stage (c-index of 0.672 vs. 0.646, 0.688 vs. 0.665, and 0.702 vs. 0.661, respectively). Finally, multivariate analysis revealed that the predictive accuracy of the model integrating pathological tumor (pT) stage and LN invasion levels in RFS, CSS and OS was greater than that of the conventional model that included pT and pN stage (c-index of 0.723 vs. 0.703, 0.710 vs. 0.694, and 0.725 vs. 0.692, respectively). In conclusion, the model with LN invasion levels accurately predicted the prognosis of patients with BC after radical cystectomy and pelvic lymphadenectomy.\",\"PeriodicalId\":19503,\"journal\":{\"name\":\"Oncology Letters\",\"volume\":\"7 1\",\"pages\":\"517\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oncology Letters\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3892/ol.2024.14650\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology Letters","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3892/ol.2024.14650","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

转移淋巴结（LN）的结外扩展是膀胱癌（BC）预后不良的一个因素。此外，前哨淋巴结的癌症侵袭程度与黑色素瘤的预后也有关联。本研究旨在评估膀胱癌前哨淋巴结浸润程度，即膀胱癌解剖学和免疫学前哨淋巴结亚结构中的癌症浸润程度，并将其与肿瘤-结节-转移分期系统中的病理结节（pN）分期进行比较。该研究对98例接受根治性膀胱切除术和盆腔淋巴结切除术的BC患者进行了回顾性评估。淋巴结侵犯程度分类如下：0级，切除的LN内无癌细胞；1级，癌细胞局限于囊内淋巴管、囊下或横窦；2级，癌细胞浸润皮质、皮质旁或髓质；3级，癌细胞浸润或超出LN囊。0、1、2 和 3 级患者的比例分别为 70.4%（69/98）、8.2%（8/98）、14.3%（14/98）和 7.1%（7/98）。与 pN1-3 相比，使用 1-3 级 LN 侵袭的无复发生存率（RFS）、癌症特异性生存率（CSS）和总生存率（OS）的 Kaplan-Meier 生存曲线能更好地对结果患者进行分层。此外，与 pN 分期相比，LN 侵袭水平能更好地预测 RFS、CSS 和 OS（c 指数分别为 0.672 vs. 0.646、0.688 vs. 0.665 和 0.702 vs. 0.661）。最后，多变量分析显示，综合病理肿瘤（pT）分期和 LN 侵袭水平的模型对 RFS、CSS 和 OS 的预测准确性高于包括 pT 和 pN 分期的传统模型（c 指数分别为 0.723 vs. 0.703、0.710 vs. 0.694 和 0.725 vs. 0.692）。总之，LN侵袭水平模型能准确预测BC患者根治性膀胱切除术和盆腔淋巴结切除术后的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Prognostic impact of lymph node invasion levels in patients with bladder cancer undergoing radical cystectomy and pelvic lymphadenectomy.

Extranodal extension in metastatic lymph nodes (LNs) is a poor prognostic factor in bladder cancer (BC). Furthermore, cancer invasion levels in sentinel LNs are associated with prognosis in melanoma. The present study aimed to evaluate the LN invasion level, defined as the extent of cancer invasion in anatomical and immunological LN substructures, and compare it with the pathological node (pN) stage of the tumor-node-metastasis staging system in BC. A total of 98 patients with BC who underwent radical cystectomy and pelvic lymphadenectomy were retrospectively assessed. The LN invasion level was classified as follows: Level 0, no cancer cell within the resected LNs; Level 1, cancer cells confined to intracapsular lymph vessels and subcapsular or transverse sinuses; Level 2, cancer cells infiltrating the cortex, paracortex or medulla; and Level 3, cancer cells infiltrating or beyond the LN capsule. The proportion of patients with Levels 0, 1, 2 and 3 was 70.4% (69/98), 8.2% (8/98), 14.3% (14/98) and 7.1% (7/98), respectively. Kaplan-Meier survival curves of recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) with LN invasion levels better stratified outcome patient when using Levels 1-3 compared with pN1-3. In addition, LN invasion levels better predicted RFS, CSS and OS, in comparison with the pN stage (c-index of 0.672 vs. 0.646, 0.688 vs. 0.665, and 0.702 vs. 0.661, respectively). Finally, multivariate analysis revealed that the predictive accuracy of the model integrating pathological tumor (pT) stage and LN invasion levels in RFS, CSS and OS was greater than that of the conventional model that included pT and pN stage (c-index of 0.723 vs. 0.703, 0.710 vs. 0.694, and 0.725 vs. 0.692, respectively). In conclusion, the model with LN invasion levels accurately predicted the prognosis of patients with BC after radical cystectomy and pelvic lymphadenectomy.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Oncology Letters ONCOLOGY-

CiteScore

5.70

自引率

0.00%

发文量

412

审稿时长

2.0 months

期刊介绍： Oncology Letters is a monthly, peer-reviewed journal, available in print and online, that focuses on all aspects of clinical oncology, as well as in vitro and in vivo experimental model systems relevant to the mechanisms of disease. The principal aim of Oncology Letters is to provide the prompt publication of original studies of high quality that pertain to clinical oncology, chemotherapy, oncogenes, carcinogenesis, metastasis, epidemiology and viral oncology in the form of original research, reviews and case reports.