TY - JOUR
T1 - Extranodal Extension of Nodal Metastases Is a Poor Prognostic Indicator in Gastric Cancer: a Systematic Review and Meta-analysis
AU - Veronese, Nicola
AU - Wood, Laura D.
AU - Barbareschi, Mattia
AU - Cataldo, Ivana
AU - Fassan, Matteo
AU - Manzato, Enzo
AU - Cheng, Liang
AU - Maruzzo, Marco
AU - Veronese, Nicola
AU - Carraro, Sara
AU - Bagante, Fabio
AU - Nottegar, Alessia
AU - Pea, Antonio
AU - Bencivenga, Maria
AU - Luchini, Claudio
AU - Stubbs, Brendon
AU - Pea, Antonio
AU - Solmi, Marco
AU - Capelli, Paola
AU - Sergi, Giuseppe
AU - De Manzoni, Giovanni
PY - 2016
Y1 - 2016
N2 - Introduction: The extranodal extension (ENE) of nodal metastases (the extension of neoplastic cells through the nodal capsule into the perinodal soft tissue) is a histological feature that has been considered a prognostic factor in several cancers, but the role in gastric cancer was not yet investigated. We aimed to investigate the prognostic role of ENE in patients affected by gastric cancer through a systematic review and meta-analysis. Material and Methods: Two independent authors searched major databases until 09/30/2015 to identify studies providing data on gastric cancer patients’ prognostic parameters and comparing patients with ENE (ENE+) vs intra-nodal extension (ENE−). The data were summarized using risk ratios (RRs) for the number of deaths/recurrences and hazard ratios (HRs) with 95 % confidence intervals (CI), adjusted for potential confounders. Results: Nine studies followed up 3250 patients with gastric cancer (1064 ENE+ and 2186 ENE−). ENE+ was associated with a significantly higher risk of all-cause mortality (RR = 1.70; 95 % CI: 1.43–2.03, I2 = 66 %; HR = 2.14; 95 % CI: 1.66–2.75, I2 = 0 %), cancer-specific mortality (RR = 1.59; 95 % CI: 1.42–1.79; HR = 1.52; 95 % CI: 1.19–1.96), and disease recurrence (RR = 3.43, 95 % CI: 1.80–6.54, I2 = 0 %). Discussion: Judging from our results, ENE in gastric cancer patients should be considered for prognostic purposes from the gross sample to the pathology report. © 2016, The Society for Surgery of the Alimentary Tract.
AB - Introduction: The extranodal extension (ENE) of nodal metastases (the extension of neoplastic cells through the nodal capsule into the perinodal soft tissue) is a histological feature that has been considered a prognostic factor in several cancers, but the role in gastric cancer was not yet investigated. We aimed to investigate the prognostic role of ENE in patients affected by gastric cancer through a systematic review and meta-analysis. Material and Methods: Two independent authors searched major databases until 09/30/2015 to identify studies providing data on gastric cancer patients’ prognostic parameters and comparing patients with ENE (ENE+) vs intra-nodal extension (ENE−). The data were summarized using risk ratios (RRs) for the number of deaths/recurrences and hazard ratios (HRs) with 95 % confidence intervals (CI), adjusted for potential confounders. Results: Nine studies followed up 3250 patients with gastric cancer (1064 ENE+ and 2186 ENE−). ENE+ was associated with a significantly higher risk of all-cause mortality (RR = 1.70; 95 % CI: 1.43–2.03, I2 = 66 %; HR = 2.14; 95 % CI: 1.66–2.75, I2 = 0 %), cancer-specific mortality (RR = 1.59; 95 % CI: 1.42–1.79; HR = 1.52; 95 % CI: 1.19–1.96), and disease recurrence (RR = 3.43, 95 % CI: 1.80–6.54, I2 = 0 %). Discussion: Judging from our results, ENE in gastric cancer patients should be considered for prognostic purposes from the gross sample to the pathology report. © 2016, The Society for Surgery of the Alimentary Tract.
UR - http://hdl.handle.net/10447/464104
M3 - Article
VL - 20
SP - 1692
EP - 1698
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
ER -