[Minimal node affection in gastric carcinoma--pilote multicentric study results]. / Minimální uzlinové postizení u karcinomu zaludku--pilotní výsledky multicentrické studie.

INTRODUCTION: Lymphadenectomy is an essential part of surgical treatment of gastric cancer. In the part of hematoxylin-eosin negative nodes, small foci of tumour cells (micrometastastasis and isolated tumour cells) can be found using immunostaing or RT-PCR. The aim of this study is to asses clinical and prognostic relevance of these findings. MATERIAL AND METHODS: Multicenter, prospective, non-randomised clinical trial running in four Czech centres. All lymphatic nodes from patients after radical resection are stained using standard hematoxylin-eosin technique, all negative nodes are further processed with immunostaining employing cytokeratin antibody. RESULTS: In the period of two years (1st January 2009 - 31st December 2010), 73 patients (100%) were included into the study from four Czech centers. All patients underwent radical resection for gastric cancer. Subtotal resection was performed in 33 patients (45%), total gastrectomy in the remaining 40 patients (55%). Total number of acquired lymphatic nodes (LN) reached 1245, average number of nodes per one patient was 17.3. H-E metastasis were disclosed in 364 LN (29%). All H-E negative nodes were further processed using immunohistochemical staining. Lymph node micrometastasis (MM) were discovered in 35 LN (3%), isolated tumour cells (ITC) in another 72 LN (6%). Clinical and prognostic relevance of lymph node MM and ITC was assessed based on the patients' survival data. CONCLUSION: Preliminary results of this study indicate that presence of the lymph node MM and ITC in gastric cancer patients is not linked to worse oncological outcome. Based on our results we can conclude, that expensive, time consuming and technically demanding immunostaining technique could not yet be recommended as a routine part of histological investigation of lymphatic nodes.

[Incidence and prognostic significance of mesorectal extranodal tumor deposits in patients with rectal carcinoma following neoadjuvant therapy]. / Výskyt a prognostický význam extranodálních nádorových depozit v mezorektu u pacientus karcinomem rekta po neoadjuvantní terapii.

BACKGROUND: Extranodal mesorectal deposits (ENDs) occur frequently in advanced rectal tumors. It is supposed they are related to a higher incidence of local recurrence and a poor prognosis. AIM: To discover both occurrence and impact of ENDs in patients with advanced rectal cancer after neoadjuvant therapy and surgery. PATIENTS, METHOD: 325 patients meeting following criteria were enrolled: rectal adenocarcinoma, neoadjuvant therapy, anterior or AP rectal resection, complete check up information. Both fresh and archive specimens were examined using standard histopathologic methods. RESULTS: ENDs were discovered in 45 from 325 cases. The occurrence of ENDs was significantly higher in increasing stage of tumor (p < 0.001) and in increasing tumor grade (p < 0.001). Positive correlation between number of involved lymph nodes and occurrence of ENDs (p = 0.005) was proved. The 5-year survival rates were border significantly decreased in patients with ENDs (p = 0.052). CONCLUSION: ENDs are the form of metastatic spreading of primary rectal cancer and have negative prognostic impact in 5 year survival and increase local recurrence of cancer.