RT Journal Article
SR Electronic
T1 Extranodal extension of lymph node metastasis is a marker of poor prognosis in oesophageal cancer: a systematic review with meta-analysis
JF Journal of Clinical Pathology
JO J Clin Pathol
FD BMJ Publishing Group Ltd and Association of Clinical Pathologists
SP 956
OP 961
DO 10.1136/jclinpath-2016-203830
VO 69
IS 11
A1 Luchini, Claudio
A1 Wood, Laura D
A1 Cheng, Liang
A1 Nottegar, Alessia
A1 Stubbs, Brendon
A1 Solmi, Marco
A1 Capelli, Paola
A1 Pea, Antonio
A1 Sergi, Giuseppe
A1 Manzato, Enzo
A1 Fassan, Matteo
A1 Bagante, Fabio
A1 Bollschweiler, Elfriede
A1 Giacopuzzi, Simone
A1 Kaneko, Takuma
A1 de Manzoni, Giovanni
A1 Barbareschi, Mattia
A1 Scarpa, Aldo
A1 Veronese, Nicola
YR 2016
UL http://jcp.bmj.com/content/69/11/956.abstract
AB The extranodal extension (ENE) of nodal metastasis is the extension of neoplastic cells through the nodal capsule into the perinodal adipose tissue. This histological feature has recently been indicated as an important prognostic factor in different types of malignancies; in this manuscript, we aim at defining its role in the prognosis of oesophageal cancer with the tool of meta-analysis. Two independent authors searched SCOPUS and PubMed until 31 August 2015 without language restrictions. The studies with available data about prognostic parameters in subjects with oesophageal cancer, comparing patients with the presence of ENE (ENE+) versus only intranodal extension (ENE−), were considered as eligible. Data were summarised using risk ratios (RRs) for number of deaths/recurrences and HRs together with 95% CIs for time-dependent risk related to ENE+, adjusted for potential confounders. Fourteen studies were selected; they followed-up 1437 patients with oesophageal cancer for a median follow-up of 39.4 months. The presence of ENE was associated with a significantly increased risk of all-cause mortality (RR=1.33; 95% CI 1.18 to 1.50, p<0.0001, I2=49%; HR=2.72, 95% CI 2.03 to 3.64, p<0.0001, I2=0%), cancer-specific mortality (RR=1.35; 95% CI 1.14 to 1.59, p=0.001, I2=57%; HR=1.97, 95% CI 1.41 to 2.75, p<0.0001, I2=41%) and of risk of recurrence (RR=1.50, 95% CI 1.20 to 1.88, p<0.0001, I2=9%; HR=2.27, 95% CI 1.72 to 2.90, p<0.0001, I2=0%). On the basis of these results, in oesophageal cancer, ENE should be considered from the gross sampling to the pathology report, and in future oncological staging system.