Article
The difference in prognosis of extra versus intra capsular lymph node metastasis in gastric carcinoma: relevance of the response to chemotherapy
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Published: | April 21, 2016 |
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Background: Extra capsular growth (ECG) of lymph node metastases in gastric cancer is associated with poorer prognosis compared to intra capsular growth patterns (ICG). The aim of this study was to investigate whether a reduced tumor regression after neoadjuvant chemotherapy is correlated to the extra capsular growth pattern in gastric carcinoma patients.
Materials and methods: From January 2002 to July 2014, 529 consecutive patients underwent surgical treatment for gastric carcinoma at our center. 57 patients, classified as lymph node positive with a regression grade analysis of preoperative chemotherapy were identified. For these patients a nodular growth pattern analysis was performed and classified as either extra or intra capsular. The relationship between capsular growth pattern and response to neoadjuvant chemotherapy as measured by Becker’s tumor regression grading system was analyzed using the Chi-Square test.
Results: Statistical comparison of the two groups showed no significant difference in the response to chemotherapy (p = 0.890). The results are displayed in Table 1 [Tab. 1].
Conclusion: ECG in gastric carcinoma patients is not correlated with a reduced tumor regression after neoadjuvant chemotherapy. The response to preoperative chemotherapy proves statistically unrelated to the poorer prognosis of ECG carcinomas. Tumor-specific factors and immunologic differences may account for the different outcomes in patients with ECG versus ICG. In an attempt to improve treatment strategies, gastric carcinomas showing extra capsular lymph node metastassis should be subject for further analysis.