TY - JOUR
T1 - Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma
AU - van de Ven, Steffi E. M.
AU - Suzuki, Lucia
AU - Gotink, Annieke W.
AU - ten Kate, Fiebo J. C.
AU - Nieboer, Daan
AU - Weusten, Bas L. A. M.
AU - Brosens, Lodewijk A. A.
AU - van Hillegersberg, Richard
AU - Alvarez Herrero, Lorenza
AU - Seldenrijk, Cees A.
AU - Alkhalaf, Alaa
AU - Moll, Freek C. P.
AU - Curvers, Wouter
AU - van Lijnschoten, Ineke G.
AU - Tang, Thjon J.
AU - van der Valk, Hans
AU - Nagengast, Wouter B.
AU - Kats-Ugurlu, Gursah
AU - Plukker, John T. M.
AU - Houben, Martin H. M. G.
AU - van der Laan, Jaap S.
AU - Pouw, Roos E.
AU - Bergman, Jacques J. G. H. M.
AU - Meijer, Sybren L.
AU - van Berge Henegouwen, Mark I.
AU - Wijnhoven, Bas P. L.
AU - de Jonge, Pieter J. F.
AU - Doukas, Michael
AU - Bruno, Marco J.
AU - Biermann, Katharina
AU - Koch, Arjun D.
N1 - Publisher Copyright: © 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/11
Y1 - 2021/11
N2 - Aim: To quantify lymphovascular invasion (LVI) and to assess the prognostic value in patients with pT1b esophageal adenocarcinoma. Methods: In this nationwide, retrospective cohort study, patients were included if they were treated with surgery or endoscopic resection for pT1b esophageal adenocarcinoma. Primary endpoint was the presence of metastases, lymph node metastases, or distant metastases, in surgical resection specimens or during follow-up. A prediction model to identify risk factors for metastases was developed and internally validated. Results: 248 patients were included. LVI was distributed as follows: no LVI (n = 196; 79.0%), 1 LVI focus (n = 16; 6.5%), 2–3 LVI foci (n = 21; 8.5%) and ≥4 LVI foci (n = 15; 6.0%). Seventy-eight patients had metastases. The risk of metastases was increased for tumors with 2–3 LVI foci [subdistribution hazard ratio (SHR) 3.39, 95% confidence interval (CI) 2.10–5.47] and ≥4 LVI foci (SHR 3.81, 95% CI 2.37–6.10). The prediction model demonstrated a good discriminative ability (c-statistic 0.81). Conclusion: The risk of metastases is higher when more LVI foci are present. Quantification of LVI could be useful for a more precise risk estimation of metastases. This model needs to be externally validated before implementation into clinical practice.
AB - Aim: To quantify lymphovascular invasion (LVI) and to assess the prognostic value in patients with pT1b esophageal adenocarcinoma. Methods: In this nationwide, retrospective cohort study, patients were included if they were treated with surgery or endoscopic resection for pT1b esophageal adenocarcinoma. Primary endpoint was the presence of metastases, lymph node metastases, or distant metastases, in surgical resection specimens or during follow-up. A prediction model to identify risk factors for metastases was developed and internally validated. Results: 248 patients were included. LVI was distributed as follows: no LVI (n = 196; 79.0%), 1 LVI focus (n = 16; 6.5%), 2–3 LVI foci (n = 21; 8.5%) and ≥4 LVI foci (n = 15; 6.0%). Seventy-eight patients had metastases. The risk of metastases was increased for tumors with 2–3 LVI foci [subdistribution hazard ratio (SHR) 3.39, 95% confidence interval (CI) 2.10–5.47] and ≥4 LVI foci (SHR 3.81, 95% CI 2.37–6.10). The prediction model demonstrated a good discriminative ability (c-statistic 0.81). Conclusion: The risk of metastases is higher when more LVI foci are present. Quantification of LVI could be useful for a more precise risk estimation of metastases. This model needs to be externally validated before implementation into clinical practice.
KW - LVI
KW - T1b adenocarcinoma
KW - endoscopic mucosal resection
KW - esophagectomy lLymphovascular invasion
KW - lymph node metastases
KW - prediction
KW - quantification
KW - risk assessment
KW - submucosal esophageal adenocarcinoma
UR - http://www.scopus.com/inward/record.url?scp=85116331364&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ueg2.12151
DO - https://doi.org/10.1002/ueg2.12151
M3 - Article
C2 - 34609076
SN - 2050-6406
VL - 9
SP - 1066
EP - 1073
JO - United European gastroenterology journal
JF - United European gastroenterology journal
IS - 9
ER -