Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma. Issue 9 (5th October 2021)

• Record Type: Journal Article
• Authors: van de Ven, Steffi E. M.; Suzuki, Lucia; Gotink, Annieke W.; ten Kate, Fiebo J. C.; Nieboer, Daan; Weusten, Bas L. A. M.; Brosens, Lodewijk A. A.; van Hillegersberg, Richard; Alvarez Herrero, Lorenza; Seldenrijk, Cees A.; Alkhalaf, Alaa; Moll, Freek C. P.; Curvers, Wouter; van Lijnschoten, Ineke G.; Tang, Thjon J.; van der Valk, Hans; Nagengast, Wouter B.; Kats‐Ugurlu, Gursah; Plukker, John T. M.; Houben, Martin H. M. G.; van der Laan, Jaap S.; Pouw, Roos E.; Bergman, Jacques J. G. H. M.; Meijer, Sybren L.; van Berge Henegouwen, Mark I.; Wijnhoven, Bas P. L.; de Jonge, Pieter J. F.; Doukas, Michael; Bruno, Marco J.; Biermann, Katharina; Koch, Arjun D.;
• Is Part Of: United European Gastroenterology journal. Volume 9:Issue 9(2021)
• Page Start: 1066
• Page End: 1073
• Publication Date: 2021-10-05
• Subjects: endoscopic mucosal resection -- esophagectomy lLymphovascular invasion -- LVI -- lymph node metastases -- prediction -- quantification -- risk assessment -- submucosal esophageal adenocarcinoma -- T1b adenocarcinoma; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1002/ueg2.12151
• Languages: English
• ISSNs: 2050-6406

Abstract

Abstract: 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.