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van de Ven SEM, Suzuki L, Gotink AW, et al. Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma. United European Gastroenterol J. 2021;9(9):1066-1073doi: 10.1002/ueg2.12151.
van de Ven, S. E. M., Suzuki, L., Gotink, A. W., Ten Kate, F. J. C., Nieboer, D., Weusten, B. L. A. M., Brosens, L. A. A., van Hillegersberg, R., Alvarez Herrero, L., Seldenrijk, C. A., Alkhalaf, A., Moll, F. C. P., Curvers, W., van Lijnschoten, I. G., Tang, T. J., van der Valk, H., Nagengast, W. B., Kats-Ugurlu, G., Plukker, J. T. M., Houben, M. H. M. G., van der Laan, J. S., Pouw, R. E., Bergman, J. J. G. H. M., Meijer, S. L., van Berge Henegouwen, M. I., Wijnhoven, B. P. L., de Jonge, P. J. F., Doukas, M., Bruno, M. J., Biermann, K., & Koch, A. D. (2021). Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma. United European gastroenterology journal, 9(9), 1066-1073. https://doi.org/10.1002/ueg2.12151
van de Ven, Steffi E M, et al. "Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma." United European gastroenterology journal vol. 9,9 (2021): 1066-1073. doi: https://doi.org/10.1002/ueg2.12151
van de Ven SEM, Suzuki L, Gotink AW, Ten Kate FJC, Nieboer D, Weusten BLAM, Brosens LAA, van Hillegersberg R, Alvarez Herrero L, Seldenrijk CA, Alkhalaf A, Moll FCP, Curvers W, van Lijnschoten IG, Tang TJ, van der Valk H, Nagengast WB, Kats-Ugurlu G, Plukker JTM, Houben MHMG, van der Laan JS, Pouw RE, Bergman JJGHM, Meijer SL, van Berge Henegouwen MI, Wijnhoven BPL, de Jonge PJF, Doukas M, Bruno MJ, Biermann K, Koch AD. Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma. United European Gastroenterol J. 2021 Nov;9(9):1066-1073. doi: 10.1002/ueg2.12151. Epub 2021 Oct 05. PMID: 34609076; PMCID: PMC8598963.
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United European Gastroenterol J. 2021 Nov;9(9):1066-1073. doi: 10.1002/ueg2.12151. Epub 2021 Oct 05.

Lymphovascular invasion quantification could improve risk prediction of lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma.

United European gastroenterology journal

Steffi E M van de Ven, Lucia Suzuki, Annieke W Gotink, Fiebo J C Ten Kate, Daan Nieboer, Bas L A M Weusten, Lodewijk A A Brosens, Richard van Hillegersberg, Lorenza Alvarez Herrero, Cees A Seldenrijk, Alaa Alkhalaf, Freek C P Moll, Wouter Curvers, Ineke G van Lijnschoten, Thjon J Tang, Hans van der Valk, Wouter B Nagengast, Gursah Kats-Ugurlu, John T M Plukker, Martin H M G Houben, Jaap S van der Laan, Roos E Pouw, Jacques J G H M Bergman, Sybren L Meijer, Mark I van Berge Henegouwen, Bas P L Wijnhoven, Pieter J F de Jonge, Michael Doukas, Marco J Bruno, Katharina Biermann, Arjun D Koch

Affiliations

  1. Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands.
  2. Department of Pathology, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands.
  3. Department of Pathology, Isala Clinics, Zwolle, The Netherlands.
  4. Department of Public Health, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands.
  5. Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
  6. Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, The Netherlands.
  7. Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
  8. Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
  9. Department of Pathology, Pathology DNA, St. Antonius Hospital, Nieuwegein, The Netherlands.
  10. Department of Gastroenterology and Hepatology, Isala Clinics, Zwolle, The Netherlands.
  11. Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, The Netherlands.
  12. Department of Pathology, PAMM, Eindhoven, The Netherlands.
  13. Department of Gastroenterology and Hepatology, Ijsselland Hospital, Capelle aan den Ijssel, The Netherlands.
  14. Department of Pathology, Ijselland Hospital, Capelle aan den Ijssel, The Netherlands.
  15. Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, The Netherlands.
  16. Department of Pathology, University Medical Center Groningen, Groningen, The Netherlands.
  17. Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
  18. Department of Gastroenterology and Hepatology, Haga Teaching Hospital, Den Haag, The Netherlands.
  19. Department of Pathology, Haga Teaching Hospital, Den Haag, The Netherlands.
  20. Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
  21. Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
  22. Department of Surgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
  23. Department of Surgery, Erasmus MC Cancer Institute, University Medical Center, Rotterdam, The Netherlands.

PMID: 34609076 PMCID: PMC8598963 DOI: 10.1002/ueg2.12151

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.

© 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

Keywords: LVI; T1b adenocarcinoma; endoscopic mucosal resection; esophagectomy lLymphovascular invasion; lymph node metastases; prediction; quantification; risk assessment; submucosal esophageal adenocarcinoma

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