Clinical Significance and Prognostic Implications of Discontinuous Growth Pattern in Esophageal Adenocarcinoma: A Multi-Institutional Study.

Autor:	Kmeid M; Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY., Lee G; Department of Pathology, University of Alabama at Birmingham, AL., Yang Z; Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Pacheco R; Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY., Lin J; Pathology, Indiana University, Indianapolis, IN., Patil DT; Department of Pathology, Brigham and Women's Hospital, Boston, MA., Youssef M; Department of Pathology, University of Alabama at Birmingham, AL., Zhang Q; Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Alkashash AM; Pathology, Indiana University, Indianapolis, IN., Li J; Department of Pathology, Brigham and Women's Hospital, Boston, MA., Lee H; Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY.
Jazyk:	angličtina
Zdroj:	The American journal of surgical pathology [Am J Surg Pathol] 2024 Apr 01; Vol. 48 (4), pp. 447-457. Date of Electronic Publication: 2024 Jan 17.
DOI:	10.1097/PAS.0000000000002182
Abstrakt:	The significance of discontinuous growth (DG) of the tumor to include tumor deposits and intramural metastasis in esophageal adenocarcinoma (EAC) is unclear. Esophagectomy specimens from 151 treatment-naïve and 121 treated patients with EAC were reviewed. DG was defined as discrete (≥2 mm away) tumor foci identified at the periphery of the main tumor in the submucosa, muscularis propria, and/or periadventitial tissue. Patients' demographics, clinicopathologic parameters, and oncologic outcomes were compared between tumors with DG versus without DG. DGs were identified in 16% of treatment-naïve and 29% of treated cases ( P =0.01). Age, gender, and tumor location were comparable in DG+ and DG- groups. For the treatment-naïve group, DG+ tumors were larger with higher tumor grade and stage and more frequent extranodal extension, lymphovascular/perineural invasion, and positive margin. Patients with treated tumors presented at higher disease stages with higher rates of recurrence and metastasis compared with treatment-naïve patients. In this group, DG was also associated with TNM stage and more frequent lymphovascular/perineural spread and positive margin, but not with tumor size, grade, or extranodal extension. In multivariate analysis, in all patients adjusted for tumor size, lymphovascular involvement, margin, T and N stage, metastasis, neoadjuvant therapy status, treatment year, and DG, DG was found to be an independent adverse predictor of survival outcomes in EAC. DG in EAC is associated with adverse clinicopathologic features and worse patient outcomes. DG should be considered throughout the entire clinicopathologic evaluation of treatment-naïve and treated tumors as well as in future staging systems. Competing Interests: Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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