Claudio Luchini
University and Hospital Trust of Verona, Italy
Title: Extranodal extension of nodal metastasis and prognosis in cancer: the surgical pathologist’s point of view
Biography
Biography: Claudio Luchini
Abstract
Extranodal extension of nodal metastasis (ENE) is defined as the spread of a lymph node metastasis into surrounding soft tissue. Through this mechanism, neoplastic cells increase their capacity of local invasiveness as well as of intravascular invasion for distant metastasization. Although the TNM staging system acknowledges the importance of ENE in few cancer types (e.g. squamous cell carcinoma of vulva and of head and neck), no comprehensive studies have analyzed the prognostic impact of this parameter in these and in other solid malignancies. With the tool of meta-analysis, we demonstrated that ENE+ carried a significantly higher risk of all-cause mortality, cance- specific mortality and of recurrence in many cancer types, including gastrointestinal and breast tumors. ENE is a parameter very simple to be addressed by a pathologist and also very significant. Since it has been demonstrated as important in influencing the prognosis of patients with different cancer types, pathologists should document its eventual presence in their final pathology report, and future staging systems should taken ENE into account for a better stratification of patients’ prognosis.