YOU ARE NOW CONNECTED TO THE MEDLINE (1994 - 97) FILE. ==LYMPH NODE NEOPLASMS== 3 AUTHOR Siegel RJ TITLE Surgical pathology of lymph nodes in cancer staging: routine and specialized techniques. SOURCE Surg Oncol Clin N Am 1996 Jan;5(1):25-31 ABSTRACT In conclusion, routine and specialized techniques available to the pathologist for evaluating regional lymph nodes for evidence of metastatic malignancy have been presented. A variety of methods are available for increasing the number of lymph nodes identified, more thoroughly sampling the identified nodes either by gross or microscopic serial sectioning, and applying immunohistochemistry and other techniques to improve the sensitivity of detecting malignant cells. In the end, standard practice regarding the application of these techniques must be dictated by the demonstrated clinical usefulness of the information obtained, and tempered by the realities of cost and workload constraints on diagnostic pathology laboratories. In interpreting studies addressing prognostic significance of micrometastases, the definition of the term micrometastases, biologic behavior of tumors in different sites, and of tumors of different cell types from the same site (e.g., lobular versus ductal carcinoma of the breast) must be considered. Evaluating the evidence to date suggests that there may be a lower limit to the size of nodal metastases that portends an adverse prognosis. The commonly accepted definition of micrometastases as those less than 2 mm may have to be qualified as the meaning of metastases of varying sizes becomes clearer for specific subsets of patients with different tumor types. The existence of circulating tumor cells in a variety of malignancies is known but of uncertain significance in individual cases. It cannot be predicted whether sparse tumor cells found in lymph nodes are destined for immune destruction or tumor progression. For the present, it appears that careful gross sectioning and microscopic evaluation using well-accepted routine techniques will identify the vast majority of clinically significant lymph node metastases. The place of IHC and other ancillary techniques in the routine evaluation of regional lymph nodes in pathologic cancer staging remains to be determined. YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. 6 AUTHOR Takahashi T TITLE Emulsion and activated carbon in cancer chemotherapy. SOURCE Crit Rev Ther Drug Carrier Syst; VOL 2, ISS 3, 1986, P245-74 (REF: 70) ABSTRACT Based on a lipid-absorbing ability of lymphatic capillaries, a fat emulsion containing anticancer agents was applied to selectively deliver more increasing amounts of anticancer agents into regional lymph nodes. The emulsions, in which the drug solution is contained as the innermost phase or as oily soluble drug, yield high drug concentrations in the lymphatic system. Clinical trial of the emulsion method was carried out preoperatively for 180 patients with stomach cancer. As a result, the emulsion enhanced the chemotherapeutic effect of the anticancer agent on lymph node metastasis. About a 20 m mu-sized activated charcoal, in which anticancer agents were absorbed, selectively delivered the anticancer agents to the lymphatic system. The activated charcoal was also excellent carrier material for the lymphatic system, and we have applied it to patients with lymphatic metastasis. 6 AUTHOR Akamo Y AUTHOR Mizuno I AUTHOR Yotsuyanagi T AUTHOR Ichino T AUTHOR Tanimoto N AUTHOR Yamamoto T AUTHOR Nagata M AUTHOR Takeyama H AUTHOR Shinagawa N AUTHOR Yura J AUTHOR et al TITLE Chemotherapy targeting regional lymph nodes by gastric submucosal injection of liposomal adriamycin in patients with gastric carcinoma. SOURCE Jpn J Cancer Res; VOL 85, ISS 6, 1994, P652-8 ABSTRACT We investigated the delivery of adriamycin (ADR) to the regional lymph nodes of the stomach following the gastric submucosal injection of liposomal adriamycin (Lipo-ADR) in 34 gastric carcinoma patients, as well as following intravenous administration of free ADR (F-ADR) in another 18 patients. Prior to radical gastrectomy, Lipo-ADR was endoscopically injected into the gastric submucosa adjacent to the primary tumor via a needle-tipped catheter. After Lipo-ADR injection, the ADR concentration in the primary and secondary drainage lymph nodes was higher than in the other regional lymph nodes. Thus, the regional nodes more susceptible to metastasis showed higher levels of ADR. In contrast, the intravenous administration of F-ADR produced a similar and far lower ADR concentration in all the nodes. Delivery of ADR to the primary drainage lymph nodes following injection of 5 ml of Lipo-ADR was compared with delivery to the left gastric artery lymph nodes after intravenous administration of an equal dose of F-ADR. The ADR levels (micrograms/g) after gastric submucosal injection were 15.1 +/- 8.30 on day 1 (n = 4); and 11.9 +/- 4.80 on day 4 (n = 6). Those after intravenous administration were 0.29 +/- 0.10 on day 1 (n = 4); and 0.36 +/- 0.0 on day 4 (n = 2). The differences between the two groups were significant (P < 0.05). The ADR levels after the gastric submucosal injection were far higher than those after intravenous administration. These findings indicate that the gastric submucosal injection of Lipo-ADR can specifically deliver ADR to the regional lymph nodes at high concentrations. Such preoperative adjuvant chemotherapy targeting the regional lymph nodes may be useful for preventing the lymph node recurrence of gastric carcinoma. 16 AUTHOR Zuk RJ AUTHOR Jenkins BJ AUTHOR Martin JE AUTHOR Oliver RT AUTHOR Baithun SI TITLE Findings in lymph nodes of patients with germ cell tumours after chemotherapy and their relation to prognosis. SOURCE J Clin Pathol; VOL 42, ISS 10, 1989, P1049-54 ABSTRACT One hundred and forty six patients with advanced germ cell testicular tumours (38 seminomas and 108 malignant teratomas) treated by combination chemotherapy were studied over 10 years. Most of the improvement seen was in patients with malignant teratoma undifferentiated. In the most recently treated patients (1984-1987) 75% of drug resistant cases were malignant teratoma intermediate compared with 26% in the series treated between 1978-1983. The microscopic features of 52 primary testicular tumours were compared with features seen in excised retroperitoneal lymph nodes after completion of chemotherapy. Primary malignant teratoma intermediate had a higher incidence of viable malignancy in the excised tissue than malignant teratoma undifferentiated. Mature teratoma or fibronecrotic tissue within resected tissue was associated with a good prognosis. If resection was complete patients with drug resistant malignant teratoma intermediate had a more favourable prognosis than drug resistant malignant teratoma undifferentiated. It is advised that retroperitoneal node dissection should be considered in the management of patients with advanced germ cell testicular tumours, and that as complete a resection as possible be attempted to avoid the danger of missing residual disease.