TY - JOUR
T1 - Macroscopy predicts tumor progression in gastric cancer
T2 - A retrospective patho-historical analysis based on Napoleon Bonaparte's autopsy report
AU - Dawson, Heather
AU - Novotny, Alexander
AU - Becker, Karen
AU - Reim, Daniel
AU - Langer, Rupert
AU - Gullo, Irene
AU - Svrcek, Magali
AU - Niess, Jan H.
AU - Tutuian, Radu
AU - Truninger, Kaspar
AU - Diamantis, Ioannis
AU - Blank, Annika
AU - Zlobec, Inti
AU - Riddell, Robert H.
AU - Carneiro, Fatima
AU - Fléjou, Jean François
AU - Genta, Robert M.
AU - Lugli, Alessandro
N1 - Publisher Copyright:
© 2016 Editrice Gastroenterologica Italiana S.r.l.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Background The cause of Napoleon Bonaparte's death remains controversial. Originally suggested to be gastric cancer, whether this was truly neoplastic or a benign lesion has been recently debated. Aims To interpret findings of original autopsy reports in light of the current knowledge of gastric cancer and to highlight the significance of accurate macroscopy in modern-day medicine. Methods Using original autopsy documents, endoscopic images and data from current literature, Napoleon's gastric situation was reconstructed. In a multicenter collection of 2071 gastric cancer specimens, the relationship between tumor size and features of tumor progression was assessed. Results Greater tumor size was associated with advanced pT, nodal metastases and Borrmann types 3–4 (p < 0.001). The best cut-off for predicting pT3-4 tumors was 6.5 cm (AUC 0.8; OR 1.397, 95% CI 1.35–1.446), and 6 cm for lymph node metastases (AUC 0.775; OR 1.389, 95% CI 1.338–1.442). The 6 cm cut-off of had a positive predictive value of 0.820 for nodal metastases and a negative predictive value of 0.880 for distant metastases. Conclusion This analysis combines Napoleon's autopsy with present-day knowledge to support gastric cancer as his terminal illness and emphasizes the role of macroscopy, which may provide valuable information on gastric cancer progression and aid patient management.
AB - Background The cause of Napoleon Bonaparte's death remains controversial. Originally suggested to be gastric cancer, whether this was truly neoplastic or a benign lesion has been recently debated. Aims To interpret findings of original autopsy reports in light of the current knowledge of gastric cancer and to highlight the significance of accurate macroscopy in modern-day medicine. Methods Using original autopsy documents, endoscopic images and data from current literature, Napoleon's gastric situation was reconstructed. In a multicenter collection of 2071 gastric cancer specimens, the relationship between tumor size and features of tumor progression was assessed. Results Greater tumor size was associated with advanced pT, nodal metastases and Borrmann types 3–4 (p < 0.001). The best cut-off for predicting pT3-4 tumors was 6.5 cm (AUC 0.8; OR 1.397, 95% CI 1.35–1.446), and 6 cm for lymph node metastases (AUC 0.775; OR 1.389, 95% CI 1.338–1.442). The 6 cm cut-off of had a positive predictive value of 0.820 for nodal metastases and a negative predictive value of 0.880 for distant metastases. Conclusion This analysis combines Napoleon's autopsy with present-day knowledge to support gastric cancer as his terminal illness and emphasizes the role of macroscopy, which may provide valuable information on gastric cancer progression and aid patient management.
KW - Autopsy
KW - Gastric cancer
KW - Napoleon Bonaparte
KW - Tumor size
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U2 - 10.1016/j.dld.2016.07.013
DO - 10.1016/j.dld.2016.07.013
M3 - Article
C2 - 27522550
AN - SCOPUS:84981749601
SN - 1590-8658
VL - 48
SP - 1378
EP - 1385
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
IS - 11
ER -