Journal article
Macroscopy predicts tumor progression in gastric cancer: A retrospective patho-historical analysis based on Napoleon Bonaparte's autopsy report.
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Dawson H
Clinical Pathology Division, Institute of Pathology, University of Bern, Bern, Switzerland; Translational Research Unit, Institute of Pathology, University of Bern, Bern, Switzerland. Electronic address: heather.dawson@pathology.unibe.ch.
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Novotny A
Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Germany.
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Becker K
Institute of Pathology, Klinikum Rechts der Isar, Technische Universität München, Germany.
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Reim D
Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Germany.
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Langer R
Clinical Pathology Division, Institute of Pathology, University of Bern, Bern, Switzerland; Translational Research Unit, Institute of Pathology, University of Bern, Bern, Switzerland.
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Gullo I
Centro Hospitalar de São João/Medical Faculty of Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto/i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
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Svrcek M
Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Service d'Anatomie Pathologique, Paris, France.
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Niess JH
University Clinic of Visceral Surgery and Medicine, Inselspital Bern, Switzerland.
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Tutuian R
University Clinic of Visceral Surgery and Medicine, Inselspital Bern, Switzerland.
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Truninger K
Gastroenterologie Oberaargau, Langenthal, Switzerland.
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Diamantis I
Privatklinik Linde, Biel, Switzerland.
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Blank A
Clinical Pathology Division, Institute of Pathology, University of Bern, Bern, Switzerland; Translational Research Unit, Institute of Pathology, University of Bern, Bern, Switzerland.
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Zlobec I
Translational Research Unit, Institute of Pathology, University of Bern, Bern, Switzerland.
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Riddell RH
Department of Pathology and Laboratory Medicine, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada.
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Carneiro F
Centro Hospitalar de São João/Medical Faculty of Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology of the University of Porto/i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
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Fléjou JF
Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Service d'Anatomie Pathologique, Paris, France.
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Genta RM
Miraca Life Sciences, Research Institute, Irving, TX, United States; University of Texas Southwestern Medical Center, Dallas, TX, United States.
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Lugli A
Clinical Pathology Division, Institute of Pathology, University of Bern, Bern, Switzerland; Translational Research Unit, Institute of Pathology, University of Bern, Bern, Switzerland.
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Published in:
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. - 2016
English
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 6.5cm (AUC 0.8; OR 1.397, 95% CI 1.35-1.446), and 6cm for lymph node metastases (AUC 0.775; OR 1.389, 95% CI 1.338-1.442). The 6cm 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.
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Language
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Open access status
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closed
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Identifiers
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Persistent URL
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https://sonar.ch/global/documents/241740
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