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Regional failures after selective neck dissection in previously untreated squamous cell carcinoma of oral cavity. 先前未经治疗的口腔鳞状细胞癌选择性颈部清扫后的局部失败。
IF 1.5 Q4 ONCOLOGY Pub Date : 2014-01-01 Epub Date: 2014-03-11 DOI: 10.1155/2014/205715
Hassan Iqbal, Abu Bakar Hafeez Bhatti, Raza Hussain, Arif Jamshed

Aim: To share experience with regional failures after selective neck dissection in both node negative and positive previously untreated patients diagnosed with squamous cell carcinoma of the oral cavity.

Patients and methods: Data of 219 patients who underwent SND at Shaukat Khanum Cancer Hospital from 2003 to 2010 were retrospectively reviewed. Patient characteristics, treatment modalities, and regional failures were assessed. Expected 5-year regional control was calculated and prognostic factors were determined.

Results: Median follow-up was 29 (9-109) months. Common sites were anterior tongue in 159 and buccal mucosa in 22 patients. Pathological nodal stage was N0 in 114, N1 in 32, N2b in 67, and N2c in 5 patients. Fourteen (6%) patients failed in clinically node negative neck while 8 (4%) failed in clinically node positive patients. Out of 22 total regional failures, primary tumor origin was from tongue in 16 (73%) patients. Expected 5-year regional control was 95% and 81% for N0 and N+ disease, respectively (P < 0.0001). Only 13% patients with well differentiated, T1 tumors in cN0 neck were pathologically node positive.

Conclusions: Selective neck dissection yields acceptable results for regional management of oral squamous cell carcinoma. Wait and see policy may be effective in a selected subgroup of patients.

目的:探讨未经治疗的口腔鳞状细胞癌淋巴结阴性和阳性患者选择性颈部清扫术后局部失败的经验。患者和方法:回顾性分析2003 - 2010年在Shaukat Khanum肿瘤医院接受SND治疗的219例患者的资料。评估患者特征、治疗方式和局部失败。计算预期5年区域控制率并确定预后因素。结果:中位随访时间为29(9-109)个月。常见部位为舌前159例,颊黏膜22例。病理分期为N0型114例,N1型32例,N2b型67例,N2c型5例。14例(6%)临床淋巴结阴性患者失败,8例(4%)临床淋巴结阳性患者失败。在22例局部失败中,16例(73%)患者的原发肿瘤来自舌头。N0和N+疾病的5年预期区域控制率分别为95%和81% (P < 0.0001)。只有13%的cN0颈部高分化T1肿瘤病理淋巴结阳性。结论:选择性颈部清扫术对口腔鳞状细胞癌的局部治疗效果可接受。观望政策可能对选定的亚组患者有效。
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引用次数: 15
Minimally invasive esophagectomy for esophageal cancer: the first experience from Pakistan. 微创食管切除术治疗食管癌:巴基斯坦首例经验。
IF 1.5 Q4 ONCOLOGY Pub Date : 2014-01-01 Epub Date: 2014-07-20 DOI: 10.1155/2014/864705
Farrukh Hassan Rizvi, Syed Shahrukh Hassan Rizvi, Aamir Ali Syed, Shahid Khattak, Ali Raza Khan

Background: Two common procedures for esophageal resection are Ivor Lewis esophagectomy and transhiatal esophagectomy. Both procedures have high morbidity rates of 20-46%. Minimally invasive esophagectomy has been introduced to decrease morbidity. We report initial experience of MIE to determine the morbidity and mortality associated with this procedure during learning phase.

Material and methods: Patients undergoing MIE at our institute from January 2011 to May 2013 were reviewed. Record was kept for any morbidity and mortality. Descriptive statistics were presented as frequencies and continuous variables were presented as median. Survival analysis was performed using Kaplan Meier curves.

Results: We performed 51 minimally invasive esophagectomies. Perioperative morbidity was in 16 (31.37%) patients. There were 3 (5.88%) anastomotic leaks. We encountered 1 respiratory complication. Reexploration was required in 3 (5.88%) patients. Median operative time was 375 minutes. Median hospital stay was 10 days. The most frequent long-term morbidity was anastomotic narrowing observed in 5 (9.88%) patients. There were no perioperative mortalities. Our mean overall survival was 37.66 months (95% confidence interval 33.75 to 41.56 months). Mean disease-free survival was 24.43 months (95% CI 21.26 to 27.60 months).

Conclusion: Minimally invasive esophagectomy, when performed in the learning phase, has acceptable morbidity and mortality.

背景:两种常见的食管切除术是Ivor Lewis食管切除术和经食管切除术。这两种手术的发病率都高达20-46%。微创食管切除术已被引入以降低发病率。我们报告了MIE的初步经验,以确定在学习阶段与该手术相关的发病率和死亡率。材料与方法:回顾性分析2011年1月至2013年5月在我院接受MIE治疗的患者。记录所有的发病率和死亡率。描述性统计以频率表示,连续变量以中位数表示。采用Kaplan Meier曲线进行生存分析。结果:行51例微创食管切除术。围手术期发病率16例(31.37%)。吻合口瘘3例(5.88%)。我们遇到1例呼吸并发症。3例(5.88%)患者需要再次探查。中位手术时间为375分钟。平均住院时间为10天。长期发病率最高的是吻合口狭窄5例(9.88%)。无围手术期死亡。我们的平均总生存期为37.66个月(95%可信区间为33.75 ~ 41.56个月)。平均无病生存期为24.43个月(95% CI 21.26 ~ 27.60个月)。结论:在学习阶段进行微创食管切除术,其发病率和死亡率是可以接受的。
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引用次数: 4
Close margins in oral cancers: implication of close margin status in recurrence and survival of pT1N0 and pT2N0 oral cancers. 口腔癌的近切缘:pT1N0和pT2N0口腔癌复发和生存的近切缘状态的含义
IF 1.5 Q4 ONCOLOGY Pub Date : 2014-01-01 Epub Date: 2014-11-11 DOI: 10.1155/2014/545372
Sandhya Gokavarapu, Ravi Chander, Nagendra Parvataneni, Sreenivasa Puthamakula

Introduction: Among all prognostic factors, "margin status" is the only factor under clinician's control. Current guidelines describe histopathologic margin of >5 mm as "clear margin" and 1-5 mm as "close margin." Ambiguous description of positive margin in the published data resulted in comparison of microscopically "involved margin" and "close margin" together with "clear margin" in many publications. Authors attempted to compare the outcome of close and clear margins of stage I and stage II squamous cell carcinoma of oral cavity to investigate the efficacy of description of margin status.

Patients and methods: Historical cohorts of patients treated between January 2010 and December 2011 at tertiary cancer hospital were investigated and filtered for stage I and stage II primary squamous cell carcinomas of oral cavity. Patients with margin status of tumor at margin or within 1mm from cut margin were excluded and analyzed in multivariate logistic regression model for locoregional recurrences and Cox regression for overall survival.

Results: A total of 104 patients fulfilled the abovementioned criteria, of whom 36 were "clear margin" and 68 were "close margin" with median period of follow-up of 39 months. There was no significant difference in locoregional recurrence (P value: 0.0.810) and survival (P value: 0.0.851) among "close margin" and "clear margin" patients.

前言:在所有预后因素中,“切缘状态”是临床医生唯一能控制的因素。目前的指南将>5毫米的组织病理学切缘描述为“清晰切缘”,1-5毫米描述为“近切缘”。已发表资料中对正边距的模糊描述导致许多出版物将微观上的“涉及边距”和“接近边距”与“清晰边距”进行比较。作者试图比较I期和II期口腔鳞状细胞癌边缘闭合和清晰的结果,以探讨边缘状态描述的有效性。患者和方法:对2010年1月至2011年12月在三级肿瘤医院接受治疗的患者进行历史队列调查,并筛选I期和II期原发性口腔鳞状细胞癌。排除切缘或切缘1mm范围内肿瘤的患者,采用局部复发的多因素logistic回归模型和总生存期的Cox回归分析。结果:104例患者符合上述标准,其中“明确切缘”36例,“接近切缘”68例,中位随访39个月。“近切缘”和“清切缘”患者的局部复发(P值:0.0.810)和生存期(P值:0.0.851)无显著差异。
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引用次数: 12
Evaluation of a new modification of pancreaticogastrostomy after pancreaticoduodenectomy: anastomosis of the pancreatic duct to the gastric mucosa with invagination of the pancreatic remnant end into the posterior gastric wall for patients with cancer head of pancreas and periampullary carcinoma in terms of postoperative pancreatic fistula formation. 胰十二指肠切除术后胰胃吻合术的新改良:胰管与胃粘膜吻合,胰残端内陷胃后壁,胰头癌及壶腹周围癌患者术后胰瘘形成评价
IF 1.5 Q4 ONCOLOGY Pub Date : 2014-01-01 Epub Date: 2014-09-16 DOI: 10.1155/2014/490386
Mohamed Mazloum Osman, Walid Abd El Maksoud

Background/objectives: Postoperative pancreatic fistula (POPF) remains the main problem after pancreaticoduodenectomy and determines to a large extent the final outcome. We describe a new modification of pancreaticogastrostomy which combines duct to mucosa anastomosis with suturing the pancreatic capsule to posterior gastric wall and then invaginating the pancreatic remnant into the posterior gastric wall. This study was designed to assess the results of this new modification of pancreaticogastrostomy.

Methods: The newly modified pancreaticogastrostomy was applied to 37 consecutive patients after pancreaticoduodenectomy for periampullary cancer (64.86%) or cancer head of the pancreas (35.14%). Eighteen patients (48.65%) had a soft pancreatic remnant, 13 patients (35.14%) had firm pancreatic remnant, and 6 patients (16.22%) had intermediate texture of pancreatic remnant. Rate of mortality, early postoperative complications, and hospital stay were also reported.

Results: Operative mortality was zero and morbidity was 29.73%. Only three patients (8.11%) developed pancreatic leaks; they were treated conservatively. Eight patients (16.1%) had delayed gastric emptying, one patient (2.70%) had minor hemorrhage, one patient (2.70%) had biliary leak, and four patients (10.81%) had superficial wound infection.

Conclusions: The new modified pancreatogastrostomy seems safe and reliable with low rate of POPF. However, further prospective controlled trials are essential to support these results.

背景/目的:术后胰瘘(POPF)仍然是胰十二指肠切除术后的主要问题,并在很大程度上决定了最终的预后。我们描述了一种新的胰胃吻合术,将胰囊缝合于胃后壁,然后将胰残体内陷于胃后壁。本研究旨在评估这种新改良胰胃造口术的结果。方法:对37例连续行胰十二指肠切除术的壶腹周围癌(64.86%)或胰头癌(35.14%)患者应用新改良胰胃造口术。软质胰腺残余18例(48.65%),硬质胰腺残余13例(35.14%),中等质地胰腺残余6例(16.22%)。报告了死亡率、术后早期并发症和住院时间。结果:手术死亡率为零,发病率为29.73%。仅有3例(8.11%)发生胰腺渗漏;他们接受了保守治疗。胃排空延迟8例(16.1%),轻度出血1例(2.70%),胆漏1例(2.70%),创面浅表感染4例(10.81%)。结论:新型改良胰胃吻合术安全可靠,POPF发生率低。然而,进一步的前瞻性对照试验是支持这些结果的必要条件。
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引用次数: 0
Strategies to evaluate synchronous carcinomas of the colon and rectum in patients that present for emergent surgery. 在急诊手术中评估结肠和直肠同步癌患者的策略。
IF 1.5 Q4 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-02-06 DOI: 10.1155/2013/309439
Jennifer L Agnew, Benjamin Abbadessa, I Michael Leitman

It is not always possible to evaluate patients that present acutely with carcinoma of the colon and rectum for synchronous lesions. Patients that require emergent surgery necessitate urgent and efficient operation. Patients with lower gastrointestinal bleeding, perforation, or obstruction represent a challenging subset of patients with colorectal cancer. An organized approach to these patients in the effort not to overlook a synchronous carcinoma is important. The present paper provides an evidenced-based approach to this special situation.

它并不总是可能评估患者的急性结肠癌和直肠癌的同步病变。需要紧急手术的病人需要紧急有效的手术。下消化道出血、穿孔或梗阻患者是结直肠癌患者中一个具有挑战性的子集。对这些患者采取有组织的方法,努力不忽视同步癌是重要的。本文提供了一种基于证据的方法来解决这一特殊情况。
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引用次数: 6
Tumor regression grades: can they influence rectal cancer therapy decision tree? 肿瘤消退等级:能否影响直肠癌治疗决策树?
IF 1.5 Q4 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-09-25 DOI: 10.1155/2013/572149
Marisa D Santos, Cristina Silva, Anabela Rocha, Eduarda Matos, Carlos Nogueira, Carlos Lopes

Background: Evaluating impact of tumor regression grade in prognosis of patients with locally advanced rectal cancer (LARC).

Materials and methods: We identified from our colorectal cancer database 168 patients with LARC who received neoadjuvant therapy followed by complete mesorectum excision surgery between 2003 and 2011: 157 received 5-FU-based chemoradiation (CRT) and 11 short course RT. We excluded 29 patients, the remaining 139 were reassessed for disease recurrence and survival; the slides of surgical specimens were reviewed and classified according to Mandard tumor regression grades (TRG). We compared patients with good response (Mandard TRG1 or TRG2) versus patients with bad response (Mandard TRG3, TRG4, or TRG5). Outcomes evaluated were 5-year overall survival (OS), disease-free survival (DFS), local, distant and mixed recurrence.

Results: Mean age was 64.2 years, and median followup was 56 months. No statistically significant survival difference was found when comparing patients with Mandard TRG1 versus Mandard TRG2 (p = .77). Mandard good responders (TRG1 + 2) have significantly better OS and DFS than Mandard bad responders (TRG3 + 4 + 5) (OS p = .013; DFS p = .007).

Conclusions: Mandard good responders had a favorable prognosis. Tumor response (TRG) to neoadjuvant chemoradiation should be taken into account when defining the optimal adjuvant chemotherapy regimen for patients with LARC.

背景:评价肿瘤消退等级对局部晚期直肠癌(LARC)患者预后的影响。材料和方法:我们从我们的结直肠癌数据库中确定了168例LARC患者,他们在2003年至2011年期间接受了新辅助治疗并进行了完整的肠系膜切除手术:157例接受了基于5- fu的放化疗(CRT)和11例短期放疗。我们排除了29例患者,其余139例重新评估疾病复发和生存;根据标准肿瘤消退分级(TRG)对手术标本的载玻片进行回顾和分类。我们比较了反应良好的患者(标准TRG1或TRG2)和反应不良的患者(标准TRG3、TRG4或TRG5)。评估的结果包括5年总生存期(OS)、无病生存期(DFS)、局部、远处和混合性复发。结果:平均年龄64.2岁,中位随访56个月。与标准TRG1组相比,标准TRG2组患者的生存期无统计学差异(p = 0.77)。标准良好应答者(TRG1 + 2)的OS和DFS明显优于标准不良应答者(TRG3 + 4 + 5) (OS p = 0.013;DFS p = .007)。结论:良好应答者预后良好。在确定LARC患者的最佳辅助化疗方案时,应考虑肿瘤对新辅助放化疗的反应(TRG)。
{"title":"Tumor regression grades: can they influence rectal cancer therapy decision tree?","authors":"Marisa D Santos,&nbsp;Cristina Silva,&nbsp;Anabela Rocha,&nbsp;Eduarda Matos,&nbsp;Carlos Nogueira,&nbsp;Carlos Lopes","doi":"10.1155/2013/572149","DOIUrl":"https://doi.org/10.1155/2013/572149","url":null,"abstract":"<p><strong>Background: </strong>Evaluating impact of tumor regression grade in prognosis of patients with locally advanced rectal cancer (LARC).</p><p><strong>Materials and methods: </strong>We identified from our colorectal cancer database 168 patients with LARC who received neoadjuvant therapy followed by complete mesorectum excision surgery between 2003 and 2011: 157 received 5-FU-based chemoradiation (CRT) and 11 short course RT. We excluded 29 patients, the remaining 139 were reassessed for disease recurrence and survival; the slides of surgical specimens were reviewed and classified according to Mandard tumor regression grades (TRG). We compared patients with good response (Mandard TRG1 or TRG2) versus patients with bad response (Mandard TRG3, TRG4, or TRG5). Outcomes evaluated were 5-year overall survival (OS), disease-free survival (DFS), local, distant and mixed recurrence.</p><p><strong>Results: </strong>Mean age was 64.2 years, and median followup was 56 months. No statistically significant survival difference was found when comparing patients with Mandard TRG1 versus Mandard TRG2 (p = .77). Mandard good responders (TRG1 + 2) have significantly better OS and DFS than Mandard bad responders (TRG3 + 4 + 5) (OS p = .013; DFS p = .007).</p><p><strong>Conclusions: </strong>Mandard good responders had a favorable prognosis. Tumor response (TRG) to neoadjuvant chemoradiation should be taken into account when defining the optimal adjuvant chemotherapy regimen for patients with LARC.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"572149"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/572149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31830431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
Comparison of Clinicopathological Characteristics in the Patients with Cardiac Cancer with or without Esophagogastric Junctional Invasion: A Single-Center Retrospective Cohort Study. 贲门癌伴或不伴食管胃交界浸润患者的临床病理特征比较:一项单中心回顾性队列研究
IF 1.5 Q4 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-01-10 DOI: 10.1155/2013/189459
Hiroaki Ito, Haruhiro Inoue, Noriko Odaka, Hitoshi Satodate, Michitaka Suzuki, Shumpei Mukai, Yusuke Takehara, Tomokatsu Omoto, Shin-Ei Kudo

Background. This study addresses clinicopathological differences between patients with gastric cardia and subcardial cancer with and without esophagogastric junctional invasion. Methods. We performed a single-center, retrospective cohort study. We studied patients who underwent curative surgery for gastric cardia and subcardial cancers. Tumors centered in the proximal 5 cm of the stomach were classed into two types, according to whether they did (Ge) or did not (G) invade the esophagogastric junction. Results. A total of 80 patients were studied; 19 (73.1%) of 26 Ge tumors and 16 (29.6%) of 54 G tumors had lymph nodes metastases. Incidence of nodal metastasis in pT1 tumors was significantly higher in the Ge tumor group. No nodal metastasis in cervical lymph nodes was recognized. Only two patients with Ge tumors had mediastinal lymph node metastases. Incidence of perigastric lymph node metastasis was significantly higher in those with Ge tumors. Ge tumors tended to be staged as progressive disease using the esophageal cancer staging manual rather than the gastric cancer staging manual. Conclusion. Because there are some differences in clinicopathological characteristics, it is thought to be adequate to distinguish type Ge from type G tumor.

背景。本研究探讨贲门癌和贲门下癌患者有无食管胃交界浸润的临床病理差异。方法。我们进行了一项单中心、回顾性队列研究。我们研究了接受胃贲门癌和心下癌手术治疗的患者。以胃近端5cm为中心的肿瘤根据有无侵犯食管胃交界(G)分为两类。结果。共研究了80例患者;26例Ge肿瘤中有19例(73.1%)发生淋巴结转移,54例G肿瘤中有16例(29.6%)发生淋巴结转移。Ge肿瘤组pT1肿瘤淋巴结转移发生率明显增高。未发现颈淋巴结转移。只有2例Ge肿瘤发生纵隔淋巴结转移。胃癌组胃周淋巴结转移发生率明显增高。使用食管癌分期手册而非胃癌分期手册,胃癌肿瘤倾向于分期为进展性疾病。结论。由于两者在临床病理特征上存在一定差异,因此认为区分Ge型和G型肿瘤是足够的。
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引用次数: 3
Surgical margins in breast conservation. 乳房保护的手术边缘。
IF 1.5 Q4 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-01-21 DOI: 10.1155/2013/136387
Sheldon Marc Feldman
Significant progress has been made in the diagnosis and treatment of breast cancer during the past 30 years. The increased availability of screening mammography has resulted in a higher percentage of woman being diagnosed with early stage disease allowing the option of breast conservation therapy to be more widely available. Long-term follow-up studies clearly demonstrate equivalent survival with breast conservation surgery (lumpectomy) and radiotherapy versus total mastectomy [1–3]. The importance of obtaining clear lumpectomy surgical margins has been well established in minimizing the risk of local recurrence [4]. Unfortunately there is a lack of uniform guidelines in terms of what constitutes an adequately clear lumpectomy margin. Substantial debate about bigger margins being better continues [5]. This has led to wide variations in lumpectomy margin reexcision rates from 15 to 47% [6]. These additional surgical procedures cause significant patient distress, utilize health care resources, and can adversely affect cosmesis. From the patient perspective, they may wonder why we did not get it right the first time. They want their cancer gone while maintaining a normal appearance. This special issue highlights the areas of controversy and demonstrates current best practices and emerging novel approaches towards optimal breast conservation approach. The goal is to improve our ability to provide breast-conserving approaches for breast cancer while avoiding multiple surgical procedures, minimizing recurrence risk while obtaining excellent cosmesis. We have chosen 6 of 16 submissions to be published in this special issue. Each paper was evaluated by at least two expert reviewers and revised according to review comments. P. Ananthakrishnan et al. provide an excellent comprehensive review article on all aspects involved in optimizing breast conservation. They include discussion of preoperative breast imaging, lesion localization, impact of tumor biology and systemic therapy, intraoperative lesion identification and margin assessment techniques, the role of margin ablation and oncoplastic techniques. They also discuss the promise of ductal anatomy mapping toward the goal of validating the “Sick lobe hypothesis” [7, 8] which may allow for more accurate identification of breast tissue to be targeted for excision. R. Emmadi and E. L. Wiley provide an excellent review from the pathology perspective of the different approaches to margin assessment. They explore issues of specimen processing, fixation, cutting techniques, and reporting. They well explain the reasons for the reporting variations between institutions and the need for standardization. J. L. Baker et al. present a scholarly review of our current understanding of the issue of atypical ductal hyperplasia (ADH) as it relates to surgical margins. They highlight the large interobserver variability among pathologists in differentiating ADH from low-grade ductal carcinoma in situ (DCIS). The
{"title":"Surgical margins in breast conservation.","authors":"Sheldon Marc Feldman","doi":"10.1155/2013/136387","DOIUrl":"https://doi.org/10.1155/2013/136387","url":null,"abstract":"Significant progress has been made in the diagnosis and treatment of breast cancer during the past 30 years. The increased availability of screening mammography has resulted in a higher percentage of woman being diagnosed with early stage disease allowing the option of breast conservation therapy to be more widely available. Long-term follow-up studies clearly demonstrate equivalent survival with breast conservation surgery (lumpectomy) and radiotherapy versus total mastectomy [1–3]. The importance of obtaining clear lumpectomy surgical margins has been well established in minimizing the risk of local recurrence [4]. Unfortunately there is a lack of uniform guidelines in terms of what constitutes an adequately clear lumpectomy margin. Substantial debate about bigger margins being better continues [5]. This has led to wide variations in lumpectomy margin reexcision rates from 15 to 47% [6]. These additional surgical procedures cause significant patient distress, utilize health care resources, and can adversely affect cosmesis. From the patient perspective, they may wonder why we did not get it right the first time. They want their cancer gone while maintaining a normal appearance. \u0000 \u0000This special issue highlights the areas of controversy and demonstrates current best practices and emerging novel approaches towards optimal breast conservation approach. The goal is to improve our ability to provide breast-conserving approaches for breast cancer while avoiding multiple surgical procedures, minimizing recurrence risk while obtaining excellent cosmesis. We have chosen 6 of 16 submissions to be published in this special issue. Each paper was evaluated by at least two expert reviewers and revised according to review comments. \u0000 \u0000P. Ananthakrishnan et al. provide an excellent comprehensive review article on all aspects involved in optimizing breast conservation. They include discussion of preoperative breast imaging, lesion localization, impact of tumor biology and systemic therapy, intraoperative lesion identification and margin assessment techniques, the role of margin ablation and oncoplastic techniques. They also discuss the promise of ductal anatomy mapping toward the goal of validating the “Sick lobe hypothesis” [7, 8] which may allow for more accurate identification of breast tissue to be targeted for excision. \u0000 \u0000R. Emmadi and E. L. Wiley provide an excellent review from the pathology perspective of the different approaches to margin assessment. They explore issues of specimen processing, fixation, cutting techniques, and reporting. They well explain the reasons for the reporting variations between institutions and the need for standardization. \u0000 \u0000J. L. Baker et al. present a scholarly review of our current understanding of the issue of atypical ductal hyperplasia (ADH) as it relates to surgical margins. They highlight the large interobserver variability among pathologists in differentiating ADH from low-grade ductal carcinoma in situ (DCIS). The ","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2013 ","pages":"136387"},"PeriodicalIF":1.5,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/136387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31231457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Are the American Society for Radiation Oncology guidelines accurate predictors of recurrence in early stage breast cancer patients treated with balloon-based brachytherapy? 美国放射肿瘤学会指南是否能准确预测接受球囊近距离放疗的早期乳腺癌患者的复发?
IF 1.5 Q4 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-12-08 DOI: 10.1155/2013/829050
Moira K Christoudias, Abigail E Collett, Tari S Stull, Edward J Gracely, Thomas G Frazier, Andrea V Barrio

The American Society for Radiation Oncology (ASTRO) consensus statement (CS) provides guidelines for patient selection for accelerated partial breast irradiation (APBI) following breast conserving surgery. The purpose of this study was to evaluate recurrence rates based on ASTRO CS groupings. A single institution review of 238 early stage breast cancer patients treated with balloon-based APBI via balloon based brachytherapy demonstrated a 4-year actuarial ipsilateral breast tumor recurrence (IBTR) rate of 5.1%. There were no significant differences in the 4-year actuarial IBTR rates between the "suitable," "cautionary," and "unsuitable" ASTRO categories (0%, 7.2%, and 4.3%, resp., P = 0.28). ER negative tumors had higher rates of IBTR than ER positive tumors. The ASTRO groupings are poor predictors of patient outcomes. Further studies evaluating individual clinicopathologic features are needed to determine the safety of APBI in higher risk patients.

美国放射肿瘤学学会(ASTRO)共识声明(CS)为保乳手术后患者选择加速部分乳房照射(APBI)提供了指南。本研究的目的是评估基于ASTRO CS分组的复发率。一项针对238例接受球囊APBI近距离放射治疗的早期乳腺癌患者的研究表明,4年精算同侧乳腺癌复发率(IBTR)为5.1%。“适宜”、“警示”和“不适宜”ASTRO类别的4年精算IBTR率无显著差异(分别为0%、7.2%和4.3%)。, p = 0.28)。ER阴性肿瘤的IBTR率高于ER阳性肿瘤。ASTRO分组不能很好地预测患者的预后。需要进一步的研究来评估个体临床病理特征,以确定APBI在高危患者中的安全性。
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引用次数: 17
Quality of life study following cytoreductive surgery and intraperitoneal chemotherapy for pseudomyxoma peritonei including redo procedures. 包括重做手术在内的腹膜假性黏液瘤细胞减少手术和腹腔化疗后的生活质量研究。
IF 1.5 Q4 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-07-28 DOI: 10.1155/2013/461041
Rachel Kirby, Winston Liauw, Jing Zhao, David Morris

Background: Our aim was to evaluate the quality of life following cytoreductive surgery and intraperitoneal chemotherapy for pseudomyxoma peritonei. We also conducted an analysis of all patients who underwent CRS and HIPEC for pseudomyxoma peritonei from 1997 to 2012.

Methods: We contacted 87 patients using the FACT C (version 4) quality of life questionnaire, and FACIT-TS-G (version 1) was also used.

Results: A total of 63 patients (response rate 72%) were available for quality of life interview and analysis. The median time from surgery to questionnaire evaluation was 31 months (range 6-161 months). 62% were females with an average age of 54 years. 22% of the patients had over one cytoreductive surgical procedure. We analysed our patients postoperatively based on physical, functional, social, and emotional well being who reported favourable outcomes in all sections. Patients who had a single procedure had a significantly higher score (P = 0.016) in the additional concerns section of the questionnaire. The patients who had a single procedure had better gastrointestinal digestion in terms of bowel control, appetite, and food digestion and also body appearance scoring.

Conclusions: 79% of the patients stated that they would undergo further cytoreductive surgery and that redo procedures do not result in a significantly worse quality of life.

背景:我们的目的是评估腹膜假性黏液瘤的细胞减少手术和腹腔化疗后的生活质量。我们还对1997年至2012年所有接受CRS和HIPEC治疗腹膜假性粘液瘤的患者进行了分析。方法:采用FACT - C(第4版)生活质量问卷和FACT - ts - g(第1版)问卷联系87例患者。结果:共纳入63例患者(有效率72%)进行生活质量访谈和分析。从手术到问卷评估的中位时间为31个月(范围6-161个月)。62%为女性,平均年龄54岁。22%的患者接受了一次以上的细胞减少手术。我们分析了术后患者的身体、功能、社交和情绪状况,并报告了所有部分的良好结果。接受单一手术的患者在问卷的附加关注部分得分显著较高(P = 0.016)。接受单一手术的患者在肠道控制,食欲,食物消化和身体外观评分方面有更好的胃肠道消化。结论:79%的患者表示他们将接受进一步的细胞减少手术,并且重做手术不会导致明显的生活质量下降。
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引用次数: 16
期刊
International Journal of Surgical Oncology
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