Abstract:
BACKGROUND:Local recurrence occurs in 10% to 20% of patients with extremity soft tissue sarcomas despite optimal treatment. The association of local recurrence with subsequent survival is controversial and conflicting. There is a need for a staging system to predict outcome in this subset of patients and also to plan optimal treatment, including adjuvant systemic therapy. METHODS:Data collected from 110 patients with locally recurrent extremity soft tissue sarcomas were studied. The influence of clinical and pathologic factors on local recurrence, distant metastasis, and disease-specific survival were analyzed by univariate and multivariate techniques. RESULTS:Of the 110 patients who presented with local recurrence, 92 had an isolated local recurrence and 18 had prior or concomitant distant metastases. The 5-year disease-specific survival for all patients was 63% and for those with isolated local recurrence, it was 69%. Histologic grade, malignant fibrous histiocytoma histology, pathologic margins, previous local recurrence, and prior radiotherapy were independent prognostic factors for subsequent local recurrence. Tumor size, histologic grade, and time to local recurrence were independent prognostic factors for distant metastasis and disease-specific survival. A prognostic index was calculated by assigning a score of 1 to 3 for each of the three independent prognostic factors for survival and added to give the prognostic index for each patient. As the prognostic index increased from 3 to 9, there was a progressive increase in the hazard ratios and a corresponding deterioration in survival. The patients were then categorized into three prognostic groups based on the hazard ratios for disease specific survival. The differences in the survival curves were highly statistically significant (P < .0001). CONCLUSIONS:Tumor size, histologic grade, and time to local recurrence are the primary determinants of distant metastases and survival in locally recurrent extremity soft tissue sarcomas. The impact of local recurrence on survival varies considerably. The nature of the local recurrence, rather than its presence per se, is a more useful guide to prognosis. We propose a simple staging system based on size, grade, and time to recurrence that correlates extremely well with prognosis and may serve as a guide to make therapeutic decisions in patients with locally recurrent extremity soft tissue sarcomas.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Ramanathan RC,A'Hern R,Fisher C,Thomas JMdoi
10.1007/s10434-001-0278-zkeywords:
subject
Has Abstractpub_date
2001-05-01 00:00:00pages
278-89issue
4eissn
1068-9265issn
1534-4681journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Emerging evidence suggests that G9a, a histone methyltransferase, is involved in tumor progression and metastasis. However, the functional significance of G9a in endometrial carcinogenesis has not been defined. METHODS:The differential expression of G9a in cancer and normal tissues was assessed using an arr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4379-5
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Chemotherapy is increasingly used before hepatic resection, with controversial impact regarding liver function. This study aimed to assess the capacity of 99mTc-labelled-mebrofenin SPECT-hepatobiliary scintigraphy (HBS) to predict liver dysfunction due to chemotherapy and/or chemotherapeutic-associated liver...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08988-4
更新日期:2020-08-24 00:00:00
abstract:BACKGROUND:Cancer treatment costs are not routinely addressed in shared decisions for breast cancer surgery. Thus, we sought to characterize cost awareness and communication among surgeons treating breast cancer. METHODS:We conducted a self-administered, confidential electronic survey among members of the American Soc...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07594-3
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Laparoscopic pancreaticoduodenectomy with venous reconstruction is not commonly performed due to its technical challenges. In this video, we focus on the technical aspects for how to perform this procedure safely. METHODS:In a 69-year-old female with jaundice and diarrhea, a computed tomography scan showed ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6762-5
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:The aim of this study is to evaluate the safety and efficacy of induction modified 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus bevacizumab followed by S- 1-based chemoradiotherapy in magnetic resonance imaging (MRI)-defined poor-risk locally advanced low rectal cancer. PATIENTS AND METHODS:This...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07342-7
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Laparoscopic liver resection for perihilar cholangiocarcinoma (pCCA) is still in its infancy. The biliary-enteric reconstruction represents one of the most delicate parts of this minimally invasive procedure. METHODS:In this study, a 78-year old woman with perihilar cholangiocarcinoma (pCCA) type 3b underwe...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09175-1
更新日期:2020-09-30 00:00:00
abstract:BACKGROUND:Examination of pathology slides is a routine part of a breast cancer second opinion. The purpose of this study was to determine how often the pathologic second opinion (1) altered the diagnosis and (2) resulted in a change in the surgical procedure. METHODS:Patients presenting between 1997 and 2001 for a se...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02574516
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Hyperbilirubinemia is commonly observed in patients requiring pancreatoduodenectomy (PD). Thus far, literature regarding the danger of operating in the setting of hyperbilirubinemia is equivocal. What remains undefined is at what specific level of bilirubin there is an adverse safety profile for undergoing P...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08044-w
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:After introduction of the clamp-crushing technique in the 1970s, various devices have been developed for transection of the liver with the aim of further reducing blood loss and improving the outcome of patients who undergo hepatic resection. We performed a meta-analysis to quantitatively compare the clamp-c...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/s10434-008-0266-7
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Preoperative differentiation between high-grade malignancy and others (benign or low-grade tumors) is more important than differentiation between malignant and benign tumors for surgical planning, treatment outcome, and prognosis in salivary gland tumors. Fine needle aspiration cytology (FNAC) has a relative...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-2903-z
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Locally advanced esophageal cancer is often treated with a trimodality approach. While a substantial proportion of such patients initially achieve a clinical complete response (cCR) after chemoradiation, only a small proportion achieve durable control. We analyzed patients who reached cCR after definitive ch...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3303-0
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:We previously reported that the one-step nucleic acid amplification (OSNA) assay provided a judgment performance for colorectal cancer equivalent to a 2-mm-interval histopathological examination of lymph nodes (concordance 97.1 %, n = 385 lymph nodes). In this prospective multicenter study, we uncovered an O...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-015-4880-x
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The patients with early gastric cancer who have undergone incomplete endoscopic resection (ER) generally need additional surgery because of the possibility of lymph node metastasis. The aim of study was to evaluate the optimal time interval from ER to additive surgery by evaluating the effect of time interva...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3299-5
更新日期:2014-01-01 00:00:00
abstract::A 54-year-old woman with multiple telangiectatic hepatocellular adenoma without degeneration (>5 cm) underwent laparoscopic right hepatectomy with the hanging maneuver. The patient was installed in the supine position with the legs spread apart. Five trocars were used for the intervention. The liver hanging maneuver w...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3809-0
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Postoperative chemoradiation and perioperative chemotherapy using epirubicin/cisplatin/5-fluorouracil (ECF) represent two standards of care for resectable gastric cancer. In the TOPGEAR (Trial Of Preoperative therapy for Gastric and Esophagogastric junction AdenocaRcinoma) trial, we hypothesized that adding ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1245/s10434-017-5830-6
更新日期:2017-08-01 00:00:00
abstract::Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TILs) is an emerging immunotherapy for metastatic cancer. Surgeons play a central role in ACT treatments by performing resection of tumors from which TILs are isolated. It is important that surgeons have familiarity with this emerging treatment method bec...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6266-8
更新日期:2018-02-01 00:00:00
abstract:INTRODUCTION:Survival in elderly patients undergoing mastectomy or lumpectomy has not been specifically analyzed. METHODS:Patients older than 70 years of age with clinical stage I invasive breast cancer, undergoing mastectomy or lumpectomy with or without radiation, and surveyed within 3 years of their diagnosis, were...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5582-8
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Abnormal phosphatase and tensin analog (PTEN) gene expression has been noted in neoplasms. The PTEN protein cleaves phosphate groups from cellular growth kinases, inhibiting tumor propagation. A downstream target of PTEN is AKT, a serine-threonine kinase that when activated inhibits apoptosis. We sought to d...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02573071
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Long interspersed nuclear element-1 (LINE-1) methylation status, representing global DNA methylation levels, is associated with patient prognosis in several types of cancer. This study was designed to examine the prognostic significance of LINE-1 methylation in patients with hepatocellular carcinoma (HCC) an...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3874-4
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Surgical resection is the most important therapeutic intervention for eligible patients with pancreatic cancer; however, a majority of patients never receive surgery for a variety of reasons, including patient refusal. Utilizing the National Cancer Database, we investigated the associated sociodemographic an...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6708-y
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The current standard for obtaining accurate sentinel lymph node (SLN) mapping is intraparenchymal lymphophilic dye/radiocolloid injection close to the breast tumor. We hypothesized that common lymphatic trunks drain both a large volume of breast parenchyma and skin and that intradermal or intraparenchymal ro...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0837-3
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Chyle fistula is a relatively rare complication of neck dissection, and there is a lack of consensus regarding its incidence, risk factors, and management. METHODS:Between 2007 and 2014, a total of 472 cases of neck dissection involving the level IV compartment were included in the study. The incidence, ris...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-015-4822-7
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Anatomical resection (AR) is a recommended surgical treatment for hepatocellular carcinoma (HCC), although the conventional procedure (dye injection) for AR is difficult to reproduce.1,2 The tumor-feeding portal pedicle compression technique has been proposed as an easy, reversible, repeatable, and oncologic...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08644-x
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Intraoperative ultrasound (IOUS)-guided lumpectomy in early breast cancer has shown advantages over other techniques. However, the use of IOUS has been less explored after neoadjuvant treatment (NAT). This study aimed to compare IOUS- and wire localization (WL)-guided surgery in breast cancer patients after ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4935-z
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Sarcopenia is recognized as an important prognostic factor in various types of cancer, including gastric cancer. While long-term survival analyses typically focus on overall and disease-specific survival, death from other causes has received far less attention. METHODS:We reviewed medical records of 491 gas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6354-4
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:This work is aimed at comparing mucinous colorectal adenocarcinomas (MUC) and non-mucinous colorectal adenocarcinomas (non-MUC), and at verifying the existence of two different subgroups of MUC, in terms of clinicopathological features, chromosomal alterations, and outcome, in a geographical area where mucin...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9757-1
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The status of the axillary lymph nodes in nonmetastatic lymph node-positive breast cancer (BC) patients remains the single most important determinant of overall survival (OS). Although the absolute number of nodes involved with cancer is important for prognosis, the role of the total number of excised nodes ...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-009-0653-8
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:There is no consensus as to the impact of lymph node micrometastasis on survival of patients with gastric cancer. The aim of this study was to clarify the prognostic significance of lymph node micrometastasis in patients with histologically node-negative gastric cancer. METHODS:Lymph nodes (n = 2039) from 6...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02574499
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Modified Appleby procedure could be indicated in stage III locally advanced body pancreatic ductal adenocarcinoma (PDAC) involving the celiac axis after neoadjuvant treatment. PATIENTS AND METHODS:We report the case of a 38-year-old woman presenting a tumor arising from the body of the pancreas, involving t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09212-z
更新日期:2020-10-21 00:00:00
abstract:BACKGROUND:COX inhibitors and beta-blockers were recently suggested to reduce cancer progression through inhibition of tumor proliferation and growth factor secretion, induction of tumor apoptosis, and prevention of cellular immune suppression during the critical perioperative period. Here we evaluated the perioperativ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9890-5
更新日期:2008-07-01 00:00:00