Abstract:
BACKGROUND:Limb salvage after primary site failure of extremity soft tissue sarcoma is a challenging problem. Amputation may be the most effective treatment option in selected patients with local recurrence. We compared the outcome of patients treated with amputation versus limb-sparing surgery (LSS) for locally recurrent extremity sarcoma. METHODS:From 1982 to 2000, 1178 patients with localized primary extremity sarcoma underwent LSS. Of these, 204 (17%) developed local recurrence. Eighteen (9%) required major amputation and the remainder underwent LSS, of which 34 were selected for matched-pair analysis according to established prognostic variables. Rates of recurrence or death were estimated by the Kaplan-Meier method. Following adjustment for prognostic variables, a Mantel-Haenszel test was used to compare the outcome between the two treatment groups. RESULTS:Patients in each group were well matched. All patients had high-grade tumors deep to the fascia. Median time to local recurrence was similar for both groups. Median follow-up was 95 months. Amputation was associated with a significant improvement in local control of disease (94% vs. 74%; P = .04). We observed no difference in disease-free (P = .48), disease-specific (P = .74), or overall survival (P = .93) between the two groups. Median postrecurrence survival was 20 months and 5-year OS was 36% for the entire study group. CONCLUSIONS:Limb-sparing treatment achieves local control in the majority of recurrent extremity sarcomas for which amputation is infrequently indicated. Amputation improves local disease control but not survival under these circumstances.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Stojadinovic A,Jaques DP,Leung DH,Healey JH,Brennan MFdoi
10.1007/s10434-001-0509-3keywords:
subject
Has Abstractpub_date
2001-07-01 00:00:00pages
509-18issue
6eissn
1068-9265issn
1534-4681journal_volume
8pub_type
杂志文章abstract:BACKGROUND:The interval between preoperative chemoradiotherapy and surgery reportedly affects perioperative outcomes and survival; however, the optimal interval in esophageal cancer patients remains uncertain. OBJECTIVE:Our aim was to determine whether a prolonged interval between preoperative neoadjuvant chemoradioth...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09206-x
更新日期:2020-10-13 00:00:00
abstract:PURPOSE:To ensure a surgical margin of ≥1 cm for the effective treatment of phyllodes tumors of the breast (PTB) a second resection has been recommended, but the outcomes of an extensive series of cases employing the aforementioned criterion cast doubt on this clinical approach. The aim of this study was to identify th...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4395-5
更新日期:2015-09-01 00:00:00
abstract:INTRODUCTION:Lymphadenectomy and thyroidectomy is standard treatment for medullary thyroid carcinoma (MTC), but the prognostic importance of the number of lymph nodes removed (lymph node yield, LNY) and the proportion of metastatic lymph nodes resected (metastatic lymph node ratio, MLNR) is unknown. We hypothesized tha...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0022-z
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Metastatic breast cancer is an aggressive disease associated with recurrence and decreased survival. To improve outcomes and develop more effective treatment strategies for patients with breast cancer, it is important to understand the molecular mechanisms underlying metastasis. METHODS:We used allelic imba...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9815-3
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel approach to delivering intraperitoneal chemotherapy (IPC) as a pressurized aerosol. One of the assumed advantages is the homogeneous drug distribution in the intraperitoneal cavity compared with conventional liquid in situ chemotherapy. Howe...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4954-9
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:To identify melanoma patients at sufficiently low risk of nodal metastases who could avoid sentinel lymph node biopsy (SLNB), several statistical models have been proposed based upon patient/tumor characteristics, including logistic regression, classification trees, random forests, and support vector machi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1979-6
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Spleen-preserving laparoscopic distal pancreatectomy would be an ideal approach for benign and borderline malignant tumors in the distal pancreas.1 However, this procedure requires advanced surgical experience and technique because of the disadvantages of conventional laparoscopic surgery.2 METHODS:A 35-yea...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1816-y
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The ToGA trial demonstrated the significant efficacy of trastuzumab in addition to chemotherapy in patients with HER2-positive gastric cancer (GC). Although trastuzumab has become a key drug in breast cancer treatment, resistance to trastuzumab is a major problem in clinical practice. The aim of the current ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3325-7
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Papillary lesions of the breast are a relatively rare, but heterogeneous group ranging from benign to atypical and malignant. Debate exists regarding the optimal management of these lesions. In the absence of more accurate risk-stratification models, traditional management guidelines recommend surgical excis...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-015-4773-z
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Aromatic amines, well-known bladder carcinogens, derived from cigarette smoke are activated by acidic urine. We herein determined whether urinary pH levels are associated with bladder recurrence in upper tract urothelial carcinoma patients with a positive smoking history. METHODS:A total of 256 upper tract uro...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5555-y
更新日期:2016-12-01 00:00:00
abstract::Lymph node status is the most reliable prognostic indicator for patients with melanoma and breast cancer. Because it is the first node draining the primary cancer, the sentinel lymph node (SLN) is most likely to harbor metastatic cancer cells. The Breslow thickness of the primary melanoma and the size of primary breas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02523627
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Persistent or recurrent primary hyperparathyroidism (1 degrees HPTH) is ideally treated with limited dissection, based on accurate localization, to minimize operative risks. To accurately localize parathyroid tissue, we employed ultrasound-guided fine needle aspiration (US FNA) with an on-site rapid parathyr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9180-z
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Isolated limb infusion (ILI) is a recently described minimally invasive technique developed in Australia for delivering regional chemotherapy. This study examined the efficacy and toxicity of ILI, compared to hyperthermic isolated limb perfusion (HILP), in treating extremity in-transit melanoma. METHODS:Var...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-008-9988-9
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Intraperitoneal chemotherapy has an established role in the treatment of selected patients with colorectal peritoneal metastases. Oxaliplatin is highly suitable as a chemotherapeutic agent for hyperthermic intraperitoneal chemotherapy (HIPEC), but its use to date has been limited because of the morbidity cau...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5665-6
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:This study evaluates the accuracy of computed tomography (CT) scoring of the peritoneal cancer index (PCI) and examines its association with surgical morbidity and outcomes in pseudomyxoma peritonei. METHODS:Forty-seven patients with pseudomyxoma peritonei had preoperative evaluation of CT scans and were tr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1492-3
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Survival for positive sentinel lymph node (SLN) patients does not differ between completion lymph node dissection (CLND) and nodal observation (OBS). However, treating these patients with CLND and checkpoint inhibitors, such as pembrolizumab (PEM), improves outcomes. This study evaluated the cost-effectivene...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09137-7
更新日期:2020-09-19 00:00:00
abstract:BACKGROUND:FOXC2 has been implicated in cancer progression through its induction of epithelial-to-mesenchymal transition. We analyzed the clinical significance of FOXC2 in esophageal cancer cases, in which early distant metastasis or invasion to nearby organs is an obstacle to treatment. METHODS:Quantitative reverse t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1274-y
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Previous studies showed conflicting and inconsistent results regarding the effect of anatomic location of the melanoma on sentinel lymph node (SLN) positivity and/or survival. This study was conducted to evaluate and compare the effect of the anatomic locations of primary melanoma on long-term clinical outco...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-2977-7
更新日期:2013-09-01 00:00:00
abstract::Hiatal hernia (HH) is an infrequent yet potentially life-threatening complication after esophagectomy. Several studies have reported the incidence of this complication after both open and minimally invasive esophagectomy (MIE). This meta-analysis aimed to determine the pooled incidence of HH after both types of esopha...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1245/s10434-016-5155-x
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Results concerning the side effects of oxaliplatin associated with fluorouracil and leucovorin (FOLFOX) in older patients are controversial. The objective of this study was to assess the use and the toxicity of FOLFOX in patients aged 70 years and older as administered in current practice. METHODS:Among 305...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3438-z
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:The biopsy method of choice for soft tissue sarcomas (STS) of the limb and limb girdle is controversial. There have been no randomized controlled trials that compare incision biopsy with Tru-cut biopsy. We present a large series, which includes an analysis of the effectiveness of Tru-cut core biopsy both in ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0080-y
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:This study was designed to describe patient, disease, and treatment characteristics of women diagnosed with breast cancer at the Breast Examination Center of Harlem (BECH) and to determine whether these characteristics have changed over time. METHODS:Retrospective chart review of women diagnosed with breast...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4240-2
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the diagnostic and prognostic value of circulating endothelial cell (CEC), a potential surrogate of tumor angiogenesis, in malignant pleural mesothelioma (MPM). METHODS:We prospectively evaluated CEC count in 4.0 mL of peripheral blood sampled from patients with ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2506-0
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Distal pancreatectomy with celiac axis resection (DP-CAR) is a treatment option for selected patients with pancreatic cancer involving the celiac axis. A recent multicenter European study reported a 90-day mortality rate of 16%, highlighting the importance of patient selection. The authors constructed a risk...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-018-07101-0
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:AJCC staging of pancreatic cancer (PAC) is used to determine prognosis, yet survival within each stage shows wide variation and remains unpredictable. We hypothesized that tumor grade might be responsible for some of this variation and that the addition of grade to current AJCC staging would provide improved...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1071-7
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The keystone flap is being promoted as an advance in oncological surgical reconstruction. Wound closure with this island flap involves two V-Y advancements toward the center and along the long axis of the island, at right angles to the line of maximum tension when the wound is closed. It is implied that the ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2684-9
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Isolated hepatic perfusion has been used in patients with colorectal cancer (CRC) metastatic to the liver. We sought to determine whether perfusion with antisense oligodeoxynucleotides results in the downregulation of beta-catenin and whether this improves tumor response to isolated limb perfusion (ILP) in a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.10.005
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node biopsy (SLNB) has been shown to reduce many of the long-term complications associated with a traditional axillary lymph node dissection (ALND); however, short-term outcomes have yet to be characterized. This study was designed to identify trends and differences in 30-day outcomes of parti...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3248-3
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:For patients with rectal cancer, there is a greater risk of a positive radial margin or local tumor recurrence when an abdominoperineal versus low anterior resection is performed, or when tumors are in an anterior versus nonanterior location. In response, clinical leaders have encouraged perineal dissection ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2016-5
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The value of adjuvant therapy for esophageal squamous cell carcinoma (ESCC) has been controversial, at least partially due to the lack of efficient criteria for selecting suitable patients. This study aimed to explore the existence of parameters related to lymph node (LN) status that can predict the value of...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07489-3
更新日期:2019-08-01 00:00:00