Abstract:
BACKGROUND:Isolated limb perfusion (ILP) results in complete response (CR) rates of 60% to 90% in patients with regionally advanced melanoma. Survival after a CR may be influenced by various factors, particularly out-of-field disease in iliac lymph nodes (ILN) identified during lower-extremity ILP. We examined clinical and pathological parameters, including ILN status and outcome, for patients with in-transit melanoma who had a CR to ILP. METHODS:From May 1992 to July 1997, 50 patients (16 men and 34 women; median age, 57 years) with stage IIIA or IIIAB melanoma had a CR to a 90-minute hyperthermic iliac ILP with melphalan (10 mg/L limb volume, n = 20) or melphalan and tumor necrosis factor (4-6 mg+/-200 microg interferon; n = 30). Clinical and pathological parameters were analyzed by univariate and Cox proportional hazards models to determine which were associated with survival or in-field recurrence. RESULTS:The median in-field recurrence-free survival in the cohort of 50 patients after a CR to ILP was 1.4 years, and the actuarial 5-year in-field recurrence-free survival was 30%. By univariate analysis, there was a trend for improved outcome with female sex and stage IIIA (vs. IIIAB) at initial diagnosis was associated with improved survival after a CR to ILP (P = .056 and .012, respectively). Eleven (22%) of 50 patients had positive ILNs identified and resected at ILP. The probability of overall in-field recurrence was 70% after 4 years, and there was no difference between those with or without positive ILNs; median time to in-field recurrence was 13 and 19 months, respectively (P = .62). Similarly, overall survival was not influenced by positive ILN status (median [months]: +ILN, 69 vs. -ILN, 58; P = .68). Of note, Cox models identified that the risk of death was significantly greater in those with a history of prior systemic therapy (hazard ratio: 2.67 [95% confidence interval, 1.17-6.11]; P = .02) and those with an in-transit lesion size > or =1.4 cm2 (hazard ratio, 3.12 [95% confidence interval, 1.30-7.5]; P = .011). When these two variables were combined, there was a highly significant association with shortened survival (P = .002 by log-rank test). CONCLUSIONS:These data indicate that for patients undergoing ILP and in whom positive ILNs are found and resected, ILP is justified. In addition, patients who have a CR after ILP and have a history of prior treatment or larger lesions should be considered for adjuvant systemic therapy.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Zogakis TG,Bartlett DL,Libutti SK,Liewehr DJ,Steinberg SM,Fraker DL,Alexander HRdoi
10.1007/s10434-001-0771-4keywords:
subject
Has Abstractpub_date
2001-12-01 00:00:00pages
771-8issue
10eissn
1068-9265issn
1534-4681journal_volume
8pub_type
杂志文章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:Recent population-based studies have highlighted a disproportionate increase in the incidence of rectal cancer among adults younger than aged 50 years. To determine whether different intervention and surveillance strategies might be needed for younger patients, the patterns of care and oncologic outcomes amo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1674-7
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:The risk of axillary failure (AF) after accelerated partial breast irradiation (APBI) using MammoSite brachytherapy is unknown and has been source of concern as the axillary region is not treated with this technique. We aimed to determine the rate of AF in patients treated with APBI and identify factors asso...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1734-z
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Resectability rates for extrahepatic cholangiocarcinoma have increased over time, but long-term survival after resection alone with curative intent remains poor. Recent series suggest improved survival with adjuvant therapy. Patient subsets benefiting most from adjuvant therapy have not been clearly defined....
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6095-9
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Debate regarding axillary dissection in the treatment of women with small invasive cancers of the breast has been increasing. Recently, omission of axillary dissection has been proposed because of the reported low incidence of nodal metastases in women with such cancers. Variation in the incidence of nodal m...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1007/BF02303756
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Local excision might represent an alternative to total mesorectal excision for patients with locally advanced rectal cancer who achieve a major or complete clinical response after neoadjuvant chemoradiotherapy. METHODS:Between August 2005 and July 2011, 63 patients with mid-low rectal adenocarcinoma who had...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09243-6
更新日期:2020-10-30 00:00:00
abstract:BACKGROUND:To determine whether the administration of renin-angiotensin system (RAS) inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), affect disease outcome in non-muscle-invasive bladder cancer (NMIBC). METHODS:A total of 330 patients with initially diag...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2568-z
更新日期:2012-11-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6799-5
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The SentiMAG Multicentre Trial evaluated a new magnetic technique for sentinel lymph node biopsy (SLNB) against the standard (radioisotope and blue dye or radioisotope alone). The magnetic technique does not use radiation and provides both a color change (brown dye) and a handheld probe for node localization...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-013-3379-6
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Clinical trials report improved overall survival following neoadjuvant chemoradiotherapy in patients undergoing surgery for esophageal adenocarcinoma, with a 10-15% survival improvement. MicroRNAs (miRNAs) are small noncoding RNAs that are known to direct the behavior of cancers, including response to treatm...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6626-z
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Patients with resected extrahepatic bile duct adenocarcinoma who have microscopically positive resection margins and/or pathologic locoregional nodal involvement (R1pN1) have a high-risk of locoregional recurrence, and therefore, we advocate the use of adjuvant chemoradiation. To evaluate the safety and effe...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9998-7
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Data on the importance of margin status after total thyroidectomy for papillary thyroid cancer (PTC) remain limited. This study sought to identify factors associated with positive margins and to determine the impact of positive margins on survival for patients with PTC. METHODS:The National Cancer Data Base...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4867-7
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node biopsy (SLNB) has become a standard for axillary staging for early breast cancer patients. Prior studies suggest that SLNB may be more sensitive for the identification of lymph node disease than axillary lymph node dissection (ALND). We hypothesized that SLNB use increases the incidence o...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9109-6
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:The Affordable Care Act (ACA) was instated on 23 March 2010 to improve healthcare quality, reduce costs, and increase access. The Pretty in Pink Foundation (PIPF), a non-profit 501(C)(3) organization in North Carolina, provides financial assistance and in-kind support to individuals seeking help with breast ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5311-3
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:In several neoplastic diseases, including breast cancer, immunosuppression correlates with disease stage, progression, and outcome. Thus, thorough analysis of immune parameters in breast cancer patients may be beneficial in designing effective anticancer immune-based therapies. METHODS:We investigated dendr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/aso.2004.05.027
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:A positive circumferential radial margin (CRM) after rectal cancer surgery is an important predictor of local recurrence. The definition of a positive CRM differs internationally, and reported rates vary greatly in the literature. This study used time-series population-based data to assess positive CRM rates...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4893-5
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:In 2007, the National Quality Forum (NQF) released four performance measures for the treatment of breast cancer. We proposed to study the degree of adherence with these measures among participating institutions in a multi-institutional trial. METHODS:American College of Surgeons Oncology Group (ACOSOG) Z001...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-0980-9
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Dysregulation of apoptosis is a key factor in carcinogenesis and tumor progression. X-linked inhibitor of apoptosis (XIAP) is the most potent member of the inhibitor of apoptosis protein (IAP) family, which directly inhibits apoptosis by binding to caspases. Antagonists of XIAP have recently been identified:...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0062-4
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:CD8+ T cell-eliciting vaccines are being investigated in breast cancer patients. Preclinical data showed that trastuzumab increases the susceptibility of tumor cells to lysis by vaccine-generated CD8+ T cells, suggesting potential benefit of a combination immunotherapy strategy. The current trial was underta...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5844-0
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate postoperative pain and postoperative nausea and vomiting (PONV) in patients with paravertebral blocks (PVB) undergoing breast cancer surgery with or without axillary staging. METHODS:An Institutional Review Board approved, retrospective chart review from January 200...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-011-1899-5
更新日期:2012-02-01 00:00:00
abstract:INTRODUCTION:The National Comprehensive Cancer Network (NCCN) developed clinical practice guidelines for germline pathogenic variants in highly penetrant genes, such as TP53 and PTEN, and in moderately penetrant genes, such as CHEK2, ATM and PALB2. Whether the practice of radiographic surveillance of patients with path...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08191-0
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The role of postmastectomy radiotherapy (PMRT) in breast cancer patients receiving neoadjuvant chemotherapy (NAC) is controversial. We aimed to evaluate the effectiveness of radiotherapy in patients treated with NAC and mastectomy in the Japanese Breast Cancer Registry. METHODS:We enrolled patients who rece...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07453-1
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:This multicenter analysis evaluated patient outcome and clinical pathologic features of thymic epithelial tumors after complete surgical resection and adjuvant treatment. METHODS:Histologic classification and clinical staging were performed according to WHO classification and Masaoka staging system, respect...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-013-3018-2
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Primary extended resection has been proposed as the initial treatment for patients with retroperitoneal sarcoma. This approach comprises an extended en-bloc resection of the directly infiltrated organs and adjacent uninvolved organs. The results of such radical surgery have yet to be validated. This retrospe...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4380-z
更新日期:2015-10-01 00:00:00
abstract::Over a decade since the discovery of EGFR mutation, and 6 years since prospective clinical trial data proved that routine molecular pathology tests improve survival in stage IV lung cancer, there is still debate whether to test patients with earlier stages of disease (stage I-III). As discoveries of targeted drugs for...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-015-4704-z
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The management of state III breast cancer is challenging; it often includes multimodal treatment with systemic therapy and/or radiation therapy and surgery. Immediate breast reconstruction has not traditionally been performed in these patients. We review the results of immediate transverse rectus abdominis m...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02305667
更新日期:1996-07-01 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:PURPOSE:This study was designed to compare the clinical outcomes of patients who underwent limited resection (LR) versus pancreaticoduodenectomy (PD) for duodenal gastrointestinal stromal tumors (GISTs). METHODS:A systematic review of the literature was performed to identify studies analyzing the clinical outcomes of ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1245/s10434-014-3788-1
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Identification of novel molecules implicated in the malignancy of gastric cancer (GC) is key to the development of personalized treatments and the improvement of patient outcome. Neurotrophin receptor-interacting melanoma antigen-encoding protein (NRAGE) regulates apoptosis and metastasis via interactions wi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5375-0
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Extension of lymphadenectomy in gastric cancer is controversial, and preoperative diagnosis of lymph node metastases (LNM) is difficult. Therefore, knowledge-based systems such as the Maruyama computer program (MCP) are being developed. MCP shows good prognostic value for the compartments; however, for diffe...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/ASO.2004.04.018
更新日期:2004-05-01 00:00:00