Abstract:
BACKGROUND:Breast conservation therapy (BCT) and adjuvant hormonal therapy for estrogen-receptor positive breast cancers have become standard of care. Our objectives were to evaluate trends in the surgical management and adjuvant therapy for early-stage breast cancer and to identify factors predicting survival. METHODS:Using the National Cancer Data Base (NCDB), patients with node-negative breast cancers less than 1 cm (T1aN0M0 and T1bN0M0) from 1993-2004 were identified. The time periods of 1993-1994, 1998-1999, and 2003-2004 were compared to analyze trends in surgical management and adjuvant therapy. Cox Proportional Hazards modeling was used to examine factors predicting survival. RESULTS:Overall, 123,212 cases of T1aN0M0 or T1bN0M0 breast cancer were identified. The use of breast conservation surgery increased from 61.3% in 1993/1994 to 78.3% in 2003/2004 with a concomitant decrease in the use of mastectomy. The use of radiation therapy also increased from 51.9% in 1993/1994 to 62.0% in 2003/2004. Adjuvant hormonal therapy administration rose sharply from 26.7% in 1993/1994 to 44.7% in 2003/2004. After adjusting for potential confounders, the difference in 5-year survival rates for T1a (94.3%) and T1b (93.1%) tumors was marginal (P = .04). Age, grade, size, and failure of BCS patients to receive radiation therapy and hormonal therapy were independent predictors of a higher likelihood of death. CONCLUSIONS:BCS utilization increased over time, but mastectomy rates may still be considered high given the small size of tumors in this cohort and the percent of patients eligible for BCT. The use of hormonal therapy increased significantly over the past decade. Further investigation into patient and physician factors affecting treatment choices is needed if BCT and hormonal therapy utilization is to increase.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Kennedy T,Stewart AK,Bilimoria KY,Patel-Parekh L,Sener SF,Winchester DPdoi
10.1245/s10434-007-9441-5subject
Has Abstractpub_date
2007-10-01 00:00:00pages
2918-27issue
10eissn
1068-9265issn
1534-4681journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Appendiceal goblet cell adenocarcinoma (GCA) is often misclassified and mistreated due to mixed histologic features. In general, cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is standard of care for peritoneal carcinomatosis (PC) from mucinous appendiceal tumors; however, i...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07932-5
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The impact of cardiorespiratory comorbidity on operative outcomes after esophagectomy remains controversial. This study investigated the effect of cardiorespiratory comorbidity on postoperative complications for patients treated for esophageal or gastroesophageal junction cancer. PATIENTS AND METHODS:A Euro...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-019-07478-6
更新日期:2019-09-01 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:BACKGROUND:The impact of tumor focality on type of surgery, local recurrence rate, and survival after neoadjuvant chemotherapy (NACT) for breast cancer is not fully understood. This study aimed to compare local recurrence-free survival (LRFS), disease-free survival (DFS), and overall survival (OS) according to focality...
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/s10434-014-4122-7
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:Regional lymph node metastasis is an important prognostic factor for patients with gastric cancer. Occult tumour cells (OTCs), including either micrometastases (MMs) or isolated tumour cells (ITCs), may be a key factor in the development of cancer recurrence in pN0 patients. AIMS:We aimed to determine the...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08524-4
更新日期:2020-10-01 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:OBJECTIVE:The aim of this study was to determine the impact of the results of the 12-gene DCIS Score assay on (i) radiotherapy recommendations for patients with pure ductal carcinoma in situ (DCIS) following breast-conserving surgery (BCS), and (ii) patient decisional conflict and state anxiety. METHODS:Thirteen sites...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-016-5583-7
更新日期:2017-03-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6894-7
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Esophageal cancer is an aggressive cancer with poor prognosis. However, little is known about the immune response in the tumor microenvironment after neoadjuvant chemotherapy. PURPOSE:To investigate the immunological impact of neoadjuvant chemotherapy in the tumor microenvironment of esophageal squamous cel...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1906-x
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Current mammographic technology has resulted in increased detection of ductal carcinoma in situ (DCIS). It is necessary to assess which patients presenting with DCIS are good candidates for breast conservation and which of these patients should receive adjuvant radiation. METHODS:We accrued clinical data fo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303484
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Malignant obstruction of the proximal colon (MOPC) traditionally has been treated with acute resection. However, morbidity and mortality rates following these emergency surgeries are high. Initial bowel decompression by stent placement or stoma construction has been used for distal obstructions as an alterna...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5247-7
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Recent literature has shown that lymph node ratio (LNR) is superior to the number of positive lymph nodes (pLNs) in predicting the prognosis in several malignances other than colon cancer. We hypothesize that LNR may play a similar role in stage III colon cancer. METHODS:We included 24,477 stage III colon c...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9716-x
更新日期:2008-06-01 00:00:00
abstract:PURPOSE:Reasons for variable utilization of adjuvant chemotherapy (ACT) for colon cancer have not been well described. We report medical oncology (MO) referral patterns and subsequent use of ACT. METHODS:Treatment records were linked to the population-based Ontario Cancer Registry to describe MO referral and ACT use a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5181-8
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Near-infrared (NIR) fluorescent sentinel lymph node (SLN) mapping in breast cancer requires optimized imaging systems and lymphatic tracers. MATERIALS AND METHODS:A small, portable version of the FLARE imaging system, termed Mini-FLARE, was developed for capturing color video and two semi-independent channe...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1566-x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Two prospective, randomized trials, TARGIT-A and ELIOT, have shown intraoperative radiation therapy to be a safe alternative, with a low-risk of local recurrence, compared with whole breast radiation therapy, following breast-conserving surgery, for selected low-risk patients. We report the first 1000 tumors...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6614-3
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Cryotherapy is a method of in situ destruction of tumors by freeze/thaw mechanisms. Cancer cells located in the peripheral zone of the tumor undergoing cryotherapy can die by apoptosis. We hypothesized that p21WAF1 is involved in the mediation of cryotherapy-induced apoptosis. METHODS:HT29 cells grown on a ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.11.021
更新日期:2005-09-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6784-z
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The accurate preoperative diagnosis of depth of tumor invasion and nodal status in distal rectal cancer is important because neoadjuvant chemotherapy or lateral pelvic lymph node dissection is indicated for patients with T3-T4 tumor or nodal involvement. This study aimed to determine the optimal cutoff value...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3972-3
更新日期:2015-01-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6885-8
更新日期:2018-12-01 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:BACKGROUND:The American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) staging system for gastric cancer incorporates the absolute number of metastatic lymph nodes (N status) and is optimally used when >or=15 nodes are examined. The ratio of metastatic to examined nodes (N ratio) is an effec...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-0914-6
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:This prospective multicenter sentinel lymph node (SLN) trial investigated whether molecular analysis would improve the detection of SLN metastases and their prognostic value. We report mammaglobin quantitative real-time polymerase chain reaction (qRT-PCR) results and clinical outcome for 547 patients (mean f...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-010-1262-2
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Although the standard of care after recurrence of epithelial ovarian cancer (EOC) is chemotherapy, increasing data suggest that combining cytoreductive surgery with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising option for patients with recurrent EOC. Our aim was to determine...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-015-4991-4
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Reactive oxygen species (free radicals) play an important role in carcinogenesis. Extensive antioxidant defense mechanisms counteract free radicals in mammalian cells. Oxidative stress is a disturbance in the balance between the production of free radicals and antioxidant defenses. There is direct evidence t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3859-3
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The value of p53 status for predicting response to chemotherapy-based treatment in patients with esophageal cancer has been controversial. We conducted a meta-analysis to elucidate the correlation of p53 status with the response to chemotherapy-based treatment. METHODS:Studies were searched in PubMed, Embas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/s10434-012-2859-4
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:In patients with colorectal hepatic metastases, response rates with hepatic arterial infusion (HAI) FUdR (5-Fluoro-2-deoxyuridine) are significantly higher than with systemic fluoropyrimidines. We report a novel animal model of intrahepatic therapy for hepatic metastasis for the study of methods to increase ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02409049
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Heat shock protein 27 (hsp-27) is overexpressed in approximately 67% pure ductal carcinoma in situ (DCIS), in approximately 50% DCIS associated with invasive ductal carcinoma (IDC), and in approximately 25% IDC alone. If this decrease in hsp-27 expression has a role in the progression of malignancy in IDC, w...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02306091
更新日期:1996-11-01 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:PURPOSE:Breast-conserving therapy (BCT) is an accepted method of treating early breast cancer. We hypothesized that routine excision of additional cavity shave margins (CSM) at time of initial partial mastectomy reduces the need for additional surgery. METHODS:A single-institution retrospective review was performed of...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1420-6
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Visceral fat accumulation and muscle depletion have been identified as poor prognostic factors for various cancers. However, the significance of visceral adiposity and sarcopenic visceral obesity on outcomes after resection of pancreatic cancer remains unclear. METHODS:A retrospective analysis of 301 patien...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6077-y
更新日期:2017-11-01 00:00:00