Abstract:
BACKGROUND:Up to 60% of breast cancer patients who undergo breast-conserving surgery (BCS) require re-excision to obtain clear margins, causing delays in adjuvant treatment and poor aesthetic results. However, patient and treatment-related factors associated with re-excision are not well defined. METHODS:We surveyed all women undergoing breast conserving surgery between January 2002 and May 2006 regarding their breast disease (n = 714, response rate = 79.5%). The medical record was reviewed to determine the receipt of re-excision lumpectomy following BCS, and obtain tumor stage, histology, and biopsy method (surgical versus needle biopsy). Patient age, breast size, tumor location in the breast, and receipt of chemotherapy were self-reported. Logistic regression was used to determine significant predictors of re-excision lumpectomy. RESULTS:In this sample, 51.4% of women required only one breast excision, 41.9% required two breast excisions, and 6.6% required three breast excisions. Overall, 10.8% of women required a mastectomy following initial attempt at BCS. Factors significantly correlated with re-excision lumpectomy included smaller breast size (A cup: OR = 2.7; 95%CI: 1.32-5.52; B cup: 1.63; 95%CI: 1.02-2.62), lobular histology (OR = 1.93; 95%CI: 1.15-3.25), and receipt of surgical biopsy (OR = 3.35; 95%CI: 2.24-5.02). Women who received adjuvant chemotherapy (OR = 2.49; 95%CI: 1.19-5.22) were more likely to require re-excision compared with women who received neoadjuvant chemotherapy. CONCLUSIONS:Re-excision lumpectomy is common, and is significantly correlated with smaller breast size, lobular histology, surgical biopsy, and chemotherapy timing. Attention to these risk factors can improve the quality of care delivered to BCS patients by decreasing the cost and morbidity associated with multiple re-excision procedures.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Waljee JF,Hu ES,Newman LA,Alderman AKdoi
10.1245/s10434-007-9777-xsubject
Has Abstractpub_date
2008-05-01 00:00:00pages
1297-303issue
5eissn
1068-9265issn
1534-4681journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Vitamin B12 deficiency is a common long-term sequelae after total gastrectomy. Intramuscular injection of vitamin B12 is the only known treatment. We investigated the efficacy and safety of oral vitamin B12 replacement for gastric cancer patients with vitamin B12 deficiency after total gastrectomy. METHODS:...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1764-6
更新日期:2011-12-01 00:00:00
abstract::C.R. Farley and M.C. Perez contributed equally to this publication and are co-first authors. J.S. Zager and M.C. Lowe contributed equally to this publication and are co-corresponding authors. ...
journal_title:Annals of surgical oncology
pub_type: 已发布勘误
doi:10.1245/s10434-020-08871-2
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Our study aims to determine whether patients with lobular-type breast cancer have significantly improved rates of breast conservation (BCT) after neoadjuvant chemotherapy (nCT). METHODS:Patients who received nCT and surgery within three prospective trials between 1995 and 2007 at the Medical University of...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1879-9
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The role of surgical resection in patients with large or multinodular hepatocellular carcinoma (HCC) remains unclear. This study evaluated the long-term outcome of patients with hepatic resection for large (>5 cm in diameter) or multinodular (more than three nodules) HCC by using a multi-institutional databa...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/ASO.2005.06.004
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:The sentinel lymph node (SLN) is the first lymph node in the regional nodal basin to receive metastatic cells. In-transit nodes are found between the primary melanoma site and regional nodal basins. To date, this is one of the first reports on micrometastasis to in-transit nodes. METHODS:Retrospective datab...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0444-3
更新日期:2001-06-01 00:00:00
abstract::Barrett's esophagus (BE) is a premalignant lesion known to sequentially progress to esophageal adenocarcinoma. Management of BE has changed significantly over the last 5 years with the development of endoscopic resection and ablation, which has replaced esophagectomy as the treatment of choice in BE with high-grade dy...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-011-2163-8
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Peritoneal carcinomatosis (PC) in the setting of mucinous appendiceal neoplasms is characterized by the intraperitoneal accumulation of mucinous ascites and mucin-secreting epithelial cells that leads to progressive compression of intra-abdominal organs, morbidity, and eventual death. We assessed postoperati...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2241-6
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:In cutaneous melanoma (CM), the present methods of lymph node (LN) staging have not sufficiently utilized the prognostic information of metastatic LNs. In this study, we aimed to construct prognostic nomograms based on the number of positive LNs (PLNs) and other clinicopathologic characteristics of CM patien...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09556-6
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:We investigated the relationship between pathologic T-stage and mesorectal metastases after preoperative chemoradiotherapy (CRT) for clinical stage II to III rectal carcinoma. METHODS:The records of consecutive patients with clinical stage II to III carcinoma of the mid or low rectum who underwent surgery a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.03.044
更新日期:2005-02-01 00:00:00
abstract::Hilar cholangiocarcinoma is an uncommon cause of malignant biliary obstruction marked by local tumor spread for which surgery offers the only chance of cure. The diagnostic evaluation and surgical management of this disease continues to evolve. Although direct cholangiography and endoscopic biliary procedures have bee...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1007/s10434-000-0055-4
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:In past decade, the treatment of gastric adenocarcinoma has evolved as a result of the publication of two seminal randomized controlled trials. We aimed to examine treatment trends for resectable gastric cancer (stage I-III) using the National Cancer Data Base (NCDB). Our hypothesis was that the use of chemo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3314-x
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:The ACOSOG Z0011 (Z11) trial demonstrated that in patients with nonpalpable axillary lymph nodes (LN) and one to two positive sentinel LN (SLN), axillary LN dissection (ALND) is unnecessary.JAMA 305:569-575, [2011], Ann Surg 264:413-42, [2016] The Z11 trial did not require preoperative axillary ultrasound (a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5935-y
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:Evidence from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial suggests completion axillary lymph node dissection (cALND) after positive sentinel lymph node biopsy (+SLNB) does not improve outcomes in select patients, leading to practice variation. A multidisciplinary group of surgeons,...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5310-4
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The clinical impact of sentinel lymph node biopsy (SLNB) in gastric cancer is controversial. We performed a prospective trial to compare different methods: radiocolloid method (RM), dye method (DM), and both methods simultaneously (dual method, or DUM) for reliability and therapeutic consequences. METHODS:R...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-007-9367-y
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:We provide a statistical analysis of the learning phase for sentinel node biopsy. METHODS:Four learning phases were analyzed: 25, 50, 75, and 150 procedures with a corresponding number of 10, 20, 30, and 60 tumor-positive cases. Critical values of nonidentification rate and false-negative rate were defined....
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02557365
更新日期:2002-03-01 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:BACKGROUND:The presence of tumor cells at the margins of breast lumpectomy specimens is associated with an increased risk of ipsilateral tumor recurrence. Twenty to 30 % of patients undergoing breast-conserving surgery require second procedures to achieve negative margins. This study evaluated the adjunctive use of the...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-014-3602-0
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:To examine the association between the number of lymph nodes retrieved and oncologic outcome after preoperative chemoradiation for rectal cancer according to tumor regression grade. METHODS:Patients with rectal cancer who underwent curative surgery between May 2004 and December 2012 were analyzed retrospective...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4235-z
更新日期:2015-01-01 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:As increased focus is placed on quality of care in surgery, readmission is an increasingly important metric by which hospital and surgeon quality is measured. For complex pancreatic surgery, we hypothesized that increased pancreaticoduodenectomy (PD) volume may mitigate readmission rates. METHODS:The Univer...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4451-1
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Inadequately treated multifocal and multicentric disease results in increased local recurrence following breast-conserving surgery. The accurate preoperative diagnosis of multifocal/ centric breast cancer would facilitate the planning of appropriate surgery and prevent reoperation for residual disease. While...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-999-0599-x
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:A small differentiated gastric cancer with minute submucosal invasion after endoscopic resection is regarded as the curative resection criterion of an expanded indication. However, recent studies have shown a high incidence of lymph node metastasis in those meeting the expanded criteria. The aim of this stud...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4308-z
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The Oncotype DX® assay has been validated in predicting response to adjuvant chemotherapy in breast cancer. Its role in neoadjuvant chemotherapy (NCT) has not been established. METHODS:The National Cancer Database was used to identify all patients with T1-T3, ER-positive, HER2-negative primary invasive brea...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-07107-8
更新日期:2019-02-01 00:00:00
abstract::Cancer Prevention is an emerging field, capturing the old traditional concept of anticipating the development of a major disease and preventing its full impact by early detection, treatment, or aborting the tumorigenic process by a "molecular vaccine" and alleviating the full impact of the disease. Surgeons are import...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-007-9485-6
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Although often proposed as a means to reduce the harmful consequences of tumor spill, water lavage has yet to be systematically evaluated in relevant in vitro and in vivo models. This study evaluates the mechanisms and utility of a single water lavage to improve the sequelae of tumor spill during laparotomy....
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1588-4
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:The efficacy of chemoprevention for breast cancer risk reduction has been demonstrated in randomized controlled trials; however, use remains low. We sought to determine whether uptake differed by risk factors, and to identify reasons for refusal and termination. METHODS:Women seen in a high-risk c...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07236-8
更新日期:2019-07-01 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:BACKGROUND:Current understanding of the lymphatic system of the breast is derived mainly from the work of the anatomist Sappey in the 1850s, with many observations made during the development and introduction of breast lymphatic mapping and sentinel node biopsy contributing to our knowledge. METHODS:Twenty four breast...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9709-9
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The enhanced esthetics and demonstrated oncologic safety of nipple-sparing mastectomy (NSM) in selected patients have resulted in increased rates among patients with locally advanced breast cancer and/or additional risk factors (obesity, prior radiation, surgery). Limited data exist on complication and recon...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07560-z
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:We sought to examine how splenectomy as part of up-front cytoreductive surgery in ovarian cancer influences the postoperative course and affects survival. METHODS:We reviewed cases of ovarian cancer diagnosed at Massachusetts General Hospital from 1994 to 2008 and found 44 patients who had a splenectomy as par...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-011-1661-z
更新日期:2011-10-01 00:00:00