Abstract:
BACKGROUND:Clinical practice guidelines have been developed to improve melanoma patient care. However, it is unclear whether failure to comply with these standards (either excessive or inadequate treatment) increases morbidity or relapse rates. Therefore, we undertook this study to evaluate the effect of variance from National Comprehensive Cancer Network (NCCN) recommendations on postoperative complication rates and disease recurrence. METHODS:We retrospectively reviewed our institutional cancer registry data on 327 clinically node-negative melanoma patients and assessed compliance with NCCN guidelines, complication rates, and outcome. Data were confirmed by chart, pathology report, and operative note review. Statistical analysis was performed by using the SAS statistical software package. RESULTS:Postoperative complications were documented in 17% of patients and were 3.4-fold higher for patients treated in a margin-noncompliant fashion and 2.4-fold higher for patients treated in a lymph-node-noncompliant manner (P < 0.001 for both). After mean follow-up of 51 months, disease recurred in 58 patients (18%) at a mean of 33 months (range 4-93 months). Locoregional disease alone as the first site of relapse was seen in 24% of margin-noncompliant versus 6% of margin-compliant cases and in 33% of lymph-node-noncompliant versus 6% of lymph-node-compliant cases (P < 0.0001). CONCLUSION:While there are valid reasons for variance from treatment algorithms, these data suggest that compliance with NCCN guidelines improves outcome and decreases morbidity in clinically node-negative melanoma patients.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Erickson Foster J,Velasco JM,Hieken TJdoi
10.1245/s10434-008-0021-0subject
Has Abstractpub_date
2008-09-01 00:00:00pages
2395-402issue
9eissn
1068-9265issn
1534-4681journal_volume
15pub_type
杂志文章abstract:BACKGROUND:The incidence of thyroid cancer is increasing worldwide. The findings of up to 30% of thyroid fine-needle aspiration biopsies (FNAB) are inconclusive, primarily as a result of several thyroid histologic subtypes with overlapping cytologic features. MicroRNAs (miRNAs) are small noncoding RNAs and have been im...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1766-4
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Whether breast cancer surgeons are adequately trained, skilled, and experienced to provide breast cancer genetic assessment, testing, and counseling came under debate in September 2013 when a major third-party payer excluded nongenetics specialists from ordering such testing. A literature search having faile...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3711-9
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Malignant ascites (MA) is a distressing problem usually managed by repeated paracenteses. Paracentesis represents a meaningful time point in identifying patients with a specific presentation. OBJECTIVE:The objective of this study is to examine symptom clustering in MA patients at paracentesis. METHODS:Pre-...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0774-0
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Since its introduction, the sentinel lymph node biopsy (SLNB) has become the standard staging procedure in clinical node-negative melanoma patients. A negative SLNB, however, does not guarantee a recurrence-free survival. Insight into metastatic patterns and risk factors for recurrence in SLNB negative melan...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5566-8
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Primary breast cancers that overexpress human epidermal growth factor receptor 2 have variable biological features and clinical outcomes. A subgroup of HER2-overexpressing tumors that express basal-like immunohistochemical markers-the so-called basal-HER2+ subtype--is associated with poor prognosis. We inves...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2032-5
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Epithelial cells in the bone marrow of patients with gastric cancer suggest tumor dissemination; however, their prognostic implications are controversial. We prospectively evaluated the correlation of bone marrow findings, recurrence rate, and disease-free survival after long-term follow-up. METHODS:Bone ma...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9039-3
更新日期:2007-02-01 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:Esophageal cancer frequently metastasizes to lymph nodes along the recurrent laryngeal nerve (RLN),1 therefore it is essential to dissect RLN nodes for curative esophagectomy.2 Right-sided aortic arch (RAA), a rare congenital anomaly, occurs in approximately 0.1% of adults.3 Because RAA forms a vascular ring...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6355-3
更新日期:2018-05-01 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:BACKGROUND:In our own experience over the last 15 years, the primary transpelvic vertical rectus abdominis myocutaneous (VRAM) flap is a reliable tool to prevent perineal wound complications after cylindrical excision in radical anorectal tumor surgery. To minimize the operative trauma in such patients, we performed a ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1977-8
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Although many experiences using the da Vinci Robot System have been reported by several groups, there is substantial controversy over the role of the robot in thyroidectomy. We performed a systematic review and meta-analyses in order to evaluate the safety and effectiveness of robotic thyroidectomy (RT) comp...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1245/s10434-015-4375-9
更新日期:2015-09-01 00:00:00
abstract:PURPOSE:Recent studies indicated that the scaffolding adaptor protein GAB2 (GRB2-associated binding protein 2) plays a critical role in the proliferation and migration of various cancers. This study aimed to determine the role of aberrant GAB2 expression in human colorectal cancer (CRC). METHODS:Quantitative real-time...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3889-x
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The optimal time between neoadjuvant chemotherapy (NAC) and gastrectomy for gastric cancer (GC) remains unknown. This study aimed to investigate the association between the time-to-surgery (TTS) interval and the major pathologic response (mPR). METHODS:In this study, 280 consecutive GC patients who underwen...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09507-1
更新日期:2021-01-08 00:00:00
abstract:BACKGROUND:Endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) are both used to resolve jaundice before surgery for perihilar cholangiocarcinoma (PHC). PTBD has been associated with seeding metastases. The aim of this study was to compare overall survival (OS) and the incidence of in...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4676-z
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Retroperitoneal lymphadenectomy (RPLND), chemotherapy, and active surveillance represent treatment options for patients with nonseminomatous germ-cell tumors of the testis (NSGCTT). Our objective was to assess the utilization rate of RPLND in patients with NSGCTT. METHODS:Within the Surveillance, Epidemiolo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1722-3
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The Ki-67 index is an established prognostic marker for recurrence after resection of pancreatic neuroendocrine tumors (PanNETs) that groups tumors into three categories: low grade (< 3%), intermediate grade (3-20%), and high grade (> 20%). Given that the majority of resected PanNETs have a Ki-67 less than 3...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6140-8
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Isolated regional failure of nasopharyngeal carcinoma (NPC) after primary treatment is traditionally treated with radical neck dissection (RND). The roles of modified radical neck dissection (MRND) and postoperative radiotherapy after salvage surgery currently remain unclear. METHODS:Medical records from ou...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2018-3
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Poly(ADP-ribose) polymerase (PARP) is an important regulator of programmed cell death in response to alkylating agents such as temozolomide (TMZ). The goal of this study was to determine if a systemically administered PARP-inhibitor (INO-1001) could augment the efficacy of TMZ in a rat model of extremity mal...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-0971-x
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Microsatellites are short repetitive nucleotide sequences that, through mutation, can undergo either expansion or contraction. This novel mutational mechanism known as microsatellite instability may play a role in carcinogenesis. We investigated the incidence of microsatellite instability in a series of prim...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303580
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:OncotypeDX recurrence score (RS)® has been found to predict recurrence and disease-free survival in patients with node negative breast cancer. Whether RS is useful in guiding locoregional therapy decisions is unclear. We sought to evaluate the relationship between RS and lymph node burden. METHODS:Patients ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-7059-4
更新日期:2019-03-01 00:00:00
abstract:PURPOSE:There is no consensus on what constitutes adequate negative margins in breast-conserving therapy (BCT). We systematically review the evidence on surgical margins in BCT for invasive breast cancer to support the development of clinical guidelines. METHODS:Study-level meta-analysis of studies reporting local rec...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/s10434-014-3480-5
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:We reviewed single-institution experience using brachytherapy alone for primary high-grade soft tissue sarcoma of the extremity. METHODS:Between July 1982 and September 1997, 202 adult patients with primary high-grade soft tissue sarcoma of the extremity were treated with limb-sparing surgery and adjuvant b...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/aso.2002.9.1.48
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:High-grade (HG) mucinous appendiceal neoplasms (MAN) have a worse prognosis than low-grade histology. Our objective was to assess the safety and efficacy of cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) in patients with high-grade, high-volume (HG-HV) peritoneal metastase...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4838-z
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Isolated limb infusion (ILI) with cytotoxic drugs has been used since 1992 to treat advanced melanoma confined to a limb. Over this time the technique has undergone progressive modification. In this study we evaluated our experience with ILI by analyzing outcome and toxicity from an "early" and a "late" trea...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-011-1646-y
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:There are various methods for the detection of sentinel lymph nodes (SLNs) in breast cancer by using a combined method with blue dye and radioisotope (RI) tracers. The purpose of the study was to reveal any correlation between concordance of the tracers and the order of harvest with the presence of metastase...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.07.013
更新日期:2005-06-01 00:00:00
abstract:PURPOSE:To evaluate the effect of body composition on outcomes after hepatic resection for patients with hepatocellular carcinoma (HCC). METHODS:We performed 190 hepatic resections for HCC and divided the patients into 2 groups on the basis of visceral fat area (VFA), assessed by computed tomographic measurement at th...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3686-6
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant cancer syndrome. Up to 30% of families with HDGC have mutations in the E-cadherin gene, CDH1. The role of prophylactic versus therapeutic gastrectomy for HDGC was studied prospectively. METHODS:Eighteen consecutive patients with CDH1 mutation...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1648-9
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:In the surgical treatment of adrenocortical carcinoma (ACC), lymphadenectomy may improve oncologic outcome. However, patterns of metastatic lymphatic spread in ACC are unknown. METHODS:Clinical data of patients included in the European Network for the Study of Adrenal Tumors (ENSAT) registry were retrospect...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6999-z
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Guidelines recommend sentinel lymph node dissection (SLND) for patients with clinical stage I/IIA/IIB breast cancer; however, a significant fraction of patients do not undergo this procedure. We sought to identify factors associated with noncompliance with the SLND benchmark in early-stage breast cancer. MA...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1248-0
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Male breast cancer accounts for less than 1% of all breast cancers, yet males have a worse prognosis than females with breast cancer. METHODS:Using the 1988-2003 Surveillance, Epidemiology, and End Results Program data, we conducted a retrospective, population-based cohort study to investigate stage-specifi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1468-3
更新日期:2011-07-01 00:00:00