Abstract:
BACKGROUND:Breast-conserving surgery (BCS) requires clear surgical margins to minimize local recurrence. We sought to identify groups of patients at higher risk of involved margins who might benefit from preoperative counselling and/or more generous excision at the first operation. METHODS:We reviewed demographic, clinical, radiological and pathological records of all women diagnosed with ductal carcinoma in situ (DCIS) or invasive cancer (IC) through a population-based breast screening program in Melbourne, Australia between 1994 and 2005. RESULTS:A total of 2,160 women were diagnosed with DCIS or IC. We excluded 199 who had mastectomy (TM) as initial procedure or had missing data. Three hundred and thirteen had a diagnostic biopsy. Of 1,648 women who had BCS after a preoperative diagnosis of DCIS or IC, 13.5% had involved margins, 16.6% had close (=1 mm), and 69.8% clear (>1 mm) margins. Of the patients, 281/1,648 (17.1%) underwent re-excision, of whom 93 (33.1%) had residual disease identified. Mammographic microcalcifications (P < 0.0001), absence of a mammographic mass (P = 0.002), presence of DCIS (P < 0.0001), high tumour grade (P < 0.0001), large size (P < 0.0001), multifocal disease (P < 0.0001) and lobular histology (P = 0.005) were associated with involved margins. Microcalcifications (odds ratio [OR] 1.97), large size (OR 4.22) and multifocal disease (OR 2.85) were independently associated with involved margins. Residual disease was associated with involved margins (P < 0.0001), presence of DCIS (P = 0.05) and large tumour size (P = 0.01). CONCLUSION:After BCS, patients with mammographic microcalcifications, larger tumour size and multifocal tumours are more likely to have involved margins. Patients with involved margins, large tumour size and/or a DCIS component are more likely to have residual disease on re-excision.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Kurniawan ED,Wong MH,Windle I,Rose A,Mou A,Buchanan M,Collins JP,Miller JA,Gruen RL,Mann GBdoi
10.1245/s10434-008-0054-4subject
Has Abstractpub_date
2008-09-01 00:00:00pages
2542-9issue
9eissn
1068-9265issn
1534-4681journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Although lateral pelvic node dissection (LPND) is recommended for rectal cancer with clinically metastatic lateral pelvic lymph nodes (LPNs), LPNs may respond to neoadjuvant chemoradiotherapy (nCRT). Our aim was to determine the optimal indication for LPND after nCRT for mid/low rectal cancer. METHODS:Of 2,...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-014-3559-z
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:The goal of this multicenter study was to clarify the determinants of local excision for patients with T1-T2 lower rectal cancer. METHODS:Data from 567 consecutive patients who underwent radical resection for T1-T2 lower rectal cancer at 12 institutions between 1991 and 1998 were reviewed. Rates of lymph no...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-009-0849-y
更新日期:2010-04-01 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:PURPOSE:The purpose of this study was to identify prognostic genes by integrated microarray analysis between comparative genomic hybridization and gene expression with laser microdissection in non-small cell lung cancer (NSCLC). METHODS:Integrated microarray analysis in 11 lung adenocarcinomas was performed, and sever...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3059-6
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Hospital readmissions and reoperations are quality indicators of patient care. In 2012, the National Surgical Quality Improvement Program (ACS-NSQIP) began reporting details regarding unplanned reoperations within 30 days of initial procedure. The main objective of this study was to identify reoperation rate...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4741-7
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Intraoperative identification of positive sentinel lymph nodes in patients with breast cancer may avoid a return to the operating room. METHODS:In a group of 402 consecutive patients with primary breast cancer who underwent sentinel lymph node biopsy, an intraoperative examination (IE) was obtained in 236 c...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/ASO.2004.12.005
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Liver-directed therapies have been used to treat neuroendocrine liver metastases (NELM) for both symptomatic improvement and tumor growth control. We reviewed our experience with NELM to investigate the outcomes of available treatment modalities and to identify prognostic factors for survival. METHODS:We id...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5839-x
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:With cholangiocarcinoma, the only hope of a cure is resection. This study was undertaken to determine the impact of margin status, stage, tumor location, and adjuvant therapy on survival after resection of extrahepatic cholangiocarcinoma. METHODS:From 1985-2006, 91 patients underwent resections of cholangio...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9756-2
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Early diagnosis of superior mesenteric artery (SMA) involvement is vital for patients with a borderline resectable cancer of the pancreatic head to achieve an R0 resection. We aimed to detect the effect of the inferior infracolic 'superior mesenteric artery first' approach with a no-touch isolation surgical ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5542-3
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Radiofrequency ablation (RFA) is being used to treat primary and metastatic liver tumors. The indications, treatment planning, and limitations of hepatic RFA must be defined and refined by surgeons treating hepatic malignancies. METHODS:A review of the experience using RFA to treat unresectable primary and ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/aso.2003.07.017
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Improved survival has been reported for diffuse malignant peritoneal mesothelioma (DMPM) treated by surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). The significance of lymph node involvement in this disease is still poorly understood. METHODS:Prospectively collected clinical da...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0756-2
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Neuroendocrine tumors of the pancreas, such as insulinoma, are difficult to localize, and complete resection is essential for cure. Our hypothesis is that a near-infrared (NIR) fluorophore exhibiting uptake in insulinoma could provide high-sensitivity detection intraoperatively. MATERIALS AND METHODS:The op...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0868-8
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Inconsistent data suggests extranodal spread (ENS) is an adverse prognostic factor in Stage III melanoma patients but it remains contentious. By rigorously matching cohorts, this study sought to clarify associations with recurrence and survival. METHODS:Melanoma patients with lymph node metastases (AJCC Sta...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5723-0
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:According to the revised staging of the American Joint Committee on Cancer, 8th edition (AJCC8), the N category in pancreatic ductal adenocarcinoma is classified as N0 (0), N1 (1-3), and N2 (≥ 4) based on the number of metastatic lymph nodes (LNs). This study aimed to validate this classification and analyze...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-019-07390-z
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:In synovial sarcomas alterations in the cyclin D1-CDK4/6-Rb axis have been described. Also, β-catenin, a cyclin D1 regulator, is often overexpressed. Additionally, studies have shown that the t(X;18) translocation influences tumor behavior partly through cyclin D1 activation. We investigated how alterations ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5341-x
更新日期:2016-09-01 00:00:00
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 analyze the relationship between the size of metastatic sentinel lymph nodes (SLNs) and the risk of non-sentinel lymph node (non-SLN) metastasis in endometrial cancer. PATIENTS AND METHODS:From a total of 328 patients with endometrial cancer who underwent SLN mapping from January 2013 to April 2019, 142 pat...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08045-9
更新日期:2020-05-01 00:00:00
abstract:PURPOSE:To evaluate the results of restaging completely resected stage IIIB/C melanoma prior to start of adjuvant therapy. PATIENTS AND METHODS:One hundred twenty patients with stage IIIB or IIIC (AJCC 2009) melanoma who underwent complete surgical resection were screened for inclusion in our trial investigating adjuv...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07274-2
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Performing a sentinel lymph node biopsy (SLNB) is the standard of care for axillary nodal staging in patients with invasive breast cancer and clinically negative nodes. The procedure provides valuable staging information with few complications when performed by experienced surgeons. However, variation in pro...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5432-8
更新日期:2016-10-01 00:00:00
abstract:PURPOSE:To determine the risk factors related to adnexal involvement in endometrial cancer (EC) and its implications for ovarian preservation in young women. METHODS:We analyzed a series of 802 patients who were treated at AC Camargo Cancer Center from July 1991 to July 2017. Patients who had peritoneal or systemic di...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08261-8
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:The COVID-19 pandemic has posed extraordinary demands from patients, providers, and health care systems. Despite this, surgical oncologists must maintain focus on providing high-quality, empathetic care for the almost 2 million patients nationally who will be diagnosed with operable cancer this year. The foc...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08673-6
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Secure methods for clinical detection of the sentinel node (SN) are in great demand to avoid unnecessary resection. This was a clinical exploration/feasibility study of a novel detection system for SN biopsy using indocyanine green (ICG) fluorescence imaging in gastric cancer surgery. METHODS:SN biopsy usin...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9872-7
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:The combination of neoadjuvant radiochemotherapy and parenchyma-preserving sleeve resection for lung cancer remains controversial because of potentially increased rate of anastomotic breakdown. We analyzed the effects of applying a decellularized human dermis transplant seeded with autologous fibroblasts in ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3209-x
更新日期:2013-12-01 00:00:00
abstract:INTRODUCTION:Guidelines for screening mammography have been established by numerous medical societies. Guidelines have not been established for follow-up mammography for patients who have been treated with breast-conserving surgery. Many radiologists recommend mammography of the treated breast 6 months after completion...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2480-6
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Failure to rescue (FTR) is a quality-of-care indicator in pancreatic surgery, but may also identify patients who may not tolerate major postoperative complications despite being treated with best available care. Previous studies found that high visceral adipose tissue-to-skeletal muscle ratio is associated w...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-017-6216-5
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The intraoperative epidural analgesia (EA) has the potential to reduce stress response to surgical trauma which induces a transient immunoactivation that has a negative impact on the outcome. This study investigates the effect of intraoperative EA versus intravenous analgesia (IA) on the immune function. ME...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-011-1700-9
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Response to chemotherapy and anatomical spread are significant prognostic factors in patients with esophageal squamous cell carcinoma (ESCC) treated by chemotherapy then surgery. Predicting the response to chemotherapy would allow significant optimization of cancer treatment. METHODS:Genomic mutation and pr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0851-4
更新日期:2010-02-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6645-9
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Pseudoangiomatous stromal hyperplasia (PASH) is a benign localized fibrotic lesion in which clusters of spindle cells form cleftlike spaces, resembling ectatic vessels. Its relationship to breast cancer risk has not been characterized. MATERIALS AND METHODS:Histological presence of PASH was evaluated by rev...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1170-5
更新日期:2010-12-01 00:00:00
abstract:INTRODUCTION:Main-duct intraductal papillary mucinous neoplasms of the pancreas (M-IPMN) are potentially malignant cystic neoplasms that can degenerate into invasive malignancy in 43 % of cases.1 Although laparoscopic pancreaticoduodenectomy and distal pancreatectomy have been previously described for the management of...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5481-z
更新日期:2017-02-01 00:00:00