Abstract:
BACKGROUND:Approximately 3-5% of patients with thin (≤ 1 mm) cutaneous melanomas develop distant metastases. We sought to identify clinical and pathologic factors associated with distant metastasis and survival in a large number of patients with thin melanoma treated at a single institution. METHODS:We identified patients with a single invasive melanoma ≤ 1 mm in thickness diagnosed between January 1983 and December 2003 who developed distant metastasis (cases), and matched patients with no recorded recurrence during follow-up (control subjects). Cases and control subjects were matched for age, sex, and year of primary melanoma diagnosis. Associations of clinical and pathologic parameters with distant metastasis-free survival and melanoma-specific survival were analyzed. RESULTS:A total of 178 cases and 178 control subjects were identified. Factors associated with development of distant metastasis were: increasing Breslow thickness (P < 0.001), increasing Clark level of invasion (P < 0.001), increasing mitotic rate (P = 0.001), ulceration (P = 0.025), and American Joint Committee on Cancer T subcategory (P < 0.001). Multivariable models including Breslow thickness (but not Clark level) showed that factors independently associated with poorer distant metastasis-free survival were increasing age [hazard ratio (HR) 1.01, 95% confidence interval (CI) 1.00-1.02]; increasing Breslow thickness (HR 3.21, 95% CI 1.73-5.94, and HR 3.77, 95% CI 2.11-6.74 for 0.51-0.75 mm and 0.76-1.00 mm, respectively, compared with 0.01-0.50 mm); ulceration (HR 1.87, 95% CI 1.14-3.06) and mitotic rate (HR 1.13, 95% CI 1.05-1.21). Similar associations with melanoma-specific survival were found. CONCLUSIONS:Clinical and pathologic predictors of distant metastasis and survival identified in this large study of patients with thin primary cutaneous melanomas will enable more accurate stratification of risk of distant metastasis and poor survival in such patients, and will assist in formulating clinical management and follow-up regimens based on the level of risk.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Murali R,Haydu LE,Long GV,Quinn MJ,Saw RP,Shannon K,Spillane AJ,Stretch JR,Kefford RF,Thompson JF,Scolyer RAdoi
10.1245/s10434-012-2265-ysubject
Has Abstractpub_date
2012-06-01 00:00:00pages
1782-9issue
6eissn
1068-9265issn
1534-4681journal_volume
19pub_type
临床试验,杂志文章abstract:BACKGROUND:Girdin was identified as a novel Akt substrate that contributes to a positive feedback loop between Girdin and Akt. Although several recent studies have demonstrated that Girdin is involved in tumor metastasis, the clinical implications of Girdin in breast cancer remain unclear. METHODS:To retrospectively e...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3746-y
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Although the National Comprehensive Cancer Network (NCCN) guidelines recommend use of lymph node dissection (LND) in patients with pancreatic neuroendocrine tumors (pNETs) > 2 cm, there is limited evidence to support the association between use of LND and overall survival (OS). METHODS:Patients with resecte...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07506-5
更新日期:2019-09-01 00:00:00
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, cli...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0054-4
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Racial disparities in outcomes have been documented among patients with esophageal cancer. The purpose of this study is to identify mechanisms for ethnicity/race-related differences in the use of cancer-directed surgery and mortality. METHODS:Data from the Surveillance, Epidemiology and End Results (SEER) p...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2807-3
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The management of breast cancer (BC) skin metastases represents a therapeutic challenge. Electrochemotherapy (ECT) combines the administration of bleomycin with temporary permeabilization induced by locally administered electric pulses. Preliminary experience with ECT in BC patients is encouraging. METHODS:...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-015-4779-6
更新日期:2015-12-01 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:Dynamic contrast-enhanced magnetic resonance imaging (MRI) of the breast is highly sensitive for the diagnosis of primary breast malignancy. We investigated the clinical application of dedicated dynamic breast MR for routine screening for local recurrence following breast-conserving therapy. METHODS:Patient...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303784
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Experimental studies have revealed that D2-40 is useful in identifying the presence of lymphatic invasion in various malignant neoplasms, but the clinical significance remains unclear. The purpose of this study is to assess the clinical significance of D2-40 status in completely resected non-small cell lung ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0432-6
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Sarcopenia is recognized as an important prognostic factor in various types of cancer, including gastric cancer. While long-term survival analyses typically focus on overall and disease-specific survival, death from other causes has received far less attention. METHODS:We reviewed medical records of 491 gas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6354-4
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to establish and validate an individualized nomogram for predicting disease-specific survival (DSS) in patients with non-metastatic ampullary carcinoma after surgery. METHODS:The nomogram was prepared using retrospective data from the Surveillance, Epidemiology, and End Results data...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-07115-8
更新日期:2019-04-01 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:Prostate cancer is often diagnosed early enough in its clinical course to permit radical prostatectomy to be done with curative intent, yet many patients experience tumor recurrence. Most patients receive postoperative surveillance, but the intensity of testing varies appreciably. We sought to evaluate the i...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-000-0339-8
更新日期:2000-06-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the accuracy of breast magnetic resonance imaging (MRI) to predict residual lesion size after neoadjuvant chemotherapy (NAC) and to determine the factors that influence the accuracy of response prediction. METHODS:This study comprised 166 patients who underwent MRI bef...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-2925-6
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Although controversial, recent data suggest a benefit associated with primary tumor resection (PTR) in metastatic colon cancer (mCC) patients. However, utilization of the various management strategies over time relative to surgery, in particular multimodality treatment (MMT), as well as the impact of age on ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-5073-3
更新日期:2016-06-01 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: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:Despite advancements in radiologic imaging and minimally invasive surgery, the evaluation and management of insulinomas is institution and surgeon dependent. Therefore, the reported surgical outcomes are highly variable. We compared the surgical management and outcomes of insulinomas between two internationa...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-008-0157-y
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:NIMA-related kinase 2 (NEK2), an enzyme involved in the development and progression of cancer, is abnormally expressed in a wide variety of human cancers, including colorectal cancer (CRC), and is known to have roles in cell division and mitotic regulation through centrosome splitting. We investigated the cl...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3264-3
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:To evaluate the effect and safety of laparoscopy-assisted renal autotransplantation treatment for primary ureteral cancer (PUC). METHODS:Medical records of patients undergoing hand-assisted retroperitoneoscopic nephroureterectomy–extracorporeal total ureterectomy–renal autotransplantation–pyelocystostomy (L...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3382-y
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether patient satisfaction, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, is associated with short-term outcomes after major cancer surgery. MATERIALS AND METHODS:We first used national Medicare claims to identi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6049-2
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:To identify melanoma patients at sufficiently low risk of nodal metastases who could avoid sentinel lymph node biopsy (SLNB), several statistical models have been proposed based upon patient/tumor characteristics, including logistic regression, classification trees, random forests, and support vector machi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1979-6
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Surgical resection of the primary tumor for patients who present with incurable stage IV colorectal cancer is controversial. National practice patterns have not been described. We evaluated the use of primary tumor resection in patients presenting with stage IV colorectal cancer. METHODS:Patients with stage...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.06.012
更新日期:2005-08-01 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:Epigenetic silencing of tumor-related genes by CpG island methylation is an important mechanism for the development of many tumors, including gastric carcinoma. Deregulation of transcription factor 4 (TCF4) by promoter methylation was recently shown to play a key role in gastric carcinogenesis. METHODS:The ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1131-z
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Oncoplastic surgery for breast cancer is a novel concept that combines a plastic surgical procedure with breast-conserving treatment to improve the final cosmetic results. The aim of this study was to evaluate the oncological safety of oncoplastic procedures by studying the status of the surgical margins of ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.12.046
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Nonpalpable breast lesions are being detected with increasing frequency with the advent of improved mammographic techniques. Although only 20-30% of these lesions are malignant, definitive diagnosis has usually required a needle-localization excisional biopsy, which is costly and increases the psychological ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02307063
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Although the sentinel lymph node (SLN) hypothesis has been applied to many tissues and organs, liver has remained unstudied. Currently, it is unclear whether hepatic SLNs even exist. If so, they could alter the management of intrahepatic cholangiocarcinoma and other hepatic malignancies by minimizing the ext...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4601-5
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify an evidence-based f...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08240-z
更新日期:2020-06-01 00:00:00
abstract:PURPOSE:Recently, the American Joint Committee on Cancer (AJCC) 7th edition proposed new response criteria for neoadjuvant chemotherapy (NAC) in breast cancer. The purpose of this study was to evaluate the clinical usefulness of AJCC response criteria. METHODS:A total of 398 consecutive stage II or III breast cancer p...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2756-x
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Little is known about metastatic patterns in patients with obstructing colorectal cancer (CRC). OBJECTIVE:The aim of this study was to determine if metastatic patterns in patients with CRC differ between patients with or without obstruction. METHODS:This single-center, observational, retrospective cohort s...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08119-8
更新日期:2020-04-01 00:00:00