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 recurrence (LR) data relative to final microscopic margin status and the threshold distance for negative margins. LR proportion was modeled using random-effects logistic meta-regression. RESULTS:Based on 33 studies (LR in 1,506 of 28,162), the odds of LR were associated with margin status [model 1: odds ratio (OR) 1.96 for positive/close vs negative; model 2: OR 1.74 for close vs. negative, 2.44 for positive vs. negative; (P < 0.001 both models)] but not with margin distance [model 1: >0 mm vs. 1 mm (referent) vs. 2 mm vs. 5 mm (P = 0.12); and model 2: 1 mm (referent) vs. 2 mm vs. 5 mm (P = 0.90)], adjusting for study median follow-up time. There was little to no statistical evidence that the odds of LR decreased as the distance for declaring negative margins increased, adjusting for follow-up time [model 1: 1 mm (OR 1.0, referent), 2 mm (OR 0.95), 5 mm (OR 0.65), P = 0.21 for trend; and model 2: 1 mm (OR 1.0, referent), 2 mm (OR 0.91), 5 mm (OR 0.77), P = 0.58 for trend]. Adjustment for covariates, such as use of endocrine therapy or median-year of recruitment, did not change the findings. CONCLUSIONS:Meta-analysis confirms that negative margins reduce the odds of LR; however, increasing the distance for defining negative margins is not significantly associated with reduced odds of LR, allowing for follow-up time. Adoption of wider relative to narrower margin widths to declare negative margins is unlikely to have a substantial additional benefit for long-term local control in BCT.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Houssami N,Macaskill P,Marinovich ML,Morrow Mdoi
10.1245/s10434-014-3480-5subject
Has Abstractpub_date
2014-03-01 00:00:00pages
717-30issue
3eissn
1068-9265issn
1534-4681journal_volume
21pub_type
杂志文章,meta分析abstract:BACKGROUND:AJCC staging of pancreatic cancer (PAC) is used to determine prognosis, yet survival within each stage shows wide variation and remains unpredictable. We hypothesized that tumor grade might be responsible for some of this variation and that the addition of grade to current AJCC staging would provide improved...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1071-7
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The impact of re-resection of a positive intraoperative bile duct margin on clinical outcomes for resectable hilar cholangiocarcinoma (HCCA) remains controversial. We sought to define the impact of re-resection of an initially positive frozen-section bile duct margin on outcomes of patients undergoing surger...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6382-0
更新日期:2018-05-01 00:00:00
abstract::Investigators at many cancer centers have verified that the sentinel node (SN) is the first lymph node to receive lymphatic drainage from a primary breast cancer and therefore the node most likely to contain metastatic tumor cells. When sentinel lymph node dissection (SLND) is undertaken by an experienced multidiscipl...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Radical gastrectomy is the cornerstone of the treatment of locally advanced gastric cancer. This study was designed to evaluate factors associated with a tumor-positive resection margin after gastrectomy and to evaluate the influence of hospital volume. METHODS:In this Dutch cohort study, patients with junc...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07381-0
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Although an age cutoff of 45 years has often been adopted to stratify cancer risk in papillary thyroid carcinoma (PTC), both cancer-specific survival (CSS) and disease-specific survival (DFS) continue to worsen beyond this cutoff. This study aimed to determine whether advanced age (i.e., >60 years) at diagno...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4055-1
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Brain metastases account for 20-54% of reported deaths from melanoma. Duration and quality of survival depend on the extent of metastatic disease and response to treatment. Treatment goals are palliation of symptoms and prolongation of life. No studies have directly compared surgery alone and surgery with ad...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02305789
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Surgery alone is often inadequate for advanced-stage gastric cancer. Surgical complications may delay adjuvant therapy. Understanding these complications is needed for multidisciplinary planning. MATERIAL AND METHODS:The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-014-3664-z
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Tumor thickness and nodal status are important predictors of survival following curative resection for gastric cancer. Lymphovascular invasion (LVI) is a potential predictor of biological behavior. The relationship between LVI and tumor thickness (T status) has not been established in population-based studie...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/ASO.2004.09.002
更新日期:2004-06-01 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:Excess visceral adipose tissue may promote cancer development and progression via an obesity-related metabolic derangements, including adipocytokine-related inflammation, insulin resistance, and hypoxia. The relationship between visceral fat content and patient prognosis has been reported in some types of ca...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4432-4
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Despite a growing body of literature on oncologic and reconstructive outcomes after total skin-sparing mastectomy (TSSM), some questions related to this approach remain unanswered, including strategies for managing tumor involvement of the nipple while maintaining the aesthetic benefits of TSSM. METHODS:A p...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4646-5
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:This work is aimed at comparing mucinous colorectal adenocarcinomas (MUC) and non-mucinous colorectal adenocarcinomas (non-MUC), and at verifying the existence of two different subgroups of MUC, in terms of clinicopathological features, chromosomal alterations, and outcome, in a geographical area where mucin...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9757-1
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The association between procedure volume and clinical outcomes has led many to advocate centralization of cancer procedures at high-volume centers (HVCs). Regional studies show practice patterns changing with increasing centralization of esophageal and pancreatic procedures at HVCs but little change for colo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1159-0
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Resection of melanoma metastatic to the liver remains controversial. We evaluated the efficacy of hepatic resection in patients with metastatic ocular and cutaneous melanoma and assessed factors that could affect survival after resection. METHODS:Forty patients with hepatic melanoma metastasis underwent res...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/ASO.2006.01.016
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemotherapy is an accepted standard for locally advanced esophagogastric junction adenocarcinoma. However, the dysphagia frequently associated with this condition may interfere with patient tolerance of this treatment. In many centers, invasive tube feeding, placed either endoscopically, radiogr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4270-9
更新日期:2015-01-01 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: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:The aim of this study was to assess the incidence, characteristics, treatment, and survival of patients with tracheal malignancies in the Netherlands. METHODS:All cases of tracheal cancer entered into the database of the Netherlands Cancer Registry in the period 1989-2002 were selected. Data on histological...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9229-z
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Anaplastic thyroid carcinoma (ATC) is one of the most aggressive solid tumors known to affect humans and carries a dismal prognosis. Our primary aim was to review its epidemiology, biology, risk factors, and prognostic indicators. We also reviewed the individual and combined roles of surgery, radiotherapy, c...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/ASO.2006.05.042
更新日期:2006-04-01 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:BACKGROUND:Major hepatectomy for intrahepatic cholangiocarcinoma (ICC) sometimes involves resection of major hepatic veins, which might result in the future liver remnant (FLR) congestion. The necessity and efficacy of resection and reconstruction of the middle hepatic vein (MHV) during right or left hemihepatectomy fo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5384-z
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Ductal carcinoma in situ with microinvasion (DCISM) is a rare diagnosis with a good prognosis. Although nodal metastases are uncommon, sentinel lymph node biopsy (SLNB) remains standard care. Volume of disease in invasive breast cancer is associated with SLNB positivity, and, thus we hypothesized that in a l...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3920-2
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Histologic grade, TNM stage, and Nottingham Prognostic Index are traditional prognostic tools for breast cancer. "IHC-molecular" classification of breast cancer can also identify patients at different recurrence risks and provides insight into cancer therapy. However, cancers in each group are heterogeneous....
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3691-9
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:0.6-12.7% of patients with primary cutaneous melanoma will develop additional melanomas. Pathologic features of tumors in patients with multiple primary cutaneous melanomas have not been well described. In this large, international, multicenter, case-control study, we compared the clinicopathologic features ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-011-2058-8
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Surgery is the most important treatment for nonmetastatic breast cancer; however, the utilization of modern surgical techniques in management of breast cancer in mainland China has not been reported. METHODS:The medical records of 5887 consecutive breast cancer patients treated surgically in the past 16 yea...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9436-2
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) is known to reduce inflammatory response in relation to surgery. Inflammation may promote recurrence of cancer, thus inhibition by use of NSAIDs could reduce recurrence after surgery. OBJECTIVE:The aim of this study was to examine the associ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07600-8
更新日期:2019-11-01 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:This study was conducted to investigate whether annual surgical unit caseload affects extent of breast cancer surgery, breast cancer recurrence or breast cancer-specific survival. METHODS:In a population-based cohort study, 12,604 women diagnosed with breast cancer in Finland during the years 1998-2001 were...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1514-1
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:There are few reports on a dual dye and isotope approach using laparoscopy in gastric cancer sentinel node mapping. The aim of this study is to evaluate the feasibility of laparoscopic sentinel basin dissection for gastric cancer using simultaneous indocyanine green (ICG) and (99m)Tc-antimony sulfur colloid ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1221-y
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Examination of 15 or more lymph nodes is necessary for accurate staging of gastric adenocarcinoma. This study examined whether prognostic discrimination is improved by distinguishing between pT2 tumors limited to the muscularis propria (MP) and those extending to subserosa (SS). METHODS:A single-institution...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/aso.2003.09.009
更新日期:2003-08-01 00:00:00