Abstract:
BACKGROUND:Patients with palpable melanoma groin metastases have a poor prognosis. There is debate whether a combined superficial and deep groin dissection (CGD) is necessary or if superficial groin dissection (SGD) alone is sufficient. AIM:The aim of this study was to analyze risk factors for deep pelvic nodal involvement in a retrospective, multicenter cohort of palpable groin melanoma metastases. This could aid in the development of an algorithm for selective surgery in the future. METHODS:This study related to 209 therapeutic CGDs from four tertiary centers in The Netherlands (1992-2013), selected based on complete preoperative imaging and pathology reports. Analyzed risk factors included baseline and primary tumor characteristics, total and positive number of inguinal nodes, inguinal lymph node ratio (LNR) and positive deep pelvic nodes on imaging (computed tomography [CT] ± positron emission tomography [PET], or PET - low-dose CT). RESULTS:Median age was 57 years, 54 % of patients were female, and median follow-up was 21 months (interquartile range [IQR] 11-46 months). Median Breslow thickness was 2.10 mm (IQR 1.40-3.40 mm), and 26 % of all primary melanomas were ulcerated. Positive deep pelvic nodes occurred in 35 % of CGDs. Significantly fewer inguinal nodes were positive in case of negative deep pelvic nodes (median 1 [IQR 1-2] vs. 3 [IQR 1-4] for positive deep pelvic nodes; p < 0.001), and LNR was significantly lower for negative versus positive deep pelvic nodes [median 0.15 (IQR 0.10-0.25) vs. 0.33 (IQR 0.14-0.54); p < 0.001]. A combination of negative imaging, low LNR, low number of positive inguinal nodes, and no extracapsular extension (ECE) could accurately predict the absence of pelvic nodal involvement in 84 % of patients. CONCLUSIONS:Patients with negative imaging, few positive inguinal nodes, no ECE, and low LNR have a low risk of positive deep pelvic nodes and may safely undergo SGD alone.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Oude Ophuis CM,van Akkooi AC,Hoekstra HJ,Bonenkamp JJ,van Wissen J,Niebling MG,de Wilt JH,van der Hiel B,van de Wiel B,Koljenović S,Grünhagen DJ,Verhoef Cdoi
10.1245/s10434-015-4602-4subject
Has Abstractpub_date
2015-12-01 00:00:00pages
S1172-80eissn
1068-9265issn
1534-4681pii
10.1245/s10434-015-4602-4journal_volume
22 Suppl 3pub_type
杂志文章,多中心研究abstract:BACKGROUND:COX inhibitors and beta-blockers were recently suggested to reduce cancer progression through inhibition of tumor proliferation and growth factor secretion, induction of tumor apoptosis, and prevention of cellular immune suppression during the critical perioperative period. Here we evaluated the perioperativ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9890-5
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Data on isolated limb perfusion (ILP) in elderly melanoma patients are scarce. We aimed to evaluate the efficacy and safety of ILP in our institutional cohort of melanoma patients. METHODS:We performed retrospective analysis of stage IIIB/C melanoma patients who underwent ILP for melanoma in-transit metasta...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5803-9
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The prognostic value of c-erbB-2 and vascular endothelial growth factor (VEGF) expression in colorectal liver metastases (CLM) is unclear. The purpose of this study was to clarify the relationship of c-erbB-2 and VEGF with the clinicopathological parameters and the survival results in CLM. METHODS:For 44 pa...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0897-3
更新日期:2010-06-01 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:Initial therapy for early hepatocellular carcinoma (HCC) with well-compensated cirrhosis is controversial. While we previously reported on the effect of clinical factors and surgeon specialty on choice of therapy for early HCC, other nonclinical factors also may impact decision-making. METHODS:Surgeons who ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2619-5
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Curative resection has been shown to be one of the key factors influencing survival of pancreatic ductal adenocarcinoma (PDAC) patients. Although general guidelines for the processing of pancreatic specimens have been established, there is currently no widely accepted standardized protocol for pathological e...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9839-8
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:The oncological safety of skin-sparing mastectomy (SSM) has been the object of several studies. METHODS:From June 2003 to January 2004, 42 breast cancer patients, stage 0 to IIIA, underwent SSM. Before surgery, two lines were drawn on the breast skin, representing SSM and conventional mastectomy incisions. ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.11.027
更新日期:2005-12-01 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:Resection margin status is a known prognosticator in patients who undergo resection for hilar cholangiocarcinoma. However, the influence of an isolated positive circumferential margin on clinical outcome is unclear. METHODS:Patients with resected de novo hilar cholangiocarcinoma from two European hepatobili...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09105-1
更新日期:2020-09-10 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:Barrett's esophagus (BE) is a premalignant lesion characterized by replacement of normal squamous epithelium with columnar epithelium. This lesion can progress to dysplasia and adenocarcinoma. Recently, the Fas receptor and retinoblastoma (Rb) protein have been described as important mediators of apoptosis a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-999-0298-7
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Many invasive breast cancers are accompanied by a variety of noninvasive components. Histological distinctions have been made between these components, but to understand their importance, it is essential to examine their molecular biology. METHODS:Proliferative indices, oncoproteins, and steroid receptor ex...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02306378
更新日期:1995-09-01 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:Two prospective, randomized trials, TARGIT-A and ELIOT, have shown intraoperative radiation therapy to be a safe alternative, with a low-risk of local recurrence, compared with whole breast radiation therapy, following breast-conserving surgery, for selected low-risk patients. We report the first 1000 tumors...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6614-3
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Debate regarding axillary dissection in the treatment of women with small invasive cancers of the breast has been increasing. Recently, omission of axillary dissection has been proposed because of the reported low incidence of nodal metastases in women with such cancers. Variation in the incidence of nodal m...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1007/BF02303756
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Recently, ultrasound (US)-guided needle biopsy has been proposed as an acceptable alternative to open biopsy in women with nonpalpable breast masses. This study evaluated the accuracy of US-guided needle biopsy of nonpalpable breast masses performed by surgeons at the time of the initial clinical examination...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02305766
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Isolated limb infusion (ILI) is a limb-preserving treatment for in-transit extremity melanoma. The benefit of resecting residual disease after ILI is unclear. METHODS:A multi-institutional experience was analyzed comparing patients who underwent ILI plus resection of residual disease (ILI + RES) versus ILI-...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-013-3336-4
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:We sought to determine the competence of medical students and surgery residents in evaluating clinical problems (using both real and simulated patients) in surgical oncology. METHODS:Forty-five third-year medical students, 23 first postgraduate year (PGY-1) residents, and seven second postgraduate year (PGY...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303525
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:The benefit of adjuvant treatment in gastric adenocarcinoma was demonstrated by randomized, controlled trials of patients with locally advanced tumors. Thus, its role for stage IIB-IIIC disease is widely accepted. We aimed to identify patients with stage IA-IIA gastric adenocarcinoma who have a poor prognosi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2852-y
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a "clinic-ready" intraoperative d...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5337-6
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Preoperative localization is the first step towards minimally invasive targeted parathyroidectomy. While there are data emphasizing that surgeon experience optimizes operative outcomes, the role of the radiologist's experience in successful preoperative imaging is unclear. We hypothesized that the accuracy o...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2581-2
更新日期:2012-11-01 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:Little is known about complications after major duodenopancreatic surgery for duodenopancreatic neuroendocrine tumors (dpNETs) in multiple endocrine neoplasia type 1 (MEN1). Therefore, the incidence and severity of complications after major surgery for MEN1-related dpNETs were assessed. METHODS:Patients wer...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09496-1
更新日期:2021-01-31 00:00:00
abstract:BACKGROUND:This study evaluates the accuracy of computed tomography (CT) scoring of the peritoneal cancer index (PCI) and examines its association with surgical morbidity and outcomes in pseudomyxoma peritonei. METHODS:Forty-seven patients with pseudomyxoma peritonei had preoperative evaluation of CT scans and were tr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1492-3
更新日期:2011-06-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6970-z
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:With the exception of papillary and follicular thyroid cancer, malignant cancers of the thyroid, parathyroid, adrenal, and endocrine pancreas are uncommon. These rare malignancies present a challenge to both the clinician and patient, because few data exist on their incidence or survival. We analyzed the incide...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4901-9
更新日期:2016-02-01 00:00:00
abstract::Adenocarcinoma of the pancreas continues to be a formidable disease. In the United States, patients who have had resected disease are generally offered adjuvant chemoradiation. The current National Comprehensive Cancer Network practice guidelines uniformly support this practice. We reviewed seven selected series to ev...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/aso.2003.06.015
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:There is evidence that insulin-like growth factors play a role in the development of breast cancer. Antiestrogens reduce circulating levels of IGF-I, but the influence of other breast cancer treatments, including surgery, is unknown and is investigated in this study. METHODS:Circulating serum concentrations...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0025-5
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Guidelines regarding specific resection margins for primary Merkel cell carcinoma (MCC) are not well established. The current National Comprehensive Cancer Network (NCCN) guidelines recommend 1- to 2-cm resection margins. This study aimed to determine the impact of margin width on local recurrence (LR), dise...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6688-y
更新日期:2018-10-01 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