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 prospectively maintained database of patients undergoing TSSM and immediate breast reconstruction from 2005 to 2013 was reviewed. Outcomes included tumor involvement of resected nipple tissue and subsequent management, recurrences after nipple involvement, and trends in management of involved nipple tissue. RESULTS:The study included 1176 breasts in 751 patients treated with TSSM. The follow-up period was 31.3 months. The nipple-areolar complex (NAC) of 32 breasts (2.7 %) had a positive margin or involvement of nipple tissue. Of these breasts, 56 % contained invasive cancer, and 44 % had in situ disease. Management included repeat excision (11 cases, 34 % of cases), radiation of the NAC (as part of the postmastectomy breast field) without further excision (5 cases, 16 %), complete NAC removal (8 cases, 25 %), and no further treatment (8 cases, 25 %). Management by complete NAC skin excision significantly decreased during the study period (p = 0.003). The overall local recurrence rate was 6.2 %. No patients had recurrence in the preserved NAC skin. CONCLUSIONS:Despite expanding indications for TSSM, it can be performed safely with low rates of nipple involvement. Over time, tumor involvement of the nipple has been treated with re-excision or other alternative approaches to NAC removal that preserve the aesthetic benefits of total skin-sparing approaches without an early adverse impact on local recurrence.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Amara D,Peled AW,Wang F,Ewing CA,Alvarado M,Esserman LJdoi
10.1245/s10434-015-4646-5subject
Has Abstractpub_date
2015-11-01 00:00:00pages
3803-8issue
12eissn
1068-9265issn
1534-4681pii
10.1245/s10434-015-4646-5journal_volume
22pub_type
杂志文章abstract:BACKGROUND:We sought to identify genes associated with the progression and metastasis of esophageal squamous-cell cancer by comparing the expression profiles of normal, primary cancer, and metastatic cancer cells isolated with laser microdissection. METHODS:Oligo microarray analysis identified several lymph node-speci...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1271-1
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) is an accurate, reliable, and simple procedure to perform, and it is nowadays accepted as a standard diagnostic method for the differential diagnosis of thyroid nodules. However, a major limitation of US-FNAB is indeterminate cytology results at a t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-0992-5
更新日期:2010-08-01 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:The role neoadjuvant chemoradiotherapy (nCRT) plays in oncological outcomes in early T-stage rectal cancer is uncertain. The present work aims to clarify prognostic outcomes by estimating the effect of nCRT on tumor recurrence prior to major surgery compared with major surgery alone. PATIENTS AND METHODS:Pr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-019-08105-0
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Anatomical resection (AR) is a recommended surgical treatment for hepatocellular carcinoma (HCC), although the conventional procedure (dye injection) for AR is difficult to reproduce.1,2 The tumor-feeding portal pedicle compression technique has been proposed as an easy, reversible, repeatable, and oncologic...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08644-x
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Genetic and epigenetic alterations during development of pancreatic ductal adenocarcinomas (PDAC) are well known. Genetic and epigenetic data were correlated with tumor biology to find specific alterations responsible for invasion and metastasis in pancreatic ductal adenocarcinomas. METHODS:A total of 16 hu...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0531-4
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Peritoneal metastases portend poor prognosis in the setting of standard chemotherapy. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) improves outcomes, but relapse is common. We report a phase II trial evaluating the safety and efficacy of adjuvant αDC1 vaccination with chemo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09464-9
更新日期:2021-01-05 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
abstract:BACKGROUND:Extending the original criteria of the Chemoradiotherapy for Oesophageal Cancer followed by Surgery Study (CROSS) in daily practice may increase the treatment outcome of esophageal cancer (EC) patients. This retrospective national cohort study assessed the impact on the pathologic complete response (pCR) rat...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09372-y
更新日期:2020-11-28 00:00:00
abstract:PURPOSE:The peritoneal cancer index (PCI) is used to refer gastrointestinal malignancy patients to either palliative or curative management of their peritoneal carcinomatosis. The aim of this retrospective study was to evaluate the prognostic value of the PCI in patients with primary advanced epithelial ovarian cancer ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4329-7
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Intraoperative imprint cytology (IC) is one of several accurate, proven methods to detect tumor cells in sentinel lymph nodes (SLN) from patients with operable breast cancer. In patients treated with neoadjuvant chemotherapy (NAC), studies have demonstrated the feasibility and accuracy of SLN biopsy procedur...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-0952-0
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Routine cross-sectional imaging for staging of early-stage cutaneous melanoma is not recommended. This study sought to investigate the use of imaging for staging of cutaneous melanoma in the United States. METHODS:Patients with nonmetastatic cutaneous melanoma newly diagnosed between 2000 and 2007 were iden...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4268-3
更新日期:2015-04-01 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: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:Tumor budding is associated with adverse histology and is a predictor of lymph node metastasis. However, it remains unclear whether tumor budding is predictive of a poor prognosis for colon cancer patients. This study sought to investigate the prognostic significance of tumor budding in colon cancer. METHOD...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6135-5
更新日期:2018-01-01 00:00:00
abstract::Integrins play an important role in various lymphocyte functions. In this study, we isolated lamina propria lymphocytes (LPL) and tumor-infiltrating lymphocytes (TIL) from normal and malignant tissues in patients with colorectal cancer, and examined the expression of beta1 and beta2 integrins on these lymphocytes quan...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-999-0500-y
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Recent data have demonstrated multiple benefits of intra- and postoperative fluid restriction in major abdominal surgery; however, data regarding the outcomes of fluid restriction in cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) are limited. This study evaluates the safety...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-018-07092-y
更新日期:2019-02-01 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:Local excision might represent an alternative to total mesorectal excision for patients with locally advanced rectal cancer who achieve a major or complete clinical response after neoadjuvant chemoradiotherapy. METHODS:Between August 2005 and July 2011, 63 patients with mid-low rectal adenocarcinoma who had...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09243-6
更新日期:2020-10-30 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:Recently, traditional laparoscopic anterior resection has been used for rectal cancer, offering good functional results compared with open resection and resulting in better early postoperative outcomes. Few studies investigating the role of robot-assisted tumor-specific rectal surgery (RTSRS) have been carri...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-010-0909-3
更新日期:2010-06-01 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::Selected patients with hepatocellular carcinoma are candidates to receive potentially curative treatments, such as hepatic resection or liver transplantation, but nevertheless there is a high risk of tumor recurrence. Microvascular invasion is a histological feature of hepatocellular carcinoma related to aggressive bi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-012-2513-1
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Recent literature has shown that lymph node ratio (LNR) is superior to the number of positive lymph nodes (pLNs) in predicting the prognosis in several malignances other than colon cancer. We hypothesize that LNR may play a similar role in stage III colon cancer. METHODS:We included 24,477 stage III colon c...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9716-x
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Surgery for locally advanced rectal cancers beyond the plane of total mesorectal excision (TME) or extramesorectal nodal involvement should include complete resection. This study evaluated the oncologic feasibility and safety of robot-assisted surgery for rectal cancer beyond the TME plane. METHODS:The stud...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5117-3
更新日期:2016-07-01 00:00:00
abstract:INTRODUCTION:Plantar melanomas are a challenge to reconstruct after wide excision. Non-glaborous skin grafts have resulted in tissue loss, hyperkeratosis, marginal scarring, and poor functional outcomes, leading many to utilize various flaps for reconstruction that are technically demanding and associated with increase...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4449-8
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Integration of palliative care services into the surgical treatment plan is important for holistic patient care. We sought to examine the association between patient race/ethnicity and county-level vulnerability relative to patterns of hospice utilization. PATIENTS AND METHODS:Medicare Standard Analytic Fil...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09227-6
更新日期:2020-10-14 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:Data from randomized controlled trials support use of a diverting stoma in rectal cancer patients with low anastomoses, but there is little data on how this impacts patient quality of life (QOL). This study prospectively evaluates QOL in stage I-III rectal cancer patients undergoing sphincter-preserving surg...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-010-1446-9
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Extensive lymph node dissection (LND) is beneficial in primarily resected esophageal cancer patients. Such benefit was believed to be seen in neoadjuvant chemoradiotherapy (CRT)-treated patients, but evidence was inconsistent. We hypothesized that CRT might offset the benefit of LND in certain subgroup of pa...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2402-7
更新日期:2012-10-01 00:00:00