A Comparative Validation of Primary Surgical Versus Post-neo-adjuvant Chemotherapy Sentinel Lymph Node Biopsy for Stage III Breast Cancers.


INTRODUCTION:Sentinel lymph node biopsy (SLNB) is the standard of care for staging N0 primary early breast cancers (EBC). Patients in developing countries mostly present with large (LOBC) or locally advanced cancers (LABC) and are treated with neo-adjuvant chemotherapy (NACT). Accuracy of SLNB in staging stage III N0 and post-NACT N0 patients is uncertain. This prospective validation study on LOBC/LABC patients compared the accuracy of SLNB between primary versus post-NACT surgery. MATERIALS AND METHODS:Fifty T3/T4, N0 patients undergoing primary surgery (Group I) and 70 LOBC/LABC (index stage) treated with NACT and N0 at the time of surgery (Group II) were inducted. Validation SLNB was performed using low-cost methylene-blue and (99m)Tc-Antimony colloid. SLN identification (IR) and false-negative (FNR) rates were compared between the groups. Sub-group analysis was done in Group II per index tumor and nodal stage to identify factors predicting SLN IR and FNR in post-NACT patients. SLN IR and FNR in both groups were compared with those in previously published SLN validation study and meta-analysis in EBC. RESULTS:Using combination of blue-dye and radio-colloid, post-NACT SLN IR and FNR (82.9, 13.5 %) were far inferior to T3/T4 primary surgery group (94, 7.7 %; p values 0.034, 0.041) and in EBC. SLN IR using blue-dye alone was dismally low in post-NACT LABCs. Factors predicting unidentified post-NACT SLN and false-negative SLNB included young age, LVI, skin infiltration, extra-nodal spread or N2a stage, and UOQ tumors. CONCLUSIONS:Accuracy of SLNB in T3, N0 tumors undergoing primary surgery is comparable to that of SLNB for N0 EBC. In post-NACT patients, SLNB IR are lower and FNR are higher. Factors predictive of non-identification and false-negative SLNB include pre-NACT skin involvement (T4b), N2a stage or extra-nodal invasion and LVI, and to a lesser extent, young age and UOQ location of the tumor.


World J Surg


World journal of surgery


Agarwal G,Rajan S,Gambhir S,Lal P,Krishnani N,Kheruka S




Has Abstract


2016-07-01 00:00:00














  • Patterns of anterior abdominal stab wounds and their management at Princess Basma teaching hospital, North of Jordan.

    abstract:BACKGROUND:With the progressive use of new diagnostic techniques, the management of penetrating abdominal stab wounds is changing. Most studies have been conducted in well-equipped trauma centers in developed countries, and there is a paucity of reports from general teaching hospitals with limited resources. We reviewe...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Omari A,Bani-Yaseen M,Khammash M,Qasaimeh G,Eqab F,Jaddou H

    更新日期:2013-05-01 00:00:00

  • Emergency Abdominal Operations in the Elderly: A Multivariate Regression Analysis of 430 Consecutive Patients with Acute Abdomen.

    abstract:BACKGROUND:This study is intended to ascertain if outcome of acute abdominal surgery among elderly patients with acute abdominal pain have improved. METHODS:Altogether 456 patients aged >65 years underwent emergency abdominal surgery between the years 2007 and 2009 in our hospital. After excluding emergency reoperatio...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Ukkonen M,Kivivuori A,Rantanen T,Paajanen H

    更新日期:2015-12-01 00:00:00

  • Use of Liver Function Tests as First-line Diagnostic Tools for Predicting Common Bile Duct Stones in Acute Cholecystitis Patients.

    abstract:BACKGROUND:Prior studies have examined the use of liver function tests (LFT) for predicting the presence of common bile duct (CBD) stones in chronic cholecystitis (CC) patients. It is currently unclear whether LFT are also useful for predicting CBD stones in patients with acute cholecystitis (AC). METHODS:Of 1059 pati...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Ahn KS,Yoon YS,Han HS,Cho JY

    更新日期:2016-08-01 00:00:00

  • Cardiopulmonary assessment: is improvement needed?

    abstract::Clinical parameters alone have repeatedly been proven unreliable in assessing cardiopulmonary status, especially in hemodynamically unstable patients. To learn if we had a diagnostic problem in our hospital, we compared physician assessment of cardiac index (CI) and thoracic fluid content (TFC) to values obtained usin...

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章


    authors: Van De Water JM,Dalton ML,Parish DC,Vogel RL,Beatty JC,Adeniyi SO

    更新日期:2005-01-01 00:00:00

  • Labour Market Participation After Emergency Laparotomy: A Nationwide Cohort Study with Long-Term Follow-Up.

    abstract:BACKGROUND:Many patients who undergo emergency laparotomy are working, which is a key determinant for an individual's socio-economic status and financial security. The objectives of this study were to compare labour market participation and sick leave in a nationwide patient population undergoing non-malignant emergenc...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Thygesen LC,Gögenur I

    更新日期:2019-03-01 00:00:00

  • Evidence-based assessment of the role of ultrasonography in the management of benign thyroid nodules.

    abstract:BACKGROUND:Although ultrasonographic (US) evaluation is currently recommended for the workup of all palpable thyroid nodules, little guidance exists regarding the manner in which US data are to be used. Herein, we examine the available evidence and recommend how US can be used most effectively to predict malignancy. We...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Morris LF,Ragavendra N,Yeh MW

    更新日期:2008-07-01 00:00:00

  • Clinical Trials of Active Surveillance of Papillary Microcarcinoma of the Thyroid.

    abstract:BACKGROUND:The incidence of thyroid cancer is increasing globally. This is mainly due to the increase in the detection of small papillary carcinomas, including papillary microcarcinomas (PMC) 1 cm or smaller. It was suggested recently that PMCs are overdiagnosed and overtreated. METHODS:In 1993, the author proposed a ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Miyauchi A

    更新日期:2016-03-01 00:00:00

  • Recombinant human erythropoietin and hemoglobin concentration at operation and during the postoperative period: reduced need for blood transfusions in patients undergoing colorectal surgery--prospective double-blind placebo-controlled study.

    abstract::In a double-blind placebo-controlled study we investigated the effect of recombinant human erythropoietin (r-HuEPO), on the perioperative hemoglobin concentration and the use of blood transfusions in patients undergoing elective colorectal surgery with a preoperative hemoglobin level

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Qvist N,Boesby S,Wolff B,Hansen CP

    更新日期:1999-01-01 00:00:00

  • Donor age affects liver regeneration during early period in the graft liver and late period in the remnant liver after living donor liver transplantation.

    abstract:BACKGROUND:The aim of the present study was to evaluate the influence of donor age on liver regeneration and surgical outcomes in recipients and donors. PATIENTS AND METHODS:Among 101 cases of adult-to-adult living donor liver transplantation (LDLT) between March 2002 and March 2011, according to donor age: younger (Y...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Tanemura A,Mizuno S,Wada H,Yamada T,Nobori T,Isaji S

    更新日期:2012-05-01 00:00:00

  • Impact of transjugular intrahepatic portosystemic shunt on orthotopic liver transplantation.

    abstract::Transjugular intrahepatic portosystemic shunt (TIPS) is being increasingly utilized prior to liver transplantation for portal hypertensive bleeding refractory to sclerotherapy or as initial management of variceal bleeding. The impact of TIPS on subsequent orthotopic liver transplantation (OLT) is uncertain. The purpos...

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章


    authors: Menegaux F,Baker E,Keeffe EB,Monge H,Egawa H,Esquivel CO

    更新日期:1994-11-01 00:00:00

  • Laparoscopic fundoplication with prosthetic hiatal closure.

    abstract:BACKGROUND:Despite the good results reported after laparoscopic fundoplication, failure is still a major problem. Hiatal disruption is one of the common patterns of anatomical failure. The aim of this study was to compare the results of suture repair of diaphragmatic crura with routine polypropylene mesh reinforcement ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Turkcapar A,Kepenekci I,Mahmoud H,Tuzuner A

    更新日期:2007-11-01 00:00:00

  • Correction to: Effectiveness of Topical Insulin Dressings in Management of Diabetic Foot Ulcers.

    abstract::In the original article, Mehreen K. Bhettani's last name and Mubarik Rehman's first name are misspelled. ...

    journal_title:World journal of surgery

    pub_type: 杂志文章,已发布勘误


    authors: Bhettani MK,Rehman M,Altaf HN,Altaf OS

    更新日期:2020-06-01 00:00:00

  • Indications for early postoperative intraperitoneal chemotherapy of advanced gastric cancer: results of a prospective randomized trial.

    abstract::Previous analysis of this prospective randomized trial and meta-analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis....

    journal_title:World journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Yu W,Whang I,Chung HY,Averbach A,Sugarbaker PH

    更新日期:2001-08-01 00:00:00

  • Is There Justification for Total Thyroidectomy in Low-Risk Papillary Thyroid Carcinoma? A Decision-Analysis Model.

    abstract:BACKGROUND:Low-risk papillary thyroid carcinoma is commonly treated surgically. However, uncertainties exist in regard to the optimal extent of surgery. We approached this question using a decision-analysis model. METHODS:A Markov model was used to compare outcome between patients with small (1-2 cm) low-risk PTC trea...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Stern S,Hilly O,Horowitz E,Leshno M,Feinmesser R

    更新日期:2015-11-01 00:00:00

  • Pancreaticoduodenal resection for malignancy in a low-volume center: long-term outcomes from a developing country.

    abstract:BACKGROUND:The technical complexity of pancreatic resection has made it a specialized procedure performed in high-volume centers. It has been shown that patients operated on in high-volume pancreatobiliary centers have fewer complications and better survival. The purpose of this study was to share our experience with a...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Bhatti AB,Yusuf MA,Kazmi SA,Syed AA

    更新日期:2014-10-01 00:00:00

  • Parafibromin, galectin-3, PGP9.5, Ki67, and cyclin D1: using an immunohistochemical panel to aid in the diagnosis of parathyroid cancer.

    abstract:BACKGROUND:Parathyroid cancer is rare. Differentiating parathyroid carcinoma from degenerative changes at histopathology can be difficult and studies investigating the value of single immunohistochemical markers have had variable results. In this study we aimed to investigate whether a panel of immunohistochemistry mar...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Truran PP,Johnson SJ,Bliss RD,Lennard TW,Aspinall SR

    更新日期:2014-11-01 00:00:00

  • Educational and clinical impact of Advanced Trauma Life Support (ATLS) courses: a systematic review.

    abstract:BACKGROUND:We aimed to systematically review the literature on the educational impact of Advanced Trauma Life Support (ATLS) courses and their effects on death rates of multiple trauma patients. METHODS:All Medline, Pubmed, and the Cochrane Library English articles on the educational impact of ATLS courses and their e...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Mohammad A,Branicki F,Abu-Zidan FM

    更新日期:2014-02-01 00:00:00

  • Pre-operative radiotherapy as adjuvant treatment in rectal cancer.

    abstract::From January, 1975 to December, 1987, 241 patients with rectal cancer underwent pre-operative irradiation and surgical resection. The radiation was delivered with 25 MeV photons, 5 days per week by 2.4 grays fractions up to a total dose of 36 grays. Surgery was curative in 195 patients; 57% had abdomino-perineal resec...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Izar F,Fourtanier G,Pradere B,Chiotasso P,Bloom E,Fontes-Dislaire I,Bugat R,Daly N

    更新日期:1992-01-01 00:00:00

  • Clinicopathological study on carcinoma of the extrahepatic bile duct with special focus on cancer invasion on the surgical margins.

    abstract::To clarify the clinical significance of the status of surgical margins, especially the dissected margin in the transverse direction, a clinicopathologic study was performed on 60 patients with carcinoma of the bile duct who underwent radical resection. The patients in group A (n = 28) had no cancer invasion within 5 m...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Ogura Y,Takahashi K,Tabata M,Mizumoto R

    更新日期:1994-09-01 00:00:00

  • Optimal Prediction of the Central Venous Catheter Insertion Depth Targeting the Cavoatrial Junction.

    abstract:BACKGROUND:Central venous catheters should be positioned at the cavoatrial junction or the right atrium. If catheters are inserted to a depth derived by adding the length between the needle insertion point and the clavicular notch and the length between the clavicular notch and the carina, the catheter tip can be place...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Mo H,Ahn S,Lee J,Cho S,Min SK

    更新日期:2020-07-01 00:00:00

  • Acute Limb Ischemia Secondary to Native Artery Occlusion: Results of a Contemporary Case Series.

    abstract:BACKGROUND:The treatment of acute limb ischemia (ALI) has barely changed over the last years. However, the progressive implementation of anticoagulants, antiplatelet agents or statins within the population might have modified the profile and prognosis of patients suffering an ALI. The aim of this study was to evaluate ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Seguí N,Ruiz-Carmona C,Velescu A,Mateos E,Elosua R,Clará A

    更新日期:2018-08-01 00:00:00

  • Risk Factors for Early Postoperative Small Bowel Obstruction After Anterior Resection for Rectal Cancer.

    abstract:PURPOSE:The aim of the study was to evaluate risk factors for small bowel obstruction (SBO) in early postoperative period after anterior resection for rectal cancer. METHODS:Patients who underwent anterior resection (AR) [high AR (HAR) or low AR (LAR)] for rectal cancer between January 2009 and April 2016 were enrolle...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Suwa K,Ushigome T,Ohtsu M,Narihiro S,Ryu S,Shimoyama Y,Okamoto T,Yanaga K

    更新日期:2018-01-01 00:00:00

  • Developing Metrics to Define Progress in Children's Surgery.

    abstract::There is a need for relevant, valid, and practical metrics to better quantify both need and progress in global pediatric surgery and for monitoring systems performance. There are several existing surgical metrics in use, including disability-adjusted life years (DALYs), surgical backlog, effective coverage, cost-effec...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Poenaru D,Seyi-Olajide JO

    更新日期:2019-06-01 00:00:00

  • Quality of life of patients with inflammatory bowel disease after surgery.

    abstract::Quality of life is an important outcome measure following surgery for ulcerative colitis. Quality of life incorporates not only the physical or functional outcome; it also considers the emotional and social well-being of patients. Quality of life may be measured using disease-specific or generic quality of life measur...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: McLeod RS,Baxter NN

    更新日期:1998-04-01 00:00:00

  • 10-Year Oncologic Outcomes After Laparoscopic or Open Total Mesorectal Excision for Rectal Cancer.

    abstract:BACKGROUND:Only few studies have compared laparoscopic total mesorectal excision (LTME) and open total mesorectal excision (OTME) for rectal cancer with follow-up longer than 5 years. The aim of this study was to compare 10-year oncologic outcomes after LTME and OTME for nonmetastatic rectal cancer. METHODS:We conduct...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Allaix ME,Giraudo G,Ferrarese A,Arezzo A,Rebecchi F,Morino M

    更新日期:2016-12-01 00:00:00

  • Long-term quality of life after hepatic resection: health is not simply the absence of disease.

    abstract:BACKGROUND:Due to advances in operative methods and perioperative care, mortality and morbidity following major hepatic resection have decreased substantially, making long-term quality of life (QoL) an increasingly prominent issue. We evaluated whether postoperative diagnosis was associated with long-term QoL and healt...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Banz VM,Inderbitzin D,Fankhauser R,Studer P,Candinas D

    更新日期:2009-07-01 00:00:00

  • Cost-effectiveness of a district trauma hospital in Battambang, Cambodia.

    abstract:BACKGROUND:The Emergency Hospital in Battambang, Cambodia, is essentially a surgical center for victims of injuries. METHODS:Using methods previously described, operating costs were calculated, and effectiveness of treatment was estimated for 957 patients undergoing 895 surgical procedures over a 3 month period (Octob...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Gosselin RA,Heitto M

    更新日期:2008-11-01 00:00:00

  • The rate-limiting step: the provision of safe anesthesia in low-income countries.

    abstract:BACKGROUND:The importance of safe anesthesia for the best possible surgical outcomes in every patient is not disputed in high resource settings. Low-income countries lag far behind in the provision of, and training for, safe anesthesia practice. Too little is known about numbers and types of providers in a majority of ...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Hendel S,Coonan T,Thomas S,McQueen K

    更新日期:2015-04-01 00:00:00

  • Clinical and pathologic differences between BRCA1-, BRCA2-, and non-BRCA-associated breast cancers in a multiracial developing country.

    abstract:BACKGROUND:Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but to date there have only been limited numbers of studies of BRCA1- and BRCA2-associated cancers among Asians. Malaysia is a multiracial country with three main races: Malays, Chinese, Indians. We determined whether tumor pa...

    journal_title:World journal of surgery

    pub_type: 杂志文章


    authors: Yip CH,Taib NA,Choo WY,Rampal S,Thong MK,Teo SH

    更新日期:2009-10-01 00:00:00

  • Moving from data collection to application: a systematic literature review of surgical capacity assessments and their applications.

    abstract:BACKGROUND:Over the past decade, assessments of surgical capacity in low- and middle-income countries (LMICs) have contributed to our understanding of barriers to the delivery of surgical services in a number of countries. It is yet unclear, however, how the findings of these assessments have been applied and built upo...

    journal_title:World journal of surgery

    pub_type: 杂志文章,评审


    authors: Carlson LC,Lin JA,Ameh EA,Mulwafu W,Donkor P,Derbew M,Rodas E,Mkandawire NC,Dhanaraj M,Yangni-Angate H,Sani R,Labib M,Barbero R,Clarke D,Smith MD,Sherman L,Mutyaba FA,Alexander P,Hadley LG,VanRooyen MJ,Kushner AL

    更新日期:2015-04-01 00:00:00