Abstract：
BACKGROUND:Surgery is the only curative treatment for primary cutaneous melanoma, therefore it is important to determine excision margins that minimise risk of local recurrence, distant recurrence and death. METHODS:MEDLINE, EMBASE and Cochrane CENTRAL were searched from 2009 to 2015. Inclusion criteria were: population/setting - patients with primary melanoma; comparison - narrow versus wide margins; outcomes - overall survival, melanoma-specific survival, recurrence-free survival, and loco-regional recurrence; design - randomized controlled trials (RCTs). Results were pooled using meta-analysis and data explored using likelihood Bayesian probability plots. RESULTS:Six RCTs with 4233 patients were included. Narrow margins were defined as 1 or 2 cm of clinically normal skin around the melanoma; wide margins as 3, 4 or 5 cm. Hazard ratios (HR) were as follows (HR>1 indicates wide margin better): overall survival 1.09 (95% CI 0.98-1.22; p=0.1); melanoma-specific survival 1.17 (CI 1.03-1.34; p=0.02); recurrence-free survival 1.08 (CI 0.97-1.20; p=0.2); loco-regional recurrence 1.10 (CI 0.96-1.26; p=0.2), with no evidence of heterogeneity between trials for any end point or within subgroup analyses. There was an 94% probability that overall survival was worse with a narrow margin and a 43% probability that it was more than 10% worse in proportional terms (i.e. HR>1.1). Probabilities that narrow margins were worse were 99%, 92% and 92% for melanoma-specific survival, recurrence-free survival and loco-regional recurrence respectively. CONCLUSIONS:Contrary to recommendations in several national guidelines that narrow margins are safe, this systematic review and meta-analysis provides evidence that a narrow margin may lead to a worse outcome than a wide margin.
journal_name
Cancer Treat Revjournal_title
Cancer treatment reviewsauthors
Wheatley K,Wilson JS,Gaunt P,Marsden JRdoi
10.1016/j.ctrv.2015.10.013subject
Has Abstractpub_date
2016-01-01 00:00:00pages
73-81eissn
0305-7372issn
1532-1967pii
S0305-7372(15)00199-1journal_volume
42pub_type
杂志文章,meta分析,评审abstract：BACKGROUND:The incidence of brain metastases (BM) in melanoma patients is common and associated with poor prognosis. MAP-kinase inhibitors and immunologic checkpoint blockade antibodies led to improved survival of metastatic melanoma patients; however, patients with BM are under-represented or excluded from the majorit...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2016.03.003
更新日期：2016-04-01 00:00:00
abstract：:The term Unfit refers to older cancer patients not amenable with standard treatment and needing therefore a modified or attenuated treatment or also not deserving an active therapeutic approach. To determine whether an old patient is Unfit a Multidimensional Geriatric Evaluation is needed, but to spare time, shortened...
journal_title：Cancer treatment reviews
pub_type： 杂志文章
doi：10.1016/j.ctrv.2009.04.006
更新日期：2009-10-01 00:00:00
abstract：:Sarcomas of the head and neck region are a rare group of tumors in children and present challenges with regard to evaluation and treatment. Rhabdomyosarcomas are the most common sarcomas of the head and neck in children. Presence of metastases and complete surgical resectability continue to be the most relevant clinic...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2011.04.005
更新日期：2011-10-01 00:00:00
abstract：:Oxaliplatin is widely regarded as being active in cisplatin-resistant cancer. We undertook a systematic review of the literature to identify, describe and critique the clinical and pre-clinical evidence for the use of oxaliplatin in patients with "cisplatin-resistant" cancer. We identified 25 pre-clinical cell models ...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2007.01.009
更新日期：2007-06-01 00:00:00
abstract：:Borderline ovarian tumours (BOT) may occur in young women and have an excellent survival rate. Therefore, there is the obligation to put emphasis on fertility preservation in affected women. On the other hand, it has also been underlined that the disease should be managed with caution because these tumours can relapse...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2016.06.010
更新日期：2016-09-01 00:00:00
abstract：:Diffusion-weighted magnetic resonance imaging (DW-MRI) is used extensively to improve tumour detection and localization because it offers excellent soft tissue contrast between malignant and non-malignant tissues. It also provides a quantitative biomarker; the apparent diffusion coefficient (ADC) can be derived from D...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2015.03.010
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND:We performed a systematic review and meta-analysis of randomised trials of neo-adjuvant hormone therapy (NHT) in localised and locally advanced prostate cancer to assess the effectiveness of this therapy. METHODS:We searched MEDLINE, The Cochrane Library, Science Citation Index, LILACS and SIGLE for randomi...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.ctrv.2008.08.002
更新日期：2009-02-01 00:00:00
abstract：:We have previously shown that the stem cell inhibitory peptide pGlu-Glu-Asp-Cys-Lys (pEEDCK monomer) leads to a good tolerance of otherwise lethal multiple ara-C doses and an increased survival of ara-C + peptide treated mice. This effect was due to the prevention of drug-induced CFU-S proliferation, thus keeping stem...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/0305-7372(90)90068-q
更新日期：1990-09-01 00:00:00
abstract：:Surgery has been considered the standard of care in patients with early-stage non-small cell lung cancer (NSCLC), as well as in some cases of stage III, for a long time. Poor survival after complete resection has led to the search for new therapeutic strategies such as combining anticancer treatments. However, at the ...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1053/ctrv.2001.0218
更新日期：2001-04-01 00:00:00
abstract：:Prostate cancer is the most common malignancy in elderly men and is often associated with bone metastases. Although bone metastases are osteosclerotic, histological and biochemical studies clearly indicate an increase of both bone formation and bone resorption, providing the rational for using bisphosphonate as a pall...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1053/ctrv.2000.0213
更新日期：2001-06-01 00:00:00
abstract：:Metastatic breast cancer is ultimately an incurable disease, although recent data have shown that its incidence is decreasing and that patients with metastatic breast cancer live longer. This improvement in survival seems to be linked with the introduction of new therapeutic agents, novel combinations of existing ther...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2009.10.001
更新日期：2010-02-01 00:00:00
abstract：:Patients with malignant disease may need hormonal therapy as primary or adjuvant treatment or for palliation. Oestrogens usually decrease serum levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), increase high density lipoprotein cholesterol (HDL-C) concentration, but induce an elevation ...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2008.09.007
更新日期：2009-04-01 00:00:00
abstract：:Gastric cancer is still a major health problem and a leading cause of cancer mortality despite a worldwide decline in incidence. Environmental and Helicobacter pylori (Hp) acting early in life in a multistep and multifactorial process may cause intestinal type carcinomas, whereas genetic abnormalities are related more...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1053/ctrv.2000.0164
更新日期：2000-08-01 00:00:00
abstract：:Capecitabine is an orally administered fluoropyrimidine carbamate which has been developed as a prodrug of 5-FU with the goal to improve its tolerability and intratumoral drug concentration. The review aims to provide an evidence-based update of clinical trials investigating the clinical efficacy, adverse-event profil...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/S0305-7372(10)70020-7
更新日期：2010-11-01 00:00:00
abstract：:In the last ten years, the development of several novel targeted drugs and the refinement of state of the art technologies such as the genomics and proteomics and their introduction to clinical practice have revolutionized the management of patients affected by cancer. However, everyday practice points out several cli...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2007.10.001
更新日期：2008-04-01 00:00:00
abstract：:Due to differences in anatomy, primary rectal and colon cancer require different staging procedures, different neo-adjuvant treatment and different surgical approaches. For example, neoadjuvant radiotherapy or chemoradiotherapy is administered solely for rectal cancer. Neoadjuvant therapy and total mesorectal excision...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2015.06.007
更新日期：2015-09-01 00:00:00
abstract：:Breast cancer is the most common malignancy in women worldwide, with a relatively high proportion of patients experiencing resistance to standard treatments. Cellular immunotherapy (CI), which is based on the extraction, modification, and re-infusion of the patient's immune cells, is showing promising results in these...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2020.102089
更新日期：2020-11-01 00:00:00
abstract：:Differentiated thyroid cancer is the most common endocrine malignancy, and its incidence has been rising rapidly over the past 10 years. Although most patients with this disease have an excellent prognosis, a subset develops a more aggressive disease phenotype refractory to conventional therapies. Until recently, ther...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2015.06.002
更新日期：2015-09-01 00:00:00
abstract：:Lung cancer represents the most common cause of brain dissemination. Oncogene-addicted (EGFR- and ALK-positive) non-small cell lung cancers (NSCLCs) are characterized by a unique metastatic neurotropism resulting in a particularly high incidence of brain metastases. The goal of optimal brain metastases management is t...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2018.10.011
更新日期：2018-12-01 00:00:00
abstract：:There has been much progress in the understanding of the relationship between the immune system and colorectal cancer. This has led to the use of immunomodulatory therapy in the adjuvant and palliative treatment of the condition. Although attempts at the use of non-specific immunomodulation with agents such as levamis...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1053/ctrv.1999.0160
更新日期：2000-06-01 00:00:00
abstract：:Drug resistance is a major problem in the treatment of solid tumours. Based on a steep dose-response relationship for especially alkylating agents on tumour cell survival, high-dose chemotherapy was considered of interest for the treatment of solid tumours. Results of phase 1 and 2 studies with high-dose chemotherapy ...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2005.02.002
更新日期：2005-05-01 00:00:00
abstract：:Galectins belong to a family of carbohydrate-binding proteins with an affinity for β-galactosides. Galectin-1 is differentially expressed by various normal and pathologic tissues and displays a wide range of biological activities. In oncology, galectin-1 plays a pivotal role in tumor growth and in the multistep proces...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2013.07.007
更新日期：2014-03-01 00:00:00
abstract：:Metastatic colorectal cancer (CRC) is most frequently seen in the liver. Resection of metastases remains the treatment of choice; however, the majority of patients are ineligible for surgery due to unfavorable location, size, or number of metastases; insufficient liver reserve; or extrahepatic disease. The activity of...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2008.01.004
更新日期：2008-06-01 00:00:00
abstract：INTRODUCTION:Identification of membrane proteins expressed exclusively on tumor cells is a goal for cancer drug development. The receptor tyrosine kinase-like orphan receptor type 1 and 2 (ROR1/2), are type-I transmembrane proteins expressed in cancer but not in adult normal tissue. Here, we explore the prognostic role...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,meta分析
doi：10.1016/j.ctrv.2019.05.006
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Epidemiological evidence supports the existence of a survival advantage for female patients with melanoma. This survival advantage often persists when other prognostic variables are taken into account. The basis for this female advantage or male disadvantage is not established although female sex steroids ca...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1053/ctrv.2001.0220
更新日期：2001-08-01 00:00:00
abstract：:Patients with solid tumours are at risk of impaired bone health from metastases and cancer therapy-induced bone loss (CTIBL). We review medical management of bone health in patients with solid tumours over the past 30 years, from first-generation bisphosphonates to the receptor activator of nuclear factor κB ligand (R...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2019.05.003
更新日期：2019-06-01 00:00:00
abstract：:The estrogen receptor α (ER) and the progesterone receptor (PgR) are one of the most important prognostic and predictive immunohistochemical markers in breast cancer. Breast cancers may express various profiles of hormone receptors: ER(+)/PgR(+), ER(-)/PgR(-), ER(+)/PgR(-) and ER(-)/PgR(+). The existence of the latter...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2018.05.005
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:Different modalities of treatment in early laryngeal cancer lead to equivalent oncological outcomes. Hence this systematic review was undertaken to synthesise the key oncological outcomes following primary open partial laryngectomy for laryngeal cancer. METHODS:A systematic review of the English literature ...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.ctrv.2011.05.010
更新日期：2012-05-01 00:00:00
abstract：:RAS family proteins (including KRAS and NRAS) play important roles in the epidermal growth factor receptor (EGFR) signaling pathway. Mutations in RAS genes (occurring at loci in exons 2, 3, and 4) often result in constitutive activation of RAS proteins and persistent downstream signaling. Mutations in KRAS exon 2 (cod...
journal_title：Cancer treatment reviews
pub_type： 杂志文章,评审
doi：10.1016/j.ctrv.2015.05.008
更新日期：2015-09-01 00:00:00
abstract：:From a theoretical viewpoint, intraperitoneal therapy (IP) in patients with ovarian cancer, a malignancy which remains mainly confined to the peritoneal cavity, is logical. Over the past decades this approach has evolved into a therapeutic strategy for a selected group of patients. Data available at present suggest a ...
journal_title：Cancer treatment reviews
pub_type： 杂志文章
doi：10.1053/ctrv.1999.0152
更新日期：2000-04-01 00:00:00
