Abstract:
INTRODUCTION:Survival in elderly patients undergoing mastectomy or lumpectomy has not been specifically analyzed. METHODS:Patients older than 70 years of age with clinical stage I invasive breast cancer, undergoing mastectomy or lumpectomy with or without radiation, and surveyed within 3 years of their diagnosis, were identified from the Surveillance, Epidemiology, and End Results and medicare health outcomes survey-linked dataset. The primary endpoint was breast cancer-specific survival (CSS). RESULTS:Of 1784 patients, 596 (33.4 %) underwent mastectomy, 918 (51.4 %) underwent lumpectomy with radiation, and 270 (15.1 %) underwent lumpectomy alone. Significant differences were noted in age, tumor size, American Joint Committee on Cancer (AJCC) stage, lymph node status (all p < 0.0001) and number of positive lymph nodes between the three groups (p = 0.003). On univariate analysis, CSS for patients undergoing lumpectomy with radiation [hazard ratio (HR) 0.61, 95 % confidence interval (CI) 0.43-0.85; p = 0.004] was superior to mastectomy. Older age (HR 1.3, 95 % CI 1.09-1.45; p = 0.002), two or more comorbidities (HR 1.57, 95 % CI 1.08-2.26; p = 0.02), inability to perform more than two activities of daily living (HR 1.61, 95 % CI 1.06-2.44; p = 0.03), larger tumor size (HR 2.36, 95 % CI 1.85-3.02; p < 0.0001), and positive lymph nodes (HR 2.83, 95 % CI 1.98-4.04; p < 0.0001) were associated with worse CSS. On multivariate analysis, larger tumor size (HR 1.89, 95 % CI 1.37-2.57; p < 0.0001) and positive lymph node status (HR 1.99, 95 % CI 1.36-2.9; p = 0.0004) independently predicted worse survival. CONCLUSIONS:Elderly patients with early-stage invasive breast cancer undergoing breast conservation have better CSS than those undergoing mastectomy. After adjusting for comorbidities and functional status, survival is dependent on tumor-specific variables. Determination of lymph node status remains important in staging elderly breast cancer patients.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Mogal HD,Clark C,Dodson R,Fino NF,Howard-McNatt Mdoi
10.1245/s10434-016-5582-8subject
Has Abstractpub_date
2017-01-01 00:00:00pages
100-107issue
1eissn
1068-9265issn
1534-4681pii
10.1245/s10434-016-5582-8journal_volume
24pub_type
杂志文章abstract:BACKGROUND:Adenoviral gene therapy is a promising new approach for the treatment of neoplastic diseases. To design rational clinical trials and distinguish the effects of therapeutic transgene expression from those caused by viral infection alone, the immune response to the vector must be understood. In these experimen...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-999-0088-2
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Low-grade appendiceal mucinous neoplasms (LAMNs) are tumors that often present with widespread mucin in the peritoneal cavity (pseudomyxoma peritonei [PMP]). Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are effective treatment, but no published recommendations exist regar...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-019-07678-0
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:We aim to report our results in terms of chronic toxicities and cosmetic outcomes after intraoperative radiotherapy (IORT) using kV X-rays in women treated for early breast cancer at our institution. METHODS:Patients with early breast carcinoma were recruited between April 2011 and November 2014. After breast-...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5920-5
更新日期:2017-09-01 00:00:00
abstract::Genetic polymorphisms play an important role in clinical response to cytotoxic therapies. We hypothesized that polymorphisms in cell cycle genes may modulate response to preoperative chemoradiation and survival of pancreatic cancer patients. We evaluated 12 single-nucleotide polymorphisms (SNPs) of ten cell cycle gene...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0220-8
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Our objective was to correlate the extent of margin positivity and the findings on re-excision specimens of infiltrating mammary carcinoma. METHODS:We selected 50 consecutive cases of infiltrating mammary carcinoma, including both infiltrating ductal carcinoma and infiltrating lobular carcinoma, with positi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/aso.2003.05.030
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Preoperative breast and lung markers have significant drawbacks, including migration, patient discomfort, and scheduling difficulties. SignalMark is a novel localizer device with a unique signal on Doppler ultrasound. OBJECTIVE:We aimed to evaluate intraoperative identification of SignalMark microspheres co...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6707-z
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Survival estimates following surgical resection of gastric adenocarcinoma are traditionally reported as survival from the date of surgery. Conditional survival (CS) estimates, however, may be more clinically relevant by accounting for time already survived. We assessed CS following surgical resection for gas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4116-5
更新日期:2015-02-01 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:PURPOSE:Neuropathic pain (NPP) following breast surgery extends morbidity in the postoperative period. The incidence and etiology of postoperative NPP remains unclear and under-reported in literature. This study aims to define the incidence of neuropathic pain following breast surgery and to identify patient characteri...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3156-6
更新日期:2013-10-01 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:Lymph node metastasis is widely accepted as one of the most important determinants of prognosis in colorectal cancer (CRC) patients. Therefore, there is an urgent need to identify molecular markers that can be used to predict lymph node metastasis. MATERIALS AND METHODS:Candidate genes were found using LMD ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1002-7
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Whether routinely prescribed opioids are necessary for pain control after discharge among lumpectomy/sentinel node biopsy (Lump/SLNB) patients is unclear. We hypothesize that Lump/SLNB patients could be discharged without opioids, with a failure rate < 10%. This study prospectively examines outcomes after ch...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08886-9
更新日期:2020-11-01 00:00:00
abstract:INTRODUCTION:Primary pancreatic lymphoma (PPL) is a rare tumor that is often misdiagnosed. Clinicopathologic features, optimal therapy, and outcomes are not well defined. We reviewed our institutional experience with PPL. METHODS:Search of our institutional database identified that between 1987-2012, 21,760 patients w...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4176-6
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Distal pancreatectomy with celiac axis resection (DP-CAR) is a treatment option for selected patients with pancreatic cancer involving the celiac axis. A recent multicenter European study reported a 90-day mortality rate of 16%, highlighting the importance of patient selection. The authors constructed a risk...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-018-07101-0
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Angiotensin 2 is a key biologic peptide in the renin-angiotensin system (RAS) that regulates blood pressure and renal hemodynamics. The potential role of the RAS in the promotion of tumor growth, angiogenesis, and metastasis also has been shown in the past few decades. This study investigated the prognostic ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4436-0
更新日期:2015-10-01 00:00:00
abstract:PURPOSE:To report outcomes for breast-conserving therapy using adjuvant accelerated partial breast irradiation with interstitial multicatheter brachytherapy by a cooperative group of institutions. METHODS:From 1992 to 2013, a total of 1356 patients were treated with breast-conserving surgery and adjuvant accelerated p...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4563-7
更新日期:2015-12-01 00:00:00
abstract::Many examples highlight the power of gene expression profiles, or signatures, to provide an understanding of biological phenotypes. This is best seen in the context of cancer, where expression signatures have tremendous power to identify new cancer subtypes and to predict clinical outcomes. Gene expression profiles ha...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1855-4
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Preoperative chemoradiotherapy has been widely adopted as the standard of care for stage II-III rectal cancers. However, patients with T3N0 lesions had been shown to have a better prognosis than other categories of locally advanced tumor. Thus, neoadjuvant chemoradiation is likely to be overtreatment in this...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0796-7
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:The 5th edition of Breast Imaging Reporting and Data System subdivides suspicious calcifications into two categories: 4B-amorphous, coarse heterogeneous, and fine pleomorphic calcifications; 4C-fine linear or fine linear branching calcifications. We investigated whether these revised categories are appropria...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4362-6
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Lateral lymph node dissection (LND) in the absence of macroscopic nodal metastasis remains controversial in sporadic medullary thyroid carcinoma (MTC). OBJECTIVES:The aims of our study were to determine the risk of lateral lymph node (LN) metastases with a focus on lateral contralateral N1, and to define a ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5292-2
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Tumor-associated glycoprotein-72 (TAG-72) is a mucin-like high-molecular-weight glycosylated protein complex overexpressed by many adenocarcinomas. Antigen-directed cancer surgery using radiolabeled anti-TAG-72 murine monoclonal antibodies (muMAbs) has been previously investigated for colorectal cancer. Surv...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1880-3
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:For patients with colorectal liver metastases, resection is the treatment of choice. Careful selection of these patients is crucial in order to reduce the chance of unexpected findings at laparotomy and abandoning further surgical intervention. Here, we evaluate the predictive value of CT and FDG-PET of the ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9259-6
更新日期:2007-02-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6961-0
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:Rates of both unilateral (UM) and contralateral prophylactic mastectomy (CPM) for unilateral early-stage breast cancer (ESBC) have been increasing since 2003. Recent studies suggest that this increase may be due to women choosing UM and CPM because of fear. We conducted an in-depth qualitative study to identify...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4033-7
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:L-phenylalanine mustard (LPAM) has been the standard for use in regional chemotherapy (RC) for unresectable in-transit melanoma. Preclinical data demonstrated that regional temozolomide (TMZ) may be more effective. METHODS:Patients with AJCC Stage IIIB or IIIC extremity melanoma who failed previous LPAM-bas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-014-3887-z
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:Evidence from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial suggests completion axillary lymph node dissection (cALND) after positive sentinel lymph node biopsy (+SLNB) does not improve outcomes in select patients, leading to practice variation. A multidisciplinary group of surgeons,...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5310-4
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Invasive ductal carcinoma (IDC) with lobular features (IDC-L) is not recognized as a subtype of breast cancer. We previously showed that IDC-L may be a variant of IDC with clinicopathological characteristics more similar to invasive lobular carcinoma (ILC). We sought to determine the re-excision rates of IDC...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3871-7
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Pathological responses of neoadjuvant chemotherapy (NCT) are associated with survival outcomes in patients with breast cancer. Previous studies constructed models using out-of-date variables to predict pathological outcomes, and lacked external validation, making them unsuitable to guide current clinical pra...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09214-x
更新日期:2020-10-23 00:00:00
abstract:BACKGROUND:Sentinel lymph node (SLN) mapping for melanoma and breast cancer has greatly enhanced the identification of micrometastases in many patients, thereby upstaging a subset of these patients. The purpose of this study was to see if SLN mapping technique could be used to identify SLNs in colorectal cancer and to ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-000-0120-z
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer may prevent the development of an impaired nutritional status due to reduced surgical stress compared with open distal gastrectomy (ODG). METHODS:This study was performed as an exploratory analysis of a phase III trial comparing LADG and ODG ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-014-3509-9
更新日期:2014-06-01 00:00:00