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%, this study aimed to stratify this group further to predict disease recurrence more accurately. METHODS:The Ki-67 index was pathologically re-reviewed and scored by a pathologist blinded to all other clinicopathologic variables using tissue microarray blocks made in triplicate. All patients who underwent curative-intent resection of non-metastatic PanNETs at a single institution from 2000 to 2013 were included in the study. The primary outcome was recurrence-free survival (RFS). RESULTS:Of 113 patients with well-differentiated PanNETs resected, 83 had tissue available for pathologic re-review. The Ki-67 index was lower than 3% for 72 tumors (87%) and between 3 and 20% for 11 tumors (13%). Considering only Ki-67 less than 3%, the tumors were further stratified by Ki-67 into three groups: group A (< 1%, n = 43), group B (1-1.99%, n = 23), and group C (2-2.99%, n = 6). Compared with group A, groups B and C more frequently had advanced T stage (T3: 44% and 67% vs 12%; p = 0.003) and lymphovascular invasion (50% and 83% vs 23%; p = 0.007). Groups B and C had similar 1- and 3-year RFS, both less than group A. After combining groups B and C, a Ki-67 of 1-2.99% was associated with decreased RFS compared with group A (< 1%). This persisted in the multivariable analysis (hazard ratio [HR] 8.6; 95% confidence interval [CI] 1.0-70.7; p = 0.045), with control used for tumor size, margin-positivity, lymph node involvement, and advanced T stage. CONCLUSIONS:PanNETs with a Ki-67 of 1-2.99% exhibit distinct biologic behavior and earlier disease recurrence than those with a Ki-67 lower than 1%. This new stratification scheme, if externally validated, should be incorporated into future grading systems to guide both surveillance protocols and treatment strategies.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Lopez-Aguiar AG,Ethun CG,Postlewait LM,Zhelnin K,Krasinskas A,El-Rayes BF,Russell MC,Sarmiento JM,Kooby DA,Staley CA,Maithel SK,Cardona Kdoi
10.1245/s10434-017-6140-8subject
Has Abstractpub_date
2018-01-01 00:00:00pages
290-298issue
1eissn
1068-9265issn
1534-4681pii
10.1245/s10434-017-6140-8journal_volume
25pub_type
杂志文章abstract:BACKGROUND:There is conflicting evidence concerning platelet status and hepatocellular carcinoma (HCC) prognosis. We evaluated the prognostic value of platelet-based indices, including platelet count, platelet/lymphocyte ratio (PLR), and aspartate aminotransferase to platelet ratio index (APRI) in HCC after hepatic res...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3771-x
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Patients want information to search for destination of care for breast-conserving surgery (BCS). To inform patients wanting a lumpectomy, we aimed to develop a pilot project that communicated composite quality measure (QM) results using a '4-star' rating system. Two patient-centered QMs were included in the ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6479-5
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Liver kinase B1 (LKB1) loss by gene mutation, loss of heterozygosity, and promoter methylation rarely occurs in colorectal cancer. We wondered whether LKB1 loss could be deregulated at the transcriptional level to promote tumor progression and poor outcome in colorectal cancer. METHODS:Mechanistic studies w...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3824-1
更新日期:2014-12-01 00:00:00
abstract::Isolated hepatic perfusion (IHP) is a proven approach for regional delivery of chemotherapy in patients with unresectable primary and metastatic tumors of the liver. Most trials of IHP have utilized melphalan as the active drug in the perfusate. We performed a phase I trial to evaluate the efficacy, safety, and maximu...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0179-5
更新日期:2009-02-01 00:00:00
abstract::Until the late 1990s, the application of the sentinel node (SN) concept to gastrointestinal (GI) malignancies was not recognized because of the multidirectional and complicated lymphatic flow from the GI tract. However, several studies supporting the validity of the SN concept for GI cancers have been reported in the ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1007/BF02523637
更新日期:2004-03-01 00:00:00
abstract:INTRODUCTION:Actual 5-year survival rates of 10-18% have been reported for patients with resected pancreatic adenocarcinoma (PC), but the use of multimodality therapy was uncommon in these series. We evaluated long-term survival and patterns of recurrence in patients treated for PC with contemporary staging and multimo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0295-2
更新日期:2009-04-01 00:00:00
abstract:PURPOSE:To determine whether the benefits of sentinel-node-based management (SNBM) over routine axillary clearance (RAC) persisted to 5 years. METHODS:A total of 1088 women with breast cancer less than 3 cm in diameter and clinically negative axillary nodes were randomized to SNBM with axillary clearance if the sentin...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-016-5669-2
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND/AIM:Perioperative administration of immunoenriched diets attenuates the perioperative inflammatory response and reduces postoperative infection complications. However, many questions still remain unresolved in this area, such as the length of diet administration, diet composition, and the mechanisms involved...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-007-9407-7
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Calciphylaxis is a rare condition associated with chronic renal failure and entails a very poor prognosis. Pathogenesis is poorly understood but involves abnormalities in calcium and phosphorus metabolism that lead to vascular and extravascular calcification. Patients present with painful ulcerating plaques ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2006.03.042
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Recurrent laryngeal nerve (RLN) injury is a rare complication for patients undergoing neck exploration for primary hyperparathyroidism (pHPT). Distances between RLNs and parathyroid adenomas have not been previously published. In this study we used a RLN monitor to identify the RLN and to measure the proximi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2495-z
更新日期:2012-11-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node biopsy (SLNB) is recommended for intermediate thickness melanoma, but for thick melanoma, guidelines are less definitive about the use of SLNB in this population. We present a study on thick melanoma evaluating for prognostic factors. PATIENTS AND METHODS:The Sentinel Lymph Node Working ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08706-0
更新日期:2021-02-01 00:00:00
abstract::Investigators at many cancer centers have verified that the sentinel node (SN) is the first lymph node to receive lymphatic drainage from a primary breast cancer and therefore the node most likely to contain metastatic tumor cells. When sentinel lymph node dissection (SLND) is undertaken by an experienced multidiscipl...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Intraperitoneal chemotherapy is used to treat peritoneal surface-spreading malignancies. We sought to determine whether volume and surface area of the intraperitoneal chemotherapy compartments are associated with overall survival and posttreatment glomerular filtration rate (GFR) in malignant peritoneal meso...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-2976-8
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemoradiotherapy (CRT) followed by radical surgery including total mesorectal excision (TME) is standard treatment in patients with locally advanced rectal cancer. Emerging data indicate that patients with complete pathologic response (ypCR) after CRT have favorable outcome, suggesting the possi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1822-0
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:This anatomic study details the lymphatic drainage of the upper extremity (UE) and breast, as well as its course in the axilla and its relation to axillary reverse mapping. Two aspects important for breast cancer surgery were followed: connection between the lymphatics of the UE and breast, and the possible ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2363-x
更新日期:2012-10-01 00:00:00
abstract:PURPOSE:Breast-conserving therapy (BCT) is an accepted method of treating early breast cancer. We hypothesized that routine excision of additional cavity shave margins (CSM) at time of initial partial mastectomy reduces the need for additional surgery. METHODS:A single-institution retrospective review was performed of...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1420-6
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Little is known about metastatic patterns in patients with obstructing colorectal cancer (CRC). OBJECTIVE:The aim of this study was to determine if metastatic patterns in patients with CRC differ between patients with or without obstruction. METHODS:This single-center, observational, retrospective cohort s...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08119-8
更新日期:2020-04-01 00:00:00
abstract:PURPOSE:Reasons for variable utilization of adjuvant chemotherapy (ACT) for colon cancer have not been well described. We report medical oncology (MO) referral patterns and subsequent use of ACT. METHODS:Treatment records were linked to the population-based Ontario Cancer Registry to describe MO referral and ACT use a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5181-8
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Identification of melanoma patients who need completion lymphadenectomy and adjuvant treatment after positive sentinel lymph node (SLN) biopsy would be a fundamental step forward toward personalized medicine. This study tested the hypothesis that the microscopic features of metastatic SLNs might predict not ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9734-8
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:We performed robot-assisted neck dissection (RAND) via a modified face-lift (MFLA) or retroauricular approach for neck management and carried out free flap reconstruction via these approaches in patients with head and neck cancer. We assessed the feasibility of free flap reconstruction in patients who had un...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2731-6
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:This work is aimed at comparing mucinous colorectal adenocarcinomas (MUC) and non-mucinous colorectal adenocarcinomas (non-MUC), and at verifying the existence of two different subgroups of MUC, in terms of clinicopathological features, chromosomal alterations, and outcome, in a geographical area where mucin...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2008-05-01 00:00:00
abstract:PURPOSE:Intraoperative margin assessment can reduce positive margins in patients undergoing breast-conserving surgery. However, reports on intraoperative margin assessment have described only the use of either imprint cytology or frozen section. This study was designed to elucidate the effect of intraoperative margin a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2020-08-19 00:00:00
abstract:BACKGROUND:Despite the potential for residual lymph node metastases after a negative or positive sentinel lymph node biopsy (SLNB), breast cancer patients rarely experience regional recurrences (RRs). This study aimed to quantify the effects of nonsurgical treatments on RR incidence among SLNB-negative (SLNB N0) breast...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Intraoperative ultrasound (IOUS)-guided lumpectomy in early breast cancer has shown advantages over other techniques. However, the use of IOUS has been less explored after neoadjuvant treatment (NAT). This study aimed to compare IOUS- and wire localization (WL)-guided surgery in breast cancer patients after ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4935-z
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Pretreatment evaluation of axillary lymph nodes (ALNs) and marking of biopsied nodes in patients with newly diagnosed breast cancer is becoming routine practice. We sought to test tattooing of biopsied ALNs with a sterile black carbon suspension (Spot™). The intraoperative success of identifying tattooed ALN...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4034-6
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Women considering risk reduction surgery after a diagnosis of breast/ovarian cancer and/or inherited cancer gene mutation face difficult decisions. The safety of combined breast and gynecologic surgery has not been well studied; therefore, we evaluated the outcomes for patients who have undergone coordinated...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5479-6
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Surgical resection with curative intent for giant cell tumor of bone (GCTB) may be associated with severe morbidity. This interim analysis evaluated reduction in surgical invasiveness after denosumab treatment in patients with resectable GCTB. METHODS:Patients with primary or recurrent GCTB, for whom the in...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4634-9
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The risk of colorectal cancer (CRC) in chronic kidney disease (CKD) patients relative to the general population is unknown. The aim of this population-based study was to investigate the risk of CRC in patients with CKD. METHODS:The study cohort included patients aged ≥18 years diagnosed with CKD between 200...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
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更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:This study aimed to review the outcomes of laparoscopic colorectal resection for patients with stage IV colorectal cancer. METHODS:From the prospectively collected database for patients who underwent surgery for colorectal cancer in our institution, those with stage IV colorectal cancer who underwent electi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9820-6
更新日期:2008-05-01 00:00:00