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https://www.readbyqxmd.com/read/29351120/grading-using-ki-67-index-and-mitotic-rate-increases-the-prognostic-accuracy-of-pancreatic-neuroendocrine-tumors
#1
Prejesh Philips, David A Kooby, Shishir Maithel, Nipun B Merchant, Sharon M Weber, Emily R Winslow, Syed Ahmad, Hong J Kim, Charles R Scoggins, Kelly M McMasters, Robert C G Martin
OBJECTIVES: To measure the usefulness of Ki-67 proliferative index (Ki-67 index) as a prognostic variable for grading pancreatic neuroendocrine tumors. METHODS: A multi-institutional prospective database comprising 350 patients. Grading based on mitotic activity (<2 mitoses/10 high-power fields, 2-20 and >20) and Ki-67 index (<3% per 10 high-power fields, 3%-20% and >20%). Final grade selected based on higher grade of either variable. RESULTS: Most patients were in the less than 3% (n = 158) and 3% to 20% Ki-67 category (n = 107), with a minority being high-grade (Ki-67 > 20%, n = 27)...
January 18, 2018: Pancreas
https://www.readbyqxmd.com/read/29351098/prognostic-factors-change-over-time-after-hepatectomy-for-colorectal-liver-metastases-a-multi-institutional-international-analysis-of-1099-patients
#2
Georgios Antonios Margonis, Stefan Buettner, Nikolaos Andreatos, Doris Wagner, Kazunari Sasaki, Carlotta Barbon, Andrea Beer, Carsten Kamphues, Inger Marie Løes, Jin He, Timothy M Pawlik, Klaus Kaczirek, George Poultsides, Per Eystein Lønning, John L Cameron, Hans Joerg Mischinger, Federico N Aucejo, Martin E Kreis, Christopher L Wolfgang, Matthew J Weiss
OBJECTIVE: To evaluate the changing impact of genetic and clinicopathologic factors on conditional overall survival (CS) over time in patients with resectable colorectal liver metastasis. BACKGROUND: CS estimates account for the changing likelihood of survival over time and may reveal the changing impact of prognostic factors as time accrues from the date of surgery. METHODS: CS analysis was performed in 1099 patients of an international, multi-institutional cohort...
January 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29350102/preoperative-clinical-and-sonographic-predictors-for-lateral-cervical-lymph-node-metastases-in-sporadic-medullary-thyroid-carcinoma
#3
Hye-Seon Oh, Hyemi Kwon, Eyun Song, MinJi Jeon, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee, Suck Joon Hong, Won Bae Kim, YoungKee Shong, Jung Hwan Baek, Won Gu Kim
<b><i>Background</i></b> Total thyroidectomy and cervical lymph node (LN) dissection is generally recommended in patients with medullary thyroid carcinoma (MTC). However, there is no clear evidence for whom to perform prophylactic lateral neck dissection in MTC patients without evident lateral cervical lymph node (LCLN) metastasis in preoperative images. This study evaluated the preoperative features for predicting the LCLN metastasis of MTC. <b><i>Methods</i></b> We included 26 MTC patients with LCLN metastasis at initial surgery (N1b group) and 47 MTC patients without any LN metastasis or recurrence of disease (N0-NED group)...
January 19, 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29349605/improved-effectiveness-of-stereotactic-radiosurgery-in-large-brain-metastases-by-individualized-isotoxic-dose-prescription-an-in-silico-study
#4
Jaap D Zindler, Jacqueline Schiffelers, Philippe Lambin, Aswin L Hoffmann
INTRODUCTION: In large brain metastases (BM) with a diameter of more than 2 cm there is an increased risk of radionecrosis (RN) with standard stereotactic radiosurgery (SRS) dose prescription, while the normal tissue constraint is exceeded. The tumor control probability (TCP) with a single dose of 15 Gy is only 42%. This in silico study tests the hypothesis that isotoxic dose prescription (IDP) can increase the therapeutic ratio (TCP/Risk of RN) of SRS in large BM. MATERIALS AND METHODS: A treatment-planning study with 8 perfectly spherical and 46 clinically realistic gross tumor volumes (GTV) was conducted...
January 18, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/29349591/radical-resection-of-a-giant-retroperitoneal-calcifying-fibrous-tumor-combined-with-right-hepatectomy-and-reconstruction-of-the-inferior-vena-cava-and-bilateral-renal-veins
#5
Masaki Kimura, Hiroki Kato, Seishiro Sekino, Narihiro Ishida, Katsutoshi Murase, Katsuya Shimabukuro, Takafumi Sekino, Kiyoshi Doi, Masayuki Matsuo
BACKGROUND: We report a case of a giant retroperitoneal calcifying fibrous tumor (CFT) treated by radical tumor resection combined with right hepatectomy and reconstruction of the inferior vena cava (IVC) and bilateral renal veins. Only three case reports of CFT arising in the retroperitoneum have been reported until today. CASE PRESENTATION: In a 19-year-old female patient, computed tomography (CT) images showed a well-demarcated expansile lesion around the IVC accompanied by focal calcification, whereas the IVC that was circumferentially surrounded by the lesion was dilated due to the desmoplastic reaction...
January 18, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29349483/surgical-outcomes-of-primary-versus-post-neoadjuvant-chemotherapy-breast-conservation-surgery-a-comparative-study-from-a-developing-country
#6
Gaurav Agarwal, Chaitra Sonthineni, Sabaretnam Mayilvaganan, Anjali Mishra, Punita Lal, Vinita Agrawal
INTRODUCTION: In India and other developing countries, breast conservation surgery (BCS) rates in breast cancer patients are low due to advanced disease at presentation and misconceptions about BCS outcomes. Many patients presenting with large or locally advanced breast cancers (LABC) can be offered post-neoadjuvant chemotherapy (NACT) BCS, safety of which is not as well established as that of primary BCS. This retrospective study compared pathological and surgical outcome parameters in patients undergoing primary and post-NACT BCS...
January 18, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29347887/cryo-assisted-resection-en-bloc-and-cryoablation-in-situ-of-primary-breast-cancer-coupled-with-intraoperative-ultrasound-guided-tracer-injection-a-preliminary-clinical-study
#7
Nikolai N Korpan, Kecheng Xu, Philipp Schwarzinger, Masashi Watanabe, Gerhard Breitenecker, Le Pivert Patrick
The aim of the study was to perform cryosurgery on a primary breast tumor, coupled with simultaneous peritumoral and intratumoral tracer injection of a blue dye, to evaluate lymphatic mapping. We explored the ability of our strategy to prevent tumor cells, but not that of injected tracers, to migrate to the lymphovascular drainage during conventional resection of frozen breast malignancies. Seventeen patients aged 51 (14) years (mean [standard deviation]), presenting primary breast cancer with stage I to IV, were randomly selected and treated in The Rudolfinerhaus Private Clinic in Vienna, Austria, and included in this preliminary clinical study...
January 1, 2018: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/29347883/pulmonary-laser-metastasectomy-by-1318-nm-neodymium-doped-yttrium-aluminum-garnet-laser-a-retrospective-study-about-laser-metastasectomy-of-the-lung
#8
Calogero Porrello, Roberto Gullo, Antonino Vaglica, Gregorio Scerrino, Giuseppe Salamone, Leo Licari, Cristina Raspanti, Eliana Gulotta, Gaspare Gulotta, Gianfranco Cocorullo
BACKGROUND: The lungs are among the first organ affected by remote metastases from many primary tumors. The surgical resection of isolated pulmonary metastases represents an important and effective element of therapy. This is a retrospective study about our entire experience with pulmonary resection for metastatic cancer using 1318-nm neodymium-doped yttrium-aluminum garnet laser. METHOD: In this single-institution study, we retrospectively analyzed a group of 209 patients previously treated for primary malignant solid tumors...
January 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29346790/multivisceral-resection-for-locally-invasive-colorectal-liver-metastases-outcomes-of-a-matched-cohort-analysis
#9
Fiona Hand, Rebeca Sanabria Mateos, Michael Durand, David Fennelly, Ray McDermott, Donal Maguire, Justin Geoghegan, Des Winter, Emir Hoti
Local invasion of adjacent viscera by colorectal liver metastases (CRLM) is no longer considered an absolute contraindication to curative hepatic resection. A growing number of observational analyses have illustrated the feasibility of such resections; however, the evidence base is at best heterogeneous with a lack of evidence comparing similar patient groups. We aimed to evaluate the outcomes of hepatectomy for CRLM when combined with other viscera and compare to a matched cohort of isolated hepatic resections...
January 18, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29346043/analysis-of-margin-classification-systems-for-assessing-the-risk-of-local-recurrence-after-soft-tissue-sarcoma-resection
#10
Kenneth R Gundle, Lisa Kafchinski, Sanjay Gupta, Anthony M Griffin, Brendan C Dickson, Peter W Chung, Charles N Catton, Brian O'Sullivan, Jay S Wunder, Peter C Ferguson
Purpose To compare the ability of margin classification systems to determine local recurrence (LR) risk after soft tissue sarcoma (STS) resection. Methods Two thousand two hundred seventeen patients with nonmetastatic extremity and truncal STS treated with surgical resection and multidisciplinary consideration of perioperative radiotherapy were retrospectively reviewed. Margins were coded by residual tumor (R) classification (in which microscopic tumor at inked margin defines R1), the R+1mm classification (in which microscopic tumor within 1 mm of ink defines R1), and the Toronto Margin Context Classification (TMCC; in which positive margins are separated into planned close but positive at critical structures, positive after whoops re-excision, and inadvertent positive margins)...
January 18, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29345155/minimally-invasive-adrenal-surgery-virtue-or-vice
#11
Jared S Winoker, David T Ahlborn, Olamide O Omidele, Gustavo Fernandez-Ranvier, Ithaar H Derweesh, Reza Mehrazin
Adrenocortical carcinoma (ACC) is a rare malignancy associated with poor prognosis despite available treatments. In patients with localized or locally advanced disease, complete resection with negative margins offers the only potential for cure. Unfortunately, most patients develop local and distant recurrence following initial resection highlighting the importance of meticulous surgical technique in the hands of an experienced surgeon. While minimally invasive surgery (MIS) has supplanted open surgery for small to medium-sized benign adrenal tumors, controversy surrounds the use of MIS for resection of ACC...
January 18, 2018: Future Oncology
https://www.readbyqxmd.com/read/29344878/gemcitabine-and-taxane-adjuvant-therapy-with-chemoradiation-in-resected-pancreatic-cancer-a-novel-strategy-for-improved-survival
#12
Zaheer S Kanji, Alicia M Edwards, Margaret T Mandelson, Nadav Sahar, Bruce S Lin, Kasra Badiozamani, Guobin Song, Adnan Alseidi, Thomas R Biehl, Richard A Kozarek, William S Helton, Vincent J Picozzi, Flavio G Rocha
BACKGROUND: Gemcitabine-taxane combination chemotherapy has demonstrated a survival benefit clinically in metastatic pancreatic cancer (PC). The authors present their experience with gemcitabine and docetaxel (gem/tax)-based adjuvant treatment (Rx) after surgery with curative intent. METHODS: Patients with de novo resectable PC from January 2010 to December 2015 were identified from the authors' institutional database and registry. The study included only patients who received gem/tax as their initial Rx administered exclusively at the authors' institution with or without chemoradiation (CRTx)...
January 17, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29344436/exploring-laser-induced-breakdown-spectroscopy-as-a-potential-tool-in-mohs-micrography-a-mini-review
#13
REVIEW
Sandeep Singh, Rupak Desai, Mitul Modi, Showket Hussain
Mohs micrographic surgery is the technique of surgically removing skin tumors by gradually excising thin layers and visualizing under a microscope till a tumor-free zone is obtained. During the surgical procedure, visible tumors are surgically removed. During the second stage, if tumor margins are clear with the positive specimen at depth, only depth cavitations need to be done without altering the tumor diameter. Defining the depth during this procedure is a major challenge due to the nonexistence of proper guidelines...
November 13, 2017: Curēus
https://www.readbyqxmd.com/read/29344119/effect-of-lipodox-in-combination-with-bevacizumab-in-a-patient-with-a-metastatic-malignant-phyllodes-breast-tumor-a-case-report
#14
Chin Cheng Su, Chih-Jung Chen, Shou-Jen Kuo
A 76-year-old female patient with a malignant phyllodes tumor underwent modified radical mastectomy and wide excision. Multiple nodules were observed in the operated wound area. Positron emission tomography-computed tomography (PET-CT) revealed recurrent disease in the left breast, the adjacent left third rib, the left internal mammary region and the left ilium. A novel formulation of bevacizumab (5 mg/m2, first day) in combination with liposomal doxorubicin (Lipodox, 30 mg/m2, second day) was administered for 3 cycles every 2 weeks, and subsequently wide excision was performed...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29341506/impact-of-preoperative-anemia-on-outcomes-in-patients-undergoing-curative-resection-for-gastric-cancer-a-single-institution-retrospective-analysis-of-2163-chinese-patients
#15
Xuechao Liu, Haibo Qiu, Yuying Huang, Dazhi Xu, Wei Li, Yuanfang Li, Yingbo Chen, Zhiwei Zhou, Xiaowei Sun
We sought to evaluate whether preoperative anemia was an important determinant of survival in gastric cancer (GC). A single institution cohort of 2163 GC patients who underwent curative resection were retrospectively analyzed. Anemia was defined as a preoperative hemoglobin level <120 g/L in males and <110 g/L in females. Overall survival (OS) was analyzed using the Kaplan-Meier method, and a multivariate Cox proportional hazards model was performed to identify the independent prognostic factor. Anemic patients had a poorer OS compared with nonanemic patients after resection for tumor-nodes-metastasis (TNM) stage III tumors (5-year OS rate: 32...
January 17, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29340993/laparoscopic-assisted-modified-intersphincter-resection-for-ultralow-rectal-cancer
#16
Haiyang Zhou, Canping Ruan, Zhiguo Wang, Zhiqian Hu
BACKGROUND: Intersphincter resection (ISR) is considered to be a superior technique offering sphincter preservation in patients with ultralow rectal cancer.1 Because high-definition laparoscopy offers wider and clearer vision into the narrow pelvic cavity and intersphincteric space, ISR has been further refined.2 However, functional outcome after ISR has not been optimal. More than half of patients receiving ISR suffer partial or even complete anal incontinence.3 We therefore propose a laparoscopic-assisted modified ISR, with the aim of improving sphincter function following ISR...
January 16, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29340932/robotic-scanning-device-for-intraoperative-thyroid-gland-endomicroscopy
#17
Haibo Wang, Shuxin Wang, Jinhua Li, Siyang Zuo
Probe-based confocal laser endomicroscopy has a high potential to be a promising tool that can provide intraoperative high-resolution in vivo morphological imaging at cellular and subcellular levels for thyroidectomy, and allow real-time assessment of tumor margins. However, the typical images acquired with this technique cover a very small area limited by the field of view of the probe, accompanied by tissue deformation and inconsistent probe-tissue contact when operated manually. In this paper, a novel compact robotic device for large area scanning has been developed...
January 16, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29340482/clear-cell-odontogenic-carcinoma-of-the-mandible-a-treatment-strategy
#18
Sabrina Ferreira, Leonardo Perez Faverani, Gabriel Mulinari Dos Santos, Everton Pontes Martins, Idelmo Rangel Garcia Júnior
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine...
January 15, 2018: Journal of Applied Oral Science: Revista FOB
https://www.readbyqxmd.com/read/29339655/the-impact-of-arterial-clamping-technique-in-robot-assisted-partial-nephrectomy-on-renal-function-and-surgical-outcomes-six-year-experience-at-siriraj-hospital-thailand
#19
Tawatchai Taweemonkongsap, Chalairat Suk-Ouichai, Ekkarin Chotikawanich, Siros Jitpraphai, Varat Woranisarakul, Patkawat Ramart, Kittipong Phinthusophon, Teerapon Amornvesukit, Sunai Leewansangtong, Sittiporn Srinualnad, Chaiyong Nualyong
INTRODUCTION: Robot-assisted partial nephrectomy (RAPN) with different arterial clamping techniques has increasingly been performed to avoid ischemic injury to nephron. However, postoperative renal function remains controversial. We determine the impact of each renal arterial clamping on surgical and renal outcomes after RAPN. MATERIALS AND METHODS: Patients who underwent RAPN at Siriraj Hospital from 2010 to 2016 were retrospectively reviewed and stratified into 3 cohorts: main-clamp (MAC), selective-clamp, and off-clamp...
January 16, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29338088/margins-in-breast-cancer-how-much-is-enough
#20
REVIEW
Melissa Pilewskie, Monica Morrow
The appropriate negative margin width for women undergoing breast-conserving surgery for both ductal carcinoma in situ (DCIS) and invasive carcinoma is controversial. This review examines the available data on the margin status for invasive breast cancer and DCIS, and highlights the similarities and differences in tumor biology and standard treatments that affect the local recurrence (LR) risk and, therefore, the optimal surgical margin. Consensus guidelines support a negative margin, defined as no ink on tumor, for invasive carcinoma treated with breast-conserving therapy...
January 16, 2018: Cancer
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