Lymphnode dissection

Context: Medullary thyroid carcinoma (MTC), being an aggressive disease, requires meticulous follow-up and multidisciplinary management. The clinical presentation, management, outcome of MTC varies among different populations. Aims: An audit was conducted to evaluate the demography, clinical presentation, management, and outcome of MTC in a tertiary care center in South India. Settings and Design: A retrospective analysis was conducted of data from hospital records of patients with MTC treated at our center from 2004 to 2019...

INTRODUCTION: Sentinel lymph node detection is a surgical procedure that allow to avoid systematic lymphadenectomy in those tumor in early stage where lymph node spread is not sure. If the Sentinel lymph node is not involved by tumour in 98-99% of case other lymph nodes are clean. The reason why less radical surgery is chosen is linked to the lower post-operative morbidity rate, the risk of lower limb lymphedema decreases. The aim of this review is to summarize what is the state of art of using the Sentinel Lymphnode Dissection (SLD) technique and what are the future goals to improve the safety and the reliability...

Breast lymphedema (BLE) is a rather common complication occurring after surgical breast cancer treatment. Microsurgical lymphovenous anastomosis (LVA) is a validated technique for the management of lymphedema in the extremities and it is gaining approval also for the breast one. Here, we report a case of breast lymphedema successfully treated with LVA. A 52 years old woman referred chronic erythema, diffuse swelling and pain after breast surgery, axillary lymphnode dissection and adjuvant radiotherapy. Conservative treatments had been performed for 14 months without improvement of symptoms...

Chemo and radiotherapy are actually the gold standard of treatment for locally-advanced cervical cancer. We report a case report showing a repaired (video 1) right obturator nerve after an incidental injury during a right internal iliac artery closure with 10 mm titanium clip for severe pelvic bleeding in a patient with locally-advanced cervical cancer. A 52 year-old postmenopausal woman with a chemo and radio-resistant locally-advanced squamous cervical cancer was admitted at our department for severe vaginal bleeding after two previous uterine artery embolizations...

Soft tissue sarcomas are a rare group of malignant tumors that often require an extensive surgical resection to be safely treated. When they are localized in the upper medial thigh, this treatment inevitably leads to large defects frequently causing a series of early and late postoperative complications. Among these, lymphocele and lymphedema are rather common and should try to be avoided. Many solutions with a demonstrated efficacy have been described for this purpose after groin dissection procedure, ranging from lymphovenous anastomosis to pedicled or free flaps...

INTRODUCTION: Adjuvant hormone therapy is the standard treatment after total prostatectomy with positive lymph node. However, this treatment has side effects and at the time of the PSA era and extensive lymph node dissection, this principle is questioned. The aim of this study is to describe the oncological characteristics of patients that may explain the delay in introducing hormone therapy in patients with positive lymph node. METHODS: Monocentric, retrospective study of 161 patients from November 1988 to February 2018 in a single French University Hospital, having undergone radical prostatectomy with positive lymph nodes on pathology...

OBJECTIVE: To assess the diagnostic performance of Gallium-68 prostate-specific membrane antigen PET-computed tomography (Ga-PSMA PET-CT) in primary lymphnodal staging of patients with intermediate-risk and high-risk prostate cancer and to compare it with multiparametric MRI (mp-MRI) whenever available. MATERIALS AND METHODS: Ga-PSMA PET-CT scans of 51 patients (average age 66.0 ± 7.0 years) with biopsy-proven intermediate-risk and high-risk prostatic cancer who were managed by radical prostatectomy and extended pelvic lymph nodal dissection were retrospectively analyzed...

BACKGROUND: Some Trials have demonstrated that the rate of false negative results of a sentinel lymph node biopsy in patients undergoing neoadjuvant chemotherapy is >10%. The aim of this study is to identify the predictive factors of a pathologic complete response in the axilla in order to make a better choice between the performance of an axillary lymphadenectomy or the performance of a sentinel lymph node biopsy. METHODS: All patients diagnosed with positive axillary lymph nodes and achieving a clinical complete response after a neoadjuvant therapy were the object of our study...

BACKGROUND: The role of lymphonodal dissection during surgery for a tumor of the urinary tract remains controversial. OBJECTIVE: To analyze anatomical bases of lymphonodal dissection in tumors of the upper urinary tract and analyze its impact on survival, recurrence, and staging. Acquisition of data: A web-based search for scientific articles using Medline/Pubmed was carried out to identify and analyze articles on the practice and the role of lymphonodal dissection in this indication...

BACKGROUND: The prognosis of patients affected by pancreatic adenocarcinoma and periampullary tumors is dismal, mainly due to aggressive tumor biology and low rate of resectability at the diagnosis. Among resectable patients, the quality of surgical resection, with a particular focus on the complete resection of the retropancreatic tissue (the so-called "mesopancreas") encircling the superior mesenteric artery (SMA), has a cardinal role. With this assumption, many pancreatic surgeons recommend periadventitial dissection of the SMA in order to obtain a total mesopancreas excision (TMpE), maximizing surgical margin and minimizing R1 resection rate...

BACKGROUND: Breast cancer is the most frequent neoplasm in women. Axillary lymph nodes dissection represents the treatment of choice in locally advanced breast cancer for prognostic and curative purposes. Seroma formation, an abnormal collection of fluid in the dead space of the axilla, is described in Literature with a wide range of incidence (3-85%). It is a source of significant morbidity and discomfort. The aim of the study is to compare the different haemostasis devices used in breast surgery, investigating the eventual superiority of an instrument among the others in terms of intraoperative and postoperative outcome, especially of seroma formation...

Endoscopic submucosal dissection (ESD) represents the standard of care for early gastric cancer in Eastern countries. Nevertheless, in the West, this procedure is not widespread. Aim of the study was to confirm the feasibility and the efficacy of ESD in the West. A total of 60 ESD were performed between January 2005 and December 2014 by two expert endoscopists. The analysis, based on a retrospective collected database, was conducted by dividing the study period in three subgroups. Clinical and technical outcomes have been compared...

BACKGROUND: The decision making process for axillary dissection has changed in recent years for patients with early breast cancer and positive sentinel lymph nodes (LN). The question now arises, what is the optimal surgical treatment for patients with positive axillary LN (pN+). This article tries to answer the following questions: (1) Is there a survival benefit for breast cancer patients with 3 or more positive LN (pN3+) and with more than 10 removed LN? (2) Is there a survival benefit for high risk breast cancer patients (triple negative or Her2 + breast cancer) and with 3 or more positive LN (pN3+) with more than 10 removed LN? (3) In pN + patients is the prognostic value of the lymph node ratio (LNR) of pN+/pN removed impaired if 10 or less LN are removed? METHODS: A retrospective database analysis of the multi center cohort database BRENDA (breast cancer under evidence based guidelines) with data from 9625 patients from 17 breast centers was carried out...

OBJECTIVES: To report pre-, postoperative and oncological outcomes in patients treated with spot-specific sLND for patients with exclusive nodal recurrence after PCa primary treatment. MATERIALS AND METHODS: With regard to salvage treatment failure (sTF), 46 consecutive patients, undergoing 52 sLND for nodal recurrence detected by PET/CT scan were stratified in 3 groups (group A: post-sLND PSA nadir < 0.01 ng/ml and in follow-up reaching a value > 0...

BACKGROUND:  Endoscopic submucosal dissection (ESD) is the standard-procedure in Asia for the treatment of early gastric cancer (EGC) within defined criteria. In Europe, this technique is being used more and more frequently. In the context of risk constellations (submucosal invasion, lymphangioinvasion, poorly differentiated carcinoma), the occurrence of lymph node metastases is possible. We defined a low-risk group (differentiated, mucosal EGC without ulceration and vascular infiltration, size independent) to investigate the endoscopic outcome and the long-term course of this special group with excellent prognosis...

A 66-year-old man was referred to our hospital for an abnormal shadow. Chest computed tomography (CT)showed a heterogeneous mass with well-defined border in the right S10and ipsilateral pleural effusion. Fluorodeoxyglucose-positron emission tomography(FDG-PET)showed the accumulation in the mass and pleural effusion. Right lower lobectomy with lymphnode dissection was performed for diagnosis and treatment. Histologically,the tumor was mainly composed of complicated spindle-shaped cells with extensive necrosis, showing a large number of nuclear fission images...

Objective: To analyse the risk factors for periportal lymphnode (No.12p LN) in advanced gastric cancer. Methods: A retrospective analysis of 183 patients with advanced gastric cancer from January 2005 to December 2010, and all patients were underwent D2 lymphadenectomy in addition to No. 12p LN dissections. Potential clinicopathological factors that could influence No. 12p LN metastasis were statistically analyzed. Results: There were 18 cases (9.8%) with periportal lymphnode metastasis. A logistic regression analysis suggested that the Borrmann type (Ⅲ/Ⅳ versus Ⅰ/Ⅱ, P =0...

Our study aimed to investigate the association between metabolic syndrome and postoperative survival in patients with esophageal squamous cell carcinoma, and evaluate whether metabolic syndrome can predict the prognosis in esophageal cancer patients. The retrospective study reviewed 519 patients with esophageal squamous cell carcinoma who had received esophagetomy and lymphnode dissections in the Department of Thoracic Surgery, Qilu Hospital of Shandong University between January 2007 and December 2011. All patients were followed up until December 2016...

RATIONALE: Renal cell carcinoma associated with Xp11.2 translocations/TFE3 gene fusions is a rare subtype of renal cell carcinoma. This predominantly occurs in juveniles, but rarely seen in adults with lymph node or organic metastasis and a worsened prognosis. PATIENTS CONCERNS: Herein, we presented 3 adult cases of Xp11-RCC. Two patients were in early stage and good condition, and the third patient had lymph node metastasis but showed no recurrence after a 3-month follow-up...

BACKGROUND: Breast cancer is the most common cancer in women and second most common type of cancer overall. The prime objectives of axillary surgery in the management of breast cancer are 1) accurate staging, 2) treatment to cure and 3) quantitative information of metastatic lymph nodes for prognostic purposes and allocation to adjuvant protocols. During axillary dissection, all 3 level lymphnodes are removed, while the important axillary structures (axillary vein, long thoracic and thoracodorsal nerves) are preserved...