Search results for "excision"
showing 10 items of 266 documents
Is sentinel lymph node biopsy more accurate than axillary dissection on staging the nodal involvement in breast cancer patients?
2007
Today evaluation of axillary involvement can be routinely performed with the technique of sentinel lymph node biopsy (SLNB). One of the greatest advantages of SLNB is the nearly total absence of local postoperative complications. It is important to understand whether SLNB is better than axillary lymph-node dissection (ALND) for staging axillary nodal involvement. The aim of the study was to evaluate the axillary staging accuracy comparing three different methods: axillary dissection, sentinel node biopsy with the traditional 4-6 sections and sentinel node biopsy with complete analysis of the lymph node. 527 consecutive patients (525 females and 2 males) with invasive breast cancer < or = 3 …
Validity of Laparoscopic Staging to Avoid Adjuvant Chemoradiation following Radical Surgery in Patients with Early Cervical Cancer
2012
<b><i>Purpose:</i></b> To determine the rate of unavoidable adjuvant chemoradiation (RCTX) due to histologic results after radical surgery in patients with early cervical cancer. <b><i>Patients and Methods:</i></b> Between May 2004 and July 2011, 448 consecutive patients diagnosed with invasive cervical cancer stage IA1 L1 to IIA underwent laparoscopic staging at the Department of Gynecology and Gynecologic Oncology at Charité Berlin. Only in patients without lymph node metastases (n = 394) on frozen section, radical operation was continued either by laparoscopic radical hysterectomy (n = 228) or by radical vaginal trachelectomy (n = 166). The…
Omitting axillary lymph node dissection after positive sentinel lymph node in the post-Z0011 era: Compliance with NCCN and ASCO clinical guidelines a…
2021
Summary Purpose In the ACOSOG Z0011 trial, patients with primary breast cancer and 1–2 tumor-involved sentinel lymph nodes (SLNs) undergoing breast-conserving surgery had no oncological outcome benefit after axillary lymph node dissection (ALND), despite a relevant rate of non-SLN metastases of 27%. According to the St Gallen expert consensus, and NCCN and ASCO clinical guidelines, ALND may be avoided in patients who meet all ACOSOG Z0011 inclusion criteria. This recommendation can also be extended to patients undergoing mastectomy, with 1 or 2 positive SLNs and an indication for chest wall radiation, in whom axillary radiotherapy can be proposed as an alternative to completion ALND. The ai…
Extended surgical safety margins and ulceration are associated with an improved prognosis in pleomorphic dermal sarcomas
2019
BACKGROUND Pleomorphic dermal sarcomas (PDS) are frequent UV-induced sarcomas of the skin of intermediate grade malignant potential. Despite the fact that PDS have a noteworthy potential to recur (up to 28%) as well as to metastasize (up to 20%), there are no specific clinical guidelines with respect to follow-up these patients. Moreover, little is known about clinical, histological or molecular prognostic factors in PDS. OBJECTIVE The aim of the present study was to identify risk factors to predict relapse in a large multicentre sample cohort of PDS which could aid to optimize personalized treatment recommendations regarding surgical safety margins and adjuvant radiotherapy. METHODS Patien…
Macroscopic assessment of mesorectal excision in rectal cancer
2009
BACKGROUND: High quality of surgical technique and the use of descriptive measures to assess and report surgical proficiency have been shown to influence locoregional tumor control in patients with rectal cancer. In this study, the authors have aimed to audit the implementation of a macroscopic assessment of mesorectal excision (MAME) and to investigate factors that influenced surgical quality and disease recurrence. METHODS: All curative resections for rectal cancer were prospectively evaluated for MAME between 1998 and 2007. Mesorectal specimens were graded into 3 types: complete, nearly complete, and incomplete categories. Univariate and multivariate analyses identified independent risk …
Preoperative chemoradiation may not always be needed for patients with T3 and T2N+ rectal cancer
2011
BACKGROUND: Preoperative chemoradiation is becoming the standard treatment for patients with locally advanced rectal cancer. However, since the introduction of total mesorectal excision (TME), local recurrence rates have been reduced significantly, and some patients can be spared from potentially toxic over treatment. The current study was designed to assess the factors that predict recurrence in an institutional series of patients with rectal cancer who had clinical T2 lymph node-positive (cT2N+) tumors or cT3N0/N+ tumors and underwent radical surgery without receiving preoperative chemoradiation. METHODS: Between November 1997 and November 2008, the authors' multidisciplinary group preope…
Implication of the Examining Pathologist to Meet the Oncologic Standard of Lymph Node Count after Laparoscopic Lymphadenectomy
2010
<i>Objective:</i> The lymph node number as benchmark in oncologic operations depends on the patient’s anatomy, surgeon’s skill and pathologist’s accuracy. The influence of the pathologist is barely evaluated. <i>Methods:</i> A retrospective analysis of lymph node numbers after 700 laparoscopic lymphadenectomies in correlation to the examining pathologists was done. Three surgeons from the same department performed all operations at 2 campi, where 2 separate pathology institutions exist. Lymph node specimens were assigned randomly to any of the 62 involved pathologists. <i>Results:</i> The mean number of lymph nodes was equal for all surgeons. Lymph node s…
External Validation of Nomogram Predicting the Probability of Specimen-Confined Disease (pT2-3a, R0N0) in Patients Undergoing Radical Prostatectomy a…
2014
Introduction: Before radical prostatectomy (RP), a nomogram [Briganti et al., Eur Urol 2012;61:584-592] permits to measure the probability of specimen-confined (SC) disease (pT2-pT3a, node negative with negative margins) in high-risk prostate cancer (PCa). The aim of our study was to perform an external validation of this nomogram. Materials and Methods: Between 2007 and 2011, 623 patients with high-risk PCa (prostate-specific antigen (PSA) >20 ng/ml and/or biopsy Gleason score ≥8 and/or clinical stage T3) underwent RP and pelvic lymph node dissection at tertiary referral centers. Multivariable logistic regression models predicting the presence of SC disease were built in; we then used the …
Spontaneous regression of multiple melanocytic nevi after melanoma: report of 3 cases.
2014
Complete spontaneous regression of multiple melanocytic nevi after melanoma is an extremely rare phenomenon. We report 3 cases of patients with a history of melanoma that showed regression of almost all melanocytic nevi over time. One of the patients had 2 simultaneous primary cutaneous melanomas without metastasis. In the other 2 patients, regression of the melanocytic nevi was seen after the development of metastasis in lymph nodes. These patients had spontaneously developed an efficient immune response against melanocytes, and they would represent paradigmatic examples of the spontaneous immune responses in melanoma patients. Better understanding of the mechanisms involved in the complet…
Follow-up after transanal endoscopic microsurgery or transanal excision of large benign rectal polyps
1998
Methods: Between January 1986 and December 1995, 238 patients with benign rectal polyps under-went either transanal endoscopic microsurgery (n = 226) or transanal excision (n = 12) at the Clinic of General and Abdominal Surgery, Johannes Gutenberg-University, Mainz. Results: Mean polyp size was 4.2 cm; 89.1% of polyps measured more than 2 cm in diameter. In 89.1% of cases, histological analysis revealed polyps containing tubulovillous or villous adenomas. Synchronous colonic polyps were detected in 12.5% of patients. Follow-up data are available on 222 patients (94%). At follow-up examination, 169 of the 193 surviving patients (87.6%) were recurrence free. Seven of 193 patients (3.6%) had d…