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Ann Surg Oncol 2022 May 24. Epub 2022 May 24.

Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA.

Background: Until 2001, the paradigm guiding the management of women with de novo metastatic breast cancer (dnMBC) stipulated that primary-site locoregional therapy (PSLT) did not alter the course of metastatic disease and was necessary only for palliation of symptoms. Since 2002, retrospective data have begun questioning this paradigm. However, selection biases driving an observed survival advantage associated with PSLT in dnMBC were quickly recognized and led to several randomized clinical trials (RCTs) addressing this question. Read More

Ann Surg Oncol 2022 May 24. Epub 2022 May 24.

VCORE - Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation, Henry Ford Hospital, Detroit, MI, USA.

Background: It is unknown whether the addition of anti-androgen therapy (AAT) to late salvage radiation therapy (sRT) can lead to oncological outcomes equivalent to that of early sRT in men with recurrent prostate cancer (CaP) after surgery.

Methods: Data on 670 men who participated in the Radiation Therapy Oncology Group (RTOG)-9601 trial and who experienced biochemical recurrence were extracted using the National Clinical Trials Network (NCTN) data archive platform. Patients were stratified into four treatment groups: early sRT (pre-sRT prostate-specific antigen [PSA] < 0. Read More

Ann Surg Oncol 2022 May 24. Epub 2022 May 24.

Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Background: Patients with sentinel lymph node-positive (SLN+) melanoma are increasingly undergoing active nodal surveillance over completion lymph node dissection (CLND) since the Second Multicenter Selective Lymphadenectomy Trial (MSLT-II). Adherence to nodal surveillance in real-world practice remains unknown.

Methods: In a retrospective cohort of SLN+ melanoma patients who underwent nodal surveillance at a single institution from July 2017 through April 2021, this study evaluated adherence to nodal surveillance ultrasound (US). Read More

Ann Surg Oncol 2022 May 24. Epub 2022 May 24.

Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.

Background: Delays between breast cancer diagnosis and surgery are associated with worsened survival. Delays are more common in urban-residing patients, although factors specific to surgical delays among rural and urban patients are not well understood.

Methods: We used a 100% sample of fee-for-service Medicare claims during 2007-2014 to identify 238,491 women diagnosed with early-stage breast cancer undergoing initial surgery and assessed whether they experienced biopsy-to-surgery intervals > 90 days. Read More

Ann Surg Oncol 2022 May 23. Epub 2022 May 23.

Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Ann Surg Oncol 2022 May 23. Epub 2022 May 23.

Department of Orthopedic Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, Sichuan, China.

Background: Due to radical resection, endoprosthetic reconstruction (EPR) is more invasive and increases the risk of dislocation. Therefore, the suitability of EPR for elderly patients with metastatic tumor needs further investigation.

Methods: Seventy-one adult patients with isolated proximal femoral bone metastases who underwent EPR were retrospectively analyzed and stratified into two groups: elderly age group (≥60 years, n = 31) and younger age group (<60 years, n = 40). Read More

Ann Surg Oncol 2022 May 23. Epub 2022 May 23.

Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, Japan.

Background: Pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN) is defined as PDAC occurring apart from IPMN. This study comprehensively investigated the molecular biologic characteristics of PDAC concomitant with IPMN in major genetic alterations, tumor microenvironment, and prognosis by contrast with those of conventional PDAC.

Methods: The study retrospectively reviewed the data of 158 surgically resected PDAC patients. Read More

Ann Surg Oncol 2022 May 23. Epub 2022 May 23.

Departments of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Ann Surg Oncol 2022 May 23. Epub 2022 May 23.

Department of Oncology and Hemato-Oncology, University of Milan, 20122, Milan, Italy.

Risk-reducing mastectomy is considered a safe and effective surgical procedure in high-risk individuals with BRCA1/2 germline mutations. Multigene panels identify women with alterations in breast cancer susceptibility genes other than BRCA1/2. International guidelines classify these genes as high-, moderate-, and low-penetrance based on their associated relative risk for breast cancer. Read More

Ann Surg Oncol 2022 May 22. Epub 2022 May 22.

Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Background: The incidence of hepatocellular carcinoma (HCC) has substantially increased over the last two decades within the Veteran Affairs Health System (VAHS). This study aims to describe the temporal trend of early-stage HCC (ES-HCC) treatment in the VAHS and identify patient/hospital factors associated with treatment disparities.

Patients And Methods: VA Corporate Data Warehouse was used to identify patients diagnosed with ES-HCC (stages I/II) from 2001 to 2015. Read More

Ann Surg Oncol 2022 May 21. Epub 2022 May 21.

Division of General Thoracic Surgery, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.

Ann Surg Oncol 2022 May 21. Epub 2022 May 21.

Department of Surgical Oncology, The University of Texas at MD Anderson Cancer Center, Houston, TX, USA.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon peripheral T cell lymphoma arising in response to textured-surface breast implants. Frequently, BIA-ALCL is indolent and typically presents with peri-implant swelling after breast reconstruction or cosmetic augmentation. However, patients can present with an invasive breast or chest wall mass, palpable lymphadenopathy, or metastatic disease. Read More

Ann Surg Oncol 2022 May 20. Epub 2022 May 20.

Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, 730-0052, Japan.

Ann Surg Oncol 2022 May 20. Epub 2022 May 20.

Division of Surgical Oncology, Department of Surgery, Mount Sinai Hospital/Icahn School of Medicine, New York, NY, USA.

Ann Surg Oncol 2022 May 20. Epub 2022 May 20.

Department of Surgery, Barnes-Jewish Hospital and the Alvin J. Siteman Cancer Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.

Background: Frailty is associated with postoperative mortality, but its significance after hepatectomy for colorectal liver metastases (CRLM) is poorly defined. This study evaluated the impact of frailty after hepatectomy for CRLM.

Methods: The study identified 8477 patients in National Surgical Quality Improvement Program databases from 2014 to 2019 and stratified them by frailty score using the risk analysis index as very frail (>90th percentile), frail (75th-90th percentile), or non-frail (< 75th percentile). Read More

Ann Surg Oncol 2022 May 19. Epub 2022 May 19.

Department of Gynaecologic Surgery, Gustave-Roussy, Villejuif, France.

Background: Endometrioid borderline ovarian tumor (EBOT) is a rare subtype of borderline ovarian malignancies. This study was designed to determine the prognosis of a series of EBOT.

Methods: This is a retrospective review of patients with EBOT treated in or referred to our institutions and a centralized, histological review by a reference pathologist. Read More

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Introduction: Although outcomes are similar following breast-conserving surgery (BCS) or mastectomy among sporadic breast cancer patients, data are mixed for women with a germline BRCA mutation. We sought to compare outcomes among a modern cohort of BRCA mutation carriers undergoing BCS versus mastectomy.

Methods: Women with a BRCA mutation and an index breast cancer from 2006-2015 were retrospectively identified from institutional databases. Read More

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX, USA.

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Background: Surgery with radical intent is the only potentially curative option for entero-pancreatic neuroendocrine tumors (EP-NETs) but many patients develop recurrence even after many years. The subset of patients at high risk of disease recurrence has not been clearly defined to date.

Objective: The aim of this retrospective study was to define, in a series of completely resected EP-NETs, the recurrence-free survival (RFS) rate and a risk score for disease recurrence. Read More

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Breast Surgery Strategic Program, Candiolo Cancer Institute, FPO - IRCCS, Str. Provinciale 142, Candiolo, Torino, Italy.

Background: Robotic nipple-sparing mastectomy (RNSM) has been developed to reduce conspicuous scar and increase the quality of life in women. This study aimed to evaluate the surgical and oncologic outcomes of RNSM with immediate breast reconstruction (IBR) compared with conventional nipple-sparing mastectomy (CNSM).

Patients And Methods: This international multicenter, pooled analysis of individual patient-level data enrolled a total of 755 procedures in 659 women (609 had breast cancer and 50 underwent risk-reducing mastectomy) who underwent nipple-sparing mastectomy with IBR. Read More

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Department of Surgery, Brooke Army Medical Center, Ft. Sam Houston, TX, USA.

Background: Neoadjuvant chemotherapy (NAC) or chemoradiation (NAC+XRT) is incorporated into the treatment of localized pancreatic adenocarcinoma (PDAC), often with the goal of downstaging before resection. However, the effect of downstaging on overall survival, particularly the differential effects of NAC and NAC+XRT, remains undefined. This study examined the impact of downstaging from NAC and NAC+XRT on overall survival. Read More

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Department of Surgery, New York-Presbyterian, Brooklyn Methodist Hospital, Brooklyn, NY, USA.

Background: Postmastectomy breast reconstruction is an essential element of multidisciplinary breast cancer care but may be underutilized.

Methods: This retrospective study analyzed mastectomy patients (2018-2021) at an urban hospital. Multivariable logistic regression was performed, and a mixed-effects logistic regression model was constructed to determine patient-level factors (age, race, body mass index, comorbidities, smoking status, insurance, type of surgery) and provider-level factors (breast surgeon gender, participation in multidisciplinary breast clinic) that influence reconstruction. Read More

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Background: Risk-based thresholds to guide management are undefined in the treatment of primary cutaneous melanoma but are essential to advance the field from traditional stage-based treatment to more individualized care.

Methods: To estimate treatment risk thresholds, hypothetical clinical melanoma scenarios were developed and a stratified random sample was distributed to expert melanoma clinicians via an anonymous web-based survey. Scenarios provided a defined 5-year risk of recurrence and asked for recommendations regarding clinical follow-up, imaging, and adjuvant therapy. Read More

Ann Surg Oncol 2022 May 18. Epub 2022 May 18.

Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Background: The mainstay of treatment of well-differentiated thyroid cancer (WDTC) is surgery followed by adjuvant radioactive iodine therapy. Postoperative radiation therapy (PORT) is rarely used.

Objective: The aim of our study was to report our experience of patients with WDTC who were selected to receive PORT. Read More

Ann Surg Oncol 2022 May 17. Epub 2022 May 17.

Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA.

Ann Surg Oncol 2022 May 17. Epub 2022 May 17.

Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.

Ann Surg Oncol 2022 May 17. Epub 2022 May 17.

Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA.

Ann Surg Oncol 2022 May 17. Epub 2022 May 17.

Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, OH, USA.

Ann Surg Oncol 2022 May 17. Epub 2022 May 17.

Department of Renal Cancer and Melanoma, Peking University Cancer Hospital and Institute, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing, China.