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| http://dx.doi.org/10.21037/hbsn-24-576 | DOI Listing |
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De-Escalation of Nodal Surgery in Clinically Node-Positive Breast Cancer.
JAMA Surg
January 2025
Breast Unit, Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye.
Importance: Increasing evidence supports the oncologic safety of de-escalating axillary surgery for patients with breast cancer after neoadjuvant chemotherapy (NAC).
Objective: To evaluate the oncologic outcomes of de-escalating axillary surgery among patients with clinically node (cN)-positive breast cancer and patients whose disease became cN negative after NAC (ycN negative).
Design, Setting, And Participants: In the NEOSENTITURK MF-1803 prospective cohort registry trial, patients from 37 centers with cT1-4N1-3M0 disease treated with sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) alone or with ypN-negative or ypN-positive disease after NAC were recruited between February 15, 2019, and January 1, 2023, and evaluated.
Guiding Sole Intraoperative Radiotherapy in Breast Cancer According to ASTRO Guidelines: Mitigating Adverse Outcomes in a Taiwan Single-Center.
Cancer Med
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Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan.
Background: Intraoperative radiotherapy (IORT) is considered a de-escalating adjuvant treatment for breast cancer low-risk patients. However, the broader criteria applied by the Taiwan IORT Study Cooperative Group led to an increased rate of locoregional recurrence (LRR) among patients receiving only IORT. Consequently, we revised the criteria for sole IORT treatment to include patients who meet the American Society for Radiation Oncology (ASTRO) eligibility standards.
View Article and Find Full Text PDFDoes a Restrictive Diagnostic Work-up for Thyroid Nodules Lead to a Different Papillary Thyroid Cancer Patient Population? A Comparison Between Dutch and U.S. T1-T3 Patient Population.
World J Surg
December 2024
Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Introduction: The 2015 American Thyroid Association guidelines recommend de-escalating surgical treatment for papillary thyroid cancer (PTC). We hypothesize that the Dutch PTC population might differ due to a restrictive diagnostic policy that mainly selects symptomatic and palpable thyroid nodules for further diagnostics, potentially selecting relatively more aggressive tumors. We aimed to describe the Dutch PTC population because differences in populations can have consequences for the adoption of foreign guidelines.
View Article and Find Full Text PDFDe-Escalating Surgery in Merkel Cell Carcinoma With Clinical Nodal Disease.
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Department of Surgery, Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background: Merkel cell carcinoma (MCC) is a radiosensitive aggressive skin cancer that spreads via the lymphatics. There is uncertainty regarding the optimal management of the nodal basin for patients with MCC with clinically positive nodes. We study the efficacy of single node excision (SNE) as an alternative to a therapeutic lymph node dissection (TLND) in patients with limited nodal disease.
View Article and Find Full Text PDFDe-escalating surgical treatment in low stage gallbladder cancer.
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Department of Surgery, Erasmus Medical Center, Erasmus University, Rotterdam, The Netherlands.
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