American journal of clinical oncology
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Am. J. Clin. Oncol. · Feb 2014
Lymph node ratio is an independent prognostic factor after resection of periampullary malignancies: data from a tertiary referral center in the middle East.
The prognostic impact of nodal involvement in resected pancreatic carcinoma and biliary malignancy has been relatively well established. It has been suggested that lymph node ratio (LNR) may be a more informative way of stratifying patients with node positive disease. Our retrospective review aimed to investigate the significance of such variables and test for independent prognostic factors for survival. ⋯ After pancreaticodudonectomy for adenocarcinoma of the pancreas and biliary malignancies, ratio-based lymph node staging is an independent and powerful prognostic factor.
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To determine prognostic factors and optimal timing of postoperative radiation therapy (RT) in adult low-grade gliomas. ⋯ This study supports the association between aggressive surgical resection and better OS and PFS, and between postoperative RT and improved PFS in patients receiving STR/biopsy only. In addition, our findings suggest that delaying RT until progression is safe in patients who are eligible.
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To evaluate the long-term treatment outcomes for patients with giant cell tumor of bone (GCTB) treated with radiotherapy with or without surgical resection. ⋯ Moderate-dose radiotherapy for GCTB provides a long-term LC >80%, justifying its role as an alternative to morbid surgery.
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Am. J. Clin. Oncol. · Aug 2013
Comparative StudyIncreasing use of elective mastectomy and contralateral prophylactic surgery among breast conservation candidates: a 14-year report from a comprehensive cancer center.
First-line surgical options for early-stage breast cancer include breast-conserving surgery (BCS) or mastectomy. We analyzed factors that influence the receipt of mastectomy and resultant trends over time. ⋯ In this longitudinal registry study, major independent determinants of mastectomy for early-stage breast cancer include year of diagnosis, insurance status, and stage. Mastectomy rates declined until 2004, but have since increased in conjunction with immediate reconstruction and contralateral prophylactic mastectomy. Additional study is needed to identify the underlying reasons for and unintended consequences of the reemergence of radical surgery for early-stage breast cancer in the era of multidisciplinary care.
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Am. J. Clin. Oncol. · Aug 2013
Comparative StudyLymph node ratio is an independent prognostic factor in gastric cancer after curative resection (R0) regardless of the examined number of lymph nodes.
The purpose of this study was to evaluate the outcome of the ratio between metastatic and examined lymph nodes (N ratio) in gastric cancer patients with <15 examined lymph nodes after curative resection. ⋯ The metastatic lymph node ratio is an independent prognostic factor regardless of the examined number of lymph nodes. In predicting the prognosis of gastric cancer, the staging system based on the metastatic lymph node ratio is more reliable than the system based on the number of metastatic lymph nodes regardless of the examined number of lymph nodes. This can help improve the TNM staging classification of gastric cancer and reduce the International Union Against Cancer N categories of stage migration.