Annals of surgical oncology
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Editorial Comment
Pulmonary metastasectomy for melanoma: beyond the standard of care.
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Little is known about the interaction among surgeons, patients, and other physicians in selecting breast cancer surgery. ⋯ High-volume surgeons and those in cancer centers more frequently endorse current clinical guidelines that favor BCS over mastectomy, resulting in greater conflict with patients. These findings support patient reports that patient choice is a key factor in continued mastectomy use.
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Although changes in lipid profile have been documented in gastrointestinal cancers, the specific relationship between serum lipid levels and lymph node (N) stages in gastric cancer remains uncertain. ⋯ For gastric cancer patients, preoperative low serum HDL-C concentration or high TC/HDL-C ratio might be a potential biomarker of advanced pN(2-3) stages, especially for those with the histologically differentiated type.
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The overall survival with non-cardia gastric adenocarcinoma in the United States has remained poor and relatively unchanged over the past 2 decades. This brings into question the utilization and quality of gastrectomy and lymphadenectomy. We examined the trends, extent, and determinants of surgical treatment and the influence of gastrectomy and adequacy of lymphadenectomy (defined as collection of 15 or more lymph nodes) on non-cardia gastric cancer survival. ⋯ Gastrectomy for non-cardia gastric adenocarcinoma is underutilized, especially for localized disease. In the majority of operations for non-cardia gastric cancer, LN collection is inadequate. Racial and geographic variations with gastric resection and LN sampling are as significant as patient age and stage of the cancer. Disparities based on race and geographic region, as well as surgeon and facility factors need to be investigated and addressed to bring forth improvements in outcomes for non-cardia adenocarcinoma.