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Usefulness of Breast MRI for Safe Omission of Axillary Lymph Nodes Dissection in Sentinel Node-Positive Breast Cancer Patients 被引量:2
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作者 Hiromi Fuchikami Naoko Takeda Kazuhiko Sato 《Journal of Cancer Therapy》 2017年第11期1049-1057,共9页
Background: Preoperative identification of patients with extensive lymph node metastasis (LNM) is important for safe omission of axillary lymph node dissection (ALND) in sentinel node (SN)-positive (SN+) breast cancer... Background: Preoperative identification of patients with extensive lymph node metastasis (LNM) is important for safe omission of axillary lymph node dissection (ALND) in sentinel node (SN)-positive (SN+) breast cancer patients. Methods: We evaluated retrospectively the collected data of 758 breast cancer patients who underwent axillary surgery between 2008 and 2017, excluding those who received neoadjuvant chemotherapy. Results: Of the 758 patients, 607 were not suspicious to have LNM by axillary ultrasound (AUS-), but 38 suspicious cases were found by breast magnetic resonance imaging (MRI). Of 15 patients undergoing axillary fine needle biopsy (AFNA) due to second-look axillary ultrasound (AUS), 9 underwent ALND because of a positive AFNA (AFNA+). Among 81 (10.9%) patients undergoing ALND due to SN+ findings, 6 (7.4%) had extensive LNM (LNM ≥ 4). If MRI was not performed, among the 90 of 673 patients undergoing ALND who had SN+ findings, 12 (13.3%) had LNM ≥ 4. Conclusions: The proportion of cases with LNM ≥ 4 was reduced from 13.3% to 7.4% among patients undergoing SN biopsies combined with breast MRI. ALND might be omitted safely in SN+ cases according to detailed preoperative evaluations using additional breast MRI to ultrasound. 展开更多
关键词 breast Cancer SENTINEL node axillary lymph node dissection breast MRI
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Early Results of Omitting Completion Axillary Lymph Node Dissection in Sentinel Lymph Node Metastasis-Positive Breast Cancer Patients 被引量:1
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作者 Junko Honda Hisashi Matsuoka +5 位作者 Chieko Hirose Taeko Nagao Takahiro Yoshida Masako Takahashi Issei Imoto Mitsunori Sasa 《Advances in Breast Cancer Research》 2013年第4期126-132,共7页
Background: We investigated the early results of omitting completion axillary lymph node dissection (ALND) for axillary node metastasis-negative (N0), sentinel node (SN) metastasis-positive breast cancer patients. Pat... Background: We investigated the early results of omitting completion axillary lymph node dissection (ALND) for axillary node metastasis-negative (N0), sentinel node (SN) metastasis-positive breast cancer patients. Patients and Methods: 489 patients had invasive N0 breast cancer treated without completion ALND, regardless of their SN metastasis status. Analyses included the associations between the SN metastasis status, clinicopathological findings and recurrence, between recurrence and clinicopathological findings, and recurrence-free survival. Results: 430 patients were SN biopsy (SNB)-negative, and 59 were SNB-positive. The SNB-positive patients received significantly more potent adjuvant therapy than the SNB-negative patients. Median follow-up was 3.7 years, and the axillary node recurrence was seen in 6 patients (1.2%) and recurrence in 21 patients. The SN status showed no associations with the clinicopathological findings or recurrence. Univariate analysis showed recurrence was associated with absence of hormonal therapy, ER-negative, PgR-negative, HER2-positive or triple-negative (TNBC) disease, a tumor ≥2.1 cm and higher nuclear grade. Multivariate analysis showed recurrence was associated with absence of hormonal therapy and a tumor ≥2.1 cm. Cox proportional hazards model showed recurrence was extremely early in ER-negative and TNBC patients. Conclusion: Completion ALND can be skipped in N0 breast cancer patients even if they are SNB-positive, but adjuvant therapy is essential. 展开更多
关键词 axillary lymph node dissection breast Cancer SENTINEL node Biopsy
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No Axillary Lymph Node Dissection in Breast Cancer Patients with Sentinel Lymph Node Micrometastasis
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作者 Marco Gipponi Piero Fregatti +6 位作者 Federica Murelli Paolo Meszaros Francesca Depaoli Cecilia Margarino Paola Baccini Marina Gualco Daniele Friedman 《Advances in Breast Cancer Research》 2014年第1期12-16,共5页
Follow-up data of a series of 75 breast cancer patients with sentinel node (SN) micrometastases only (between 0.2 and 2 mm) and favorable histopathological features of the primary tumor (well-differentiated, T1 tumors... Follow-up data of a series of 75 breast cancer patients with sentinel node (SN) micrometastases only (between 0.2 and 2 mm) and favorable histopathological features of the primary tumor (well-differentiated, T1 tumors without lymphovascular invasion) who refused completion axillary lymph node dissection (ALND) or who were unsuitable for surgery were assessed in order to detect the rate of axillary recurrence after an adjuvant chemoand/or hormonal adjuvant treatment was given. The great majority of patients (81.3%) did not undergo ALND due to the existence of favorable histopathologic factors while the rest were equally distributed among over 75-year-old women (10.6%) and patients at a high surgical risk due to comorbid conditions (9.3%). Sixty-six patients (88%) underwent conservative treatment (lumpectomy followed by adjuvant breast radiotherapy) while the remaining nine patients (12%) had total mastectomy;72 out of 75 patients (96%) received some forms of adjuvant chemoand/or hormone-therapy. After a median follow-up of 38 months (range 12 - 84 months), nine out of 75 patients (12%) had a disease relapse, only one of them (1.3%) being affected by an axillary recurrence in the untreated axilla three years after primary surgery. On these grounds, completion ALND could be safely omitted in patients with SN micrometastasis and favorable histopathological characteristics of the primary neoplasm due to the very low rate of axillary recurrence with no detrimental effect on survival. 展开更多
关键词 SENTINEL lymph node axillary lymph node dissection breast Cancer
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Clinical significance of the negative lymph node count after the axillary dissection of breast cancer patients
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作者 Yufeng Yao Jinhai Tang +1 位作者 Jianwei Qin Jianping Gong 《The Chinese-German Journal of Clinical Oncology》 CAS 2012年第7期407-410,共4页
Objective: The purpose of this study was to evaluate the impact of the negative lymph node (LN) count on the survival of the breast cancer patients in early stage after the axillary dissection. Methods: The breast... Objective: The purpose of this study was to evaluate the impact of the negative lymph node (LN) count on the survival of the breast cancer patients in early stage after the axillary dissection. Methods: The breast cancer patients with T1-2N0-1M0 stage between January 2001 and December 2005 in Jiangsu Cancer Hospital, who underwent the axillary LNs dissection, were enrolled in this study. We analyzed the data of these patients including information of follow-up and postop- erative pathological results. All patients were divided into two groups according to the axillary LN status and each group was divided into four subgroups according to the negative LN count. Cox regression analysis was performed to screen the patho- logical factor including the negative LN count on the survival and to compare the different negative LN count on the survival. Results: COX proportional hazard regression model showed that the survival of the breast cancer was significantly associ- ated with the negative LN count. In T1 2N0 group, when the negative LN count was 3 or less, 4 to 5, 6 to 9 and 10 or more, the median survival time was (82.6 ±4.1) months, (101.5 ± 1.3) months, (104.7 ±1.0) months, and (110.5 ±0.9) months respectively (P 〈 0.05). In T1-2N0 group, when the negative LN count was 6 or less, 7 to 8, 9 to 10 and 11 or more, the median survival time was (95.4 ± 1.9) months, (101.8 ± 1.1) months, (104.9 ± 1.0) months, and (106.5 ± 0.9) months respectively (P 〈 0.05). Conclusion: The negative LN count can reflect the adequacy of the axillary dissection. Increasing negative LN count is independently associated with improved survival in pT1-2N0M0 or pT1-2N0M0 staging breast cancer patients. The negative LN count should be considered for incorporation into staging for breast cancer with the axillary LN dissection. 展开更多
关键词 breast cancer lymph node (LN) dissection survival analysis
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Efficacy and prognosis of mastoscopic axillary lymph node dissection for breast cancer:a systematic evaluation and meta-analysis
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作者 Hong-Yi Lan Yi-Hua Fan +4 位作者 Yang Chen Wan-Ting Cui Wen-Han Li Hao-Fang Guan Xin-Ju Li 《TMR Cancer》 2021年第4期18-27,共10页
Objective:To systematically evaluate the efficacy and prognosis of breast lumpectomy axillary lymphatic dissection for the treatment of breast cancer.Methods:We use computer to search PubMed,The Cochrane Library,EMBAS... Objective:To systematically evaluate the efficacy and prognosis of breast lumpectomy axillary lymphatic dissection for the treatment of breast cancer.Methods:We use computer to search PubMed,The Cochrane Library,EMBASE,Web of Science,China Knowledge Network,Wanfang database,VIP database and CBM for randomized controlled trials(RCTs)of breast lumpectomy in axillary lymphatic dissection for breast cancer.The search time frame was from the database establishment to July 2021.Meta-analysis was performed using Revman 5.4.1 software after 2 investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results:A total of 20 RCTs including 2672 patients were included.Mastoscopic axillary lymph node dissection(MALND)was used in the trial group and conventional axillary lymph node dissection(CALND)was used in the control group.The results showed that the trial group was more effective in controlling bleeding volume[MD=-54.72,95%CI(-79.73,-29.71),P<0.00001],postoperative drainage[MD=-98.99,95%CI(-128.83,-69.15),P<0.00001],length of hospital stay[MD=-2.75,95%CI(-4.67,-0.83),P=0.005],and incidence rate of adverse reaction[RR=0.30,95%CI(0.19,0.45),P<0.00001]were superior to the control group,and the differences were statistically significant.Conclusions:Current evidence suggests that MALND can achieve better outcomes compared with CALND.It is more advantageous in controlling the bleeding volume,postoperative drainage,length of hospital stays,and incidence rate of adverse events. 展开更多
关键词 axillary lymph node dissection breast lumpec-tomy breast cancer Randomized controlled trial META-ANALYSIS
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Axillary lymph node dissection plus radiotherapy may be an optimal strategy for patients with occult breast cancer
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作者 Lixi Li Di Zhang +4 位作者 Tingyu Wen Yun Wu Dan Lv Jingtong Zhai Fei Ma 《Journal of the National Cancer Center》 2022年第4期198-204,共7页
Background:Because of the rarity of occult breast cancer(OBC)and limited experience in OBC treatment,the optimal treatment strategy is unknown.This study aimed to compare the efficacy of axillary lymph node dissection... Background:Because of the rarity of occult breast cancer(OBC)and limited experience in OBC treatment,the optimal treatment strategy is unknown.This study aimed to compare the efficacy of axillary lymph node dissection(ALND)plus radiotherapy with that of mastectomy plus ALND in patients with OBC.Methods:Relevant clinical data between January 2004 and December 2015 were retrospectively collected from the Surveillance,Epidemiology,and End Results database.The clinical characteristics and prognoses of patients who underwent ALND plus radiotherapy or mastectomy plus ALND were compared before and after propensity score matching.Results:Overall,569 eligible patients with OBC were included in this study.Of these,247 patients underwent ALND plus radiotherapy and 322 underwent mastectomy plus ALND.The 5-year overall survival(OS)rates in the ALND plus radiotherapy group and the mastectomy plus ALND group were 89.2%and 80.6%,respectively;and the corresponding 5-year breast cancer-specific survival(BCSS)rates were 95.2%and 93.0%,respectively.After propensity score matching,the OS in the ALND plus radiotherapy group was significantly better than that in the mastectomy plus ALND group.In addition,further subgroup analyses revealed that ALND plus radiotherapy prolonged OS in the pN3 subgroup.Among patients receiving adjuvant chemotherapy,those who underwent ALND plus radiotherapy had better BCSS and OS than those who underwent mastectomy plus ALND.Conclusions:ALND plus radiotherapy could improve the OS of patients with OBC,especially those with pN3 disease and those receiving chemotherapy.ALND combined with radiotherapy is the optimal treatment strategy for patients with imaging-negative OBC. 展开更多
关键词 Occult breast cancer axillary lymph node dissection RADIOTHERAPY MASTECTOMY Surveillance Epidemiology and End Results
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Clinical Study of Double Contrast-Enhanced Ultrasound Combined with Dye Method and Marker Placement to Identify and Locate Sentinel Lymph Nodes in Patients with Breast Cancer
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作者 Dayan Yang Lini Gao 《Advances in Breast Cancer Research》 CAS 2024年第3期49-58,共10页
Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with brea... Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transvenous ultrasonography can accurately localize sentinel lymph nodes and improve the sensitivity and accuracy of the diagnosis of metastatic SLN. 展开更多
关键词 Sentinel lymph nodes breast Cancer ULTRASOUND ULTRASONOGRAPHY axillary lymph nodes
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Axillary lymph node management in breast cancer with positive sentinel lymph node biopsy 被引量:7
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作者 Ioannis A Voutsadakis Silvana Spadafora 《World Journal of Clinical Oncology》 CAS 2015年第1期1-6,共6页
The surgical treatment of localized breast cancer has become progressively less aggressive over the years.The management of the axillary lymph nodes has been modified by the introduction of sentinel lymph node biopsy.... The surgical treatment of localized breast cancer has become progressively less aggressive over the years.The management of the axillary lymph nodes has been modified by the introduction of sentinel lymph node biopsy. Axillary dissection can be avoided in patients with sentinel lymph node negative biopsies. Based on randomized trials data, it has been proposed that no lymph node dissection should be carried out even in certain patients with sentinel lymph node positive biopsies. This commentary discusses the basis of such recommendations and cautions against a general omission of lymph node dissection in breast cancer patients with positive sentinel lymph node biopsies. Instead, an individualized approach based on axillary tumor burden and biology of the cancer should be considered. 展开更多
关键词 Tumor sub-types Micro-metastatic node POSITIVE breast cancer axillary lymph node dissection Macro-metastatic axillary recurrence
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Accuracy of Ultrasound Examination of Loco-Regional Lymph Nodes in Breast Cancer Follow-Up and Its Role in the Axillary Surgical Management 被引量:1
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作者 Jacopo Nori Icro Meattini +7 位作者 Dalmar Abdulcadir Elisabetta Giannotti Diego De Benedetto Luis Sanchez Lorenzo Orzalesi Simonetta Bianchi Leonardo Capaccioli Lorenzo Livi 《Advances in Breast Cancer Research》 2014年第1期5-11,共7页
Objective: Major international guidelines have not standardized the sequence of diagnostic examinations during the follow-up of a patient with a diagnosed breast cancer. The aim of this study is to investigate the acc... Objective: Major international guidelines have not standardized the sequence of diagnostic examinations during the follow-up of a patient with a diagnosed breast cancer. The aim of this study is to investigate the accuracy of sonography in the diagnosis of loco-regional lymphatic recurrences in comparison to the core needle biopsy results. Materials and Methods: Among 6455 patients who were followed up with clinical examination, mammography and ultrasound between January 2004 and November 2011, 125 (1.93%) patients had to be investigated with a core needle biopsy of a sonographically suspicious loco-regional lymph node. Results: Among the whole series, a total of 142 ultrasound-guided core needle biopsies were performed. Follow-up for the primary tumor lasted for a median time of 6.1 years (range 1 - 27 years). Ultrasound of suspicious loco-regional lymph nodes showed a sensitivity of 89.5%, a specificity of 87.1% and a positive predictive value of 89.5%. Conclusions: In our experience, ultrasound of suspicious loco-regional lymph nodes showed good accuracy and it should be a part of the standard examinations performed during follow-up for breast cancer. 展开更多
关键词 Ultrasound Loco-Regional lymph nodes breast Cancer FOLLOW-UP SENTINEL node dissection axillary Surgery
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The number of tumor-free axillary lymph nodes removed as a prognostic parameter for node-negative breast cancer 被引量:1
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作者 Fei Gao Ni He Pei-Hong Wu 《Chinese Journal of Cancer》 SCIE CAS CSCD 2014年第11期569-573,共5页
Recently, there has been controversy about the relationship between the number of lymph nodes removed and survival of patients diagnosed with lymph node-negative breast cancer. To assess this relationship, 603 cases o... Recently, there has been controversy about the relationship between the number of lymph nodes removed and survival of patients diagnosed with lymph node-negative breast cancer. To assess this relationship, 603 cases of lymph node-negative breast cancer with a median of 126 months of follow-up data were studied. Patients were stratified into two groups(Group A, 10 or fewer tumor-free lymph nodes removed; Group B, more than 10 tumor-free lymph nodes removed). The number of tumor-free lymph nodes in ipsilateral axillary resections as well as 5 other disease parameters were analyzed for prognostic value. Our results revealed that the risk of death from breast cancer was significantly associated with patient age, marital status, histologic grade, tumor size, and adjuvant therapy. The 5- and 10-year survival rates for patients with 10 or fewer tumor-free lymph nodes removed was 88.0% and 66.4%, respectively, compared with 69.2% and 51.1%, respectively, for patients with more than 10 tumor-free lymph nodes removed. For patients with 10 or fewer tumor-free lymph nodes removed, the adjusted hazard ratio(HR) for risk of death from breast cancer was 0.579(95% confidence interval, 0.492-0.687, P < 0.001), independent of patient age, marital status, histologic grade, tumor size, and adjuvant therapy. Our study suggests that the number of tumor-free lymph nodes removed is an independent predictor in cases of lymph node-negative breast cancer. 展开更多
关键词 淋巴结肿大 乳腺癌 肿瘤 阴性 预后 辅助治疗 置信区间 预测因子
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Determination of Metastatic Axillary Lymph Node in Breast Cancer: Differentiation with Dynamic MRI Examination by Signal Intensity-Time Curves
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作者 Duzgun Yildirim Baki Ekci +1 位作者 Bengi Gurses Ahmet Kaur 《Journal of Cancer Therapy》 2011年第4期557-566,共10页
Purpose: We aimed to evaluate the role of dynamic magnetic resonance imaging (MRI) in the detection of axillary lymph node metastasis based on the signal intensity-time curves. Materials and Methods: The data of 120 p... Purpose: We aimed to evaluate the role of dynamic magnetic resonance imaging (MRI) in the detection of axillary lymph node metastasis based on the signal intensity-time curves. Materials and Methods: The data of 120 patients (benign patients, n = 91;malignant patients, n = 29) who underwent dynamic breast MRI were reviewed. The lymph nodes with the strongest criteria for malignancy (morphological-dynamic properties) were included in the analysis. Signal intensity-time curves were plotted by the software. Results: Of 29 patients with breast cancer, axillary lymph nodes were involved in 21 and not involved in the remaining 8. There was no significant difference between benign and malignant cases in terms of the distributions of Type Ia, Type Ib and Type IV curves (p = 0.12), whereas a significant difference was found between benign and malignant cases in terms of the distributions of Type II and III curves (p Conclusion: On dynamic MRI studies, benign and metastatic lymph nodes display different signal intensity-time curves. 展开更多
关键词 Dynamic Magnetic Resonance Imaging breast neoplasms axillary lymph nodes lymphATIC Metastasis Sensitivity-Specificity
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Axillary Sentinel Lymph Node Biopsy for Breast Cancer and Melanoma Patients after Previous Axillary Surgery: A Systematic Review
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作者 Maurice Matter Sebastien Romy +2 位作者 Ariane Boubaker Olivier Michielin Nicolas Demartines 《Journal of Cancer Therapy》 2013年第9期1395-1402,共8页
Objective: Sentinel lymph node biopsy (SLNB) is a validated staging technique for breast carcinoma. Some women are exposed to have a second SLNB due to breast cancer recurrence or a second neoplasia (breast or other).... Objective: Sentinel lymph node biopsy (SLNB) is a validated staging technique for breast carcinoma. Some women are exposed to have a second SLNB due to breast cancer recurrence or a second neoplasia (breast or other). Due to modified anatomy, it has been claimed that previous axillary surgery represents a contra-indication to SLNB. Our objective was to analyse the literature to assess if a second SLNB is to be recommended or not. Methods: For the present study, we performed a review of all published data during the last 10 years on patients with previous axilla surgery and second SLNB. Results: Our analysis shows that second SLNB is feasible in 70%. Extra-axillary SNs rate (31%) was higher after radical lymph node dissection (ALND) (60% - 84%) than after SLNB alone (14% - 65%). Follow-up and complementary ALND following negative and positive second SLNB shows that it is a reliable procedure. Conclusion: The review of literature confirms that SLNB is feasible after previous axillary dissection. Triple technique for SN mapping is the best examination to highlight modified lymphatic anatomy and shows definitively where SLNB must be performed. Surgery may be more demanding as patients may have more frequently extra-axillary SN only, like internal mammary nodes. ALND can be avoided when second SLNB harvests negative SNs. These conclusions should however be taken with caution because of the heterogeneity of publications regarding SLNB and surgical technique. 展开更多
关键词 breast neoplasms MELANOMA Sentinel lymph node Biopsy dissection lymphATIC Vessels SURGERY lymphATIC Anatomy
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Expression of the Apoptosis Inhibitor Survivin and its correlation with Thymidine Kinase and Axillary Lymph Node Metastasis in Breast Cancer
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作者 Jian-Ping WU Yun-Feng ZHOU Zhi-Guo LUO Ming-Sheng ZHANG(Dept of Radio-Chemotherapy, Zhongnan Hospital,Cancer Research Center, Wuhan University,Wuhan 430071,China) 《生物医学工程学杂志》 EI CAS CSCD 北大核心 2005年第S1期133-134,共2页
关键词 Expression of the Apoptosis Inhibitor Survivin and its correlation with Thymidine Kinase and axillary lymph node Metastasis in breast Cancer IAPs
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Study of the Relations among Tumor Size and Axillary Lymph Nodes Involvement with the Prognosis of Patients with Breast Cancer Surgery in Shohada Hospital in Tehran, Tajrish
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作者 Elham Sadeghi Sara Sadeghi 《Journal of Pharmacy and Pharmacology》 2016年第9期501-510,共10页
Facts and evidence hold out a steadily increasing prevalence of breast cancer in the mid-1940s. In most cases, the disease is discovered when the disease has reached an advanced stage, therefore, early diagnosis can s... Facts and evidence hold out a steadily increasing prevalence of breast cancer in the mid-1940s. In most cases, the disease is discovered when the disease has reached an advanced stage, therefore, early diagnosis can significantly reduce the burden of disease. Breast cancer has some risk factors, such as tumor size and lymph node involvement. The aim of this study was to evaluate the correlation between tumor size and axillary lymph node involvement and the prognosis for patients with breast cancer has been surgery. The study population consisted of 100 patients with breast cancer surgery at Shohada Hospital of Tajrish during the last 10 years. The results suggest that lymph node involvement was significantly associated with prognosis in patients with breast cancer and in cases where the tumor size was less than 1 cm, it has no impact on the prognosis of breast cancer. Also, a family history of the disease among close relatives is an independent risk factor for poor prognosis, in patients with breast cancer in general it can be said that involvement of lymph nodes in patients with breast cancer is due to an unfavorable prognosis; but the number of lymph nodes involved and the size of the tumor did not have any effect on the prognosis. 展开更多
关键词 Tumor size axillary lymph nodes the prognosis screening breast cancer.
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Factors associated with levelⅢlymph nodes positive and survival analysis of its dissection in patients with breast cancer
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作者 Heming Zheng Lixi Luo Wenhe Zhao 《Laparoscopic, Endoscopic and Robotic Surgery》 2020年第2期43-47,共5页
Objective:Surgical resection remains the mainstream radical therapy in patients with breast cancer.Given that no consensus has been reached on the exact indication for levelⅢlymph node dissection,the aim of this stud... Objective:Surgical resection remains the mainstream radical therapy in patients with breast cancer.Given that no consensus has been reached on the exact indication for levelⅢlymph node dissection,the aim of this study is to explore factors associated with levelⅢlymph nodes positive and survival analysis of its dissection in patients with breast cancer.Materials and methods:A retrospective study including 61 patients after levelⅠ-Ⅲdissection via a smaller incision of pectoralis major and 61 patients experiencing only levelⅠandⅡclearance was performed.Clinicopathological outcomes were compared initially and survival analysis was conducted subsequently.Results:No significant differences were presented in baseline and clinicopathological characteristics between the two groups.Ten(16.4%)patients’levelⅢnodes were proven positive after levelⅢdissection.Positive nodes in levelⅠandⅡlymph nodes over 9 was demonstrated as an independent predictor of levelⅢnodes positive(OR:200.75[95%CI:7.77e5187.19],p-0.001).Although the levelⅠ-Ⅲlymph node dissection group presented a seemingly better disease-free survival,statistical significance was not detected(p-0.21).Conclusions:This study revealed that having positive nodes in levelⅠandⅡlymph nodes over 9 was a risk factor of levelⅢlymph nodes positive.But levelⅢlymph node dissection does not offer definite survival benefit. 展开更多
关键词 breast cancer lymph node dissection Disease-free survival
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Huang's three-step maneuver for laparoscopic spleen-preserving No.10 lymph node dissection for advanced proximal gastric cancer 被引量:47
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作者 Chang-Ming Huang Qi-Yue Chen +3 位作者 Jian-Xian Lin Chao-Hui Zheng Ping Li Jian-Wei Xie 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2014年第2期208-210,共3页
Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding ... Due to the complexity of the splenic hilar vessels, their anatomical variation and the narrow and deep space, as well as the bleeding-prone splenic parenchyma and the difficulty to manage splenic or vascular bleeding at the splenic hilum,the procedure remains challenging and technically demanding procedure for the performance of laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection. Based on our experiences, we gradually explored a set of procednral operation steps called "Huang's three-step maneuver". In this paper, we not only provide the concrete operation steps for the surgeon, but we also provide our recommended technique of pulling and exposure for assistants. This new maneuver simplifies the complicated procedure and improves the efficiency of laparoscopic spleen-preserving splenic hilar lymphadenectomy, making it easier to master and allowing for its widespread adoption. 展开更多
关键词 Stomach neoplasms spleen preservation LAPAROSCOPY lymph node dissection
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Analysis of factors related to non-sentinel lymph node metastasis in 296 sentinel lymph node-positive Chinese breast cancer patients 被引量:18
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作者 Amina Maimaitiaili Di Wu +3 位作者 Zhenyu Liu Haimeng Liu Xiamusiye Muyiduli Zhimin Fan 《Cancer Biology & Medicine》 SCIE CAS CSCD 2018年第3期282-289,共8页
Objective: Axillary lymph node dissection(ALND) may be unnecessary in 20%–60% of breast cancer patients with sentinel lymph node(NSLN) metastasis. The aim of the present study was to review the medical records of Chi... Objective: Axillary lymph node dissection(ALND) may be unnecessary in 20%–60% of breast cancer patients with sentinel lymph node(NSLN) metastasis. The aim of the present study was to review the medical records of Chinese patients with early-stage breast cancer and positive NSLN metastasis to identify clinicopathological characteristics as risk factors for non-NSLN metastasis.Methods: The medical records of 2008 early-stage breast cancer patients who received intraoperative sentinel lymph node biopsy(SLNB) between 2006 and 2016 were retrospectively reviewed. These patients were clinically and radiologically lymph nodenegative and had no prior history of receiving neoadjuvant chemotherapy or endocrinotherapy. The clinicopathological characteristics of patients with positive NSLN metastasis who underwent ALND were investigated.Results: In the present study, 296 patients with positive NSLN metastases underwent ALND. Positive non-NSLN metastases were confirmed in 95 patients(32.1%). On univariate analysis, ≥ 3 positive NSLN metastases(P <0.01), NSLN macrometastases(P =0.023), and lymphovascular invasion(P = 0.04) were associated with non-NSLN metastasis(P <0.05). In multivariate analysis, the number of positive SLNs was the most significant predictor of non-SLN metastasis. For patients with 0, 1, 2, or 3 associated risk factors, the non-SLN metastatic rates were 11.5%, 22.5%, 35.2%, and 73.1%, respectively.Conclusions: The number of positive NSLNs, NSLN macrometastases, and lymphovascular invasion were correlated with nonSLN metastasis. The number of positive SLNs was an independent predictor for non-NSLN metastasis. When 2 or 3 risk factors were present in one patient, the probability of non-NSLN was higher than that in the American College of Surgeons Oncology Group Z0011 trial(27.3%); thus, avoiding ALND should be considered carefully. 展开更多
关键词 breast cancer sentinel lymph node metastasis axillary lymph node dissection non-sentinel lymph node metastasis
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Role of 3DCT in laparoscopic total gastrectomy with spleen-preserving splenic lymph node dissection 被引量:22
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作者 Jia-Bin Wang Chang-Ming Huang +4 位作者 Chao-Hui Zheng Ping Li Jian-Wei Xie Jian-Xian Lin Jun Lu 《World Journal of Gastroenterology》 SCIE CAS 2014年第16期4797-4805,共9页
AIM: To investigate whether computed tomography with 3D imaging (3DCT) can reduce the risks associated with laparoscopic surgery.
关键词 Stomach neoplasms Spleen preservation LAPAROSCOPY lymph node dissection Computed tomography angiography with three-dimensional imaging
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Selective lateral lymph node dissection after neoadjuvant chemoradiotherapy in rectal cancer 被引量:15
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作者 Jia-Nan Chen Zheng Liu +8 位作者 Zhi-Jie Wang Shi-Wen Mei Hai-Yu Shen Juan Li Wei Pei Zheng Wang Xi-Shan Wang Jun Yu Qian Liu 《World Journal of Gastroenterology》 SCIE CAS 2020年第21期2877-2888,共12页
BACKGROUND Lateral lymph node metastasis is one of the leading causes of local recurrence in patients with advanced mid or low rectal cancer.Neoadjuvant chemoradiotherapy(NCRT)can effectively reduce the postoperative ... BACKGROUND Lateral lymph node metastasis is one of the leading causes of local recurrence in patients with advanced mid or low rectal cancer.Neoadjuvant chemoradiotherapy(NCRT)can effectively reduce the postoperative recurrence rate;thus,NCRT with total mesorectal excision(TME)is the most widely accepted standard of care for rectal cancer.The addition of lateral lymph node dissection(LLND)after NCRT remains a controversial topic.AIM To investigate the surgical outcomes of TME plus LLND,and the possible risk factors for lateral lymph node metastasis after NCRT.METHODS This retrospective study reviewed 89 consecutive patients with clinical stage II-III mid or low rectal cancer who underwent TME and LLND from June 2016 to October 2018.In the NCRT group,TME plus LLND was performed in patients with short axis(SA)of the lateral lymph node greater than 5 mm.In the non-NCRT group,TME plus LLND was performed in patients with SA of the lateral lymph node greater than 10 mm.Data regarding patient demographics,clinical workup,surgical procedure,complications,and outcomes were collected.Multivariate logistic regression analysis was performed to evaluate the possible risk factors for lateral lymph node metastasis in NCRT patients.RESULTS LLN metastasis was pathologically confirmed in 35 patients(39.3%):26(41.3%)in the NCRT group and 9(34.6%)in the non-NCRT group.The most common site of metastasis was around the obturator nerve(21/35)followed by the internal iliac artery region(12/35).In the NCRT patients,46%of patients with SA of LLN greater than 7 mm were positive.The postoperative 30-d mortality rate was 0%.Two(2.2%)patients suffered from lateral local recurrence in the 2-year follow up.Multivariate analysis showed that cT4 stage(odds ratio[OR]=5.124,95%confidence interval[CI]:1.419-18.508;P=0.013),poor differentiation type(OR=4.014,95%CI:1.038-15.520;P=0.044),and SA≥7 mm(OR=7.539,95%CI:1.487-38.214;P=0.015)were statistically significant risk factors associated with LLN metastasis.CONCLUSION NCRT is not sufficient as a stand-alone therapy to eradicate LLN metastasis in lower rectal cancer patients and surgeons should consider performing selective LLND in patients with greater LLN SA diameter,poorer histological differentiation,or advanced T stage.Selective LLND for NCRT patients can have a favorable oncological outcome. 展开更多
关键词 Rectal neoplasms Neoadjuvant therapies Lateral lymph node dissection Locoregional recurrence lymphatic metastasis Total mesorectal excision
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Locoregional treatment of early breast cancer with isolated tumor cells or micrometastases on sentinel lymph node biopsy 被引量:1
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作者 Agnès Tallet Eric Lambaudie +4 位作者 Monique Cohen Mathieu Minsat Marie Bannier Michel Resbeut Gilles Houvenaeghel 《World Journal of Clinical Oncology》 CAS 2016年第2期243-252,共10页
The advent of sentinel lymph-node technique has led to a shift in lymph-node staging,due to the emergence of new entities namely micrometastases(p N1mi) and isolated tumor cells [p N0(i+)].The prognostic significance ... The advent of sentinel lymph-node technique has led to a shift in lymph-node staging,due to the emergence of new entities namely micrometastases(p N1mi) and isolated tumor cells [p N0(i+)].The prognostic significance of this low positivity in axillary lymph nodes is currently debated,as is,therefore its management.This article provides updates evidence-based medicine data to take into account for treatment decision-making in this setting,discussing the locoregional treatment in p N0(i+) and p N1 mi patients(completion axillary dissection,axillary irradiation with or without regional nodes irradiation,or observation),according to systemic treatment,with the goal to help physicians in their daily practice. 展开更多
关键词 breast cancer MICROMETASTASES axillary lymph node dissection RADIOTHERAPY Isolated tumor cells
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