Safe Negative Margin Width in Breast Conservative Therapy: Results from a Population with a High Percentage of Negative Prognostic Factors

2014 ◽  
Vol 38 (11) ◽  
pp. 2863-2870 ◽  
Author(s):  
Abu Bakar Bhatti ◽  
Amina Khan ◽  
Narjis Muzaffar ◽  
Neelam Siddiqui ◽  
Aamir Syed ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Conservative Therapy ◽  
Negative Margin ◽  
Breast Conservative Therapy ◽  
Margin Width

Safe negative-margin width in breast-conservative therapy: Results from a population with a high percentage of negative prognostic factors.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 75-75
Author(s):  
Abu Bakar Hafeez Bhatti ◽  
Amina Iqbal Khan ◽  
Muhammad Awais Aamir ◽  
Mazhar Ali Shah ◽  
Neelam Siddiqui ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Conservative Therapy ◽  
Negative Margin ◽  
Locoregional Control ◽  
Treatment Modalities ◽  
Categorical Variables ◽  
Close Margin ◽  
Cox Regression Analysis ◽  
Breast Conservative Therapy ◽  
Margin Width

75 Background: There remains a controversy in literature regarding adequate width of negative surgical margins in breast conservative therapy (BCT). Majority of patients included in studies on outcomes of BCT had favorable prognostic factors. Pakistani population is known to have an elevated expression of unfavorable prognostic factors. This study was done to determine safe negative margin width in a patient population with significantly higher percentage of unfavorable prognostic factors undergoing BCT. Methods: A review of patients who received BCT from 1997-2009 at Shukat Khanum Cancer Hospital was performed. A total of 603 patients whose margin status could be assessed were included. Patients were divided into close ( ≤ 2mm), free (> 2-10mm), and wide (> 10mm) margin groups. Patient characteristics, medical treatment modalities, and number of locoregional recurrences were observed for each margin group. Chi square and Fisher’s exact test were used for categorical variables. Five year locoregional control was determined for margin groups. Univariate and multivariate Cox regression analysis was performed to determine independent predictors of locoregional recurrence. Results: Out of total, 415 (69%) patients were <50 years of age. There were 82 (15%) T3/T4, 337 (56%) poorly differentiated and 238 (39%) ER/PR–ve tumors. Nodal positivity was present in 314 (52%) patients. A higher percentage of T3/T4 tumors in close margin group (25% versus 13% and 7%) (p < 0.0001) was observed. Use of neoadjuvant chemotherapy was significantly higher in close margin group (33% versus 29% and 16%) (p < 0.0001). The actual number of observed locoregional recurrences was 16 (12%), 8 (3%), and 10 (4.6%) in close, free, and wide margin groups (p = 0.002) while the expected 5 year locoregional control was 90%, 97%, and 96% (p = 0.002) respectively. On multivariate analysis tumor size stage, nodal involvement and negative margin width were independent predictors of locoregional failure. Conclusions: A negative margin width of 2mm might represent an adequate negative margin width in populations with a higher percentage of unfavorable prognostic factors.

scholarly journals Concomitant Boost Versus Sequential Boost in Breast Conservative Therapy for Early Stage Breast Cancer

2013 ◽  
Vol 9 (Issue 3-4) ◽  
pp. 74-81
Author(s):  
Salah El-Mesidy ◽  
Asmaa Hassan ◽  
Mohamed Abdelrahman ◽  
Shaimaa Lasheen ◽  
Waleed Hammam ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Conservative Therapy ◽  
Early Stage ◽  
Early Stage Breast Cancer ◽  
Breast Conservative Therapy ◽  
Sequential Boost ◽  
Concomitant Boost

scholarly journals Comparison between Early and Late Onset Breast Cancer in Pakistani Women Undergoing Breast Conservative Therapy: is There any Difference?

2014 ◽  
Vol 15 (13) ◽  
pp. 5331-5336 ◽  
Author(s):  
Abu Bakar Hafeez Bhatti ◽  
Aarif Jamshed ◽  
Amina Khan ◽  
Neelam Siddiqui ◽  
Nargis Muzaffar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Conservative Therapy ◽  
Late Onset ◽  
Breast Conservative Therapy ◽  
Pakistani Women

Survival outcomes of schirrhus gastric cancer treated by multidisciplinary treatments: Putative impact on prognosis by DCS NAC.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 128-128
Author(s):  
Keishi Yamashita ◽  
Kei Hosoda ◽  
Natsuya Katada ◽  
Hiromitsu Moriya ◽  
Hiroaki Mieno ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Hazard Model ◽  
Margin Status ◽  
Negative Margin ◽  
University Hospital ◽  
Proportional Hazard ◽  
Late Period ◽  
Proportional Hazard Model ◽  
Multivariate Proportional Hazard

128 Background: Among gastric cancer, schirrhus exhibited the poorest prognosis, and many patients die even after curative resection due to recurrence. Although progress of multidisciplinary treatments of advanced gastric cancer is outstanding, recent clinical outcome is obscure by such intensive treatments. Methods: Among the 5,664 gastric cancer patients who underwent gastrectomy between 1971 and 2013 in the Kitasato University Hospital, 287 of shirrhus gastric cancer were included (5%). We divided the total periods into early (1971-2004) and late period (2005-2013), and compared their prognosis. Multivariate proportional hazard model was applied to the significant univariate prognostic factors (p<0.05), and identified independent prognostic factors (IPFs). Finally we compared the IPFs in terms of periods, and discuss the most appropriate treatments. Results: (1) Five-year survival rate was 13% and 31% in the early and late periods, respectively (p=0.0010). Between the periods, there were significant differences of pT (p=0.013), CY (p<0.0001), and Margin status (p=0.041). (2) Univariate prognostic factors were age (p=0.032), pT (p=0.0009), pN (p<0.0001), P (p=0.0033), CY (p=0.0002), and Margin status (p<0.0001). Multivariate proportional hazard model elucidated IPFs of pN (pN0-2 vs pN3a-X, p<0.0001) and Margin status (positive vs negative, p=0.0003). If the 2 factors were combined, patients with pN0-2 plus margin negative showed much better survival (about 40% of 5-year OS) than otherwise cases (below 10%)(p<0.0001). (3) Comparison of the IPFs between early and late periods, margin positive cases were significantly less infrequent in the late period. This may be aggressive application of neoadjuvant chemotherapy of DCS (Docetaxel/CDDP/S1). Conclusions: Due to recent progress of multidisciplinary treatments of preoperative aggressive chemotherapy and surgery with curative intent for negative margin for schirrhus gastric cancer, its 5-year survival was dramatically improved. pN0-2 patients were promising for reasonable prognosis if negative margin is secured, so intraoperative diagnosis must be urgently developed.

scholarly journals Co-Overexpression of GEP100 and AMAP1 Proteins Correlates with Rapid Local Recurrence after Breast Conservative Therapy

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e76791 ◽  
Author(s):  
Rumiko Kinoshita ◽  
Jin-Min Nam ◽  
Yoichi M. Ito ◽  
Kanako C. Hatanaka ◽  
Ari Hashimoto ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Conservative Therapy ◽  
Breast Conservative Therapy
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