scholarly journals Dissections of regional lymph nodes for treatment of skin cancer: predicting annual caseloads that will optimise outcomes

2015 ◽  
Vol 97 (1) ◽  
pp. 52-55 ◽  
Author(s):  
JK Dickson ◽  
A Davies ◽  
S Rahman ◽  
C Sethu ◽  
JRO Smith ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Lymph Nodes ◽  
Service Provision ◽  
Regional Lymph Nodes ◽  
Funnel Plot ◽  
Patient Demographics ◽  
South West ◽  
High Prevalence ◽  
Funnel Plots ◽  
Lower Limits

Introduction Dissection of regional lymph nodes (RLNs) can lead to significant morbidity and a high prevalence of complications. Published guidance states that these procedures should be carried out by surgeons who are members of a specialist skin multidisciplinary team who carry out a combined minimum of 15 axillary/groin dissections per year. However, there is little evidence to guide this minimum figure of procedures. We report on the burden of service provision and prevalence of complications across the South West of England and Wales. Methods A 12-month review of dissections of RLNs for skin cancer was undertaken covering five Plastic Surgery Units with a collective catchment of 8.4 million people. Detailed data were collected on patient demographics, pathology, timing of surgery, and prevalence of complications. Results A total of 163 dissections were carried out. Forty-three per cent of patients experienced one or more complication. In that 12-month period, an average of 8 axillary/groin dissections was carried out per surgeon. A funnel plot demonstrated that the prevalence of complications for individual surgeons was within the limit of the plot but, in many cases, this was based only on a relatively small number of procedures per consultant. If surgeons carried out 10 procedures per year, the upper and lower limits on the plot were 73% and 11%, respectively. Conclusions Funnel plots can provide a useful guide as to whether the prevalence of complications for procedures for individual surgeons lies within acceptable limits. Based on these results, 10 procedures per consultant per year should be sufficient to enable meaningful assessment of the prevalence of complications.

High prevalence of isolated tumor cells (ITC) in regional lymph nodes from PN0 colorectal cancer

2006 ◽  
Vol 38 ◽  
pp. S107
Author(s):  
C. Mescoli ◽  
L. Giacomelli ◽  
E. Portolan ◽  
V. Russo ◽  
G. Ingravallo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Nodes ◽  
Tumor Cells ◽  
Isolated Tumor Cells ◽  
Regional Lymph Nodes ◽  
High Prevalence

scholarly journals Laparoscopic Radical Antegrade Modular Pancreatosplenectomy: Preliminary Experience with 10 Cases

2021 ◽  
Author(s):  
Renchao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
Regional Lymph Nodes ◽  
Patient Demographics ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract BackgroundThe radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS.Methods: From December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables , postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected.Results：LRAMPS was performed successfully in all the patients. The median operative time was 235 minutes (range, 212-270min), with an EBL of 120ml(range,100-200ml) . Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days(range,9- 24d).The median count of retrieved lymph nodes was 15 (range, 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection.Median follow-up time was 11 months (range, 3–14m). Two patients developed disease recurrence(pancreatic bed recurrence and liver metastasis) 9 months,10 months after surgery,respectively. Others survived without tumor recurrence or metastasis．ConclusionsLRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

scholarly journals Laparoscopic Radical Antegrade Modular Pancreatosplenectomy: Preliminary Experience with 10 Cases

2020 ◽  
Author(s):  
Ren-Chao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
Regional Lymph Nodes ◽  
Patient Demographics ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract Background: The radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS. Methods: From December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables , postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected.Results: LRAMPS was performed successfully in all the patients. The median operative time was 235 minutes (range, 212-270min), with an EBL of 120ml(range,100-200ml) . Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days(range,9- 24d).The median count of retrieved lymph nodes was 15 (range, 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection.Median follow-up time was 11 months (range, 3–14m). Two patients developed disease recurrence(pancreatic bed recurrence and liver metastasis) 9 months,10 months after surgery,respectively. Others survived without tumor recurrence or metastasis．Conclusions: LRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

Power-Enhanced Funnel Plots for Meta-Analysis

2020 ◽  
Vol 228 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Michael Kossmeier ◽  
Ulrich S. Tran ◽  
Martin Voracek
Keyword(s):  
Statistical Power ◽  
Meta Analysis ◽  
Relevant Information ◽  
Selective Reporting ◽  
Graphical Display ◽  
Funnel Plot ◽  
Evidential Value ◽  
Graphical Displays ◽  
Funnel Plots ◽  
Meta Analyses

Abstract. Currently, dedicated graphical displays to depict study-level statistical power in the context of meta-analysis are unavailable. Here, we introduce the sunset (power-enhanced) funnel plot to visualize this relevant information for assessing the credibility, or evidential value, of a set of studies. The sunset funnel plot highlights the statistical power of primary studies to detect an underlying true effect of interest in the well-known funnel display with color-coded power regions and a second power axis. This graphical display allows meta-analysts to incorporate power considerations into classic funnel plot assessments of small-study effects. Nominally significant, but low-powered, studies might be seen as less credible and as more likely being affected by selective reporting. We exemplify the application of the sunset funnel plot with two published meta-analyses from medicine and psychology. Software to create this variation of the funnel plot is provided via a tailored R function. In conclusion, the sunset (power-enhanced) funnel plot is a novel and useful graphical display to critically examine and to present study-level power in the context of meta-analysis.

A case of primary biliary cirrhosis with sarcoid reaction in the regional lymph nodes after surgery of early gastric cancer

Kanzo ◽  
2005 ◽  
Vol 46 (7) ◽  
pp. 437-442 ◽  
Author(s):  
Tadashi YOSHIDA ◽  
Atsushi NAGASAKA ◽  
Yayoi OGAWA ◽  
Syuji NISHIKAWA ◽  
Akifumi HIGUCHI
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Primary Biliary Cirrhosis ◽  
Lymph Nodes ◽  
Biliary Cirrhosis ◽  
Regional Lymph Nodes ◽  
Sarcoid Reaction

BIOPSY OF THE SIGNALING LYMPH NODES IN GASTRIC CANCER - CURRENT STATUS OF THE PROBLEM AND PROSPECTS

2018 ◽  
Vol 64 (3) ◽  
pp. 335-344
Author(s):  
Aleksey Karachun ◽  
Yuriy Pelipas ◽  
Oleg Tkachenko ◽  
D. Asadchaya
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Stomach Cancer ◽  
Current Status ◽  
Regional Lymph Nodes ◽  
Systematic Analysis ◽  
Tumor Spread ◽  
Special Value

The concept of biopsy of sentinel lymph node as the first lymph node in the pathway of lymphogenous tumor spread has been actively discussed over the past decades and has already taken its rightful place in breast and melanoma surgery. The goal of this method is to exclude vain lymphadenectomy in patients without solid tumor metastases in regional lymph nodes. In the era of minimally invasive and organ-saving operations interventions it seems obvious an idea to introduce a biopsy of sentinel lymph node in surgery of early gastric cancer. Meanwhile the complexity of lymphatic system of the stomach and the presence of so-called skip metastases are factors limiting the introduction of a biopsy of sentinel lymph node in stomach cancer. This article presents a systematic analysis of biopsy technology of signaling lymph node as well as its safety and oncological adequacy. Based on literature data it seems to us that the special value of biopsy of sentinel lymph nodes in the future will be in the selection of personalized surgical tactics for stomach cancer.

QUANTITATIVE AND QUALITATIVE CHARACTERISTICS OF METASTASES IN REGIONAL LYMPH NODES - RISK FACTORS FOR THE RECURRENCE OF PAPILLARY THYROID CANCER IN CHILDREN AND ADOLESCENTS

2018 ◽  
Vol 64 (2) ◽  
pp. 159-165
Author(s):  
Mikhail Fridman ◽  
Svetlana Mankovskaya ◽  
Olga Krasko
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Children And Adolescents ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Regional Lymph Nodes ◽  
Cancer In Children ◽  
Qualitative Characteristics

Among the factors determining the relapse/persistence of papillary thyroid cancer in children and adolescents the most important are the age of the patient (p= 0.003), the presence of concomitant background pathology (p

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