Sandra L Wong

..The National Quality Forum and other organizations recently endorsed a 12-node minimum as a measure of hospital quality...

..They are distinct entities, but both are locally aggressive processes which are plagued with attendant morbidity and high recurrence rates. Complete surgical resection is the mainstay of treatment...

..A survey of its members was conducted to determine which domains of "outcomes" are important and relevant to surgical oncologists...

..Through the largest single-institution series of head and neck melanoma patients, the authors set out to demonstrate that SLNB accuracy and prognostic value in the head and neck region are comparable to other sites...

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..We examined whether the size and location of the metastases within the SLN may help further stratify the risk of additional positive NSLN...

..Merkel cell carcinoma (MCC) is a relatively rare, potentially aggressive cutaneous malignancy. We examined the clinical and histologic features of primary MCC that may correlate with the probability of a positive sentinel lymph node (SLN)...

..There were no deaths associated with either procedure. CONCLUSIONS: SLN biopsy alone is associated with significantly less morbidity compared with SLN biopsy plus CLND...

..Patients with positive SLN are more likely than those with negative SLN to develop both local/in-transit recurrence and distant metastases within a short follow-up period...

..For patients with melanoma, interval or in-transit sentinel lymph nodes (SLNs) have the same risk for nodal metastasis as SLN in traditional (ie, cervical, axillary, and inguinal) nodal basins...

..We sought to examine the effect this change has on the morbidity of the operation...

..Axillary nodal staging remains important in such patients; SLN biopsy is an ideal method to obtain this staging information...

..The authors examined the impact of SLN biopsy on prognosis and outcome in this patient population...

..There may be additional prognostic significance to melanoma spreading from the SLN to nonsentinel lymph nodes (NSLN). We examined the implications of a positive NSLN for overall and distant disease-free survival...

..The objectives of the current study were to verify those previous results and to create a prediction model for the better selection of which patients with melanoma should undergo SLN biopsy...

..CONCLUSIONS: Preoperative lymphoscintigraphy and meticulous intraoperative search for blue/radioactive nodes may improve results in H&N melanomas...

..Subareolar or periareolar injection of radioactive technetium sulfur colloid is equivalent to other injection techniques for breast cancer sentinel lymph node (SLN) biopsy...

..CONCLUSIONS: This study underscores the importance of ongoing prospective randomized trials in determining the therapeutic value of CLND after positive SLN biopsy in melanoma patients...

..We sought to validate recently published models meant to predict sentinel node status...

..ROS and etoposide, when combined with E2F-1 overexpression, induce apoptosis in an additive manner. This chemogene combination may provide a potentially useful therapeutic strategy for advanced pancreatic cancer...

..0 cm or smaller. Patients should be aware of the potential for false-negative results in SLN biopsy, but this risk is outweighed by the decreased morbidity associated with the procedure itself...

..Standard axillary dissection should be performed when a SLN cannot be identified...

..We believe that the dermal lymphatics of the breast represent a clinically relevant metastatic pathway to the axilla...

..75 mm and Clark level II or III melanoma. In our experience, no single clinicopathologic factor was predictive of nodal metastases. The prognostic implications of positive SLNs in thin melanoma remain undefined...

..Despite growing calls for using lymph node counts as a hospital quality indicator, it has not been established that hospitals that obtain more lymph node have better outcomes...

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..This tool takes several characteristics into account simultaneously. This model should enable improved patient counseling and treatment selection...

..Finally, the authors have provided treatment guidelines based on the available evidence and their multidisciplinary experience...

..However, it is difficult to define clinicopathologic factors that reliably predict the presence of nodal metastasis. The prognostic significance of a positive sentinel lymph node in thin melanoma remains to be defined...

..Mechanisms underlying such disparities have not been fully explored. We examined the role of hospital factors in racial differences in late mortality after surgery for breast or colon cancer...

..In our experience, drainage to multiple lymphatic basins was not an independent risk factor for sentinel lymph node metastasis and has no independent prognostic significance...

..This article reviews available literature on the role of pretreatment imaging in patients with newly diagnosed cutaneous melanoma...

..CONCLUSIONS: Excisional biopsy does not significantly affect the accuracy of SLN biopsy, nor does the type of definitive surgical procedure...

..Although hospital procedure volume is clearly related to operative mortality with many cancer procedures, its effect on late survival is not well characterized...

..Minimally invasive techniques have proven equally efficacious provided appropriate oncologic resections are performed...

..However, relations between resource availability and utilization are relatively unexplored in cancer care, including perioperative adjuvant therapy...

..75, P < .005). Cause-specific mortality can be reliably and systematically measured after cancer surgery. Understanding variation in cause-specific mortality can inform future quality improvement efforts...

..This may represent a potentially useful combination gene therapy strategy for metastatic colon cancer...

..Racial disparities in outcomes have been documented among patients with esophageal cancer. The purpose of this study is to identify mechanisms for ethnicity/race-related differences in the use of cancer-directed surgery and mortality...

..We queried a small sample of surgeons at three academic medical centers to determine whether key elements of surgical practice were concordant with available evidence...

..This analysis was performed to determine, among patients with positive SLNs, the rate of nodal metastasis found in nonsentinel nodes (NSNs)...

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..The improved ID rate may be related to improved technical details, while the FN rate has not changed significantly. This highlights the ongoing need for surgeons to perform backup axillary dissection during their initial learning phase...