Annals of surgical oncology
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Comparative Study
Lack of independent significance of a close (<1 mm) circumferential resection margin involvement in esophageal and junctional cancer.
For rectal cancer, an involved circumferential resection margin (CRM), defined as tumor cells within 1 mm of the CRM, is of established prognostic significance. This definition for the esophagus, however, is controversial, with the UK Royal College of Pathologists (RCP) recommending the 1 mm definition, while the College of American Pathologists (CAP) advises that only tumor cells at the cut margin (0 mm) define an incomplete (R1) resection. The aim of this study was to compare the clinical significance of both definitions in patients with pT3 tumors. ⋯ A CRM margin of <1 mm is common in pT3 esophageal tumors, a finding consistent with other reports. The <1 mm definition was not associated with node positivity, local recurrence, or survival, in contrast to actual involvement at the margin, suggesting lack of independent prognostic significance of the RCP definition and possible superiority of the CAP criteria for prospective registration of CRM.
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Multicenter Study
Telementoring: a multi-institutional experience with the introduction of a novel surgical approach for adrenalectomy.
Telementoring is a video-conferencing tool which can deliver expert opinion to physicians and their patients in remote locations. We report our experience with the use of telementoring as a technique to instruct in the performance of posterior retroperitoneoscopic adrenalectomy (PRA). Issues regarding utility, regulation, and future directions of telementoring are addressed. ⋯ Telementoring is a technical application with utility in remotely helping and guiding another surgeon through the execution of a novel surgical approach. The cyberspace consultation is safe and enhances patient care through a real-time collaborative approach which extends beyond the confines of one institution and one surgeon. Aspects concerning improvement in both implementation and regulation of telementoring mandate further research and creation of nationwide guidelines.
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To investigate whether the quantitative elasticity index of shear wave elastography (SWE) can predict extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC) preoperatively. ⋯ Quantitative elasticity index of SWE could predict pathologic ETE, and SWE could be a complimentary method to grayscale US for preoperative prediction of prognostic factors of PTC.