Annals of surgical oncology
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Multicenter Study
Perioperative hyperfractionated high-dose rate brachytherapy for the treatment of soft tissue sarcomas: multicentric experience.
Low-dose rate brachytherapy is a well-established adjuvant treatment for soft tissue sarcomas (STS). The experience with high-dose rate brachytherapy (HDR BT) in this indication is limited. The purpose of our study was to evaluate the viability of perioperative hyperfractionated HDR BT for STS. ⋯ Our study suggests that perioperative HDR BT is a promising method for achieving high biological doses with good LC in the postoperative radiotherapy of STS and that combination of BT and EBRT provides better tumor control than BT alone.
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To evaluate factors associated with optimal cosmetic results at 36 months for early-stage breast cancer patients enrolled on the American Society of Breast Surgeons (ASBrS) MammoSite Breast Brachytherapy registry trial. ⋯ APBI delivered by MammoSite brachytherapy lead to good/excellent cosmesis in 93% of patients with 3-year follow-up. Breast wound infection, use of chemotherapy, and skin spacing were found to be the three most important predictors of cosmesis at 36 months in our cohort of patients.
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Multicenter Study
Pain palliation in patients with bone metastases using MR-guided focused ultrasound surgery: a multicenter study.
Noninvasive thermal ablation using magnetic resonance (MR)-guided focused ultrasound (MRgFUS) has been shown to be clinically effective in uterine fibroids, and is being evaluated for ablation of breast, liver, and brain lesions. Recently MRgFUS has been evaluated for palliation of pain caused by bone metastases. We present the clinical results of a multicenter study using MRgFUS for palliation of bone metastases pain. ⋯ The results suggest that MRgFUS has the ability to provide an accurate, effective, and safe noninvasive palliative treatment for patients with bone metastases.
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Multicenter Study
Age-, race-, and ethnicity-related differences in the treatment of nonmetastatic rectal cancer: a patterns of care study from the national cancer data base.
Recent studies suggest that older patients and minorities are less likely to receive surgical and adjuvant therapy for rectal cancer. We analyzed the independent effect of age and race/ethnicity on treatment for rectal cancer controlling for comorbidity and socioeconomic status using a nationwide sample ⋯ A high proportion of older patients with rectal cancer do not receive appropriate surgical or adjuvant therapy, even when controlling for comorbidity. African American patients are also less likely to undergo resection, but are equally likely to undergo sphincter preservation and adjuvant therapy compared with whites. Efforts are needed to uncover the root causes underlying these observations and optimize treatment of rectal cancer.
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Multicenter Study
Surgical treatment of hepatocellular carcinoma beyond Milan criteria. Results of liver resection, salvage transplantation, and primary liver transplantation.
There is no clear consensus regarding the best treatment strategy for patients with advanced hepatocellular carcinoma (HCC). ⋯ For patients with HCC beyond Milan criteria, multimodality treatment-including LR, salvage OLT, and primary OLT-results in long-term survival in half of the patients. When indicated, LR can optimize the use of scarce donor organs by leaving OLT as a reserve option for early stage HCC recurrence.