Annals of surgery
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This study examines the association between nodal positivity and risk of developing breast cancer-related lymphedema (BCRL) in patients who underwent axillary lymph node dissection (ALND). ⋯ These results are counterintuitive to the conventional understanding of the pathophysiology of BCRL. A possible explanation is that patients who develop disease in axillary lymph nodes and subsequently undergo ALND have more time and ability to develop lymphatic collaterals, which may provide adequate lymphatic drainage following surgery, thereby reducing the risk of developing BCRL.
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Randomized Controlled Trial Multicenter Study
Risk factors for adverse outcome in patients with rectal cancer treated with an abdominoperineal resection in the total mesorectal excision trial.
This study was performed to identify tumor- and patient-related risk factors for distal rectal cancer in patients treated with an abdominoperineal resection (APR) associated with positive circumferential resection margin (CRM), local recurrence (LR), and overall survival (OS). ⋯ Age, T-stage, N-stage, CRM, distance of the tumor to the anal verge, and tumor location were independent risk factors for adverse outcome in patients treated with an APR for low rectal cancer. Anterior location, specifically in women, more often requires downstaging and/or more extended resection to obtain free margins.
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Multicenter Study
Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma.
To determine if ifosfamide-based chemotherapy (IF) offers a survival benefit to adult patients with primary extremity synovial sarcoma. ⋯ Ifosfamide-based chemotherapy was associated with an improved DSS in adult patients with high-risk, primary, extremity, synovial sarcoma and should be considered in the treatment of such patients.
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Multicenter Study
Specificity of procedure volume and in-hospital mortality association.
Several studies have examined the association between procedure-specific volume and in-hospital mortality and concluded that high-volume hospitals have lower mortality rates when compared with low-volume hospitals. There is a paucity of studies examining the association between unrelated procedure volume and in-hospital mortality. The objective of our study is to examine the procedure-specific volume-outcome association as well as unrelated procedure volume-outcome association for 5 procedures: coronary artery bypass graft (CABG), percutaneous coronary interventions (PCI), elective abdominal aortic aneurysm repair (AAA), pancreatectomy (PAN), and esophagectomy (ESO). ⋯ Hospital volume-in-hospital mortality association appears largely to be specific to the procedure being studied.
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Review
Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review.
To assess the safety and efficacy of self-expanding metallic stents (SEMS) placement for the relief of malignant colorectal obstruction in comparison to surgical procedures through a systematic review of the literature. ⋯ Stenting appears to be a safe and effective addition to the armamentarium of treatment options for colorectal obstructions. However, the small sample sizes of the included studies limited the validity of the findings of this review. The results of additional comparative studies currently being undertaken will add to the certainty of the conclusions that can be drawn.