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2.
Sci Rep ; 12(1): 7297, 2022 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-35508484

RESUMO

One-step nucleic acid amplification (OSNA) is a rapid intraoperative molecular detection technique for sentinel node assessment via the quantitative measurement of target cytokeratin 19 (CK19) mRNA to determine the presence of metastasis. It has been validated in breast cancer but its application in lung cancer has not been adequately investigated. 214 LNs from 105 patients with 100 primary lung cancers, 2 occult primary lung tumors, and 3 metastatic lung tumors, who underwent surgical lung resection with LN dissection between February 2018 and January 2020, were assessed. Resected LNs were divided into two parts: one was snap-frozen for OSNA and the other underwent rapidly frozen histological examination. Intraoperatively collected LNs were evaluated by OSNA using loop-mediated isothermal amplification and compared with intraoperative pathological diagnosis as a control. Among 214 LNs, 14 were detected as positive by OSNA, and 11 were positive by both OSNA and intraoperative pathological diagnosis. The sensitivity and specificity of OSNA was 84.6% and 98.5%, respectively. The results of 5 of 214 LNs were discordant, and the remainder all matched (11 positive and 198 negative) with a concordance rate of 97.7%. Although the analysis of public mRNA expression data from cBioPortal showed that CK19 expression varies greatly depending on the cancer type and histological subtype, the results of the five cases, except for primary lung cancer, were consistent. OSNA provides sufficient diagnostic accuracy and speed and can be applied to the intraoperative diagnosis of LN metastasis for non-small cell lung cancer.


Assuntos
Neoplasias da Mama , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Neoplasias da Mama/patologia , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Feminino , Humanos , Queratina-19/análise , Queratina-19/genética , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/cirurgia , Linfonodos/patologia , Metástase Linfática/patologia , Técnicas de Amplificação de Ácido Nucleico/métodos , Estudos Prospectivos , RNA Mensageiro/análise , RNA Mensageiro/genética , Biópsia de Linfonodo Sentinela
3.
J Drugs Dermatol ; 21(5): 510-516, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35533034

RESUMO

Malignant melanoma is one of the most aggressive solid tumors but has low morbidity if treated at an early stage. Over the past decade, the advent of targeted therapy and immunotherapy have productively enriched the treatment options for advanced melanomas and further improved the prognosis. The treatment of melanoma is a rapidly evolving field. In patients with sentinel lymph node (SLN)-positive (SLN+) melanoma, the role of complete lymph node dissection (CLND) is still a matter of debate. Sentinel lymph node biopsy (SLNB) is a staging procedure for melanoma that is routinely offered to patients with tumor thickness ≥1 mm or ≥0.8 mm with additional risk factors and is widely accepted as an important diagnostic and prognostic tool, since SLN+ patients can receive adjuvant targeted treatment or immunotherapy. Currently, the role of CLND has largely been replaced by often recommended adjuvant therapies since their approval. This article provides an overview of sentinel lymph-node surgery in cutaneous melanoma. J Drugs Dermatol. 2022;21(5):510-516. doi:10.36849/JDD.6198.


Assuntos
Melanoma , Linfonodo Sentinela , Neoplasias Cutâneas , Humanos , Fatores Imunológicos , Metástase Linfática/patologia , Melanoma/diagnóstico , Melanoma/patologia , Melanoma/cirurgia , Prognóstico , Estudos Retrospectivos , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
6.
Med Arch ; 76(1): 34-38, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35422568

RESUMO

Background: Sentinel lymph node biopsy is one of the minimally invasive techniques that can confirm the presence of metastasis of regional lymph nodes in cancer. Sentinel lymph node biopsy can be done with a lymph mapping technique using blue-dye, radiotracer, or a combination of both. In developing countries, sentinel lymph node biopsy is often done with a single agent, which is the blue dye. The limitation of conducting SLNB in Indonesia is the availability of patent blue dye and radioisotope tracer. To overcome that, a hormonal receptor is expected to aid in predicting sentinel lymph node metastasis. Objective: The aim of this study was to investigate the hormonal receptor as a prognostic factor of sentinel lymph node metastasis in breast cancer. Methods: This study was conducted in Universitas Sumatera Utara Teaching Hospital with the acknowledgment from the Ethics Committee of the respected hospital by the number of 116/KEP/USU/2020. Total of 51 patients participated in this research. Results: Statistically, the p-value in each immunohistochemistry group is > 0.05 in all ER (+) / PR (+); ER (+) / PR (-); ER (-) / PR (+) groups. This shows that there is no significant relationship between hormonal receptors on sentinel lymph node metastases. Conclusion: The statistical evaluation showed that there is no significant correlation between the hormonal receptor and sentinel lymph node metastasis (p>0.05), but is found clinically significant. Therefore, hormonal receptors should be considered as a predicting factor for sentinel lymph node metastasis.


Assuntos
Neoplasias da Mama , Axila/patologia , Axila/cirurgia , Neoplasias da Mama/patologia , Feminino , Humanos , Indonésia , Linfonodos/patologia , Metástase Linfática , Biópsia de Linfonodo Sentinela/métodos
7.
J Am Coll Surg ; 234(5): 774-782, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35426390

RESUMO

BACKGROUND: Breast angiosarcoma is a rare malignancy classically associated with hematogenous metastases. We sought to determine the prevalence of pathologic nodal involvement in patients with nonmetastatic, resected breast angiosarcoma and its association with overall survival. STUDY DESIGN: The National Cancer Database was used to identify patients with nonmetastatic angiosarcoma of the breast who underwent surgical resection from 2004 to 2017. The prevalence of regional lymph node operation and nodal positivity was calculated. The Kaplan-Meier method was used to evaluate overall survival among node-positive and node-negative patients. Cox proportional hazard modeling was used to evaluate the adjusted association of nodal positivity with overall survival. RESULTS: We included 991 patients with angiosarcoma. The median age was 69 years (interquartile range 57 to 78), and the cohort was 99% female. A total of 298 patients (30%) had pathologic regional nodal evaluation. Of those, 15 (5.0%) had positive regional lymph nodes. Node-positive patients had significantly worse survival than patients with negative regional lymph nodes. After adjusting for patient, tumor, and treatment factors, a positive regional lymph node was associated with worse overall survival compared with patients with no nodal evaluation (hazard ratio 3.20; 95% CI 1.75 to 5.86; p < 0.001). CONCLUSIONS: Patients with nonmetastatic angiosarcoma of the breast have a 5% regional lymph node positivity rate, which is at a common threshold to consider evaluation, and identifies patients with poor survival. A prospective study to determine performance characteristics of sentinel lymph node biopsy is warranted.


Assuntos
Neoplasias da Mama , Hemangiossarcoma , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Hemangiossarcoma/patologia , Hemangiossarcoma/cirurgia , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Masculino , Estadiamento de Neoplasias , Estudos Prospectivos , Biópsia de Linfonodo Sentinela
8.
Radiologia (Engl Ed) ; 64 Suppl 1: 28-36, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35428464

RESUMO

OBJECTIVE: This study aimed to determine the ability of axillary ultrasonography to predict the number of lymph nodes with metastases found in sentinel node axillary surgery or axillary lymph node resection in patients recently diagnosed with breast cancer after percutaneous biopsy. METHODS: This prospective study included patients diagnosed with invasive breast cancer by percutaneous biopsy. Axillary lymph nodes were classified at ultrasound examination as suspicious or not suspicious, and the number of suspicious nodes was compared with the number classified as suspicious in the surgical specimen. RESULTS: We included 142 patients, 4 of whom had bilateral cancer; 133 of the 146 tumors were clinically classified as T1-T2 N0. The median number of suspicious lymph nodes at ultrasound was 2 (1-6), and the median number of suspicious lymph nodes in the surgical biopsy specimen was 1 (1-16); the difference was not significant (p = 0.1). The correlation between the number of positive lymph nodes on axillary ultrasound and the number of metastatic lymph nodes in the surgical specimen was 72.7% p = 0.0002 and the concordance was 79% (95%CI 62.4%-95.6%) p = 0.0001. For diagnosing high axillary tumor load (≥3 metastatic lymph nodes) versus low axillary tumor load (<3 metastatic lymph nodes), axillary ultrasound had 86.6% sensitivity, 83.3% specificity, 92% PPV, and 71.4% NPV. CONCLUSION: Our results show that preoperative axillary ultrasound can differentiate between low and high tumor load and can be used as a tool to select the type of treatment. These results need to be confirmed in randomized multicenter studies.


Assuntos
Neoplasias da Mama , Axila/diagnóstico por imagem , Axila/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Estudos Prospectivos , Biópsia de Linfonodo Sentinela/métodos , Carga Tumoral , Ultrassonografia/métodos
9.
World J Gastroenterol ; 28(12): 1284-1287, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35431511

RESUMO

Near infrared fluorescence using indocyanine green is beneficial for visual assessment of blood vessels, blood flow, and tissue perfusion, sentinel lymph node biopsy, lymph node road mapping, identification of the vascular system round the major vessels, and the detection of ureters in order to reduce the risk of iatrogenic ureteral lesions in colorectal surgery.


Assuntos
Cirurgia Colorretal , Procedimentos Cirúrgicos do Sistema Digestório , Linfonodo Sentinela , Fluorescência , Humanos , Verde de Indocianina , Imagem Óptica/métodos , Biópsia de Linfonodo Sentinela/métodos
10.
Gan To Kagaku Ryoho ; 49(4): 433-435, 2022 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-35444128

RESUMO

CASE: A 37-year-old pregnant woman arrived at our hospital with an abnormal mammogram. MEDICAL HISTORY: Mammography performed in June 2018 revealed an abnormal shadow on the left breast. Cytology from the 6-mm tumor in the left upper-outer quadrant revealed a malignancy. At the same time, a transvaginal echo revealed cysts, and the patient was diagnosed at 5 weeks gestation. Needle biopsy revealed a luminal A-like cStage Ⅰ, cT1bN0M0 invasive ductal carcinoma (IDC). Tumor resection and sentinel lymph node biopsy were performed under local anesthesia at 12 weeks gestation, and post-delivery adjuvant therapy was planned. Histologic examination of the resected tumor revealed that it was HER2-positive( immunohistochemistry score 3+); therefore, we had to reconsider the use of trastuzumab and decided to administer it to the patient after childbirth. The patient gave birth by cesarean section, and weekly paclitaxel plus trastuzumab was initiated 7 months after surgery. The patient is currently alive without recurrence. DISCUSSION: We faced several difficulties during the treatment of this patient. Postoperative adjuvant therapy is recommended to be administered 8 weeks after the surgical resection of the tumor. However, in our case, given that the tumor was HER2-positive, we could administer adjuvant therapy with trastuzumab only after delivery. Although the prevalence of breast cancer in women below the age of 40 years in Japan is currently as low as 4-6%, the incidence of pregnancy-associated breast cancer is predicted to increase as the number of elderly primigravida increases due to later marriage.


Assuntos
Neoplasias da Mama , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Cesárea , Quimioterapia Adjuvante , Feminino , Humanos , Gravidez , Receptor ErbB-2 , Biópsia de Linfonodo Sentinela , Trastuzumab
11.
Zhonghua Wei Chang Wai Ke Za Zhi ; 25(4): 295-299, 2022 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-35461195

RESUMO

Gastric cancer is one of the most common gastrointestinal malignancies, and the incidence and mortality of gastric cancer remain high in China. In recent years, with the rapid popularization of laparoscopic technology, fluorescent laparoscopic technology is increasingly getting mature, providing a new method for accurate clinical tracing of lymph nodes and prediction of tumor metastasis lymph nodes. A large number of scientific research experiments and clinical trials have shown that, laparoscopic lymph node diagnosis technology based on the fluorescent indocyanine green (ICG) can significantly improve the efficiency of lymphadenectomy and prediction accuracy of lymph node metastasis, and can reveal a more accurate scope of lymphadenectomy in gastric cancer for surgeons, so as to avoid excessive adenectomy as well as iatrogenic injuries on patients. Although the status of the technology in gastric cancer surgery mentioned above continues improving, the overall operation process details of ICG fluorescence imaging, standardized fluorescence detecting equipment, and postoperative pathological examination process still need to be further optimized.


Assuntos
Laparoscopia , Neoplasias Gástricas , Corantes , Gastrectomia , Humanos , Verde de Indocianina , Excisão de Linfonodo/métodos , Linfonodos/patologia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
12.
Plast Reconstr Surg ; 149(5): 995e-1008e, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35472052

RESUMO

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand the indications for and prognostic value of sentinel lymph node biopsy in skin cancer. 2. Learn the advantages and disadvantages of various modalities used alone or in combination when performing sentinel lymph node biopsy. 3. Understand how to perform sentinel lymph node biopsy in skin cancer patients. SUMMARY: Advances in technique used to perform sentinel lymph node biopsy to assess lymph node status have led to increased accuracy of the procedure and improved patient outcomes.


Assuntos
Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas , Humanos , Linfonodos/patologia , Prognóstico , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
13.
Lancet ; 399(10333): 1412-1428, 2022 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-35397864

RESUMO

Endometrial cancer is the most common gynaecological cancer in high income countries and its incidence is rising globally. Although an ageing population and fewer benign hysterectomies have contributed to this trend, the growing prevalence of obesity is the major underlying cause. Obesity poses challenges for diagnosis and treatment and more research is needed to offer primary prevention to high-risk women and to optimise endometrial cancer survivorship. Early presentation with postmenopausal bleeding ensures most endometrial cancers are cured by hysterectomy but those with advanced disease have a poor prognosis. Minimally invasive surgical staging and sentinel-lymph-node biopsy provides a low morbidity alternative to historical surgical management without compromising oncological outcomes. Adjuvant radiotherapy reduces loco-regional recurrence in intermediate-risk and high-risk cases. Advances in our understanding of the molecular biology of endometrial cancer have paved the way for targeted chemotherapeutic strategies, and clinical trials will establish their benefit in adjuvant, advanced, and recurrent disease settings in the coming years.


Assuntos
Neoplasias do Endométrio , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/epidemiologia , Neoplasias do Endométrio/terapia , Feminino , Humanos , Histerectomia , Excisão de Linfonodo , Estadiamento de Neoplasias , Obesidade/complicações , Obesidade/epidemiologia , Radioterapia Adjuvante , Biópsia de Linfonodo Sentinela
14.
Oral Maxillofac Surg Clin North Am ; 34(2): 273-281, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35400571

RESUMO

The utilization of sentinel lymph node (SLN) biopsy has transformed the workup and staging of intermediate-thickness cutaneous melanomas. SLN biopsy, performed at the time of primary tumor excision, accurately maps lymph nodes at risk of harboring occult metastatic deposits from head and neck cutaneous melanomas and represents the current standard of care. Completion lymphadenectomy identifies additional tumor in 12% to 24% of SLN biopsy positive cases but does not affect melanoma-specific survival.


Assuntos
Neoplasias de Cabeça e Pescoço , Melanoma , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Linfonodos/patologia , Melanoma/patologia , Melanoma/cirurgia , Estadiamento de Neoplasias , Estudos Retrospectivos , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas , Síndrome
15.
Oral Maxillofac Surg Clin North Am ; 34(2): 251-262, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35428503

RESUMO

Surgical management of head and neck melanoma starts from the primary biopsy of the cutaneous site by a narrow excision with a 1 to 3 mm margins. The margin should include the whole breadth and sufficient depth of the lesion. The key is not to transect the lesion. With the advent of molecular testing, gene expression profiling, and immunotherapies, the surgical management of advanced melanoma has changed. Sentinel lymph node biopsy is an essential armamentarium for T2a and higher staging/greater than 1 mm thick and advance stage disease. Molecular pathogenesis and cancer immunology are recognized in the recent treatment protocols along with surgery in advanced stages of melanoma.


Assuntos
Neoplasias de Cabeça e Pescoço , Melanoma , Neoplasias Cutâneas , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Metástase Linfática , Margens de Excisão , Melanoma/patologia , Melanoma/cirurgia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
16.
Sci Rep ; 12(1): 6917, 2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35484369

RESUMO

Prophylactic elective neck dissection (ND) with navigation surgery using radioisotope-based sentinel lymph node biopsy (SLNB) is non-inferior to elective ND in terms of survival but has an advantage in postoperative functional disability. We conducted a subgroup analysis to identify predictive factors for false-negative (FN)-SLNB in patients with early oral cavity cancer. This study is a supplementary analysis using the dataset of a previously reported randomized clinical trial on SLN navigation surgery for oral cancers. This study investigated the association of clinical and SLN-related factors with false-negative cases in the SLNB group. From 2011 to 2016, 275 patients were enrolled and randomly assigned to the ND and SLNB study groups, with 134 patients assigned to the SLNB group. In the SLNB group, seven cases with negative SLNs and neck recurrences were judged as FN-SLNBs according to the general definition. The number of detected SLNs with and without adjusting for the propensity score was significantly associated with FNs in the logistic analysis. FN-SLNB was associated with the number of identified SLNs, suggesting the need for careful postoperative monitoring for neck recurrence in patients with one or two identified SLNs after acquiring sufficient experience in the identification technique.


Assuntos
Neoplasias Bucais , Biópsia de Linfonodo Sentinela , Humanos , Neoplasias Bucais/patologia , Neoplasias Bucais/cirurgia , Pescoço/patologia , Esvaziamento Cervical , Biópsia de Linfonodo Sentinela/métodos
17.
BMC Cancer ; 22(1): 445, 2022 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-35461213

RESUMO

BACKGROUND: Standard groin treatment in recurrent vulvar cancer consists of uni- or bilateral inguinofemoral lymphadenectomy (IFL), whereas in the primary setting women with selected unifocal tumours will undergo a sentinel lymph node (SLN) procedure. The SLN procedure results in fewer short and long-term sequelae compared to IFL, but some concerns must first be considered. Lymph drainage of the vulvar region can be affected by a previous surgery, which might reduce the number of detectable SLN nodes (feasibility) but increase the chance of encountering aberrant lymph drainage patterns such as bilateral SLNs in lateral tumours or SLNs at unexpected locations. Therefore, the SLN procedure potentially carries a higher risk of groin recurrence if a tumour positive node is not retrieved, but may also improve outcomes for women with aberrant drainage patterns. Since the relative benefits and drawbacks of the SLN procedure are still unclear we will investigate the safety of the SLN procedure in women with a first recurrent vulvar cancer. In a simultaneously started registration study we prospectively gather information on women with a first recurrence of vulvar cancer ineligible for the SLN procedure. METHOD: In this prospective multicentre observational study all women with a first recurrence of vulvar cancer will be asked to consent to the collection of information on their diagnostics, treatment and outcome, and to complete quality of life and lymph oedema questionnaires. Women with unifocal tumours smaller than 4 cm and unsuspicious groin nodes will be offered the SLN procedure, with follow-up every 3 months together with imaging at 6 and 12 months when the SLN is tumour negative. The primary outcome is groin recurrence within 2 years of initial surgery. A total of 150 women with negative SLNs will be required to demonstrate safety, a stopping rule will apply and an extensive statistical analysis has been designed. DISCUSSION: Should the SLN procedure prove feasible and safe in recurrent vulvar cancer, it will be available for implementation in clinics worldwide. The inclusion of women ineligible for the SLN procedure in the current prospective study will help to bridge knowledge gaps and define future research questions. TRIAL REGISTRATION: Medical Ethical Committee approval number NL70149.078.19 (trial protocol version 2.0, date March 2nd, 2020). Affiliation: Erasmus Medical Centre. Dutch trial register NL8467 . Date of registration 19.03.2020.


Assuntos
Carcinoma de Células Escamosas , Linfadenopatia , Linfonodo Sentinela , Neoplasias Vulvares , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfadenopatia/patologia , Metástase Linfática/patologia , Estudos Multicêntricos como Assunto , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estudos Observacionais como Assunto , Estudos Prospectivos , Qualidade de Vida , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
18.
BJS Open ; 6(2)2022 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-35380620

RESUMO

BACKGROUND: Axillary lymph node status remains the most powerful prognostic indicator in invasive breast cancer. Ductal carcinoma in situ (DCIS) is a non-invasive disease and does not spread to axillary lymph nodes. The presence of an invasive component to DCIS mandates nodal evaluation through sentinel lymph node biopsy (SLNB). Quantification of the necessity of upfront SLNB for DCIS requires investigation. The aim was to establish the likelihood of having a positive SLNB (SLNB+) for DCIS and to establish parameters predictive of SLNB+. METHODS: A systematic review was performed as per the PRISMA guidelines. Prospective studies only were included. Characteristics predictive of SLNB+ were expressed as dichotomous variables and pooled as odds ratios (o.r.) and associated 95 per cent confidence intervals (c.i.) using the Mantel-Haenszel method. RESULTS: Overall, 16 studies including 4388 patients were included (mean patient age 54.8 (range 24 to 92) years). Of these, 72.5 per cent of patients underwent SLNB (3156 of 4356 patients) and 4.9 per cent had SLNB+ (153 of 3153 patients). The likelihood of having SLNB+ for DCIS was less than 1 per cent (o.r. <0.01, 95 per cent c.i. 0.00 to 0.01; P < 0.001, I2 = 93 per cent). Palpable DCIS (o.r. 2.01, 95 per cent c.i. 0.64 to 6.24; P = 0.230, I2 = 0 per cent), tumour necrosis (o.r. 3.84, 95 per cent c.i. 0.85 to 17.44; P = 0.080, I2 = 83 per cent), and grade 3 DCIS (o.r. 1.34, 95 per cent c.i. 0.80 to 2.23; P = 0.270, I2 = 0 per cent) all trended towards significance in predicting SLNB+. CONCLUSION: While aggressive clinicopathological parameters may guide SLNB for patients with DCIS, the absolute and relative risk of SLNB+ for DCIS is less than 5 per cent and 1 per cent, respectively. Well-designed randomized controlled trials are required to establish fully the necessity of SLNB for patients diagnosed with DCIS. REGISTRATION NUMBER: CRD42021284194 (https://www.crd.york.ac.uk/prospero/).


Assuntos
Neoplasias da Mama , Carcinoma Intraductal não Infiltrante , Adulto , Idoso , Idoso de 80 Anos ou mais , Axila/patologia , Neoplasias da Mama/cirurgia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/cirurgia , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Estudos Prospectivos , Biópsia de Linfonodo Sentinela , Adulto Jovem
20.
Pathol Res Pract ; 233: 153805, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35361504

RESUMO

BACKGROUND: The diagnosis of nodal nevi (NN) is challenging as they mimic melanoma metastases (MM), with a detection rate mostly ranging between 1% and 11% in sentinel lymph node biopsy (SLNB). Herein, we assessed the incidence of NN and the association with the clinical-pathological features of primary melanoma, adopting the updated European Organisation for Research and Treatment of Cancer (EORTC) protocol for SLNB. METHODS: All cases of paired melanoma and SLNB were retrospectively evaluated (April 2019-May 2020). Appropriate statistical tests were adopted, with significant variables included in the logistic regression model. RESULTS: 81 patients and a total of 186 lymph nodes (LNs) were included. Eleven patients had only NN and 4 had both NN and MM (18.5%); 29 LNs (15.6%) showed at least one NN and 12 (6.5%) showed more than one NN (a total amount of 43 NN was detected). All NN and none MM stained for p16. NN were associated with age < 60 years (p: 0.042), no ulceration (p: 0.025) and nevus-associated melanoma (NAM) (p: 0.018), with this latter being the only predictor at the logistic regression model (p: 0.022). CONCLUSIONS: The updated EORTC protocol shows a high number of NN and highlights a strong association with NAM.


Assuntos
Melanoma , Nevo , Neoplasias Cutâneas , Humanos , Linfonodos/patologia , Melanoma/patologia , Pessoa de Meia-Idade , Nevo/diagnóstico , Estudos Retrospectivos , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/patologia
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