Diagnostic value of intraoperative histopathological examination of the sentinel nodes in breast cancer and skin melanoma—Preliminary results of single centre retrospective study

Niziołek, Aleksander; Murawa, Dawid

doi:10.1016/j.rpor.2013.03.005

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…The frozen section method is characterized by an accuracy of 79-98%, a sensitivity of 55-91%, and a false negative rate of 9-45% [38]. In the group of patients with malignant melanoma examined by Nizolek et al, sensitivity was 66.7%, and no false positives were observed [39]. Gipponi et al evaluated 169 patients, and in their examinations, they demonstrated false negative results of 5.3% [40].…”

Section: Discussionmentioning

confidence: 99%

A Two-Step Approach to the Surgical Treatment of Soft-Tissue Sarcomas

Fulchignoni,

Cianni,

Matrangolo

et al. 2024

Current Oncology

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Background: Nowadays, limb-sparing procedures are the gold standard in the treatment of soft-tissue sarcomas of the limbs. Wide tumor resection with appropriate oncological margins, reconstruction, and stabilization of the involved bone and joint and restoration of the soft tissue lost are essential in order to obtain good clinical and functional outcomes. Tumor excision and soft-tissue reconstruction performed in one-step surgery is chosen by many centers as the preferred approach; however, according to our experience in some selected patients, two-step surgery performed using a dermal regeneration template first and then a margin revision, taking into account the definitive results of the anatomopathological exam conducted over the surgical specimen from the previous surgery, associated with definitive reconstruction surgery over a healthy bed of granulated tissue, showed many potential benefits. Methods: A retrospective observational study was conducted on thirteen patients who underwent a two-step reconstruction procedure using dermal substitution after soft-tissue sarcoma excision. Results: Clinically, the enrolled patients achieved excellent contour and cosmesis of their surgical wounds, with a mean VSS value of 3.07. During the follow-up period, no local recurrences were observed in any patient. Conclusions: Two-step surgery represents the most suitable solution to allow surgical radicality with minimal recurrency and adequate soft-tissue reconstruction, avoiding the possibility of wasting autologous tissue. Our patients generally embraced this approach and the management that followed.

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Section: Discussionmentioning

confidence: 99%

A Two-Step Approach to the Surgical Treatment of Soft-Tissue Sarcomas

Fulchignoni,

Cianni,

Matrangolo

et al. 2024

Current Oncology

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“…Metoda ta daje porównywalne rezultaty do mastektomii, przez co stosowana jest jako alternatywa wywołująca mniejsze obciążenie pacjenta [42]. Koncepcja zastosowania jednej dawki promieniowania podanej jedynie do loży guza powstała w oparciu o fakt, że większość wznów miejscowych pojawia się w regionie ogniska pierwotnego [43,44]. Badanie mikrośrodowiska guza po napromieniowaniu może pomóc w zrozumieniu jego wpływu na wzrost i progresję nowotworu.…”

Section: Wnioskiunclassified

Biologiczne aspekty śródoperacyjnej radioterapii i roli płynów pooperacyjnych w terapii raka piersi

Piotrowski

Kulcenty

Murawa

et al. 2016

LOS

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W ciągu ostatniego stulecia radykalna mastektomia stanowiła główną metodę terapii pacjentów z nowotworem piersi. Dopiero pod koniec dwudziestego wieku mastektomia została zastąpiona przez zastosowanie oszczędzającego zabiegu chirurgicznego połączonego z frakcjonowaną radioterapią zewnętrzną (ang. external beam radiation therapy, EBRT), co znacznie obniżyło ryzyko wystąpienia u pacjentów wznowy miejscowej [1]. Pomimo osiągania dobrych wyników leczenia bez występowania ciężkich skutków ubocznych, czas trwania terapii EBRT stanowi poważne ograniczenie. Pacjenci mieszkający w dużej odległości od ośrodka radioterapii lub pacjenci wycieńczeni po przebytej chemioterapii często nie otrzymują radioterapii po wycięciu guza lub poddawani są zabiegowi mastektomii [2]. Rozwiązaniem tego problemu może być zastosowanie śródoperacyjnej radioterapii (ang. intraoperative radiotherapy, IORT), która podawana jest w jednej dawce w trakcie zabiegu chirurgicznego do loży po wycięciu guza. Rezultaty badań klinicznych ELIOT i TARGIT-A pokazały, że zastosowanie tej metody w odpowiednio wyselekcjonowanej grupie pacjentów może przynieść lepsze wyniki niż zastosowanie techniki EBRT [3, 4]. Jednak efekty działania śródoperacyjnej radioterapii na mikrośrodowisko guza nie są dobrze poznane. Wykazano, że proces zapalny wywołany zabiegiem chirurgicznym może stymulować wzrost pozostałych po zabiegu operacyjnym komórek nowotworowych [5]. Co więcej, najnowsze wyniki badań sugeruje, że proces ten może być hamowany poprzez zastosowanie radioterapii [6]. Lepsze zrozumienie interakcji zachodzących pomiędzy komórkami nowotworu piersi i mikrośrodowiskiem guza w odpowiedzi na napromieniowanie może pozwolić na odkrycie nowych strategii terapii nowotworów piersi.

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Features of Defeats of Sentinel Lymph Nodes at Primary Melanoma of Skin

Ершов

Анисимова

Вашкуров

et al. 2019

The Scientific Notes of the Pavlov university

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Introduction. Each tenth tumor of skin is melanoma. Presence of tumor cells in sentinel lymph node influenced the medical tactics.The objective of the research was to study the metastasis of skin melanoma into the clinically negative regional lymph nodes.Material and methods. Histological, immunohistochemical, cytological and immunocytochemical methods were used to study biopsies of regional lymph nodes in 60 patients with skin melanoma.Results. 5 % of patients were diagnosed with melanoma in situ, 15 % – Т1, 28.3 % – Т2, 23.3 % – Т3, 28.3 % – Т4. At outflow of the lymph through 1 collector, the metastases in sentinel lymph node (SLN) was defined in 51 %, through 2 collectors – in 81.8 % of cases. Tumor cells damaged single lymph node in 35.3 % of cases, two and more lymph nodes in 64.7 % of cases. Metastases in SLN with formation of secondary tumor at the T1 melanoma were observed at 11.1 %, T2 – 5.9 %, T3 – 21.4 %, T4 – 47.1 % of studies. Clusters of cells or isolated cells of melanoma in SLN at Т1 were noted in 22.2 %, at Т2 – in 41.2 %, at Т3 – in 42.9 %, at Т4 – in 35.3 % of cases. At outflow of lymph through 1 collector, metastasises of melanoma in non-sentinel lymph nodes (NSLN) were revealed in 24 %, through 2 collectors – in 44.4 % of cases. Secondary changes of NSLN were noted in 16.7 % of cases of defeat of single SLN, in 31.8 % of cases of defeat of two and more SLN. Metastases of melanoma were revealed in 69.2 % of cases of formation of secondary tumor and in 4.8 % of cases of presence of clusters in SLN in removed NSLN.Conclusion. At increase of Тmelanoma of the skin, the quantity of sentinel lymph nodes with reactive changes decreased, and their number with metastases increased. Metastatic defeat of sentinel lymph nodes at outflow of lymph through 2 lymph collectors in two and more SLN and NSLN exceeded the defeat of SLN at outflow of lymph through 1 lymph collector in single lymph nodes. The use of immunocytochemical method of research allowed to expand pathomorphological verification of metastatic defeat of sentinel lymph nodes by 66.7%.

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Diagnostic value of intraoperative histopathological examination of the sentinel nodes in breast cancer and skin melanoma—Preliminary results of single centre retrospective study

Abstract: The method of intraoperative histopathological evaluation of the sentinel nodes enables identification of metastases in these lymph nodes and gives a possibility to carry out a one-step regional lymphadenectomy and start the adjuvant therapy earlier.

Cited by 3 publications

References 34 publications

A Two-Step Approach to the Surgical Treatment of Soft-Tissue Sarcomas

A Two-Step Approach to the Surgical Treatment of Soft-Tissue Sarcomas

Biologiczne aspekty śródoperacyjnej radioterapii i roli płynów pooperacyjnych w terapii raka piersi

Features of Defeats of Sentinel Lymph Nodes at Primary Melanoma of Skin

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