Do Patients After Reexcision Due to Involved or Close Margins Have the Same Risk of Local Recurrence as Those After One-Step Breast-Conserving Surgery?

Hennigs, André; Fuchs, Valerie; Sinn, Hans‐Peter; Riedel, Fabian; Rauch, Geraldine; Smetanay, Katharina; Golatta, Michael; Domschke, Christoph; Schuetz, Florian; Schneeweiß, Andreas; Sohn, Christof; Heil, Joerg

doi:10.1245/s10434-015-5067-1

Cited by 28 publications

(16 citation statements)

References 28 publications

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“…A second operation can cause discomfort and stress to the patient, lead to an increased risk of surgical complications and to poor aesthetic outcome, delay adjuvant therapy and increase health care costs [2,4e6]. Furthermore, the patients who undergo a re-excision may have an increased risk of developing LR, compared to patients with only one operation [7].…”

Section: Introductionmentioning

confidence: 99%

Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery

Niinikoski

Leidenius

Vaara

et al. 2019

European Journal of Surgical Oncology

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Background: This retrospective cohort study aims to compare surgical margins, reoperations and local recurrences after conventional or oncoplastic breast conservation surgery (BCS). Furthermore, we aim to investigate differences between various oncoplastic techniques. Material and methods: We reviewed 1800 consecutive patients with primary invasive breast cancer (N ¼ 1707) or ductal carcinoma in situ (N ¼ 93) who underwent BCS at Helsinki University Hospital between 2010 and 2012. Results: Conventional BCS was performed in 1189 (66.1%) patients, oncoplastic BCS in 611 (33.9%). Various oncoplastic techniques were used. Patients with oncoplastic BCS had more often multifocal (p < 0.001), larger (p < 0.001), palpable tumours (p < 0.001) with larger resection specimens (p < 0.001). The amount of resected tissue varied substantially depending on the oncoplastic technique. Patients treated with oncoplastic BCS were younger (p < 0.001) and their tumours were more aggressive according to histological grade (p < 0.001), T-stage (p < 0.001), Ki-67 (p < 0.001) and lymph node status (p < 0.001). There was no difference, however, in surgical margins (p ¼ 0.578) or reoperation rates (p ¼ 0.430) between the groups. A total of 152 (8.4%) patients were reoperated because of insufficient margins, 96 (8.1%) in the conventional, 56 (9.2%) in the oncoplastic BCS group. The median follow-up time was 75 (2e94) months. There was no difference in local recurrence-free survival between the conventional and oncoplastic BCS groups (log-rank test, p ¼ 0.172). Conclusions: Oncoplastic BCS was used for larger, multifocal and more aggressive tumours. Nevertheless, no difference in reoperation rate or local recurrences were found. Oncoplastic BCS is as safe as conventional BCS enabling breast conserving for patients who otherwise were candidates for mastectomy.

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Section: Introductionmentioning

confidence: 99%

Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery

Niinikoski

Leidenius

Vaara

et al. 2019

European Journal of Surgical Oncology

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“…In this study, we also found that several expression characteristics of genetic perturbations, such as stem cell up, breast cancer ductal invasive up, multicancer invasiveness signature, gastric cancer advanced vs early up and mammary stem cell up were related to the IRGPs model. These results have been veri ed by corresponding experiments [47][48][49][50][51], con rming their importance in tumor development and cell growth. These ndings indicated that IRGPs model might play an essential role in tumor invasiveness and progression in COAD.…”

Section: Discussionmentioning

confidence: 63%

Establishment of an immune-related gene pairs model to predict colon adenocarcinoma prognosis

Luo

Liu

Wang

et al. 2020

Preprint

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Background. Colon cancer is the most common type of gastrointestinal cancer and has high morbidity and mortality. Colon adenocarcinoma(COAD) is the main pathological type of colon cancer. There is a lot of evidence describing the correlation between the prognosis of COAD and the immune system. The objective of the current study was the development of a robust prognostic immune-related gene pairs (IRGPs) model for estimating overall survival of COAD. Methods. The gene expression profiles and clinical information of patients with colon adenocarcinoma come from TCGA and GEO databases and are divided into training and validation cohorts. Immune genes were selected which show significantly association with prognosis. Results. Among 1647 immune genes, a 17 IRGPs model was built which was significantly associated with OS in the training cohort. In the training and validation data set, the IRGPs model divided patients into high-risk groups and low-risk groups, and the prognosis of the high-risk group was significantly worse(P＜0.001). Univariate and multivariate Cox proportional hazard analysis confirmed the feasibility of this model. Functional analysis confirmed that multiple tumor progression and stem cell growth-related pathways in high-risk groups were up-regulated. T cells regulatory and Macrophage M0 were significantly highly expressed in the high-risk group. Conclusion. We successfully constructed an IRGPs model that can predict the prognosis of COAD, which provides new insights into the treatment strategy of COAD.

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“…In this study, we also found that several expression characteristics of genetic perturbations, such as increased stem cells, increased breast cancer ductal invasion, a multicancer invasiveness signature, increased advanced vs early gastric cancer and increased mammary stem cells, were related to the IRGP model. These results were veri ed by corresponding experiments [54][55][56][57][58], con rming their importance in tumor development and cell growth. These ndings indicate that the IRGP model may play an essential role in tumor invasiveness and progression in COAD.…”

Section: Discussionmentioning

confidence: 65%

Establishment of an immune-related gene pair model to predict colon adenocarcinoma prognosis

Luo

Liu

Wang

et al. 2020

Preprint

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Background. Colon cancer is the most common type of gastrointestinal cancer and has high morbidity and mortality. Colon adenocarcinoma (COAD) is the main pathological type of colon cancer, and much evidence has supported the correlation between the prognosis of COAD and the immune system. The current study aimed to develop a robust prognostic immune-related gene pair (IRGP) model to estimate the overall survival of patients with COAD. Methods. The gene expression profiles and clinical information of patients with colon adenocarcinoma were obtained from the TCGA and GEO databases and were divided into training and validation cohorts. Immune genes were selected that showed a significant association with prognosis. Results. Among 1,647 immune genes, a model with 17 IRGPs was built that was significantly associated with OS in the training cohort. In the training and validation datasets, the IRGP model divided patients into the high-risk group and low-risk group, and the prognosis of the high-risk group was significantly worse (P＜0.001). Univariate and multivariate Cox proportional hazard analyses confirmed the feasibility of this model. Functional analysis confirmed that multiple tumor progression and stem cell growth-related pathways were upregulated in the high-risk groups. Regulatory T cells and macrophages M0 were significantly highly expressed in the high-risk group. Conclusion. We successfully constructed an IRGP model that can predict the prognosis of COAD, providing new insights into the treatment strategy of COAD.

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Do Patients After Reexcision Due to Involved or Close Margins Have the Same Risk of Local Recurrence as Those After One-Step Breast-Conserving Surgery?

Cited by 28 publications

References 28 publications

Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery

Resection margins and local recurrences in breast cancer: Comparison between conventional and oncoplastic breast conserving surgery

Establishment of an immune-related gene pairs model to predict colon adenocarcinoma prognosis

Establishment of an immune-related gene pair model to predict colon adenocarcinoma prognosis

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