Erratum to: Clinical competence in the surgery of rectal cancer: the Italian Consensus Conference

Piccoli, Micaela; Agresta, Ferdinando; Trapani, Vincenzo; Nigro, Casimiro; Pende, Vito; Campanile, Fabio Cesare; Vettoretto, Nereo; Enrico, B.; Bianchi, Paolo Pietro; Cavaliere, Davide; Ferulano, G. P.; Torre, Filippo La; Lirici, Marco Maria; Rea, Roberto; Ricco, G; Orsenigo, E.; Barlera, Simona; Lettieri, Emanuele; Romano, G.

doi:10.1007/s00384-014-1913-z

Cited by 3 publications

(5 citation statements)

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“…Success rates are also affected by the level of training and the volume of cases being managed. 24,25 In veterinary oncology, an incomplete excision has also been reported to be significantly more likely when the tumour was excised by a surgical resident compared with a specialist surgeon. 26 Our current determination of recurrence risk following surgery is based on literature derived from cases managed in specialist centres or by individuals that have an interest or focus on oncologic surgery.…”

Section: Influence Of Surgical Quality On Tumour Recurrencementioning

confidence: 99%

“…Variances in outcomes are recognised in human oncology when patients have been operated by a non‐specialist surgeon compared to a surgical oncology specialist. Success rates are also affected by the level of training and the volume of cases being managed 24,25 . In veterinary oncology, an incomplete excision has also been reported to be significantly more likely when the tumour was excised by a surgical resident compared with a specialist surgeon 26…”

Section: Introductionmentioning

confidence: 99%

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Defining the relevance of surgical margins. Part two: Strategies to improve prediction of recurrence risk

Bray¹,

Eward

Breen

2023

Vet Comparative Oncology

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Due to the complex nature of tumour biology and the integration between host tissues and molecular processes of the tumour cells, a continued reliance on the status of the microscopic cellular margin should not remain our only determinant of the success of a curative‐intent surgery for patients with cancer. Based on current evidence, relying on a purely cellular focus to provide a binary indication of treatment success can provide an incomplete interpretation of potential outcome. A more holistic analysis of the cancer margin may be required. If we are to move ahead from our current situation – and allow treatment plans to be more intelligently tailored to meet the requirements of each individual tumour – we need to improve our utilisation of techniques that either improve recognition of residual tumour cells within the surgical field or enable a more comprehensive interrogation of tumour biology that identifies a risk of recurrence. In the second article in this series on defining the relevance of surgical margins, the authors discuss possible alternative strategies for margin assessment and evaluation in the canine and feline cancer patient. These strategies include considering adoption of the residual tumour classification scheme; intra‐operative imaging systems including fluorescence‐guided surgery, optical coherence tomography and Raman spectroscopy; molecular analysis and whole transcriptome analysis of tissues; and the development of a biologic index (nomogram). These techniques may allow evaluation of individual tumour biology and the status of the resection margin in ways that are different to our current techniques. Ultimately, these techniques seek to better define the risk of tumour recurrence following surgery and provide the surgeon and patient with more confidence in margin assessment.

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Section: Influence Of Surgical Quality On Tumour Recurrencementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Defining the relevance of surgical margins. Part two: Strategies to improve prediction of recurrence risk

Bray¹,

Eward

Breen

2023

Vet Comparative Oncology

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“…40 Variances in surgical proficiency between nonspecialist surgeons and oncology specialists have been identified in human medicine, with success rates affected by the level of training and the volume of cases being managed. 41,42 Significantly lower rates of local recurrence for colorectal cancer, 43,44 bladder cancer, 45 and other cancer types [46][47][48] are reported when surgery was performed by a specialist compared to a less-experienced surgeon. Because of the complexity of care demanded for some uncommon tumour types such as soft tissue sarcoma, it is recommended these tumours should only be operated by trained surgeons in dedicated centres.…”

Section: The Surgeon: Challenges With Defining the Resection Marginmentioning

confidence: 99%

“…In one veterinary study, an incomplete excision was significantly more likely when the tumour was excised by a surgical resident compared with a specialist surgeon 40 . Variances in surgical proficiency between non‐specialist surgeons and oncology specialists have been identified in human medicine, with success rates affected by the level of training and the volume of cases being managed 41,42 . Significantly lower rates of local recurrence for colorectal cancer, 43,44 bladder cancer, 45 and other cancer types 46–48 are reported when surgery was performed by a specialist compared to a less‐experienced surgeon.…”

Section: The Surgeon: Challenges With Defining the Resection Marginmentioning

confidence: 99%

Evaluating the relevance of surgical margins. Part one: The problems with current methodology

Bray¹,

Eward

Breen

2022

Vet Comparative Oncology

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The goal of cancer surgery is to achieve a “clean” microscopic resection, with no residual tumour remaining in the wound. To achieve that goal, the surgeon typically incorporates a measured buffer of grossly normal tissue about the entire circumference of the tumour. Microscopic analysis of the resection boundaries is then performed to determine if all traces of the tumour have been completely removed. This analysis is thought to provide a surrogate indication as to the likelihood for that tumour to recur after surgery. However, it is recognised that tumour recurrence may not occur even when microscopic evidence of tumour has been identified at the resection margins, and recurrence can also occur when conventional histology has considered the tumour to have been completely removed. The explanations for this dichotomy are numerous and include technical and practical limitations of the processing methodology, and also several surgeon‐related and tumour‐related reasons. Ultimately, the inability to confidently determine when a tumour has been removed sufficiently to prevent recurrence can impact on the ability to provide owners with confident treatment advice. In this article, the authors describe the challenges with defining the true extent of the tumour margin from the perspective of the surgeon, the pathologist and the tumour. The authors also provide an analysis of why our current efforts to ensure that all traces of the local tumour have been successfully removed may provide an imperfect assessment of the risk of recurrence.

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“…Kötelező standard a minimális volumenre vonatkozóan nincsen[19], de évi 12 esetnél kevesebb TAMIS-műtétet centrumonként nem érdemes elvégezni (a szerző személyes szakmai véleménye szerint).-Figyelembe véve a rectum polypok sphyncterközeli jellegét, minden lehetséges diagnosztikus eljárás után is malignitás vonatkozásában bizonytalan helyzetben a TAMIS "nagy biopsiaként" egy darabban, épben történő polyp eltávolítással alkalmas kiegészítő diagnosztikus lépés, mely az esetek egy jelentős részében terápiás értékűnek bizonyul.…”

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Colorectalis polypok és korai rákok sebészete – Elvárható standardok

Bánky

Lakatos

Rozman

et al. 2023

MaSeb

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ÖsszefoglalásA jóindulatú colorectalis polypok, valamint korai malignus elváltozások hagyományosan a gastroenterologia, azaz az endoscopos eltávolítás hatáskörébe tartoznak. Annak ellenére, hogy mind az endoscopos képalkotás minősége, mind pedig az egyéb diagnosztikus modalitások nagy fejlődésen mentek keresztül az elmúlt évtizedben, a nagy, sessilis és lateralisan terjedő colon és rectum polypok magukban hordozzák a malignitás, sőt, az eltávolítás pillanatáig fel nem ismert malignitás lehetőségét. Mindez nagy körültekintésre, óvatosságra, a sebésznek akár a diagnosztikus fázisba való bevonására készteti a gastroenterologust. Összefoglaló közleményünkben a colon és a rectum jóindulatú és korai rosszindulatú daganatainak jelenleg elfogadott optimális diagnosztikus és kezelési elveit foglaljuk össze. Végül ajánlást fogalmazunk meg a minőségi colorectalis polyp sebészet legfontosabb sarokpontjaira vonatkozóan.

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Erratum to: Clinical competence in the surgery of rectal cancer: the Italian Consensus Conference

Cited by 3 publications

References 0 publications

Defining the relevance of surgical margins. Part two: Strategies to improve prediction of recurrence risk

Defining the relevance of surgical margins. Part two: Strategies to improve prediction of recurrence risk

Evaluating the relevance of surgical margins. Part one: The problems with current methodology

Colorectalis polypok és korai rákok sebészete – Elvárható standardok

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