Clinical Surgical Oncology最新文献

{"title":"Top 50 most influential publications in robotic-assisted pulmonary lobectomy","authors":"Lauren C. Ladehoff ,&nbsp;Kristie M. Labib ,&nbsp;Richard Rivera ,&nbsp;William J. West III ,&nbsp;Cole R. Fiedler ,&nbsp;Eric M. Toloza","doi":"10.1016/j.cson.2024.100054","DOIUrl":"10.1016/j.cson.2024.100054","url":null,"abstract":"<div><h3>Background</h3><p>Since the early 2000s, robotic-assisted surgery has evolved in the field of thoracic surgery, and robotic-assisted pulmonary lobectomy (RAPL) has become a popular and safe treatment method for patients seeking removal of lung cancer. The purpose of the current study was to identify and examine the top-50 most influential articles in RAPL from 2003 to 2021 using bibliometric analysis.</p></div><div><h3>Hypothesis, materials, and methods</h3><p>The Clarivate Web of Science Core Collection was systematically searched to gather data on RAPL. Descriptive information for each article was collected and reported using descriptive statistics. The terms “robotic” AND “pulmonary” AND “lobectomy” were used to search this database and returned 468 articles published since 2003.</p></div><div><h3>Results</h3><p>Bibliometric analysis of the top-50 most influential manuscripts concluded that these articles were published between the years 2003 and 2021 and were collectively cited 2476 times. Mean number of total citations per article was 49.5 (95% confidence interval [37.8, 61.2]). The most influential articles experienced greatest increase in citations in 2020 with 450 total citations and an average of 9.0 citations per article. Our analysis demonstrated an increase in total number of citations for RAPL from 2003 to 2021, and 68% of the most cited articles were published after 2016. All 50 articles were published in English, and the United States (32) and the People's Republic of China (6) had the top number of publications. The top affiliation was the University of Michigan with 6 publications. The most popular journals were Annals of Thoracic Surgery and the Journal of Thoracic and Cardiovascular Surgery, with 7 and 6, respectively, of the top 50 manuscripts.</p></div><div><h3>Conclusion</h3><p>Given the rising popularity of RAPL since 2003, a current list of the most influential articles in RAPL can provide a reference point to guide better practice and address future areas of thoracic research.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 3","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000229/pdfft?md5=ccff1531ebef604d774c569d8ef1f8e9&pid=1-s2.0-S2773160X24000229-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of three new wireless non-radiation techniques for localisation of non-palpable breast cancer - An updated systematic review and pooled meta-analysis","authors":"Kumaresh Timma Subramanian ,&nbsp;Abdolazeem Elnour ,&nbsp;Vijay Kurup","doi":"10.1016/j.cson.2024.100051","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100051","url":null,"abstract":"<div><p>With a logistical advantage, new wire-free procedures have simplified implantation and retrieval of non-palpable breast cancers with enhanced clinical outcomes. The objective of current systematic review and meta-analysis is to assess the clinical effectiveness between three new wireless non-radiation localisation techniques, such as <strong>Magseed</strong>, <strong>Radiofrequency identification TAG</strong> and <strong>Savi-scout reflector</strong> from published literature over a 3 year period. The study, following PRISMA guidelines, identified 26 studies from 2020 to 2022 involving 6275 innovative agents, analyzing three groups. Statistical analysis using Medcalc software showed a pooled positive margin rate of <strong>12.28% (95% CI, 10–15%</strong>) and a re-excision rate of <strong>11.29% (95%CI, 9–14%)</strong> for all three wireless group combined whereas studies that compare them with wire showed higher positive margin rate of <strong>14.87% (95% CI, 12–18%)</strong> and re-excision rate of <strong>16.23% (95% CI, 14–18%)</strong> for wire-guided localisation. Compared with odd's ratio, there was no statistical significance for margin involvement between WGL and novel agents <strong>OR 0.870 95% CI (0.707</strong>–<strong>1.071); z=-1.310 p=0.190;</strong> however, there was a statistical significance with fewer re-excision for wireless group <strong>OR 0.791; 95% CI (0.648</strong>–<strong>0.965); z=-2.309 p=0.021</strong>. In sub group analysis with kruskal-wallis test, there was no statistical significance between each group for both margin-positivity <strong>(p=0.797; Chi</strong>^{<strong>2</strong>} <strong>0.605)</strong> and re-excision rates (<strong>p=0.464; chi</strong>^{<strong>2</strong>}<strong>1.535)</strong>. Consolidated insertion and retrieval success for wireless group were <strong>98.13%</strong> and <strong>99.13</strong>% respectively whereas WGL had a similar retrieval success rate of <strong>99.63%.</strong> To establish the best localisation approach, future prospective randomised trials will be required to assess quantitative cost-effective analyses.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 3","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000199/pdfft?md5=d109fb7dadd9ac34022192165d22242d&pid=1-s2.0-S2773160X24000199-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141539781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective inguinofemoral node dissection for stage III vulvar squamous cancer: Feasibility and safety","authors":"","doi":"10.1016/j.cson.2024.100050","DOIUrl":"10.1016/j.cson.2024.100050","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the feasibility and outcomes of selective inguinal lymph node dissection (ILND) in stage III vulvar squamous cancer.</div></div><div><h3>Methods</h3><div>This study was approved by the Committee of Fudan University Shanghai Cancer Center. Ninety-one patients with stage III vulvar squamous cancer between March 2018 and March 2021 were included in this study. Thirty-one patients chose radical excision with selective ILND while 60 patients received radical excision with complete ILND voluntarily. After surgery, all the patients received postoperative external beam radiotherapy (EBRT). All the patients were invited to fill out two questionnaires: the EORTC QLQ-C30 and a vulvar specific questionnaire.</div></div><div><h3>Results</h3><div>The median follow-up time was 34 (16–50) months. There was no statistical difference in recurrence (<em>p</em>＞0.05) or overall survival (<em>p</em>＞0.05) in the two groups. Moreover, no difference in overall quality of life was observed between the two groups. The major difference was the increase in complaints of edema and body image after complete ILND.</div></div><div><h3>Conclusions</h3><div>Patients who underwent selective ILND reported less treatment related morbidity without affecting survival and overall quality of life compared to those who underwent complete ILND. Selective ILND may be a reasonable alternative for stage III vulvar squamous cancer in the future.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 4","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Langer's arch?","authors":"Georgi P. Georgiev","doi":"10.1016/j.cson.2024.100049","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100049","url":null,"abstract":"","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000175/pdfft?md5=b5988e711570db73eef883a9d0be9f30&pid=1-s2.0-S2773160X24000175-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141292319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparation of single or staged surgical management in acute obstructive non-metastatic colorectal cancer patients aged over 75","authors":"Jian Cui ,&nbsp;Jinxin Shi ,&nbsp;Hao Feng ,&nbsp;Danian Tang ,&nbsp;Xianglong Cao ,&nbsp;Wenrui Xu ,&nbsp;Zijian Li ,&nbsp;Tao Yu ,&nbsp;Chunlong Wang ,&nbsp;Qi An ,&nbsp;Gang Zhao","doi":"10.1016/j.cson.2024.100048","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100048","url":null,"abstract":"<div><h3>Purpose</h3><p>Management of obstructive colorectal cancer (OCRC) can be achieved through either emergent resection of the primary tumor (single operation), or the creation of temporary decompression stoma or self-expandable metallic stents (SEMS) insertion followed by tumor resection (staged procedure). The aim of the study was to compare the short-term outcomes of single and staged surgery in acute non-metastatic elderly OCRC patients.</p></div><div><h3>Methods</h3><p>Twenty-two elderly patients (aged over 75) scheduled to receive either single surgery (n ​= ​14) or staged surgery (n ​= ​8) for the management of acute OCRC were enrolled from 2012 to 2017. The stoma rate, postoperative complications were compared.</p></div><div><h3>Results</h3><p>The stoma rate was 42.9% in single surgery group and 25% in SEMS group. No difference was found in the rate of total complications (50% vs 25%, <em>P</em> ​= ​0.25). In the single surgery group, four patients (28.6%) experienced SSIs, and pneumonia occurred in three patients (21.4%), whereas none of the patient in staged surgery had infection related complication. Overall, the rate of infection related complication in single surgery group (50%) was significantly higher than that in staged surgery group (P ​= ​0.015).</p></div><div><h3>Conclusions</h3><p>Either single or stage surgery is feasible for acute elderly OCRC patients. However, single surgery is associated with significant increase in infection related complication.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000163/pdfft?md5=d4673fd94bd826626e1ea68c4af3a90e&pid=1-s2.0-S2773160X24000163-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141424018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of non-colorectal non-neuroendocrine liver oligometastases: Sarcoma, breast, gastric, and pancreatic cancers","authors":"Huda Muhammad,&nbsp;Brendan Visser","doi":"10.1016/j.cson.2024.100047","DOIUrl":"10.1016/j.cson.2024.100047","url":null,"abstract":"","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000151/pdfft?md5=462d00407e9a50d1c722b1f0c746a871&pid=1-s2.0-S2773160X24000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of preoperative biliary drainage on the outcomes of surgical treatment in cholangiocarcinoma: A propensity score matching analysis","authors":"Poowanai Sarkhampee ,&nbsp;Sunhawit Junrungsee ,&nbsp;Apichat Tantraworasin ,&nbsp;Pongserath Sirichindakul ,&nbsp;Weeris Ouransatien ,&nbsp;Satsawat Chansitthichok ,&nbsp;Nithi Lertsawatvicha ,&nbsp;Paiwan Wattanarath","doi":"10.1016/j.cson.2024.100046","DOIUrl":"10.1016/j.cson.2024.100046","url":null,"abstract":"<div><h3>Background</h3><p>Hyperbilirubinemia is known to increase morbidity and mortality in patients undergoing liver resection for cholangiocarcinoma (CCA). Preoperative biliary drainage (PBD) in patients who have no acute cholangitis or require portal vein embolization is still debatable. The goal of this study is to investigate how PBD affects the surgical results after liver resection.</p></div><div><h3>Methods</h3><p>Between October 2013 and December 2020, CCA patients presenting with obstructive jaundice who underwent liver resection were retrospectively reviewed. The pre-operative, peri-operative and post-operative characteristics were extracted. To compare the outcomes of the PBD and direct surgery groups, propensity score matching analysis (PSM) and multivariable risk regression analysis were used to analyze.</p></div><div><h3>Results</h3><p>A total of 355 patients were enrolled, with 99 of them undergoing PBD. At diagnosis, those with PBD showed significantly greater bilirubin levels than those without (20.7 vs 9.6 ​mg/dL, p ​&lt; ​0.001). However, after drainage, the bilirubin level in the PBD group was lower than the direct surgery group (5.5 vs 9.6 ​mg/dL, p ​&lt; ​0.001). Overall postoperative morbidity and mortality were unaffected by PBD in full patient cohort. However, after PSM, PBD was associated with decreased major post-hepatectomy liver failure (PHLF) and 90-day mortality rate, (20.3% vs 39.24%, p ​= ​0.014 and 3.8% vs 22.8%, p ​= ​0.001, respectively). At multivariable analysis of PSM patient cohort, PBD was associated with decreased major post-operative complication (RR 0.64, 95%CI 0.419–0.986), PHLF (RR 0.40, 95%CI 0.227–0.705) and 90-day mortality (RR 0.21, 95%CI 0.086–0.629).</p></div><div><h3>Conclusion</h3><p>PBD was associated with decreased post-hepatectomy liver failure and postoperative mortality after liver resection in jaundiced CCA patients.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100046"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X2400014X/pdfft?md5=a80a5d767d9fdb0cb84a2b2fa0857b4e&pid=1-s2.0-S2773160X2400014X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of free flap reconstruction after resection of extremity and trunk soft tissue sarcomas. Results of two referral centers in Argentina","authors":"Sergio D. Quildrian ,&nbsp;Walter S. Nardi ,&nbsp;María G. Vega ,&nbsp;Jorge A. Chapela","doi":"10.1016/j.cson.2024.100042","DOIUrl":"https://doi.org/10.1016/j.cson.2024.100042","url":null,"abstract":"<div><h3>Introduction</h3><p>For patients affected by extremity or trunk soft-tissue sarcomas (STS) large resections might be needed to achieve negative margins. This is a common scenario especially in locally advanced or recurrent tumors often within a pre-irradiated field. The objective of this study was to evaluate the results of free-flap reconstructions (FFR) after sarcoma surgery.</p></div><div><h3>Objective</h3><p>The endpoints were surgical results, quality of surgical margins and oncological outcome.</p></div><div><h3>Methods</h3><p>Retrospective analysis of patients with extremity and trunk STS with free-flap reconstruction between 2008 and 2022. Demographic and tumor data, perioperative treatment, margin status, morbidity and evolution were evaluated.</p></div><div><h3>Results</h3><p>Of 467 patients, 25 (5.35%) required 26 free-flap reconstructions. Surgery was performed on an irradiated field in 8 (32%) patients. Reconstructions were mostly needed for distal lower extremity resections and the most common type of flap used was antero-lateral tight (ALT) flap. No R2 resections were performed. R0 and R1 resections were achieved in 22 (84.6%) and 4 (15.4%), respectively. All R1 resections were preplanned positive along a preserved critical structure. Surgical morbidity rate was 26% (7/26) and the re-operation rate was 15% (4/26) with 7.7% flap losses (2/26). At a median follow-up of 38 months, 7 (28%) patients presented local recurrences.</p></div><div><h3>Conclusion</h3><p>In a referral sarcoma center, having a multidisciplinary surgical team capable of complex resections and reconstructions is of utmost importance for a correct and integral surgical planning. This allows optimal oncologic resections with acceptable morbidity.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100042"},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000102/pdfft?md5=6d17535901518222a974c5e50a578554&pid=1-s2.0-S2773160X24000102-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140647220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of patients with liposarcoma: A retrospective review over 12 ​Years in a single center","authors":"Teck Liang Tie,&nbsp;Suryasmi Duski","doi":"10.1016/j.cson.2024.100043","DOIUrl":"10.1016/j.cson.2024.100043","url":null,"abstract":"<div><h3>Background</h3><p>Liposarcoma is the most common soft tissue sarcoma, which comprises around 20% of soft tissue sarcoma. While diverse therapeutic approaches exist for liposarcoma, the primary goal remains the achievement of effective local disease control. Wide resection of liposarcoma is the cornerstone of treatment. Radiotherapy is often employed as an adjuvant measure to enhance the local disease control. At Hospital Kuala Lumpur, the treatment protocol includes R0 resection and followed by adjuvant radiotherapy. This study aims to review the demographic characteristic of liposarcoma patients and evaluate the efficacy of their treatment based on the treatment protocol.</p></div><div><h3>Method and material</h3><p>This is a retrospective cohort study. A total of 72 patients (male/female ​= ​43/29) were included in this study. Recorded parameters included the histologic subtype, tumor location, treatment modality, resection margin, radiotherapy status, and occurrences of local recurrence and metastasis.</p></div><div><h3>Result</h3><p>Histopathological examination revealed a varied spectrum of liposarcoma subtypes, with the predominant subtype being atypical lipomatous tumor (n ​= ​35), followed by myxoid liposarcoma (n ​= ​32), two cases of dedifferentiated liposarcoma, and three cases of pleomorphic liposarcoma. Of these patients, 69 underwent resection, while three necessitated amputations. Total 62 achieving negative and 10 cases had R1 margins. Adjuvant radiotherapy was administered in 58 cases. Overall, the local recurrence was observed in only six cases.</p></div><div><h3>Conclusion</h3><p>This study emphasizes that achieving R0 resection is the fundamental approach in the treatment of liposarcoma and is able to minimize the risk of local recurrence.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100043"},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000114/pdfft?md5=9a7e709be8275846f088f8a25dacb874&pid=1-s2.0-S2773160X24000114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140766881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nationwide analysis of the breast cancer guidelines adherence in Bulgaria","authors":"Dobromir Dimitrov ,&nbsp;Iskra Daskalova ,&nbsp;Ivelina Petrova ,&nbsp;Meri Shoshkova ,&nbsp;Tsanko Yotsov ,&nbsp;Damyan Boychev ,&nbsp;Tihomir Andreev ,&nbsp;Nikolai Ramadanov ,&nbsp;Martin Karamanliev","doi":"10.1016/j.cson.2024.100044","DOIUrl":"10.1016/j.cson.2024.100044","url":null,"abstract":"<div><h3>Introduction</h3><p>The diagnosis and treatment of breast cancer have tremendously changed in the last decades improving the survival and quality of life of the patients. Adherence to clinical practice guidelines in oncology significantly improves patients’ recurrence-free and overall survival. Nowadays, no national registry/database for breast cancer patients is available. This study aims to perform a nationwide analysis of the breast cancer guidelines adherence in Bulgaria, in particular regarding the diagnostic methods for histological confirmation and the types of radical surgery performed using an artificial intelligence (AI) powered software.</p></div><div><h3>Materials and methods</h3><p>We analyzed data from January 2019 to August 2023 nationwide using the platform with access to anonymized medical information from Bulgaria's leading territorial oncology hospitals. A total of 13,790 patients met the inclusion criteria.</p></div><div><h3>Results</h3><p>The gold standard diagnostic tool, CNB, was done in 5427 patients (39.35%), an intraoperative frozen section was performed as a method for confirmation of breast cancer in 6257 patients (45.37%) and the standard technique for lymph node evaluation, sentinel lymph node biopsy, was done in 357 patients (2.99%).</p></div><div><h3>Conclusion</h3><p>In Bulgaria, there are still difficulties in achieving comparable rates of core-needle biopsy for the diagnosis of breast cancer and we have demonstrated unacceptably high rates of frozen section use for intraoperative diagnosis of breast cancer. Breast-conserving surgery is widely accepted and available, but still, the rates are lower than usual for developed countries. The rates of sentinel lymph node biopsy, however, are unreasonably low.</p></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"3 2","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773160X24000126/pdfft?md5=515dd0a0605a48fa490612aebfb3e8a8&pid=1-s2.0-S2773160X24000126-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}