Seminars in surgical oncology最新文献

{"title":"Prognostic factors in non-small cell lung cancer.","authors":"Merrill J Solan,&nbsp;Maria Werner-Wasik","doi":"10.1002/ssu.10023","DOIUrl":"https://doi.org/10.1002/ssu.10023","url":null,"abstract":"<p><p>Identification of prognostic factors is critical in optimizing treatment for patients with cancer. The purpose of this work is to review the modern literature with regard to prognostic factors for patients with non-small-cell lung cancer (NSCLC) taking into account ongoing advances in clinical evaluation, staging, surgery, radiation therapy, chemotherapy, and molecular biology in this widely heterogeneous patient population.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 2","pages":"64-73"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40823981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New TNM staging criteria for head and neck tumors.","authors":"Brian O'Sullivan,&nbsp;Jatin Shah","doi":"10.1002/ssu.10019","DOIUrl":"https://doi.org/10.1002/ssu.10019","url":null,"abstract":"<p><p>Cancers of the head and neck have always represented a unique perspective in cancer staging. Not only are these lesions numerous in terms of anatomic sites of origin, but, unlike most other major cancers, they frequently and readily lend themselves to adequate clinical assessment by visual inspection and palpation, which greatly facilitates documentation by the trained clinician. In addition, their location often involves treatment programs that focus on nonsurgical organ-preservation strategies, and thus anatomic and histological data for comprehensive pathologic staging are often not available. Nevertheless, the processes involved in surgical decision-making and radiotherapy treatment planning require meticulous assessment and documentation of the extent of locoregional disease. For all these reasons it is especially important to perform reliable and accurate pretreatment clinical staging of head and neck cancers. Also, many patients who succumb to head and neck cancer do so as a result of locoregional disease. Therefore, the staging system must take into account detailed local anatomic features that dictate management, since the degree of involvement of these structures by tumor may be as important as distant metastasis in threatening survival. For this reason the most recent cancer staging classification (6th edition) of the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC) includes new criteria for the more advanced cases (e.g., T4 categories and stage IV disease). These criteria reflect the fact that in heterogeneous populations there is a realistic opportunity for cure in some patients but not in others. This review summarizes the criteria used in the new TNM for head and neck tumors, and outlines the rationale behind the current changes. It also provides some guidance regarding optimal source data to facilitate classification in the registry setting. In addition, the need for additional changes in the future is recognized.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 1","pages":"30-42"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22534159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TNM: evolution and relation to other prognostic factors.","authors":"Leslie H Sobin","doi":"10.1002/ssu.10014","DOIUrl":"https://doi.org/10.1002/ssu.10014","url":null,"abstract":"<p><p>The TNM Classification describes the anatomic extent of cancer. TNM's ability to separately classify the individual tumor (T), node (N), and metastasis (M) elements and then group them into stages differs from other cancer staging classifications (e.g., Dukes), which are only concerned with summarized groups. The objectives of the TNM Classification are to aid the clinician in the planning of treatment, give some indication of prognosis, assist in the evaluation of the results of treatment, and facilitate the exchange of information. During the past 50 years, the TNM system has evolved under the influence of advances in diagnosis and treatment. Radiographic imaging (e.g., endoscopic ultrasound for the depth of invasion of esophageal and rectal tumors) has improved the accuracy of the clinical T, N, and M classifications. Advances in treatment have necessitated more detail in some T4 categories. Developments in multimodality therapy have increased the importance of the \"y\" symbol and the R (residual tumor) classification. New surgical techniques have resulted in the elaboration of the sentinel node (sn) symbol. The use of immunohistochemistry has resulted in the classification of isolated tumor cells and their distinction from micrometastasis. The most important challenge facing users of the TNM Classification is how it should interface with the large number of non-anatomic prognostic factors that are currently in use or under study. As non-anatomic prognostic factors become widely used, the TNM system provides an inviting foundation upon which to build a prognostic classification; however, this carries a risk that the system will be overwhelmed by a variety of prognostic data. An anatomic extent-of-disease classification is needed to aid practitioners in selecting the initial therapeutic approach, stratifying patients for therapeutic studies, evaluating non-anatomic prognostic factors at specific anatomic stages, comparing the weight of non-anatomic factors with extent of disease, and communicating the extent of disease data in a uniform manner. Methods are needed to express the overall prognosis without losing the vital anatomic content of TNM. These methods should be able to integrate multiple prognostic factors, including TNM, while permitting the TNM system to remain intact and distinct. This article discusses examples of such approaches.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 1","pages":"3-7"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22534763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET scanning in lung cancer: current status and future directions.","authors":"Michael P Mac Manus,&nbsp;Rodney J Hicks","doi":"10.1002/ssu.10032","DOIUrl":"https://doi.org/10.1002/ssu.10032","url":null,"abstract":"<p><p>Positron emission tomography (PET) represents a dramatic advance in the imaging of lung cancer. It is valuable for the diagnosis, staging, prognosis, and restaging of disease, and is most useful in patients considered for potentially curative therapy for non-small-cell lung cancer (NSCLC). In this work the current status and potential future applications of PET scanning in lung cancer are discussed. The relevant literature is also discussed, with an emphasis on studies with clinical applicability. Most of these studies involved the use of 18F-fluorodeoxyglucose (FDG). Numerous studies of the use of PET to assess undiagnosed pulmonary nodules have reported significant improvements in accurate diagnosis or exclusion of malignancy compared to conventional structural imaging alone. All of these studies, including metaanalysis, have shown that PET is more accurate than CT-based structural imaging in staging the mediastinum in surgical candidates. PET may have value in radiotherapy planning, and PET-based staging more accurately predicts survival in radiotherapy-treated patients than conventional staging. The rate of unsuspected distant metastasis detection in stage III disease exceeds 20%. PET also facilitates an accurate assessment of response in patients treated with radical chemoradiation or neoadjuvant therapy prior to surgery. PET has rapidly become an indispensable part of the evaluation of patients with potentially curable lung cancer; however, more work is required to define its role.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 3","pages":"149-55"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40901914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient management scenario: a framework for clinical decision and prognosis.","authors":"Mary Gospodarowicz,&nbsp;Brian O'Sullivan","doi":"10.1002/ssu.10015","DOIUrl":"https://doi.org/10.1002/ssu.10015","url":null,"abstract":"<p><p>The depiction of prognosis is one of the main activities and a mainstay in medical practice. In cancer, as in other diseases, the prognosis differs for a variety of situations and evolves with time and with medical interventions. Although most commonly described at diagnosis, prognosis may be defined at any time during the course of the disease and for any endpoint including response to therapy, failure of treatment, survival, or preservation of function, and so forth. To facilitate the accurate portrayal of the future, the prognosis should be defined within a specific setting, referred to as a 'management scenario'. In the concept of a management scenario, the prognosis is defined using systematically considered prognostic factors, interventions and the outcome of interest. A deliberate and careful determination of prognosis is essential to clinical decision making and patient care. We illustrate the use of the concept of management scenario in several clinical examples.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22534764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative chemoradiation for locally advanced rectal adenocarcinoma-the University of Florida experience.","authors":"William M Mendenhall,&nbsp;Jean-Nicolas Vauthey,&nbsp;Robert A Zlotecki,&nbsp;Robert D Marsh,&nbsp;Edward M Copeland","doi":"10.1002/ssu.10045","DOIUrl":"https://doi.org/10.1002/ssu.10045","url":null,"abstract":"<p><p>To evaluate the efficacy of preoperative radiotherapy alone or combine with chemotherapy. Between 1975 to 1997, 318 patients with locally advanced rectal adenocarcinomas were treated with preoperative radiation therapy. Between 1991 and 1997, approximately 60% of patients received fluorouracil (5-FU)-based adjuvant chemotherapy. Patients treated since 1991 had improved downstaging compared with those treated prior to 1991. Patients treated between 1991 and 1997 were also more likely to undergo a sphincter preserving surgical procedure. Preoperative chemoradiation probably results in improved downstaging and survival compared with preoperative irradiation alone.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 4","pages":"261-4"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24102182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curative approaches to lung cancer in the elderly.","authors":"Martin Weinmann,&nbsp;Frank Zimmermann,&nbsp;Michael Bamberg,&nbsp;Branislav Jeremic","doi":"10.1002/ssu.10036","DOIUrl":"https://doi.org/10.1002/ssu.10036","url":null,"abstract":"<p><p>Lung cancer is a common disease in elderly patients, and the increase in the size of the elderly population will lead to an increased proportion of elderly among lung cancer patients in the future. The prognosis of lung cancer is still poor, but curative approaches are feasible for patients with local stage NSCLC and for some patients with limited disease (LD) SCLC. The evidence for these curatively-intended approaches is derived from studies that are usually performed with highly selected patients. Elderly patients are underrepresented, and in daily clinical practice elderly patients are less likely to be treated with full standard approaches. We used the data from studies that focused particularly on the elderly, or provided subgroup information on age, to analyze the feasibility of applying current standard approaches to the elderly. We also discuss alternative approaches. Age alone is a very uncertain prognostic criterion for outcome or tolerability of treatment. It is much more important to obtain a comprehensive geriatric assessment of each individual patient. When adequate patient selection is provided, standard treatment approaches appear to be feasible for elderly (>70 years) patients with good performance status.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 3","pages":"182-9"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40823977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Cancer","authors":"Putnam","doi":"10.1007/b97840","DOIUrl":"https://doi.org/10.1007/b97840","url":null,"abstract":"","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"175 1","pages":"89-90"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79759948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrectomy, peritonectomy, and perioperative intraperitoneal chemotherapy: the evolution of treatment strategies for advanced gastric cancer.","authors":"Paul H Sugarbaker,&nbsp;Wansik Yu,&nbsp;Yutaka Yonemura","doi":"10.1002/ssu.10042","DOIUrl":"https://doi.org/10.1002/ssu.10042","url":null,"abstract":"<p><p>Gastric cancer disseminates by hematogenous, lymphatic, and transcoelomic routes. For maximal containment of the malignant process, perioperative intraperitoneal chemotherapy is necessary in two groups of patients in whom the primary cancer can be resected. Those patients who have been resected for cure and have a high likelihood of microscopic residual disease require intraperitoneal chemotherapy. This includes all T3 and T4 patients, and patients with N2 nodes present. A series of randomized and nonrandomized clinical studies have established the benefits of perioperative intraperitoneal chemotherapy in this group of patients. Patients with stage IV disease who are able to undergo a palliative resection require these treatments if peritoneal seeding is observed. Systemic chemotherapy is largely ineffective for peritoneal seeding, while intraperitoneal chemotherapy is most likely to produce a response with small volume, surgically debulked carcinomatosis. In addition, intraperitoneal chemotherapy can eliminate the future development of debilitating ascites. Sufficient data are available from the gastric cancer literature to support the use of these combined treatments on a routine basis if the primary cancer is resectable and gastrointestinal function can be reestablished.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 4","pages":"233-48"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24102269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TNM, sixth edition: new developments in general concepts and rules.","authors":"Leslie H Sobin","doi":"10.1002/ssu.10017","DOIUrl":"https://doi.org/10.1002/ssu.10017","url":null,"abstract":"<p><p>This article describes changes and clarifications in the 6th edition of TNM that concern site-independent rules, regarding such aspects as sentinel lymph node biopsy, methods to distinguish between micrometastasis and isolated tumor cells, classification of tumors undergoing treatment, tumor deposits in lymph drainage beds, the number of lymph nodes needed for pathologic classification, and classification of residual tumor. These changes mainly reflect advances in diagnosis and treatment, and modulate rather than change the basic rules of classification.</p>","PeriodicalId":77390,"journal":{"name":"Seminars in surgical oncology","volume":"21 1","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"2003-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ssu.10017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22534157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}