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Xu ZC, Su BA, Li JC, Cheng WF, Chen J. Pattern of relapse following three-field lymphadenectomy of esophageal carcinoma and related factors predictive of recurrence. Cancer Radiother 2023; 27:189-195. [PMID: 36754752 DOI: 10.1016/j.canrad.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/28/2022] [Accepted: 09/01/2022] [Indexed: 02/09/2023]
Abstract
PURPOSE For treatment of esophageal carcinoma, the optimal postoperative radiotherapy target volume after three-field lymph node dissection (3-FLD) had not been determined. We analyzed local recurrence pattern of thoracic esophageal carcinoma and risk factors of lymph node recurrence after 3-FLD without prophylactic radiotherapy. MATERIAL AND METHODS We reviewed 1282 patients with thoracic esophageal squamous cell carcinoma (ESCC) who were treated with 3-FLD without radiotherapy from 2010 to 2018 and analysed local recurrence patterns and risk factors of lymph node recurrence, in order to provide a reference for determination of the radiotherapy target volume for thoracic ESCC. RESULTS The lymph node recurrence accounted for 91.0% of treatment failures. The mediastinal, cervical and abdominal lymph node recurrence accounted for 84.92%, 36.07% and 22.30%, respectively (χ2=264.776, P=0.000). The superior, middle and inferior mediastinal lymph node recurrence rates were 67.54%, 27.87% and 0.98%, respectively (χ2=313.600, P=0.000). Cervical metastases were significantly associated with N stage and Preoperative cervical lymph node status. Abdominal metastases were significantly associated with the number of preoperative abdominal lymph node metastases (LNM), tumor location and N stage. CONCLUSIONS The main pattern of local-regional recurrence might be lymph node metastasis after radical 3-FLD without radiotherapy in esophageal carcinoma. The dangerous lymph node recurrence regions included neck, superior and middle mediastinum. The abdominal areas might be irradiated for lower TEC patients with preoperative abdominal LNM.
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Affiliation(s)
- Z-C Xu
- First Hospital of Quanzhou Affiliated to Fujian Medical University, 362000 Quanzhou, People's Republic of China
| | - B-A Su
- First Hospital of Quanzhou Affiliated to Fujian Medical University, 362000 Quanzhou, People's Republic of China
| | - J-C Li
- The Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, 350000 Fuzhou, People's Republic of China.
| | - W-F Cheng
- The Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, 350000 Fuzhou, People's Republic of China
| | - J Chen
- The Teaching Hospital of Fujian Medical University, Fujian Provincial Cancer Hospital, 350000 Fuzhou, People's Republic of China
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Altaf W, Attarde D, Sancheti P, Shyam A. Triggering of Thumb by a Ganglion Cyst of the Flexor Tendon Sheath at A1 Pulley: A Case Report. J Orthop Case Rep 2021; 11:10-12. [PMID: 34239820 PMCID: PMC8241247 DOI: 10.13107/jocr.2021.v11.i03.2064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Ganglions of the wrist and hand are commonly seen but the most common sites are in the dorsum of the wrist followed by the volar side in the distal forearm at the wrist crease. The Ganglion cysts arising from the flexor tendon sheath are rare and only a few are reported in the literature. Case Report: We report a rare case of a ganglion cyst of the flexor tendon sheath at A1 pulley of thumb in a 35-year-old male who came with the complaint of chronic triggering of the left thumb. The histopathological examination confirmed the ganglion which was removed from the A1 pulley area. Conclusion: A1 pulley ganglion causing trigger thumb is uncommon entity. Although, traditional treatment for this is conservative or aspiration. High recurrence is observed. When it comes to preservation of fine movements such as thumb, aggressive approach involving exploration and excision of cyst gives good functional outcome and reduces chance of recurrence.
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Affiliation(s)
- Warid Altaf
- Department of Orthopaedics, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India
| | - Dheeraj Attarde
- Department of Orthopaedics, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India
| | - Parag Sancheti
- Department of Orthopaedics, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India
| | - Ashok Shyam
- Department of Orthopaedics, Sancheti Institute of Orthopaedics and Rehabilitation, Pune, Maharashtra, India.,Indian Orthopaedic Research Group, Thane, Maharashtra, India
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Tan CL, Lian DWQ, Kuick CH, Chan YH, Chang KTE. Cells with ganglionic differentiation frequently stain for VE1 antibody: a potential pitfall. Brain Tumor Pathol 2020; 37:14-21. [PMID: 31820133 DOI: 10.1007/s10014-019-00356-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
Mitogen-activated protein kinase (MAPK) pathway plays a major role in pediatric low-grade gliomas (pLGGs). Immunohistochemistry with mutant-specific antibody, VE1, has appeared to be the most affordable and rapidly deployable method to identify tumors with aberrant MAPK signaling pathway, by highlighting tumor with BRAFV600E mutation. Nonetheless, positive staining cases but not associated with BRAFV600E mutation are also seen. We analyzed 62 pLGGs for the two commonest genetic aberrations in MAPK pathway: KIAA1549-BRAF fusion, using reverse-transcriptase polymerase chain reaction, and BRAFV600E mutation, using VE1 antibody and Sanger sequencing. We recorded a specificity and accuracy rate of 68.75% and 75%, respectively, for VE1, when strong cytoplasmic staining is observed. Interestingly, we observed that cells with ganglionic features frequently bind VE1 but not associated with BRAFV600E mutation. Such observation was also confirmed in four cases of differentiating neuroblastoma. This false positive staining may serve as an important confounder in the interpretation of VE1 immunoreactivity with major therapeutic implication. It is important to confirm the presence of BRAFV600E mutation by DNA-based method, especially in tumor entities not known to, or rarely harbor such mutations.
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Rogé M, Thureau S, Dampierre J, Dubray B, Rivera S. [Prophylactic nodal radiotherapy for breast cancer]. Cancer Radiother 2019; 23:904-912. [PMID: 31594695 DOI: 10.1016/j.canrad.2019.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 11/24/2022]
Abstract
Adjuvant radiotherapy is a key treatment in early-stage breast cancer. The meta-analysis by the Early Breast Cancer Trialist's Collaborative Group (EBCTCG) has demonstrated a decreased risk of locoregional relapse and death after whole-breast radiotherapy. Prophylactic lymph nodes irradiation in breast cancer has also proven to be beneficial in several therapeutic trials. At a time when three-dimensional conformal radiotherapy has become the standard procedure and with the development of intensity-modulated radiation therapy, defining nodal volumes is essential and practices should be harmonized to assess and compare the efficiency and toxicity of radiotherapy. Furthermore, the indication of lymph nodes irradiation has to take into account the risk/benefit balance as expanding the irradiated volume can increase radio-induced toxicity. Selection of patients receiving this treatment is essential. The aim of this update is to define nodal volumes, to precise the indications of their irradiation and to present the expected benefits as well as the potential side effects.
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Affiliation(s)
- M Rogé
- Département d'oncologie radiothérapie, centre Henri-Becquerel, 1, rue d'Amiens,76000 Rouen, France.
| | - S Thureau
- Département d'oncologie radiothérapie, centre Henri-Becquerel, 1, rue d'Amiens,76000 Rouen, France
| | - J Dampierre
- Service de pneumologie oncologie thoracique et soins intensifs respiratoires, centre hospitalier universitaire de Rouen, 1, rue de Germont, 76000 Rouen, France
| | - B Dubray
- Département d'oncologie radiothérapie, centre Henri-Becquerel, 1, rue d'Amiens,76000 Rouen, France
| | - S Rivera
- Gustave-Roussy Cancer Campus, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Université Paris-Sud, 114, rue Édouard-Vaillant, 94805 Villejuif, France
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Sidibe I, Biau J, Graff P. [Oral cavity and pharyngo-laryngeal squamous cell carcinoma. What lymph node volumes to select for external beam radiation therapy?]. Cancer Radiother 2019; 23:696-700. [PMID: 31447343 DOI: 10.1016/j.canrad.2019.07.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 07/08/2019] [Indexed: 11/21/2022]
Abstract
The selection of target volumes for head and neck cancer radiation therapy, particularly prophylactic volumes that reflect infra-clinic spreads, is a complex process. It is based on the knowledge of the natural history of these tumors and must take into consideration the special challenges due to the diversity and complexity of head and neck anatomy. The dosimetric and ballistic precision provided by modern radiation techniques has required strong strategic deliberation to ensure the relevance and reproducibility of target volumes. Specifically, regarding cervical lymph node volumes, two issues emerged. What lymph node area to select depending on the location and the staging of the primary tumor? How to convey that choice in the process of treatment planning and delivery? This debate has been progressively enriched over time resulting in the publication of several international guidelines to standardize the terminology of head and neck lymph node areas and to lay solid science-based foundations to drive practices. This abundance of information makes these guidelines complex, but their accurate understanding is required for adequate usage. We provide an overview of the main published recommendations for the selection of lymph node target volumes when treating oral cavity and pharyngo-laryngeal squamous cell carcinoma with radiation therapy.
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Lee SJ, Hyun YS, Baek SH, Seo JH, Kim HH. Posterior Interosseous Nerve Palsy Caused by a Ganglion of the Arcade of Frohse. Clin Shoulder Elb 2018; 21:252-255. [PMID: 33330185 PMCID: PMC7726401 DOI: 10.5397/cise.2018.21.4.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/14/2018] [Accepted: 10/22/2018] [Indexed: 11/25/2022] Open
Abstract
A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient’s fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.
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Affiliation(s)
- Seung Jin Lee
- Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Yoon Suk Hyun
- Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Seung Ha Baek
- Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Ji Hyun Seo
- Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
| | - Hyun Ho Kim
- Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Seoul, Korea
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Lin IC, Shin AY, Bishop AT. Dorsal Capsular Defect and Synovial Fistula to the Fourth Extensor Compartment: A Late Complication after Arthroscopic Dorsal Wrist Ganglionectomy. J Hand Surg Asian Pac Vol 2018; 23:404-407. [PMID: 30282537 DOI: 10.1142/s2424835518720244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Arthroscopic dorsal wrist ganglionectomy is demonstrably a safe procedure with recurrence rates comparable to open surgery. We present a patient with wrist pain following arthroscopic ganglion excision. MRI and arthroscopic findings showed a large dorsal capsular defect, synovial fistula to the fourth extensor compartment, and dorsal radiocarpal ligament resection. Ligament reconstruction and capsular imbrication resolved her symptoms. We postulate that this complication resulted from a large capsular resection. Because we feel that it can be difficult to judge the size of the debridement through an arthroscope, the need for adequate capsular resection in dorsal wrist ganglionectomy needs to be balanced by consideration of potential complications from more aggressive capsular debridement, and thus we feel that capsular resection should be limited to no more than 1 cm2.
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Affiliation(s)
- Ines C Lin
- † Division of Plastic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Alexander Y Shin
- * Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Allen T Bishop
- * Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
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Laffay L, Gérinière L, Couraud S, Souquet PJ. [Endobronchial ultrasound transbronchial needle aspiration initiation into the Lyon Sud hospital center: Experience of the first three years]. Rev Pneumol Clin 2016; 72:17-24. [PMID: 26305022 DOI: 10.1016/j.pneumo.2015.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 02/23/2015] [Accepted: 03/01/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Endobronchial ultrasound is a recent technique for the diagnosis and the lymph node staging in lung cancer. It also showed interest in non tumoral mediastinal lymph nodes diagnosis. This work relates the CHLS first three years' experience in terms of EEB practical use as a new diagnostic tool in this field. METHODS Retrospective study of consecutive cases patients having undergone endobronchial ultrasound from November 2008 till June 2011 in the CHLS. RESULTS On 65 endobronchial ultrasound, general anesthesia was practiced in 89 % of the cases, with a good tolerance in 81 % of the cases. In 77 % cases, EEB allowed diagnosis and avoided mediastinoscopy in 60.5 % of the cases. The respective sensibility, specificity, positive and negative predictive values were 74 %, 100 %, 100 % and 48 %. CONCLUSION These data, reflect of a novice team experience, illustrate the results obtained in the current practice in terms of etiologic diagnosis. Endobronchial ultrasound seems destined to a bright future but requires the development of dedicated centers allowing pulmonologists training and specialized pathologists in this field.
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Affiliation(s)
- L Laffay
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine et de maïeutique Lyon-Sud Charles-Mérieux, université Lyon-1, 69600 Oullins, France.
| | - L Gérinière
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - S Couraud
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine et de maïeutique Lyon-Sud Charles-Mérieux, université Lyon-1, 69600 Oullins, France
| | - P-J Souquet
- Service de pneumologie aiguë spécialisée et cancérologie thoracique, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Faculté de médecine et de maïeutique Lyon-Sud Charles-Mérieux, université Lyon-1, 69600 Oullins, France
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