Letteratura scientifica selezionata sul tema "Lateral lymph nodes"
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Articoli di riviste sul tema "Lateral lymph nodes"
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Qian, XiaoYu, Jian Tang, Yongquan Chu, Liang Chen, Ziqiang Chen e Lin Li. "Application of Carbon Nanoparticle Tracers in the Lateral Neck Lymph Nodes of CN1bx Patients with Papillary Thyroid Carcinoma". Journal of Nanoscience and Nanotechnology 21, n. 11 (1 novembre 2021): 5408–13. http://dx.doi.org/10.1166/jnn.2021.19472.
Testo completoAbstract (sommario):
This study aimed to investigate the applicability of carbon nanoparticle tracers in the lateral neck lymph nodes of CN1bx patients with papillary thyroid carcinoma surgery. 73 patients with papillary thyroid carcinoma at our hospital between January 2019 to December 2019 were suspected metastasis in the lateral neck lymph node before surgical treatment. During the operation, carbon nanoparticle tracers were used as black staining tracers for the lateral neck lymph nodes to detect metastasis in each Compartment of the neck. The lateral Compartment is defined as level ll-V The black-stained lymph nodes, dyed by Carbon nanoparticle tracers, and non-dyed lymph nodes were compared. Post-surgery paraffin pathology was adopted as the gold standard to calculate the predictive performance of the carbon nanoparticle tracers in detecting lymph node biopsy metastasis. 59 of the patients (80.8%) had lateral neck metastasis. The black-stained lymph nodes, dyed by Carbon nanoparticle tracers, in Compartment IV exhibited the highest proportions in the case number submitted for detection and in lymph nodes metastasis, followed by Compartment III. The metastasis rate of the dyed lymph nodes in areas III and IV was significantly higher than that of non-dyed lymph nodes (P < 0.05). The sensitivity and accuracy of the dyed lymph node biopsy in Compartments III—IV were 90% and 93.2%, respectively. This predictive performance was similar to that Compartments ll-V combined. In conclusion, when carbon nanoparticle tracers are used for lymph node biopsy, high sensitivity and accuracy are obtained in lateral neck compartments III—IV, making these compartments ideal for lymph node biopsy.
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Graceffa, Giuseppa, Giuseppina Orlando, Gianfranco Cocorullo, Sergio Mazzola, Irene Vitale, Maria Pia Proclamà, Calogera Amato et al. "Predictors of Central Compartment Involvement in Patients with Positive Lateral Cervical Lymph Nodes According to Clinical and/or Ultrasound Evaluation". Journal of Clinical Medicine 10, n. 15 (30 luglio 2021): 3407. http://dx.doi.org/10.3390/jcm10153407.
Testo completoAbstract (sommario):
Lymph node neck metastases are frequent in papillary thyroid carcinoma (PTC). Current guidelines state, on a weak level of evidence, that level VI dissection is mandatory in the presence of latero-cervical metastases. The aim of our study is to evaluate predictive factors for the absence of level VI involvement despite the presence of metastases to the lateral cervical stations in PTC. Eighty-eight patients operated for PTC with level II–V metastases were retrospectively enrolled in the study. Demographics, thyroid function, autoimmunity, nodule size and site, cancer variant, multifocality, Bethesda and EU-TIRADS, number of central and lateral lymph nodes removed, number of positive lymph nodes and outcome were recorded. At univariate analysis, PTC location and number of positive lateral lymph nodes were risk criteria for failure to cure. ROC curves demonstrated the association of the number of positive lateral lymph nodes and failure to cure. On multivariate analysis, the protective factors were PTC located in lobe center and number of positive lateral lymph nodes < 4. Kaplan–Meier curves confirmed the absence of central lymph nodes as a positive prognostic factor. In the selected cases, Central Neck Dissection (CND) could be avoided even in the presence of positive Lateralcervical Lymph Nodes (LLN+).
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Baytinger, V. F., O. S. Kurochkina, E. G. Zvonarev e A. A. Loyt. "Postmastectomic lymphedema prevention: modern possibilities". Issues of Reconstructive and Plastic Surgery 24, n. 2 (31 agosto 2021): 15–27. http://dx.doi.org/10.52581/1814-1471/77/02.
Testo completoAbstract (sommario):
A three-dimensional computer model of the topographic and anatomical variants of the lymph nodes in the axillary fossa gives reason to doubt the indisputability of the known data on the normal anatomy of the lymph nodes. This mainly concerns the presence of a lateral (shoulder) group of axillary lymph nodes (4-6 nodes), which can be located not only on the medial, but also on the posterior surface of the shoulder. In some cases, this group of axillary lymph nodes is generally absent in its typical place and is in close proximity to the central (intermediate) group of lymph nodes. Attention to the lateral (shoulder) group of lymph nodes is due to the fact that through them lymph drainage occurs from the entire superficial (epifascial) lymphatic system of the volar surface of the upper limb (skin and subcutaneous tissue). From the lateral group of lymph nodes, lymph drainage goes either to the central group or to the deltapectoral lymph nodes. In the course of axillary lymph node dissection of I, II and III levels in breast cancer, it is possible to save only the deltapectal lymph node with its afferent and efferent vessels, which provides full-fledged lymphatic drainage from the dorsolateral surface of the upper limb. But in this situation, without lymphatic drainage (superficial and deep) with preserved lymph production, the inner (volar) part of the upper limb remains, where lymphostasis begins to develop. An exception is the variant of localization of the brachial group of lymph nodes on the posterior surface of the shoulder, in which it is possible to preserve the lateral group of lymph nodes, which does not fall into the block of adipose tissue with other regional lymph nodes, and therefore partially preserve the lymph drainage from the medial surface of the ipsilateral upper limb towards the deltapectoral lymph node. Taking into account the topographic and anatomical variability of the lymph drainage collectors in the axillary fossa and the varied nature of the involvement of lymph nodes in the metastatic process, in each clinical case, the standard preoperative mapping of axillary lymph nodes (reverse lymphatic mapping) does not allow predicting the risk and timing of the development of postoperative upper limb lymphedema. The advantage of our technology two-contrast fluorescent lymphography - is the possibility of visual differentiation of all elements of lymph drainage from the mammary gland (indocyanine green - ICG) and the ipsilateral upper limb (methylene blue - MB). According to the results of the study, it will be possible to clarify the localization of the lateral (shoulder) group of axillary lymph nodes, topographic and anatomical features of the lymphatic drainage collectors in the axillary fossa and indications for lymphovenous shunting for primary surgical prevention of postmastectomy lymphedema of the upper limb.
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Christou, Niki, Jeremy Meyer, Christophe Combescure, Alexandre Balaphas, Joan Robert-Yap, Nicolas C. Buchs e Frédéric Ris. "Prevalence of Metastatic Lateral Lymph Nodes in Asian Patients with Lateral Lymph Node Dissection for Rectal Cancer: A Meta-analysis". World Journal of Surgery 45, n. 5 (4 febbraio 2021): 1537–47. http://dx.doi.org/10.1007/s00268-021-05956-1.
Testo completoAbstract (sommario):
AbstractImportanceRectal cancers occupy the eighth position worldwide for new cases and deaths for both men and women. These cancers have a high tendency to form metastases in the mesorectum but also in the lateral lymph nodes. The therapeutic approach for the involved lateral lymph nodes remains controversial.ObjectiveWe performed a systematic review and meta-analysis to assess the prevalence of metastatic lateral lymph nodes in patients with lateral lymph node dissection (LLND) for rectal cancer, which seems to be a fundamental and necessary criterion to discuss any possible indications for LLND.MethodsData sources–study selection–data extraction and synthesis–main outcome and measures. We searched MEDLINE, EMBASE and COCHRANE from November 1, 2018, to November 19, 2018, for studies reporting the presence of metastatic lateral lymph nodes (iliac, obturator and middle sacral nodes) among patients undergoing rectal surgery with LLND. Pooled prevalence values were obtained by random effects models, and the robustness was tested by leave-one-out sensitivity analyses. Heterogeneity was assessed using the Q-test, quantified based on the I2 value and explored by subgroup analyses.ResultsOur final analysis included 31 studies from Asian countries, comprising 7599 patients. The pooled prevalence of metastatic lateral lymph nodes was 17.3% (95% CI: 14.6–20.5). The inter-study variability (heterogeneity) was high (I2 = 89%). The pooled prevalence was, however, robust and varied between 16.6% and 17.9% according to leave-one-out sensitivity analysis. The pooled prevalence of metastatic lymph nodes was not significantly different when pooling only studies including patients who received neoadjuvant treatment or those without neoadjuvant treatment (p = 0.44). Meta-regression showed that the pooled prevalence was associated with the sample size of studies (p < 0.05), as the prevalence decreased when the sample size increased.ConclusionThe pooled prevalence of metastatic lateral lymph nodes was 17.3% among patients who underwent rectal surgery with LLND in Asian countries. Further studies are necessary to determine whether this finding could impact the therapeutic strategy (total mesorectal excision with LLNDversustotal mesorectal excision with neoadjuvant radiochemotherapy).
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Sato, Hiroshi, Yutaka Miyawaki, Masayasu Aikawa, Kojun Okamoto, Shinichi Sakuramoto, Shigeki Yamaguchi e Isamu Koyama. "PS02.013: THORACOSCOPIC ESOPHAGECTOMY WITH RADICAL LYMPH NODE DISSECTION FOR THORACIC ESOPHAGEAL CARCINOMA IN THE LEFT LATERAL DECUBITUS POSITION". Diseases of the Esophagus 31, Supplement_1 (1 settembre 2018): 124. http://dx.doi.org/10.1093/dote/doy089.ps02.013.
Testo completoAbstract (sommario):
Abstract Background The rates of thoracoscopic esophagectomy performed in the prone and left lateral decubitus positions are similar in Japan. We retrospectively reviewed short term outcomes of thoracoscopic esophagectomy for esophageal cancer performed in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation in a single institution. This study aimed to evaluate the feasibility of applying this procedure. Methods Between July 2013 and March 2017, 83 patients with esophageal cancer underwent thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation. The thoracic procedure is performed as follows: The lymph nodes around the right recurrent laryngeal nerve are dissected. On the cranial side, the lymph node dissection is advanced to the level of the inferior thyroid artery. Then, the assistant rotates the trachea toward the ventral side, and the lymph nodes around the left recurrent laryngeal nerve are dissected. The middle and inferior mediastinal lymph nodes are dissected including supradiaphragmatic lymph nodes and the dorsal lymph nodes around the thoracic descending aorta. Then, the esophagus is transected using an automatic suture device. Finally, the tracheal bifurcation area lymph nodes are dissected. We retrospectively analyzed these patients. Results The completion rate of thoracoscopic esophagectomy was 94.0%, and the procedure was converted to thoracotomy in five patients, due to hemorrhage, severe adhesion. The mean intrathoracic operative time, intrathoracic blood loss, and number of dissected mediastinal lymph nodes were 220.0 min, 130.1 mL, and 22.0, respectively. Postoperative complications included pneumonia (8.4%), anastomotic leakage (16.9%), and recurrent nerve paralysis (8.4%). Postoperative (30d) mortality was 1/83 (1.2%) due to ARDS. Conclusion Standardization of the procedure for thoracoscopic esophagectomy in the left lateral decubitus position under artificial pneumothorax by CO2 insufflation, with a standardized clinical pathway for perioperative care led to favorable surgical outcomes. Disclosure All authors have declared no conflicts of interest.
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Aboelatta, Ibrahim H., Soliman A. El-Shakhs, Abd Elmieniem F. Mohammed e Mohammed H. Milegy. "Role of pelvic lymphadenectomy in rectal cancer". International Surgery Journal 6, n. 6 (28 maggio 2019): 1838. http://dx.doi.org/10.18203/2349-2902.isj20192150.
Testo completoAbstract (sommario):
Background: Rectal cancer constitutes about one third of all colorectal cancer cases. Total mesorectal excision has become the gold standard in rectal cancer treatment. However total mesorectal excision does not involve any approaches for lateral pelvic lymph nodes (LPLN), which may be asource of local recurrences. Tumor containing LPLN were reported to be found in about 10%-20% of the rectal cancer patients. In japan lateral pelvic lymph node metastasis is accepted to be curable with excision.Methods: This study included 20 patients presented to Menofia Hospital for elective colorectal re sections and LPLN dissection, in the period from July 2016 to January 2019.Results: This study on 13 male (65%), 7 female (35%), all patients included in the study underwent preoperative chemoradiation according to the technique described by Marks et al. with an overall administration of 45 cGy over 5 weeks. Dissection of 180 lymph nodes was retrieved (20%) lymph nodes pathologically were positive for malignancy.Conclusions: Lateral pelvic lymph nodes dissection is an important in rectal cancer treatment.
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Wu, Xin, Binglu Li, Chaoji Zheng, Wei Liu, Tao Hong e Xiaodong He. "Risk Factors for Lateral Lymph Node Metastases in Patients With Sporadic Medullary Thyroid Carcinoma". Technology in Cancer Research & Treatment 19 (1 gennaio 2020): 153303382096208. http://dx.doi.org/10.1177/1533033820962089.
Testo completoAbstract (sommario):
Purpose: Medullary thyroid carcinoma is a rare endocrine malignancy; 75% of patients with this disease have sporadic medullary thyroid carcinoma. While surgery is the only curative treatment, the benefit of prophylactic lateral neck dissection is unclear. This study aimed to analyze the clinicopathological risk factors associated with lateral lymph node metastases and determine the indication for prophylactic lateral neck dissection in patients with sporadic medullary thyroid carcinoma. Methods: The medical records of patients with medullary thyroid carcinoma who were treated at our hospital between January 2002 and January 2020 were retrospectively reviewed; a database of their demographic characteristics, test results, and pathological information was constructed. The relationship between lateral lymph node metastases and clinicopathologic sporadic medullary thyroid carcinoma features were analyzed using univariate and multivariate analyses. Results: Overall, 125 patients with sporadic medullary thyroid carcinoma were included; 47.2% and 39.2% had confirmed central and lateral lymph node metastases, respectively. Univariate and multivariate analyses identified 2 independent factors associated with lateral lymph node metastases: positive central lymph node metastases (odds ratio = 9.764, 95% confidence interval: 2.610–36.523; p = 0.001) and positive lateral lymph nodes on ultrasonography (odds ratio = 101.747, 95% confidence interval: 14.666–705.869; p < 0.001). Conclusion: Medullary thyroid carcinoma is a rare endocrine malignancy. Lymph node metastases are common in patients with sporadic medullary thyroid carcinoma. Prophylactic lateral neck dissection is recommended for patients who exhibit positive central lymph node metastases and/or positive lateral lymph nodes on ultrasonography.
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Morohashi, Hajime, Yoshiyuki Sakamoto, Takuya Miura, Daichi Ichinohe, Kotaro Umemura, Takanobu Akaishi, Kentaro Sato et al. "Effective dissection for rectal cancer with lateral lymph node metastasis based on prognostic factors and recurrence type". International Journal of Colorectal Disease 36, n. 6 (1 febbraio 2021): 1251–61. http://dx.doi.org/10.1007/s00384-021-03870-5.
Testo completoAbstract (sommario):
Abstract Purpose There are no reports showing the significance and effective range of dissection for patients with lateral lymph node metastasis (LLNM). This study aimed to investigate the indications for lateral lymph node dissection (LLND) in patients with LLNM based on prognostic factors and recurrence types. Methods We reviewed 379 patients with advanced rectal cancer who were treated with total mesorectal excision plus LLND. We analyzed background factors and survival times of patients who had LLNM to determine prognostic factors and recurrence types. Results Pathological LLNM occurred in 44 (11.6%). Among patients with LLNM, the predictors of poor prognoses, according to univariate analysis, were > 3 node metastases, the presence of node metastasis on both sides, and spreading beyond the internal iliac lymph nodes. Moreover, LLNM beyond the internal iliac region was found to be an independent prognostic risk factor. Twenty-eight of the 44 patients with lateral lymph node metastasis (64%) relapsed, 22 of whom had distant metastases and 11 of whom experienced local recurrences. Among the latter group, nine (20%) and two (5%) had recurrences in the central and lateral pelvis, respectively. Conclusion The therapeutic benefit of resection was high, especially in patients with ≤ 3 positive lateral lymph nodes, one-sided bilateral lymph node areas, and positive nodes localized near the internal iliac artery.
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Hacker, Neville F., Ellen Barlow, Stephen Morrell e Katrina Tang. "Medial Inguino-Femoral Lymphadenectomy for Vulvar Cancer: An Approach to Decrease Lymphedema without Compromising Survival". Cancers 13, n. 22 (19 novembre 2021): 5806. http://dx.doi.org/10.3390/cancers13225806.
Testo completoAbstract (sommario):
Background: Lower limb lymphedema is a long-term complication of inguino-femoral lymphadenectomy and is related to the number of lymph nodes removed. Our hypothesis was that lymph nodes lateral to the femoral artery could be left in situ if the medial nodes were negative, thereby decreasing this risk. Methods: We included patients with vulvar cancer of any histological type, even if the cancer extended medially to involve the urethra, anus, or vagina. We excluded patients whose tumor extended (i) laterally onto the thigh, (ii) posteriorly onto the buttocks, or (iii) anteriorly onto the mons pubis. After resection, the inguinal nodes were divided into a medial and a lateral group, based on the lateral border of the femoral artery. Results: Between December 2010 and July 2018, 76 patients underwent some form of groin node dissection, and data were obtained from 112 groins. Approximately one-third of nodes were located lateral to the femoral artery. Positive groin nodes were found in 29 patients (38.2%). All patients with positive nodes had positive nodes medial to the femoral artery. Five patients (6.6%) had positive lateral inguinal nodes. The probability of having a positive lateral node given a negative medial node was estimated to be 0.00002. Conclusion: Provided the medial nodes are negative, medial inguino-femoral lymphadenectomy may suffice and should reduce lower limb lymphedema without compromising survival.
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Lee, Cortney Y., Samuel K. Snyder, Terry C. Lairmore, Sean C. Dupont e Daniel C. Jupiter. "Utility of Surgeon-Performed Ultrasound Assessment of the Lateral Neck for Metastatic Papillary Thyroid Cancer". Journal of Oncology 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/973124.
Testo completoAbstract (sommario):
Ultrasound is the recommended staging modality for papillary thyroid cancer. Surgeons proficient in US assessment of the neck and experienced in the management of papillary thyroid cancer (PTC) appear uniquely qualified to assess the lateral cervical lymph nodes for metastatic disease. Of 310 patients treated for PTC between 2000 and 2008, 109 underwent surgeon-performed ultrasound (SUS) of the lateral neck preoperatively. Fine needle aspiration was performed on suspicious lateral lymph nodes. SUS findings were compared with FNA cytology and results of postoperative imaging studies. The sensitivity and negative predictive value of SUS were 88% and 97%, respectively. Four patients were found to have missed metastatic disease within 6 months. No patient underwent a nontherapeutic neck dissection. SUS combined with US-guided FNA of suspicious lymph nodes can accurately stage PTC to reliably direct surgical management.
Tesi sul tema "Lateral lymph nodes"
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Quadros, Claudio de Almeida. "Linfonodectomia retroperitoneal e pélvica lateral guiada por radiotraçador e azul patente no estadiamento do adenocarcinoma do reto". Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-09122009-152351/.
Testo completoAbstract (sommario):
INTRODUÇÃO: A excisão total do mesorreto é o procedimento cirúrgico padrão para o tratamento do adenocarcinoma do reto. Resultados satisfatórios, em termos de prognóstico, alcançados com a associação da linfonodectomia retroperitoneal e pélvica lateral questionam se somente a excisão total do mesorreto seria suficiente para um estadiamento adequado, podendo afetar decisões relacionadas ao tratamento adjuvante. Este estudo avaliou o impacto das metástases em linfonodos retroperitoneais e/ou pélvicos laterais na mudança do estadiamento de pacientes com adenocarcinoma do reto e a acurácia da identificação de metástases em linfonodos das cadeias retroperitoneais e/ou pélvicas laterais com o uso de tecnécio-99m-fitato e/ou azul patente. MÉTODOS: Foi realizado estudo prospectivo de janeiro de 2004 a agosto de 2008, composto por 97 pacientes com adenocarcinoma do reto extraperitoneal submetidos a tratamento cirúrgico curativo com excisão total do mesorreto e linfonodectomia retroperitoneal e pélvica lateral, com pesquisa de linfonodos das cadeias retroperitoneais e pélvicas laterais identificados com tecnécio-99m-fitato e/ou corados em azul patente. Os linfonodos radioativos e/ou azuis, quando negativos ao exame histopatológico com hematoxilina-eosina, foram submetidos à multisecções histológicas com uso de técnicas imunohistoquímicas com anticorpos anticitoqueratinas (AE1/AE3). RESULTADOS: A média de linfonodos nas peças de excisão total do mesorreto foi de 11,5 (1119/97) e nas cadeias retroperitoneais e pélvicas laterais foi de 11,7 (1136/97). A linfonodectomia retroperitoneal e pélvica lateral identificou metástases em 17,5% dos pacientes do estudo e promoveu aumento do estádio TNM II para III em 8,2% dos pacientes. As variáveis relacionadas à presença de linfonodos retroperitoneais e/ou pélvicos laterais metastáticos foram o estádio III estabelecido na peça cirúrgica da excisão total do mesorreto (P < 0,04); a classificação pT3/pT4 do tumor primário (P = 0,047); níveis elevados de antígeno carcinoembrionário, com média de 30,6 ng/ml e mediana de 9,9 ng/ml (P = 0,014); e grandes tumores, com tamanho médio de 5,5 ± 3,2 cm (P = 0,03). A migração do tecnécio e/ou azul patente para linfonodos retroperitoneais e/ou pélvicos laterais ocorreu em 37,1% (36/97), modificando o estadiamento em 11,1% dos pacientes estudados. A acurácia do uso do tecnécio e/ou azul patente na detecção de metástases nos linfonodos retroperitoneais e pélvicos laterais foi de 100%, com sensibilidade de 100%, valor preditivo negativo de 100% e zero de falso-negativos. CONCLUSÕES: Deve-se aprimorar o uso de marcadores na identificação de metástases para indicação seletiva da linfonodectomia retroperitoneal e pélvica lateral em adenocarcinoma retal.BACKGROUND: Total mesorectal excision is the standard surgical procedure for rectal adenocarcinoma treatment. Good prognostic results achieved with retroperitoneal and lateral pelvic lymphadenectomy have questioned that total mesorectal excision might not be satisfactory for adequate patient staging, affecting adjuvant therapeutic definitions. The aims of this study were to define the upstaging impact of metastasis to retroperitoneal and/or lateral pelvic nodes in patients with rectal adenocarcinoma and the accuracy of dye and/or probe search in the detection of metastatic retroperitoneal and/or lateral pelvic nodes. METHODS: A prospective study was carried on from January of 2004 to August of 2008, composed of 97 extraperitoneal rectal adenocarcinoma patients submitted to curative intent surgeries with total mesorectal excision and retroperitoneal and lateral pelvic lymphadenectomy, with retroperitoneal and lateral pelvic nodes mapping using technetium-99m-phytate and/or patent blue. The radioactive and/or blue nodes, when negative to histopathological hematoxylin-eosin staining, were submitted to step-sectioning and immunohistochemical examination with antibody against cytokeratin (AE1/AE3). RESULTS: Mean node count of the mesorectal excision specimen was 11.5 (1119/97) and of the retroperitoneal and lateral pelvic lymphadenectomy was 11.7 (1136/97). Retroperitoneal and lateral pelvic lymphadenectomy identified metastasis in 17.5% of the studied patients and modified TNM stage II to III in 8.2% of the patients. Factors related to metastatic retroperitoneal and lateral pelvic nodes were stage III defined by examination of the surgical specimen of the total mesorectal excision (P < 0,004); tumor pT3/pT4 classification (P = 0,047); high levels of carcinoembryonic antigen, with average of 30.6 ng/ml and median of 9.9 ng/ml (P = 0,014); and large tumors, with mean size of 5.5 cm ± 3,2 cm (P = 0,03). Technetium and/or patent blue migration to retroperitoneal and/or lateral pelvic nodes occurred in 37.1% (36/97), upstaging 11.1% of the studied patients. Technetium and/or patent blue accuracy in the detection of metastasis to retroperitoneal and/or lateral pelvic nodes was of 100%, with sensibility of 100%, negative predictive value of 100% and zero false negatives. CONCLUSIONS: The use of markers should be improved in the identification of metastasis for selective indication of retroperitoneal and lateral pelvic lymphadenectomy.
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Kroon, Hidde Maarten. "Management of Lateral Lymph Node Metastasis in Rectal Cancer". Thesis, 2022. https://hdl.handle.net/2440/135590.
Testo completoAbstract (sommario):
Introduction: Pre-treatment abnormal lateral lymph nodes (LLNs) are present in approximately 20% of patients with locally advanced rectal cancer. Western treatment of LLNs consists of neoadjuvant (chemo)radiotherapy (nCRT) followed by total mesorectal excision (TME), meaning these nodes are not removed surgically. There is, however, potential benefit in performing an additional lateral lymph node dissection (LLND) as enlarged LLNs have been shown to be predictive for local recurrence. Furthermore, the impact on oncological outcomes when enlarged LLNs harbour malignant features is currently unknown. Therefore, the aims of this thesis were to investigate if patients benefit from an additional LLND after nCRT and to determine oncological outcomes when malignant features are present in enlarged LLNs. Methods: A multi-centre cohort study was conducted at six tertiary referral centres in the US, the Netherlands and Australia. All patients had locally advanced rectal cancer with enlarged LLNs with a short-axis of ≥5mm. Malignant features were defined as nodes with internal heterogeneity and/or border irregularity. Firstly, patients who underwent nCRT followed by TME (LLND-) were compared to those who underwent a LLND in addition to nCRT and TME (LLND+). Next, a systematic review and meta-analysis was performed on studies comparing LLND- versus LLND+. Finally, patients with and without malignant features were compared. Outcomes of interest were local recurrence-free survival (LRFS), distant metastatic-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). Results: LLND+ patients (n=44) were younger with higher ASA-classifications and ypN-stages compared to LLND- patients (n=115). LLND+ patients had larger median LLNs short-axes and received more adjuvant chemotherapy (100 vs. 30%; p<0.0001). Between groups, LRFS was 97% for LLND+ versus 89% for LLND- (p=0.13). DFS (p=0.94) and OS (p=0.42) were similar. LLND was an independent significant factor for local recurrences (p=0.01) in the multi-variate analysis. Sub-analysis of patients who underwent long-course nCRT and had adjuvant chemotherapy (LLND- n=30, LLND+ n=44) demonstrated a higher LRFS for LLND+ patients (97% versus 84% for LLND-; p=0.04). DFS (p=0.10) and OS (p=0.11) were similar between groups. Seven studies were included in the systematic review. Five-year LRFS after LLND+ was improved (range 85-95%) compared to LLND- (43-89%; statistically significant in three studies). DFS was increased after LLND+ (range 61-74%) compared to LLND- (54-79%; significant in three studies). No study reported five-year overall survival benefit after LLND+ (range 72-80%; 69-91% for LLND-). In the analysis of malignant features, median LLNs short-axis was 7mm (range 5-28) for the complete cohort, of whom 60 patients (52%) had malignant features. LLNs with malignant features showed no difference in LRFS (p=0.20) but had worse DMFS (p=0.004) and OS (p=0.006) compared to those without malignant features. Cox regression analysis confirmed malignant features as an independent factor for DMFS. Conclusions: This thesis suggests that a LLND in addition to nCRT in locally advanced rectal cancer improves LRFS and DFS, and that malignant features present in enlarged LLNs are predictive for a worse DMFS. More high-quality studies are required to further explore the value of LLND and the role of malignant features in LLNs.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2022
Capitoli di libri sul tema "Lateral lymph nodes"
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Watanabe, Toshiaki, e Soichiro Ishihara. "Management of Lateral Pelvic Lymph Nodes". In Rectal Cancer, 213–30. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-16384-0_13.
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Kapila, Ayush K., e Assaf A. Zeltzer. "Lateral Thoracic Artery Lymph Nodes (LTLN) for Lower Limb Lymphedema". In Clinical Scenarios in Reconstructive Microsurgery, 699–708. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-23706-6_111.
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Ilgan, Seyfettin. "Management of Recurrent Lymph Nodes in Central and Lateral Neck in the Follow-Up of Differentiated Thyroid Carcinoma". In Thyroid and Parathyroid Diseases, 305–11. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-78476-2_48.
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Konishi, Tsuyoshi. "Laparoscopic Lateral Pelvic Lymph Node Dissection". In Minimally Invasive Surgical Techniques for Cancers of the Gastrointestinal Tract, 275–85. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-18740-8_30.
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Konishi, Tsuyoshi. "Robotic Lateral Pelvic Lymph Node Dissection". In Robotic Colorectal Surgery, 121–32. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-15198-9_11.
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Fujita, Shin, e Kenjiro Kotake. "Lateral Lymph Node Dissection for Rectal Cancer". In Modern Management of Cancer of the Rectum, 187–97. London: Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-6609-2_13.
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Liang, Jin-Tung. "Minimally Invasive Lateral Pelvic Lymph Node Dissection". In Minimally Invasive Surgical Techniques for Cancers of the Gastrointestinal Tract, 287–94. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-18740-8_31.
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Kobayashi, Hirotoshi, e Kenichi Sugihara. "Lateral Pelvic Lymph Node Dissection (Pelvic Sidewall Dissection)". In Springer Surgery Atlas Series, 299–316. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-60827-9_13.
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Kusters, Miranda, Yoshihiro Moriya, Harm J. T. Rutten e Cornelis J. H. van de Velde. "Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection". In Rectal Cancer, 53–78. Totowa, NJ: Humana Press, 2010. http://dx.doi.org/10.1007/978-1-60761-567-5_4.
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Dayan, Joseph H. "Step-by-Step Instruction: Lateral Thoracic Vascularized Lymph Node Transplant Procedure". In Multimodal Management of Upper and Lower Extremity Lymphedema, 123–27. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-93039-4_17.
Testo completoAtti di convegni sul tema "Lateral lymph nodes"
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Sun, Zhihui, Jia Liu, Peisong Wang, Yanhua Li, Zhi Lv, Yi Han e Guang Chen. "The Features of Lymph Node Metastasis of Differentiated Thyroid Carcinoma and the Choice of Lateral Neck Lymph Nodes Dissection". In 2016 8th International Conference on Information Technology in Medicine and Education (ITME). IEEE, 2016. http://dx.doi.org/10.1109/itme.2016.0081.
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Moreno, Marcelo, Amauri de Oliveira, Tália Cássia Boff, Gabriela Nogueira Matschinski e Izadora Czarnobai. "SQUAMOUS CELL CARCINOMA METASTASIS OF THE MAMMARY GLAND: CASE REPORT". In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1007.
Testo completoAbstract (sommario):
Introduction: Primary squamous cell carcinoma (SCC) of the breast is a rare neoplasm, which represents less than 0.1% of invasive breast cancers. Therefore, it is essential to discriminate between a primary SCC and a metastatic SCC. In order to be considered a primary carcinoma of the breast, a histological examination of the lesion must show more than 90% of squamous neoplastic cells, in addition to the absence of cutaneous SCC or other anatomical sites. Extra-mammary neoplasm metastases are uncommon, representing 0.5% to 2% of breast malignancies. Metastatic SCC in the mammary gland is an uncommon event. To date, only three cases were reported in the literature of secondary involvement of vulvar SCC in the mammary gland. The objective of this work is to report the case of a patient with secondary mammary metastasis to a vulva SCC. Case report: A 74-year-old female patient who underwent radical modified vulvectomy 10 years before. Her pathological stage was characterized as IIIB. For this reason, she was also submitted to adjuvant treatment with chemotherapy associated with radiotherapy to the vulvar region, inguinal lymph node chains and pelvic arteries. On the ninth year of cancer follow-up, she presented recurrence in the vaginal wall. In the complementary image exams, an extentension of neoplasia to pelvic organs was identified, but no distant metastatic lesions were found. She underwent monobloc resection of pelvic organs, with reconstruction of the urinary and intestinal transits. The patient showed a good clinical evolution, with no pelvic complaints. After one year, the patient returned complaining of a nodule in the right breast. On physical examination, a lesion was observed at the junction of the lateral quadrants of the breast, measuring +/- 3.5 cm, with associated inflammatory signs and imprecise limits, with a central region showing a fistulous orifice through which the necrotic material passed. On the mammography, a dense, rounded and partially delimited lesion was identified. She underwent a core biopsy that described a SCC. According to her clinical history, it was considered a remote relapse of the vulvar SCC. The patient was submitted to a quadrantectomy with an ipsilateral axillary lymphadenectomy and reconstruction with a lateral thoracic flap. On an anatomopathological examination there was a description that the neoplasm would invade the underlying muscle tissue; and the resection margins were free. Four out of the fourteen isolated axillary lymph nodes had metastases, without perinodal soft tissue invasion. Six months after breast surgery, the patient evolved metastases to both lungs and soon after she died without response to the systemic treatment employed. This report was approved by the Research Ethics – UFFS (Universidade Federal da Fronteira Sul) (number 4.034.565).
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Casimiro, Icrad, e Sabrina Ribas Freitas. "NECROTIZING FASCIITIS IN A UNUSUAL SITE: A CASE REPORT". In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2104.
Testo completoAbstract (sommario):
Case Report: A 56-year-old woman, multiparous patient, diabetic, hypertensive and tabagist, and taking insulin, metformin, losartan, propranolol, hydrochlorothiazide, and aspirin presents to a clinic. She also had a previous surgery for extraction of a duodenum carcinoma and a nodule in lower lateral quadrant of right breast about 15 years ago, which on previous ultrasound was hyperechoic, with heterogeneous content, measuring about 27×18.5×25 mm. Upon arrival at the hospital, the patient had an ulcerated lesion with a central necrotic area in the lower outer quadrant of the right breast, with drainage of bloody secretion and a foul odor, and a generalized hyperemia in the region of the right breast. On physical examination, the patient had local hyperemia and areas of fluctuation in lateral quadrants. There were no palpable lymph nodes. The results of her initial laboratory investigations showed a leukocytosis and an increased erythrocyte sedimentation rate and C-reactive protein. A computed tomography scan of the breast, chest, and abdomen showed massive subcutaneous emphysema in the right breast, extending from the subcutaneous region of the anterolateral and abdominal chest wall to the right iliac fossa, associated with diffuse densification of the muscular fascia and adjacent subcutaneous tissue. She was treated with intravenous broad-spectrum antibiotics that included 1 g of oxacillin and 1.5 g of metronidazole. She underwent surgical debridement for 3 consecutive days, starting 24 hours after hospital admission. She was recommended 1 g of ceftriaxone and amphotericin B along with antibiotic therapy. At the second surgery, a wound tissue was collected for histopathological examination discarding malignancy. Five weeks later, wounds appeared clean, healing with pink granulation tissue. Conclusion: This case shows that early diagnosis and management of necrotizing fasciitis of the breast can be lifesaving and may allow for breast conservation. Early aggressive debridement combined with antibiotic therapy resulted in successful wound healing and preservation of tissue with a satisfactory cosmetic outcome.
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Kaur, Inderjit, Swarupa Mitra, Manoj Kumar Sharma, Upasna Saxena, Parveen Ahlawat, Amit Kumar Choudhary, Sarthak Tandon e Prashant Surkar. "Case report of vaginal melanoma". In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685371.
Testo completoAbstract (sommario):
Primary malignant melanoma of vagina is a rare disease with a predilection for local recurrence, distant metastasis and short survival time. Due to the low incidence and lack of reporting in the literature, treatment choices still remain controversial. We describe 2 cases of vaginal malignant melanoma. A 42 yr old female presented with complaints of post coital and per vaginal bleed of 1 month duration. Examination findings show growth 6 cm x 6 cm on anterior vaginal wall, another 3 x 3 cm lesion on right lateral vaginal wall. Vaginal biopsy showed malignant melanoma, S-100 and HMB-45 positive while negative for CK and LCA. MRI Whole abdomen showed altered lesion [3.8cm (AP), 6.0cm (TR) and 4.9cm (CC)] in upper 2/3rd of vagina extending into vaginal fornices and abutting right lower cervix superiorly, right paravaginal extension and mesorectal fascia. No significant enlarged lymph nodes were seen. In view of localised disease she underwent Type III Radical hysterectomy with bilateral salpingo-ophorectomy with bilateral pelvic lymphnode dissection with total vaginectomy. Histopathology s/o 2 tumour nodules, one located in the anterior vaginal cuff measuring – 5 x 5 x 3.2 cm, another located in right lateral vaginal cuff measuring 2.5 x 3 x 1.5 cm, malignant melanoma with involvement of the cervix with full thickness stromal invasion (2.8/2.8 cm,) invading perivaginal soft tissue, distance of invasive carcinoma from closest stromal margin <0.1cm (12 O’ clock), LVI, PNI – not seen, all pelvic LN free (0/25). In view of positive margin and full thickness stromal involvement, she received radiotherapy to pelvis and Inguinal region to a dose of 45 Gy/25# followed by a boost of 16 Gy/8# to the tumour bed till 01/01/16. Another case is a 40 yrs female, presented with complaints of bloody discharge per vaginum of 4 months duration. On examination, there was a large growth occupying the vagina till introitus. Cervix normal, para free. MRI Pelvis showed altered lesion involving left lateral uterine cervix and upper 2/3rd of vagina with full thickness stromal involvement with mild left parametrial, anterior and posterior paravaginal extension, measuring 2.9 x 4.5 x 5.3 cm. Few subcmlymphnodes were seen in bilateral external and internal iliac regions (L>R). Vaginal Biopsy was suggestive of Malignant Melanoma, expressing S-100, HMB 45 and SDX-10. Metastatic work up was negative. She underwent RH with total vaginectomy with bilateral PLND with RPLND. HPR showed exophytic black growth seen involving all quadrants of vagina, extending upwards into both lips of cervix – 7 x 6 x 2.5 cm, Malignant melanoma, distance of invasive carcinoma from closest margin: <0.1 cm (paravaginal soft tissue), 3/8 right Pelvic LN, ECE +, 01/9 Left pelvic LN, ECE absent, 0/6 Right common iliac LN, 0/1 Reperitoneal LN was seen. She received adjuvant radiotherapy to a dose of 50 Gy/25# to the pelvis and inguinals→ boost of 6 Gy/3# to nodal regions showing ECE & 10 Gy/5# to the primary region.
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Han, Zhe, Shuai Xue, Peisong Wang e Li Zhang. "Central Lymph Node Metastasis as a Predictor for Lateral Lymph Node Metastasis in Clinically Node-Negative T3 and T4 Papillary Thyroid Carcinoma". In 2018 9th International Conference on Information Technology in Medicine and Education (ITME). IEEE, 2018. http://dx.doi.org/10.1109/itme.2018.00028.
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Kaur, Inderjit. "Case report of vaginal melanoma". In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685370.
Testo completoAbstract (sommario):
Primary malignant melanoma of vagina is a rare disease with a predilection for local recurrence, distant metastasis and short survival time. Due to the low incidence and lack of reporting in the literature, treatment choices still remain controversial. We describe 2 cases of vaginal malignant melanoma. A 42 yr old female presented with complaints of post coital and per vaginal bleed of 1 month duration. Examination findings shows growth 6 cm x 6 cm on anterior vaginal wall, another 3 x 3 cm lesion on right lateral vagianl wall. Vaginal biopsy showed malignant melanoma, S-100 and HMB-45 positive while negative for CK and LCA. MRI Whole abdomen showed altered lesion [3.8 cm (AP), 6.0 cm (TR) and 4.9 cm (CC)] in upper 2/3rd of vagina extending into vaginal fornices and abutting right lower cervix superiorly, right paravaginal extension and mesorectal fascia. No significant enlarged lymph nodes were seen. In view of localised disease she underwent Type III Radical hysterectomy with bilateral salpingo-ophorectomy with bilateral pelvic lymphnode dissection with total vaginectomy. Histopathology s/o 2 tumour nodules, one located in the anterior vaginal cuff measuring – 5 x 5 x 3.2 cm, another located in right lateral vaginal cuff measuring 2.5 x 3 x 1.5 cm, malignant melanoma with involvement of the cervix with full thickness stromal invasion (2.8/2.8 cm,) invading perivaginal soft tissue, distance of invasive carcinoma from closest stromal margin <0.1 cm (12 O’ clock), LVI, PNI – not seen, all pelvic LN free (0/25). In view of positive margin and full thickness stromal involvement, she received radiotherapy to pelvis and Inguinal region to a dose of 45 Gy/25# followed by a boost of 16 Gy/8# to the tumour bed till 01/01/16. Another case is a 40 yrs female, presented with complaints of bloody discharge per vaginum of 4 months duration. On examination, there was a large growth occupying the vagina till introitus. Cervix normal, para free. MRI Pelvis showed altered lesion involving left lateral uterine cervix and upper 2/3rd of vagina with full thickness stromal involvement with mild left parametrial, anterior and posterior paravaginal extension, measuring 2.9 x 4.5 x 5.3 cm. Few subcmlymphnodes were seen in bilateral external and internal iliac regions (L>R). Vaginal Biopsy was suggestive of Malignant Melanoma, expressing S-100, HMB 45 and SDX-10. Metastatic work up was negative. She underwent RH with total vaginectomy with bilateral PLND with RPLND. HPR showed exophytic black growth seen involving all quadrants of vagina, extending upwards into both lips of cervix – 7 x 6 x 2.5 cm, Malignant melanoma, distance of invasive carcinoma from closest margin: <0.1 cm (paravaginal soft tissue), 3/8 right Pelvic LN, ECE +, 01/9 Left pelvic LN, ECE absent, 0/6 Right common iliac LN, 0/1 Reperitoneal LN was seen. She received adjuvant radiotherapy to a dose of 50 Gy/25# to the pelvis and inguinals→ boost of 6 Gy/3# to nodal regions showing ECE & 10Gy/5# to the primary region.
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"Vulvar cancer: Patterns of recurrence and clinicopathological prognostic factors involved in recurrent cases". In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685347.
Testo completoAbstract (sommario):
Objective: Vulvar cancer is a rare disease, with an incidence of 0.6% of all female malignancies. With the advances in management of carcinoma vulva to individualisation of treatment to reduce the psychosexual impact an aggressive treatment can have, it is imperative to understand the patterns of recurrence and the common prognostic factors involved. The aim of this study was to determine prognostic variables for recurrence and survival and to identify patterns of recurrence in patients with vulvar cancer. Materials and Methods: All patients (n=87) with primary vulvar cancer treated at the Rajiv Gandhi Cancer Institute between January, 2006 to January, 2015 who underwent surgery were retrospectively analysed regarding the prognostic relevance of different clinicopathological variables. Recurrences were evaluated with regard to their characteristics and localisation and the variables associated with them were analyzed. Results: Age, stage of tumor, size of tumor, location of tumor (central or lateral), lymph node metastasis, depth of invasion and involvement of resection margins, associated intraepithelial abnormality predicted disease-free and overall survival. In multivariate analysis, lymph node status and positive margin status was the most important independent prognostic factor (p = 0.002). Irrespective of the initial nodal involvement, recurrences occurred primarily in the vulvar region. Conclusion: Inguinofemoral lymph node status and adequate margins at initial diagnosis is of critical prognostic importance for patients with vulvar cancer. Further tumour biological characteristics need to be identified to stratify patients with nodal involvement for adjuvant radiotherapy of the vulva to prevent local recurrences.
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Demirkiran, F., T. Bese, BO Kayan, S. Acikgoz e S. Gokmen. "EP1251 The robotic surgical management of upper paraaortic lymph node recurrancy of uterine cervical cancer in lateral decubitus position -Video presentation". In ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.1257.
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Nascimento, Ranier Colbek, e Sabrina Ribas Freitas. "A 29-YEAR-OLD PREGNANT WOMAN WITH METASTATIC BREAST CANCER: A CASE REPORT". In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2107.
Testo completoAbstract (sommario):
Pregnancy-associated breast cancer (PABC) is defined as a breast cancer diagnosed during pregnancy, lactation, or in the first postpartum year. PABC is a rare complication that occurs in approximately 0.01% to 0.03% of all pregnancies. The difficulty in diagnosis worsens the prognosis. D.G., 29-year-old, female, noted a mass in her right breast in June 2020. One month later with 13+4 weeks’ gestation, she presented to the obstetrics emergency with recurrent episodes of lower back pain. She was released home with pain relief and was instructed to realize a mammography due to the presence of a 4-cm mass on physical examination of the right breast. Patient returned 12 days later with severe low back pain, a BIRADS 4C mammography, and multiple liver lesions in total abdomen ultrasound. Core-needle biopsy demonstrated a stage II invasive ductal carcinoma with hormone receptors positive and human epidermal growth factor receptor 2 positive. There is involvement of the axilla and intramammary lymph nodes. Magnetic resonance imaging of the lower back and sacroiliac joint was performed and found multiple lesions suspected of metastasis in the inferior thoracic vertebrae, lumbar vertebrae, sacrum, ilium, and femurs. Computed tomography (CT) of the thorax identified a 2.3×1.8 cm irregular lesion in the right breast compatible with the primary neoplasm. Chemotherapy was initiated till she was 31 weeks’ gestation. After childbirth, she reinitiates chemotherapy. Three months later, the patient has convulsive episodes. Cranial CT was done and found multiple lesions compatible with brain metastasis, so she initiated brain radiotherapy. PABC can present itself as a challenging situation with nonspecific symptoms and at an advanced stage. Therefore, it is important to have the PABC in our list of differential diagnoses in this patient.
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Yamashita, Emilly Sayuri, e Hilton Mariano da Silva Júnior. "Garcin syndrome by giant cell lung tumor". In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.056.
Testo completoAbstract (sommario):
Context: Garcin syndrome is the presence of at least seven ipsilateral cranial nerves palsy, absence of long tract motor or sensory disturbance and intracranial hypertension, and skull base osteoclastic injury. Case report: A 46-year-old woman presented left hypoesthesia. One week later she developed left palsy peripheral facial, the Bell’s palsy. Then, she manifested left deafness and diplopia. The MRI revealed an extra axial lesion in left pre-pontine area. She reported weight loss of 11 kg in 4 months and denied smoking. Palpable lymph nodes were noted on left cervical chain. Neurological examination revealed left cranial nerves V, VI, VII, VIII, IX, X, XI and XII paralysis. Tonus, strength and sensitivity were normal in 4 limbs. After four months, another MRI exhibited an extra axial tumor along the meninges. Chest CT showed an ill-defined left lower lobe lesion. The biopsy revealed a giant cell lung carcinoma (GCC), with cervical bones and encephalus metastasis. She underwent a WBRT radiotherapy. After seven sessions, she presented a cardiorespiratory arrest with death. Conclusion: We can conclude that Garcin syndrome rare condition can have a GCC metastasis involvement. GCC is common um male and smokers. This is the first report of Bell’s palsy as a primary manifestation of GCC, and is also the first case that GCC have Garcin syndrome association. We can assume GCC is a etiology of Garcin syndrome and Bell’s palsy, including in non-smokers.