scholarly journals A uniform residual tumor (R) classification

Cancer ◽  
2009 ◽  
Vol 115 (15) ◽  
pp. 3483-3488 ◽  
Author(s):  
Christian Wittekind ◽  
Carolyn Compton ◽  
Phil Quirke ◽  
Iris Nagtegaal ◽  
Susanne Merkel ◽  
...  
Keyword(s):  
Residual Tumor ◽  
R Classification

Residual Tumor (R) Classification in Colorectal Cancer: Reduced, Expanded, or Not Uniform?

2011 ◽  
Vol 135 (3) ◽  
pp. 288-288
Author(s):  
Giacomo Puppa ◽  
Luca Bortolasi ◽  
Romano Colombari ◽  
Kieran Sheahan
Keyword(s):  
Colorectal Cancer ◽  
Residual Tumor ◽  
R Classification

scholarly journals Analysis of Margin Classification Systems for Assessing the Risk of Local Recurrence After Soft Tissue Sarcoma Resection

2018 ◽  
Vol 36 (7) ◽  
pp. 704-709 ◽  
Author(s):  
Kenneth R. Gundle ◽  
Lisa Kafchinski ◽  
Sanjay Gupta ◽  
Anthony M. Griffin ◽  
Brendan C. Dickson ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Multidisciplinary Treatment ◽  
Residual Tumor ◽  
Classification Systems ◽  
Positive Margins ◽  
Risk Levels ◽  
R Classification ◽  
Margin Classification

Purpose To compare the ability of margin classification systems to determine local recurrence (LR) risk after soft tissue sarcoma (STS) resection. Methods Two thousand two hundred seventeen patients with nonmetastatic extremity and truncal STS treated with surgical resection and multidisciplinary consideration of perioperative radiotherapy were retrospectively reviewed. Margins were coded by residual tumor (R) classification (in which microscopic tumor at inked margin defines R1), the R+1mm classification (in which microscopic tumor within 1 mm of ink defines R1), and the Toronto Margin Context Classification (TMCC; in which positive margins are separated into planned close but positive at critical structures, positive after whoops re-excision, and inadvertent positive margins). Multivariate competing risk regression models were created. Results By R classification, LR rates at 10-year follow-up were 8%, 21%, and 44% in R0, R1, and R2, respectively. R+1mm classification resulted in increased R1 margins (726 v 278, P < .001), but led to decreased LR for R1 margins without changing R0 LR; for R0, the 10-year LR rate was 8% (range, 7% to 10%); for R1, the 10-year LR rate was 12% (10% to 15%) . The TMCC also showed various LR rates among its tiers ( P < .001). LR rates for positive margins on critical structures were not different from R0 at 10 years (11% v 8%, P = .18), whereas inadvertent positive margins had high LR (5-year, 28% [95% CI, 19% to 37%]; 10-year, 35% [95% CI, 25% to 46%]; P < .001). Conclusion The R classification identified three distinct risk levels for LR in STS. An R+1mm classification reduced LR differences between R1 and R0, suggesting that a negative but < 1-mm margin may be adequate with multidisciplinary treatment. The TMCC provides additional stratification of positive margins that may aid in surgical planning and patient education.

The Pathologist and the Residual Tumor (R) Classification

1994 ◽  
Vol 190 (2) ◽  
pp. 115-123 ◽  
Author(s):  
P. Hermanek ◽  
Ch. Wittekind
Keyword(s):  
Residual Tumor ◽  
R Classification

Residual tumor (R) classification and prognosis

1994 ◽  
Vol 10 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Paul Hermanek ◽  
Christian Wittekind
Keyword(s):  
Residual Tumor ◽  
R Classification

Prediction of residual tumor and overall survival after first-line surgery in patients with pancreatic ductal adenocarcinoma using preoperative magnetic resonance imaging findings

2021 ◽  
pp. 028418512199999
Author(s):  
Jae Seok Bae ◽  
Jung Hoon Kim ◽  
Hyo-Jin Kang ◽  
Joon Koo Han
Keyword(s):  
Magnetic Resonance Imaging ◽  
Overall Survival ◽  
Magnetic Resonance ◽  
Portal Vein ◽  
Residual Tumor ◽  
Ductal Adenocarcinoma ◽  
Resonance Imaging ◽  
First Line ◽  
R Classification ◽  
Preoperative Magnetic Resonance

Background Complete resection is the only potentially curative treatment in patients with pancreatic ductal adenocarcinoma (PDA) and is associated with a longer overall survival (OS) than incomplete resection of tumor. Hence, prediction of the resection status after surgery would help predict the prognosis of patients with PDA. Purpose To predict residual tumor (R) classification and OS in patients who underwent first-line surgery for PDA using preoperative magnetic resonance imaging (MRI). Material and Methods In this study, 210 patients with PDA who underwent MRI and first-line surgery were randomly categorized into a test group (n=150) and a validation group (n=60). The R classification was divided into R0 (no residual tumor) and R1/R2 (microscopic/macroscopic residual tumor). Preoperative MRI findings associated with R classification and OS were assessed by using logistic regression and Cox proportional hazard models. In addition, the prediction models for the R classification and OS were validated using calibration plots and C statistics. Results On preoperative MRI, portal vein encasement (odds ratio 4.755) was an independent predictor for R1/R2 resection ( P=0.040). Tumor size measured on MRI (hazard ratio [HR] per centimeter 1.539) was a predictor of OS, along with pathologic N1 and N2 stage (HR 1.944 and 3.243, respectively), R1/R2 resection (HR 3.273), and adjuvant chemoradiation therapy (HR 0.250) ( P<0.050). Calibration plots demonstrated satisfactory predictive performance. Conclusion Preoperative MRI was valuable for predicting R1/R2 resection using portal vein encasement. Tumor size measured on MRI was useful for the prediction of OS after first-line surgery for PDA.

Combination of microsurgery and Gamma Knife surgery for the treatment of intracranial chondrosarcomas

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 18-25 ◽  
Author(s):  
Petter Förander ◽  
Tiit Rähn ◽  
Lars Kihlström ◽  
Elfar Ulfarsson ◽  
Tiit Mathiesen
Keyword(s):  
Gamma Knife ◽  
Cranial Nerve ◽  
Residual Tumor ◽  
Local Tumor Control ◽  
Gamma Knife Surgery ◽  
Long Term Results ◽  
Tumor Control ◽  
Low Grade ◽  
Cranial Nerve Palsies ◽  
Tumor Volume Reduction

ObjectIntracranial chondrosarcomas have a high risk of recurrence after surgery. This retrospective study of patients with intracranial chondrosarcoma was conducted to determine the long-term results of microsurgery followed by Gamma Knife surgery (GKS) for residual tumor or recurrence.MethodsThe authors treated nine patients whose median age was 36 years. Seven patients had low-grade chondrosarcomas (LGCSs), whereas mesenchymal chondrosarcomas (MCSs) were diagnosed in two. Radiosurgery was performed in eight patients, whereas one patient declined further surgical intervention and tumor-volume reduction necessary for the GKS.The patients were followed up for 15 to 173 months (median 108 months) after diagnosis and 3 to 166 months (median 88 months) after GKS. Seven patients had residual tumor tissue after microsurgery, and two operations appeared radical. In the two latter cases, tumors recurred after 25 and 45 months. Thus, definite tumor control was not achieved after surgery alone in any patient, whereas the addition of radiosurgery allowed tumor control in all six patients with LGCSs. Two of these patients experienced an initial tumor regrowth after GKS; in both cases the recurrences were outside the prescribed radiation field. The patients underwent repeated GKS, and subsequent tumor control was observed. An MCS was diagnosed in the remaining two patients. Complications after microsurgery included diplopia, facial numbness, and paresis. After GKS, one patient had radiation necrosis, which required microsurgery, and two patients had new cranial nerve palsies.Conclusions Tumor control after microsurgery alone was not achieved in any patient, whereas adjuvant radiosurgery provided local tumor control in six of eight GKS-treated patients. Tumor control was not achieved in the two patients with MCS. Similar to other treatments for intracranial chondrosarcoma, morbidity after micro- and radiosurgical combination therapy was high and included severe cranial nerve palsies.

Spreading of the vestibular schwannoma into porus acusticus internus. Endoscopic removal possibilities

2018 ◽  
pp. 40-44
Author(s):  
Orest Palamar ◽  
Andriy Huk ◽  
Dmytro Okonskyi ◽  
Ruslan Aksyonov ◽  
Dmytro Teslenko
Keyword(s):  
Vestibular Schwannoma ◽  
Internal Auditory Canal ◽  
Residual Tumor ◽  
Endoscopic Technique ◽  
Vestibular Schwannomas ◽  
Endoscopic Removal ◽  
Tumor Removal ◽  
Tumor Spread ◽  
Microsurgical Technique ◽  
Tumor Visualization

Aim: To investigate the features of the vestibular schwannoma spread into the internal auditory canal and the possibilities of endoscopic removal. Objectives: To improve tumor visualization in the internal auditory canal; to create a sufficient view angle for tumor removal during endoscopic opening of the internal auditory canal. Materials and methods: The results of surgical treatment of 20 patients with vestibular schwannomas in which the tumor spread to the internal auditory canal were analyzed. Microsurgical tumor removal was performed in 14 cases; Fully endoscopic removal of vestibular schwannomas was performed in 6 cases. The internal auditory canal opening was performed in 14 cases using microsurgical technique and in 6 cases with fully the endoscopic technique. Results: Gross total removal was achieved in 18 cases, subtotal removal in 2 cases. The tumor spread into the internal auditory canal was removed in all cases (100%). Opening the internal auditory canal using the endoscopic technique allows to increase the view angle (up to 20%) and to visualize along the axis of canal. Conclusions: 1) Endoscopic assistance technique allows to improve residual tumor visualization much more better then microsurgical technique; 2) Internal auditory canal opening using endoscopic technique is much more effective than the microsurgical technique (trepanning depth is larger); 3) Endoscopic methods for the internal auditory canal opening allows to increase canal angle view up to 20% (comparing to the microsurgical view).

DETECTION OF RESIDUAL LUNG CANCER CELLS BY PCR-BASED GENETIC TESTING FOR ROS1-TRANSLOCATION: CASE REPORT

2018 ◽  
Vol 64 (3) ◽  
pp. 331-334
Author(s):  
Fedor Moiseenko ◽  
Vladislav Tyurin ◽  
Nikita Levchenko ◽  
Yevgeniy Levchenko ◽  
Aglaya Ievleva ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Morphological Analysis ◽  
Pathologic Complete Response ◽  
Residual Tumor ◽  
Complete Response ◽  
Convincing Evidence ◽  
Pcr Analysis ◽  
Specific Gene ◽  
Highly Sensitive ◽  
Reliable Monitoring

A patient with lung cancer carrying ROS1 translocation was treated by crizotinib and then subjected to surgery. Morphological analysis revealed pathologic complete response in surgically removed tissues, while PCR test provided convincing evidence for the presence of residual tumor cells. PCR analysis of lung cancer specific gene translocations allows carrying out highly sensitive and reliable monitoring of tumor disease during the course of treatment.

SURGERY FOR RESIDUAL DISEASE AFTER RADIOTHERAPY IN LOCALLY ADVANCED CERVICAL CANCER

2019 ◽  
Vol 65 (5) ◽  
pp. 721-725
Author(s):  
Elmira Shakirova ◽  
Andrey Panov ◽  
Alevtina Akhmetzyanova ◽  
Aliya Gafiullina ◽  
L. Ibragimova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Residual Disease ◽  
Locally Advanced ◽  
Residual Tumor ◽  
Advanced Cervical Cancer ◽  
Mri Imaging ◽  
Recurrent Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Visible Effect ◽  
Adjuvant Hysterectomy

Aims: Chemoradiation (CRT) is the standard treatment for locally advanced cervical cancer (LACC). However part of the patients develop recurrence during the first year after treatment despite good visible effect at the first follow-up. The role of completion surgery after radiotherapy (RT) is still debated. A number of papers have showed that up to 60% of patients have residual tumor after CRT and RT. But such a surgery is not widely recommended because of increased morbidity of the treatment. The aim of this study was to assess the results of surgery after radiotherapy of LACC. Method: We retrospectively evaluated data on 86 patients with cervical cancer IB - IIIB stages (mostly stage IIB) who underwent surgery in different modalities after CRT and RT with good clinical response in our department in 2015-2018. Results: When small asymptomatic residual disease was detected early after radiotherapy radical hysterectomy was feasible in most of the cases. Patients with clinical manifestation of recurrence had very poor prognosis. Surgery of recurrent cervical cancer sufficiently deteriorates quality of life, even if possible. Conclusion: Thorough examination with adding MRI imaging after initial treatment of cervical cancer needed to identify patients who may benefit from adjuvant hysterectomy.

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