The authors conducted a retrospective analysis with 5-to 30-year follow-up on 109 patients in order to determine the optimum management of nonmedullary thyroid cancer. Results of total thyroidectomy were compared to partial thyroidectomy, among patients well matched for prognostic indicators. No differences in cancer mortality or recurrence rates were evident. However, there were significantly more complications when total thyroidectomy was employed. In view of these results, partial thyroidectomy is recommended as the treatment of choice for nonmedullary thyroid cancer.Cancer 58:2320-2328, 1986.ONTROVERSY CONCERNING the treatment of non-C medullary thyroid cancer still exists, despite critical analysis of operative results for many years. Surgeons are divided into three camps: those advocating routine total thyroide~tomy,'-~ those advocating routine partial thyroidectomy (consisting of at least removal of one entirelobe and isthmus, to include a portion of the contralateral lobe when required for the resection of all gross tumor),6-' and those advocating total thyroidectomy selectively in patients displaying adverse prognostic fact o r~. '~-'~ The current study identifies the factors which influence prognosis and evaluates their implications on operative strategy. The advantages and complications of partial vcrsus total thyroidectomy are retrospectively evaluated. 1955 and 1979, 117 patients underwent thyroid surgery for nonmedullary primary thyroid carcinoma at Saint John Hospital in Detroit, Michigan. Follow-up with a minimum of 5 to 30 years (mean, 12.7 years) was possible in 109 patients by hospital and office records and by direct correspondence. Patients and Methods BetweenNomenclature devised by the American Thyroid Association was used for tumor clas~ification.~~ Papillary tumors were subdivided into pure papillary and mixed pap-

In the last 11 years (November 1989-December 2000), 5526 laparoscopic cholecystectomies were performed in a community residency training program. Two cases (0.04%) of remote complications secondary to spilled gallstones were identified. A 75-year-old woman presented with a sterile abscess in the abdominal wall containing gallstones 4 years and 4 months after an elective laparoscopic cholecystectomy. The second patient, a 43-year-old woman, presented with a subdiaphragmatic/subhepatic abscess containing gallstones. The abscess grew the same bacteria that were present 2 years and 3 months previously during a laparoscopic cholecystectomy for acute gangrenous cholecystitis. In both cases, pigmented gallstones were identified. Causes of gallstone spillage, means of prevention, and ways of managing this complication are discussed.

Background: Radiotherapy association with immunotherapy has a strong rationale. This study evaluates this combination before surgery in locally advanced rectal cancer (RC).Methods: R-IMMUNE (NCT03127007), a multicentric phase Ib/II prospective trial includes patients with stage II/III RC treated with a preoperative combination of radio-chemotherapy (45-50 Gy/25 fractions, 5FU 225 mg/m2/d, 5d/w from week 1-5) + atezolizumab 1200 mg/infusion (ATZ). The phase Ib had a 3+3 design with a safety period up to surgery and evaluated a single infusion of ATZ at week 3. The phase II, in progress, evaluates 4 infusions of ATZ at weeks 3, 6, 9 and 12. Surgery is planned at week 15. Primary objectives are safety and efficacy based on pathological complete response rate (pCR). Based on a 2-stage Simon design, 36 patients are needed in the phase II to detect a pCR rate increase from 15% to 35% (a ¼ 0.1 and b ¼ 0.1). At least 4 pCRs must be observed among 19 patients treated in the 1 st stage to move the 2 nd stage. abstracts Annals of OncologyVolume 32 -Issue S5 -2021 S537

No abstract

The Advanced Breast Biopsy Instrumentation (ABBI; U.S. Surgical Corp., Norwalk, CT) system is the newest technology available for the evaluation and diagnosis of nonpalpable breast lesions. It requires the breast imaging specialist, often a radiologist, to localize the suspicious lesion to x, y, and z coordinates in a digital mammogram unit The coordinates are then used by the surgeon to operate and direct the ABBI biopsy device around the lesion to obtain an excisional biopsy. Mammographic confirmation of the specimen is then immediately obtained. First introduced in the United States in April 1996, the ABBI system is aimed at rivaling the previously relied upon methods of needle-localized and core needle breast biopsies. In this study, we analyzed the first 15 months of use of the ABBI system in a community hospital to evaluate its applicability and efficacy in the diagnosis of nonpalpable breast lesions. Eighteen surgeons and three radiologists performed a total of 230 cases on 223 patients (seven patients had bilateral breast biopsies). The lesions biopsied included 114 clustered microcalcifications, 115 masses, and 1 retained guidewire from a previous needle-localized breast biopsy. The average time for the complete procedure was 65 minutes. Breast cancer was identified in 36 patients (36 of 230,15.7%) and 1 additional patient had an incidental finding of lobular carcinoma in situ. The malignancies included 20 cases of invasive ductal carcinoma, 12 cases of ductal carcinoma in situ, and four cases of invasive lobular carcinoma. Overall, 84 per cent of the patients had a definitive benign diagnosis and required no further surgical treatment of their mammographic finding. There have been no known missed lesions after use of the ABBI procedure. In conclusion, our experience has shown the ABBI system to be a valuable option in the management of selected patients with nonpalpable breast lesions.