Radioguided occult lesion localization and sentinel node and occult lesion localization in breast cancer: The future beckons

Jha, Deepak Kumar; Deo, Svs; Malhotra, Mandeep Singh

doi:10.4103/2454-6798.173283

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…2,3 However, the incidence of margin-positive excision can be as high as 47%. 4 There are also risks of inaccurate positioning and wire displacement after positioning. The first radioisotope-guided occult lesion localisations (ROLL) procedure was performed in 1996.…”

Section: Introductionmentioning

confidence: 99%

“…6 Radioisotope-guided localisation also offers an additional benefit of localising sentinel lymph nodes, during the same procedure by injecting 99m Tc labelled filtered sulphur colloid (<22 μm) instead. 4 The aims of the present study were to assess the technical success rate of localisation and to investigate factors affecting the accuracy of ROLL in localisation of nonpalpable breast lesions.…”

Section: Introductionmentioning

confidence: 99%

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Factors Affecting Accuracy of Stereotactic Radioisotope-guided Occult Lesion Localisation for Breast Lesions

Wong

Fung

et al. 2022

Hong Kong Journal of Radiology

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Objectives:To assess the surgical success rate of stereotactic radioisotope-guided occult lesion localisation (ROLL) and to identify factors affecting its accuracy. Methods: We retrospectively identified all stereotactic ROLL procedures from June 2017 to August 2018 at a regional hospital in Hong Kong. Demographic data, imaging results, previous biopsy records, surgical records, and pathology results were reviewed. Independent-sample t tests and Fisher's exact test were used to assess the association of multiple factors (including age, breast thickness, depth of lesion, type of target, approach direction, pathology, operator experience) with localisation accuracy using a 5-mm deviation between the centres of the mammographic targets and the scintigraphic image as the threshold. Results: A total of 77 ROLL procedures were identified. Of them, 55 were localisations of nonpalpable lesions and 22 were combined radioisotope-guided sentinel node and occult breast lesion localisations. The overall surgical success rate for removal of the target lesion was 85.7%, and for excision of malignant nonpalpable breast lesions with clear margins the success rate was 83.9%. Specimen mammogram and scintigraphic images were available in 68 cases for subsequent analysis for factors affecting localisation accuracy. A preoperative diagnosis of invasive carcinoma was associated with poorer target localisation (p = 0.015). Injection of radioisotope via a lateromedial direction was associated with better target localisation (p = 0.044). Conclusion: Stereotactic ROLL is effective in localising nonpalpable breast lesions with a high surgical success rate.There is a significant association between invasive carcinoma with worse localisation. Injection of radioisotope in lateromedial directions is associated with better localisation accuracy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors Affecting Accuracy of Stereotactic Radioisotope-guided Occult Lesion Localisation for Breast Lesions

Wong

Fung

et al. 2022

Hong Kong Journal of Radiology

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The Effectiveness and Safety of Open Versus laparoscopic Surgery for Rectal Cancer after Preoperative Chemo-radiotherapy: A Meta-Analysis

Zhang

Guo

Zheng

et al. 2019

CCHTS

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Background: Only a limited number of studies considered the combined chemo-radiation therapy after surgery for treating locally advanced rectal cancer. Comparative studies on laparoscopic and open procedures indicated that laparoscopy surgery may be associated with fewer postoperative complications. Despite encouraging results from rectal cancer patients who received neoadjuvant chemo-radiotherapy prior to laparoscopic surgery, the acceptance of this procedure remains controversial, and conflicting evidence exists only in the form of retrospective trials. Objectives: Since laparoscopic surgery was introduced into clinical practice to treat rectal cancer after neoadjuvant chemo-radiotherapy, it has been discussed controversially whether laparoscopic surgery can be performed as effectively as an open procedure. To overcome the biases inherent in any nonrandomized comparison, we analyzed the propensity-matched analysis and randomized clinical trial. In this study, we set out to determine whether laparoscopic resection was non-inferior to open resection in treatment outcomes of rectal cancer after neoadjuvant chemo-radiotherapy. Method: Publications on laparoscopic surgery in comparison with open thoracotomy in treatment outcomes of rectal cancer after neo-adjuvant chemo-radiotherapy to November 2017 were collected. Summary hazard ratios (HRs) of endpoints of interest such as 3-OS (overall survival), 3-DFS (disease-free survival), and individual postoperative complications were analyzed in all trials. By using fixed- or random-effects models according to the heterogeneity, meta-analysis Revman 5.3 software was applied to analyze combined pooled HRs. Results: A total of 6 trials met our inclusion criteria. The pooled analysis of 3-DFS showed that laparoscopic surgery did not improve disease -free survival, compared with open thoracotomy (OR =1.48, 95% CI 0.95 – 2.29; P = 0.08), as well with the 3-OS (OR=0.96, 95%CI=0.66-1.41, P=0.084). The pooled result of duration of surgery indicated that laparoscopic surgery had a tendency towards a longer surgery time (SMD= 43.96, 95% CI 34.04– 53.88; P 0.00001) and a shorter hospital stay (SMD= -0.97, 95% CI -1.75– -0.18; P=0.02). However, no significant differences between laparoscopic surgery and open thoracotomy were observed in terms of the meta-analysis on the number of removed lymph nodes (SMD =-0.37, 95% CI -0.1.77 – 1.03; P = 0.60), blood loss (SMD =-21.30, 95% CI -0.48.36 – 5.77; P = 0.12), positive circumferential resection margin (OR =0.73, 95% CI 0.22– 2.48; P = 0.61) or postoperative complications (OR =0.89, 95% CI 0.67 – 1.17; P = 0.40) l. Conclusions: The current data supported the concept that laparoscopic surgery had correlated with a longer operative time but a shorter hospital stay, without superior advantages in short-term survival rates or oncologic efficiency for locally treating advanced rectal cancer after neoadjuvant chemoradiotherapy. However, prospective investigation on long-term oncological results from laparoscopic surgery is required in the future to verify the benefits of laparoscopic surgery over open surgery after chemo-radiation therapy for treating locally advanced rectal cancer.

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Radioguided occult lesion localization and sentinel node and occult lesion localization in breast cancer: The future beckons

Cited by 2 publications

References 33 publications

Factors Affecting Accuracy of Stereotactic Radioisotope-guided Occult Lesion Localisation for Breast Lesions

Factors Affecting Accuracy of Stereotactic Radioisotope-guided Occult Lesion Localisation for Breast Lesions

The Effectiveness and Safety of Open Versus laparoscopic Surgery for Rectal Cancer after Preoperative Chemo-radiotherapy: A Meta-Analysis

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