Article
Oncology
Ji Young You, Eun Sook Lee, Siew Kuan Lim, Youngmee Kwon, So-Youn Jung
Summary: According to the study, performing sentinel lymph node biopsy (SLNB) without axillary lymph node dissection (ALND) may be a reasonable treatment option for patients with positive lymph nodes after breast cancer surgery. There was no significant difference in the loco-regional recurrence rates between SLNB with ALND and SLNB alone.
FRONTIERS IN ONCOLOGY
(2023)
Article
Oncology
Qiufan Zheng, Hanjia Luo, Wen Xia, Qianyi Lu, Kuikui Jiang, Ruoxi Hong, Fei Xu, Shusen Wang
Summary: This study found significant differences in overall survival and breast cancer-specific survival between SLNB and ALND, with SLNB showing a slight survival advantage.
BREAST CANCER RESEARCH AND TREATMENT
(2022)
Article
Oncology
Alexander C. J. van Akkooi, Dirk Schadendorf, Alexander M. M. Eggermont
Summary: Sentinel lymph node biopsy (SLNB) was introduced in the 1990s to identify patients who may benefit from completion lymph node dissection. SLNB staging has been found to be the best for staging melanoma. Adjuvant systemic therapy and biomarkers are emerging, which might reduce the need for SLNB staging in the future.
EUROPEAN JOURNAL OF CANCER
(2023)
Article
Oncology
Peiyong Li, Ciqiu Yang, Junsheng Zhang, Yitian Chen, Xiaoqi Zhang, Minting Liang, Na Huang, Yilin Chen, Kun Wang
Summary: Sentinel lymph node biopsy can provide survival results equivalent to axillary lymph node dissection for patients with cN0 and T1-2 breast cancer; however, whether it can be performed on patients with T3-4c breast cancer is still controversial.
Article
Oncology
Ian Campbell, Neil Wetzig, Owen Ung, David Espinoza, Gelareh Farshid, John Collins, James Kollias, Val Gebski, Rebecca Mister, R. John Simes, Martin R. Stockler, Grantley Gill
Summary: For early breast cancer patients who are clinically node-negative, sentinel node-based management (SNBM) is the international standard of care. In the SNAC1 study, we report the rates of axillary recurrence, overall survival, and breast cancer-specific survival at 10 years.
Article
Oncology
Isaac Cebrecos, Eduard Mension, Inmaculada Alonso, Helena Castillo, Esther Sanfeliu, Sergi Vidal-Sicart, Sergi Ganau, Maria Vidal, Francesco Schettini
Summary: In early stage breast cancer patients without lymph node metastasis, the presence of positive sentinel lymph nodes after primary systemic treatment directs axillary lymph node dissection. This study aimed to identify factors associated with non-sentinel lymph node involvement and develop a predictive score. The results showed that non-sentinel lymph node involvement was infrequent (22.2%) and associated with progesterone receptor levels and macrometastatic sentinel lymph nodes. The developed predictive score accurately predicted the absence of non-sentinel lymph node involvement, suggesting that unnecessary axillary lymph node dissection could be safely avoided in most patients.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Oncology
Jing Si, Rong Guo, Huan Pan, Xiang Lu, Zhiqin Guo, Chao Han, Li Xue, Dan Xing, Wanxin Wu, Caiping Chen
Summary: The aim of this study was to determine whether breast cancer patients with mastectomy and false-negative frozen section in sentinel lymph node biopsy (SLNB) could forgo axillary lymph node dissection (ALND). The study found that SLNB and axillary radiation therapy could effectively replace ALND in selected patients who met specific criteria.
FRONTIERS IN ONCOLOGY
(2022)
Article
Oncology
Stacy B. Sanders, Tanya L. Hoskin, Arielle P. Stafford, Judy C. Boughey
Summary: This study evaluated the rate of non-sentinel lymph node (NSLN) positivity and factors influencing this in patients with a positive sentinel lymph node (SLN) following neoadjuvant chemotherapy (NAC). The results showed a high rate of nodal positivity on completion axillary lymph node dissection (cALND) in the setting of positive SLN after NAC, supporting the current standard of routine cALND. In patients with cN+ disease, NSLN positivity varied based on tumor biology, multicentricity/multifocality, number of positive SLNs, and SLN metastasis size.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Oncology
Gilles Houvenaeghel, Monique Cohen, Pedro Raro, Jeremy De Troyer, Pierre Gimbergues, Christine Tunon de Lara, Vivien Ceccato, Veronique Vaini-Cowen, Christelle Faure-Virelizier, Frederic Marchal, Tristan Gauthier, Eva Jouve, Pierrick Theret, Claudia Regis, Philippe Gabelle, Julia Pernaut, Francesco Del Piano, Gauthier D'Halluin, Stephane Lantheaume, Emile Darai, Bassoodeo Beedassy, Caroline Dhainaut-Speyer, Xavier Martin, Sophie Girard, Richard Villet, Emilie Monrigal, Theophile Hoyek, Jean-Francois Le Brun, Pierre-Emmanuel Colombo, Agnes Tallet, Jean-Marie Boher
Summary: The study analyzed the treatment and pathological results of patients included in the SERC trial, a multicenter randomized non-inferiority phase-3 trial comparing completion axillary lymph node dissection (cALND) with sentinel lymph node biopsy alone in breast cancer patients. Patients with one or two involved sentinel nodes by micro- or macro-metastases may not require cALND, but further research is needed for those with more than two involved nodes.
Article
Oncology
Anna C. Beck, Monica Morrow
Summary: Although sentinel lymph node biopsy is the preferred method for axillary staging and therapeutic for limited nodal disease, axillary lymph node dissection is still necessary in certain cases and for maintaining local control with heavy axillary tumor burden. Knowledge of the number of involved axillary nodes, obtained through axillary lymph node dissection, is also needed for tailored systemic therapies. Ongoing trials will explore the possibility of radiotherapy as a replacement for axillary lymph node dissection in certain circumstances.
Article
Medicine, General & Internal
Se Hyun Oh, Ju Hyeon Kim, Seung Tae Seong, Jun Young Park, Jae Hyun Lee, Ghi Chan Kim, Ho Joong Jeong, Young Joo Sim
Summary: This study investigated the impact of axillary site radiation therapy on lymphoscintigraphy in breast cancer-related lymphedema patients who underwent sentinel lymph node dissection. The results suggest that both SLND and aRTx affect the activity of axillary lymph nodes and adversely affect lymphatic flow, becoming risk factors for lymphedema. Additionally, lymphedema may develop even in patients with normal lymphoscintigraphy.
Article
Oncology
Zhao Bi, Jia-Jian Chen, Peng-Chen Liu, Peng Chen, Wei-Li Wang, Yan-Bing Liu, Chun-Jian Wang, Peng-Fei Qiu, Qing Lv, Jiong Wu, Yong-Sheng Wang
Summary: This study developed a predictive model based on a multi-center retrospective database to accurately predict whether HR+/HER2- patients can undergo genomic tests. Through multivariate logistic regression analysis, imaging abnormal nodes, the number of positive SLNs, the number of negative SLNs, pathological tumor stage, and lympho-vascular invasion were identified as independent predictors for patients having <= 3 total metastatic ALNs.
FRONTIERS IN ONCOLOGY
(2021)
Article
Oncology
Jennifer Q. Zhang, Giacomo Montagna, Varadan Sevilimedu, Kelly Abbate, Jillian Charyn, Babak Mehrara, Monica Morrow, Andrea Barrio
Summary: This study evaluates the effect of axillary lymph node dissection (ALND) on quality of life (QOL) in breast cancer patients. The results show that QOL scores initially decrease after ALND but improve by 6 months post-surgery. Decreases in QOL were independent of arm volume. Patients with worse QOL were more likely to seek lymphedema therapy, although the effect of therapy on QOL remains unknown.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Oncology
Amparo Garcia-Tejedor, Carlos Ortega-Exposito, Sira Salinas, Ana Luzardo-Gonzalez, Catalina Falo, Evelyn Martinez-Perez, Hector Perez-Montero, M. Teresa Soler-Monso, Maria-Teresa Bajen, Ana Benitez, Raul Ortega, Anna Petit, Anna Guma, Miriam Campos, Maria J. Pla, Sonia Pernas, Judith Penafiel, Carlos Yeste, Miguel Gil-Gil, Ferran Guedea, Jordi Ponce, Maria Laplana
Summary: This study aims to evaluate whether axillary radiotherapy (ART) is non-inferior to axillary lymph node dissection (ALND) in patients with limited lymphatic involvement after neoadjuvant systemic treatment (NST), and whether it reduces surgery-related adverse effects.
FRONTIERS IN ONCOLOGY
(2023)
Article
Surgery
Y. Andersson, L. Bergkvist, J. Frisell, J. de Boniface
Summary: The SENOMIC trial found that omitting axillary lymph node dissection in patients with breast cancer and sentinel node micrometastases had excellent 3-year event-free survival rates. However, patients who underwent mastectomy had worse tumor characteristics and higher risk of recurrence, especially without adjuvant radiotherapy. Long-term follow-up and enrollment of mastectomy patients are crucial.
BRITISH JOURNAL OF SURGERY
(2021)
Editorial Material
Oncology
Himanshu Nagar, Silvia C. Formenti
NATURE REVIEWS CLINICAL ONCOLOGY
(2020)
Editorial Material
Oncology
Himanshu Nagar, Daniel E. Spratt
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2020)
Article
Urology & Nephrology
Vishesh Agrawal, Xiaoyue Ma, Jim C. Hu, Christopher E. Barbieri, Himanshu Nagar
Summary: The optimal treatment for intermediate risk prostate cancer remains unclear. National Comprehensive Cancer Network (NCCN) guidelines suggest active surveillance, prostatectomy, or radiotherapy. This study analyzed U.S. national trends in active surveillance for men with intermediate risk prostate cancer, finding an increasing use of active surveillance with clinical and socioeconomic disparities.
JOURNAL OF UROLOGY
(2021)
Letter
Medicine, General & Internal
Vishesh Agrawal, Xiaoyue Ma, Jim C. Hu, Christopher E. Barbieri, Himanshu Nagar
Article
Oncology
David J. Byun, S. Peter Wu, Himanshu Nagar, Naamit K. Gerber
Summary: This study evaluated the treatment trends and impact on overall survival in young women with pure DCIS. The use of bilateral mastectomy is increasing in younger patients without improving overall survival. Endocrine therapy rates are lower in BM, UM, and BCS-alone groups compared with BCS + RT in ER+ patients.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Editorial Material
Oncology
Himanshu Nagar, Daniel E. Spratt
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Reza Farjam, Sean S. Mahase, Shu Ling Chen, Madeline Coonce, Ryan T. Pennell, Ryan Fecteau, Bilal Chughtai, J. Keith Dewyngaert, Josephine Kang, Silvia Ch Formenti, Himanshu Nagar
Summary: The study found that rectal spacing significantly reduced the maximum dose delivered to the rectum and bladder, and decreased the necessity for adaptive planning. Patients without rectal spacing had a higher rate of dose constraint violation (91%) compared to those with rectal spacer (52%).
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Reza Farjam, Himanshu Nagar, Xi Kathy Zhou, David Ouellette, Silvia Chiara Formenti, J. Keith DeWyngaert
Summary: The study aimed to develop a deep learning model for generating synthetic CT for prostate cancer patients, showing that the U-NET model can generate synthetic CT of different tissue types during training; data augmentation and a specific loss function can improve model accuracy, but training time and image standardization do not significantly affect accuracy.
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
(2021)
Letter
Radiology, Nuclear Medicine & Medical Imaging
Adithya Balasubramanian, Himanshu Nagar, Christopher E. Barbieri, Scott T. Tagawa, Timothy D. McClure
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
(2021)
Review
Oncology
Soumyajit Roy, Nicholas G. Zaorsky, Hilary P. Bagshaw, Alejandro Berlin, Alison Tree, Sandra Turner, Bridget Koontz, Paul Nguyen, Ronald Chen, Robert T. Dess, William C. Jackson, Amar U. Kishan, Bradley Stish, Himanshu Nagar, Edwin Posadas, Phuoc T. Tran, Abhishek Solanki, Neal D. Shore, Gordon Guo, Lee Ponsky, Jonathan E. Shoag, Alicia K. Morgans, Jorge A. Garcia, Timothy N. Showalter, Felix Y. Feng, Daniel E. Spratt
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2022)
Article
Oncology
Juana Martinez, Kritika Subramanian, Daniel Margolis, Elisabeth O'Dwyer, Joseph Osborne, Yuliya Jhanwar, Himanshu Nagar, Nicholas Williams, Arindam RoyChoudhury, Gabriela Madera, John Babich, Sandra Huicochea Castellanos
Summary: PSMA PET/MRI demonstrates a higher detection rate than conventional mpMRI in patients with biochemically recurrent prostate cancer, with consistent results across PSA levels, treatment modalities, and androgen deprivation therapy time. The study findings suggest that PSMA PET/MRI has superior sensitivity compared to mpMRI.
TRANSLATIONAL ONCOLOGY
(2022)
Article
Urology & Nephrology
Mark N. Alshak, Andrew Eidelberg, Susana Martinez Diaz, Michelina D. Stoddard, Silvia Formenti, Himanshu Nagar, Josephine Kang, Bilal Chughtai
Summary: This study aimed to compare lower urinary tract symptoms (LUTS) in men undergoing SBRT with and without SpaceOAR hydrogel. The study found that the use of SpaceOAR was associated with lower rates of post-SBRT urinary frequency and nocturia. There was no significant difference in acute gastrointestinal symptoms. Additionally, the use of alpha-inhibitors was lower in the SpaceOAR group at different time points.
WORLD JOURNAL OF UROLOGY
(2022)
Article
Oncology
Vishesh Agrawal, Xiaoyue Ma, Jim C. Hu, Christopher E. Barbieri, Himanshu Nagar
Summary: This study analyzed the national trends in demographic, clinical, and socioeconomic factors associated with ADT use in men with intermediate-risk prostate cancer who have undergone definitive radiation therapy. The findings showed variable ADT use among men with intermediate-risk prostate cancer, with factors such as age, year of diagnosis, race, insurance type, PSA level, tumor stage, and treatment center influencing its use.
ADVANCES IN RADIATION ONCOLOGY
(2021)
Article
Oncology
Kai Yun Ooi, Ian Pereira, Himanshu Nagar, Richard Simcock, S. Matthew Katz, C. Christopher Parker, Colleen Lawton, Hina Saeed
Summary: This global collaborative review on the postoperative management of prostate cancer suggested a stronger signal for the uptake of early salvage radiation treatment with careful PSA monitoring, more sensitive PSA triggers, and expected access to radiotherapy. Questions still remain on potential exceptions and barriers to use. These require better decision-making tools for all practice settings, consideration of newer technologies, more pragmatic trials, and better use of social media for knowledge translation.
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY
(2021)
Review
Urology & Nephrology
Sean Mahase, Himanshu Nagar
EUROPEAN UROLOGY OPEN SCIENCE
(2020)