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1
Ichaba, Mutuma, and Felix Musau. "Minimizing Routing Overheads in Zone Routing Protocol (ZRP); Replacing Zone Radius with Node Location Information." International Journal of Computer Applications Technology and Research 11, no. 04 (April 2022): 145–54. http://dx.doi.org/10.7753/ijcatr1104.1007.
Повний текст джерелаАнотація:
There are many routing protocols suggested for use in Mobile Ad Hoc Networks (MANETs). Among them (the routing protocols) is the Zone Routing Protocol (ZRP). ZRP uses the concept of zones to ensure that proactive activities are limited to a defined area around a node. The zone is determined by the radius (hops). By limiting a proactive zone on the radius, the transmission of data packets is made effective. However, any node that resides beyond the zone, is reachable reactively. The literature review indicates that one of the shortcomings in ZRP is the overlapping of zones. Furthermore, the exercise of determining zone radius is complicated. The overlapping of zones occurs because individual nodes and their zones are determined by a hop-count radius. Consequently, this overlapping of zones leads to increased routing overhead in ZRP. In an effort to resolve zone overlapping and thus reduce routing overheads, this study suggests the application of the Location-Aided Routing (LAR) Scheme I in the Interzone Routing Protocol (IARP) scheme of ZRP. By applying LAR Scheme 1 algorithm, the need for a hop-count-based radius is eliminated. Location information of nodes in IARP ensures that zones do not overlap, resulting in reduced routing overheads. This study simulates elementary parameters of delay, drop rates, deliver ratio, and the general throughput of ZRP based on the number of nodes, the area, and the size of the data packets. The conventional algorithm of ZRP was rendered on NS-2 and while the nodal-location enhanced ZRP algorithm on OMNET++. Simulation results suggest that the positionally enhanced ZRP algorithm minimizes zonal overlapping hence better data packets throughput, minimized delay and drop rates, and augmented data packets delivery ratio.
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Bai, Bing, Zhenqian Feng, Baokang Zhao, and Jinshu Su. "Benefiting from the community structure in opportunistic forwarding." Computer Science and Information Systems 10, no. 2 (2013): 865–76. http://dx.doi.org/10.2298/csis120921038b.
Повний текст джерелаАнотація:
In Delay Tolerant Networks (DTNs), an end-to-end connectivity cannot be assumed for node mobility and lack of infrastructure. Due to the uncertainty in nodal mobility, routing in DTNs becomes a challenging problem. To cope with this, many researchers proposed opportunistic routing algorithms based on some utilities. However, these simple metrics may only capture one facet of the single node?s mobility process, which cannot reflect the inherent structure of the networks well. Recently, some researchers introduce the Complex network analysis (CNA) to formulate and predict the future contact in DTNs. The community structure is one of the most important properties of CNA. And it reveals the inherent structure of the complex network. In this paper, we present a community-based single-copy forwarding protocol for DTNs routing, which efficiently utilizes the community structure to improve the forwarding efficiency. Simulation results are presented to support the effectiveness of our scheme.
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Chikh, Asma, and Mohamed Lehsaini. "Link Quality and Load Balancing Multipath Geographic Routing for Wireless Multimedia Sensor Networks." International Journal of Wireless Networks and Broadband Technologies 10, no. 1 (January 2021): 45–58. http://dx.doi.org/10.4018/ijwnbt.2021010103.
Повний текст джерелаАнотація:
Multimedia applications in wireless multimedia sensor networks (WMSNs) demand a high level of quality of service (QoS) requirements. The multipath routing approach is considered as an effective solution to meet these requirements. However, the high-energy consumption in WMSNs is a critical concern for lifetime of network contains sensor nodes with limited battery. Many proposed works have designed multipath routing protocols to provide load balancing between discovered paths, although there is a trade-off between power efficiency and data delivery. This paper proposes a link quality and load balancing multipath geographic routing (LQLB-MGR) protocol for WMSNs. This protocol consists of two phases. The first phase is responsible to find multiple node-disjoint paths with high link quality and the second phase allows load balancing between the discovered paths based on nodal residual energy. Simulation results show that LQLB-MGR provides better performance compared to other protocols.
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Das, Priyanka, Prosenjit Chowdhury, Bikash Poudel, and Tanmay De. "Fibonary Spray and Wait Routing in Delay Tolerant Networks." International Journal of Electrical and Computer Engineering (IJECE) 6, no. 6 (December 1, 2016): 3205. http://dx.doi.org/10.11591/ijece.v6i6.10361.
Повний текст джерелаАнотація:
<p>Although there has been a tremendous rise in places being connected through the Internet or any other network protocol, there still lie areas, which remain out of reach due to various reasons. For all such places the answer is a Delay Tolerant Network (DTN). A DTN is such a network where there is no fixed or predefined route for messages and no such guarantee whatsoever of all messages being correctly routed. DTN can be considered as a superset of networks wherein other networks such as adhoc, mobile, vehicular etc. form the subset. Therefore routing in DTN is a very chancy affair where one has to maximize on the present network scenarios to get any fruitful result other than depending on past information. Also protocols here need to be less complex and not increase the already high nodal overhead. In this paper we propose a new approach, the Fibonary Spray and Wait, which does exactly this. It forwards copies of a message in a modified Binary Spray and Wait manner so that it performs well even in non independent and identically distributed node structure. We have supported our statements with mathematical as well as simulation analysis.</p>
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Das, Priyanka, Prosenjit Chowdhury, Bikash Poudel, and Tanmay De. "Fibonary Spray and Wait Routing in Delay Tolerant Networks." International Journal of Electrical and Computer Engineering (IJECE) 6, no. 6 (December 1, 2016): 3205. http://dx.doi.org/10.11591/ijece.v6i6.pp3205-3216.
Повний текст джерелаАнотація:
<p>Although there has been a tremendous rise in places being connected through the Internet or any other network protocol, there still lie areas, which remain out of reach due to various reasons. For all such places the answer is a Delay Tolerant Network (DTN). A DTN is such a network where there is no fixed or predefined route for messages and no such guarantee whatsoever of all messages being correctly routed. DTN can be considered as a superset of networks wherein other networks such as adhoc, mobile, vehicular etc. form the subset. Therefore routing in DTN is a very chancy affair where one has to maximize on the present network scenarios to get any fruitful result other than depending on past information. Also protocols here need to be less complex and not increase the already high nodal overhead. In this paper we propose a new approach, the Fibonary Spray and Wait, which does exactly this. It forwards copies of a message in a modified Binary Spray and Wait manner so that it performs well even in non independent and identically distributed node structure. We have supported our statements with mathematical as well as simulation analysis.</p>
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Alghamdi, Saleh A. "Load balancing maximal minimal nodal residual energy ad hoc on-demand multipath distance vector routing protocol (LBMMRE-AOMDV)." Wireless Networks 22, no. 4 (August 11, 2015): 1355–63. http://dx.doi.org/10.1007/s11276-015-1029-6.
Повний текст джерела
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Avvedimento, Stefania, Sara Todeschini, Carlo Giudicianni, Armando Di Nardo, Tom Walski, and Enrico Creaco. "Flowing Blow-Offs: A Solution to Maintain Adequate Disinfectant Residuals of Dead-End Nodes in WDNs." Proceedings 48, no. 1 (November 12, 2019): 20. http://dx.doi.org/10.3390/ecws-4-06443.
Повний текст джерелаАнотація:
Flushing plans within a water distribution network (WDN) provide a tool for improving disinfectant residuals and removing stagnant water. The problem of low disinfectant residuals occurs in areas of a WDN such as dead-end nodes, in which low flow conditions and long residence times lead to excessive decay of the disinfectant upstream from users. Here, a methodology is presented to maintain adequate disinfectant residuals in WDNs that have numerous dead-end nodes. The slight increase in nodal outflows at these sites, which can be obtained through the opening of a blow-off at the hydrant site, can help in tackling this problem. The methodology is based on the combined use of optimization and of flow routing/water quality modelling. The concentration of disinfectant at the source(s) and the values of nodal emitter coefficients at the critical dead-end nodes are the decisional variables to be optimized. Two objective functions are considered in the optimization, namely the total volume of water delivered in the network and the total mass of disinfectant injected into the network. The effectiveness of the methodology is proven on a real WDN, yielding an insight into the economic feasibility of the solution.
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Mohanaprakash, K., and T. GunaSekar. "Efficient and Secure Remote Health Management in Cloud in Vehicular Adhoc Network Environment." Journal of Medical Imaging and Health Informatics 11, no. 12 (December 1, 2021): 2966–75. http://dx.doi.org/10.1166/jmihi.2021.3905.
Повний текст джерелаАнотація:
Vehicle Ad Hoc Networks (VANETs) is a crucial communications framework for transferring messages between any healthcare systems. The dilemma of fixing the safest efficient route is a tedious issue in VANET. Hence the secure and most reliable way will give the appropriate solution for the routing issues in the VANET. In this paper, by using the Multi-Objective Bio-inspired Heuristic Cuckoo Search Node optimization algorithm is designed to find the efficient safest route for transferring health data within a short period. After seeing the efficient route, the node can be distinguished upon the traffic and security by using the Stochastic Discriminant Random Forest Node Classifier. Then in the selected route, the nodal distance can be calculated by applying the delay-based weighted end-to-end approach for traffic analysis. Then the authentic vehicle node can be analyzed through the Trust Aware extreme Gradient Boosting Node Classification based Secured Routing (TAXGBNC-SR) Technique. The obtained information that can be stored in the cloud. It deal with the multiple number of tasks gives to the ARM micro-controllers in order to perform the multiple tasks that gets logged in the cloud via Internet of Things technology (Iot).
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Latif, Kamran, Nadeem Javaid, Imdad Ullah, Zeeshan Kaleem, Zafar Abbas Malik, and Long D. Nguyen. "DIEER: Delay-Intolerant Energy-Efficient Routing with Sink Mobility in Underwater Wireless Sensor Networks." Sensors 20, no. 12 (June 19, 2020): 3467. http://dx.doi.org/10.3390/s20123467.
Повний текст джерелаАнотація:
Underwater Wireless Sensor Networks (UWSNs) are an enabling technology for many applications in commercial, military, and scientific domains. In some emergency response applications of UWSN, data dissemination is more important, therefore these applications are handled differently as compared to energy-focused approaches, which is only possible when propagation delay is minimized and packet delivery at surface sinks is assured. Packet delivery underwater is a serious concern because of harsh underwater environments and the dense deployment of nodes, which causes collisions and packet loss. Resultantly, re-transmission causes energy loss and increases end-to-end delay ( D E 2 E ). In this work, we devise a framework for the joint optimization of sink mobility, hold and forward mechanisms, adoptive depth threshold ( d t h ) and data aggregation with pattern matching for reducing nodal propagation delay, maximizing throughput, improving network lifetime, and minimizing energy consumption. To evaluate our technique, we simulate the three-dimensional (3-D) underwater network environment with mobile sink and dense deployments of sensor nodes with varying communication radii. We carry out scalability analysis of the proposed framework in terms of network lifetime, throughput, and packet drop. We also compare our framework to existing techniques, i.e., Mobicast and iAMCTD protocols. We note that adapting varying d t h based on node density in a range of network deployment scenarios results in a reduced number of re-transmissions, good energy conservation, and enhanced throughput. Furthermore, results from extensive simulations show that our proposed framework achieves better performance over existing approaches for real-time delay-intolerant applications.
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Noureddine, Seddiki, Benahmed Khelifa, and Belgachi Mohammed. "Approach to minimizing consumption of energy in wireless sensor networks." International Journal of Electrical and Computer Engineering (IJECE) 10, no. 3 (June 1, 2020): 2551. http://dx.doi.org/10.11591/ijece.v10i3.pp2551-2561.
Повний текст джерелаАнотація:
The Wireless Sensor Networks (WSN) technology has benefited from a central position in the research space of future emerging networks by its diversity of applications fields and also by its optimization techniques of its various constraints, more essentially, the minimization of nodal energy consumption to increase the global network lifetime. To answer this saving energy problem, several solutions have been proposed at the protocol stack level of the WSN. In this paper, after presenting a state of the art of this technology and its conservation energy techniques at the protocol stack level, we were interested in the network layer to propose a routing solution based on a localization aspect that allows the creation of a virtual grid on the coverage area and introduces it to the two most well-known energy efficiency hierarchical routing protocols, LEACH and PEGASIS. This allowed us to minimize the energy consumption and to select the clusters heads in a deterministic way unlike LEACH which is done in a probabilistic way and also to minimize the latency in PEGASIS, by decomposing its chain into several independent chains. The simulation results, under "MATLABR2015b", have shown the efficiency of our approach in terms of overall residual energy and network lifetime.
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Khayyat, Ahmad, and Ahmed Safwat. "The Synchronized Peer-to-Peer Framework and Distributed Contention-Free Medium Access for Multihop Wireless Sensor Networks." Journal of Sensors 2008 (2008): 1–28. http://dx.doi.org/10.1155/2008/728415.
Повний текст джерелаАнотація:
IEEE 802.15.4 is a low-power, low-rate MAC/PHY standard that meets most of the stringent requirements of singlehop wireless sensor networks. Sensor networks with nodal populations composed of thousands of devices have been envisioned in conjunction with environmental, vehicular, military applications, and many others. However, such large sensor network deployments necessitate multihop support as well as low power consumption. In the light of the standard's extremely limited joint support of the two aforementioned attributes, this paper presents two essential contributions. First, a framework is proposed to implement a new IEEE 802.15.4 operating mode, namely, thesynchronized peer-to-peermode. This mode is designed to enable the standard's low-power features in peer-to-peer multihop-ready topologies. The second contribution is a distributed GTS(dGTS)management scheme designed to function in the newly devised network mode. This protocol provides reliable contention-free access in peer-to-peer topologies in a completely distributed manner. Assuming optimal routing, our simulation experiments reveal perfect delivery ratios as long as the traffic load does not reach or surpass its saturation threshold. dGTS sustains at least twice the delivery ratio of contention-based access under suboptimal dynamic routing. Moreover, the dGTS scheme exhibits minimum power consumption by eliminating the retransmissions attributed to contention, which, in turn, reduces the number of transmissions to a minimum.
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Mazinani, Sayyed Majid, and Sara Moshtaghi. "A NEW SPECTRUM AND ENERGY AWARE ROUTING PROTOCOL IN COGNITIVE RADIO SENSOR NETWORK." IIUM Engineering Journal 19, no. 2 (December 1, 2018): 118–33. http://dx.doi.org/10.31436/iiumej.v19i2.927.
Повний текст джерелаАнотація:
ABSTRACT: Cognitive radio sensor network (CRSN) is a new generation of communication systems that wants to solve the overcrowded spectrum utilization of the unlicensed bands. It has combined sensor networks and cognitive radio technology, so it has the challenges of energy restriction of sensors and also dynamic spectrum access of the cognitive radio network. On the other hand, considering both of these challenges in the routing protocol plays a basic role in network performance and we can’t apply the routing protocols that have been proposed for wireless sensor networks and cognitive radio networks, separately, in the CRSN. Therefore, this article has tried to provide a new spectrum and energy-aware routing protocol in which the source is able to choose the most stable route in the aspect of node residual energy or spectrum access probability. Not only can considering the nodal residual energy and spectrum access in the route discovery process avoid repetitive link failure, but it also can increase the network lifetime. This protocol has been compared with ESAC, SCR, ERP, and SER. The result of this comparison has shown that our protocol reduces end-to-end delay, control overhead, throughput, and lifetime in comparison to other protocols, especially in small-scale networks.
ABSTRAK: Rangkaian sensor radio kognitif (CRSN) adalah generasi baru sistem telekomunikasi bagi menyelesaikan masalah kesesakan pada pemakaian band spektrum tidak berlesen. Ianya adalah kombinasi rangkaian sensor dan teknologi radio kognitif. Oleh itu, ia mempunyai cabaran sekatan tenaga pada sensor dan kemasukan spektrum secara dinamik pada rangkaian radio kognitif. Pada masa sama, dengan mengambil kira kedua-dua cabaran pada protokol rangkaian ini telah memainkan peranan asas pada prestasi rangkaian dan kami tidak boleh mengguna pakai protokol rangkaian yang telah diguna pakai pada rangkaian sensor tanpa wayar dan rangkaian radio kognitif secara asing dalam CRSN. Oleh itu, artikel ini cuba menyediakan spektrum baru dan pengawasan tenaga pada protokol rangkaian, di mana sumber boleh memilih laluan rangkaian yang stabil dengan mengambil kira pada aspek baki tenaga nod atau kebarangkalian akses spektrum. Selain itu, ianya dapat mengelakkan kegagalan laluan berulang juga menambahkan jangka hayat rangkaian. Protokol ini telah dibandingkan dengan ESAC, SCR, ERP dan SER. Perbandingan keputusan menunjukkan protokol ini mengurangkan kelewatan hujung-ke-hujung, mengawal kesesakan, mambaiki jumlah penghantaran dan menambah tempoh hayat berbanding protokol lain, khususnya pada rangkaian skala kecil.
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Avvedimento, Stefania, Sara Todeschini, Sauro Manenti, and Enrico Creaco. "Comparison of Techniques for Maintaining Adequate Disinfectant Residuals in a Full-Scale Water Distribution Network." Water 14, no. 7 (March 24, 2022): 1029. http://dx.doi.org/10.3390/w14071029.
Повний текст джерелаАнотація:
The present work provides a numerical comparison of different techniques that can be adopted to guarantee sufficient disinfectant residuals in a water distribution network (WDN) when chlorine or chloramine is used as disinfectant. First, while considering chlorine as a disinfectant, the implementation of booster stations in bulk areas and continuous outflows at dead-end nodes was considered. Afterward, the comparison between continuous and intermittent outflows was performed. The water volume being the same, water is provided through blowoffs for 24 h or for limited durations, respectively. Finally, the extent to which the results change was analyzed when chloramine is used instead of chlorine. The methodology is based on the use of the flow routing/water quality modeling software EPANET and its multispecies extension EPANET-MSX on a full-scale WDN. The results show that all the operational measures analyzed are effective to tackle the problem of low disinfectant residuals in WDN. Booster stations are effective to obtain a more uniform distribution of disinfectant throughout the WDN, while nodal blowoffs seem to be a necessary solution for the numerous and scattered dead-end nodes of WDN. The use of chloramine yielded a decrease in the number of blowoffs to open and in blowoff outflows.
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Kennecke, Hagen F., Caroline H. Speers, Catherine A. Ennis, Karen Gelmon, Ivo A. Olivotto, and Malcolm Hayes. "Impact of Routine Pathology Review on Treatment for Node-Negative Breast Cancer." Journal of Clinical Oncology 30, no. 18 (June 20, 2012): 2227–31. http://dx.doi.org/10.1200/jco.2011.38.9247.
Повний текст джерелаАнотація:
Purpose Routine secondary pathology review influences diagnosis and treatment among patients diagnosed with breast cancer. The impact of review on patients with node-negative breast cancer and the nature of the pathology elements leading to management changes are not well described. Methods Patients with node-negative, invasive, or in situ breast cancer and evaluable nodes referred to the British Columbia Cancer Agency during two time periods between 2004 and 2007 were included. Pathologists with expertise in breast cancer reviewed the original reports and slides. Biomarker testing was not routinely repeated. Medical record review was conducted to determine whether original pathology was changed and whether recommended therapy was affected. Results Among 906 eligible patients, 405 (45%) received a pathology review. Univariate comparisons revealed that reviewed patients were younger (P < .001) and more likely to have close margins (P < .001), whereas other characteristics were similar. A total of 102 pathology changes were documented among 81 patients (20%). The most frequently changed elements were grade (40%) and lymphovascular (26%), nodal (15%), and margin (12%) status. These changes resulted in 27 treatment modifications among 25 patients (6%). Treatment changes were primarily related to nodal and margin status, and only two of 27 were related to measurement of tumor biology in women with estrogen receptor–positive, node-negative breast cancer. Conclusion Reported rates of change are significant and warrant routine secondary pathology review among patients with node-negative breast cancer or ductal carcinoma in situ before final treatment is recommended. Review remains relevant in the era of gene expression signatures to determine margin and nodal status.
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Gubbala, Phanedra K., Alexandros Laios, Zhe Wang, Sunanda Dhar, Pubudu J. Pathiraja, Krishnayan Haldar, and Sean T. Kehoe. "Routine Intraoperative Frozen Section Examination to Minimize Bimodal Treatment in Early-Stage Cervical Cancer." International Journal of Gynecologic Cancer 26, no. 6 (July 2016): 1148–53. http://dx.doi.org/10.1097/igc.0000000000000738.
Повний текст джерелаАнотація:
ObjectiveIn early-stage cervical cancer, single modality therapy is the main objective, to minimize patient morbidity while offering equivalent cure rates. Intraoperative frozen section examination (FSE) of lymph nodes (LNs) can facilitate this aim, ensuring that radical surgery is avoided in patients requiring adjuvant therapy for metastatic LN involvement. We aimed to evaluate the accuracy of routine intraoperative FSE of pelvic LNs during the surgical staging of early-stage cervical cancers and identify a group at low risk for nodal metastases.MethodsA retrospective cohort study of 94 women aged 23 to 80 years who underwent primary surgery and planned intraoperative FSE of the pelvic LNs at the gynecological cancer center in Oxford was performed. The diagnostic value of FSE and the prediction of metastatic nodal disease were assessed by use of preoperative and intraoperative variables.ResultsA total of 1825 LNs were submitted for FSE. Of 94 women (13.8%), 13 had positive LNs at FSE. Two false-negative cases were reported with micrometastases but no false-positive cases. Frozen section examination as a diagnostic test reached a sensitivity of 86.7% and a specificity of 100%. A regression model including grade I to II and tumor size of less than 20 mm identified a low-risk group for LN involvement.ConclusionsIn light of diverse practice patterns, FSE should be routinely offered to women with early-stage cervical cancer in a 1-step protocol. We equally devised a model to predict those patients at least risk of nodal disease, who may be spared of FSE.
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Epstein, R. "Is routine axillary nodal dissection necessary in the treatment of breast cancer?" European Journal of Cancer 32, no. 9 (August 1996): 1461–63. http://dx.doi.org/10.1016/s0959-8049(96)90056-8.
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Barr, L. "Is routine axillary nodal dissection necessary in the treatment of breast cancer?" European Journal of Cancer 32, no. 9 (August 1996): 1463. http://dx.doi.org/10.1016/s0959-8049(96)90057-x.
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Fentiman, I. S. "Is routine axillary nodal dissection necessary in the treatment of breast cancer?" European Journal of Cancer 32, no. 9 (August 1996): 1460–61. http://dx.doi.org/10.1016/0959-8049(95)00656-7.
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Pagani, O., M. Ruggeri, T. Rusca, R. Graffeo, E. Gallerani, M. Locatelli, M. Conti Beltraminelli, S. Longhi, L. Mazzucchelli, and A. Goldhirsch. "Does HER2/neu expression affect adjuvant treatment choices in routine clinical practice?" Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 10667. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.10667.
Повний текст джерелаАнотація:
10667 Background: HER2/neu (HER2) amplification is a recognized independent prognostic and predictive factor. We retrospectively examined the correlation between HER2 expression and adjuvant therapy in patients (pts) with early breast cancer (EBC) at our Institution (IOSI). Materials and Methods: From January 2003, 326 consecutive pts with EBC have been treated at IOSI and all clinical and pathological data have been prospectively collected into a specifically designed data base (CARMA). HER2 expression was assessed by the c-erbB-2 oncoprotein antibody (NCL-L-CB11) in 309 pts (95%). FISH was not routinely performed. Endocrine responsiveness (ER+) is defined as Er and/or PgR expression by immunohistochemistry. Results: Overall, 58 pts (19%) had HER2+ disease. FISH was performed in 15 pts (24%) with doubtful antibody overexpression (2+) and did not confirm HER2 amplification in 4 cases (27%). Nodal involvement was not assessed in 1 HER2+ (2%) and in 12 HER2- pts (5%) due to advanced age. Menopausal status did not differ in HER2 positive and negative pts (29% and 27% premenopausal pts, respectively). The distribution of adjuvant chemotherapy (CT) according to tumour characteristics in HER2 positive and negative pts was as follows: An anthracycline-containing regimen was chosen in 88% of HER2+ pts receiving adjuvant CT as compared to 70% of HER2- pts. Outside of a clinical trial adjuvant Tamoxifen was given to 57% of HER2+/ER+ pts as compared to 75% of HER2−/ER+ pts. Conclusions: Overall, HER2+ pts showed less endocrine responsiveness (64% versus 88%) and more extensive nodal involvement (43% versus 30% with >3 positive nodes) as compared to HER2− pts. A greater proportion of HER2+ women received adjuvant CT, irrespective of other prognostic and predictive factors. In particular, a significant higher proportion of HER2+ pts with minimal nodal involvement (1–3 positive nodes) and ER+ disease received CT as compared to the equivalent HER2- subset (45% versus 26%, respectively). [Table: see text] No significant financial relationships to disclose.
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Serra, M., L. Cirera, R. Rami-Porta, R. Bastus, S. Gonzalez, M. Simó, M. Domenech, E. Barbeta, J. M. Soler, and J. Belda. "Routine positron emission tomography (PET) and selective mediastinoscopy is as good as routine mediastinoscopy to rule out N2 disease in non-small cell lung cancer (NSCLC)." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 7031. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.7031.
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7031 Background: To evaluate the presence of mediastinal lymph node spread of NSCLC after changing the clinical staging protocol from routine to selective surgical mediastinal exploration (SME) based on PET. Methods: From 1994 to 2003, routine SME (mediastinoscopy, parasternal mediastinotomy or extended cervical mediastinoscopy) was performed to 655 patients (pts) with NSCLC as the last clinical staging procedure prior to thoracotomy. Those with no mediastinal involvement underwent thoracotomy with lung resection (T) and systematic nodal dissection (SND). From 2004, PET was routinely done in 90 pts and SME was reserved for those with positive mediastinal or hiliar uptake on PET, mediastinal lymph node diameter greater than 1cm in shorter axis on computerized tomography, and in tumors contacting with the mediastinum. All other pts and those with negative SME underwent T and SND. Results: Among 655 pts studied between 1994 and 2003, 236 (36%) had positive SME; 419 underwent T and SND and 40 (6.1%) were classsified as pN2. Of the 90 evaluable pts with PET, 27 had increased uptake in the mediastinum an 17 had positive SME; the remaining 10 ptes with negative SME underwent T and SND and 7 of them were found to have no nodal disease (false positive PET), but three of them were found to have nodal disease. Of the 63 pts with no uptake in the mediastinum, 29 underwent SME for reasons stated above: 5 SME was positive; in 24 SME was negative and the patients underwent T and SND: 21 were pN0 and 3 were pN2. Only 1 tumor of the remaining 34 pts with negative PET who underwent T and SND without SME was classified pN2. Additionally, in 1 pt PET detected N2 disease but not N3. 4 (4.5%) pts with pN2 disease were clinically understaged (negative PET and negative SME) and underwent thoracotomy. 3 pts with positive PET who underwent SME were classified pN0, but they were pN2 (false negative SME). In total, 7 (7.8%) pts with pN2 disease were clinically understaged and underwent T. This rate is not statisticallly different from the 6.1% pN2 tumor found after routine SME. Conclusions: In this preliminary study, this new clinical staging protocol with routine PET and selective SME saves up to 35% of SME and yields a similar rate of pN2 disease compared to routine SME. No significant financial relationships to disclose.
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Komine, M., K. Kawasako, M. Okamoto, K. Matsuda, K. Hirayama, K. Takehana, M. Koiwa, T. Kurosawa, and H. Taniyama. "Epithelioid Cells in Mediastinal Lymph Nodes of Cattle without Cancer." Veterinary Pathology 46, no. 3 (January 27, 2009): 430–38. http://dx.doi.org/10.1354/vp.08-vp-0166-t-fl.
Повний текст джерелаАнотація:
Epithelioid cells are found in lymph nodes in cases of metastatic carcinoma; however, epithelioid cells with benign features have also been discovered incidentally in lymph nodes. Epithelioid cells were observed in mediastinal lymph nodes of cattle without cancer during routine diagnostic necropsy. To explain this finding, the authors evaluated the prevalence and histopathologic, immunohistochemical, and ultrastructural features retrospectively using mediastinal lymph nodes from 110 cattle and found that 66 of the lymph nodes contained epithelioid cells. In all 66 nodes, most of the epithelioid cells were individual or aggregated in nodal sinuses; in 21 nodes, some epithelioid cells formed tubular structures. The individual and aggregated epithelioid cells were mostly considered to be mesothelial in origin by immunohistochemical and ultrastructural examination; presumably, they entered the lymph nodes via lymphatic vessels, because they were found in afferent lymphatic vessels and nodal sinuses. Although the presence of epithelioid cells in lymph nodes prompts suspicion of metastatic carcinoma, the epithelioid cells in these bovine lymph nodes did not disrupt nodal architecture, lacked atypia or mitotic figures, and did not invade nodal parenchyma.
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Martín-Aguilar, Lorena, Elba Pascual-Goñi, Cinta Lleixà, Marina Frasquet, Herminia Argente, Angel Cano-Abascal, Jordi Diaz-Manera, et al. "Antibodies against nodo-paranodal proteins are not present in genetic neuropathies." Neurology 95, no. 4 (February 26, 2020): e427-e433. http://dx.doi.org/10.1212/wnl.0000000000009189.
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ObjectiveTo study the presence of nodal and paranodal immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies in patients with genetic neuropathies.MethodsA total of 108 patients with genetic neuropathies from 3 different centers were included. The presence of IgG and IgM antibodies against neurofascin-155 (NF155), nodal neurofascin (NF186 and NF140), and contactin-1 (CNTN1) were investigated with a cell-based assay (CBA) using immunocytochemistry in transfected HEK293 cells. Sera with positive or uncertain results were further tested by ELISA and immunohistochemistry in pig teased-nerve fibers.ResultsSix patients with Charcot-Marie-Tooth disease (CMT) had an uncertain staining pattern for IgM against nodal neurofascin that was not confirmed by ELISA. Two patients with CMT had an uncertain staining pattern for IgG against nodal neurofascin that was not confirmed by ELISA or immunohistochemistry. One patient with CMT with a confirmed GJB1 mutation tested positive for IgG against NF155 by CBA and ELISA (1/900), but was not confirmed by immunohistochemistry and was ultimately classified as negative.ConclusionsAntibodies against nodal or paranodal antigens were not detected in our cohort of patients with CMT, as previously reported. Some patients may falsely test positive for any of the techniques; confirmatory techniques should be incorporated into the routine testing.
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Tanboga, Ibrahim Halil, Mustafa Kurt, Tayyar Gökdeniz, Turgay Isik, Mehmet Ekinci, Ahmet Kaya, Enbiya Aksakal, and Serdar Sevimli. "Is routine echocardiography necessary after catheter ablation of atrioventricular nodal re-entrant tachycardia?" Cardiology Journal 19, no. 3 (May 30, 2012): 274–77. http://dx.doi.org/10.5603/cj.2012.0049.
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Glover, A. R., C. P. Allan, M. J. Wilkinson, D. C. Strauss, J. M. Thomas, and A. J. Hayes. "Outcomes of routine ilioinguinal lymph node dissection for palpable inguinal melanoma nodal metastasis." British Journal of Surgery 101, no. 7 (April 22, 2014): 811–19. http://dx.doi.org/10.1002/bjs.9502.
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Clark, Leslie Horn, Emily Meichun Ko, Victoria Lin Bae-Jump, and Paola A. Gehrig. "Risk factors for nodal metastasis in women with grade 3 endometrial cancer." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e15511-e15511. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e15511.
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e15511 Background: No studies have reported on the association of nodal metastases and lower uterine segment (LUS) in grade 3 endometrial cancer. Our study aimed to determine the frequency of nodal metastasis in these high-risk patients stratified by LUS involvement. Methods: A retrospective analysis was conducted on grade 3 endometrial cancer cases from 2005-2010. Statistical analyses were performed using summary frequencies and multivariate logistic regression analysis, with two-tailed p values of <0.05 considered significant. Results: 329 cases were identified. 80.9% women underwent retroperitoneal node dissection, of whom 95.1% underwent pelvic (P) node dissection and 85.3% underwent periaortic (PA) node dissection. Of the women who had nodal dissection, mean age was 65.3 and BMI 31.1. Histology included 33.5% endometrioid, 49.3% serous or clear cell, and 15.4% carcinosarcoma. Stage distribution included 57.6% stage I, 8.0% stage II, 29.8% stage III, and 4.6% stage IV. Of LUS+ cases, 42% (56/132) had nodal metastases, in contrast to 12.7% (17/134) of LUS- cases. Sensitivity of + nodes by LUS was 76.6%, with a specificity of 60.6%, positive predictive value of 42.4%, and negative predictive value of 87.3%. Of LUS+ cases, 49/123 (39.8%) had +P nodes; 27/106 (21.8%) +PA nodes; and 21/100 (21%) had both +P/PA nodes. Of LUS- cases, 15/130 (11.5%) had +P nodes; 7/121 (5.8%) +PA nodes; and 4/121(3.3%) had both +P/PA nodes. Confirming the above findings, when adjusting for myometrial invasion and lymphovascular invasion, overall nodal status, +P nodal status and PA nodal status were independently associated with LUS (p<0.000; p=0.001; p=0.003 respectively). Conclusions: There is debate regarding the utility of lymph node assessment in women with endometrial cancer. However, women with grade 3 endometrial cancer are at high risk for nodal involvement. This information is critical in determining post-operative adjuvant therapy. This data suggests women with grade 3 endometrial cancer, particularly those with lower uterine segment involvement, should undergo routine lymphadenectomy due to the high risk of nodal involvement.
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Vazquez-Sequeiros, Enrique, Michael J. Levy, Jonathan E. Clain, David A. Schwartz, Gavin C. Harewood, Diva Salomao, and Maurits J. Wiersema. "Routine vs. selective EUS-guided FNA approach for preoperative nodal staging of esophageal carcinoma." Gastrointestinal Endoscopy 63, no. 2 (February 2006): 204–11. http://dx.doi.org/10.1016/j.gie.2005.08.053.
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AbdRabo, Ayman AbdAllah, Mohamed Fayek Mahfouz, Ahmed Adel Darwish, and Ahmed Yosry AbdulAleem Ammar. "The Evaluation of Routine Central Nodal Dissection in Radiologically Node Negative Differentiated Thyroid Carcinoma." Egyptian Journal of Hospital Medicine 73, no. 1 (October 1, 2018): 5709–14. http://dx.doi.org/10.21608/ejhm.2018.11766.
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Ferrari, A., G. Bisogno, M. Casanova, C. Meazza, L. Piva, G. Cecchetto, I. Zanetti, et al. "Paratesticular Rhabdomyosarcoma: Report From the Italian and German Cooperative Group." Journal of Clinical Oncology 20, no. 2 (January 15, 2002): 449–55. http://dx.doi.org/10.1200/jco.2002.20.2.449.
Повний текст джерелаАнотація:
PURPOSE: We report the experience of the German-Italian Cooperative Group with 216 pediatric patients with paratesticular rhabdomyosarcoma treated over 20 years. PATIENTS AND METHODS: At diagnosis, 198 patients had localized disease and 18 had distant metastases. Among the nonmetastatic patients, complete tumor resection was performed in 83% of cases. Evaluation of the retroperitoneal lymph nodes changed over the years from routine surgical staging to radiologic assessment. All patients received chemotherapy, which was reduced in intensity and duration for patients with low-risk features in subsequent protocols. Radiotherapy was administered to 10% of patients. RESULTS: Among 72 patients with a negative retroperitoneal computed tomography (CT) scan, surgical assessment detected nodal involvement in only one case. Among 23 patients with enlarged nodes on CT scans, surgery confirmed nodal spread in 65% of patients. No differences in the rate of nodal involvement were observed over the years. With a median follow-up of 110 months, 5-year survival was 85.5% for the series as a whole, 94.6% for patients with localized disease, and 22.2% for metastatic cases. Retroperitoneal nodal recurrence was the major cause of treatment failure. Univariate analysis revealed the prognostic value of tumor invasiveness, size, and resectability, as well as of nodal involvement and age, in patients with localized tumor. CONCLUSION: The outcome for patients with localized paratesticular rhabdomyosarcoma is excellent, despite the reduction in chemotherapy over the years: an alkylating agent–free and anthracycline-free regimen is adequate treatment for low-risk patients. Surgical assessment of the retroperitoneum must be reserved for patients with enlarged nodes on CT scans. Children over 10 years old carry a higher risk of nodal involvement and relapse.
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Wong, Jan H., Susan Steinemann, Paul Tom, Shane Morita, and Pamela Tauchi-Nishi. "Volume of Lymphatic Metastases Does Not Independently Influence Prognosis in Colorectal Cancer." Journal of Clinical Oncology 20, no. 6 (March 15, 2002): 1506–11. http://dx.doi.org/10.1200/jco.2002.20.6.1506.
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PURPOSE: To evaluate the prognostic relevance of the volume of nodal metastatic disease in colorectal cancer patients. PATIENTS AND METHODS: One hundred node-positive patients with T2 or T3 carcinoma of the colon or rectum after routine histologic examination of the regional nodes were studied. The metastatic tumor was measured with an ocular micrometer, and the tumor volume was determined. RESULTS: The mean lymph node metastatic tumor volume was 5.1 ± 4.99 mm3 (range, 0.05 to 83,434 mm3). There was only a weak positive correlation with number of nodes involved with metastatic disease and tumor volume in nodes (r = .45). Median follow-up was 39 months (range, 1 to 87 months). The number of nodes was highly predictive of outcome. Individuals with one to three positive nodes had a substantially better survival than individuals with four or more positive nodes (P < .001). The volume of nodal metastatic disease correlated with outcome (P = .019). Patients dying as a result of disease had substantially greater mean metastatic nodal volume than those who were alive (3,705 v 1,783 mm3; P = .036). However, the total metastatic nodal volume did not, independent of positive nodes or number of positive nodes, predict outcome. Individuals with micrometastatic nodal volume did not have improved survival when compared with individuals with macrometastatic nodal volume (P = .79). CONCLUSION: The number of nodes involved with metastatic tumor, rather the volume of metastatic involvement of the regional lymph nodes, predicts outcome. These results suggest that micrometastatic disease may have a similar prognosis as macrometastatic disease when the same number of lymph nodes are involved with metastatic tumor.
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Sharma, S., D. A. Chaukar, M. Bal, and A. K. D'Cruz. "Is routine neck dissection warranted at salvage laryngectomy?" Journal of Laryngology & Otology 135, no. 9 (July 9, 2021): 785–90. http://dx.doi.org/10.1017/s0022215121001808.
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AbstractBackgroundThere is controversy regarding management of the neck at salvage laryngectomy. The aim of this study was to perform an analysis to determine the incidence of occult node positivity in this group and analyse factors affecting it.MethodA retrospective analysis of 171 patients who underwent salvage total laryngectomy between 2000 and 2015 for recurrent or residual disease following definitive non-surgical treatment and were clinico-radiologically node negative at the time salvage laryngectomy was carried out.ResultsA total of 171 patients with laryngeal or hypopharyngeal cancers underwent concurrent neck dissection at laryngectomy. There were 162 patients (94.7 per cent) who underwent bilateral neck dissection, and 9 patients (5.3 per cent) who underwent ipsilateral neck dissection. The occult lateral nodal metastasis rate was 10.5 per cent. Of various factors, initial node positive disease was the only factor predicting occult metastasis on univariable and multivariable analysis (p = 0.001).ConclusionRisk of occult metastasis is high in patients who have node positive disease before starting radiotherapy. This group should be offered elective neck dissection.
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Unger, J. B., D. L. Lilien, G. Caldito, J. J. Ivy, A. Charrier, and B. Bellaire. "The prognostic value of pretreatment 2-(18F)-fluoro-2-deoxy-D-glucose positron emission tomography scan in women with cervical cancer." International Journal of Gynecologic Cancer 17, no. 5 (September 2007): 1062–67. http://dx.doi.org/10.1111/j.1525-1438.2007.00902.x.
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There is substantial risk that prognosis determined with routine clinical staging for cervical cancer may be inaccurate. This is primarily due to understaging due to the lack of detection of nodal disease. This is particularly true for para-aortic nodal metastases. Treatment based on such staging may also be inadequate for the same reason. Positron emission tomography (PET) has been demonstrated to be useful in the staging of cervical cancer and superior to either computed tomography or magnetic resonance imaging in the detection of nodal disease. Our objective was to determine the prognostic value of pretreatment 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) PET scan in women with cervical cancer. We reviewed the records of 56 women with cervical cancer who underwent FDG PET scan prior to treatment. The primary outcome was the effect of abnormal FDG uptake consistent with metastatic nodal disease on 20-month disease-free survival. The pretreatment PET scan demonstrated abnormal FDG uptake in the pelvic nodes alone in 14 (25%) women, in pelvic and para-aortic nodes in 10 (17.9%), and in neither pelvic nor para-aortic nodes in 32 (57.1%). Women with positive pelvic nodes by PET as well as women with positive para-aortic nodes had significantly poorer 20-month disease-free survival compared to women with negative nodes (P= 0.0003 and P= 0.0017, respectively). We conclude that pretreatment FDG PET scan revealing abnormal FDG uptake consistent with nodal disease is a robust predictor of disease recurrence and may alter the therapeutic management of some patients.
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Barry, M., and M. R. Kell. "Profile of axillary nodal disease from the Irish National Breast Cancer Screening Program in the era of sentinel node biopsy." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e11629-e11629. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e11629.
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e11629 Introduction: Ireland offers a socialized national breast cancer screening program (Breastcheck) to women between 50 and 65 years of age with the aim of reducing breast cancer mortality. Historical axillary staging for screen detected breast cancer has shown nodal positivity in 25% of cases. This study examines axillary nodal disease from the Irish national breast cancer screening program in the era of sentinel lymph node biopsy (SLNB). Methods: Patients with clinically and radiologically early stage screen detected breast cancer and negative axillae are offered therapeutic surgery with SLNB. We examined prospective Breastcheck data collected from 2006 and 2007. Results: 136,527 women attended for routine screening and from these 574 invasive breast cancers were detected. 55 (9.6%) were clinically/radiologically axillary node positive at diagnosis. 519 clinically node negative patients proceeded to therapeutic surgery with SLNB, 113 (22%) were found to have a positive SLNB. Overall nodal positivity was 29.3% in this asymptomatic population. We examined tumour characteristics, hormone profile and HER-2 status from the SLNB group and tumor size was the only factor significantly associated with a positive SLNB (20.1mm vs. 14.3mm, p, 0.01). Conclusions: SLNB accurately detects axillary nodal disease from a purely screen detected population. Based on historic data, SLNB is superior to axillary sampling in this population. No significant financial relationships to disclose.
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Ide, Taketoshi, Takamichi Ito, Maiko Wada-Ohno, and Masutaka Furue. "Preoperative Screening CT and PET/CT Scanning for Acral Melanoma: Is it Necessary?" Journal of Clinical Medicine 10, no. 4 (February 17, 2021): 811. http://dx.doi.org/10.3390/jcm10040811.
Повний текст джерелаАнотація:
The efficacy of preoperative imaging for acral melanoma (AM) has not been fully evaluated. We examined the accuracy of imaging modalities in the detection of nodal and distant metastases in patients with AM. A retrospective review of 109 patients with AM was performed. All patients had no clinical signs suggestive of distant metastases, and underwent preoperative screening computed tomography (CT) and positron emission tomography (PET)/CT scans. Of 100 patients without lymphadenopathy, 17 patients were suspected of having nodal metastasis in CT and PET/CT, but only two of them were confirmed on histopathological analysis. On the other hand, 12 out of 83 negatively imaged patients showed histopathological signs of nodal metastasis; thus, the sensitivity and specificity of nodal detection were 14.3% and 82.6%, respectively. Regard to the detection of distant metastases, four patients were suspected of having metastasis, but this was later ruled out. The remaining 96 negatively imaged patients were confirmed to have no metastasis at the time of CT and PET/CT by the follow-up. In contrast, distant metastases were found by CT and PET/CT in four of nine patients (44.4%) with lymphadenopathy. Routine preoperative CT and PET/CT for AM patients without lymphadenopathy may not be warranted because of low sensitivity and specificity, but it can be considered for those with lymphadenopathy.
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Tanboga, I. H., M. Kurt, T. Gokdeniz, T. Işik, M. Ekinci, A. Kaya, E. Aksakal, and S. Sevimli. "PP-321 IS ROUTINE ECHOCARDIOGRAPHY NECESSARY AFTER CATHETER ABLATION OF ATRIOVENTRICULAR NODAL RE-ENTRANT TACHYCARDIA?" International Journal of Cardiology 155 (March 2012): S206. http://dx.doi.org/10.1016/s0167-5273(12)70498-9.
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Keswani, Rajesh N., Dayna Early, Steven a. Edmundowicz, Ramaswamy Govindan, and Riad R. Azar. "Routine PET Does Not Alter Nodal Staging in Patients Undergoing EUS-FNA for Esophageal Cancer." Gastrointestinal Endoscopy 67, no. 5 (April 2008): AB100. http://dx.doi.org/10.1016/j.gie.2008.03.115.
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Lee, Belinda, Adrian K. Lim, Jonathan Krell, Keshthra Satchithananda, Jacqueline S. Lewis, R. Charles Coombes, and Justin Stebbing. "The efficacy of axillary ultrasound in the detection of nodal metastasis in breast cancer." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e21137-e21137. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e21137.
Повний текст джерелаАнотація:
e21137 Background: Recent reports indicate a lack of survival benefit for axillary node dissection (ALND) versus sentinel lymph node biopsy in early breast cancer. To study this further we assessed the accuracy and effectiveness of ultrasound in detecting axillary nodal involvement in breast cancer patients, aimed at refining and evaluating our current clinical pathways as newly diagnosed invasive breast cancer patients routinely undergo pre-surgical axillary ultrasound. Methods: Ultrasound data were collected from consecutive breast cancer cases over 3 years. Images were reviewed by experienced radiologists and made the following assessments on size, morphology, fatty hilum and cortical thickness of the ipsilateral axillary nodes. The findings were correlated with histology outcomes following ALND. Results: 260 cases were included in the analysis, 113 (43.5%) had evidence of metastatic nodal involvement at final histology. Of these, 59/113 (52.2%) reported positive findings on ultrasonography. The overall positive predictive value of ultrasound for detecting metastatic nodal involvement measured 0.70. The negative predictive value was 0.61. The sensitivity was 52%, specificity measured 78% and the accuracy was 65%. The ultrasound morphological lymph node features with the greatest correlation with malignancy were absence of a fatty hilum (p=0.003) and increased cortical thickness (p=0.03). Cases with a metastatic nodal burden density of a least 20% were more likely to report an abnormal axillary ultrasound. (p=0.009). Conclusions: Axillary ultrasound has a low NPV and negative sonographic results do not exclude axillary node metastases with sufficient sensitivity, to justify its routine clinical use. Clinical pathways need to consider an evidence-based approach, focusing on the criteria by which we select breast cancer patients for axillary nodal dissection.
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Rizkou, F. E., D. Berrada El Azizi, S. Salhi, O. Benhoummad, Y. Rochdi, and A. Raji. "Primary Extra-Nodal Non-Hodgkin Lymphoma of the Cheek: A Rare Case Report and Literature Review." European Journal of Medical and Health Sciences 4, no. 1 (February 23, 2022): 41–44. http://dx.doi.org/10.24018/ejmed.2022.4.1.1177.
Повний текст джерелаАнотація:
Non-Hodgkin’s lymphomas are a group of highly diverse lymphoproliferative malignancies and have great tendency to involve in organs and tissues that typically don’t contain lymphoid cells. Primary extra-nodal NHL of the oral cavity are thin on the ground, and cheek location is one of the rarest intraoral sites involved. The majority of oral NHLs reported are of diffuse large B-cell type. The present case highlights one of the scarce forms of primary extra-nodal non-Hodgkin; cheek location reveled by a swelling in the right cheek. Routine laboratory tests were within normal limits and clinical examination showcases painless, poorly limited mass. CT and MRI were performed revealing an enhanced tissue lesion with muscular infiltration and no bone lysis. An initial biopsy of the lesion was determined insignificant. A resection biopsy was evaluated using histologic techniques and immunohistochemistry, which established the proper diagnosis of extra-nodal diffuse large B-cell lymphoma. In view of their malignant nature and the fact that only histopathological examination can define the diagnosis, we report this case to aid an early recognition, diagnosis, and treatment, that are essential for a patient’s survival.
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Kim, Christine H., Robert A. Soslow, Kay J. Park, Emma L. Barber, Fady Khoury-Collado, Joyce N. Barlin, Yukio Sonoda, Martee L. Hensley, Richard R. Barakat, and Nadeem R. Abu-Rustum. "Pathologic Ultrastaging Improves Micrometastasis Detection in Sentinel Lymph Nodes During Endometrial Cancer Staging." International Journal of Gynecologic Cancer 23, no. 5 (June 2013): 964–70. http://dx.doi.org/10.1097/igc.0b013e3182954da8.
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ObjectiveTo describe the incidence of low-volume ultrastage-detected metastases in sentinel lymph nodes (SLNs) identified at surgical staging for endometrial carcinoma and to correlate it with depth of myoinvasion and tumor grade.MethodsWe reviewed all patients who underwent primary surgery for endometrial carcinoma with successful mapping of at least one SLN at our institution from September 2005 to December 2011. All patients underwent a cervical injection for mapping. The SLN ultrastaging protocol involved cutting an additional 2 adjacent 5-μm sections at each of 2 levels, 50-μm apart, from each paraffin block lacking metastatic carcinoma on routine hematoxylin and eosin (H&E) staining. At each level, one slide was stained with H&E and with immunohistochemistry (IHC) using anticytokeratin AE1:AE3.Micrometastases (tumor deposits >0.2 mm and ≤2 mm) and isolated tumor cells (≤0.2 mm) were classified as low-volume ultrastage-detected metastases if pathologic ultrastaging was the only method allowing detection of such nodal disease.ResultsOf 508 patients with successful mapping, 413 patients (81.3%) had endometrioid carcinoma. Sixty-four (12.6%) of the 508 patients had positive nodes: routine H&E detected 35 patients (6.9%), ultrastaging detected an additional 23 patients (4.5%) who would have otherwise been missed (4 micrometastases and 19 isolated tumor cells), and 6 patients (1.2%) had metastatic disease in their non-SLNs. The incidence rates of low-volume ultrastage-detected nodal metastases in patients with grades 1, 2, and 3 tumors were 3.8%, 3.4%, and 6.9%, respectively. The frequency rates of low-volume ultrastage-detected metastases in patients with a depth of myoinvasion of 0, less than 50%, and 50% or more were 0.8%, 8.0%, and 7.4%, respectively. Lymphovascular invasion was present in 20 (87%) of the cases containing low-volume ultrastage-detected metastases in the lymph nodes.ConclusionsSentinel lymph node mapping with pathologic ultrastaging in endometrial carcinoma detects additional low-volume metastases (4.5%) that would otherwise go undetected with routine evaluations. Our data support the incorporation of pathologic ultrastaging of SLNs in endometrial carcinoma with any degree of myoinvasion. The oncologic significance of low-volume nodal metastases requires long-term follow-up.
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Koulaxouzidis, Georgios, Grigorios Karagkiouzis, Marios Konstantinou, Ioannis Gkiozos, and Konstantinos Syrigos. "Sampling versus systematic full lymphatic dissection in surgical treatment of non-small cell lung cancer." Oncology Reviews 7, no. 1 (June 18, 2013): 2. http://dx.doi.org/10.4081/oncol.2013.e2.
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The extent of mediastinal lymph node assessment during surgery for non-small cell cancer remains controversial. Different techniques are used, ranging from simple visual inspection of the unopened mediastinum to an extended bilateral lymph node dissection. Furthermore, different terms are used to define these techniques. Sampling is the removal of one or more lymph nodes under the guidance of pre-operative findings. Systematic (full) nodal dissection is the removal of all mediastinal tissue containing the lymph nodes systematically within anatomical landmarks. A Medline search was conducted to identify articles in the English language that addressed the role of mediastinal lymph node resection in the treatment of non-small cell lung cancer. Opinions as to the reasons for favoring full lymphatic dissection include complete resection, improved nodal staging and better local control due to resection of undetected micrometastasis. Arguments against routine full lymphatic dissection are increased morbidity, increase in operative time, and lack of evidence of improved survival. For complete resection of non-small cell lung cancer, many authors recommend a systematic nodal dissection as the standard approach during surgery, and suggest that this provides both adequate nodal staging and guarantees complete resection. Whether extending the lymph node dissection influences survival or recurrence rate is still not known. There are valid arguments in favor in terms not only of an improved local control but also of an improved long-term survival. However, the impact of lymph node dissection on long-term survival should be further assessed by large-scale multicenter randomized trials.
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Lee, B., A. Lim, J. Krell, K. Satchithananda, J. S. Lewis, J. Stebbing, and F. Meric-Bernstam. "Re-evaluating the efficacy of axillary ultrasound in the detection of nodal metastasis and its impact on clinical practice." Journal of Clinical Oncology 29, no. 27_suppl (September 20, 2011): 4. http://dx.doi.org/10.1200/jco.2011.29.27_suppl.4.
Повний текст джерелаАнотація:
4 Background: Recent reports have indicated a lack of overall survival benefit for axillary node dissection versus sentinel lymph node biopsy in early breast cancer. To study this further, we wished to assess the accuracy and effectiveness of ultrasound guided fine needle aspiration (FNA) cytology in detecting lymph node involvement in breast cancer patients, in order to refine and evaluate our current clinical pathways as newly diagnosed invasive breast cancer patients routinely undergo pre-surgical axillary ultrasound. Methods: An FNA was taken from nodes of consecutive patients, which appeared abnormal on ultrasonography based on size, morphology, fatty hilum and cortical thickness measurements. Ultrasound and FNA cytological findings were correlated with histology following axillary node dissection. Of 260 cases, 123 (47.3%) had metastatic nodal involvement. Of these cases, only 66 (53.7%) were reported as positive on US findings. Results: The overall positive predictive value (PPV) of ultrasound for detecting metastatic nodal involvement measured 0.82, and the negative predictive value (NPV) was 0.60. The sensitivity was 0.54, specificity measured 0.85 and the accuracy was 0.68. The ultrasound morphological nodal features with the greatest correlation with malignancy were absence of a fatty hilum (p=0.003) and an increased cortical thickness (p=0.03). Cases with a metastatic nodal burden density of a least 20% were also more likely to be detected as abnormal on axillary ultrasound. (p=0.009). Conclusions: Axillary ultrasound has a low NPV and negative sonographic results do not exclude node metastases with sufficient sensitivity in most cases, to justify its routine clinical use. [Table: see text]
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Evison, Matthew, Tim Edwards, Haval Balata, Alex Tempowski, Benjamin Teng, Paul Bishop, Eustace Fontaine, et al. "Prevalence of nodal metastases in lymph node stations 8 & 9 in a large UK lung cancer surgical centre without routine pre-operative EUS nodal staging." Lung Cancer 115 (January 2018): 127–30. http://dx.doi.org/10.1016/j.lungcan.2017.11.023.
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Bazan, Jose, Dominic DiCostanzo, Lonika Majithia, Allison Marie Quick, Nilendu Gupta, and Julia R. White. "Rates of unacceptable variation (UV) of normal tissue constraints in patients undergoing chest wall/breast and regional nodal irradiation (RNI) in a routine clinical practice." Journal of Clinical Oncology 33, no. 28_suppl (October 1, 2015): 67. http://dx.doi.org/10.1200/jco.2015.33.28_suppl.67.
Повний текст джерелаАнотація:
67 Background: TheNSABP B51/RTOG 1304 clinical trial defines dose-volume constraints for targets/normal tissue receiving RNI. We sought to evaluate UV rate in normal tissue based on the NSABP B51/RTOG 1304 protocol in patients receiving chestwall/breast (CW/B) and RNI in daily practice. Methods: Treatment records of CW/B+RNI patients from 2/2012-5/2015 were studied for: CW or B radiotherapy (RT), RT type (intensity modulated [IMRT] or 3D conformal [3DCRT]), internal mammary node (IMN) inclusion, primary site boost, and nodal boost. No case is enrolled on B51/1304. Dose volume histogram (DVH) was analyzed for the rate of ≥ 1 UV for the following normal tissue constraints: Heart mean dose ≤ 5 Gy; ipsilateral lung (IL): V20 ≤ 35%, V10 ≤ 60%, V5 ≤ 70%; contralateral lung (CL) V5 ≤ 15%; contralateral breast (CB) V4.1 ≤ 5%. Logistic regression is used to test the association between UV and key variables. Results: 203 consecutive cases received CW/B+RNI (105 left, 98 right). RT was to CW in 170 (84%), B in 33 (16%), primary site boost 133 (66%), and IMN 170 (84%). 38 (19%) received IMRT and 14 (6.9%) had a nodal boost. 46 patients (22.6%) had ≥ 1 UV. 19 patients (9.4%) had ≥ 2 UV, all in IMRT patients. 2 patients (1.0%) had a heart UV at 5.2 Gy and 5.6 Gy. The most common UV was CB (n = 32, 15.7%) and IL V5 (n = 22, 10.8%). Higher UV rates are associated with use of IMRT (vs. 3DCRT): 86.8% vs. 7.9%, OR = 77.2 (95% CI 25.7-231.4, p < 0.0001); IMN irradiation: OR = 11.5 (95% CI 1.5-86.8, p = 0.02); and use of nodal boost: OR = 7.4 (95% CI 2.3-23.4, p = 0.001). The most common UVs in IMRT cases are CB (n = 27, 71%), IL V5 (n = 19, 50%), CL V5 (n = 14, 37%) and for 3DCRT are IL V20 (n = 5, 3%), CB (n = 5, 3%) and IL V5 (n = 3, 1.8%). On multivariate analysis, use of IMRT (OR = 64.7, 95% CI 20.8-201.5, p < 0.001) and use of nodal boost (OR = 5.5, 95% CI 1.1-27.1, p = 0.04) but not IMN irradiation (OR = 2.7, 95% CI 0.3-22.0, p = 0.35) were independently associated with higher UV rate. Conclusions: The rate of UV per B51/1304 criteria with 3DCRT in routine clinical practice is low (7.9%). Women treated with IMRT had a significantly higher overall UV rate and clinicians should be aware of this as they initiate treatment planning for RNI.
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Ozluk, E., and R. Shackelford. "Extra-nodal Rosai-Dorfman Disease Confined to Breast." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S41—S42. http://dx.doi.org/10.1093/ajcp/aqaa161.087.
Повний текст джерелаАнотація:
Abstract Introduction/Objective First described by Rosai and Dorfman in 1969, Rosai-Dorfman Disease (RDD) is an uncommon, idiopathic, reactive lymph node process with an unknown etiology. It may involve extra-nodal organs including the skin, bone, soft tissue, and eyes. However, breast involvement is rare and RDD confined to breast without nodal involvement is extremely uncommon. Methods Here we present a case of RDD confined to breast. The patient was a 51-year-old African American woman who was found to have an irregular, solid left breast mass on routine mammogram, which had speculated irregular margins and measured of 37.0 x 32.0 x 32.0 mm. She did not have any symptoms, nor any palpable lymph nodes. The clinician stated that the lesion was highly suspicious for a breast malignancy and requested a fine needle aspiration (FNA) of the mass, followed by total excision. Results An FNA was interpreted as atypical histiocytic cells in a mixed lymphoid background. Histopathologic examination revealed an ill-defined mass with sheets of histiocytes, plasma cells, and a mixed lymphocytic population, with occasional germinal centers. Some of the histiocytes were spindle shaped and associated with storiform collagen deposition. The histiocytes had single and multiple nuclei and exhibited occasional emperipolesis. Immunohistochemical staining with S100 diffusely highlighted the histiocytes, whereas CD1a was negative. CD3 and CD20 immunostains were positive for mixed-type lymphocytic infiltration. Cytokeratin staining was performed and reassuringly stained only the benign ductal cells. A diagnosis of RDD of the breast was made, based on these histopathologic findings. Conclusion We report an example of an extra-nodal RDD involving the mammary gland that was initially suspected to be breast carcinoma. RDD may still be a diagnostic challenge, especially in a patient with suspected carcinoma. It is the pathologist’s role to lead the clinician to the proper diagnosis and render a correct histopathologic diagnosis.
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Hennequin, Christophe, Pierre Mongiat-Artus, Eric De Kerviler, Laetitia Vercellino, Vincent Ravery, Paul Meria, Stephane Culine, Francois Desgrandchamps, and Laurent Quero. "How many patients could have a salvage local treatment after radiotherapy/brachytherapy for prostate cancer?" Journal of Clinical Oncology 34, no. 2_suppl (January 10, 2016): 23. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.23.
Повний текст джерелаАнотація:
23 Background: In our institution, as soon as biochemical relapse (BR; nadir PSA + 2 ng/ml) occurred after external beam radiotherapy (EBRT) or brachytherapy (BT), 18-fluorocholine-PET-CT (18-FCH-PET) with or without multiparametric prostate MRI are performed. The aim is to select patients for a salvage local treatment (SLT) with a curative intent. We presented here the results of this approach. Methods: Records of patients with BR, without clinical evidence of relapsing disease and with at least a18-FCH-PET performed, were retrospectively reviewed. Patients were considered eligible for SLT if the relapse was only local or in case of nodal relapse reasonably encompass in a RT field. Results: Between 2010 and 2014, 89 pts were included, 23 initially treated with BT and 66 with EBRT. Prognostic group at diagnosis were: favourable: 25 (28%), intermediate: 35 (39%), unfavourable: 29 (33%). At the time of relapse, mean age was 72 yrs and mean PSA level: 6.2 ng/ml. After 18-FCH-PET ± MRI, patients were classified as: no target lesion identified: 20 (22.5%); local relapse: 35 (39%); nodal relapse: 22 (25%); distant metastases: 12 (13%.5%). Among 35 pts with a local relapse, 14 had SLT (cryotherapy:13; cyberknife:1). Reasons to not performed SLT were: advanced age or poor performance status: 10; Gleason 8-10: 2; T3 on MRI: 2; Patient refusal (fear of incontinence): 7. Among 22 pts with a nodal relapse, only 3 could have salvage EBRT. Reasons to not performed SLT were: old age or poor PS: 5; extensive nodal relapse: 8; local and nodal relapse: 6. At the end, 57 pts (64%) are potentially eligible for SLT and 17 (19%) could have it. Conclusions: In routine practice, in a population of 89 pts with a BR, 64% are eligible for SLT but 19% could have it. Main reasons for not having SLT were absence of target lesions, extensive disease, or advanced age. This result justified the realisation of an extensive staging at the time of BR after EBRT or brachytherapy.
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Bjelovic, Milos, Predrag Pesko, Marjan Micev, Vera Todorovic, Goran Trajkovic, Dejan Stojakov, and Predrag Sabljak. "Prevalence and importance of nodal micrometastasis in patients with gastric adenocarcinoma." Srpski arhiv za celokupno lekarstvo 132, no. 7-8 (2004): 230–35. http://dx.doi.org/10.2298/sarh0408230b.
Повний текст джерелаАнотація:
Micrometastasis is a microscopic (less than 2 mm) deposit of malignant cells separated from the primary tumor. The incidence and importance of occult perigastric lymph node involvement were analyzed in 26 pNO patients using the prospective method. The occult lymph node involvement was detected by immunohistochemical method using the anticyto-keratin 8/18 antibody. Prevalence of clinically significant occult lymph node involvement (Mi+) was statistically significant, and found in 38.5% of pNO patients. Out of tumor characteristics analyzed as possible predictors of occult lymph node involvement, the histological grade (GH) and the involvement of lymphatic vessels within gastric wall (pLl) had significant effect on the respective evaluation. The patients with histological grade 3 and 4 had occult lymph node involvement more often than those with grade 1 and 2 (p<0.05). More than 60% of pL1 patients had occult lymph node involvement LN (Mi+). Due to high prevalence of micrometastatic lymph node involvement, detection with specific immunohistochemical or molecular biology techniques should be a part of routine specimen examination in patients with pNO gastric cancer.
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Bland, Kirby I. "Failure of Routine Axillary Nodal Sampling to Predict Survival Outcomes in Lymph Node-Negative (N0) Breast Cancer." Annals of Surgery 237, no. 2 (February 2003): 168–70. http://dx.doi.org/10.1097/01.sla.0000048442.78125.a0.
Повний текст джерела
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Dobrocky, I., S. Kemka, L. Rohac, and P. Hudec. "Low Dose Contrast Helical CT in Nodal Staging of Head and Neck Tumours." Rivista di Neuroradiologia 11, no. 4 (August 1998): 525–29. http://dx.doi.org/10.1177/197140099801100412.
Повний текст джерелаАнотація:
The aim of the study is to evaluate the accuracy of helical CT with low dose contrast in the nodal staging of head and neck tumours. Fifty-one patients were included in the study. 1 ml/kg of body weight of 300 mgI/ml contrast was injected at a rate of 1.5 ml/s. The total volume ranged according to the patient's weight between 45 and 100 ml (mean 70 ml). Axial diameter of 15 resp. 10 mm was set as a criterion for malignant involvement. The overall sensitivity for detection of malignant nodes was 92%, specificity 88%, accuracy 90%. The overall accuracy in nodal staging was 90%, sensitivity 96%, specificity 80%. The quality of contrast enhancement was scored with 2.5 on a 3 point scale (1-poor, 2-good, 3-excellent). The sensitivity, specificity and accuracy in detecting metastatic lymph nodes with this technique in patients with head and neck cancer is comparable to studies performed with high dose. The maximal axial diameter of the LN is a suitable parameter for the daily routine.
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Ortigoza Capetillo, Gerardo Mario, Alberto Pedro Lorandi Medina, and Alfonso Cuauhtemoc García Reynoso. "Reordering edges and elements in unstructured meshes to reduce execution time in Finite Element Computations." Nova Scientia 10, no. 20 (May 25, 2018): 263–79. http://dx.doi.org/10.21640/ns.v10i20.1317.
Повний текст джерелаАнотація:
Reverse Cuthill McKee (RCM) reordering can be applied to either edges or elements of unstructured meshes (triangular/tetrahedral) , in accordance to the respective finite element formulation, to reduce the bandwidth of stiffness matrices . Grid generators are mainly designed for nodal based finite elements. Their output is a list of nodes (2d or 3d) and an array describing element connectivity, be it triangles or tetrahedra. However, for edge-defined finite element formulations a numbering of the edges is required. Observations are reported for Triangle/Tetgen Delaunay grid generators and for the sparse structure of the assembled matrices in both edge- and element-defined formulations. The RCM is a renumbering algorithm traditionally applied to the nodal graph of the mesh. Thus, in order to apply this renumbering to either the edges or the elements of the respective finite element formulation, graphs of the mesh were generated. Significant bandwidth reduction was obtained. This translates to reduction in the execution effort of the sparse-matrix-times-vector product. Compressed Sparse Row format was adopted and the matrix-times-vector product was implemented in an OpenMp parallel routine.
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Steinbuss, Georg, Mark Kriegsmann, Christiane Zgorzelski, Alexander Brobeil, Benjamin Goeppert, Sascha Dietrich, Gunhild Mechtersheimer, and Katharina Kriegsmann. "Deep Learning for the Classification of Non-Hodgkin Lymphoma on Histopathological Images." Cancers 13, no. 10 (May 17, 2021): 2419. http://dx.doi.org/10.3390/cancers13102419.
Повний текст джерелаАнотація:
The diagnosis and the subtyping of non-Hodgkin lymphoma (NHL) are challenging and require expert knowledge, great experience, thorough morphological analysis, and often additional expensive immunohistological and molecular methods. As these requirements are not always available, supplemental methods supporting morphological-based decision making and potentially entity subtyping are required. Deep learning methods have been shown to classify histopathological images with high accuracy, but data on NHL subtyping are limited. After annotation of histopathological whole-slide images and image patch extraction, we trained and optimized an EfficientNet convolutional neuronal network algorithm on 84,139 image patches from 629 patients and evaluated its potential to classify tumor-free reference lymph nodes, nodal small lymphocytic lymphoma/chronic lymphocytic leukemia, and nodal diffuse large B-cell lymphoma. The optimized algorithm achieved an accuracy of 95.56% on an independent test set including 16,960 image patches from 125 patients after the application of quality controls. Automatic classification of NHL is possible with high accuracy using deep learning on histopathological images and routine diagnostic applications should be pursued.
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Hu, Man, Bingjie Fan, Li Kong, and Jinming Yu. "Is CT-based selective nodal irradiation safe for clinical stage N0-1 LD-SCLC patients?" Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e18551-e18551. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e18551.
Повний текст джерелаАнотація:
e18551 Background: Radiotherapy plays an important role in the management of limited-disease small-cell lung cancer (LD-SCLC). However, volume of irradiation remains unanswered as well as optimal total dose, timing and sequencing of radiation. In this study, we compared the clinical lymph node staging with pathological staging, with the aim of investigating the safety of CT-based selective nodal irradiation for clinical stage N0-1 LD-SCLC patients. Methods: From July 2004 to March 2012, 20 potentially operable patients with clinical stage N0-1 LD-SCLC underwent contrast-enhanced CT scans and other routine initial staging procedures followed by radical resection of primary tumor and systemic intra-thoracic lymph node dissection. The results of reviewing clinical staging for the mediastinal lymph node metastases were compared with pathologic findings. Results: Preoperative nodal staging was compared with postoperative pathological staging, 35% (7 of 20) of patients were under staged by clinical staging. Of all the 7 patients with mediastinal lymph node metastases, 4 patients (57.1%) had subcrinal nodes (station 7) metastases, 1 had right upper paratracheal nodes (station 2R) metastases, 1 had left lower paratracheal nodes (station 4L) metastases, 1 had aortopulmonary nodes (station 5) metastases. Conclusions: CT-based selective nodal irradiation for LD-SCLC may result in geographical miss in clinical stage N0-1 patients. Mediastinal lymph node regions especially the subcrinal nodes should be contained in the clinical target volume for radiotherapy.