The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Minna T. Kääriäinen - One of the best experts on this subject based on the ideXlab platform.
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Predictors of Metastasis and Outcome Following True Negative Sentinel Node Biopsy
Journal of Surgical Research, 2019Co-Authors: Johanna Palve, Tiina Luukkaala, Minna T. KääriäinenAbstract:Up to 30% of sentinel node-Negative patients develop metastases during follow-up. Negative sentinel node biopsies (SNB) can be classified to false (FN) and True Negative (TN) categories. Little attention has been paid to the characteristics and outcomes of patients who experience direct distant metastasis following TN-SNB. In this retrospective study of a melanoma database at Tampere university hospital we analyzed characteristics and outcome following metastases after TN-SNB. A total of 506 patients underwent SNB between 2006 and 2016. After review, SNBs were classified FN, TN and True positive (TP). Follow-up was performed until 30.4.2019. Of SN-Negative patients, 74 of 396 (19%) developed recurrence, including 17 (4%) local, 22 (6%) regional lymph node (FN) and 35 (9%) direct distant metastases (TN-D). False Negative rate was 16% and Negative predictive value 93.8%. Locoregional recurrences occurred earlier compared to distal metastases (median of 2.14 /2.93 years). Compared to patients without recurrence, thickness ≥ 2 mm (univariable p
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predictors of metastasis and outcome following True Negative sentinel node biopsy
Journal of Surgical Research, 2019Co-Authors: Johanna Palve, Tiina Luukkaala, Minna T. KääriäinenAbstract:Up to 30% of sentinel node-Negative patients develop metastases during follow-up. Negative sentinel node biopsies (SNB) can be classified to false (FN) and True Negative (TN) categories. Little attention has been paid to the characteristics and outcomes of patients who experience direct distant metastasis following TN-SNB. In this retrospective study of a melanoma database at Tampere university hospital we analyzed characteristics and outcome following metastases after TN-SNB. A total of 506 patients underwent SNB between 2006 and 2016. After review, SNBs were classified FN, TN and True positive (TP). Follow-up was performed until 30.4.2019. Of SN-Negative patients, 74 of 396 (19%) developed recurrence, including 17 (4%) local, 22 (6%) regional lymph node (FN) and 35 (9%) direct distant metastases (TN-D). False Negative rate was 16% and Negative predictive value 93.8%. Locoregional recurrences occurred earlier compared to distal metastases (median of 2.14 /2.93 years). Compared to patients without recurrence, thickness ≥ 2 mm (univariable p<0.001), male gender (p=0.021), nodular melanoma (p=0.001), ulceration (p<0.001) and location in upper limb region (p=0.062) were predictors of TN-D. The 5-year melanoma specific survival in TN-D patients did not differ significantly from TP patients (2.36 /2.26 years). TN-D is associated with nodular melanomas in upper limb region, male gender, cervical SNBs and ulcerated tumors with Breslow thickness ≥ 2 mm. These patients should be considered at high-risk relapse and mortality. Surveillance imaging to detect distant metastases is mandatory regardless of SNB status. In future, inclusion criteria for therapy trials for high-risk SNB-Negative patients might also be worth considering.
Johanna Palve - One of the best experts on this subject based on the ideXlab platform.
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Predictors of Metastasis and Outcome Following True Negative Sentinel Node Biopsy
Journal of Surgical Research, 2019Co-Authors: Johanna Palve, Tiina Luukkaala, Minna T. KääriäinenAbstract:Up to 30% of sentinel node-Negative patients develop metastases during follow-up. Negative sentinel node biopsies (SNB) can be classified to false (FN) and True Negative (TN) categories. Little attention has been paid to the characteristics and outcomes of patients who experience direct distant metastasis following TN-SNB. In this retrospective study of a melanoma database at Tampere university hospital we analyzed characteristics and outcome following metastases after TN-SNB. A total of 506 patients underwent SNB between 2006 and 2016. After review, SNBs were classified FN, TN and True positive (TP). Follow-up was performed until 30.4.2019. Of SN-Negative patients, 74 of 396 (19%) developed recurrence, including 17 (4%) local, 22 (6%) regional lymph node (FN) and 35 (9%) direct distant metastases (TN-D). False Negative rate was 16% and Negative predictive value 93.8%. Locoregional recurrences occurred earlier compared to distal metastases (median of 2.14 /2.93 years). Compared to patients without recurrence, thickness ≥ 2 mm (univariable p
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predictors of metastasis and outcome following True Negative sentinel node biopsy
Journal of Surgical Research, 2019Co-Authors: Johanna Palve, Tiina Luukkaala, Minna T. KääriäinenAbstract:Up to 30% of sentinel node-Negative patients develop metastases during follow-up. Negative sentinel node biopsies (SNB) can be classified to false (FN) and True Negative (TN) categories. Little attention has been paid to the characteristics and outcomes of patients who experience direct distant metastasis following TN-SNB. In this retrospective study of a melanoma database at Tampere university hospital we analyzed characteristics and outcome following metastases after TN-SNB. A total of 506 patients underwent SNB between 2006 and 2016. After review, SNBs were classified FN, TN and True positive (TP). Follow-up was performed until 30.4.2019. Of SN-Negative patients, 74 of 396 (19%) developed recurrence, including 17 (4%) local, 22 (6%) regional lymph node (FN) and 35 (9%) direct distant metastases (TN-D). False Negative rate was 16% and Negative predictive value 93.8%. Locoregional recurrences occurred earlier compared to distal metastases (median of 2.14 /2.93 years). Compared to patients without recurrence, thickness ≥ 2 mm (univariable p<0.001), male gender (p=0.021), nodular melanoma (p=0.001), ulceration (p<0.001) and location in upper limb region (p=0.062) were predictors of TN-D. The 5-year melanoma specific survival in TN-D patients did not differ significantly from TP patients (2.36 /2.26 years). TN-D is associated with nodular melanomas in upper limb region, male gender, cervical SNBs and ulcerated tumors with Breslow thickness ≥ 2 mm. These patients should be considered at high-risk relapse and mortality. Surveillance imaging to detect distant metastases is mandatory regardless of SNB status. In future, inclusion criteria for therapy trials for high-risk SNB-Negative patients might also be worth considering.
Tiina Luukkaala - One of the best experts on this subject based on the ideXlab platform.
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Predictors of Metastasis and Outcome Following True Negative Sentinel Node Biopsy
Journal of Surgical Research, 2019Co-Authors: Johanna Palve, Tiina Luukkaala, Minna T. KääriäinenAbstract:Up to 30% of sentinel node-Negative patients develop metastases during follow-up. Negative sentinel node biopsies (SNB) can be classified to false (FN) and True Negative (TN) categories. Little attention has been paid to the characteristics and outcomes of patients who experience direct distant metastasis following TN-SNB. In this retrospective study of a melanoma database at Tampere university hospital we analyzed characteristics and outcome following metastases after TN-SNB. A total of 506 patients underwent SNB between 2006 and 2016. After review, SNBs were classified FN, TN and True positive (TP). Follow-up was performed until 30.4.2019. Of SN-Negative patients, 74 of 396 (19%) developed recurrence, including 17 (4%) local, 22 (6%) regional lymph node (FN) and 35 (9%) direct distant metastases (TN-D). False Negative rate was 16% and Negative predictive value 93.8%. Locoregional recurrences occurred earlier compared to distal metastases (median of 2.14 /2.93 years). Compared to patients without recurrence, thickness ≥ 2 mm (univariable p
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predictors of metastasis and outcome following True Negative sentinel node biopsy
Journal of Surgical Research, 2019Co-Authors: Johanna Palve, Tiina Luukkaala, Minna T. KääriäinenAbstract:Up to 30% of sentinel node-Negative patients develop metastases during follow-up. Negative sentinel node biopsies (SNB) can be classified to false (FN) and True Negative (TN) categories. Little attention has been paid to the characteristics and outcomes of patients who experience direct distant metastasis following TN-SNB. In this retrospective study of a melanoma database at Tampere university hospital we analyzed characteristics and outcome following metastases after TN-SNB. A total of 506 patients underwent SNB between 2006 and 2016. After review, SNBs were classified FN, TN and True positive (TP). Follow-up was performed until 30.4.2019. Of SN-Negative patients, 74 of 396 (19%) developed recurrence, including 17 (4%) local, 22 (6%) regional lymph node (FN) and 35 (9%) direct distant metastases (TN-D). False Negative rate was 16% and Negative predictive value 93.8%. Locoregional recurrences occurred earlier compared to distal metastases (median of 2.14 /2.93 years). Compared to patients without recurrence, thickness ≥ 2 mm (univariable p<0.001), male gender (p=0.021), nodular melanoma (p=0.001), ulceration (p<0.001) and location in upper limb region (p=0.062) were predictors of TN-D. The 5-year melanoma specific survival in TN-D patients did not differ significantly from TP patients (2.36 /2.26 years). TN-D is associated with nodular melanomas in upper limb region, male gender, cervical SNBs and ulcerated tumors with Breslow thickness ≥ 2 mm. These patients should be considered at high-risk relapse and mortality. Surveillance imaging to detect distant metastases is mandatory regardless of SNB status. In future, inclusion criteria for therapy trials for high-risk SNB-Negative patients might also be worth considering.
Rafael S Andrade - One of the best experts on this subject based on the ideXlab platform.
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True Negative predictive value of endobronchial ultrasound in lung cancer are we being conservative enough
The Annals of Thoracic Surgery, 2013Co-Authors: Bryan A Whitson, Shawn S Groth, David D Odell, Eleazar P Briones, Michael A Maddaus, Jonathan Dcunha, Rafael S AndradeAbstract:Background Mediastinal staging in patients with non-small cell lung cancer (NSCLC) with endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) requires a high Negative predictive value (NPV) (ie, low false Negative rate). We provide a conservative calculation of NPV that calls for caution in the interpretation of EBUS results. Methods We retrospectively analyzed our prospectively gathered database (January 2007 to November 2011) to include NSCLC patients who underwent EBUS-FNA for mediastinal staging. We excluded patients with metastatic NSCLC and other malignancies. We assessed FNAs with rapid on-site evaluation (ROSE). The calculation of NPV is NPV=True Negatives/True Negatives + false Negatives. However, this definition ignores nondiagnostic samples. Nondiagnostic samples should be added to the NPV denominator because decisions based on nondiagnostic samples could be flawed. We conservatively calculated NPV for EBUS-FNA as NPV=True Negatives/True Negatives + false Negatives + nondiagnostic. We defined false Negatives as Negative FNAs but NSCLC-positive surgical biopsy of the same site. Nondiagnostic FNAs were nonrepresentative of lymphoid tissue. We compared diagnostic performance with the inclusion and exclusion of nondiagnostic procedures. Results We studied 120 patients with NSCLC who underwent EBUS-FNA; 5 patients had false Negative findings and 10 additional patients had nondiagnostic results. The NPV with and without inclusion of nondiagnostic samples was 65.9% and 85.3%, respectively. Conclusions The inclusion of nondiagnostic specimens into the conservative, worst-case-scenario calculation of NPV for EBUS-FNA in NSCLC lowers the NPV from 85.3% to 65.9%. The True NPV is likely higher than 65.9% as few nondiagnostic specimens are false Negatives. Caution is imperative for the safe application of EBUS-FNA in NSCLC staging.
Christian Brambilla - One of the best experts on this subject based on the ideXlab platform.
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immunoscintigraphy using 111in labelled f ab 2 fragments of anti carcinoembryonic antigen cea monoclonal antibody for staging of non small cell lung carcinoma
European Journal of Cancer, 1994Co-Authors: Jean-philippe Vuillez, Jean Claude Saccavini, Pierre Yves Brichon, Elisabeth Brambilla, D Moro, G. Ferretti, Christian BrambillaAbstract:Abstract 28 patients with primitive lung cancers were imaged by immunoscintigraphy (IS) with 111 indium-labelled F(ab′) 2 anti-carcinoembryonic antigen (CEA), to assess this technique for mediastinal staging. IS revealed primitive tumours in 21 cases in whom mediastinal extension was assessed. There was concordance between clinical staging and IS confirmed by surgery in 17 cases, and discordance in 4. After surgery, discordance was in favour of IS in 2 cases (1 True positive and 1 True Negative) and in favour of clinical staging in 2 (false positive of immunoscintigraphy). Anti-CEA IS could be useful for improving mediastinal staging of lung cancer.
