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Romy M. van Amelsfoort, Iris Walraven, Jacobien Kieffer, Edwin P.M. Jansen, Annemieke Cats, Nicole C.T. van Grieken, Elma Meershoek-Klein Kranenbarg, Hein Putter, Johanna W. van Sandick, Karolina Sikorska, Cornelis J.H. van de Velde, Neil K. Aaronson, Marcel Verheij, and on behalf of the CRITICS Investigators

Background Gastric cancer is the fifth most common malignancy worldwide and the fourth most common cause of cancer-related death. 1 For patients from Western countries with gastric cancer, the prognosis remains poor after surgery alone, and

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Kari E. Hacker, Shitanshu Uppal, and Carolyn Johnston

borderline ovarian tumors (BOTs) and low-grade epithelial ovarian carcinomas (LG-EOCs) Assess the role of surgery, chemotherapy and fertility/hormonal preservation in the management of BOTs and LG-EOCs The International Federation of Gynecology and

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Siddhartha Yadav, Sri Harsha Tella, Anuhya Kommalapati, Kristin Mara, Kritika Prasai, Mohamed Hamdy Mady, Mohamed Hassan, Rory L. Smoot, Sean P. Cleary, Mark J. Truty, Lewis R. Roberts, and Amit Mahipal

gallbladder. Patient-related factors, such as age and functional status, are not included in the staging system. These factors and other laboratory parameters may be helpful in the prognostication of patients with GBC who are not candidates for surgery. 7 , 8

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Richard Li, Wei-Hsien Hou, Joseph Chao, Yanghee Woo, Scott Glaser, Arya Amini, Rebecca A. Nelson, and Yi-Jen Chen

dissection, has been established as the primary curative treatment modality for locally advanced gastric cancer. 3 , 4 Perioperative chemotherapy, adjuvant chemotherapy, or adjuvant chemoradiation (CRT) are given in conjunction with surgery based on data

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NCCN Guidelines® Insights: Breast Cancer, Version 4.2021

Featured Updates to the NCCN Guidelines

William J. Gradishar, Meena S. Moran, Jame Abraham, Rebecca Aft, Doreen Agnese, Kimberly H. Allison, Sarah L. Blair, Harold J. Burstein, Chau Dang, Anthony D. Elias, Sharon H. Giordano, Matthew P. Goetz, Lori J. Goldstein, Sara A. Hurvitz, Steven J. Isakoff, Rachel C. Jankowitz, Sara H. Javid, Jairam Krishnamurthy, Marilyn Leitch, Janice Lyons, Jennifer Matro, Ingrid A. Mayer, Joanne Mortimer, Ruth M. O'Regan, Sameer A. Patel, Lori J. Pierce, Hope S. Rugo, Amy Sitapati, Karen Lisa Smith, Mary Lou Smith, Hatem Soliman, Erica M. Stringer-Reasor, Melinda L. Telli, John H. Ward, Kari B. Wisinski, Jessica S. Young, Jennifer L. Burns, and Rashmi Kumar

developed by a multidisciplinary panel of representatives from NCCN Member Institutions with breast cancer–focused expertise in the fields of medical oncology, surgical oncology, radiation oncology, pathology, reconstructive surgery, and patient advocacy

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Hillary Johnson-Jahangir, William Sherman, and Désirée Ratner

metastasis, because the lung is the most common site of spread. 6 – 8 Surgical excision with careful margin evaluation is the preferred treatment for DFSP. Low recurrence rates have been shown after Mohs micrographic surgery (MMS) or wide local excision

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Stanley J. Miller, Murad Alam, James Andersen, Daniel Berg, Christopher K. Bichakjian, Glen Bowen, Richard T. Cheney, L. Frank Glass, Roy C. Grekin, Anne Kessinger, Nancy Y. Lee, Nanette Liegeois, Daniel D. Lydiatt, Jeff Michalski, William H. Morrison, Kishwer S. Nehal, Kelly C. Nelson, Paul Nghiem, Thomas Olencki, Clifford S. Perlis, E. William Rosenberg, Ashok R. Shaha, Marshall M. Urist, Linda C. Wang, and John A. Zic

carcinomas that develop in the high-risk mask area of the face are more likely to recur and metastasize than those that develop on the trunk and extremities. Adapted with permission from Swanson NA. Mohs surgery: technique, indications, applications, and

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George D. Demetri, Robert S. Benjamin, Charles D. Blanke, Jean-Yves Blay, Paolo Casali, Haesun Choi, Christopher L. Corless, Maria Debiec-Rychter, Ronald P. DeMatteo, David S. Ettinger, George A. Fisher, Christopher D. M. Fletcher, Alessandro Gronchi, Peter Hohenberger, Miranda Hughes, Heikki Joensuu, Ian Judson, Axel Le Cesne, Robert G. Maki, Michael Morse, Alberto S. Pappo, Peter W. T. Pisters, Chandrajit P. Raut, Peter Reichardt, Douglas S. Tyler, Annick D. Van den Abbeele, Margaret von Mehren, Jeffrey D. Wayne, and John Zalcberg

diagnostics, pathology, radiation oncology, and surgery to discuss the optimal approach to care for patients with GIST at all stages of the disease. The GIST Task Force is composed of NCCN faculty and other key experts from the United States, Europe, and

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Nina N. Sanford, Todd A. Aguilera, Michael R. Folkert, Chul Ahn, Brandon A. Mahal, Herbert Zeh, Muhammad S. Beg, John Mansour, and David J. Sher

in the United States treated at American College of Surgeons’ Commission on Cancer–accredited programs and was used to identify patients diagnosed with pathologic stage I–III pancreatic adenocarcinoma who underwent definitive surgery, defined as

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Mohamedtaki A. Tejani, Anna ter Veer, Dana Milne, Rebecca Ottesen, Tanios Bekaii-Saab, Al B. Benson III, Deborah Schrag, Stephen Shibata, John Skibber, Martin Weiser, Neal Wilkinson, and Steven J. Cohen

mucinous appendiceal adenocarcinomas (when surgery is not a viable option) has not been established. Several retrospective analyses 4 - 6 failed to show a significant benefit from systemic chemotherapy. However, these were small series that did not