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Tobin Strom, Javier F. Torres-Roca, Akash Parekh, Arash O. Naghavi, Jimmy J. Caudell, Daniel E. Oliver, Jane L. Messina, Nikhil I. Khushalani, Jonathan S. Zager, Amod Sarnaik, James J. Mulé, Andy M. Trotti, Steven A. Eschrich, Vernon K. Sondak, and Louis B. Harrison

consult with recurrent or metastatic disease (n=143), satellite or in-transit metastasis only (AJCC N2c nodal stage; n=4), unknown recurrence status (n=99), unclear treatment records (n=17), or <12 months follow-up from the time of lymph node dissection

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Maria A. Kouvaraki, Suzanne E. Shapiro, Jeffrey E. Lee, Douglas B. Evans, and Nancy D. Perrier

Thyroid carcinoma has a unique biologic behavior characterized by early spread to regional lymph nodes and occasional extrathyroidal soft tissue extension but a low incidence of distant metastasis and infrequent disease-related death. Therefore, controversy exists over the proper extent of thyroidectomy and regional lymph node dissection in patients with differentiated thyroid carcinoma (DTC) and medullary thyroid carcinoma (MTC). The modest disease-specific mortality makes it unlikely that the extent of surgery will ever be the subject of a prospective randomized trial. Although more extensive cervical surgery may have only a limited effect on the duration of survival in patients with DTC, it may significantly improve quality of life by minimizing cervical recurrence. The high rates of cervical recurrence in patients with DTC and MTC have alerted physicians to the importance of fine-needle aspiration biopsy and ultrasonography for the diagnosis, preoperative staging, and follow-up of thyroid cancer. In patients with MTC, death caused by disease is uncommon in the absence of radiographically evident distant metastasis at the time of thyroidectomy. Cervical recurrence is even more common with MTC, and the need for compartment-oriented lymphadenectomy is accepted as standard surgical treatment to minimize disease recurrence. Postoperatively, calcitonin (CT) levels can be used to guide clinical management, but basal CT levels should not be used to direct the timing of prophylactic thyroidectomy in affected high-risk patients with familial MTC.

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Frank Qian Zhan, Vathani Sharon Packianathan, and Nathalie Charlotte Zeitouni

Merkel cell carcinoma (MCC) is a rare but aggressive cutaneous malignancy of neuroendocrine origin. Its incidence has tripled over the past 15 years. This article reviews the recent advancement in diagnosis, discoveries in pathogenesis, and updates in management. The acronym, AEIOU, has been proposed to aid in clinical identification. In addition to cytokeratin 20, newer immunohistochemical stains (in particular thyroid transcription factor-1 and neurofilament protein) have proven to be essential in pathologic diagnosis. Although immune suppression and ultraviolet radiation have long been associated with the MCC oncogenesis, recent studies also show involvement of a new polyomavirus and bcl-2. Several tumor classifications have been published in the literature, with the 4-tiered system from Memorial Sloan-Kettering Cancer Center the most widely used. A similar classification with additional distinctions among nodal disease is being constructed. A multidisciplinary treatment algorithm is recommended for MCC. Surgical excision with adjuvant radiotherapy (RT) is indicated for localized tumors. RT is favored over complete lymph node dissection and chemotherapy for regional lymph node involvement. For distant metastasis, management should be individualized with a combination of palliative surgery, RT, and chemotherapy.

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Tina J. Hieken, Mariana B. Sadurní, Enrica Quattrocchi, Ajdin Kobic, Sindhuja Sominidi-Damodaran, Lisette Meerstein, Jvalini T. Dwarkasing, Alina G. Bridges, and Alexander Meves

complication rates for SLN procedures performed between 2004 and 2018 across Mayo Clinic tertiary care sites. Complications evaluated were lymphedema, seroma, infection/cellulitis, hematoma, and wound dehiscence. Patients who proceeded to completion lymph node

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Jordan McDonald, Anupam Rishi, Sabrina Saeed, Rutika Mehta, David Pointer, Jessica Frakes, Sarah Hoffe, Jacques Fontaine, and Jose Pimiento

Background : Esophagectomy with lymph node dissection following neoadjuvant therapy is the standard of care for resectable esophageal cancer. We explore whether a relationship exists between the examined lymph node (ELN) count and overall survival

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Stephen B. Edge and David G. Sheldon

survivors 20 years after diagnosis . Cancer 2001 ; 92 : 1368 – 1377 . 25 Kelemen PR Lowe V Phillips N . Positron emission tomography and sentinel lymph node dissection in breast cancer . Clin Breast Cancer 2002 ; 3 : 73 – 77 . 26

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Matthew D. Galsky, Harry W. Herr, and Dean F. Bajorin

treatment of invasive bladder cancer: Long-term results in 1,054 patients . J Clin Oncol 2001 ; 19 : 666 – 675 . 2 Vieweg J Gschwend JE Herr HW . Pelvic lymph node dissection can be curative in patients with node positive bladder cancer . J

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Robert Torrey, Philippe E. Spiess, Sumanta K. Pal, and David Josephson

the results of the first randomized trial comparing lymph node dissection at the time of radical nephrectomy and radical nephrectomy alone in patients with clinical N0M0 disease. They found that of the patients who underwent lymph node dissection, 4

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Wui-Jin Koh, Benjamin E. Greer, Nadeem R. Abu-Rustum, Sachin M. Apte, Susana M. Campos, John Chan, Kathleen R. Cho, David Cohn, Marta Ann Crispens, Nefertiti DuPont, Patricia J. Eifel, David K. Gaffney, Robert L. Giuntoli II, Ernest Han, Warner K. Huh, John R. Lurain III, Lainie Martin, Mark A. Morgan, David Mutch, Steven W. Remmenga, R. Kevin Reynolds, William Small Jr, Nelson Teng, Todd Tillmanns, Fidel A. Valea, Nicole R. McMillian, and Miranda Hughes

dissection depends on whether pelvic nodal disease and/or LVSI is present and the size of the tumors. Fertility-Sparing: For patients who desire fertility preservation, cone biopsy with or without pelvic lymph node dissection is recommended. 73 , 74 For

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Quan P. Ly and Aaron R. Sasson

. Extended lymph node dissection for gastric cancer: who may benefit? Final results of the randomized dutch gastric cancer group trial . J Clin Oncol 2004 ; 22 : 2069 – 2077 . 33. Cuschieri A Weeden S Fielding J . Patient survival after D1 and