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Ernest S. Han and Mark Wakabayashi

goal of maximal cytoreduction. Minimally invasive surgery has evolved over the past several decades and is now commonly used for appendectomies and cholecystectomies. Minimally invasive surgery for gynecologic malignancies has been primarily focused

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Kathryn P. Pennington, Renata R. Urban and Heidi J. Gray

Use of minimally invasive surgery (MIS) in the management of early-stage cervical cancer (ESCC), previously considered an acceptable alternative to open surgery, 1 was recently challenged by results of the Laparoscopic Approach to Cervical

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Alfredo A. Santillan, Jeffrey M. Farma, Kenneth L. Meredith, Nilay R. Shah and Scott T. Kelley

Esophageal cancer represents a major public health problem worldwide. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and expertise in them. This article reviews the most recent and largest series evaluating MIE techniques. Recent larger series have shown MIE to be equivalent in postoperative morbidity and mortality rates to conventional surgery. MIE has been associated with less blood loss, less postoperative pain, and decreased intensive care unit and hospital length of stay compared with conventional surgery. Despite limited data, conventional surgery and MIE have shown no significant difference in survival, stage for stage. The myriad of MIE techniques complicates the debate of defining the optimal surgical approach for treating esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.

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Amanda N. Fader

and Obstetrics, The Johns Hopkins School of Medicine. In fact, less may be more when it comes to minimally invasive surgery (MIS) for the primary treatment of certain gynecologic cancers, she added. Dr. Fader is an editorial board member for

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Thomas A. D'Amico

Lung cancer is the most common cause of death by malignancy, responsible for more deaths than the next 4 causes combined and predicted to account for nearly 220,000 new cancer diagnoses and 160,000 deaths in 2009. The cornerstone of therapy for early-stage lung cancer is lobectomy and mediastinal lymph node dissection. Although lobectomy is considered the standard procedure, segmentectomy may be appropriate for selected patients. Conventional approaches to resection may be used, including posterolateral and muscle-sparing thoracotomy. However, minimally invasive lobectomy and segmentectomy procedures are now commonly used with superior outcomes.

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Rajinder S. Grover, Kemp Kernstine and Amrita Krishnan

PET scan and PET/CT scans are being widely used for staging of diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma. They are sensitive and specific imaging techniques available for lymphoma. However, practicing hematologists must be aware of false-positive tests, which can upgrade the stage of the lymphoma significantly and may alter the treatment paradigm for an individual patient. This report describes a case of DLBCL that was upgraded with PET/CT scan to stage IVA from stage IA. Pursuit of tissue biopsy with minimally invasive surgery eventually confirmed it to be stage IA DLBCL and paraesophageal leiomyoma. This case highlights the potential pitfalls of modern imaging techniques and the need for histologic diagnosis.

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Robert J. Morgan Jr., Ronald D. Alvarez, Deborah K. Armstrong, Barry Boston, Robert A. Burger, Lee-may Chen, Larry Copeland, Marta Ann Crispens, David Gershenson, Heidi J. Gray, Perry W. Grigsby, Ardeshir Hakam, Laura J. Havrilesky, Carolyn Johnston, Shashikant Lele, Ursula A. Matulonis, David M. O'Malley, Richard T. Penson, Steven W. Remmenga, Paul Sabbatini, Russell J. Schilder, Julian C. Schink, Nelson Teng and Theresa L. Werner

Ovarian neoplasms consist of several histopathologic entities, and treatment depends on the specific tumor type. Epithelial ovarian cancer comprises most malignant ovarian neoplasms (∼ 80%)1; however, other less-common pathologic subtypes must be considered in treatment guidelines. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Ovarian Cancer discuss epithelial ovarian cancer (including borderline or low malignant potential) and less-common histopathologies, including malignant germ cell neoplasms, carcinosarcomas (malignant mixed Müllerian tumors of the ovary [MMMT]), and sex cord-stromal tumors. The guidelines also discuss fallopian tube and primary peritoneal cancers, which are less-common neoplasms that are managed similarly to epithelial ovarian cancer. However, the less-common histologies of ovarian cancer are managed differently. Information on the less-common ovarian histopathologies are not published in this issue of JNCCN, but can be found online at www.NCCN.org. Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States and the country's fifth most common cause of cancer mortality in women. In 2010, an estimated 21,900 new diagnoses and 13,900 deaths will occur from this neoplasm in the United States; fewer than 40% of women with ovarian cancer are cured.2,3 The incidence of ovarian cancer increases with age and is most prevalent in the eighth decade of life, with a rate of 57 per 100,000 women. The median age at diagnosis is 63 years, and 70% of patients present with advanced disease.4 Epidemiologic studies have identified risk factors for ovarian cancer. A 30% to 60% decreased risk of cancer is associated...
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Junction Cancers Hazard Lisa MD Yang Gary MD McAleer Mary Frances MD, PhD Hayman James MD, MBA Willett Christopher MD 10 2008 6 6 9 9 870 870 878 878 0060870 10.6004/jnccn.2008.0065 Minimally Invasive Surgery for

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Robert J. Morgan Jr.

encourages enrollment of patients to currently ongoing clinical trials. Weak clinical data mean less robust recommendations. In surgery, advances in technique (e.g., minimally invasive surgery to treat early or advanced ovarian cancer) are reviewed by Han

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.0010 Indications for Minimally Invasive Surgery for Ovarian Cancer Han Ernest S. MD, PhD Wakabayashi Mark MD, MPH 1 2011 9 9 1 1 126 126 132 132 0090126 10.6004/jnccn.2011.0011