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Anuhya Kommalapati, Sri Harsha Tella, Adams Kusi Appiah, Lynette Smith, and Apar Kishor Ganti

, private insurance, higher education status, lower T and N stages, and treatment at high-volume centers ( Table 3 ). Approximately 25% of the patients treated at high-volume facilities received surgical therapy (either alone or in combination) as part of

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Matthew G. Ewend, David E. Morris, Lisa A. Carey, Alim M. Ladha, and Steven Brem

Brain metastases are an increasingly important determinant of survival and quality of life in patients with cancer. Current approaches to the management of brain metastases are driven by prognostic factors, including the Karnofsky Performance Status, tumor histology, number of metastases, patient age, and status of systemic disease. Most brain metastases are treated with radiosurgery, computer-assisted surgery, or whole brain radiation therapy. Remarkable advances in computer-assisted neuronavigation have made neurosurgical removal of metastases safer, even in eloquent areas of the brain. Computerization also enhances the efficacy and safety of conformal radiosurgery planning using various modern stereotactic radiosurgery (SRS) technologies, including newer frameless-based systems. Controversial issues include whether to defer whole brain radiotherapy (WBRT) in patients undergoing SRS or image-guided surgery and when to use SRS “boost” in a patient undergoing WBRT. The determination of how best to apply these treatments for individual patients cannot be standardized to a single paradigm, but data from well-controlled studies help physicians make informed decisions about the benefits and risks of each approach.

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Alison M. Lake and William W. Roberts

Upper tract transitional cell carcinoma (TCC) accounts for approximately 5% of urothelial tumors. Surgical therapy for upper tract TCC is based on tumor grade, stage, location, and confounding factors of individual cases. Options for treatment range from minimally invasive procedures, such as ureteroscopy, to open nephroureterectomy. Laparoscopic nephroureterectomy is progressively eclipsing open nephroureterectomy in the surgical management of upper tract TCC. This article discusses the surgical options for managing upper tract TCC and their considerations for use.

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

Both locally advanced and metastatic renal cell carcinoma (RCC) present a challenge in terms of their optimal management. This article reviews the literature and evaluates the role of surgery in the treatment of advanced RCC. Surgery is the optimal treatment for locally advanced RCC and minimal, resectable, metastatic disease. Patients with metastatic disease, and some forms of locally advanced disease, may also benefit from multimodal management with local surgical therapy and systemic treatment using either immunotherapy or targeted therapy. Regardless of the disease stage, patients with locally advanced or metastatic RCC represent heterogenous patient populations with different disease characteristics and risk factors. Individualization of care in the setting of a sound oncologic framework may optimize the risk/benefit ratio within individual patient cohorts.

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Mark Bloomston, Henry Kaufman, John Winston, Mark Arnold, and Edward Martin

comparing laparoscopic-assisted colectomy versus open colectomy for colon cancer . J Natl Cancer Inst Monogr 1995 ; 19 : 51 – 56 . 2 The Clinical Outcomes of Surgical Therapy Study Group . A comparison of laparoscopically assisted and open

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Robert J. Downey and Lee M. Krug

cell carcinoma: relationship to surgical therapy . Semin Oncol 1978 ; 5 : 272 – 279 . 8 Fox W Scadding JG . Medical Research Council comparative trial of surgery and radiotherapy for primary treatment of small-celled or oat

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Lauren E. Kernochan and Rochelle L. Garcia

Edited by Kerrin G. Robinson

mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus . Gynecol Oncol 2007 ; 107 : 177 – 185 . 27 Cicin I Saip P Eralp Y . Ovarian carcinosarcomas: clinicopathological prognostic factors and evaluation of

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Vivian E. Strong, Thomas A. D’Amico, Lawrence Kleinberg, and Jaffer Ajani

in the submucosa (T1b) or deeper are treated with esophagectomy. The treatment of patients with T2,N0 disease is controversial, with some centers preferring primary surgical therapy with or without adjunct therapy, whereas others prefer induction

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Jeffrey A. Norton, Tony D. Fang, and Robert T. Jensen

& Wilkins ; 2001 : 291 – 344 . 36. Thompson NW . Multiple endocrine neoplasia type I. Surgical therapy . Cancer Treat Res 1997 ; 89 : 407 – 419 . 37. Bartsch DK Langer P Wild A . Pancreaticoduodenal endocrine tumors in multiple

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Richard B. Hostetter, Min Yan, Houman Vaghefi, Kenneth Pennington, and Gary Cornette

, original magnification x100). The patient's care and management were presented before the multidisciplinary sarcoma conference, and the decision was made to proceed with a more thorough surgical staging and more radical oncologic surgical therapy