Khaled Abdel Wahab

Accuracy of Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer Patients; Single Center Experience

Purpose: Most important factor affecting prognosis of breast cancer is axillary nodal involvement. Several studies evaluated the accuracy of Sentinel lymph node biopsy in breast cancer patients post neoadjuvant chemotherapy. In this study, we will examine accuracy and feasibility of using Sentinel lymph node biopsy in predicting axillary lymph node status in breast cancer patients after neoadjuvant chemotherapy. Methods: 45 female patients with resectable, nonmetastatic breast carcinoma cases who received neoadjuvant chemotherapy were enrolled in this study according to the routine Mansoura Oncology Center—guidelines of management of breast cancer. Methylene blue dye used for detection of Sentinel lymph node. Results: Successful Sentinel lymph node detection was 82.2%. Skin involvement (T4 disease) were linked to a low identification (P = 0.005). False negative rate equals 11/27 = (40.7%).With advancement of the stage of the tumor, the incidence of false negative results increases significantly (p = 0.012) with 95% confidence interval; 1.2 - 5.4. Conclusion: Sentinel lymph node should be adopted to be the standard method for axillary staging with T1-3 tumors after receiving neoadjuvant chemotherapy, in T4 patients, it is associated with low detection rate & high false negative rate making it doubtful technique for axillary staging.

Surgery after neoadjuvant chemotherapy for muscle invasive bladder cancer: clinicopathological and surgical outcomes

In the United States, bladder cancer (BC) accounts for about 5% of newly diagnosed cancer cases. It is reported to be the 4th most common cancer in men and the 9th in women. It has the fifth highest incidence of all malignancies, with more than 74,000 newly diagnosed cases and 15,000 deaths in 2014. In Egypt, BC is considered the 2nd most common cancer in men (12.7%) after hepatocellular carcinoma (18.7%), and one of the most common cancers in women after breast cancer (38.8%), lymphoma, leukemia and ovarian cancer.

Parotid Quadrantectomy Is a Safe Management for Localized Pleomorphic Adenoma

Aim Pleomorphic adenoma is the most common benign tumor of the parotid gland and is classically treated with superficial or total parotidectomy. Less radical surgeries have been proposed to minimize the risk of facial nerve injury. The oncological safety of these procedures remains controversial. We conducted this study to evaluate the safety of superficial hemi-lobectomy (quadrantectomy). Patients and methods Retrospective analysis was conducted on the paraffin sections of archived superficial parotidectomy specimens from 11 male and 6 female patients (median age 33 years). The microscopic extent of extra-capsular extension was determined on pathological revision. In addition, prospective evaluation of 12 quadrantectomy procedures (M/F = 7/5, median age = 36 years) compared to 24 radical surgeries (M = F, median age = 40 years) regarding temporary and persistent facial nerve dysfunction on routine clinical assessment and recurrence rate. Results On retrospective pathological revision, pleomorphic adenomata had a median microscopic spread of 3 mm beyond capsule in paraffin sections (SD = 3.6). On prospective analysis with a median follow-up of 33 months (range = 18–54 months), quadrantectomy had similar relative risk of temporary facial nerve dysfunction evaluated at the immediate postoperative period as well as persistent nerve dysfunction assessed at 3 months (P = 0.701 and P = 0.902, respectively). Of the whole study population, one case of recurrence after total parotidectomy was observed at mid-term follow-up (P = 1.000). Conclusion Parotid quadrantectomy is a safe management for smaller pleomorphic adenomata localized close to one of the two divisions of the facial nerve.

Versatility in Mandibular Reconstruction after Ablative Tumor Surgery, Single Center Experience

Introduction Mandibular reconstruction using vascularized osteocutaneous flaps is necessary to improve functional outcomes, such as jaw movement and mastication, and aesthetics after the wide resection of the mandible [1].

Epidemiological and Pathological Correlates of Postoperative Mortality of Patients with Ovarian Cancer

Background: Epithelial ovarian cancer is the most lethal gynecologic malignancy and is the fifth most common cause of cancer-related death among women. The current study was designed to investigate the epidemiological and pathological correlates of postoperative mortality of ovarian cancer at a tertiary care center in Mansoura, Egypt. Methods: An epidemiological analysis of prospectively collected data of ninety five primary ovarian cancer cases referred to the Surgical Oncology Center at Mansoura University Hospitals, Mansoura, Egypt. The association of the epidemiological, pathological data and the serum levels of the tumor marker CA-125 and 6-months and 1-year mortality was statistically tested. Results: A total of 95 ovarian cancer cases were included in the current study. The mean age of patients was 52.18 ranging from 14 to 98 years, and the median age was 53 years. Pathological examination showed that serous cancers were the most common type detected in 46 (48%), followed by adenocarcinoma in 24 (25%) and then mucinous in 9 (9 %) patients. Cases presented at late stages of the ovarian cancer disease with 51 (55%) cases presenting with stage III and IV. The majority of cases (n=83, 88.1%) received neo adjuvant chemotherapy. The average serum CA- 125 level was 325.38 U/ml with 50 % of cases had readings equal to or more than 233.15 U/ml. The mortality rate at 6 months was 4% and at 1-year was 17%. Age was positively correlated with 6 months mortality (p<0.05). Ninety percent of deaths at one year occurred in patients more than 45 years of age and 50% of deaths occurred in patients more than 60 years of age. Conclusion: In a tertiary care surgical oncology center in Mansoura, Egypt, patients with ovarian cancer are more commonly to present with later stage