Omission of chemotherapy for hormone receptor-positive and human epidermal growth factor receptor 2-negative breast cancer: patterns of treatment and outcomes from the Korean Breast Cancer Society Registry.

Purpose: Although adjuvant chemotherapy (CTx) is still recommended for high-risk patients with hormone receptor-positive and human epidermal receptor (HER)-2-negative breast cancer, recent studies found that selected patients with low disease burden may be spared from CTx and receive hormonal treatment (HT) alone. This study aims to evaluate the trends of treatment (CTx + HT vs. HT alone) in Korea and to assess the impact on overall survival (OS) according to treatment pattern. Methods: The Korean Breast Cancer Society Registry was queried (2000 to 2018) for women with pT1-2N0-1 hormone receptor-positive and HER2-negative disease who underwent surgery and adjuvant systemic treatment (CTx and HT). Clinicopathologic factors, change in pattern of treatment over time, and OS for each treatment option were analyzed. Results: A total of 40,938 women were included in the study; 20,880 (51.0%) received CTx + HT, while 20,058 (49.0%) received HT only. In recent years, there has been a steady increase in the use of HT alone, from 21.0% (2000) to 64.6% (2018). In Cox regression analysis, age, type of breast and axillary operations, T and N stages, body mass index, histologic grade, and presence of lymphovascular invasion were prognostic indicators for OS. There was no significant difference between CTx + HT and HT alone in terms of OS (P = 0.126). Conclusion: Over the years, there has been a shift from CTx + HT to HT alone without a significant difference in OS. Therefore, HT alone could be a safe treatment option in selected patients, even those with T2N1 disease.

Experience with small-incision and conventional cholecystectomies in a community hospital

We reviewed the results of 25 small-incision cholecystectomies and 79 conventional cholecystectomies performed at Visayas Community Medical Center from January 1, 2000 to January 31, 2002. There were no differences in the mean age and the male to female ratio in both groups. The mean duration of operation for the small-incision cholecystectomy group was 132.2 minutes while it took 133.4 minutes in the conventional cholecystectomy group. Resumption of regular diet in the small-incision cholecystectomy group was 2.5 days while it took 4 days in the conventional cholecystectomy group. Postoperative hospital stay ranged from 3 to 6 days with a mean of 4 days in the small-incision cholecystectomy group. On the other hand, postoperative hospital stay ranged from 4 to 10 days with a mean of 7.3 days in the conventional cholecystectomy group. Complications seen included postoperative fever, intraoperative bleeding, wound infection and bile leak. Overall, our study confirmed the earlier resumption to regular diet and shorter postoperative stay, thus, faster recovery in the small-incision cholecystectomy group. However, no conclusion can be made because of limitations in the study design and the small sample size. (Author)

A 10 year review of primary soft tissue sarcomas at the Vicente Sotto Memorial Medical Center

A retrospective record review of the clinical characteristics and management of primary soft tissue sarcomas in patients admitted to the surgical department of a government hospital, from January 1991 to December 2000, was done. A total of 54 cases were studied. Data showed that patients had a mean age of 45 years with an equal sex distribution. Forty two percent of sarcomas affected the lower limbs. Thirty-three percent of all cases were fibrosarcomas, and most were more than 5 cm in size and situated deep in to the fascial layer. Twenty patients (37 percent) had distant metastases on admission, 45 percent of which involved the lungs. Wide excision was the most common surgical procedure during the last three years of the study period, with less patients refusing surgery than previous years when amputation was the usual treatment. Wide excision resulted in complete gross tumor extirpation in 94 percent of cases. However, after discharge, most patients did not return for follow-up nor complied with the prescribed adjuvant treatments. (Author)