Pathologic findings on re-excision of the primary site in XXXX @entity1 considered for treatment by primary radiation therapy.

@entity1 @entity3821 @entity0 @entity41 @entity5 @entity189 @entity513 @entity2483
Gross excision of the @entity5 followed by radiotherapy is used for treatment of early @entity0 . Local recurrence after this form of treatment is uncommon except in @entity1 with infiltrating @entity513 whose excision specimens reveal an @entity2483 ( @entity2483 ). It is unclear whether this observation is due to a qualitative difference in the response of @entity5 with @entity2483 to radiation or to a quantitative difference in the @entity5 burden remaining after gross excision in @entity1 with @entity2483 . To address this question, the authors examined pathologic material in 71 @entity1 with infiltrating @entity513 treated with gross excision of the @entity5 and then selected for re-excision of the @entity5 site prior to radiotherapy because of the presence of either @entity2483 in the primary excision specimen or microscopic @entity5 at or close to margins in the initial excision. @entity189 was seen in 62% of all @entity1 but was more frequent among the 25 @entity1 with @entity2483 than the 46 without (88% vs. 48%, P = 0.002). The nature of the @entity41 differed for @entity1 with and without @entity2483 in the primary excision specimen. @entity189 in @entity1 with @entity2483 was often widespread and composed predominantly of @entity3821 . In contrast, @entity41 in @entity1 without @entity2483 usually consisted of only scattered microscopic foci of infiltrating and/or @entity3821 . The authors conclude that @entity1 with @entity2483 treated with gross excision of the @entity5 frequently have considerable residual @entity3821 near the primary site. This finding may account for the increased risk of local recurrence observed in @entity1 with @entity2483 treated without re-excision of the @entity5 site before radiation therapy.
