The Landmark Series

The Annals of Surgical Oncology (ASO) is pleased to announce, The Landmark Series. As described by ASO Editor-in-Chief, Kelly M. McMasters, MD, PhD, “The Landmark Series is designed to trace the origins of current multidisciplinary therapy for each type of solid tumor, and demonstrate the logical progression of clinical trials and other key evidence. It is meant to be an educational resource, for trainees and practicing cancer specialists alike, in the understanding of evidence-based cancer management.” Read the complete introductory editorial by Dr. McMasters.

New articles in this series are published on an ongoing basis. Please review the complete listing of articles, organized by cancer type, below.

Updated: June 23, 2020

The Landmark Series: Axillary Management in Breast Cancer

Carla S. Fischer, MD, Julie A. Margenthaler, MD, Kelly K. Hunt, MD and Theresa Schwartz, MD

The evolution in axillary management for patients with breast cancer has experienced multiple dramatic changes over the past several decades. The end result has been an overall de-escalation of surgery in the axilla. Here are reviewed the landmark trials that have formed the basis for our current treatment guidelines. Ann Surg Oncol 27, 724 – 729 (2020).

The Landmark Series: Adjuvant Radiation Therapy for Breast Cancer

Stephanie A. Valente, DO and Chirag Shah, MD

This Landmark Series evaluating radiation therapy for breast cancer is a review of milestone trials which have established treatment paradigms to improve both local control and survival for breast cancer patients. Ann Surg Oncol 27, 2203 – 2211 (2020).

The Landmark Series: Management of Lateral Lymph Nodes in Locally Advanced Rectal Cancer

Oliver Peacock, BMBS, PhD and George J. Chang, MD, MS

The aims of this Landmark Series are to present the recent key studies and evolution of lateral pelvic lymph node management in locally advanced rectal cancer and secondly to propose a management strategy for the lateral compartment based on the current evidence. Ann Surg Oncol (2020).

The Landmark Series: Gallbladder Cancer

Adrianna C. Gamboa, MD, MS and Shishir K. Maithel, MD

This Landmark Series reviews the diagnosis, presentation, and management of gallbladder cancer and specifically discusses the surgical approach and guidelines for adjuvant therapy and explores future studies for delivering neoadjuvant therapy prior to re-resection for incidentally discovered gallbladder cancer. Ann Surg Oncol (2020).

The Landmark Series: Intrahepatic Cholangiocarcinoma

Jordan M. Cloyd, MD, Aslam Ejas, MD, MPH, and Timothy M. Pawlik, MD, MPH, MTS, PhD

Intrahepatic cholangiocarcinoma is an aggressive biliary tract cancer with distinct anatomic, molecular, and clinical characteristics that distinguishes it from other biliary tract cancers. In this Landmark Series review, we highlight the critical studies that have defined the surgical management of ICC, as well as several randomized controlled trials that have investigated adjuvant therapy strategies. Ann Surg Oncol (2020).

The Landmark Series: Regional Therapy of Recurrent Cutaneous Melanoma

Georgia M. Beasley, MD, Jonathan S. Zager, MD and John F. Thompson, MD

In-transit melanoma represents a distinct disease pattern in which melanoma recurs as dermal or subcutaneous nodules between the primary melanoma site and the draining regional lymph node basin. The disease pattern is often not amenable to complete surgical resection. Here are reviewed landmark studies describing and evaluating regional chemotherapy and intralesional therapies for patients with in-transit melanoma metastases. Ann Surg Oncol 27,35 – 43 (2020).

The Landmark Series: Randomized Trials Examining Surgical Margins for Cutaneous Melanoma

C.V. Angeles, MD, S. L. Wong, MD and G. Karakousis, MD

Between 1980-2004 there have been six randomized controlled trials (RCTs) performed to evaluate the width of surgical margin excision for primary cutaneous melanoma and its influence on recurrence and survival. These RTCs, related current recommendations and long-term follow-up data, as well as a contemporary, actively enrolling trial are summarized and discussed in this Landmark Series. Ann Surg Oncol 27, 3 – 12 (2020).

The Landmark Series: MSLT-1, MSLT-2 and DeCOG (Management of Lymph Nodes)

Danielle M. Bello, MD and Mark B. Faries, MD

This review focuses on the three landmark, randomized controlled trials that evaluated the role of surgery for regional lymph nodes in melanoma: Multicenter Selective Lymphadenectomy Trial I (MSLT-I), German Dermatologic Cooperative Oncology Group-Selective Lymphadenectomy Trial (DeCOG-SLT), and Multicenter Selective Lymphadenectomy Trial II (MSLT-II). Ann Surg Oncol 27, 15 – 21 (2020).

The Sunbelt Melanoma Trial

Michael E. Egger, MD, MPH, Charles R. Scoggins, MD, MBA and Kelly M. McMasters, MD, PhD

The Sunbelt Melanoma Trial was a multi-center, prospective randomized clinical trial that evaluated the role of high dose interferon alfa-2b (HDI) therapy in patients with a single positive sentinel lymph node (SLN) metastasis treated with a completion lymph node dissection (CLND). Although this trial did not demonstrate an improvement in survival with HDI, it is an important trial that highlights the importance of surgeon-initiated randomized clinical trials that incorporate surgical techniques, molecular biomarkers, and adjuvant therapy. Ann Surg Oncol 27, 28 – 34 (2020).

The Landmark Series: Non-melanoma Skin Cancers

Ann Y. Lee, MD and Russel S. Berman, MD

This article reviews the landmark clinical trials that led to the first FDA-approved drugs for basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma and places them in the context of current national guidelines. Ann Surg Oncol 27, 22 – 27 (2020).

The Landmark Series: Neoadjuvant Systemic Therapy (NAST) for Stage 3 Melanoma Patients – A Potential Paradigm Shift in Management

Andrew J. Spillane, MD, Alexander M. Menzies, MBBS, PhD and Alexander C. J. van Akkooi, MD, PhD

For high-risk stage 3 patients neoadjuvant immune checkpoint blockade (ICB) and targeted therapies present a promising novel approach to improving survival outcomes. This Landmark Series review focusses on four immune therapy and two targeted therapy clinical trials reported in the era of modern systemic therapy. Ann Surg Oncol (2020).

The Landmark Series: Multimodality Therapy for Stage 3A Non-small Cell Lung Cancer

Marcus E. Eby, MD and Christopher W. Seder, MD

This review focuses on the landmark trials Southwest Oncology Group (SWOG) 8805 and Intergroup (INT) 0139, and their role in establishing current treatment algorithms using induction chemoradiotherapy and the potential benefits of surgical resection for select patients with stage IIIA non-small cell lung cancer. Ann Surg Oncol (2020).

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