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Saphner and colleagues [ 5] reported that patients with oestrogen receptor (ER -positive vER -positiveativersusours have distinct recurrence kinetumoursithave-negative patients exhibiting a greater hazardistincturecurrenceing the first 5 years, and a lower hazard of recurrence from years 5 to 12, as compared with ER-positive patients.
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Using a PCR-based approach, it was recently shown that clonally related ipsilateral recurrences were more frequently of higher histological grade and developed sooner after initial treatment than clonally distinct ipsilateral recurrences [ 9], and it has also been reported that women with clonally related ipsilateral recurrences had poorer outcomes than patients with unrelated tumor pairs [ 37].
They suggest that each peak is generated by clustering similar recurrences while different peaks result from distinct categories of recurrence.
A few explanations have been suggested to help interpret this finding, assuming that each peak is generated by clustering of similar recurrences and different peaks result from distinct categories of recurrence.
Korst et al. described 3 distinct patterns of recurrence following RFA of BE: endoscopically invisible intestinal metaplasia underneath neosquamous epithelium, visible recurrence in the tubular esophagus, and intestinal metaplasia of the gastroesophageal junction [ 61].
They also found that the subgroups display distinct patterns of recurrence in terms of timing and the sites of metastasis.
This model classifies test individuals into two risk groups with distinct survival characteristics (recurrence: p = 0.003; breast cancer death: p = 0.001).
The distinct and predictable recurrence and subsequent death risk patterns indicate a likely synchronizing effect of the surgical resection upon subsequent metastatic cancer development, apparently similar in all seeded distant organs [ 4].
The results of the present study argue against these views and support the concept that different peaks are related to the intrinsic general pathway of the metastasis development, not to distinct categories of recurrence.
It would be most interesting to determine in more recent patient series whether hormone receptor status is associated with distinct patterns of recurrences to individual metastatic sites.
5, 11 Our study revealed distinct histopathological features and recurrence patterns for MAC and SC (Table 2), which were discussed previously.
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