A patient who has had a lumpectomy with positive margins as part of their treatment for a current DCIS diagnosis is eligible (post-excision mammogram required at enrollment to establish a new baseline)
Surgical margins must be clear of invasive carcinoma; if there is microscopic residual ductal in situ disease present at lumpectomy or total mastectomy margins, further excision is highly recommended; if further excision is not undertaken, the subject may still be entered on study, provided that in addition to breast or chest wall irradiation, a boost to the tumor bed is delivered; in situ lobular disease at the margin is acceptable
For patients who undergo lumpectomy, the margins of the resected specimen must be histologically free of invasive tumor and ductal carcinoma in situ (DCIS) as determined by the local pathologist; if pathologic examination demonstrates tumor at the line of resection, additional excisions may be performed to obtain clear margins; if tumor is still present at the resected margin after re-excision(s), the patient must undergo mastectomy to be eligible; (patients with margins positive for lobular carcinoma in situ [LCIS] are eligible without additional resection)
For patients who undergo mastectomy, the margins must be free of residual gross tumor; (patients with microscopic positive margins are eligible as long as post-mastectomy radiation therapy [RT] of the chest wall will be administered)
The interval between the last surgery for breast cancer (including re-excision of margins) and randomization must be no more than 60 days
Completely resected stage IB (>= 4 cm), II or IIIA non-squamous NSCLC with negative margins; patients may not have received neoadjuvant therapy (chemo- or radio-therapy) for this lung cancer
Evidence that tumor is adherent to or invading the mesorectal fascia on imaging studies such that the surgeon would not be able to perform an R0 resection (one with negative margins)
Must have completed definitive resection of primary tumor\r\n* Negative margins for both invasive and ductal carcinoma in situ (DCIS) are desirable, however patients with positive margins may enroll if the treatment team believes no further surgery is possible and patient has received radiotherapy; patients with margins positive for lobular carcinoma in situ (LCIS) are eligible\r\n* Either mastectomy or breast conserving surgery (including lumpectomy or partial mastectomy) is acceptable\r\n* Sentinel node biopsy either pre or post neoadjuvant chemotherapy (i.e. at the time of definitive surgery) are allowed; axillary dissection is encouraged in patients with lymph node involvement, but is not mandatory
No invasive cancer at the surgical margins
For patients who undergo lumpectomy, the margins of the resected specimen or re-excision must be histologically free of invasive tumor and DCIS as determined by the local pathologist; additional operative procedures may be performed to obtain clear margins; if tumor is still present at the resected margin after re-excision(s), the patient must undergo total mastectomy to be eligible; (patients with margins positive for lobular carcinoma in situ [LCIS] are eligible without additional resection)
For patients who undergo mastectomy, the margins must be histologically free of residual (microscopic or gross) tumor
Patients with microscopic positive margins after definitive surgery
Completed adequate breast surgery defined as:\r\n* The inked margins of breast conservation surgery or mastectomy must be histologically free of invasive breast cancer and ductal carcinoma in situ with the exception of the posterior margin if this margin is the pectoralis major fascia or the anterior margin if this is the dermis; patients with resection margins positive for lobular carcinoma in situ are eligible\r\n* Patients with breast conservation must have adjuvant radiotherapy; patients having mastectomy may have adjuvant radiotherapy according to local policy and/or international guidelines
Patients with tumor in the parametria, pelvic lymph nodes or any other extra uterine site or with positive surgical margins
Margins of the resected specimen or re-excision specimen must be histologically free of invasive tumor and ductal carcinoma in situ (DCIS) as determined by the pathologist\r\n* Notes: Additional operative procedures may be performed to obtain clear margins; focally positive margins are acceptable based on technical feasibility of additional surgery and/or the potential for benefit with further surgery based on the extent and location of the positive margin (eg, focally positive deep margin at the pectoralis fascia); also, patients with margins positive for lobular carcinoma in situ (LCIS) are eligible without additional resection
Microscopic positive margins after definitive surgery\r\n* Note: Patients with microscopically focally positive margins following lumpectomy or mastectomy are not excluded if re-excision is not technically feasible and/or there is no benefit to further surgery based on the extent and location of the positive margin
Tumor is deemed to be resectable with negative margins by conventional surgical standards
Diagnosed with residual pathologic disease after being surgically rendered free of disease with negative margins following complete resection
If there are 3 or more attempts by the surgeon to clear margins, patient is not eligible for study
Patients will have close margins
Positive margins after definitive surgery
Prior surgery for recurrent or new SCCHN is allowed in previously irradiated patients; a minimum of 4 weeks should elapse between any surgery and treatment on study; however, high-risk pathologic features should be present, such as positive margins, positive lymphadenopathy, perineural or angiolymphatic invasion
Subjects must have a histologically confirmed pancreatic adenocarcinoma that has had an R0 (negative margins) or R1 (microscopically positive margins) resection
Must have had surgical treatment of the breast - either mastectomy or breast preserving surgery, such as lumpectomy. Re-excision of surgical margins is permitted.
Surgical margins that cannot be microscopically assessed or are positive at pathologic evaluation. (If surgical margins are rendered free of disease by re-excision, the patient is eligible).
Inability to localise surgical bed on CT scans and/or surgical margins (cm) not known
One or more high risk features including: seminal vesicle invasion, extracapsular extension, positive margins, or a PSA post surgery between 0.2 and < 2.0
Must have undergone gross total resection of the primary tumor with curative intent within the past 8 weeks with surgical pathology demonstrating >= 1 of the following criteria for \intermediate\ risk of recurrence:\r\n* Perineural invasion\r\n* Lymphovascular invasion\r\n* Single lymph node > 3 cm or at least 2 nodes without evidence of extracapsular extension\r\n* Close margins defined as < 5 mm but not frankly positive (in the case of ambiguous, controversial, or superseded margins, final clinical assessment regarding margin status will prevail)\r\n* Pathologically confirmed T3 or T4 primary tumor.
INCLUSION - TREATMENT: Fibrotic area of prior tumor located at least 3 mm away from surgical margins
The primary tumor must be considered resectable by RP with gross negative margins as determined by a urologist. (Applicable to cohorts A and B1 only)
Has undergone a partial nephroprotective or radical complete nephrectomy (and complete resection of solid, isolated, soft tissue metastatic lesion(s) in M1 NED participants) with negative surgical margins.
Negative inked histologic margins from lumpectomy, with the exception of a focus of positive margin at the pectoralis fascia
Multicentric cancer in the ipsilateral breast as diagnosed by clinical examination, imaging, or pathologic assessment, not amenable to excision with negative margins with a single lumpectomy
Primary tumor excised by radical inguinal orchiectomy and pathology consistent with pure seminoma with negative surgical margins
Surgical treatment of the breast with lumpectomy plus (+) clinical target volume (CTV) margin up to 65 cc's or 5 cm in maximum dimension with histologically confirmed margins free of tumor (negative margins defined as no tumor on ink in all directions); re-excision of surgical margins is permitted
Pathologic T1 or T2 disease, resected with negative margins (>= 2mm)
Presence of close (< 2 mm) or positive margins
Focally positive surgical margins are permitted
Patients treated with simple cystectomy with macroscopically negative margins are eligible for this study
All tumors (invasive and non-invasive disease) must be excised with a minimum margin width of >= 2 mm; re-excision of surgical margins is permitted; focally close (< 2 mm) or positive (tumor cells at the inked edge of the specimen) margins determined to be at an anatomic boundary of resection by the surgeon, such as posterior fascia for posterior margins or skin for anterior margins, are also acceptable
The patient must be enrolled on the study within 42 days following the last surgery for breast cancer (lumpectomy, re-excision of margins, or axillary staging procedure)
Surgical margins that cannot be microscopically assessed or are positive at pathological evaluation; a focally positive margin determined to be at an anatomic boundary of resection by the surgeon, such as posterior fascia for posterior margins and skin for anterior margins, is also acceptable; if surgical margins are rendered free of disease by re-excision, the patient is eligible
Must have a lumpectomy performed, with documented negative surgical margins by 0.2 cm or more. If re-excision results in negative surgical margins 0.2 cm or more, patient is eligible.
If markers or clips were placed at the time of surgery, patient must be able to start treatment within 12 weeks after lumpectomy or re-excision for adequate margins.
Surgical treatment of the breast must have been lumpectomy; the margins of the resected specimen must be histologically free of tumor (DCIS and invasive); reexcision of surgical margins is permitted
Surgical margins that cannot be microscopically assessed or are positive at pathologic evaluation; (if surgical margins are rendered free of disease by reexcision, the patient is eligible)
Histologically positive margins
Negative inked histologic margins of lumpectomy (no invasive cells at margin) or negative re-excision specimen to be confirmed prior to radiation
The subject must have a complete removal of the primary HNSCC lesion with negative gross and microscopic margins; documentation of margins by frozen sections at surgery is recommended; patients who have already had surgery and have available banked tumor samples can be enrolled AFTER surgery
Surgical treatment of the breast must have been lumpectomy; the margins of the resected specimen must be histologically free of tumor (negative surgical margins per National Surgical Adjuvant Breast and Bowel Project [NSABP] criteria)
Surgical margins that cannot be microscopically assessed or that are positive
Patients with positive or close (< 3 mm) resection margins
Biopsy-proven invasive breast cancer, excised with negative margins of at least 1 mm
Patients with an HGG that was completely resected with good margins
Patients must have had either breast-conserving surgery with planned radiation therapy or total mastectomy (with or without planned postmastectomy radiation); patients must have clear margins from both invasive breast cancer and DCIS (as per local institutional guidelines); lobular carcinoma in situ (LCIS) at the margins is allowed
Patients at initial presentation of melanoma must undergo an adequate wide excision of the primary lesion, if present; patients with previously diagnosed melanoma must have had all current disease resected with pathologically negative margins and must have no evidence of disease at the primary site or must undergo re-resection of the primary site; a full lymphadenectomy meeting the criteria outlined is required for all node-positive patients including those with positive sentinel nodes; patients with recurrent disease who have had a prior complete lymphadenectomy fulfill this requirement as long as all recurrent disease has been resected; for all patients, all disease must have been resected with negative pathological margins and no clinical, radiologic, or pathological evidence of any incompletely resected melanoma; patients must be registered within 98 days of the last surgery performed to render the patient free of disease
Positive surgical margins are permitted if the surgeon confirms complete resection of gross metastatic disease, and post-operative scans are negative
Patients must have undergone a full surgical resection (radical nephrectomy or partial nephrectomy), including removal of all clinically positive nodes; surgical margins must be negative; patients with positive renal vein margins are eligible unless there is invasion of the renal vein wall at the margin (provided no other margins are positive); patients must plan to start study drug within 84 days after the date of full surgical resection; patients must have recovered from any surgical related complications
Gross total resection of the primary tumor with curative intent must be completed within 7 weeks of registration with surgical pathology demonstrating one or more of the following “intermediate” risk factors:\r\n* Perineural invasion\r\n* Lymphovascular invasion\r\n* Single lymph node > 3 cm or >= 2 lymph nodes (all < 6 cm) (no extracapsular extension)\r\n* Close margin(s) of resection, defined as cancer extending to within 5 mm of a surgical margin, and/or an initially focally positive margin that is subsequently superseded by intraoperative negative margins; similarly, patients whose tumors had focally positive margins in the main specimen but negative margins from re-excised samples in the region of the positive margin are eligible; for questions or ambiguities about an individual case, contact Dr. Machtay and/or Dr. Holsinger prior to enrolling the patient\r\n* Pathologically confirmed T3 or T4a primary tumor; for questions or ambiguities about an individual case, contact Dr. Machtay and/or Dr. Holsinger prior to enrolling the patient\r\n* T2 oral cavity cancer with > 5 mm depth of invasion
Per the operative and/or pathology report, positive margin(s) (defined as tumor present at the cut or inked edge of the tumor), nodal extracapsular extension, and/or gross residual disease after surgery; note: patients whose tumors had focally positive margins in the main specimen but negative margins from re-excised samples in the region of the positive margin are eligible; for questions or ambiguities about an individual case, contact Dr. Machtay and/or Dr. Holsinger prior to enrolling the patient
One of the following pathologic T-classifications: pT2 or pT3\r\n* Patients with positive surgical margins are eligible
Histologic diagnosis of resected stages IIIB/IIIC/IV melanoma, with no evidence of disease clinically and radiologically, and negative surgical margins; all melanomas regardless of primary site of disease will be allowed
Biopsy-proven invasive breast cancer, excised with negative margins of at least 1 mm
Negative histologic margins of partial mastectomy or re-excision specimen; margins generally are positive if there is invasive or noninvasive tumor at the inked resection margin, close but negative if the tumor is within 2 mm of the inked margin and negative if the tumor is at least 2 mm away from the inked edge
Surgical margins which cannot be microscopically assessed or are positive at pathological evaluation
The final margins of the resected specimen must be histologically free of tumor
Surgical margins that cannot be microscopically assessed or that are positive
All tumor removed by either a modified radical mastectomy or a segmental mastectomy (lumpectomy)\r\n* NOTE: management of axillary lymph nodes is up to the treating provider; however, all surgical margins should be clear of invasive cancer or DCIS (i.e., no tumor on ink); the local pathologist must document negative margins of resection in the pathology report; if all other margins are clear, a positive posterior (deep) margin is permitted, provided the surgeon documents that the excision was performed down to the pectoral fascia and all tumor has been removed; likewise, if all other margins are clear, a positive anterior (superficial; abutting skin) margin is permitted provided the surgeon documents that all tumor has been removed
Patients must have pathological Gleason (pG) sum 8-10; or pG sum 7 and either pT3 or R1 disease (i.e. positive margins)
Must have completed definitive resection of primary tumor. The most recent surgery for breast cancer must have been completed at least 14 days prior (but no more than 84 days prior) to study registration. NOTE: Negative margins for both invasive and ductal carcinoma in situ (DCIS) are desirable, however participants with positive margins may enroll if the treatment team believes no further surgery is possible and patient has received radiotherapy. Participants with margins positive for lobular carcinoma in situ (LCIS) are eligible. Either mastectomy or breast conserving surgery (including lumpectomy or partial mastectomy) is acceptable.
Cone margins and endocervical curettage (ECC) specimen negative for invasive cancer, cervical intraepithelial neoplasia (CIN) II, CIN III or adenocarcinoma-in-situ; (a negative margin is defined as no invasive cancer within 1.0 mm of both the endocervical and ectocervical margins and no adenocarcinoma in situ [AIS] or CIN II or CIN III at the inked or cauterized margin; one repeat cone and ECC permitted)
Cone margins or ECC specimen positive for invasive cancer, CIN II, CIN III or adenocarcinoma-in-situ (one repeat cone permitted)
Gross residual tumor or positive margins after surgery that is un-excised, as radiation dose in the study will be limited to 60 Gy.
All tumor should be removed by either a modified radical mastectomy or a segmental mastectomy (lumpectomy), with either a sentinel node biopsy or axillary dissection\r\n* All margins should be clear of invasive cancer or DCIS (i.e. no tumor on ink); the local pathologist must document negative margins of resection in the pathology report; if all other margins are clear, a positive posterior (deep) margin is permitted, provided the surgeon documents that the excision was performed down to the pectoral fascia and all tumor has been removed; likewise, if all other margins are clear, a positive anterior (superficial; abutting skin) margin is permitted provided the surgeon documents that all tumor has been removed; radiation therapy to the conserved breast is required
Patients must have clear margins after wide local excision; patients with nodes that are palpable or detectable on radiologic imaging must have an adequate lymphadenectomy
Negative margins after lumpectomy (re-excision for initial positive margins is allowed-negative margins defined as >= 2 mm clear of tumor in all directions); histological negative margins closer than 2 mm are permitted in the circumstance where the margin of excision is limited by adjacent tissues such as pectoral muscle or skin, but in the opinion of the surgeon and radiation oncologist an oncologically adequate excision was achieved
Final surgical margins negative defined as no tumor on ink; lobular carcinoma in situ involving the final surgical margin will be disregarded
Close (<3mm) or positive surgical margins on microscopic evaluation with no gross residual tumor
Have pathology-proven complete removal of all primary and liver metastatic CRC lesions. Subjects with positive margins will not be eligible for the study.
Negative surgical margins, defined as no margin-labeling ink on tumor cells from margin evaluation
Histologic proof of presence of residual tumor in liver explants and /or positive resection margins
Negative inked histologic margins from mastectomy pathology (no invasive cells at margin)
Repeat surgeries for oncologic reasons (positive margins)
pT1 breast cancer, excised with negative margins\r\n* Low risk-pTis breast cancer, excised with negative margins\r\n* Criteria for low risk-pTis:\r\n** Screen-detected\r\n** Low to intermediate nuclear grade\r\n** =< 2.5 cm in size\r\n** Resected with negative margins at >= 3 mm
Breast-conserving surgery with surgical excision of all gross disease with negative surgical margins (with the exception of a positive margin at skin and/or fascia where no more breast tissue can be removed) or mastectomy surgery with no gross residual disease
Tumor distance, including tumor free margins, should not be more than 40mm from the rectal wall.
New diagnosis if a previous breast cancer patient with negative surgical margins
Positive surgical margins
Positive surgical margins, or
Undergoing a second lumpectomy procedure because of positive margins in a previous surgery prior to entering this study.
Subjects undergoing a second surgery because they had positive margins in a previous surgery.
Women with positive margins after primary surgery
Women presenting after excision with positive margins are eligible; Ki-67, cyclooxygenase 2 (Cox-2), cyclin-dependent kinase inhibitor 2A (P-16), expression in immediately adjacent tissue is similar to what is found in DCIS\r\n* Note: Positive margins are defined as DCIS present at the inked margin or DCIS < 1 mm from the margin