Abstract:
BACKGROUND:Long-term transcutaneous tunneled central venous catheters are frequently placed in cancer patients, accounting for significant costs and morbidity. Factors influencing outcome, though, are poorly studied. METHODS:Between June 1991 and June 1993, 923 central venous tunneled catheters were placed in 791 patients at Memorial Sloan-Kettering Cancer Center. Placement-, device-, and patient-related parameters were charted prospectively (median follow-up: 120 days) and correlated to device-specific outcome events. RESULTS:Median patient age was 28.5 years (range: 0.025 - 84.5). Disease distribution included hematologic malignancies (64.7%), solid tumors (30.4%), and others (4.9%). Primary indications for line access included chemotherapy (72.8%), bone marrow transplantation (18.7%), total parenteral nutrition (6.4%), and drug administration (2.1%). There were 11 insertion complications (1.2%), including insertion failure (n = 6), hemorrhage (n = 4), and malposition (n = 1). Subsequent to placement, a proven or suspected device-specific complication occurred in 540 lines (58.5%). Per 10,000 catheter days, there were 17.6 infection episodes, 8.1 thrombotic complications, 6.9 instances of catheter breakage, 3.5 accidental or inadvertent cases of displacement, and 0.6 device leaks. Reasons for line removal or other termination of follow-up were patient's death (32.1%), treatment end (28%), infection (19.6%), suspected infection (6.3%), displacement (6.8%), thrombosis (3.1%), leak (1%), and others (3.1%). Median device-specific duration was 365 days, compared with a median complication-free device-specific duration of 167 days (P < 0.0001), reflecting a highly significant device salvage rate after complications. Catheter tip position emerged as the dominant independent prognostic factor for reduced device-specific duration or complication-free device-specific duration. CONCLUSIONS:Transcutaneous tunneled central venous lines can be placed safely, with a considerable incidence of subsequent device-specific complications, but a high salvage rate. Factors determining outcome are related to device placement, as well as the patient's disease status. In this study, patients alive 90 days after catheter placement had a 37% chance for a device complication, with a 20% chance for device loss. Future analyses of intermediate-term intravenous access should employ the measurement of device-specific outcome as a reference parameter to assess clinical results.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Schwarz RE,Coit DG,Groeger JSdoi
10.1007/s10434-000-0441-ykeywords:
subject
Has Abstractpub_date
2000-07-01 00:00:00pages
441-9issue
6eissn
1068-9265issn
1534-4681journal_volume
7pub_type
杂志文章abstract::Breast surgery has evolved as a subspecialty of general surgery and requires a working knowledge of benign and malignant diseases, surgical techniques, shared decision-making with patients, collaboration with a multi-disciplinary team, and a basic foundation in surgical ethics. Ethics is defined as the practice of ana...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-015-4751-5
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Postoperative changes after axillary lymph node surgery may significantly alter breast cancer survivors' (BCS) quality of life. Although sentinel lymph node biopsy (SLNB) has less immediate morbidity than axillary lymph node dissection (ALND), its long-term impact on shoulder abduction, arm swelling, and neu...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9909-y
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Adaptor proteins, with multimodular structures, can participate in the regulation of various cellular functions. A novel adaptor protein XB130 has been implicated as a substrate and regulator of tyrosine kinase-mediated signaling and in controlling cell proliferation and apoptosis in thyroid and lung cancer ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2474-4
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:The 1998 post-operative radiotherapy meta-analysis for lung cancer showed a survival detriment associated with radiation for stage I-II resected non-small cell lung cancer (NSCLC), but has been criticized for including antiquated radiation techniques. We analyzed the National Cancer Database (NCDB) to determ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5786-6
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Low-dose rate brachytherapy is a well-established adjuvant treatment for soft tissue sarcomas (STS). The experience with high-dose rate brachytherapy (HDR BT) in this indication is limited. The purpose of our study was to evaluate the viability of perioperative hyperfractionated HDR BT for STS. METHODS:Fort...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-009-0684-1
更新日期:2010-01-01 00:00:00
abstract:PURPOSE:The purpose of this study was to obtain a comprehensive understanding of the impact of postoperative tumor marker (TM) normalization on survival after pancreatectomy for pancreatic carcinoma. We propose the concept of surgical RECIST based on residual tumor and TM status. METHODS:A total of consecutive patient...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1311-x
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:We present an alternative access technique to facilitate preperitoneoscopic (extraperitoneal laparoscopic) approach for radical prostatectomy, herniorrhaphy, and other pelvic procedures. METHODS:A 0 degrees telescope was mounted into a Visiport Optical Trocar (Visiport), and via a periumbilical incision it ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9883-4
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Liver metastasis of gastric cancer (GC) is highly associated with poor prognosis. The development of sensitive biomarkers for detecting and predicting liver metastasis is required for better clinical outcome. OBJECTIVE:In this study, we aimed to identify novel genes associated with liver metastasis of GC. ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07985-6
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Dynamic contrast-enhanced magnetic resonance imaging (MRI) of the breast is highly sensitive for the diagnosis of primary breast malignancy. We investigated the clinical application of dedicated dynamic breast MR for routine screening for local recurrence following breast-conserving therapy. METHODS:Patient...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303784
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:This study aimed to determine the relationship between mammographic calcifications and magnetic resonance imaging (MRI) tumoral enhancement before and after neoadjuvant chemotherapy (NAC) and to assess the impact of these findings on surgical management. METHODS:This Institutional Review Board-approved, Hea...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5741-y
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Among all in-breast tumor recurrences (IBTR) following breast-conserving therapy (BCT), some comprise metachronous new primaries (NPs) while others are true recurrences (TRs). Establishing this distinction remains a challenge. METHODS:We studied 3932 women who underwent BCT for stage I-III breast cancer fro...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6209-4
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The maximum size of adrenal tumors that should be removed with a laparoscopic approach is controversial. It has been suggested that laparoscopic adrenalectomy is appropriate only for adrenal tumors < 6 cm in size. We report our experience with laparoscopic adrenalectomy in patients with adrenal tumors of > o...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02557272
更新日期:2002-06-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6852-4
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Remnant gastric cancer (RGC) has a major impact on the long-term survival of postgastrectomy patients. In this study, we established surveillance endoscopy guidelines for postgastrectomy patients based on the risk of RGC. PATIENTS AND METHODS:A total of 6365 patients who underwent gastrectomy at Seoul St. M...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08517-3
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:This anatomic study details the lymphatic drainage of the upper extremity (UE) and breast, as well as its course in the axilla and its relation to axillary reverse mapping. Two aspects important for breast cancer surgery were followed: connection between the lymphatics of the UE and breast, and the possible ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2363-x
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:We performed robot-assisted neck dissection (RAND) via a modified face-lift (MFLA) or retroauricular approach for neck management and carried out free flap reconstruction via these approaches in patients with head and neck cancer. We assessed the feasibility of free flap reconstruction in patients who had un...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2731-6
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The role of supplemental oxygen therapy in the healing of esophagojejunal anastomosis is still very much in an experimental stage. The aim of the present prospective, randomized study was to assess the effect of administration of perioperative supplemental oxygen therapy on esophagojejunal anastomosis, where...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-012-2714-7
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Little is known about metastatic patterns in patients with obstructing colorectal cancer (CRC). OBJECTIVE:The aim of this study was to determine if metastatic patterns in patients with CRC differ between patients with or without obstruction. METHODS:This single-center, observational, retrospective cohort s...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08119-8
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Dermatofibrosarcoma protuberans (DFSP) is a dermal sarcoma often diagnosed by excision biopsy, and is often incompletely excised, with high recurrence rates. Traditional wide excision involves resection margins of 2-4 cm, often resulting in morbid procedures requiring surgical reconstruction. An alternative ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08011-5
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:The risk of axillary failure (AF) after accelerated partial breast irradiation (APBI) using MammoSite brachytherapy is unknown and has been source of concern as the axillary region is not treated with this technique. We aimed to determine the rate of AF in patients treated with APBI and identify factors asso...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1734-z
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Melanoma metastatic to the gastrointestinal (GI) tract is asymptomatic or presents with pain, bleeding, or obstruction. To determine whether surgery influences outcomes, we reviewed our experience with this patient population. METHODS:Medical records of patients with metastatic melanoma to the GI tract were...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-999-0155-8
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:We seek to determine whether laparoscopic hyperthermic intraperitoneal chemoperfusion (LS-HIPEC) improves overall survival (OS) in patients with gastric and gastroesophageal adenocarcinoma and low-volume peritoneal metastasis compared with standard of care treatment. PATIENTS AND METHODS:We reviewed data fr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08968-8
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Definitive treatment of Graves' disease includes radioactive iodine (RAI) and thyroidectomy, but utilization varies. We hypothesize that, in addition to clinical reasons, there are socioeconomic factors that influence whether a patient undergoes thyroidectomy or RAI. METHODS:Patients treated for Graves' dis...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4095-6
更新日期:2015-04-01 00:00:00
abstract:INTRODUCTION:The introduction of the sentinel lymph node biopsy (SLNB) in breast cancer has renewed interest in lymphatic drainage to the internal mammary (IM) nodes. The clinical impact of tumor positive IM nodes is not completely clear. This study evaluated the incidence and impact on overall survival of metastatic I...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-015-4535-y
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The current technique for locating nonpalpable breast lesions is wire localization (WL). Radioactive seed localization and intraoperative ultrasound were developed to improve difficulties with WL. The SAVI SCOUT surgical guidance system was developed to improve these methods. The SCOUT system is a non-radioa...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-5079-x
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Touch imprint cytology (TIC) is a fast, cheap and specific intraoperative examination of the sentinel lymph nodes (SLNs) in early breast cancer patients. The results of TIC in patients with ultrasonically (US) uninvolved axillary lymph nodes are not known. The objective of our study was to compare the result...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9957-3
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:The FAK gene encodes a 125-kDa tyrosine kinase (p125FAK) involved in signal transduction pathways used in cell adhesion, motility, and anchorage-independent growth. Because thyroid carcinomas have a wide variability in their propensity for invasion and metastasis, we studied the expression of FAK in a variet...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02409059
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Current mammographic technology has resulted in increased detection of ductal carcinoma in situ (DCIS). It is necessary to assess which patients presenting with DCIS are good candidates for breast conservation and which of these patients should receive adjuvant radiation. METHODS:We accrued clinical data fo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303484
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Limited data are available on the use of cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (HIPEC) in patients with recurrent stage III ovarian cancer. METHODS:Patients with recurrent, heavily pretreated ovarian cancer were enrolled onto a phase II multimodal protocol consisting of exte...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0878-6
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Despite advances in the treatment of patients with gastric cancer, the debate over the optimal extent of lymphadenectomy continues. METHOD:A review of the classification, rationale for, and boundaries of lymphadenectomy is presented. A review of the available literature comparing D1 versus D2 versus D3 lymp...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07417-5
更新日期:2019-09-01 00:00:00