Abstract:
:Previous analysis of this prospective randomized trial and meta-analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis. From 1990 to 1995 a series of 248 patients with biopsy-proven gastric cancer were randomized intraoperatively to receive early postoperative intraperitoneal mitomycin C and 5-fluorouracil (125 patients) versus surgery only (123 patients). Gastric resection plus early postoperative intraperitoneal chemotherapy showed improved overall survival compared to surgery only (54% and 38%, respectively; p = 0.0278). There were statistically significant differences in patients with stage III (57% and 23%, respectively; p = 0.0024) and in those with stage IV (28% and 5%, respectively; p = 0.0098) gastric cancer. The improvement in survival rate was statistically significant for the subgroup of patients with gross serosal invasion (52% and 25%, respectively; p = 0.0004) and patients with lymph node metastasis (46% and 22%, respectively; p = 0.0027). The surgeons' impression about lymph node status was unreliable, but assessment of serosal invasion was accurate in 80% of cases. Gross serosal invasion with or without frozen section evaluation of lymph nodes can be used as the major selection criteria for early postoperative intraperitoneal chemotherapy of advanced gastric cancer.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Yu W,Whang I,Chung HY,Averbach A,Sugarbaker PHdoi
10.1007/s00268-001-0067-7keywords:
subject
Has Abstractpub_date
2001-08-01 00:00:00pages
985-90issue
8eissn
0364-2313issn
1432-2323journal_volume
25pub_type
临床试验,杂志文章,随机对照试验abstract::Surgeons often are faced with the challenge of balancing truth telling and the maintenance of hope in the setting of a poor prognosis. This ethical dilemma is informed by conflicting appeals to principles of autonomy and nonmaleficence, where a patient's right to be told important medical information must be weighed a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2566-3
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:The impact of time to readmission (TTR) on post-discharge mortality has not been well examined. We sought to define the impact of TTR on postoperative mortality after liver or pancreas surgery. METHODS:A retrospective cohort analysis of liver and pancreas surgical patients was conducted using 2013-2015 Medi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4766-8
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Substernal thyroidectomy (ST), as compared to conventional, cervical thyroidectomy, is a technically demanding procedure that is associated with increased morbidity and mortality. We tested the hypothesis that outcomes following ST are improved at centers that perform a high volume of thyroidectomies. METHO...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9347-1
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Better prognostic markers are needed for pancreatic endocrine tumors. Survivin is an apoptosis inhibitor that is suggested to have a negative prognostic impact in several tumor types. Contradictory data exist, especially regarding the significance of a nuclear versus cytoplasmic location of survivin. The pro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1345-7
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Resection of hepatocellular carcinoma (HCC) located in the right liver often requires hepatic mobilization. However, exposure of the HCC may be restricted when using the conventional abdominal approach (AA). In such cases, a thoracoabdominal approach (TA) can provide a good operating field. Although several ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1023-9
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Restless legs syndrome (RLS) is a common and poorly understood movement disorder that leads to unpleasant leg sensations. Although RLS can be idiopathic, secondary etiologies such as iron deficiency and renal failure are common. The aim of this prospective cohort study was to evaluate whether RLS is a common...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s00268-013-2185-4
更新日期:2013-12-01 00:00:00
abstract::We analyzed clinical features and genetic alterations in the noncancerous and cancerous biliary lesions obtained from pancreaticobiliary maljunction (PBM) patients. Gallbladder (GB) and bile duct (BD) lesions were obtained surgically from 36 patients with PBM, and polymerase chain reaction (PCR) methods were used to e...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0187-0
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Artificial intelligence is touted as the future of medicine. Classical algorithms for the detection of common bile duct stones (CBD) have had poor clinical uptake due to low accuracy. This study explores the challenges of developing and implementing a machine-learning model for the prediction of CBD stones i...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05820-8
更新日期:2021-02-01 00:00:00
abstract::Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directe...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012362
更新日期:1999-07-01 00:00:00
abstract::We have evaluated survival and tumor-related symptoms in the presence of mesenteric lymph node and liver metastases in relation to surgical procedures in 314 patients (148 women, mean age at diagnosis 61 years; 249 with liver metastases) treated for midgut carcinoid tumors. Of the operated patients, 46% presented with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6630-z
更新日期:2002-08-01 00:00:00
abstract::A new technique for ligating vessels and similar structures that offers more security is described. The aim of the study was to test whether this hypothesis was correct. Six different types of knots, including the one described in this article were compared by a strength-testing study. The knots were tied on a silicon...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7675-6
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare single-port access cholecystectomy (SPA) with the standard laparoscopic technique (LC) regarding the duration of the operation, complications, learning curve, late postoperative quality of life (QoL) and the incidence of incisional hernias. METHODS:Between June 2009 and ...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s00268-013-1946-4
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the efficacy of the Nd:YAG laser for treating stage I squamous cell carcinoma (SCC) of the lip. The retrospective study was performed in a tertiary care referral hospital in northern India. METHODS:In January 2007 the records of patients treated by Nd:YAG laser ablation o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9363-1
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The histone deacetylase (HDAC) inhibitors have emerged as the useful reagents that epigenetically modulate the expression of various genes. In the present study, the effects of HDAC inhibitors on the expression of inflammation-related genes and lung injury during sepsis were investigated. METHODS:Mice were ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0493-5
更新日期:2010-07-01 00:00:00
abstract::With the recent regulations limiting resident work hours, it has become more important to understand how residents spend their time. The volume and content of the pages they receive provide a valuable source of information that give insight into their workload and help identify inefficiencies in hospital communication...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0740-9
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Medullary thyroid cancer (MTC) disseminates early to lymph nodes (LN). There is no pre- or intraoperative marker to exclude LN involvement and thereby avoid lateral neck dissection in LN-negative patients. MATERIALS AND METHODS:This study was intended to verify the observation that patients with MTC lacking...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0391-4
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The Acute Care Surgery (ACS) model was developed as a dedicated service for the provision of 24/7 nontrauma emergency surgical care. This systematic review investigated which components are essential in an ACS model and the state of implementation of ACS models worldwide. METHODS:A literature search was con...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-020-05536-9
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Billions of people worldwide lack access to safe affordable surgery. Surgical missions and non-governmental organisations (NGO) are vital in meeting this need, but long-term outcomes are rarely reported. Mercy Ships is a surgical NGO, and we aimed to measure disability-free survival, impact and patient satis...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3745-1
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Neuroendocrine neoplasias (NEN) of the gastroenteropancreatic (GEP) system frequently present with metastatic deposits. The proliferation marker Ki-67 is used for diagnosis and to assess the prognosis of disease. The aim of our study was to evaluate the usefulness of Ki-67 % in the assessment of NEN patients...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2451-0
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Although the low central venous pressure (LCVP) technique is used to decrease blood loss during liver resection, its efficacy and safety during transplant procedures are still debatable. Our study aimed to assess the effects of this technique and its clinical safety for recipients undergoing liver transplant...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-010-0544-y
更新日期:2010-08-01 00:00:00
abstract::Resection remains the treatment of choice in liver cancer. In order to avoid liver transplantation in conventionally unresectable tumors ex-situ ("bench" procedure), in-situ and ante-situm resection technique should be preferred whenever feasible. Despite the deficiency of donor organs, a single center experience with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00299775
更新日期:1995-11-01 00:00:00
abstract::This paper investigates methodological limitations of the volume-outcome relationship. A brief overview of quality measurement is followed by a discussion of two important aspects of the relationship. ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7993-8
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:The quantification and analysis of adverse events is essential to benchmark surgical outcomes and establish a foundation for quality improvement interventions. We developed a hybrid electronic medical record (HEMR) system for the accurate collection and integration of data into a structured morbidity and m...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2766-x
更新日期:2015-01-01 00:00:00
abstract::Bacterial biofilms develop on a number of living and inert surfaces within the urinary tract, producing chronic intractable infections. The role of exopolysaccharides in producing a variety of extracellular polymeric substances according to the infection site and bacterial species and the clinical features of the resu...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010203
更新日期:2000-10-01 00:00:00
abstract::Some 25%-70% of sporadic medullary thyroid carcinomas (MTCs) are associated with somatic mutations within the RET proto-oncogene. In a significant number of MTCs, however, no such genetic variations can be detected, which implies alternative pathogenic molecular alterations. To assess altered RET mutation-specific gen...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7748-y
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Alternative methods to overcome limitations of electromyogram (EMG) tube applied for intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) during thyroidectomy have been introduced. In this study, we evaluated the feasibility of adhesive skin electrodes for IONM of RLN in patients who unde...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05208-3
更新日期:2020-01-01 00:00:00
abstract:INTRODUCTION:Recently, more aggressive variants of so-called well-differentiated thyroid carcinomas have been identified such as the tall cell variant, columnar cell variant, diffuse sclerosing variant, insular carcinoma, and Hürthle cell (oncocytic, oxyphilic) carcinomas. METHODS:An evidence-based review was performe...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-006-0837-3
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Africa's health workforce crisis has recently been emphasized by major international organizations. As a part of this discussion, it has become apparent that the workforce required to deliver surgical services has been significantly neglected. METHODS:This paper reviews some of the reasons for this relative...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9473-4
更新日期:2008-06-01 00:00:00
abstract::Reported incidence rates of carcinoma in patients with achalasia and the prevalence of achalasia in patients with esophageal cancer vary widely in the literature. The prognosis of an "achalasia-carcinoma" is generally considered poor, although systematic studies assessing the incidence, prevalence, and prognosis of pa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0026-3
更新日期:2001-06-01 00:00:00
abstract::A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted, especially during the last decade. This change in regimen was first seen in the handling of splenic trauma, initiated by pediatric surgeons. Later, the concept of conservative management was also introduced among a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658672
更新日期:1990-07-01 00:00:00