Abstract:
:A minority of patients with papillary thyroid carcinoma (PTC) is at high-risk of developing recurrent disease and death. Risk group stratification as defined by age, metastases to distant site, extrathyroidal invasion, and tumor size (AMES) criteria is frequently employed to identify high-risk patients for aggressive surgical and adjuvant treatments. The present study aimed at evaluating risk factors and the impact of treatment on cause-specific mortality (CSM) in this group of high-risk patients. From 1961 to 2000,150 of 499 patients surgically treated for PTC were considered as high-risk by AMES criteria. At 10-years CSM was significantly higher in high-risk patients (28%) than in low-risk patients (2%) (p < 0.0001). The clinicopathologic features, treatment, and outcome of AMES high-risk patients were retrospectively studied and risk factors for CSM were analyzed. There were 58 men and 92 women with a median age of 62 years (range: 18-87 years). Bilateral thyroidectomy was performed for 143 (95%) patients and concomitant neck dissection was performed for 82 patients (55%). Thirty-six patients (24%) underwent incomplete tumor excision with residual disease. Radioactive iodine (I131) ablation and external-beam irradiation were administered to 102 (68%) and 46 patients (31%), respectively. Over a median follow-up of 7.6 years, the overall mortality was 23% and 44%, whereas the CSM was 14% and 28% at 5 and 10 years, respectively. Using the Cox proportional hazard model, distant metastasis at presentation, incomplete tumor excision, and no postoperative I131 treatment were independent prognostic factors of poor survival. Patients who underwent an incomplete excision showed improved survival after I131 ablation (p = 0.0008), external-beam irradiation (p = 0.02), or both forms of treatment (p = 0.04). Within this high-risk AMES group, International Union Against Cancer (UICC) pTNM staging and MACIS (Metastasis, Age, Completeness, Invasion, Size) scoring correlated significantly with CSM. AMES high-risk PTC patients should undergo total thyroidectomy aiming at complete tumor resection followed by I131 ablation. External-beam irradiation should be added for patients with residual disease after an incomplete excision.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Lo CY,Chan WF,Lam KY,Wan KYdoi
10.1007/s00268-004-7420-6keywords:
subject
Has Abstractpub_date
2004-11-01 00:00:00pages
1103-9issue
11eissn
0364-2313issn
1432-2323journal_volume
28pub_type
杂志文章abstract::The value of surgical resection for patients with chronic pancreatitis has been debated on account of persistent symptoms and the morbidity of the operative procedure, both immediate and delayed. This paper explores the consequence of pancreatoduodenectomy in 175 patients with chronic pancreatitis who were operated on...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7239-6
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to report on the application of a minimally invasive technique to the radical extirpation of primary and recurrent pilonidal disease. This technique does not require specific equipments, is ordinarily performed under local anesthesia on an outpatient basis, and provides optimal cosm...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05313-3
更新日期:2020-04-01 00:00:00
abstract::Surgical management of hepatic hydatid disease has been associated with an overall local recurrence rate of approximately 10%. Local recurrence is rarely seen following complete resection of an intact cyst and is usually the result of spillage of live parasites or leaving a residual cyst wall containing germinal epith...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680020011
更新日期:2001-01-01 00:00:00
abstract::The authors' affiliations are updated as reflected here. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-020-05519-w
更新日期:2020-08-01 00:00:00
abstract::Treacher Collins Syndrome is a rare bilateral congenital deformity occurring in 1 in 10,000 births. It is also known, in the European literature, as Franceschetti Syndrome, and is additionally known as mandibulofacial dysostosis. It is a syndrome with a very wide spectrum of manifestations characterized by distortions...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01660753
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Connective tissue growth factor (CTGF) expression changes variously in different human malignancies. The role of CTGF in hepatocellular carcinoma (HCC) is still not clear. The purpose of this study was to investigate the role of serum CTGF in patients with HCC and its correlation with HCC angiogenesis. METH...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0648-4
更新日期:2010-10-01 00:00:00
abstract::In the Surgical Department of the University of Erlangen, 307 reconstructions in all areas of the arterial tree were performed with PTFE (GORE-TEX) grafts, of which 188 were performed in the femoral-popliteal and femoral-crural areas. Femoral-popliteal bypass grafts above the knee joint remained patent in 93% of the p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02393582
更新日期:1980-01-01 00:00:00
abstract::This retrospective study reports our experience managing 78 patients with adenocarcinoma of the esophagus and gastroesophageal junction operated between January 1982 and December 1996. Altogether 18 patients presented with stage I and II disease, and 60 patients had stage III and IV disease at presentation; 56 patient...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013179
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Cancer (QLQ-C30) and the site-specific module for gastric cancer (QLQ-STO22) have seldom been used to measure the postoperative health-related quality of life (HRQOL) in Japanese gastric cancer patients. The ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0860-2
更新日期:2011-02-01 00:00:00
abstract::It is a fundamental clinical observation that wounds do not heal in tissue that does not bleed, and they almost always heal in tissue that bleeds extensively. Continuous supply of oxygen to the tissue through microcirculation is vital for the healing process and for resistance to infection. Evaluation of tissue perfus...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7398-5
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Sometimes, it seems to be difficult to preserve the aberrant hepatic artery (HA) during pancreaticoduodenectomy (PD), with respect to en bloc lymph node dissection, especially in the case of aberrant right hepatic artery (RHA). Therefore, we evaluated the influence of incomplete en bloc lymph node (LN) disse...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0063-x
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Midgut malrotation most commonly presents in young children. This diagnosis is not often entertained in the adolescent or adult with abdominal complaints. We reviewed our experience with this subset of malrotation patients. METHODS:A retrospective review of medical records from adolescent or adult patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9490-3
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Adhesions due to the reactions caused by the grafts used in primary vascular operations can lead to various problems when a secondary operation is necessary. These problems include bleeding, injuries to neighboring organs, and complications occurring due to a prolonged operation. We investigated the effects ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0750-1
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Acute appendicitis is the most common abdominal emergency in clinical surgery. This study was designed to compare the diagnostic value of the Pediatric Appendicitis Score (PAS) with that of the Alvarado score based on different time points in children with right lower quadrant (RLQ) abdominal pain. METHODS:...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s00268-011-1310-5
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Differentiated thyroid cancer (DTC) with distant metastases at presentation is uncommon; the prognosis of patients with this condition is more favorable than for other cancers. Demographic, clinical, and pathologic characteristics are described at a population level; factors associated with long-term disease...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2006-9
更新日期:2013-07-01 00:00:00
abstract::The aim of this study was to evaluate prognostic factors after the recurrence of hepatocellular carcinoma (HCC) in patients who had undergone hepatic resection. We used univariate and multivariate retrospective analyses of 29 clinicopathologic factors in 143 patients with recurrent HCC. Patients were classified into f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7205-y
更新日期:2004-07-01 00:00:00
abstract:INTRODUCTION:Jejunal diverticula are rare lesions, and when complications arise, they pose diagnostic difficulties. Perforation is a common complication resulting in an acute abdomen, although preoperative diagnosis is usually not possible. The "gold standard" for management for patients with complications is surgery. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9469-0
更新日期:2008-07-01 00:00:00
abstract::Jaundice in patients of advanced carcinoma of the gallbladder requires palliation for the distressing symptoms of pruritus and cholangitis. Intrahepatic segment III duct cholangiojejunostomy is a means for alleviating the obstruction with malignant porta block. The authors reviewed their experience with this procedure...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900319
更新日期:1997-10-01 00:00:00
abstract::The imaging characteristics of diagnostic ultrasound (US) are determined by the ultrasonic properties of tissue. The velocity of propagation of US and the attenuation are the 2 most important parameters. These determine the frequency with which the tissues may be imaged, which in turn sets a fundamental limit on the a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910026
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:The number of lymph nodes retrieved and examined from a resected colon cancer specimen may be crucial for correct staging. We examined if efforts to increase the lymph node harvest to more than 12 lymph nodes per specimen would upstage some patients from TNM stage II to III. METHODS:Three hospitals compared...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00268-011-1248-7
更新日期:2011-12-01 00:00:00
abstract::Blood loss during liver transection and ischemia-reperfusion injury associated with hepatic inflow occlusion are significant drawbacks during liver surgery. Sixteen patients underwent liver resection using the Monopolar Floating Ball (FB) plus LigaSure (LS) diathermy without occlusion of the hepatoduodenal ligament (g...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7167-5
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Medullary thyroid carcinoma (MTC) originates from calcitonin-producing cells of the thyroid. In 2009, we published our first report on the biological characteristics and prognosis of 118 MTC patients. Herein, we enrolled a larger number of patients with longer follow-up periods to further study the biologica...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4738-z
更新日期:2018-12-01 00:00:00
abstract::Intraperitoneal forgotten foreign bodies are prone to create adhesions and to encapsulate, or to provoke an exudative response, with or without accompanying bacterial infection. Often a process of self-extrusion is initiated. This is also true for gossypibomas, retained surgical sponges. Presentation is possible as a ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689910084
更新日期:2000-05-01 00:00:00
abstract::Cost-benefit and cost-effectiveness analyses (CEAs) are only now beginning to be used by business, government, and policymakers to evaluate various medical treatments. The evolution of why CEAs are being demanded is reviewed. To date, a formal CEA of obesity treatments has not been published. This article outlines how...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900508
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:There is no clear consensus on the efficacy and safety of hyaluronate-carboxymethylcellulose membrane (Seprafilm) for preventing postoperative abdominal adhesion. This study is a meta-analysis of the available evidence. METHODS:A search of the MEDLINE, EMBASE, and the Cochrane Library identified eight studi...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-007-9242-9
更新日期:2007-11-01 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:Up to 50% of patients in intensive care units develop intraabdominal hypertension (IAH) in the course of medical treatment. If not detected on time and treated adequately, IAH may develop into an abdominal compartment syndrome (ACS) which is associated with a high mortality rate. Patients undergoing cardiac ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05917-0
更新日期:2021-01-22 00:00:00
abstract:BACKGROUND:A lower-pitched voice is one of the most common voice alterations after thyroidectomy without laryngeal nerve injury. The aim of this study was to evaluate the acoustic and stroboscopic changes and the treatment outcomes in patients with a lower-pitched voice with the goal of eventually establishing a therap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2062-1
更新日期:2013-08-01 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:Trauma continues to be a major health problem worldwide, particularly in the developing world, with high mortality and morbidity. Yet most developing countries lack an organized trauma system. Furthermore, developing countries do not have in place any accreditation process for trauma centers; thus, no accept...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2538-7
更新日期:2014-08-01 00:00:00