Abstract：
BACKGROUND:Consensus guidelines recommend prolonged thromboprophylaxis for up to 4 weeks after major abdominopelvic cancer operations. Several factors impede widespread adoption of these guidelines. These include lack of awareness, cost, increased bleeding complications, increased incidence of heparin-induced thrombocytopenia, and poor patient compliance. METHODS:A cost-effectiveness model was constructed comparing four potential strategies to postdischarge thromboprophylaxis in surgical oncology patients: (1) low-molecular-weight heparin (LMWH) once daily; (2) low-dose unfractionated heparin (LDUH) three times daily; (3) oral aspirin once daily; or (4) no prolonged prophylaxis. Probabilities and costs were estimated on the basis of published literature and average Medicare reimbursement. The decision analysis was conducted from the perspective of the health care system, with the primary end point being cost per patient without venous thromboembolism (VTE). Sensitivity analyses tested the robustness of the results. RESULTS:LDUH was most cost-effective, saving $154 per patient without VTE compared with no prophylaxis. LMWH was not cost-effective, incurring a cost of $230 per patient without VTE compared with no prophylaxis. Aspirin was a viable alternative to LDUH, saving $123 compared with no prophylaxis. When poor compliance was considered, aspirin became the dominant strategy. Sensitivity analyses failed to show any instance where LMWH was cost-effective. In terms of population costs, widespread use of LDUH after discharge would save $30.3 million per year in the United States. CONCLUSIONS:Although all chemical prophylaxis is effective in preventing VTE in the outpatient setting after cancer surgery, either LDUH or aspirin are the most cost-effective, depending on patient compliance.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Bradley CT,Brasel KJ,Miller JJ,Pappas SGdoi
10.1245/s10434-009-0671-6subject
Has Abstractpub_date
2010-01-01 00:00:00pages
31-9issue
1eissn
1068-9265issn
1534-4681journal_volume
17pub_type
杂志文章abstract：BACKGROUND:The relation of dialysis to tumor recurrence in patients with upper tract urothelial cancer (UTUC) is unknown; however, a limited number of small-scale studies suggest that patients with renal diseases prior to UTUC are more likely to exhibit bladder recurrence. We performed a population-based analysis to de...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-017-6295-3
更新日期：2018-04-01 00:00:00
abstract：:In 2009, 2 single-institution studies from the United States reported increasing mastectomy rates during the last decade. We have recently reported unilateral mastectomy trends from a European database and demonstrated a significant trend of decreasing mastectomy rates from 38.1 % in 2005 to 13.1 % in 2010. A recent s...
journal_title：Annals of surgical oncology
pub_type： 社论
doi：10.1245/s10434-013-2982-x
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:Pleomorphic carcinomas of the lung are uncommon malignant tumors composed of carcinomatous and sarcomatous components and are distinguished from other non-small-cell lung carcinomas by a more aggressive clinical course with early distant metastases and far worse survival. Epidermal growth factor receptor (EG...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-011-1621-7
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:Spleen-preserving laparoscopic distal pancreatectomy would be an ideal approach for benign and borderline malignant tumors in the distal pancreas.1 However, this procedure requires advanced surgical experience and technique because of the disadvantages of conventional laparoscopic surgery.2 METHODS:A 35-yea...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-011-1816-y
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:Small bowel adenocarcinoma is a relatively rare cancer, often diagnosed in an advanced stage. In localized and resectable disease, surgery alone or in combination with adjuvant chemotherapy is the mainstay of treatment. In the recently published National Comprehensive Cancer Network Clinical Practice guideli...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-020-08926-4
更新日期：2021-02-01 00:00:00
abstract：BACKGROUND:Locally advanced esophageal cancer is often treated with a trimodality approach. While a substantial proportion of such patients initially achieve a clinical complete response (cCR) after chemoradiation, only a small proportion achieve durable control. We analyzed patients who reached cCR after definitive ch...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-013-3303-0
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:The clinical impact of sentinel lymph node biopsy (SLNB) in gastric cancer is controversial. We performed a prospective trial to compare different methods: radiocolloid method (RM), dye method (DM), and both methods simultaneously (dual method, or DUM) for reliability and therapeutic consequences. METHODS:R...
journal_title：Annals of surgical oncology
pub_type： 临床试验,杂志文章
doi：10.1245/s10434-007-9367-y
更新日期：2007-07-01 00:00:00
abstract：BACKGROUND:Up to 60% of breast cancer patients who undergo breast-conserving surgery (BCS) require re-excision to obtain clear margins, causing delays in adjuvant treatment and poor aesthetic results. However, patient and treatment-related factors associated with re-excision are not well defined. METHODS:We surveyed a...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-007-9777-x
更新日期：2008-05-01 00:00:00
abstract：BACKGROUND:The aim of this retrospective analysis was to analyze the results of treatment of patients with cervical node metastases from carcinoma of occult primary with a policy including neck dissection and postoperative comprehensive radiotherapy. METHODS:Ninety patients were treated with curative intent from 1990 ...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-006-9329-9
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Cholangiocarcinoma can be classified in intrahepatic cholangiocarcinoma (ICC) and perihilar cholangiocarcinoma (PCC). Moreover, PCC includes two different forms: extrahepatic (EH) PCC, which arises from the perihilar EH large ducts, and intrahepatic (IH) PCC, in which a significant liver mass invades the per...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-015-5046-6
更新日期：2016-05-01 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:Neoadjuvant chemoradiotherapy (CRT) followed by radical surgery including total mesorectal excision (TME) is standard treatment in patients with locally advanced rectal cancer. Emerging data indicate that patients with complete pathologic response (ypCR) after CRT have favorable outcome, suggesting the possi...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-011-1822-0
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:Few studies have been undertaken to evaluate the prognostic value of age at diagnosis for determining breast cancer survival in a large population. METHODS:Using the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database consisting of 18 population-based cancer registri...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-014-4108-5
更新日期：2015-04-01 00:00:00
abstract：INTRODUCTION:Evidence from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial suggests completion axillary lymph node dissection (cALND) after positive sentinel lymph node biopsy (+SLNB) does not improve outcomes in select patients, leading to practice variation. A multidisciplinary group of surgeons,...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-016-5310-4
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:The occurrence of seroma formation after axillary lymphadenectomy for breast cancer cannot be ignored. Various approaches have been used in an effort to reduce it, but these results are still controversial. We aimed to describe a new method of application of OK-432 (Sapylin, heat-treated Su strain of Strepto...
journal_title：Annals of surgical oncology
pub_type： 杂志文章,随机对照试验
doi：10.1245/s10434-012-2728-1
更新日期：2013-05-01 00:00:00
abstract：BACKGROUND:In patients with colorectal hepatic metastases, response rates with hepatic arterial infusion (HAI) FUdR (5-Fluoro-2-deoxyuridine) are significantly higher than with systemic fluoropyrimidines. We report a novel animal model of intrahepatic therapy for hepatic metastasis for the study of methods to increase ...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1007/BF02409049
更新日期：1996-01-01 00:00:00
abstract：PURPOSE:Our aim was to investigate the detrusor muscle sampling rate after monopolar versus bipolar transurethral resection of bladder tumor (TURBT). METHODS:This was a single-center, prospective, randomized, phase III trial on monopolar versus bipolar TURBT. Baseline patient characteristics, disease characteristics a...
journal_title：Annals of surgical oncology
pub_type： 杂志文章,随机对照试验
doi：10.1245/s10434-016-5700-7
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:CD44 isoforms serve as a marker for cancer stem cells. CD44 variant 9 (CD44v9) contributes to the defense against reactive oxygen species, resulting in resistance to chemoradiotherapy. However, the significance of CD44v9 in patients with lung adenocarcinoma is unknown. METHODS:We used immunohistochemical an...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-018-07137-2
更新日期：2019-05-01 00:00:00
abstract：PURPOSE:The aim of this review was to examine the incidence of nipple-areola complex (NAC) involvement, the rates of NAC recurrence, and the data regarding the role of radiation therapy (RT) following nipple-sparing mastectomy (NSM). METHODS:A literature review was performed using the PubMed search engine, with articl...
journal_title：Annals of surgical oncology
pub_type： 杂志文章,评审
doi：10.1245/s10434-013-3446-z
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:The role neoadjuvant chemoradiotherapy (nCRT) plays in oncological outcomes in early T-stage rectal cancer is uncertain. The present work aims to clarify prognostic outcomes by estimating the effect of nCRT on tumor recurrence prior to major surgery compared with major surgery alone. PATIENTS AND METHODS:Pr...
journal_title：Annals of surgical oncology
pub_type： 杂志文章,多中心研究
doi：10.1245/s10434-019-08105-0
更新日期：2020-05-01 00:00:00
abstract：:The number of early gastric cancer (EGC) cases has been increasing because of improved diagnostic procedures. Applications of function-preserving gastric cancer surgery may therefore also be increasing because of its low incidence of lymph node metastasis, excellent survival rates, and the possibility of less-invasive...
journal_title：Annals of surgical oncology
pub_type： 杂志文章,评审
doi：10.1245/s10434-013-2931-8
更新日期：2013-08-01 00:00:00
abstract：BACKGROUND:A patient's likelihood of dying from breast cancer or another cause can be assessed with competing risks analyses. METHODS:Data for a cohort of 678 patients with primary invasive breast cancer accrued from 1971 to 1990, updated to 1995, included cause of death (e.g., breast cancer vs. other cause). We inves...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1007/BF02303502
更新日期：1998-06-01 00:00:00
abstract：BACKGROUND:Sensitive biomarkers are necessary for risk classification of patients with gastric cancer (GC), especially ones at risk of distant metastases. Melanoma-associated antigen (MAGE)-D2 has been reported to play a role in the process of cell adhesion and metastatic potential of tumor cells in colorectal cancer. ...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-015-4457-8
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:To investigate the efficacy and safety of adding continuous occlusion of hepatic artery proper to intermittent Pringle maneuver in partial hepatectomy for ruptured hepatocellular carcinoma. MATERIALS AND METHODS:This is a retrospective study on data that were prospectively collected and entered into a compu...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-010-1484-3
更新日期：2011-06-01 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:Radiation from medical imaging may induce cellular damage and increase the risk of cancer. While health care workers are restricted to an annual dose of 50 milliSieverts (mSv), the exposure to patients is not typically recorded. After breast-conservation therapy (BCT), patients are subjected to screening m...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-010-1279-6
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND:Women with breast cancer treated by mastectomy with immediate breast reconstruction can get exceptionally good results if the reconstruction is performed with autogenous tissue using the transverse rectus abdominis myocutaneous (TRAM) flap. Bilateral reconstruction with TRAM flaps is also possible, but only ...
journal_title：Annals of surgical oncology
pub_type： 临床试验,杂志文章
doi：10.1007/BF02303609
更新日期：1994-11-01 00:00:00
abstract：BACKGROUND:Liver kinase B1 (LKB1) loss by gene mutation, loss of heterozygosity, and promoter methylation rarely occurs in colorectal cancer. We wondered whether LKB1 loss could be deregulated at the transcriptional level to promote tumor progression and poor outcome in colorectal cancer. METHODS:Mechanistic studies w...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-014-3824-1
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:Inadequately treated multifocal and multicentric disease results in increased local recurrence following breast-conserving surgery. The accurate preoperative diagnosis of multifocal/ centric breast cancer would facilitate the planning of appropriate surgery and prevent reoperation for residual disease. While...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1007/s10434-999-0599-x
更新日期：1999-09-01 00:00:00
abstract：BACKGROUND:The American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) staging system for gastric cancer incorporates the absolute number of metastatic lymph nodes (N status) and is optimally used when >or=15 nodes are examined. The ratio of metastatic to examined nodes (N ratio) is an effec...
journal_title：Annals of surgical oncology
pub_type： 杂志文章
doi：10.1245/s10434-010-0914-6
更新日期：2010-05-01 00:00:00
