Abstract:
BACKGROUND:The association between procedure volume and clinical outcomes has led many to advocate centralization of cancer procedures at high-volume centers (HVCs). Regional studies show practice patterns changing with increasing centralization of esophageal and pancreatic procedures at HVCs but little change for colorectal procedures. We hypothesize that similar trends are occurring nationwide. METHODS:Secondary data analysis was performed by means of the National Inpatient Sample. We examined trends in hospital procedure volume from 1999 to 2007 for all extirpative esophageal, pancreatic, and colorectal cancer procedures. Survey-weighted multivariate logistic regressions were used to examine the likelihood of surgery at a low-volume center (LVC) over time as well as to determine sociodemographic factors associated with surgery at LVCs. RESULTS:A total of 351,164 cases met the inclusion criteria (6,345 esophagus, 17,658 pancreas, 255,753 colon, 71,408 rectum). The likelihood of surgery at a LVC in 2007 compared to 1999 was as follows: esophagus odds ratio [OR] 0.42 (95% confidence interval [95% CI], 0.34, 0.53), pancreas OR 0.40 (95% CI, 0.35, 0.46), colon OR 0.88 (95% CI, 0.85, 0.91), rectum OR 0.83 (95% CI, 0.78, 0.89). Admission through an emergency department was associated with a higher likelihood of surgery at a LVC, even after adjusting for clinical and sociodemographic factors. Volume was also associated with race and payer; black patients and the uninsured were particularly likely to remain at LVCs. CONCLUSIONS:Practice patterns have changed substantially to follow national recommendations for centralization of complex cancer surgery. Despite this, disparities remain with regard to access to HVCs.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Stitzenberg KB,Meropol NJdoi
10.1245/s10434-010-1159-0subject
Has Abstractpub_date
2010-11-01 00:00:00pages
2824-31issue
11eissn
1068-9265issn
1534-4681journal_volume
17pub_type
杂志文章abstract:BACKGROUND:In breast cancer treatment, intraoperative sentinel lymph node (SLN) evaluation is used to identify patients who may potentially benefit from immediate completion of axillary lymph node dissection. METHODS:Prospectively collected breast cancer registry data identified 516 SLN biopsies between January 2003 a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9270-y
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:During the breast lumpectomy procedure, surgeons traditionally elect to use either a superficial or full-thickness closure when sealing the wound depending on surgeon preference as well as desired outcomes. The purpose of this study was to examine dosimetric endpoints in patients with superficial versus full...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2775-7
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:There is evidence that insulin-like growth factors play a role in the development of breast cancer. Antiestrogens reduce circulating levels of IGF-I, but the influence of other breast cancer treatments, including surgery, is unknown and is investigated in this study. METHODS:Circulating serum concentrations...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0025-5
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Two prospective, randomized trials, TARGIT-A and ELIOT, have shown intraoperative radiation therapy to be a safe alternative, with a low-risk of local recurrence, compared with whole breast radiation therapy, following breast-conserving surgery, for selected low-risk patients. We report the first 1000 tumors...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6614-3
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Breast-conserving surgery (BCS) requires clear surgical margins to minimize local recurrence. We sought to identify groups of patients at higher risk of involved margins who might benefit from preoperative counselling and/or more generous excision at the first operation. METHODS:We reviewed demographic, cli...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0054-4
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The time interval between CRT and surgery in rectal cancer patients is still the subject of debate. The aim of this study was to first evaluate the nationwide use of restaging magnetic resonance imaging (MRI) and its impact on timing of surgery, and, second, to evaluate the impact of timing of surgery after ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-07097-7
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The risk factors and incidence of venous thromboembolism (VTE) are not well defined in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). We sought to characterize the incidence, risk factors, and pharmacothromboprophylaxis strategies for VTE after CRS/HIPEC....
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-019-07414-8
更新日期:2019-07-01 00:00:00
abstract:PURPOSE:Reasons for variable utilization of adjuvant chemotherapy (ACT) for colon cancer have not been well described. We report medical oncology (MO) referral patterns and subsequent use of ACT. METHODS:Treatment records were linked to the population-based Ontario Cancer Registry to describe MO referral and ACT use a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5181-8
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Robotic total mesorectal excision (R-TME), a novel way for minimally invasive treatment of rectal cancer, was shown in previous studies to be safe and effective. However, comparison with laparoscopic total mesorectal excision (L-TME) has drawn contradictory disputes, especially concerning operative high-risk...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-015-5048-4
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The use of routine CT imaging for surveillance in asymptomatic patients with cutaneous melanoma is controversial. We report our experience using a surveillance strategy that included CT imaging for a cohort of patients with high-risk melanoma. METHODS:A total of 466 patients with high-risk cutaneous melanom...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5768-8
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:We investigated the possible lobe-specific lymph node (LN) metastasis pattern of early-stage peripheral non-small cell lung cancers (NSCLC) and define the extent of lobe-specific LN dissection for them. METHODS:We retrospectively collected clinical data of patients undergoing lobectomy or segmentectomy with ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07926-3
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION:Actual 5-year survival rates of 10-18% have been reported for patients with resected pancreatic adenocarcinoma (PC), but the use of multimodality therapy was uncommon in these series. We evaluated long-term survival and patterns of recurrence in patients treated for PC with contemporary staging and multimo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0295-2
更新日期:2009-04-01 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:Antiangiogenic therapies have been developed recently in combination with traditional chemotherapy for patients with metastatic colorectal cancer. The aim of this study was to clarify the association between messenger RNA (mRNA) levels of vascular endothelial growth factor (VEGF) and its receptors (VEGFR) in...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9811-7
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:The prognosis of patients with peritoneally metastasized colorectal cancer has improved significantly with the introduction of cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS + HIPEC). Although a macroscopically complete resection is achieved in nearly every patient, recurren...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4297-y
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:The aim of this study is to evaluate the safety and efficacy of induction modified 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus bevacizumab followed by S- 1-based chemoradiotherapy in magnetic resonance imaging (MRI)-defined poor-risk locally advanced low rectal cancer. PATIENTS AND METHODS:This...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07342-7
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Whether routinely prescribed opioids are necessary for pain control after discharge among lumpectomy/sentinel node biopsy (Lump/SLNB) patients is unclear. We hypothesize that Lump/SLNB patients could be discharged without opioids, with a failure rate < 10%. This study prospectively examines outcomes after ch...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08886-9
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The standard treatment for patients 75 years of age or younger with cStage 2 or 3 esophageal cancer is preoperative chemotherapy followed by esophagectomy. The optimal treatment for elderly patients, especially those considered vulnerable, remains unclear. METHODS:This study retrospectively reviewed the dat...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09072-7
更新日期:2020-09-02 00:00:00
abstract:BACKGROUND:The Oncotype DX® assay has been validated in predicting response to adjuvant chemotherapy in breast cancer. Its role in neoadjuvant chemotherapy (NCT) has not been established. METHODS:The National Cancer Database was used to identify all patients with T1-T3, ER-positive, HER2-negative primary invasive brea...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-07107-8
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The sentinel lymph node (SLN) concept has been gaining attention for gastrointestinal neoplasms but remains controversial for esophageal cancer. This study evaluated the feasibility of SLN identification using intraoperative indocyanine green (ICG) fluorescence imaging (IGFI) navigated by preoperative comput...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1922-x
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Although the sentinel lymph node (SLN) hypothesis has been applied to many tissues and organs, liver has remained unstudied. Currently, it is unclear whether hepatic SLNs even exist. If so, they could alter the management of intrahepatic cholangiocarcinoma and other hepatic malignancies by minimizing the ext...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4601-5
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The modifiable variable best proven to improve survival after resection of pancreatic adenocarcinoma is the addition of adjuvant chemotherapy. A theoretical advantage of minimally invasive pancreaticoduodenectomy (MI-PD) is the potential for greater use and earlier initiation of adjuvant therapy, but this be...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4937-x
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Patients with biliary tract adenocarcinoma with nodal involvement have a poor prognosis. There is currently no standardized method for intraoperative lymph node assessment. The current study aimed to determine the prognostic significance of the highest peripancreatic lymph node (HPLN) in biliary tract malign...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3352-4
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Cytoreductive therapy for metastatic carcinoid provides symptomatic relief and improvement in overall survival. We evaluated whether CgA and 5HIAA could predict symptomatic relief and control of disease progression after cytoreductive surgery. METHODS:We retrospectively reviewed 70 patients who underwent cy...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9148-z
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Endoscopic resection (ER) is an effective treatment for early gastric cancer (EGC) without lymph node metastasis. However, after ER additional surgery may be needed to manage the risks presented by residual cancer or lymph node metastasis. METHODS:ER was performed on 344 gastric adenocarcinomas between Nove...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9536-z
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:The American Joint Committee on Cancer (AJCC) substantially changed the staging of cutaneous squamous cell carcinoma (cSCC) in the 7th edition of its staging manual. We aim to compare the 7th edition AJCC staging of nodal metastases from cSCC with the N1S3 staging system. METHODS:Analysis of 603 patients fr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-012-2504-2
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Performing a sentinel lymph node biopsy (SLNB) is the standard of care for axillary nodal staging in patients with invasive breast cancer and clinically negative nodes. The procedure provides valuable staging information with few complications when performed by experienced surgeons. However, variation in pro...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5432-8
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Pancreatic ductal adenocarcinoma (PDAC) frequently resists conventional cytotoxic therapy. The antitumor effects of endothelial monocyte-activating polypeptide II (EMAP) have been attributed to its antiendothelial and antiangiogenic activities. We tested the hypothesis that a combination of EMAP with bevaciz...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0879-5
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Sarcopenia is recognized as an important prognostic factor in various types of cancer, including gastric cancer. While long-term survival analyses typically focus on overall and disease-specific survival, death from other causes has received far less attention. METHODS:We reviewed medical records of 491 gas...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6354-4
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Surgical resection of the primary tumor for patients who present with incurable stage IV colorectal cancer is controversial. National practice patterns have not been described. We evaluated the use of primary tumor resection in patients presenting with stage IV colorectal cancer. METHODS:Patients with stage...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.06.012
更新日期:2005-08-01 00:00:00