Abstract:
PURPOSE:The volume of surgical procedures performed by hospitals and surgeons has a strong influence on outcomes for a number of surgeries. We examined the influence of surgeon and hospital case volume on morbidity, mortality, and resource utilization for women with endometrial cancer undergoing laparoscopic hysterectomy. METHODS:Perspective, a nationwide inpatient database developed to measure utilization and quality, was used to examine women with endometrial cancer who underwent laparoscopic hysterectomy with or without lymphadenectomy from 2000 to 2010. Perioperative morbidity, mortality, and cost were compared using Chi-square tests and multivariable generalized estimating equations. RESULTS:A total of 4,137 patients were identified. The overall complication rate was 9.8% for low-volume vs. 10.4% for high-volume surgeons [multivariable odds ratio (OR) = 0.71; 95% confidence interval (CI), 0.41-1.22]. The rates of intraoperative complications, surgical-site complications, medical complications, transfusion, and reoperation were similar for patients treated by low- and high-volume surgeons (p > 0.05 for all). The adjusted estimate for hospital cost for patients treated by high- compared with low-volume surgeons was 219 USD (95% CI, -790 to 1,228 USD). The odds ratio for any complication in high- compared with low-volume hospitals was 1.24 (95% CI, 0.78-1.96). The average cost for patients treated in high- compared with low-volume facilities was -815 USD (95% CI, -1,641 to 11 USD). Neither physician nor hospital volume had a statistically significant effect on perioperative mortality. CONCLUSION:Laparoscopic hysterectomy for endometrial cancer is well tolerated and associated with an acceptable morbidity profile. Surgeon and hospital volume appear to have little effect on perioperative morbidity, mortality, and resource utilization.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Wright JD,Hershman DL,Burke WM,Lu YS,Neugut AI,Lewin SN,Herzog TJdoi
10.1245/s10434-011-2090-8subject
Has Abstractpub_date
2012-03-01 00:00:00pages
948-58issue
3eissn
1068-9265issn
1534-4681journal_volume
19pub_type
杂志文章abstract:BACKGROUND:For some types of cancer, postoperative complications can negatively influence survival, but the association between these complications and oncological outcomes is unclear for patients with esophageal cancer who receive preoperative treatments. METHODS:Data were retrospectively analyzed for patients who un...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-5045-7
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Medical photography has become an important component of the evaluation and management of patients across many specialties. It is increasingly utilized in contemporary practice with modern smartphones and enhanced digital media. Photography can enhance and improve treatment plans and communication between pr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-018-6603-6
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The interval between preoperative chemoradiotherapy and surgery reportedly affects perioperative outcomes and survival; however, the optimal interval in esophageal cancer patients remains uncertain. OBJECTIVE:Our aim was to determine whether a prolonged interval between preoperative neoadjuvant chemoradioth...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09206-x
更新日期:2020-10-13 00:00:00
abstract::Tumors treated with preoperative chemotherapy or radiation often demonstrate evidence of response in the resection specimen. Pathologic response is often interpreted as a surrogate for recurrence or survival outcomes. With a valid surrogate for long-term outcomes, investigators can explore treatment strategies with im...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-009-0374-z
更新日期:2009-06-01 00:00:00
abstract::Selected patients with hepatocellular carcinoma are candidates to receive potentially curative treatments, such as hepatic resection or liver transplantation, but nevertheless there is a high risk of tumor recurrence. Microvascular invasion is a histological feature of hepatocellular carcinoma related to aggressive bi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-012-2513-1
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Postoperative complications are associated with poor cancer-specific survival in various types of cancer surgery. Recent studies suggest that systemic inflammation induced by surgical trauma can accelerate the adhesion of circulating tumor cells to the vascular endothelium of distant organs, resulting in ear...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5655-8
更新日期:2017-04-01 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:Surgery is the standard treatment for primary, gastrointestinal stromal tumor (GIST); however, surgical resection often is not curative, particularly in large GIST. Five years after complete removal of their tumor, approximately half of treated patients relapse. Imatinib, an oral tyrosine kinase inhibitor (T...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1053-9
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Peritoneal carcinomatosis of colorectal cancer is probably best treated by cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). In The Netherlands Cancer Institute, this treatment has been performed since 1995. The long tradition of this treatment enabled us to study long-term survival in det...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1007/s10434-004-1167-z
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Although the standard of care after recurrence of epithelial ovarian cancer (EOC) is chemotherapy, increasing data suggest that combining cytoreductive surgery with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising option for patients with recurrent EOC. Our aim was to determine...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-015-4991-4
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:The National Comprehensive Cancer Network (NCCN) developed clinical practice guidelines for germline pathogenic variants in highly penetrant genes, such as TP53 and PTEN, and in moderately penetrant genes, such as CHEK2, ATM and PALB2. Whether the practice of radiographic surveillance of patients with path...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08191-0
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Measurement of body composition by computed tomography (CT) is an advancing field. Sarcopenia, myosteatosis, and visceral obesity (VO) have been identified as predictive of survival in colorectal cancer (CRC). We performed a systematic review of contemporary studies to characterize this association and highl...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-018-6395-8
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Clinical practice guidelines have been developed to improve melanoma patient care. However, it is unclear whether failure to comply with these standards (either excessive or inadequate treatment) increases morbidity or relapse rates. Therefore, we undertook this study to evaluate the effect of variance from ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0021-0
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The optimal time interval to define early recurrence (ER) among patients who underwent resection of gallbladder cancer (GBC) is not well defined. We sought to develop and validate a novel GBC recurrence risk (GBRR) score to predict ER among patients undergoing resection for GBC. PATIENTS AND METHODS:Patient...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09108-y
更新日期:2021-01-01 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:Inconsistent data suggests extranodal spread (ENS) is an adverse prognostic factor in Stage III melanoma patients but it remains contentious. By rigorously matching cohorts, this study sought to clarify associations with recurrence and survival. METHODS:Melanoma patients with lymph node metastases (AJCC Sta...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5723-0
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:For patients with rectal cancer, there is a greater risk of a positive radial margin or local tumor recurrence when an abdominoperineal versus low anterior resection is performed, or when tumors are in an anterior versus nonanterior location. In response, clinical leaders have encouraged perineal dissection ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2016-5
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the diagnostic and prognostic value of circulating endothelial cell (CEC), a potential surrogate of tumor angiogenesis, in malignant pleural mesothelioma (MPM). METHODS:We prospectively evaluated CEC count in 4.0 mL of peripheral blood sampled from patients with ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2506-0
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new technology for delivering intraperitoneal chemotherapy. It is generally assumed that with PIPAC, the ratio of peritoneal to systemic drug concentration is superior to liquid hyperthermic intraperitoneal chemotherapy (HIPEC). To date, no direct...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07695-z
更新日期:2019-12-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6850-6
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Although advocated by some, minimally invasive adrenalectomy (MIA) for adrenocortical carcinoma (ACC) is controversial. Moreover, the oncologic implications for patients requiring conversion to an open procedure during attempted MIA for ACC are not extensively reported. PATIENTS AND METHODS:The National Can...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08824-9
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Contralateral prophylactic mastectomy (CPM) is expected to add surgical morbidity but this incremental risk has not yet been defined. We sought to quantify the additional risks associated with CPM and determine how these risks influence the time to adjuvant therapy. METHODS:We identified women undergoing ma...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3903-3
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Granulomatous mastitis is an uncommon chronic inflammatory breast condition that is characterized by granulomatous inflammation. Granulomatous mastitis presents a challenging clinical scenario, because it can mimic carcinoma. The etiology and optimal treatment remain unclear. We report our experience with gr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3895-z
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node biopsy (SLNB) has been shown to reduce many of the long-term complications associated with a traditional axillary lymph node dissection (ALND); however, short-term outcomes have yet to be characterized. This study was designed to identify trends and differences in 30-day outcomes of parti...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3248-3
更新日期:2014-01-01 00:00:00
abstract:PURPOSE:To evaluate the efficacy in terms of local control (LC) of 24 h infusion of gemcitabine plus radiotherapy after surgery for pancreatic cancer. METHODS:Weekly gemcitabine (100 mg/m(2)) was provided as a 24-hour infusion during the course of radiotherapy (50.4 Gy to the tumor, 39.6 Gy to the nodes). Patients sub...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2767-7
更新日期:2013-02-01 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:The prognosis of advanced nodal (N3) squamous cell carcinoma of the head and neck (HNSCC) is poor. We investigated whether surgery or radiotherapy of early (T1-2) primary stage HSNCC is preferable to limit the overall morbidity after upfront neck dissection (uND) for N3 disease. METHODS:This retrospective m...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-019-07589-0
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The delta-shaped gastroduodenostomy, an intracorporeal Billroth-I anastomosis after laparoscopic distal gastrectomy and using only endoscopic linear staplers, has been increasingly adopted by gastrointestinal surgeons.1 (-) 5 We modified this technique to simplify operation procedures and reduce surgical tra...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3862-8
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Carcinomatosis of colorectal origin is increasingly treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CS-HIPEC). This procedure commonly involves multivisceral resection (MVR) with potentially high morbidity. We analyzed the effect of MVR on the outcome after CS-HIPEC. METHODS:...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0105-x
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Preoperative staging is essential for planning of optimal therapy for patients with rectal cancer. Recently, magnetic resonance imaging (MRI) is used frequently because of its benefits of clear pelvic image are better than other diagnostic methods. The purpose of this study was to determine accuracy rates an...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-000-0732-3
更新日期:2000-12-01 00:00:00