Abstract:
BACKGROUND:We investigated the implications of HER2 amplification in Asian women with small, node-negative breast cancer in low- and middle-income countries (LMCs). METHODS:We reviewed the charts patients treated between 1989 and 2009 with breast conservation therapy for node-negative breast cancers measuring ≤ 2 cm. Disease-free survival (DFS), ipsilateral breast tumor recurrence (IBTR), distant disease-free survival (DDFS), and overall survival (OS) rates were estimated using the Kaplan-Meier method and were compared by the log-rank test. Potential covariates-age, tumor grade, hormone receptor status--were analyzed by multivariate analysis. RESULTS:A total of 519 patients were studied including 204 (39%) and 315 (61%) patients diagnosed with pT1ab and pT1c tumors, respectively. Median follow-up was 57 months. HER2 amplification was found in 17.1% of all patients and in 16.7% patients with pT1ab tumors. Among patients with T1ab tumors, 73.0 and 9.3% underwent adjuvant hormonal and chemotherapy, respectively; 3 of 34 T1ab patients with HER2-amplified tumors received trastuzumab. HER2 amplification was associated with poorer 5-year DFS (83.7% vs. 95.5%, P < 0.0001), DDFS (87.5% vs. 97.9%, P < 0.0001), and IBTR (8.6% vs. 2.1%, P < 0.0001) rates in patients with pT1 tumors. Multivariate analysis showed that HER2 amplification remained a significant negative prognostic factor for DFS [hazard ratio (HR) 4.1, 95% confidence interval (CI) 2.1-7.8, P < 0.0001], DDFS (HR 6.3, 95% CI 2.4-17.0, P < 0.0001), and IBTR (HR 4.5, 95% CI 2.0-10.0, P < 0.0001) rates. In the pT1ab subgroup, univariate analysis showed that HER2 amplification prognosticated for DFS (85.1% vs. 95.7%, P = 0.022) and IBTR (14.9% vs. 3.5%, P = 0.004) rates but not for the OS (100% vs. 99.2%, P = 0.487) rate. Similar results were obtained after excluding patients given trastuzumab. CONCLUSIONS:The decision to use trastuzumab in HER2-amplified pT1ab tumors must balance their poor outcome against intrinsic financial limitations in LMCs. Patient selection criteria needs fine-tuning, and resource-sensitive regimens must be explored.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Wong FY,Yip CS,Chua ETdoi
10.1007/s00268-011-1353-7subject
Has Abstractpub_date
2012-02-01 00:00:00pages
287-94issue
2eissn
0364-2313issn
1432-2323journal_volume
36pub_type
杂志文章abstract:BACKGROUND:Scarce data are available on the characteristics of postoperative organ failure (POF) and mortality after gastrectomy. We aimed to describe the causes of organ failure and mortality related to gastrectomy for gastric cancer and to identify patients with POF who are at a risk of failure to rescue (FTR). METH...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05382-9
更新日期:2020-05-01 00:00:00
abstract::Individuals in clinical training programs concerned with critical medical care must learn to manage clinical cases effectively as a member of a team. However, practice on live patients is often unpredictable and frequently repetitive. The widely substituted alternative for real patients-high-fidelity, manikin-based si...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9354-2
更新日期:2008-02-01 00:00:00
abstract::Innovation is responsible for most advances in the field of surgery. Innovative approaches to solving clinical problems have significantly decreased morbidity and mortality for many surgical procedures, and have led to improved patient outcomes. While innovation is motivated by the surgeon's expectation that the new a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2568-1
更新日期:2014-07-01 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:Although 18F-fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) is a potentially powerful, non-invasive imaging tool in differentiating adrenal metastasis from benign disease, some adenomas also exhibit high FDG uptake, therefore mimicking metastasis (i.e., false...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3035-3
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the relationship between the method of transport after injury and survival among trauma patients admitted to a Level 1 trauma facility in Los Angeles, California. METHODS:The trauma registry of LAC+USC Medical Center was reviewed to identify all injured patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0185-1
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Flow disruptions (FDs) are deviations from the progression of care that compromise safety or efficiency. The frequency and specific causes of FDs remain poorly documented in trauma care. We undertook this study to identify and quantify the rate of FDs during various phases of trauma care. METHODS:Seven trai...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2306-0
更新日期:2014-02-01 00:00:00
abstract::To pursue a suitable central airway replacement, we conducted central airway reconstruction using autologous pulmonary tissue flaps lined with alloy stents in five patients after extensive tracheal resection. Preoperative and postoperative arterial blood gas analysis and pulmonary function tests were used to evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3066-9
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Insertion of a nasogastric tube (NGT) in an anesthetized, paralyzed, and intubated patient is difficult, and many methods have been proposed to aid in the procedure. We present a simple insertion technique. METHODS:A silicone NGT was made rigid by filling it with distilled water and freezing it. Patients we...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-009-0144-x
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:The survival impact of distal pancreatectomy (DP) with celiac axis resection for locally advanced pancreatic body/tail cancer remains unclear. METHODS:A total of 16 patients underwent DP with celiac axis resection, while 76 underwent standard DP for pancreatic body/tail cancer. The indications for DP with c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3670-3
更新日期:2017-01-01 00:00:00
abstract::Calcium oxalate is a major component of renal stones, and its urinary concentration plays an important role in stone formation. Even a small increase in urinary oxalate has a significant impact on calcium oxalate saturation. Although primary hyperoxaluria is relatively uncommon, patients with calcium oxalate stones ha...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010193
更新日期:2000-10-01 00:00:00
abstract::Subfascial elimination of incompetent perforating veins is the most effective therapeutic principle in the treatment of trophic skin disorders associated with varicosis. A recently developed endoscopic technique allows accurate sectioning of perforating veins with direct observation of the veins and minor trauma. From...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067007
更新日期:1992-09-01 00:00:00
abstract::Genital manifestations of lymphatic filariasis (genital LF) are a significant cause of disfigurement and disability in the developing world. Surgery is the standard treatment; however, definitive publications are lacking and best practice remains unclear. An exhaustive search strategy using keyword and subject heading...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-015-3220-4
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects. METHODS:The study included 109 cT1...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4345-4
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Accurate presurgical assessment is important to anticipate postoperative complications, especially in the growing proportion of elderly cancer patients. We designed a study to define which comorbid conditions at the time of diagnosis predict complications after surgery for colorectal cancer. PATIENTS:A rand...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0711-8
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the predictive value of the preoperative three-dimensional reconstructed volume (3D volumetry) for outcomes of laparoscopic splenectomy. The impact of splenomegaly on the feasibility of laparoscopic splenectomy is still debated. We hypothesized that splenic volumetry ma...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1789-4
更新日期:2013-01-01 00:00:00
abstract::Endoscopic sphincterotomy (EST) is an established method for treatment of retained or recurrent common bile duct (CBD) calculi after cholecystectomy. Present experience shows that few patients have recurrent biliary tract complications, but follow-up periods are most often short. EST was performed in 147 patients with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900043
更新日期:1996-03-01 00:00:00
abstract:INTRODUCTION:Acute intestinal ischemia is in most cases a lethal condition with a low survival rate. Risk factors of perioperative mortality are poorly defined. The aim of this study was to define risk factors that predict an adverse outcome of acute mesenteric ischemia (AMI). METHODS:A total of 132 consecutive patien...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0560-5
更新日期:2006-08-01 00:00:00
abstract::Secretin is a stimulator of both endocrine and exocrine secretions of the pancreas, and we aimed to evaluate its effects on splanchnic blood flow in rats with a microsphere technique. Anesthetized rats were infused with secretin (0.5 or 2.0 micrograms/kg body weight/hr) for 10 minutes. Some animals were normoglycemic,...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0037-0
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Tumors producing adrenocorticotropic hormone (ACTH) or corticotropin releasing hormone (CRH) often remain undiagnosed until severe Cushing's syndrome appears, and it may be difficult to distinguish from Cushing's syndrome due to pituitary tumors. Many patients suffer from disease spread, with metastases in t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0347-8
更新日期:2006-05-01 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::The metabolic changes in cancer cachexia appear to be mediated by a complex network of proinflammatory cytokines, neuroendocrine hormones, neurotransmitters, eicosanoids, and tumor-derived factors produced by the body in response to the tumor and by the tumor itself. The relative importance of these various mediator p...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689910110
更新日期:2000-06-01 00:00:00
abstract::The most common causes of variceal bleeding are cirrhosis, schistosomiasis, and extrahepatic portal venous obstruction. The prognosis for an individual patient depends on the severity of the bleeding episode and the underlying liver function. Liver function is determined to a large extent by the underlying liver patho...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00294397
更新日期:1994-03-01 00:00:00
abstract::This retrospective study in 79 surgically treated patients with a proximal bile duct carcinoma revealed 12 patients with a median age of 59.5 years (range 21-73 years) who survived more than 5 years. These 12 patients were analyzed to identify specific patient characteristics for long-term survival. Fifteen patients d...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900571
更新日期:1999-01-01 00:00:00
abstract::Childhood papillary thyroid carcinoma is associated with more locally aggressive and more frequent distant disease than its adult counterpart. Recurrence rates tend to be higher in children, but cause-specific mortality remains low. Optimal initial treatment of childhood papillary thyroid carcinoma should include tota...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-004-7605-z
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:This study aims to determine the prevalence and predictive factors for recurrence after sentinel lymph node biopsy (SLNB) and for sentinel lymph node positivity by SLNB in our population. METHODS:We followed up all SLNBs performed between 2002 and 2010 and analyzed data by R (version2.10.1), considering p <...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1420-0
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Despite wide acknowledgement of the importance of sarcopenia and prognostic markers such as the neutrophil-to-lymphocyte ratio, the impact on cancer patient survival of the timing of sarcopenia's emergence and its severity is not well understood, nor is the association between sarcopenia and prognostic marke...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05344-w
更新日期:2020-05-01 00:00:00
abstract::Surgical education in the United Kingdom has evolved to meet the need of the National Health Service (NHS) for a relatively small body of consultants practicing autonomously and carrying ultimate clinical responsibility for their patients. This form of specialist practice is markedly different from that found in most ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00298916
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Surgical 'never events' have serious adverse outcomes for patients. A never event can be defined as a serious, avoidable patient safety incident that would not occur if necessary preventative measures are implemented. The literature from South Africa on this topic is limited. This study aims to understand th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05008-9
更新日期:2019-09-01 00:00:00
abstract::We determined the relative value of the metastatic colorectal cancer doubling time as a predictor of recurrence and survival after hepatectomy in comparison with other established predictors. Consecutive patients who underwent hepatic resection ( n = 144) for colorectal cancer liver metastases were studied retrospecti...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7088-3
更新日期:2004-03-01 00:00:00