Abstract:
BACKGROUND:Papillary thyroid carcinoma (PTC) frequently recurs to the lymph nodes, which may not be fatal immediately but is a stressor for physicians and patients. Recurrence to the distant organs, although less frequent, is often life-threatening, and the lung and bone are organs to which PTC is likely to recur. In the present study we investigated factors predicting recurrence of PTC to the lymph nodes, lung, and bone in a large number of patients undergoing long-term follow-up. METHODS:A total of 5,768 PTC patients (608 males and 5,159 females) without distant metastasis at diagnosis who underwent initial surgery between 1987 and 2004 in Kuma Hospital were enrolled in this study. The postoperative follow-up ranged from 12 to 280 months, and was 129 months (10.8 years) on average. RESULTS:To date, node, lung, and bone recurrences have been detected in 389 (7%), 118 (2%), and 33 patients (0.6%), respectively, and 57 patients (1%) have died of PTC. We examined the prognostic significance of the tumor size (T), extrathyroid extension (Ex), age 55 years or older (Age), male gender (Gender), clinical node metastasis (N), and extranodal tumor extension (LN-Ex) for each outcome on multivariate analysis. Age, Gender, T > 2 cm, N, and Ex were independent predictors of lymph node recurrence. Age, Ex, T > 2 cm, and N were independent prognostic factors for lung recurrence. Ex, T > 4 cm, and N independently predicted bone recurrence. Of these, N ≥ 3 cm had the strongest prognostic value for lymph node, lung, and bone recurrences. In contrast, Age was the strongest predictor for carcinoma death. LN-Ex also had a prognostic value for carcinoma death, although it was not a predictor of carcinoma recurrence. Ex, N ≥ 3 cm, and T > 2 cm also had a prognostic impact on carcinoma death. CONCLUSIONS:Large lymph node metastasis showed a strong prognostic impact on carcinoma recurrence not only to the lymph nodes but also to the lung and bone, and carcinoma death. Extrathyroid extension also independently predicted these recurrences and carcinoma death, although hazard ratios were lower than for large node metastasis. Age 55 years or older, in contrast, was the strongest predictor of carcinoma death. Extranodal tumor extension did not independently affect recurrence, but it had prognostic significance for carcinoma death. These findings suggest that recurring PTC lesions of older patients and/or extranodal tumor extensions are difficult to control and very progressive.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Ito Y,Kudo T,Kobayashi K,Miya A,Ichihara K,Miyauchi Adoi
10.1007/s00268-012-1423-5subject
Has Abstractpub_date
2012-06-01 00:00:00pages
1274-8issue
6eissn
0364-2313issn
1432-2323journal_volume
36pub_type
杂志文章abstract:BACKGROUND:LLR is widely adapted for HCC, while LLR in PS segments is still challenging. With recent improvement of techniques and accumulation of experiences, LLR in PS segments is feasible, but studies investigating the result after the modifications are lacking. METHODS:In this single-center, retrospective study, 1...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05912-5
更新日期:2021-01-13 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:Duct-to-mucosa pancreatojejunostomy after pancreatoduodenectomy can be technically difficult, particularly in cases with a non-dilated pancreatic duct. We devised a novel procedure employing a pancreatic duct holder and mucosa squeeze-out technique facilitating duct-to-mucosa anastomosis. We compared the per...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3659-y
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Postoperative ileus is a common problem with significant clinical and economic consequences. We hypothesized that Gastrografin may have therapeutic utility by accelerating the recovery of postoperative ileus after colorectal surgery. The aim of this trial was to study the impact of oral Gastrografin administ...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-015-3260-9
更新日期:2016-01-01 00:00:00
abstract::Experience with screening for colorectal cancer has been disappointing. Prevention of this disease seems to be a more beneficial research direction. Although radical surgery presents the best treatment option, it is nonetheless an inadequate strategy by itself. A new dose intensive approach would temporally combine su...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01789207
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:The Institute of Medicine has identified atrial fibrillation (AF) among national priorities for research. We examine the incidence of AF and its association with outcomes of patients undergoing abdominal surgery. METHODS:Patients ≥ 55 years who underwent abdominal surgery captured in a State Inpatient Datab...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2777-7
更新日期:2015-01-01 00:00:00
abstract::Little evidence is available regarding long-term survival of patients with gallbladder cancer that is discovered at the time of laparoscopic cholecystectomy (LC). Therefore the present study was performed to evaluate long-term outcomes of this disease. Of 1546 patients who underwent LC for benign gallbladder disease b...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7886-x
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abstract:BACKGROUND:We hypothesized that a dedicated collaborative transdisciplinary Geriatric Surgery Service (GSS) will improve care for elderly colorectal surgery patients. METHODS:Patients older than 75 years of age who underwent major colorectal surgery were included in this study. The Geriatric Surgery Service employed a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1112-9
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Recurrent spontaneous pneumothorax is widely treated by video-assisted thoracoscopic (VATS) bullectomy and pleurodesis. Treatment of postoperative pain with nonsteroidal antiinflammatory drugs (NSAIDs) is controversial as many surgeons believe that it reduces the efficacy of pleurodesis and increases the pne...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1207-3
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. METHODS:The study was designed as a controlled, prospective, cohort study including 38 patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1590-4
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abstract::The combination of conventional traumatic injuries and radiation exposure has synergistic consequences, the full extent of which may take days to weeks to become apparent. Our understanding of such is derived from a variety of laboratory and clinical scenarios involving both therapeutic and accidental exposures. When ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02066992
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abstract::Those benign breast disorders that are amenable to improvement by aesthetic surgery are discussed from the points of view of indications, techniques, and results. ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658430
更新日期:1989-11-01 00:00:00
abstract:INTRODUCTION:The surgical repair of large irreducible scrotal hernias is, in general, technically difficult. Laparoscopic repair for these cases is controversial, although extraperitoneal and transperitoneal approaches have been described. We present a small series of patients with large irreducible groin hernias (omen...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9157-5
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Pheochromocytoma with synchronous ipsilateral adrenal cortical adenoma (PSCA) may present with mixed clinical, biochemical, and radiological features characteristic to each neoplasm subtype. METHODS:All patients with a pathological diagnosis of pheochromocytoma were evaluated for an ipsilateral cortical ade...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4110-8
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Team familiarity has been shown to be important for operative efficiency and number of complications, but it is unclear for which types of operations and for which team members familiarity matters the most. The objective of this study is to further our understanding of familiarity in the OR by quantifying th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05657-1
更新日期:2020-11-01 00:00:00
abstract::Clinical, endoscopic, and laboratory data were collected prospectively in 701 patients with bleeding peptic ulcer. The overall rebleeding rate was 16.1% and increased the risk of a fatal outcome by 17 fold (1.2% versus 20.6%, p less than 0.001). Rebleeding was documented in more than 75% of the group who did not survi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01664889
更新日期:1990-03-01 00:00:00
abstract::A semiquantitative assessment of multiple histological parameters was applied retrospectively to 66 patients with stage I and II squamous cell carcinoma of the floor of the mouth to determine if prognostic information relative to cervical node metastases could be obtained. Three parameters relating to the tumor cell p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658802
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Ultrasound (US) and sestamibi (MIBI) are traditionally considered positive or negative. The purpose of this study was to define and test a new scoring system for MIBI and US and to determine whether this can improve their accuracy for primary hyperparathyroidism. METHODS:This is a prospective study of 200 c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1666-1
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Splenic trauma is a common organ injury following blunt abdominal trauma. In order to establish the contemporary epidemiology of blunt splenic trauma in Scotland and to detect risk factors associated with patient outcomes, analysis of a multi-center database of trauma patients was performed. METHODS:The stu...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9218-9
更新日期:2007-11-01 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:The evolution of diagnostic procedures has resulted in an increase in early detection of pathologically T1 (pT1) colorectal cancer (CRC). However, the risk factors affecting long-term outcomes of patients with pT1 CRCs have been unclear. The aim of the present study was to identify risk factors for postopera...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1378-y
更新日期:2012-02-01 00:00:00
abstract::Surgical resection remains the therapy of choice for the treatment of potentially curable gastrointestinal tract (GI) malignancies. Many of these tumors are incurable at the time of diagnosis and therapy should be directed towards palliation with the intent of minimizing pain, bleeding, obstruction, and potential morb...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067061
更新日期:1992-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0138-8
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:This study reviews the 15 year program of our Department of Pediatric Surgery for the treatment and follow-up of children born with a cleft in Benin and Togo. METHODS:We analyzed files of children born in Africa with a cleft. They were referred to us through a nongovernmental organization (NGO) between 1993...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1607-z
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:The long-term course after peptic ulcer perforation is unclear, but because the ulcer population is generally older and has concomitant disease, the long-term prognosis may be expected to be poor. METHODS:In a study based on prospective data collection, all patients with peptic ulcer perforation treated at ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9370-2
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The use of the Harmonic Scalpel (HS) for cystic duct ligation began with little data about its efficacy or safety. On the other hand, there is not any literature available about the use of PlasmaKinetic Sealer (PK) for closing the cystic duct in laparoscopic cholecystectomy (LC). Therefore, this study was de...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0819-3
更新日期:2011-04-01 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::The clinicopathological characteristics relevant to prognosis after surgical treatment of intrahepatic cholangiocarcinoma (ICC) remain unclear. In this study, the clinicopathological features of 19 patients with mass-forming ICC, the most common form of the disease, were reviewed to analyze prognostic determinants. Tw...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0291-1
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to describe the perioperative and long-term results of carotid endarterectomy (CEA) in patients aged 60 or less and compare them to patients of more advanced age in a retrospective single-centre case-control study. METHODS:From January 1996 to December 2014, 5893 consecutive CEAs wer...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4133-1
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Open surgical cricopharyngeal myotomy(CM) is considered standard of care for Zenker's diverticulum(ZD). Trans-oral CM has been described using a rigid stapling device for two decades; however, this remains problematic for severely kyphotic patients. This problem can be overcome with flexible endoscopy utiliz...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3442-0
更新日期:2016-06-01 00:00:00