Abstract:
BACKGROUND:Endoscopic biliary drainage (EBD) and percutaneous transhepatic biliary drainage (PTBD) are both used to resolve jaundice before surgery for perihilar cholangiocarcinoma (PHC). PTBD has been associated with seeding metastases. The aim of this study was to compare overall survival (OS) and the incidence of initial seeding metastases that potentially influence survival in patients with preoperative PTBD versus EBD. METHODS:Between 1991 and 2012, a total of 278 patients underwent preoperative biliary drainage and resection of PHC at 2 institutions in the Netherlands and the United States. Of these, 33 patients were excluded for postoperative mortality. Among the 245 included patients, 88 patients who underwent preoperative PTBD (with or without previous EBD) were compared to 157 patients who underwent EBD only. Survival analysis was done with Kaplan-Meier and Cox regression with propensity score adjustment. RESULTS:Unadjusted median OS was comparable between the PTBD group (35 months) and EBD-only group (41 months; P = 0.26). After adjustment for propensity score, OS between the PTBD group and EBD-only group was similar (hazard ratio, 1.05; 95 % confidence interval, 0.74-1.49; P = 0.80). Seeding metastases in the laparotomy scar occurred as initial recurrence in 7 patients, including 3 patients (3.4 %) in the PTBD group and 4 patients (2.7 %) in the EBD-only group (P = 0.71). No patient had an initial recurrence in percutaneous catheter tracts. CONCLUSIONS:The present study found no effect of PTBD on survival compared to patients with EBD and no increase in seeding metastases that developed as initial recurrence. These data suggest that PTBD can safely be used in preoperative management of PHC.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Wiggers JK,Groot Koerkamp B,Coelen RJ,Doussot A,van Dieren S,Rauws EA,Schattner MA,van Lienden KP,Brown KT,Besselink MG,van Tienhoven G,Allen PJ,Busch OR,D'Angelica MI,DeMatteo RP,Gouma DJ,Kingham TP,Verheij J,Jarnagidoi
10.1245/s10434-015-4676-zsubject
Has Abstractpub_date
2015-12-01 00:00:00pages
S1156-63eissn
1068-9265issn
1534-4681pii
10.1245/s10434-015-4676-zjournal_volume
22 Suppl 3pub_type
杂志文章abstract:BACKGROUND:In several neoplastic diseases, including breast cancer, immunosuppression correlates with disease stage, progression, and outcome. Thus, thorough analysis of immune parameters in breast cancer patients may be beneficial in designing effective anticancer immune-based therapies. METHODS:We investigated dendr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/aso.2004.05.027
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:In a mouse model of hepatic metastasis, we herein analyzed whether the CXC chemokine macrophage inflammatory protein (MIP)-2, a functional analogue of the human interleukin 8, stimulates tumor cell migration in vitro and angiogenesis and tumor growth in vivo. METHODS:By using chemotaxis chambers, CT26.WT co...
journal_title:Annals of surgical oncology
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abstract:BACKGROUND:Approximately 3-5% of patients with thin (≤ 1 mm) cutaneous melanomas develop distant metastases. We sought to identify clinical and pathologic factors associated with distant metastasis and survival in a large number of patients with thin melanoma treated at a single institution. METHODS:We identified pati...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
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abstract:INTRODUCTION:Our study aims to determine whether patients with lobular-type breast cancer have significantly improved rates of breast conservation (BCT) after neoadjuvant chemotherapy (nCT). METHODS:Patients who received nCT and surgery within three prospective trials between 1995 and 2007 at the Medical University of...
journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
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abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 社论
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abstract::Barrett's esophagus (BE) is a premalignant lesion known to sequentially progress to esophageal adenocarcinoma. Management of BE has changed significantly over the last 5 years with the development of endoscopic resection and ablation, which has replaced esophagectomy as the treatment of choice in BE with high-grade dy...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
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更新日期:2012-05-01 00:00:00
abstract::The purpose of this study was to clarify the outcome of the ratio between metastatic and examined lymph nodes (N ratio) in gastric cancer patients with < or =15 examined lymph nodes after D2 lymphadenectomy. A retrospective study was performed in 906 patients with gastric cancer who had undergone D2 resection. Patient...
journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Breast reconstruction following mastectomy has been shown to have a salutary effect on the overall psychological well-being of women being treated for breast cancer. Unfortunately, however, not every patient is an ideal candidate for reconstruction. Complications stemming from reconstructive surgery can caus...
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更新日期:2017-04-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2010-11-01 00:00:00
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journal_title:Annals of surgical oncology
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pub_type: 杂志文章,多中心研究
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更新日期:2008-02-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:1998-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2016-06-01 00:00:00
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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
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2016-02-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2003-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2002-11-01 00:00:00