Abstract:
PURPOSE:To investigate the relationship between surgeon caseload and surgery type, and variation in the surgical treatment of early stage breast cancer patients in Alberta, Canada. METHODS:All women diagnosed with stage I to III breast cancer in Alberta from 2002 to 2010 were identified from the Alberta Cancer Registry. Type of surgery, surgeon (anonymized), and hospital were obtained from provincial physician claims data. Multilevel logistic regression with surgeons and hospitals as crossed random effects was used to estimate adjusted odds ratios (OR) of receiving mastectomy by surgeon volume. Empirical Bayes estimation was used to estimate adjusted OR for individual surgeons and hospitals. RESULTS:Mastectomy was found to be inversely related to surgeon volume among stage I and II patients. Patients whose surgery was conducted by a low-volume surgeon had twice the odds of receiving mastectomy as those that had surgery performed by a very high-volume surgeon (stage I OR 2.36, 95 % confidence interval 1.40, 3.97; stage II OR 1.96, 95 % confidence interval 1.13, 3.42). OR of mastectomy varied widely by individual surgeon beyond the variation explained by the factors investigated. CONCLUSIONS:Surgeon characteristics, including surgeon volume, are associated with surgery type received by breast cancer patients in Alberta. Significant variation in the likelihood of breast-conserving surgery (BCS) by surgeon is concerning given the potential benefits of BCS for those who are eligible.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Fisher S,Yasui Y,Dabbs K,Winget Mdoi
10.1245/s10434-016-5118-2subject
Has Abstractpub_date
2016-06-01 00:00:00pages
1845-51issue
6eissn
1068-9265issn
1534-4681pii
10.1245/s10434-016-5118-2journal_volume
23pub_type
杂志文章abstract:PURPOSE:This study was designed to determine invasive cancer upstaging rates at surgical excision following vacuum-assisted biopsy of ductal carcinoma in situ (DCIS) among women meeting eligibility for active surveillance trials. METHODS:Patients with vacuum-assisted, biopsy-proven DCIS at a single center from 2008 to...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6018-9
更新日期:2017-11-01 00:00:00
abstract:INTRODUCTION:In adrenal tumors, size ≥ 4 cm has been an indication for adrenalectomy due to concern for malignancy. We compared mass size to imaging features (ImF) for accuracy in diagnosing adrenal malignancy. METHODS:Data were retrieved for 112 consecutive patients who had adrenalectomy from January 2011 to August 2...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4684-z
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Many invasive breast cancers are accompanied by a variety of noninvasive components. Histological distinctions have been made between these components, but to understand their importance, it is essential to examine their molecular biology. METHODS:Proliferative indices, oncoproteins, and steroid receptor ex...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02306378
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Percutaneous biliary drainage (PBD) is used to relieve malignant bile duct obstruction (MBO) when endoscopic drainage is not feasible. Little is known about the effects of PBD on the quality of life (QoL) in patients with MBO. The aim of this study was to evaluate changes in QoL and pruritus after PBD and to...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1045-9
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:A positive circumferential radial margin (CRM) after rectal cancer surgery is an important predictor of local recurrence. The definition of a positive CRM differs internationally, and reported rates vary greatly in the literature. This study used time-series population-based data to assess positive CRM rates...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4893-5
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Postoperative chemoradiation and perioperative chemotherapy using epirubicin/cisplatin/5-fluorouracil (ECF) represent two standards of care for resectable gastric cancer. In the TOPGEAR (Trial Of Preoperative therapy for Gastric and Esophagogastric junction AdenocaRcinoma) trial, we hypothesized that adding ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1245/s10434-017-5830-6
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:The purpose of this study was to obtain a comprehensive understanding of the impact of postoperative tumor marker (TM) normalization on survival after pancreatectomy for pancreatic carcinoma. We propose the concept of surgical RECIST based on residual tumor and TM status. METHODS:A total of consecutive patient...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1311-x
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Repeat sentinel lymph node biopsy (rSLNB) has increasingly been used in patients with ipsilateral breast tumor recurrence (IBTR). The safety in terms of regional disease control after this procedure remains unclear. This study evaluates occurrence of regional recurrence as first event in patients with IBTR a...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6384-y
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Inflammatory breast cancer (IBC) is an aggressive form of breast cancer characterized by rapid progression and early metastatic dissemination. The purpose of this study was to assess contemporary rates of local regional recurrence (LRR) in the era of trimodality therapy for nonmetastatic IBC and identify ris...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5952-x
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Primary gastrointestinal sarcomas are uncommon, and the clinicopathological determinants of survival remain unclear. In order to correlate clinical presentation, pathological assessment, and treatment with outcome, we have analyzed our institution's recent experience with these tumors. METHODS:Records of ad...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303698
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Despite data from randomized trials supporting omission of radiation therapy (RT) for women ≥ 70 years of age with T1, estrogen receptor-positive (ER+) tumors undergoing breast-conserving therapy (BCT), RT usage remains high. We reviewed our institutional experience to determine if risk factors for local rec...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-07151-4
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Survival for positive sentinel lymph node (SLN) patients does not differ between completion lymph node dissection (CLND) and nodal observation (OBS). However, treating these patients with CLND and checkpoint inhibitors, such as pembrolizumab (PEM), improves outcomes. This study evaluated the cost-effectivene...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09137-7
更新日期:2020-09-19 00:00:00
abstract:BACKGROUND:Limited data exist that describe the long-term outcomes from additional surgery following non-curative endoscopic resection (ER) of early gastric cancer (EGC) in older people. This study aimed to determine the appropriate treatment strategy for these patients. METHODS:We analyzed data from 2895 patients who...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5888-1
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Laparoscopic rectal cancer surgery aims to provide patients with curative resection while minimizing postoperative morbidity and mortality. This study used meta-analytical techniques to compare laparoscopic and open surgery as the primary treatment for patients with rectal cancer with regard to short-term an...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/ASO.2006.05.045
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Girdin was identified as a novel Akt substrate that contributes to a positive feedback loop between Girdin and Akt. Although several recent studies have demonstrated that Girdin is involved in tumor metastasis, the clinical implications of Girdin in breast cancer remain unclear. METHODS:To retrospectively e...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3746-y
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Recent studies indicate that women with unilateral breast cancer are choosing contralateral prophylactic mastectomy (CPM) at an increasing rate. There is limited literature evaluating the postoperative complication rates associated with CPM without breast reconstruction. The objective of this study was to co...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-013-3116-1
更新日期:2013-10-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6885-8
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a new noninvasive diagnostic method for pancreaticobiliary (PB) imaging without endoscopy, sedation, or iodinated contrast. The purpose of this study was to evaluate the ability of MRCP to depict pancreatic and biliary ductal anatomy compared to that of e...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303747
更新日期:1997-12-01 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::Until the late 1990s, the application of the sentinel node (SN) concept to gastrointestinal (GI) malignancies was not recognized because of the multidirectional and complicated lymphatic flow from the GI tract. However, several studies supporting the validity of the SN concept for GI cancers have been reported in the ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1007/BF02523637
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:An expert consensus meeting had defined the standard lymphadenectomy during pancreatoduodenectomy for an adenocarcinoma of the head of the pancreas. There is a controversy regarding the possibility to perform this optimal lymphadenectomy by minimally invasive approach. PATIENTS:The patient was a 68-year-old...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5421-y
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Tissue destruction by cryosurgery not only is mediated by direct cell damage, but also involves secondary mechanisms, such as ischemia due to shutdown of the microcirculation. Clinicians favor repetitive cryoapplication, although there is no proven evidence for a more effective tumor eradication. METHODS:Th...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.04.014
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Response to chemotherapy and anatomical spread are significant prognostic factors in patients with esophageal squamous cell carcinoma (ESCC) treated by chemotherapy then surgery. Predicting the response to chemotherapy would allow significant optimization of cancer treatment. METHODS:Genomic mutation and pr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0851-4
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the outcome of patients that received neoadjuvant chemotherapy prior to resection for colorectal liver metastases (CRLM) and compare them with a matched cohort of patients that underwent resection followed by adjuvant chemotherapy. METHODS:687 patients have undergone cur...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9533-2
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Despite the widespread use of the sentinel lymph node biopsy technique, many patients with invasive breast cancer still undergo an axillary lymph node dissection and are at risk of arm lymphedema. With the new awareness of lymphatic spread in the axillary nodes, it should be possible to define a new surgical...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9450-4
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:The strategy of radical surgery for stage 2 endometrial cancer (EC) remains controversial. This meta-analysis aimed to investigate the impact of radical hysterectomy (RH) versus simple hysterectomy (SH) on survival of patients with stage 2 EC. METHODS:A systematic review was conducted to identify studies co...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/s10434-019-07472-y
更新日期:2019-09-01 00:00:00
abstract::Breast cancer is a progressive, phenotypic, genetic and epigenetic alteration, induced by various stimulants of which the principal steroid hormone, estrogen, initiates and promotes neoplastic transformation of normal ductal mammary epithelium to acquire distinct biochemical and molecular characteristics. The molecula...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1007/s10434-999-0528-z
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Although significant progress has been made in the management of children with Wilms tumor, two major controversies still exist: the extent of radiographic evaluation necessary before surgery and the role of preoperative chemotherapy. This study sought to determine whether patients with Wilms tumor who prese...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303774
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Isolated regional failure of nasopharyngeal carcinoma (NPC) after primary treatment is traditionally treated with radical neck dissection (RND). The roles of modified radical neck dissection (MRND) and postoperative radiotherapy after salvage surgery currently remain unclear. METHODS:Medical records from ou...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2018-3
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Most patients with melanoma have a thin (≤1.00 mm) lesion. There is uncertainty as to which patients with thin melanoma should undergo sentinel lymph node (SN) biopsy. We sought to quantify the proportion of SN metastases in patients with thin melanoma and to determine the pooled effect of high-risk features...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析,评审
doi:10.1245/s10434-016-5137-z
更新日期:2016-12-01 00:00:00