Abstract:
BACKGROUND:The prognosis of intrahepatic cholangiocarcinoma (ICC) remains poor despite improvements in treatment and post-operative clinical management. We review our experiences and evaluate our current surgical approaches by comparing patients from two consecutive treatment periods. METHODS:One hundred forty-four patients who underwent hepatectomy for ICC between 1993 and 2014 were divided into groups that received treatment before (n = 65, first period) and after 2006 (n = 79, second period), when new treatment options such as adjuvant chemotherapy and multimodal therapy for recurrence were introduced. Clinicopathological characteristics and survival outcomes were compared between the groups. RESULTS:First-period patients exhibited more advanced tumor characteristics, including larger tumors, higher serum carbohydrate antigen 19-9 levels, and vascular invasion. Median overall survival (OS) durations of the first- and second-period groups were 21.4 and 57.7 months, respectively (p < 0.001); corresponding median disease-free survival (DFS) durations were 12.2 and 16.6 months, respectively (p = 0.027). Multivariate analysis found an independent association of the treatment time period with OS and DFS. Notably, second-period patients with N1 disease achieved a longer OS and DFS (median OS time: 12.4 and 26.0 months, p = 0.0018, and median DFS: 4.7 and 10.7 months p = 0.019, respectively). Among recurrent patients (first, n = 50 and second, n = 44), second-period patients had a significantly longer survival after recurrence (8.0 vs. 22.3 months, p < 0.001). CONCLUSION:ICC patients, particularly those with N1 disease, achieved significant survival improvements that were partly attributable to patient selection, adjuvant chemotherapy, and multimodal treatment after recurrence.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Yoh T,Hatano E,Nishio T,Seo S,Taura K,Yasuchika K,Okajima H,Kaido T,Uemoto Sdoi
10.1007/s00268-016-3583-1subject
Has Abstractpub_date
2016-09-01 00:00:00pages
2229-36issue
9eissn
0364-2313issn
1432-2323pii
10.1007/s00268-016-3583-1journal_volume
40pub_type
杂志文章abstract::Adenocarcinomas of the esophagogastric junction (AEG) are now recognized as a separate tumor entity with increasing incidence. The aim of the present study was to evaluate whether positron emission tomography (PET) using the glucose analog F-18-fluorodeoxyglucose (FDG) can be used for metabolic characterization of thi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7058-9
更新日期:2003-09-01 00:00:00
abstract::Two-hundred and fifty patients undergoing initial exploration for primary hyperparathyroidism were analyzed for differences in clinical presentation, biochemical status, pathology, and outcome of surgery. In patients less than 60 years of age (younger patients, n = 119) the most common preoperative symptoms and signs ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02067389
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:As more patients undergo diagnostic thyroid surgery, the development of posthemithyroidectomy hypothyroidism is becoming a major concern. We hypothesized that the preoperative thyrotropin (thyroid-stimulating hormone, TSH) level and ultrasonographically measured thyroid volume, both commonly available in thy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9717-3
更新日期:2008-11-01 00:00:00
abstract::The role of nitric oxide in mediating smooth muscle relaxation is well established. Less is known about the downstream signaling events inside the smooth muscle cell that produce relaxation of the contractile machinery. One possible effector molecule is the small heat shock protein HSP20. Increased phosphorylation of ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-002-4052-6
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Recent studies have shown a 7-15% lymph node (LN) metastasis rate in submucosal invasive colorectal cancer (SICC). Identifying risk factors for LN metastasis is crucial in selecting therapeutic modalities for SICC. We assessed the possibility of and the risk factors for LN metastasis in SICC. METHODS:We per...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9628-3
更新日期:2008-09-01 00:00:00
abstract:PURPOSE:Management of anal fistula represents a balance between curing the condition and maintaining anal continence. Recent reports of the results of the porcine anal fistula plug have demonstrated excellent fistula healing rates without reporting significant complications. METHODS:The outcome of patients who underwe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9504-1
更新日期:2008-06-01 00:00:00
abstract::Persistent pain after hernia repair is common, although it is usually mild. In 3% of patients it is severe, however, and has significant effects on work and social activities. The purpose of this review was to examine factors that affect pain after hernia repair. Although the type of anaesthetic used, local or general...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7903-0
更新日期:2005-08-01 00:00:00
abstract::Most adrenal incidentalomas are nonfunctioning cortical adenomas that do not require surgery. Operative treatment is indicated if the incidentaloma has malignant features as seen during the radiologic workup, is hormonally active, or grows during follow-up. A conservative attitude is justified in asymptomatic patients...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910095
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Efficient DNA damage repair by MutL-homolog DNA mismatch repair (MMR) enzymes, MLH1, MLH3, PMS1 and PMS2, are required to maintain thyrocyte genomic integrity. We hypothesized that persistent oxidative stress and consequent transcriptional dysregulation observed in thyroid follicles will lead to MMR deficien...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4299-6
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Esophagectomy carries high morbidity, mainly respiratory. Minimally invasive surgery has been demonstrated to improve postoperative outcome in digestive surgery, without impairment of oncological results. A prospective study was conducted to evaluate feasibility, postoperative outcome, and mid-term oncologic...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0627-3
更新日期:2006-08-01 00:00:00
abstract::Radiologically demonstrable pancreatic endocrine tumors are a frequent requirement for exploration in patients with multiple endocrine neoplasia type I (MEN-I). Such delayed intervention is accompanied by a 30% to 50% incidence of pancreatic endocrine metastases. This study explores biochemical tumor markers and opera...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900451
更新日期:1998-07-01 00:00:00
abstract::Of the 2790 patients with gastric carcinoma who underwent surgery between January 1978 and December 1993, there were 224 who underwent a D2 resection for cancer of the proximal third of the stomach. Survival in these patients was retrospectively analyzed with special reference to the survival benefit of pancreaticospl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900283
更新日期:1997-07-01 00:00:00
abstract::Sixty-one patients who were diagnosed with mucosal gastric cancer have been successfully treated with two laparoscopic techniques at our institute from March 1992 to March 1997. One is laparoscopic wedge resection of the stomach using a lesion-lifting method for lesions of the anterior wall, the lesser curvature, and ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013167
更新日期:1999-02-01 00:00:00
abstract::We have previously demonstrated that there are two subgroups of patients with different types of biliary bile acid output after relief of obstructive jaundice by percutaneous transhepatic biliary drainage (PTBD). The reason for two groups is not clear but is possibly the difference in hepatic reserve function. The aim...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0249-3
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Macroscopic extrathyroidal extension (ETE) is a poor prognostic factor in papillary thyroid carcinoma (PTC). However, intraoperative inspection for ETE is often inaccurate and could lead the surgeon to misconstrue simple adhesion as gross ETE. Such confusion could result in more aggressive treatment than nec...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2034-5
更新日期:2013-07-01 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::Expression of sialyl-Lewisx (sLex) antigen was studied immunohistochemically in 110 resected human gastric carcinomas using an anti-sLex monoclonal antibody. Lymph node, liver, and peritoneal metastases were clearly more prevalent in tumors expressing high levels of sLex than in those with no or low-level sLex express...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900304
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:The lung is the most common site of extrahepatic metastasis from hepatocellular carcinoma (HCC). The aim of this study was to evaluate the significance and long-term outcomes of pulmonary metastasectomy for HCC, especially in patients with multiple nodules or repeated pulmonary recurrence. METHODS:We retros...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3213-3
更新日期:2016-02-01 00:00:00
abstract::This study was first designed to investigate systematically the kinetics of surface expression of scavenger receptors (SRs) and CD14 on alveolar macrophages in vivo and in vitro and their relation with local pro- and antiinflammatory responses in endotoxemia. The expression of SR and CD14 in lungs was down- and up-reg...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6548-5
更新日期:2003-01-01 00:00:00
abstract::The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0239-5
更新日期:2002-04-01 00:00:00
abstract::Although emergency department thoracotomy (EDT) is often considered a controversial "last chance" method of resuscitation, we hypothesized that EDT performed in a busy urban Level I trauma center has significant salvage rates despite the absence of traditional survival predictors. A retrospective review revealed that ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9392-9
更新日期:2008-04-01 00:00:00
abstract:PURPOSE:The aim of the study was to evaluate risk factors for small bowel obstruction (SBO) in early postoperative period after anterior resection for rectal cancer. METHODS:Patients who underwent anterior resection (AR) [high AR (HAR) or low AR (LAR)] for rectal cancer between January 2009 and April 2016 were enrolle...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4152-y
更新日期:2018-01-01 00:00:00
abstract::This paper describes a model humanitarian mission to Guyana; it illustrates the value of excellent ongoing care in collaboration with local physicians and surgeons, cooperation with local government and medical officials, and frequent periodic follow-up missions (always to the same hospital, working with the same staf...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3049-x
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:Restorative surgery for rectal cancer is usually criticized by its functional outcomes. The aim of this study is to assess the efficacy "taeniectomy" pouch in comparison with transverse coloplasty pouch. STUDY DESIGN:This was a prospective controlled study. Most patients who were candidate for low rectal resec...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-04890-z
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The pancreatic fistula rate following distal pancreatectomy ranges widely, from 13.3 to 64.0 %. The optimal closure method of the pancreatic remnant remains controversial, especially regarding whether to use a stapler. METHODS:All patients who underwent distal pancreatectomy in five Japanese hospitals from ...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00268-012-1595-z
更新日期:2012-08-01 00:00:00
abstract::This study aimed (1) to develop a simple scoring system incorporating ultrasound (US) examination and clinical or laboratory predictors for increasing diagnostic accuracy in acute appendicitis (AA), and (2) to evaluate the performance of the scoring system as compared to that of previous models. Fifteen variables incl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7853-6
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Emerging evidences have gradually revealed the skeletal muscle attenuation (MA) was not only reflected the accumulation of lipids in skeletal muscle but also associated with physiological and pathological states. The aim of this study was to evaluate the impact of MA on the prognosis of pancreatic cancer pat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3205-3
更新日期:2015-12-01 00:00:00
abstract::A randomized, double-blind multicenter trial was performed to compare the safety and efficacy of a new low-molecular-weight heparin (LMWH) (LU 47311, Clivarine) and standard unfractionated heparin for the prophylaxis of postoperative venous thromboembolism. Altogether 1351 patients scheduled to undergo abdominal surge...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/s002689900185
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Significant barriers limit the safe and timely provision of surgical and anaesthetic care in low- and middle-income countries. Nearly one-half of Mongolia's population resides in rural areas where the austere geography makes travel for adequate surgical care very difficult. Our goal was to characterize the a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0904-7
更新日期:2011-02-01 00:00:00
abstract::The present study documents the indications and results of endoscopic sphincterotomy (ES) performed over 7 years in a surgical endoscopy unit. Potential improvement of results over this time period was analyzed. ES was associated with rare but undesirable morbidity and mortality. Specific improvement of results over t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900195
更新日期:1997-01-01 00:00:00