Abstract:
BACKGROUND:The decision to receive adjuvant chemotherapy is far from evident and remains controversial in patients with American Joint Committee on Cancer stage II colon cancer. This study analyzes several pathological characteristics in order to assess their (combined) predictive value for outcomes in stage II colon cancer. METHODS:All stage II patients treated surgically for colon cancer at our tertiary care center (2004-2011) were extracted from a prospectively maintained, Institutional Review Board-approved data repository (n = 313). Mortality and metastasis were compared, including multivariable Cox regression adjusted for stage subdivisions (IIA/IIB/IIC) and potential confounders. RESULTS:Colon cancer-specific mortality was substage independently increased in patients with baseline carcinoembryonic antigen (CEA) >5 ng/L [hazard ratio (HR) 2.88; p = 0.022], large vessel invasion (LVI; HR 4.59; p < 0.001), perineural invasion (HR 3.08; p = 0.006), and extramural vascular invasion (EMVI; HR 4.96; p < 0.001). Overall mortality adjusted for substage, age, and comorbidity was also significantly higher in patients with high-grade disease (HR 2.54; p < 0.001), LVI (HR 1.74; p = 0.015), perineural (HR 2.42; p < 0.001), and EMVI (HR 2.79; p < 0.001). Metastatic recurrence adjusted for adjuvant chemotherapy status had substage-independent associations with baseline CEA >5 ng/L (HR 2.37; p = 0.046), LVI (HR 3.07; p = 0.001), perineural invasion (HR 2.57; p = 0.010), and EMVI (HR 2.83; p = 0.002). The number of high-risk features (0, 1, 2-3, 4+) was associated with a clear incremental increase in overall and disease-specific mortality and recurrence (p ≤ 0.001). The major inflection point is at two high-risk characteristics or more, whereas 5-year survival is almost halved from 77.4 % to 31.7 % (p < 0.001). CONCLUSIONS:The risk score introduced provides a prognostic tool based on readily available data extracted from baseline pathology and preoperative CEA, which provides an easy method to stratify risks of mortality and recurrence and may therefore help in treatment decisions after surgery in stage II patients.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Amri R,England J,Bordeianou LG,Berger DLdoi
10.1245/s10434-016-5387-9subject
Has Abstractpub_date
2016-11-01 00:00:00pages
3907-3914issue
12eissn
1068-9265issn
1534-4681pii
10.1245/s10434-016-5387-9journal_volume
23pub_type
杂志文章abstract:BACKGROUND:In one third of patients who die of rectal cancer, a pelvic recurrence after resection represents isolated disease for which re-resection may provide cure. These extensive resections can carry high morbidity. Proper patient selection is desirable but difficult. Hydronephrosis has been documented previously t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/ASO.2005.10.004
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Axillary nodal status is the most important prognostic factor for patients with breast cancer. Clinical assessment and imaging modalities are not always reliable. Surgical removal and histopathological examination of axillary lymph nodes remain essential methods of staging the axilla. However, the optimal ma...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-008-9863-8
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Recently, traditional laparoscopic anterior resection has been used for rectal cancer, offering good functional results compared with open resection and resulting in better early postoperative outcomes. Few studies investigating the role of robot-assisted tumor-specific rectal surgery (RTSRS) have been carri...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-010-0909-3
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:More information is needed for selection of patients with peritoneal metastases from endometrial cancer (EC) to undergo cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS:This study analyzed clinical, pathologic, and treatment data for patients with peritoneal metast...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-017-6307-3
更新日期:2018-03-01 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: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:Trastuzumab in association with systemic cytotoxic chemotherapy is the standard of care for patients with advanced HER2-positive gastric carcinoma (GC). However, HER2 as a prognostic factor in GC remains controversial. METHODS:HER2 overexpression and amplification was evaluated by immunohistochemistry (IHC)...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2818-0
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Intraperitoneal chemotherapy has an established role in the treatment of selected patients with colorectal peritoneal metastases. Oxaliplatin is highly suitable as a chemotherapeutic agent for hyperthermic intraperitoneal chemotherapy (HIPEC), but its use to date has been limited because of the morbidity cau...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5665-6
更新日期:2017-04-01 00:00:00
abstract::Cervical cancer incidence and mortality have declined in developed countries during the past few decades as a result of screening programs and vaccination. However, it remains a significant cause of cancer-related mortality in young women. Early-stage cervical cancer, defined as disease limited to the cervix, has trad...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09265-0
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) is known to reduce inflammatory response in relation to surgery. Inflammation may promote recurrence of cancer, thus inhibition by use of NSAIDs could reduce recurrence after surgery. OBJECTIVE:The aim of this study was to examine the associ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07600-8
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Isolated limb perfusion (ILP) results in complete response (CR) rates of 60% to 90% in patients with regionally advanced melanoma. Survival after a CR may be influenced by various factors, particularly out-of-field disease in iliac lymph nodes (ILN) identified during lower-extremity ILP. We examined clinical...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0771-4
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:The 5th edition of Breast Imaging Reporting and Data System subdivides suspicious calcifications into two categories: 4B-amorphous, coarse heterogeneous, and fine pleomorphic calcifications; 4C-fine linear or fine linear branching calcifications. We investigated whether these revised categories are appropria...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4362-6
更新日期:2015-09-01 00:00:00
abstract::Preoperative, operative, and postoperative factors may all contribute to high rates of anemia in patients undergoing surgery for cancer. Allogeneic blood transfusion is associated with both infectious risks and noninfectious risks such as human errors, hemolytic reactions, transfusion-related acute lung injury, transf...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-007-9502-9
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Understanding the natural progression of untreated gastric cancer is critical for determining the disease prognosis as well as treatment options and timing. The aim of this study is to analyze the natural history of gastric cancer. PATIENTS AND METHODS:We included patients with gastric cancer who had not re...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07455-z
更新日期:2019-09-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6852-4
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:High-grade (HG) mucinous appendiceal neoplasms (MAN) have a worse prognosis than low-grade histology. Our objective was to assess the safety and efficacy of cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) in patients with high-grade, high-volume (HG-HV) peritoneal metastase...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4838-z
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:This study aimed to compare clinicopathologic features and outcomes between patients with familial non-medullary thyroid carcinoma (FNMTC) and patients with sporadic non-medullary thyroid carcinoma (SNMTC) after performing individual risk factor-matching. Additionally, the study evaluated a dynamic risk stra...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09025-0
更新日期:2020-08-14 00:00:00
abstract:BACKGROUND:Local excision might represent an alternative to total mesorectal excision for patients with locally advanced rectal cancer who achieve a major or complete clinical response after neoadjuvant chemoradiotherapy. METHODS:Between August 2005 and July 2011, 63 patients with mid-low rectal adenocarcinoma who had...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09243-6
更新日期:2020-10-30 00:00:00
abstract:PURPOSE:Treatment of synovial sarcoma (SS) is challenging because of its unpredictable clinical behavior. We reviewed our institutional experience with pediatric SS to identify prognostic indicators and survival outcomes. METHODS:We retrospectively reviewed all pediatric/adolescent patients (age<22 years) with confirm...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2587-9
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:Patients with locally advanced cervical cancer (LACC) are usually treated with concurrent chemoradiotherapy. Extended-field chemoradiotherapy is indicated in case of para-aortic node involvement at initial assessment. 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18-FDG PET/CT) i...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-011-1583-9
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The risk factors and incidence of venous thromboembolism (VTE) are not well defined in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). We sought to characterize the incidence, risk factors, and pharmacothromboprophylaxis strategies for VTE after CRS/HIPEC....
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-019-07414-8
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Major hepatectomy for intrahepatic cholangiocarcinoma (ICC) sometimes involves resection of major hepatic veins, which might result in the future liver remnant (FLR) congestion. The necessity and efficacy of resection and reconstruction of the middle hepatic vein (MHV) during right or left hemihepatectomy fo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5384-z
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Liver metastasis of gastric cancer (GC) is highly associated with poor prognosis. The development of sensitive biomarkers for detecting and predicting liver metastasis is required for better clinical outcome. OBJECTIVE:In this study, we aimed to identify novel genes associated with liver metastasis of GC. ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07985-6
更新日期:2020-06-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6970-z
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Improved survival has been reported for diffuse malignant peritoneal mesothelioma (DMPM) treated by surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). The significance of lymph node involvement in this disease is still poorly understood. METHODS:Prospectively collected clinical da...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0756-2
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Radical cystectomy is a standard treatment for muscle-invasive bladder cancer but frequently entails postoperative pulmonary complications (PPCs). Nutrition is closely associated with postoperative outcomes. Therefore, we evaluated the impact of preoperative prognostic nutritional index (PNI) on PPCs in radi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08994-6
更新日期:2020-08-09 00:00:00
abstract:BACKGROUND:We present an alternative access technique to facilitate preperitoneoscopic (extraperitoneal laparoscopic) approach for radical prostatectomy, herniorrhaphy, and other pelvic procedures. METHODS:A 0 degrees telescope was mounted into a Visiport Optical Trocar (Visiport), and via a periumbilical incision it ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9883-4
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Hepatic artery infusion (HAI) chemotherapy is an effective regional therapy for unresectable colorectal liver metastases (U-CRLM).1 , 2 One of its limitations is the need for a laparotomy, which can delay the use of systemic therapy.3 Here, we describe a purely robotic technique for placement of an HAI pump ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5484-9
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The maximum size of adrenal tumors that should be removed with a laparoscopic approach is controversial. It has been suggested that laparoscopic adrenalectomy is appropriate only for adrenal tumors < 6 cm in size. We report our experience with laparoscopic adrenalectomy in patients with adrenal tumors of > o...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02557272
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:CA 19-9 levels are useful for the diagnosis of patients with pancreatic adenocarcinoma. However, interest has recently turned toward its use as a prognostic indicator. The purpose of this study is to determine whether postoperative CA 19-9 levels predict disease-free survival (DFS) and median survival (MS) i...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02305535
更新日期:1997-10-01 00:00:00