Abstract:
BACKGROUND:Gastrointestinal leak (GIL) after cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC) is associated with significant morbidity and mortality. This study aimed to identify GIL prognostic factors and its impact on overall survival. METHODS:A retrospective analysis of a prospectively maintained database comprising 1270 CRS/HIPEC procedures was performed. Type of GIL, functional and resection status, morbidity, mortality, and survival were reviewed. RESULTS:Gastrointestinal leaks were identified in 8.7% (110/1270) of CRS/HIPEC procedures, including 53 anastomotic leaks (4.2%), 53 hollow viscus perforations (4.2%), and four leaks at unknown sites. The multivariate predictors of leak were Eastern Cooperative Oncology Group (ECOG) functional status (ECOG 1 vs. 0: odds ratio [OR] 2.12, p = 0.009; ECOG 2 vs. 0: OR 2.90, p = 0.004), and number of anastomoses (OR 5.34; p < 0.0001). The in-hospital mortality rate for the GIL cohort was 21.8% (24/110), with a 72% (80/110) reoperation rate. The leak cohort had a higher major morbidity rate (88.3 vs. 23.3%; p < 0.0001), a longer hospital stay (39.0 vs. 9.9 days; p < 0.0001), and a longer intensive care unit (ICU) stay (7.7 vs. 1.7 days; p = 0.0003). After surgical mortality was excluded, the overall survival periods for the leak and no-leak patients with complete cytoreduction were respectively 1.5 and 4.98 years (p = 0.0001). Clinically significant decreases in survival were observed for all primary malignancies. CONCLUSIONS:Gastrointestinal leak after CRS/HIPEC is a source of significant mortality, with a decrease in overall survival even after complete CRS. Preoperative functional status and number of anastomoses are predictors of leak for CRS/HIPEC patients.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Chouliaras K,Levine EA,Fino N,Shen P,Votanopoulos KIdoi
10.1245/s10434-016-5738-6subject
Has Abstractpub_date
2017-04-01 00:00:00pages
890-897issue
4eissn
1068-9265issn
1534-4681pii
10.1245/s10434-016-5738-6journal_volume
24pub_type
杂志文章abstract:BACKGROUND:The clinical impact of sentinel lymph node biopsy (SLNB) in gastric cancer is controversial. We performed a prospective trial to compare different methods: radiocolloid method (RM), dye method (DM), and both methods simultaneously (dual method, or DUM) for reliability and therapeutic consequences. METHODS:R...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-007-9367-y
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Using 4-year nationwide population-based data for Taiwan, this study compared in-hospital surgical mortality rates with hospital volume for five cancer-related gastrointestinal resections. METHODS:The study sample was drawn from the Taiwan National Health Insurance Research Database. A total of 34,715 patie...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9005-0
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Dendritic cells (DC) are potent professional antigen-presenting cells that can activate naive T lymphocytes and initiate cellular immune responses. As adjuvants, DC may be useful for enhancing immunogenicity and mediating tumor regression. Endogenous expression of antigen by DC could offer the potential adva...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303766
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:There are few reports on microvascular invasion (MVI) located intra- or extratumorally and prognosis of hepatocellular carcinoma (HCC). OBJECTIVE:The aim of this study was to evaluate patient outcome according to the location of MVI, and to build a nomogram predicting extratumoral MVI. METHODS:We included ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07365-0
更新日期:2019-08-01 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:Complete ablation rates after a single session of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) vary from 48% to 97%. Limited data are available regarding risk factors and prognostic significance of incomplete ablation. METHODS:Between April 2001 and March 2006, 298 patients underwent RFA ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9733-9
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the introduction of diagnostic laparoscopy (DLS) in patients with colorectal peritoneal metastases (PM) to prevent non-therapeutic laparotomies during cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC). METHODS:Patients with histologically...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07957-w
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:There is conflicting evidence concerning platelet status and hepatocellular carcinoma (HCC) prognosis. We evaluated the prognostic value of platelet-based indices, including platelet count, platelet/lymphocyte ratio (PLR), and aspartate aminotransferase to platelet ratio index (APRI) in HCC after hepatic res...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3771-x
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Microinvasive ductal carcinoma (DCISM), defined as DCIS with a focus of invasive carcinoma ≤ 1 mm, can be managed similarly to pure DCIS; however, management of the axilla in DCISM has been a subject of debate. Reports in the literature differ on the utility and necessity of sentinel lymph node biopsy (SLNB)...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08606-3
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Consensus guidelines recommend prolonged thromboprophylaxis for up to 4 weeks after major abdominopelvic cancer operations. Several factors impede widespread adoption of these guidelines. These include lack of awareness, cost, increased bleeding complications, increased incidence of heparin-induced thrombocy...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0671-6
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:RAS mutation status is an important prognostic factor after resection of liver metastases (LiM) from colorectal cancer (CRC). The prognostic significance of RAS after resection of lung (LuM) and peritoneal (PM) metastases from CRC is unknown. METHODS:Between 2005 and 2014, all consecutive patients with know...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6141-7
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The ToGA trial demonstrated the significant efficacy of trastuzumab in addition to chemotherapy in patients with HER2-positive gastric cancer (GC). Although trastuzumab has become a key drug in breast cancer treatment, resistance to trastuzumab is a major problem in clinical practice. The aim of the current ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3325-7
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The increasing use of mammography has led to a significant increase in the detection of clinically occult lesions, the majority of which prove to be benign. SFNB has been suggested as a means of expediting a diagnosis for lesions that are malignant while limiting surgical biopsies for those that are benign. ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02305799
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Gastric cancer is one of the most common gastrointestinal malignancies world-wide. Some studies have suggested that it has a worse prognosis in young than in elderly patients. METHODS:All young and elderly patients treated for gastric adenocarcinoma during the period 1988 to 1994 in a tertiary referral cent...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-000-0515-x
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:The EUropean REgistration of Cancer CAre (EURECCA) consortium aims to investigate differences in treatment and to improve cancer care through Europe. The purpose of this study was to compare neo- and adjuvant chemotherapy (ACT) and outcome after tumor resection for pancreatic adenocarcinoma stage I and II in...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-018-6705-1
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:The current standard for obtaining accurate sentinel lymph node (SLN) mapping is intraparenchymal lymphophilic dye/radiocolloid injection close to the breast tumor. We hypothesized that common lymphatic trunks drain both a large volume of breast parenchyma and skin and that intradermal or intraparenchymal ro...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0837-3
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Remnant gastric cancer (RGC) has a major impact on the long-term survival of postgastrectomy patients. In this study, we established surveillance endoscopy guidelines for postgastrectomy patients based on the risk of RGC. PATIENTS AND METHODS:A total of 6365 patients who underwent gastrectomy at Seoul St. M...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08517-3
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Various patient, treatment, and pathologic factors have been associated with an increased risk of local recurrence (LR) following breast-conserving therapy (BCT) for ductal carcinoma in situ (DCIS). However, the strength and importance of individual factors has varied; whether combining factors improves pred...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4641-x
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The diagnostic phase of care is an anxiety-provoking and stressful experience for the potential breast cancer patient. A multidisciplinary team of breast cancer specialists embarked on a new initiative to pilot a Rapid Diagnosis and Support (RADS) Clinic to coordinate the diagnostic workup and nursing suppor...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3120-5
更新日期:2013-10-01 00:00:00
abstract:METHODS:This study evaluated the effectiveness and morbidity associated with 116 peritoneovenous shunts inserted into 89 patients for symptomatic malignant ascites between 1981 and 1991. All patients had previously failed standard medical therapy of salt and fluid restriction, diuretics, and intermittent peritoneal asp...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02303809
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:The prognosis for patients with locally advanced thoracic esophageal cancer is extremely unfavorable. We have been administering neoadjuvant chemoradiotherapy (CRT) followed by esophagectomy to these patients and studying whether REG I expression in untreated endoscopic biopsy specimens is predictive of pati...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-006-9075-z
更新日期:2006-12-01 00:00:00
abstract::Information is lacking regarding the interaction of established breast cancer risk factors and patient age. We attempted to study this interaction in high-risk women at the extremes of age in our population. The Women-At-Risk Registry was queried for women who were < or =35 and > or =70 years of age. Enrollment criter...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0176-8
更新日期:2009-01-01 00:00:00
abstract:PURPOSE:The volume of surgical procedures performed by hospitals and surgeons has a strong influence on outcomes for a number of surgeries. We examined the influence of surgeon and hospital case volume on morbidity, mortality, and resource utilization for women with endometrial cancer undergoing laparoscopic hysterecto...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2090-8
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:In our own experience over the last 15 years, the primary transpelvic vertical rectus abdominis myocutaneous (VRAM) flap is a reliable tool to prevent perineal wound complications after cylindrical excision in radical anorectal tumor surgery. To minimize the operative trauma in such patients, we performed a ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1977-8
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Mammary ductoscopy allows direct visualization of the ductal system and a method for directed excision and pathologic diagnosis. We reviewed our experience with mammary ductoscopy in the evaluation of pathologic nipple discharge. METHODS:We reviewed all patients who underwent ductoscopy for pathologic nipple...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1962-2
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The extent of neck dissection (ND) appropriate for necks yielding clinical evidence of metastases of papillary thyroid carcinoma (PTC) is controversial. The need for level IIb lymph node (LN) dissection is particularly uncertain in view of its association with postoperative shoulder dysfunction. In the prese...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0367-y
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Two-stage hepatectomy (TSH) is well established for the treatment of patients who have colorectal cancer liver metastases (CRLM) with a small liver remnant. The technique of associating liver partitioning and portal vein occlusion for staged hepatectomy (ALPPS) has been advocated as a novel tool to increase ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-014-4291-4
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The determination of the incidence and prevalence of rare diseases is important for economists and health-care providers. Pseudomyxoma peritonei (PMP) is a rare, slow-growing abdominal cancer that represents a substantial burden on both patients and health-care systems. The incidence rate was previously appr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08655-8
更新日期:2021-01-01 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:Heated intraoperative intraperitoneal chemotherapy achieves high peritoneal concentrations with limited systemic absorption and has become an important tool in the management of patients with peritoneal carcinomatosis from low-grade malignancies such as pseudomyxoma peritonei and in selected cases of high-gr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-000-0296-2
更新日期:2000-05-01 00:00:00