Abstract：
BACKGROUND:Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. METHODS:Medical records of 419 patients with a diagnosis of breast cancer from a university hospital between 1997 and 2002 were reviewed. Tumor characteristics were given a value reflecting the impact on survival. Tumor diameter was assigned 1 point per cm, specifically: 1 point for 0.1 to 1 cm, 2 points for 1.1 to 2 cm, 3 points for 2.1 to 5 cm, and 4 points for 5.1 cm and over. Nodal status was assigned 1 point if the patient had 1 to 3 positive nodes, 5 points if 4 to 10 positive nodes were found, and 10 points if more than 10 nodes were identified. Hormone receptor status was given 1 point if either estrogen or progesterone receptors were not present or 2 points if both were absent. The breast cancer severity score (BCSS) was used to analyze overall and disease-free survival by Kaplan-Meier analysis. Significance of differences in survival was determined by log-rank analysis. RESULTS:An increased severity score was inversely proportional to overall and disease-free survivals. A BCSS of greater than 7 was most predictive of outcome with 5-year survival of 68%; and a BCSS of less than 7 had a 5-year survival of 98% (P = 0.0028). A BCSS of greater than 7 also discriminated disease-free survival within stage II (P = 0.02) and stage III (P = 0.01). CONCLUSIONS:The BCSS provides a better resolution of outcome than traditional staging, and works both for overall survival and within specific stages. Using the BCSS, management and follow-up can be specifically tailored for low- and high-risk patients.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Jimenez-Lee R,Ham B,Vetto J,Pommier Rdoi
10.1016/s0002-9610(03)00283-6subject
Has Abstractpub_date
2003-10-01 00:00:00pages
404-8issue
4eissn
0002-9610issn
1879-1883pii
S0002961003002836journal_volume
186pub_type
杂志文章abstract：BACKGROUND:Previous studies have shown that advanced age, diabetes, and male gender are associated with higher morbidity and mortality after bariatric surgery. Those risk factors are characteristic of patients in the Veterans Affairs (VA) health care system. Laparoscopic Roux-en-Y gastric bypass (RYGB) has become an es...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.07.021
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:The ideal treatment algorithm for suspected choledocholithiasis is not yet well defined. Imaging options include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and intraoperative cholangiogram (IOC). MRCP is diagnostic, while the other two modalitie...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.10.025
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND:Patient factors impact laparoscopic cholecystectomy (LC) difficulty, specifically operative duration. This study quantifies the impact of patient factors on LC duration. METHODS:The national surgery database (American College of Surgeons National Surgical Quality Improvement Program) was reviewed for all el...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.01.024
更新日期：2016-08-01 00:00:00
abstract：:A simple classification of inguinal hernias is presented which can be valuable to surgeons as a (1) blueprint for dissecting the canal, (2) means for choosing the most appropriate operative procedure, (3) means for evaluating and correlating the prognosis of postoperative symptoms, time of convalescence, and degree of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90564-3
更新日期：1989-03-01 00:00:00
abstract：BACKGROUND:Emergency surgical airway is a low frequency, high risk clinical scenario. Implementing a simulation-based curriculum may bridge the gap in surgical training and address quality assurance/performance improvement (QAPI) needs. METHODS:We designed and implemented an Advanced Surgical Airway Curriculum (ASAC) ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.09.026
更新日期：2019-03-01 00:00:00
abstract：BACKGROUND:This study determined the degree to which ward evaluations, the American Board of Surgery In-Training Examination (ABSITE), and an Objective Structured Clinical Examination (OSCE) provide equivalent information about intern performance. METHODS:Twenty-two general surgery interns completed both the ABSITE an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80187-1
更新日期：1995-04-01 00:00:00
abstract：:A recent retrospective study proposed that the following screening criteria be used in identifying critically ill trauma patients receiving aminoglycosides who are at significant risk to develop renal dysfunction: (1) post-admission shock, (2) minimum serum concentration more than 2 mg/L, and (3) diagnosis of septicem...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(05)81007-4
更新日期：1990-11-01 00:00:00
abstract：BACKGROUND:Minor burns represent .96% to 1.5% of emergency department visits, yet burn center referral is common. Analysis of the Grady Memorial Hospital Burn Center examined the feasibility and savings if pediatric burns were managed locally with as-needed consultation. METHODS:Prospective data on 219 consecutive adm...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.06.036
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:The use of 5 or more medications is defined as polypharmacy (PPM). The clinical impact of PPM on the isolated severe traumatic brain injury (TBI) patient has not been defined. METHODS:A retrospective cohort study was performed at our academic level 1 trauma center examining patients with isolated TBI. Pre-i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.07.010
更新日期：2017-06-01 00:00:00
abstract：BACKGROUND:This report describes estimated 4-year tumor bed and ipsilateral breast recurrence-free intervals, event-free survival, disease-specific survival, and overall survival in a cohort of MammoSite brachytherapy (MBT) patients with mature follow-up treated at a single institution over a 6-year period. METHODS AN...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.03.005
更新日期：2010-02-01 00:00:00
abstract：BACKGROUND:The generative learning model posits that individuals remember content they have generated better than materials created by others. The goals of this study were to evaluate question generation as a study method for the American Board of Surgery In-Training Examination (ABSITE) and determine whether practice ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2015.08.033
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:A nonintrusive e-mail reminder incorporating teaching tips and manuscripts was developed to supplement resident-as-teacher curricula. METHODS:Ten high-yield manuscripts and 10 teaching tips exemplifying the themes of mentorship or role modeling, teaching methods, adult learning theory, feedback, and the res...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.05.004
更新日期：2017-01-01 00:00:00
abstract：:We review herein our experience in the management of bleeding esophageal varices in cirrhotic patients and consider our findings in light of the dramatic changes in the treatment of cirrhosis resulting from the more widespread use of orthotopic liver transplantation (OLT). It does not seem realistic, at present, to pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80878-5
更新日期：1990-07-01 00:00:00
abstract：BACKGROUND:Coagulopathy is frequently encountered during supraceliac aortic clamping. Patients are routinely heparinized during these operations. This experiment was undertaken to evaluate the effect of supraceliac aortic cross-clamping (XC) on heparin pharmacodynamics. MATERIAL AND METHODS:Fourteen mongrel dogs were ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00140-7
更新日期：1996-08-01 00:00:00
abstract：BACKGROUND:An assessment was made of the change and the effect of a histamine H(2)-receptor blocker (H(2)-blocker) or omeprazole on gastric pH after surgery. METHODS:Eighty patients who underwent colon resection for colorectal cancer were divided into groups of 20. Group I received neither H(2)-blocker nor omeprazole....
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2002.10.002
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND:There are controversial data on the relationship between trauma and body mass index. We investigated this relationship in traumatic hemorrhagic shock. METHODS:The "Glue Grant" database was analyzed, stratifying patients into underweight, normal weight (NW), overweight, Class I obesity, Class II obesity, and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.12.016
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Among patients with adhesive small bowel obstruction (ASBO) initially managed with a conservative strategy, predicting risk of operation is difficult. METHODS:We investigated ASBO patients at 2 different periods to derive and validate a clinical prediction model for risk of operation. RESULTS:One hundred f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.07.045
更新日期：2010-08-01 00:00:00
abstract：BACKGROUND:The National Trauma Data Bank (NTDB) includes patient comorbidities. This study evaluates factors of trauma centers associated with higher rates of missing comorbidity data. METHODS:Proportions of missing comorbidity data from facilities in the NTDB from 2011 to 2014 were evaluated for associations with fac...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2018.01.031
更新日期：2018-09-01 00:00:00
abstract：:Fixation of polypropylene (Marlex) mesh in the epigastrium and at the iliac crest can be ineffective because of insufficient local fascia; however, two techniques have been described to obtain firm and durable attachment of polypropylene grafts at these sites. Perichondral slips at the costal margin permit very satisf...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80194-x
更新日期：1985-06-01 00:00:00
abstract：:The clinical course of 39 patients on HPN for 5.5 years at The Cleveland Clinic Foundation were reviewed. Rehospitalization and mortality rates were relatively low in this group of patients who had significant disease processes. Rehospitalization and mortality were usually due to the primary underlying disease process...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90174-5
更新日期：1983-01-01 00:00:00
abstract：BACKGROUND:The efficacy of antibiotics in appendicitis remains controversial, and physicians are not confident in prescribing antibiotics as the first line treatment. This network meta-analysis was conducted to assess the efficacy and safety of individual antibiotics in uncomplicated appendicitis. METHODS:Randomized c...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/j.amjsurg.2018.10.009
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:The objective of this study was to characterize variations in packed red blood cell (PRBC) transfusion practices in critically ill patients and to identify which factors influence such practices. We hypothesized that significant variation in transfusion triggers exists among acute care surgeons. METHODS:A s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.08.024
更新日期：2015-07-01 00:00:00
abstract：:Mediastinal tracheostomy has been associated with high morbidity and mortality, often due to skin necrosis, with resultant exposure of the great vessels and subsequent hemorrhage. During a 4 year period, 11 patients underwent mediastinal tracheostomy. Reconstruction included the use of a pectoralis major musculocutane...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90377-5
更新日期：1984-10-01 00:00:00
abstract：BACKGROUND:Despite impressive results with the Lap-Band in Europe and Australia, the early Food and Drug Administration A trial in the United States showed fairly poor results. This prospective study attempts to determine if the Lap-Band can produce effective weight loss in morbidly obese Americans. METHODS:Five hundr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.08.059
更新日期：2004-12-01 00:00:00
abstract：:Ostomy closure following the Hartmann procedure is perceived to be associated with higher morbidity and mortality rates than is ostomy closure following divided colostomy, loop colostomy, and divided ileostomy-colostomy so that ostomy closure after Hartmann procedure may be denied to certain patients. To test that per...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90125-w
更新日期：1991-12-01 00:00:00
abstract：:Miliary tuberculosis is the most lethal form of tubercular disease. If dissemination of tubercle bacilli occurs without therapy, death is almost certain. The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory. The presence of a ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90402-x
更新日期：1975-09-01 00:00:00
abstract：:A study by questionnaire was sent to 134 Surgical Services at Veterans Administration Hospitals to ascertain the prevalence of the practice of preoperative hydration during the period of hydropenia preceding surgery. A 92.5 per cent response was noted and the following conclusions are drawn: (1) The majority of Vetera...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90075-7
更新日期：1977-02-01 00:00:00
abstract：BACKGROUND:Skin-sparing mastectomy represents a new surgical approach that allows a mastectomy while preserving the natural skin envelope of the breast. It facilitates immediate breast reconstruction using an implant or myocutaneous flap, resulting in excellent cosmesis. DATA SOURCES:A PubMed database literature searc...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2004.02.004
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:Estrogen-receptor (ER)-, progesterone-receptor (PR)-, and androgen-receptor (AR)-negative breast cancer cells are unaffected by treatment with dehydroepiandrosterone-sulfate (DHEAS) and an aromatase inhibitor (AI). We hypothesized that cell growth would be inhibited with DHEAS/AI treatment after successful t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.02.004
更新日期：2006-05-01 00:00:00
abstract：BACKGROUND:As laparoscopic experience increases, ever more challenging cases are attempted. Enlarged surgeon experience, along with better technology, has been lauded as improving outcomes. The purpose of this study is to see if this applies to the management of acute cholecystitis. METHODS:We reviewed our experience ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01089-9
更新日期：2002-12-01 00:00:00
