Abstract:
SUMMARY BACKGROUND DATA:Previous studies have suggested a variety of factors that may affect the false negative (FN) rate for sentinel lymph node (SLN) biopsy in breast cancer. Because FN results are relatively rare, no prior studies have had sufficient sample size to allow detailed statistical analysis of factors predicting FN results. METHODS:Patients with clinical stage T1-2, N0 invasive breast cancer were enrolled in a prospective, multicenter study. All patients underwent SLN biopsy, followed by planned completion axillary dissection regardless of the SLN results, to assess the FN rate. SLN biopsy was performed using radioactive colloid injection in combination with isosulfan blue dye in 94% of cases. Dermal, subdermal, peritumoral, or subareolar radioactive colloid injection techniques were used at the discretion of each institution. Univariate and multivariate analyses were performed to identify factors associated with a FN result. RESULTS:SLNs were identified in 3870 of 4117 patients (94%). There were 1243 true positive, 2521 true negative, and 106 FN results. Age, histologic subtype, the number of non-SLN removed, tumor palpability, type of breast biopsy, and SLN injection technique were not significant factors. On multivariate analysis, tumor size <2.5 cm, upper outer quadrant tumor location, removal of only a single SLN, minimal surgeon experience, presence of a single positive axillary LN, and use of immunohistochemistry (IHC) for SLN analysis were independently associated with an increased risk of FN results. CONCLUSIONS:Surgeon experience, tumor size and location, and the number of SLN removed are preoperative and intraoperative factors that independently predict the risk of a FN result. In contrast to suggestions from other smaller studies, age does not affect the likelihood of a FN result; a lesser, rather than greater, number of positive axillary nodes was associated with an increased likelihood of a FN result; and IHC analysis of the SLN increases, rather than decreases, the risk of FN results.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Martin RC 2nd,Chagpar A,Scoggins CR,Edwards MJ,Hagendoorn L,Stromberg AJ,McMasters KM,University of Louisville Breast Cancer Sentinel Lymph Node Study.doi
10.1097/01.sla.0000165200.32722.02subject
Has Abstractpub_date
2005-06-01 00:00:00pages
1005-12; discussion 1012-5issue
6eissn
0003-4932issn
1528-1140pii
00000658-200506000-00018journal_volume
241pub_type
杂志文章,多中心研究abstract::The proportion of the population of the U.S. 65 years of age and over is increasing. Biliary tract disease is estimated to involve 15% of the adult population. A review of 12,200 patients treated surgically at one medical center reveals that 2401 (20%) had acute cholecystitis. There were 93 deaths, for a mortality rat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198101000-00009
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the results of a vertical rectus abdominis myocutaneus (VRAM) flap after abdomino-perineal resection (APR) for anal cancer (AC). BACKGROUND DATA:APR is the only curative treatment for AC that recurs or persists after radiochemotherapy. To obtain a clear surgical margin, APR frequently includes a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181bce334
更新日期:2009-11-01 00:00:00
abstract::The understanding of the association of mammalian ovarian function with lactation was common knowledge to dairy-men early in the 19th century or earlier. This thesis reviews the application of these empiric observations to lactation in humans by Beatson of Glasgow, supported by his preliminary laboratory investigation...
journal_title:Annals of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/00000658-197612000-00009
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVE:The objective of our study was to determine if differences in outcomes at treating facilities can help explain these age-based racial disparities in survival after trauma. BACKGROUND:It has been previously demonstrated that racial disparities in survival after trauma are dependent on age. For patients younge...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000809
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:To investigate the workup/treatment provided to pregnant motor vehicle accident (MVA) casualties in a mature trauma system. Adherence to recommendations was used to measure quality of care. BACKGROUND:MVAs affect approximately 3% of pregnant women. Trauma casualty outcome improves after implementation of gui...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822638d4
更新日期:2011-08-01 00:00:00
abstract::Peripheral vascular disease of the extremities causes ischemic pain and, at times, skin ulcerations and gangrene. It has been suggested that epidural spinal electrical stimulation (ESES) could improve peripheral circulation. Since 1978 we have used ESES in 34 patients with severe limb ischemia; all had resting pain an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198507000-00017
更新日期:1985-07-01 00:00:00
abstract::Forty-three patients (mean age 62 +/- 1 years) were treated for ventricular septal defect (VSD) secondary to myocardial infarction. Whenever possible, operation was postponed until six weeks post-onset chest pain. However, hemodynamic instability, evidenced by cardiogenic shock, refractory pulmonary edema, or a rising...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197709000-00004
更新日期:1977-09-01 00:00:00
abstract::Although many factors may influence the choice of the operative incision, physiologic safety in terms of the degree of postoperative hypoxemia should be considered. No data currently exist to delineate in markedly obese patients the effect of the operative incision on the extent or duration of this hypoxemia. Fifty-f...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-197506000-00012
更新日期:1975-06-01 00:00:00
abstract:OBJECTIVE:There were 2 objectives: first, to investigate how many patients were excluded from surgery on the basis of the radiological extent of the peritoneal carcinomatosis (PC) or the clinical examination; and second, to develop a score based primarily on serum tumor markers (STMs) that could predict short cancer-sp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318254f281
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of modest endotoxemia on postoperative antithrombin deficiency and cholestasis. SUMMARY BACKGROUND DATA:It has not been determined whether endotoxin translocation in small amounts is a physiological phenomenon or whether it is a potential health hazard. METHODS:Blood endotoxin, ant...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000082711.77096.71
更新日期:2003-08-01 00:00:00
abstract::Forty-nine patients undergoing elective or emergent gastric surgery have been included in this study. Gastric needle aspiration was performed at the time of surgery in each case, followed by qualitative aerobic and anaerobic bacteriologic analysis. In 18 patients undergoing elective operation for chronic nonobstructin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197511000-00004
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVE:To determine the association between preoperative bowel preparation and 30-day outcomes after elective colorectal resection. METHODS:Patients from the 2012 Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who underwent elective colorectal rese...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001041
更新日期:2015-08-01 00:00:00
abstract::Of 915 resections for bronchogenic carcinoma over a 25-year period (1945-1969), 249 patients survived over 5 years; 127 of the patients eligible survived over 10 years, 61 over 15 years, and 22 over 20 years. The case material was divided into three time periods: 1945-49, 1950-59 and 1960-69, as well as by extent of r...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197609000-00010
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:The presence and number of nodal metastasis significantly impact colon cancer prognosis. Similarly, the number of resected/evaluated nodes impacts staging accuracy. This ratio of metastatic to examined nodes or lymph node ratio (LNR) may have independent prognostic value in colon carcinoma. PURPOSE:: To eva...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ffa780
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:To determine the impact of tumor characteristics and treatment approach on (1) local recurrence, (2) scoliosis development and (3) patient-reported quality of life in children with sarcoma of the chest wall. SUMMARY BACKGROUND DATA:Children with chest wall sarcoma require multimodal therapy including chemoth...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004579
更新日期:2020-11-04 00:00:00
abstract::A right axillary to left brachial arterial bypass (saphenous vein) was used in the treatment of a left subclavian artery obstruction secondary to radical mastectomy and irradiation 28 years previously. The axillary bypass was chosen over other surgical approaches because of its simplicity and efficacy. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197406000-00001
更新日期:1974-06-01 00:00:00
abstract:OBJECTIVE:To identify predictive factors associated with operative morbidity, mortality, and survival outcomes in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) undergoing total neoadjuvant therapy (TNT). BACKGROUND:The optimal preoperative treatment sequencin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003284
更新日期:2021-02-01 00:00:00
abstract::The management of parotid sialoceles and fistulae have been unsatisfactory in the past, and numerous methods of treatment with varying success and morbidity have been described. The present prospective study reports results of conservative therapy in 51 patients over a 3-year period. In 50 patients, the injury healed ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198901000-00015
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). SUMMARY BACKGROUND DATA:Multiple patient relocations during MCIs may contribute to chaos. One hospital changed its MCI patient relocation policy during a wave of M...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819a6f17
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To determine the role of the microvascular endothelium in the regulation of regenerating liver mass after partial hepatectomy. SUMMARY BACKGROUND DATA:Angiogenesis is critical for both pathologic and physiologic processes. The ability of certain tissues, such as the liver, kidney, and spleen, to regenerate a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000059986.96051.EA
更新日期:2003-04-01 00:00:00
abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198701000-00012
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node (SLN) biopsy is fast becoming the standard for testing lymph node involvement in many institutions. However, questions remain as to the best method of injection. The authors hypothesized that a subareolar injection of material would drain to the same lymph node as a peritumoral injection,...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199906000-00013
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of thrombopoietin on liver regeneration after hepatectomy and antifibrosis under conditions of liver cirrhosis in rats. SUMMARY BACKGROUND DATA:We revealed that platelets induced by thrombopoietin administration promote liver regeneration after hepatectomy in the normal liver. METHODS...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31818584c7
更新日期:2008-11-01 00:00:00
abstract::Between 1968 and 1984 liver resection with curative attempt was performed in 22 patients with hilar cholangiocarcinoma. Right lobectomy was performed in 4 patients, extended right lobectomy in 7, left lobectomy in 8, and excision of the median segment segment of the left lobe (segment IV) in 3. Bilio-enteric continuit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198802000-00002
更新日期:1988-02-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of adjunctive IPC to standard prophylaxis of postoperative VTE in patients at extremely high-risk. SUMMARY OF BACKGROUND DATA:The standard prophylaxis for postoperative VTE is insufficient in extremely high-risk patients. It is unclear whether an adjunctive use of IPC would result in a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004556
更新日期:2020-11-12 00:00:00
abstract:OBJECTIVE:The aim of this study was to improve the 8th edition (8th) of the American Joint Committee on Cancer (AJCC) staging system for pancreatic ductal adenocarcinoma (PDAC). BACKGROUND:The new 8th AJCC staging system for PDAC was released in October, 2016, and will be applied in clinical practice in 2018. METHODS...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002668
更新日期:2019-05-01 00:00:00
abstract::Interactions between molecules control intra- and intercellular physiology. Cancer is emerging as a disease in which individual molecules are either overproduced, mutated, expressed at inappropriate stages of development, or lost due to inheritance or aberrant mitotic division. The major players in this contest of cel...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199007000-00002
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:This study was conducted to evaluate those factors associated with popliteal artery injury that influence amputation, with emphasis placed on those that the surgeon can control. SUMMARY BACKGROUND DATA:Generally accepted factors impacting amputation after popliteal artery injury include blunt trauma, prolong...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199705000-00009
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:To review the literature on current management of hepatocellular carcinoma (HCC). BACKGROUND:Hepatocellular carcinoma represents one of the most common malignancies worldwide with a rising incidence in western countries. There have been substantial advances in the surgical and medical treatment of HCC within...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e31820d944f
更新日期:2011-03-01 00:00:00
abstract::The etiology and mechanisms by which severe trauma or sepsis induce hepatic failure are unknown. Previously we showed that Kupffer cells (KC), the fixed macrophages of the liver, induce a profound decrease in hepatocyte (HC) total-protein synthesis when exposed to endotoxin. Furthermore we demonstrated that endotoxin-...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00009
更新日期:1990-10-01 00:00:00