Abstract:
OBJECTIVE:To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. BACKGROUND:Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathologic tumor size after neoadjuvant chemotherapy is critical in guiding surgical therapy. Although physical examination, ultrasonography, and mammography have all been used to predict residual tumor size, there have been conflicting reports about the accuracy of these methods in the neoadjuvant setting. METHODS:We reviewed the records of 189 patients who participated in 1 of 2 protocols using doxorubicin-containing neoadjuvant chemotherapy, and who had assessment by physical examination, ultrasonography, and/or mammography no more than 60 days before their surgical resection. Size correlations were performed using Spearman rho analysis. Clinical and pathologic measurements were also compared categorically using the weighted kappa statistic. RESULTS:Size estimates by physical examination, ultrasonography, and mammography were only moderately correlated with residual pathologic tumor size after neoadjuvant chemotherapy (correlation coefficients: 0.42, 0.42, and 0.41, respectively), with an accuracy of +/-1 cm in 66% of patients by physical examination, 75% by ultrasonography, and 70% by mammography. Kappa values (0.24-0.35) indicated poor agreement between clinical and pathologic measurements. CONCLUSION:Physical examination, ultrasonography, and mammography were only moderately useful for predicting residual pathologic tumor size after neoadjuvant chemotherapy.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Chagpar AB,Middleton LP,Sahin AA,Dempsey P,Buzdar AU,Mirza AN,Ames FC,Babiera GV,Feig BW,Hunt KK,Kuerer HM,Meric-Bernstam F,Ross MI,Singletary SEdoi
10.1097/01.sla.0000197714.14318.6fsubject
Has Abstractpub_date
2006-02-01 00:00:00pages
257-64issue
2eissn
0003-4932issn
1528-1140pii
00000658-200602000-00016journal_volume
243pub_type
杂志文章abstract:OBJECTIVE:To assess our outcomes after minimally invasive esophagectomy (MIE). SUMMARY BACKGROUND DATA:Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days. MIE has the potential to improve th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000089858.40725.68
更新日期:2003-10-01 00:00:00
abstract::Although the clinical results of Brooke ileostomy are good, patients are permanently incontinent of stool and gas. Alternative operations designed to restore enteric continence, such as ileal pouch-anal anastomosis, must not only be as safe and effective as Brooke ileostomy, but should provide an improved quality of l...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198905000-00015
更新日期:1989-05-01 00:00:00
abstract::Twenty-two patients undergoing elective abdominal surgery were given total parenteral nutrition (TPN) after the operation. The TPN contained either a conventional amino acid solution supplemented with glutamine or a conventional amino acid solution without supplementation. To study amino acid and protein metabolism, m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198904000-00011
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review and meta-analysis of studies comparing operative to nonoperative therapy in adult FC patients. Outcomes were duration of mechanical ventilation (DMV), intensive care unit length of stay (ICULOS), hospital length of stay (HLOS), mortality, incidence of pneumonia, and tracheostomy...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0b013e3182895bb0
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to report the long-term results of percutaneous isolated liver chemoperfusion with hepatic venous isolation and charcoal hemoperfusion (HVI-CHP) in patients with multiple advanced hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:The results of conventional chemotherapy includ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199804000-00012
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA:Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-te...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199904000-00016
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181afe0ab
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:We report on a new side-to-side isoperistaltic strictureplasty (SSIS), the Michelassi II or end-to-side-to-side-to-end strictureplasty, performed with discontinuous bowel loops. SUMMARY BACKGROUND DATA:The SSIS Michelassi strictureplasty was described a quarter of a century ago to avoid massive bowel resecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003430
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To identify factors that predict fourth- and fifth-year surgical resident satisfaction of attending teaching quality. SUMMARY BACKGROUND DATA:With the training of surgical residents undergoing major changes, a key issue facing surgical educators is whether high-quality surgeons can still be produced. Innovat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000150257.04889.70
更新日期:2005-02-01 00:00:00
abstract::The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00013
更新日期:1983-04-01 00:00:00
abstract::The effect of reperfusion following hemorrhagic shock on splanchnic prostanoid release was studied. Anesthetized male rats were bled to a mean arterial blood pressure of 30 mmHg for 30 minutes and either killed or treated with shed blood for 60 minutes and then killed. The superior mesenteric arterial bed was cannulat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199012000-00006
更新日期:1990-12-01 00:00:00
abstract::: The field of Endocrine Surgery is linked to extraordinary contributions made by Hopkins leaders in surgery including William Stewart Halsted, Harvey Cushing, and John L Cameron. Halsted's contributions to the anatomic basis of thyroid and parathyroid surgery were based on his experimental and clinical work performed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002519
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to investigate the effects of ethanol on pancreatic blood flow and interstitial pH in chronic pancreatitis. BACKGROUND:Ethanol is known to contribute to the development of both acute and chronic pancreatitis. However, it is unclear how ethanol precipitates episodes of acute pa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199702000-00011
更新日期:1997-02-01 00:00:00
abstract::Seventeen patients with femoral arteriovenous bovine shunts (FAVBS) were evaluated to delineate the cardiovascular consequences of the procedure. The resting cardiac index (CI), as estimated by echocardiography, was increased in 8 patients (47%). Twelve of the 17 patients (71%) had more than a 20% reduction in CI afte...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197607000-00017
更新日期:1976-07-01 00:00:00
abstract:OBJECTIVE:We merged direct, multisource, and systematic assessments of surgeon behavior with malpractice claims, to analyze the relationship between surgeon 360-degree reviews and malpractice history. BACKGROUND:Previous work suggests that malpractice claims are associated with a poor physician-patient relationship, w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002742
更新日期:2019-07-01 00:00:00
abstract::Despite the rarity of chronic relapsing pancreatitis in children, in the last 15 years at Vanderbilt University Medical Center and its Children's Hospital we have used longitudinal pancreaticojejunostomy in treatment of eight patients whose symptoms began in childhood. Duration of symptoms ranged from 2 to 36 years. S...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198405000-00017
更新日期:1984-05-01 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 investigate whether subclassification of microscopic vascular invasion (MiVI) affects the long-term outcome after curative surgical resection or liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). SUMMARY OF BACKGROUND DATA:The most important factor for TNM staging in HCC is MiVI, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003781
更新日期:2020-01-14 00:00:00
abstract:OBJECTIVE:The authors determined if more radical surgery with extended lymphadenectomy improves the results of gastrectomy in patients with adenocarcinoma of the gastric antrum. SUMMARY BACKGROUND DATA:The overall survival in patients with gastric cancer is disappointing. Improved survival has been reported by Japanes...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199408000-00009
更新日期:1994-08-01 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:OBJECTIVE:To determine whether an intervention with smoking cessation starting 4 weeks before general and orthopedic surgery would reduce the frequency of postoperative complications. SUMMARY BACKGROUND DATA:Complications are a major concern after elective surgery and smokers have an increased risk. There is insuffici...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0b013e3181889d0d
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:Individualized risk assessment in patients with UICC stage II colon cancer based on a panel of molecular genetic alterations. BACKGROUND:Risk assessment in patients with colon cancer and localized disease (UICC stage II) is not sufficiently reliable. Development of metachronous metastasis is assumed to be g...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318272de87
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia. BACKGROUND:Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002278
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To investigate the roles and underlying mechanism of an inflammatory mediator-lipocalin-2 (Lcn2) in small-for-size fatty graft liver injury. BACKGROUND:Understanding of the distinct mechanism regulating small-for-size fatty liver graft injury will be crucial to prevent marginal graft failure during living do...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000427
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the effect of cancer-related genes and their mutations analyzed by next-generation sequencing (NGS) on the oncological outcome after resection of colorectal liver metastases (CRLM). BACKGROUND:Traditional prognostic scores include clinical and pathological parameters of pr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003527
更新日期:2019-11-01 00:00:00
abstract::Despite the dramatically increased entry of women into general surgery and surgical subspecialties, traditionally male-dominated fields, there remains a gross under-representation of women in the leadership positions of these departments. Women begin their careers with fewer academic resources and tend to progress thr...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3182111120
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:To compare outcomes for patients with hepatocellular carcinoma (HCC) treated with either liver resection or transplantation. METHODS:A retrospective, single-institution analysis of 413 HCC patients from 1999 to 2009. RESULTS:A total of 413 patients with HCC underwent surgical resection (n = 106) and transpl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822ca66f
更新日期:2011-09-01 00:00:00
abstract::Renal scintiphotography with (131)I-hippurate was the primary diagnostic procedure in evaluating renal failure and complications in over 500 transplant patients. This diagnostic test has become our principal method of evaluation and followup of renal transplants, especially in the early post-transplant period. It has ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197409000-00014
更新日期:1974-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the epidemiology of Clostridium difficile colitis (CDC) in a subset of patients admitted specifically to a surgical service. SUMMARY BACKGROUND DATA:CDC is an increasingly prevalent nosocomial infection that can prolong hospitalization and adversely affect patient outcome. Although this disease h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199802000-00021
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:To evaluate (1) levels of the host-defense/antimicrobial peptide LL-37 in patients with trauma and hemorrhagic shock (HS) and (2) the effects of a synthetic host-defense peptide; Pep19-4LF on multiple organ failure (MOF) associated with HS. BACKGROUND:HS is a common cause of death in severely injured patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002186
更新日期:2018-08-01 00:00:00