Abstract:
OBJECTIVE:By comparing cohorts in 2 exclusive time frames, the factors that affected the surgical outcomes of patients with hepatocellular carcinoma (HCC) are presented. SUMMARY BACKGROUND DATA:Reportedly, survival results of patients with HCC who underwent hepatectomy have improved in recent years. However, the major factors contributing to these favorable outcomes have not been fully explained. METHODS:Between January 1985 and December 2000, 610 patients with HCC underwent liver resections as a primary and curative resection. They were categorized into 2 groups according to the year in which the surgeries were performed: before 1990 (n = 212; early group); and after 1991 (n = 398; late group). Clinicopathologic data, survival data, type of recurrence, and treatment of intrahepatic recurrence were compared between the 2 groups. RESULTS:Clinicopathologic data were almost identical between the groups except for age, blood loss, and duration of surgery. The overall survival rate was significantly better in the late group compared with the early group (58.0% vs. 39.1% at 5 years, P < 0.0001). By contrast, disease-free survival remained unchanged (27.8% vs. 26.2% at 5 years, P = 0.2887). The most common type of recurrence was intrahepatic relapse, and there was no difference in the rate and the type of recurrence between the 2 groups. The 5-year survival rate after recurrence was increased in the late group (21.8% vs. 11.6%, P = 0.0002). Stratified analysis by the type of initial recurrence revealed that better survival in the late group was achieved only in solitary intrahepatic recurrences, not in multiple intrahepatic or extrahepatic recurrences. Changes in modality of treatment of recurrence were observed only in the management of solitary intrahepatic recurrences, where percutaneous ablation therapies were more frequently applied with new ablation techniques. Patients that had undergone ablation therapies in the late group had better postrecurrent survival than those in the early group. Multivariate analysis showed that presence of local ablation therapies was an independent favorable prognostic factor only in the late group. CONCLUSIONS:Significant improvements in outcomes were achieved in patients with HCC who underwent curative liver resections. Percutaneous ablation therapy for intrahepatic recurrence was considered to be a major contributory factor for improving survival after recurrence, as well as for overall survival.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Taura K,Ikai I,Hatano E,Fujii H,Uyama N,Shimahara Ydoi
10.1097/01.sla.0000217921.28563.55subject
Has Abstractpub_date
2006-08-01 00:00:00pages
265-73issue
2eissn
0003-4932issn
1528-1140pii
00000658-200608000-00014journal_volume
244pub_type
杂志文章abstract:OBJECTIVE:To review the Department of Veteran Affairs (VA) and the Society of Thoracic Surgeons (STS) national databases over the past 10 years to evaluate their relative similarities and differences, to appraise their use as quality improvement tools, and to assess their potential to facilitate improvements in quality...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200110000-00006
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:To examine treatment trends in invasive lobular carcinoma (ILC) over the last 15 years and, in particular, to compare rates of recurrence and disease-free survival associated with breast conservation therapy compared with mastectomy. SUMMARY BACKGROUND DATA:The biologic characteristics of ILC make it difficu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000171306.74366.22
更新日期:2005-08-01 00:00:00
abstract::From 1979 to 1983, 1726 carotid endarterectomies were performed at the Cleveland Clinic. During this period, 39 men (mean age, 60 years) and 22 women (mean age, 63 years) required 65 reoperations (3.8%) for correction of recurrent carotid stenosis occurring 3 to 194 months (mean, 42 months) after previous endarterecto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198507000-00004
更新日期:1985-07-01 00:00:00
abstract::This report defines the incidence of variations in the renal vascular pedicle in a group of patients with normal renal function as determined by standard laboratory criteria. The study group consisted of 166 patients undergoing renal arteriography as potential renal allograft donors. Ninety-seven patients were male an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00014
更新日期:1978-07-01 00:00:00
abstract::The prolonged feeding of chenodeoxycholic acid produces hepatic injury in both pregnant and non-pregnant baboons. CDC feeding does not adversely affect ovarina function and no teratogenic effects of this bile acid were noted in 16 live birth and two stillborn progeny of CDC fed animals. However, 10 of the 16 live birt...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197610000-00012
更新日期:1976-10-01 00:00:00
abstract:OBJECTIVE:The authors determine the reliability, validity, and usefulness of the Objective Structured Clinical Examination (OSCE) in the evaluation of surgical residents. SUMMARY BACKGROUND DATA:Interest is increasing in using the OSCE as a measurement of clinical competence and as a certification tool. However, conce...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199512000-00007
更新日期:1995-12-01 00:00:00
abstract::A patient with a syphilitic aneurysm of the aorta treated by the insertion of wire is presented. The patient remained well for almost 40 years, but finally succumbed after rupture. The autopsy findings are discussed. To our knowledge, this represents the longest reported survival after treatment of an aortic aneurysm ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197612000-00014
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVE:Influence of sacral nerve modulation (SNM) on cerebral somatosensory evoked potentials (SEP) was determined in patients with incontinence and constipation. BACKGROUND:Selection of patients with incontinence and constipation for SNM could be improved. METHODS:The latency (ms) of SEP induced by pudendal nerve...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182196ff4
更新日期:2011-07-01 00:00:00
abstract::Blunt carotid artery trauma is uncommon but has been associated with severe, permanent neurologic deficits in 42% and mortality in 30% of 96 patients previously reported in the English literature. Since neurologic symptoms characteristically develop only after a latent interval and since physical evidence of significa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198003000-00014
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:The authors determined the impact of a positive cytotoxic crossmatch on the outcome of liver transplantation. SUMMARY BACKGROUND DATA:Liver allografts rarely undergo hyperacute rejection, but transplants performed across a positive cytotoxic crossmatch tend to follow a different clinical course, with higher ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199608000-00009
更新日期:1996-08-01 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 evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on fasting and meal-stimulated release of the gut hormones ghrelin, pancreatic polypeptide (PP), peptide-YY (PYY), glucagon-like peptide-1 (GLP-1), and amylin and of the adipocytokine leptin. BACKGROUND:Mounting evidence suggests that the mechan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826e1846
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:The present study investigated the role of mental skills in surgery through the unique lens of current surgeons who had previously served as Olympic athletes, elite musicians, or expert military personnel. BACKGROUND:Recent work has demonstrated great potential for mental skills training in surgery. However,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003573
更新日期:2019-08-28 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the oncological outcomes of robotic total mesorectal excision (TME) at an NCI designated cancer center. SUMMARY BACKGROUND DATA:The effectiveness of laparoscopic TME could not be established, but the robotic-assisted approach may hold some promise, with improved visualiza...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002112
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:To specifically target tumor angiogenesis by linking transgene expression of engineered mesenchymal stem cells to angiopoietin-1-induced differentiation. BACKGROUND:Mesenchymal stem cells (MSCs) have been used to deliver therapeutic genes into solid tumors. These strategies rely on their homing mechanisms on...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181fcb5d8
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVES:The aim of this systematic review was to assess the impact of surgical safety checklists on the quality of teamwork and communication in the operating room (OR). BACKGROUND:Safety checklists have been shown to impact positively on patient morbidity and mortality following surgery, but it is unclear whether ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000206
更新日期:2013-12-01 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:INTRODUCTION:Radiation therapy is increasingly used as adjuvant treatment of many childhood and adult malignancies. Radiation-induced sarcoma is a well recognized if uncommon event. The objective of this study is to determine the prevalence and long-term outcome for patients who develop radiation-induced sarcomas. MET...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000128686.51815.8b
更新日期:2004-06-01 00:00:00
abstract::The ability of surgeons to accelerate wound healing through pharmacologic intervention is limited. The effects of locally applied, biosynthetic human epidermal growth factor (EGF) and transforming growth factor-beta (TGF-beta) on tensile strength of experimental incisions were investigated. A single dose of EGF in sal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198812000-00019
更新日期:1988-12-01 00:00:00
abstract::During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accident...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198502000-00011
更新日期:1985-02-01 00:00:00
abstract::Twenty-seven patients with postoperative enterocutaneous fistulas were treated with parenteral nutrition and SMS 201-995 (100 micrograms/8 hours, subcutaneously), a long half-life somatostatin analogue. At the time SMS 201-995 was started, 11 patients had low output fistulas (less than 1000 ml/48 hours), 11 patients h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198907000-00009
更新日期:1989-07-01 00:00:00
abstract::The effects of two levels of protein intake on protein metabolism in six severely burned adult patients were studied (means of 70% BSA burned). A crossover experimental design enabled the authors to study each patient at the end of two three-day dietary regimens. All diets were isocaloric and provided approximately 25...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198302000-00007
更新日期:1983-02-01 00:00:00
abstract::Staging laparotomy (multiple liver and lymph node biopsies and splenectomy) was performed at the North Carolina Baptist Hospital in 123 patients with Hodgkin's disease. There were no deaths. Wound, pulmonary, intra-abdominal or urinary tract complications developed in 17 patients. Of those complications, one case each...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198005000-00008
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVE:The primary objective was to compare overall survival (OS) in patients with colorectal cancer (CRC) with nonresectable liver-only metastases treated by liver transplantation or chemotherapy. BACKGROUND:CRC is the third most common cancer worldwide. About 50% of patients will develop metastatic disease primar...
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.0000000000000786
更新日期:2015-05-01 00:00:00
abstract::Ileovesical and ileosigmoid fistulae were found to coexist in 22 patients with Crohn's ileocolitis. Persistent or recurrent urinary tract infection was a complaint in all cases, and 11 patients reported pneumaturia and/or fecaluria. Thus, bladder involvement was either suspected or clinically apparent in each patient....
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198801000-00010
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVES:To determine whether the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule confers higher value for physician work in procedure and test codes than in Evaluation and Management (E/M) codes. BACKGROUND:Medicare Payment Advisory Commission previously demonstrated that time for medical serv...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000990
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to identify determinants of disease recurrence after potentially curative resection of colorectal cancer. SUMMARY BACKGROUND DATA:The identification of patients at increased risk of disease recurrence is currently based on pathological factors. Recently, there has been consider...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31821fd469
更新日期:2011-07-01 00:00:00
abstract::Delivery of cardioplegic (CP) solutions to all regions of the myocardium is critical for optimal myocardial protection during cardiac surgery. However, there are little data regarding the effects of CP agents upon coronary vascular resistance (CVR) and CP delivery. Accordingly, we evaluated blood CP (Hct 30) delivery ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198309000-00003
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVE:To assess development of mucosal damage in the esophageal remnant in regard to the level of the esophagogastrostomy reconstruction either in a right chest or in a left neck position. SUMMARY BACKGROUND DATA:Esophagectomy with gastric interposition creates an in vivo human model of pathologic esophageal reflu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31818eec06
更新日期:2009-02-01 00:00:00
abstract::The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the tempor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198710000-00011
更新日期:1987-10-01 00:00:00