Abstract:
BACKGROUND:Phyllodes tumors (PTs) of the breast are rare, and their prognosis and treatment are still subject of discussion. The purpose of this study is to clarify therapeutic aspects and prognostic factors of this disease. PATIENTS AND METHODS:We retrospectively reviewed the medical records of 106 patients who had histologically confirmed PTs collected over a period of 10 years. RESULTS:The mean age was 39.5 years (14-71 years). The mean tumoral size was 83 mm (15-250). According to criteria of Azzopardi and Salvadori, tumors were classified into 3 groups: benign (62 cases, 58.4%), borderline (16 cases, 15%), and malignant (28 cases, 26.4%). Eighty-two patients (77.4%) were treated conservatively (62 benign, 11 borderline, and 9 malignant) and 24 (22.6%) by radical surgery (5 borderline and 19 malignant). For malignant PTs treated by enucleation or local excision with or without reexcision of the tumor bed, the 5-year overall and disease-free survivals were 28.5% and 15.6% versus 72.7% and 73.6% when the surgery was radical (mastectomy with or without axillary dissection) (P = .12 and P = .0022). For the other histotypes, this difference disappeared. The rate of recurrence was 12.2% (13) after a mean follow-up of 39 months (5 benign, 2 borderline, and 5 malignant). The treatment of recurrences consisted of radical mastectomy (8 cases), simple mastectomy (2 cases), and local excision in 3 cases. Eight patients developed metastases, 2 of whom after recurrences. The 5-year overall and disease-free survivals were 86.54% and 78%, respectively. In univariate analysis, age and recurrences are not of prognostic value for survival, whereas tumor size, histotype, necrosis, cytonuclear atypia, tumor margins, and number of mitosis were significant prognostic factors for survival. In a multivariate study, only cytonuclear atypia remained an independent predictor for survival. CONCLUSION:According to our results, we recommend for malignant PT a simple mastectomy, whereas for borderline and benign PT, treatment is based rather on wide excision passing in healthy tissue.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Ben Hassouna J,Damak T,Gamoudi A,Chargui R,Khomsi F,Mahjoub S,Slimene M,Ben Dhiab T,Hechiche M,Boussen H,Rahal Kdoi
10.1016/j.amjsurg.2006.04.007subject
Has Abstractpub_date
2006-08-01 00:00:00pages
141-7issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(06)00297-2journal_volume
192pub_type
杂志文章abstract:BACKGROUND:Several recent studies have suggested that Braun enteroenterostomy (BEE) during conventional pancreatoduodenectomy might decrease delayed gastric emptying (DGE). However, the advantages and disadvantages of performing BEE during pylorus-preserving pancreatoduodenectomy (PPPD) remain controversial. METHODS:T...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.05.007
更新日期:2015-02-01 00:00:00
abstract::Performing a timely fasciotomy for compartment syndrome prevents ischemic injury to muscles and nerves. Fasciotomy entails incision of the overlying skin and investing fascia of the compartment, relieving pressure and enhancing tissue perfusion. Delayed primary closure is ideal, but because of skin edge retraction, th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90130-9
更新日期:1994-04-01 00:00:00
abstract::An analysis of unsuccessful extractions of retained biliary calculi using basket catheters reveals more than half the failures are related to the selection, placement, and size of the T tube. A new T tube has been developed which will improve postoperative access to the common duct and facilitate removal of retained c...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90164-2
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:Arterial base deficit (BD) is a commonly used marker of injury severity and endpoint of resuscitation but requires an arterial puncture and blood gas analysis. Serum bicarbonate (HCO3) is routinely obtained as part of the chemistry panel on most admissions. We hypothesized that serum HCO3 strongly correlates ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.08.024
更新日期:2005-12-01 00:00:00
abstract::The antiproliferative effects of somatostatin on hepatocytes stimulated by hepatocyte growth factor (HGF) or epidermal growth factor (EGF) were investigated using primary cultures of adult rat hepatocytes. Somatostatin inhibits HGF-induced (at a dose of 10 ng/mL) or EGF-induced (at a dose of 100 ng/mL) 3H-thymidine in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90271-r
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Surgery is an environment in which being an expert requires the ability to manage the unexpected. This feature has necessitated a shift in surgical decision-making research. The present study explores the processes by which surgeons assess and respond to nonroutine challenges in the operating room. METHODS:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.10.005
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Establishment of an instant, reproducible, and reliable rat model of a refined 3-cuff technique for performing orthotopic intestinal transplantation is reported, and the surgical skills required to perform modified surgical procedure are discussed. METHODS:A retrospective analysis was used to study 270 rat ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.057
更新日期:2009-07-01 00:00:00
abstract::Computerized tomographic scanning is being used with increasing frequency for the detection of abdominal aortic prosthetic complications. Although computerized tomography remains a very precise method for direct imaging of the retroperitoneal space, the interpretation of a postoperative computerized tomographic scan i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90125-4
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:Open and laparoscopic antireflux surgeries are standard for the treatment of gastroesophageal reflux disease (GERD). The in-hospital outcomes of laparoscopic and open antireflux procedures were analyzed and compared at US academic medical centers. METHODS:Using International Classification of Diseases, Nint...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2008.07.041
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical ex...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.06.015
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Decrease in blood pressure (BP) is the major goal of adrenalectomy for primary aldosteronism. Nevertheless, the optimal timing to assess these outcomes and the needed duration of follow-up are uncertain. We systematically reviewed the literature regarding trends in BP-related outcomes during follow-up after ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2020.12.003
更新日期:2020-12-03 00:00:00
abstract::Enhanced recovery after surgery (ERAS) is a multimodal protocol applied towards perioperative patient care. ERAS programs are implemented by a multidisciplinary team centered around the patient, incorporating outpatient clinical staff, preoperative nurses, anesthesiologists, operative nurses, postoperative recovery st...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2019.11.009
更新日期:2020-03-01 00:00:00
abstract::Operative liver biopsy findings were reviewed in 164 consecutive, unselected patients with alcoholic cirrhosis who had bleeding from esophageal varices and underwent emergency portacaval shunt. The survival rate up to 10 years in 49 patients with acute alcoholic hepatitis and alcoholic cirrhosis was not significantly ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90038-2
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Several anecdotal papers suggest that laparoscopic cholecystectomy can be done safely in pregnant patients, but few patients are reported and other patients such as those who underwent laparoscopic appendectomy are often included. A larger series would help clarify the situation. METHODS:The Connecticut Lap...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0002-9610(99)00007-0
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:The aim of this analysis is to compare the postoperative outcomes of resection and enucleation of small pancreatic neuroendocrine tumors (PNETs). METHODS:The 2014-17 American College of Surgeons-NSQIP dataset was queried. Patients undergoing pancreatoduodenectomy (N = 297) or distal pancreatectomy (N = 712)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.12.013
更新日期:2020-12-08 00:00:00
abstract:BACKGROUND:In view of the indolent nature of most cancers of the thyroid, particularly of the papillary and follicular variety, the decision to remove a segment of the upper aerodigestive tract when the cancer is either close to or invading this area is a difficult one. It was felt relevant to review the experience at ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80136-9
更新日期:1994-12-01 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::Small intestinal epithelium digests and absorbs nutrients. Crypt stem cell transplantation can generate neomucosa with normal morphology, but the digestive and absorptive capacities of this neomucosa are unknown. This study evaluates stem cell induced neomucosal brush border digestive enzyme activity and nutrient tran...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80119-6
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Multivisceral resection is often required in the treatment of locally advanced rectal cancers. Such resections are relatively rare and oncologic outcomes, especially when sphincter preservation is performed, are not fully demonstrated. METHODS:A retrospective review was conducted of patients who underwent m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.10.014
更新日期:2015-03-01 00:00:00
abstract::A procedure of tape-guided living donor left hepatectomy is described. A tape was placed along the anterior wall of the inferior vena cava for left liver with caudate lobe, and along Arantius' ligament for left liver without caudate lobe. The final step of liver transection was applied by dividing the liver parenchyma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.09.044
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Invasion of the larynx by differentiated thyroid gland carcinoma is uncommon but causes serious morbidity and mortality when present. METHODS:The clinicopathologic characteristics of 5 patients in which a total laryngectomy had to be performed for differentiated thyroid carcinoma are analyzed. Special refer...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.04.009
更新日期:2005-07-01 00:00:00
abstract::Information illustrating the benefits of fracture stabilization after multiple trauma has been gathering for almost a century. At the turn of the last century, the introduction of the Thomas splint clearly demonstrated the importance of skeletal stabilization in the management of these patients. The introduction of st...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/s0002-9610(02)00865-6
更新日期:2002-06-01 00:00:00
abstract::Patients who had undergone inguinal herniorrhaphy with local, general, or spinal anesthesia were surveyed for satisfaction with the anesthesia. A review of complications was carried out for these same patients to determine comparative rates in the three anesthesia groups. Patients were stratified by age and concomitan...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90154-1
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Academic institutions have increasingly focused on educating physicians and surgeons in concepts of value-based care, including quality improvement (QI). The extent to which QI curricular competencies are addressed in specialty surgical residency training is unclear. METHODS:A survey instrument was develope...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.036
更新日期:2020-09-29 00:00:00
abstract::From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80438-6
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Because the abdominal insufflation and desufflation associated with laparoscopic procedures may adversely effect a compromised myocardium, patients with significant cardiopulmonary disease should be closely monitored during these procedures. The utility of intraoperative pulmonary artery catheter (PAC) and t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80137-8
更新日期:1995-02-01 00:00:00
abstract::The use of intraoperative autotransfusion provides a safe and cost-effective means of salvaging operative blood loss and reducing or eliminating the use of stored homologous bank blood with its inherent difficulties and risks. The risk of disease transmission or various reactions is minimized. Autotransfusion provides...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90122-3
更新日期:1979-04-01 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::When dense hemiparesis has developed appropriate to the operated vessel after carotid surgery, the patient has been immediately returned to the operating room for reexploration of the vessel and thrombectomy. Over a 5-year period, we identified four patients who developed dense hemiparesis in the recovery room postope...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81262-0
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:How systemic inflammation-based prognostic scores such as the modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR) differ across populations of patients with colorectal cancer (CRC) remains unknown. The present study examined the mGPS and NLR in patients from United Kingdom (UK) and...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.08.044
更新日期:2018-09-01 00:00:00