Abstract:
BACKGROUND:Cancer of unknown primary (CUP) origin is a very aggressive disease with a poor prognosis. Most of the literature reports of CUP are generated from tertiary cancer centers. METHODS:A retrospective chart review of all patients with a diagnosis of CUP was performed between January 1995 and January 2005. Age, gender, diagnostic evaluation, histologic diagnosis, location of metastases, treatment, and survival were recorded. RESULTS:Ninety-one patients met the inclusion criteria. The pathologic diagnoses included adenocarcinoma (42.8%), undifferentiated carcinoma (34.5%), squamous cell carcinoma (9.8%), neuroendocrine cancer (6.5%), sarcoma (3.2%), and nonspecific malignant neoplasm (3.2%). The overall mean survival was 9.2 months (95% confidence interval, 6.1-12.4 mo), and for squamous cell carcinoma was 26.9 months (standard error, 5.7; P = .007). CONCLUSIONS:CUP encompasses a variety of different pathologic entities with an overall dismal 5-year survival. Nonetheless, squamous cell and neuroendocrine CUP are associated with a significantly better early prognosis than the other malignancies.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Pimiento JM,Teso D,Malkan A,Dudrick SJ,Palesty JAdoi
10.1016/j.amjsurg.2007.08.039subject
Has Abstractpub_date
2007-12-01 00:00:00pages
833-7; discussion 837-8issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(07)00763-5journal_volume
194pub_type
杂志文章abstract::In a 2 year period, 60 consecutive feeding enterostomies were placed in malnourished patients. The major complication rate was 1.6 percent. Total complications were 8 percent. Thirty day mortality was 13 percent. Nearly all patients were given isosmotic nonelemental diets. The incidence of diarrhea was 2 percent with ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80102-1
更新日期:1985-03-01 00:00:00
abstract::A persistent perineal sinus may develop in patients undergoing proctocolectomy for inflammatory bowel disease. Healing may resist the traditional methods of wound management. Wide excision including coccygectomy, transposition of the vascularized gracilis muscle flap into the rigid cavity, and wound closure have led t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90290-3
更新日期:1984-07-01 00:00:00
abstract::We have confirmed earlier findings that treatment with allopurinol offers some protection to the kidney from ischemic damage caused by total interruption of renal circulation. With this evidence, a clinical trial is warranted, particularly when periods of warm ischemia are unavoidable. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90171-9
更新日期:1976-06-01 00:00:00
abstract::The aim of this study was to evaluate whether total gastrectomy performed for gastric cancer leads to an increased risk of cholelithiasis and whether the method of reconstruction of the digestive tract influences that risk. A total of 102 patients who had undergone total gastrectomy for gastric cancer between 1980 and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80573-2
更新日期:1993-07-01 00:00:00
abstract::Three distinct forms of postoperative breakdown after Nissen fundoplication have been discussed. Disruption and recurrent reflux is most common, with slipping occurring infrequently. For the first time, three patients developing a proximal gastric pouch deformity causing partial obstruction of the fundus without recur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90278-1
更新日期:1977-07-01 00:00:00
abstract:BACKGROUND:Hypercapnia and local pressure effects unique to CO(2) base minimally invasive surgery alter renal blood flow. We have demonstrated laparoscopic antireflux surgery to have an additional impact upon hemodynamics (decreased cardiac output), potentially extending known effects upon renal blood flow. METHODS:We...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00824-3
更新日期:2002-04-01 00:00:00
abstract::Since its inception in 1994, the National Surgical Quality Improvement Program (NSQIP) has been used to compare the performance of all Veterans Administration (VA) hospitals offering major surgical procedures. The program's outcome data are used to identify areas of both excellent and poor performance. The data can al...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.10.004
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:To improve surgical training standards, it is necessary to first define the elements of high-quality training and methods for measuring them. METHODS:Semistructured interviews were conducted with attending (n = 10) and resident (n = 10) general surgeons. An interview topic guide was used to elicit end users...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.07.044
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture. METHODS:The goal of this study was to assess whether professionalism has taken root in the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.05.007
更新日期:2012-01-01 00:00:00
abstract::1. A well defined group of patients have been studied. 2. Composite operation resulted in a 56 per cent five year disease-free survival rate. 3. Treatment of recurrent disease with irradiation increased the five year survival to 61 per cent. 4. Preoperative irradiation for squamous cell carcinoma of the intraoral cavi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90490-0
更新日期:1975-10-01 00:00:00
abstract::A survey was made of 112 cases of gallstone ileus reported in the Japanese literature, including 3 of our cases. The ratio of males to females was 1 to 1.1, the age range was 13 to 87 years, and biliary-enteric fistulas were demonstrated in 81 percent of the patients. Although cholecystoduodenal fistula was most commo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90185-3
更新日期:1980-09-01 00:00:00
abstract:BACKGROUND:The survival of patients with metastatic melanoma is poor. The response rates for chemotherapy and immunotherapy have been low, with no real improvement in survival. We reviewed the results of surgical resection. METHODS:We performed a retrospective review of the medical records of all patients who underwen...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(98)00041-5
更新日期:1998-05-01 00:00:00
abstract::The obturator hernia is rare, accounting for only 0.05% of all hernias and 0.2% of all small-bowel obstructions requiring laparotomy at our institution. Typically, there is a delay in diagnosis and surgical intervention, despite the presence of a bowel obstruction. A laparotomy is needed, not a preoperative diagnosis....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80256-6
更新日期:1995-07-01 00:00:00
abstract::In an attempt to determine the late effects and associated morbidity of radiotherapy on normal tissue, patients with squamous carcinoma of the oral cavity and oropharynx were retrospectively reviewed. Between 1964 and 1975, 569 patients with cancer of the floor of the mouth, oral tongue, tonsil, and retromolar trigone...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90247-7
更新日期:1983-10-01 00:00:00
abstract::A prospective study of 390 indwelling central venous catheters placed by way of the subclavian route identified bacteremia and tracheostomy as the only significant variables associated with the colonization of the catheters by pathogenic microorganisms. Catheter-related sepsis was likely in only 3 of 33 episodes of pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90085-0
更新日期:1979-06-01 00:00:00
abstract:OBJECTIVE:A large number of necrotizing soft tissue infections (NSTI) treated at a single institution over an 8-year period were analyzed with respect to microbial pathogens recovered, treatment administered, and outcome. Based on this analysis, optimal empiric antibiotic coverage is proposed. METHODS:A retrospective ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00360-3
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:To assess the impact of adding a surgical oncologist to our faculty we examined the operative experience in our program before and after the addition. METHODS:Operative case numbers reported to the American Board of Surgery over a 10-year period were analyzed. This time period encompassed 5 years before and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.01.001
更新日期:2004-01-01 00:00:00
abstract::Forty-one patients with significant pulmonary emboli were reviewed. The presence of heart disease and obesity was found with relatively constant frequency throughout the groups presented. Postoperative infections (wounds or abscess) were frequently associated with fatal or significant pulmonary embolism, particularly ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90067-9
更新日期:1979-03-01 00:00:00
abstract::Adult male rats underwent common bile duct ligation or sham celiotomy. At intervals of 7 and 14 days postoperatively, bacteremia was induced by intravenous injection of 10(9) Escherichia coli or intraperitoneal injection of 10(6) E. coli. Serial quantitative blood cultures and quantitative whole organ cultures were ob...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90530-8
更新日期:1989-02-01 00:00:00
abstract::Primary prevention is defined as the prevention of gallstone formation; secondary prevention is defined as the prevention of clinical manifestations of gallstones--symptoms or more severe complications. For primary prevention, general "wellness" measures can be recommended from a theoretic standpoint. These include el...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80958-4
更新日期:1993-04-01 00:00:00
abstract::The mesocaval graft for portal decompression is applicable in infants and children with portal hypertension secondary to extrahepatic or intrahepatic causes. It is recommended in patients in whom extensive previous surgery in the portahepatis (Kasai procedure) would make dissection of the portal vein difficult and end...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90011-9
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic adrenalectomy has gained acceptance in the treatment of adrenal tumors. We examine our initial 73 patients and highlight the change in patient selection and outcome that experience brings. METHODS:A prospective study from 2000 to 2005 enrolled 73 consecutive laparoscopic adrenalectomy patients ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2006.01.042
更新日期:2006-05-01 00:00:00
abstract::The satisfactory substitute for catgut suture, Vicryl (polyglactin 910) suture, was used in fifty-three patients who underwent general and thoracic surgical procedures. Theoretical advantages of increased strength, controlled absorption by slow depolymerization and dissolution, and superior handling characteristics we...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90367-1
更新日期:1977-08-01 00:00:00
abstract:BACKGROUND:A review of 1993 data on length of stay (LOS) and charges for diagnosis-related group (DRG) 195 (complicated cholecystectomies) showed that Maricopa Medical Center charged more and had longer LOS than all other area hospitals. METHODS:Twenty DRG 195 charts were analyzed for the causes of the inefficiencies....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80035-x
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:The role of stereotactic fine-needle aspiration cytology (SFNAC) in the diagnosis of nonpalpable breast lesions is poorly defined. PATIENTS AND METHODS:Data were prospectively collected from 225 consecutive patients with nonpalpable breast lesions who had aspiration cytology followed by immediate surgical e...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(05)80116-3
更新日期:1994-12-01 00:00:00
abstract:AIMS:Assessing endoscopic technical skills competency in a structured manner is a topical issue, in light of several workforce factors that may affect the training of future endoscopists. To date there has been little attempt to comprehensively assess both generic and specific technical skills in lower gastrointestinal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.10.024
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Response evaluation criteria in solid tumors (RECIST) is the accepted method for determining tumor progression. However, RECIST may not estimate disease burden accurately because the axial plane often does not produce the actual longest diameter. Volumetric measurements may be an alternative to better determ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.007
更新日期:2012-11-01 00:00:00
abstract::In an effort to assess the impact of enhanced macrophage function in acute pancreatitis, mice were subjected to a choline-deficient diet supplemented by ethionine to induce necrotizing pancreatitis. Treatment with the macrophage stimulant glucan resulted in improved survival rates (58 percent versus 14 percent) and ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90197-8
更新日期:1987-01-01 00:00:00
abstract::Recently, carotid plaque factors, specifically intraplaque hemorrhage, have been studied with respect to the production of cerebrovascular symptoms. Ninety-five carotid endarterectomies were performed and the plaques that were removed were examined for intraplaque hemorrhage. Patients were separated into three groups:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90450-1
更新日期:1984-12-01 00:00:00
abstract::A combination of heparin and dihydroergotamine mesylate (Heparin-Dihydergot) has been shown to be more effective than either of these drugs alone in preventing postoperative venous thromboembolism. The possible mechanism for the synergistic effect of heparin and dihydroergotamine was assessed. Phlebograms obtained aft...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:
更新日期:1985-10-08 00:00:00