Abstract:
BACKGROUND:The aims of this study were to analyze the overall survival of patients with cirrhosis and small hepatocellular carcinoma (HCC) and identify independent pretreatment predictors of survival in Brazil. METHODS:Between 1998 and 2003, 74 patients with cirrhosis and small HCC were evaluated. Predictors of survival were identified using the Kaplan-Meier survival curves and the Cox model. RESULTS:The overall survival rates were 80%, 41%, and 17% at 12, 36, and 60 months, respectively. The mean length of follow-up after HCC diagnosis was 23 months (median 22 mo, range: 1 to 86 mo) for the entire group. Univariate analysis showed that model for endstage liver disease (MELD) score (P=0.016), Child-Pugh classification (P=0.007), alpha-fetoprotein level (P=0.006), number of nodules (P=0.041), tumor diameter (P=0.009), and vascular invasion (P<0.0001) were significant predictors of survival. Cox regression analysis identified vascular invasion (relative risk=14.60, confidence interval 95%=3.3-64.56, P<0.001) and tumor size >20 mm (relative risk=2.14, confidence interval 95%=1.07-4.2, P=0.030) as independent predictors of decreased survival. Treatment of HCC was related to increased overall survival. CONCLUSIONS:Identification of HCC smaller than 20 mm is associated with longer survival. Presence of vascular invasion, even in small tumors, maybe associated with poor prognosis. Treatment of small tumors of up to 20 mm diameter is related to increased survival.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Kikuchi LO,Paranaguá-Vezozzo DC,Chagas AL,Mello ES,Alves VA,Farias AQ,Pietrobon R,Carrilho FJdoi
10.1097/MCG.0b013e31817ff199subject
Has Abstractpub_date
2009-02-01 00:00:00pages
191-5issue
2eissn
0192-0790issn
1539-2031journal_volume
43pub_type
杂志文章abstract::We reviewed 195 colonoscopies to determine whether procedure efficiency differed with the use of an intermediate-length (135 cm) colonoscope compared with a long (165 cm) colonoscope. The cecum was intubated with the 135-cm scope in 92.6% of procedures and with the 165-cm colonoscope in 96.8% of procedures (chi 2 meth...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199507000-00008
更新日期:1995-07-01 00:00:00
abstract::During the past three decades, important advances in our understanding of the pathophysiology of chronic pancreatitis (CP), improved results of major pancreatic resections (including pancreatoduodenectomy), and integration of sophisticated diagnostic methods in clinical practice resulted in significant changes in our ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/00004836-200201000-00014
更新日期:2002-01-01 00:00:00
abstract::A 37-year-old man had fever, weight loss, malaise, right upper quadrant pain, lymphadenopathy, and a twofold elevation of serum alkaline phosphatase, transaminases, and gamma glutamyl transpeptidase. Granulomas were found on liver biopsy after 2 1/2 months of illness. Treatment with isoniazid and rifampin for 2 months...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198906000-00021
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:An association between Helicobacter pylori infection and colorectal neoplasia has been reported in cross-sectional studies. GOALS:We examined the association between H. pylori infection and the development of advanced colorectal neoplasia (AN) in a screening cohort. STUDY:We identified 3753 adults, who und...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001273
更新日期:2020-09-01 00:00:00
abstract::The fear of cancer has evoked calls for intensive surveillance programs in Barrett's esophagus. Two evolving issues are fueling this fire: (a) the rising risk of adenocarcinoma of the esophagus over the past 20 years and (b) the coincidental increase in the recognized prevalence of Barrett's esophagus in the general p...
journal_title:Journal of clinical gastroenterology
pub_type: 社论
doi:10.1097/00004836-199609000-00002
更新日期:1996-09-01 00:00:00
abstract:GOALS:We investigated the distribution of pathogens on stool gastrointestinal (GI) polymerase chain reaction (PCR) testing in those who subsequently developed inflammatory bowel disease (IBD). BACKGROUND:Infectious gastroenteritis has been associated with later development of IBD. STUDY:This retrospective study inclu...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001470
更新日期:2020-11-25 00:00:00
abstract::Aortoesophageal fistula is a rare cause of massive gastrointestinal hemorrhage, and may occur as a sequela to prosthetic replacement of the thoracic aorta. Esophageal compression necrosis with leakage of microorganisms into the proximal suture line is probably central to pathogenesis. Like the more common aortoduodena...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198412000-00009
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND AND THE STUDY AIM:Crohn's disease (CD) is a chronic inflammatory disorder defined as a transmural inflammation of the bowel wall, affecting the small and large intestine. The Capsule Endoscopy Crohn's Disease Activity Index (CECDAI or Niv score) was devised to measure mucosal disease activity. We extended th...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000000720
更新日期:2018-01-01 00:00:00
abstract:GOALS:To describe the association of untreated celiac disease with hyperhomocysteinemia and variants of the methylenetetrahydrofolicacid reductase (MTHFR) gene found in clinical practice. STUDY:Case studies with description of associated clinical, biochemical, and genetic findings and review of literature. RESULTS:Fi...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200608000-00007
更新日期:2006-08-01 00:00:00
abstract::The advent of new diagnostic and therapeutic modalities for Helicobacter pylori allows any physician to offer curative antibiotic regimens to patients with peptic ulcer disease and gastritis. This article describes new management strategies and discusses the advantages of each. In the old strategy, endoscopy was perfo...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::We undertook a 12-year review of the elective and emergency surgery for duodenal ulcer in Queen Mary Hospital, Hong Kong, to ascertain whether the introduction of cimetidine as treatment for duodenal ulcer had led to a reduction in the number of elective and emergency operations being performed for duodenal ulcer. The...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198802000-00007
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:Hepatitis C virus genotype differences seem to be of considerable clinical significance because they affect responses to antiviral therapy. HCV genotype 4 is rare in the United States and there are few published data regarding response to therapy in patients with HCV genotype 4 infection. OBJECTIVES:To asse...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200401000-00014
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Pancreatic cancer (PC) is one of the leading causes of cancer death in Western countries. An increased risk for PC is known in a number of hereditary tumor syndromes. In selected individuals at high risk of developing PC, surveillance of the pancreas might be able to detect premalignant lesions and early inv...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3181981123
更新日期:2009-10-01 00:00:00
abstract::Forty-five polyps were encountered at duodenoscopy between 1973 and 1978. Upper gastrointestinal x-rays were helpful in 25 patients, 13 of whom had duodenal polyps and 12 duodenal deformity or mass lesions. Polyps in 23 patients were larger than 1 cm in size. Biopsies were done in 38 patients; in 19 there was only nor...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198106000-00007
更新日期:1981-06-01 00:00:00
abstract:BACKGROUND/GOALS:Many patients with a history of injection drug use (IDU) are excluded from hepatitis C virus (HCV) treatment. This prospective multicenter study aimed to determine the impact of IDU history on HCV treatment candidacy and outcomes. STUDY:Between 1999 and 2001, 4318 HCV-infected patients seen at 24 VA M...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章,多中心研究
doi:10.1097/01.mcg.0000212644.82853.51
更新日期:2007-02-01 00:00:00
abstract::Desmoid tumors may occur sporadically or as part of the extraintestinal manifestations of familial adenomatous polyposis. Different phenotypes have been described and some genotype-phenotype correlations have been raised, associated with different sites of germline mutations in the adenomatous polyposis coli (APC) gen...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e3180325252
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Elevated plasma total homocysteine (tHcy) is associated with a higher risk of thrombosis. Crohn's disease (CD) is associated with hypercoagulability of undefined etiology. We investigated tHcy in patients with CD and its relationship with vitamin status, disease activity, location, duration, and history of t...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200108000-00008
更新日期:2001-08-01 00:00:00
abstract::Mycosis fungoides is a cutaneous T-cell lymphoma that can disseminate to multiple organs. We report a patient who presented with obstructive jaundice caused by isolated involvement of the extrahepatic biliary tree by mycosis fungoides. Initially, endoscopic examinations and biopsies of the biliary tree and liver faile...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199901000-00015
更新日期:1999-01-01 00:00:00
abstract::A 41-year-old man with human immunodeficiency virus (HIV) (CD4 count, 446/mm3) developed a protracted course of abdominal pain, weight loss, and increasing liver function tests after undergoing a metronidazole treatment regimen for Giardia enteritis. Three months later, endoscopic retrograde cholangiography (ERCP) sho...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200108000-00018
更新日期:2001-08-01 00:00:00
abstract::Sucralfate binds to duodenal and gastric ulcers and to gastric erosions produced by ethanol and anti-inflammatory drugs. The affinity of sucralfate for defective mucosa is explained by the drug's viscous adhesiveness and the formation of polyvalent bridges between the negatively charged sucralfate polyanions and posit...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:Diverticular disease (DD) is a common gastrointestinal inflammatory disorder associated with an enteric neuropathy. Although enteric glial cells (EGCs) are essential regulators of intestinal inflammation and motility functions, their contribution to the pathophysiology of DD remains unclear. Therefore, we an...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0000000000001011
更新日期:2019-07-01 00:00:00
abstract::A case of Sturge-Weber syndrome (SWS) with gastrointestinal hemorrhage is presented. SWS is a neurocutaneous disorder characterized by cutaneous facial angioma leptomeningeal angioma with seizures and other neurologic complications. Associated anomalies beyond the encephalofacial territory are very rare. The patient p...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200001000-00019
更新日期:2000-01-01 00:00:00
abstract::We observed jejunal water and sodium secretion in two patients with chronic idiopathic intestinal pseudo-obstruction by standard perfusion techniques. The ability of glucose to reverse this secretory state was impaired. These observations suggest that a jejunal secretory state may contribute to the diarrhea in chronic...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199004000-00008
更新日期:1990-04-01 00:00:00
abstract::Adhesive tape wound around the shaft of an upper GI endoscope serves as a simple method to dilate upper GI strictures under endoscopic control. This technique avoids the need for guidewires and fluoroscopy. ...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-198506000-00005
更新日期:1985-06-01 00:00:00
abstract::Gastric cytoprotection in response to different agents (prostaglandins, carotenoids, etc.) failed to occur after surgical vagotomy. Decreased gastric emptying and the increased vascular permeability were tested in ethanol-treated rats without and with bilateral surgical vagotomy. The experiments were carried out on Sp...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199206001-00025
更新日期:1992-01-01 00:00:00
abstract::In 1992, a 61-year-old man who complained of recurrent episodes of fever and jaundice was diagnosed as having sclerosing cholangitis. In the three years that followed, the clinical picture progressively worsened; and, in 1995, the patient was hospitalized again for biliary obstruction. A liver transplantation was excl...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200003000-00017
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:The sensitivity and specificity of current antihuman tissue transglutaminase (tTG) IgA assays used to detect celiac disease reportedly approach 100%. In addition, the sensitivity of new generation deamidated gliadin peptide (alpha-DGP) antibody assays has also been reported to be similar to the tTG IgA assay...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/MCG.0b013e31816200e5
更新日期:2009-03-01 00:00:00
abstract::Brunner's gland hamartomas are rare benign duodenal tumors often discovered incidentally during endoscopy or on an upper gastrointestinal series. These tumors arise mainly in the duodenal bulb and can present with gastrointestinal bleeding or symptoms of intestinal obstruction. When symptomatic, surgical or endoscopic...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199812000-00017
更新日期:1998-12-01 00:00:00
abstract::Pyogenic abscesses of the liver occur in association with a variety of diseases. Sometimes they are caused by anaerobic infections of liver metastases. Uncommonly, however, multiple hepatic abscesses caused by anaerobic bacteria are the presenting signs of unsuspected colonic cancer in the absence of liver metastases....
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-199206000-00013
更新日期:1992-06-01 00:00:00
abstract::Unbuffered rapid urease test (RUT) is an accurate, rapid, and inexpensive method of detecting Helicobacter pylori. However, it is generally recommended to prepare the reagent daily. This prospective study was undertaken to evaluate the shelf-life of our unbuffered RUT at -20 degrees C. Two sets of antral biopsies (X2)...
journal_title:Journal of clinical gastroenterology
pub_type: 杂志文章
doi:10.1097/00004836-200009000-00010
更新日期:2000-09-01 00:00:00