Abstract:
OBJECTIVE:To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-term outcomes is still indefinite. METHODS:Two hundred thirty HCC patients who met the Milan criteria and were suitable to be treated by either RES or RFA entered into a randomized controlled trial. The patients were regularly followed up after treatment for 5 years (except for those who died). The primary end point was overall survival; the secondary end points were recurrence-free survival, overall recurrence, and early-stage recurrence. RESULTS:The 1-, 2-, 3-, 4- and 5-year overall survival rates for the RFA group and the RES group were 86.96%, 76.52%, 69.57%, 66.09%, 54.78% and 98.26%, 96.52%, 92.17%, 82.60%, 75.65%, respectively. The corresponding recurrence-free survival rates for the 2 groups were 81.74%, 59.13%, 46.08%, 33.91%, 28.69% and 85.22%, 73.92%, 60.87%, 54.78%, 51.30%, respectively. Overall survival and recurrence-free survival were significantly lower in the RFA group than in the RES group (P = 0.001 and P = 0.017). The 1-, 2-, 3-, 4-, and 5-year overall recurrence rates were 16.52%, 38.26%, 49.57%, 59.13%, and 63.48% for the RFA group and 12.17%, 22.60%, 33.91%, 39.13%, and 41.74% for the RES group. The overall recurrence was higher in the RFA group than in the RES group (P = 0.024). CONCLUSIONS:Surgical resection may provide better survival and lower recurrence rates than RFA for patients with HCC to the Milan criteria.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Huang J,Yan L,Cheng Z,Wu H,Du L,Wang J,Xu Y,Zeng Ydoi
10.1097/SLA.0b013e3181efc656subject
Has Abstractpub_date
2010-12-01 00:00:00pages
903-12issue
6eissn
0003-4932issn
1528-1140pii
00000658-201012000-00003journal_volume
252pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:The aim of this prospective study was to determine incidence, duration, and risk factors for postoperative delirium (PD) in elderly patients undergoing major abdominal surgery. SUMMARY BACKGROUND DATA:The incidence and risk factors of PD after major abdominal surgery in elderly patients are not well document...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c1cfc9
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of the response to preoperative chemotherapy, especially tumor progression, on the outcome following resection of multiple colorectal liver metastases (CRM). SUMMARY BACKGROUND DATA:Hepatic resection is the only treatment that currently offers a chance of long-term survival, althoug...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000145964.08365.01
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To prevent bile duct injury by using a cold 5% glucose isotonic solution cooling in the bile ducts when radiofrequency (RF) is performed in a porcine model. SUMMARY BACKGROUND DATA:Complications that may arise during liver RF ablation include biliary stenosis and abscesses. METHODS:The RITA 1500 generator w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000193831.39362.07
更新日期:2006-01-01 00:00:00
abstract:PURPOSE:Though histological grade is known to have a major prognostic impact in metastatic mucinous appendiceal adenocarcinomas, the prognostic impact of grade in localized disease, and the validity of the American Joint Committee on Cancer AJCC Staging Manual 7th edition's decision to combine moderately and poorly dif...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318269d680
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Some, but not all, studies using registry data have suggested a small but significant long-term survival advantage following a curative surgical resection of gastric cancer at hospitals where the volume of such surgeries is high. However, because such data may be significantly influenced by the impact of pos...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000245469.35088.42
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To investigate Fas and FasL expression in pancreatic tissues and cultured pancreatic cancer cell lines, and to assess the ability of anti-Fas antibodies to induce apoptosis. SUMMARY BACKGROUND DATA:Activation of the Fas receptor by Fas-ligand (FasL) results in apoptosis, and dysregulation of this pathway may...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200003000-00010
更新日期:2000-03-01 00:00:00
abstract::Three methods of closing bronchial stumps were evaluated in 90 dogs undergoing left pneumonectomy:interrupted 3-0 silk sutures, interrupted 3-0 nylon sutures, and stapling with an automatic device. The dogs were sacrificed at 24 hours, 3, 5, 7, 10, and 14 days after pneumonectomy. Brochial stump leakage pressures and ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197608000-00012
更新日期:1976-08-01 00:00:00
abstract:OBJECTIVE:Esophagectomy for esophageal cancer is associated with substantial postoperative morbidity as a result of infectious complications. In a prior phase II study, granulocyte colony-stimulating factor (G-CSF) was shown to improve leukocyte function and to reduce infection rates after esophagectomy. The aim of the...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.sla.0000129705.00210.24
更新日期:2004-07-01 00:00:00
abstract::In our series of 101 patients with small bowel bypass for morbid obesity, nine developed biliary calculi postoperatively during a mean follow-up of 29.6 months. The development of gallstones depends in part on biliary cholesterol saturation and on the zeta potential of bile. In eight consecutive patients, the lithogen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197801000-00011
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the in vivo effects of hypertonic saline (HTS) resuscitation on the interactions of endothelial cells (ECs) and polymorphonuclear neutrophils (PMNs) and vascular permeability after hemorrhagic shock. SUMMARY BACKGROUND DATA:The PMN has been implicated in the pathogenesis of EC damage and organ in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200211000-00014
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVES:Congenital diaphragmatic hernia (CDH) remains a significant cause of neonatal morbidity and mortality. SUMMARY OF BACKGROUND DATA:Previous studies have suggested that hospital volume is an independent predictor of in-hospital mortality. We sought to validate this effect using a large national database incor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181f5b538
更新日期:2010-10-01 00:00:00
abstract::Computed tomography and, to a lesser extent, ultrasonography provide detailed anatomic localization of intra-abdominal abscesses that permit precise percutaneous placement of catheters large enough to effect drainage. Using routes similar to surgical approaches, the authors have used this technique as definitive thera...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198110000-00014
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:To identify prognostic factors and reasons for improved survival over time in patients with esophageal cancer. SUMMARY BACKGROUND DATA:Management strategies for esophageal cancer have evolved with time. The impact of chemoradiation in the overall treatment results has not been adequately studied. METHODS:Fr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000086545.45918.ee
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:Few studies have evaluated long-term outcomes after orthotopic liver transplantation (OLT). This work analyzes the experience of nearly 2 decades by the same team in a single center. Outcomes of OLT and factors affecting survival were analyzed. METHODS:Retrospective analysis of 3200 consecutive OLTs that wer...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000164077.77912.98
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review of economic evaluations of enhanced recovery pathways (ERP) for colorectal surgery. BACKGROUND:Although there is extensive literature investigating the clinical effectiveness of ERP, little is known regarding its cost-effectiveness. METHODS:A systematic literature search ident...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e318295fef8
更新日期:2014-04-01 00:00:00
abstract::Hemodynamic and metabolic consequences of a 90-minute period of liver ischemia followed by 120 minutes of reperfusion were studied in rats that were awake during most of the experiment and in rats anesthetized with either pentobarbital (40 mg/kg body weight) or chloralose (30 mg/kg X hour) during the complete length o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199007000-00004
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to identify the survival of patients with locally advanced pancreatic cancer (LAPC) and assess the effect of surgical resection after neoadjuvant therapy on patient outcomes. BACKGROUND:An increasing number of LAPC patients who respond favorably to neoadjuvant therapy undergo surgica...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002753
更新日期:2019-08-01 00:00:00
abstract::Severe hemorrhage associated with major trauma and vascular procedures is seen frequently in our operating rooms. Immediate autotransfusion has enabled us to safely and adquately correct blood losses without placing overwhelming demands on our blood bank. Since October 1973, a device capable of retrieving, filtering a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197703000-00013
更新日期:1977-03-01 00:00:00
abstract::The hospital records of 41 patients with a diagnosis of early postoperative small bowel obstruction were reviewed in an attempt to identify criteria which could be used to separate those patients who would require an operation to resolve their obstruction, from those who would resolve with nonoperative therapy. The us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198001000-00014
更新日期:1980-01-01 00:00:00
abstract::This study examines the influence of total parenteral nutrition (TPN) compared with 5% dextrose (D5) infusion on skeletal muscle and adipose tissue lipoprotein lipase (LPL) activity in nutritionally depleted, injured and infected patients. The plasma concentrations of glucose, free fatty acid (FFA), triglyceride and i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198112000-00003
更新日期:1981-12-01 00:00:00
abstract::Glucose metabolism is affected by various pathologic states including tumors. In this project, glucose turnover and recycling rates in 11 patients with colorectal carcinoma were measured using a double-labelled 3-3H and 1-14C glucose injection technique. Fasting blood glucose, lactate, pyruvate, alanine, glycerol, 3-h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198311000-00007
更新日期:1983-11-01 00:00:00
abstract:OBJECTIVE:To achieve consensus on the best practices in the management of ventral hernias (VH). BACKGROUND:Management patterns for VH are heterogeneous, often with little supporting evidence or correlation with existing evidence. METHODS:A systematic review identified the highest level of evidence available for each ...
journal_title:Annals of surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/SLA.0000000000001701
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of peptide receptor radionuclide therapy (PRRT) on somatostatin receptor (SSR)-transfected colon carcinoma cells in a rat liver metastases model. SUMMARY BACKGROUND DATA:Previously the authors have shown highly effective therapy with PRRT of SSR-positive tumors. This treatment is SSR-m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200212000-00004
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To examine the outcome of technical variant liver transplant techniques relative to whole organ liver transplantation in pediatric liver transplant recipients. BACKGROUND:Technical variant liver transplant techniques comprising split, reduced, and live-donor liver transplantation evolved to address the need ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3180caa415
更新日期:2007-08-01 00:00:00
abstract::MINI: In cases of true short esophagus diagnosed intraoperatively with an endoscopic-laparoscopic method, Collis-Nissen and stomach around stomach fundoplication procedures achieved similar results. The notion that the gastric fundus must be wrapped around a conveniently long segment of the tubular esophagus to obtain...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003582
更新日期:2019-09-03 00:00:00
abstract:BACKGROUND:Hospitals increasingly rely on surgical quality assessment programs that require considerable resources to capture outcomes after hospital discharge. However, it is unclear whether capturing postdischarge complications and deaths is important. Our objectives were (1) to determine the frequency of postdischar...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e4846e
更新日期:2010-07-01 00:00:00
abstract::Prior experience with the rare combination of horseshoe kidney and significant atherosclerotic vascular disease suggests difficulty in intraoperative management, often requiring division of the renal isthmus or sacrifice of some renal tissue. Seven patients have been managed successfully over the past ten years at The...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00012
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:Determine whether absorbable or nonabsorbable mesh in repair of large hiatus hernias reduces the risk of recurrence, compared with suture repair. BACKGROUND:Repair of large hiatus hernia is associated with radiological recurrence rates of up to 30%, and to improve outcomes mesh repair has been recommended. P...
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.0000000000000842
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:To determine and compare the frequency of cancer-associated genetic abnormalities in esophageal metaplasia biopsies with and without goblet cells. BACKGROUND:Barrett's esophagus is associated with increased risk of esophageal adenocarcinoma (EAC), but the appropriate histologic definition of Barrett's esopha...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000424
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31817b65f2
更新日期:2008-07-01 00:00:00