Abstract:
OBJECTIVE:The aim of this study was to emphasize the importance of a subclassification in the TNM staging system of rectal cancer. BACKGROUND:The clinical significance of the mesorectal extension of rectal cancer is unclear. PATIENTS AND METHODS:Data from 463 consecutive patients with stage IIa disease (T3N0) undergoing curative surgery at 28 institutes were analyzed. The measurement of the distance of the mesorectal extension (DME) was histologically evaluated. Risk factors for recurrence, for the optimal cutoff point of the DME, independent prognostic factors, and for survivals were studied using receiver operating characteristic curve and logistic and Cox regression analyses. Survivals were calculated using the Kaplan-Meier method. RESULTS:A value of 4 mm was determined as the optimal cutoff point. The patients were subdivided into 2 groups: DME ≤ 4 mm and DME > 4 mm at the optimal cutoff point. DME > 4 mm had the greatest impact on recurrence-free survival [P = 0.00023, hazard ratio (HR): 2.26, 95% confidence interval (95% CI): 1.465-3.492, L/U ratio: 0.420] and was an independent adverse prognostic factor (P = 0.00323, HR: 1.97, 95% CI: 1.254-3.091). The distant metastasis rate in DME > 4 mm was higher 16.7% than that in DME ≤ 4 mm (P = 0.00177, OR: 2.61, 95% CI: 1.430-4.761). The incidence of local recurrence was not influenced by DME. The recurrence-free 5-year survival rate in DME ≤ 4 mm was significantly better than that in DME > 4 mm (86.6% vs 71.3%, P = 0.00015, HR: 0.44, 95% CI: 0.286-0.683). The cancer-specific survival rate in DME ≤ 4 mm was also significantly better than that in DME > 4 mm (91.3% vs 82.2%, P = 0.000664, HR: 0.52, 95% CI: 0.325-0.843). CONCLUSIONS:A subclassification according to mesorectal extension based on a 4-mm cutoff point is needed for the TNM staging system. However, further prospective study is necessary to prove reproducibility and validity of the cutoff point.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Shirouzu K,Akagi Y,Fujita S,Ueno H,Takii Y,Komori K,Ito M,Sugihara K,Japanese Society for Cancer of the Colon and Rectum (JSCCR) on Clinical Significance of the Mesorectal Extension of Rectal Cancer.doi
10.1097/SLA.0b013e3182119331subject
Has Abstractpub_date
2011-04-01 00:00:00pages
704-10issue
4eissn
0003-4932issn
1528-1140pii
00000658-201104000-00011journal_volume
253pub_type
杂志文章,多中心研究abstract::Records of 32 patients with 34 villous and tubulovillous adenomas of the duodenum, treated at the Cleveland Clinic over the past 21 years, were reviewed. Twenty-two patients (69%) had complete resection of the adenoma; the incidence of malignancy was 47%. Five patients underwent a Whipple procedure; 4 patients had seg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198803000-00002
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of a novel 2-stage treatment with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP) for multiple hepatocellular carcinoma (HCC), which was previously unresectable. SUMMARY BACKGROUND DATA:Surgical resection is the treatment of choice for HCC, but the majority of p...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/01.sla.0000103133.03688.3d
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:We assessed circulating tumor cells (CTCs) with epithelial and mesenchymal phenotypes as a potential prognostic biomarker for patients with pancreatic adenocarcinoma (PDAC). BACKGROUND:PDAC is the fourth leading cause of cancer death in the United States. There is an urgent need to develop biomarkers that pr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001600
更新日期:2016-12-01 00:00:00
abstract::Although survival from primary breast cancer has improved with earlier diagnosis and treatment, the management of the opposite breast is still in question. The risk factors for bilaterality are known, and preoperative mammography is occasionally helpful, but identification of early second breast cancer is very limited...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198506000-00001
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVES:Early hospital readmission is a common and costly problem in the Medicare population. In 2009, the Centers for Medicaid and Medicare Services began mandating hospital reporting of disease-specific readmission rates. We sought to determine the rate and predictors of readmission after colectomy for cancer, as ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181d3d27c
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVES:Aggressive human melanomas express, C-X-C chemokine receptor 4 (CXCR4), the receptor for the chemokine, stromal cell-derived factor-1alpha (SDF-1α). The CXCR4-SDF-1α axis has been postulated to increase melanoma invasiveness. We discovered that SDF-1α specifically upregulates E-selectin on endothelial cells,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822a72dc
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:Cetuximab, a monoclonal antibody targeting epidermal growth factor receptor (EGFR), has been proven to be efficient in metastatic colorectal cancer (mCRC); however, the therapeutic response is variable and markers predictive of response are urgently required. This study was conducted to determinate the predic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181bc9d96
更新日期:2010-02-01 00:00:00
abstract::Thrombosis of the portal vein with or without patency of its tributaries used to be a contraindication to orthotopic liver transplantation (OLTX) until quite recently. Rapid progress in the surgical technique of OLTX in the last few years has demonstrated that most patients with portal vein thrombosis can be safely an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199103000-00003
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To evaluate readmissions following laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass (LRYGB). BACKGROUND:Few studies have evaluated national readmission rates for primary bariatric surgery with national, bariatric-specific data. ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002079
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To review a single center's 10-year experience with liver transplantation (LTx) for the biliary atresia-polysplenia syndrome (BA-PS) and to define surgical and clinical guidelines for its management. SUMMARY BACKGROUND DATA:BA is the most common indication for pediatric liver transplantation (LTx) and is ass...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199804000-00022
更新日期:1998-04-01 00:00:00
abstract::Transcutaneous tissue oxygen tension (PtcO2) was evaluated as a noninvasive diagnostic test for peripheral arterial insufficiency; PtcO2 was measured at rest, during exercise, and following exercise at three leg sites in 36 controls and 138 patients with exercise-induced leg pain. Resting foot PtcO2 differed significa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198408000-00007
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVE:To determine long-term survival after pancreatoduodenectomy for pancreatic ductal adenocarcinoma and to identify clinical factors associated with long-term survival. SUMMARY BACKGROUND DATA:The prognosis for long-term survival even after potentially curative resection for pancreatic adenocarcinoma is thought...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181613142
更新日期:2008-03-01 00:00:00
abstract::Twenty-four patients with intra-peritoneal infections were studied sequentially to evaluate neutrophil chemotaxis, spontaneous migration, and chemiluminescence. In six patients, infection was due to spontaneous disease processes and 18 others, infection was a sequel of intra-abdominal operation. In the patients studie...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198107000-00003
更新日期:1981-07-01 00:00:00
abstract:OBJECTIVES:We hypothesized that distinct sets of functional trajectories can be identified in the year before and after major surgery, with unique transition probabilities from pre to postsurgical functional trajectories, and that outcomes would be better among participants undergoing elective versus nonelective surger...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002659
更新日期:2018-12-01 00:00:00
abstract::A prospective study of factors predisposing to infection in badly injured patients has disclosed: the dominant roles of two specific parameters: monocyte antigen presenting capacity, and opsonic capacity of diluted serum; the potential value of further assessment of: the predictive value of plots of activated T-cells/...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1986-09-01 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 aim of this study was to evaluate expression of cancer risk-associated biomarkers in columnar epithelium at squamocolumnar junctions produced by an ablation procedure and proton pump inhibitors in incompletely ablated Barrett's esophagus (BE) patients that were nondysplastic prior to ablation. SUMMARY BA...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000224913.19922.7e
更新日期:2006-12-01 00:00:00
abstract::Fifteen patients with Zollinger-Ellison syndrome followed at the National Institutes of Health with extensive metastatic disease had an actuarial 5-year survival of 20%. Therefore, in 1982 a prospective study to examine the effect and feasibility of removing all gross tumor in selected patients with extensive metastat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198604000-00003
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the results of liver resection for patients with bilateral hepatic metastases from colorectal cancer. We aimed to assess the evolution of the technical approach over time and correlations with morbidity, mortality, and oncologic outcome. SUMMARY BACKGROUND DATA:Although...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181557e47
更新日期:2008-01-01 00:00:00
abstract::We analyzed the course of 186 patients with external gastrointestinal fistulas treated at the University of California Medical Center, San Francisco from 1968 to 1977. There were 82 patients in the earlier group (1968-1971) and 104 patients in the later group (1972-1977). The groups differed in that 35% of patients in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197810000-00003
更新日期:1978-10-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to assess the impact of pouch reconstruction on perioperative outcomes, postprandial symptoms, nutritional and anthropometric parameters, and overall quality of life after total gastrectomy for gastric malignancy. SUMMARY BACKGROUND DATA:The short-term perioperative risks and longer ...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000003082
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To describe the incidence and risk factors for mortality and morbidity in patients with cirrhosis undergoing elective or emergent abdominal surgeries. BACKGROUND:Postoperative morbidity and mortality are higher in patients with cirrhosis; variation by surgical procedure type and cirrhosis severity remain unc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003674
更新日期:2019-10-23 00:00:00
abstract:OBJECTIVE:The primary aim of this study was to delineate the role of computed tomography (CT) in patients undergoing NOM for AGSW. BACKGROUND:Nonoperative management (NOM) of abdominal gunshot wounds (AGSWs) remains controversial. METHODS:This prospective study included all patients with abdominal gunshot injuries ad...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000000879
更新日期:2015-04-01 00:00:00
abstract::The incidence of renovascular hypertension in the transplanted kidney is reported to range between 5 and 15%. A review of 391 consecutive renal transplant patients revealed 16 patients (5.4%) with hypertension secondary to partial obstruction of renal arterial blood flow. The clinical course of this group of patients ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198011000-00010
更新日期:1980-11-01 00:00:00
abstract:OBJECTIVE:To determine whether F-fluorodeoxyglucose (F-FDG) micro-positron emission tomography (micro-PET) can predict abdominal aortic aneurysm (AAA) rupture. BACKGROUND:An infrarenal AAA model is needed to study inflammatory mechanisms that drive rupture. F-FDG PET can detect vascular inflammation in animal models a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000602
更新日期:2015-02-01 00:00:00
abstract::Nine patients with arteriographic right colon arteriovenous malformations (AVM's) are reviewed. Even though five of the eight surviving patients had diverticulosis in remaining colon, right colectomy with removal of the AVM effectively controlled bleeding in seven of the eight patients in follow-up intervals of 14-66 ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197908000-00013
更新日期:1979-08-01 00:00:00
abstract:OBJECTIVE:To analyze long-term weight loss, changes in comorbidities and quality of life, and late complications after laparoscopic and open gastric bypass. SUMMARY BACKGROUND DATA:Early results from our prospective randomized trial comparing the outcome of laparoscopic versus open gastric bypass demonstrated less pos...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000197381.01214.76
更新日期:2006-02-01 00:00:00
abstract::Percutaneous transhepatic bile drainage was performed in 13 patients with obstructive jaundice, using a combination of the PTC technique and a Seldinger angiography catheter. In 11 cases, the outflow of bile through the catheter was satisfactory and complications were few. Since the risk of the procedure is low and it...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197701000-00018
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To determine the effect of allogeneic blood transfusion (ABT) on clinical outcomes in patients with colorectal cancer undergoing surgery. BACKGROUND:Perioperative ABTs may be associated with adverse clinical outcomes. METHODS:Systematic review of the literature with odds ratio (OR) and incidence rate ratio ...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0b013e31825b35d5
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To investigate potential impacts of restructuring general surgery training on colorectal (CR) surgery recruitment and expertise. SUMMARY BACKGROUND DATA:In response to the American Surgical Association Blue Ribbon Committee report on surgical education (2004), the American Board of Colon and Rectal Surgery, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ad64f1
更新日期:2009-07-01 00:00:00