Abstract:
OBJECTIVE:To compare outcomes for patients with hepatocellular carcinoma (HCC) treated with either liver resection or transplantation. METHODS:A retrospective, single-institution analysis of 413 HCC patients from 1999 to 2009. RESULTS:A total of 413 patients with HCC underwent surgical resection (n = 106) and transplantation (n = 270) or were listed without receiving transplantation (n = 37). Excluding transplanted patients with incidental tumors (n = 50), 257 patients with suspected HCC were listed with the intent to transplant (ITT). The median diameter of the largest tumor by radiography was 6.0 cm in resected, 3.0 cm in transplanted, and 3.4 cm in the listed-but-not-transplanted patients. Median time to transplant was 48 days. Recurrence rates were 19.8% for resection and 12.1% for all ITT patients. Overall, patient survival for resection versus ITT patients was similar (5-year survival of 53.0% vs 52.0%, not significant). However, for HCC patients with model end-stage liver disease (MELD) scores less than 10 and who radiologically met Milan or UCSF (University of California, San Francisco) criteria, 1-year and 5-year survival rates were significantly improved in resected patients. For patients with MELD score less than 10 and who met Milan criteria, 1-year and 5-year survival were 92.0% and 63.0% for resection (n = 26) versus 83.0% and 41.0% for ITT (n = 73, P = 0.036). For those with MELD score less than 10 and met UCSF criteria, 1-year and 5-year survival was 94.0% and 62.0% for resection (n = 33) versus 81.0% and 40.0% for ITT (n = 78, P = 0.027). CONCLUSIONS:Among known HCC patients with preserved liver function, resection was associated with superior patient survival versus transplantation. These results suggest that surgical resection should remain the first line therapy for patients with HCC and compensated liver function who are candidates for resection.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Koniaris LG,Levi DM,Pedroso FE,Franceschi D,Tzakis AG,Santamaria-Barria JA,Tang J,Anderson M,Misra S,Solomon NL,Jin X,DiPasco PJ,Byrne MM,Zimmers TAdoi
10.1097/SLA.0b013e31822ca66fsubject
Has Abstractpub_date
2011-09-01 00:00:00pages
527-37; discussion 537-8issue
3eissn
0003-4932issn
1528-1140pii
00000658-201109000-00016journal_volume
254pub_type
杂志文章abstract::From 1975 through 1988, 257 patients with carcinoma of the thoracic esophagus have been treated in our department. Operability was 90% (232/257); overall resectability, 77% (198/257), and for the operated group, 85% (198/232). Hospital mortality rate was 9.6% but decreased to 3% over the period 1986 to 1988. There wer...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199211000-00010
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Aortic elasticity creates a cushion that protects the heart from pressure injury, and a recoil that helps perfuse the coronary arteries. TEVAR has become first-line therapy for many aortic pathologies including trauma, but stent-grafts stiffen the aorta and likely increase LV afterload. OBJECTIVE:Test the h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003768
更新日期:2020-01-03 00:00:00
abstract::Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had associated inflammatory bowel disease, 72 had no such history, and 18 had iatrogenic injury or stone disease. A total of 233 biliary operations were performed, with a 75% rate of temporary improvement after initial operation. Subsequent op...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00017
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:The authors evaluated the outcome and potential prognostic factors of 60 patients with surgically resected periampullary tumors. SUMMARY BACKGROUND DATA:Periampullary carcinomas exhibit different clinical behaviors according to their site of origin. There are no prognostic factors for deciding the type of su...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199511000-00005
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To explore the impact of short-term surgical missions (STMs) on medical practice in Guatemala as perceived by Guatemalan and foreign physicians. SUMMARY BACKGROUND DATA:STMs send physicians from high-income countries to low and middle-income countries to address unmet surgical needs. Although participation a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003292
更新日期:2019-04-18 00:00:00
abstract::This review brings the total number of biliary cysts reported in the world literature to 955. Eighty-one per cent of patients are females and 61% were discovered before age ten. The classical triad of right upper quadrant pain, right upper quandrant mass, and juandice is present in 38% of cases. The duration of sympto...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-197511000-00017
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to determine whether trainee involvement in esophageal cancer resection is associated with adverse patient outcomes. BACKGROUND:Operative experience for surgical trainees is under threat. A number of factors have been implicated in this leading to fewer hours for training. Es...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002047
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The presence and number of nodal metastasis significantly impact colon cancer prognosis. Similarly, the number of resected/evaluated nodes impacts staging accuracy. This ratio of metastatic to examined nodes or lymph node ratio (LNR) may have independent prognostic value in colon carcinoma. PURPOSE:: To eva...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ffa780
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the association between gabapentinoids on the day of surgery and adverse postoperative outcomes in patients undergoing colorectal surgery in the United States. BACKGROUND:Gabapentinoids, gabapentin and pregabalin, are recommended in multimodal analgesia protocols for ac...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003317
更新日期:2019-12-01 00:00:00
abstract::In nonfunctioning islet cell tumors of the pancreas, hormone production is not clinically evident. This type of tumor constituted 15% of all islet cell tumors seen at the Mayo Clinic from 1960 through 1978. Although identical to functioning islet cell tumors embryologically and histologically, the nonfunctioning tumor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00010
更新日期:1981-02-01 00:00:00
abstract::Fetus-in-fetu is an unusual cause of retroperitoneal abdominal mass in infants, which most likely arises from inclusion of a monozygotic, diamniotic twin. This entity is distinguished from teratoma by its embryological origin, its unusual location in the retroperitoneal space, its invariable benignity, and by the pres...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00011
更新日期:1974-07-01 00:00:00
abstract:OBJECTIVE:To directly compare the oncologic outcomes of TLPD and OPD in the setting of pancreatic ductal adenocarcinoma. BACKGROUND:Total laparoscopic pancreaticoduodenectomy (TLPD) has been demonstrated to be feasible and may have several potential advantages over open pancreaticoduodenectomy (OPD), including lower b...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000937
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:To examine the feasibility and outcomes of video-based peer feedback through social networking to facilitate robotic surgical skill acquisition. BACKGROUND:The acquisition of surgical skills may be challenging for novel techniques and/or those with prolonged learning curves. METHODS:Randomized controlled tr...
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.0000000000000756
更新日期:2015-05-01 00:00:00
abstract::Reservoir and ileostomies were performed in 54 patients between 1972 and 1975. Primary colonic pathology included chronic ulcerative colitis in 47 patients, Crohn's colitis in one, familial polyposes in 5 and Gardner's Syndrome in one. Followup is complete and varies from 6 months to three years. All but three patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197702000-00008
更新日期:1977-02-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of adjunctive IPC to standard prophylaxis of postoperative VTE in patients at extremely high-risk. SUMMARY OF BACKGROUND DATA:The standard prophylaxis for postoperative VTE is insufficient in extremely high-risk patients. It is unclear whether an adjunctive use of IPC would result in a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004556
更新日期:2020-11-12 00:00:00
abstract:OBJECTIVE:The outcome of pelvic exenteration was compared in patients with locally advanced primary (LAP) cancer and recurrent rectal cancer (RRC). BACKGROUND:There are few reports comparing the results of pelvic exenteration for primary advanced rectal cancer and RRC. METHODS:Consecutive patients undergoing pelvic e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828a0d22
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To investigate long-term outcomes of locally advanced rectal cancer (LARC) patients with postchemoradiotherapy (post-CRT) pathologic complete response of primary tumor (ypT0) and determine prognostic significance of post-CRT pathologic nodal (ypN) status. BACKGROUND:LARC patients with post-CRT pathologic com...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181f3f1b1
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:Comparison of minimal access retroperitoneal pancreatic necrosectomy (MARPN) versus open necrosectomy in the treatment of infected or nonresolving pancreatic necrosis. SUMMARY OF BACKGROUND DATA:Infected pancreatic necrosis may lead to progressive organ failure and death. Minimal access techniques have been ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181d96c53
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:The primary objective was to compare overall survival (OS) in patients with colorectal cancer (CRC) with nonresectable liver-only metastases treated by liver transplantation or chemotherapy. BACKGROUND:CRC is the third most common cancer worldwide. About 50% of patients will develop metastatic disease primar...
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.0000000000000786
更新日期:2015-05-01 00:00:00
abstract::A four year experience with the adaptation of the flexible fiberoptic endoscope to the intraoperative environment is presented in 30 patients. The technique of intraoperative endoscopy was utilized in a wide variety of difficult gastrointestinal surgical problems to include the location of the site and cause of bleedi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198006000-00004
更新日期:1980-06-01 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:OBJECTIVES:To compare the effects of intraoperative goal-directed fluid therapy (GDFT) with conventional fluid therapy, and determine whether there was a difference in outcome between studies that did and did not use Enhanced Recovery After Surgery (ERAS) protocols. METHODS:Meta-analysis of randomized controlled trial...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000001366
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:This study aimed at: (1) documenting the evolution of surgical results of esophagectomy in a high-volume center, (2) identifying predictive factors of pulmonary complications and mortality, and (3) examining whether preoperative chemoradiation therapy would complicate postoperative recovery. SUMMARY BACKGROU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000143123.24556.1c
更新日期:2004-11-01 00:00:00
abstract::The peripheral nitrogen wasting and loss of functional capacity caused by the malnutrition of disease and the immobilization of hospitalization may not be readily reversed by refeeding alone. In order to examine submaximal exercise as an adjunctive anabolic stimulus to intravenous refeeding (IVF) in depleted subjects,...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198803000-00012
更新日期:1988-03-01 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:OBJECTIVE:To compare surgical versus medical treatment of type 2 diabetes mellitus (T2DM) remission and comorbidities in patients with a body mass index (BMI) less than 35 kg/m2. BACKGROUND:Obesity surgery can achieve remission of T2DM and its comorbidities. Metabolic surgery has been proposed as a treatment option fo...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0000000000001014
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:Metabolic activity of transformed human liver (Hep G2) cells and primary rat hepatocytes were compared during in vitro application of a gel entrapment bioartificial liver. BACKGROUND:Clinical trials of bioartificial liver devices containing either transformed liver cells or primary hepatocytes have been init...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::Early aggressive therapy with maintenance infusions of methylprednisolone sodium succinate and gentamicin sulfate significantly increases the probability for survival of baboons given LD100 Escherichia coli. The present study was designed to determine if baboons would recover when initiation of treatment was delayed u...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198107000-00009
更新日期:1981-07-01 00:00:00
abstract::A retrospective analysis was made of the complications from pelvic exenterations performed over the past 30 years for colorectal adenocarcinoma at the Roswell Park Cancer Institute. Seventy-five patients underwent exenteration, 51 for primary disease (PD) and 24 for recurrent disease (RD). Both total and posterior exe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199201000-00009
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Esophageal cancer surgery carries a risk of splenic injury, which may require splenectomy, but predictors of such events remain uncertain. Moreover, the hypothesis that incidental splenectomy carries a worse prognosis deserves attention. DESIGN:A population-based, nationwide cohort study was conducted on 167...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000650
更新日期:2015-01-01 00:00:00