Abstract:
OBJECTIVES:The American Joint Committee on Cancer (AJCC) staging system for gastric cancer bases N status on absolute number of metastatic nodes, regardless of the number of examined nodes. We examined a modified staging system utilizing node ratio (Nr), the ratio of metastatic to examined nodes. METHODS:A total of 18,043 gastric cancer patients who underwent gastrectomy were identified from the US Surveillance, Epidemiology, and End Results (SEER) database. A training set was divided into 5 Nr groups, and a TNrM staging system was constructed. Median survival and overall survival, based on 7th edition AJCC and TNrM staging systems, were compared, and the analysis was repeated in a validation set. RESULTS:Median examined nodes were 10 to 11. For the training set, overall survival for all 5 AJCC N categories was significantly different when subgrouped into 15 or fewer versus more than 15 examined nodes, but overall survival was similar regardless of the number of examined nodes in 4 of 5 Nr categories. Seven AJCC stages had statistically different overall survival between subgroups, whereas only 1 TNrM stage had statistically different overall survival between subgroups. When misclassification was defined as any subgroup in which median survival fell outside the 95% confidence interval of the group's overall median survival, AJCC staging misclassified 57% of patients and TNrM staging misclassified only 12%. Similar results were found in the validation set. CONCLUSIONS:The AJCC system classifies SEER gastric cancer patients into stages in which subgroups often have wide variations in survival. For patients undergoing limited lymph node analysis, the proposed TNrM system may predict survival more accurately.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Wang J,Dang P,Raut CP,Pandalai PK,Maduekwe UN,Rattner DW,Lauwers GY,Yoon SSdoi
10.1097/SLA.0b013e31824857e2subject
Has Abstractpub_date
2012-03-01 00:00:00pages
478-85issue
3eissn
0003-4932issn
1528-1140journal_volume
255pub_type
杂志文章abstract:BACKGROUND/OBJECTIVE:The National Surgical Quality Improvement Program (NSQIP) has demonstrated quality improvement in the VA and pilot study of 14 academic institutions. The objective was to show that American College of Surgeons (ACS)-NSQIP helps all enrolled hospitals. METHODS:ACS-NSQIP data was used to evaluate im...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b4148f
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To compare surgical safety and efficiency of 2 image guidance modalities, perfect augmented reality (AR) and side-by-side unregistered image guidance (IG), against a no guidance control (NG), when performing a simulated laparoscopic cholecystectomy (LC). BACKGROUND:Image guidance using AR offers the potentia...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002793
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic significance of histologic type/subtype in a large series of patients with primary resected retroperitoneal sarcoma. BACKGROUND:The histologic diversity and rarity of retroperitoneal sarcoma has hampered the ability to predict patient outcome. METHODS:From a single-institution, p...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001149
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:To assess relative clinical and economic performance of the revised American Thyroid Association (ATA) thyroid cancer guidelines compared to current standard of care. BACKGROUND:Diagnosis of thyroid cancer in the United States has tripled whereas mortality has only marginally increased. Most patients present...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003074
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To develop a prediction model for clinical outcomes after unilateral adrenalectomy for unilateral primary aldosteronism. SUMMARY BACKGROUND DATA:Unilateral primary aldosteronism is the most common surgically curable form of endocrine hypertension. Surgical resection of the dominant overactive adrenal in unil...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003200
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To assess and report on surgeons' ability to identify and manage incidences of harassment. BACKGROUND:The Royal Australasian College of Surgeons is committed to driving out discrimination, bullying, harassment, and sexual harassment from surgical training and practice, through changing the culture of the wor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002434
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:To develop a risk prediction model for serious complications after bariatric surgery. BACKGROUND:Despite evidence for improved safety with bariatric surgery, serious complications remain a concern for patients, providers and payers. There is little population-level data on which risk factors can be used to ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318230058c
更新日期:2011-10-01 00:00:00
abstract::Two hundred thirty-four patients with extensive ulcerative colitis from the city of Göteborg, Sweden have been followed up and the cumulative risk of development of cancer of the large bowel was estimated. These patients constitute all persons in this region who developed an extensive ulcerative colitis between 1951 a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197812000-00018
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVE:There were 2 objectives: first, to investigate how many patients were excluded from surgery on the basis of the radiological extent of the peritoneal carcinomatosis (PC) or the clinical examination; and second, to develop a score based primarily on serum tumor markers (STMs) that could predict short cancer-sp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318254f281
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To investigate the workup/treatment provided to pregnant motor vehicle accident (MVA) casualties in a mature trauma system. Adherence to recommendations was used to measure quality of care. BACKGROUND:MVAs affect approximately 3% of pregnant women. Trauma casualty outcome improves after implementation of gui...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822638d4
更新日期:2011-08-01 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:The authors analyzed patient care (1981-1995) and financial data (1991-1996) to determine if differential workloads existed at a major academic health center. SUMMARY BACKGROUND DATA:Academic health centers differ markedly from community-based medical centers, but they are required to compete with others who...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199709000-00013
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To determine the incidence of Wnt pathway activation in patients with stage I NSCLC and its influence on lung cancer recurrence. BACKGROUND:Despite resection, the 5-year recurrence with localized stage I nonsmall cell lung cancer (NSCLC) is 18.4%-24%. Aberrant Wnt signaling activation plays an important role...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826d81fd
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To compare single-layered hand-sewn cervical end-to-side (ETS) anastomosis with end-to-end (ETE) anastomosis in a prospective randomized fashion. BACKGROUND:The preferred organ used for reconstruction after esophagectomy for cancer is the stomach. Previous studies attempted to define the optimal site of anas...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31822676a9
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that the avoidance of preoperative fasting by hypocaloric nutrition attenuates protein catabolism after surgery. SUMMARY BACKGROUND DATA:Prolonged fasting before major abdominal procedures has been demonstrated to accentuate the catabolic response to surgery. METHODS:Twenty-two pati...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31818842d8
更新日期:2008-12-01 00:00:00
abstract::One hundred fifty-five adult patients with "operable" soft part sarcomas including rhabdomyosarcoma, liposarcoma, leiomyosarcoma and fibrosarcoma of the trunk and extremities are reviewed. Local recurrences of 93% and 60% occurred after local and wide excisions of the primary tumor. In this series of patients, amputat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197506000-00007
更新日期:1975-06-01 00:00:00
abstract:OBJECTIVE:This prospective observational study was designed to assess Pediatric Quality of Life (PedsQL) after surgical treatment for congenital diaphragmatic hernia (CDH), esophageal atresia/tracheoesophageal fistula (EA/TEF), Hirschsprung disease (HD), gastroschisis (GAS), omphalocele (OMP), and necrotizing enterocol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002918
更新日期:2018-09-01 00:00:00
abstract::This study explores whether fetal allograft survival is age dependent and organ specific. Fetal rat tissue (renal, gonadal, hepatic) from the third trimester of gestation (days 15-21) was transplanted into 306 outbred adult rats for 10-30 days. Grafts were studied by morphometric and histologic analysis. Ten days afte...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198610000-00008
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the minimum amount of weight loss required to see a reduction in major adverse cardiovascular events (MACE). BACKGROUND:Although obesity is an established risk factor for morbidity and mortality, the minimum amount of weight loss to have a meaningful impact on cardiovas...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004369
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the reduction in the incidence of parastomal hernia (PH) after placement of prophylactic synthetic mesh using a modified Sugarbaker technique when a permanent end-colostomy is needed. SUMMARY OF BACKGROUND DATA:Prevention of PH formation is crucial given the high prevalenc...
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.0000000000001684
更新日期:2016-12-01 00:00:00
abstract::In a study of wound healing at high altitude, subcutaneously implanted PTFE tubes were used to stimulate and measure accumulation of wound hydroxyproline (an index of collagen) in 26 patients who had appendectomy and in 38 patients who had cholecystectomy. Patient age, length of surgery, and postoperative recovery see...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198703000-00006
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the psychosocial outcomes and body image of patients 2 years postmastectomy reconstruction using a multicenter, multisurgeon approach. BACKGROUND:Although breast reconstruction has been shown to confer significant psychosocial benefits in breast cancer patients at year 1 postreconst...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3181728a5c
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). SUMMARY BACKGROUND DATA:Multiple patient relocations during MCIs may contribute to chaos. One hospital changed its MCI patient relocation policy during a wave of M...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819a6f17
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. BACKGROUND:Training on VR simulators has been shown to improve technical performance in the operating room (OR). Current...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000254
更新日期:2014-03-01 00:00:00
abstract::Over the past 27 years cavernous hemangioma of the liver has been diagnosed in 12 nonoperated patients and in 16 patients who had resection of the lesion at Strong Memorial Hospital. In almost all patients the diagnosis was suggested by an imaging procedure. In the 12 nonoperated patients the average size of the tumor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00003
更新日期:1987-05-01 00:00:00
abstract::Four hundred twenty-six patients with esophageal atresia with or without tracheoesophageal fistula have been primarily cared for at the University of Michigan Medical Center since Cameron Haight's initial experience with this entity. Over the period of observation, the incidence of new cases as well as the number of a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198610000-00013
更新日期:1986-10-01 00:00:00
abstract::A major surgical procedure can impair the delayed hypersensitivity response. This impairment is associated with suppressor cell activity that can alter either afferent or efferent responses. Using the third party mixed leukocyte culture to define cell types involved, major immune impairment was seen with the combinati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00010
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:The efficacy of irrigating the peritoneal cavity during appendectomy for perforated appendicitis has been debated extensively. To date, prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing peritoneal irrigation to suction alone during laparoscopic append...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31826a91e5
更新日期:2012-10-01 00:00:00
abstract::A series of patients showing a previously unrecognized type of sliding hiatus hernia is presented and analyzed. This type of hernia is characterized by reflux of the mucous membrane of the Hiss angle into the lumen of the esophagus. The occurrence of mucosal prolapse is a secondary phase of gastroesophageal reflux. Th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198508000-00004
更新日期:1985-08-01 00:00:00
abstract::The etiology of hepatic insufficiency associated with the multiple systems organ failure (MSOF) syndrome is unclear. The authors have investigated the possibility that a macrophage/Kupffer cell mediated modulation of hepatocyte function may play a role in this phenomenon. Isolated rat hepatocytes were cultured, and th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00