Patient selection for cytoreductive surgery in colorectal peritoneal carcinomatosis using serum tumor markers: an observational cohort study.

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-specific survival (<12 months). BACKGROUND:Patient selection and prediction of prognosis is crucial for successful treatment of colorectal PC. METHODS:All patients with colorectal PC referred for cytoreductive surgery and intraperitoneal chemotherapy (2005-2008) at Uppsala University hospital were included. Patients were divided into 2 groups-nonsurgery and surgery. Clinicopathological and laboratory parameters were collected in the surgery group. A Corep (COloREctal-Pc) score was developed using hazard ratios from histology, hematological status, serial serum tumor markers (STMs), and STM changes over time. Sensitivity, specificity, positive predicted value (PPV), and negative predicted value (NPV) were calculated in a second validating dataset (n = 24) with a survival cutoff of less than 12 months. RESULTS:A total of 107 patients were included in the study, 42 in the nonsurgery group and 65 in the surgery group. In the nonsurgery group, 2 patients were excluded solely on the basis of the radiological extent of PC and 7 patients on clinical examination. The Corep score ranged from 0 to 18. A score of 6 or more showed a validated sensitivity of 80%, specificity 100%, PPV 1.0, and NPV 0.93. CONCLUSIONS:Radiological extent of PC was not a main deciding factor for treatment decisions and had less impact than the clinical examination. The Corep score identified patients with short cancer-specific survival that may not be suitable for treatment.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Cashin PH,Graf W,Nygren P,Mahteme H

doi

10.1097/SLA.0b013e318254f281

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

1078-83

issue

6

eissn

0003-4932

issn

1528-1140

journal_volume

256

pub_type

杂志文章
  • The role of vascular laboratory criteria in the selection of patients for lower extremity amputation.

    abstract::We evaluated clinical and vascular laboratory data on 126 patients with below-knee or forefoot amputation. Vascular laboratory examination included Doppler systolic blood pressure and arterial wave form analysis using the segmental plethysmograph. Fifty-four patients had below-knee amputation. A calf systolic pressure...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198204000-00014

    authors: Nicholas GG,Myers JL,DeMuth WE Jr

    更新日期:1982-04-01 00:00:00

  • Impact of a clinical pathway for elective infrarenal aortic reconstructions.

    abstract:OBJECTIVE:To determine the impact of a clinical pathway for elective infrarenal aortic reconstruction on outcome, resource utilization, and cost in a university medical center. SUMMARY BACKGROUND DATA:Clinical pathways have been reported to control costs, reduce resource utilization, and maintain or improve the qualit...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199805000-00009

    authors: Huber TS,Carlton LM,Harward TR,Russin MM,Phillips PT,Nalli BJ,Flynn TC,Seeger JM

    更新日期:1998-05-01 00:00:00

  • Changing paradigm in the management of hepatocellular carcinoma improves the survival benefit of early detection by screening.

    abstract:OBJECTIVE:To evaluate the impact of improved surgical management of hepatocellular carcinoma (HCC) on the survival of patients with screened HCC. SUMMARY BACKGROUND DATA:It is unclear whether the advent of new treatment modalities such as liver transplantation and radiofrequency ablation (RFA) in recent years have imp...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31816a747a

    authors: Chan AC,Poon RT,Ng KK,Lo CM,Fan ST,Wong J

    更新日期:2008-04-01 00:00:00

  • Frailty as a Predictor of Death or New Disability After Surgery: A Prospective Cohort Study.

    abstract:OBJECTIVE:To compare the accuracy of the modified Fried Index (mFI) and the Clinical Frailty Scale (CFS) to predict death or patient-reported new disability 90 days after major elective surgery. BACKGROUND:The association of frailty with patient-reported outcomes, and comparisons between preoperative frailty instrumen...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002967

    authors: McIsaac DI,Taljaard M,Bryson GL,Beaulé PE,Gagné S,Hamilton G,Hladkowicz E,Huang A,Joanisse JA,Lavallée LT,MacDonald D,Moloo H,Thavorn K,van Walraven C,Yang H,Forster AJ

    更新日期:2020-02-01 00:00:00

  • The impact of gastric distension on the lower esophageal sphincter and its exposure to acid gastric juice.

    abstract:BACKGROUND AND AIMS:The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low resting pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdominal portion of the LES...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181e3e411

    authors: Ayazi S,Tamhankar A,DeMeester SR,Zehetner J,Wu C,Lipham JC,Hagen JA,DeMeester TR

    更新日期:2010-07-01 00:00:00

  • Thoracoscopic surgery for diseases of the lung and pleura. Effectiveness, changing indications, and limitations.

    abstract:OBJECTIVE:This study compared the results of video-assisted thoracic surgery (VATS) with thoracoscopic surgery (TS) for diseases of the lung and pleura. SUMMARY BACKGROUND DATA:No studies exist that compare the capabilities of VATS with advanced video systems and instrumentation to that of TS which has been done for 8...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199305010-00018

    authors: Daniel TM,Kern JA,Tribble CG,Kron IL,Spotnitz WB,Rodgers BM

    更新日期:1993-05-01 00:00:00

  • Ultrasound-guided radiofrequency-assisted segmental liver resection: a new technique.

    abstract::Segmental hepatectomy is appealing for several reasons including preservation of liver parenchyma, reduction of intraoperative blood loss, and blood replacement by dividing tissues along the anatomic planes. A simple technique guided by intraoperative ultrasound is described here using radio-frequency energy to create...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181b0c38a

    authors: Curro G,Bartolotta M,Barbera A,Jiao L,Habib N,Navarra G

    更新日期:2009-08-01 00:00:00

  • Hyperparathyroidism associated with the enlargement of two or three parathyroid glands.

    abstract::Eighty-five (23%) of 375 patients undergoing surgery for primary hyperparathyroidism were found to have enlargement (greater than 50 mg) of two or three parathyroid glands. Of 76 patients followed from 12 to 140 months after surgery, eight (10.5%) developed hypercalcemia at 1, 4, 45, 64, 74, 79, 84, and 133 months. In...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198511000-00001

    authors: Wells SA Jr,Leight GS,Hensley M,Dilley WG

    更新日期:1985-11-01 00:00:00

  • What Promotes Surgeon Practice Change? A Scoping Review of Innovation Adoption in Surgical Practice.

    abstract:OBJECTIVE:The goal of this scoping review was to summarize the literature on facilitators and barriers to surgical practice change. This information can inform research to implement best practices and evaluate new surgical innovations. BACKGROUND:In an era of accelerated innovations, surgeons face the difficult decisi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004355

    authors: Arroyo NA,Gessert T,Hitchcock M,Tao M,Smith CD,Greenberg C,Fernandes-Taylor S,Francis DO

    更新日期:2020-08-26 00:00:00

  • Subareolar versus peritumoral injection for location of the sentinel lymph node.

    abstract:BACKGROUND:Sentinel lymph node (SLN) biopsy is fast becoming the standard for testing lymph node involvement in many institutions. However, questions remain as to the best method of injection. The authors hypothesized that a subareolar injection of material would drain to the same lymph node as a peritumoral injection,...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000658-199906000-00013

    authors: Klimberg VS,Rubio IT,Henry R,Cowan C,Colvert M,Korourian S

    更新日期:1999-06-01 00:00:00

  • Comparison of randomized controlled trial registry entries and content of reports in surgery journals.

    abstract:OBJECTIVE:To evaluate discrepancies between trial registry entries and final reports of randomized controlled trials (RCTs) published in major general surgical journals. BACKGROUND:Health care decisions are based on published results in peer-reviewed journals. Mandatory trial registration was introduced to increase tr...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318283cf7f

    authors: Rosenthal R,Dwan K

    更新日期:2013-06-01 00:00:00

  • Variation in practice and resource utilization associated with the diagnosis and management of appendicitis at freestanding children's hospitals: implications for value-based comparative analysis.

    abstract:OBJECTIVE:To characterize the scope and magnitude of practice variation associated with the diagnosis and treatment of appendicitis at freestanding children's hospitals. BACKGROUND:Variation in care has been associated with poor outcomes and is believed to be a key driver of excess health care spending. METHODS:Retro...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000246

    authors: Rice-Townsend S,Barnes JN,Hall M,Baxter JL,Rangel SJ

    更新日期:2014-06-01 00:00:00

  • Sciatic and Femoral Nerve Resection During Extended Radical Surgery for Advanced Pelvic Tumours: Long-term Survival, Functional, and Quality-of-life Outcomes.

    abstract:OBJECTIVE:To report survival, functional, and quality-of-life (QoL) outcomes after extended radical resection for advanced pelvic tumors with en bloc sciatic or femoral nerve resection. BACKGROUND:Advanced pelvic tumors involving the sciatic or femoral nerve have traditionally been considered inoperable. Small studies...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003390

    authors: Brown KGM,Solomon MJ,Lau YC,Steffens D,Austin KKS,Lee PJ

    更新日期:2019-06-07 00:00:00

  • Can Laparoscopic Cholecystectomy Prevent Recurrent Idiopathic Acute Pancreatitis?: A Prospective Randomized Multicenter Trial.

    abstract:OBJECTIVE:The aim of the present trial was to ascertain whether laparoscopic cholecystectomy (LCC) can prevent recurrent attacks of idiopathic acute pancreatitis (IAP). SUMMARY:Up to 50% to 75% of IAP may be due to microlithiasis, which is undetectable by conventional imaging methods. METHODS:This randomized, prospec...

    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.0000000000001469

    authors: Räty S,Pulkkinen J,Nordback I,Sand J,Victorzon M,Grönroos J,Helminen H,Kuusanmäki P,Nordström P,Paajanen H

    更新日期:2015-11-01 00:00:00

  • A Comparative Analysis of Survival and Funding Discrepancies in Cancers With High Mortality.

    abstract:OBJECTIVE:Comparative analyses of survival and funding statistics in cancers with high mortality were performed to quantify discrepancies and identify areas for intervention. BACKGROUND:Discrepancies in research funding may contribute to stagnant survival rates in pancreatic ductal adenocarcinoma (PDAC). METHODS:The ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003042

    authors: Hall BR,Cannon A,Atri P,Wichman CS,Smith LM,Kumar S,Batra SK,Wang H,Ganti AK,Sasson AR,Are C

    更新日期:2020-02-01 00:00:00

  • Thromboresistant surface coatings for the measurement of cardiac output through continuous low flow peripheral A-V shunts.

    abstract::The dilution technique for determining cardiac output using indocyanine green dye is limited in patients weighing less than 20 kg because of the obligatory volume loss. Reproducible achieved using the green dye dilution method by the establishment of a low flow peripheral arteriovenous shunt. The shunt materials were ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198001000-00020

    authors: Deeb GM,Borovetz HS,Griffith BP,Hardesty RL

    更新日期:1980-01-01 00:00:00

  • Prognostic value of preoperative clinical staging assessed by computed tomography in resectable gastric cancer patients: a viewpoint in the era of preoperative treatment.

    abstract:BACKGROUND:In the era of pre- or perioperative therapy for gastric cancer, clinical staging before treatment appears to be increasingly important for prognosis, yet there are no data on the subject for resectable gastric cancer patients. OBJECTIVES:To evaluate the prognostic role of preoperative locoregional staging i...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181ca69a7

    authors: Park SR,Kim MJ,Ryu KW,Lee JH,Lee JS,Nam BH,Choi IJ,Kim YW

    更新日期:2010-03-01 00:00:00

  • Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study).

    abstract:OBJECTIVE:To investigate which perioperative treatment, ie, laparoscopic or open surgery combined with fast track (FT) or standard care, is the optimal approach for patients undergoing segmental resection for colon cancer. SUMMARY BACKGROUND DATA:Important developments in elective colorectal surgery are the introducti...

    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.0b013e31821fd1ce

    authors: Vlug MS,Wind J,Hollmann MW,Ubbink DT,Cense HA,Engel AF,Gerhards MF,van Wagensveld BA,van der Zaag ES,van Geloven AA,Sprangers MA,Cuesta MA,Bemelman WA,LAFA study group.

    更新日期:2011-12-01 00:00:00

  • Institutional and individual learning curves for focused abdominal ultrasound for trauma: cumulative sum analysis.

    abstract:OBJECTIVE:To evaluate both institutional and individual learning curves with focused abdominal ultrasound for trauma (FAST) by analyzing the incidence of diagnostic inaccuracies as a function of examiner experience for a group of trauma surgeons performing the study in the setting of an urban level I trauma center. SU...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200005000-00009

    authors: McCarter FD,Luchette FA,Molloy M,Hurst JM,Davis K Jr,Johannigman JA,Frame SB,Fischer JE

    更新日期:2000-05-01 00:00:00

  • Reduction in alternative complement pathway mediated C3 conversion following burn injury.

    abstract::Studies were performed to further investigate an abnormality of the alternative complement pathway associated with burn injury. C3 conversion by inulin and cobra venom factor was measured in serial serum samples from 18 burned patients and in the sera from 25 normal controls. C3 conversion by both activating substance...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198108000-00018

    authors: Bjornson AB,Bjornson HS,Altemeier WA

    更新日期:1981-08-01 00:00:00

  • Histologic Subtype Defines the Risk and Kinetics of Recurrence and Death for Primary Extremity/Truncal Liposarcoma.

    abstract:OBJECTIVE:We sought to define the prognostic significance of histologic subtype for extremity/truncal liposarcoma (LPS). BACKGROUND:LPS, the most common sarcoma, is comprised of 5 histologic subtypes. Despite their distinct behaviors, LPS outcomes are frequently reported as a single entity. METHODS:We analyzed data o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003453

    authors: Bartlett EK,Curtin CE,Seier K,Qin LX,Hameed M,Yoon SS,Crago AM,Brennan MF,Singer S

    更新日期:2019-07-05 00:00:00

  • Appraisal of laparoscopic cholecystectomy.

    abstract::This paper reports the experience of three general surgeons performing 304 laparoscopic cholecystectomies in three private hospitals between October 1989 and November 1990. Laparoscopic cholecystectomy boasts two major advantages over the conventional procedure: the remarkable reduction in postoperative pain and econo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199106000-00017

    authors: Graves HA Jr,Ballinger JF,Anderson WJ

    更新日期:1991-06-01 00:00:00

  • Prophylactic and preventive antibiotic therapy: timing, duration and economics.

    abstract::Previous studies have demonstrated that administered antibiotics must be active against major anticipated pathogens and must have reached sufficient concentrations in the tissue or body fluid at risk by the time of bacterial challenge if prophylactic therapy is to be maximally effective in reducing the infection rate ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-197906000-00004

    authors: Stone HH,Haney BB,Kolb LD,Geheber CE,Hooper CA

    更新日期:1979-06-01 00:00:00

  • Carcinoid syndrome from gastrointestinal carcinoids without liver metastasis.

    abstract::Although patients with bronchial and ovarian carcinoid tumors can develop the carcinoid syndrome (diarrhea and/or flushing) in the absence of hepatic metastasis, it is believed that development of the carcinoid syndrome in patients with carcinoid tumors of gastrointestinal origin occurs only after the patient has hepa...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198207000-00008

    authors: Feldman JM,Jones RS

    更新日期:1982-07-01 00:00:00

  • Long-term Results of a Randomized Double-blinded Prospective Trial of a Lightweight (Ultrapro) Versus a Heavyweight Mesh (Prolene) in Laparoscopic Total Extraperitoneal Inguinal Hernia Repair (TULP-trial).

    abstract:OBJECTIVE:The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair. BACKGROUND:Lightweight meshes reduce postoperative pain and stiffness in open anterior ingu...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000001579

    authors: Burgmans JP,Voorbrood CE,Simmermacher RK,Schouten N,Smakman N,Clevers G,Davids PH,Verleisdonk EM,Hamaker ME,Lange JF,van Dalen T

    更新日期:2016-05-01 00:00:00

  • The influence of a brief preoperative illness on postoperative healing.

    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

    authors: Goodson WH 3rd,Lopez-Sarmiento A,Jensen JA,West J,Granja-Mena L,Chavez-Estrella J

    更新日期:1987-03-01 00:00:00

  • An in vitro evaluation of the stability of mechanical properties of surgical suture materials in various pH conditions.

    abstract::The effects of pH on the tensile properties of eight commonly used 2-0 suture materials--plain catgut, Dexon, Vicryl, silk, Nurolon, Ethilon, Mersilene, and Prolene--were examined. The pH level ranged from 3.0 to 10.0. In general, absorbable suture materials were more sensitive to pH than non-absorbable suture materia...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198308000-00019

    authors: Chu CC,Moncrief G

    更新日期:1983-08-01 00:00:00

  • Effect of postdischarge morbidity and mortality on comparisons of hospital surgical quality.

    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

    authors: Bilimoria KY,Cohen ME,Ingraham AM,Bentrem DJ,Richards K,Hall BL,Ko CY

    更新日期:2010-07-01 00:00:00

  • Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan Breast Reconstruction Outcomes Study.

    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

    authors: Atisha D,Alderman AK,Lowery JC,Kuhn LE,Davis J,Wilkins EG

    更新日期:2008-06-01 00:00:00

  • Low degree of formal education and musical experience predict degree of music-induced stress reduction in relatives and friends of patients: a single-center, randomized controlled trial.

    abstract:OBJECTIVE:To determine the factors that may predict music-induced relaxation in friends and family of patients in the emergency department. BACKGROUND:It remains unclear to date which demographic and experiential factors predict the effectiveness of music-induced relaxation. Furthermore, in-hospital stressors for frie...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e31828ee1da

    authors: Tilt AC,Werner PD,Brown DF,Alam HB,Warshaw AL,Parry BA,Jazbar B,Booker A,Stangenberg L,Fricchione GL,Benson H,Lillemoe KD,Conrad C

    更新日期:2013-05-01 00:00:00