Indications and outcome of pelvic exenteration for locally advanced primary and recurrent rectal cancer.


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 exenteration between 2006 and 2011 were identified from a prospectively maintained database. The main endpoints were 3-year disease-free survival (DFS) and local recurrence-free survival (LRFS). RESULTS:Of 100 exenterative operations, 55 were for LAP cancer and 45 for RRC. Exenteration of 1 pelvic compartment was required in 30 cases, 2 compartments in 49 cases, and 3 of 4 compartments in 21 cases. R0, R1, and R2 resections were achieved in 78, 15, and 7 cases, respectively. R0 rates were significantly higher in LAP cancer than in RRC (91% vs 62%, P = 0.001). Three-year DFS for R0, R1, and R2 resections was 67%, 49%, and 0%, respectively (P < 0.001). For R0 resections only, DFS in LAP cancer was 76% and 57% in RRC (P = 0.212). On multivariate analysis, a positive resection margin (hazard ratio, 4.04; P < 0.001) and positive lymph node staging (hazard ratio, 2.43; P = 0.022) were significant predictors of reduced DFS. Three-year LRFS for R0 resection was 86% for LAP cancer and 84% for RRC (P = 0.817). On multivariate analysis, only a positive resection margin was a significant predictor of reduced LRFS (hazard ratio, 5.48; P = 0.002). CONCLUSIONS:Resection margin status is more important than primary or recurrent cancer in predicting long-term outcome.


Ann Surg


Annals of surgery


Bhangu A,Ali SM,Brown G,Nicholls RJ,Tekkis P




Has Abstract


2014-02-01 00:00:00












  • Functional and Cognitive Decline Among Older Adults After High-Risk Surgery.

    abstract:OBJECTIVE:The aim of this study was to determine whether older adults are at higher risk of lasting functional and cognitive decline after surgery, and the impact of decline on survival and healthcare use. SUMMARY BACKGROUND DATA:Patient-centered outcomes after surgery are poorly characterized. METHODS:Using data fro...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Suwanabol PA,Li Y,Abrahamse P,De Roo AC,Vu JV,Silveira MJ,Mody L,Dimick JB

    更新日期:2020-05-11 00:00:00

  • Hilar cholangiocarcinoma: current management.

    abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Ito F,Cho CS,Rikkers LF,Weber SM

    更新日期:2009-08-01 00:00:00

  • Prognostic significance of DNA replication errors in young patients with colorectal cancer.

    abstract:OBJECTIVE:To determine the DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. SUMMARY BACKGROUND DATA:Recent studies suggest that patients with RER-positive CRC have an improved prognosis....

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lukish JR,Muro K,DeNobile J,Katz R,Williams J,Cruess DF,Drucker W,Kirsch I,Hamilton SR

    更新日期:1998-01-01 00:00:00

  • Response of protein and urea kinetics in burn patients to different levels of protein intake.

    abstract::The effects of two levels of protein intake on protein metabolism in six severely burned adult patients were studied (means of 70% BSA burned). A crossover experimental design enabled the authors to study each patient at the end of two three-day dietary regimens. All diets were isocaloric and provided approximately 25...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Wolfe RR,Goodenough RD,Burke JF,Wolfe MH

    更新日期:1983-02-01 00:00:00

  • Intraperitoneal povidone-iodine in experimental peritonitis.

    abstract::Two experimental models were utilized to study the efficacy of intraperitoneal povidone-iodine in an established peritonitis. In both models, there was a 100% mortality in the povidone-iodine treated group. In laboratories which have reported favorable results, the animals were treated before peritonitis was allowed t...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lagarde MC,Bolton JS,Cohn I Jr

    更新日期:1978-06-01 00:00:00

  • The gastrointestinal tract. The "undrained abscess" of multiple organ failure.

    abstract:OBJECTIVE:This study determined the association between proximal gastrointestinal (GI) colonization and the development of intensive care unit (ICU)-acquired infection and multiple organ failure (MOF) in a population of critically ill surgical patients. SUMMARY BACKGROUND DATA:ICU-acquired infection in association wit...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Marshall JC,Christou NV,Meakins JL

    更新日期:1993-08-01 00:00:00

  • Simulation improves resident performance in catheter-based intervention: results of a randomized, controlled study.

    abstract:OBJECTIVES:Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. METHODS:Twenty...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Chaer RA,Derubertis BG,Lin SC,Bush HL,Karwowski JK,Birk D,Morrissey NJ,Faries PL,McKinsey JF,Kent KC

    更新日期:2006-09-01 00:00:00

  • Genetic polymorphisms and the risk of infection following esophagectomy. positive association with TNF-alpha gene -308 genotype.

    abstract:OBJECTIVE:To examine the association of single nucleotide polymorphisms (SNPs) in inflammation-related genes in the development of infections following esophagectomy. SUMMARY BACKGROUND DATA:Genetic polymorphisms for immunoregulatory cytokines may explain individual variation in response to trauma. Esophagectomy is as...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Azim K,McManus R,Brophy K,Ryan A,Kelleher D,Reynolds JV

    更新日期:2007-07-01 00:00:00

  • A multifactorial analysis of melanoma: III. Prognostic factors in melanoma patients with lymph node metastases (stage II).

    abstract::Twelve prognostic features of melanoma were examined in a series of 185 patients with nodal metastases (Stage II), who underwent surgical treatment at our institution during the past 20 years. Forty-four per cent of the patients presented with synchronous nodal metastases (substage IIA), 44% of the patients had delaye...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Balch CM,Soong SJ,Murad TM,Ingalls AL,Maddox WA

    更新日期:1981-03-01 00:00:00

  • APC and PIK3CA Mutational Cooperativity Predicts Pathologic Response and Survival in Patients Undergoing Resection for Colorectal Liver Metastases.

    abstract:OBJECTIVE:The aim of the study was to determine the prognostic impact of co-existence of APC and PIK3CA mutations in patients undergoing preoperative chemotherapy and resection for colorectal liver metastases (CLM). BACKGROUND:Co-occurring genetic events have been shown to drive carcinogenesis in multiple malignancies...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Yamashita S,Chun YS,Kopetz SE,Maru D,Conrad C,Aloia TA,Vauthey JN

    更新日期:2020-12-01 00:00:00

  • Treatment trends in early-stage invasive lobular carcinoma: a report from the National Cancer Data Base.

    abstract:OBJECTIVE:To examine treatment trends in invasive lobular carcinoma (ILC) over the last 15 years and, in particular, to compare rates of recurrence and disease-free survival associated with breast conservation therapy compared with mastectomy. SUMMARY BACKGROUND DATA:The biologic characteristics of ILC make it difficu...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Singletary SE,Patel-Parekh L,Bland KI

    更新日期:2005-08-01 00:00:00

  • Preoperative evaluation of patients for liver resection. Appropriate CT imaging.

    abstract:OBJECTIVE:The authors determined which combination of computed tomography scans is most helpful for preoperative assessment of patients with liver tumors. SUMMARY BACKGROUND DATA:Multi-institutional studies have shown that the most important prognostic factors for selection of patients with metastatic colorectal cance...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Karl RC,Morse SS,Halpert RD,Clark RA

    更新日期:1993-03-01 00:00:00

  • Does the incorporation of motion metrics into the existing FLS metrics lead to improved skill acquisition on simulators? A single blinded, randomized controlled trial.

    abstract:OBJECTIVE:We hypothesized that training to expert-derived levels of speed and motion will lead to improved learning and will translate to better operating room (OR) performance of novices than training to goals of speed or motion alone. BACKGROUND:Motion tracking has been suggested to be a more sensitive performance m...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Stefanidis D,Yonce TC,Korndorffer JR Jr,Phillips R,Coker A

    更新日期:2013-07-01 00:00:00

  • Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging.

    abstract::A method of clinical staging for infants with necrotizing enterocolitis (NEC) is proposed. On the basis of assigned stage at the time of diagnosis, 48 infants were treated with graded intervention. For Stage I infants, vigorous diagnostic and supportive measures are appropriate. Stage II infants are treated medically,...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Bell MJ,Ternberg JL,Feigin RD,Keating JP,Marshall R,Barton L,Brotherton T

    更新日期:1978-01-01 00:00:00

  • Molecules, cancer, and the surgeon. A review of molecular biology and its implications for surgical oncology.

    abstract::Interactions between molecules control intra- and intercellular physiology. Cancer is emerging as a disease in which individual molecules are either overproduced, mutated, expressed at inappropriate stages of development, or lost due to inheritance or aberrant mitotic division. The major players in this contest of cel...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Arbeit JM

    更新日期:1990-07-01 00:00:00

  • Neutrophils dysfunction during the course of intra-abdominal infection.

    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


    authors: Solomkin JS,Bauman MP,Nelson RD,Simmons RL

    更新日期:1981-07-01 00:00:00

  • First-line chemotherapy improves the resection rate and long-term survival of locally advanced (T4, any N, M0) squamous cell carcinoma of the thoracic esophagus: final report on 163 consecutive patients with 5-year follow-up.

    abstract:OBJECTIVE:The objective of this prospective, nonrandomized study was to evaluate the immediate and long-term results of first-line chemotherapy and possible surgery in locally advanced, presumably T4 squamous cell esophageal cancer. SUMMARY BACKGROUND DATA:Locally advanced esophageal cancer is rarely operable and has ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Ancona E,Ruol A,Castoro C,Chiarion-Sileni V,Merigliano S,Santi S,Bonavina L,Peracchia A

    更新日期:1997-12-01 00:00:00

  • 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-sp...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Cashin PH,Graf W,Nygren P,Mahteme H

    更新日期:2012-12-01 00:00:00

  • A randomized clinical trial of moxalactam alone versus tobramycin plus clindamycin in abdominal sepsis.

    abstract::One hundred patients with intraabdominal infections were assigned randomly in double-blind fashion to receive either the combination of tobramycin plus clindamycin (TM/C) or moxalactam (MOX) alone. Fifty patients comprised each group, but one patient in each group died of infection before 48 hours treatment. In the re...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Schentag JJ,Wels PB,Reitberg DP,Walczak P,Van Tyle JH,Lascola RJ

    更新日期:1983-07-01 00:00:00

  • Chronic respiratory symptoms and occult gastroesophageal reflux. A prospective clinical study and results of surgical therapy.

    abstract::Seventy-seven patients with a primary complaint of persistent cough, wheezing, and/or recurrent pneumonia were evaluated for the presence of occult gastroesophageal reflux disease. Fifty-four patients (70%) had increased esophageal acid exposure on 24-hour pH monitoring of the distal esophagus. In 28% of these patient...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: DeMeester TR,Bonavina L,Iascone C,Courtney JV,Skinner DB

    更新日期:1990-03-01 00:00:00

  • Cost-effectiveness of Enhanced Recovery Versus Conventional Perioperative Management for Colorectal Surgery.

    abstract:OBJECTIVE:To determine the cost-effectiveness of enhanced recovery pathways (ERPs) versus conventional care for patients undergoing elective colorectal surgery. BACKGROUND:ERPs for colorectal surgery are clinically effective, but their cost-effectiveness is unknown. METHODS:A multi-institutional prospective cohort co...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Lee L,Mata J,Ghitulescu GA,Boutros M,Charlebois P,Stein B,Liberman AS,Fried GM,Morin N,Carli F,Latimer E,Feldman LS

    更新日期:2015-12-01 00:00:00

  • Long-Term Survival After Minimally Invasive Versus Open Esophagectomy for Esophageal Cancer: A Nationwide Propensity-Score Matched Analysis.

    abstract:OBJECTIVES:This study aimed to compare long-term survival following minimally invasive esophagectomy (MIE) versus open esophagectomy (OE) for esophageal cancer using a nationwide propensity-score matched cohort. SUMMARY BACKGROUND DATA:MIE provides lower postoperative morbidity and mortality, and similar short-term on...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kalff MC,Fransen LFC,de Groot EM,Gisbertz SS,Nieuwenhuijzen GAP,Ruurda JP,Verhoeven RHA,Luyer MDP,van Hillegersberg R,van Berge Henegouwen MI,Dutch Upper Gastrointestinal Cancer Audit group.

    更新日期:2020-12-23 00:00:00

  • Comparison of four provocative tests for the diagnosis of gastrinoma.

    abstract::In an attempt to determine the best provocative test for the diagnosis of gastrinoma, ten normal subjects, 13 patients with known gastrinoma, and one patient with presumed gastrinoma were administered four regimens: (1) rapid calcium infusion (2 mg Ca++/kg/min), (2) secretin (2 clinical units (CU)/kg/bolus), (3) long ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Romanus ME,Neal JA,Dilley WG,Leight GS,Linehan WM,Santen RJ,Farndon JR,Jones RS,Wells SA Jr

    更新日期:1983-05-01 00:00:00

  • Thrombotic complications of heparin therapy: including six cases of heparin--induced skin necrosis.

    abstract::Thrombotic complications of heparin administration were observed in eight patients during a two year period. At sites of subcutaneous heparin injection, six patients developed areas of the skin and subcutaneous necrosis. Systemic thrombotic events and thrombocytopenia were observed in two of these patients when they r...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: White PW,Sadd JR,Nensel RE

    更新日期:1979-11-01 00:00:00

  • Prophylactic antibiotics in vascular surgery. Topical, systemic, or both?

    abstract::A prospective, randomized, blinded study was performed to determine whether prophylactic antibiotics would reduce the incidence of infection in peripheral vascular surgery and whether the route of antibiotic administration was important. Patients undergoing a vascular procedure with a groin incision were allocated to ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Pitt HA,Postier RG,MacGowan AW,Frank LW,Surmak AJ,Sitzman JV,Bouchier-Hayes D

    更新日期:1980-09-01 00:00:00

  • Preoperative Gemcitabine-based Chemoradiation Therapy for Borderline Resectable Pancreatic Cancer: Impact of Venous and Arterial Involvement Status on Surgical Outcome and Pattern of Recurrence.

    abstract:OBJECTIVE:To evaluate the outcome of preoperative gemcitabine-based chemoradiation therapy (CRT) for borderline resectable pancreatic cancer (BRPC), focusing on the associations among the tumor-vascular relationship, surgical outcomes, and pattern of recurrence. SUMMARY BACKGROUND DATA:Among the various multimodal tre...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Takahashi H,Akita H,Tomokuni A,Kobayashi S,Ohigashi H,Fijiwara Y,Yano M,Sakon M,Ishikawa O

    更新日期:2016-12-01 00:00:00

  • Significant contribution of the portal vein to blood flow through the common bile duct.

    abstract:OBJECTIVE:The aim of this study was to determine the contribution of the hepatic artery, gastroduodenal artery, and portal vein to the microvascular blood flow in the common bile duct (CBD). BACKGROUND:Biliary complications are a common cause of graft loss after liver transplantation. The occurrence is, partly, attrib...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Slieker JC,Farid WR,van Eijck CH,Lange JF,van Bommel J,Metselaar HJ,de Jonge J,Kazemier G

    更新日期:2012-03-01 00:00:00

  • The spectrum and natural history of common bile duct stenosis in chronic alcohol-induced pancreatitis.

    abstract::Sixty patients with chronic alcohol-induced pancreatitis with endoscopic retrograde cholangiopancreatography evidence of common bile duct stenosis were studied to determine the clinical spectrum and natural history of this complication, as well as the indications for biliary bypass. In 17% of patients, common bile duc...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kalvaria I,Bornman PC,Marks IN,Girdwood AH,Bank L,Kottler RE

    更新日期:1989-11-01 00:00:00

  • Group IIA phospholipase A2 mediates lung injury in intestinal ischemia-reperfusion.

    abstract:OBJECTIVE:To assess the mechanistic role of group IIA phospholipase A2 (PLA2) in the process of local and distant organ injury after intestinal ischemia-reperfusion. SUMMARY BACKGROUND DATA:Intestinal ischemia-reperfusion produces lung injury by a mechanism that involves PLA2 activation, but it is unclear which isozym...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Koike K,Yamamoto Y,Hori Y,Ono T

    更新日期:2000-07-01 00:00:00

  • Impairment of pulmonary macrophage function with total parenteral nutrition.

    abstract:OBJECTIVE:The effects of total parenteral nutrition (TPN) administration on pulmonary macrophage function and host response to gram-negative pulmonary infection were evaluated. SUMMARY BACKGROUND DATA:Administration of TPN resulted in increased infectious complications in traumatized and perioperative patients, but un...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Shou J,Lappin J,Daly JM

    更新日期:1994-03-01 00:00:00