Abstract:
OBJECTIVE:The current pathological lymph node (pN) staging is based on the number of positive lymph nodes but does not take into consideration characteristics of the involved lymph nodes itself. The current study aims to examine the prognostic value of extracapsular lymph node involvement (EC-LNI) and intracapsular lymph node involvement (IC-LNI) for esophageal adenocarcinoma treated by primary surgery. METHODS:From the databases of five European high volume centers, 1639 adenocarcinoma patients with primary R0-resection were withheld after excluding 90-day mortality. Oncologic variables, including number of resected lymph nodes, number of resected positive lymph nodes, and EC-LNI/IC-LNI were examined. The Union Internationale contre le Cancer (UICC) 7th edition prognostic staging was used as baseline staging system. Statistical analysis was performed by Cox proportional hazards modeling and verified using the Random Survival Forest technique. RESULTS:EC-LNI showed significantly worse overall 5-year survival compared with IC-LNI overall (13.4% vs 37.2%, P < 0.0001), including in each pN-category [16.4% vs 45.6% in pN1 (P < 0.0001), 16.1% vs 23.8% (P = 0.047) in pN2 (P = 0.065), and 8.7% vs 26.3% in pN3 categories, respectively]. pN1 IC-LNI patients show a 5-year overall survival comparable (P = 0.92) with stage IIB (ie, pT3N0). Reclassifying the UICC prognostic stages according to these findings into an adapted staging model showed a significant (P < 0.0001) increase in homogeneity, discriminatory ability, and monotonicity compared with the original UICC TNM 7th edition prognostic staging. CONCLUSIONS:These data suggest that lymph node capsular status is an important prognostic factor and should be considered for the future edition of the TNM staging system for esophageal cancer.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Nafteux PR,Lerut AM,Moons J,Hölscher AH,Bollschweiler E,van Berge Henegouwen MI,Lagarde SM,van Lanschot JJ,Messager M,Mariette C,D'Journo XB,Thomas PA,De Leyn PRdoi
10.1097/SLA.0000000000001463subject
Has Abstractpub_date
2015-11-01 00:00:00pages
809-15; discussion 815-6issue
5eissn
0003-4932issn
1528-1140pii
00000658-201511000-00016journal_volume
262pub_type
杂志文章,多中心研究,随机对照试验abstract::In an effort to minimize the nutritional complications that follow resection of the pancreas for severe chronic pancreatitis, the authors have performed a duodenum-preserving total pancreatectomy in eight patients for severe unremitting pain requiring large doses of opiate analgesia. Good relief of pain was obtained i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199111000-00007
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of debriefing and feedback on intraoperative nontechnical performance as an instructional strategy in surgical training. BACKGROUND:Regulatory authorities for accreditation in North America have included nontechnical skills such as communication and teamwork in the competencies ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000001297
更新日期:2016-05-01 00:00:00
abstract::After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197501000-00025
更新日期:1975-01-01 00:00:00
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
doi:10.1097/00000658-198305000-00015
更新日期:1983-05-01 00:00:00
abstract::Circular, full-thickness dermal burn- and freeze-produced wounds were produced in rats to compare the difference in healing between the two types of thermal injuries. Contraction did not occur in wounds (n = 30) caused by freezing, while burn wounds (n = 30) contracted to less than one-third of original size by 21 day...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198002000-00019
更新日期:1980-02-01 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::Controversy continues concerning the advisability of routine shunting, no shunting, or selective shunting during carotid endarterectomy. Because of its reflection of the physiologic state of the end organ, the authors chose routine 18 lead EEG monitoring as a guide to selective shunting and as an indication of adequat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198306000-00009
更新日期:1983-06-01 00:00:00
abstract::Closed suction drainage has been used to prevent seroma formation after lumpectomy and axillary node dissection for breast cancer. To study the efficacy of closed suction drains, the authors conducted a prospective randomized study from 1987 to 1990 of 227 axillary dissections. One hundred eight were randomized to a d...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199202000-00009
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. BACKGROUND:Pathological LN status is a major disease prognostic factor and marker...
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.0000000000000991
更新日期:2015-05-01 00:00:00
abstract::Staging laparotomy (multiple liver and lymph node biopsies and splenectomy) was performed at the North Carolina Baptist Hospital in 123 patients with Hodgkin's disease. There were no deaths. Wound, pulmonary, intra-abdominal or urinary tract complications developed in 17 patients. Of those complications, one case each...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198005000-00008
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVE:To understand whether racial disparities in surgery for lower-extremity arterial disease are minimized by high-quality providers, or instead, differential treatment of otherwise similar patients pervades all settings. SUMMARY BACKGROUND DATA:Black patients are substantially more likely than whites to undergo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b41d53
更新日期:2009-09-01 00:00:00
abstract::Metabolic changes in six severely affected tetanus patients suffering from characteristic labile hypertension (maximum systolic blood pressure greater than 200 mmHG, maximum diurnal change in systolic pressure greater than 100 mmHg) were investigated. Daily urinary excretion of urea nitrogen increased gradually from t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199101000-00011
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To find out how women with breast or ovarian cancer rate their chances of carrying hereditary factors for these cancers and to determine the extent to which they overestimate their risk. SUMMARY BACKGROUND DATA:BRCA1 and BRCA2 are genes that cause breast and ovarian cancer when they are inherited in families...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199809000-00010
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To determine whether increasing distance between helicopter ambulance airbase and either home residence or referring facility is associated with an increased risk of injury-related mortality. BACKGROUND:A dramatic increase in the absolute number and utilization of Helicopter Emergency Medical Services transp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31827ee6b0
更新日期:2013-06-01 00:00:00
abstract::Total hemolytic complement (CH50), conversion of C3 by inulin and cobra venom factor (CoVF), and immunochemical levels of Clq, C4, C2, C3, C5, factor B, properdin, C3b inactivator (KAF), and immunoglobulins (Igs) G, A, and M were measured in the sera of ten patients with abdominal trauma and ten medical patients with ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00017
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia. BACKGROUND:Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002278
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA:Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-te...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199904000-00016
更新日期:1999-04-01 00:00:00
abstract::Introduction of the automatic implantable cardioverter defibrillator (AICD) has dramatically affected the surgical treatment of malignant ventricular tachyarrhythmias. The authors continue to perform electrophysiologically directed subendocardial resection (SER) of left ventricular (LV) scars in selected patients, and...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199209000-00010
更新日期:1992-09-01 00:00:00
abstract::As a result of this retrospective analysis of hemorrhage from a porta-systemic venous shunt occurring within the small intestine, we believe that the early diagnosis of the syndrome is strongly suggested by the presence of varices in unusual locations demonstrated by the venous phase of mesenteric arteriography. In al...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197601000-00005
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To compare the modified Rossetti fundoplication with the classic Nissen. SUMMARY BACKGROUND DATA:The traditional surgical treatment of gastroesophageal reflux in children has been the classic Nissen fundoplication, defined by liver mobilization, crural repair, takedown of short gastric vessels, and floppy wr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199906000-00003
更新日期:1999-06-01 00:00:00
abstract::This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198512000-00004
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:The aim of this prospective study was to determine incidence, duration, and risk factors for postoperative delirium (PD) in elderly patients undergoing major abdominal surgery. SUMMARY BACKGROUND DATA:The incidence and risk factors of PD after major abdominal surgery in elderly patients are not well document...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c1cfc9
更新日期:2010-04-01 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:OBJECTIVE:Our aim was to evaluate recurrence patterns of surgically resected PDAC patients with negative (pN0) or positive (pN1) lymph nodes. SUMMARY BACKGROUND DATA:Pancreatic ductal adenocarcinoma (PDAC) is predicted to become the second leading cause of cancer death by 2030. This is mostly due to early local and di...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003123
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. BACKGROUND:Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001979
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To study the incidence of gastroesophageal reflux (GER)related complications after correction of esophageal atresia (EA). SUMMARY BACKGROUND DATA:The association of EA and GER in children is well known. However, little is known about the prevalence of GER and its potential complications in adults who have un...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000094303.07910.05
更新日期:2003-11-01 00:00:00
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
更新日期:1998-05-01 00:00:00
abstract::In construction of the eosphagojejunostomy after total gastrectomy, the EEA stapled (US Surgical Corporation, Norwalk, CT) and the two-layer interrupted 3-0 Dexon anastomoses are compared concerning the radiological appearance, breaking strength, circulation, and collagen concentration. Thirty female pigs were used. A...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198604000-00017
更新日期:1986-04-01 00:00:00
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
更新日期:2010-07-01 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