Abstract:
BACKGROUND:The Masaoka-Koga classification describes the extent and spread of thymic epithelial malignancies. The objective of this study was to evaluate the Masaoka-Koga and the new TNM-staging system regarding differences in stage distributions, clinical implementation and therapeutic consequences. METHODS:Retrospective analysis of all patients who underwent surgery between January 2005 and December 2015 for thymoma/thymic carcinoma in two centres for thoracic surgery. The final tumour stages were determined on the basis of preoperative imaging, surgical reports and histological findings. RESULTS:A total of 118 patients (male 51%) with a mean age of 56 ± 14.8 years were included. Indications for surgery were primary mediastinal tumour (n = 97), pleura dissemination (n = 15) or mediastinal recurrence (n = 7). Radical tumour resection was performed in 92% of patients (n = 109) within one operation, whereas 8% of patients (n = 9) underwent two operations. Surgical revision was necessary in 12 patients (10.1%) and in-hospital mortality was 1.7% (n = 2). Early Masaoka-Koga stages I (n = 34) and II (n = 16) shifted to the new UICC stage I (T1: n = 58). Locally advanced stages (Masaoka-Koga stage III n = 22 vs. UICC stage IIIA + IIIB n = 20) and metastasised stages (Masaoka-Koga stage IV n = 36 vs. UICC stage IV n = 39) remained very similar. CONCLUSIONS:The new TNM staging system gave rise to changes, especially in early stages (downstaging), but these had no therapeutic implications. Although advanced stages were very similar, the new TNM staging provides more clinically relevant differentiation. HINTERGRUND:Die Masaoka-Koga-Klassifikation beschreibt die Ausbreitung von malignen Thymustumoren. Ziel der Studie ist der Vergleich dieser Tumorklassifikation mit der neuen TNM-Klassifikation, um Unterschiede in der Stadienverteilung, klinische Anwendbarkeit und therapeutische Konsequenzen zu evaluieren. METHODEN:Retrospektive Analyse aller operativ behandelten Patienten mit einem Thymom/Thymuskarzinom, die im Zeitraum von Januar 2005 bis Dezember 2015 in 2 thoraxchirurgischen Zentren behandelt wurden. Das exakte Tumorstadium wurde durch die Bildgebung, Auswertung der Operationsberichte und histologische Befunde festgelegt. ERGEBNISSE:Insgesamt wurden 118 Patienten (männlich 51%) mit einem mittleren Alter von 56 ± 14,8 Jahren eingeschlossen. Indikationen für die Operation waren der Primärtumor (n = 97), ein pleuraler Tumorbefall (n = 15) und das mediastinale Tumorrezidiv (n = 6). Die radikale Tumorresektion erfolgte in 92% der Fälle einzeitig (n = 109), während 9 Patienten (8%) zweizeitig operiert wurden. Eine operative Revision war bei n = 12 (10,1%) notwendig und die Letalität im Krankenhaus betrug 1,7% (n = 2). Da das Masaoka-Koga-Stadium I (n = 34) und II (n = 16) in der TNM-Klassifikation unter dem Stadium T1 (n = 58) zusammengefasst wird, umfasst dieses Stadium mehr Fälle als in der Masaoka-Koga-Klassifikation. Die lokal fortgeschrittenen Stadien (Masaoka-Koga-Stadium III n = 22 vs. UICC-Stadium IIIA + IIIB n = 20) und die metastasierten Stadien (Masaoka-Koga-Stadium IV n = 36 vs. UICC-Stadium IV n = 39) waren im Vergleich annähernd unverändert. SCHLUSSFOLGERUNG:Durch die neue TNM-Klassifikation ergaben sich Änderungen insbesondere in den Anfangsstadien (Downstaging), jedoch ohne therapeutische Konsequenz. Obwohl die Zuordnung zu den fortgeschrittenen Stadien fast unverändert blieb, bietet die neue TNM-Klassifikation hier klinisch relevante Differenzierungen.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Ried M,Eicher MM,Neu R,Kraus D,Inderhees S,Marx A,Hofmann HSdoi
10.1055/a-0606-5603subject
Has Abstractpub_date
2018-08-01 00:00:00pages
S44-S50issue
S 01eissn
0044-409Xissn
1438-9592journal_volume
143pub_type
杂志文章abstract:AIM:Aim of the study was to compare pullout resistance of pedicle screws after conventional and fluoroscopic computer-assisted implantation in the cadaveric thoracic and lumbar spine. METHODS:Pedicle screws were inserted in a total of 10 vertebrae of different human specimens: 10 screws were placed using conventional ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2006-950383
更新日期:2006-10-01 00:00:00
abstract:UNLABELLED:At our institution we have used fresh-frozen allografts for the reconstruction of the anterior and posterior cruciate ligament since 1993. METHOD:In this retrospective study we evaluated the clinical outcome of 325 fresh-frozen allografts (bone-patellar-tendon-bone allografts and Achilles-bone-tendon allogr...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-35129
更新日期:2002-10-01 00:00:00
abstract::After operation of uncomplicated forms of appendicitis in children postoperative complications characterised by sudden vehement stomach-ache, quickly increasing tension of the abdominal wall, rise of temperature, pulse and white blood cells as well as vomitus, mostly on the fifth post-operative day could be observed. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Modern oncological liver surgery continues to push the limits of resectability by incorporating an array of new developments in the fields of surgery, anaesthesia and intensive care, oncology, radiology and transplantation medicine. New criteria for determining the resectability of primary and secondary liver tumours ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1350815
更新日期:2014-04-01 00:00:00
abstract::Injuries, burns, and surgical intervention may lead to temporary depression of immune defence. Today, life-threatening infections may be caused by bacteria, such as pseudomonas, bacteroids, serratia as well as by viruses, including cytomegaly virus, and yeasts. Severe infections of that kind may be countered by adequa...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1987-01-01 00:00:00
abstract::Since 1977 the diffuse malignant mesothelioma of the pleura and peritoneum caused by asbestos represents one of the most often compensated occupational cancers in Germany. Because of the probability of an asbestos-related etiology, it is considered as a "signal tumour", mainly indicating exposure to asbestos dust at t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2001-12499
更新日期:2001-03-01 00:00:00
abstract::Between 1964 to 1974 2940 patients underwent chest operations. 15 cases with abdominal complications among them are analyzed. 10 patients had bleeding gastric or duodenal ulcers with a high mortality rate. Postoperative gastric distention was one of the most important causes. A gastric tube should be introduced whenev...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::The role of Calcitonin as a secretory inhibition agent in the treatment of acute pancreatitis was studied by a randomized and prospective procedure. The recovery time of the main laboratory findings, the hospitalization duration, the complications and the mortality were not affected by Calcitonin. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1981-01-01 00:00:00
abstract::The special way of infection of the lymphogenic osteomyelitis caused by trivial trauma is demonstrated in 4 cases. Germ ascension is done by lymphatics or fissures in the tissue, as it is well known in the panaritium ossale. The treatment consists in removing the focus of infection, irrigation-suction drainage and spe...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1976-01-01 00:00:00
abstract::The problem of solitary plasmacytoma is demonstrated in a rare case. The diagnosis was delayed for different causes. The course was followed up over 6 years. The difficulties of diagnosis and further treatment are discussed. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract::Hybrid systems with hepatocyte cultures in bioreactors are in development for therapeutical liver assistance. Here, a culture model with a special bioreactor construction was developed: Capillary membrane systems create a three dimensional artificial framework for hepatocyte adhesion, aggregation and reorganization of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::The surgical approach to malignant hepatoma in cirrhotic liver has continued to be an unresolved problem. Early diagnosis, differentiated indication, and surgical techniques need further improvement, before adjuvant therapy can be discussed. All surgeons are called upon to verify experience of the past and to integrat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1989-01-01 00:00:00
abstract::Two surgical methods are compared: resection of the stricture and replacement by large bowel (out of 64 cases, 63 were elective and one emergency), and the usual anti-reflux procedures (13 cases). In this series the mortality rate and the functional results are reported as more favourable after resection and replaceme...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::The use of Hemostypic agents like oxised regenerated cellulose and collagen sponge is widespread in cases with severe hemorrhage that cannot be treated by conservative measure. With these materials however one cannot bring compression to the source of bleeding. We therefore have been using absorbable mesh (Vicryl, Dex...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Surgical education in the United States historically was influenced by the German educational system. Currently residents spend five years to become general surgeons. Education focuses on the teaching of surgical basic sciences and practical instruction in the operating room and at the bedside. Students interested in ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:AIM OF INVESTIGATION:The treatment of nonunions complicated by infection and bone loss is divided into two stages. Having calmed down the infection by stabilizing, removal of infected and necrotic tissue and local antibacterial measures, the bone loss has to be filled up. Bridging the gap by means of autogenous cancell...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To review the endogenous alterations generating critical illness in bowel obstruction. DATA SOURCES:Own experimental and clinical investigations and relevant articles published in international literature. DATA SYNTHESIS AND CONCLUSIONS:Large bowel obstruction is mostly confined to the colon. Passive dilata...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract::This survey covers the problems of immunologic monitoring of patients and the spectrum of methods of diagnosing various types of immunopathological reactions. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Immediate operative reconstruction of ligament injuries of the knee joint is recommended for the performance age. The optimal operation time is within 24 hours after the accident, it should be done within 72 hours. The important advantage of this early operation in comparison to a non-operative treatment is the possib...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Esophageal malignoma is among the most frequent causes for cancer-related deaths. The only definite curative therapy is esophagectomy embedded in various multimodal treatment regimens. The aim of this study was to evaluate long-term development after esophageal surgery in the last two decades in order to obs...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-119892
更新日期:2018-04-01 00:00:00
abstract::Reference is made in this paper to the role played by the CEA level as an important marker for indication of second-look and third-look operations for colorectal carcinoma. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::Surgical treatment of patients suffering from monogenetic forms of morbid obesity is considered to be the poorest investigated theme in bariatric surgery. This review article presents aspects of genetic disorders in morbid obesity as well as some aspects of surgical treatment in patients with monogenetic forms of morb...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-981161
更新日期:2007-06-01 00:00:00
abstract::Normal ranges, which were set up for quality control, serve to define an acceptable qualitative niveau of treatment. To establish such criteria, it is important to consider group-specific characteristics during investigations. Results of clinical trials are the basics to determine the normal range of parameters of qua...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::Intraabdominal abscesses are life-threatening complications of inflammatory processes or major surgery. Ultrasonography, computed tomography, magnetic resonance, and scintigraphy are the diagnostic methods of choice. The sole diagnosis intraabdominal abcess" is insufficient to recommend a specific therapeutic strategy...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1993-01-01 00:00:00
abstract::Postpneumonectomy empyema represents a frequently lethal complication. It remains unsolved whether prophylactic antibiotics achieve a bactericidal concentration in the pleural cavity after pneumonectomy. 12 patients undergoing pneumonectomy received ciprofloxacin intravenously (2 x 200 micrograms/d) and orally (2 x 50...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::The functioning of our anti-infectious regimen now working over a period of 7 years with 4 checks per year has been controlled. The wound infection rate came up to a percentage of 1.55. Blunders concerning chemical disinfection especially could be detected in spite of check-ups made every 3 months. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::By introduction of laparoscopic cholecystectomy, an increase of accidental common bile duct injuries up to 1.2% has been reported. In the present study of 325 cholecystectomies we evaluated whether mandatory intraoperative cholangiography (IOC) can reduce the rate of accidental bile duct injuries or, at least, identif...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::307 Patients with intraabdominal infections were operated between 8/1988 to 8/1991. Simple clinical parameters (according to the Mannheimer Peritonitis-Index) were evaluated before treatment. The classical therapeutic concept of one-stage laparotomy with drainage of the abdomen was performed in 223 patients initially....
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Small cell lung cancer accounts for roughly 14% of all lung cancers and is characterized by rapid progression, early distant metastasis and poor prognosis. Only a minority of patients presents with early stage disease upon initial diagnosis where surgical resection may be discussed. In addition, various treatment moda...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-110185
更新日期:2018-02-01 00:00:00
abstract::Psychooncology is an interdisciplinary field that focuses on the various somatic, social and psychological factors influencing the well-being of oncological patients. Although the importance of psychooncological support of cancer patients is well accepted, universal standards for psychooncological care have not been e...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1004664
更新日期:2008-02-01 00:00:00