Abstract:
OBJECTIVE:The aim of the study was to identify the survival of patients with locally advanced pancreatic cancer (LAPC) and assess the effect of surgical resection after neoadjuvant therapy on patient outcomes. BACKGROUND:An increasing number of LAPC patients who respond favorably to neoadjuvant therapy undergo surgical resection. The impact of surgery on patient survival is largely unknown. MATERIALS AND METHODS:All LAPC patients who presented to the institutional pancreatic multidisciplinary clinic (PMDC) from January 2013 to September 2017 were included in the study. Demographics and clinical data on neoadjuvant treatment and surgical resection were documented. Primary tumor resection rates after neoadjuvant therapy and overall survival (OS) were the primary study endpoints. RESULTS:A total of 415 LAPC patients were included in the study. Stratification of neoadjuvant therapy in FOLFIRINOX-based, gemcitabine-based, and combination of the two, and subsequent outcome comparison did not demonstrate significant differences in OS of 331 non-resected LAPC patients (P = 0.134). Eighty-four patients underwent resection of the primary tumor (20%), after a median duration of 5 months of neoadjuvant therapy. FOLFIRINOX-based therapy and stereotactic body radiation therapy correlated with increased probability of resection (P = 0.006). Resected patients had better performance status, smaller median tumor size (P = 0.029), and lower median CA19-9 values (P < 0.001) at PMDC. Patients who underwent surgical resection had significant higher median OS compared with those who did not (35.3 vs 16.3 mo, P < 0.001). The difference remained significant when non-resected patients were matched for time of neoadjuvant therapy (19.9 mo, P < 0.001). CONCLUSIONS:Surgical resection of LAPC after neoadjuvant therapy is feasible in a highly selected cohort of patients (20%) and is associated with significantly longer median overall survival.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Gemenetzis G,Groot VP,Blair AB,Laheru DA,Zheng L,Narang AK,Fishman EK,Hruban RH,Yu J,Burkhart RA,Cameron JL,Weiss MJ,Wolfgang CL,He Jdoi
10.1097/SLA.0000000000002753subject
Has Abstractpub_date
2019-08-01 00:00:00pages
340-347issue
2eissn
0003-4932issn
1528-1140journal_volume
270pub_type
杂志文章abstract:OBJECTIVE:The aim of this study was to evaluate the association between metformin and survival of gastric cancer (GC) patients. BACKGROUND:Metformin has recently received attention as a potential anticancer treatment. However, no study has shown the survival benefit of metformin for GC patients. METHODS:A total of 19...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001086
更新日期:2016-01-01 00:00:00
abstract::Severe hemorrhage associated with major trauma and vascular procedures is seen frequently in our operating rooms. Immediate autotransfusion has enabled us to safely and adquately correct blood losses without placing overwhelming demands on our blood bank. Since October 1973, a device capable of retrieving, filtering a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197703000-00013
更新日期:1977-03-01 00:00:00
abstract::Three hundred seventeen carotid endarterectomies performed on 240 consecutive patients in four Charleston hospitals were reviewed. The overall incidence of stroke was 10.7% and the mortality 3.2%. From these 317 operations a standardized series of 253 operations performed on neurologically stable patients was analyzed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197706000-00010
更新日期:1977-06-01 00:00:00
abstract:BACKGROUND:A recent revision of the American Joint Committee on Cancer (AJCC) staging for gallbladder cancer (6th Edition) involved some major changes. Most notably, T2N0M0 tumors were moved from stage II to stage IB; T3N1M0 disease was moved from stage III to stage IIB; and T4NxM0 (x = any) tumors were moved from stag...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000219737.81943.4e
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:A simulator to enable safe practice and assessment of ALND has been designed, and face, content and construct validity has been investigated. SUMMARY AND BACKGROUND DATA:The reduction in the number of ALNDs conducted has led to decreased resident exposure and confidence. METHODS:A cross-sectional multicente...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003946
更新日期:2020-06-24 00:00:00
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
doi:10.1097/00000658-198911000-00007
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:To compare outcomes for patients with hepatocellular carcinoma (HCC) treated with either liver resection or transplantation. METHODS:A retrospective, single-institution analysis of 413 HCC patients from 1999 to 2009. RESULTS:A total of 413 patients with HCC underwent surgical resection (n = 106) and transpl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822ca66f
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare silicone-banded sleeve gastrectomy (BSG) to nonbanded sleeve gastrectomy (SG) regarding weight loss, obesity-related comorbidities, and complications. SUMMARY BACKGROUND DATA:As a primary bariatric procedure, SG leads to excellent weight loss, yet weight regain is a relev...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000004174
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to achieve limb salvage in patients with locally advanced soft tissue sarcomas that can only be treated by amputation or functionally mutilating surgery by performing an isolated limb perfusion (ILP) with tumor necrosis factor (TNF) + melphalan (M) as induction biochemotherapy t...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/00000658-199612000-00011
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the gene expression signature of hepatocellular carcinoma (HCC) in relation to the gross morphology. BACKGROUND:Eggel's nodular type of HCC is morphologically subclassified into the single nodular (SN) type, the single nodular type with extranodular growth (SNEG), and the confluent multinodular (...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181f9bc00
更新日期:2011-01-01 00:00:00
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
doi:10.1097/00000658-198103000-00023
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:To compare the systemic cytokine response in patients after laparoscopic-assisted resection with those after open resection of rectosigmoid carcinoma. SUMMARY BACKGROUND DATA:Laparoscopic resection of colorectal carcinoma is technically feasible, but objective evidence of its benefit is scarce. Systemic cyto...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200004000-00008
更新日期:2000-04-01 00:00:00
abstract::One hundred sixty-three patients undergoing reoperative parathyroidectomy were evaluated before and after operation to determine the incidence of, risk factors for, and morbidity of vocal cord paralysis. These patients were compared to 77 patients undergoing initial parathyroid operation, only one of whom had vocal co...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198603000-00011
更新日期:1986-03-01 00:00:00
abstract::A sterile Doppler probe was used for intraoperative monitoring of the integrity of carotid endarterectomy of 125 vessels of 107 patients. Our objective was to reduce the contribution of residual carotid lesions to recurrent stenosis, which was evaluated by Doppler spectrum analysis in the early (less than 3 months, 66...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198606000-00010
更新日期:1986-06-01 00:00:00
abstract::The accuracy of endoscopy and directed biopsy in the differential diagnosis of gastric lesions was evaluated by comparing the diagnoses of one endoscopic procedure (endoscopy and multiple directed biopsies) with the definitive diagnoses in 333 patients. The overall endoscopic and bioptic accuracy rate for all patients...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198202000-00018
更新日期:1982-02-01 00:00:00
abstract:OBJECTIVE:To investigate the risk factors for conversion during laparoscopic liver resection and its effect on patient outcome in a large cohort of patients. Additional analysis of outcomes in patients who required conversion for unfavorable intraoperative findings and conversion for unfavorable intraoperative events w...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002332
更新日期:2018-12-01 00:00:00
abstract::A total of 360 patients underwent preoperative cardiac risk assessment using 23 clinical parameters, seven multivariate clinical scoring systems, and quantitative dipyridamole-thallium imaging to predict postoperative and long-term myocardial infarction and cardiac death after noncardiac surgery. There were 30 postope...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199208000-00010
更新日期:1992-08-01 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:OBJECTIVE:To assess whether perioperative variables or deviation from enhanced recovery after surgery (ERAS) items could be associated with delayed discharge after esophagectomy, and to convert them into a scoring system to predict it. SUMMARY BACKGROUND DATA:ERAS perioperative pathways have been recently applied to e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002775
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Because continuity of care (CC) is a necessary component of resident education, this analysis was done to understand what keeps CC between residents and patients low and how it can be most effectively improved. BACKGROUND:Many authors lament low CC between residents and patients, especially in the era of dut...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182468dcf
更新日期:2012-04-01 00:00:00
abstract::Despite recommended preoperative preparation with alpha-adrenergic blockers, severe hemodynamic instability may occur during operations to resect pheochromocytoma. We combined the alpha-blocker phenoxybenzamine with the tyrosine hydroxylase inhibitor metyrosine in an attempt to better manage the hypertension of patien...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199011000-00010
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:The authors review the general surgical complications of cardiopulmonary bypass, including newer procedures such as heart and lung transplantation, to identify patients at higher risk. SUMMARY BACKGROUND DATA:Although rare, the general surgical complications of cardiopulmonary bypass are associated with high...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199505000-00006
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of anesthesia induced mild systemic hypothermia on hepatic injury in lean and obese rats during warm ischemia. SUMMARY BACKGROUND DATA:Hepatic warm ischemia during surgery remains a significant problem, particularly in organs with presumed baseline dysfunction. METHODS:The left and me...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000154259.73060.f1
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To develop evidence-based recommendations for safe, effective, and appropriate thyroidectomy. BACKGROUND:Surgical management of thyroid disease has evolved considerably over several decades leading to variability in rendered care. Over 100,000 thyroid operations are performed annually in the US. METHODS:The...
journal_title:Annals of surgery
pub_type: 杂志文章,实务指引
doi:10.1097/SLA.0000000000003580
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To determine whether the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule confers higher value for physician work in procedure and test codes than in Evaluation and Management (E/M) codes. BACKGROUND:Medicare Payment Advisory Commission previously demonstrated that time for medical serv...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000990
更新日期:2015-08-01 00:00:00
abstract::From July 1983 through December 1987, 300 consecutive patients with penetrating gunshot wounds of the abdomen causing visceral or vascular injuries were treated. Resuscitative thoracotomy was required in 20 patients (6.6%), and only two survived. The most commonly injured organs were the small bowel (60%), colon (41.6...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198809000-00014
更新日期:1988-09-01 00:00:00
abstract::Hypersensitive carotid sinus is a rare cause of spontaneous syncopal attacks. It must be differentiated from the other more common causes, such as intrinsic cardiac disease, vasovagal responses, postural hypotension and cerebrovascular insufficiency, although it may accompany these conditions. The definition of caroti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197905000-00006
更新日期:1979-05-01 00:00:00
abstract:OBJECTIVE:To train surgeons in a standardized technique of sentinel lymph node biopsy and to prepare them for the requirements of a prospective randomized surgical trial. SUMMARY BACKGROUND DATA:The NSABP B32 trial opened to accrual in May 1999. A significant component of this trial was a prerandomization training pha...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000149429.39656.94
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:The authors assessed the impact of gastrinoma resection on the subsequent development of hepatic metastases in Zollinger-Ellison syndrome. SUMMARY BACKGROUND DATA:The symptoms of acid hypersecretion can be controlled medically in Zollinger-Ellison syndrome with high-dose pharmacologic therapy. The current ro...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199409000-00008
更新日期:1994-09-01 00:00:00
abstract:UNLABELLED:This population-based study evaluates the association between hospital volume and CRM (circumferential resection margin) involvement, adjusted for other confounders, in rectal cancer surgery. A low hospital volume (<20 cases/year) was independently associated with a higher risk of CRM involvement (odds ratio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001009
更新日期:2016-04-01 00:00:00