Abstract:
OBJECTIVE:The aim of the study was to determine the rate, predictors, and impact of complete pathologic response (cPR) to pretransplant locoregional therapy (LRT) in a large, multicenter cohort of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT). BACKGROUND:LRT is used to mitigate waitlist dropout for patients with HCC awaiting LT. Degree of tumor necrosis found on explant has been associated with recurrence and overall survival, but has not been evaluated in a large, multicenter study. METHODS:Comparisons were made among patients receiving pre-LT LRT with (n = 802) and without (n = 2637) cPR from the United States Multicenter HCC Transplant Consortium (UMHTC), and multivariable predictors of cPR were identified using logistic regression. RESULTS:Of 3439 patients, 802 (23%) had cPR on explant. Compared with patients without cPR, cPR patients were younger; had lower Model for End-stage Liver Disease (MELD) scores, AFP levels, and neutrophil-lymphocyte ratios (NLR); were more likely to have tumors within Milan criteria and fewer LRT treatments; and had significantly lower 1-, 3-, and 5-year incidence of post-LT recurrence (1.3%, 3.5%, and 5.2% vs 6.2%, 13.5%, and 16.4%; P < 0.001) and superior overall survival (92%, 84%, and 75% vs 90%, 78%, and 68%; P < 0.001). Multivariable predictors of cPR included age, sex, liver disease diagnosis, MELD, AFP, NLR, radiographic Milan status, and number of LRT treatments (C-statistic 0.67). CONCLUSIONS:For LT recipients with HCC receiving pretransplant LRT, achieving cPR portends significantly lower posttransplant recurrence and superior survival. Factors predicting cPR are identified, which may help prioritize patients and guide LRT strategies to optimize posttransplant cancer outcomes.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
DiNorcia J,Florman SS,Haydel B,Tabrizian P,Ruiz RM,Klintmalm GB,Senguttuvan S,Lee DD,Taner CB,Verna EC,Halazun KJ,Hoteit M,Levine MH,Chapman WC,Vachharajani N,Aucejo F,Nguyen MH,Melcher ML,Tevar AD,Humar A,Mobleydoi
10.1097/SLA.0000000000003253subject
Has Abstractpub_date
2020-04-01 00:00:00pages
616-624issue
4eissn
0003-4932issn
1528-1140journal_volume
271pub_type
杂志文章,多中心研究abstract:OBJECTIVE:To develop and validate a robust, objective mobility assessment tool, Hamlyn Mobility Score (HMS), using a wearable motion sensor. BACKGROUND:Advances in reconstructive techniques allow more limbs to be salvaged. However, evidence demonstrating superior long-term outcomes compared with amputation is unavaila...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000711
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Our goal was to describe contemporary management and in-hospital mortality associated with blunt thoracic aortic intimal tears (IT) within the American College of Surgeons Trauma Quality Improvement Program. SUMMARY BACKGROUND DATA:The evidence basis for nonoperative expectant management of traumatic IT of t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004415
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to examine the ability of Focused Assessment Using Sonography for Trauma (FAST) to discriminate between survivors and nonsurvivors undergoing resuscitative thoracotomy (RT). BACKGROUND:RT is a high-risk, low-salvage procedure performed in arresting trauma patients with poorly ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001421
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:To establish reliable standards for surgical application to elderly patients 75 years old or older with gastric or colorectal cancer with special reference to the postoperative recovery of activities of daily living (ADL) and quality of life (QOL). SUMMARY BACKGROUND DATA:ADL and QOL are important outcomes o...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3180caa3fb
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Retroperitoneal sarcomas (RPS) are rare tumors composed of several well defined histologic subtypes. The aim of this study was to analyze patterns of recurrence and treatment variations in a large population of patients, treated at reference centers. METHODS:All consecutive patients with primary RPS treated...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001447
更新日期:2016-05-01 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::This is the first reported case of mumps hemorrhagic pancreatitis in a child, documented at operation, and by rising mumps titers and complicated by a pseudocyst. In severe cases when surgery is indicated, drainage of the lesser sac usually prevents pseudocyst formation. If a pseudocyst occurs, drainage is required to...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00012
更新日期:1974-07-01 00:00:00
abstract:OBJECTIVE:To investigate potential impacts of restructuring general surgery training on colorectal (CR) surgery recruitment and expertise. SUMMARY BACKGROUND DATA:In response to the American Surgical Association Blue Ribbon Committee report on surgical education (2004), the American Board of Colon and Rectal Surgery, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ad64f1
更新日期:2009-07-01 00:00:00
abstract::Twenty-three selected patients presenting with massive bleeding from peptic ulcers underwent emergency parietal cell vagotomy (PCV). Nineteen patients had a duodenal ulcer, two a prepyloric ulcer, and one a gastric ulcer. The patients were studied retrospectively with regard to postoperative mortality and morbidity, e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198711000-00005
更新日期:1987-11-01 00:00:00
abstract::Blunt carotid artery trauma is uncommon but has been associated with severe, permanent neurologic deficits in 42% and mortality in 30% of 96 patients previously reported in the English literature. Since neurologic symptoms characteristically develop only after a latent interval and since physical evidence of significa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198003000-00014
更新日期:1980-03-01 00:00:00
abstract::This review brings the total number of biliary cysts reported in the world literature to 955. Eighty-one per cent of patients are females and 61% were discovered before age ten. The classical triad of right upper quadrant pain, right upper quandrant mass, and juandice is present in 38% of cases. The duration of sympto...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-197511000-00017
更新日期:1975-11-01 00:00:00
abstract:OBJECTIVES:The authors determined the effect of complications on length of stay (LOS) in surgical patients. SETTING:From 1987 to 1990, in the Professional General Surgical Unit of Royal Victoria Hospital, a retrospective survey was conducted on 5128 consecutively admitted patients with 396 different diagnosis; 228 dif...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199412000-00006
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:To assess the strategy of combining oncolytic herpes simplex virus (HSV) therapy with immunomodulatory therapy as treatment for experimental colon cancer. The oncolytic HSV recombinant NV1023 and the interleukin 12 (IL-12)-secreting oncolytic NV1042 virus were evaluated in vitro and in vivo with respect to an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200106000-00012
更新日期:2001-06-01 00:00:00
abstract::The obturator bypass graft operation can be performed in a moderately simplified manner by a technique that allows extension of indications for the procedure beyond situations in which sepsis is present in the groin. Long-term analysis of the results of the cases available for study indicates that the procedure may ve...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198303000-00015
更新日期:1983-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of peptide receptor radionuclide therapy (PRRT) on somatostatin receptor (SSR)-transfected colon carcinoma cells in a rat liver metastases model. SUMMARY BACKGROUND DATA:Previously the authors have shown highly effective therapy with PRRT of SSR-positive tumors. This treatment is SSR-m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200212000-00004
更新日期:2002-12-01 00:00:00
abstract::The clinical outcome in 155 patients with papillary or follicular carcinoma of the thyroid gland operated on over a 25-year period demonstrated no difference in survival rates or incidence of recurrent tumor between those treated by total thyroidectomy and those undergoing less than total thyroidectomy. However, the c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198012000-00001
更新日期:1980-12-01 00:00:00
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
doi:10.1097/SLA.0000000000004708
更新日期:2020-12-23 00:00:00
abstract:OBJECTIVE:In Western populations, long-term survival rates after curative resection of gastric cancer remain extremely poor. The lack of effective adjuvant therapy has prompted the evaluation of neoadjuvant approaches. Since 1988, we have conducted three separate phase II trials using neoadjuvant chemotherapy to treat ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199903000-00001
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. BACKGROUND:Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in recta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002719
更新日期:2019-06-01 00:00:00
abstract::: Since their discovery, neutrophil extracellular traps (NETs) have been implicated in a broad array of functions, both beneficial and detrimental to the host. Indeed, NETs have roles in infection, sepsis, wound healing, thrombotic disease, and cancer propagation, all of which are directly implicated in the care of su...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000003586
更新日期:2020-08-01 00:00:00
abstract::Umbilical hernia is a common finding in cirrhotic patients with ascites. Spontaneous disruption of the hernia and attendant discharge of ascitic fluid is an unusual and rarely reported complication in these patients and is associated with an overall mortality rate of nearly 30%. During the 5-year period 1977-1982, nin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198307000-00006
更新日期:1983-07-01 00:00:00
abstract::Although previous studies have suggested that bacteria may contribute to pigment gallstone formation, the current experiments provide evidence that bacteria have a central role in this process. The studies included scanning electron microscopy (SEM) of gallstones, measurements of bacterial adherence to gallstones in v...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198709000-00002
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:To determine the effects of recombinant human insulin-like growth factor-1 (IGF-1) complexed with its principal binding protein, IGFBP-3, on skeletal muscle metabolism in severely burned children. SUMMARY BACKGROUND DATA:Severe burns are associated with a persistent hypermetabolic response characterized by h...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199905000-00014
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To identify predictive factors associated with operative morbidity, mortality, and survival outcomes in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) undergoing total neoadjuvant therapy (TNT). BACKGROUND:The optimal preoperative treatment sequencin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003284
更新日期:2021-02-01 00:00:00
abstract::Cadaver kidneys remain a scarce resource, yet single pediatric donor kidneys are underutilized at some centers. Between 1967 and 1984, 133 single pediatric and 318 adult donor cadaver transplants were performed. Patient and graft survival, renal function, and complications in adult recipients grouped by donor age were...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198608000-00011
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVES:We recently reported increased CD4 CD25 T regulatory (Treg) activity after burn injury in mice. This study sought to determine if Tregs mediate the reduction in TH1-type immunity after serious injury in man and if Treg function is altered by injury. METHODS:Peripheral blood was withdrawn from 19 consenting ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000239031.06906.1f
更新日期:2006-10-01 00:00:00
abstract::Pulmonary microembolism of microaggregates associated with massive blood transfusion may be a cause of post-traumatic pulmonary embolism. The purpose of this study was to investigate in the dog the influence on certain physiologic parameters of transfusion of blood containing platelet: white blood cell: fibrin (PWF) a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197501000-00012
更新日期:1975-01-01 00:00:00
abstract::Ventral anomalies of accessory pulmonary tissue have been classified as "bronchopulmonary foregut malformations." Between July 1, 1981, and May 31, 1985, 10 children with bronchopulmonary malformations have been cared for on the Pediatric Surgical Service at the University of Virginia. Six patients had bronchogenic cy...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198605000-00011
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to identify the utility of "keyhole" thoracotomy approaches to single vessel coronary artery bypass surgery. SUMMARY BACKGROUND DATA:Although minimally invasive surgery is efficacious in a wide variety of surgical disciplines, it has been slow to emerge in cardiac surgery. Amo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199610000-00004
更新日期:1996-10-01 00:00:00
abstract::The physiologic sufficiency of regenerated lung lymphatics after surgical transection of the lung hilum was studied experimentally. Dogs were prepared by surgical interruption of all left lung hilar tissues and structures except the skeletonized pulmonary artery and the pulmonary veins; continuity of the bronchus was ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198008000-00005
更新日期:1980-08-01 00:00:00