Abstract:
OBJECTIVE:We developed and validated a nomogram predicting the likelihood of occult lymph node metastases in surgically resectable esophageal cancers. BACKGROUND:Patients with esophageal cancer with positive lymph nodes benefit from neoadjuvant therapy, but limitations in current clinical staging techniques mean nodal metastases often go undetected preoperatively. METHODS:The National Cancer Database was queried for patients with clinical T1-3N0M0 cancer undergoing upfront esophagectomy from 2004 to 2014. Multivariable logistic regression was used to develop the risk model using both statistical significance and clinical importance criteria for variable selection. Predictive accuracy was assessed and bootstrapping was used for validation. A nomogram was constructed for presentation of the final model. RESULTS:Of 3186 patients, 688 (22%) had pathologic lymph node involvement (pN+) and 2498 (78%) had pN0 status. Variables associated with pN+ status included histology [adenocarcinoma vs squamous: odds ratio (OR) 1.75], tumor stage (T1: reference, T2: OR 1.90, T3: OR 2.17), tumor size (<1 cm: reference, 1-2 cm: OR 2.25, 2-3 cm: OR 3.82, 3-4 cm: OR 5.40, 4-5 cm: OR 5.66, ≥5 cm: OR 6.02), grade (1: reference, 2: OR 2.62, 3: OR 4.39, 4: OR 4.15, X: OR 1.87), and presence of lymphovascular invasion (absent: reference, present: OR 4.70, missing: OR 1.87), all P < 0.001. A nomogram with these variables had good predictive accuracy (Brier score: 0.14, calibration slope: 0.97, c-index: 0.77). CONCLUSIONS:We created a nomogram predicting the likelihood of pathologic lymph node involvement in patients with esophageal cancer who are clinically node negative using a generalizable dataset. Risk stratification with this nomogram could improve delivery of appropriate perioperative care.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Semenkovich TR,Yan Y,Subramanian M,Meyers BF,Kozower BD,Nava R,Patterson GA,Kreisel D,Puri Vdoi
10.1097/SLA.0000000000003450subject
Has Abstractpub_date
2019-07-03 00:00:00eissn
0003-4932issn
1528-1140pub_type
杂志文章abstract::The value of the amylase--creatinine clearance ratio (ACCR) in the diagnosis of postoperative pancreatitis was prospectively assessed. In 77 patients undergoing operations known to have a significant incidence of postoperative pancreatitis (gastric, biliary or pancreatic) i.e. "high risk" group, the ACCR was abnormall...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198008000-00011
更新日期:1980-08-01 00:00:00
abstract::The object of this study was to compare the ultrastructure pulmonary effects of the infusion of homologous and heterologous serum albumin solution in the treatment of hemorrhagic shock in baboons. Adult baboons subjected to hemorrhagic shock were resuscitated with either baboon serum albumin, human serum albumin, or R...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197902000-00016
更新日期:1979-02-01 00:00:00
abstract:UNLABELLED:One hundred consecutive laparoscopic adrenal procedures for a variety of endocrine disorders were reviewed. There was no mortality, morbidity was 12%, and conversions was 3%. During follow-up, none had recurrence of hormonal excess. Laparoscopic adrenalectomy is the procedure of choice for adrenal removal ex...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199709000-00003
更新日期:1997-09-01 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:SUMMARY BACKGROUND DATA:The extent of hepatectomies is limited by the functional reserve of the remnant liver. The introduction of preoperative portal vein occlusion techniques to induce a preoperative hyperplasia of the future liver remnant has reduced the risk of postoperative liver failure. However, it has remained ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31816a9d7c
更新日期:2008-05-01 00:00:00
abstract::As a consequence of an experience with 175 patients undergoing reoperation for persistent or recurrent hyperparathyroidism, the authors have evolved an approach to management. The emphasis is on the confirmation of the diagnosis; the critical evaluation of invasive and noninvasive localization tests, techniques of int...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Controversy exists on the use of mesh in the repair of paraesophageal hernias (PEH). This debate centers around the type of mesh used, its value in preventing recurrence, its short- and long-term complications, and the consequences of those complications compared with primary repair. Decision analysis is a m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182822c8c
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the oncologic and functional outcomes of laparoscopic total mesorectal excision (TME) with colonic J-pouch reconstruction. BACKGROUND:TME is considered the established gold standard in rectal cancer surgery. However, data on laparoscopic sphincter-preserving TME are limited. METHOD...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000202180.16723.03
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the current knowledge on the risk factors for recurrence, efficacy of adjuvant therapy in preventing recurrence, and the optimal management of recurrence after resection of hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:The long-term prognosis after resection of HCC remains unsatisfactor...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-200007000-00003
更新日期:2000-07-01 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:OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC). DESIGN:A prospective cohort study. BACKGROUND:nCRT is increasingly standard of care in LAEC, with pCR a ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001902
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:Regional circulatory changes in intestinal mucosa were evaluated after the onset of septic shock and the effect of nitric oxide (NO) inhibition on mucosal blood flow was investigated at different locations along the intestine. SUMMARY BACKGROUND DATA:The response of intestinal blood flow to different physiol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199801000-00018
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH). BACKGROUND:Emerging data suggest young age is a predictor of increased local recurrence. METHODS:POSH is a ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001930
更新日期:2017-07-01 00:00:00
abstract::Occurence of gastroenteric fistulae in non-surgically treated peptic ulcer disease is rare as suggested by only 26 cases published in the literature so far. We had the opportunity to care for 3 patients with this problem in a period of one year. At our institution, a search of the medical records dating back to 1955 y...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197608000-00017
更新日期:1976-08-01 00:00:00
abstract:OBJECTIVE:To determine whether imputed data can be used to produce unbiased hospital quality measures. BACKGROUND:Different methods for handling missing data may influence which hospitals are designated as quality outliers. METHODS:Monte-Carlo simulation study based on 63,020 patients with no missing data in 68 hospi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31818e544b
更新日期:2009-01-01 00:00:00
abstract::Chronic idiopathic intestinal pseudo-obstruction is an increasingly recognized syndrome in which patients usually present with an acute or chronic history suggestive of intestinal obstruction, although no obstructing lesion is found at surgery. The diagnosis can be suspected in most cases from the clinical presentatio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198012000-00011
更新日期:1980-12-01 00:00:00
abstract::A prospective study was performed on 358 patients to examine the diagnosis, management, and natural history of fish bone ingestion. All patients admitted with the complaint had a thorough oral examination. Flexible endoscopy under local pharyngeal anesthesia would be performed on patients with negative findings. Of 11...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199004000-00012
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:To evaluate discrepancies between trial registry entries and final reports of randomized controlled trials (RCTs) published in major general surgical journals. BACKGROUND:Health care decisions are based on published results in peer-reviewed journals. Mandatory trial registration was introduced to increase tr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318283cf7f
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To determine if an aggressive surgical approach, with an increase in R0 resections, has resulted in improved survival for patients with gallbladder cancer. SUMMARY BACKGROUND DATA:Many physicians express a relatively nihilistic approach to the treatment of gallbladder cancer; consensus among surgeons regardi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000154118.07704.ef
更新日期:2005-03-01 00:00:00
abstract::This report defines the incidence of variations in the renal vascular pedicle in a group of patients with normal renal function as determined by standard laboratory criteria. The study group consisted of 166 patients undergoing renal arteriography as potential renal allograft donors. Ninety-seven patients were male an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00014
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE AND SUMMARY BACKGROUND DATA:Sentinel lymph node (LN) sampling, a technique widely used to manage breast cancer and melanoma, seeks to select LNs that accurately predict regional node status and can be extensively examined to identify nodal metastatic disease not detected by standard histopathological staging....
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/01.sla.0000140753.41357.20
更新日期:2004-10-01 00:00:00
abstract::MINI: In cases of true short esophagus diagnosed intraoperatively with an endoscopic-laparoscopic method, Collis-Nissen and stomach around stomach fundoplication procedures achieved similar results. The notion that the gastric fundus must be wrapped around a conveniently long segment of the tubular esophagus to obtain...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003582
更新日期:2019-09-03 00:00:00
abstract::The relationship between two variables may be mathematically coupled if either one or both variables are derived and/or calculated, and this can lead to erroneous results and invalid conclusions. The purpose of this report is to identify four types of mathematic coupling of data. Type 1 coupling involves directional c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00008
更新日期:1981-03-01 00:00:00
abstract::Current treatment modalities for thrombotic thrombocytopenic purpura (TTP) include plasmapheresis (PP), splenectomy, steroids, dextran, other antiplatelet agents, and vinca alkaloids. Prior to the development of PP and use of multimodality treatment for TTP, mortality rates exceeded 50%. This report reviews 11 patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198509000-00007
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:This study determined whether there are any laboratory or other features that will enable prediction of spontaneous closure in patients with gastrointestinal cutaneous fistulas. SUMMARY BACKGROUND DATA:Although the anatomic criteria for spontaneous closure of gastrointestinal cutaneous fistulas have been pre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199306000-00003
更新日期:1993-06-01 00:00:00
abstract::A female patient with Gardner's syndrome was treated with delta1-testololactone (200 mg daily) because of growth of a large desmoid tumor in the pelvis and lower abdomen and a tumor in a scar from a previous laparotomy. There was also pain and swelling of the left leg. An immediate effect of the drug therapy was compl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197503000-00009
更新日期:1975-03-01 00:00:00
abstract::Carcinoma of the gallbladder is an uncommon, but not rare tumor that is associated with a 5% five-year survival rate after resection and this rate has not appreciably improved over the last decades in most series. Nevin et al.(20) however have reported that favorably staged gallbladder cancers (according to histologic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198205000-00012
更新日期:1982-05-01 00:00:00
abstract::During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accident...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198502000-00011
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVE:To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys. BACKGROUND:A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo sto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003702
更新日期:2019-12-05 00:00:00
abstract:OBJECTIVE:To analyze outcomes after open small-incision surgery (minilaparotomy) and laparoscopic surgery for gallstone disease in general surgical practice. METHODS:This study was a randomized, single-blind, multicenter trial comparing laparoscopic cholecystectomy (LC) to minilaparotomy cholecystectomy (MC). Both ele...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-200112000-00005
更新日期:2001-12-01 00:00:00