Abstract：
BACKGROUND:Immunosuppressed patients have an increased risk of developing anal cancer, but little data exists regarding outcomes of this population. METHODS:A retrospective review of anal cancer patients at a single academic institution from 2006 to 2017 was performed. RESULTS:19 (14%) of 136 anal cancer patients were immunosuppressed. Immunosuppressed patients were more likely to be hypoalbuminemic (21% vs. 6%, p = 0.025), less likely to complete chemotherapy (58% vs. 80%, p = 0.031) or exhibit a complete response to chemoradiation (57% vs. 82%, p = 0.037), and more likely to experience recurrence (53% vs. 25%, p = 0.013). Hypoalbuminemia was significantly associated with worse overall (HR 6.4, CI 2.2-19.2, p < 0.001) and progression-free (HR 4.4, CI 1.8-10.4, p < 0.001) survival. CONCLUSIONS:Immunosuppressed patients have poor tolerance of chemotherapy and response to chemoradiation, and an increased rate of recurrence. This finding is possibly due to the relationship between immunosuppression and hypoalbuminemia, which was associated with worse overall and progression-free survival.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Bingmer K,Ofshteyn A,Dietz DW,Stein SL,Steinhagen Edoi
10.1016/j.amjsurg.2019.08.011subject
Has Abstractpub_date
2020-01-01 00:00:00pages
88-92issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(19)30886-4journal_volume
219pub_type
杂志文章abstract：BACKGROUND:We developed a model for capitation and global pricing for carotid endarterectomy. METHODS:A care algorithm for diagnosis, perioperative management, and postoperative care using cost data was developed. Perioperative care charges were extrapolated from a 1-year experience and applied to models to determine ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00128-7
更新日期：1998-08-01 00:00:00
abstract：:In this retrospective study, a cohort of gastric ulcer patients treated with antacids was compared with a well-matched group of patients treated with a combination of antacids and cimetidine. Cimetidine combined with antacids enhanced gastric ulcer healing, thereby significantly reducing the number of gastric ulcer op...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80151-3
更新日期：1985-05-01 00:00:00
abstract：BACKGROUND:Training surgeons in vital decision-making skills remains unstructured. We aimed to map a process of care from the perspective of surgical decision making and test whether it could be deconstructed into an accessible format for trainees. METHODS:Semistructured interviews were conducted with 10 experienced s...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2007.02.016
更新日期：2008-05-01 00:00:00
abstract：:Surgical clips (metallic or plastic) are frequently used for hemostasis and tumor marking. This study evaluated the radiographic and computerized tomographic appearance of different clips and their relative interference with computerized tomographic scans. Metallic clips (stainless steel, tantalum, and titanium) can a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90142-9
更新日期：1984-05-01 00:00:00
abstract：:False aneurysm formation in a twenty-nine year old black woman treated for renovascular hypertension secondary to fibromuscular hyperplasia by knitted Dacron prosthetic patch angioplasty is reported. Etiologic mechanisms are discussed. The most likely factors leading to false aneurysm formation in this patient are dis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90366-4
更新日期：1976-11-01 00:00:00
abstract：:Two patients with coexisting neurofibromatosis and hyperparathyroidism are described, bringing the total number of such cases in the world literature to seven. Other more classic examples of the association of tumorous conditions of neuroectodermal and entodermal origin are discussed to support the suggestion that the...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90079-5
更新日期：1979-03-01 00:00:00
abstract：BACKGROUND:The underutilization of radiation therapy after breast-conserving surgery in early-stage breast cancer patients has been attributed to the inconvenience and potential side effects of whole-breast radiation treatment regimens. Accelerated partial-breast irradiation (APBI) involves twice-daily treatments more ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.06.024
更新日期：2016-07-01 00:00:00
abstract：:Surgical patients are at high risk to develop nosocomial pneumonia, although an accurate diagnosis is difficult to make. Staphylococcus aureus and Pseudomonas aeruginosa are the most common pathogens, but Acinetobacteris emerging as an important pathogen. Because affected patients are often critically ill with multisy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：
更新日期：2000-02-01 00:00:00
abstract：BACKGROUND:Prognosis in peritoneal carcinomatosis from gastric cancer has improved with cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy. The aim of this study was to identify predictive factors for incomplete CS. METHODS:Forty-five patients undergoing laparotomy for gastric cancer with periton...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.009
更新日期：2013-06-01 00:00:00
abstract：:Endocrine tumors arising sporadically or as a manifestation of the multiple endocrine neoplasia type I syndrome (MEN I) have been shown to have mutations on chromosome 11. These mutations can be detected at the molecular level by loss of heterozygosity (LOH) for DNA markers from chromosome 11. This study represents on...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90071-x
更新日期：1994-01-01 00:00:00
abstract：:Sixty-seven cases of neck exploration for suspected hyperparathyroidism were reviewed. Thirty-nine patients underwent removal of an adenoma with biopsy of one or more other parathyroid glands. In another group, nine patients underwent removal of the adenoma only. Both groups have had no recurrences of hyperparathyroid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90389-5
更新日期：1976-09-01 00:00:00
abstract：:Surgeons need to be aware of the various options available to remove enlarged gallbladders or gallstones lost during laparoscopic cholecystectomy. Every attempt should be made to recover stones that have escaped from a ruptured gallbladder during laparoscopic cholecystectomy, short of converting to laparotomy. Initial...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80949-3
更新日期：1993-04-01 00:00:00
abstract：:Between 1960 and 1990, a total of 998 patients were treated at the Sydney Melanoma Unit for cutaneous melanoma of the head and neck. There were 595 male and 403 female patients, with a median age of 53 years. The most common primary lesion site was the face (47%), followed by the neck (29%), scalp (14%), and ear (10%)...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90138-4
更新日期：1991-10-01 00:00:00
abstract：BACKGROUND:Diabetes mellitus (DM) is associated with adverse events or complications in various gastrointestinal diseases. In this study, we examined whether diabetic patients had higher risk for the development of complicated acute appendicitis than nondiabetic patients. The relevant risk factors also were determined....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.05.042
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:This study attempts to determine if enough pathological abnormalities in gastric remnants from sleeve gastrectomy exist to warrant full pathologic evaluation in all remnants. METHODS:Data was collected on patients undergoing sleeve gastrectomy between 08/01/2011 and 06/30/2014. Significant abnormalities wer...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.06.029
更新日期：2017-12-01 00:00:00
abstract：:Appendicitis in preschool children is not uncommon. A duration of greater than 40 hours usually implied perforation. The most common findings were abdominal pain, tenderness, temperature elevation and vomiting. In the presence of perforation or abscess formation, appendectomy followed by copious wound irrigation, absc...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90265-2
更新日期：1980-02-01 00:00:00
abstract：:The clinical efficacy and safety of cefotetan was assessed in two multicenter clinical trials involving 335 evaluable patients hospitalized with obstetric and gynecologic infections. In Study I, cefotetan was compared with moxalactam and in Study II, cefotetan was compared with cefoxitin. The clinical response rate in...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(88)80214-9
更新日期：1988-05-31 00:00:00
abstract：BACKGROUND:We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. METHODS:A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, E...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.08.019
更新日期：2019-07-01 00:00:00
abstract：OBJECTIVE:Minority patients are at risk for delayed breast cancer treatment. Using nonsurgical breast specialists could improve access but requires appropriate referral to ensure prompt cancer care. Our objective was to evaluate a referral triage system in a combined medical/surgical breast health program (BHP). METHO...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.06.014
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:To determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed. METHODS:FAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.021
更新日期：2006-11-01 00:00:00
abstract：:Wounds will readily acquire bacteria, unless protective measures are taken. The bacterial protection afforded by conventional absorbent cellulose dressings has been shown to be limited, particularly in the presence of serous exudate that may compromise dressing integrity. In addition, dressings may shed particles that...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(94)90006-x
更新日期：1994-01-01 00:00:00
abstract：BACKGROUND:The aim of this study is to establish a relationship between critical ischemia of the lower limb and kidney dysfunction. MATERIALS AND METHODS:At rest, urine samples were collected from three groups: group A, 16 patients with critical ischemia; group B, 22 patients with stable intermittent claudication; and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01406-x
更新日期：2003-04-01 00:00:00
abstract：:We studied the effect of high caloric parenteral nutrition on the rate of gastric emptying of solid food. The linear pattern of gastric emptying was not altered by parenteral nutrition, but the gastric emptying rate was consistently slowed. The degree of slowing of gastric emptying while on parenteral nutrition correl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90338-6
更新日期：1979-11-01 00:00:00
abstract：:Exposed bone, even in conjunction with a fracture, will cover spontaneously with granulation tissue followed by epithelium, or will sequestrate and then cover, providing there is adequate circulation at the wound site. The healing process is lengthy but need not interfere with the reestablishment of function of the wo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90115-6
更新日期：1979-04-01 00:00:00
abstract：:Understanding variation in perioperative opioid exposure and its effect on patients' outcomes is critical for pain management. This study characterized perioperative exposure to morphine and its association with postoperative pain and 30-day readmissions. We utilized nationwide Veterans Healthcare Administration (VHA)...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.06.022
更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.008
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Motility disturbances in the Roux loop can negatively influence the outcome of reflux gastritis; the uncut Roux loop does not have these disadvantages, but is less suitable for clinical application because of staple dehiscence. The reported "cut-closed-reconnected" Roux loop has the same physiological starti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00246-4
更新日期：2000-02-01 00:00:00
abstract：:This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90191-7
更新日期：1987-08-01 00:00:00
abstract：BACKGROUND:HIV and AIDS continues to be a significant health problem with many patients requiring the attention of a general surgeon. METHOD:A retrospective case note review over a two-year period was undertaken. RESULTS:237 patients underwent invasive procedures. The majority 100 patients (145 procedures) were for v...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00054-2
更新日期：1996-07-01 00:00:00
abstract：BACKGROUND:The upper thigh is an alternative but infrequently used site to the forearm for placement of subcutaneous polytetrafluoroethylene (PTFE) arteriovenous conduits in patients requiring hemodialysis for end stage renal failure. This site has the great advantage of easier accessibility for self-cannulation. METH...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00405-9
更新日期：1997-04-01 00:00:00
