Abstract:
OBJECTIVE:The aim of this study was to assess the effect of cancer-related genes and their mutations analyzed by next-generation sequencing (NGS) on the oncological outcome after resection of colorectal liver metastases (CRLM). BACKGROUND:Traditional prognostic scores include clinical and pathological parameters of primary tumor and metastases. The modified clinical risk score (m-CS), based on size of metastases, primary tumor nodal status, and RAS mutation status outperformed traditional scores. We hypothesized to further improve the scoring system based on the results of NGS. METHODS:Cancer tissues of 139 patients with CRLM were used for NGS. The work-up included the analysis of recurrent somatic mutations and copy number changes of 720 genes. Clinical data were extracted from a prospectively collected institutional liver database. RESULTS:Depending on significance, the following cancer-related genes and their alterations (%) were further investigated: APC (86%), TP53 (78%), KRAS (29%), SMAD4 (15%), PIK3CA (14%), BRAF (8%), ERBB2 (6%), SMAD3 (5%), SMAD2 (4%), and NRAS (4%). The most predictive parameters for poor oncological outcome were alterations in the SMAD family (P = 0.0186) and RAS-RAF pathway (P = 0.032). Refining the m-CS by replacing RAS with RAS-RAF pathway and adding SMAD family resulted in an extended clinical risk score which is highly predictive for oncological outcome (P < 0.0001). CONCLUSION:In conclusion, mutations of the SMAD family revealed a strong prognostic effect after surgery for CRLM. Integration of alterations of the SMAD family as well as the RAS/RAF pathway resulted in a new, still simple but highly prognostic score.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Lang H,Baumgart J,Heinrich S,Tripke V,Passalaqua M,Maderer A,Galle PR,Roth W,Kloth M,Moehler Mdoi
10.1097/SLA.0000000000003527subject
Has Abstractpub_date
2019-11-01 00:00:00pages
799-805issue
5eissn
0003-4932issn
1528-1140pii
00000658-201911000-00012journal_volume
270pub_type
杂志文章abstract:OBJECTIVE:The authors evaluated the causal relationship between entrapment of the posterior tibial nerve and neuropathic pain and describe the results of nerve decompression in a selected group of patients with intractable pain. SUMMARY BACKGROUND DATA:Painful metabolic neuropathy has, until recently, been thought to ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199506000-00005
更新日期:1995-06-01 00:00:00
abstract::We reviewed 37 consecutive, hemodynamically stable patients (16 adults, 21 children) who had splenic injuries diagnosed by computed tomography (CT) scan to compare the CT evaluation with operative assessment of injury and eventual treatment. Computed tomographic scans and operative findings were graded by a splenic in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199005000-00009
更新日期:1990-05-01 00:00:00
abstract::The dilution technique for determining cardiac output using indocyanine green dye is limited in patients weighing less than 20 kg because of the obligatory volume loss. Reproducible achieved using the green dye dilution method by the establishment of a low flow peripheral arteriovenous shunt. The shunt materials were ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198001000-00020
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:"The elderly" is an often used but poorly defined descriptor of surgical patients. Investigators have used varying subjectively determined age cutoffs to report outcomes in the elderly. We set out to use objective outcomes data to determine the "at-risk" elderly population. METHODS: PATIENTS:129,331 patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182a196d8
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. BACKGROUND:Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000197714.14318.6f
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes of bilateral subtotal (BST) versus total thyroidectomy (TT) for benign bilateral thyroid disease (BBTD). BACKGROUND:The extent of thyroid resection in benign goiter is controversial. Potential advantages of TT over BST may include: one-stage removal of incidental thyroid cancer, and a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182360118
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND AND AIMS:The lower esophageal sphincter (LES) in patients with gastroesophageal reflux disease often has a low resting pressure and a short abdominal length. The mechanism by which this occurs is unknown. We hypothesize that gastric distension causes progressive effacement of the abdominal portion of the LES...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e3e411
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181afe0ab
更新日期:2009-08-01 00:00:00
abstract::Midgestation fetal wound healing is characterized by healing without fibrosis or scar formation. The mechanisms that underlie this remarkable process are mediated in part through a fetal wound extracellular matrix rich in hyaluronic acid. In this study a newly developed assay was used to determine the hyaluronic acid ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199104000-00003
更新日期:1991-04-01 00:00:00
abstract::Pancreas transplantation has evolved dramatically since its introduction in 1966. As new centers for transplantation have developed, the evaluation of complications associated with pancreas transplantation has led to advances in surgical technique. Furthermore, surgical alterations of the pancreas resulting from trans...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199206000-00005
更新日期:1992-06-01 00:00:00
abstract::Reframing healthcare delivery in terms of the principles of complex adaptive systems has practical implications for addressing the challenges in improving surgical care. In an Integrated Practice Unit (IPU) - such as a surgical service line, a surgical in-patient floor, or an acute care unit - a diverse group of careg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001251
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:The effects of total parenteral nutrition (TPN) administration on pulmonary macrophage function and host response to gram-negative pulmonary infection were evaluated. SUMMARY BACKGROUND DATA:Administration of TPN resulted in increased infectious complications in traumatized and perioperative patients, but un...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199403000-00009
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to identify the association between early postoperative troponin elevations and outcomes after major colorectal surgery. BACKGROUND:Myocardial infarction is the leading cause of death after noncardiac surgery. Most postoperative myocardial infarctions are clinically silent, and asymp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001854
更新日期:2016-10-01 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::Appendicitis is more common in developed than in developing societies and appendiceal fecaliths are thought to have an etiologic role in the disease. The geographic distribution of appendiceal fecaliths was investigated by systematic, intraoperative palpation of the appendix in patients in Toronto, Canada and Johannes...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198507000-00013
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVES:Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. METHODS:Twenty...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000234932.88487.75
更新日期:2006-09-01 00:00:00
abstract::The relative importance of oxygen in relation to resistance to infection was assessed in 24 mongrel dogs. Rectus abdominis musculocutaneous (MC) and corresponding cutaneous random pattern (RP) flaps based at the level of the xiphoid were elevated, replaced, and sutured. Immediately after the surgical procedure, 0.1 ml...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198812000-00018
更新日期:1988-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to perform a systematic review and meta-analysis to assess the accuracy of different surgical axillary staging procedures compared with ALND. SUMMARY OF BACKGROUND DATA:Optimal axillary staging after neoadjuvant systemic therapy (NST) in node-positive breast cancer is an area of con...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000003075
更新日期:2019-03-01 00:00:00
abstract::In a five-year study of massive upper gastrointestinal hemorrhage, 143 patients had esophageal varices diagnosed on emergency endoscopic examination. Seventy-one patients had active bleeding from varices and required Sengstaken tube tamponade during at least one hospital admission. The remaining patients included 33 w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198110000-00015
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether the Hospital Readmissions Reduction Program, a national program that introduced financial penalties for high readmission rates for certain medical conditions, had a "spillover" effect on surgical conditions. SUMMARY BACKGROUND DATA:During the past decade, ther...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002350
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To summarize the current world position on laparoscopic liver surgery. SUMMARY BACKGROUND DATA:Multiple series have reported on the safety and efficacy of laparoscopic liver surgery. Small and medium sized procedures have become commonplace in many centers, while major laparoscopic liver resections have been...
journal_title:Annals of surgery
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1097/sla.0b013e3181b3b2d8
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to examine a multi-institutional experience with adrenal metastases to describe survival outcomes and identify subpopulations who benefit from adrenal metastasectomy. BACKGROUND:Adrenalectomy for metastatic disease is well-described, although indications and outcomes are incomplete...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003876
更新日期:2020-05-18 00:00:00
abstract:OBJECTIVE:To describe the field of surgical innovation from a historical perspective, applying new findings from research in technology innovation. BACKGROUND:While surgical innovation has a rich tradition, as a field of study it is embryonic. Only a handful of academic centers of surgical innovation exist, all of whi...
journal_title:Annals of surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1097/01.sla.0000242706.91771.ce
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To develop a model of established respiratory immunity against Pseudomonas aeruginosa pneumonia and to investigate the effects of route and type of nutrition on this immunity. SUMMARY BACKGROUND DATA:Diet influences the ability of gut-associated lymphoid tissue (GALT) to maintain mucosal immunity. Complex en...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199902000-00016
更新日期:1999-02-01 00:00:00
abstract::Thrombosis of the portal vein with or without patency of its tributaries used to be a contraindication to orthotopic liver transplantation (OLTX) until quite recently. Rapid progress in the surgical technique of OLTX in the last few years has demonstrated that most patients with portal vein thrombosis can be safely an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199103000-00003
更新日期:1991-03-01 00:00:00
abstract::Extracorporeal Membrane Oxygenation (ECMO) has been available to neonates with respiratory failure at the University of Michigan School of Medicine since June 1981. In order to evaluate the impact of this type of pulmonary support, a retrospective analysis of 50 neonates with posterolateral congenital diaphragmatic he...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-198902000-00014
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To determine the incidence of anastomotic-related morbidity following Transanal Total Mesorectal Excision (TaTME) and identify independent risk factors for failure. BACKGROUND:Anastomotic leak and its sequelae are dreaded complications following gastrointestinal surgery. TaTME is a recent technique for recta...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002653
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318288e1d4
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:This review summarizes reporting of complications of esophageal cancer surgery. BACKGROUND:Accurate assessment of morbidity and mortality after surgery for cancer is essential to compare centers, allow data synthesis, and inform clinical decision-making. A lack of defined standards may distort clinically rel...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3182480a6a
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To investigate the safety of radical resection for retroperitoneal sarcoma (RPS). BACKGROUND:The surgical management of RPS frequently involves complex multivisceral resection. Improved oncologic outcomes have been demonstrated with this approach compared to marginal excision, but the safety of radical resec...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002250
更新日期:2018-05-01 00:00:00