Abstract：
BACKGROUND:The proportion of positive among examined lymph nodes (lymph node ratio [LNR]) has been recently proposed as an useful and easy-to-calculate prognostic factor for patients with cutaneous melanoma. However, its independence from the standard prognostic system TNM has not been formally proven in a large series of patients. METHODS:Patients with histologically proven cutaneous melanoma were identified from the Surveillance Epidemiology End Results database. Disease-specific survival was the clinical outcome of interest. The prognostic ability of conventional factors and LNR was assessed by multivariable survival analysis using the Cox regression model. RESULTS:Eligible patients (n = 8,177) were diagnosed with melanoma between 1998 and 2006. Among lymph node-positive cases (n = 3,872), most LNR values ranged from 1% to 10% (n = 2,187). In the whole series (≥5 lymph nodes examined) LNR significantly contributed to the Cox model independently of the TNM effect on survival (hazard ratio, 1.28; 95% confidence interval, 1.23-1.32; P < .0001). On subgroup analysis, the significant and independent prognostic value of LNR was confirmed both in patients with ≥10 lymph nodes examined (n = 4,381) and in those with TNM stage III disease (n = 3,658). In all cases, LNR increased the prognostic accuracy of the survival model. CONCLUSION:In this large series of patients, the LNR independently predicted disease-specific survival, improving the prognostic accuracy of the TNM system. Accordingly, the LNR should be taken into account for the stratification of patients' risk, both in clinical and research settings.
journal_name
Surgeryjournal_title
Surgeryauthors
Mocellin S,Pasquali S,Rossi CR,Nitti Ddoi
10.1016/j.surg.2011.02.021subject
Has Abstractpub_date
2011-07-01 00:00:00pages
83-90issue
1eissn
0039-6060issn
1532-7361pii
S0039-6060(11)00077-8journal_volume
150pub_type
杂志文章相关文献
SURGERY文献大全abstract：BACKGROUND:Improvements in outcomes after pancreatoduodenectomy (PD) have permitted more complex resections. Complete extirpation at PD may require multivisceral resection (MVR-PD); however, descriptions of morbidity of MVR-PD are limited to small, single-institution series. METHODS:The National Surgical Quality Impro...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2013.12.020
更新日期：2014-03-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to review the results of lower extremity revascularization in patients with end-stage renal disease and to determine in these patients the functional benefit and cost of an aggressive approach to limb preservation. METHODS:During a 5-year period at our institution, 33 bypass op...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2000.108049
更新日期：2000-09-01 00:00:00
abstract：INTRODUCTION:Hypothermia is a well-known risk factor for postoperative complications because it prolongs the monocyte inflammatory response. The purpose of this study was to investigate whether temperature-activated ion channels (transient receptor protein channels [TRP] A1 and V1) mediate the effects of temperature on...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.03.065
更新日期：2015-09-01 00:00:00
abstract：:Percutaneous drainage (PCD) of abdominal infection is a therapeutic modality whose role is not well defined. Surgical literature on abdominal infection cites a cumulative mortality rate in the range of 20% to 30%, markedly dissimilar from the 80% to 90% cure rates reported in the literature on PCD. We reviewed the PCD...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：INTRODUCTION:Routine, whole-body computed tomography imaging (PAN-SCAN) has been shown to identify unexpected injuries and alter the management of patients presenting with blunt trauma. We sought to characterize the changes in practice over time and the utility of PAN-SCAN imaging in elderly patients who fall and requi...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2013.07.015
更新日期：2013-10-01 00:00:00
abstract：BACKGROUND:An understanding of the regeneration power and operative risk of steatotic livers after hepatectomy is still unclear. We evaluated the volume regeneration and outcome of steatotic livers after donor hepatectomy. METHODS:Fifty-four, consecutive living liver donors from September 2002 to December 2003 were ev...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.09.007
更新日期：2006-04-01 00:00:00
abstract：BACKGROUND:Patients in the accelerated or blastic phases of chronic myelogenous leukemia (CML) often have painful splenomegaly and secondary thrombocytopenia. We tested the hypothesis that splenectomy can be performed with minimal complications in advanced CML, thereby alleviating pain, reversing thrombocytopenia, and ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90259-2
更新日期：1997-07-01 00:00:00
abstract：BACKGROUND:The quick parathyroid hormone assay (QPTH) reliably measures intact parathyroid hormone (iPTH) levels intraoperatively. The accuracy in predicting postoperative calcemia is related to blood sample timing and the criteria applied. To improve specificity or to decrease the cost of QPTH, several criteria have b...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2003.06.001
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND:Surgery for pancreatic necrosis is associated with a high morbidity and mortality. The aim of this study was to review the incidence of early and late complications after pancreatic necrosectomy in a large contemporary series of patients. METHODS:The clinical outcomes of 88 patients who underwent pancreatic...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.01.003
更新日期：2005-05-01 00:00:00
abstract：:We studied the effect of the topical application of the nonsteroidal anti-inflammatory agent, flurbiprofen, on postburn hypermetabolism and systemic lipid peroxidation. Twelve sheep with a 15% total body surface third-degree burn were monitored over a 4-day postburn period. In six sheep, a single application of a 5% f...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：:The esophageal mucosa is exposed to damaging agents both by ingestion and reflux. Using our in vivo rabbit model of esophagitis, we have observed that acute luminal exposure (within 1 to 5 minutes) to potentially harmful agents, such as acid, bile, or ethanol, induces a rapid increase in mucosal blood flow; whereas pr...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1991-08-01 00:00:00
abstract：BACKGROUND:Despite successful revascularization of ischemic extremities, multiorgan dysfunction syndrome develops in some patients. Mechanisms responsible for this are not known; however, the gastrointestinal tract has been implicated as a possible mediator. Our objective was to demonstrate increased intestinal mucosal...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(96)80076-6
更新日期：1996-09-01 00:00:00
abstract：BACKGROUND:To clarify the biologic behavior of the early signet-ring cell cancers (SRCs) by comparing the clinicopathologic features and the incidence of lymph node metastasis between different histologic types of early gastric cancer (EGC) and to propose the indications of endoscopic surgery for SRCs. METHODS:Clinico...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2010.07.006
更新日期：2011-03-01 00:00:00
abstract：:The effect of chronic electrical stimulation on muscle mass of pedicled diaphragmatic muscle grafts (DMGs) implanted into the right ventricle was studied in 21 dogs. Nineteen dogs, followed up to 70 days (mean, 34 days), were divided into three groups. In six dogs (control) the DMG was not stimulated. In six other dog...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1981-08-01 00:00:00
abstract：:The proliferative defects observed in phagocytic stem cells after major thermal injuries may be caused by an inadequate production of colony-stimulating factors (CSFs), a family of hemopoietic cytokines necessary for the production and function of granulocytes and monocytes. In this study a biologic response modifier ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：BACKGROUND:Adequate surgical care is lacking in many low- and middle-income countries because of diverse barriers preventing patients from reaching providers. We sought to assess perceived difficulties to accessing surgical care in Nepal using the Surgeons OverSeas Assessment of Surgical Need tool. METHODS:Fifteen of ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.03.012
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Adhesions to polypropylene mesh used for abdominal wall hernia repair may eventuate in intestinal obstruction or enterocutaneous fistula. A Seprafilm Bioresorbable Membrane translucent adhesion barrier has been shown to inhibit adhesions. This investigation was designed to determine if Seprafilm alters abdom...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2000.106810
更新日期：2000-07-01 00:00:00
abstract：BACKGROUND:Seeding of vascular grafts with genetically engineered human endothelial cells (hECs) secreting antithrombogenic or fibrinolytic agents has considerable clinical potential. METHODS:An adenoviral vector was used to transfer the human tissue-type plasminogen activator (htPA) gene to hECs, and the ability of t...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90269-5
更新日期：1997-07-01 00:00:00
abstract：BACKGROUND:In anticipation of developing gene therapy against thyroid carcinoma we created an expression vector using the thyroglobulin (Tg) gene promoter. The inhibition of both Tg and thyroid-specific transcription factor (TTF-1 and PAX-8) gene expression, however, has been well documented in thyroid carcinomas. We t...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.1998.92008
更新日期：1998-12-01 00:00:00
abstract：BACKGROUND:Estimating the risk of postoperative complications can be performed by surgeons with detailed clinical information or by patients with limited information. Our objective was to compare three estimation models: (1) the All Information Model, using variables available from the American College of Surgeons Nati...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2014.03.002
更新日期：2014-07-01 00:00:00
abstract：:Cholecystectomy will not always relieve the abdominal symptoms of the patient with gallstones. The functional effects of gallbladder removal in a patient with a patent cystic duct are not known in detail. Studies of the function of the gallbladder and pancreas have suggested feedback mechanisms for the release of chol...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：:The specific susceptibility of the intestinal mucosa to low blood flow states is related to the "physiologic" makeup of the intestinal milieu. Pancreatic proteases appear to play a crucial role in the ischemic autodigestion of the intestinal mucosa. Moreover, trypsin can activate the conversion of xanthine dehydrogena...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases, and their pathogenesis is attributed, in part, to alterations of the mucosal immune system. This study was designed to define the possible contribution of epithelial cells to the activation of lamina propria T lymphocytes (LP...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90091-x
更新日期：1997-10-01 00:00:00
abstract：:Current systemic immunosuppressive regimens are unable to prevent lung allograft rejection consistently and are associated with significant morbidity and death. Acute rejection has occurred in 40% and chronic rejection in 50% of our lung recipients. We hypothesized that regional immunotherapy with aerosolized cyclospo...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1990-08-01 00:00:00
abstract：:The clinical results of vascularized pancreas transplants have improved somewhat during the last 5 years, the but technical problems of handling the pancreatic duct remain difficult. Clinical isolated islet allografts have rarely if ever succeeded. Rejection appears to be a more severe problem in pancreas or islet tra...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1982-08-01 00:00:00
abstract：BACKGROUND:Thoracopancreatic fistula is a rare clinical entity but a serious complication of inflammatory pancreatic diseases, caused by a disruption of the pancreatic ductal system. Its diagnosis is frequently misleading, however, and thus is often delayed. METHODS:Seven patients with thoracopancreatic fistula who pr...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2006.02.020
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND:The deliberate induction of carbon dioxide pneumoperitoneum during laparoscopic surgery could be a possible source of cardiovascular collapse. The effects of elevated intraabdominal pressure (IAP) on systemic hemodynamics and splanchnic blood flow created by insufflation of carbon dioxide were examined in an...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：BACKGROUND:The objective of the current study was to define the incidence, as well as time course of mortality within the first year after liver transplantation. METHODS:Data on adult, first-time liver transplant recipients transplanted between February 2002 and June 2016 were obtained from the United Network for Orga...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.04.039
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Recent trends toward regionalization of complex surgical procedures may increase the risk for care fragmentation during readmissions. Conflicting conclusions have been reported regarding risk factors and consequences of nonindex readmissions (ie, readmission to a separate hospital than the one where surgery ...
journal_title：Surgery
pub_type： 杂志文章,meta分析
doi：10.1016/j.surg.2018.08.021
更新日期：2019-03-01 00:00:00
abstract：BACKGROUND:This study sought to determine whether a protective diverting ileostomy improves short-term outcomes in patients with rectal resection and colonic J-pouch reconstruction for low anastomoses. Criteria for the use of a proximal stoma in rectal resections with colonic J-pouch reconstruction have not been define...
journal_title：Surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.surg.2015.11.006
更新日期：2016-04-01 00:00:00
