Abstract:
OBJECTIVE:We examined management strategies, overall survival (OS), and progression-free survival (PFS) among patients with PMNSGCTs undergoing resection and multidisciplinary management at a high-volume institution. SUMMARY OF BACKGROUND DATA:Outcomes after resection of PMNSGCTs are not well-characterized, with limited data on factors associated with survival. METHODS:We reviewed patients with PMNSGCT who underwent resection between 1980 and 2019. Median follow-up was 3.4 years. Preoperative therapy (including use of bleomycin), surgical management, recurrence, and survival were examined. Factors associated with survival were analyzed using Cox regression. RESULTS:In total, 113 patients were included [median age, 28 years (range, 16-65)]. Preoperative serum tumor markers (STMs) normalized/decreased in 74% of patients. Pathology included necrosis only (25%), teratoma +/- necrosis (20%), viable nonteratomatous germ cell tumor +/- teratoma (41%), and secondary somatic-type malignancy +/- teratoma (20%). Bleomycin chemotherapy was not associated with pulmonary complications or 90-day mortality. Patients receiving second-line chemotherapy followed by resection had significantly worse OS and PFS than patients receiving first-line chemotherapy followed by resection. On multivariable analysis, R1/R2 resection (HR, 3.92; P < 0.001) and increasing postoperative STMs (HR, 4.98; P < 0.001) were associated with shorter PFS; necrosis on pathology (HR, 0.42, P = 0.043) was associated with longer PFS. CONCLUSIONS:In patients with PMNSGCT undergoing resection, completeness of resection, postoperative pathology, and postoperative STMs were associated with PFS. Induction bleomycin was not associated with pulmonary complications or mortality in patients undergoing resection. Patients undergoing second-line chemotherapy followed by resection have a poor prognosis, with long-term survival of 22%.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Caso R,Jones GD,Bains MS,Hsu M,Tan KS,Feldman DR,Funt SA,Reuter VE,Bosl GJ,McHugh D,Huang J,Molena D,Amar D,Fischer G,Rusch VW,Jones DRdoi
10.1097/SLA.0000000000003754subject
Has Abstractpub_date
2020-01-21 00:00:00eissn
0003-4932issn
1528-1140pub_type
杂志文章abstract:OBJECTIVE:The aim of this study was to determine inguinal hernia recurrence rates 5 years after endoscopic totally extraperitoneal (TEP) inguinal hernia repair when either lightweight or heavyweight mesh was used. BACKGROUND:Recurrence is an important complication of inguinal hernia surgery. Higher recurrence rates of...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002649
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:This study evaluates the effects of mechanical bowel preparation (MBP) on anastomosis below the peritoneal verge and questions the influence of MBP on anastomotic leakage in combination with a diverting ileostomy in lower colorectal surgery. SUMMARY BACKGROUND DATA:In a previous large multicenter randomized ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181c0e75c
更新日期:2010-01-01 00:00:00
abstract::In an effort to minimize the nutritional complications that follow resection of the pancreas for severe chronic pancreatitis, the authors have performed a duodenum-preserving total pancreatectomy in eight patients for severe unremitting pain requiring large doses of opiate analgesia. Good relief of pain was obtained i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199111000-00007
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of modest endotoxemia on postoperative antithrombin deficiency and cholestasis. SUMMARY BACKGROUND DATA:It has not been determined whether endotoxin translocation in small amounts is a physiological phenomenon or whether it is a potential health hazard. METHODS:Blood endotoxin, ant...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000082711.77096.71
更新日期:2003-08-01 00:00:00
abstract::Despite recommended preoperative preparation with alpha-adrenergic blockers, severe hemodynamic instability may occur during operations to resect pheochromocytoma. We combined the alpha-blocker phenoxybenzamine with the tyrosine hydroxylase inhibitor metyrosine in an attempt to better manage the hypertension of patien...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199011000-00010
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000520
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of adjunctive IPC to standard prophylaxis of postoperative VTE in patients at extremely high-risk. SUMMARY OF BACKGROUND DATA:The standard prophylaxis for postoperative VTE is insufficient in extremely high-risk patients. It is unclear whether an adjunctive use of IPC would result in a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004556
更新日期:2020-11-12 00:00:00
abstract::A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198105000-00018
更新日期:1981-05-01 00:00:00
abstract::Neurologic events following carotid reconstructive surgery for symptomatic cerebral occlusive disease are generally reported to be one to two per cent. One of the events leading to this incidence is thrombosis of the endarterectomized internal carotid artery (ICA) after surgery. Since antiplatelet drugs have been foun...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198506000-00014
更新日期:1985-06-01 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::A technique for repairing benign hilar hepatic duct strictures using transhepatic intubation with a large bore silastic stent is described. This procedure has been used in 10 patients. In 9 instances the stricture involved the common hepatic duct, and in one patient the right and left hepatic ducts. Nine of the strict...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197605000-00005
更新日期:1976-05-01 00:00:00
abstract:OBJECTIVES:The aim of this systematic review was to assess the impact of surgical safety checklists on the quality of teamwork and communication in the operating room (OR). BACKGROUND:Safety checklists have been shown to impact positively on patient morbidity and mortality following surgery, but it is unclear whether ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000206
更新日期:2013-12-01 00:00:00
abstract::Four hundred twenty-six patients with esophageal atresia with or without tracheoesophageal fistula have been primarily cared for at the University of Michigan Medical Center since Cameron Haight's initial experience with this entity. Over the period of observation, the incidence of new cases as well as the number of a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198610000-00013
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the reduction in the incidence of parastomal hernia (PH) after placement of prophylactic synthetic mesh using a modified Sugarbaker technique when a permanent end-colostomy is needed. SUMMARY OF BACKGROUND DATA:Prevention of PH formation is crucial given the high prevalenc...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000001684
更新日期:2016-12-01 00:00:00
abstract::Analysis of experience with chronic bleeding peptic ulcer in 504 patients, admitted from 1960 to 1971, shows a hospital mortality of 12%. This retrospective review suggested that early endoscopic diagnosis, adequate resuscitation and a policy of early selective surgery was necessary if mortality was to be reduced. Wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198401000-00008
更新日期:1984-01-01 00:00:00
abstract:UNLABELLED:SUMMARY BACKGROUND DATA AND OBJECTIVE: Persistent pain affects everyday activities in 5% to 8% of patients after groin hernia repair. Because previous reports on the effect of neurectomy and/or mesh removal suffer from methodological problems we performed a detailed prospective trial of the effect of neurect...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0b013e31818eec49
更新日期:2009-02-01 00:00:00
abstract::Metabolic and hormonal studies were performed in 6 infants during the first 3 months of life while receiving 3 different types of parenteral nutrition: 1) 20% glucose and a nitrogen source (Dudrick's method) 2) 12% glucose, a nitrogen source and soybean fat emulsion (Intralipid method) and 3) 12% glucose, a nitrogen s...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-197507000-00012
更新日期:1975-07-01 00:00:00
abstract::Early aggressive therapy with maintenance infusions of methylprednisolone sodium succinate and gentamicin sulfate significantly increases the probability for survival of baboons given LD100 Escherichia coli. The present study was designed to determine if baboons would recover when initiation of treatment was delayed u...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198107000-00009
更新日期:1981-07-01 00:00:00
abstract:OBJECTIVE:Our goal was to perform a comparative effectiveness study of intravenous (IV)-only versus IV + enteral contrast in computed tomographic (CT) scans performed for patients undergoing appendectomy across a diverse group of hospitals. BACKGROUND:Small randomized trials from tertiary centers suggest that enteral ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000272
更新日期:2014-08-01 00:00:00
abstract::Diminished poststenotic pressure and flow accompanied experimental application of multiple subcritical arterial stenoses in series. Effects of additional stenoses, causing equivalent constrictions, were cumulative in a nonlinear fashion. Seven-hundred-twenty measurements were performed using 10 cm ileofemoral canine a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197711000-00020
更新日期:1977-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. BACKGROUND:LDLT and ABO-mismatched transplantation constitute feasible options to alleviate organ shortage in chil...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001094
更新日期:2015-12-01 00:00:00
abstract::The subcutaneous administration of insulin did not induce a significant effect on oxidative phosphorylation of the mitochondria from normal rat liver. However, in rats subjected to ligation of a branch of portal vein, the phosphorylative activity of the mitochondria from the ligated lobe deprived of portal blood fell ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197411000-00002
更新日期:1974-11-01 00:00:00
abstract:OBJECTIVE:To evaluate recent surgical strategy for hilar cholangiocarcinoma (HC) of the left-side predominance. BACKGROUND:When employing left hemihepatectomy (LH) for HC, vasculobiliary anatomy of the right liver often makes it difficult to achieve a tumor-free margin of the right posterior sectional bile duct (RPSBD...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000584
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To identify and prioritize hazards in surgical wards and recommend interventions. BACKGROUND:Retrospective and prospective studies report the frequency and severity of surgical adverse events, but not in sufficient detail to allow interventions to be recommended in surgical wards. METHODS:Seventy hours of o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824f5f36
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. BACKGROUND:Pathological LN status is a major disease prognostic factor and marker...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000000991
更新日期:2015-05-01 00:00:00
abstract::Metoclopramide or placebo was administered postoperatively in a randomized, double-blind fashion to 115 patients undergoing laparotomy. The effect of metoclopramide on postoperative adynamic ileus (PAI) was evaluated. The patients were stratified into two groups: Group A--those with laparotomy without a gastrointestin...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-197907000-00006
更新日期:1979-07-01 00:00:00
abstract::We analyzed the course of 186 patients with external gastrointestinal fistulas treated at the University of California Medical Center, San Francisco from 1968 to 1977. There were 82 patients in the earlier group (1968-1971) and 104 patients in the later group (1972-1977). The groups differed in that 35% of patients in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197810000-00003
更新日期:1978-10-01 00:00:00
abstract::Twelve patients with anal incontinence due to neurologic disease or failure of previous incontinence surgery underwent implantation of an artificial anal sphincter. The system used was a modification of the AMS 800 artificial urinary sphincter. In two patients, infection necessitated removal of the system, and in four...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199204000-00013
更新日期:1992-04-01 00:00:00
abstract::Abdominal aortic aneurysmectomy is being performed with progressively lower operative mortality and morbidity. Three hundred thirty seven patients have had elective aneurysm repair since 1954. Factors affecting mortality and morbidity in the last 108 cases are analyzed. Seventy-four per cent of patients had pre-existi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00020
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:To study risk factors for early and late death after heart transplantation in the current era. SUMMARY BACKGROUND DATA:The current cardiac transplant population differs from earlier periods in that an increasing number of sicker patients, such as those with ventricular assist device (LVAD) support, prior car...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200009000-00002
更新日期:2000-09-01 00:00:00