Abstract:
OBJECTIVE:The objective of this study was to characterize the patterns of first recurrence after curative-intent resection for pancreatic adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA:We evaluated the first site of recurrence after neoadjuvant treatment as locoregional (LR) or distant metastasis (DM). To validate our findings, we evaluated the pattern from two phase II clinical trials evaluating neoadjuvant chemotherapy (NAC) in PDAC. METHODS:We identified site of first recurrence from a retrospective cohort of patients from 2011-2017 treated with neoadjuvant chemotherapy followed by chemoradiation and then an operation or an operation first followed by adjuvant therapy, as well as two separate prospective cohorts of patients derived from two phase II clinical trials evaluating patients treated with neoadjuvant chemotherapy in borderline-resectable and locally advanced PDAC RESULTS:: In the retrospective cohorts, 160 out of 285 patients (56.1%) recurred after a median disease-free survival (mDFS) of 17.2 months. The pattern of recurrence was DM in 81.9% of patients, versus LR in 11.1%. This pattern was consistent in patients treated with upfront resection and adjuvant chemotherapy (DM 83.0%, LR 16.9%) regardless of margin-involvement (DM 80.1%, LR 19.4%). The use of NAC did not alter pattern of recurrence; 81.7% had DM and 18.3% had LR. This pattern also remained consistent regardless of margin-involvement (DM 94.1%, LR 5.9%). In the Phase II borderline-resectable trial (NCI# 01591733) cohort of 32 patients, the mDFS was 34.2 months. Pattern of recurrence remained predominantly DM (88.9%) versus LR (11.1%). In the Phase II locally-advanced trial (NCI# 01821729) cohort of 34 patients, the mDFS was 30.7 months. Although there was a higher rate of local recurrence in this cohort, pattern of first recurrence remained predominantly DM (66.6%) versus LR (33.3%) and remained consistent independent of margin-status. CONCLUSIONS:The pattern of recurrence in PDAC is predominantly DM rather than LR, and is consistent regardless of the use of NAC and margin involvement.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Chawla A,Qadan M,Castillo CF,Wo JY,Allen JN,Clark JW,Murphy JE,Catalano OA,Ryan DP,Ting DT,Deshpande V,Weekes CD,Parikh A,Lillemoe KD,Hong TS,Ferrone CRdoi
10.1097/SLA.0000000000004585subject
Has Abstractpub_date
2020-10-19 00:00:00eissn
0003-4932issn
1528-1140pub_type
杂志文章abstract:BACKGROUND:Some, but not all, studies using registry data have suggested a small but significant long-term survival advantage following a curative surgical resection of gastric cancer at hospitals where the volume of such surgeries is high. However, because such data may be significantly influenced by the impact of pos...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000245469.35088.42
更新日期:2007-03-01 00:00:00
abstract::Twelve prognostic features of melanoma were examined in a series of 185 patients with nodal metastases (Stage II), who underwent surgical treatment at our institution during the past 20 years. Forty-four per cent of the patients presented with synchronous nodal metastases (substage IIA), 44% of the patients had delaye...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00023
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to evaluate the effect of radiotherapy (RT) on sexual function in patients undergoing oncologic resection for rectal cancer, and to develop a mathematical model for quantifying the risk of sexual dysfunction through time for this group of patients. METHODS:Data were prospec...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000183608.24549.68
更新日期:2005-10-01 00:00:00
abstract::Nineteen patients with primary duodenal carcinoid were analysed retrospectively, and eight of the tumors were immunocytochemically examined. One tumor contained somatostatin, two tumors gastrin, two tumors both these peptides, and one tumor contained serotonin. In two tumors no peptide or amine could be demonstrated. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00003
更新日期:1983-04-01 00:00:00
abstract::Six patients with surgically treated Menetrier's disease are presented. Diffuse or focal cystic hyperplasia of mucous secreting epithelium of the fundus with antral sparing characterized the stomachs in all of these cases. In most instances the disorder was found during evaluation of non-specific complaints of pain, n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197704000-00015
更新日期:1977-04-01 00:00:00
abstract:OBJECTIVE:To assess long-term outcome and prognostic factors for extreme surgery by vascular and plastic surgical teamwork for leg salvage in patients with critically ischemic large tissue defects. SUMMARY BACKGROUND DATA:Combined vascular reconstruction and microvascular free-flap transfer has been used to improve di...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000247985.45541.e8
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. BACKGROUND:Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoreti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001924
更新日期:2017-08-01 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 purpose of the study was to test the hypothesis that cardiac mucosa, carditis, and specialized intestinal metaplasia at an endoscopically normal-appearing cardia are manifestations of gastroesophageal reflux disease. SUMMARY BACKGROUND DATA:In the absence of esophageal mucosal injury, the diagnosis of ga...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199710000-00013
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To document the decreased incidence of surgical complications after pancreas transplantation in recent times. SUMMARY BACKGROUND DATA:Compared with other abdominal transplants, pancreas transplants have historically had the highest incidence of surgical complications. However, over the past few years, the au...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200002000-00017
更新日期:2000-02-01 00:00:00
abstract::The significance of regional therapy against the intrahepatic recurrence for hepatocellular carcinoma (HCC) was evaluated. During the past 6 years, 101 patients who had radical operations for HCC (liver cirrhosis, 75%; chronic hepatitis, 22%) were followed. Forty-seven patients (47%) had recurrences; the liver was the...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198707000-00006
更新日期:1987-07-01 00:00:00
abstract:PURPOSE:The effects of regionalization of tertiary care were studied by analyzing cost and outcome for pancreaticoduodenectomies in a state in which the majority of these high-risk procedures were performed in one hospital. METHODS:Using Maryland inpatient discharge data via a retrospective study, the authors compared...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199501000-00005
更新日期:1995-01-01 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::Estrogen (ER), progesterone (PgR), and androgen (AR) receptors were measured in two simultaneous or subsequent specimens taken each from 259 patients with breast cancer. We studied in 182 patients results from receptor assays, either from one tumor or from the primary tumor, and a lymph node metastasis, and in 77 sequ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198503000-00008
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVES:Because neural invasion (NI) is still inconsistently reported and not well characterized within gastrointestinal malignancies (GIMs), our aim was to determine the exact prevalence and severity of NI and to elucidate the true impact of NI on patient's prognosis. BACKGROUND:The union internationale contre le ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000968
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:We aimed to determine the unbiased mortality rates for pancreatic surgery procedures at the national level through a comprehensive analysis of every inpatient case in Germany. SUMMARY OF BACKGROUND DATA:Several studies have proclaimed a general improvement of perioperative outcomes following pancreatic surge...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001693
更新日期:2016-12-01 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:OBJECTIVE:The authors determined whether caloric restriction (CR) either acutely or chronically, alters heat shock protein 70 (hsp70) gene expression in the gut. SUMMARY BACKGROUND DATA:Caloric restriction prolongs the life span and delays age-related disease (e.g., cancer) in mammals; the mechanisms responsible for t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199605000-00015
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To review the physiologic effects of carbon dioxide (CO2) pneumoperitoneum in the morbidly obese. SUMMARY BACKGROUND DATA:The number of laparoscopic bariatric operations performed in the United States has increased dramatically over the past several years. Laparoscopic bariatric surgery requires abdominal in...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/01.sla.0000151791.93571.70
更新日期:2005-02-01 00:00:00
abstract::Adipocyte lipolysis and its adrenergic control were studied in vitro from normal patients and those with trauma and sepsis. The adrenergic receptors were studied in terms of their responsiveness, a measure of the postreceptor mechanism, and their sensitivity, a measure of the receptor number or affinity. With early tr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198712000-00010
更新日期:1987-12-01 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:OBJECTIVE:Length of stay (LOS) is an important outcome as a marker of resource consumption. Determining which factors increase LOS may provide information on reducing costs and improving the delivery of care. The purpose of this study was to determine the independent association of intraoperative process of care and po...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199908000-00016
更新日期:1999-08-01 00:00:00
abstract::A new approach for preventing and treating sepsis due to central venous catheter (CVC) has been devised at the Istituto Nazionale Tumori of Milan. A prospective protocol has been developed that includes the weekly exchange of the CVC via a guidewire as well as its exchange when a CVC-related sepsis is suspected. Growt...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-198307000-00009
更新日期:1983-07-01 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:OBJECTIVE:The authors evaluated the morbidity, mortality, and quality of life after pancreatic debridement for necrosis and compared these values to those for quality of life after elective medical and surgical management for chronic pancreatitis. SUMMARY BACKGROUND DATA:Quality of life after pancreatic debridement fo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199606000-00005
更新日期:1996-06-01 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:To investigate the incidence of nodal metastasis in a consecutive series of patients treated at the authors' institution with highly selective criteria, and to determine the impact that lymphatic mapping and sentinel node biopsy have on the detection of nodal metastases in this carefully selected patient popu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071564.27229.A9
更新日期:2003-06-01 00:00:00
abstract::Prolonged veno arterial extracorporeal bypass (50-80% of cardiac output) was evaluated in normal, unanesthetized sheep. The evaluation protocol included serial measurements of hemodynamics, pulmonary and renal function, serum enzymes to detect organ damage, and detailed studies of coagulation and platelets. Blood expo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197412000-00010
更新日期:1974-12-01 00:00:00
abstract:OBJECTIVE:To analyze the challenges encountered during surgical quality improvement interventions, and explain the relative success of different intervention strategies. SUMMARY BACKGROUND DATA:Understanding why and how interventions work is vital for developing improvement science. The S3 Program of studies tested wh...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001583
更新日期:2016-12-01 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