Abstract:
BACKGROUND:While stereotactic ablative radiotherapy (SABR) is increasingly emerging as an alternative to surgery for node-negative non-small cell lung cancer (NSCLC), there is poor understanding of patients who may most benefit SABR compared to surgery. OBJECTIVE:This study examined the relationship between tumor size and the comparative outcomes of SABR and sublobar resection in patients with node-negative NSCLC. RESULTS:A total of 59,949 patients met study criteria: 19,888 (33%) underwent SABR, 33,052 (55%) wedge resection, and 7009 (12%) segmental resection. In multivariable regression, a significant three-way interaction was found between histology, tumor size, and type of treatment. After stratification by histology, a significant interaction between tumor size and treatment was preserved for patients with adenocarcinoma and squamous cell carcinoma. Sublobar resection was associated with greater survival compared to SABR for tumor sizes greater than 6 and 8 mm for patients with adenocarcinoma and squamous cell carcinoma, respectively. SABR was associated with similar survival compared to sublobar resection for patients with papillary and large cell histology. CONCLUSIONS:In this NCDB analysis, sublobar resection was associated with greater survival compared to SABR for lesions >6 or 8 mm in patients with adenocarcinoma or squamous cell carcinoma; however, SABR was associated with similar survival compared to sublobar resection in patients with aggressive tumors including papillary and large cell histology. Histologic diagnosis in patients with even small tumors may enable better treatment selection in those who cannot tolerate lobectomy.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Raman V,Jawitz OK,Cerullo M,Voigt SL,Rhodin KE,Yang CJ,D'Amico TA,Harpole DH,Kelsey CR,Tong BCdoi
10.1097/SLA.0000000000004730subject
Has Abstractpub_date
2021-01-07 00:00:00eissn
0003-4932issn
1528-1140pii
00000658-900000000-93789journal_volume
Publish Ahead of Printpub_type
杂志文章abstract:OBJECTIVE:To evaluate the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on hospital readmission after common surgical procedures. SUMMARY BACKGROUND DATA:Hospital readmissions following surgery lead to worse patient outcomes and wasteful spending. ACOs, and their associated hospitals,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002737
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Gastrectomy remains a major operation with potential for significant deterioration in patients' health-related quality of life (QOL). This study assessed differences in QOL among patients after distal (DG), proximal (PG), or total (TG) gastrectomy. METHODS:We prospectively enrolled patients undergoing gastr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828c4a19
更新日期:2013-06-01 00:00:00
abstract::A prospective randomized trial was undertaken to evaluate effects of lumbar sympathectomy as an adjunct to reconstructive surgery of the lower limb. The objective of this study was to assess the early postoperative effect of these procedures on pedal vasomotor tone. A pedal arterial resistance index (PARI) at rest was...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-197602000-00009
更新日期:1976-02-01 00:00:00
abstract:OBJECTIVE:To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. BACKGROUND:Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002462
更新日期:2018-12-01 00:00:00
abstract::All patients who underwent isolated myocardial revascularization procedures from 1967-70 (n = 741) were compared with the first 1,000 patients who received similar elective operations each year from 1971 through 1978. Data from these eight years were processed through a computerized cardiovascular information registry...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197910000-00004
更新日期:1979-10-01 00:00:00
abstract::The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00013
更新日期:1983-04-01 00:00:00
abstract::We have demonstrated previously that oxygen-derived free radicals are important mediators of tissue injury following ischemia (total venous occlusion) and reperfusion in small (3 cm X 6 cm) island skin flaps in rats. In this study, we evaluated extension of this concept to regional ischemia in large (8 cm X 8 cm) acut...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198503000-00018
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:This study determined whether there are any laboratory or other features that will enable prediction of spontaneous closure in patients with gastrointestinal cutaneous fistulas. SUMMARY BACKGROUND DATA:Although the anatomic criteria for spontaneous closure of gastrointestinal cutaneous fistulas have been pre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199306000-00003
更新日期:1993-06-01 00:00:00
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 limit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003754
更新日期:2020-01-21 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::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:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001796
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG) have been associated with a high remission rate of type 2 diabetes mellitus (T2DM). However, whether such remission is associated with full restoration of postprandial glucose profile and/or the potentially nonrestored glycemic profile is associate...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000586
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to use updated data and Bayesian methods to evaluate the effectiveness of hyperoxia to reduce surgical site infections (SSIs) and/or mortality in both colorectal and all surgery patients. Because few trials assessed potential harms of hyperoxia, hazards were not included. BACKGRO...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0b013e31826cc8da
更新日期:2012-12-01 00:00:00
abstract::Hypersensitive carotid sinus is a rare cause of spontaneous syncopal attacks. It must be differentiated from the other more common causes, such as intrinsic cardiac disease, vasovagal responses, postural hypotension and cerebrovascular insufficiency, although it may accompany these conditions. The definition of caroti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197905000-00006
更新日期:1979-05-01 00:00:00
abstract:OBJECTIVE:A randomized controlled trial was conducted to clarify the effectiveness of intraoperative blood salvage in reducing blood loss. BACKGROUND:Although reduction of central venous pressure (CVP) is thought to decrease blood loss during liver resection, no consistently effective and safe method for obtaining the...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000255562.60215.3b
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the relation between delay in surgery because of preoperative biliary drainage (PBD) and survival in patients scheduled for surgery for pancreatic head cancer. BACKGROUND:Patients with obstructive jaundice due to pancreatic head cancer can undergo PBD. The associated delay of surgery can lead to ...
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.0b013e3181fd36a2
更新日期:2010-11-01 00:00:00
abstract::The effects of severe infection on luminal transport of amino acids and glucose by the small intestine were investigated. Studies were done in endotoxin-treated rats and in septic patients who underwent resection of otherwise normal small bowel. In rats the kinetics of the brush border glutamine transporter and the gl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199105000-00004
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of cultured epidermal autografts (CEA) for closure of burn wounds in pediatric burn patients with full-thickness burns of more than 90% total body surface area. SUMMARY BACKGROUND DATA:Paucity of donor sites in massive burns makes the use of expanded skin of paramount importance. CEA t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200006000-00011
更新日期:2000-06-01 00:00:00
abstract::Resting energy expenditure (REE), nutritional parameters, and substrate levels were measured using a technique to minimize artifacts in 11 control patients, nine patients with localized, and four patients with diffuse neoplastic disease. Patients with diffuse disease had significantly increased percentage preillness w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198403000-00008
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:To determine prospectively the immunologic response and adverse clinical events in surgical patients exposed to bovine thrombin during cardiac surgical procedures. SUMMARY BACKGROUND DATA:Topical bovine thrombin is used extensively as a hemostatic agent during cardiovascular surgery. Antibodies developing af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200101000-00014
更新日期:2001-01-01 00:00:00
abstract:PURPOSE:To assess the efficacy of isolated pelvic perfusion (IPP) with tumor necrosis factor (TNF)-α and melphalan in patients with locally advanced cancers in the pelvic and groin area requiring mutilating surgery. METHODS:A total of 27 patients were enrolled (carcinoma, n = 17; sarcoma/melanoma, n = 4; and endocrine...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318242ebe7
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To determine the impact of length of stay upon 30-day outcomes. BACKGROUND:It has been recommended the goal length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) should be 1 day to improve resource utilization. This study's aim was to assess LRYGB outcomes by LOS. METHODS:Data were obtain...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000227
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the short-term outcomes and long-term survival of laparoscopic rectal cancer resection at a single institution with 579 cases over a 15-year period. SUMMARY BACKGROUND DATA:The use of laparoscopic resection for colon cancer has been shown to be safe with comparable oncolo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31818e418a
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to define the incidence and etiology of small bowel obstruction (SBO) after nephrectomy for Wilms' tumor. SUMMARY BACKGROUND DATA:Intestinal obstruction is one of the most common postoperative complications after nephrectomy for nephroblastoma. However, few reports have evaluated ri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199321850-00011
更新日期:1993-11-01 00:00:00
abstract::A method of clinical staging for infants with necrotizing enterocolitis (NEC) is proposed. On the basis of assigned stage at the time of diagnosis, 48 infants were treated with graded intervention. For Stage I infants, vigorous diagnostic and supportive measures are appropriate. Stage II infants are treated medically,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197801000-00001
更新日期:1978-01-01 00:00:00
abstract::The effects of two levels of protein intake on protein metabolism in six severely burned adult patients were studied (means of 70% BSA burned). A crossover experimental design enabled the authors to study each patient at the end of two three-day dietary regimens. All diets were isocaloric and provided approximately 25...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198302000-00007
更新日期:1983-02-01 00:00:00
abstract:OBJECTIVE:We assessed circulating tumor cells (CTCs) with epithelial and mesenchymal phenotypes as a potential prognostic biomarker for patients with pancreatic adenocarcinoma (PDAC). BACKGROUND:PDAC is the fourth leading cause of cancer death in the United States. There is an urgent need to develop biomarkers that pr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001600
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:To determine whether the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule confers higher value for physician work in procedure and test codes than in Evaluation and Management (E/M) codes. BACKGROUND:Medicare Payment Advisory Commission previously demonstrated that time for medical serv...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000990
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:We report on a new side-to-side isoperistaltic strictureplasty (SSIS), the Michelassi II or end-to-side-to-side-to-end strictureplasty, performed with discontinuous bowel loops. SUMMARY BACKGROUND DATA:The SSIS Michelassi strictureplasty was described a quarter of a century ago to avoid massive bowel resecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003430
更新日期:2020-01-01 00:00:00