Abstract:
:Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed in 4.8% after a mean followup of 3.6 years. Of those referred with metastatic disease (98 patients), mortality was 35% after a mean followup of 5.9 years. Male patients (p less than 0.04) and patients with axial primaries (p less than 0.05) were at an increased risk of metastasis. Severe histologic regression was present in 40% of the primary lesions that metastasized and in only 17% of similar lesions that did not (p less than 0.001). Increased age was associated with increased local skin metastases, but not with increased nodal or distant metastases. A prognostic model was designed, using two clinical risk factors (axial primary site and male sex) and two histologic risk factors (Clark's Level IV and severe histologic regression). The prognostic model identified a low-risk population--women with extremity primaries--with an actuarial risk of metastasis at 10 years that was less than 3%. Patients with either (1) both clinical risk factors or (2) one clinical risk factor and one histologic risk factor were identified as high-risk patients. Their actuarial risk of metastasis was 11% at 5 years and 22% at 10 years (p = 0.0084). Identifying high-risk and low-risk patients with thin melanomas may improve guidelines for the application of adjuvant therapies to this population.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Slingluff CL Jr,Vollmer RT,Reintgen DS,Seigler HFdoi
10.1097/00000658-198808000-00004subject
Has Abstractpub_date
1988-08-01 00:00:00pages
150-61issue
2eissn
0003-4932issn
1528-1140journal_volume
208pub_type
杂志文章abstract:SUMMARY BACKGROUND DATA:During the past five decades, significant improvements have been made in the diagnosis and treatment of thoracic outlet syndrome (TOS) secondary to sports activities, breast implants, or median sternotomy. METHODS, RESULTS, AND CONCLUSIONS:Of more than 15,000 patients evaluated for TOS, 3914 un...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199810000-00017
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Fine-needle aspiration (FNA) is currently the primary diagnostic procedure in diagnosing thyroid malignancy and guides surgeons on patient selection for thyroidectomy for thyroid nodules. Diagnostic sensitivity is reported to be approximately 80%; however, patients with negative FNA results do not necessaril...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3180f61adc
更新日期:2007-11-01 00:00:00
abstract::The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00032
更新日期:1974-10-01 00:00:00
abstract:OF BACKGROUND DATA:Unspecified kidney donation (UKD) describes living donation of a kidney to a stranger. The practice is playing an increasingly important role within the transplant programme in the United Kingdom, where these donors are commonly used to trigger a chain of transplants; thereby amplifying the benefit d...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000003855
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To determine the disease-free survival (DFS) and recurrence after the treatment of patients with rectal cancer with open (OPEN) or laparoscopic (LAP) resection. BACKGROUND:This randomized clinical trial (ACOSOG [Alliance] Z6051), performed between 2008 and 2013, compared LAP and OPEN resection of stage II/II...
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.0000000000003002
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes of TransCarotid Artery Revascularization with flow reversal (TCAR) to the gold standard carotid endarterectomy (CEA) using data from the Society for Vascular Surgery Vascular Quality Initiative TCAR Surveillance Project. SUMMARY BACKGROUND DATA:TCAR is a novel minimally invasive proce...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004496
更新日期:2020-09-15 00:00:00
abstract:OBJECTIVE:To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181efc656
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:The authors' aim was to determine the requirement for an active interleukin (IL)-1 receptor during the development and progression of acute pancreatitis. SUMMARY OF BACKGROUND DATA:Interleukin-1 is a pro- inflammatory cytokine that has been shown to be produced during acute pancreatitis. Earlier animal studi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199602000-00008
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:Marked variations in sentinel lymph node dissection (SLND) technique have been identified, and definitive qualifications for SLND performance remain controversial. Based on previous reports and expert opinion, we predicted that 20 to 30 cases of SLND with axillary lymph node dissection (ALND) would enable sur...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1097/01.sla.0000184210.68646.77
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease (CD). SUMMARY BACKGROUND DATA:The risk factors of morbidity after surgery for CD, particularly the role of anti-TNF therapy, remain controversial and have not been evaluated in a large prospective cohort study. METHODS:Fr...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002017
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To determine the early effects of therapy of endotoxin (ET) shock with epinephrine, norepinephrine, or dopexamine on splanchnic circulation, oxygen metabolism, sigmoid mucosal pHi, bacterial translocation, and morphologic integrity of the ileal, colonic, and sigmoid mucosa. SUMMARY BACKGROUND DATA:Conflictin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199808000-00014
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To examine the association of single nucleotide polymorphisms (SNPs) in inflammation-related genes in the development of infections following esophagectomy. SUMMARY BACKGROUND DATA:Genetic polymorphisms for immunoregulatory cytokines may explain individual variation in response to trauma. Esophagectomy is as...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.sla.0000259389.09161.49
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:This single-institution review examined the incidence of biliary stricture formation after pancreaticoduodenectomy (PD) for benign and malignant periampullary disease. BACKGROUND:The incidence and course of stricture of the hepaticojejunostomy have not been documented after PD. METHODS:Between January 1995 ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000216285.07069.fc
更新日期:2006-05-01 00:00:00
abstract::Fifty-one adult patients were referred for surgical treatment during the time period from July 1980 to November 1985. The average age was 59 +/- 6 years (19-70 years). All patients had symptomatic ventricular tachycardia that was refractory to standard or experimental drug therapy. On the basis of patient condition, s...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198606000-00013
更新日期:1986-06-01 00:00:00
abstract::In 1974 total colectomy and ileoanal straight endorectal pull-through (ERPT) were first used at our institution for the definitive management of total colonic Hirschsprung's disease in infants and children. Early success with this operation encouraged us to use this procedure in children and adults with ulcerative col...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199009000-00002
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:The authors determined the incidence of complications in 133 patients who had undergone staging laparotomy with splenectomy before treatment for Hodgkin's disease (stages I-IV). METHODS AND MATERIALS:Medical records were reviewed, and the patients or their relatives were interviewed. Median follow-up after l...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199406000-00004
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:Demonstrate intratumoral genetic heterogeneity in rectal cancer. BACKGROUND:Several clinical management decisions in rectal cancer may be influenced by pretreatment biopsy information. However, in the setting of significant intratumoral heterogeneity, biopsies may not be representative of the entirety of the...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001937
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To identify predictive factors associated with operative morbidity, mortality, and survival outcomes in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) undergoing total neoadjuvant therapy (TNT). BACKGROUND:The optimal preoperative treatment sequencin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003284
更新日期:2021-02-01 00:00:00
abstract::Two patients with aortic abdominal aneurysms in association with horseshoe kidney are presented, making a total of 34 cases recorded in the literature. In 29 patients, the aneurysm was resected and five patients were non-resectable. Because of the abnormalities in vascular supply to the abnormal kidney, it is importan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197503000-00015
更新日期:1975-03-01 00:00:00
abstract::From 1975 through 1988, 257 patients with carcinoma of the thoracic esophagus have been treated in our department. Operability was 90% (232/257); overall resectability, 77% (198/257), and for the operated group, 85% (198/232). Hospital mortality rate was 9.6% but decreased to 3% over the period 1986 to 1988. There wer...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199211000-00010
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Many women who present with desmoid-type fibromatosis (DF) have had a recent pregnancy. Long-term data about disease behavior during and after pregnancy are lacking. OBJECTIVE:To investigate the possible relationship between DF and pregnancy. PATIENTS AND METHODS:A cohort of women with DF and pregnancy was...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000224
更新日期:2014-05-01 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:This prospective observational study was designed to assess Pediatric Quality of Life (PedsQL) after surgical treatment for congenital diaphragmatic hernia (CDH), esophageal atresia/tracheoesophageal fistula (EA/TEF), Hirschsprung disease (HD), gastroschisis (GAS), omphalocele (OMP), and necrotizing enterocol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002918
更新日期:2018-09-01 00:00:00
abstract::Cardiopulmonary bypass (CPB) using nonpulsatile flow (NPF) is advocated for refractory cardiac arrest. This study examined cerebral outcome after resuscitation with pulsatile flow (PF) versus NPF. Dogs arrested for 12.5 minute were reperfused with NPF (n = 11) using roller pump CPB or PF (n = 11) using mechanical bive...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199110000-00012
更新日期:1991-10-01 00:00:00
abstract::Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had associated inflammatory bowel disease, 72 had no such history, and 18 had iatrogenic injury or stone disease. A total of 233 biliary operations were performed, with a 75% rate of temporary improvement after initial operation. Subsequent op...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00017
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To analyze the yield and rate of node metastases (pN1) for prophylactic central (CND) and lateral neck dissection (LND) for papillary thyroid carcinoma, the risk factors for pN1, and outcomes. BACKGROUND:Prophylactic CND and LND are not routinely employed. Adjuvant radioiodine treatment may be modulated, how...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824b7b68
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the preoperative relationships of hypertension and diabetes mellitus in severe obesity and the effects of gastric bypass (GBP)-induced weight loss. SUMMARY BACKGROUND DATA:Severe obesity is associated with multiple comorbidities, particularly hypertension and type 2 diabetes mellitus, that may af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071560.76194.11
更新日期:2003-06-01 00:00:00
abstract::In a prospective, block-randomized, multicenter study, the safety and efficacy of cefoxitin in preoperative prophylaxis were studied. 1735 patients undergoing appendectomy were evaluable, and half of these patients received 2 g of cefoxitin before undergoing operation. The patients were divided into three groups: pati...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-198903000-00010
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:To determine the effect of allogeneic blood transfusion (ABT) on clinical outcomes in patients with colorectal cancer undergoing surgery. BACKGROUND:Perioperative ABTs may be associated with adverse clinical outcomes. METHODS:Systematic review of the literature with odds ratio (OR) and incidence rate ratio ...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0b013e31825b35d5
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVES:Aggressive human melanomas express, C-X-C chemokine receptor 4 (CXCR4), the receptor for the chemokine, stromal cell-derived factor-1alpha (SDF-1α). The CXCR4-SDF-1α axis has been postulated to increase melanoma invasiveness. We discovered that SDF-1α specifically upregulates E-selectin on endothelial cells,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822a72dc
更新日期:2011-09-01 00:00:00