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71.
Audet P Pressacco J Burke M Reinhold C 《Magnetic Resonance Imaging Clinics of North America》2000,8(4):887-914
This article reviews the most common gynecologic malignancies and their MR imaging features. The overall goal remains early disease detection and accurate staging to optimize treatment and thereby to reduce morbidity and mortality. MR imaging, when available, may play an important role in the accurate staging and evaluation of female pelvic malignancies and, thus, may become part of their routine investigation. In the authors' experience, MR imaging has proven useful in the preoperative evaluation of these malignancies. With ongoing research into imaging protocols designed to improve image quality and reduce examination time, the importance of MR imaging will continue to grow. 相似文献
72.
Pierre Lantelme Hélène Eltchaninoff Muriel Rabilloud Géraud Souteyrand Marion Dupré Marco Spaziano Marc Bonnet Clément Becle Benjamin Riche Eric Durand Erik Bouvier Jean-Nicolas Dacher Pierre-Yves Courand Lucie Cassagnes Eduardo E. Dávila Serrano Pascal Motreff Loic Boussel Thierry Lefèvre Brahim Harbaoui 《JACC: Cardiovascular Imaging》2019,12(1):123-132
Objectives
The aim of this study was to develop a new scoring system based on thoracic aortic calcification (TAC) to predict 1-year cardiovascular and all-cause mortality.Background
A calcified aorta is often associated with poor prognosis after transcatheter aortic valve replacement (TAVR). A risk score encompassing aortic calcification may be valuable in identifying poor TAVR responders.Methods
The C4CAPRI (4 Cities for Assessing CAlcification PRognostic Impact) multicenter study included a training cohort (1,425 patients treated using TAVR between 2010 and 2014) and a contemporary test cohort (311 patients treated in 2015). TAC was measured by computed tomography pre-TAVR. CAPRI risk scores were based on the linear predictors of Cox models including TAC in addition to comorbidities and demographic, atherosclerotic disease and cardiac function factors. CAPRI scores were constructed and tested in 2 independent cohorts.Results
Cardiovascular and all-cause mortality at 1 year was 13.0% and 17.9%, respectively, in the training cohort and 8.2% and 11.8% in the test cohort. The inclusion of TAC in the model improved prediction: 1-cm3 increase in TAC was associated with a 6% increase in cardiovascular mortality and a 4% increase in all-cause mortality. The predicted and observed survival probabilities were highly correlated (slopes >0.9 for both cardiovascular and all-cause mortality). The model’s predictive power was fair (AUC 68% [95% confidence interval [CI]: 64% to 72%]) for both cardiovascular and all-cause mortality. The model performed similarly in the training and test cohorts.Conclusions
The CAPRI score, which combines the TAC variable with classical prognostic factors, is predictive of 1-year cardiovascular and all-cause mortality. Its predictive performance was confirmed in an independent contemporary cohort. CAPRI scores are highly relevant to current practice and strengthen the evidence base for decision making in valvular interventions. Its routine use may help prevent futile procedures. 相似文献73.
Maria Q. B. Petzel RD Nathan H. Parker BS Alan D. Valentine MD Sébastien Simard PhD Graciela M. Nogueras-Gonzalez MPH Jeffrey E. Lee MD Peter W. T. Pisters MD Jean-Nicolas Vauthey MD Jason B. Fleming MD Matthew H. G. Katz MD 《Annals of surgical oncology》2012,19(13):4078-4084
Background
Fear of disease recurrence is well documented among cancer survivors, but its significance among patients treated for solid pancreatic and periampullary neoplasms is unknown despite the known risk of recurrence associated with these tumors. We hypothesized that fear of cancer recurrence (FCR) represents a common source of psychosocial distress in this population and sought to characterize subgroups for whom FCR might represent a target for intervention to improve quality of life.Methods
We conducted a cross-sectional study of FCR in patients who were disease-free after potentially curative pancreatectomy for ductal or periampullary adenocarcinoma or pancreatic neuroendocrine tumor. We assessed seven discrete dimensions of FCR using the Fear of Recurrence Inventory and evaluated quality of life and psychosocial distress using the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire and the Hospital Anxiety and Depression Scale.Results
Of 354 eligible patients, 240 (68?%) participated in the study a median of 48?months after potentially curative pancreatectomy. An FCR severity score indicative of frequent fearful thoughts, emotional disturbance and functional impairment was identified in 37, 28, and 35?% of patients with pancreatic adenocarcinoma, nonpancreatic periampullary adenocarcinoma, and pancreatic neuroendocrine tumor, respectively. Anxiety (P?<?0.001) and low quality of life (P?=?0.028) were independently associated with a clinically significant level of FCR, but histopathologic diagnosis and clinicopathologic markers of prognosis were not.Conclusions
FCR represents a significant concern for one-third of patients after curative surgery for a pancreatic or periampullary tumor, regardless of their actual likelihood of recurrence or disease-related death. 相似文献74.
Piardi T Gheza F Ellero B Woehl-Jaegle ML Ntourakis D Cantu M Marzano E Audet M Wolf P Pessaux P 《Annals of surgical oncology》2012,19(6):2020-2026
Background
Hepatocellular carcinoma (HCC) is an indication for liver resection or transplantation (LT). In most centers, patients whose HCC meets the Milan criteria are considered for LT. The first objective of this study was to analyze whether there is a correlation between the pathologic characteristics of the tumor, survival and recurrence rate. Second, we focused our attention on vascular invasion (VI).Methods
From January 1997 to December 2007, a total of 196 patients who had a preoperative diagnosis of HCC were included. The selection criteria for LT satisfied both the Milan and the San Francisco criteria (UCSF). Demographic, clinical, and pathologic information were recorded.Results
HCC was confirmed in 168 patients (85.7%). The median follow-up was 74?months. The pathologic findings showed that 106 patients (54.1%) satisfied the Milan criteria, 134 (68.4%) the UCSF criteria of whom 28 (14.3%) were beyond the Milan criteria but within the UCSF criteria, and 34 (17.3%) beyond the UCSF criteria. VI was detected in 41 patients (24%). The 1-, 3-, and 5-year overall survival rates were 90%, 85%, and 77%, respectively, according to the Milan criteria and 90%, 83%, and 76%, respectively, according to the UCSF criteria (P?=?NS). In univariate and multivariate analyses, tumor size and VI were significant prognostic factors affecting survival (P?0.001). Two factors were significantly associated with VI: alfa-fetoprotein level of >400?ng/ml and tumor grade G3.Conclusions
Tumor size and VI were the only significant prognostic factors affecting survival of HCC patients. Primary liver resection could be a potential selection treatment before LT. 相似文献75.
76.
Parikh AA Abdalla EK Vauthey JN 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2005,7(4):254-258
This article reviews the preoperative evaluation and operative considerations in patients with hilar cholangiocarcinoma. The preoperative evaluation is based on the imaging evaluation of the longitudinal and radial extent of the tumour along and around the hepatic duct confluence. The use of portal vein embolization to increase the safety of extended hepatectomy and the extent of surgical resection (caudate lobe and portal vein) are discussed within the context of recently published series. 相似文献
77.
No diel variations of plasma cortisol levels were found in Gasterosteus aculeatus acclimated to two different photoperiod conditions: 14L:10D and 9L:15D. However, under long photoperiods, G. aculeatus exhibited higher plasma cortisol levels than under short photoperiods, suggesting that elevated plasma cortisol levels are associated with the spring migration and/or reproductive activities. This decrease of plasma cortisol levels is particularly marked in male G. aculeatus. Under the 9L:15D photoperiod, males had lower plasma cortisol levels than females, in contrast to 14L:10D, where no significant sex differences were found. 相似文献
78.
79.