Stratifying SLN incidence in intermediate thickness melanoma patients
Guidelines for melanoma recommend sentinel lymph node biopsy (SLNB) in patients with melanomas ≥1 mm thickness. Recent single institution studies have found tumors
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| Veröffentlicht in: | The American journal of surgery 2018-04, Vol.215 (4), p.699-706 |
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| creator | Chang, James M. Kosiorek, Heidi E. Dueck, Amylou C. Leong, Stanley P.L. Vetto, John T. White, Richard L. Avisar, Eli Sondak, Vernon K. Messina, Jane L. Zager, Jonathan S. Garberoglio, Carlos Kashani-Sabet, Mohammed Pockaj, Barbara A. |
| description | Guidelines for melanoma recommend sentinel lymph node biopsy (SLNB) in patients with melanomas ≥1 mm thickness. Recent single institution studies have found tumors |
| doi_str_mv | 10.1016/j.amjsurg.2017.12.009 |
| format | Article |
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A retrospective review of the Sentinel Lymph Node Working Group multicenter database identified patients with intermediate thickness melanoma (1.01–4.00 mm) who had SLNB, and assessed predictors for positive SLNB.
3460 patients were analyzed, 584 (17%) had a positive SLNB. Univariate factors associated with a positive SLNB included age <60 (p < .001), tumor on the trunk/lower extremity (p < .001), Breslow depth ≥2 mm (p < .001), ulceration (p < .001), mitotic rate ≥1/mm2 (p = .01), and microsatellitosis (p < .001). Multivariate analysis revealed age, location, and Breslow depth as significant predictors. Patients ≥75 with lesions 1.01–1.49 mm on the head/neck/upper extremity and 1.5–1.99 mm without high-risk features had <5% risk of SLN positivity.
Intermediate thickness melanoma has significant heterogeneity of SLNB positivity. Low-risk subgroups can be found among older patients in the absence of high-risk features.
•Intermediate thickness melanoma has heterogeneous risk for nodal metastases.•Groups that are low risk for nodal metastases may be spared a sentinel lymph node biopsy.•Elderly patients in particular may have low risk of nodal metastases.]]></description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2017.12.009</identifier><identifier>PMID: 29502857</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Aged ; Biopsy ; Databases, Factual ; Dissection ; Female ; Head ; Humans ; Incidence ; Lesions ; Lymph ; Lymph nodes ; Lymphatic Metastasis - pathology ; Lymphatic system ; Male ; Medical prognosis ; Melanoma ; Melanoma - pathology ; Metastasis ; Middle Aged ; Morbidity ; Multivariate analysis ; Neck ; Patients ; Retrospective Studies ; Risk ; Risk Factors ; Risk groups ; Sentinel Lymph Node - pathology ; Sentinel Lymph Node Biopsy ; Skin cancer ; Skin Neoplasms - pathology ; Statistical analysis ; Subgroups ; Tumors ; Variance analysis</subject><ispartof>The American journal of surgery, 2018-04, Vol.215 (4), p.699-706</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Apr 1, 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-8321f67c8a520ec73a871d3fc1c324ec98bf7f0e9f170148f2fabb4b17619d553</citedby><cites>FETCH-LOGICAL-c495t-8321f67c8a520ec73a871d3fc1c324ec98bf7f0e9f170148f2fabb4b17619d553</cites><orcidid>0000-0003-0771-464X ; 0000-0002-9912-1085</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2017296168?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,64361,64363,64365,65309,72215</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29502857$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, James M.</creatorcontrib><creatorcontrib>Kosiorek, Heidi E.</creatorcontrib><creatorcontrib>Dueck, Amylou C.</creatorcontrib><creatorcontrib>Leong, Stanley P.L.</creatorcontrib><creatorcontrib>Vetto, John T.</creatorcontrib><creatorcontrib>White, Richard L.</creatorcontrib><creatorcontrib>Avisar, Eli</creatorcontrib><creatorcontrib>Sondak, Vernon K.</creatorcontrib><creatorcontrib>Messina, Jane L.</creatorcontrib><creatorcontrib>Zager, Jonathan S.</creatorcontrib><creatorcontrib>Garberoglio, Carlos</creatorcontrib><creatorcontrib>Kashani-Sabet, Mohammed</creatorcontrib><creatorcontrib>Pockaj, Barbara A.</creatorcontrib><title>Stratifying SLN incidence in intermediate thickness melanoma patients</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description><![CDATA[Guidelines for melanoma recommend sentinel lymph node biopsy (SLNB) in patients with melanomas ≥1 mm thickness. Recent single institution studies have found tumors <1.5 mm a low-risk group for positive SLNB.
A retrospective review of the Sentinel Lymph Node Working Group multicenter database identified patients with intermediate thickness melanoma (1.01–4.00 mm) who had SLNB, and assessed predictors for positive SLNB.
3460 patients were analyzed, 584 (17%) had a positive SLNB. Univariate factors associated with a positive SLNB included age <60 (p < .001), tumor on the trunk/lower extremity (p < .001), Breslow depth ≥2 mm (p < .001), ulceration (p < .001), mitotic rate ≥1/mm2 (p = .01), and microsatellitosis (p < .001). Multivariate analysis revealed age, location, and Breslow depth as significant predictors. Patients ≥75 with lesions 1.01–1.49 mm on the head/neck/upper extremity and 1.5–1.99 mm without high-risk features had <5% risk of SLN positivity.
Intermediate thickness melanoma has significant heterogeneity of SLNB positivity. Low-risk subgroups can be found among older patients in the absence of high-risk features.
•Intermediate thickness melanoma has heterogeneous risk for nodal metastases.•Groups that are low risk for nodal metastases may be spared a sentinel lymph node biopsy.•Elderly patients in particular may have low risk of nodal metastases.]]></description><subject>Age</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Databases, Factual</subject><subject>Dissection</subject><subject>Female</subject><subject>Head</subject><subject>Humans</subject><subject>Incidence</subject><subject>Lesions</subject><subject>Lymph</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Melanoma</subject><subject>Melanoma - pathology</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Multivariate analysis</subject><subject>Neck</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Sentinel Lymph Node - pathology</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Skin cancer</subject><subject>Skin Neoplasms - pathology</subject><subject>Statistical analysis</subject><subject>Subgroups</subject><subject>Tumors</subject><subject>Variance analysis</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkc1u1DAUhS0EotPCI4AisWGT4OvEsb0BoaqUSiO6KKwtx7meOkySwXYq9e3xdIaKskGyZF_5O_fvEPIGaAUU2g9DZcYhLmFTMQqiAlZRqp6RFUihSpCyfk5WlFJWqhboCTmNccghQFO_JCdMccokFytycZOCSd7d-2lT3Ky_FX6yvsfJYn7lkzCM2HuTsEi33v6cMMZixK2Z5tEUuyzFKcVX5IUz24ivj_cZ-fHl4vv513J9fXl1_nld2kbxVMqagWuFlYYzilbURgroa2fB1qxBq2TnhKOoHAgKjXTMma5rOhAtqJ7z-ox8POTdLV1uy-bawWz1LvjRhHs9G6-f_kz-Vm_mO82VkK2CnOD9MUGYfy0Ykx59tLjN8-C8RJ13SWXTAJcZffcPOsxLmPJ4e0qwvNd2T_EDZcMcY0D32AxQvTdKD_po1INMA9PZqKx7-_ckj6o_zmTg0wHAvM87j0FH6_e-9D6gTbqf_X9K_Aa1MagI</recordid><startdate>20180401</startdate><enddate>20180401</enddate><creator>Chang, James M.</creator><creator>Kosiorek, Heidi E.</creator><creator>Dueck, Amylou C.</creator><creator>Leong, Stanley P.L.</creator><creator>Vetto, John T.</creator><creator>White, Richard L.</creator><creator>Avisar, Eli</creator><creator>Sondak, Vernon K.</creator><creator>Messina, Jane L.</creator><creator>Zager, Jonathan S.</creator><creator>Garberoglio, Carlos</creator><creator>Kashani-Sabet, Mohammed</creator><creator>Pockaj, Barbara A.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-0771-464X</orcidid><orcidid>https://orcid.org/0000-0002-9912-1085</orcidid></search><sort><creationdate>20180401</creationdate><title>Stratifying SLN incidence in intermediate thickness melanoma patients</title><author>Chang, James M. ; Kosiorek, Heidi E. ; Dueck, Amylou C. ; Leong, Stanley P.L. ; Vetto, John T. ; White, Richard L. ; Avisar, Eli ; Sondak, Vernon K. ; Messina, Jane L. ; Zager, Jonathan S. ; Garberoglio, Carlos ; Kashani-Sabet, Mohammed ; Pockaj, Barbara A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c495t-8321f67c8a520ec73a871d3fc1c324ec98bf7f0e9f170148f2fabb4b17619d553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Aged</topic><topic>Biopsy</topic><topic>Databases, Factual</topic><topic>Dissection</topic><topic>Female</topic><topic>Head</topic><topic>Humans</topic><topic>Incidence</topic><topic>Lesions</topic><topic>Lymph</topic><topic>Lymph nodes</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Melanoma</topic><topic>Melanoma - pathology</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Multivariate analysis</topic><topic>Neck</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Risk groups</topic><topic>Sentinel Lymph Node - pathology</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Skin cancer</topic><topic>Skin Neoplasms - pathology</topic><topic>Statistical analysis</topic><topic>Subgroups</topic><topic>Tumors</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, James M.</creatorcontrib><creatorcontrib>Kosiorek, Heidi E.</creatorcontrib><creatorcontrib>Dueck, Amylou C.</creatorcontrib><creatorcontrib>Leong, Stanley P.L.</creatorcontrib><creatorcontrib>Vetto, John T.</creatorcontrib><creatorcontrib>White, Richard L.</creatorcontrib><creatorcontrib>Avisar, Eli</creatorcontrib><creatorcontrib>Sondak, Vernon K.</creatorcontrib><creatorcontrib>Messina, Jane L.</creatorcontrib><creatorcontrib>Zager, Jonathan S.</creatorcontrib><creatorcontrib>Garberoglio, Carlos</creatorcontrib><creatorcontrib>Kashani-Sabet, Mohammed</creatorcontrib><creatorcontrib>Pockaj, Barbara A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, James M.</au><au>Kosiorek, Heidi E.</au><au>Dueck, Amylou C.</au><au>Leong, Stanley P.L.</au><au>Vetto, John T.</au><au>White, Richard L.</au><au>Avisar, Eli</au><au>Sondak, Vernon K.</au><au>Messina, Jane L.</au><au>Zager, Jonathan S.</au><au>Garberoglio, Carlos</au><au>Kashani-Sabet, Mohammed</au><au>Pockaj, Barbara A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stratifying SLN incidence in intermediate thickness melanoma patients</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2018-04-01</date><risdate>2018</risdate><volume>215</volume><issue>4</issue><spage>699</spage><epage>706</epage><pages>699-706</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract><![CDATA[Guidelines for melanoma recommend sentinel lymph node biopsy (SLNB) in patients with melanomas ≥1 mm thickness. Recent single institution studies have found tumors <1.5 mm a low-risk group for positive SLNB.
A retrospective review of the Sentinel Lymph Node Working Group multicenter database identified patients with intermediate thickness melanoma (1.01–4.00 mm) who had SLNB, and assessed predictors for positive SLNB.
3460 patients were analyzed, 584 (17%) had a positive SLNB. Univariate factors associated with a positive SLNB included age <60 (p < .001), tumor on the trunk/lower extremity (p < .001), Breslow depth ≥2 mm (p < .001), ulceration (p < .001), mitotic rate ≥1/mm2 (p = .01), and microsatellitosis (p < .001). Multivariate analysis revealed age, location, and Breslow depth as significant predictors. Patients ≥75 with lesions 1.01–1.49 mm on the head/neck/upper extremity and 1.5–1.99 mm without high-risk features had <5% risk of SLN positivity.
Intermediate thickness melanoma has significant heterogeneity of SLNB positivity. Low-risk subgroups can be found among older patients in the absence of high-risk features.
•Intermediate thickness melanoma has heterogeneous risk for nodal metastases.•Groups that are low risk for nodal metastases may be spared a sentinel lymph node biopsy.•Elderly patients in particular may have low risk of nodal metastases.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29502857</pmid><doi>10.1016/j.amjsurg.2017.12.009</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0771-464X</orcidid><orcidid>https://orcid.org/0000-0002-9912-1085</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aged Biopsy Databases, Factual Dissection Female Head Humans Incidence Lesions Lymph Lymph nodes Lymphatic Metastasis - pathology Lymphatic system Male Medical prognosis Melanoma Melanoma - pathology Metastasis Middle Aged Morbidity Multivariate analysis Neck Patients Retrospective Studies Risk Risk Factors Risk groups Sentinel Lymph Node - pathology Sentinel Lymph Node Biopsy Skin cancer Skin Neoplasms - pathology Statistical analysis Subgroups Tumors Variance analysis |
| title | Stratifying SLN incidence in intermediate thickness melanoma patients |
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