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Item does not contain fulltext, Survival and cause of death was investigated for Primary Surgical Therapy (PST) and Primary Endocrine Therapy (PET). Of women aged >/=75 years 113 patients received PET, 233 patients underwent PST. PST gave better survival, although this group was younger (p < 0.001). During follow-up the percentage of deaths due to breast cancer was similar and stable in both groups. Increased age was associated with a higher risk on death due to other causes (HR 1.11; CI 1.07-1.14), not on death due to breast cancer (HR 0.94; CI 0.87-1.01). The association of type of treatment and death due to breast cancer was not different between both groups in univariate analyses (HR 0.78; CI 0.44-1.39). In the multivariate model this non-significance remained after correcting for tumor size and age (HR 0.68; CI 0.33-1.42). Treatment should not be based merely on surgical treatment. PET may be an acceptable alternative.

Item does not contain fulltext, Survival and cause of death was investigated for Primary Surgical Therapy (PST) and Primary Endocrine Therapy (PET). Of women aged >/=75 years 113 patients received PET, 233 patients underwent PST. PST gave better survival, although this group was younger (p < 0.001). During follow-up the percentage of deaths due to breast cancer was similar and stable in both groups. Increased age was associated with a higher risk on death due to other causes (HR 1.11; CI 1.07-1.14), not on death due to breast cancer (HR 0.94; CI 0.87-1.01). The association of type of treatment and death due to breast cancer was not different between both groups in univariate analyses (HR 0.78; CI 0.44-1.39). In the multivariate model this non-significance remained after correcting for tumor size and age (HR 0.68; CI 0.33-1.42). Treatment should not be based merely on surgical treatment. PET may be an acceptable alternative.

Contains fulltext : 95575.pdf (publisher's version ) (Open Access), BACKGROUND: The median laparotomy is frequently used by abdominal surgeons to gain rapid and wide access to the abdominal cavity with minimal damage to nerves, vascular structures and muscles of the abdominal wall. However, incisional hernia remains the most common complication after median laparotomy, with reported incidences varying between 2-20%. Recent clinical and experimental data showed a continuous suture technique with many small tissue bites in the aponeurosis only, is possibly more effective in the prevention of incisional hernia when compared to the common used large bite technique or mass closure. METHODS/DESIGN: The STITCH trial is a double-blinded multicenter randomized controlled trial designed to compare a standardized large bite technique with a standardized small bites technique. The main objective is to compare both suture techniques for incidence of incisional hernia after one year. Secondary outcomes will include postoperative complications, direct costs, indirect costs and quality of life. A total of 576 patients will be randomized between a standardized small bites or large bites technique. At least 10 departments of general surgery and two departments of oncological gynaecology will participate in this trial. Both techniques have a standardized amount of stitches per cm wound length and suture length wound length ratio's are calculated in each patient. Follow up will be at 1 month for wound infection and 1 year for incisional hernia. Ultrasound examinations will be performed at both time points to measure the distance between the rectus muscles (at 3 points) and to objectify presence or absence of incisional hernia. Patients, investigators and radiologists will be blinded during follow up, although the surgeon can not be blinded during the surgical procedure. CONCLUSION: The STITCH trial will provide level 1b evidence to support the preference for either a continuous suture technique with many small tissue bites in the aponeurosis only or fo

Item does not contain fulltext, Survival and cause of death was investigated for Primary Surgical Therapy (PST) and Primary Endocrine Therapy (PET). Of women aged >/=75 years 113 patients received PET, 233 patients underwent PST. PST gave better survival, although this group was younger (p < 0.001). During follow-up the percentage of deaths due to breast cancer was similar and stable in both groups. Increased age was associated with a higher risk on death due to other causes (HR 1.11; CI 1.07-1.14), not on death due to breast cancer (HR 0.94; CI 0.87-1.01). The association of type of treatment and death due to breast cancer was not different between both groups in univariate analyses (HR 0.78; CI 0.44-1.39). In the multivariate model this non-significance remained after correcting for tumor size and age (HR 0.68; CI 0.33-1.42). Treatment should not be based merely on surgical treatment. PET may be an acceptable alternative.

Contains fulltext : 95575.pdf (publisher's version ) (Open Access), BACKGROUND: The median laparotomy is frequently used by abdominal surgeons to gain rapid and wide access to the abdominal cavity with minimal damage to nerves, vascular structures and muscles of the abdominal wall. However, incisional hernia remains the most common complication after median laparotomy, with reported incidences varying between 2-20%. Recent clinical and experimental data showed a continuous suture technique with many small tissue bites in the aponeurosis only, is possibly more effective in the prevention of incisional hernia when compared to the common used large bite technique or mass closure. METHODS/DESIGN: The STITCH trial is a double-blinded multicenter randomized controlled trial designed to compare a standardized large bite technique with a standardized small bites technique. The main objective is to compare both suture techniques for incidence of incisional hernia after one year. Secondary outcomes will include postoperative complications, direct costs, indirect costs and quality of life. A total of 576 patients will be randomized between a standardized small bites or large bites technique. At least 10 departments of general surgery and two departments of oncological gynaecology will participate in this trial. Both techniques have a standardized amount of stitches per cm wound length and suture length wound length ratio's are calculated in each patient. Follow up will be at 1 month for wound infection and 1 year for incisional hernia. Ultrasound examinations will be performed at both time points to measure the distance between the rectus muscles (at 3 points) and to objectify presence or absence of incisional hernia. Patients, investigators and radiologists will be blinded during follow up, although the surgeon can not be blinded during the surgical procedure. CONCLUSION: The STITCH trial will provide level 1b evidence to support the preference for either a continuous suture technique with many small tissue bites in the aponeurosis only or fo

Item does not contain fulltext, Survival and cause of death was investigated for Primary Surgical Therapy (PST) and Primary Endocrine Therapy (PET). Of women aged >/=75 years 113 patients received PET, 233 patients underwent PST. PST gave better survival, although this group was younger (p < 0.001). During follow-up the percentage of deaths due to breast cancer was similar and stable in both groups. Increased age was associated with a higher risk on death due to other causes (HR 1.11; CI 1.07-1.14), not on death due to breast cancer (HR 0.94; CI 0.87-1.01). The association of type of treatment and death due to breast cancer was not different between both groups in univariate analyses (HR 0.78; CI 0.44-1.39). In the multivariate model this non-significance remained after correcting for tumor size and age (HR 0.68; CI 0.33-1.42). Treatment should not be based merely on surgical treatment. PET may be an acceptable alternative.

Contains fulltext : 95575.pdf (publisher's version ) (Open Access), BACKGROUND: The median laparotomy is frequently used by abdominal surgeons to gain rapid and wide access to the abdominal cavity with minimal damage to nerves, vascular structures and muscles of the abdominal wall. However, incisional hernia remains the most common complication after median laparotomy, with reported incidences varying between 2-20%. Recent clinical and experimental data showed a continuous suture technique with many small tissue bites in the aponeurosis only, is possibly more effective in the prevention of incisional hernia when compared to the common used large bite technique or mass closure. METHODS/DESIGN: The STITCH trial is a double-blinded multicenter randomized controlled trial designed to compare a standardized large bite technique with a standardized small bites technique. The main objective is to compare both suture techniques for incidence of incisional hernia after one year. Secondary outcomes will include postoperative complications, direct costs, indirect costs and quality of life. A total of 576 patients will be randomized between a standardized small bites or large bites technique. At least 10 departments of general surgery and two departments of oncological gynaecology will participate in this trial. Both techniques have a standardized amount of stitches per cm wound length and suture length wound length ratio's are calculated in each patient. Follow up will be at 1 month for wound infection and 1 year for incisional hernia. Ultrasound examinations will be performed at both time points to measure the distance between the rectus muscles (at 3 points) and to objectify presence or absence of incisional hernia. Patients, investigators and radiologists will be blinded during follow up, although the surgeon can not be blinded during the surgical procedure. CONCLUSION: The STITCH trial will provide level 1b evidence to support the preference for either a continuous suture technique with many small tissue bites in the aponeurosis only or fo