Clinical Surgical Oncology最新文献

{"title":"Outpatient revisits associated with three sentinel lymph node detection techniques for breast cancer: A propensity score weighted analysis","authors":"Michelle P. Sosa ,&nbsp;Deirdre G. McNicholas ,&nbsp;Arbelina B. Bebla ,&nbsp;Seth Emont ,&nbsp;Zhun Cao ,&nbsp;Manu Tyagi ,&nbsp;Craig Lipkin ,&nbsp;Sommer Gunia","doi":"10.1016/j.cson.2025.100087","DOIUrl":"10.1016/j.cson.2025.100087","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluates whether near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) is associated with a lower outpatient (OP) revisit rate compared to isosulfan blue (IB) or methylene blue (MB) when combined with technetium-99m (Tc99m) for sentinel lymph node (SLN) mapping of breast cancer.</div></div><div><h3>Materials and methods</h3><div>This retrospective observational study included adult female patients with a breast cancer diagnosis who underwent SLN mapping and had an index OP discharge between July 1, 2017 and August 31, 2022 ​at a U.S. hospital contributing to the Premier Healthcare Database. Patients were grouped by SLN mapping method: IB ​+ ​Tc99m, MB ​+ ​Tc99m, and ICG ​+ ​Tc99m. The primary outcome was OP revisit rates at 30, 60, and 90 days post-discharge. Propensity score weighting adjusted for differences in baseline characteristics.</div></div><div><h3>Results</h3><div>5.6 ​% (n ​= ​60,068) of the 1,067,677 adult female patients with a breast cancer diagnosis underwent SLN mapping, and 54.9 ​% (n ​= ​32,970) met the inclusion criteria. In the propensity-weighted sample (n ​= ​2002), the ICG ​+ ​Tc99m cohort had the lowest OP revisit rates at all time points compared to IB ​+ ​Tc99m and MB ​+ ​Tc99m: at 30 days, 36.4 ​% vs. 43.1 ​% vs. 43.2 ​%; at 60 days, 50.9 ​% vs. 55.8 ​% vs. 56.2 ​%; and at 90 days, 55.9 ​% vs. 59.7 ​% vs. 60.0 ​% (all p ​&lt; ​.05). Adjusted odds ratios (aORs) confirmed the ICG ​+ ​Tc99m cohort's reduced OP revisits: 30-day aOR, 0.74 (0.63–0.88); 60-day aOR, 0.80 (0.68–0.94); and 90-day aOR, 0.84 (0.71–0.99) (all p ​&lt; ​.05).</div></div><div><h3>Conclusion</h3><div>NIRF with ICG ​+ ​Tc99m was associated with significantly fewer OP revisits, suggesting that this method may improve patient outcomes and the continuum of care for breast cancer patients.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of large models in imaging diagnosis and prognostic analysis in hepatocellular carcinoma","authors":"Jiapei Lin ,&nbsp;Yilin Li ,&nbsp;Dongrui Li ,&nbsp;Liyong Zhuo ,&nbsp;Jian Wei ,&nbsp;Jingwei Wei","doi":"10.1016/j.cson.2025.100083","DOIUrl":"10.1016/j.cson.2025.100083","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, with high incidence and death rates. Despite significant progress in conventional diagnostic methods such as imaging studies and biomarkers, inherent limitations hinder their effectiveness. The rapid development of large model techniques has unveiled considerable potential for improving imaging-based diagnosis and prognostic evaluation of HCC. This review highlights recent advances in applying large models to HCC, emphasizing developments in deep neural network architecture and multimodal data integration. It examines how these models enhance early diagnosis accuracy through automated feature extraction and explores their role in integrating clinical variables, radiomics, genomics, and pathology data, offering novel perspectives for prognosis assessment. Despite their promise, challenges such as data quality, model interpretability, and generalization capacity remain. The review concludes by discussing the future potential of large models in HCC diagnosis and prognosis, addressing key challenges and ethical considerations for clinical adoption.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 2","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking systems in navigated lower abdominopelvic surgery, a review","authors":"Laura Aguilera Saiz ,&nbsp;Harald C. Groen ,&nbsp;Wouter J. Heerink ,&nbsp;Theo J.M. Ruers","doi":"10.1016/j.cson.2025.100084","DOIUrl":"10.1016/j.cson.2025.100084","url":null,"abstract":"<div><div>The lower abdominopelvic region is characterized by complex anatomy harbouring many vital structures in a constrained area. Advanced guidance can enhance the precision and efficiency of lower abdominopelvic surgical procedures. This can be achieved with image-guided surgical navigation systems, which use preoperative data to display real-time updates of intraoperative data. The current literature review explores the current state and prospective approaches for developing clinical navigation systems tailored for the lower abdominopelvic region. We aim to identify current knowledge gaps and technological challenges in navigation and explore potential solutions proposed in the literature. A comprehensive literature review of the current state of the art of navigation systems was performed. Relevant clinical and technical information from the publications was extracted and added value of navigation systems was analysed. According to the reviewed literature, existing commercial navigation systems focus mainly on rigid structure navigation. Despite being certified for spine, hip, knee and neurosurgery, commercial systems were used in 16 out of 29 studies for non-rigid pelvic surgery, which was outside their intended use. Comparative studies showed that navigation was of added value for surgical efficiency and clinical outcomes. Navigation in lower abdominopelvic surgeries contributed to more precise resection margins and reduction of local recurrences, resulting in more precise and safe surgeries. Various promising navigation systems show high performance in lower abdominopelvic surgery. However, their implementation is mainly examined in feasibility studies. Consequently, the use of navigation systems in clinical standard routine still remains limited.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 2","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training and learning curves in robotic pancreatic surgery","authors":"Anas A. Preukschas ,&nbsp;Amila Cizmic ,&nbsp;Philip C. Müller ,&nbsp;Christoph Kümmerli ,&nbsp;Faik Güntac Uzunoglu ,&nbsp;Thilo Hackert ,&nbsp;Felix Nickel","doi":"10.1016/j.cson.2025.100081","DOIUrl":"10.1016/j.cson.2025.100081","url":null,"abstract":"<div><div>Robotic pancreatic surgery is complex, and its establishment in an institution require a structured approach to secure optimal short- and long-term outcomes. This article provides a structured training proposition for robotic pancreatic surgery and gives an overview of the learning curves and examines the key takeaways.</div><div>The preclinical training in robotic pancreatic surgery can be divided into a basic and advanced phase. The basic phase includes virtual reality training, biotissue drills, and specialized training courses. The advanced phase consists of reaching benchmarks for the biotissue drills and completing video-based training. After establishing a dedicated interprofessional surgical team index procedures and first robotic pancreatic cases can be performed under the supervision of a proctor.</div><div>Three phases of clinical training are proposed: competency, proficiency, and mastery. Competency referring to be able to perform the procedure without supervision in patients without risk factors and with average technical difficulty. Proficiency signifying consistently reaching benchmark- and textbook outcome in patients with risk factors and extended indications. Mastery is achieving benchmark values for morbidity rates even in complex cases requiring vessel or multi-visceral resections and with patients having multiple risk factors.</div><div>The number of cases to overcome the initial phase of the learning curve vary between 7 and 46 for robotic distal pancreatectomy and 8–100 for robotic partial pancreaticoduodenectomy. Significantly longer learning phases of 60–200 cases are reported to complete all three learning phases.</div><div>In conclusion the hallmarks for safe and efficient implementation of robotic pancreatic surgery are a dedicated team, structured training program and stepwise patient selection.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 2","pages":"Article 100081"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the prophylactic use of superficial inferior epigastric vessels (SIEV) for the super-drainage of deep inferior epigastric perforator flaps (DIEPs), correlated to patient demographic, anatomical and operative risk factors","authors":"Rhea M Iyer","doi":"10.1016/j.cson.2025.100082","DOIUrl":"10.1016/j.cson.2025.100082","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;The purpose of this research is to demonstrate the benefit of SIEV inclusion and to identify the factors that deem a patient a suitable for SIEV grafting in a large patient cohort. By doing so we aim to facilitate more efficient preoperative planning and decrease the return to theatre (RTT) rates resulting from venous congestion or inappropriate SIEV use.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a retrospective study conducted at the St. Andrew's Centre for Burns and Plastic Surgery in Broomfield Hospital, United Kingdom. 60 patients who underwent a DIEP flap reconstruction between January 1st, 2020, and December 31, 2021, were selected based on having undergone a unilateral DIEP reconstruction either with or without additional SIEV use with no other adjunct flap technique used. The patients were stratified into two cohort groups: DIEP ​+ ​SIEV use patient group (&lt;em&gt;n&lt;/em&gt; ​= ​30) and DIEP only patients (&lt;em&gt;n&lt;/em&gt; ​= ​30). For these patients a range of biographical data was obtained including: the presence of co – morbidities (BMI, BP, co – existing conditions such as diabetes mellitus) as well as flap characteristics (flap weight, time taken to raise the flap and the ischaemia time) from the free – flap audit forms and this was compared to anatomical data that was obtained from the pre – operative CT angiography reports detailing vascular characteristics: the Size/calibre of the SIEV (large = &gt;3.0 ​mm, medium ​= ​2.0–3.0 ​mm and small = &lt;2.0mm), the presence of venous anastomosis and midline crossover. The data was recorded on a spreadsheet and compared with the DIEP only group to ascertain, p – values using Chi&lt;sup&gt;2&lt;/sup&gt;/Fisher's Exact Test (for non – parametric/binary data) and the Two – Tailed P – values (parametric data) where appropriate, Microsoft Excel's correlation toolkit was also used to determine the extent of correlation between the cohort groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;For non-parametric values (binary) statistical significance was present for: High BMI defined as BMI &gt;26 ​kg/m2 (p ​= ​0.01), High BP-defined as BP ​&gt; ​140/90 ​mmHg (P ​&lt; ​0.01), Vein 2-IMVP (anastomosis between the second vein used whether this be a SIEV or not and the IMVP within the chest wall (p ​&lt; ​0.00001), Large SIEV calibre – defined as &gt;3 ​mm (p ​= ​0.015) and small SIEV calibre – defined as &lt;2.00 ​mm (p ​= ​0.0251). The average flap weight in the DIEP ​+ ​SIEV cohort was 857.80g and in the DIEP only cohort was 641.92g (p ​= ​0.024) therefore a larger flap weight was associated with SIEV usage in our cohort. Patients presenting with these characteristics conferred a superficial venous drainage system dominance and were therefore more numerous in the DIEP ​+ ​SIEV cohort group compared to the DIEP only group. The RTT was defined to be 3-times higher in the DIEP only group and the overall cost benefit of primary SIEV use, extrapolated for the defined year period was determined to be £26","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 2","pages":"Article 100082"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of ICG-guided bilateral lateral lymph node dissection in rectal cancer","authors":"Wenlong Qiu ,&nbsp;Yu Liu ,&nbsp;Wei Zhao ,&nbsp;Shiwen Mei ,&nbsp;Yuegang Li ,&nbsp;Qian Liu","doi":"10.1016/j.cson.2025.100079","DOIUrl":"10.1016/j.cson.2025.100079","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess the necessity and outcomes of bilateral lateral lymph node dissection (LLND) in rectal cancer, while exploring the role of Indocyanine Green (ICG) in enhancing surgical precision.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 157 patients who underwent LLND between January 1, 2010, and December 31, 2022. The study focused on the incidence of bilateral lymph node metastasis, the predictors of metastasis, and the role of ICG-guided dissection in improving surgical outcomes. Propensity score matching (PSM) was used to compare the outcomes between the control and fluorescence-guided lymph node dissection (FLND) groups.</div></div><div><h3>Results</h3><div>Bilateral lateral lymph node metastasis was found in 6.4 ​% of patients. Positive D2 lymph nodes were the only significant predictor of bilateral metastasis. ICG, used via submucosal injection, significantly improved lymph node identification and dissection accuracy. Patients in the FLND group had a higher median number of harvested lymph nodes (32 vs. 19, P ​= ​0.042) and better postoperative outcomes, including shorter hospital stay (6 vs. 9 days, P ​= ​0.038) and less blood loss (30 ​ml vs. 180 ​ml, P ​&lt; ​0.001). Kaplan-Meier analysis showed no significant differences in disease-free survival (P ​= ​0.658) or overall survival (P ​= ​0.331) between groups.</div></div><div><h3>Conclusion</h3><div>While ICG-enhanced bilateral LLND improves short-term surgical outcomes, its impact on long-term survival remains unclear. The findings suggest selective use of bilateral LLND based on specific risk factors, particularly in patients with positive D2 lymph nodes. Further studies are required to refine guidelines and establish the procedure's long-term benefits.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 2","pages":"Article 100079"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing informed consent in oncological surgery through digital platforms and artificial intelligence","authors":"Alex Boddy","doi":"10.1016/j.cson.2025.100080","DOIUrl":"10.1016/j.cson.2025.100080","url":null,"abstract":"<div><div>Informed consent is a cornerstone of ethical medical practice, particularly in high-stakes oncological surgery where treatment options are complex and risks are significant. This paper explores the potential of digital platforms and artificial intelligence (AI) to enhance the informed consent process. The traditional consent process, reliant on face-to-face interactions and paper-based documentation, is increasingly being supplemented by digital solutions that offer remote consultations, personalized patient information, and electronic consent forms. These digital pathways not only improve accessibility and patient comprehension but also streamline documentation, reducing errors and administrative burdens. AI technologies, including ambient digital scribes and large language models (LLMs), could further augment this process by generating personalized risk assessments, simplifying complex medical information, and facilitating multilingual communication. However, success will also depend on addressing ethical concerns, ensuring equitable access, and preserving the irreplaceable human connection between patients and clinicians. By augmenting rather than replacing clinician expertise, digital platforms and AI can empower patients to make truly informed decisions in oncological care.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 2","pages":"Article 100080"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness and safety of stereotactic body radiotherapy (SBRT), proton therapy (PT), and irreversible electroporation (IRE) for localized prostate cancer","authors":"Judit Erdos,&nbsp;Louise Schmidt","doi":"10.1016/j.cson.2025.100078","DOIUrl":"10.1016/j.cson.2025.100078","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review evaluates the effectiveness and safety of three innovative treatments – stereotactic body radiotherapy (SBRT), proton therapy (PT), and irreversible electroporation (IRE) – against existing treatments for localized prostate cancer.</div></div><div><h3>Methods and materials</h3><div>We performed a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, considering articles on patient-relevant outcomes (quality of life, survival and safety) published between February 2018 and February 2024 in English or German.</div></div><div><h3>Results</h3><div>Randomized controlled trials (RCTs) could not be identified for IRE and PT, preventing definitive effectiveness assessments. The evidence on IRE from five observational studies (n ​= ​846) is insufficient for conclusive toxicity evaluations. For PT, eight observational studies (n ​= ​5514) show inconsistent gastrointestinal (GI) and genitourinary (GU) toxicity trends, with long-term data indicating persistent GI symptoms and a significant increase in severe GU toxicities. For SBRT, three RCTs (n ​= ​2138) and two observational studies (n ​= ​460) could be found. The results show minor, non-significant differences in survival rates compared to conventional fractionation, a type of external radiation, after two and five years. Cumulative grade ≥1 GI toxicity with SBRT was significantly lower than with conventional fractionation at treatment end and at one year. Initial GU acute toxicities were lower in the SBRT group but not significantly different after one year. Observational data confirms low initial GU acute toxicities, aligning with RCT trends by three months.</div></div><div><h3>Conclusions</h3><div>The evidence for SBRT, PT, and IRE in treating localized prostate cancer is inconclusive. While it is unclear whether these therapies can replace more invasive procedures like prostatectomy or significantly improve quality of life or survival, SBRT appears as effective as conventional fractionation for survival outcomes in low-to intermediate-risk patients. Further RCTs are needed to evaluate the long-term effectiveness and safety of these treatments compared to standard methods.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100078"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of inflammation and muscle dedifferentiation in the prognosis of retroperitoneal dedifferentiated liposarcoma","authors":"Dorian Yarih Garcia-Ortega ,&nbsp;Gabriela Concepción Alamilla-García ,&nbsp;Ana Paulina Melendez-Fernandez ,&nbsp;Sylvia Veronica Villavicencio-Valencia ,&nbsp;Claudia Haydee Sarai Caro-Sanchez ,&nbsp;Kuauhyama Luna-Ortiz","doi":"10.1016/j.cson.2025.100072","DOIUrl":"10.1016/j.cson.2025.100072","url":null,"abstract":"<div><h3>Introduction</h3><div>Retroperitoneal liposarcomas (RPLS) is the most prevalent soft tissue sarcomas in this location; dedifferentiated liposarcoma (DDLS) poses significant challenges for treatment due to its aggressive nature and poor prognosis. Myogenic dedifferentiation within DDLS may influence surgical outcomes and patient survival. This study investigates the impact of myogenic dedifferentiation and neutrophil-lymphocyte ratio (NLR) as an inflammatory marker on surgical complications and treatment outcomes in RPLS.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the medical records of 176 patients diagnosed with retroperitoneal sarcoma from January 1, 2005, to December 31, 2018. Fifty patients with DDLPS met the inclusion criteria. Immunohistochemical analyses for muscle-specific markers identified myogenic dedifferentiation. Patients were grouped based on the presence of myogenic dedifferentiation. Preoperative NLR was calculated, and a receiver operating characteristic (ROC) curve determined the optimal NLR cut-off for stratifying inflammatory profiles. Associations between myogenic dedifferentiation, NLR, surgical complications, and treatment outcomes were analyzed.</div></div><div><h3>Results</h3><div>Patients with myogenic dedifferentiation had significantly higher surgical complication rates and lower overall survival (median OS: 26.6 vs. 40.8 months, p ​&lt; ​0.001). An NLR cut-off of 2.6 (AUC ​= ​0.775, 95% CI: 0.63–0.91) predicted myogenic dedifferentiation with 86.7% sensitivity and 54.6% specificity. Elevated NLR was strongly associated with myogenic dedifferentiation (odds ratio ​= ​7.71, 95% CI: 1.51–39.41, p ​= ​0.014), suggesting a heightened inflammatory response influencing tumor aggressiveness.</div></div><div><h3>Conclusion</h3><div>Myogenic dedifferentiation and elevated NLR are associated with increased surgical complications and poorer prognosis in patients with DDLPS. The strong correlation between high NLR and myogenic dedifferentiation underscores the potential role of inflammation in tumor progression. These findings highlight the need for further research into immunotherapy as a possible treatment option for this patient subset to improve management and outcomes.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized pancreaticojejunostomy by double U-stitch technique in open, laparoscopic, and robotic pancreatoduodenectomies","authors":"Jiang Liu ,&nbsp;Jie Hua ,&nbsp;Rong Tang ,&nbsp;Wei Wang","doi":"10.1016/j.cson.2024.100070","DOIUrl":"10.1016/j.cson.2024.100070","url":null,"abstract":"<div><h3>Introduction</h3><div>To evaluate the efficacy and safety of the Double U-Stitch technique in open, laparoscopic and robotic pancreaticoduodenectomy.</div></div><div><h3>Materials and methods</h3><div>A retrospective study was conducted involving 180 patients who underwent pancreaticoduodenectomy (PD) at the Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, between November 2021 to December 2023. Patients were categorized into three groups: open pancreaticoduodenectomy (OPD), laparoscopic pancreaticoduodenectomy (LPD), and robotic pancreaticoduodenectomy (RPD). The Double U-Stitch technique was applied in all cases and perioperative data were collected.</div></div><div><h3>Results</h3><div>All Double U-Stitch techniques were completed according to the standard, whether in the OPD group, LPD group, or RPD group. The average pancreaticojejunal anastomosis time was less than 25min (14.5min in the OPD group, 24.2min in the LPD group and 24.4min in the RPD group, P ​&lt; ​0.0001). The incidence of clinically relevant pancreatic fistula was 11.6% in OPD group and 9.5% in minimally invasive group (LPD ​+ ​RPD) (P ​&gt; ​0.05). There was a low incidence rate of postoperative complications which consisted of bile leak, intra-abdominal infection, hemorrhage, and delayed gastric emptying. There was no 90-day mortality observed.</div></div><div><h3>Conclusion</h3><div>The Double U-Stitch technique demonstrated comparable safety and efficacy across different surgical approaches for PD.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 1","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}