Clinical Surgical Oncology最新文献

{"title":"From support to strategy: The evolving role of perioperative nutrition in regulating the prognosis of colorectal cancer surgery","authors":"Qian Wu ,&nbsp;Chi Huang ,&nbsp;Fengmin Zhang ,&nbsp;Chengle Zhuang","doi":"10.1016/j.cson.2025.100110","DOIUrl":"10.1016/j.cson.2025.100110","url":null,"abstract":"<div><div>The global burden of colorectal cancer (CRC) continues to rise, and the role of perioperative nutrition is shifting from \"passive support\" to an \"active therapeutic\" strategy. This narrative review synthesizes recent evidence on metabolic reprogramming and prehabilitation, immunonutrition and microbiome-guided approaches, enteral nutrition and long-term prognosis, and AI-enabled precision nutrition within CRC perioperative care. Findings indicate that multimodal prehabilitation-structured exercise combined with targeted nutrition-enhances metabolic flexibility, mitigates insulin resistance and inflammation, increases preoperative functional reserve, and improves postoperative complications and recovery trajectories. Immunonutrition (e.g., omega-3 fatty acids, arginine, glutamine) and probiotic/prebiotic interventions strengthen the intestinal barrier and recalibrate the immunosuppressive tumor microenvironment, with signals for reduced infections and overall complications. Enteral nutrition correlates with improved survival, while composite nutrition-inflammation indices (PNI, CONUT, GNRI) independently refine risk stratification and optimize prognostic modeling. Microbiome- and multi-omics-informed precision nutrition, supported by AI-based dietary assessment and dynamic monitoring, offers feasible pathways for individualized interventions. However, real-world implementation is constrained by under-recognition of malnutrition, resource limitations, and variability in Enhanced Recovery After Surgery (ERAS) adherence.</div></div><div><h3>Conclusions</h3><div>Establishing nutrition as a strategic pillar of CRC perioperative management is evidence-based. Priorities include consensus-driven, operational evaluation and intervention workflows; clear population stratification and biomarker-guided decision criteria; and strengthened long-term follow-up and multidisciplinary collaboration to translate and amplify the metabolic and immune benefits into tangible clinical gains.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736748","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":"The clinical application of A new DSA-Guided axillary vein puncture technique for venous infusion port","authors":"Liu Mei ,&nbsp;Xu Yue ,&nbsp;Mu Ning,&nbsp;Li Feng'e,&nbsp;Wu Shengnan,&nbsp;Lv Huan,&nbsp;Wang Xinyi,&nbsp;Ma Chunhua","doi":"10.1016/j.cson.2025.100098","DOIUrl":"10.1016/j.cson.2025.100098","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the feasibility of a new guidance method for axillary vein puncture, a totally implantable venous access port (TIVAP) was implanted via axillary vein puncture guided by a 30-degree contralateral oblique view of digital subtraction angiography (DSA).</div></div><div><h3>Methods</h3><div>This retrospective study reviewed clinical data of 275 patients who underwent TIVAP implantation at the Oncology Treatment Center of Tianjin Union Medical Center (February 2022–November 2024). The success rate of puncture, puncture-related complications, and short-term follow-up outcomes in patients undergoing TIVAP implantation via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA were analyzed.</div></div><div><h3>Results</h3><div>57 patients were implanted with TIVAP via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA. The right axillary vein approach was used in 53 cases (93.0 ​%), and the left axillary vein approach was used in 4 cases (7.0 ​%), among which 2 cases were switched to the left side due to venous anomalies on the right side. The puncture success rate was 100 ​%. Two cases (3.5 ​%) had accidental puncture of the subclavian artery, but no local hematoma occurred after compression. There were no puncture-related complications such as pneumothorax, air embolism, arrhythmia, or nerve damage. All patients completed a 1-month follow-up, during which no delayed hematoma, venous thrombosis, or port infection was detected.</div></div><div><h3>Conclusion</h3><div>TIVAP implantation via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA demonstrated high technical success and acceptable short-term safety and serves as a feasible alternative in selected patients.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684843","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":"The management of Juvenile Tumour Systems implants following limb salvage surgery for bone sarcoma: A British consensus informing best practice and consistent care","authors":"Rebecca O'Keeffe ,&nbsp;Sarah Massey","doi":"10.1016/j.cson.2025.100099","DOIUrl":"10.1016/j.cson.2025.100099","url":null,"abstract":"<div><h3>Aims</h3><div>The aim of this study was to gain a consensus for best practice of follow up of patients following limb salvage surgery with a Juvenile tumour Systems (JTS) extendible implant to benchmark and guide consistent care.</div></div><div><h3>Methods</h3><div>A two-round modified Delphi study was conducted by paediatric sarcoma specialists. They identified 8 areas of follow up care that required consensus agreement. Statements were based around leg length measurement, long-leg X-Rays, joint range of movement, procedure within the lengthening appointment, physiotherapy, shoe raises, training, frequency of appointments. A pre-determined threshold of &gt;70 ​% for consensus, with a threshold of &gt;60 ​% being considered as ‘points to consider’.</div></div><div><h3>Results</h3><div>Sixteen professionals and manufacturers consented to be part of the consensus. A total of 63 statements were generated for the initial questionnaire, at the end of which 9 statements reached consensus. The remaining 54 statements were discussed and refined to 31 for the second questionnaire. Following two rounds of questionnaires and web conferences a total of 29 statements reached consensus.</div></div><div><h3>Conclusion</h3><div>Paediatric sarcoma specialists have reached expert consensus to provide a framework for consistent follow up management of JTS implants, many of which could be generalised to other non-invasive growing implants. We would recommend that clinicians use these statements to ensure follow-up care is consistent.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435364","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":"Role of primary tumour surgery in the management of oligometastatic breast cancer","authors":"Byung Choi,&nbsp;Amr Mousa,&nbsp;Tyler Longbone,&nbsp;Lavandan Jegatheeswaran,&nbsp;Mohammed Elsiddig,&nbsp;Vishal Patel,&nbsp;Ekambaram Babu,&nbsp;Arunmoy Chakravorty","doi":"10.1016/j.cson.2025.100101","DOIUrl":"10.1016/j.cson.2025.100101","url":null,"abstract":"<div><div>Metastatic breast cancer has long considered an incurable disease, however a subset coined oligometastatic breast cancer (OMBC) has challenged this assumption. OMBC represents a stable entity that presents as an intermediary state between locoregional and widespread disease where metastasised cells are limited to suitable sites potentially amenable to treatment. However, the treatment for OMBC is not standardised and a major limitation is diagnostic difficulty as it relies only on imaging findings. In the United Kingdom, a case by case discussion of treatment is made due to lack of guidance or framework. The role of primary surgical excision of the breast tumour in OMBC has been scrutinised with varying outcomes to date. This review evaluates the role of primary surgical excision and future directions in the field of OMBC management. Most studies to date have been retrospective in nature, given the diagnostic challenges of OMBC and studies to date have failed to show conclusive evidence regarding surgery to the primary tumour. Some favourable factors seem to be hormone receptor positivity and bone pre-dominant metastasis, however there is a need for better understanding in the distinct biology of OMBC to characterise and determine the value of surgery to the primary tumour as well as adjuvant oncological treatments.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468953","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":"The gut microbiota and colorectal cancer: Molecular insights and translational implications","authors":"Jinmiao Chen ,&nbsp;Xiuqi Du ,&nbsp;Minke Shao ,&nbsp;Yifan Sun ,&nbsp;Xinyu Shi ,&nbsp;Songbing He","doi":"10.1016/j.cson.2025.100107","DOIUrl":"10.1016/j.cson.2025.100107","url":null,"abstract":"<div><div>In recent years, the gut microbiota have identified as a modifiable key environmental factor influencing the development and progression of colorectal cancer (CRC). Molecular epidemiological studies, including cross-sectional and prospective cohort designs, have consistently identified distinct microbial dysbiosis in CRC patients, characterized by an enrichment of pro-inflammatory and genotoxin-producing bacteria, alongside a reduction in protective commensals. Mendelian randomization analyses further support a causal role for specific microbial taxa in CRC pathogenesis. Mechanistically, gut microbes contribute to tumorigenesis through direct genotoxic effects (e.g., DNA damage), activation of inflammatory pathways, and metabolite-mediated interactions—exhibiting dual roles, as seen with short-chain fatty acids versus secondary bile acids. These processes often interact with host genetic backgrounds, forming complex gene-environment interactions. These findings the potential of microbiota-derived signatures as biomarkers for early detection and prognostic prediction. Furthermore, microbiota-targeted strategies—such as dietary interventions, probiotics, pharmaceuticals, and nanotechnology-based approaches—are being actively explored for precision prevention and treatment of CRC.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617989","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":"Immunofluorescence and targeted removal of the axillary sentinel lymph node in early-stage breast cancer: a simple, safe and effective anatomical approach","authors":"Stéphane Lantheaume ,&nbsp;Sandrine Soler ,&nbsp;Isabelle Ben Taàrit ,&nbsp;Anne Le Hémon-Lepaul ,&nbsp;Sophie Lantheaume ,&nbsp;Céline Lenck ,&nbsp;François Sensenbrenner","doi":"10.1016/j.cson.2025.100109","DOIUrl":"10.1016/j.cson.2025.100109","url":null,"abstract":"<div><h3>Introduction</h3><div>The reference technique for axillary sentinel lymph node (SLN) detection in women with breast cancer uses the radioactive marker, technetium (Tc99m), which makes ambulatory surgery difficult and carries a risk of irradiation to the patient and the medical teams. The aim of this study was to investigate the feasibility of using immunofluorescence (IF), a new non-radioactive technique, for SLN detection in women with early-stage breast cancer (ESBC).</div></div><div><h3>Materials and methods</h3><div>Patients were included if they were suffering from ESBC (T1/T2 N0) or ductal carcinoma in situ. The SLN was first detected using IF with indocyanine green and was then confirmed using Tc99m.</div></div><div><h3>Results</h3><div>A total of 268 women with ESBC were included (median age: 61.4 years). Tumour location in the breast correlated with SLN location according to the anatomic classification ABCD, with &gt;75 ​% of tumours located in the outer quadrants of the breast. IF was positive in 96 ​% of cases and allowed precise anatomic location of the SLN. The SLN was located in zone A in 87.7 ​% of patients and zone B in 10.1 ​%, which corresponds to the path of the lateral thoracic vein. Only 2.2 ​% of tumours were in zone C and none were in zone D. Rate of failure of detection by IF alone was 4.1 ​%, associated with a mean BMI of 26.8 ​kg/m².</div></div><div><h3>Conclusion</h3><div>IF is an economic, non-invasive, non-radioactive technique for SLN detection in ESBC. Surgeons should be aware of this new, alternative procedure so that it can be used more widely in the future.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736749","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":"The role of artificial intelligence in emergency general surgery: Trends, advances, and future directions","authors":"Lasitha B. Samarakoon ,&nbsp;Elon Correa ,&nbsp;Wen Y. Chung","doi":"10.1016/j.cson.2025.100103","DOIUrl":"10.1016/j.cson.2025.100103","url":null,"abstract":"<div><div>Artificial intelligence (AI) is increasingly integrated into emergency general surgery (EGS), offering advances in diagnosis, decision support, operative planning, intraoperative guidance, and postoperative management. This review synthesises current evidence on AI applications in EGS, drawing on meta-analyses, large-scale datasets, and landmark studies. Key domains include risk prediction, intraoperative assistance, surgical video analysis, training, prehabilitation, and operational coordination. Evidence shows AI can improve diagnostic accuracy, streamline workflows, and enhance patient outcomes, though benefits vary by setting, resource availability, and clinical domain. Adoption is accelerating, supported by rising global funding, yet constrained by regulatory, ethical, and implementation challenges. Addressing these barriers, standardising evaluation metrics, and expanding high-quality, multicentre trials will be essential to realise AI's full potential in EGS.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520967","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":"Delayed diagnosis May lead to giant cell tumor of bone progression","authors":"M.J.C. Duivenvoorden ,&nbsp;R. Hemke ,&nbsp;G.G.J. Krebbekx ,&nbsp;J.A.M. Bramer ,&nbsp;N.P. Denswil ,&nbsp;G.M.M.J. Kerkhoffs ,&nbsp;F.G.M. Verspoor","doi":"10.1016/j.cson.2025.100106","DOIUrl":"10.1016/j.cson.2025.100106","url":null,"abstract":"<div><h3>Introduction</h3><div>Giant Cell Tumor of Bone is an intermediate, locally aggressive tumor that is often diagnosed at an advanced stage due to diagnostic delays. Hypothetically, diagnostic delays may result in advanced disease, necessitating more invasive surgery and causing significant lifelong burden. This systematic review explores the available literature on diagnostic and treatment delays in Giant Cell Tumor of Bone.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using the Medline, Embase, and Cochrane databases on February 9, 2023. A total of 15 studies representing 34 cases (32 cases analyzed) were included after thorough review and critical appraisal.</div></div><div><h3>Results</h3><div>Fifteen articles representing 32 cases were included. The median age of the included cases was 29 years (IQR 24–41). Tumor locations included the foot (22 ​%), spine (19 ​%), distal ulna (16 ​%), and other sites (43 ​%). Campanacci grades 2 and 3 (used to assess tumor severity) were reported in 16 ​% and 81 ​% of cases, respectively. Primary GCTB accounted for 88 ​% of cases, while 12 ​% involved local recurrence. The median diagnostic delay was 5.5 months (IQR 3.0–13.5). Patient-related delays (13 cases) had a median of 6 months (IQR 3–35), referral delays (19 cases) had a median of 4 months (IQR 3–12), and diagnostic delays (4 cases) had a median of 2.5 months (IQR 1–4).</div></div><div><h3>Conclusion</h3><div>Diagnostic delays in Giant Cell Tumor of Bone were identified, and were often associated with advanced disease. Further research involving a larger number of cases is essential to assess the impact of these delays on clinical outcomes and disease progression.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684842","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":"Metastatic sites and surgical management in stage IV ovarian cancer: Is there a place for debulking surgery in FIGO stage IVB patients? A retrospective study from the ESME national cohort","authors":"Navid Mokarram Dorri ,&nbsp;Laura Foulhioux ,&nbsp;Christophe Zemmour ,&nbsp;Quentin Dominique Thomas ,&nbsp;Hélène Costaz ,&nbsp;Fabrice Narducci ,&nbsp;Thierry Petit ,&nbsp;Cécile Loaec ,&nbsp;Enora Laas ,&nbsp;Frédéric Guyon ,&nbsp;François Cherifi ,&nbsp;Aude-Marie Savoye ,&nbsp;Domenico Ferraioli ,&nbsp;Rossi Lea ,&nbsp;Thibault de la Motte Rouge ,&nbsp;Frederic Marchal ,&nbsp;Marie Gosset ,&nbsp;Christophe Pomel ,&nbsp;Anne-Laure Martin ,&nbsp;Eric Lambaudie","doi":"10.1016/j.cson.2025.100113","DOIUrl":"10.1016/j.cson.2025.100113","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the surgical management and oncologic outcomes of patients with FIGO stage IV ovarian cancer, using data from the French national ESME cohort.</div></div><div><h3>Methods</h3><div>This retrospective multicenter study included patients diagnosed with FIGO stage IV ovarian cancer between January 2011 and December 2016, treated in 18 French Comprehensive Cancer Centers participating in the ESME-OVR program. Clinical characteristics, treatment strategies, metastatic site patterns, and survival outcomes (overall survival [OS], progression-free survival [PFS]) were analyzed and compared between FIGO IVA and IVB stages.</div></div><div><h3>Results</h3><div>A total of 159 patients were identified, of whom 107 (67.3 ​%) had FIGO stage IVB disease. Regardless of metastatic stage, surgical strategies and were comparable. Complete debulking surgery was achieved in 75 ​% of cases. Most of FIGO stage IVB patients (88.8 ​%) presented a single metastatic site including extra-abdominal lymph nodes (50.5 ​%), liver (20.6 ​%), and lungs (10.3 ​%); 15.9 ​% of patient with distant metastases underwent local treatment and predominantly targeted nodal disease. Complete debulking surgery was significantly associated with improved OS and PFS (p ​= ​0.002 and p ​&lt; ​0.001, respectively), while local treatment of metastases did not provide survival benefit. The number of metastatic sites did not significantly influence prognosis.</div></div><div><h3>Conclusions</h3><div>Complete debulking surgery is the critical factor from a progronostic point of view, whether in FIGO stage IVA or IVB. Feasibility of local treatment for distant metastases is observed, its impact on oncologic outcomes remains unclear and we need further prospective investigation. Surgical strategies should be integrated into a personalized approach to optimize management in advanced-stage disease.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789821","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":"Reappraising the prognostic role of liver resection as part of extended cholecystectomy for T2 gallbladder cancer","authors":"Hirotoshi Noda,&nbsp;Yoshiyasu Kato,&nbsp;Ryo Ashida,&nbsp;Katsuhisa Ohgi,&nbsp;Shimpei Otsuka,&nbsp;Hideyuki Dei,&nbsp;Katsuhiko Uesaka,&nbsp;Teiichi Sugiura","doi":"10.1016/j.cson.2025.100112","DOIUrl":"10.1016/j.cson.2025.100112","url":null,"abstract":"<div><h3>Background</h3><div>The role of liver resection (LR) as extended cholecystectomy for T2 gallbladder cancer (GBC) remains controversial.</div></div><div><h3>Methods</h3><div>100 patients with pathological (p) T2 GBC who underwent curative surgery between 2003 and 2023 were retrospectively analyzed. Prognostic outcomes were compared between patients who underwent LR (LR+) and those who did not (LR–), with subgroup analyses by T2 substage. To assess the accuracy of preoperative T staging, 72 additional pT1/3 patients who underwent surgical resection during the same study period were evaluated.</div></div><div><h3>Results</h3><div>The LR+ (n ​= ​78) and LR– (n ​= ​22) groups showed no differences in overall survival (OS, <em>P</em> ​= ​0.552) or recurrence-free survival (RFS, <em>P</em> ​= ​0.538). Subgroup analyses showed no survival advantage with LR in both T2a and T2b cases. A multivariable analysis identified lymph node metastasis, elevated CA19-9, and tumor location (neck) as independent predictors of OS, but not LR (<em>P</em> ​= ​0.806). Similarly, LR was not a risk factor for RFS (<em>P</em> ​= ​0.677). Local recurrence occurred in one patient (LR ​+ ​group). Diagnostic accuracy of T2 was 64.5 ​%. 2 cases of clinical T2b cases were upstaged to pT3.</div></div><div><h3>Conclusions</h3><div>LR did not provide clear oncological benefits in T2 GBC when adequate preoperative and intraoperative assessment was ensured. For T2a tumors, LR is likely to be omitted without compromising oncological outcomes. For even T2b cases, omission may be considered when hepatic invasion is carefully excluded.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736747","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}