Clinical Surgical Oncology最新文献

{"title":"Establishment and development of minimally invasive surgery for nasopharyngeal carcinoma","authors":"Tao Jiang,&nbsp;Ming-yuan Chen","doi":"10.1016/j.cson.2025.100111","DOIUrl":"10.1016/j.cson.2025.100111","url":null,"abstract":"<div><div>Recurrent nasopharyngeal carcinoma (rNPC) is insensitive to radiotherapy, and re-irradiation lead to severe adverse reactions. Studies have confirmed that endoscopic nasopharyngectomy(ENPG) combined with vascularized nasal mucosal flap repair is superior to re-irradiation with intensity-modulated radiation therapy (IMRT) in terms of survival rate, quality of life and medical costs. This surgical approach has been widely recognized and shows advantages in early-stage rNPC, marking minimally invasive surgery (MIS) for rNPC as an important treatment option. However, the efficacy of surgery for patients with de novo early-stage nasopharyngeal carcinoma(NPC) and advanced rNPC remains controversial. With the standardization and popularization of surgical procedures for NPC, the improvement of surgical staging, the perioperative management of the internal carotid artery(ICA), the advancement of skull base defect repair technology, the implementation of reasonable postoperative treatment and follow-up, as well as the innovation of lymph node dissection technology, MIS for NPC will play an increasingly important role in the treatment of NPC. Evidence-based medical evidence have confirmed that MIS offers definite survival benefits and safety advantages rNPC, serving as the core treatment option for resectable rNPC. Meanwhile, its preliminary application in de novo early-stage NPC has demonstrated potential in avoiding radiotherapy-induced injuries, opening up a new direction for disease treatment. Nevertheless, the surgical treatment of NPC still requires more multi-center and clinical studies for further validation and improvement.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736746","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":"Corrigendum to “Outpatient revisits associated with three sentinel lymph node detection techniques for breast cancer: A propensity score weighted analysis” [Clin. Surg. Oncol. 4 (2025)100087]","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.2025.100114","DOIUrl":"10.1016/j.cson.2025.100114","url":null,"abstract":"","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789820","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":"Automated CT-based sarcopenia assessment for risk stratification of patients undergoing colorectal cancer resection","authors":"Johannes Vogelsang ,&nbsp;Gernot Pucher ,&nbsp;Fabian Hörst ,&nbsp;René Hosch ,&nbsp;Johannes Haubold ,&nbsp;Philipp Keyl ,&nbsp;Christopher M. Sauer ,&nbsp;David Albers ,&nbsp;Peter Markus ,&nbsp;Jan P. Neuhaus ,&nbsp;Andreas D. Rink ,&nbsp;Jürgen Treckmann ,&nbsp;Ulf P. Neumann ,&nbsp;Kai Nassenstein ,&nbsp;Michael Forsting ,&nbsp;Hideo A. Baba ,&nbsp;Jan Egger ,&nbsp;Stefan Kasper ,&nbsp;Martin Schuler ,&nbsp;Felix Nensa ,&nbsp;Julius Keyl","doi":"10.1016/j.cson.2025.100105","DOIUrl":"10.1016/j.cson.2025.100105","url":null,"abstract":"<div><div>Despite the prognostic relevance of sarcopenia in colorectal cancer, it has not yet been incorporated into routine clinical patient assessment. This study investigates the potential of automatically CT-derived muscle-to-bone ratio (MBR) for preoperative stratification of colorectal cancer patients.</div><div>We retrospectively analyzed CT images of 117 colorectal cancer patients undergoing surgical resection. A deep learning model was used to assess the abdominal MBR as a measure of sarcopenia. Univariable and multivariable analyses were performed to analyze the association between MBR and overall survival (OS), in-hospital mortality, length of stay (LOS), and postoperative C-reactive protein (CRP) levels.</div><div>In univariable analysis, preoperative MBR was significantly associated with OS (hazard ratio (HR) 0.29, 95 ​% CI: 0.13–0.64, p ​&lt; ​0.005). In multivariable analysis adjusted for age, sex, and UICC stage, higher MBR remained independently associated with improved OS (HR 0.28, 95 ​% CI: 0.10–0.79, p ​= ​0.017) and reduced in-hospital mortality (coefficient (β) ​= ​-2.58, p ​= ​0.031). Subgroups based on MBR showed significantly different OS in Kaplan-Meier analysis (p ​&lt; ​0.005). Furthermore, patients with low preoperative MBR exhibited significantly higher postoperative CRP values (p ​= ​0.039). No significant association was observed between MBR and LOS.</div><div>Our study demonstrates the potential of deep learning-derived MBR for automated sarcopenia assessment and patient stratification in colorectal cancer surgery.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617992","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":"Breaking barriers: Pembrolizumab's role in overcoming targeted therapy resistance in BRAF-mutant melanoma","authors":"Omer A. Idris ,&nbsp;Abdulaziz Shebrain ,&nbsp;Ali Jawad ,&nbsp;Sabrina C. Pacione ,&nbsp;Delour Haj ,&nbsp;Hanin Bzizi ,&nbsp;Yaqub O. Ahmedfiqi ,&nbsp;Bahar Saadaie Jahromi ,&nbsp;Nicholas Deleon ,&nbsp;Tiantian Zhang ,&nbsp;Amanda Hunt ,&nbsp;Ramona Meraz Lewis ,&nbsp;Diana Westgate","doi":"10.1016/j.cson.2025.100095","DOIUrl":"10.1016/j.cson.2025.100095","url":null,"abstract":"<div><div>Melanoma, a malignancy of melanocytes, has increased globally, posing significant treatment challenges. BRAF mutations, particularly V600E and V600K variants, occur in approximately 40–60 ​% of cutaneous melanomas and activate the MAPK/ERK signaling pathway. Although BRAF and MEK inhibitors have improved response rates and survival, acquired resistance—due to genetic alterations, activation of alternative pathways, and phenotypic changes—remains a major hurdle.</div><div>Pembrolizumab, an anti-PD-1 immune checkpoint inhibitor, has emerged as a promising option to overcome resistance to targeted therapies. This review explores the rationale for using pembrolizumab post-resistance, emphasizing its ability to enhance immune recognition through the immunogenic effects of prior targeted therapies and its synergistic potential when combined with BRAF and MEK inhibitors. Clinical evidence from KEYNOTE trials and real-world studies demonstrates pembrolizumab's efficacy as monotherapy and in combination regimens, leading to improved progression-free and overall survival in patients with advanced melanoma. Mechanistic insights from preclinical studies suggest that targeted therapies modulate the tumor microenvironment and enhance antigen presentation, augmenting the effectiveness of pembrolizumab. Novel biomarkers such as tumor mutational burden (TMB), PD-L1 expression, and circulating tumor DNA (ctDNA) are examined for their potential to predict treatment response and guide personalized therapy. Challenges related to increased toxicity in combination therapies, economic impact, and patient heterogeneity are discussed, highlighting the need for careful patient selection and management strategies. Future directions include optimizing treatment sequencing, exploring novel therapeutic combinations, and advancing personalized medicine through integrative genomic and immunologic data. This review underscores the pivotal role of pembrolizumab in managing BRAF-mutant melanoma and emphasizes the importance of integrated therapeutic strategies to improve patient outcomes.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988235","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":"Outcome of patients scheduled for CRS and HIPEC yet only undergoing explorative laparotomy","authors":"Valentinus Valdimarsson,&nbsp;Ingvar Syk,&nbsp;Victor Verwaal","doi":"10.1016/j.cson.2025.100093","DOIUrl":"10.1016/j.cson.2025.100093","url":null,"abstract":"<div><h3>Background</h3><div>Some patients scheduled for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) only undergo explorative laparotomy (open/close procedure) due to extensive tumor spread or challenges in achieving complete cytoreduction (CC0). This study aimed to evaluate the surgical outcomes and overall survival in patients with peritoneal surface malignancy (PSM) who only undergo open/closed laparotomy.</div></div><div><h3>Methods</h3><div>All patients scheduled for CRS and HIPEC in Malmö, Sweden, between 2015 and 2023, who only underwent open/close laparotomy were included. Patients without malignant diagnoses were excluded. Clinical, survival, and complication data were analyzed.</div></div><div><h3>Results</h3><div>A total of 28 patients underwent open/closed laparotomy only. Before the laparotomy, 15 (54 ​%) patients had undergone diagnostic laparoscopy with a median PCI score of 13.0 (IQR 10.0–19.0). During the laparotomy, the median PCI score was found to be 29.0 (IQR 25.5–33.0). The most common reason for not proceeding with CRS and HIPEC surgery was a high PCI score (61 ​%). Three patients (11 ​%) experienced serious postoperative complications (Clavien-Dindo ≥3b), and one patient died during the first postoperative day. After the explorative laparotomy, twenty-one (78 ​%) patients received palliative chemotherapy (median survival of 13.4 months), whereas six received none (median survival of 3.5 months), with missing data from one patient.</div></div><div><h3>Conclusion</h3><div>Patients diagnosed with PSM who undergo only exploratory laparotomy (open/close) have a very poor prognosis. Exploratory laparotomy poses a significant risk of serious postoperative complications, as well as a lengthy hospital stay. Improved diagnostic tools are urgently needed to help identify the right patients for CRS and HIPEC treatment.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018766","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":"Bibliometric and visualized analysis of fertility preservation in patients with gynecological malignancies from 2014 to 2023","authors":"Zhanghuan Li ,&nbsp;Wenqi Du ,&nbsp;Yufei Qin ,&nbsp;Yinghui Yang ,&nbsp;Yuxia Gao ,&nbsp;Jing Yang ,&nbsp;Xiaojie Feng ,&nbsp;Wenqiang Fan ,&nbsp;Wenxiang Wang","doi":"10.1016/j.cson.2025.100085","DOIUrl":"10.1016/j.cson.2025.100085","url":null,"abstract":"<div><h3>Objective</h3><div>Fertility preservation in patients with gynecological malignancies (FP-GM) has gained increasing attention. This study conducts a bibliometric analysis of FP-GM research, aiming to identify key themes, influential publications, major contributors, and emerging trends that have shaped the field over the last decade.</div></div><div><h3>Methods</h3><div>Data were sourced from the Web of Science Core Collection (WOSCC). Tools such as CiteSpace and VOSviewer were utilized to conduct a detailed bibliometric analysis, focusing on keyword co-occurrence, citation bursts, collaboration networks, and clusters of influential references.</div></div><div><h3>Results</h3><div>A total of 2029 original articles were identified, involving 11446 authors from 342 countries and 8693 institutions, and published across 417 academic journals. Annual Publication generally shows an increasing trend. The USA is leading much of the advancement in this field. <em>The International Journal of Gynecological Cancer</em> published the most articles, and the journal with the most citations was <em>Fertility and Sterility</em>. Grynberg, Michael was the author with the most publications, and Donnez, J was the author with the most citations. The most frequently occurring keywords were “fertility preservation”, “cancer”, “women” and “chemotherapy”. Clusters of references including “cryopreservation techniques”, “ovarian cancer”, “cervical cancer”, “endometrial cancer” and so on. Citation bursts underscored the impact of guidelines and experimental research on the evolution of FP-GM.</div></div><div><h3>Conclusion</h3><div>Research on FP-GM is dominated by cryopreservation techniques and the reproductive consequences of cancer treatments. Influential guidelines and experimental research have shaped the field, with emerging interest in fertility-sparing treatments and hormonal preservation strategies, indicating a continuous evolution in clinical practices.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867119","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":"Artificial intelligence and machine learning in thoracic surgery- A scoping review","authors":"K. Kutywayo ,&nbsp;K. Chandarana ,&nbsp;I. Das ,&nbsp;S. Rathinam","doi":"10.1016/j.cson.2025.100086","DOIUrl":"10.1016/j.cson.2025.100086","url":null,"abstract":"<div><div>Artificial intelligence (AI) and machine learning (ML) are rapidly transforming thoracic surgery, offering innovative solutions to enhance patient care, improve surgical outcomes, improve surgical training, and increase efficiency. This scoping review provides a comprehensive overview of the current applications, challenges, and future directions of AI and ML in thoracic surgery.</div><div>Key applications of AI in thoracic imaging include lung nodule detection and characterisation, with deep learning algorithms demonstrating performance comparable to or exceeding that of human radiologists. Radiomics combined with ML techniques show promise in tumour characterisation and classification of non-small cell lung cancer subtypes. In preoperative planning, AI-powered 3D reconstruction and virtual reality systems enable detailed surgical simulation and risk assessment.</div><div>Augmented reality and computer-assisted navigation systems are being developed to enhance surgical precision intraoperatively. While fully autonomous robotic surgery remains a distant goal, AI-enhanced robotic platforms are advancing rapidly. Postoperatively, AI algorithms show potential for predicting outcomes, interpreting pulmonary function tests, and guiding rehabilitation strategies.</div><div>Despite these advancements, several challenges persist, including data quality and quantity issues, algorithm interpretability, and the need for rigorous clinical validation. Ethical considerations surrounding AI implementation in healthcare also require careful attention.</div><div>Future directions include integrating multimodal data, developing real-time intraoperative guidance systems, and creating adaptive AI models capable of continuous learning. As these technologies mature, they have the potential to revolutionise thoracic surgical practice, ultimately improving patient outcomes.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703728","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":"Evaluating the quality and readability of AI-generated ophthalmic surgery education: A four model comparison","authors":"Rickvir S. Sidhu ,&nbsp;Arrane Selvamogan","doi":"10.1016/j.cson.2025.100092","DOIUrl":"10.1016/j.cson.2025.100092","url":null,"abstract":"","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104480","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":"AI-driven surgical oncology: Innovations, challenges, and the path ahead","authors":"Wen Yuan Chung","doi":"10.1016/j.cson.2025.100088","DOIUrl":"10.1016/j.cson.2025.100088","url":null,"abstract":"","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144685630","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":"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":"2025-09-01","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}