Surgical Oncology Insight最新文献

{"title":"Robotic right posterior sectionectomy for biliary cystadenoma. Description of standardized approach in anatomical liver resection","authors":"Parisa Y. Kenary,&nbsp;Sharona Ross,&nbsp;Iswanto Sucandy","doi":"10.1016/j.soi.2025.100127","DOIUrl":"10.1016/j.soi.2025.100127","url":null,"abstract":"<div><h3>Objective</h3><div>With recent advances in surgical technology, minimally invasive liver resection is gradually becoming the gold-standard practice <span><span>1</span></span>, <span><span>2</span></span>, <span><span>4</span></span>. Biliary cystadenoma is a rare tumor with malignant potential, therefore parenchymal-sparing liver resection is the preferred approach <span><span>3</span></span>, <span><span>4</span></span>. Due to its technical challenge, laparoscopic or robotic anatomical right posterior sectionectomy are infrequently performed in daily practice and rarely described in multimedia literatures. Herein, we describe our standardized technique for robotic right posterior sectionectomy.</div></div><div><h3>Methods</h3><div>A 65-year-old woman presented with a complex 5.3 cm multiloculated liver cyst involving segment 6/7. CT scan and MRI revealed multiple enhancing solid mural nodules and thickened septum concerning for neoplasm. Right posterior sectoral portal vein and hepatic artery were ligated to establish inflow control. After an adequate liver mobilization and dissection of hepatocaval confluence, the line of the parenchymal transection was drawn toward the root of the right hepatic vein following a demarcation line. Mapping of the middle and right hepatic veins was undertaken using ultrasonic guidance. Parenchymal division was undertaken under intermittent Pringle maneuver as necessary. The operation was completed with transection of the right hepatic vein using a robotic stapler.</div></div><div><h3>Results</h3><div>The operative time of 5 hours with minimal blood loss. The postoperative course was uneventful. A final pathology report confirmed a 6 cm multiloculated biliary cystadenoma without evidence of invasive carcinoma.</div></div><div><h3>Conclusion</h3><div>Robotic right posterior sectionectomy is technically demanding, however feasible, safe, and reproducible. We believe this technique can provide an alternative method to the conventional open operation for segment 6/7 liver tumor resection.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100127"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183218","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":"Hepatic and peri-hepatic cytoreductive surgery in low-grade appendiceal mucinous neoplasms","authors":"Catherine R. Lewis,&nbsp;Tamara L. Floyd,&nbsp;Casey J. Allen,&nbsp;David L. Bartlett,&nbsp;Patrick L. Wagner","doi":"10.1016/j.soi.2025.100125","DOIUrl":"10.1016/j.soi.2025.100125","url":null,"abstract":"<div><h3>Background</h3><div>Low-grade appendiceal mucinous neoplasm (LAMN) is a rare tumor that carries a risk of rupture causing pseudomyxoma peritonei (PMP). With PMP, intraperitoneal surfaces and organs become involved, including the liver capsule, porta hepatis, and peri-hepatic regions. Extensive porta hepatis and peri-hepatic involvement in PMP is often cited as a contraindication for cytoreduction. We present a retrospective review of successful cytoreductive surgery (CRS) in patients with LAMN involvement of the porta hepatis and peri-hepatic tissues.</div></div><div><h3>Methods</h3><div>A retrospective review identified patients over a 3-year period with a diagnosis of LAMN with porta hepatis and peri-hepatic involvement. Peri-operative records were reviewed for all patients who met study criteria.</div></div><div><h3>Results</h3><div>We identified 41 patients with LAMN and porta hepatis and/or peri-hepatic involvement who underwent CRS with successful debulking of these regions. Non-anatomic hepatic parenchymal resection was required in 19 patients. Median peritoneal carcinoma index was 28, and median length of stay was 13.5 days. Clavien-Dindo Grade ≥ 3 complications were seen following 36 % of cases, with no liver-specific morbidity and no peri-operative mortalities.</div></div><div><h3>Discussion</h3><div>Peri-hepatic or portal involvement by PMP can be safely addressed during CRS and should not preclude attempts at complete cytoreduction in appropriate patients who may achieve long-term disease control.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100125"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183215","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":"Optimal surveillance for detecting sarcoma lung metastasis – A systematic review","authors":"Neha Malik,&nbsp;Kate Krause,&nbsp;Emily Z. Keung,&nbsp;Heather G. Lyu,&nbsp;Heather Lillemoe,&nbsp;Christopher Scally,&nbsp;Keila Torres,&nbsp;Kelly Hunt,&nbsp;Mary Austin,&nbsp;Christina L. Roland","doi":"10.1016/j.soi.2025.100124","DOIUrl":"10.1016/j.soi.2025.100124","url":null,"abstract":"<div><h3>Introduction</h3><div>Accurate diagnosis of lung metastasis for patients with soft tissue sarcoma (STS) can impact overall survival, but there is considerable variability in imaging utilized to detect metastasis. Chest x-ray (CXR) or computer tomography (CT) scan of the chest are the most common studies in current practice.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed. Databases were searched from inception to January 3, 2024. Articles were reviewed to determine if CXR or CT chest was associated with improved overall or recurrence-free survival in patients with STS. Articles were also reviewed for data on cost-effectiveness of CXR versus CT chest. The quality of evidence was assessed by the Critical Appraisal Skills Programme.</div></div><div><h3>Results</h3><div>259 abstracts were screened, and twenty-seven studies were selected for full-text review. Nine studies met all inclusion criteria. Seven studies included data on survival or recurrence rates and four included data on the cost of imaging modality. The seven studies all had conflicting results on the impact of CXR versus chest CT on survival and recurrence. The four studies that looked at cost found that CXR was more cost-effective, but in certain patients, screening with chest CT could be cost-effective.</div></div><div><h3>Conclusion</h3><div>The literature defining the optimal surveillance method for lung metastases for patients with STS is limited. Most of the studies had a low quality of evidence due to study design and significant risk of bias. Randomized controlled trials are needed to further understand the best imaging modality for lung metastasis surveillance in this patient population.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100124"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183475","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":"Impact of clinicopathologic factors on the number of lymph nodes examined in patients with melanoma","authors":"Jason M. Lizalek,&nbsp;Collin E. Dougherty,&nbsp;Juan A. Santamaria-Barria,&nbsp;Bradley N. Reames,&nbsp;Jason Foster,&nbsp;Joshua M.V. Mammen","doi":"10.1016/j.soi.2025.100123","DOIUrl":"10.1016/j.soi.2025.100123","url":null,"abstract":"<div><h3>Background</h3><div>Melanoma is amongst the malignancies with the greatest annual increase in incidence. The prognosis for melanoma is partially dependent on lymph node status. Staging of lymph node basins in patients without clinical evidence of lymphadenopathy is typically by sentinel lymph node (SLN) biopsy. In this study, we sought to determine factors associated with the number of sentinel lymph nodes examined.</div></div><div><h3>Methods</h3><div>The National Cancer Database Participant User File from 2018 to 2020 was queried for clinical node negative patients who underwent sentinel lymph node biopsy. Descriptive statistics were obtained. Stepwise negative binomial regression analysis was performed in addition to ANOVA, chi-squared and Student’s t-tests.</div></div><div><h3>Results</h3><div>We identified 32,516 clinically node negative patients with melanoma from 2018 to 2020 who had undergone sentinel lymph node biopsy. Using a stepwise negative binomial model, male patients had a 3.8 % increase in the number of SLNs examined compared to females, while each year of age predicted a 0.3 % decrease in the number of SLNs examined. Breslow thickness &gt; 2 mm was associated with a 6.9 % increase in SLN examined. Primary sites with multiple potential lymphatic drainage basins including ear, lip, scalp &amp; neck, and trunk were associated with a 55.2 %, 29.6 %, 46.6 %, 43.4 % increase in SLNs examined, respectively. The study did not identify a difference in overall survival based on the number of lymph nodes examined (p = 0.25).</div></div><div><h3>Conclusion</h3><div>The number of sentinel lymph nodes examined in melanoma patients is associated positively with younger age, male sex, Breslow thickness, and primary site.</div></div><div><h3>Synopsis</h3><div>A National Cancer Database study of sentinel lymph node biopsy yield in clinically node-negative melanoma patients showed association with age, sex, Breslow thickness, and primary site. Clinicopathologic factors were predictive of sentinel lymph node yield, indicating other influences rather than objective sentinel lymph node criteria on node biopsy.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100123"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183473","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":"Fusobacterium nucleatum in appendiceal cancer: Prevalence and influence on the tumor immune microenvironment","authors":"Hyun Park ,&nbsp;Chelsea Knotts ,&nbsp;Rose Blodgett ,&nbsp;Catherine R. Lewis ,&nbsp;David L. Bartlett ,&nbsp;Neda Dadgar ,&nbsp;Patrick L. Wagner","doi":"10.1016/j.soi.2025.100122","DOIUrl":"10.1016/j.soi.2025.100122","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Fusobacterium nucleatum</em> (<em>Fn</em>) has gained notoriety for its propensity toward mucosal invasion in acute appendicitis and its potential involvement in development or progression of colorectal cancer. We hypothesized that <em>Fn</em> may be linked to appendiceal cancer (AC). To explore the potential connection, we quantitatively examined the presence of <em>Fn</em> in appendiceal tissue across various histological diagnoses.</div></div><div><h3>Methods</h3><div>A total of 50 formalin-fixed paraffin-embedded tissues were obtained from archival appendectomy specimens. RNA-in situ hybridization (RNA-ISH) with an <em>Fn</em>-specific probe was performed, and immunohistochemical staining was performed on tumor-associated CD3 + and CD8 + lymphocytes. The digital images were analyzed using QuPath and Aperio ImageScope.</div></div><div><h3>Results</h3><div>RNA-ISH showed significantly higher <em>Fn</em> content in the appendiceal pathology with increased <em>Fn</em> levels in acute appendicitis, low-grade AC, and high-grade AC relative to the Fn level of a normal appendix. Also, <em>Fn</em> content was strongly associated with decreased CD8 + lymphocyte density within high-grade AC, but no significant association was found with CD3 + lymphocyte density and tumor grades.</div></div><div><h3>Discussion</h3><div>In this study, we confirmed previous reports of <em>Fn</em> levels within normal appendiceal tissue and acute appendicitis and extended this finding to a range of appendiceal neoplasms. The inverse relationship between <em>Fn</em> and CD8 + cell density within high-grade AC in our series also suggests a potential role for <em>Fn</em> in shaping the AC microenvironment toward an immune-suppressed or immune-excluded phenotype. Further study is planned to include larger case numbers with a wider variety of histological subtypes of AC and peritoneal metastatic lesions to enrich the understanding of the immunological and microbial microenvironment in AC for novel opportunities for targeted therapy.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100122"},"PeriodicalIF":0.0,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183474","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":"Circulating tumor DNA predicts recurrence in patients receiving adjuvant hepatic artery infusion chemotherapy for resected colorectal liver metastases","authors":"Noah A. Cohen ,&nbsp;Nazanin Khajoueinejad ,&nbsp;Umut Sarpel ,&nbsp;Spiros Hiotis ,&nbsp;Parissa Tabrizian ,&nbsp;Myron Schwartz ,&nbsp;Benjamin J. Golas ,&nbsp;Daniel M. Labow ,&nbsp;Celina Ang","doi":"10.1016/j.soi.2024.100121","DOIUrl":"10.1016/j.soi.2024.100121","url":null,"abstract":"<div><h3>Objective</h3><div>The role of circulating tumor DNA (ctDNA) in management of patients with colorectal cancer is evolving, however, there are no data on ctDNA monitoring in patients with resected colorectal liver metastases (CRLM) who receive adjuvant hepatic artery (HAI) chemotherapy. We report our center’s initial experience with postoperative ctDNA monitoring in patients receiving adjuvant HAI chemotherapy.</div></div><div><h3>Summary background</h3><div>Adjuvant HAI chemotherapy improves survival after CRLM resection. ctDNA has been shown to predict recurrence in patients with resected CRLM, however no ctDNA data are available in patients who receive adjuvant HAI chemotherapy.</div></div><div><h3>Methods</h3><div>All patients with CRLM who underwent surgical resection and HAI pump placement at our center were included in this study. Demographic, clinicopathologic, radiographic, and ctDNA data are reported.</div></div><div><h3>Results</h3><div>From 2019–2024, 13 patients with CRLM underwent surgical resection and HAI pump placement and had ctDNA testing. With median follow-up of 2.6 years (1.14–4.15), 11 (85 %) patients experienced recurrence at a median of 7.9 months (2.3–22.5). In total, 10 (77 %) patients were ctDNA-positive all of whom had radiographic evidence of recurrence. Three patients have died at the time of last follow-up.</div></div><div><h3>Conclusions</h3><div>After surgical resection and HAI chemotherapy, ctDNA was detectable in most patients, and was associated with radiographic recurrence in all ctDNA-positive patients. We report a high recurrence rate in this series of heavily-pretreated patients with known risk factors for recurrence.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100121"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182588","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":"Real-world outcomes with T-VEC in patients with anti-PD-1 resistant in-transit disease from melanoma and Merkel cell carcinoma","authors":"David G. Su ,&nbsp;Madeline McNamara ,&nbsp;Margaret A. Kaszycki ,&nbsp;Alexander E. Frey ,&nbsp;Jeffrey J. Ishizuka ,&nbsp;Philippos A. Costa ,&nbsp;Thuy T. Tran ,&nbsp;Harriet M. Kluger ,&nbsp;James E. Clune ,&nbsp;Sarah A. Weiss ,&nbsp;Kelly L. Olino","doi":"10.1016/j.soi.2024.100120","DOIUrl":"10.1016/j.soi.2024.100120","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>Talimogene laherparepvec (T-VEC) is an intralesional cancer immunotherapy in patients with unresectable stage IIIB-IV melanoma and Merkel cell carcinoma (MCC). This study assesses T-VEC outcomes in patients with in-transit melanoma and MCC refractory to anti-PD-1 blockade.</div></div><div><h3>Methods</h3><div>All patients with advanced melanoma or MCC with ≥ 1 measurable lesion(s) were retrospectively evaluated from 2019 to 2023. Only those who received ICI therapy for ≥ 3 months with progression of regional metastasis prior to receiving T-VEC were included. Clinicopathologic and treatment data were reviewed.</div></div><div><h3>Results</h3><div>Seventeen patients underwent T-VEC therapy, consisting of thirteen melanoma and four MCC cases. Median age was 75.9 and 79.6 for melanoma and MCC cases respectively. Eleven melanoma (84 %) and three MCC (75 %) cases received extremity injections. Median number of in-transit metastatic sites for melanoma and MCC were 4 and 10; respectively, and the median number of treatment cycles per patient was five in both groups. Ten total patients responded with 8 complete responses and 2 partial responses, while five (4 melanoma; 1 MCC) had disease progression. Of seventeen patients, two discontinued T-VEC due to grade 3 + adverse events.</div></div><div><h3>Conclusion</h3><div>T-VEC following or in conjunction with immunotherapy exhibits tolerability and potential benefit in patients with advanced MCC and melanoma.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100120"},"PeriodicalIF":0.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183472","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":"Prognostic impact of the CALLY index in patients with resectable pancreatic cancer","authors":"Satoshi Matsui,&nbsp;Yoshiyasu Kato,&nbsp;Katsuhisa Ohgi,&nbsp;Ryo Ashida,&nbsp;Mihoko Yamada,&nbsp;Shimpei Otsuka,&nbsp;Katsuhiko Uesaka,&nbsp;Teiichi Sugiura","doi":"10.1016/j.soi.2024.100119","DOIUrl":"10.1016/j.soi.2024.100119","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic significance of the preoperative C-reactive protein-albumin-lymphocyte (CALLY) index has been reported in various cancers. However, its role in pancreatic cancer remains unclear.</div></div><div><h3>Methods</h3><div>A cohort of 307 patients with resectable pancreatic cancer (RPC) who underwent curative surgery without neoadjuvant therapy, between July 2012 and December 2019, was analyzed. The CALLY index was defined as (albumin × lymphocytes)/ (C-reactive protein × 10⁴). The cutoff value of the CALLY index was determined according to　receiver operating characteristics analysis using survival status at 3-year follow-up. The association of the CALLY index with disease-free survival (DFS) and overall survival (OS) was investigated using univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>The median CALLY index was 4.5, with an interquartile range of 1.4–12.3. The cutoff value of the CALLY index was set at 3.0, dividing patients into a CALLY-high group (&gt; 3.0; n = 180) and a CALLY-low group (≤ 3.0; n = 127). The DFS and OS were significantly worse in the CALLY-low group versus the CALLY-high group (<em>p</em> &lt; 0.001 and <em>p</em> &lt; 0.001, respectively). Multivariate analysis, using preoperative clinicopathological variables, revealed a CALLY index ≤ 3.0 as an independent prognostic factor for DFS (hazard ratio [HR] 1.43, <em>p</em> = 0.041) and OS (HR 1.56, <em>p</em> = 0.012).</div></div><div><h3>Conclusions</h3><div>In RPC, survival outcomes were significantly stratified by the CALLY index = 3.0, with &lt; 3 being a significantly poor prognostic factor for DFS and OS. The CALLY index may be useful in predicting long-term survival in patients with RPC.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182587","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":"Risk factors for early versus late venous thromboembolism after cytoreductive surgery and HIPEC","authors":"Sohini Khan ,&nbsp;Kaitlyn Kelly ,&nbsp;Jula Veerapong ,&nbsp;Andrew M. Lowy ,&nbsp;Joel M. Baumgartner","doi":"10.1016/j.soi.2024.100118","DOIUrl":"10.1016/j.soi.2024.100118","url":null,"abstract":"<div><h3>Background</h3><div>Patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) often have extensive cancer burden, long operative times, and reduced mobility postoperatively – known risk factors for venous thromboembolism (VTE). It is unknown whether risk factors differ for early versus late VTEs post-CRS-HIPEC.</div></div><div><h3>Methods</h3><div>We retrospectively studied patients undergoing CRS-HIPEC from 2007 to 2021 and analyzed VTEs occurring within 60 days of surgery. VTEs ≤ postoperative day (POD) 7 were “early”; those after POD 7 were “late”. Associated risk factors were analyzed using student’s t-test, Chi-squared test, and logistic regression.</div></div><div><h3>Results</h3><div>By POD 60, 35 of 682 CRS-HIPEC patients (5.1 %) had VTEs – eight (22.9 %) early and 27 (77.1 %) late. All early VTEs were pulmonary emboli vs. 63 % of late VTEs (p = 0.041); five (62.5 %) early VTEs were serious (Clavien-Dindo grade ≥3) vs. two (7.4 %) late VTEs (p = 0.005). Early VTEs were associated with primary ovarian cancer (37.5 % vs. 4.2 %, p &lt; 0.001), extensive pelvic dissection (87.5 % vs. 50.1 %, p = 0.035), PCI 31–39 (p = 0.002), OR time (558 vs. 420 min, p = 0.015), EBL (650 vs. 150 mL, p = 0.005), and intraoperative transfusion (62.5 % vs. 13.1 %, p = 0.002). Late VTEs were associated with higher Caprini score (9 vs. 8, p = 0.038), lower serum albumin (4.1 vs. 4.3, p = 0.002), PCI 31–39 (p = 0.012) and serious inpatient postoperative complications (22.2 % vs. 7.3 %, p = 0.008).</div></div><div><h3>Conclusions</h3><div>Severity and risk factors are markedly different for early vs. late VTEs following CRS-HIPEC. Early VTEs are more serious and associated with primary ovarian cancer and extensive cytoreduction including pelvic dissection highlighting the need for alternative prophylaxis strategies and clinical scrutiny in these populations.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183471","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":"Analysis of 3144 case reports in the gastrointestinal stromal tumor literature: Identification of underappreciated demographics, clinical presentations, and biology","authors":"Tannaz Ranjbarian ,&nbsp;Mark Antkowiak ,&nbsp;Terence M. Doherty ,&nbsp;Yeseob Jee ,&nbsp;Jason K. Sicklick","doi":"10.1016/j.soi.2024.100117","DOIUrl":"10.1016/j.soi.2024.100117","url":null,"abstract":"<div><h3>Objective</h3><div>Gastrointestinal stromal tumors (GIST) were first described in 1998 and are now known to be the most common soft tissue sarcoma. Numerous case reports are still frequently published reporting various aspects of GIST. This prompted us to review these reports to identify common elements, changes over time, and underappreciated aspects of GIST, as well as to ask whether further exploration is truly warranted.</div></div><div><h3>Methods</h3><div>A search of the NCBI PubMed database from 5/1/1998–8/5/2023 identified all case reports on GIST using the terms “GIST” OR “gastrointestinal stromal tumor” AND “case report.” Publications were classified into 19 categories, subcategorized, and analyzed using descriptive statistics.</div></div><div><h3>Results</h3><div>A total of 4350 articles were found, with 3144 case reports representing 3348 patients included for analysis. The five most represented categories were tumor location (30.3 %), presentation (27.5 %), operative approach (12.1 %), concomitant malignancy (9.2 %), and metastatic site (8.4 %). Notable findings included rare but clinically important features such as tumor-associated paraneoplastic syndromes (0.6 %) and brain metastases (0.6 %). Additionally, 38 cases (1.2 %) were reported in neonates, infants, and children ≤ 12 years old.</div></div><div><h3>Conclusions</h3><div>We describe GIST case reports published over a 25-year period and classified them based upon abstract content. We were surprised to uncover an array of underappreciated aspects of GIST, speaking to the narrow but important role of publishing case reports on the novel and unusual aspects of rare diseases that would otherwise not be appreciated in larger case series or in population-based studies. Thus, we recommend judicious publication of GIST case reports, particularly those that emphasize previously unknown or unappreciated aspects of disease biology or novel approaches to management.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183469","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}