Surgical Oncology Insight最新文献

{"title":"The influence of postoperative morbidity on medium to long-term quality of life trajectories following cytoreductive surgery for peritoneal malignancy – A prospective cohort study","authors":"Daniel Steffens ,&nbsp;Preet G.S. Makker ,&nbsp;Nabila Ansari ,&nbsp;Michael J. Solomon ,&nbsp;Henna Solanki ,&nbsp;Brendan Moran ,&nbsp;Cherry Koh","doi":"10.1016/j.soi.2023.100004","DOIUrl":"10.1016/j.soi.2023.100004","url":null,"abstract":"<div><h3>Purpose</h3><p>Cytoreductive surgery (CRS) improves survival of selected patients with peritoneal malignancy. However, postoperative morbidity rates remain high. The aim of this study was to determine the impact of postoperative morbidity on the quality of life (QOL) trajectories of patients undergoing CRS.</p></div><div><h3>Methods</h3><p>This prospective cohort study included consecutive patients undergoing CRS for peritoneal malignancy between April 2017 and March 2023. QOL measures were collected at baseline, pre-discharge, 3, 6, 12, 18 and 24 months postoperatively using the short-form 36 (SF-36v2) survey. Postoperative in-hospital complications were defined according to the Clavien-Dindo Classification. Differences in QOL trajectories for patients with, and without, postoperative complications, length of stay (short versus long) were determined using mixed effects analyses.</p></div><div><h3>Results</h3><p>A total of 368 patients were included. Mean age was 55 years and 56.2% were female. The main indications for CRS were colorectal peritoneal metastases (46.9%) and appendix adenocarcinoma (23.9%). Overall, QOL decreased sharply from baseline to pre-hospital discharge, returning to baseline 6 to 12 months post-surgery. Severity of postoperative complication and longer length of stay were the main factors negatively impacting physical component trajectories. Postoperative complication, severity of complication and longer length of stay negatively influenced mental component scores, mostly at pre-discharge.</p></div><div><h3>Conclusions</h3><p>QOL following CRS returns to baseline levels within 6 to 12 months. Postoperative morbidity was associated with poorer health related QOL trajectories. Interventions aimed at reducing postoperative morbidity and targeted support may enhance long-term QOL outcomes.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100004"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295024702300004X/pdfft?md5=f0741d00f795e09d0f1fb1074854e80d&pid=1-s2.0-S295024702300004X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191550","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":"Parenchymal sparing liver resection for cytoreduction of neuroendocrine tumors metastases","authors":"Julie Hallet ,&nbsp;Sean Bennett ,&nbsp;Calvin Law","doi":"10.1016/j.soi.2023.100003","DOIUrl":"10.1016/j.soi.2023.100003","url":null,"abstract":"<div><h3>Background</h3><p>Due to unique indolent biology, neuroendocrine tumors (NETs) can be managed for many years with prolonged survival. Goals of NETs therapy differ from other more common solid malignancies. Cytoreductive surgery plays an important role in the multidisciplinary management of NETs. It offers an opportunity to reduce both tumor burden and hormonal load to improve symptom-free survival and quality of life, and spare systemic therapy options. Parenchyma-sparing liver cytoreduction is recommended technique to preserve liver parenchyma for future treatments upon progression or recurrence.</p></div><div><h3>Methods</h3><p>This video reviews parenchyma-sparing cytoreductive surgery for NETs liver metastases. Approaches and techniques, and their rationale are reviewed.</p></div><div><h3>Results</h3><p>We focus on the management of hepatic metastases in well differentiated low grade intestinal neuroendocrine neoplasm (or NET). The video reviews the steps of parenchyma-sparing liver metastases with enucleation for NETs. Considering the goal for cytoreduction for an indolent disease, wide margins are not aimed for. We highlight the technical aspects of enucleations to avoid anatomical resection and preserve parenchyma, which is critical in minimizing morbidity and optimizing long-term sequencing of therapies for a chronic malignancy.</p></div><div><h3>Conclusion</h3><p>We herein illustrate the steps and rationale for hepatic parenchyma-sparing cytoreduction for metastatic NETs. This approach can lead to significant tumoral and hormonal control, with favorable long-term outcomes. Parenchyma-sparing resection should be used over anatomical resection.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100003"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247023000038/pdfft?md5=54480d7ef4c5ffcd845c91efad1a99df&pid=1-s2.0-S2950247023000038-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139019441","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":"A Practical Approach for Drain Fluid Analysis Following Genitourinary Surgery","authors":"Benjamin N. Schmeusser ,&nbsp;Edouard H. Nicaise ,&nbsp;Arnold R. Palacios ,&nbsp;Eric Midenberg ,&nbsp;Mohammed Said ,&nbsp;Jeffrey Pearl ,&nbsp;Kenneth Ogan ,&nbsp;Viraj A. Master","doi":"10.1016/j.soi.2023.100001","DOIUrl":"10.1016/j.soi.2023.100001","url":null,"abstract":"<div><h3>Purpose</h3><p>Drain evaluation and management is an essential skill for practicing surgeons. There are a multitude of laboratory analyses that may assist in the elucidation of a drain fluid source. Our goal is to review the current biochemical analyses of drain fluid available in an effort to guide perioperative management.</p></div><div><h3>Materials and methods</h3><p>A PubMed search of all available English language literature for drain fluid analysis following urologic and general surgeries was conducted. Further sources were identified in the reference lists of identified articles. All relevant articles published were reviewed and used to delineate the appropriate drain fluid tests that could be ordered. The interpretation of these test results was also discussed. The data was then presented in a series of patient scenarios that exemplify postoperative complications seen.</p></div><div><h3>Results</h3><p>Biochemical analysis of drain fluid can be used to assist in the diagnosis of the postoperative urologic tract, intestinal, hepatopancreaticobiliary, and infectious complications. Drain fluid studies including creatinine, urea, triglyceride, cell count, protein, pH, specific gravity, gram stain, culture, lactate dehydrogenase, amylase, lipase, albumin, bilirubin, and alkaline phosphatase have been reviewed accordingly.</p></div><div><h3>Conclusions</h3><p>Commonly available laboratory analyses may assist the surgeon in perioperative drain management. Our review summarizes these studies through case examples. Understanding the applicability of these studies is essential to improve surgical practice.</p></div><div><h3>Synopsis</h3><p>A review of drain fluid evaluation and management in genitourinary procedures as depicted in a case-by-case fashion. This article demonstrates the indications and utilities of drain fluid studies in postoperative patients to best assist and inform surgical practice.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100001"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247023000014/pdfft?md5=8a5e9878494da764bb613544b348c3f7&pid=1-s2.0-S2950247023000014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139304393","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":"Laparoscopic radical antegrade modular pancreatosplenectomy (RAMPS) for a large SPEN of distal pancreas","authors":"Naveena AN Kumar ,&nbsp;Akhil Palod,&nbsp;Nawaz Usman,&nbsp;Nithesh JB","doi":"10.1016/j.soi.2023.100002","DOIUrl":"10.1016/j.soi.2023.100002","url":null,"abstract":"","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100002"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247023000026/pdfft?md5=2a1d40d8b252376c01607ef9bbabc3de&pid=1-s2.0-S2950247023000026-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139014852","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":"Multidisciplinary management of pleomorphic dermal sarcoma of the scalp: A single institution study","authors":"Megan L. Sulciner ,&nbsp;Jiping Wang ,&nbsp;Miranda B. Lam ,&nbsp;Jason L. Hornick ,&nbsp;Dennis P. Orgill ,&nbsp;Elizabeth H. Baldini ,&nbsp;Chandrajit P. Raut ,&nbsp;Mark Fairweather","doi":"10.1016/j.soi.2024.100036","DOIUrl":"10.1016/j.soi.2024.100036","url":null,"abstract":"<div><h3>Background</h3><p>Pleomorphic dermal sarcoma (PDS) of the scalp is a rare cutaneous malignancy, the location of which creates unique technical and cosmetic obstacles. Optimal management is not defined. We reviewed our institution’s approach and outcomes for this entity.</p></div><div><h3>Materials &amp; methods</h3><p>Between 2000–2020, 15 patients with scalp PDS were evaluated and treated at our multidisciplinary sarcoma center. Patient characteristics, treatment approach, and outcomes were analyzed.</p></div><div><h3>Results</h3><p>Thirteen patients (87%) presented with primary disease alone, one (7%) presented with recurrent disease after initial resection, and one (7%) presented with synchronous primary and metastatic disease. Radiation therapy (RT) was recommended in 10 patients (67%) and completed in 8 (53%) (3 preoperative, 5 postoperative). Eight patients (53%) underwent staged plastic surgery complex wound closure. Thirteen patients were alive without disease, one was alive with disease, and one was deceased with known recurrent disease at time of last follow-up.</p></div><div><h3>Conclusion</h3><p>Limited data are available to guide management of scalp PDS. Due to possible need for staged plastic surgery closure to ensure negative margins and optimize wound healing, initiation of postoperative RT may be delayed. Future multi-institutional study is required to further define the extent of surgery and role and timing of RT.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 2","pages":"Article 100036"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000458/pdfft?md5=80850a8c77b4e340559fe09d4e8f878f&pid=1-s2.0-S2950247024000458-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140088232","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":"Clinical challenges in breast care for patients with PTEN pathogenic variants: A case series and literature review","authors":"Austin D. Williams ,&nbsp;Jennifer LaRoy ,&nbsp;Tiana Le ,&nbsp;Debra A. Mangino ,&nbsp;Mark E. Robson ,&nbsp;Alexandra S. Heerdt ,&nbsp;Tracy-Ann Moo","doi":"10.1016/j.soi.2024.100016","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100016","url":null,"abstract":"","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 2","pages":"Article 100016"},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000124/pdfft?md5=80c8a074c5de1c73e2949041bd091efb&pid=1-s2.0-S2950247024000124-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069152","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":"Message from the Editor-in-Chief","authors":"Shishir K. Maithel","doi":"10.1016/j.soi.2024.100015","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100015","url":null,"abstract":"","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100015"},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000112/pdfft?md5=ac0c001d704895209619ea9a986e2eab&pid=1-s2.0-S2950247024000112-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941812","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 effect of the pandemic on colorectal cancer in the United States: An increased disease burden","authors":"Tommaso Violante ,&nbsp;Davide Ferrari ,&nbsp;Courtney N. Day ,&nbsp;Kellie L. Mathis ,&nbsp;Eric J. Dozois ,&nbsp;David W. Larson","doi":"10.1016/j.soi.2024.100014","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100014","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic posed an unprecedented global threat to healthcare systems, causing delays in colorectal cancer (CRC) diagnoses. This study aims to assess the impact of COVID-19 on the presentation of cancer stages in the U.S.</p></div><div><h3>Methods</h3><p>Data from the national cancer database (2015–2020) were analyzed, categorizing patients into pre-COVID (2015–2019) and COVID (2020) groups for evaluation.</p></div><div><h3>Results</h3><p>In the COVID group, patients with colon cancer had a notably higher prevalence of Clinical stage IV disease at diagnosis, accompanied by an increased incidence of metastatic disease (Clinical stage IV C, 12.9% vs. 4.5%, p &lt; 0.001). Similar trends were observed for rectal cancer (Clinical stage IV C, 2.2% vs. 0.8%, p &lt; 0.001). Black patients, those with specific insurance status (Medicaid or not insured vs. private insurance), and patients in the COVID cohort were significantly associated with worse clinical stages in both colon and rectal cancer on multivariable analysis.</p></div><div><h3>Conclusion</h3><p>The impact of COVID-19 has led to a notable surge in advanced-stage colorectal cancer diagnoses, with ongoing repercussions anticipated. Colorectal surgeons should devise strategies to address this issue and establish pandemic preparedness measures for future healthcare crises.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100014"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000100/pdfft?md5=a064e4bcd84766e58462a083d4d6890a&pid=1-s2.0-S2950247024000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139749208","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":"Associations between pancreatectomy type, treatment sequence and textbook oncologic outcomes in patients with localized pancreatic adenocarcinoma","authors":"Mohamedraed Elshami,&nbsp;John B. Ammori,&nbsp;Jeffrey M. Hardacre,&nbsp;Jordan M. Winter,&nbsp;Lee M. Ocuin","doi":"10.1016/j.soi.2024.100012","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100012","url":null,"abstract":"<div><h3>Background</h3><p>Prior studies have shown that achievement of textbook oncologic outcomes (TOO) after pancreatectomy for pancreatic adenocarcinoma (PDAC) is associated with better survival outcomes. However, the associations between TOO, procedure type, and treatment sequence has not been examined.</p></div><div><h3>Methods</h3><p>Patients with resected PDAC were identified within the National Cancer Database (2010–2018). We analyzed rates of TOO (defined as no 30-day readmission, no 90-day mortality, no prolonged length of stay, negative surgical margins, receipt of multi-agent chemotherapy, and nodal yield ≥12) stratified by procedure (pancreatoduodenectomy vs. distal pancreatectomy vs. total pancreatectomy) and treatment sequence (up-front surgery vs. neoadjuvant therapy).</p></div><div><h3>Results</h3><p>A total of 20,155 patients were identified. Patients who underwent distal pancreatectomy were less likely to have TOO compared to pancreatoduodenectomy (12.6% vs. 17.5%; OR=0.77, 95% CI: 0.68–0.88). There was no difference in TOO between patients who underwent total pancreatectomy compared to pancreatoduodenectomy (16.4% vs. 17.5%; OR=0.96, 95% CI: 0.84–1.11). Neoadjuvant chemotherapy was associated with a 5-fold increase in the odds of TOO (OR=5.07, 95% CI: 4.35–5.91). TOO was associated with improved OS regardless of surgical procedure (pancreatoduodenectomy: median OS: 33.7 vs. 20.5mo; HR=0.69, 95% CI: 0.65–0.73; distal pancreatectomy: median OS: 35.8 vs. 23.9mo; HR=0.73, 95% CI: 0.64–0.84; total pancreatectomy: median OS: 30.1 vs. 19.9mo; HR=0.69, 95% CI: 0.61–0.79).</p></div><div><h3>Conclusions</h3><p>The rate of TOO was lower for distal pancreatectomy as compared to pancreatoduodenectomy or total pancreatectomy. Neoadjuvant therapy was associated with higher likelihood of TOO. Regardless of pancreatectomy type, TOO was associated with improved OS.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100012"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000082/pdfft?md5=3c795ca7a99d59e29d8373401f1711e7&pid=1-s2.0-S2950247024000082-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139744110","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":"Miscategorized lymph nodes in colorectal cancer: A potential pitfall of pre-surgical imaging","authors":"Muhammad O. Awiwi ,&nbsp;Neal Bhutani ,&nbsp;Brian K. Bednarski ,&nbsp;Tyuyoshi Konishi ,&nbsp;Ajaykumar C. Morani ,&nbsp;George J. Chang ,&nbsp;Harmeet Kaur","doi":"10.1016/j.soi.2024.100011","DOIUrl":"10.1016/j.soi.2024.100011","url":null,"abstract":"","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 1","pages":"Article 100011"},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000070/pdfft?md5=b2ca75469634b04bd6e44cda262a24b2&pid=1-s2.0-S2950247024000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139814961","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}