Surgical Oncology Insight最新文献

{"title":"Utility of tumor-informed circulating tumor DNA for detection of minimal residual disease after curative-intent therapy in localized pancreatic cancer","authors":"Erin M. Dickey ,&nbsp;Mary P. Martos ,&nbsp;Ujwal Yanala ,&nbsp;Andres Corona ,&nbsp;Nkiruka Ezenwajiaku ,&nbsp;Joseph Pizzolato ,&nbsp;Dido Franceschi ,&nbsp;Alan S. Livingstone ,&nbsp;Gretel Terrero ,&nbsp;Caitlin A. Hester ,&nbsp;Nipun B. Merchant ,&nbsp;Jashodeep Datta ,&nbsp;Peter J. Hosein","doi":"10.1016/j.soi.2024.100116","DOIUrl":"10.1016/j.soi.2024.100116","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with localized PDAC have high recurrence rates even after curative-intent therapies. Detection of minimal residual disease (MRD) can inform prognosis and may be therapeutically actionable. Tumor-informed circulating tumor (ct)DNA has been shown to be useful for MRD detection in other cancers, but its utility in localized PDAC patients undergoing curative-intent therapy is not well established.</div></div><div><h3>Methods</h3><div>ctDNA samples (total 106) from 32 patients, following completion of all curative-intent therapy, were subjected to Signatera™ analysis (Natera, Inc.). Recurrence-free survival (RFS) data was calculated using Kaplan-Meier estimates. Data from three previously presented studies using the same platform were pooled for validation.</div></div><div><h3>Results</h3><div>In our cohort (n = 32), ctDNA positivity rate was 28.1 % (9/32) with a median follow-up time of 17.7 months (range 4–62). Median RFS was significantly lower in patients with positive ctDNA (3.6 vs. 29.0 months, p &lt; 0.001; HR: 72.1 [8.6—604.9]). Correlation of positive ctDNA with radiographic recurrence showed a sensitivity of 47.4 % (9/19), specificity of 100 % (13/13), PPV of 100 % (9/9), and NPV of 56.5 % (13/23). In the pooled cohort (n = 172), sensitivity was 66.7 % (50/75), specificity 77.3 % (75/97), PPV 69.4 % (50/72), and NPV 75.0 % (75/100).</div></div><div><h3>Conclusions</h3><div>Positive tumor-informed ctDNA test shows a high specificity and PPV for radiographic recurrence and is associated with significantly worse RFS. However, sensitivity of the test remains low.</div></div><div><h3>Synopsis</h3><div>In patients with localized PDAC completing curative-intent therapies, tumor-informed ctDNA assessment shows high specificity for radiographic recurrence and is associated with worse RFS. However, sensitivity remains low and presents an opportunity for improved calibration of this platform.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183470","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":"Incidence and factors associated with heart disease in patients diagnosed with small bowel and broncho-pulmonary neuroendocrine tumors: A population-based analysis","authors":"Julie Hallet ,&nbsp;Shaheeda Ahmed ,&nbsp;Simron Singh ,&nbsp;Sten Myrehaug ,&nbsp;Wing C. Chan ,&nbsp;Anna Gombay ,&nbsp;Calvin Law","doi":"10.1016/j.soi.2024.100115","DOIUrl":"10.1016/j.soi.2024.100115","url":null,"abstract":"<div><h3>Background</h3><div>Heart disease is a complication of neuroendocrine tumors (NETs). Little is known about its occurrence in all patients diagnosed with NETs. We examined the occurrence of valvular and congestive heart disease and the use of echocardiography after NETs diagnosis.</div></div><div><h3>Methods</h3><div>We conducted a population-based retrospective cohort study of small bowel and broncho-pulmonary NETs (2000–2019). Heart disease was defined as new congestive heart failure or valvular disease. Cumulative incidence functions (CIF with 95 %CI) of heart disease and use of echocardiography were computed accounting for the competing risk of death.</div></div><div><h3>Results</h3><div>Of 5735 patients with NETs, 54.1 % had small bowel primaries and 48.8 % metastatic disease. The CIF of heart disease in all patients was 10.7 % (9.8–11.7 %) at 10 years. Heart disease was more frequent for small bowel (10-year CIF 12.7 % [11.2–14.2 %]) than broncho-pulmonary (10-year CIF 9.1 % [8.0–10.3 %]) NETs. Of 1864 patients with available urinary 5HIAA data, 64.0 % had elevated results. Heart disease was more frequent with elevated serotonin (10-year CIF 13.5 % [11.3–15.9 %]). 10-year CIF for echocardiography in all patients was 64.7 % (63.3–66.1 %), and exceeded 50 % in all sub-groups. Patterns of echocardiography CIF mirrored those of heart disease.</div></div><div><h3>Conclusions</h3><div>Valvular and congestive heart disease occurred in 10 out of 100 patients in the 10 years after small bowel and broncho-pulmonary NETs diagnosis. Patterns of echocardiography use suggest that testing is not influenced by NET disease characteristics, with risks of under-detection in at-risk individuals.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183468","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":"Role of immunotherapy in the management of primary melanoma of the vagina: A national analysis of a rare aggressive malignancy","authors":"Yingjoy Li ,&nbsp;Sarah W. Yuen ,&nbsp;Tu Tran ,&nbsp;Kenneth G. Linden ,&nbsp;Warren Chow ,&nbsp;James G. Jakowatz ,&nbsp;Maki Yamamoto ,&nbsp;Thuy B. Tran","doi":"10.1016/j.soi.2024.100113","DOIUrl":"10.1016/j.soi.2024.100113","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Primary melanoma of the vagina (PMV) is a rare, aggressive gynecological malignancy that presents significant challenges to women’s health. Despite advancements in immunotherapy (IO), the impact of IO on PMV remains unknown. This study aims to investigate prognostic factors associated with long-term survival in patients with PMV.</div></div><div><h3>Methods</h3><div>The National Cancer Database was queried from 2004 to 2019 to identify patients with PMV. Demographics, tumor characteristics, and treatment type were evaluated. The Kaplan Meier method was used to estimate overall survival (OS). Multivariate Cox regression analysis was performed to determine predictors of survival.</div></div><div><h3>Results</h3><div>Our cohort included 884 women with PMV; 16.0 % were treated with IO. There were no differences in 5-year overall survival based on pathological characteristics or receipt of IO. Surgical resection was associated with improved 5-year OS (24.4 % vs. 8.6 %, p &lt; 0.001). Five-year OS was higher in patients who underwent lymphadenectomy (31.0 % vs. 19.4 %, p = 0.003) and who had negative surgical margins (28.0 % vs. 21.0 %, p = 0.04). Among patients who did not undergo surgery, those who received IO had nearly 2-fold higher 5-year OS, but this did not reach significance (13.7 % vs. 7.7 %, p = 0.066). On multivariable analysis, older age, nodal metastasis, and higher comorbidity were independent predictors of poor OS, while receipt of IO was not. Surgical resection was the strongest independent predictor of improved OS.</div></div><div><h3>Conclusions</h3><div>Surgical intervention with lymphadenectomy and negative margins was associated with prolonged survival in patients with PMV, while IO was not. Further investigation is needed to identify optimal treatment strategies for PMV.</div></div><div><h3>Synopsis</h3><div>In this retrospective study of patients diagnosed with primary melanoma of the vagina, immunotherapy offered limited survival benefit, regardless of curative-intent surgery. Surgical intervention with lymphadenectomy and negative margins remained the most robust predictors of improved overall survival.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143183217","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":"Superparamagnetic tracer and paramagnetic seed for marking of sentinel lymph nodes and index metastatic nodes before neoadjuvant chemotherapy to facilitate subsequent sentinel lymph node biopsy and targeted axillary dissection in breast cancer patients: A feasibility study","authors":"Kian Chin ,&nbsp;Roger Olofsson Bagge ,&nbsp;Nushin Mirzaei ,&nbsp;Anikó Kovács ,&nbsp;Henrik Leonhardt ,&nbsp;Pontus Zaar ,&nbsp;Andreas Karakatsanis ,&nbsp;Eirini Pantiora ,&nbsp;Staffan Eriksson ,&nbsp;Maria Ekholm ,&nbsp;Alastair Thompson ,&nbsp;Peter Barry ,&nbsp;Michael Boland ,&nbsp;Vivian Man ,&nbsp;Ava Kwong ,&nbsp;Fredrik Wärnberg","doi":"10.1016/j.soi.2024.100114","DOIUrl":"10.1016/j.soi.2024.100114","url":null,"abstract":"<div><h3>Background/objective</h3><div>Axillary staging after neoadjuvant chemotherapy (NACT) is associated with low detection and high false negative rates for sentinel lymph node biopsies (SLNB). The optimal method for lymphatic mapping is not determined. The aim was to study the feasibility of pre-marking axillary lymph nodes before NACT with a paramagnetic approach, utilizing superparamagnetic iron oxide nanoparticles (SPIO) and paramagnetic seeds (Magseed®).</div></div><div><h3>Methods</h3><div>Eighty patients with clinically node negative (cN0) and node positive (cN+) breast cancers were included. All had SPIO injected before and technetium-99m (Tc⁹⁹^m) after NACT. The index metastatic nodes (Index-met) were pre-marked with Magseed®⁾. Primary endpoint was SLN and Index-met detection per patient. Secondary endpoints were concordance and reversed concordance of tracers.</div></div><div><h3>Results</h3><div>Thirty-nine cN0 and 37 cN+ patients who underwent SLNB and targeted axillary dissections (TAD) were eligible for analyses. The overall SLN detection with SPIO and Tc⁹⁹^m were: 65/76 (86 %) vs. 60/76 (79 %), (95 % CI for difference between tracers 1 %-12 %, p = 0.01) respectively. The overall concordance and reversed concordance were 84/106 (79 %) vs. 84/193 (49 %), (95 % CI 21 %-39 %, p &lt; 0.001) respectively. Detection of Index-met with Magseed® and Tc⁹⁹^m were 36/37 (97 %) vs. 20/36 (56 %), (95 % CI 27 %-59 %, p &lt; 0.001) respectively. The median number of nodes retrieved with SPIO and Tc⁹⁹^m were 2 (IQR 1–3) and 1 (IQR 1–2) (p &lt; 0.001), respectively.</div></div><div><h3>Conclusions</h3><div>It was feasible to perform axillary staging by pre-marking the relevant lymph nodes using a paramagnetic approach before NACT. Notably, a large proportion of SPIO marked lymph nodes were different from those marked by Tc⁹⁹^m.</div></div><div><h3>Synopsis</h3><div>This study investigated using a paramagnetic approach for axillary nodal mapping <em>before</em> neoadjuvant chemotherapy comparing to a conventional mapping performed after chemotherapy. The results indicated feasibility of the paramagnetic method which also identified a different group of lymph nodes. However, these results require a further validation with a larger study.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143182391","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":"Outcomes of minimally invasive and open prophylactic gastrectomy for hereditary diffuse gastric cancer","authors":"Sara K. Daniel,&nbsp;Deshka S. Foster,&nbsp;M. Usman Ahmad,&nbsp;Joseph D. Forrester,&nbsp;Byrne Lee,&nbsp;Daniel Delitto,&nbsp;Amanda R. Kirane,&nbsp;Brendan C. Visser,&nbsp;Monica M. Dua,&nbsp;Jeffrey A. Norton,&nbsp;George A. Poultsides","doi":"10.1016/j.soi.2024.100112","DOIUrl":"10.1016/j.soi.2024.100112","url":null,"abstract":"<div><h3>Background</h3><div>Mutations in the <em>CDH1</em> gene predispose individuals to hereditary diffuse gastric cancer. As these tumors can evade endoscopic screening, prophylactic total gastrectomy is often recommended. Since skill with minimally invasive surgery (MIS) has progressed, we compared <em>CDH1</em> mutation carriers who underwent open vs MIS total gastrectomy.</div></div><div><h3>Methods</h3><div>A retrospective review of 48 <em>CDH1</em> carriers who underwent total gastrectomy from May 2004 to April 2023 was performed. Eight patients were excluded because they were symptomatic prior to surgery and had advanced signet ring cell adenocarcinoma.</div></div><div><h3>Results</h3><div>Twenty-eight open and 12 MIS total gastrectomy patients were included; one MIS case was converted to open. The groups were comparable regarding age, comorbidities, and pre-operative carcinoma identified (42 % vs 36 %). Blood loss was lower with MIS gastrectomy (200 vs 23 mL) while operative time was longer (163 vs 286 minutes). The number of lymph nodes harvested (18 vs 23) and the percentage with carcinoma (86 % vs 92 %) were not different between open and MIS approaches. Length of stay was shorter after MIS gastrectomy (7 vs 5 days). In the MIS group, there were no major post-operative complications (2.5 % open) or readmissions within 90 days (11 % open). Subsequent surgery or dilation was infrequent (18 % vs 8 %). Less weight loss was seen after MIS gastrectomy, reaching significance at 9 months post-operatively (-25 % vs −13 %).</div></div><div><h3>Conclusions</h3><div>MIS total gastrectomy is the preferred operation for <em>CDH1</em> carriers, resulting in shorter hospitalization without compromising pathology or safety.</div></div><div><h3>Synopsis</h3><div>Minimally invasive total gastrectomy performed for patients with CDH1 mutations has minimal short- or long-term complications and was associated with shorter length of stay and less weight loss than open total gastrectomy, without compromising lymph node yield or margin status.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745868","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 an online risk prediction tool for sentinel node metastasis on clinical decision-making in melanoma care: A mixed methods study","authors":"Rehana A. Salam ,&nbsp;Serigne N. Lo ,&nbsp;Alexander H.R. Varey ,&nbsp;Andrew J. Spillane ,&nbsp;Michael A. Henderson ,&nbsp;Richard A. Scolyer ,&nbsp;Victoria J. Mar ,&nbsp;John F. Thompson ,&nbsp;Robyn P.M. Saw ,&nbsp;Alexander C.J. van Akkooi ,&nbsp;Jonathan R. Stretch ,&nbsp;Alison Button-Sloan ,&nbsp;Angela Hong ,&nbsp;Rachael L. Morton ,&nbsp;Caroline G. Watts ,&nbsp;Andrea L. Smith ,&nbsp;Anne E. Cust","doi":"10.1016/j.soi.2024.100111","DOIUrl":"10.1016/j.soi.2024.100111","url":null,"abstract":"<div><h3>Background</h3><div>The decision to perform a sentinel lymph node biopsy (SLNB) procedure can be guided by risk prediction tools. We aimed to investigate the impact of an online risk prediction tool for sentinel node metastasis on clinical decision-making.</div></div><div><h3>Methods</h3><div>We conducted a mixed methods study using an online questionnaire and semi-structured interviews between April 2022 and March 2023. Australian clinicians and patients/carers who were using the Melanoma Institute Australia risk prediction tool were invited to participate.</div></div><div><h3>Results</h3><div>Sixty-one participants completed the questionnaire (52 clinicians including 36 general practitioners of whom 32 worked at skin cancer clinics; 14 surgeons; and 9 patients/carers). More than half of the clinicians reported that the tool had influenced the number of patients they were referring for SLNB procedures: 40 % reported increased referrals, 9 % reported fewer referrals, and 33 % reported no change. Over half (57 %) of the patient/carer participants reported using the risk tool alongside a clinician for shared decision-making. Interview findings suggested that the tool made clinicians feel more confident in their clinical decision to perform or refer patients for consideration of SLNB. Clinicians found the tool useful in guiding discussions about SLNB. However, there was uncertainty in interpreting risk scores if they had wide confidence intervals and some ambiguity in clinical decision-making if the risk score did not align with the clinician’s expectations.</div></div><div><h3>Conclusion</h3><div>This online risk prediction tool was acceptable to clinicians and patients/carers, useful for clinical decision-making and led to increased discussion between clinicians and patients regarding the SLNB procedure.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703376","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":"Erratum [Surg Oncol Insight 1 (2024)] – Part 2","authors":"","doi":"10.1016/j.soi.2024.100108","DOIUrl":"10.1016/j.soi.2024.100108","url":null,"abstract":"","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592971","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":"Effect of travel distance on outcomes of patients with malignant peritoneal mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy","authors":"Javid Sadjadi,&nbsp;Li Luo,&nbsp;Bridget Fahy,&nbsp;Alissa Greenbaum","doi":"10.1016/j.soi.2024.100110","DOIUrl":"10.1016/j.soi.2024.100110","url":null,"abstract":"<div><h3>Background</h3><div>Malignant peritoneal mesothelioma (MPM) is a rare disease with a generally poor prognosis treated with systemic chemotherapy alone. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) can offer improved overall survival in select patients. This study examined the effect of travel distance on oncologic outcomes in patients with MPM undergoing CRS-HIPEC.</div></div><div><h3>Methods</h3><div>The National Cancer Database (NCDB) was reviewed from 2006 to 2020. The primary variable was distance traveled to CRS-HIPEC facility (&lt;50 miles versus ≥50 miles). Primary outcome was overall survival. Secondary outcomes examined 30- and 90-day post-surgical outcomes.</div></div><div><h3>Results</h3><div>Overall, 650 patients met inclusion criteria; 345 patients traveled &lt; 50 miles and 305 patients traveled ≥ 50 miles. Rates of MPM were highest in the Northeast, Middle and South Atlantic regions. Patients traveling ≥50 miles were younger, had a lower median income, and were more likely to be privately insured and treated at an academic center. There was no difference in overall survival between groups (p=0.87). Secondary outcomes were comparable: 30-day survival was 98 % in both groups (p=0.9), 90-day survival was 93 % in both groups (p=0.9), 30-day readmission rate was 11 % in the shorter travel distance group versus 7 % (p=0.2). Hospital length of stay (LOS) was longer in the ≥50 miles group (9 vs 8 days; p=0.02).</div></div><div><h3>Conclusions</h3><div>Outcomes following CRS-HIPEC for MPM did not differ based upon distance traveled for treatment, though patients who travel ≥ 50 miles have an increased LOS. Regionalization of CRS-HIPEC for MPM does not result in worse oncologic or surgical outcomes.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 1","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722786","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":"Surviving to thriving: Virtual nutrition education in patients with breast cancer","authors":"Trevor F. Roush ,&nbsp;Anna S. Sarkisova ,&nbsp;Jeanette M. Lamb ,&nbsp;Susan K. Boolbol ,&nbsp;Carinne W. Anderson","doi":"10.1016/j.soi.2024.100109","DOIUrl":"10.1016/j.soi.2024.100109","url":null,"abstract":"<div><h3>Introduction</h3><div>Improved outcomes in the treatment of breast cancer has increased the importance of formal survivorship. National guidelines and accreditation standards require institutional survivorship programs; however, implementation presents operational challenges. While existing literature affirms the need for clinician involvement in survivorship, applicability to virtual formats is unknown. Here we report our 3-year experience with design and implementation of virtual nutrition workshops in breast cancer survivorship.</div></div><div><h3>Materials and methods</h3><div>Free virtual workshops were developed by an interdisciplinary team and offered to eligible participants on a quarterly basis. Workshop content focused on diet, nutrition, and exercise in cancer prevention, development, and recurrence. A question-and-answer session addressed misconceptions about nutrition and cancer. Participants were invited to participate in an evaluation survey after each workshop. Post-workshop assessment of course effectiveness was performed with a four-point Likert scale and qualitative comments.</div></div><div><h3>Results</h3><div>116 women participated in the workshops. Quarterly attendance consistently grew and averaged sixteen participants per session. Post workshop surveys demonstrated significant improvements in participants’ knowledge, and likelihood of behavioral modification. 93 % of participants had the highest rating for likelihood of making a change to their diet, and 83 % for likelihood of making changes to physical activity. Qualitative feedback supported both the effectiveness of the education as well as the virtual group setting.</div></div><div><h3>Conclusions</h3><div>Virtual group workshops are effective for survivorship education. They present a feasible way to improve access to oncologic-trained dieticians for low-acuity concerns. The realistic design affords itself to easy reproducibility in other institutions seeking to implement disease-specific survivorship programs.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573303","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":"Implant outcomes following breast conservation therapy in patients with history of augmentation mammoplasty","authors":"Abigail Krull ,&nbsp;Sarah Mclaughlin ,&nbsp;Santo Maimone ,&nbsp;James Jakub ,&nbsp;Brian Rinker ,&nbsp;Laura Vallow ,&nbsp;Lauren Cornell","doi":"10.1016/j.soi.2024.100107","DOIUrl":"10.1016/j.soi.2024.100107","url":null,"abstract":"<div><h3>Background</h3><div>In women who are eligible, breast conservation therapy (BCT) is often the preferred local treatment for early-stage BC. Concern for implant contracture in patients undergoing BCT including radiation therapy (RT) with prior augmentation mammoplasty has been expressed in several prior studies. The exact incidence of patient dissatisfaction remains unknown.</div></div><div><h3>Methods</h3><div>A single institution retrospective review was performed for patients with prior augmentation mammoplasty who received BCT for BC between 2010 and 2020. 77 patients met inclusion criteria. Of these, 34 were consented and completed study survey which included validated BREAST-Q modules. Data was reviewed with primarily descriptive analyses. P-values were calculated from Fisher’s exact test and Kruskal-Wallis rank sum test.</div></div><div><h3>Results</h3><div>34 patients completed study survey, with 55.9 % of patients (n=19) having silicone implants and 44.1 % (n=15) having saline. Most implants (91.1 %, n=31) were retropectoral. Median total dose of RT was 4005 cGy and median age of implants at BC diagnosis was 16 years (range 2, 40). 41 % (n=14) of patients reported dissatisfaction with breast appearance, with median BREAST-Q RASCH score for satisfaction with breasts 48 (range 20–82). No differences in breast satisfaction were seen in patients with silicone implants compared to saline (p= 0.171) although there were improved reported physical well-being chest scores in patients with saline implants (median 100 vs 89; p = 0.039).</div></div><div><h3>Conclusions</h3><div>A large proportion of women are dissatisfied with implant appearance following BCT with RT. Future larger studies are needed to explore contributing factors for dissatisfaction including implant type, location, RT dosing and fractionation.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573302","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}