Surgical Oncology Insight最新文献

{"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}

{"title":"Outcomes of mediastinal envelope closure during minimally invasive esophagectomy","authors":"Cynthia J. Susai ,&nbsp;Katemanee Burapachaisri ,&nbsp;Yun-Yi Hung ,&nbsp;Kian C. Banks ,&nbsp;Nathan J. Alcasid ,&nbsp;Rachel E. Wile ,&nbsp;Katherine E. Barnes ,&nbsp;Jeffrey B. Velotta","doi":"10.1016/j.soi.2024.100104","DOIUrl":"10.1016/j.soi.2024.100104","url":null,"abstract":"<div><h3>Background</h3><div>Limited outcomes data exists regarding whether mediastinal envelope closure during minimally invasive esophagectomy (MIE) is related to outcomes including anastomotic leak and postoperative pyloric dilation. We hypothesized that mediastinal envelope closure would be associated with fewer adverse outcomes.</div></div><div><h3>Methods</h3><div>Patients undergoing MIE between 9/1/2017 and 11/15/2021 were studied. Patients were divided into two groups, complete envelope closure (CC) or partially closed/ not closed (NC), and baseline characteristics and outcomes were compared. Multivariable logistic regression analysis was performed to evaluate variables associated with a composite outcome of anastomotic leak and/or pyloric dilation.</div></div><div><h3>Results</h3><div>We identified 181 patients. Age, sex, race/ethnicity, BMI, smoking history, CCI, ECOG status, operative duration, cancer stage/histology, intraoperative fluids, EBL, and EEA size were not statistically different between the CC and NC groups, though use of indocyanine green-enhanced fluorescence evaluation (ICG) was significantly different (24.5 % versus 67.6 %, p &lt;0.001). The CC group experienced lower rates of anastomotic leak (2 % vs 14.7 %, p = 0.007), postoperative pyloric dilation (15.6 % vs 32.4 %, p = 0.025), and delayed gastric emptying (6.1 % vs 20.6 %, p = 0.015). Risk factors for a composite outcome defined as anastomotic leak and/or pyloric dilation were evaluated using a multivariable logistic regression, and NC was an independent predictor of this composite outcome (aOR 3.74, p = 0.007).</div></div><div><h3>Conclusions</h3><div>Complete mediastinal envelope closure is associated with decreased rates of anastomotic leak, postoperative pyloric dilation, and delayed gastric emptying. Further prospective trials involving mediastinal envelope closure are warranted to elucidate its positive effect on postoperative outcomes.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100104"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554646","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 analysis of neuroendocrine tumor misdiagnosis and associated costs","authors":"Callisia N. Clarke ,&nbsp;David Ray ,&nbsp;Nicole Princic ,&nbsp;Meghan Moynihan ,&nbsp;Alexandria Phan","doi":"10.1016/j.soi.2024.100105","DOIUrl":"10.1016/j.soi.2024.100105","url":null,"abstract":"<div><h3>Purpose</h3><div>Conditions for which neuroendocrine tumor (NET) is commonly misdiagnosed were compared among patients with and without NET, and the associated healthcare costs were described.</div></div><div><h3>Methods</h3><div>Adults with a NET diagnosis were selected retrospectively from the IBM MarketScan claims databases during 1/1/2015–12/31/2018 (earliest = index), comprising the NET cases. Non-NET controls included age/gender matched patients without any cancer diagnoses. Patients were followed for a five year look back period when conditions for which NET is commonly misdiagnosed (gastrointestinal, respiratory, metabolic [i.e. liver disease], dermatologic) were measured and compared between cases and matched controls using odds ratios. Misdiagnosis-related costs were reported per patient per month (PPPM) from the earliest misdiagnosis to NET diagnosis. Patients with pancreatic adenocarcinoma misdiagnoses and related costs were reported separately.</div></div><div><h3>Results</h3><div>This analysis included 3460 NET cases and 10,370 non-NET controls (mean age 61 years). Compared to non-NET controls, 70 % of NET cases had a diagnosis of a gastrointestinal, respiratory, metabolic, or dermatologic condition, with 2.07 higher odds (95 % CI 1.91–2.25). Median time from earliest potential misdiagnosis to NET was 3.4 years. Overall mean (standard deviation) healthcare costs related to misdiagnoses were $2858 ($6495) PPPM. Costs were highest for gastrointestinal misdiagnoses ($3350 [$7108]). Among NET cases, 69 (2 %) patients had a pancreatic adenocarcinoma misdiagnosis; related PPPM costs were substantial ($29,321 [$62,385]) and driven by outpatient services including treatment administration.</div></div><div><h3>Conclusion</h3><div>The increased odds of common misdiagnosis conditions among NET cases compared with non-NET controls, contributing to unnecessary healthcare costs, supports the need for accurate identification of NET.</div></div><div><h3>Synopsis</h3><div>The majority of patients with NET (70 %) were previously misdiagnosed, occurring a median of 3.4 years before correct diagnosis. Total mean healthcare costs related to misdiagnoses were $2858 PPPM and costs related to pancreatic adenocarcinoma misdiagnoses were substantial ($29,321 PPPM).</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100105"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531314","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":"Definition of early recurrence of hepatocellular carcinoma based on the concordance index and optimal treatment strategy","authors":"Kei Kitamura,&nbsp;Toshiro Ogura,&nbsp;Ibuki Fujinuma,&nbsp;Satoshi Nomura,&nbsp;Takashi Fukuda,&nbsp;Amane Takahashi","doi":"10.1016/j.soi.2024.100106","DOIUrl":"10.1016/j.soi.2024.100106","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) has a high rate of recurrence and requires multiple treatment options. Early recurrence has been associated with poor prognosis; however, the timing of early recurrence varies in the literature. Therefore, in this study, we aimed to determine the timing of early recurrence with the best prognostic value and clarify the appropriate treatment strategy.</div></div><div><h3>Methods</h3><div>This retrospective study conducted to determine prognosis and treatments included 274 patients with HCC who underwent liver resection at the Saitama Cancer Center. The prognostic value of early recurrence at each surveillance period was calculated using Harrell's concordance index (C-index).</div></div><div><h3>Results</h3><div>The C-index at 9 months postoperatively was 0.656, which was the highest cut-off value for early recurrence. Notably, 122 patients had no recurrence, 58 had early recurrence (&lt;9 months), and 94 had late recurrence (≥9 months). The 5-year overall survival (OS) of patients with early recurrence was worse (16.5 %, p&lt;0.001), whereas that of those with late and no recurrences were similar (79.2 % vs. 70.9 %, p=0.86). The 5-year OS rate of patients with late intrahepatic recurrence in the surgery group was 100 %.</div></div><div><h3>Conclusion</h3><div>The optimal cutoff value for the timing of early recurrence was 9 months postoperatively. The early recurrence group had a high rate of extrahepatic recurrence and poor OS, whereas late recurrences were mostly intrahepatic, with no difference in prognosis between the late and no recurrence groups. Patients with intrahepatic recurrence after &gt;9 months are considered for rehepatectomy because of its good outcomes.</div></div><div><h3>Synopsis</h3><div>The C-index-based optimal cutoff for the timing of early HCC recurrence was 9 months postoperatively. The early recurrence group had a high rate of extrahepatic recurrence and poor OS, whereas late recurrences were mostly intrahepatic with a good prognosis.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531313","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":"Variability in treatment approaches, outcomes, and recurrence patterns after curative intent treatment for primary retroperitoneal sarcomas in Latin America: A report on 333 patients from LATAMSARC collaborative working group","authors":"Dorian Yarih García-Ortega ,&nbsp;Sergio Damian Quildrian ,&nbsp;Nicolas A. Devaud ,&nbsp;Catherine Sarre-Lazcano ,&nbsp;Diana Otero Norza ,&nbsp;Paul Adriazola Vicente","doi":"10.1016/j.soi.2024.100103","DOIUrl":"10.1016/j.soi.2024.100103","url":null,"abstract":"<div><h3>Background and objective</h3><div>Retroperitoneal sarcomas (RPS) are rare tumors with several well-defined histologic subtypes. This study aimed to assess the epidemiology, treatment patterns, and outcomes of patients with retroperitoneal sarcoma in Latin America and analyze patterns of recurrence and treatment variations in a large population of patients treated at reference centers.</div></div><div><h3>Methods</h3><div>This retrospective descriptive study utilized an electronic database of medical records from LATAMSARC (a group studying sarcomas consisting of different centers in various countries in Latin America, including Argentina, Chile, Costa Rica, Mexico, and Peru). Adult patients (≥18 years) with retroperitoneal sarcoma who underwent surgery at six cancer centers in Latin America were included. Key outcomes were practice patterns, overall survival (OS), and progression-free survival (PFS).</div></div><div><h3>Results</h3><div>In this retrospective study, 333 patients diagnosed with retroperitoneal sarcomas met the inclusion/exclusion criteria. The cohort consisted of 157 females (42.3 %) and 176 males (57.7 %), with an average age of 53.9 years (SD 13.37). Histology most commonly included Dedifferentiated Liposarcoma (31.5 %), Well-Differentiated Liposarcoma (29.7 %), and Leiomyosarcoma (9.9 %). The tumors predominantly resided in the retroperitoneum (81.7 %) and showed a mean diameter of 23.53 cm (SD 13.8 cm). Surgical interventions varied, with Complete Compartmental Resection performed in 31.2 % of cases and Simple Complete Resection in 29.4 %. Postoperative complications were documented, with Clavien-Dindo Grade ≥3 complications occurring in 16.8 % of patients. An R0/1 resection was obtained in 91.6 % of cases. The ICU admission rate post-surgery was 18.6 %. Adjuvant treatments included radiotherapy in 8.1 %. Local recurrence occurred in 20.7 % of cases, with the majority being ipsilateral. Distal recurrence was observed in 15 patients, predominantly affecting the liver. The mean overall survival was 65.5 months, and disease-free survival was 47.0 months.</div></div><div><h3>Conclusion</h3><div>This study provides information on the epidemiology, treatment patterns, and outcomes of retroperitoneal sarcomas in a group of reference centers in Latin America. These results represent Latin America's largest body of evidence on retroperitoneal sarcomas.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417400","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":"Is pancreatic adenosquamous carcinoma (PASC) a surgical disease? A large healthcare system review","authors":"Kyuseok Im,&nbsp;Niharika Kareddy,&nbsp;Vikas Satyananda,&nbsp;Victoria V. O’Connor","doi":"10.1016/j.soi.2024.100102","DOIUrl":"10.1016/j.soi.2024.100102","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Pancreatic cancer represents an increasing cause of cancer-related deaths. Pancreatic adenosquamous carcinoma (PASC) is a rare subtype of pancreas cancer. Optimal treatment is not well-defined. This review aims to provide a detailed analysis of the natural history, management, and outcomes of the patients with PASC within a single large healthcare system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;A large healthcare database was used to retrospectively identify all patients with histological diagnosis of PASC from 2010 to 2020. The cohort was evaluated as a whole and according to the following management modalities: operative, non-metastatic non-operative, and patients with metastatic disease. Abstracted data included patient characteristics, oncologic characteristics at presentation, and details of surgical and non-surgical treatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In total, 60 patients with PASC were identified. All patients had confirmed histopathological diagnosis of PASC. Mean age at the time of diagnosis was 70.9 years, and 28 patients were male (46.7 %). Most patients presented with pancreas head tumors (60 %). Thirty-four patients presented with non-metastatic disease (56.6 %). The operative group consisted of 17 patients (28.3 %). Most patients received adjuvant systemic therapy (70.6 %). Majority of patients experienced recurrence (76.5 %), with median time to recurrence at 6.5 months. Median overall survival in the operative group was 19.1 months. Seventeen patients with non-metastatic disease (28.3 %) did not undergo resection. Median overall survival of this cohort was 3.3 months. Systemic chemotherapy was used in 8 patients. Approximately half of patients with non-metastatic disease (9/17) did not receive any treatment due to rapid physical deterioration or poor functional status at baseline. Median survival for the non-treatment group was 1.7 months. At presentation, 26 patients (43.3 %) had metastatic disease. Most common site of metastasis was the liver. Median survival for patients with metastatic disease was 3.1 months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;PASC is a distinct entity from glandular PDAC, and it appears to be a more aggressive disease process. Complete resection confers survival benefit but is not curative. Furthermore, few patients undergo surgery, even with seemingly resectable disease. Systemic therapy administration is limited in many patients due to physiologic decline. Dismal clinical course and poor survival is universal among all patients who do not undergo any treatment modality, regardless of metastatic status. Globally grim prognosis appears to be due early systemic effects, disease progression and lack of effective systemic therapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;PASC remains a poorly understood cancer and portends particularly poor prognosis. It is associated with a rapid clinical decline, poor response to systemic therapy, early recurrence, an","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417399","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":"Systemic inflammatory markers: Predictors of survival in mucinous appendix cancer patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy","authors":"Sergei Iugai,&nbsp;Vadim Gushchin,&nbsp;Mary Caitlin King,&nbsp;Vladislav Kovalik,&nbsp;Luis Felipe Falla-Zuniga,&nbsp;Carol Nieroda,&nbsp;Armando Sardi","doi":"10.1016/j.soi.2024.100101","DOIUrl":"10.1016/j.soi.2024.100101","url":null,"abstract":"<div><h3>Introduction</h3><div>Inflammatory markers have been investigated as predictors of prognosis in various malignancies, but their role in mucinous appendix cancer (MAC) remains controversial. We evaluated the association between complete blood count-derived markers and survival in MAC patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC).</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of a single-center database (1998–2023) including newly diagnosed MAC patients who underwent complete (CC-0/1) CRS/HIPEC. Preoperative values of neutrophil-to-lymphocyte ratio (NLR), derived NLR, platelets-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated. For markers strongly associated with survival, we used time-dependent ROC analysis to define cutoffs to predict 5-year overall survival (OS). The Kaplan-Meier method with and Cox regression were employed for survival analysis.</div></div><div><h3>Results</h3><div>Of 626 CRS/HIPEC cases, 211 were eligible. NLR (p=0.049), dNLR (p=0.049), and MLR (p&lt;0.001) were significantly associated with OS, while PLR was not. MLR demonstrated the strongest prognostic power (AUC=0.682) with the optimal cut-off 0.29. There were no significant differences in age, grade, or peritoneal cancer index (PCI) between patients with MLR&lt;0.29 and MLR≥0.29. Five-year progression-free (PFS) and OS were 72.2 % and 83.2 % for MLR&lt;0.29 and 54.2 % and 66.6 % for MLR≥0.29, respectively. After adjusting for age, PCI, and grade, MLR≥0.29 was associated with worse 3-year PFS (hazard ratio [HR] 1.74, 95 % confidence interval [CI]:1.02–2.97, p=0.044) and 3-year and 5-year OS (HR 1.87, 95 %CI: 1.00–3.47, p=0.049).</div></div><div><h3>Conclusion</h3><div>MLR has emerged as an independent predictor of survival in MAC patients undergoing CRS/HIPEC. Along with other prognostic factors, MLR≥0.29 may be potentially used for preoperative risk stratification.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100101"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432011","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":"Combining liver-directed and immunotherapy in advanced hepatocellular carcinoma: A review and future directions","authors":"Pranav Kumar ,&nbsp;Chase J. Wehrle ,&nbsp;Keyue Sun ,&nbsp;Chunbao Jiao ,&nbsp;Rebecca Panconesi ,&nbsp;Mingyi Zhang ,&nbsp;Noah X. Tocci ,&nbsp;Hanna Hong ,&nbsp;Abby Gross ,&nbsp;Erlind Allkushi ,&nbsp;Maureen Whitsett Linganna ,&nbsp;Andrea Schlegel ,&nbsp;Toms Augustin ,&nbsp;Charles Miller ,&nbsp;David CH Kwon ,&nbsp;Kazunari Sasaki ,&nbsp;Federico Aucejo","doi":"10.1016/j.soi.2024.100100","DOIUrl":"10.1016/j.soi.2024.100100","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) is a highly morbid tumor with diverse genomic heterogeneity that poses a major therapeutic barrier. Systemic immunotherapy is often considered in the treatment of advanced HCC, but immunotherapy has been limited by high rates of resistance and immune evasion. Newer studies have explored the combination of locoregional treatments (LRTs), a common approach to intermediate-stage HCC or as a bridge to transplant, with immunotherapy. This review explores the current evidence regarding combination systemic immunotherapy with locoregional transarterial, ablation, and histotripsy modalities, as well as leading theories on the mechanism of their synergistic effects. Combinations of transarterial or ablative therapy with multikinase (MKIs) or immune checkpoint inhibitors (ICIs) have been linked to prolonged survival and delayed tumor progression/recurrence, though treatment-induced adverse effects remain an important consideration. Ablation and histotripsy may augment the efficacy of immunotherapy through the abscopal effect, in which subsequent immune response to local tumor destruction may enhance immunogenic cell death, even in satellite, untreated lesions. Newer management strategies may utilize circulating tumor DNA (ctDNA) for improved surveillance and early detection of recurrence.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357650","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":"Immunotherapy in gastroesophageal adenocarcinoma: What is the state of management?","authors":"Katherine M. Bever","doi":"10.1016/j.soi.2024.100099","DOIUrl":"10.1016/j.soi.2024.100099","url":null,"abstract":"<div><h3>Introduction and design</h3><div>This review summarizes clinical data available that supports the use of immune checkpoint inhibitors (ICIs) in the treatment of gastroesophageal adenocarcinoma (GEA). and current approvals as well as current and emerging biomarkers to guide patient selection for this approach. Included in this review is an assessment of clinical data in advanced/metastatic GEA and resectable GEA as well as biomarkers of response to ICIs in GEA, including mismatch repair deficiency, PDL1 expression, tumor mutation burden, and Epstein-Barr virus.</div></div><div><h3>Results and conclusion</h3><div>ICIs are active in GEA and both nivolumab and pembrolizumab are approved in in the front-line metastatic setting in combination with chemotherapy. Other ICIs are in development. Incorporation of ICI with chemotherapy appears to improve pathologic response rates in the resectable setting; however, longer term follow up is needed to confirm a survival benefit from this approach.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417401","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":"Timing of breast biopsy and axillary ultrasound does not affect the false positive rate of the axillary ultrasound","authors":"Gregory Stimac ,&nbsp;Aryana Jones ,&nbsp;Faryal Afridi ,&nbsp;Georgia Vasilakis ,&nbsp;Madison Miranda ,&nbsp;Rebecca Norcini ,&nbsp;Kristin Lupinacci ,&nbsp;Michael S. Cowher","doi":"10.1016/j.soi.2024.100098","DOIUrl":"10.1016/j.soi.2024.100098","url":null,"abstract":"<div><h3>Background</h3><div>The determination of axillary lymph node metastases is an important component of breast cancer treatment planning. Lymph node biopsies can be performed simultaneously with breast biopsy or at a later time. However, a post-breast biopsy ultrasound of the axilla may appear abnormal due to reactivity in the axillary lymph nodes. This study examined the timing of the axillary ultrasound (AUS) in relation to a breast biopsy to determine if it would affect patient management.</div></div><div><h3>Methods</h3><div>All newly diagnosed breast cancers from 2016 to 2017 were analyzed. We analyzed the timing of breast abnormality diagnosis, breast ultrasound, breast biopsy, AUS, and the AUS biopsy (AUSBx). An interval AUS was considered one that was not performed on the same day as a breast biopsy. True positive (TP), false positive (FP), true negative (TN), and false negative (FN) values were calculated. Chi-square analysis and Fisher exact test were performed on categorical data, and a student’s t-test was performed for continuous variables. Significance was determined to be p &lt; 0.05.</div></div><div><h3>Results</h3><div>Same-day TP and FP AUS rates were 66.5 % and 33.5 %, respectively, and interval TP and FP AUS rates were 60.1 % and 39.9 %, respectively (p = 0.4708). The same-day TN and FN AUS rates were 90.6 % and 9.4 %, respectively, and interval TN and FN rates were 82.4 % and 17.6 %, respectively (p = 0.3917).</div></div><div><h3>Conclusion</h3><div>Overall TP, FP, TN, and FN rates did not differ between patients who received same-day or interval AUS studies.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 4","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357558","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}