Surgical Oncology Insight最新文献

{"title":"Advancements in the surgical management of pancreatic masses: A comprehensive review","authors":"Cara Mohammed ,&nbsp;Patricio Xavier Duran S ,&nbsp;Hugh Kolomar ,&nbsp;Tanmay Thirth ,&nbsp;Simcha Bulmash ,&nbsp;Sharvari Vikram Joshi ,&nbsp;Tannia Payan Serrano ,&nbsp;Greeshma Reddy ,&nbsp;Turimula Arpan ,&nbsp;Deepika Palegar Thuli ,&nbsp;Areehah Zafar Masood ,&nbsp;Manju Rai","doi":"10.1016/j.soi.2025.100147","DOIUrl":"10.1016/j.soi.2025.100147","url":null,"abstract":"<div><div>Pancreatic masses encompass a heterogeneous group of neoplasms, ranging from benign lesions like serous cystadenomas to malignant entities such as pancreatic ductal adenocarcinoma (PDAC). Timely and accurate differentiation between these masses is critical for tailoring optimal therapeutic strategies. This narrative review highlights the evolving landscape of surgical management for pancreatic masses, emphasizing the advancements in diagnostic modalities, surgical techniques, and perioperative care. Imaging modalities, including contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasound (EUS), have enhanced the precision of diagnosis and staging. Histopathological evaluation remains indispensable for definitive diagnosis. Surgical interventions, including partial and total pancreatectomy, are explored based on tumor type and staging, with resection offering the only curative option for PDAC. Minimally invasive approaches, such as laparoscopic and robotic-assisted surgeries, have demonstrated reduced morbidity, quicker recovery, and comparable oncological outcomes to open procedures. The role of neoadjuvant therapy is discussed for resectable and borderline resectable tumors, with evidence suggesting improved surgical outcomes and overall survival. The review also addresses postoperative challenges, including pancreatic fistulas, delayed gastric emptying, and the management of endocrine and exocrine insufficiencies. Palliative strategies, such as biliary bypass and endoscopic stenting, are detailed for non-resectable tumors, prioritizing symptom relief and quality of life. Emerging technologies like intraoperative imaging, artificial intelligence, and precision medicine are reshaping the surgical approach, enabling personalized treatment plans. This comprehensive overview underscores the importance of a multidisciplinary approach in optimizing outcomes for patients with pancreatic neoplasms.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective evaluation of the quality of life and safety in patients receiving hepatic artery infusion pump chemotherapy","authors":"LaDonna E. Kearse ,&nbsp;Courtney Day ,&nbsp;Andrea Zironda ,&nbsp;Jessica Mitchell ,&nbsp;Zhaohui Jin ,&nbsp;Susanne G. Warner ,&nbsp;Cornelius A. Thiels","doi":"10.1016/j.soi.2025.100159","DOIUrl":"10.1016/j.soi.2025.100159","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Hepatic Artery Infusion (HAI) Pump placement and subsequent 6 + months of HAI chemotherapy is an intensive treatment regimen available to select patients with colorectal liver metastasis. The effects on quality of life (QOL) from HAI placement and chemotherapy are largely unknown. We aimed to evaluate the use of patient-reported outcome (PRO) surveys to measure the QOL in these patients.</div></div><div><h3>Methods</h3><div>Patients scheduled for HAI pump placement between 2022 and 2023 were prospectively enrolled. PROs were collected using PROMIS and LASA scales preoperatively, postoperative (POD) days 2, 7, 14, and monthly until 6 months. Complications were recorded using Clavien-Dindo score.</div></div><div><h3>Results</h3><div>Twelve patients were included. Median [IQR] age at surgery was 55.0 (43.8–62.5) years. All patients successfully initiated HAI and systemic therapy. Mean (± SD) LASA QOL was 8.0 ± 1.9 preoperatively, 6.4 ± 1.8 on POD 2, 7.2 ± 1.3 at 1 month, 8.2 ± 1.3 at 3 months, and 7.5 ± 1.7 at 6 months. LASA QOL, pain severity, and fatigue scores returned to baseline in 8/11, 10/11, and 8/11 patients at 3 months, respectively. At 6 months, 3/11, 9/11, and 7/11 patients reported return to baseline social, pain, and fatigue scores.</div></div><div><h3>Conclusions</h3><div>PROMIS and LASA measures are potential tools for evaluating PROs in patient undergoing HAI therapy. Preliminary data suggests baseline QOL mostly returns within 3 months of HAI placement, and initiation of HAI treatment does not appear to significantly impact QOL. These results support the inclusion of such PROs in future randomized trials to assess effects of HAI chemotherapy on QOL.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical cancer patients’ attitudes and beliefs about cannabis at a midwest comprehensive cancer center","authors":"Kenneth F. Newcomer ,&nbsp;Erica K. Barnell ,&nbsp;Felicia Zhang ,&nbsp;Joel Vetter ,&nbsp;Evan M. Bagley ,&nbsp;Marvin Petty ,&nbsp;Kerri A. Ohman ,&nbsp;William G. Hawkins","doi":"10.1016/j.soi.2025.100154","DOIUrl":"10.1016/j.soi.2025.100154","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal (GI) cancer and its treatments often cause physical (e.g., pain, weight loss, vomiting) and neuropsychiatric symptoms (e.g., anxiety, poor sleep, depressed mood). Despite increasing availability of cannabis, regional patterns of use among cancer patients remain unclear, and surgeons often lack insight into patient attitudes regarding cannabis for symptom management.</div></div><div><h3>Methods</h3><div>Patients with GI cancer were recruited from a Midwest Comprehensive Cancer Center. The cohort included patients who had undergone surgery during treatment. A confidential survey assessed symptoms, cannabis use history, and attitudes toward cannabis for palliation. Survey methods followed the Theory of Planned Behavior, with responses measured using a Likert scale.</div></div><div><h3>Results</h3><div>Of the 64 survey respondents, 66 % had undergone surgery. Cancer distribution included 25 colorectal cases, 20 pancreatic cases, 8 esophagogastric cases, and 11 other cancer types. Within 30 days of survey completion, severe physical and neuropsychiatric symptoms were reported by 39 % and 24 % patients, respectively. Active cannabis use was reported by 19 %, with 90 % citing symptom relief as the primary motivation. Only half of cannabis users disclosed their use to physicians. Use barriers included cost and accessibility. Among nonusers, 67 % were interested in medicinal cannabis. Favorable views of cannabis were reported by 74 %, with younger patients reporting significantly increased positive attitudes.</div></div><div><h3>Conclusions</h3><div>Cannabis use among cancer patients is common. Most patients believe cannabis improves cancer-related symptoms, yet many do not discuss its use with healthcare providers. Enhanced communication could improve quality of life for patients benefiting from cannabis.</div></div><div><h3>Synopsis</h3><div>Cannabis use among gastrointestinal cancer patients is common, with most seeking symptom relief. Despite favorable attitudes, many patients do not disclose use to physicians. Improved communication may enhance quality of life through symptom management.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in surgical treatment of stage IV melanoma: A SEER database study.","authors":"Orly N Farber, Yu-Jen Chen, George Molina, Olivia Monton, Elizabeth J Lilley","doi":"10.1016/j.soi.2025.100176","DOIUrl":"10.1016/j.soi.2025.100176","url":null,"abstract":"<p><strong>Introduction: </strong>Immunotherapy for advanced melanoma has improved survival outcomes and changed the surgical management of this disease. Prior work demonstrated no difference in rates of resection for stage IV melanoma after the introduction of immunotherapy. However, prior data were limited by shorter study durations and by only examining distant resections. As such, we sought to expand this work by examining longitudinal trends in both primary and distant resections for patients with advanced melanoma in the years after immunotherapy approvals.</p><p><strong>Methods: </strong>This retrospective cohort study used the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database to capture adult patients diagnosed with stage IV cutaneous melanoma between 2004 and 2020. We identified the annual percentage of patients who underwent surgical resections.</p><p><strong>Results: </strong>Of the 10,632 case records included, significantly fewer patients underwent surgical resection in the post-immunotherapy era (2011-2020) as compared to the pre-immunotherapy era (2004-2013) (50.4 % vs. 59.6 %, p < 0.0001). In our interrupted time series, we found a significant decline in the rate of all surgical resections in the post-immunotherapy era, decreasing by 0.97 % per year (p < 0.0001). There were significant decreases in the rates of both primary and distant resections in the post-immunotherapy era. For primary resections alone, we observed a significant level of change with annual rates of surgery declining by 5.1 % (p = 0.014) after 2011.</p><p><strong>Conclusions: </strong>This study confirms that a significant - albeit declining - proportion of patients with stage IV melanoma undergo both primary and distant resections in the post-immunotherapy era.</p><p><strong>Synopsis: </strong>Since the initial approval of immunotherapy to treat advanced melanoma in 2011, the role of surgical care for melanoma has evolved. This study examined trends in the utilization of surgery for patients with stage IV melanoma before and after 2011. We identified patients diagnosed with stage IV melanoma between 2004 and 2020 (N = 10,632) from the Surveillance, Epidemiology, and End Results database. Using an interrupted time series analysis, we compared the proportion of patients who underwent either primary or distant surgical resections in the pre- and post-immunotherapy eras (59.6 % vs. 50.4 %, respectively; p < 0.0001). There was a significant decline in the rate of all surgical resections in the post-immunotherapy era, decreasing by 0.97 % per year (p < 0.0001). These results highlight diminishing but still robust surgical treatment of stage IV melanoma since the introduction of immunotherapy.</p>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066988","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 positive peritoneal cytology (POPEC) in gastric cancer: Multi-centre European retrospective cohort study","authors":"Richard Owen ,&nbsp;Swathikan Chidambaram ,&nbsp;Khalid Shamiyah ,&nbsp;Jessie A Elliott ,&nbsp;Jakob Hedberg ,&nbsp;Sivesh Kamarajah ,&nbsp;Frederik Klevebro ,&nbsp;Marcel Andre Schneider ,&nbsp;Lana Fourie ,&nbsp;Christian Gutschow ,&nbsp;Magnus Nilsson ,&nbsp;Ewen Griffiths ,&nbsp;Ricardo Rosati ,&nbsp;Javed Sultan ,&nbsp;Manuel Pera ,&nbsp;Peter Grimminger ,&nbsp;Guillaume Piessen ,&nbsp;Clarisse Eveno ,&nbsp;Jelle Ruurda ,&nbsp;Richard van Hillegersberg ,&nbsp;John Saunders","doi":"10.1016/j.soi.2025.100145","DOIUrl":"10.1016/j.soi.2025.100145","url":null,"abstract":"<div><h3>Objective</h3><div>Positive peritoneal cytology is traditionally viewed as representative of metastatic disease and a poor prognostic factor. The objective of this multi-center study was to define the prognostic role of peritoneal cytology in curative gastrectomy, evaluate international variation in cytology sampling, and assess the impact on positive peritoneal cytology yields.</div></div><div><h3>Methods</h3><div>This was a multi-center international retrospective cohort study of 16 tertiary gastric cancer centers. Adult patients who underwent peritoneal lavage cytology at staging laparoscopy and subsequent gastrectomy between 2009 and 2023 were included. The primary outcome measure was overall survival at five years. Multivariable Cox regression provided hazard ratios (HRs) with 95 % CIs, adjusted for relevant confounding factors.</div></div><div><h3>Results</h3><div>837 patients with no radiological or macroscopic M1 disease were included, with a mean age of 66 (IQR 58–73) and 71 % were male. Non-distal gastric cancer was most common (47 %), with 59 % and 43 % of tumors staged pT3/4 and pN2/3, respectively. 66 patients (7.9 %) had positive cytology. Positive cytology was not associated with overall survival in multivariable analysis, controlled for stage and neoadjuvant treatment (HR=1.0; 95 %CI 0.51–2.0). Higher T and N stages were associated with positive cytology (p &lt; 0.001). The proportion of patients with positive cytology was variable, depending on how many quadrants were sampled.</div></div><div><h3>Conclusion</h3><div>Positive peritoneal cytology with otherwise M0 disease was not associated with decreased survival after curative intent gastrectomy in this study, meaning prospective study is needed. The technique of performing peritoneal washings influenced cytology yield and thus must be standardized in a much-needed prospective evaluation of peritoneal cytology.</div></div><div><h3>Synopsis</h3><div>The POPEC multicenter international retrospective cohort study included 837 patients receiving curative gastrectomy. This study showed the technique of performing peritoneal washings influenced cytology yield, however positive peritoneal cytology was not associated with decreased survival. Therefore, positive peritoneal cytology should not be considered an absolute contradiction to curatively intended gastrectomy.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Littoral cell angioma unveiled: Exploring diagnosis, treatment, and malignant potential","authors":"Caitlin Blades ,&nbsp;Vivian Duarte ,&nbsp;Aline Hikari Ishida ,&nbsp;David Pfau ,&nbsp;Nikhil Madhuripan ,&nbsp;Patrick Henn ,&nbsp;Benedetto Mungo ,&nbsp;Martin McCarter ,&nbsp;Ana Gleisner ,&nbsp;Sumaya Abdul Ghaffar","doi":"10.1016/j.soi.2025.100178","DOIUrl":"10.1016/j.soi.2025.100178","url":null,"abstract":"<div><h3>Introduction</h3><div>Littoral cell angioma (LCA) is a rare vascular tumor of the spleen that is mostly benign but has malignant potential. Differentiating between these forms is challenging and relies on surgical pathology for final diagnosis, with splenectomy serving as both a diagnostic and curative measure. As metastatic LCA is exceedingly rare, limited data on treatment and follow-up is available in the existing literature.</div></div><div><h3>Methods</h3><div>A retrospective review of LCA cases treated at our institution from 2000 to 2023 was conducted. A comprehensive literature review was also performed to assess treatment options, long-term follow-up, and prognosis for malignant LCA.</div></div><div><h3>Results</h3><div>The cohort included six patients, with a mean age of 67 years. Two-thirds of cases were incidentally diagnosed. Five patients underwent splenectomy. Pathological examination revealed splenomegaly in two-thirds of the cohort. One patient developed liver and retroperitoneal metastases six years post-splenectomy. Pazopanib was chosen as the first-line treatment following consultation with a multidisciplinary team. After six months of daily Pazopanib, the patient exhibited reduced lymphadenopathy and stable disease in the liver. A literature review identified seven cases of metastatic LCA, predominantly focusing on diagnosis and revealing a gap in information on treatment regimens, follow-up strategies, and prognosis.</div></div><div><h3>Conclusion</h3><div>LCA presents significant diagnostic and therapeutic challenges, particularly in metastatic cases. For those, these findings suggest the need for extended follow-up beyond the conventional five-year cancer benchmark and individualized treatment approaches. Reporting metastatic and other complex LCA cases is crucial for enhancing the literature and guiding healthcare providers in managing this rare disease.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taiwan Expert Consensus on the appropriate treatment strategies for HER2-low breast cancer","authors":"Shou-Tung Chen ,&nbsp;Chi-Cheng Huang ,&nbsp;Ta-Chung Chao ,&nbsp;Wei-Pang Chung ,&nbsp;Chih-Yi Hsu ,&nbsp;Cheng-Ping Yu ,&nbsp;Wen-Ling Kuo ,&nbsp;Po-Hsiang Huang ,&nbsp;Dwan-Ying Chang ,&nbsp;Yi-Fang Tsai ,&nbsp;Hsu-Huan Chou ,&nbsp;Jun-Ping Shiau ,&nbsp;Kuo-Ting Lee ,&nbsp;CHIN-YAO LIN ,&nbsp;Ming-Yang Wang ,&nbsp;An-Chieh Feng ,&nbsp;Liang-Chih Liu ,&nbsp;Jiun-I. Lai ,&nbsp;Yuan-Ching Chang ,&nbsp;Guo-Shiou Liao","doi":"10.1016/j.soi.2025.100171","DOIUrl":"10.1016/j.soi.2025.100171","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) is one of the most common cancers among women in Taiwan, with an increasing incidence rate. Advancements in treatment, particularly new-generation antibody-drug conjugates (ADCs), have shown promise for HER2-low BC. This consensus aims to help clinicians formulate treatment guidelines for HER2-low patients.</div></div><div><h3>Methods</h3><div>The Taiwan Breast Cancer Society convened a multidisciplinary panel to conduct a systematic literature review and discuss nine key topics. The panel utilized the US Preventive Services Task Force and GRADE approach for evidence grading and employed the modified Delphi technique to achieve expert consensus.</div></div><div><h3>Results</h3><div>The panel developed 25 consensus statements regarding ADCs and HER2 status. Key findings include that HER2 expression is necessary for trastuzumab-DM1 (T-DM1) and trastuzumab deruxtecan (T-DXd), while TROP2 testing is not required for sacituzumab govitecan (SG). T-DXd is the preferred second-line treatment for HER2-positive metastatic breast cancer and is effective in HER2-low disease and brain metastases. For HR-positive/HER2-negative metastatic breast cancer, both T-DXd and SG improve outcomes after endocrine therapy and CDK4/6 inhibitors. In triple-negative breast cancer, SG offers significant benefits in refractory cases. For HER2-low breast cancer, T-DXd is considered first in HR-positive cases, and SG in HR-negative cases. The routine sequential use of multiple ADCs is not currently supported by evidence</div></div><div><h3>Conclusion</h3><div>This consensus provides essential insights into HER2-low BC, highlighting its characteristics and evolving treatment options, serving as a practical reference for clinicians.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100171"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of post-operative portal vein thrombosis after pancreatectomy: A systematic review","authors":"Autumn Beavers ,&nbsp;Juliet S. Lumati ,&nbsp;Erika Clarke ,&nbsp;Yilin Yang ,&nbsp;Jin He","doi":"10.1016/j.soi.2025.100158","DOIUrl":"10.1016/j.soi.2025.100158","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-operative portal vein thrombosis (PPVT) is a potentially fatal complication following pancreatectomy and can occur in 1.2–5 %¹ of patients after resection. Treatment strategies include therapeutic anticoagulation (TAC), portal vein stent (PVS), or thrombectomy. To date, there has been no consensus on the optimal treatment strategy. The objective of this study is to systematically review the incidence and management of PPVT following pancreatectomy and to compare the clinical outcomes of treatment.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and searched Embase, PubMed, Cochrane, Web of Science, and Scopus databases for studies published between December 1990 and July 2022. MeSH terms were used to identify quantitative studies involving pancreatectomies and PPVT. We extracted data on the PPVT incidence, management, and clinical outcomes, which included thrombus resolution rate and 90-day mortality. Two reviewers [YY, AB] independently performed study selection, data abstraction, and quality assessment.</div></div><div><h3>Results</h3><div>Of the 1028 studies initially identified, 12 were eligible for inclusion. Pancreatoduodenectomy, distal pancreatectomy, and total pancreatectomy were the most common surgeries performed. The incidence of PPVT ranged from 1.5 % to 26 %. Five studies reported outcomes of TAC, three reported outcomes of PVS, and five reported outcomes for patients treated with multiple strategies. Of the TAC-only studies, 1 study reported 100 % thrombus resolution (n = 2). 3 studies found no difference in thrombus resolution rate or mortality. In the 3 studies that reported PVS-only, initial technical success rates were 66.7 % (n = 3), 100 % (n = 3), and 100 % (n = 9), respectively. Long-term patency rates were not uniformly reported. Most deaths were reported in studies that performed surgical thrombectomy (4 studies, mortality rate of 40–100 %) compared to TAC-only (1 study, mortality rate of 33 %), and PVS-only (1 study, mortality rate of 66 %).</div></div><div><h3>Conclusion</h3><div>PPVT is often managed with combined strategies and, less commonly with thrombectomy or PVS alone. PVS has high initial technical success rates, though the long-term patency rate is limited to small case series. Mortality was most frequently reported in patients treated with surgical thrombectomy; this might be because of selection bias for high-risk patients. Thrombus resolution after treatment was not consistently reported in the literature. Given the significant heterogeneity between studies, there is no consensus on the optimal strategy. Larger quantitative studies that routinely assess treatment response and report long-term outcomes are needed.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the ability of Timed Up and Go and Modified Frailty Index-5 compared to Fried frailty index to objectively identify frail patients undergoing evaluation for surgery","authors":"Gregory Palmateer ,&nbsp;William Luke ,&nbsp;Adam Braunschweig ,&nbsp;Benjamin Schmeusser ,&nbsp;Eric Midenberg ,&nbsp;Dattaraya Patil ,&nbsp;Nahar Imtiaz ,&nbsp;Samay Patel ,&nbsp;Susan Mumford ,&nbsp;Ethan Kearns ,&nbsp;Khushali Vashi ,&nbsp;Mohammad Hajiah ,&nbsp;Valentina Grajales ,&nbsp;Shreyas S. Joshi ,&nbsp;Vikram M. Narayan ,&nbsp;Kenneth Ogan ,&nbsp;Viraj A. Master","doi":"10.1016/j.soi.2025.100183","DOIUrl":"10.1016/j.soi.2025.100183","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty is associated with worsened perioperative outcomes, and well studied tools like the Fried Frailty Index are impractical in busy clinical settings. This study evaluated the utility of clinic administered Timed Up &amp; Go (TUG) test and the modified frailty index-5 (MFI-5) in identifying frail patients prior to urologic surgery.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from 106 patients in with concurrent Fried, TUG, and MFI-5 scores. Spearman’s rank correlation assessed relationships among measures, and diagnostic accuracy was used to identify optimal cutoffs.</div></div><div><h3>Results</h3><div>Of the cohort, 38.7 % were frail as measured by the gold standard Fried Frailty Index, TUG and MFI-5 scores were significantly higher in frail patients. TUG showed moderate correlation with Fried frailty achieving an area under the curve (AUC) of 0.794, while MFI-5 was mildly correlated with an AUC of 0.612. A TUG ≥ 11 s and MFI-5 ≥ 0.3 offered the highest classification accuracy.</div></div><div><h3>Conclusions</h3><div>TUG better correlated with Fried frailty status than MFI-5 with a TUG ≥ 11 s best predicting frailty in our cohort.</div></div><div><h3>Synopsis</h3><div>Fried frailty predicts poor surgical outcomes but is impractical to assess. Among urologic cancer patients, Timed Up and Go (TUG) moderately correlated with Fried frailty and may offer a practical, objective, and reliable alternative for measuring frailty.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative biomarkers may predict nodal status in pancreatic ductal adenocarcinoma","authors":"Noah S. Brown ,&nbsp;Matthew A. Firpo ,&nbsp;Courtney L. Scaife","doi":"10.1016/j.soi.2025.100157","DOIUrl":"10.1016/j.soi.2025.100157","url":null,"abstract":"<div><h3>Introduction</h3><div>The current standard for preoperative nodal staging for pancreatic adenocarcinoma, endoscopic ultrasound, varies widely in its accuracy, with pathologic concurrence as low as 41 %. Patients who are found to have 4 or more pathologically positive lymph nodes are defined as N2 nodal status. These patients experience extremely poor overall survival.</div></div><div><h3>Objective</h3><div>We sought to identify any biomarkers specific to this patient population to better stratify these patients pre-operatively.</div></div><div><h3>Methods</h3><div>We began with an existing database of patients with histologically confirmed pancreatic adenocarcinoma treated at the University of Utah between January 2004 and October 2019. These patients and their biological samples have already been screened using a 31 analyte panel to detect early stage disease. We recategorized these patients using the updated AJCC 8th edition introducing N2 disease. The individual analytes were then screened for their ability to distinguish N2 disease.</div></div><div><h3>Results</h3><div>Basigin (BSG) was significantly elevated in N2 disease (mean 17.45, SD 13.53) compared to N0 disease (mean 12.09, SD 11.47), p = 0.014 by Dunn's test) while Leucine-rich alpha-2-glycoprotein 1 (LRG1) was significantly decreased in N2 disease (mean 3446.21, SD 2719.12) compared to N0 disease (mean 5727.25, SD 3236.40, p = 0.025).</div></div><div><h3>Conclusion</h3><div>BSG and LRG1 could be useful in preoperatively identifying candidates that would benefit most from resection. This offers a foundation for future studies to combine biomarkers and clinical factors into a machine learning algorithm to reliably distinguish N2 disease in the preoperative setting. This may affect the pre-surgical discussion and provide vital prognostic information to patients.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}