Surgical Oncology Insight最新文献

{"title":"Hyperthermic intraperitoneal chemotherapy (HIPEC) vs. postoperative intraperitoneal (IP) chemotherapy – Impact on health-related quality of life in primary ovarian cancer patients after cytoreductive surgery","authors":"Luis Felipe Falla-Zuniga ,&nbsp;Armando Sardi ,&nbsp;Mary Caitlin King ,&nbsp;Andrei Nikiforchin ,&nbsp;Felipe Lopez-Ramirez ,&nbsp;Philipp Barakat ,&nbsp;Carol Nieroda ,&nbsp;Vadim Gushchin ,&nbsp;Teresa Diaz-Montes","doi":"10.1016/j.soi.2024.100073","DOIUrl":"10.1016/j.soi.2024.100073","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare health-related quality of life (HRQL) in primary ovarian cancer (OC) patients with peritoneal metastases (PM) after undergoing upfront cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) as part of a phase 2 trial (NCT-02124421).</p></div><div><h3>Methods</h3><p>Patients with stage III/IV high-grade serous OC were randomized (1:1) to either CRS/HIPEC with carboplatin followed by 6 cycles of adjuvant systemic chemotherapy (carboplatin/paclitaxel) or CRS followed by 6 cycles of combination intraperitoneal/intravenous chemotherapy (cisplatin/paclitaxel). The trial outcome index (TOI) of the Functional Assessment of Cancer Therapy-Ovarian (FACT-O) questionnaire was used to assess HRQL. The FACT-O was administered at randomization and postoperatively at 6 weeks and 6, 12, and 24 months, or until disease recurrence/death. HRQL was analyzed using a linear mixed model.</p></div><div><h3>Results</h3><p>Sixteen patients were enrolled in each group. All (32/32) patients completed questionnaires at baseline and 53.1 % (17/32) at 24 months. Reasons for missing scores were similar between groups. Average TOI was similar between treatment arms at each time point. In both arms, mean TOI was below baseline at 6 weeks (p = 0.798) and 6 months (p = 0.821) after CRS, but recovered at 12 months (p = 0.518). No significant differences were found in FACT-O total score or FACT-O individual dimensions over time between groups.</p></div><div><h3>Conclusions</h3><p>No long-term HRQL impairment was observed when HIPEC was added to CRS in primary OC. Access to CRS/HIPEC as primary treatment of PM in OC should not be solely limited by concerns for patient HRQL.</p></div><div><h3>Synopsis</h3><p>Health-related quality of life (HRQL) was evaluated in primary ovarian cancer patients participating in a phase 2 trial comparing cytoreductive surgery (CRS)/HIPEC vs CRS + intraperitoneal (IP) chemotherapy. No differences between groups or long-term HRQL impairment were observed.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100073"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000823/pdfft?md5=f53bec984c897a816cebb73fd53f1a8d&pid=1-s2.0-S2950247024000823-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694620","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":"Evolving patterns of metastatic spread, treatment, and outcome for patients with oligometastatic colorectal cancer","authors":"Helen Pham ,&nbsp;Sangeetha Ramanujam ,&nbsp;Hui-Ling Yeoh ,&nbsp;Phillip Antippa ,&nbsp;Nezor Houli ,&nbsp;Ben Thomson ,&nbsp;Suzanne Kosmider ,&nbsp;Catherine Dunn ,&nbsp;Yat Hang To ,&nbsp;Margaret Lee ,&nbsp;Vanessa Wong ,&nbsp;Susan Caird ,&nbsp;Jeremy Shapiro ,&nbsp;Matthew Burge ,&nbsp;Hui-Li Wong ,&nbsp;Brigette Ma ,&nbsp;Stephanie Hui-Su Lim ,&nbsp;Javier Torres ,&nbsp;Belinda Lee ,&nbsp;Marty Smith ,&nbsp;Peter Gibbs","doi":"10.1016/j.soi.2024.100076","DOIUrl":"10.1016/j.soi.2024.100076","url":null,"abstract":"<div><h3>Introduction</h3><p>The assessment and management of oligometastatic colorectal cancer has evolved over the last two decades. We aimed to examine trends in the presentation, management and outcomes of patients presenting with liver-only disease, given recent changed standards for baseline imaging, and evolving definitions of resectability. Patients with lung-only disease can provide a contemporaneous control group.</p></div><div><h3>Methods</h3><p>Prospectively maintained data from the multi-site Treatment of Recurrent and Advanced Colorectal Cancer Registry were reviewed over three consecutive periods; 2009–2013, 2014–2018, and 2019–2023. Survival outcomes were determined by Kaplan-Meier method.</p></div><div><h3>Results</h3><p>Of 4613 patients with metastatic colorectal cancer, median age was 66 years (interquartile range 56–76), and 2356 (51 %) patients had a single metastatic site. Compared to the earlier periods, patients diagnosed in 2019–2023, were younger, had better ECOG scores and were more likely to have three or more metastatic sites. The proportion of patients with liver-only metastases decreased over the three consecutive periods, from 32.0 % (n = 462), to 27.0 % (n = 498) to 25.9 % (n = 33), p &lt; 0.001, however the proportion of liver-only metastases patients undergoing resection increased from 41.5 to 59.3 %, p &lt; 0.001. The incidence and resection rate of lung-only metastases was unchanged over time.</p></div><div><h3>Conclusion</h3><p>The increasing number of metastatic sites and reduced number of patients with liver-only metastases is potentially explained by the increased use of FDG-PET imaging at baseline. The increased proportion of patients with liver-only disease undergoing resection may be explained by advancement in surgical techniques, improvements in systemic therapies and the evolving definition of resectable disease.</p></div><div><h3>Synopsis</h3><p>The pattern and treatment of metastatic colorectal cancer has evolved over the last two decades. This study examines the trends in presentation management and outcomes of patients with metastatic colorectal cancer using a multi-site database.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000859/pdfft?md5=6585052520717c8c298475369e4e20b3&pid=1-s2.0-S2950247024000859-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638856","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 irreversible electroporation on survival among patients with borderline resectable/locally advanced pancreatic cancer: A single center experience","authors":"Mohammed O. Suraju ,&nbsp;Yutao Su ,&nbsp;Jeremy Chang ,&nbsp;Aditi Katwala ,&nbsp;Apoorve Nayyar ,&nbsp;Darren M. Gordon ,&nbsp;Scott K. Sherman ,&nbsp;Hisakazu Hoshi ,&nbsp;James R. Howe ,&nbsp;Carlos H.F. Chan","doi":"10.1016/j.soi.2024.100075","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100075","url":null,"abstract":"<div><h3>Background</h3><p>The use of Irreversible Electroporation (IRE) in borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) is increasing. However, its potential impact on survival has been debated. We hypothesized that addition of IRE to the conventional multimodal therapy would be associated with improved overall survival (OS) in BR/LA PDAC patients.</p></div><div><h3>Methods</h3><p>Among patients received neoadjuvant chemotherapy, we identified PDAC patients with BR/LA disease who underwent resection alone, resection+IRE, IRE alone, and no resection but would have been eligible for IRE. Kaplan-Meier method with Peto-Peto modified log-rank test and Cox proportional hazard were used in survival analyses.</p></div><div><h3>Results</h3><p>102 patients were included in the cohort – 40 resection-only (18 % LA), 13 resection+IRE (46 % LA), 14 IRE-only (93 % LA), and 35 unresected (77 % LA). Median age was 65. IRE patients had a median follow-up of 22 months [95 %CI:14–28], while for non-IRE patients it was 17 months [95 %CI:12–26]. Median age and proportion without comorbidities did not significantly differ across groups. Median OS was 30 months [95 %CI:30-NR] among patients who underwent resection+IRE, 27 months [95 %CI:23–48] for resection-only, 28 months [95 %CI:16-NR] for IRE-only, and 14 months [95 %CI:10–20] for unresected patients. In multivariable analyses, resection (HR:0.26 [95 %CI:0.13–0.54], <em>P</em> &lt; 0.001), neoadjuvant chemoradiation (HR:0.50 [95 %CI:0.28–0.88], <em>P</em> = 0.017), and IRE (HR:0.49 [95 %CI:0.26–0.94], <em>P</em> = 0.03) were independently associated with decreased risk of mortality.</p></div><div><h3>Conclusions</h3><p>IRE may enhance survival in BR/LA PDAC patients who receive conventional multimodal therapy. Prospective studies are needed to confirm the potential benefits of IRE as an adjunct during pancreatic resection after multimodal neoadjuvant therapy for BR/LA PDAC.</p></div><div><h3>Synopsis</h3><p>Irreversible electroporation can be a valuable adjunct to the current multimodal therapy for treating borderline resectable and locally advanced pancreatic cancer.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100075"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000847/pdfft?md5=579a9caf5cd707c0b3ca943b58830539&pid=1-s2.0-S2950247024000847-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607214","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 systematic review of sebaceous carcinoma of the breast from 2000–2023: A rare entity with high recurrence rates","authors":"Lauren N. Cohen ,&nbsp;Colleen Flanagan ,&nbsp;Amanda L. Kong ,&nbsp;Chandler S. Cortina","doi":"10.1016/j.soi.2024.100074","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100074","url":null,"abstract":"<div><h3>Synopsis</h3><p>Sebaceous carcinoma of the breast is a rare breast neoplasm with a small number of published cases. We report an updated systematic review of these cases to provide insight into the patient demographics, clinical presentation, and patient outcomes.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000835/pdfft?md5=2b6d37157268a2288c9646c800b37359&pid=1-s2.0-S2950247024000835-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141593952","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 prospective multi-institutional trial examining the feasibility, accuracy and learning curve of fluorescence imaging for sentinel node localization in melanoma","authors":"Colette R. Pameijer ,&nbsp;Rogerio I. Neves ,&nbsp;James R. Nitzkorski ,&nbsp;Michael C. Lowe","doi":"10.1016/j.soi.2024.100071","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100071","url":null,"abstract":"<div><h3>Background</h3><p>Sentinel node biopsy is a standard component of staging for patients with melanoma. Lymphoscintigraphy with technetium99 (^99mTc) is highly reliable but not patient centered, requiring a separate visit to radiology and often a painful injection. We assessed intra-operative real-time fluorescence lymphangiography as an alternative to ^99mTc for sentinel node localization in patients with extremity melanoma.</p></div><div><h3>Methods</h3><p>A multi-center single arm prospective trial was conducted for patients with extremity melanoma. All subjects had lymphoscintigraphy with ^99mTc prior to surgery and a dermal injection of indocyanine green in the operating room. The surgeon was blinded to the lymphoscintigraphy results and used real-time fluorescence imaging to localize the sentinel nodes. Success rate and operative times were recorded.</p></div><div><h3>Results</h3><p>Four surgeons enrolled 35 subjects with melanoma of the upper or lower extremity, excluding hands and feet, who met criteria for sentinel node biopsy based on NCCN guidelines. Each surgeon enrolled at least 8 subjects. The overall success rate for the first sentinel node was 83 % (29/35). The success rate varied between the axilla and groin, and between first, second and third sentinel nodes. The average time to identify the first sentinel node was 14 min, with no consistent improvement over time. There were no complications related to the ICG.</p></div><div><h3>Conclusions</h3><p>The success rate of sentinel node localization with indocyanine green and fluorescence imaging is high, but not high enough to use this method alone. ICG can safely replace blue dye. The learning curve for this technique is likely more than 8 patients.</p></div><div><h3>Synopsis</h3><p>ICG and fluorescence imaging may aid in sentinel node localization but should not replace lymphoscintigraphy with ^99mTc. ICG with fluorescence imaging can safely replace blue dye. The learning curve for this technique is at least 8 patients.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295024702400080X/pdfft?md5=683c2bca3c4ec84b4155dd046af1108d&pid=1-s2.0-S295024702400080X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of a positive resection margin in locoregional appendix cancer and its impact on survival: The national cancer database analysis","authors":"Ekaterina Baron,&nbsp;Chih Ching Wu,&nbsp;Andrei Nikiforchin,&nbsp;Raquel Abengozar Mingorance,&nbsp;Stephanie C. Carr,&nbsp;Jessica A. Wernberg,&nbsp;Rohit Sharma","doi":"10.1016/j.soi.2024.100072","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100072","url":null,"abstract":"<div><h3>Introduction</h3><p>The impact of a positive resection margin (RM+) in appendiceal cancer (AC) remains unclear, with small studies suggesting it does not worsen survival in low-grade subtypes. We aimed to evaluate RM+ rates, its risk factors, and survival outcomes across different AC histologies.</p></div><div><h3>Methods</h3><p>We conducted a multicenter retrospective cohort study using the National Cancer Database (2004–2019) and including stage I-III AC cases. Surgical and survival outcomes were compared between RM+ and RM- groups, with logistic regression analyzing the association of RM+ and its predictors. Subgroup analysis was performed for low/high tumor grade (LG/HG), mucinous/non-mucinous pathology (MAC/NMAC), and signet ring cell carcinoma (SRC).</p></div><div><h3>Results</h3><p>Among 6800 patients identified, 737 (10.8 %) had RM+, while 6063 (89.2 %) had RM-. RM+ rates varied across AC histologies: 10.9 % in LG-MAC, 17.0 % in HG-MAC, 7.8 % in LG-NMAC, 13.9 % in HG-NMAC, and 17.9 % in SRC. RM+ correlated with significantly worse survival in LG-MAC (HR 1.67), HG-MAC (HR 1.83), LG-NMAC (HR 2.04), and SRC (HR 2.37) but not in HG-NMAC after adjusting to other factors. Predictors of RM+ included pT stage, preoperative chemotherapy in LG tumors and pT stage and positive lymph nodes in HG tumors whereas more extensive resection was associated with RM- in both LG and HG.</p></div><div><h3>Conclusion</h3><p>RM+ worsens survival in most AC subtypes, highlighting the importance of achieving negative margins. Extensive resection, like right hemicolectomy, can improve RM- rate, but factors such as pT stage, lymph node status, and preoperative chemotherapy also affect RM+. Surgeons should prioritize achieving RM- in all AC histologies.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000811/pdfft?md5=bea5968875967fb0b29097f4858ba440&pid=1-s2.0-S2950247024000811-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540383","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":"Increased rate of upstaging of plantar melanomas may warrant more radical treatment: Study at a single NCI-designated Cancer Center","authors":"Michelle Jeffery ,&nbsp;Vasileios Tsagkalidis ,&nbsp;Brennan Cook ,&nbsp;Vadim Koshenkov ,&nbsp;Adam C. Berger","doi":"10.1016/j.soi.2024.100070","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100070","url":null,"abstract":"<div><h3>Background</h3><p>Acral lentiginous melanoma holds the worst prognosis of all cutaneous melanomas. We aim to further detail the incidence of upstaging in plantar melanoma (PM) as well as identify factors associated with upstaging.</p></div><div><h3>Methods</h3><p>A retrospective analysis of medical records was performed of patients who underwent surgical intervention for non-metastatic primary PM at a single NCI-designated Comprehensive Cancer Center (January 2011-August 2023). The primary outcome was rate of upstaging, defined as an increase in the T-stage on final surgical pathology compared to biopsy. Clinical and pathologic staging were determined by the AJCC 8th edition. Statistical analysis included Pearson’s Chi-squared test, Fisher’s exact test, Wilcoxon rank sum test, and Kruskal-Wallis rank sum test.</p></div><div><h3>Results</h3><p>Forty-nine patients were identified, with an average age of 65 years (51 % male). Majority self-identified as Caucasian (55 %). Initial biopsy techniques were shave (49 %), punch (34 %) and excisional (17 %). Twenty-four patients (50 %) demonstrated upstaging. Seventy-seven percent (n = 10) of patients with clinical Tis were upstaged. Eight patients required reoperation due to upstaging, with 6 having melanoma in situ on biopsy. On multivariable logistic regression, patients with clinical Tis-T1 were more likely to be upstaged compared to T2-T3 (OR 8.75, p &lt; 0.041). Type of biopsy, lesion size &lt; 15 mm and positive deep margins on biopsy were not associated with risk of upstaging.</p></div><div><h3>Conclusions</h3><p>Our findings suggest a high incidence of upstaging of PM with no identifiable factors associated with upstaging. Patients with clinical Tis or T1 PM should undergo resection with wider margins and be strongly considered for sentinel lymph node biopsy at time of index operation.</p></div><div><h3>Synopsis</h3><p>In this large cohort of patients with non-metastatic primary plantar melanoma, half of the cohort was upstaged following resection. The risk was higher in patients diagnosed with Tis or T1 on biopsy compared to T2-T3. Biopsy type, lesion size &lt; 15 mm and positive deep biopsy margins were not associated with upstaging. More radical treatment of plantar melanomas may be warranted.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000793/pdfft?md5=52147f236ba1e9580635be5863c0208e&pid=1-s2.0-S2950247024000793-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480565","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":"Association of surgical margin on prognosis after hepatectomy for colorectal cancer liver metastases with RAS mutations","authors":"Takuya Tajiri,&nbsp;Kosuke Mima,&nbsp;Hiromitsu Hayashi ,&nbsp;Yuji Miyamoto,&nbsp;Yuki Adachi,&nbsp;Takashi Ofuchi,&nbsp;Kosuke Kanemitsu,&nbsp;Toru Takematsu,&nbsp;Rumi Itoyama.,&nbsp;Yuki Kitano,&nbsp;Shigeki Nakagawa,&nbsp;Hirohisa Okabe,&nbsp;Katsunori Imai,&nbsp;Hideo Baba","doi":"10.1016/j.soi.2024.100069","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100069","url":null,"abstract":"<div><h3>Background</h3><p>Although outcomes of treatment for colorectal cancer liver metastases (CRLM) have improved with multidisciplinary treatment, recurrence rates after resection of liver metastases are still high. Although surgical margin (SM) is considered irrelevant in the case of R0 resection, its effectiveness is still unclear. In this study, we investigated the prognostic association of SM in CRLM according to RAS status.</p></div><div><h3>Methods</h3><p>Of 220 patients who had undergone initial hepatic resection for CRLM at our hospital between January 2000 and February 2020, finally, 164 remained in the study cohort. SMs (mms) were measured by macroscopic and microscopic examinations. Associations between SM, presence or absence of RAS mutations, and prognosis were analyzed using multivariate analysis with the Cox proportional hazards model.</p></div><div><h3>Results</h3><p>Of the 164 patients, 68 (41 %) had RAS mutations. The RAS mutation group had significantly poorer disease-free survival (DFS) (P &lt; 0.001) and over-all survival (OS) (P &lt; 0.001). In the RAS wild group, SM status was not significantly associated with OS or DFS, whereas in the RAS mutation group, SM&lt; 2 mm was significantly associated with worse DFS (P = 0.014). Multivariate analysis showed that SM&lt; 2 mm was an independent predictor of poor DFS in the RAS mutation group (HR 21.3, 95 % CI: 2.25–201.3, P = 0.008).</p></div><div><h3>Conclusions</h3><p>RAS mutation status is an independent predictor of poor prognosis after hepatectomy for CRLM. Especially in patients with RAS mutations, SM &lt; 2 mm is associated with significantly worse post-hepatectomy DFS, suggesting achieving a wide SM (≥2 mm) is indicated in patients with RAS mutations</p></div><div><h3>Synopsis</h3><p>RAS mutation is an independent predictor of poor prognosis after hepatectomy for CRLM. Especially in patients with RAS mutations, SM &lt; 2 mm is associated with significantly worse post-hepatectomy DFS, suggesting achieving a wide SM (≥2 mm) is indicated.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000781/pdfft?md5=edc6796eeeded4f9d4a45fced5555942&pid=1-s2.0-S2950247024000781-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480564","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":"Travel distance does not affect overall survival in patients with appendiceal adenocarcinoma undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy","authors":"Javid Sadjadi,&nbsp;Li Luo,&nbsp;Bridget Fahy,&nbsp;Vinay K. Rai,&nbsp;Sarah Popek,&nbsp;Lara Baste McKean,&nbsp;Alissa Greenbaum","doi":"10.1016/j.soi.2024.100068","DOIUrl":"https://doi.org/10.1016/j.soi.2024.100068","url":null,"abstract":"<div><h3>Introduction</h3><p>Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is a potentially curative approach for appendiceal cancer (AC) with peritoneal dissemination and is most often employed at tertiary referral centers. Regionalization may provide geographic barriers to care for vulnerable patients. The aim of this study was to examine the effect of travel distance on oncologic outcomes of patients with AC treated with CRS-HIPEC.</p></div><div><h3>Methods</h3><p>The National Cancer Database (NCDB) was reviewed from 2006 through 2020 for patients with AC who underwent CRS-HIPEC. The primary comparison variable was distance (&lt;50 miles vs ≥ 50 miles from the CRS-HIPEC facility). Demographic and tumor characteristics were analyzed. Primary outcome was overall survival (OS). Secondary outcomes were 30-day and 90-day mortality, readmission, and length of stay (LOS).</p></div><div><h3>Results</h3><p>During the study period, 1703 patients met inclusion criteria, with 1000 patients travelling &lt; 50 miles for CRS-HIPEC (59 %) and 703 travelling ≥ 50 miles (41 %). Patients who traveled ≥ 50 miles were more likely to be non-Hispanic White (p &lt; 0.001), have annual income less than $74,062, be treated at an academic center and live in the South-Atlantic region of the United States. There was no significant difference in OS between groups (Figure 1). There were no significant differences in 30-day postoperative survival, 90-day survival, or 30-day readmission. Post-operative LOS was 8.0 versus 9.0 days (p &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Travel distance ≥ 50 miles was not significantly associated with decreased OS or increased postoperative mortality, suggesting that regionalization of care does not worsen oncologic outcomes for patients with AC undergoing CRS-HIPEC.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S295024702400077X/pdfft?md5=e1085278b10eea3c2cfb0cd01b11bfb6&pid=1-s2.0-S295024702400077X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595656","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":"Disaggregating U.S. Asian and Pacific Islanders: Colorectal cancer","authors":"Ian Chun ,&nbsp;Brenda Y. Hernandez ,&nbsp;Hyeong Jun Ahn ,&nbsp;Christina Wai","doi":"10.1016/j.soi.2024.100066","DOIUrl":"10.1016/j.soi.2024.100066","url":null,"abstract":"<div><h3>Background</h3><p>Colorectal cancer remains a public health concern as the 4th most common cancer in the US. Incidence and mortality have been observed to differ between races; however, Asian and Pacific Islander ethnicities are often documented in aggregate. Recognizing that these groups are heterogeneous, this study seeks to disaggregate Native Hawaiian from the broader “Asian/Pacific Islander” group and examine disparate outcomes in colorectal cancer.</p></div><div><h3>Methods</h3><p>De-identified data from the Hawaii Tumor Registry was queried to evaluate colorectal cancer in the state of Hawaii. Primary outcomes were cancer stage at diagnosis, first course of therapies received, and duration of survival from diagnosis. Chi-square analyses were performed for differences in categorical variables.</p></div><div><h3>Results</h3><p>7943 Hawaii residents were diagnosed with colorectal cancer in 2008–2018 with 1151 (14.5 %) patients identifying as Native Hawaiian. Native Hawaiians were less likely to present with localized cancer (36.7 % vs. 41.7 %; p = 0.002) and more likely to be diagnosed with distant stage cancer compared to non-Native Hawaiians (25.2 % vs. 17.67 %; p &lt; 0.0001) and, among those with distant metastases, more likely to receive chemotherapy (68.3 % vs. 61.1 %; p = 0.029). No significant differences were observed between races on analysis of CRC-specific mortality.</p></div><div><h3>Conclusion</h3><p>Significant differences exist between disaggregated Asian and Pacific Islander ethnic groups. Native Hawaiians are observed to present with more advanced cancer at the time of diagnosis in comparison to ethnicities. Disaggregating these groups reveals racial and ethnic disparities that may inform public health measures.</p></div><div><h3>Synopsis</h3><p>Disaggregating Asian and Native Hawaiian and Pacific Islander groups reveals disparities in colorectal cancer. Native Hawaiians presented with more advanced disease across all studied ethnic groups. No significant differences were observed in colorectal cancer specific mortality across groups.</p></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"1 3","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950247024000756/pdfft?md5=5e7a842a5568527a0ed648b29a9dbc8c&pid=1-s2.0-S2950247024000756-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408090","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}