Ejso最新文献

{"title":"Risk factors for lymph node metastasis and survival: Toward better endoscopic selection in ulcerative versus nonulcerative early gastric cancer","authors":"Minghan Ren ,&nbsp;Yuning Chu ,&nbsp;Rongshuang Han ,&nbsp;Yunqing Chen ,&nbsp;Tao Mao ,&nbsp;Xingsi Qi ,&nbsp;Shengbo Jin ,&nbsp;Zibin Tian","doi":"10.1016/j.ejso.2025.110497","DOIUrl":"10.1016/j.ejso.2025.110497","url":null,"abstract":"<div><h3>Background</h3><div>Lymph node metastasis (LNM) is a major determinant of patient outcomes in early gastric cancer (EGC) patients. This study aimed to identify risk factors for LNM and compare outcomes between patients with ulcerative EGC (UEGC) and with nonulcerative EGC (NUEGC).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of 1262 patients with pathologically confirmed EGC who underwent curative gastrectomy. The risk factors for LNM and overall survival (OS) were assessed. OS was estimated with Kaplan‒Meier analysis, and prognostic factors were identified via Cox regression analysis.</div></div><div><h3>Results</h3><div>LNM was significantly more common in the UEGC group (16.6 %) than in the NUEGC group (11.6 %) (P = 0.013). According to the multivariable analysis, lymphovascular invasion (LVI) (OR = 17.609, P &lt; 0.001 for NUEGC; OR = 14.587, P &lt; 0.001 for UEGC), superficial submucosal (SM1) invasion (OR = 2.622, P = 0.045 for NUEGC; OR = 2.276, P = 0.022 for UEGC), and deep submucosal (SM2) invasion (OR = 3.276, P = 0.004 for NUEGC; OR = 3.132, P = 0.001 for UEGC) were independent predictors of LNM in both groups, whereas a tumor size&gt;30 mm (OR = 2.644, P = 0.009) was a significant factor only for NUEGC patients. The 5-year OS rate was 89.9 % in the NUEGC group and 87.2 % in the UEGC group (P = 0.028, log-rank test). LNM was an independent predictor of OS in both subtypes of EGC, whereas elevated carcinoembryonic antigen (CEA) levels and SM2 invasion were significant predictors only for UEGC patients.</div></div><div><h3>Conclusion</h3><div>Compared with NUEGC, UEGC presents more aggressive pathological features and is characterized by a significantly higher rate of LNM and worse long-term patient survival, while undifferentiated UEGC &lt;2 cm potentially supports ESD expansion.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110497"},"PeriodicalIF":2.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145321873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for lymph node metastasis and survival: Toward better endoscopic selection in ulcerative versus nonulcerative early gastric cancer","authors":"Minghan Ren ,&nbsp;Yuning Chu ,&nbsp;Rongshuang Han ,&nbsp;Yunqing Chen ,&nbsp;Tao Mao ,&nbsp;Xingsi Qi ,&nbsp;Shengbo Jin ,&nbsp;Zibin Tian","doi":"10.1016/j.ejso.2025.110497","DOIUrl":"10.1016/j.ejso.2025.110497","url":null,"abstract":"<div><h3>Background</h3><div>Lymph node metastasis (LNM) is a major determinant of patient outcomes in early gastric cancer (EGC) patients. This study aimed to identify risk factors for LNM and compare outcomes between patients with ulcerative EGC (UEGC) and with nonulcerative EGC (NUEGC).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of 1262 patients with pathologically confirmed EGC who underwent curative gastrectomy. The risk factors for LNM and overall survival (OS) were assessed. OS was estimated with Kaplan‒Meier analysis, and prognostic factors were identified via Cox regression analysis.</div></div><div><h3>Results</h3><div>LNM was significantly more common in the UEGC group (16.6 %) than in the NUEGC group (11.6 %) (P = 0.013). According to the multivariable analysis, lymphovascular invasion (LVI) (OR = 17.609, P &lt; 0.001 for NUEGC; OR = 14.587, P &lt; 0.001 for UEGC), superficial submucosal (SM1) invasion (OR = 2.622, P = 0.045 for NUEGC; OR = 2.276, P = 0.022 for UEGC), and deep submucosal (SM2) invasion (OR = 3.276, P = 0.004 for NUEGC; OR = 3.132, P = 0.001 for UEGC) were independent predictors of LNM in both groups, whereas a tumor size&gt;30 mm (OR = 2.644, P = 0.009) was a significant factor only for NUEGC patients. The 5-year OS rate was 89.9 % in the NUEGC group and 87.2 % in the UEGC group (P = 0.028, log-rank test). LNM was an independent predictor of OS in both subtypes of EGC, whereas elevated carcinoembryonic antigen (CEA) levels and SM2 invasion were significant predictors only for UEGC patients.</div></div><div><h3>Conclusion</h3><div>Compared with NUEGC, UEGC presents more aggressive pathological features and is characterized by a significantly higher rate of LNM and worse long-term patient survival, while undifferentiated UEGC &lt;2 cm potentially supports ESD expansion.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110497"},"PeriodicalIF":2.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prediction model of pulmonary metastasis risk in pediatric patients with stage IIB osteosarcoma in the long bone of extremities","authors":"Guodong Zhong ,&nbsp;Wanzhen Wang ,&nbsp;Aierxiding Aimaiti ,&nbsp;Yongqian Wang ,&nbsp;Xianbiao Xie ,&nbsp;Changye Zou ,&nbsp;Junqiang Yin ,&nbsp;Jingnan Shen ,&nbsp;Gang Huang ,&nbsp;Zhiqiang Zhao","doi":"10.1016/j.ejso.2025.110509","DOIUrl":"10.1016/j.ejso.2025.110509","url":null,"abstract":"<div><h3>Introduction</h3><div>While epiphyseal plates may resist osteosarcoma invasion, the correlation between epiphyseal involvement (EI) and pulmonary metastasis (PM) or prognosis remains unclear, and no PM prediction models specifically target pediatric patients.</div></div><div><h3>Materials and methods</h3><div>This study enrolled 221 patients (≤14 years) with stage IIB osteosarcoma in the long bone of extremities. Using LASSO and multivariate Cox regression analyses, we identified significant risk factors for PM and prognosis, integrating them into a nomogram and nine machine learning (ML) models. After comprehensive performance evaluation, the optimal model was selected to predict 2-year PM risk, stratifying patients into high- and low-risk groups by median risk score.</div></div><div><h3>Results</h3><div>EI significantly correlated with increased PM risk and poorer prognosis; however, when tumors did not cross the epiphyseal plate, metastasis incidence and prognosis remained comparable irrespective of the tumor-epiphyseal distance. Key risk factors included EI, elevated alkaline phosphatase (ALP), decreased lactate dehydrogenase (LDH), poor chemotherapy response, and elevated LDH ratio. The Random Forest (RF) model showed optimal predictive performance for risk stratification.</div></div><div><h3>Conclusion</h3><div>This study establishes the first pediatric-specific PM risk prediction model for osteosarcoma, enabling personalized management, precise prognosis assessment, and optimized resource allocation, thereby demonstrating artificial intelligence's value in biomedical research.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110509"},"PeriodicalIF":2.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underreporting of molecular targets in surgically treated patients with peritoneal metastasis of gastric cancer","authors":"A. Castagna ,&nbsp;A. Ramouz ,&nbsp;I. Trinidad-Gutiérrez ,&nbsp;N. Brindl ,&nbsp;A. Brandl","doi":"10.1016/j.ejso.2025.110502","DOIUrl":"10.1016/j.ejso.2025.110502","url":null,"abstract":"<div><div>The management of gastric cancer (GC) with peritoneal metastasis (PM) remains a significant clinical challenge. Despite advances in molecular profiling, the underreporting of key molecular markers in patients undergoing surgical treatment for GC with PM is concerning. Signet ring cell (SRC) histology is associated with poor prognosis and chemoresistance, while Laurén diffuse subtype is linked to a higher risk for PM. Despite the established role of HER2 in GC progression, its impact on the efficacy of surgical treatment is not clearly defined. The lack of comprehensive reporting on these and recent molecular markers underscores the need for further research. Incorporating molecular diagnostic into clinical practice could improve the personalisation of treatment for GC with PM and overcoming important drug resistance issues, enhancing the effectiveness of current therapy approaches.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110502"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world survival benefit of adding immunotherapy to chemotherapy in esophageal cancer: A large SEER-based analysis","authors":"Jing Chen ,&nbsp;Hong-Jun Lin ,&nbsp;Chang-Qing Liu","doi":"10.1016/j.ejso.2025.110504","DOIUrl":"10.1016/j.ejso.2025.110504","url":null,"abstract":"<div><h3>Background</h3><div>The integration of immunotherapy with chemotherapy has shown promise in improving survival for advanced esophageal cancer. However, most supporting evidence comes from prospective trials with small cohorts, and large-scale real-world validation remains limited.</div></div><div><h3>Methods</h3><div>Esophageal cancer patients from the SEER database (2000–2021) were reviewed and analyzed. Patients diagnosed after 2021 were categorized into the chemotherapy plus immunotherapy group, while those diagnosed earlier formed the chemotherapy-alone group. The primary endpoint was the long-term survival. Additionally, subgroup analyses were further conducted for adenocarcinoma (AC) and squamous cell carcinoma (SC) to assess histology-specific outcomes.</div></div><div><h3>Results</h3><div>A total of 7793 patients were included (5840 chemotherapy-alone, 1953 chemotherapy plus immunotherapy). After PSM, baseline characteristics between the two groups were well balanced. Chemotherapy plus immunotherapy was identified as an independent protective factor for survival both before (HR = 0.868, 95 % CI: 0.766–0.984, P = 0.027) and after matching (HR = 0.845, 95 % CI: 0.745–0.958, P = 0.009). Subgroup analyses revealed consistent survival benefits of combination therapy in both AC and SC patients. The protective effect remained statistically significant in AC (HR = 0.822, 95 % CI: 0.682–0.990, P = 0.039), and a favorable trend was also observed in SC. In addition, female sex, married status, early T stage, and absence of distant metastasis were independently associated with better outcomes across subgroups.</div></div><div><h3>Conclusion</h3><div>This large, SEER-based real-world study confirms that adding immunotherapy to chemotherapy significantly improves survival in esophageal cancer. The benefit was observed in both adenocarcinoma and squamous cell carcinoma subtypes, supporting its broad clinical utility and the need for further prospective validation.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110504"},"PeriodicalIF":2.9,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on neoadjuvant chemotherapy efficacy in patients with breast cancer: An ambidirectional cohort study and mendelian randomization analysis","authors":"Yali Wang ,&nbsp;Jiaqi Zhan ,&nbsp;Shunyi Liu ,&nbsp;Minyan Chen ,&nbsp;Lili Chen ,&nbsp;Yuxiang Lin ,&nbsp;Jialin Hou ,&nbsp;Liuwen Yu ,&nbsp;Xiaobin Chen ,&nbsp;Weifeng Cai ,&nbsp;Yibin Qiu ,&nbsp;Qindong Cai ,&nbsp;Peng He ,&nbsp;Wenhui Guo ,&nbsp;Chunsen Xu ,&nbsp;Shunguo Lin ,&nbsp;Fangmeng Fu ,&nbsp;Chuan Wang","doi":"10.1016/j.ejso.2025.110496","DOIUrl":"10.1016/j.ejso.2025.110496","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with breast cancer are susceptible to coronavirus disease (COVID-19), which affects cancer treatment efficacy and prognosis. However, its effects on neoadjuvant chemotherapy (NAC) response and its genetic correlation with breast cancer remain unclear. We aimed to clarify these effects and investigate potential genetic associations and shared pathogenic mechanisms.</div></div><div><h3>Materials and methods</h3><div>In this ambidirectional (retrospective and prospective) cohort study involving 856 breast cancer patients receiving NAC, with and without COVID-19, we evaluated the impact of COVID-19 on NAC response using multivariable logistic regression and three matching methods: propensity score matching, inverse probability of treatment weighting, and overlap weighting. Using single-cell and bulk transcriptome data from the Gene Expression Omnibus and genetic variants from the Genome-Wide Association Study databases, we conducted Mendelian randomization (MR) analysis to explore the core cellular subsets, shared genes, causal relationships, and common pathogenic mechanisms between COVID-19 and breast cancer.</div></div><div><h3>Results</h3><div>Patients with breast cancer and COVID-19 showed poor NAC responses, including a low objective response rate and reduced likelihood of achieving RCB class 0-I in the HR+/HER2+ subgroup (OR = 0.46, <em>P</em> = 0.028, <em>P</em> for interaction = 0.024). The consistent findings from the three matching models support these results. Integrating single-cell and bulk transcriptome data with MR analyses revealed genetic correlations between COVID-19 and breast cancer and identified <em>ABLIM1</em> and <em>GZMM</em> as potential genes linked to NAC resistance.</div></div><div><h3>Conclusion</h3><div>SARS-CoV-2 infection during NAC may compromise therapeutic efficacy in patients with breast cancer. <em>ABLIM1</em> and <em>GZMM</em> may be causal genes in the genetic correlation between COVID-19 and breast cancer.</div></div><div><h3>Trial registration</h3><div>This study received retrospective registration and approval from the Ethics Committee of Fujian Medical University Union Hospital (Ethical Committee Approval No. 2024KY232).</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110496"},"PeriodicalIF":2.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine green-guided lymphadenectomy in gastric cancer after neoadjuvant chemotherapy: A systematic review and meta-analysis","authors":"Marcelo Henrique Ferreira Fernandes ,&nbsp;Ana Paula Valério-Alves ,&nbsp;Raphaela Anderson Colares ,&nbsp;José Vitor de França Xavier ,&nbsp;Thales Paulo Batista ,&nbsp;Euclides Dias Martins Filho ,&nbsp;Rafael Morriello ,&nbsp;Paulo Kassab","doi":"10.1016/j.ejso.2025.110499","DOIUrl":"10.1016/j.ejso.2025.110499","url":null,"abstract":"<div><h3>Introduction</h3><div>Indocyanine green (ICG) fluorescence imaging is emerging as a valuable tool in gastric cancer (GC) surgery. However, concerns remain about whether its efficacy is diminished following neoadjuvant chemotherapy (NAC), and its use remains controversial.</div></div><div><h3>Material and methods</h3><div>We searched PubMed, Embase and Cochrane Library for studies comparing ICG-guided with conventional lymphadenectomy in GC patients following NAC. The main outcomes were the total number of retrieved lymph nodes (LNR), proportion of patients with ≥30 LNs retrieved (PLN), non-compliance rate (NCR), estimated blood loss (EBL), length of hospital stay (LOS), operative time (OT) and overall complications (OC). Statistical analyses were performed using Review Manager 5.4.1.</div></div><div><h3>Results</h3><div>Five studies involving 694 patients treated with NAT were included, of which 344 used ICG and 350 conventional surgeries. ICG significantly increased LNR (MD = 8.98; 95 % CI: 6.76–11.20; p &lt; 0.00001; I² = 0 %), raised the chance of ≥30 LNs (RR = 1.31; 95 % CI: 1.19–1.44; p &lt; 0.00001; I² = 0 %), and reduced LN non-compliance (RR = 0.65; 95 % CI: 0.52–0.81; p &lt; 0.0001; I² = 0 %). Operative time was a little longer (MD = 7.73 min; 95 % CI: 4.72–10.73; p = 0.004; I² = 0 %). ICG slightly reduced blood loss (MD = −26.22 mL; 95 % CI: −49.76 to −2.69; p = 0.04; I² = 56 %) and length of stay (MD = −0.36 days; 95 % CI: −0.64 to −0.07; p = 0.03; I² = 0 %), with similar overall complications (RR = 0.92; 95 % CI: 0.79–1.08; p = 0.20; I² = 0 %).</div></div><div><h3>Conclusions</h3><div>ICG guidance improves the quality of D2 lymphadenectomy after NAC by higher nodal yield, greater likelihood of obtaining ≥30 LNs, and lower non-compliance rate, without increased morbidity. These findings highlight the potential of ICG to enhance surgical outcomes in this population.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110499"},"PeriodicalIF":2.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence patterns following CRS-HIPEC in patients with colorectal peritoneal metastases: Insights from the Dutch CRS-HIPEC registry","authors":"T.B.M. van den Heuvel ,&nbsp;F.N. van Erning ,&nbsp;P.H.J. Hemmer ,&nbsp;E.V.E. Madsen ,&nbsp;P.R. de Reuver ,&nbsp;R.J. Wiezer ,&nbsp;A.J. Witkamp ,&nbsp;I.H.J.T. De Hingh","doi":"10.1016/j.ejso.2025.110501","DOIUrl":"10.1016/j.ejso.2025.110501","url":null,"abstract":"<div><h3>Introduction</h3><div>Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is currently the only treatment with curative intent for selected patients with colorectal peritoneal metastases. This population-based study determined the 3-year cumulative incidence of disease recurrence after CRS-HIPEC, identified factors associated with disease recurrence and described how recurrent disease is treated.</div></div><div><h3>Materials and methods</h3><div>All patients who underwent complete CRS-HIPEC for non-appendiceal colorectal peritoneal metastases with or without extra-peritoneal metastases in 2019 were selected from the Dutch CRS-HIPEC registry. Follow up data were collected in 2023–2024. Three-year cumulative incidence of recurrence was calculated. Multivariable Cox competing risk regression analysis was used to identify factors associated with recurrence.</div></div><div><h3>Results</h3><div>A total of 157 patients was analysed with a median follow-up of 31.0 (IQR 17.8–49.5) months. The 3-year cumulative incidence of disease recurrence was 86.3 %. Three-year recurrence-free and overall survival were 13.7 % and 47.8 % respectively. The most common sites of first recurrence were the peritoneum (68.2 %), liver (40.2 %) and lung (37.9 %). Treatment of recurrence was performed in 80.3 % of patients. Treatment mostly entailed systemic therapy (67.9 %). Secondary CRS-HIPEC was performed in 7.6 % of the patients. Factors associated with a higher risk of recurrence were a higher Peritoneal Cancer Index score (HR 1.06, 95 % CI 1.03–1.09) and pN2 (HR 2.07, 95 % CI 1.28–3.36).</div></div><div><h3>Conclusion</h3><div>Most patients that underwent CRS-HIPEC for colorectal peritoneal metastases developed recurrent disease within 3 years. Future research should focus on ongoing developments in both diagnostics and treatment to prevent early recurrence.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110501"},"PeriodicalIF":2.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of body mass index on postoperative mortality after pancreatic resection: A systematic review and meta-analysis","authors":"Zi-Yu Tai ,&nbsp;Meng-Yao Li ,&nbsp;Min Sun ,&nbsp;Xin-Yun Li ,&nbsp;Chun-Dong Zhang","doi":"10.1016/j.ejso.2025.110500","DOIUrl":"10.1016/j.ejso.2025.110500","url":null,"abstract":"<div><div>To date, no meta-analysis has investigated the impact of body mass index (BMI) on postoperative mortality after pancreatic resections, and the relationship between BMI (overweight and obesity) and the risk of postoperative mortality remains largely unknown. Here, we aimed to clarify the impact of BMI on postoperative mortality after pancreatic resections. We comprehensively searched PubMed, Embase, Web of Science, and Google Scholar for relevant articles published up to June 2024. Odds ratios (ORs) and the corresponding 95 % confidence intervals (CIs) were used to synthesize and estimate results using random-effects models. Subgroup and sensitivity analyses were conducted to confirm the robustness of the main findings. The PRISMA 2020 guidelines was applied. We identified 29 studies comprising 110,885 participants. Individuals who were overweight or obese had a 52 % higher risk of postoperative mortality after pancreatic resection compared with non-overweight individuals (OR 1.52, 95 % CI 1.24–1.86), whereas obese individuals had a 66 % higher risk compared with non-obese individuals (OR 1.66, 95 % CI 1.38–1.99). The finding was consistent and robust across most subgroups and in sensitivity analyses. Overweight and obesity increased the risk of postoperative mortality following pancreatic resection, whereas in high-volume hospitals, the risk of postoperative mortality for obesity or overweight patients showed comparable outcomes compared to non-overweight individuals. Therefore, it is preferred for obese or overweight patients to receive pancreatic surgery in high-volume hospitals.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110500"},"PeriodicalIF":2.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An onco-vascular surgical approach: Internal iliac artery transposition for external iliac artery repair during cytoreductive surgery","authors":"Ezgi Altınsoy ,&nbsp;Veysel Cem Özcan ,&nbsp;Hikmat Zeynalov ,&nbsp;Enes Cebeci̇ ,&nbsp;Selim Tamam ,&nbsp;Serdar Çulcu ,&nbsp;Ali Ekrem Ünal","doi":"10.1016/j.ejso.2025.110503","DOIUrl":"10.1016/j.ejso.2025.110503","url":null,"abstract":"<div><h3>Background</h3><div>Cytoreductive surgery (CRS) in advanced pelvic malignancies may require resection of major vessels, including the external iliac artery (EIA). The aim of this study was to assess the feasibility and safety of ipsilateral transposition of the internal iliac artery as a reconstructive technique for the management of external iliac artery defects.</div></div><div><h3>Methods</h3><div>Between 2015 and 2024, six patients underwent CRS with EIA resection and reconstruction using ipsilateral IIA transposition at an expert center in surgical oncology. Postoperative vascular assessment was performed using Doppler ultrasonography and ankle-brachial index (ABI) measurements in all patients, with the exception of one patient who underwent CT angiography and conventional angiography.</div></div><div><h3>Results</h3><div>The cohort included four female and two male patients with a mean age of 58.5 years. Diagnoses included serous ovarian carcinoma (n = 2), liposarcoma (n = 2), and colorectal carcinoma (n = 2); four patients had recurrent disease. Postoperative complications occurred in four patients (67 %), including surgical site infection in two patients, urinary leakage in one patient, and enterocutaneous fistula in one patient; however, no vascular complications were observed. There was no 30-day postoperative mortality, and two patients died within the first year; one from enterocutaneous fistula complications and one from metastatic disease. Among the surviving patients, none developed chronic limb ischemia or any other symptoms related to the vascular anastomosis.</div></div><div><h3>Conclusion</h3><div>Internal iliac artery transposition is a safe and effective autologous reconstruction technique for EIA defects during CRS. This approach offers reliable vascular repair without extending operative time and may support complete oncologic resection while minimizing morbidity.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110503"},"PeriodicalIF":2.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145263697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}