Ejso最新文献

{"title":"Invasive Pleomorphic Lobular Carcinoma of the breast: Clinicopathological features, treatment patterns and outcomes","authors":"N Peradze ,&nbsp;A Polizzi ,&nbsp;E Pagan ,&nbsp;E Bottazzoli ,&nbsp;V Bagnardi ,&nbsp;C Sangalli ,&nbsp;C Morigi ,&nbsp;E De Camili ,&nbsp;P Rafaniello Raviele ,&nbsp;G Corso ,&nbsp;V Galimberti ,&nbsp;M Colleoni ,&nbsp;P Veronesi","doi":"10.1016/j.ejso.2025.109714","DOIUrl":"10.1016/j.ejso.2025.109714","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleomorphic lobular carcinoma (PLC) is a rare variant of invasive lobular carcinoma of the breast (ILC) and few studies have reported controversial data regarding its outcomes.</div><div>The information provided appears to indicate that PLC is more aggressive and has worse outcome when compared to classical ILC (cILC); however, due to its rarity, studies with a considerable cohort of patients are lacking.</div><div>The purpose of this study was to compare the clinicopathological characteristics and disease outcomes of PLC patients to those with cILC in a large cohort from a single institution.</div></div><div><h3>Methods</h3><div>A retrospective comparative study was performed, including 226 patients with PLC and 2067 patients with cILC operated at the European Institute of Oncology (EIO) between 2001 and 2018. The median follow-up period for both groups was 7 years.</div></div><div><h3>Results</h3><div>5- and 10-years invasive disease-free survival were better in the matched classical lobular carcinoma patients compared to the pleomorphic variant.</div><div>The 5- and 10-years overall survival confirmed the trend previously seen in favor of the classical variant, with a 5-year survival of 98.4% vs 83.6% and a 10-year survival of 93.4% vs 69.5%, respectively.</div></div><div><h3>Conclusions</h3><div>The pleomorphic variant has been confirmed to be characterized by worse clinicopathological characteristics and worse clinical outcomes than the classical variant.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109714"},"PeriodicalIF":3.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508096","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":"Artificial intelligence-based model to predict recurrence after local excision in T1 rectal cancer","authors":"Jiarui Su ,&nbsp;Zhiyuan Liu ,&nbsp;Haiming Li ,&nbsp;Li Kang ,&nbsp;Kaihong Huang ,&nbsp;Jiawei Wu ,&nbsp;Han Huang ,&nbsp;Fei Ling ,&nbsp;Xueqing Yao ,&nbsp;Chengzhi Huang","doi":"10.1016/j.ejso.2025.109717","DOIUrl":"10.1016/j.ejso.2025.109717","url":null,"abstract":"<div><h3>Background</h3><div>According to current guideline, patients with resected specimens showing high-risk features are recommended additional surgery after local excision (LE) of T1 colorectal cancer, despite the low incidence of recurrence. However, surgical resection in patients with low rectal cancer (RC) is challenging and may compromise anal function, leading to a low quality of life. To reduce unnecessary surgical resection in these patients, we used artificial intelligence (AI) to develop and validate a prediction model for the risk of recurrence after LE.</div></div><div><h3>Materials and methods</h3><div>We constructed an artificial neural network (ANN) to predict recurrence using pathological images from endoscopically or transanal surgically resected T1 RC specimens. Data were retrospectively obtained from two hospitals between 2001 and 2015. The model was constructed using 496 images obtained from the Guangdong Provincial People's Hospital (GDPH), and then validated using independent external datasets (150 images from Sun Yat-sen Memorial Hospital [SYSMH]) to verify its generalizability.</div></div><div><h3>Results</h3><div>The ANN model yielded good discrimination, achieving areas under the receiver operating characteristic curves (AUC) of 0.979 in the training cohort (GDPH). The AUC for the validation cohort (SYSMH) was 0.978. More importantly, the AI-based prediction model avoided more than 34.9 % of unnecessary additional surgeries compared with the current US guideline in all enrolled patients.</div></div><div><h3>Conclusions</h3><div>We propose a novel ANN model for the risk of recurrence prediction in patients with T1 RC to provide physicians and patients guidance for decisions after LE. Furthermore, this may lead to a reduction in unnecessary invasive surgeries in patients with T1 RC.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109717"},"PeriodicalIF":3.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550927","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":"Additional breast lesions on MRI in patients with small early stage luminal type breast cancer: Important consequences for future thermal ablation treatment","authors":"Sophie M. Wooldrik ,&nbsp;Linda Riks ,&nbsp;Gerson M. Struik ,&nbsp;Frank Hulsebosch ,&nbsp;Cornelis Verhoef ,&nbsp;Taco M.A.L. Klem","doi":"10.1016/j.ejso.2025.109715","DOIUrl":"10.1016/j.ejso.2025.109715","url":null,"abstract":"<div><div>In this study, data from 50 postmenopausal women with unilateral cT1N0 breast cancer, who underwent MRI as part of the THERMAC trial for a thermal ablation protocol, were analyzed. Additional MRI findings were classified as benign or malignant based on histopathology. Results showed that 30 % of patients had additional MRI findings, with 40 % of those being malignant, which led to exclusion from the trial and altered surgical management. Malignant lesions included lobular carcinoma, NST tumors, and multifocal/multicentric disease, while benign findings were predominantly fibroadenomas, cysts, and mastopathy. Malignant lesions required changes in the treatment approach, including exclusion from the ablation protocol, wider excisions, and in some cases, mastectomy. The study highlights the significant role of MRI in patient selection and treatment planning, emphasizing the need for further investigation into the long-term oncological outcomes in early-stage breast cancer patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109715"},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of a gene signature and prediction of overall survival of patients with stage IV colorectal cancer using a novel machine learning approach","authors":"Abdullah Altaf ,&nbsp;Jun Kawashima ,&nbsp;Mujtaba Khalil ,&nbsp;Hunter Stecko ,&nbsp;Zayed Rashid ,&nbsp;Matthew Kalady ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.ejso.2025.109718","DOIUrl":"10.1016/j.ejso.2025.109718","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to characterize unique gene signature patterns associated with worse overall survival (OS) among patients with stage IV colorectal cancer (CRC) using a machine learning (ML) approach.</div></div><div><h3>Methods</h3><div>Data from the AACR GENIE registry were analyzed for genetic variations (somatic mutations, structural variants and copy number alterations) among patients with CRC. Adult patients (≥18 years) with histologically confirmed stage IV CRC who underwent next-generation sequencing were included. An eXtreme Gradient Boosting (XGBoost) model was developed to predict OS and the relative importance of different genetic alterations was determined using SHapley Additive exPlanations (SHAP) algorithm.</div></div><div><h3>Results</h3><div>Among 688 patients with stage IV CRC, 54.4 % were male (n = 374) with a median age of 55 years (IQR, 46–64). An XGBoost model developed using the 200 most frequent genetic alterations demonstrated good performance to predict OS with a c-index of 0.701 (95 % CI: 0.675–0.726) on 5-fold cross-validation. The model achieved time-dependent AUC of 0.742, 0.757 and 0.793 at 12-, 24- and 36-months, respectively. The SHAP algorithm identified the top 20 genetic alterations most strongly predictive of worse OS among stage IV CRC patients. Based on the 20-gene signature, individuals at high risk had worse 12- and 36-month OS versus low-risk patients (82.6 % vs. 97.1 % and 30.1 % vs. 72.6 %, respectively; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The XGBoost ML model identified a unique gene signature that accurately risk stratified stage IV CRC patients. ML models that incorporate molecular information represent an opportunity to predict long-term outcomes and potentially identify novel therapeutic targets for stage IV CRC patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 5","pages":"Article 109718"},"PeriodicalIF":3.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471170","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":"Reply to: Enhancing feature importance analysis with Spearman's correlation with p-values: Recommendations for improving PHLF prediction.","authors":"Simone Famularo, Flavio Milana, Matteo Donadon","doi":"10.1016/j.ejso.2025.109686","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.109686","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"109686"},"PeriodicalIF":3.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499851","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":"Efficacy and safety of subtotal pelvic peritonectomy for colorectal cancer patients with peritoneal metastasis confined to the pelvic cavity","authors":"Jinghua Tang ,&nbsp;Leen Liao ,&nbsp;Binyi Xiao ,&nbsp;Qiaoqi Sui ,&nbsp;Muxu Zheng,&nbsp;Wu Jiang,&nbsp;Kai Han,&nbsp;Lingheng Kong,&nbsp;Zhizhong Pan,&nbsp;Peirong Ding","doi":"10.1016/j.ejso.2025.109703","DOIUrl":"10.1016/j.ejso.2025.109703","url":null,"abstract":"<div><h3>Background</h3><div>Cytoreductive surgery has shown survival benefits for colorectal cancer (CRC) patients with peritoneal metastasis. However, the optimal extent of peritonectomy remains controversial in cases of limited peritoneal metastases. This study modified selective pelvic peritonectomy (SPP) into subtotal pelvic peritonectomy (STPP) for metastasis confined to pelvic cavity, and aimed to evaluate its feasibility, safety, and impact on survival outcomes.</div></div><div><h3>Materials and methods</h3><div>CRC patients with limited peritoneal metastasis confined to the pelvic cavity who underwent CC0 (no macroscopic residual cancer remained) resection were included from a prospectively collected database. Surgical complications, disease-free survival (DFS), and overall survival (OS) were analyzed.</div></div><div><h3>Results</h3><div>A total of 67 patients were included (26 in the STPP group and 41 in the SPP group). Clinically, STPP was found to be feasible and without increased surgical complications or mortality rates. At a median follow-up of 33.9 months, the 3-year DFS was 65.9 % and 30.7 % in STPP and SPP groups, respectively (<em>P</em> <em>=</em> 0.002). The 3-year OS was 84.1 % and 68.5 % in STPP and SPP groups, respectively (<em>P</em> <em>=</em> 0.006). Moreover, STTP was independently associated with improved DFS (<em>HR</em> = 0.351, 95 % <em>CI</em> 0.165–0.745, <em>P</em> <em>=</em> 0.006) and OS (<em>HR</em> = 0.324, 95 % <em>CI</em> 0.116–0.902, <em>P=</em>0.032). Female gender was also independently associated with poor DFS (<em>HR</em> = 2.146, 95 % <em>CI</em> 1.078–4.271, <em>P</em> <em>=</em> 0.031). Among 24 female patients with remaining ovaries, 9 (37.5 %) cases developed metachronous ovarian metastasis, and of these 6 underwent a second operation.</div></div><div><h3>Conclusions</h3><div>Subtotal pelvic peritonectomy is associated with promising long-term outcomes in CRC patients with peritoneal metastasis confined to the pelvic cavity. Prophylactic bilateral oophorectomy should be strongly considered during cytoreductive surgery.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 5","pages":"Article 109703"},"PeriodicalIF":3.5,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512012","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":"Machine learning model based on preoperative contrast-enhanced CT and clinical features to predict perineural invasion in gallbladder carcinoma patients","authors":"Hengchao Liu,&nbsp;Zhenqi Tang,&nbsp;Xue Feng,&nbsp;Yali Cheng,&nbsp;Chen Chen,&nbsp;Dong Zhang,&nbsp;Jianjun Lei,&nbsp;Zhimin Geng,&nbsp;Qi Li","doi":"10.1016/j.ejso.2025.109697","DOIUrl":"10.1016/j.ejso.2025.109697","url":null,"abstract":"<div><h3>Background</h3><div>Perineural invasion (PNI) is an independent prognostic risk factor for gallbladder carcinoma (GBC). However, there is currently no reliable method for the preoperative noninvasive prediction of PNI.</div></div><div><h3>Methods</h3><div>This retrospective study included 180 patients with pathologically diagnosed GBC who underwent preoperative contrast-enhanced CT between January 2022 to December 2023 at one high-volume medical center from China. K-Nearest Neighbors (KNN), LightGBM (LGB), Logistic Regression (LR), XGBoost (XGB), Naive Bayes (NB), and Support Vector Machine (SVM) were employed to develop prediction models. The Shapley additive explanations (SHAP) were used to visualize models and rank the importance of features associated with PNI.</div></div><div><h3>Results</h3><div>Total bilirubin, CA19-9, imaging liver invasion, vascular invasion, T staging and N staging were identified as risk factors for PNI (<em>P</em> &lt; 0.05). The LightGBM model demonstrated the improved performance in the testing set, with the AUCs of 0.886 and 0.795 in the training and testing sets, respectively. In four machine learning algorithms prediction models demonstrated improved performance included three imaging features (imaging T staging, N staging, and vascular invasion) and two clinical features (TBIL and CA19-9). When these features were employed to develop the prediction models, the LightGBM model exhibited the higher performance than other machine learning modes in the testing set, with AUCs of 0.843 and 0.802, and ACCs of 0.786 and 0.759 in the training and testing sets, respectively.</div></div><div><h3>Conclusion</h3><div>A machine learning-based prediction model integrating contrast-enhanced CT imaging and clinical features demonstrates good performance and stability in the noninvasive preoperative identification of PNI status in GBC patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 5","pages":"Article 109697"},"PeriodicalIF":3.5,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471706","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":"Association between ERAS protocol and major postoperative complications and reasons for non-compliance in patients with esophageal cancer","authors":"Christian Geroin ,&nbsp;Jacopo Weindelmayer ,&nbsp;Serena Camozzi ,&nbsp;Barbara Leone ,&nbsp;Cecilia Turolo ,&nbsp;Maria Bencivenga ,&nbsp;Michele Sacco ,&nbsp;Carlo Alberto De Pasqual ,&nbsp;Ermes Vedovi ,&nbsp;Simone Priolo ,&nbsp;Simone Giacopuzzi","doi":"10.1016/j.ejso.2025.109707","DOIUrl":"10.1016/j.ejso.2025.109707","url":null,"abstract":"<div><h3>Introduction</h3><div>The association between each Enhanced Recovery After Surgery (ERAS) component and the incidence of major postoperative complications following Ivor Lewis or McKeown surgery is understudied. Therefore, we wanted to determine the association between ERAS components, major postoperative complications, and the reasons for non-compliance with the ERAS program.</div></div><div><h3>Methods</h3><div>Data were extracted from the prospective ERAS Registry managed by the University of Verona, Italy. We searched and compared the data for postoperative major complications (Clavien-Dindo Classification ≥3B) and reasons for non-compliance with 15 ERAS items in patients undergoing Ivor Lewis or McKeown surgery with radical intent for esophageal or esophagogastric junction cancer.</div></div><div><h3>Results</h3><div>The study sample was 346 patients: 43 (12.4 %) experienced one or more postoperative major complications. When stratified by type of surgery, complications were more frequent after McKeown surgery than after Ivor Lewis surgery (15.5 % and 11.5 %, respectively). Organizational setbacks were the most common reason for non-compliance with the ERAS program. We identified several associations between clinical and patient demographic characteristics and 90-day postsurgical complications. The multivariate model indicated an association between fewer major postoperative complications after Ivor Lewis surgery and adherence to the protocol items “soft diet intake” (adjusted odds ratio [OR], 0.23; 95 % confidence interval [CI], 0.08–0.63) and “urinary catheter removal” (adjusted OR, 0.26; 95 % CI, 0.10–0.63).</div></div><div><h3>Discussion/conclusions</h3><div>Major complications are relatively frequent, especially after McKeown surgery. What remains uncertain is whether ERAS items can predict the occurrence of postoperative complications. Adherence to the protocol may be influenced by the co-occurrence of complications, comorbidities, and organizational setbacks.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 5","pages":"Article 109707"},"PeriodicalIF":3.5,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic role of postoperative persistence of ctDNA molecular signature after liver resection for colorectal liver metastases: Preliminary results from a prospective study","authors":"Roberto Montalti ,&nbsp;Francesco Pepe ,&nbsp;Gianluca Cassese ,&nbsp;Gianluca Russo ,&nbsp;Umberto Malapelle ,&nbsp;Chiara Carlomagno ,&nbsp;Mariano Cesare Giglio ,&nbsp;Giacinto Falco ,&nbsp;Mariantonietta Alagia ,&nbsp;Giuseppe De Simone ,&nbsp;Karen Geboes ,&nbsp;Giancarlo Troncone ,&nbsp;Roberto Ivan Troisi ,&nbsp;Gianluca Rompianesi","doi":"10.1016/j.ejso.2025.109706","DOIUrl":"10.1016/j.ejso.2025.109706","url":null,"abstract":"<div><h3>Introduction</h3><div>Liver resection represents the cornerstone treatment for Colo-Rectal Liver Metastases (CRLM), but it is still followed by a high recurrence rate. The identification of a valid and reproducible predictor of recurrence can play a key role in correct and timely management of the disease. In this scenario, liquid biopsy may represent an integrative, less invasive, and easily manageable tool to clinically stratify colorectal cancer patients.We aimed to investigate the prognostic role of persistent circulating tumor DNA (ctDNA) signature on CRLM recurrence after liver resection.</div></div><div><h3>Methods</h3><div>A series of 51 consecutive patients undergoing liver resection for CRLM were prospectively enrolled between January 2020 and March 2023. Patients underwent liquid biopsy from peripheral blood samples before and after surgery. Other risk factors for disease recurrence were also investigated.</div></div><div><h3>Results</h3><div>Twenty-nine patients were found to be positive for one of the clinically relevant molecular alterations detected by NGS, at preoperative (T0) ctDNA analysis. At univariate analysis, total tumor size bigger than 60 mm (p = 0.046, HR 2.486) and postoperative persistence of ctDNA molecular signature (p = 0.024, HR 2.831) were significantly associated with recurrence. Multivariable Cox Regression analysis showed that only postoperative persistence of ctDNA molecular signature was associated with recurrence (p = 0.027, HR 2.766). Similarly, 1–3 yr DFS was significantly lower in the subgroup with persistence of molecular signature at liquid biopsy (100–49.5 % vs 57.1–21.4 %, p = 0.018).</div></div><div><h3>Conclusion</h3><div>Postoperative persistence of ctDNA molecular signature could represent a useful tool to predict recurrence after liver resection for CRLM patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109706"},"PeriodicalIF":3.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488115","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 lymphadenectomy rates in the quality assurance program in early ovarian cancer of the AGO Study Group – Real-world observations","authors":"Pauline Wimberger ,&nbsp;Jacobus Pfisterer ,&nbsp;Andreas du Bois ,&nbsp;Felix Hilpert ,&nbsp;Markus Kerkmann ,&nbsp;Jalid Sehouli ,&nbsp;Sven Mahner ,&nbsp;Nikolaus de Gregorio ,&nbsp;Lars Hanker ,&nbsp;Florian Heitz ,&nbsp;Frederik Marmé ,&nbsp;Linn Wölber ,&nbsp;Laura Holtmann ,&nbsp;Gabriele Elser ,&nbsp;Philipp Harter ,&nbsp;for the AGO Study Group","doi":"10.1016/j.ejso.2025.109696","DOIUrl":"10.1016/j.ejso.2025.109696","url":null,"abstract":"<div><h3>Objectives</h3><div>The German quality assurance program (QS-Ovar) representatively documents treatment and survival for patients with the initial diagnosis of primary ovarian cancer in the third quarters of 2004, 2008, 2012, 2016, and 2021. We evaluate lymphadenectomy (LNE) rates in dependence on histologic subtype and outcome for early ovarian cancer FIGO I.</div></div><div><h3>Methods</h3><div>Therapy quality was defined according to national guidelines. Surgical quality was categorized as “optimal“ (SUR+: maximum 1 surgical item missing), versus “suboptimal“ (SUR-); analogous categorization “optimal“ systemic treatment (CT+) and “suboptimal“ (CT-).</div></div><div><h3>Results</h3><div>Overall, 832 pts. (19.3 %) were diagnosed with FIGO I, of them 47.6 % with FIGO IC, 35.7 % had a high-grade serous subtype, 5.0 % low-grade serous, 6.9 % low-grade endometrioid, 18 % high-grade endometrioid, 11 % clear cell, and 18 % mucinous tumors. The optimal surgical standard increased from 21.1 % (2004) to 53.0 % (2012). Surgical quality has remained unchanged in 2021 with 53.8 % and SUR + -subgroup with 74.2 %. The rate of pelvic and para-aortic lymphadenectomy increased over time for high-grade serous and clear cell carcinoma and decreased for mucinous carcinoma. In 2021, 67.6 % had ≥25 resected lymph-nodes in high-grade serous, 46.2 % in low-grade serous, 52.2 % in high-grade endometrioid, 35.3 % in low-grade endometrioid, 74.1 % in clear cell and 35.7 % in mucinous tumors. In 2021, the SUR+/CT + -subgroup decreased to 62.9 % versus 69.2 % in 2016. Four-year-disease-free-survival was 86 % for SUR+/CT+, 78 % for SUR-/CT+, 68 % for SUR+/CT- and 57 % for SUR-/CT- (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>One therapy modality cannot replace another one. Although urgently required, quality of therapy has not improved in 2021.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109696"},"PeriodicalIF":3.5,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}