Ejso最新文献

{"title":"Perioperative dynamic changes of systemic inflammatory biomarkers predict tumor recurrence following curative-intent resection of hepatocellular carcinoma","authors":"Jingming Lu ,&nbsp;Fumin Wang ,&nbsp;Yaoxing Ren ,&nbsp;Yu An ,&nbsp;Francesca Ratti ,&nbsp;Hugo P. Marques ,&nbsp;Silvia Silva ,&nbsp;Olivier Soubrane ,&nbsp;Vincent Lam ,&nbsp;George A. Poultsides ,&nbsp;Irinel Popescu ,&nbsp;Razvan Grigorie ,&nbsp;Sorin Alexandrescu ,&nbsp;Guillaume Martel ,&nbsp;Aklile Workneh ,&nbsp;Andrea Ruzzenente ,&nbsp;Tom Hugh ,&nbsp;Luca Aldrighetti ,&nbsp;Itaru Endo ,&nbsp;Yi Lyu ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.ejso.2025.110320","DOIUrl":"10.1016/j.ejso.2025.110320","url":null,"abstract":"<div><h3>Background</h3><div>Hepatic inflammation during liver resection induces immune dysregulation. We sought to investigate how surgical stress reshapes systemic inflammation and affects tumor recurrence following surgical resection of hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>Patients who underwent curative resection of HCC between 2000 and 2022 were identified from an international multicenter cohort. We longitudinally quantified perioperative inflammatory dynamics, particularly neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII). The primary endpoint was recurrence-free survival (RFS). Model performance was validated through bootstrap resampling (1000 iterations) and ROC analysis.</div></div><div><h3>Results</h3><div>A total of 745 patients were included. Among the dynamic changes of inflammation cells count, only changes in NLR at postoperative day 3 versus preoperative value (ΔNLR3) was identified as a strong predictor associated with HCC recurrence (HR 1.005, 95 % 1.002–1.009; <em>p</em> = 0.002). The optimal cutoff value of <span><math><mrow><mo>Δ</mo><mi>N</mi><mi>L</mi><mi>R</mi><mn>3</mn></mrow></math></span> was defined as 47, and patients with <span><math><mrow><mo>Δ</mo><mi>N</mi><mi>L</mi><mi>R</mi><mn>3</mn></mrow></math></span> ≥ 47 had 75 % increased risk of tumor recurrence versus individuals with <span><math><mrow><mo>Δ</mo><mi>N</mi><mi>L</mi><mi>R</mi><mn>3</mn></mrow></math></span> &lt; 47 (HR 1.75, 95 % CI 1.35–2.28, p &lt; 0.001). Moreover, <span><math><mrow><mo>Δ</mo><mi>N</mi><mi>L</mi><mi>R</mi><mn>3</mn></mrow></math></span> could be utilized in differentiating high-versus low-recurrence risk patients with early staged HCC. By combining <span><math><mrow><mo>Δ</mo><mi>N</mi><mi>L</mi><mi>R</mi><mn>3</mn></mrow></math></span> with tumor-associated risk factors, we created an <em>InfTumMod</em> model, which demonstrated very good predictive accuracy of 70 % relative to tumor recurrence within the first three years following surgical resection of HCC.</div></div><div><h3>Conclusions</h3><div>The ΔNLR3 index reflected systemic inflammation and risk of tumor recurrence. The <em>InfTumMod</em> model incorporated inflammation index and tumor characteristics, which can help identify patients at higher risk of recurrence and mortality.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110320"},"PeriodicalIF":3.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604736","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 the type of pre-existing adenoma and response of rectal cancer to neoadjuvant therapy","authors":"Sameh Hany Emile ,&nbsp;Nir Horesh ,&nbsp;Zoe Garoufalia ,&nbsp;Anjelli Wignakumar ,&nbsp;Michal Perets ,&nbsp;Ebram Salama ,&nbsp;Steven D. Wexner","doi":"10.1016/j.ejso.2025.110319","DOIUrl":"10.1016/j.ejso.2025.110319","url":null,"abstract":"<div><h3>Background</h3><div>Several factors influence response to neoadjuvant therapy (NAT) for locally advanced rectal cancer. One potentially relevant factor not previously studied is the type of pre-existing adenoma. We aimed to investigate the association between the type of pre-existing adenoma and response of rectal cancer to NAT and examine the tumor characteristics by adenoma type.</div></div><div><h3>Methods</h3><div>This study was a retrospective review of patients with stage II-III rectal adenocarcinomas from the NCDB (2004–2017) who underwent proctectomy after NAT. Rectal cancers were classified and compared by the type of pre-existing adenomas: villous adenoma (VA), tubular adenoma (TA), and tubulovillous adenoma (TVA)-associated carcinomas. Case-control analysis of failure of response to NAT was conducted, including type of pre-existing adenoma as a potential covariate.</div></div><div><h3>Results</h3><div>2760 patients (69.6 % male; mean age: 59.9 years) with stage II (44.8 %) or stage III (55.2 %) rectal cancers were included. Most adenomas were TVA (78.4 %), followed by VA (21.1 %) and TA (0.5 %). 55.5 % of patients showed complete response (10 %) and partial (downstaging; 45.5 %) response after NAT. 64.3 % of TA-associated rectal carcinomas failed to respond to NAT compared to 46.4 % and 43.9 % of VA and TVA-associated carcinomas, respectively (p = 0.388). Independent predictors of failure of response to NAT were stage II disease (OR: 1.85, p &lt; 0.001), high tumor grade (OR: 1.94, p = 0.007), LVI (OR: 3.34, p &lt; 0.001), PNI (OR: 1.69, p = 0.032), and elevated pretreatment CEA (OR: 1.54, p = 0.002).</div></div><div><h3>Conclusions</h3><div>TA-associated carcinomas exhibited the lowest response to NAT, although not statistically significant. Predictors for failure of response to NAT were stage II disease, high tumor grade, LVI and PNI, and elevated pretreatment CEA levels.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110319"},"PeriodicalIF":3.5,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623768","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":"Long term outcomes of breast primary sarcomas and malignant phyllodes tumors: 20 years observational analysis of the BEAM∗ study group. (∗the breast European association for mesenchymal tumors)","authors":"Alejandro M. Sanchez ,&nbsp;Flavia De Lauretis ,&nbsp;Angela Bucaro ,&nbsp;Chiara V. Pirrottina ,&nbsp;Niccolò Borghesan ,&nbsp;Antonio Franco ,&nbsp;Lorenzo Scardina ,&nbsp;Diana Giannarelli ,&nbsp;Alba Di Leone ,&nbsp;Riccardo Masetti ,&nbsp;Armando Orlandi ,&nbsp;Alessandra Fabi ,&nbsp;Antonella Palazzo ,&nbsp;Ilaria Poli ,&nbsp;Angela Santoro ,&nbsp;Antonino Mulè ,&nbsp;Nicoletta D’Alessandris ,&nbsp;Fabio Marazzi ,&nbsp;Valeria Masiello ,&nbsp;Valeria Verusio ,&nbsp;Jenny C. Millochau","doi":"10.1016/j.ejso.2025.110265","DOIUrl":"10.1016/j.ejso.2025.110265","url":null,"abstract":"<div><h3>Background</h3><div>Primary breast sarcomas (PBS) and malignant phyllodes tumors (MPT) represent less than 1 % of breast malignancies. Current evidence relies on heterogeneous retrospective series, resulting in controversial therapeutic approaches. This study aimed to analyze long-term outcomes in a large multicentric cohort treated with consistent strategies.</div></div><div><h3>Materials and methods</h3><div>We conducted a multicentric retrospective study involving 113 patients treated for PBS (n = 42), MPT (n = 47), and mixed cases (MC, n = 24) at 11 European breast units between 2000 and 2020. Primary endpoint was disease-free survival (DFS). Secondary endpoints included overall survival (OS), local recurrence rate (LRR), and positive margin, re-excision, and axillary involvement rates. Survival analyses were performed using the Kaplan-Meier method and log-rank test.</div></div><div><h3>Results</h3><div>With a median follow-up of 95 months, the 10-year OS, DFS, and LRR for the entire cohort were 75.2 %, 61.9 %, and 18.4 %, respectively. Mixed cases exhibited the poorest outcomes (10-year OS: 57.6 %, DFS: 46.1 %), followed by PBS (OS: 67.5 %, DFS: 46.5 %). MPT demonstrated better survival rates (OS: 89.2 %, DFS: 82.9 %). Significant survival factors included histological subtype, surgical margins, and age. Notably, adjuvant chemotherapy was linked to worse outcomes (HR 5.11, 95 % CI 2.16–12.09, p &lt; 0.001 for OS), likely indicating selection bias for high-risk patients.</div></div><div><h3>Conclusions</h3><div>This study represents the largest European series with a homogeneous treatment approach and long-term follow-up. MC emerge as a distinct high-risk entity, with outcomes akin to angiosarcomas. While surgery remains the cornerstone of treatment, our data challenge the current paradigm regarding adjuvant chemotherapy, highlighting the need for new strategies, particularly for high-risk subtypes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110265"},"PeriodicalIF":3.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605424","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 prediction models for portal vein thrombosis (PVT) in patients after splenectomy: A systematic review and meta-analysis","authors":"Lumei Huang ,&nbsp;Yinfeng Han ,&nbsp;Yufeng Li,&nbsp;Juan Li","doi":"10.1016/j.ejso.2025.110300","DOIUrl":"10.1016/j.ejso.2025.110300","url":null,"abstract":"<div><h3>Background</h3><div>Portal vein thrombosis (PVT) is a serious complication following splenectomy, and its early detection is crucial for preventing adverse outcomes. Several risk prediction models have been developed to identify patients who are high risk for PVT post-splenectomy. However, the accuracy and applicability of these models have not been systematically evaluated. This work aimed to conduct a systematic review and meta-analysis to assess the performance of these prediction models.</div></div><div><h3>Methods</h3><div>Two researchers searched Chinese databases (including CNKI, VIP, SinoMed, and Wanfang) and PubMed, Web of Science, the Cochrane Library, Embase and Scopus databases to find risk prediction models for PVT in patients post-splenectomy published from inception to November 2024. Two researchers independently screened the literature, extracted relevant data, and assessed the risk of bias by using the PROBAST. Key model performance metrics, including the AUC, calibration, and validation, were extracted. A meta-analysis was performed to compare the accuracy.</div></div><div><h3>Results</h3><div>This review assessed 12 studies with 3368 patients. The prevalence of PVT varied between 17.08 % and 61.73 %. The AUC ranged from 0.735 to 0.920. The pooled AUC was 0.81(0.78–0.85), indicating moderate discrimination. Notably, only three studies performed external validation, significantly constraining the generalisability of the current models. The total bias risk was high, primarily owing to retrospective designs and inadequate model validation.</div></div><div><h3>Conclusions</h3><div>The current risk prediction models for PVT post-splenectomy show moderate discrimination but exhibit variability in performance across different populations. Clinicians should consider these models part of a comprehensive risk assessment strategy, but individualised patient evaluation remains essential.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110300"},"PeriodicalIF":3.5,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605421","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":"Cosmetic outcome and patient satisfaction following percutaneous thermal ablation of early-stage breast cancer; results of an open label randomized phase 2 trial","authors":"SophieM. Wooldrik ,&nbsp;EllesM.F. van de Voort ,&nbsp;GersonM. Struik ,&nbsp;BartJ.M. Schouten ,&nbsp;Suzanne Wilhelmus ,&nbsp;Erwin Birnie ,&nbsp;Thijs van Dalen ,&nbsp;Cornelis Verhoef ,&nbsp;TacoM.A.L. Klem","doi":"10.1016/j.ejso.2025.110305","DOIUrl":"10.1016/j.ejso.2025.110305","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the present study is to assess patient reported cosmetic outcome and satisfaction following percutaneous thermal ablation and subsequent breast-conserving surgery.</div></div><div><h3>Methods</h3><div>Cosmetic outcome and patient satisfaction were assessed in postmenopausal women diagnosed with unilateral invasive cT1N0M0 breast cancer who participated in a randomized phase 2 treat-and-resect trial comparing the efficacy of radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation (CA). Cosmetic outcome was measured subjectively with the BCTOS-13 and the Beast-Q questionnaires (0–100 score), and objectively with BCCT.core software at baseline, after thermal ablation and after surgery. Patient satisfaction was defined as satisfaction with the technique (4 point scale), recommendation of the technique to others (yes/no), and the preference for surgery of thermal ablation after completion of both treatments.</div></div><div><h3>Results</h3><div>Forty-one patients were included in the study. The overall median cosmetic outcome was good after thermal ablation, and intermediate after surgery (1.6 vs 1.8; P = 0.07). Most domains of the BREAST-Q were scored higher after thermal ablation, 95 % of patients were very satisfied or satisfied with the technique, and 91 % would prefer thermal ablation over surgery. Differences between the different techniques were limited On the BCCT.core, 94 % of cases were rated as good or excellent after thermal ablation, compared to 80 % after surgery.</div></div><div><h3>Conclusion</h3><div>The present study demonstrates that patient reported and objectivated cosmetic outcomes are good both after thermal ablation and breast-conserving surgery. Patient satisfaction was outstanding following thermal ablation, with a preference for thermal ablation observed in a group of patients who underwent both treatment options.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110305"},"PeriodicalIF":3.5,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694312","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 diaphragmatic intervention in cytoreductive surgery with heated intraperitoneal chemotherapy for colorectal carcinoma","authors":"Tiffany Williams ,&nbsp;Raymond Hayler ,&nbsp;Celine Garrett ,&nbsp;Shoma Barat ,&nbsp;Ruwanthi Wijayawardana ,&nbsp;Nima Ahmadi ,&nbsp;Winston Liauw ,&nbsp;David Morris","doi":"10.1016/j.ejso.2025.110306","DOIUrl":"10.1016/j.ejso.2025.110306","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the impact of diaphragmatic intervention for patients with colorectal carcinoma undergoing cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) on overall survival and morbidity. Peritoneal Carcinomatosis Index (PCI) was used to stratify patients by low and high-volume.</div></div><div><h3>Methods</h3><div>Analysis was performed on a prospectively maintained database, from September 1996 to November 2021. Patient demographics, operative information such as PCI, as per the Jacquet and Sugarbaker description, CC score and HIPEC agent was recorded. Postoperative complications were recorded. Patients were assessed by histological subtype, colorectal carcinoma, and then separated into low and high-volume PCI (PCI&lt;15). Patient cohort was divided into CRS with diaphragm intervention (DI) and CRS with no diaphragm intervention (NDI).</div></div><div><h3>Results</h3><div>Four-hundred and thirty-five patients over this time course were diagnosed with colorectal carcinoma, and 140 (29.9 %) patients had diaphragm involvement at time of surgery. Overall survival for patients with diaphragm involvement was a median of 26.1 months, compared to NDI at 42.4 months (p &lt; 0.001). Post-operative complications were greater in the patients with diaphragmatic intervention, particularly intra-abdominal collections (DI 30.0 % (n = 42) vs NDI 22.0 % (n = 65); p &lt; 0.001), and pleural effusions (DI 16.4 % (n = 23) vs NDI 13.2 % (n = 39); p &lt; 0.001).</div><div>When considering PCI, for low volume cohort, DI patients' median overall survival was 32.7 months compared to NDI patients with a median overall survival of 45.7 months (p = 0.015). For the high-volume cohort, PCI &gt;15, DI involvement median overall survival was 18.5 months, compared to NDI patients median overall survival of 20.7 months (p = 0.282).</div></div><div><h3>Conclusion</h3><div>CRS/HIPEC should be utilised in patients who have colorectal carcinoma and diaphragmatic disease, as overall survival is improved for patients. Greater rates of post operative complications are noted in this cohort and thus should be considered early in the post-operative period. CA19.9 should be considered an important, however not essential, aspect of pre-operative workup, with further investigation required.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110306"},"PeriodicalIF":3.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604733","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":"Is adjuvant chemotherapy beneficial in NSCLC patients over 75? Insights from a retrospective analysis","authors":"Yohann Vincent ,&nbsp;Faustine Enoch ,&nbsp;Vanessa Pauly ,&nbsp;Anne-Laure Couderc ,&nbsp;Pascale Tomasini ,&nbsp;Laurent Greillier ,&nbsp;Johan Pluvy ,&nbsp;Xavier-Benoit D'Journo ,&nbsp;Pascal-Alexandre Thomas ,&nbsp;Alex Fourdrain ,&nbsp;Alice Mogenet","doi":"10.1016/j.ejso.2025.110307","DOIUrl":"10.1016/j.ejso.2025.110307","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer remains the leading cause of cancer-related mortality worldwide. In resected stage II–III Non-Small Cell Lung Cancer (NSCLC), adjuvant chemotherapy (ACT) improves survival, but its benefit in elderly patients remains unclear due to the lack of dedicated studies. We conducted a retrospective study to assess benefit and predictive factors of ACT in NSCLC patients over 75-years-old.</div></div><div><h3>Methods</h3><div>We conducted a single-centre retrospective study at Marseille University Hospital using the EPITHOR database. Patients over 75-year-old who underwent anatomical lung resection with a theoretical ACT indication were included between 2013 and 2022. Survival outcomes were compared between ACT and non-ACT groups. The primary endpoint was 5-year mortality without recurrence, with relapse as a competing event. Exploratory outcome were 5-year overall survival and risk factors for recurrence.</div></div><div><h3>Results</h3><div>Among 129 eligible patients, 36 received ACT and 93 did not. ACT group patients were younger, had a more favourable perioperative course, and were more likely to have lymph node-positive disease (N+) (63.9 % vs. 43.0 %, <em>p = 0.031),</em> especially N2 involvement. ACT significantly decreased mortality without recurrence in univariate analysis (HR = 0.257 [95 % CI: 0.080–0.819], <em>p = 0.022</em>), but this benefit disappeared in multivariate analysis (HR = 0.461 [95 % CI: 0.144–1.473], p = <em>0.191</em>). Similarly, ACT was associated with lower overall mortality in univariate analysis but lost significance in multivariate analysis.</div></div><div><h3>Conclusion</h3><div>Oncologists preferentially offer ACT to healthier elderly patients with N+ status. While ACT appears feasible, its benefit must be balanced considering competing risks of death in elderly patients. Identifying high-risk subgroups, including those with N2 disease, is crucial to refine treatment strategies in this population.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110307"},"PeriodicalIF":3.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605425","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":"Defining replicability and evaluating reliability of intra-operative cytological bone margins assessment. A study to strengthen previous findings in advanced oral cancer","authors":"Giuditta Mannelli ,&nbsp;Chiara Marzi ,&nbsp;Lara Comini ,&nbsp;Annarita Palomba ,&nbsp;Tiziana Tatti ,&nbsp;Ersilia Lucenteforte ,&nbsp;Pierluigi Bonomo ,&nbsp;Cesare Piazza ,&nbsp;Roberto Santoro ,&nbsp;Gabriele Molteni ,&nbsp;Giuseppe Spinelli","doi":"10.1016/j.ejso.2025.110308","DOIUrl":"10.1016/j.ejso.2025.110308","url":null,"abstract":"<div><h3>Introduction</h3><div>Curative intent in advanced oral cavity squamous cell cancer (OCSCC) implies clear resection margins (R0). Controlling resection margin is a pivotal point as R status, which is under the direct control of surgeons, continues to be the most important predictor for survival. However, intra-operative bone resection margin analysis still presents technical challenges preventing its routine clinical application.</div></div><div><h3>Objective</h3><div>To introduce intra-operative cytological bone margins analysis by overcoming the previously reported technical limitations and confirming its reproducibility and reliability, to support intra-operative microscopically-guided resection.</div></div><div><h3>Methods</h3><div>A total amount of 296 cytological samples and 148 cytological controls were obtained intra-operatively from surgical resection bone-margins in 74 patients affected by OCSCC with pre-operative suspicious bone cancer infiltration. Both techniques ICAB (intra-operative cytological assessment of bone margins) and ICICAB (intra-operative cell isolation cytological assessment of bone margins) were compared with the corresponding histological final report and evaluated as potential diagnostic intra-operative tool.</div></div><div><h3>Results</h3><div>ICICAB demonstrated perfect accuracy, correctly identifying all positive and negative results as confirmed by the histological exam. Accordingly ICICAB could reliably identify cancer cells from the region of interest (ROI) analyzed.</div></div><div><h3>Discussion</h3><div>The development and assessment of a reproducible and standard intra-operative bone margins analysis, would help in reducing the discrepancy between pre-operative and final cancer-infiltrative bone status, with a following significant difference in both functional and survival outcomes for advanced OCSCC patients, through an additional reduction in costs and time-consuming rates.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110308"},"PeriodicalIF":3.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679888","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":"Pressurised intraperitoneal aerosolised chemotherapy (PIPAC) for peritoneal malignancy, a systematic review of its occupational safety","authors":"Eoghan Burke ,&nbsp;Patricia Harkins ,&nbsp;Sarah Fenn ,&nbsp;Faraz Khan ,&nbsp;Orla McCormack ,&nbsp;Jürgen Mulsow ,&nbsp;Conor Shields","doi":"10.1016/j.ejso.2025.110312","DOIUrl":"10.1016/j.ejso.2025.110312","url":null,"abstract":"<div><div>Pressurised intraperitoneal aerosolised chemotherapy (PIPAC) is an emerging technique for treating peritoneal malignancies, in which chemotherapeutic agents are delivered as an aerosol during laparoscopy. This method may provide more uniform distribution and deeper tissue penetration compared to hyperthermic intraperitoneal chemotherapy (HIPEC). However, the aerosolization of cytotoxic agents raises potential occupational health concerns for surgical and perioperative staff. This systematic review aimed to evaluate the occupational safety of the PIPAC procedure. A comprehensive search of PubMed, EMBASE, and Web of Science identified 854 studies, of which 9 met the inclusion criteria. These prospective studies, conducted across European centres between 2013 and 2021, collectively assessed 24 PIPAC procedures. Exposure was evaluated through environmental air sampling, surface wipe analysis, and biological monitoring (urine or plasma samples). Across the included studies, air contamination was consistently undetectable or below established safety thresholds. Biological monitoring also revealed no measurable systemic exposure in healthcare workers. While some surface contamination was identified, primarily on gloves and equipment, detected levels were below those commonly reported in HIPEC procedures. These findings suggest that, when appropriate safety measures are in place, PIPAC poses minimal occupational risk to healthcare staff.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110312"},"PeriodicalIF":3.5,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605420","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":"Optimising mastectomy with a focus on skin and nipple-sparing approaches: a multidisciplinary point of view","authors":"Orit Kaidar-Person ,&nbsp;Philip Poortmans ,&nbsp;Birgitte Vrou Offersen ,&nbsp;Icro Meattini ,&nbsp;Trine Tramm ,&nbsp;Petra Steyerova ,&nbsp;David Dodwell ,&nbsp;Jana de Boniface ,&nbsp;Liesbeth J. Boersma","doi":"10.1016/j.ejso.2025.110310","DOIUrl":"10.1016/j.ejso.2025.110310","url":null,"abstract":"<div><div>Mastectomy is indicated in approximately 15–30 % of breast cancer patients. Mastectomy drives the demand for breast reconstruction which is associated with an increased risk of surgical complications and in some reports poor local control. Postmastectomy irradiation is increasingly used in the context of breast reconstruction, which raises the risk of acute and late complications. Therefore, the purpose of this multidisciplinary narrative review is to provide insights into improving oncological and quality-of-life outcomes for patients undergoing mastectomy especially in combination with reconstruction.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110310"},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654740","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}