Ejso最新文献

{"title":"Impact of extensive surgery in a multidisciplinary approach of parameningeal rhabdomyosarcoma in children, adolescent and young adult population","authors":"Olivier Airaudo ,&nbsp;Romain Luscan ,&nbsp;Jean-François Honart ,&nbsp;Sylvie Helfre ,&nbsp;Stéphanie Bolle ,&nbsp;Daniel Orbach ,&nbsp;Salma Moalla ,&nbsp;Kahina Belhous ,&nbsp;Philippe Drabent ,&nbsp;Hervé Brisse ,&nbsp;Pierre Khneisser ,&nbsp;Kevin Beccaria ,&nbsp;Stephane Temam ,&nbsp;Veronique Minard-Colin ,&nbsp;Vincent Couloigner ,&nbsp;Antoine Moya-Plana","doi":"10.1016/j.ejso.2025.110486","DOIUrl":"10.1016/j.ejso.2025.110486","url":null,"abstract":"<div><h3>Context and objectives</h3><div>Parameningeal (PM) site is a well-known unfavorable site for rhabdomyosarcoma (RMS). PM RMS are usually considered unresectable and treated by radiochemotherapy. This study reviews our experience with a multidisciplinary approach, including extensive surgery.</div></div><div><h3>Method</h3><div>We included all patients treated for PM RMS requiring extensive surgery from January 1992 to December 2021.</div></div><div><h3>Results</h3><div>Thirty-one patients were included with a median age of 6 years (range 6 months–17 years). The primary site was the infratemporal fossa in 81 %, nasopharynx in 13 %, and middle ear/paranasal sinus in one case each. At diagnosis, 23 % had lymph node involvement, and 13 % had distant metastases.</div><div>Twenty-six patients received neoadjuvant chemotherapy before extensive surgery, while five underwent extensive surgery after radiochemotherapy. Free flap reconstruction was needed for 71 % of patients. Adjuvant radiotherapy (median dose: 50 Gy) was performed in 24 patients, with a median delay of 7.5 weeks post-surgery (range 3-13 weeks).</div><div>Seven recurrences (23 %) were observed: four local relapses, two leptomeningeal spreads, and one distant metastasis. The median follow-up was 81 months (range 16-223 months). The median time to relapse was 12 months (range 6-36 months). Five-year event-free and overall survival rates were both 73.9 %, with a local failure-free survival of 85.7 %.</div></div><div><h3>Conclusion</h3><div>Our study suggests that incorporating extensive surgery in PM RMS treatment improves long-term local control and survival, even in advanced cases with unfavorable features.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110486"},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157122","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 comparison and assessment model of deep vein thrombosis in patients with pituitary adenomas after Surgery:A retrospective cohort study","authors":"Hongyu Wu,&nbsp;Yu Zhang,&nbsp;Xin Ma,&nbsp;Zenghua Mi,&nbsp;Zhijun Yang","doi":"10.1016/j.ejso.2025.110485","DOIUrl":"10.1016/j.ejso.2025.110485","url":null,"abstract":"<div><h3>Background</h3><div>Deep vein thrombosis (DVT), a major component of venous thromboembolism (VTE), is a common postoperative complication. Its occurrence after pituitary adenoma surgery is influenced by multiple factors.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 1440 pituitary adenoma cases treated at Beijing Tiantan Hospital (2018–2023). The incidence of postoperative DVT was recorded, and logistic regression was used to identify associated risk factors. Differences across pituitary adenoma subtypes were compared. Additionally, Regression and machine learning models were developed to predict DVT.</div></div><div><h3>Results</h3><div>Among 397 patients who underwent postoperative lower limb ultrasound, 104 (7.2 %) developed DVT. Significant risk factors included advanced age, higher body mass index (BMI), intravenous cannulation, prolonged hospital stay, shorter preoperative activated partial thromboplastin time (APTT), longer thrombin time (TT), elevated platelet count, and higher postoperative D-dimer levels. Patients with Cushing's disease exhibited a significantly higher DVT incidence, potentially related to decreased pre- and postoperative APTT and PT/INR values. Conversely, patients with prolactin-secreting adenomas had a lower DVT incidence, possibly due to younger age and higher postoperative PT values. A support vector machine (SVM) model showed strong predictive performance (AUC: 0.82; accuracy: 86.08 %; specificity: 96.72 %).</div></div><div><h3>Conclusion</h3><div>DVT incidence varies by pituitary adenoma subtype. Machine learning enhances predictive models for postoperative DVT in pituitary adenoma patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110485"},"PeriodicalIF":2.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145156753","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":"The impact of colorectal cancer diagnosis and treatment on quality of life is increased in young patients","authors":"Van MT. Hoang,&nbsp;Brooke Turner,&nbsp;Rocita Ho,&nbsp;Julie Tucker,&nbsp;April Harrison,&nbsp;Devinder Raju,&nbsp;Karolina Juszczyk,&nbsp;Elizabeth Murphy","doi":"10.1016/j.ejso.2025.110483","DOIUrl":"10.1016/j.ejso.2025.110483","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to assess the Quality of Life (QoL) in Early Onset Colorectal Cancer (EOCRC) patients compared to older CRC (OCRC) patients, addressing unique challenges and concerns and their impacts on QoL.</div></div><div><h3>Materials and methods</h3><div>A mixed-method approach was employed, including validated QoL tools (the WHOQOL-BREF, the EORTC QLQ-C30 and QLQ-CR29) and in-depth interviews. All patients completed a one-time survey regardless of cancer stage and treatment journey. Survey data was analysed using descriptive statistics with R version 4.3.1 and interview data was analysed using the Van-Manen method.</div></div><div><h3>Results</h3><div>Ninety-three patients completed the survey, comprising 53 EOCRC and 40 OCRC patients, of whom 10 from each group consented to the interview. EOCRC patients exhibited significantly lower scores in psychological aspects compared to the OCRC cohort (52.3 ± 20.5 vs 66.4 ± 15.8, p = 0.0009, WHOQOL-BREF). They also reported more severe emotional problems (34.6 vs 60.8, p = 0.0002, QLQ-C30), greater embarrassment about their condition (44.7 vs 27.4, p = 0.04), higher levels of anxiety (22.0 vs 49.2, p = 0.00007), more concerns about weight (35.2 vs 51.7, p = 0.04) and body image (41.7 vs 65.6, p = 0.001, QLQ-CR29) compared to their older counterparts.</div><div>The qualitative interviews identified three primary themes: headspace, physical impacts, and future. The challenges and effects on QoL experienced by younger individuals are clearly reflected in altered body image and psychological distress.</div></div><div><h3>Conclusion</h3><div>EOCRC patients face significant psychological and emotional challenges compared to OCRC patients, emphasizing the need for tailored support and intervention programs across the disease trajectory to address their unique challenges.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110483"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120359","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":"The impact of colorectal cancer diagnosis and treatment on quality of life is increased in young patients","authors":"Van MT. Hoang,&nbsp;Brooke Turner,&nbsp;Rocita Ho,&nbsp;Julie Tucker,&nbsp;April Harrison,&nbsp;Devinder Raju,&nbsp;Karolina Juszczyk,&nbsp;Elizabeth Murphy","doi":"10.1016/j.ejso.2025.110483","DOIUrl":"10.1016/j.ejso.2025.110483","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to assess the Quality of Life (QoL) in Early Onset Colorectal Cancer (EOCRC) patients compared to older CRC (OCRC) patients, addressing unique challenges and concerns and their impacts on QoL.</div></div><div><h3>Materials and methods</h3><div>A mixed-method approach was employed, including validated QoL tools (the WHOQOL-BREF, the EORTC QLQ-C30 and QLQ-CR29) and in-depth interviews. All patients completed a one-time survey regardless of cancer stage and treatment journey. Survey data was analysed using descriptive statistics with R version 4.3.1 and interview data was analysed using the Van-Manen method.</div></div><div><h3>Results</h3><div>Ninety-three patients completed the survey, comprising 53 EOCRC and 40 OCRC patients, of whom 10 from each group consented to the interview. EOCRC patients exhibited significantly lower scores in psychological aspects compared to the OCRC cohort (52.3 ± 20.5 vs 66.4 ± 15.8, p = 0.0009, WHOQOL-BREF). They also reported more severe emotional problems (34.6 vs 60.8, p = 0.0002, QLQ-C30), greater embarrassment about their condition (44.7 vs 27.4, p = 0.04), higher levels of anxiety (22.0 vs 49.2, p = 0.00007), more concerns about weight (35.2 vs 51.7, p = 0.04) and body image (41.7 vs 65.6, p = 0.001, QLQ-CR29) compared to their older counterparts.</div><div>The qualitative interviews identified three primary themes: headspace, physical impacts, and future. The challenges and effects on QoL experienced by younger individuals are clearly reflected in altered body image and psychological distress.</div></div><div><h3>Conclusion</h3><div>EOCRC patients face significant psychological and emotional challenges compared to OCRC patients, emphasizing the need for tailored support and intervention programs across the disease trajectory to address their unique challenges.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110483"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120465","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":"CT-based radiomics deep learning signatures for noninvasive prediction of early recurrence after radical surgery in locally advanced colorectal cancer: A multicenter study","authors":"Yongjie Zhou ,&nbsp;Jinhong Zhao ,&nbsp;Yongming Tan ,&nbsp;Fei Zou ,&nbsp;Lei Fang ,&nbsp;Pengfei Wei ,&nbsp;Wei Zeng ,&nbsp;Lianggeng Gong ,&nbsp;Lan Liu ,&nbsp;Linhua Zhong","doi":"10.1016/j.ejso.2025.110482","DOIUrl":"10.1016/j.ejso.2025.110482","url":null,"abstract":"<div><h3>Objective</h3><div>Preoperative identification of high-risk locally advanced colorectal cancer (LACRC) patients is vital for optimizing treatment and minimizing toxicity. This study aims to develop and validate a combined model of CT-based images and clinical laboratory parameters to noninvasively predict postoperative early recurrence (ER) in LACRC patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 560 pathologically confirmed LACRC patients collected from three centers between July 2018 and March 2022 and the Gene Expression Omnibus (GEO) dataset was analyzed. We extracted radiomics and deep learning signatures (RDs) using eight machine learning techniques, integrated them with clinical-laboratory parameters to construct a preoperative combined model, and validated it in two external datasets. Its predictive performance was compared with postoperative pathological and TNM staging models. Kaplan-Meier analysis was used to evaluate preoperative risk stratification, and molecular correlations with ER were explored using GEO RNA-sequencing data.</div></div><div><h3>Results</h3><div>The model included five independent prognostic factors: RDs, lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, lymphocyte-Albumin, and prognostic nutritional index. It outperformed pathological and TNM models in two external datasets (AUC for test set 1:0.865 vs. 0.766, 0.665; AUC for test set 2: 0.848 vs. 0.754, 0.694). Preoperative risk stratification identified significantly better disease-free survival in low-risk vs. high-risk patients across all subgroups (p &lt; 0.01). High enrichment scores were associated with upregulated tumor proliferation pathways (epithelial-mesenchymal transition [EMT] and inflammatory response pathways) and altered immune cell infiltration patterns in the tumor microenvironment.</div></div><div><h3>Conclusion</h3><div>The preoperative model enables treatment strategy optimization and reduces unnecessary drug toxicity by noninvasively predicting ER in LACRC.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110482"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157124","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":"CT-based radiomics deep learning signatures for noninvasive prediction of early recurrence after radical surgery in locally advanced colorectal cancer: A multicenter study","authors":"Yongjie Zhou ,&nbsp;Jinhong Zhao ,&nbsp;Yongming Tan ,&nbsp;Fei Zou ,&nbsp;Lei Fang ,&nbsp;Pengfei Wei ,&nbsp;Wei Zeng ,&nbsp;Lianggeng Gong ,&nbsp;Lan Liu ,&nbsp;Linhua Zhong","doi":"10.1016/j.ejso.2025.110482","DOIUrl":"10.1016/j.ejso.2025.110482","url":null,"abstract":"<div><h3>Objective</h3><div>Preoperative identification of high-risk locally advanced colorectal cancer (LACRC) patients is vital for optimizing treatment and minimizing toxicity. This study aims to develop and validate a combined model of CT-based images and clinical laboratory parameters to noninvasively predict postoperative early recurrence (ER) in LACRC patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 560 pathologically confirmed LACRC patients collected from three centers between July 2018 and March 2022 and the Gene Expression Omnibus (GEO) dataset was analyzed. We extracted radiomics and deep learning signatures (RDs) using eight machine learning techniques, integrated them with clinical-laboratory parameters to construct a preoperative combined model, and validated it in two external datasets. Its predictive performance was compared with postoperative pathological and TNM staging models. Kaplan-Meier analysis was used to evaluate preoperative risk stratification, and molecular correlations with ER were explored using GEO RNA-sequencing data.</div></div><div><h3>Results</h3><div>The model included five independent prognostic factors: RDs, lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, lymphocyte-Albumin, and prognostic nutritional index. It outperformed pathological and TNM models in two external datasets (AUC for test set 1:0.865 vs. 0.766, 0.665; AUC for test set 2: 0.848 vs. 0.754, 0.694). Preoperative risk stratification identified significantly better disease-free survival in low-risk vs. high-risk patients across all subgroups (p &lt; 0.01). High enrichment scores were associated with upregulated tumor proliferation pathways (epithelial-mesenchymal transition [EMT] and inflammatory response pathways) and altered immune cell infiltration patterns in the tumor microenvironment.</div></div><div><h3>Conclusion</h3><div>The preoperative model enables treatment strategy optimization and reduces unnecessary drug toxicity by noninvasively predicting ER in LACRC.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110482"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157120","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":"Re-evaluating the necessity of removing residual calcifications detected after surgery in HR-/HER2+ breast cancer with pathologic complete response","authors":"Cho Eun Lee,&nbsp;Seok Jin Nam,&nbsp;Seok Won Kim,&nbsp;Jonghan Yu,&nbsp;Byung Joo Chae,&nbsp;Se Kyung Lee,&nbsp;Jai Min Ryu,&nbsp;Ki Jo Kim,&nbsp;Su Min Lee,&nbsp;Seung Ah Lee,&nbsp;Kawon Oh,&nbsp;Doyoun Woen,&nbsp;Kibeom Kim,&nbsp;Dahn Byun,&nbsp;Jihoon Lee,&nbsp;Jeong Eon Lee ,&nbsp;Woong Ki Park","doi":"10.1016/j.ejso.2025.110476","DOIUrl":"10.1016/j.ejso.2025.110476","url":null,"abstract":"<div><h3>Purpose</h3><div>Neoadjuvant chemotherapy(NAC) is now widely used in breast cancer to reduce tumor burden and potentially achieve pathologic complete response (pCR). However, when planning breast conserving surgery (BCS) after NAC, considerable debates remain regarding the appropriate extent of surgery. Therefore, this study was designed to comprehensively analyze residual calcifications in patients undergoing BCS following NAC, particularly regarding residual calcifications.</div></div><div><h3>Materials and methods</h3><div>This retrospective observational study included hormone receptor-negative (HR-) and human epidermal growth factor receptor 2-positive (HER2+) breast cancer patients treated with NAC followed by BCS from 2015 to 2020. Patients were grouped by the presence of residual calcifications. Imaging (including mammography and magnetic resonance imaging (MRI)), pathology, and clinical data were reviewed. Survival outcomes were analyzed using Kaplan-Meier curves and statistical tests appropriate to variable types.</div></div><div><h3>Results</h3><div>Among 150 HR-/HER2+ breast cancer patients who achieved pCR after NAC following BCS, 34 patients (22.7 %) showed residual calcifications on postoperative mammography. No statistically significant differences were observed in baseline characteristics or survival outcomes according to the presence of postoperative residual calcifications, including local recurrence free survival, disease free survival, distant metastasis free survival and overall survival. Subgroup analyses by yp T stage showed consistent results.</div></div><div><h3>Conclusion</h3><div>In HR-/HER2+ breast cancer patients achieving pCR after NAC, residual calcifications on postoperative imaging were not associated with worse survival outcomes. Close observation may be a reasonable option compared to additional surgery when negative margins and pCR are confirmed.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110476"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120463","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":"Model to predict postoperative complications after hepatectomy based on comprehensive complication index: A retrospective multicenter study","authors":"Mengwen Xue ,&nbsp;Yuhe Zhang ,&nbsp;Jiarui Li ,&nbsp;Yanan Di ,&nbsp;Kunyu Han ,&nbsp;Ruiping Bai ,&nbsp;Rui An ,&nbsp;Hui Liu ,&nbsp;Xin Shen","doi":"10.1016/j.ejso.2025.110479","DOIUrl":"10.1016/j.ejso.2025.110479","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative complications following hepatectomy are often complex and involve multiple systems. This study aims to employ the Comprehensive Complication Index (CCI) to thoroughly assess postoperative complications, identify patients at high risk for severe complications, and inform preoperative management and preventive strategies.</div></div><div><h3>Methods</h3><div>In this retrospective study, we evaluated all adverse events within 30 days post-hepatectomy. Each complication was individually assessed, and CCI scores were calculated based on the Clavien-Dindo Classification (CDC) system. Short-term outcomes were analyzed for all patients to identify predictors of severe complications.</div></div><div><h3>Results</h3><div>A total of 1350 cases were analyzed, with 21 types of complications recorded, resulting in an overall complication rate of 46.61 %. Patients in the high CCI score group experienced significantly longer postoperative and total hospital stays. Independent risk factors identified included prolonged postoperative hospital stay, increased total intraoperative output, elevated postoperative blood creatinine levels, and preoperative pulmonary comorbidities. Conversely, a higher postoperative neutrophil ratio and red blood cell count were protective factors. Two surgical teams were associated with worse postoperative CCI outcomes. The nomogram model developed in this study demonstrated strong predictive performance, with an area under the ROC curve of 0.844 (95 % CI: 0.814–0.874), a sensitivity of 86.9 %, and a specificity of 65.4 %. The model estimated a 9.36 % risk of severe complications in patients with a total score of 36.</div></div><div><h3>Conclusions</h3><div>The predictive model developed in this study effectively identifies high-risk patients for severe complications after hepatectomy. This tool can guide perioperative preventive measures and early interventions to improve patient outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110479"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218315","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":"Model to predict postoperative complications after hepatectomy based on comprehensive complication index: A retrospective multicenter study","authors":"Mengwen Xue ,&nbsp;Yuhe Zhang ,&nbsp;Jiarui Li ,&nbsp;Yanan Di ,&nbsp;Kunyu Han ,&nbsp;Ruiping Bai ,&nbsp;Rui An ,&nbsp;Hui Liu ,&nbsp;Xin Shen","doi":"10.1016/j.ejso.2025.110479","DOIUrl":"10.1016/j.ejso.2025.110479","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative complications following hepatectomy are often complex and involve multiple systems. This study aims to employ the Comprehensive Complication Index (CCI) to thoroughly assess postoperative complications, identify patients at high risk for severe complications, and inform preoperative management and preventive strategies.</div></div><div><h3>Methods</h3><div>In this retrospective study, we evaluated all adverse events within 30 days post-hepatectomy. Each complication was individually assessed, and CCI scores were calculated based on the Clavien-Dindo Classification (CDC) system. Short-term outcomes were analyzed for all patients to identify predictors of severe complications.</div></div><div><h3>Results</h3><div>A total of 1350 cases were analyzed, with 21 types of complications recorded, resulting in an overall complication rate of 46.61 %. Patients in the high CCI score group experienced significantly longer postoperative and total hospital stays. Independent risk factors identified included prolonged postoperative hospital stay, increased total intraoperative output, elevated postoperative blood creatinine levels, and preoperative pulmonary comorbidities. Conversely, a higher postoperative neutrophil ratio and red blood cell count were protective factors. Two surgical teams were associated with worse postoperative CCI outcomes. The nomogram model developed in this study demonstrated strong predictive performance, with an area under the ROC curve of 0.844 (95 % CI: 0.814–0.874), a sensitivity of 86.9 %, and a specificity of 65.4 %. The model estimated a 9.36 % risk of severe complications in patients with a total score of 36.</div></div><div><h3>Conclusions</h3><div>The predictive model developed in this study effectively identifies high-risk patients for severe complications after hepatectomy. This tool can guide perioperative preventive measures and early interventions to improve patient outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110479"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218730","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":"Re-evaluating the necessity of removing residual calcifications detected after surgery in HR-/HER2+ breast cancer with pathologic complete response","authors":"Cho Eun Lee,&nbsp;Seok Jin Nam,&nbsp;Seok Won Kim,&nbsp;Jonghan Yu,&nbsp;Byung Joo Chae,&nbsp;Se Kyung Lee,&nbsp;Jai Min Ryu,&nbsp;Ki Jo Kim,&nbsp;Su Min Lee,&nbsp;Seung Ah Lee,&nbsp;Kawon Oh,&nbsp;Doyoun Woen,&nbsp;Kibeom Kim,&nbsp;Dahn Byun,&nbsp;Jihoon Lee,&nbsp;Jeong Eon Lee ,&nbsp;Woong Ki Park","doi":"10.1016/j.ejso.2025.110476","DOIUrl":"10.1016/j.ejso.2025.110476","url":null,"abstract":"<div><h3>Purpose</h3><div>Neoadjuvant chemotherapy(NAC) is now widely used in breast cancer to reduce tumor burden and potentially achieve pathologic complete response (pCR). However, when planning breast conserving surgery (BCS) after NAC, considerable debates remain regarding the appropriate extent of surgery. Therefore, this study was designed to comprehensively analyze residual calcifications in patients undergoing BCS following NAC, particularly regarding residual calcifications.</div></div><div><h3>Materials and methods</h3><div>This retrospective observational study included hormone receptor-negative (HR-) and human epidermal growth factor receptor 2-positive (HER2+) breast cancer patients treated with NAC followed by BCS from 2015 to 2020. Patients were grouped by the presence of residual calcifications. Imaging (including mammography and magnetic resonance imaging (MRI)), pathology, and clinical data were reviewed. Survival outcomes were analyzed using Kaplan-Meier curves and statistical tests appropriate to variable types.</div></div><div><h3>Results</h3><div>Among 150 HR-/HER2+ breast cancer patients who achieved pCR after NAC following BCS, 34 patients (22.7 %) showed residual calcifications on postoperative mammography. No statistically significant differences were observed in baseline characteristics or survival outcomes according to the presence of postoperative residual calcifications, including local recurrence free survival, disease free survival, distant metastasis free survival and overall survival. Subgroup analyses by yp T stage showed consistent results.</div></div><div><h3>Conclusion</h3><div>In HR-/HER2+ breast cancer patients achieving pCR after NAC, residual calcifications on postoperative imaging were not associated with worse survival outcomes. Close observation may be a reasonable option compared to additional surgery when negative margins and pCR are confirmed.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110476"},"PeriodicalIF":2.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120371","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}