Ejso最新文献

{"title":"Muscle-specific strength predicts postoperative complications and survival in patients undergoing curative colectomy for colorectal cancer","authors":"Wen-Bo Zhai ,&nbsp;Zong-Ze Li ,&nbsp;Chen-Hao He ,&nbsp;Wen-Tao Xi ,&nbsp;Gao-Feng Wu ,&nbsp;Hao-Wen Ke ,&nbsp;Ye-Cheng Zhu ,&nbsp;Xia-Lin Yan ,&nbsp;Xian Shen ,&nbsp;Dong-Dong Huang","doi":"10.1016/j.ejso.2025.110020","DOIUrl":"10.1016/j.ejso.2025.110020","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Muscle-specific strength was recently proposed as a component for the definition of sarcopenia. However, no previous study has investigated the association between muscle-specific strength and postoperative outcomes. The present study aims to explore the association between muscle-specific strength and postoperative outcomes in patients undergoing colectomy for colorectal cancer. We also aimed to investigate whether addition of muscle-specific strength to the definition of sarcopenia could lead to an increased prognostic value for postoperative outcomes.</div></div><div><h3>Methods</h3><div>Clinical data of 1252 patients who underwent curative colectomy for colorectal cancer were prospectively collected and retrospectively analyzed. Muscle mass was measured by skeletal muscle index (SMI) determined by the preoperative computed tomography (CT) images at the third vertebra level. Grip strength and 6-m usual gait speed were measured before surgery. Muscle-specific strength was determined by the ratio of grip strength to SMI.</div></div><div><h3>Results</h3><div>Low muscle-specific strength was associated with a higher incidence of postoperative complications, longer postoperative hospital stays, and more costs. Low muscle-specific strength was an independent predictor for postoperative complications, overall survival (OS) and disease-free survival (DFS). Addition of low muscle-specific strength to low muscle mass and strength led to significant predictive value for postoperative complications, and a higher hazard ratio in predicting OS and DFS.</div></div><div><h3>Conclusion</h3><div>Low muscle-specific strength could predict adverse postoperative outcomes in patients undergoing curative colectomy for colorectal cancer. Muscle-specific strength added prognostic value to sarcopenia for the prediction of postoperative outcomes, which should be incorporated into the diagnostic criteria of sarcopenia.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110020"},"PeriodicalIF":3.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792428","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":"Clinical management and oncologic outcomes of pure pleomorphic and florid lobular carcinoma in situ of the breast: Results from a large single institution experience","authors":"M. Ferrucci ,&nbsp;D. Passeri ,&nbsp;F. Milardi ,&nbsp;A. Marchet ,&nbsp;P. Del Bianco ,&nbsp;R. Cappellesso ,&nbsp;A.P. Dei Tos","doi":"10.1016/j.ejso.2025.110021","DOIUrl":"10.1016/j.ejso.2025.110021","url":null,"abstract":"<div><h3>Introduction</h3><div>Pure pleomorphic (PLCIS) and florid (FLCIS) lobular carcinoma in situ, without concurrent invasive carcinoma (IC) or ductal carcinoma in situ (DCIS), are rare. We collected the largest and most comprehensive single-institution cohort to analyze oncological outcomes and management strategies<strong>.</strong></div></div><div><h3>Methods</h3><div>Consecutive patients diagnosed with pure PLCIS and/or FLCIS and treated at our institution between 2012 and 2021 were identified. Clinical, radiological, and pathological characteristics, along with recurrence risk, were analyzed.</div></div><div><h3>Results</h3><div>A total of 303 patients were diagnosed with PLCIS and/or FLCIS on surgical specimens. Among them, 144 PLCIS and 116 FLCIS cases were associated with IC or DCIS, leaving 43 (14.2 %) pure P-/FLCIS cases (20 PLCIS, 17 FLCIS, and six mixed cases).</div><div>Pure P-/FLCIS diagnosed on core-biopsy had a 31.3 % upgrade ratio on surgical specimens to IC (86.7 %) or DCIS (13.3 %).</div><div>Median lesion size was 15 mm. Mastectomy was performed in four cases, while 90.7 % underwent wide local excision, with 14 % positive margin rate. Sentinel lymph node biopsy was performed in four cases, with no positive nodes. No adjuvant treatment was administered, as per multidisciplinary decision.</div><div>After a median follow-up of 53 months, local recurrence (LR) occurred in 14 % of cases.</div><div>Margin involvement strongly predicted LR, which was higher in patients with final positive margins (5/6, 83.3 % vs. 0/31, 0 % in patients with clear margins, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The 31.3 % upgrade ratio from pure P-/FLCIS to IC/DCIS recommends surgical excision. Axillary surgery should be omitted. Positive margins are strongly associated with LR. Surgery with negative margins is the mainstay of treatment. Larger multicentric studies are needed.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110021"},"PeriodicalIF":3.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850078","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":"Network meta-analysis of RTCs for efficacy of neoadjuvant treatment in rectal cancer","authors":"Nir Horesh ,&nbsp;Sameh Hany Emile ,&nbsp;Zoe Garoufalia ,&nbsp;Rachel Gefen ,&nbsp;Peter Rogers ,&nbsp;Pauline Aeschbacher ,&nbsp;Ebram Salama ,&nbsp;Steven D. Wexner","doi":"10.1016/j.ejso.2025.110019","DOIUrl":"10.1016/j.ejso.2025.110019","url":null,"abstract":"<div><h3>Background</h3><div>This network meta-analysis examined the efficacy of different types of neoadjuvant therapy (NAT) for rectal cancer in improving clinical and pathologic outcomes.</div></div><div><h3>Methods</h3><div>PRISMA-compliant systematic review of PubMed and Scopus including only randomized clinical trials comparing two or more NAT regimens for rectal cancer. A network meta-analysis was undertaken for the main outcomes, including pathological complete response (pCR), disease downstaging, R0 resection, permanent stoma, and major adverse effects. Risk of bias was assessed using the ROB-2 tool.</div></div><div><h3>Results</h3><div>19 randomized controlled trials incorporating 7037 patients (62 % males) were included in the analysis. Compared to standard neoadjuvant chemoradiation (NCRT), consolidation total neoadjuvant therapy (TNT) (OR: 1.82, 95 % CI: 1.46–2.27; p &lt; 0.001) and induction TNT (OR: 1.72, 95 % CI: 1.31–2.26; p &lt; 0.001) had higher odds of achieving pCR. Induction TNT was also significantly associated with higher odds of major adverse effects than was NCRT (OR: 3.14, 95 % CI: 2.50–3.94; p &lt; 0.0001). Compared to NCRT, long course chemotherapy significantly increased the odds of R0 resection (OR: 1.42, 95 % CI: 1.13–1.78; p = 0.002), while consolidation TNT significantly increased organ preservation rates (OR: 2.82, 95 % CI: 1.58–5.05; p &lt; 0.001). Short course radiotherapy doubled the odds of positive circumferential resection margins (CRM) compared to NCRT (OR: 1.99, 95 % CI: 1.11–3.55; p = 0.02).</div></div><div><h3>Conclusions</h3><div>Consolidation and induction TNT were superior in achieving better pathological outcomes in rectal cancer, offering significant benefits over standard NCRT. However, they were associated with a higher risk of adverse effects. Conversely, short course radiotherapy was linked to higher rates of positive CRM.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110019"},"PeriodicalIF":3.5,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826253","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":"Endorectal brachytherapy for organ preservation in patients with rectal cancer: A paradigm shift?","authors":"Emmanouil Fokas ,&nbsp;Claus Rödel","doi":"10.1016/j.ejso.2025.110018","DOIUrl":"10.1016/j.ejso.2025.110018","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 110018"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799162","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":"Clinical outcomes of robotic and laparoscopic gastrectomy using propensity score matching method: Data of 5-year period in a Korean high-volume gastric cancer center","authors":"Yo-Seok Cho ,&nbsp;Felix Berlth ,&nbsp;Jeesun Kim ,&nbsp;Yun-Suhk Suh ,&nbsp;Seong-Ho Kong ,&nbsp;Do Joong Park ,&nbsp;Hyuk-Joon Lee ,&nbsp;Han-Kwang Yang","doi":"10.1016/j.ejso.2025.110014","DOIUrl":"10.1016/j.ejso.2025.110014","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the theoretical advantages of Robotic gastrectomy (RG) over laparoscopic gastrectomy (LG), the benefit of RG compared to LG remains controversial. To address this controversy, we evaluated the outcomes of RG compared to LG in the high-volume gastric cancer center.</div></div><div><h3>Materials and methods</h3><div>This single-center retrospective cohort study enrolled patients of RG and LG from January 2013 to December 2017 using propensity score matching. Results of operation, and overall survival were analyzed.</div></div><div><h3>Results</h3><div>For RG, 268 patients were enrolled, and 733 patients with LG were matched. The four gastric methods were matched at the following ratios; Distal gastrectomy (RG: 35.8 % vs LG: 38.7 %), Total gastrectomy (RG: 16.0 % vs LG: 13.9 %), Pylorus-preserving gastrectomy (RG: 46.3 % vs LG: 44.7 %), Proximal gastrectomy (RG: 1.9 % vs LG: 2.6 %) The median number of retrieved lymph nodes (RG: 36.0 vs LG: 37.0, p = 0.247) and supra-pancreatic lymph nodes (RG: 8.0 vs LG: 7.0, p = 0.647), showed no difference. No difference was observed in complications (RG: 21.3 % vs LG: 21.4 %, p = 1.000), and severe complications (RG: 13.1 % vs LG: 12.7 %, p = 0.961) The 5-year overall survival was not significantly different (RG: 94.8 % vs LG: 93.1 %, hazard ratio: 0.76, 95 % confidence interval: 0.41–1.40, p = 0.379).</div></div><div><h3>Conclusion</h3><div>Our study observed no advantage in RG compared to LG regarding short-term and oncologic outcomes. To take advantage of RG, developing new articulating efficient devices would be necessary.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110014"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792427","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":"Dual-energy CT for predicting progression-free survival of locally advanced gastric cancer after gastrectomy: Insights into tumor angiogenesis","authors":"Yiyang Liu ,&nbsp;Yusong Chen ,&nbsp;Jiao Shu ,&nbsp;Zhe Zhang ,&nbsp;Yaru You ,&nbsp;Songwei Yue ,&nbsp;Qingyu Ji ,&nbsp;Kuisheng Chen ,&nbsp;Yao Liu ,&nbsp;Bo Duan ,&nbsp;Baiqing Yu ,&nbsp;Songzi Kou ,&nbsp;Xia Pang ,&nbsp;Weitao Wang ,&nbsp;Li Yang ,&nbsp;Zihao Zhao ,&nbsp;Jianbo Gao","doi":"10.1016/j.ejso.2025.110017","DOIUrl":"10.1016/j.ejso.2025.110017","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate preoperative dual-energy CT (DECT)-derived independent risk factors affecting progression-free survival (PFS) in patients with locally advanced gastric cancer (LAGC) undergoing gastrectomy, and to reveal the underlying histopathologic changes.</div></div><div><h3>Methods</h3><div>This prospective study included patients who underwent preoperative DECT scan and gastrectomy. Clinical data, DECT-derived morphological characteristics and iodine-related parameters were comprehensively collected. Univariate and multivariate analyses were carried out to identify independent risk factors associated with PFS. The prognostic performance of various parameters was evaluated using the bootstrap-based consistency index (C-index) and time-dependent receiver operating characteristic (ROC) analysis. Kaplan-Meier curves were used to assess the differences in survival analysis. The histopathologic underpinnings of the DECT-based combined parameter for evaluating PFS were explored.</div></div><div><h3>Results</h3><div>120 LAGC patients (63.3 ± 10.9 years; 94 men) were analyzed. Age, arterial enhancement fraction (AEF), serosal invasion, and tumor thickness were identified as preoperative independent risk factors affecting PFS (all p &lt; 0.05). The combined parameters based on these risk factors achieved a C-index of 0.75, significantly or slightly superior to that of any single risk factor (all p &lt; 0.05) or postoperative pathological staging (C-index, 0.67; p &gt; 0.05). For predicting the 0.5-, 1- and 2-year PFS, the combined parameter had an area-under-the-curve (AUC) of 0.72, 0.77, and 0.74, respectively. PFS significantly differed between patients of high- and low-risks assessed with the combined parameter (p &lt; 0.001). Histopathologically, the combined parameter was associated with tumor microvessel density (r = 0.31, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The combination of DECT-derived morphological characteristics, iodine-related parameters, and clinical data helped accurately stratify PFS in LAGC before surgery and is associated with tumor angiogenesis.</div></div><div><h3>Clinical relevance statement</h3><div>Dual-energy CT was promising in the preoperative evaluation of the progression-free survival in LAGC patients after gastrectomy.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110017"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823969","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":"Failure of early interval debulking surgery after standard neoadjuvant chemotherapy: May bevacizumab add something? A large retrospective study","authors":"Raffaella Ergasti ,&nbsp;Laura Vertechy ,&nbsp;Ilary Ruscito ,&nbsp;Serena Maria Boccia ,&nbsp;Luigi Congedo ,&nbsp;Carolina Maria Sassu ,&nbsp;Filippo Maria Capomacchia ,&nbsp;Barbara Costantini ,&nbsp;Maria Grazia Distefano ,&nbsp;Giovanni Scambia ,&nbsp;Anna Fagotti ,&nbsp;Claudia Marchetti","doi":"10.1016/j.ejso.2025.110016","DOIUrl":"10.1016/j.ejso.2025.110016","url":null,"abstract":"<div><h3>Introduction</h3><div>Data are limited on the use of bevacizumab in neoadjuvant setting for High-Grade Serous ovarian Cancer (HGSC) patients. This study explores the effect of adding bevacizumab to standard neoadjuvant chemotherapy (NACT) following the failure of early Interval Debulking Surgery (eIDS).</div></div><div><h3>Materials and methods</h3><div>This monocentric study retrospectively enrolled FIGO stage IIIC-IV HGSC patients (2017–2021), persisting unresectable after three NACT cycles. Eligible patients had an ECOG performance status ≤2, were aged 40–75 years, and had no contraindications to bevacizumab administration. Patients were stratified whether they added bevacizumab from cycles 4 to 6 (CPB group) or not (CP group). The primary endpoint was the cytoreduction rate after six cycles (delayed IDS, dIDS).</div></div><div><h3>Results</h3><div>Overall, 58(23 %) patients received neoadjuvant bevacizumab(CPB), and 190 (77 %) did not (CP). Delayed IDS was performed in 117(47.6 %) patients (CPB:31–53.4 %; CP:86–45.8 %; p = 0.38), with complete gross resection rates of 83.9 % and 88.5 %, respectively (p = 0.72). Severe postoperative complications were comparable (CP: 8 %, CPB: 9.7 %, p = 0.069). Median overall survival (OS) for dIDS patients showed no significant difference (CPB: not reached, CP:38 months, p = 0.55), nor did progression-free survival (PFS; CPB:14 months, CP:12 months, p = 0.830). Conversely, among 130(52 %) patients persisting unresectable, bevacizumab significantly improved OS in the CPB group (not reached vs.18 months, p = 0.015), although PFS remained similar (CPB: 6 months, CP: 7 months, p = 0.741).</div></div><div><h3>Conclusion</h3><div>While adding bevacizumab to NACT does not seem to increase the dIDS rate, it significantly extends OS in unresectable patients. Its use may be a valuable option in selected cases after eIDS’ failure.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110016"},"PeriodicalIF":3.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143807950","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":"Survival outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in selected patients with stage IV gastric adenocarcinoma – A Canadian case series","authors":"Florence Bénard ,&nbsp;Stéphanie Marcil ,&nbsp;Lloyd Mack ,&nbsp;Melina Deban ,&nbsp;Michael Bildersheim ,&nbsp;Antoine Bouchard-Fortier ,&nbsp;Yasmin Osman ,&nbsp;Frédéric Mercier ,&nbsp;Kieran Purich ,&nbsp;Erika Haase ,&nbsp;Dan Schiller ,&nbsp;Mikael Soucisse ,&nbsp;Lucas Sidéris ,&nbsp;Guy Leblanc ,&nbsp;Pierre Dubé ,&nbsp;Cindy Boulanger-Gobeil ,&nbsp;Trevor Hamilton ,&nbsp;Mai-Kim Gervais","doi":"10.1016/j.ejso.2025.110000","DOIUrl":"10.1016/j.ejso.2025.110000","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite advances in systemic therapy, metastatic gastric cancer is associated with a poor prognosis. As peritoneal disease is common, several studies looked at the potential benefits of hyperthermic intraperitoneal chemotherapy (HIPEC) in this context, with encouraging results. However, no Canadian data currently exists on the subject.</div></div><div><h3>Materials and methods</h3><div>This study aims to report characteristics and outcomes of Canadian patients who underwent cytoreductive surgery and HIPEC (CRS-HIPEC) for gastric cancer associated with peritoneal disease or positive peritoneal cytology. This multicenter retrospective study included patients 18 years or older with gastric cancer associated with isolated peritoneal involvement who underwent CRS-HIPEC in five tertiary centers from 2016 to 2022.</div></div><div><h3>Results</h3><div>CRS-HIPEC was performed on 20 patients aged 34–69 years old, most of whom presented with poorly differentiated (90 %) adenocarcinoma, with synchronous peritoneal disease (95 %). Median PCI was 3 (0–13). The associated 90-day morbidity rate, defined as Clavien-Dindo grade III and above complications, was 10 %. At a mean follow-up of 23.3 months (range 4–48), 25 % of patients remained disease-free, with an estimated median overall survival of 24.2 months.</div></div><div><h3>Conclusion</h3><div>CRS-HIPEC for gastric cancer can achieve longer term survival in highly selected patients with low-burden peritoneal disease or positive cytology. Ongoing randomized trials will further clarify patients’ selection criteria and benefits of this approach.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110000"},"PeriodicalIF":3.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874300","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 role of computer-assisted navigation in pelvic tumor surgery: A systematic review and meta-analysis","authors":"Giuseppe Francesco Papalia ,&nbsp;Augusto Ferrini ,&nbsp;Francesco Rosario Parisi ,&nbsp;Antongiulio Manfreda ,&nbsp;Pierangelo Za ,&nbsp;Carmine Zoccali ,&nbsp;Rocco Papalia","doi":"10.1016/j.ejso.2025.110009","DOIUrl":"10.1016/j.ejso.2025.110009","url":null,"abstract":"<div><h3>Background</h3><div>Pelvic bone tumors frequently pose significant challenges due to their proximity to noble structures, including blood vessels, nerves, and organs. Computer-assisted navigation (CAN) for pelvic bone oncology surgery was introduced in the early 2000s to improve accuracy and precision of pelvic tumor resections. The objective of this systematic review and meta-analysis was to evaluate the differences in surgical accuracy, clinical outcomes, recurrence rates, and complications in pelvic bone tumor resections performed with or without CAN.</div></div><div><h3>Methods</h3><div>The literature search was independently conducted by two reviewers on September 30, 2024 on PubMed, Scopus, and Cochrane Library databases. Observational studies investigating oncologic outcomes associated with the use of navigation systems in the treatment of primary pelvic bone tumors were included. Meta-analysis was performed using Review Manager software to compare margin status, local recurrence (LR) rates, metastasis rates, and major complications between navigated and non-navigated pelvic tumor surgeries.</div></div><div><h3>Results</h3><div>Eleven studies comprising 402 patients (mean age 49.3 years) were included. CAN significantly reduced LR rate (p = 0.008) and increased the rate of negative margins (p = 0.0007) compared to non-navigated group. No significant differences were observed in metastasis rate (p = 0.18) or major complications (p = 0.16) between the two groups. The five-year overall survival averaged 78.5 % in navigated surgeries.</div></div><div><h3>Conclusion</h3><div>CAN offers significant benefits in the treatment of pelvic tumors as enhances surgical precision, reduces LR, and increases wide-margin resections compared to non-navigated surgery.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110009"},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792426","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":"Construction of nomogram prognostic model for gastric signet ring cell carcinoma: Signet ring cell proportion influencing prognosis","authors":"Wannian Sui ,&nbsp;Peifeng Chen ,&nbsp;Zhangming Chen,&nbsp;Wenxiu Han","doi":"10.1016/j.ejso.2025.110012","DOIUrl":"10.1016/j.ejso.2025.110012","url":null,"abstract":"<div><h3>Background</h3><div>Signet ring cell (SRC) carcinoma significantly impacts the prognosis of gastric cancer (GC) patients, yet the influence of SRC proportion is often overlooked. This study aims to clarify the relationship between SRC proportion and prognosis and to construct a prognostic prediction model for gastric cancer patients with SRC components (GSRCC).</div></div><div><h3>Methods</h3><div>Clinical data from 628 GSRCC patients who underwent gastrectomy at the First Affiliated Hospital of Anhui Medical University from November 2011 to December 2018 were collected. Patients were randomly divided into a training set (442 patients) and a validation set (186 patients). Prognostic risk factors were identified in the training set, and a nomogram prediction model was established. The internal and external validation were conducted on the training and validation sets.</div></div><div><h3>Results</h3><div>The SRC proportion (hazard ratio [HR]: 9.569, <em>P</em> &lt; 0.001), depth of invasion (HR: 6.838, <em>P</em> = 0.001), tumor size (HR: 1.573, <em>P</em> = 0.044), and N stage (HR: 6.511, <em>P</em> &lt; 0.001) were independent prognostic factors for GSRCC. The nomogram showed excellent performance in predicting 1-year, 3-year, and 5-year overall survival (OS) with AUC values of 0.819, 0.832, and 0.874 in the training set, and of 0.815, 0.847, and 0.876 in the validation set, respectively. Calibration curves indicated good agreement between predicted and actual survival rates.</div></div><div><h3>Conclusions</h3><div>The SRC proportion influences the prognosis of GSRCC patients. The establishment of the prognostic prediction model will provide assistance for clinical decision-making and prognosis assessment.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110012"},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783196","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}