Ejso最新文献

{"title":"The prognostic value of circumferential resection margin (CRM) definition and location in esophageal cancer: A 12-year cohort study","authors":"Ahmed M. Elshaer ,&nbsp;Sian Jones ,&nbsp;Andrew J. Cockbain ,&nbsp;Simon P.L. Dexter ,&nbsp;Heike I. Grabsch ,&nbsp;Samir P. Mehta ,&nbsp;Abeezar Sarela ,&nbsp;Nicholas P. West ,&nbsp;Jeremy D Hayden","doi":"10.1016/j.ejso.2025.110138","DOIUrl":"10.1016/j.ejso.2025.110138","url":null,"abstract":"<div><h3>Background</h3><div>The definition of the circumferential resection margin (CRM) involvement for esophageal cancer varies between the Royal College of Pathologists (RCP) and College of American Pathologists (CAP). There are insufficient data regarding the prognostic relevance of different sites of involvement at the CRM. In this study, we examined the prognostic impacts of different CRM definitions and different radial margin locations.</div></div><div><h3>Methods</h3><div>This retrospective study included 449 patients who were treated by curative esophagectomy for esophageal or junctional cancers between 2010 and 2021. The distance of the closest tumour cells to the inked CRM was examined and site of CRM involvement was recorded. Patients with an involved longitudinal resection margin were excluded. Long-term follow up data were obtained from the hospital's electronic health records.</div></div><div><h3>Results</h3><div>Tumour cells at or within 1 mm from the CRM (<em>CRM-RCP R1</em>≤1 mm) was observed in 196 patients (43.7 %). CRM(≤1 mm) was associated with poorer overall survival (OS) and disease-free survival (DFS) compared to CRM<em>-R0</em>, p-values &lt;0.001 for both. Tumour cells at the CRM (<em>CRM-CAP R1</em>-<em>0 mm</em>) was observed in 61 patients (13.6 %). Patients with CRM-0mm had poorer OS and DFS compared to CRM≤1 mm<em>,</em> p-values 0.039 and 0.013 respectively. Presence of tumour cells (CRM≤1 mm) at multiple locations of the CRM was related to poorer survival compared to a single location; (OS p-value 0.008, DFS p-value 0.05). The posterior margin was the most common positive single CRM-positive site (44 %), followed by anterior (39 %) and lateral sites (17 %). However, the anterior margins carried poorer OS and DFS compared to posterior and lateral sites, (p-values 0.37 and 0.39 respectively).</div></div><div><h3>Conclusion</h3><div>This study demonstrated that CRM involvement as defined by RCP was an independent prognostic factor for both survival and recurrence in esophageal cancer. It promoted the value of additional reporting CRM-0mm in CRM-R1 cases. The study also investigated the relative importance of reporting CRM-R1 location, which might be a useful prognostic tool in the future.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110138"},"PeriodicalIF":3.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948145","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":"Combining traditional analysis and machine learning to predict early, middle, and long-term recurrence of intrahepatic cholangiocarcinoma","authors":"Ruoyu Zhang ,&nbsp;Zengshuai Wang ,&nbsp;Min Yang ,&nbsp;Bo Chen ,&nbsp;Mei Liu ,&nbsp;Minhua Zheng ,&nbsp;Peter Xiaoping Liu ,&nbsp;Liming Wang","doi":"10.1016/j.ejso.2025.110141","DOIUrl":"10.1016/j.ejso.2025.110141","url":null,"abstract":"<div><h3>Introduction</h3><div>Intrahepatic cholangiocarcinoma (ICC) is a rare and highly aggressive cancer. Few patients are eligible for radical surgery, and most face the high risk of recurrence.</div></div><div><h3>Methods</h3><div>We developed early-, middle- and long-term (1-, 2-, and 3-year) ICC disease-free survival (DFS) prediction models using traditional Logistic analysis combined with machine learning (ML) and systematically compared the performance of traditional analysis and MLs.</div></div><div><h3>Results</h3><div>275, 256, and 238 ICC patients under radical surgery were included in the 1-, 2-, and 3-year DFS groups respectively. Five-fold cross-validation results demonstrated that both traditional Logistics and ML models exhibited remarkable robustness. MLs outperformed traditional Logistic models for DFS prediction across the AUC, accuracy and F1-scores. Specifically, the average AUC of training cohorts for the ML models were 0.878, 0.897 and 0.917 in 3 groups, compared to 0.657 (P &lt; 0.001), 0.817 (P = 0.05), and 0.798 (P = 0.005) in traditional models. The average AUCs of testing cohorts for ML models were 0.831, 0.768, 0.803 in ML models in 3 groups, compared to 0.619 (P &lt; 0.001), 0.719 (P = 0.008), 0.698 (P &lt; 0.001) in traditional models. SHAP analysis identified lymph node metastasis played significant role in all-round recurrence, T stage and neural invasion had strong correction with middle and long-term recurrence in ICC patients.</div></div><div><h3>Conclusion</h3><div>Models with high predictive efficiency across early, middle, and long-term recurrence have been successfully built. ML models outperformed Logistic models for DFS prediction in ICC patients. This study suggests new possibilities for advancing statistical analysis software, such as SPSS and Stata, through ML integration.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110141"},"PeriodicalIF":3.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167691","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 in pulmonary carcinoid prognostication: A critical appraisal","authors":"Muhammad Khubaib Iftikhar,&nbsp;Qurat ul ain Iftikhar","doi":"10.1016/j.ejso.2025.110135","DOIUrl":"10.1016/j.ejso.2025.110135","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 110135"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143947297","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 effect of liver resection in T2 and T3 gallbladder cancer","authors":"Kwang Yeol Paik ,&nbsp;Dong Do You ,&nbsp;Yoon Kyung Woo ,&nbsp;Ji Han Jung ,&nbsp;Tae Ho Hong ,&nbsp;Sung Hak Lee","doi":"10.1016/j.ejso.2025.110142","DOIUrl":"10.1016/j.ejso.2025.110142","url":null,"abstract":"<div><h3>Background</h3><div>Since the 8th edition of the American Joint Committee on Cancer (AJCC) staging system, few studies have examined long-term outcomes for gallbladder cancer.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted in March 2024 on 180 consecutive patients with T2 or T3 gallbladder carcinoma who underwent surgery between January 2010 and December 2019. Radical resection was defined as liver resection with the procurement of at least four lymph nodes.</div></div><div><h3>Results</h3><div>The 5-year overall survival (OS) rate for patients who underwent liver resection was 43.8 %, compared to 26.7 % for those who did not (<em>p</em> = 0.047). The 5-year OS for patients with fewer than four procured lymph nodes was 33.1 %, whereas it was 49.9 % for those with four or more lymph nodes (<em>p</em> = 0.052). Following radical resection, the 5-year OS rate was 52.5 %, compared to 31.7 % for those who did not undergo radical resection (<em>p</em> = 0.014). In subgroup analysis of T2a and T3 gallbladder cancer, the 5-year OS rates for patients who underwent liver resection were 72.0 % and 15.5 %, respectively, compared to 43.8 % and 0.0 % for those who did not undergo liver resection (<em>p</em> &lt; 0.05). Multivariate analysis identified T stage, perineural invasion, elevated CA 19-9 levels, and radical resection as independent prognostic factors for OS.</div></div><div><h3>Conclusions</h3><div>Radical surgery, including appropriate hepatic resection and lymph node dissection, is essential for improving long-term prognosis in T2a, T2b, and T3 gallbladder cancers. AJCC T stage, perineural invasion, elevated CA 19-9 levels, and radical resection were independently associated with OS.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110142"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167752","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":"Validation of a simulator for oncoplastic breast conserving surgery.","authors":"Laith Alghazawi, Stella Mavroveli, Eleni Anastasiou, Mohamed Attia, Natalie Johnson, Daniel Campioni-Norman, Dimitri Amiras, Andreas Ladas, Michael R Boland, George Hanna, Paul Tr Thiruchelvam, Daniel R Leff","doi":"10.1016/j.ejso.2025.110132","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.110132","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"110132"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109900","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: EUSOMA and NCCN should include clinical staging after neoadjuvant therapy as a quality indicator for treatment guidance.","authors":"Giuseppe Catanuto, Damiano Gentile, Federica Martorana, Giuseppe Curigliano, Isabel Rubio","doi":"10.1016/j.ejso.2025.110130","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.110130","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"110130"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076733","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: Comment on \"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, Mariano Cesare Giglio, Karen Geboes, Giancarlo Troncone, Roberto Ivan Troisi","doi":"10.1016/j.ejso.2025.110106","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.110106","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"110106"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119221","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":"Enhanced recovery and comparable long-term outcomes in reduced-port robotic distal gastrectomy versus conventional laparoscopic distal gastrectomy: A propensity score-matched analysis of single-center experience","authors":"Jawon Hwang ,&nbsp;Jisu Moon ,&nbsp;Ki-Yoon Kim ,&nbsp;Sung Hyun Park ,&nbsp;Minah Cho ,&nbsp;Yoo Min Kim ,&nbsp;Woo Jin Hyung ,&nbsp;Hyoung-Il Kim","doi":"10.1016/j.ejso.2025.110137","DOIUrl":"10.1016/j.ejso.2025.110137","url":null,"abstract":"<div><h3>Introduction</h3><div>Reduced-port robotic distal gastrectomy (REPRODG) combines reduced-port surgery with robotic assistance to further optimize surgical outcomes. While the advantages of both reduced-port and robotic approaches over conventional laparoscopic surgery remain controversial, evaluating these techniques together may reveal potential benefits not observed when assessed separately. This study aimed to compare the surgical and oncologic outcomes of REPRODG to those of conventional laparoscopic distal gastrectomy (CLDG).</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective analysis of 1865 patients with gastric cancer who underwent either REPRODG or CLDG between January 2015 and December 2018. Utilizing 1:1 propensity score matching, we compared short- and long-term outcomes between the groups.</div></div><div><h3>Results</h3><div>A total of 174 matched pairs of REPRODG and CLDG patients were analyzed. The REPRODG group demonstrated a shorter hospital stay (<em>p</em> = 0.006) and faster time to the first flatus (<em>p</em> = 0.001), and a lower incidence of pulmonary complications (<em>p</em> = 0.044) compared to the CLDG group. No significant differences were observed in overall and recurrence-free survival between the two groups (<em>p</em> = 0.739 and 0.564, respectively).</div></div><div><h3>Conclusions</h3><div>This study suggests that REPRODG may provide better short-term surgical outcomes to CLDG, particularly faster postoperative recovery, while maintaining comparable oncologic outcomes. Integrating robotic technology into reduced-port distal gastrectomy may further optimize postoperative recovery.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110137"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941443","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":"Incidence and prognostic role of venous thromboembolism in gastric cancer: a nationwide Finnish register study","authors":"Panu Aaltonen ,&nbsp;Harri Mustonen ,&nbsp;Pauli Puolakkainen ,&nbsp;Caj Haglund ,&nbsp;Katriina Peltola ,&nbsp;Hanna Seppänen","doi":"10.1016/j.ejso.2025.110139","DOIUrl":"10.1016/j.ejso.2025.110139","url":null,"abstract":"<div><h3>Background</h3><div>Gastric cancer (GC) is associated with a high risk of venous thromboembolism (VTE). We investigated the incidence of VTE before and after a GC diagnosis and its association with overall survival (OS).</div></div><div><h3>Methods</h3><div>We identified GC patients diagnosed in 2011–2016 from the Finnish Cancer Registry, and collected data on healthcare visits, death, and follow-up through the end of 2020. We compared patients based on their cancer stage and the type of treatment they received.</div></div><div><h3>Results</h3><div>We identified 3023 GC patients, amongst whom 995 (32.9 %) underwent gastric surgery, 134 (4.4 %) explorative surgery, and 1894 (62.7 %) no surgery for GC. The cumulative incidence of VTE at 12 and 24 months following GC diagnosis was 5.1 % [95 % confidence interval (CI) 4.31–5.89] and 5.8 % (95 % CI 4.97–6.63), respectively. VTE within one year before GC diagnosis was significantly more frequent amongst no surgery (1.9 %) patients than amongst the gastric (0.8 %) or exploratory surgery only (0.7 %) subgroups (<em>p</em> = 0.018). Median OS amongst patients who had a VTE within one year before a GC diagnosis was 4 months compared to 10 months amongst those who did not (<em>p</em> = 0.001). VTE similarly associated with a worse prognosis, whether occurring within one year before [hazard ratio (HR) 1.69] or after (HR 1.78) a GC diagnosis.</div></div><div><h3>Conclusions</h3><div>VTE associated with a worse survival, whether occurring before or after a GC diagnosis. Pre-diagnosis VTE associated with a lower likelihood of curative-intent surgery presumably due to more advanced GC or VTE-related treatment interference.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 110139"},"PeriodicalIF":3.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943296","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: Comment on \"Risk of pancreatic cancer and high-grade dysplasia in resected main-duct and mixed-type intraductal papillary mucinous neoplasms: A prevalence meta-analysis\".","authors":"Omar Mahmud, Asad Saulat Fatimi, Mahip Grewal, Ammar A Javed, Greg D Sacks","doi":"10.1016/j.ejso.2025.110111","DOIUrl":"https://doi.org/10.1016/j.ejso.2025.110111","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":" ","pages":"110111"},"PeriodicalIF":3.5,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119223","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}