Ejso最新文献

{"title":"Differences in patient- and tumor characteristics, treatment and survival between patients with screen-detected versus clinically detected colorectal peritoneal metastases","authors":"","doi":"10.1016/j.ejso.2024.108789","DOIUrl":"10.1016/j.ejso.2024.108789","url":null,"abstract":"<div><h3>Introduction</h3><div>Screening for colorectal cancer has been implemented to improve cancer-specific survival. This study aims to compare patient- and tumor characteristics, treatment, and survival between patients with screen-detected and clinically detected synchronous colorectal peritoneal metastases (CPM) in a Dutch population-based cohort.</div></div><div><h3>Methods</h3><div>Data from the Netherlands Cancer Registry (NCR) were used. Screening was performed nationwide with biennial FIT and subsequent colonoscopy if positive. Patients within the screening age (55–75 years) and diagnosed with synchronous CPM between 2014 and 2020 were included. Data from the NCR was linked to the Dutch Nationwide Pathology Databank (Palga) to identify mode of detection. Baseline characteristics and treatment were compared between screen-detected CPM patients and clinically detected CPM patients using χ₂-tests. Overall survival (OS) was compared between both groups with the log-rank test and a multivariable Cox regression analysis.</div></div><div><h3>Results</h3><div>Of 2,773 included patients with synchronous CPM, 197 (7 %) were detected by screening. In the screen-detected group, 56 (28 %) patients underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) versus 363 (14 %) in the clinically detected group (p &lt; 0.001). Median OS was 20.0 months (IQR 9.7–51.7) in the screen-detected group versus 10.8 months (IQR 3.4–25.5) in the clinically detected group (p &lt; 0.001). In the multivariable analysis, CPM detected through screening was associated with improved OS compared to clinically detected CPM (adjusted HR 0.68, 95%CI [0.57–0.81]).</div></div><div><h3>Conclusions</h3><div>Screen-detected patients with colorectal peritoneal metastases more often received treatment with curative intent and had better OS compared to clinically detected patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579059","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":"HIPEC for metastatic gastric cancer: Moving the needle towards 3-year survival","authors":"","doi":"10.1016/j.ejso.2024.108790","DOIUrl":"10.1016/j.ejso.2024.108790","url":null,"abstract":"<div><h3>Introduction</h3><div>Prior work has established hyperthermic intraperitoneal chemotherapy (HIPEC) administration as a safe treatment option for select patients with gastric adenocarcinoma and carcinomatosis. However, identifying patients who will maximally benefit from HIPEC remains unclear. This study assessed a single-institution experience with HIPEC for metastatic gastric cancer to identify variables associated with improved survival.</div></div><div><h3>Methods</h3><div>A database of patients treated for metastatic gastric adenocarcinoma at MD Anderson Cancer Center from 2013 to 2022 was queried for patients undergoing HIPEC as part of their treatment regimen. Patients were stratified by overall survival (OS)≥36 months or &lt;36 months and assessed along demographic and clinicopathologic variables to identify factors associated with OS ≥ 36 months.</div></div><div><h3>Results</h3><div>Among 104 patients, 1,2, and 3-year OS from diagnosis was 89 %,44 %, and 18 %. Patients with OS ≥ 36 months were more likely to have moderately differentiated tumors, positive cytology only (i.e. no visible carcinomatosis), and lower peritoneal cancer index (PCI) than those with OS &lt; 36 months (p = 0.002, p = 0.01, p = 0.001,respectively). Groups did not otherwise differ with respect to demographic parameters or treatment or pathologic details. Among patients who underwent gastrectomy, those with OS &lt; 36 months had higher pathologic T and N category (p = 0.003 and p = 0.02, respectively). Postoperative mortality was zero in both groups among patients undergoing gastrectomy.</div></div><div><h3>Conclusions</h3><div>HIPEC may provide more durable survival benefit among patients with metastatic gastric cancer with moderately differentiated disease, low PCI, and positive cytology alone. Additionally, among patients who undergo gastrectomy, higher final pathologic T and N category are associated with worse survival. Trials are needed to compare 3-year OS rates in patients treated with HIPEC versus systemic therapy alone.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568231","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":"Pulmonary metastasectomy for sarcoma: Insights from a referral-center cohort.","authors":"Thomas Charrier, Edouard-Frédéric Robin, Vincent De Pauw, Pascaline Boudou-Rouquette, Camille Tlemsani, Guillaume Beinse, Sixtine De Percin, Audrey Lupo, Emelyne Canny, Antonio Bobbio, Marco Alifano, Ludovic Fournel","doi":"10.1016/j.ejso.2024.108774","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108774","url":null,"abstract":"<p><strong>Introduction: </strong>The low incidence and heterogeneity of sarcomas limit understanding of their progression in metastatic cases. The use of metastasectomy is debated due to lack of consensus and evidence-based data. This study aimed to identify simple prognostic factors that could contribute to the therapeutic strategy.</p><p><strong>Methods: </strong>We retrospectively reviewed all patients undergoing pulmonary metastasectomy from sarcoma in our referral center between 2011 and 2022. Demographic, radiologic, pathologic, and operative data were collected. Oncological follow-up, survival, and risk factor analyses were performed.</p><p><strong>Results: </strong>192 patients were identified (mean age 49.3 years). Primary sarcoma arose from the trunk (24.6 %) or limbs (75.4 %), and metastases were metachronous in 85.4 % of cases. The median number of operated lesions was 2, and anatomic resection were performed in 24.1 %. The postoperative course was uneventful in 91.3 % of cases. Post-operative chemotherapy followed lung resection in 68.7 %. 1-, 3-, and 5-year Overall Survival (OS) were 89.6 %, 69.8 %, 57.6 %, respectively, with a plateau phase beyond 5 years. Higher grade or trunk location of the primary sarcoma, incomplete or anatomic pulmonary resection, and post-operative systemic treatment were significantly associated with shorter OS. No histological subtype significantly impacted OS. Location of the primary, resection type, and post-operative systemic treatment independently influenced OS. Non-anatomic and repeated pulmonary resections, were independently associated with \"long surviving\".</p><p><strong>Conclusion: </strong>In metastatic sarcoma, pulmonary resections offer prolonged survival in selected patients, supporting its essential role in the whole therapeutic strategy. Anatomic and sequential metastasectomy should be cautiously discussed.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544421","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":"Biobanking rare gynaecological tumours - How harmonised is data collection?","authors":"Sharon O'Toole, Olga Tzortzatou, Sara Casati, James P Beirne, Charles Savona-Ventura, Miriam J Azzopardi, Rita Micallef, Jean Calleja-Agius, Bridget Ellul","doi":"10.1016/j.ejso.2024.108784","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108784","url":null,"abstract":"<p><strong>Introduction: </strong>GYNOCARE, the European Network for Gynaecological Rare Cancer Research, set out to evaluate the current status of biobanks with access to rare gynaecological tumours, with a view to harmonising sample and data collection and associated consent, to facilitate collaborative cross-border research, enabling clinical trials and translational research.</p><p><strong>Methods: </strong>Two digital surveys were formulated, one covering clinical and scientific parameters and one exploring ethical and regulatory issues around informed consent.</p><p><strong>Results: </strong>Data were analysed for 20 common responses, from 7 European countries. Tissue was the main sample type biobanked with 63 % also banking blood. Documentation of clinical data, treatment regimens and classification systems varied. Eighty percent collected pathological information. Most biobanks were linked to medical records but only one fifth with national registries. The Information Sheet covered governance, benefits/risks, sharing (mainly for non-profit research), return of results and data protection safeguards. Only 37 % informed patients about sample and data storage, although about half stored samples for an indefinite time. Pseudonymisation and Data Protection Officer approval were the prime data safeguards. Less than half explained the difference between anonymisation and pseudonymisation. Broad consent was the norm (84 %) and 95 % granted the right to withdraw consent. Three countries have Biobank legislation.</p><p><strong>Conclusion: </strong>These surveys provide a snapshot of the current state of biobanks and highlight divergences in the consent process and data management. More work is needed to understand what parameters are being gathered across more EU countries and thus harmonise the sample and data collection processes to facilitate cross-border research.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563983","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":"Ovarian cancer in children and adolescents: A unique clinical challenge.","authors":"Marina Jakimovska Stefanovska, Aleksandar Celebic, Jean Calleja-Agius, Kristina Drusany Staric","doi":"10.1016/j.ejso.2024.108785","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108785","url":null,"abstract":"<p><p>Ovarian cancer in children and adolescents is rare, presenting unique diagnostic and management challenges distinct from adult cases. This paper provides a comprehensive overview of this disease, focusing on the importance of a multidisciplinary approach to care. We discuss the common presentation of ovarian malignant masses in young patients, highlighting the role of imaging and tumor markers in diagnosis. The paper delves into the surgical management of these tumors, emphasizing the importance of fertility-sparing techniques whenever possible. We explore the role of adjuvant chemotherapy, considering histological subtypes and disease stage. Furthermore, we address the good prognosis associated with early diagnosis and treatment, with survival rates exceeding 90 % in many cases. Finally, the need for long-term follow-up to monitor for potential recurrence is underscored and the long-term treatment-related effects are addressed. This review aims to guide clinicians in providing optimal care for this unique patient population, emphasizing the importance of balancing oncological control with the preservation of future fertility and quality of life.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557425","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":"Exploring the protein signature of endometrial cancer: A comprehensive review through diverse samples and mass spectrometry-based proteomics.","authors":"Oyku Su Yildirim, Pelin Yildiz, Abdullah Karaer, Jean Calleja-Agius, Sureyya Ozcan","doi":"10.1016/j.ejso.2024.108783","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108783","url":null,"abstract":"<p><p>Endometrial cancer (EC) is increasing incidence among women, and it constitutes a health problem for women globally. An important aspect of EC management involves the use of protein biomarkers for early detection and monitoring. Protein biomarkers allow the identification of high-risk patients, the detection of the disease in its early stages, and the assessment of treatment responses. Mass spectrometry (MS)-based proteomics offers robust analytical techniques and a comprehensive understanding of proteins. Proteomics methods allow scientists to investigate both the quantities and functions of proteins. Thus, it provides valuable insights into how proteins are altered under different conditions. This review summarizes recent advances in MS-based proteomic biomarker discovery for EC, focusing on different sample types and MS-based techniques used in clinical studies. The review emphasized in detail the most commonly used key sources such as blood, urine, vaginal fluids and tissue. Furthermore, MS-based proteomics techniques such as untargeted, targeted, sequential window acquisition of all theoretical mass spectra (SWATH-MS) and mass spectrometry imaging used in the discovery and validation/validation phases were evaluated. This review highlights the importance of biomarker discovery and clinical translation to improve diagnostic and therapeutic outcomes in EC. It aims to provide a comprehensive overview of MS-based proteomics in EC, guiding future research and clinical applications.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563986","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":"Residual microcalcifications after neoadjuvant systemic therapy for early breast cancer: Implications for surgical planning and long-term outcomes","authors":"","doi":"10.1016/j.ejso.2024.108781","DOIUrl":"10.1016/j.ejso.2024.108781","url":null,"abstract":"<div><div>Residual microcalcifications on mammograms after neoadjuvant chemotherapy (NACT) pose a challenge in surgical decision-making. This single-centre retrospective review of all patients who had NACT for breast cancer over five years, evaluated the relationship between pathological complete response and residual microcalcifications, controlling for tumour size, nodal stage, grade, and receptor status, as well as the impact of residual microcalcifications on recurrence and survival. There was no significant association between pathological complete response (pCR) and residual microcalcifications (p = 0.763). We computed hazard ratios (HR) for Time to recurrence (TTR) and overall survival (OS) which were both not significant, with HR = 2.599, [0.290, 23.264], p = 0.393 and HR = 1.362 [0.123, 15.062], p = 0.801 respectively. The predictive and prognostic significance of residual microcalcifications remains to be proven. The surgical excision of these lesions should be considered based on individual patient risk.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560972","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":"Eco-logistical comparison of non-radioactive seeds and the wire-guided localization for intraoperative detection of breast lesions","authors":"","doi":"10.1016/j.ejso.2024.108779","DOIUrl":"10.1016/j.ejso.2024.108779","url":null,"abstract":"<div><h3>Background</h3><div>The current standard for the preoperative marking of non-palpable breast lesions is wire guided localization (WGL) which is associated with logistical efforts and patient discomfort. Non-radioactive seeds (NRS) recently challenged the use of WGL; but do they provide a better alternative from a logistical and environmental perspective?</div></div><div><h3>Methods</h3><div>WGL standard was compared with NRS available in Germany: Magseed®, Pintuition®, SAVI SCOUT ® and LOCalizer™ on a logistical and carbon-footprinting basis. In the logistical analysis the number of patient contacts with the healthcare system for lesion localization/removal and the number of breast punctures were evaluated in two different clinical scenarios (primary surgery and secondary surgery after neoadjuvant treatment). The carbon footprints of WGL and NRS (with exception of LOCalizer) were assessed based on their material compositions and operating energy in a streamlined approach.</div></div><div><h3>Results</h3><div>Application of NRS reduces the number of contacts by 33.3 % (2 vs. 3) in primary, by 50 % (2 vs. 4) in secondary surgery, and the number of breast punctures by 33.3 % (2 vs.3). Annual Germany-wide material- and energy-based carbon footprints of NRS (1.6–3.2 tons CO₂eq) are significantly lower in comparison to WGL (10.3 tons CO₂eq). The implementation of NRS would lead to a CO₂eq reduction by around 79 % compared to WGL.</div></div><div><h3>Conclusions</h3><div>The use of NRS for the localization of non palpable breast lesions is more favorable from the environmental and logistical perspective, when compared to WGL with possible benefits for patients, healthcare providers and the environment.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568230","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":"Pre-operative evaluation of spontaneous portosystemic shunts as a predictor of post-hepatectomy liver failure in patients undergoing liver resection for hepatocellular carcinoma.","authors":"Gianluca Rompianesi, Ho-Seong Han, Giuseppe Fusai, Santiago Lopez-Ben, Marcello Maestri, Giorgio Ercolani, Marcello Di Martino, Rafael Diaz-Nieto, Benedetto Ielpo, Alejandro Perez-Alonso, Nolitha Morare, Margarida Casellas, Anna Gallotti, Angela de la Hoz Rodriguez, Fernando Burdio, Federico Ravaioli, Pietro Venetucci, Emanuela Lo Bianco, Arianna Ceriello, Roberto Montalti, Roberto Ivan Troisi","doi":"10.1016/j.ejso.2024.108778","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108778","url":null,"abstract":"<p><strong>Background: </strong>Post-hepatectomy liver failure (PHLF) can significantly compromise outcomes, especially in cirrhotic patients. The identification of accurate and non-invasive pre-operative predictors is of paramount importance to appropriately stratify patients according to their estimated risk and select the best treatment strategy.</p><p><strong>Materials and methods: </strong>Consecutive patients undergoing liver resection for HCC on cirrhosis between 1-2015 and 12-2020 at 10 international Institutions were enrolled and their pre-operative CT scans were evaluated for the presence of spontaneous portosystemic shunts (SPSS) to identify predictors of PHLF and develop a nomogram.</p><p><strong>Results: </strong>The analysis of the CT scans identified SPSS in 74 patients (17.4 %). PHLF was developed in 27 out of 425 cases (6.4 %), with grades B/C observed in 17 patients (4 %). At the multivariable analysis, the presence of SPSS resulted an independent risk factor for all-grades PHLF (OR 6.83, 95%CI 2.39-19.51, p < 0.001) and clinically significant PHLF development (OR 7.92, 95%CI 2.03-30.85, p = 0.003) alongside a patient's age ≥74 years, a pre-operative platelets count <106x10³/μL, a multiple-segments liver resection, and an intraoperative blood loss ≥1200 mL. The 30- and 90-days mortality in patients with and without SPSS resulted 2.7 % vs 0.3 % (p = 0.024) and 5.4 % vs 1.1 % (p = 0.014). The accuracy of SPSS in predicting PHLF development was 0.847 (95%n CI 0.809-0.880). The internally validated nomogram showed excellent performance in predicting grades B/C PHLF (c-statistic = 0.933 (95%CI 0.888-0.979)).</p><p><strong>Conclusion: </strong>The pre-operative presence of SPSS assessed on the pre-operative imaging proved to be a valuable radiological biomarker able to predict PHLF development in patients undergoing liver resection for HCC.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: Enhancing vulvar cancer care: Integrating biomarkers and AI for better outcomes.","authors":"Mario Preti, Luigino Dal Maso, Stefano Guzzinati, Lauro Bucchi","doi":"10.1016/j.ejso.2024.108775","DOIUrl":"https://doi.org/10.1016/j.ejso.2024.108775","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497169","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}