Ejso最新文献

{"title":"Exploratory randomized pilot study comparing speech, swallowing, and quality of life outcomes following different types of primary closure after partial glossectomy for early tongue carcinoma","authors":"Vikas Hansraj Maheshwari,&nbsp;Rohit Nayyar,&nbsp;Harit Chaturvedi,&nbsp;Akshat Malik","doi":"10.1016/j.ejso.2025.110309","DOIUrl":"10.1016/j.ejso.2025.110309","url":null,"abstract":"<div><h3>Background</h3><div>Primary closure is a common reconstructive option for smaller defects following partial glossectomy for early-stage tongue carcinoma (T1 and T2). However, the optimal technique of closure in terms of functional outcomes remains unclear. This study aimed to compare speech, swallowing, and quality of life (QOL) outcomes between different methods of primary closure.</div></div><div><h3>Methods</h3><div>This exploratory randomized pilot study was conducted between 2022 and 2023. A total of 36 patients undergoing partial glossectomy for early tongue carcinoma were randomized pre-operatively into three groups: horizontal closure, rotational closure, or healing by secondary intention. Functional outcomes, including speech and swallowing, were assessed pre-operatively, at one week, and one month post-operatively using the Speech Perceptual Index, Speech Intelligibility Score, Functional Oral Intake Scale (FOIS), Speech handicap index(SHI) and MD Anderson Dysphagia Inventory (MDADI).</div></div><div><h3>Results</h3><div>There were no statistically significant differences between the three groups in terms of speech, swallowing, or quality of life outcomes across all time points evaluated.</div></div><div><h3>Conclusion</h3><div>For smaller partial glossectomy defects(&lt;30 %) in early tongue carcinoma, the choice of closure technique — whether horizontal, rotational, or healing by secondary intention — does not significantly affect speech, swallowing, or quality of life outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110309"},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605423","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":"Real-world quality of life outcomes after prepectoral implant-based breast reconstruction with or without titanium-coated mesh (TiLOOP® Bra Pocket): A prospective cohort study","authors":"Moritz Hamann,&nbsp;Elena Bensmann,&nbsp;Anne Andrulat,&nbsp;Jasmin Festl,&nbsp;Gitti Saadat,&nbsp;Michael Braun","doi":"10.1016/j.ejso.2025.110311","DOIUrl":"10.1016/j.ejso.2025.110311","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate quality of life (QoL) one year after immediate prepectoral direct-to-implant breast reconstruction (DTIBR) with and without a titanium-coated mesh (TiLOOP® Bra Pocket).</div></div><div><h3>Methods</h3><div>In this prospective study (March 2021–February 2024), 309 DTIBR patients were analyzed. QoL was assessed preoperatively and postoperatively using the Breast-Q questionnaire (psychosocial well-being, sexual well-being, satisfaction with breasts, and physical well-being of the chest). Influencing factors were identified via linear regression.</div></div><div><h3>Results</h3><div>One-year follow-up (FUP) included 235 unilateral (85.8 %) and 31 bilateral (92.2 %, 61 breasts) DTIBR cases. After excluding 14 patients (autologous reconstruction, ADM use, or both prior and additional postoperative RT), 282 remained: 203 (71.7 %) with TiLOOP® Bra Pocket, 61 (21.9 %) without implant coverage, and 18 (6.4 %) using “dual-plane” techniques.</div><div>Mean scores showed increased psychosocial well-being (71.2–73.9) but declines in sexual well-being (64.3–60.3), satisfaction with breasts (67.3–65.2), and chest-related physical well-being (83.1–76.4). Higher preoperative scores predicted postoperative declines across all QoL domains. Older age correlated with better psychosocial (B = 0.189, p = 0.032) and physical well-being (B = 0.259, p = 0.008). TiLOOP® Bra Pocket improved psychosocial well-being (B = 4.971, p = 0.038). Satisfaction with breasts was lower with pending symmetrizing procedures (B = −13.771, p &lt; 0.001) or complications (B = −6.543, p = 0.049). Postoperative RT reduced physical well-being (B = −7.309, p = 0.008).</div></div><div><h3>Conclusion</h3><div>DTIBR results in high QoL, influenced by complications, postoperative RT, age, and preoperative satisfaction. Patients should be counseled considering these factors.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110311"},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144654741","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":"Adherence and response to supervised home-based exercise prehabilitation of unfit patients scheduled for pancreatic surgery","authors":"Nicole D. Hildebrand ,&nbsp;Allard G. Wijma ,&nbsp;Bart C. Bongers ,&nbsp;Sander S. Rensen ,&nbsp;Marcel den Dulk ,&nbsp;Joost M. Klaase ,&nbsp;Steven W.M. Olde Damink","doi":"10.1016/j.ejso.2025.110302","DOIUrl":"10.1016/j.ejso.2025.110302","url":null,"abstract":"<div><h3>Introduction</h3><div>Exercise prehabilitation yields promising results in major surgery, including pancreatic surgery. Whereas most prehabilitation studies focus on effectiveness, objectively assessed adherence data supporting feasibility of preoperative physical exercise programs are scarce. This study aimed to assess participation rate, adherence, and effectiveness of a partly supervised, home-based exercise prehabilitation program in unfit patients scheduled for pancreatic surgery.</div></div><div><h3>Material and methods</h3><div>In this prospective multicentre study, thirty unfit patients (oxygen uptake [VO₂] at ventilatory anaerobic threshold [VAT] ≤13 mL/kg/min and/or VO₂ at peak exercise [VO₂peak] ≤18 mL/kg/min) participated in a four-week home-based exercise prehabilitation program consisting of three personalized high-intensity interval training sessions per week on a remotely monitored cycle ergometer. The primary outcome was program feasibility, defined as participation rates and adherence to frequency, intensity, and time of each training session. Secondary outcomes were individual responses to the program.</div></div><div><h3>Results</h3><div>Participation rate was 63.8 % (30/47 eligible patients, median age 71 years [IQR 65–76], 16 females, 80 % malignancy). Five patients (16.6 %) dropped out. Overall adherence to the number of training sessions was 91.1 %. Adherence to frequency and intensity diminished during the second half of the program. Nevertheless, aerobic capacity improved (VO₂peak+12.4 %, p &lt; 0.001; VO₂ at the VAT +16.3 %, p = 0.002). Ultimately, twenty patients underwent surgery, without mortality but with major complications in 25.0 %.</div></div><div><h3>Conclusions</h3><div>Objective assessment of adherence to a 4-week partly supervised home-based exercise prehabilitation program by unfit patients scheduled for pancreatic surgery was high, suggesting that even suboptimal execution of a training program still improves aerobic capacity, especially in the least fit patients.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier NCT05496777.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110302"},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604735","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 ChatGPT-4o outperforms Gemini advanced in assisting multidisciplinary decision-making for advanced gastric cancer","authors":"Huizi Li","doi":"10.1016/j.ejso.2025.110217","DOIUrl":"10.1016/j.ejso.2025.110217","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110217"},"PeriodicalIF":3.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597126","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":"Comparison of short- and mid-term outcomes of robotic versus laparoscopic gastrectomy in high-risk patients with gastric cancer: a nationwide, multicentre cohort study","authors":"Wen-wu Qiu ,&nbsp;Ze-Ning Huang ,&nbsp;Tai- Yuan Li ,&nbsp;Li Zhang ,&nbsp;Jun-Jun She ,&nbsp;Bao-Qing Jia ,&nbsp;Xin-Gan Qin ,&nbsp;Shuang-Yi Ren ,&nbsp;Hong-Liang Yao ,&nbsp;Dong-Ning Liu ,&nbsp;Han Liang ,&nbsp;Fei-Yu Shi ,&nbsp;Peng Li ,&nbsp;Bo-Pei Li ,&nbsp;Xin-Sheng Zhang ,&nbsp;Kui-Jie Liu ,&nbsp;Chao-hui Zheng ,&nbsp;Jian-xian lin ,&nbsp;Chang-ming Huang ,&nbsp;Ping Li","doi":"10.1016/j.ejso.2025.110294","DOIUrl":"10.1016/j.ejso.2025.110294","url":null,"abstract":"<div><h3>Background</h3><div>To compare short-term and mid-term outcomes of robotic gastrectomy (RG) versus laparoscopic gastrectomy (LG) in high-risk gastric cancer (GC) patients.</div></div><div><h3>Methods</h3><div>Patients with ≥1 of the following criteria were defined as high-risk: age ≥80 years; BMI ≥30 kg/m²; ASA grade ≥ III; and clinical T stage (cT4). Finally, 2001 patients who underwent radical gastrectomy between August 2016 and June 2019 at eight high-volume hospitals were included and underwent 1:1 propensity score matching (PSM) with 534 patients in each group.</div></div><div><h3>Results</h3><div>After PSM, the RG group experienced less intraoperative blood loss (111.35 vs. 132.46 ml; <em>P</em> &lt; 0.001) and a lower incidence of intraoperative massive haemorrhage (2.81 % vs. 5.62 %;<em>P</em> = 0.022), postoperative grade I–II complications (9.93 % <em>vs</em>.13.86 %; <em>P</em> = 0.047), medical complications (3.93 % vs. 8.61 %; <em>P</em> = 0.002), pneumonia (3.37 % <em>vs</em>. 7.30 %; <em>P</em> = 0.004), and pleural effusion (0.00 % <em>vs</em>. 0.75 %; <em>P</em> = 0.045) than the LG group. However, RG were associated with longer operative time (225.13 vs 210.51 min, P &lt; 0.001) and significantly higher costs ($11,990 vs $8,040, P &lt; 0.001). The three-year cumulative mortality rate (RG: 18.74 % vs. LG: 21.54 %, P = 0.280) and 3-year disease-free survival rate (RG: 78.97 % vs. LG: 75.45 %, P = 0.220) exhibited no statistically significant differences between surgical approaches. The 3-year overall recurrence rate was not significantly different between the RG and LG groups (22.47 % vs. 19.66 %; P = 0.294).</div></div><div><h3>Conclusions</h3><div>RG yielded better short-term outcomes and comparable mid-term prognoses than LG for patients with high-risk resectable gastric cancer.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110294"},"PeriodicalIF":3.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605426","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":"Esophagectomy after previous pancreatic surgery – challenges and approaches","authors":"Sarah Gerber,&nbsp;Tobias Haltmeier,&nbsp;Yves M. Borbély","doi":"10.1016/j.ejso.2025.110301","DOIUrl":"10.1016/j.ejso.2025.110301","url":null,"abstract":"<div><div>Esophagectomy (EE) is the mainstay for a curative treatment of esophageal cancer. Reconstruction after EE poses specific challenges, especially in patients with a history of upper abdominal procedures, such as pancreatic resections. Adhesions, altered anatomy, and, most notably, changes in blood supply are the main concerns. The gastroepiploic arcade is particularly interesting due to its vulnerability during pancreatic surgery, where it is often divided, and its importance in the blood supply of a potential gastric conduit. Furthermore, functional aspects, as well as diabetes, gastroparesis, and malassimilation following pancreatic surgery, can complicate peri- and postoperative management. An adequate preoperative preparation with particular attention to the vascular situation and optimizing a patient's general condition is mandatory to achieve successful results.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110301"},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623769","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 association between low muscle mass and sarcopenic obesity, survival, and major complications in patients with advanced ovarian cancer undergoing primary cytoreductive surgery: A retrospective study","authors":"Niina Norppa ,&nbsp;Antti Tolonen ,&nbsp;Milja Reijonen ,&nbsp;Auni Lindgren ,&nbsp;Synnöve Staff ,&nbsp;Irina Rinta-Kiikka ,&nbsp;Sami Saarelainen ,&nbsp;Otso Arponen","doi":"10.1016/j.ejso.2025.110286","DOIUrl":"10.1016/j.ejso.2025.110286","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to determine whether imaging-derived estimates of muscle mass or sarcopenic obesity are associated with survival and surgery-related complications in patients with advanced epithelial ovarian cancer treated with primary cytoreductive surgery (PCS).</div></div><div><h3>Methods</h3><div>A skeletal muscle index (SMI) was determined by normalizing the muscle area at the level of third lumbar vertebra with the patient's height. Patients with SMI &lt;38.5 cm²/m² were deemed to have low muscle mass, and those with SMI &lt;38.5 cm²/m² and body mass index &gt;25 kg/m² were deemed to be affected by sarcopenic obesity. The relationships between low SMI and sarcopenic obesity, 1-year, 3-year, and overall survival were studied with Cox regression and Kaplan–Meier methods. The effect of SMI and sarcopenic obesity on surgery-related major complications (Clavien–Dindo ≥ IIIB) was studied with logistic regression models.</div></div><div><h3>Results</h3><div>Ninety-two patients were retrospectively included, of whom 35 (38.0 %) and 12 (13.0 %) had low muscle mass or were affected by sarcopenic obesity, respectively. Among 73 (79.3 %) patients with high-grade serous OC, the 1-year survival rates were 66.7 % and 95.3 % (hazard ratio [HR] 9.19 [95 % confidence interval (CI): 1.85–45.75]) and the 3-year survival rates were 58.3 % and 68.8 % (HR 2.95 [95 % CI: 1.10–7.92]) for patients with and without sarcopenic obesity, respectively. Neither low muscle mass nor sarcopenic obesity was associated with major complications.</div></div><div><h3>Conclusion</h3><div>Sarcopenic obesity was a marker of poor 1-year and 3-year survival in patients with high-grade serous OC. Neither low muscle mass nor sarcopenic obesity was associated with major complications in PCS.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110286"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738012","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":"Effect of physical exercise on the quality of life of women surviving breast cancer: systematic review with meta-analysis of randomized clinical trials","authors":"Dario da Silva Monte Nero ,&nbsp;Carlos Rodrigo Nascimento de Lira ,&nbsp;Claudio Luiz da Silva Lima Paz ,&nbsp;Priscila Ribas de Farias Costa ,&nbsp;Carla de Magalhães Cunha ,&nbsp;Allain Amador Bueno ,&nbsp;Rosângela Passos de Jesus ,&nbsp;Lucivalda Pereira Magalhães de Oliveira","doi":"10.1016/j.ejso.2025.110287","DOIUrl":"10.1016/j.ejso.2025.110287","url":null,"abstract":"<div><h3>Introduction</h3><div>Women surviving breast cancer (WSBC) may experience reduced quality of life (QoL) due to disease-associated manifestations and undergone treatment. Engagement in physical exercise (PE), and subsequent effects on physical capacity and social and emotional wellbeing, are known to enhance QoL.</div></div><div><h3>Method</h3><div>this systematic review meta-analysed the impact of PE, compared to respective control groups, on QoL in WSBC. Randomized clinical trials published up to December 2023, updated in February 2025, were searched in PubMed Medline, PsycInfo, EMBASE, Web of Science, LILACS, Cochrane Central, Scopus, and Google Scholar. Selected papers were catalogued in Endnote® and remaining documents exported to Rayyan®. Data analyses utilized the RoB 2 tool, Revman®, and GRADE for classification of certainty of evidence. Values of change in measurements between baseline and post-intervention were meta-analysed, with standardized mean differences calculated as effect size.</div></div><div><h3>Results</h3><div>3313 documents were identified, with 36 meeting our eligibility criteria, and 35 quantitatively analysed. The meta-analysis revealed that PE, irrespective of modality, significantly improved QoL, as assessed by the Short Form Health Survey 36 (SF-36) global health perception scale (SMD = 0.43; CI95 %: 0.12 to 0.73; p = 0.006), FACT-G (SMD = 0.56; CI95 %: 0.13 to 0.99; p ≤ 0.01), FACT-B (SMD = 0.73; CI95 %: 0.38 to 1.08; p = 0.0003), and EORTC QLQ-C30 (Global health, SMD = 0.98; 95 % CI: 0.49–1.47; p &lt; 0.00001). Subgroup analyses showed that combination of aerobic and resistance exercises yielded the most significant increase in QoL. SF-36 subdomains showed moderate to high certainty of evidence.</div></div><div><h3>Conclusion</h3><div>PE is effective in improving QoL in WSBC, particularly when combining aerobic and strength exercises. Robust public policies must encourage PE not only to reduce cancer risk but also to promote QoL improvement in WSBC.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110287"},"PeriodicalIF":3.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687155","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 prognostic role of sarcopenia and muscle wasting in adult osteosarcoma patients: A longitudinal CT morphometric analysis","authors":"Julian Kylies ,&nbsp;Tobias Malte Ballhause ,&nbsp;Jana Striefler ,&nbsp;Dominik Kylies ,&nbsp;Matthias Priemel","doi":"10.1016/j.ejso.2025.110293","DOIUrl":"10.1016/j.ejso.2025.110293","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia is a known negative prognostic factor in oncology, yet its role in osteosarcoma remains unclear. This study evaluated CT-based body composition changes and their association with survival and functional outcomes in adult osteosarcoma patients undergoing chemotherapy and surgery.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 36 patients (mean age 44.2 ± 19.0 years) with histologically confirmed, non-metastatic osteosarcoma (TNM N0M0) and at least two CT scans. Skeletal Muscle Index (SMI), Paraspinal Muscle Index (PSMI), Psoas Muscle Index (PMI), Skeletal Muscle Density (SMD), and Visceral Adipose Tissue (VAT) were measured at the L3 level. Patients were stratified by baseline sarcopenia (using established SMI cut-offs) and by ≥ 25 % vs. &lt;25 % SMI loss. Survival was assessed using Kaplan-Meier curves and Cox regression adjusted for age, sex, ECOG, tumor necrosis, margin, and tumor size.</div></div><div><h3>Results</h3><div>All CT-morphometric parameters declined significantly over time (p &lt; 0.01). Baseline sarcopenia predicted poorer survival (HR 1.30, p = 0.014). A ≥25 % SMI reduction was associated with significantly worse survival (HR 1.70, p = 0.014) and poorer functional status (higher ECOG, p &lt; 0.01). Patients with high tumor activity (elevated LDH, CRP, AP) experienced greater muscle and fat loss (p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Baseline sarcopenia and progressive SMI loss are independent predictors of poor survival in osteosarcoma patients. Severe muscle loss is also linked to functional decline. Routine CT-based body composition assessment may enhance risk stratification and guide supportive care strategies.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110293"},"PeriodicalIF":3.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570761","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":"Development and interpretation of a pathomics-driven ensemble predictive model for prognosis of intrahepatic cholangiocarcinoma","authors":"Xin Zhang ,&nbsp;Chen-song Huang ,&nbsp;Xi-Tai Huang,&nbsp;Qiong-Cong Xu,&nbsp;Ai-qing Fu,&nbsp;Jian-Peng Cai,&nbsp;Jia-Ming Lai,&nbsp;Xiao-Yu Yin","doi":"10.1016/j.ejso.2025.110295","DOIUrl":"10.1016/j.ejso.2025.110295","url":null,"abstract":"<div><h3>Background and aims</h3><div>Pathomics exhibited great potential in improving clinical management but lacked of pathomics model for the prognosis of intrahepatic cholangiocarcinoma (iCCA) because of limited interpretability. This study aimed to develop and interpret a pathomics ensemble model for the prognosis of iCCA.</div></div><div><h3>Methods</h3><div>Based on 252 iCCA patients in our center, we constructed a deep learning framework to extract pathomics features from the postoperative tumor slide, which was externally validated in The Cancer Genome Atlas database. An ensemble predictive model was then developed based on the pathomics score and clinical parameters. The areas under the receiver operating characteristic curve (AUCs) were calculated to evaluate the performances. K-means unsupervised clustering classifies iCCA into subtypes based on the pathomics features. Cellprofiler was employed to extract the quantitative histomorphological features, and the differences between subtypes in clinical outcomes, histomorphology features, and genomics were further investigated.</div></div><div><h3>Results</h3><div>The AUCs of the ensemble pathomics model for the 1-year, 2-year, and 3-year OS reached 0.902, 0.853, and 0.807, respectively. The Gradient-weighted class activation mapping analysis was performed to visualize the model attention area. Two clusters were identified using the K-means clustering, which exhibited significantly different prognosis and histomorphological features. Several genes were significantly differentially expressed, several pathways were highly enriched, and two prognosis-related genes (TPM2 and PLOD2) were identified.</div></div><div><h3>Conclusions</h3><div>This study initially developed an ensemble pathomics model for the prognosis of iCCA, which could help make individualized treatment postoperatively. Moreover, we employed various methods to improve the interpretation of the model.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110295"},"PeriodicalIF":3.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144569857","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}