Ejso最新文献

{"title":"Pre-treatment S-index as a promising prognostic indicator of treatment response and survival in patients with synchronous colorectal liver metastases: A retrospective multi-center study","authors":"Yiqiao Deng ,&nbsp;Yuan Li ,&nbsp;Rui Zhang ,&nbsp;Zhijie Wang ,&nbsp;Rui Guo ,&nbsp;Xinyu Bi ,&nbsp;Jianjun Zhao ,&nbsp;Jianguo Zhou ,&nbsp;Zhiyu Li ,&nbsp;Rui Zhang ,&nbsp;Qichen Chen ,&nbsp;Hong Zhao","doi":"10.1016/j.ejso.2025.110371","DOIUrl":"10.1016/j.ejso.2025.110371","url":null,"abstract":"<div><h3>Background</h3><div>Patients with synchronous colorectal cancer liver metastasis (CRLM) often face sub-optimal outcomes from systemic therapy or resection. This study investigates the prognostic value of the pre-treatment S-index, a reliable non-invasive marker for liver fibrosis, for outcomes in synchronous CRLM patients.</div></div><div><h3>Methods</h3><div>This study included two populations of patients with synchronous CRLM: one population undergoing resection and another population receiving systemic therapy for unresectable CRLM. Pre-treatment S-index levels were assessed from blood samples. Patients were categorized into high and low S-index groups, and comparisons were made regarding outcomes: progression-free survival (PFS), early post-operative recurrence and fibrosis in liver metastases in the resection population, and treatment response in the systemic therapy population. Multiplex immunohistochemistry/immunofluorescence (mIHC/IF) was used to investigate the distribution of immunosuppressive T-cell subsets in liver metastases.</div></div><div><h3>Results</h3><div>For synchronous CRLM patients receiving resection (n = 1000), patients with high preoperative S-index demonstrated significantly worse PFS both before (HR = 1.556, 95 % CI: 1.255–1.929; <em>P</em> &lt; 0.001) and after IPTW-adjusted Cox proportional hazards regression analysis (IPTW-adjusted HR = 1.439, 95 % CI: 1.094–1.894; <em>P</em> = 0.036). High S-index patients also exhibited an elevated risk of early recurrence, both before and after adjustment (OR = 1.556, 95 % CI: 1.255–1.929, <em>P</em> &lt; 0.001; IPTW-adjusted OR = 1.439, 95 % CI: 1.094–1.894, <em>P</em> = 0.009). For synchronous CRLM patients receiving system therapy (n = 123), a high pre-treatment S-index (OR = 34.691, <em>P</em> = 0.005) was a significant predictor of progression disease in multivariate analyses. Further, the S-index showed an AUC of 0.814 (95 %CI: 0.762–0.866, <em>P</em> &lt; 0.001) for detecting fibrosis in liver metastases, with a specificity of 0.928. mIHC/IF analysis revealed that inhibitory T cells, especially CD4⁺PD1⁺ T cells and CD4⁺FOXP3⁺ T cells, were significantly elevated in the liver metastases of the high S-index group.</div></div><div><h3>Conclusion</h3><div>This study contributed valuable evidence regarding pre-treatment S-index for association with outcomes among synchronous CRLM patients receiving resection or system therapy. Furthermore, it underscores a significant association between a high S-index and the presence of fibrosis in liver metastases, as well as more infiltration of immunosuppressive T cells in the tumor.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110371"},"PeriodicalIF":2.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996838","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":"Transparency in Externally Validated Models: A systematic review of machine learning vs. logistic regression for predicting colorectal anastomotic leakage","authors":"Sara Ben Hmido ,&nbsp;Houssam Abder Rahim ,&nbsp;Erik W. Ingwersen ,&nbsp;George Burchell ,&nbsp;Roel Hompes ,&nbsp;Donald van der Peet ,&nbsp;Eric Sonneveld ,&nbsp;Geert Kazemier ,&nbsp;Freek Daams","doi":"10.1016/j.ejso.2025.110367","DOIUrl":"10.1016/j.ejso.2025.110367","url":null,"abstract":"<div><h3>Introduction</h3><div>Colorectal resection carries a 2.8 %–30 % risk of anastomotic leakage. Machine learning can estimate risks and guide decisions, but clinical implementation remains inadequate due to transparency issues. This review assesses the performance and transparency of machine learning models compared to logistic regression.</div></div><div><h3>Methods</h3><div>A systematic review followed PRISMA guidelines. Medline, Embase, Web of Science, and Cochrane databases were searched for studies using Logistic Regression or Machine Learning with external validation for colorectal anastomotic leakage prediction. Data were extracted using CHARMS, risk of bias assessed with PROBAST, and transparency with TRIPOD + AI.</div></div><div><h3>Results</h3><div>Ten studies were included. Machine learning models were validated on smaller cohorts than logistic regression. Transparency scores ranged from 29 % to 63 %, averaging 45 % for logistic regression and 43 % for machine learning. Reporting of missing data was inconsistent, and external validation was limited. Most studies had a high risk of bias due to small sample sizes and low event counts.</div></div><div><h3>Conclusion</h3><div>In comparison to Logistic regression studies, machine learning studies are limited by small cohorts, low outcome numbers, and a lower level of transparency. Future research should prioritise transparency, adhere to TRIPOD + AI standards, and develop LR and ML models in parallel using the same datasets while ensuring separate models for colon and rectal surgery. Currently, these models are not yet suitable for clinical implementation; more robust and transparent models must be developed based on these recommendations before they can be applied in clinical practice.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110367"},"PeriodicalIF":2.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886999","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 decision making for treatment in LARC and LRRC: A qualitative study","authors":"Anwen Williams ,&nbsp;Claire O'Neill ,&nbsp;Hayley Hutchings ,&nbsp;Aaron Quyn ,&nbsp;Michael Duff ,&nbsp;John Ian Jenkins ,&nbsp;Claire Taylor ,&nbsp;Ben Griffiths ,&nbsp;Dean Harris ,&nbsp;Martyn Evans ,&nbsp;Deena Harji","doi":"10.1016/j.ejso.2025.110372","DOIUrl":"10.1016/j.ejso.2025.110372","url":null,"abstract":"<div><h3>Introduction</h3><div>Decision-making in locally advanced (LARC) and locally recurrent rectal cancer (LRRC) has transformed over recent years. Informed consent and shared decision making have allowed patients to consider what information and factors are individually important to them. There is a limited understanding of the complexities of decision-making in patients undergoing pelvic exenteration (PE) for rectal cancer. The aim of this study was to explore patients and clinicians’ perceptions on factors important during the decision-making process.</div></div><div><h3>Methods</h3><div>A prospective, cross-sectional, qualitative study was undertaken using in-depth virtual telephone audio recorded interviews across five UK centres between January and October 2020 with both patients and healthcare professionals (HCPs). The transcripts were imported into NVIVO 12 (QSR International Pty Ltd., Melbourne, Australia) and coded using the principles of thematic content analysis.</div></div><div><h3>Results</h3><div>Thirty-three interviews (25 patients (76 %) and 8 HCPs (24 %)) were conducted. Thirteen males (52 %) and 12 females (48 %) with a median age of 59 years (range 36–73) were recruited. Median time elapsed between surgery and interview was 7 months (range 3–11). Six themes emerged relevant to decision-making including: communication, recovery, psychological impact, relationships, lifestyle, support. Healthcare professionals focus primarily on treatment expectations, recovery, and psychological impact.</div></div><div><h3>Discussion</h3><div>Our study highlights the differing perspectives of patient and HCPs priorities during the decision-making process for PE. Our findings have direct relevance to framing pre-operative counselling discussions in helping patients decide on individual treatment decisions. Policy makers and clinicians need to ensure we are meeting patients’ informational needs by investing into a standardised dedicated service throughout the UK.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110372"},"PeriodicalIF":2.9,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903328","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 implications of clip migration after stereotactic-assisted vacuum-assisted breast biopsies","authors":"Gesche Schultek ,&nbsp;Bernd Gerber ,&nbsp;Steffi Hartmann ,&nbsp;Toralf Reimer ,&nbsp;Johannes Stubert ,&nbsp;Sarah Fröhlich ,&nbsp;Laura Gebert ,&nbsp;Angrit Stachs","doi":"10.1016/j.ejso.2025.110393","DOIUrl":"10.1016/j.ejso.2025.110393","url":null,"abstract":"<div><div>A stereotactic vacuum-assisted breast biopsy (VABB) is used to assess non-palpable breast lesions. The current study aims to identify possible influencing factors for clip migration and the impact of clip migration on surgery. In a retrospective study, clip migration in post-biopsy mammograms was evaluated (using a cut-off of ≥10 mm vs. &lt;10 mm). Clip migration of ≥10 mm occurred in 35 patients (20.5 %). Breast density, type of clip, and bleeding did not influence the risk of clip migration. Clip migration along the access path (z-axis) and lower breast thickness were the only significant factors in relevant clip migration. Surgery was performed on 57 patients (33.3 %), including seven cases of clip migration ≥10 mm. A wire-guided localization was possible in all cases of pre-invasive or invasive lesions due to residual microcalcifications. Clip migration immediately after a VABB is common but has little negative impact on subsequent procedures.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110393"},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864089","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":"Prehabilitation for surgical cancer patients: an active role for the caregiver?","authors":"Tracy Liu ,&nbsp;Detlef Balde ,&nbsp;Linda Edgar ,&nbsp;Francesco Carli","doi":"10.1016/j.ejso.2025.110391","DOIUrl":"10.1016/j.ejso.2025.110391","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110391"},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144892753","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":"Fertility-sparing management of low-grade endometrial stromal sarcoma: A systematic review of oncologic and reproductive outcomes","authors":"Giuseppe Cucinella ,&nbsp;Maria Cristina Solazzo ,&nbsp;Mariano Catello Di Donna ,&nbsp;Carlo Ronsini ,&nbsp;Federica Anzelmo Sciarra ,&nbsp;Stefano Restaino ,&nbsp;Vito Andrea Capozzi ,&nbsp;Roberto Beretta ,&nbsp;Giorgio Bogani ,&nbsp;Cono Scaffa ,&nbsp;Giuseppe Vizzielli ,&nbsp;Vito Chiantera","doi":"10.1016/j.ejso.2025.110382","DOIUrl":"10.1016/j.ejso.2025.110382","url":null,"abstract":"<div><h3>Objective</h3><div>Low-grade endometrial stromal sarcoma (LG-ESS) is a rare malignancy and the standard of care, precludes future childbearing. Although fertility-sparing treatment (FST) may be considered in carefully selected patients, high-quality evidence regarding its efficacy and safety is limited. This review aims to systematically evaluate the oncologic and reproductive outcomes associated with conservative treatment for LG-ESS.</div></div><div><h3>Methods</h3><div>Pubmed Database, Scopus Database and Embase Database were screened in September 2024 from the first publication about women with LG-ESS treated with a surgical FST. We included the studies containing data about oncologic, and reproductive outcomes. This study adheres to PRISMA guidelines and is registered with PROSPERO (CRD42024605140). The quality of the studies was assessed using the Newcastle–Ottawa scale.</div></div><div><h3>Results</h3><div>9 studies fulfilled inclusion criteria, and 89 patients were analyzed. Recurrence was observed in 51 out of 89 patients (57.3 %) with a mean recurrence-free interval ranging between 3 and 40.5 months. A mortality rate of 1.1 % was observed, with a mean follow-up duration ranging from 38.5 to 84.5 months. The overall pregnancy rate was 41.5 % and the live birth rate was 78.1 %. The preterm delivery rate was 8 % and 3.9 % of patients required assisted reproduction technology.</div></div><div><h3>Conclusions</h3><div>Considering the limitations of the available evidence, FST in women with LG-ESS carries a relatively high risk of tumor relapse, though it does not increase the risk of death. Fertility outcomes seem to be encouraging. Resection of the malignant uterine lesion combined with adjuvant hormonal treatment may be considered for selected early-stage patients, with close follow-up.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110382"},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903274","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":"Prognostic impact of total (Ipsilateral) retroperitoneal lipectomy vs. complete resection in retroperitoneal liposarcoma: A retrospective cohort study with nomogram","authors":"Qisheng Hao ,&nbsp;Qingze Li ,&nbsp;Hongliang Liu ,&nbsp;Kang Fu ,&nbsp;Lichao Cha ,&nbsp;Ke Yao ,&nbsp;Mingkai Gong ,&nbsp;Guofei Dong ,&nbsp;Qundong Zhou ,&nbsp;Xiangguo Hu ,&nbsp;Chengye Zhao ,&nbsp;Kai Ma ,&nbsp;Zehua Wu ,&nbsp;Zhongyi Guo ,&nbsp;Fabo Qiu ,&nbsp;Zhen Tan ,&nbsp;Lantian Tian","doi":"10.1016/j.ejso.2025.110374","DOIUrl":"10.1016/j.ejso.2025.110374","url":null,"abstract":"<div><h3>Background</h3><div>Retroperitoneal liposarcoma (RPLS), the most common retroperitoneal sarcoma, poses significant therapeutic challenges due to high recurrence rates. This study evaluates the long-term outcomes of total (Ipsilateral) retroperitoneal lipectomy (TRL) versus complete resection (CR) and develops prognostic nomograms.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 208 RPLS patients who underwent surgical treatment at the Department of Retroperitoneal Tumor Surgery, Affiliated Hospital of Qingdao University, between January 2015 and December 2022. Patients were stratified into the Complete Resection (CR) group (n = 152) and the TRL group (n = 56). Kaplan-Meier analysis and log-rank tests were used to compare overall survival (OS) and recurrence-free survival (RFS). Patients were randomly divided into training (70 %) and validation (30 %) cohorts. Univariate and multivariate Cox regression analyses identified independent prognostic factors, which were incorporated into nomograms. Model performance was assessed using the area under the curve (AUC), concordance index (C-index), calibration curves, and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>Among 208 included patients, the TRL group demonstrated significantly higher OS and RFS rates compared to the CR group. Surgical approach, subtype, and types of tumor occurrence were independent predictors of OS. Surgical approach, subtype, and duration significantly influenced RFS.</div></div><div><h3>Conclusion</h3><div>TRL may improve long-term survival outcomes in RPLS patients and could serve as a potential independent protective prognostic factor, though this requires validation through multicenter external studies. The developed nomograms for OS and RFS show promising predictive performance and potential clinical application value, but their generalizability needs to be further confirmed by external validation.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110374"},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864120","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":"Video-assisted total transthoracic liver resection for colorectal liver metastasis, safety and feasibility","authors":"P.D. Gobardhan,&nbsp;E.J. Veen,&nbsp;A.M. Rijken,&nbsp;N. Ayez","doi":"10.1016/j.ejso.2025.110389","DOIUrl":"10.1016/j.ejso.2025.110389","url":null,"abstract":"<div><h3>Introduction</h3><div>Laparoscopic resection of colorectal liver metastasis (CRLM) located in posterosuperior segments of the liver remains challenging. The primary aim of this study was to evaluate the safety and feasibility of video-assisted total thoracoscopic approach. The secondary aim was to assess the short-term outcomes associated with this technique.</div></div><div><h3>Methods</h3><div>Patients undergoing a video-assisted total thoracoscopic resection of CRLM between 2016 and 2020 at the Amphia Hospital were included. Retrospective assessment of complication rate, conversion rate, postoperative outcomes (radicality of resection) and short-term oncological outcomes (disease-free survival) was performed.</div></div><div><h3>Results</h3><div>A total of 15 patients were included in the study. In 14 patients a totally transthoracic liver resection was performed. A wedge resection was not feasible in 1 patient due to difficult anatomy, this patient underwent an ablation. Peri-operative and short- and long-term outcomes are comparable to abdominal laparoscopic liver resections. No postoperative deaths were observed within 90 days.</div></div><div><h3>Conclusion</h3><div>The video-assisted total transthoracic approach is a safe and feasible option for posterosuperior liver metastasis surgery and further studies are warranted to assess the long-term outcomes of this approach.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110389"},"PeriodicalIF":2.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864026","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":"Prognostic significance of molecular classification in high-risk endometrial cancer patients undergoing sentinel lymph node mapping","authors":"Laguna Olmos Mariano ,&nbsp;Padilla-Iserte Pablo ,&nbsp;Diaz-Feijoo Berta ,&nbsp;Arencibia Sánchez Octavio ,&nbsp;Roldan Rivas Fernando ,&nbsp;Oliver Pérez María de los Reyes ,&nbsp;Boukichou Abdelkader Nisa ,&nbsp;Fernández González Sergi ,&nbsp;Guijarro Campillo Alberto Rafael ,&nbsp;Marcos-Sanmartín Josefa ,&nbsp;Fidalgo Soledad ,&nbsp;Amengual Vila Joana ,&nbsp;Aghababyan Kristina ,&nbsp;Adiego-Calvo Ignacio ,&nbsp;Alonso Paula ,&nbsp;Iacoponi Sara ,&nbsp;SEGO Spain-GOG Group","doi":"10.1016/j.ejso.2025.110385","DOIUrl":"10.1016/j.ejso.2025.110385","url":null,"abstract":"<div><h3>Introduction</h3><div>The adoption of selective sentinel lymph node biopsy (SLNB) as a viable alternative to lymphadenectomy, along with the redefinition of nodal risk groups based on molecular classification, has significantly changed the management of early-stage, high-risk preoperative endometrial cancer.</div></div><div><h3>Materials and methods</h3><div>A retrospective, multicenter study was conducted under the auspices of the Spanish Gynecologic Oncology Group to evaluate recurrence rates and oncologic outcomes in patients stratified by molecular risk. Three groups were compared: SLNB alone (G1), SLNB combined with pelvic and/or para-aortic lymphadenectomy (G2), and pelvic and/or para-aortic lymphadenectomy without SLNB (G3). The primary endpoint was recurrence rate; secondary endpoints included disease-free survival (DFS), overall survival (OS), recurrence patterns.</div></div><div><h3>Results</h3><div>A total of 221 patients from 14 centers were included, with a median follow-up of 24.4 months (IQR 17–42). Forty-four patients (19.9 %) experienced recurrence. Relapse rates were 15.4 % in G1, 15.8 % in G2, and 22.2 % in G3 (p = 0.479). DFS rates were 84.6 % in G1, 84.1 % in G2, and 77.8 % in G3 (p = 0.56). OS rates were 94.2 %, 90.9 %, and 92.6 %, respectively (p = 0.651). Among the 44 patients with documented recurrence, seven had nodal recurrences, with only two occurring in the group managed with SLNB alone.</div></div><div><h3>Conclusion</h3><div>In this study, patients with early-stage, high-risk preoperative endometrial cancer—classified by molecular subgroups—showed no significant differences in relapse rates, disease-free survival, or overall survival across the three management strategies. Further prospective studies with longer follow-up are warranted to validate these preliminary findings.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110385"},"PeriodicalIF":2.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864031","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 hyperthermia on abdominal tissue concentrations of cisplatin during and after intraperitoneal chemotherapy – insights from a porcine model","authors":"Christina Harlev ,&nbsp;Mats Bue ,&nbsp;Elisabeth Krogsgaard Petersen ,&nbsp;Mads Kristian Duborg Mikkelsen ,&nbsp;Andrea René Jørgensen ,&nbsp;Bo Martin Bibby ,&nbsp;Anne Vibeke Schmedes ,&nbsp;Lone Kjeld Petersen ,&nbsp;Maiken Stilling","doi":"10.1016/j.ejso.2025.110378","DOIUrl":"10.1016/j.ejso.2025.110378","url":null,"abstract":"<div><h3>Background</h3><div>Epithelial ovarian cancer remains a leading cause of mortality among gynecological malignancies, with a high incidence of peritoneal carcinomatosis at diagnosis. Hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a promising treatment for advanced-stage epithelial ovarian cancer, potentially improving recurrence-free and overall survival rates. The study aimed to investigate the impact of hyperthermia on cisplatin concentrations in healthy abdominal tissues by comparing HIPEC with normothermic intraperitoneal chemotherapy (NIPEC) in a novel porcine model.</div></div><div><h3>Materials and methods</h3><div>Sixteen cancer-free pigs underwent cytoreductive surgery followed by either HIPEC or NIPEC, with cisplatin administered intraperitoneally. Microdialysis was used to measure local cisplatin concentrations in various abdominal tissues over a 6-h period.</div></div><div><h3>Results</h3><div>The analysis revealed no statistically significant or clinically relevant difference in cisplatin concentrations between the HIPEC and NIPEC groups. In both groups, cisplatin concentrations were consistently higher in the peritoneum than in other tissues, and plasma levels were significantly lower than those in abdominal tissues.</div></div><div><h3>Conclusion</h3><div>Hyperthermia did not enhance cisplatin's tissue penetration, suggesting that NIPEC may be an effective alternative to HIPEC, particularly for fragile and elderly patients. Future studies should investigate whether hyperthermia improves cisplatin delivery and cytotoxicity in tumor-infiltrated peritoneal tissues.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110378"},"PeriodicalIF":2.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852110","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}