Ejso最新文献

{"title":"Head-to-head comparison of nephrometry scores for partial nephrectomy: implications for clinical guidelines","authors":"Mattia Longoni ,&nbsp;Giorgio Brembilla ,&nbsp;Giuseppe Rosiello ,&nbsp;Pietro Scilipoti ,&nbsp;Michele Cosenza ,&nbsp;Giulio Imperiale ,&nbsp;Federico Belladelli ,&nbsp;Chiara Re ,&nbsp;Giacomo Musso ,&nbsp;Francesco Cei ,&nbsp;Lucia Salerno ,&nbsp;Andrea Folcia ,&nbsp;Chiara Ciccarone ,&nbsp;Alberto Briganti ,&nbsp;Pierre Karakiewicz ,&nbsp;Andrea Salonia ,&nbsp;Alessandro Larcher ,&nbsp;Francesco Montorsi ,&nbsp;Francesco De Cobelli ,&nbsp;Umberto Capitanio","doi":"10.1016/j.ejso.2025.110283","DOIUrl":"10.1016/j.ejso.2025.110283","url":null,"abstract":"<div><h3>Introduction</h3><div>Several nephrometry scores aim to predict partial nephrectomy (PN) outcomes. Since consensus regarding the best score is lacking, we performed a prospective head-to-head comparison of the most widely used.</div></div><div><h3>Materials and methods</h3><div>A dedicated uroradiologist prospectively reviewed preoperative CT scan to assign points to variables of interest included in RENAL, PADUA, SPARE, C-Index, DAP, and MAP score, in 202 renal cell carcinoma (RCC) surgical candidates. The primary outcome was surgical success, defined as PN completion, absence of grade &gt; II Clavien-Dindo complications, ischemia time ≤20 min, and negative surgical margins. The secondary outcome was PN completion relative to radical nephrectomy (RN). Multivariable logistic regression (MLR) models predicted study outcomes after adjusting for age, gender, ECOG performance status, preoperative renal function, and surgical approach. Receiver operating characteristic (ROC) and area under the curve (AUC) compared each nephrometry accuracy.</div></div><div><h3>Results</h3><div>Surgical success and PN completion rates were 31 % and 60 %, respectively. At MLR, RENAL, PADUA, SPARE, DAP, and MAP scores independently predicted both outcomes (p &lt; 0.001). The highest predictive accuracy for surgical success and PN completion was recorded for SPARE (AUC: 0.79 and 0.89). Intermediate accuracy was recorded for RENAL (AUC: 0.78 and 0.85), PADUA (AUC: 0.78 and 0.86), DAP (AUC: 0.76 and 0.85) and C-Index (AUC: 0.73 and 0.77). The lowest accuracy was recorded for MAP (AUC: 0.65 and 0.68).</div></div><div><h3>Conclusion</h3><div>Nephrometries are associated with surgical success and PN completion. In clinical practice, the use of SPARE should be privileged based on the highest predictive accuracy for both endpoints.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110283"},"PeriodicalIF":3.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514237","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":"Pretracheal (No.106pre) lymph node metastasis in esophageal carcinoma: A sign of widespread disease progression, but potentially treatable as oligometastatic disease through neoadjuvant chemotherapy followed by surgery - A multicenter cohort study","authors":"Shota Igaue ,&nbsp;Takeo Fujita ,&nbsp;Junya Oguma ,&nbsp;Koshiro Ishiyama ,&nbsp;Kazuma Sato ,&nbsp;Daisuke Kurita ,&nbsp;Yuto Kubo ,&nbsp;Kentaro Kubo ,&nbsp;Daichi Utsunomiya ,&nbsp;Eigo Akimoto ,&nbsp;Ryoko Nozaki ,&nbsp;Ryota Kakuta ,&nbsp;Yasuyuki Seto ,&nbsp;Hiroyuki Daiko","doi":"10.1016/j.ejso.2025.110289","DOIUrl":"10.1016/j.ejso.2025.110289","url":null,"abstract":"<div><h3>Background</h3><div>Oligometastatic disease in esophageal carcinoma includes metastases to distant organs and extra-regional lymph nodes. Pretracheal lymph node metastasis (No. 106pre in the Japanese classification) is classified as an M1 lymph node metastasis and has a poor prognosis. However, documentation is limited and has often focused on heterogeneous cohorts from earlier times. The present study examines the outcomes of pretracheal lymph node resection in modern neoadjuvant therapy followed by surgery.</div></div><div><h3>Methods</h3><div>This multicenter retrospective cohort study, conducted at two cancer centers in Japan, included esophageal carcinoma patients with clinical pretracheal lymph node metastasis who underwent neoadjuvant chemotherapy followed by esophagectomy. Short-term and long-term outcomes were analyzed.</div></div><div><h3>Results</h3><div>In total, 110 patients were included, of whom 94 were negative, and 16 were positive for pathological pretracheal lymph node metastasis (p106pre(−) and p106pre(+)). The 106pre(+) group exhibited more advanced disease and a higher average number of metastatic lymph nodes (10.0). The 3-year overall survival rate was 66.6 % in the p106pre(−) group and 29.9 % in the p106pre(+) group, significantly poorer but not as poor as previously reported. Multivariate analysis identified ypN3 as the most potent independent prognostic factor, while pathological 106pre metastasis was not an independent prognostic factor.</div></div><div><h3>Conclusions</h3><div>In this multicenter study, patients with esophageal carcinoma with clinical pretracheal lymph node metastasis who underwent esophagectomy with lymph node resection after neoadjuvant chemotherapy had better outcomes than those previously reported. Some patients achieved long-term survival, suggesting that pretracheal lymph node metastasis can be considered oligometastatic disease.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110289"},"PeriodicalIF":2.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750182","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":"Lost axillary markers after neoadjuvant chemotherapy in breast cancer patients - data from the prospective international AXSANA (EUBREAST 3) cohort study (NCT04373655)","authors":"Steffi Hartmann ,&nbsp;Maggie Banys-Paluchowski ,&nbsp;Tomasz Berger ,&nbsp;Nina Ditsch ,&nbsp;Elmar Stickeler ,&nbsp;Jana de Boniface ,&nbsp;Oreste Davide Gentilini ,&nbsp;Jennifer Schroth ,&nbsp;Guldeniz Karadeniz Cakmak ,&nbsp;Isabel T. Rubio ,&nbsp;Maria Luisa Gasparri ,&nbsp;Michalis Kontos ,&nbsp;Eduard-Alexandru Bonci ,&nbsp;Laura Niinikoski ,&nbsp;Dawid Murawa ,&nbsp;Geeta Kadayaprath ,&nbsp;David Pinto ,&nbsp;Florentia Peintinger ,&nbsp;Ellen Schlichting ,&nbsp;Lukas Dostalek ,&nbsp;Zbigniew I. Nowecki","doi":"10.1016/j.ejso.2025.110253","DOIUrl":"10.1016/j.ejso.2025.110253","url":null,"abstract":"<div><h3>Introduction</h3><div>Marking metastatic lymph nodes before neoadjuvant chemotherapy (NACT) has become increasingly popular in the surgical treatment of breast cancer. A variety of devices are currently in use. However, the significance of lost markers is poorly understood, and their impact on clinical decisions is unclear.</div></div><div><h3>Materials and methods</h3><div>Among participants enrolled in the prospective AXSANA cohort study, those planned for target lymph node biopsy (TLNB) or targeted axillary dissection (TAD) with completed post-NACT locoregional therapy (surgery and radiotherapy) by January 21, 2025, were included.</div></div><div><h3>Results</h3><div>In 88 of 1528 patients (5.8 %), axillary markers could not successfully be removed during surgery after NACT. The lost marker rate differed depending on the marker type (metallic clip/coil 7.0 %, carbon 3.1 %, radar reflector 1.4 %, magnetic seed 0.6 %, radioactive seed 0.0 %, p &lt; 0.001). Additional postoperative imaging was performed in 25 (28.4 %) and further surgery to remove axillary markers was performed in 6 (6.8 %) patients with lost markers. The proportion of patients undergoing axillary lymph node dissection (46.6 % versus 36.5 %, p 0.069) and axillary radiotherapy (51.1 % versus 50.2 %, p 0.748) did not differ between patients with and without lost markers. After an average follow-up of 21.8 months, axillary recurrences occurred in 3 patients (3.3 %) with and 16 patients (1.0 %) without lost markers (rate ratio 2.89, p 0.088).</div></div><div><h3>Conclusion</h3><div>The loss of markers in TLNB/TAD is uncommon and significantly depends on the marking technique. Lost markers may lead to diagnostic uncertainties and additional imaging or surgical procedures.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110253"},"PeriodicalIF":3.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510987","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":"Impact of hepatocellular carcinoma-related prognostic factors on combined hepatocellular cholangiocarcinoma: A surgical cohort study","authors":"Po-Da Chen ,&nbsp;Te-Wei Su ,&nbsp;Chen-Yueh Lu ,&nbsp;Mei-Pei Huang ,&nbsp;Yao-Ming Wu","doi":"10.1016/j.ejso.2025.110279","DOIUrl":"10.1016/j.ejso.2025.110279","url":null,"abstract":"<div><h3>Introduction</h3><div>Combined hepatocellular cholangiocarcinoma (cHCC-CC) exhibits features of hepatocellular carcinoma (HCC) and cholangiocarcinoma. However, whether HCC-related prognostic factors are involved in cHCC-CC remains inconclusive. This study aimed to compare the pathophysiology and recurrence factors between cHCC-CC and HCC.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed 1274 consecutive patients who underwent standard hepatectomy between January 2002 and November 2024 for preoperatively diagnosed cHCC-CC or HCC. Propensity score matching (1:2) yielded 80 patients with cHCC-CC and 160 patients with HCC for comparative analysis of clinicopathological characteristics and surgical outcomes.</div></div><div><h3>Results</h3><div>The 10-year overall survival was 11.3 % for cHCC-CC vs. 17.5 % for HCC (p &lt; 0.001), whereas the 10-year disease-free survival was 10.0 % vs. 15.6 % (p = 0.012). Early recurrence occurred in 27.5 % of cHCC-CC cases vs. 12.5 % of HCC cases. Compared to HCC, cHCC-CC showed higher prevalence of high-grade tumors (55.0 % vs. 39.4 %, p = 0.031), lack of tumor encapsulation (2.3 % vs. 14.5 %, p = 0.031), tumor necrosis (58.3 % vs. 37.8 %, p = 0.02), vascular invasion (51.3 % vs. 39.3 %, p = 0.028), lymphovascular and perineural invasion (both p &lt; 0.001), and lymph node metastasis (7.5 % vs. 1.3 %, p = 0.009). Early recurrence was significantly associated with a higher prevalence of tumor necrosis (p = 0.002), aggressive vascular invasion (p = 0.006), satellite nodules (27.3 % vs. 6.9 %, p = 0.009), and advanced tumor stage (T3–T4: 27.3 % vs. 10.3 %, p = 0.003).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that HCC-related prognostic factors significantly influence cHCC-CC progression and recurrence, emphasizing that cHCC-CC may represent an aggressive variant of HCC.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110279"},"PeriodicalIF":3.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556902","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":"Endoscopic calcium electroporation in patients with precancerous cellular changes in the esophagus","authors":"Laser Arif Bazancir ,&nbsp;Charlotte Egeland ,&nbsp;Rajendra Singh Garbyal ,&nbsp;Julie Gehl ,&nbsp;Michael Patrick Achiam","doi":"10.1016/j.ejso.2025.110290","DOIUrl":"10.1016/j.ejso.2025.110290","url":null,"abstract":"<div><h3>Background</h3><div>Barrett's esophagus high-grade dysplasia (BE HGD) can transform into esophageal adenocarcinoma (EAC) in 19–28 % of the cases. Calcium electroporation (Ca-EP) is a novel anti-cancer therapy where electrical pulses are combined with a local injection of calcium to increase intracellular calcium levels leading to cell death. Calcium electroporation has shown effect on premalignant conditions, and a relative sparing of normal tissue.</div></div><div><h3>Methods</h3><div>The primary aim of this study was to establish safety with Ca-EP in patients with BE HGD. Six patients with BE HGD scheduled for an endoscopic submucosal dissection (ESD) were treated with Ca-EP six weeks before under general anesthesia in an outpatient setting. All adverse events (AEs) were registered, and patients were evaluated with gastroscopy within one week.</div></div><div><h3>Results</h3><div>AEs included retrosternal pain, throat irritation, coughing, and headache. No serious adverse events were registered. A hyperemic area was seen in four patients directly after Ca-EP. Fibrinous coatings (four patients) and ulcers (four patients) were observed up to one week after treatment. One patient underwent two CTA scans due to pain and a visually large fibrinous clot. CTA showed no sign of perforation. Six weeks after five patients had a partial visual response with new squamous epithelium. However, all patients still had BE HGD.</div></div><div><h3>Conclusion</h3><div>Ca-EP was safe in patients with BE HGD. This study paves the way for more extensive studies to investigate the effect on dysplastic cells and its role in treating esophageal adenocarcinoma.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110290"},"PeriodicalIF":3.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514234","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":"Tumor-Boundary Response Index (TBRI)- A promising indicator for predicting outcomes in colorectal liver metastases receiving neoadjuvant therapy: Insights from a single-center retrospective study","authors":"Yin-Chen Gu ,&nbsp;Mei Yang ,&nbsp;Yan Geng ,&nbsp;Bo Zhang ,&nbsp;Bao-Rui Tao ,&nbsp;Sen-Feng Ying ,&nbsp;Rong-Quan Sun ,&nbsp;Yi-Tong Li ,&nbsp;Zhen-Mei Chen ,&nbsp;Chen-He Yi ,&nbsp;Jin Lin ,&nbsp;Rui Zhang ,&nbsp;Jie Fan ,&nbsp;Xiang-Yu Wang ,&nbsp;Jin-Hong Chen","doi":"10.1016/j.ejso.2025.110291","DOIUrl":"10.1016/j.ejso.2025.110291","url":null,"abstract":"<div><h3>Background</h3><div>Tumor regression grade (TRG) and histopathological growth pattern (HGP) reflect the response of colorectal liver metastases (CRLM) to neoadjuvant therapy (NAT) from the perspectives of the tumor and its microenvironment, respectively. Based on these two indicators, this study aimed to develop a prognostic index for CRLM undergoing surgery after NAT.</div></div><div><h3>Materials and methods</h3><div>237 patients who underwent curative-intent resection following NAT from 2012 to 2022 were selected. Correlations between HGP and TRG were assessed. Cox regression analyses were employed to determine the optimal cut-off point for constructing the Tumor-Boundary Response Index (TBRI). Kaplan-Meier analyses of overall survival (OS), disease-free survival (DFS) and hepatic relapse-free survival (hRFS) were used to evaluate the prognostic value. The predictive ability of TBRI, Fong's clinical risk score (CRS) and Genetic And Morphological Evaluation (GAME) score was compared by time-dependent receiver operating characteristic (ROC) analysis. Calibration plot was utilized to assess the goodness of fit.</div></div><div><h3>Results</h3><div>Desmoplastic HGP (dHGP) exhibited an inverse correlation with TRG in lesions. TBRI stratified patients into four tiers based on whether HGP is predominant desmoplastic (&gt;50 %) and whether TRG is ≤ 3, showing significant prognostic value in OS, DFS and hRFS (median OS for TBRI 1–4: 78.6, 42.6, 27.8 and 22.5, p &lt; 0.001; median DFS for TBRI 1–4: 22.4, 12.4, 10.9 and 6.5 months, p &lt; 0.001; median hRFS for TBRI 1–4: 29.2, 12.9, 10.9, 6.8, p &lt; 0.001). Additionally, TBRI surpassed CRS and GAME score with superior discriminatory power and displayed exceptional consistency.</div></div><div><h3>Conclusions</h3><div>TBRI demonstrated a promising ability to predict the postoperative survival of CRLM patients receiving NAT.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 10","pages":"Article 110291"},"PeriodicalIF":3.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604734","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":"Patient-attributable delay and its impact on two-year survival in breast cancer: A multicenter prospective cohort study","authors":"Desirée Martín-García ,&nbsp;Marilina García-Aranda ,&nbsp;Esperanza Varela-Moreno ,&nbsp;María Padilla-Ruiz ,&nbsp;Irene Zarcos-Pedrinaci ,&nbsp;Francisco Rivas-Ruiz ,&nbsp;Teresa Téllez ,&nbsp;Susana García-Gutiérrez ,&nbsp;Nerea González ,&nbsp;Amado Rivero ,&nbsp;Cristina Sarasqueta ,&nbsp;Lilisbeth Perestelo-Pérez ,&nbsp;Xavier Castells ,&nbsp;José María Quintana ,&nbsp;María Sala ,&nbsp;Maximino Redondo","doi":"10.1016/j.ejso.2025.110280","DOIUrl":"10.1016/j.ejso.2025.110280","url":null,"abstract":"<div><h3>Background</h3><div>Delays in the diagnosis and treatment of breast cancer can be attributed to sociodemographic characteristics, clinical-pathological factors, and the functioning of the health system. This study aims to examine the impact of patient-attributable delay (PPAD) on timely medical care and its effect on patient survival.</div></div><div><h3>Methods</h3><div>This multicenter, prospective, observational study included 543 patients diagnosed with breast cancer between 2013 and 2015. A PPAD was defined as a delay of more than 90 days between symptom onset and consultation with a primary care physician or emergency department. The rate of PPAD in this population was 14.18 %.</div></div><div><h3>Results</h3><div>Segmented analysis revealed significant associations with age and living alone, with living alone emerging as the only independent predictor of PPAD (Odds Ratio OR: 1.882; 95 % Confidence Interval CI: 1.033–3.42). Significant associations were identified between clinical stage (p &lt; 0.001), immunophenotype (p &lt; 0.001), PPAD (p &lt; 0.05), age (p &lt; 0.001), household situation (p &lt; 0.001) and body mass index (p &lt; 0.05) with breast cancer prognosis. In the multivariate analysis, PPAD was an independent risk factor for two-year mortality (OR 3.08; 95 % CI 1.05–9.07), second only to clinical stage (OR 6.78; 95 % CI 2.51–18.3). Age also remained as a significant predictor (OR 1.04; 95 % CI 1.01–1.07).</div></div><div><h3>Conclusion</h3><div>Our findings highlight the need for targeted interventions to raise cancer symptom awareness and address barriers faced by vulnerable groups, such as the elderly and individuals living alone, to reduce delays, improve clinical outcomes, increase survival rates, and ultimately the quality of life for patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110280"},"PeriodicalIF":3.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563073","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":"Retroperitoneal lymph node dissection for testis cancer: a comparison between open and robot-assisted approach in oncological and surgical outcomes","authors":"Elena Lievore ,&nbsp;Francesco Alessandro Mistretta ,&nbsp;Mattia Luca Piccinelli ,&nbsp;Chiara Vaccaro ,&nbsp;Matteo Tallini ,&nbsp;Marco Tozzi ,&nbsp;Antonio Brescia ,&nbsp;Danilo Bottero ,&nbsp;Massimilano Depalma ,&nbsp;Giuseppe Petralia ,&nbsp;Giulia Marvaso ,&nbsp;Francesco Ceci ,&nbsp;Nicola Fusco ,&nbsp;Franco Nolè ,&nbsp;Barbara Alicja Jereczek-Fossa ,&nbsp;Franco Orsi ,&nbsp;Stefano Luzzago ,&nbsp;Gennaro Musi","doi":"10.1016/j.ejso.2025.110281","DOIUrl":"10.1016/j.ejso.2025.110281","url":null,"abstract":"<div><h3>Introduction</h3><div>Retroperitoneal lymph node dissection (RPLND) is an integral part of the multidisciplinary treatment of Testis cancer (TC). Up to now, only few studies compared traditional open RPLND (O-RPLND) with minimally invasive approach. We investigated surgical outcomes and complication rates of patient with TC treated with O-RPLND or robot assisted (RA-RPLND).</div></div><div><h3>Materials and methods</h3><div>We performed a retrospective analysis of all consecutive patients who underwent RPLND for TC, between 2001 and 2023. We recorded Patient demographics, perioperative and post-operative data. Descriptive statistics depicted differences between O-RPLND and RA-RPLND. Multivariable Poisson regression models (MPRMs) tested for predictors of surgical drain permanence, NSAIDs use (days), LOS, EBL and OT. Multivariable logistic regression models (MLRM) tested for of post operative complications.</div></div><div><h3>Results</h3><div>Of 144 patients who underwent RPLND, 53 (36.4 %) were treated with RA-RPLND and 91 (63.6 %) with O-RPLND. RA-RPLND group had significantly lower median EBL (50 ml vs 150 ml in O- RPLND; p &lt; 0.01), median LOS (4 days vs 5.5 days in O-RPLND; p &lt; 0.01), median drain indwelling days (4 vs 5 in O-RPLND; p = 0.03), Hb drop (1.5 g/dl vs 1.9 g/dl; p = 0.02) and median NSAIDs use (1 day vs 3 days in O-RPLND; p &lt; 0.01). No difference in intra- and postoperative complication rates was recorded. In MPRM, RA-RPLND was associated with shorter LOS (RR:0.28; p &lt; 0.01), drain permanence time (RR: 0.83; p = 0.01), NSAIDs use (RR:0.63; p &lt; 0.01), and OT (RR 0.85; p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>RA-RPLND appears to lead to shorter LOS and permanence of surgical drain, lower need for painkillers, lower blood loss and lower OT to O-RPLND, but does not seem associated with lower complication rates compared to O-RPLND. Our findings require prospective validation in future randomized trials.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 8","pages":"Article 110281"},"PeriodicalIF":3.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511125","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":"Preoperative risk stratification for multifocal intrahepatic cholangiocarcinoma after liver resection: a multicenter analysis with CART model","authors":"Jun Fu ,&nbsp;Qizhu Lin ,&nbsp;Lifang Zheng ,&nbsp;Tingfeng Huang ,&nbsp;Jingdong Li ,&nbsp;Xinyu Bi ,&nbsp;Jianming Wang ,&nbsp;Fuyu Li ,&nbsp;Jian Wang ,&nbsp;Kui Wang ,&nbsp;Jianying Lou ,&nbsp;Yongyi Zeng","doi":"10.1016/j.ejso.2025.110277","DOIUrl":"10.1016/j.ejso.2025.110277","url":null,"abstract":"<div><h3>Background and aim</h3><div>The prognostic significance of liver resection for multifocal intrahepatic cholangiocarcinoma (ICC) remains controversial and is further complicated by the lack of reliable predictive models. This study aims to develop a prognostic Classification and Regression Tree (CART) model for resectable multifocal ICC.</div></div><div><h3>Methods</h3><div>This retrospective, multicenter cohort study included 283 patients who underwent liver resection for multifocal ICC between 2008 and 2020. Prognostic variables identified via multivariable Cox regression were used to construct a CART model. The predictive accuracy of the CART model was internally validated through 5-fold cross-validation and compared to Wang and Hyder nomogram.</div></div><div><h3>Results</h3><div>Bilobar tumors, largest tumor size &gt;6 cm, tumor number &gt;2, and Carbohydrate Antigen 19–9 &gt;37 U/mL were associated with poorer survival. The CART model stratified patients into three risk groups. Patients with two unilobar tumors and largest tumor size ≤6 cm had the most favorable prognosis, with a median OS of 37.5 months and 5-year OS of 25.6 %. In contrast, those with bilobar involvement and CA19-9 &gt;37 U/mL had the poorest outcomes, with a median OS of 11.2 months and 5-year OS of 0 %, regardless of tumor size or number. The area under the receiver operating characteristic curve (AUC) of the CART model in internal validation was 0.728. The time-dependent AUC for the CART model was 0.711, exceeding that of the Wang (0.644) and Hyder (0.618) nomograms.</div></div><div><h3>Conclusion</h3><div>The CART model provides accurate and interpretable survival prediction for patients with resectable multifocal ICC and may assist in preoperative surgical decision-making.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110277"},"PeriodicalIF":3.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556901","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":"Comment on “postoperative quality of life in patients with early-stage cervical cancer: A prospective 10-Year Follow-Up Study”","authors":"Yukun Duan,&nbsp;Hui Li,&nbsp;Yanping Gao","doi":"10.1016/j.ejso.2025.110257","DOIUrl":"10.1016/j.ejso.2025.110257","url":null,"abstract":"","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 9","pages":"Article 110257"},"PeriodicalIF":3.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539579","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}