Ejso最新文献

{"title":"The impact of immediate lipofilling on oncological outcomes, complication rates and patient reported outcomes in breast conserving surgery: a systematic review and meta-analysis","authors":"James Lucocq ,&nbsp;Hassan Baig ,&nbsp;J. Michael Dixon","doi":"10.1016/j.ejso.2025.110446","DOIUrl":"10.1016/j.ejso.2025.110446","url":null,"abstract":"<div><h3>Background</h3><div>There is concern from in-vitro studies that adipose-derived stem cells could promote cancer recurrence through their proliferative properties. The impact of immediate lipofilling (ILF) in the setting of breast conserving surgery (BCS) on oncological outcomes, complications and patient-reported outcomes are unknown.</div></div><div><h3>Methods</h3><div>A systematic search of Medline, Embase and Cochrane Central was conducted for studies investigating the impact of ILF in patients undergoing BCS. Random-effects meta-analysis were conducted for oncological outcomes (local [LR], regional [RR], distant [DR] and overall recurrence).</div></div><div><h3>Results</h3><div>Six studies fulfilled the inclusion criteria including 252 patients. The pooled LR, RR, DR and overall recurrence rates were 2.38 %, 1.52 %, 3.03 % and 5.95 %, respectively (median follow-up, 39 months). A meta-analysis of studies comparing ILF (n = 170) with no-ILF (n = 362) found no difference in LR (OR, 0.77; 95 % CI, 0.19–3.17; p = 0.714), RR (OR 1.73, 95 % CI 0.36–8.21, p = 0.686), DR (OR 1.37, 95 % CI, 0.51–3.63; p = 0.627) or overall recurrence (OR 1.23, 95 % CI, 0.60–2.52; p = 0.569). Cancer-specific survival in the ILF group was 100 % compared to 98.7 % with no-ILF. Post-operative calcifications (12.9 % [21/163] vs. 0 %; [0/72], p = 0.002) and fat necrosis (7.8 % (17/217] vs. 2.8 % [8/283], p = 0.011) were significantly more common with ILF, but early complications (e.g. haematoma and infection) showed no difference (p &gt; 0.05). Three studies reported superior Breast-Q scores in ILF compared to no-ILF. No randomised controlled trials have been conducted.</div></div><div><h3>Conclusion</h3><div>Immediate lipofilling following BCS appears oncologically safe, enhances aesthetic outcomes and causes minimal morbidity, but higher-quality studies are required.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110446"},"PeriodicalIF":2.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080049","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":"Postoperative chemotherapy versus surgery alone in esophageal squamous cell carcinoma: A single-center propensity-matched survival analysis","authors":"Youqiang Qiu ,&nbsp;Peiyuan Wang ,&nbsp;Hao He ,&nbsp;Shuoyan Liu ,&nbsp;Feng Wang","doi":"10.1016/j.ejso.2025.110441","DOIUrl":"10.1016/j.ejso.2025.110441","url":null,"abstract":"<div><h3>Background</h3><div>Current clinical guidelines lack a consensus regarding adjuvant chemotherapy (ACT) for esophageal squamous cell carcinoma (ESCC) patients undergoing primary surgical resection. Therefore, our study evaluates both the survival benefits and predictors in this specific population.</div></div><div><h3>Methods</h3><div>This retrospective study stratified 1039 ESCC patients into ACT and surgery-only groups. Propensity score matching (PSM) generated 311 matched pairs (n = 622) with balanced baseline characteristics. The endpoints were 5-year DFS and 5-year OS, analyzed by Kaplan-Meier methodology. Prognostic factors were identified through univariable and multivariable Cox regression analyses.</div></div><div><h3>Results</h3><div>With a median follow-up of 49 months, the post-PSM OS rates at the 1-, 3-, and 5-year were 89.7 %, 66.4 %, and 56.0 %, with DFS rates of 85.8 %, 63.6 %, and 53.9 %, respectively. ACT demonstrated significantly improved 5-year DFS (HR 0.69, 95 % CI 0.53–0.89; <em>P</em> = 0.004) and 5-year OS (HR 0.67, 95 % CI 0.51–0.87; <em>P</em> = 0.003) versus surgery alone. Subgroup analyses demonstrated significant DFS and OS improvements with ACT in patients with pN1-3 disease, pT3-4 tumors, and pT3N0 cases exhibiting either mid/upper thoracic location with moderate/poor differentiation or adverse pathological features (lymphovascular/perineural invasion; all <em>P</em> &lt; 0.05). Multivariable Cox regression identified BMI ≥22 kg/m², ACT, higher lymph node yield, lower metastatic nodal burden, earlier pT/N stages, and absence of LVI/PNI invasion as independent predictors of improved OS and DFS.</div></div><div><h3>Conclusions</h3><div>ACT demonstrated survival benefits in ESCC patients with advanced tumor burden (pathologically confirmed pT3-4 or pN1-3 disease) and those with pT3N0 cases harboring either mid/upper thoracic tumors with moderate/poor differentiation or adverse pathological features (LVI/PNI).</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110441"},"PeriodicalIF":2.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085467","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":"A novel nomogram for predicting long-term survival in patients with esophageal squamous cell carcinoma after minimally invasive esophagectomy","authors":"Jinlong Fang ,&nbsp;Ziyang Han ,&nbsp;Jingchuan Yu ,&nbsp;Weiguang Zhang ,&nbsp;Zhixin Huang ,&nbsp;Peipei Zhang ,&nbsp;Shaobin Yu ,&nbsp;Mingqiang Kang","doi":"10.1016/j.ejso.2025.110443","DOIUrl":"10.1016/j.ejso.2025.110443","url":null,"abstract":"<div><h3>Background</h3><div>Esophageal cancer is the 7th most common cancer worldwide, while esophageal squamous cell carcinoma (ESCC) is the 4th leading cause of cancer-related deaths in China. Minimally invasive esophagectomy (MIE) is the employed as the primary treatment for ESCC. However, there is still a lack of specialized tools for evaluating postoperative outcomes in these patients.</div></div><div><h3>Methods</h3><div>Univariate and multivariate COX regression analyses were conducted to identify the prognostic factors. A nomogram was developed for predicting the survival probabilities at 1-, 3- and 5- year after MIE. The prediction performance of the developed nomogram was evaluated using the receiver operating characteristic (ROC) curve, concordance index (C-index), calibration curve, decision curve analysis (DCA) curve and risk stratification.</div></div><div><h3>Results</h3><div>A total of 709 patients were enrolled in the study. Age, vascular invasion, pT stage and pN stage were independent predictors of the prognosis and were used to develop a nomogram model. The areas under the curve (AUC) values predicting overall survival (OS) at 1, 3 and 5 years were 0.814, 0.761 and 0.794 in the training cohort and 0.703, 0.751 and 0.780 in the validation cohort. Furthermore, the calibration plot revealed good agreement between the predicted results and actual observations. The DCA curve confirmed that the nomogram achieved higher clinical value compared to other indicators. Further, we stratified the entire patient population into low-risk group, medium risk group and high-risk group. A significant difference in survival was observed between the three groups (<em>P</em> &lt; 0.001)</div></div><div><h3>Conclusions</h3><div>A novel nomogram for predicting ESCC patient's survival outcomes after MIE. The accuracy of the proposed nomogram exceeded that of the Union for Union for International Cancer Control(UICC)/American Joint Committee on Cancer(AJCC) 8th staging systems.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110443"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118073","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":"Clinicopathological features and survival differences between G/GEJ-CSC and GAC: A Propensity score-matched, large-scale cross-population retrospective study","authors":"Kang Liu ,&nbsp;Kailai Yin ,&nbsp;Yubo Ma ,&nbsp;Ruihong Xia ,&nbsp;Yingsong Zheng ,&nbsp;Li Yuan ,&nbsp;Xiangdong Cheng ,&nbsp;Zaisheng Ye ,&nbsp;Zhengchen Jiang","doi":"10.1016/j.ejso.2025.110444","DOIUrl":"10.1016/j.ejso.2025.110444","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Gastric squamous cell carcinoma and adenosquamous carcinoma, collectively termed gastric and gastroesophageal junction carcinomas containing squamous cells (G/GEJ-CSC).Due to low incidence and high heterogeneity, their clinicopathological features and prognostic patterns lack systematic investigation. Traditional views suggest greater aggressiveness but lack large-scale evidence. This study uses large-scale cohorts to compare G/GEJ-CSC with gastric adenocarcinoma (GAC), clarifying features, prognosis, and supporting personalized treatment.</div></div><div><h3>Methods</h3><div>Retrospectively analyzed the clinicopathological features of eligible patients with G/GEJ-CSC and GAC from Zhejiang Cancer Hospital (2010–2024) and the SEER database (2004–2020). Propensity score matching was used to balance confounding factors. Kaplan-Meier method and Cox proportional hazards model were employed to evaluate survival differences.</div></div><div><h3>Results</h3><div>Compared with GAC patients, G/GEJ-CSC occurred more frequently in the gastric-esophageal junction and exhibited a significantly higher Epstein-Barr virus positivity rate, along with worse clinicopathological features. Multivariate Cox analysis showed that pathological type was an independent risk factor for overall survival (Chinese cohort:HR = 1.45,P = 0.044; SEER:HR = 1.23).Kaplan-Meier survival analysis revealed that OS was significantly inferior in G/GEJ-CSC patients compared with GAC (Chinese cohort: 5-year OS 33.0 % vs. 56.1 %, P &lt; 0.001; SEER: 34.8 % vs. 42.7 %, P = 0.013), and this difference persisted after PSM adjustment (Chinese cohort: 5-year OS 36.4 % vs. 52.0 %, P = 0.034; SEER: 34.8 % vs. 44.1 %, P = 0.041). Stratified analysis further indicated a more pronounced survival gap in early-stage patients (Chinese cohort: 5-year OS43.1 % vs.84.1 %, P &lt; 0.001; SEER: 45.4 % vs. 54.2 %, P = 0.002).</div></div><div><h3>Conclusion</h3><div>G/GEJ-CSC, a rare gastric cancer subtype, has unique aggressive biology and “early high-risk” prognosis. Need enhanced early identification and personalized treatment exploration.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110444"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079901","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 nutrition, comorbidity and complication on long term survival in gastric cancer following laparoscopic radical gastrectomy: A 10-year cohort study","authors":"Hengyi Zhang ,&nbsp;Siqi Tao ,&nbsp;Yangyang Luo ,&nbsp;Mengting Lu ,&nbsp;Guoxin Li ,&nbsp;Hao Liu","doi":"10.1016/j.ejso.2025.110442","DOIUrl":"10.1016/j.ejso.2025.110442","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies on perioperative influences in gastric cancer have largely relied on single scoring systems, overlooking the interaction between factors. This study utilized the Age-Adjusted Charlson Comorbidity Index (ACCI), Nutritional Risk Screening-2002 (NRS-2002), and Clavien-Dindo classification to assess the impact of key perioperative conditions on long-term survival in a large-scale cohort of gastric cancer patients.</div></div><div><h3>Method</h3><div>This study analyzed 2420 gastric cancer patients who underwent laparoscopic radical resection between January 2004 and December 2023 at Nanfang Hospital, Southern Medical University, Guangzhou, China. The analysis, based on postoperative complications, comorbidity burden, and nutritional status, was conducted using Clavien-Dindo classification, ACCI, and NRS-2002, and compared their impact on long-term survival.</div></div><div><h3>Result</h3><div>Patients with a low comorbidity burden have significantly higher survival rates compared to those with a high comorbidity burden (5-year: 72.5 %, 10-year: 64.4 %). Patients with better nutritional status also have higher survival rates than those with malnutrition (5-year: 72.6 %, 10-year: 65.0 %). However, postoperative complications do not significantly affect overall survival trends (P = 0.14). Among patients with the same ACCI score, those with malnutrition have significantly lower survival rates (5-year: 44.8 %, 10-year: 31.1 %). Furthermore, among patients with the same nutritional status, those with postoperative complications have markedly worse survival outcomes (5-year: 49.8 %, 10-year: 32.2 %).</div></div><div><h3>Conclusion</h3><div>A more precise assessment of the perioperative condition in gastric cancer patients would be recommended via integrating nutritional status with comorbidities or postoperative complications. Improving these conditions are expecting to enhance the long-term overall survival postoperatively.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110442"},"PeriodicalIF":2.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079947","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":"Geographic variation in surgery rates among older patients with early (ER positive HER2 negative) breast cancer: Influence of cardiovascular disease and comorbidities: A national registry dataset analysis","authors":"Emma Crewe ,&nbsp;Freya Tyrer ,&nbsp;John Deanfield ,&nbsp;Mark de Belder ,&nbsp;Jennifer Lai ,&nbsp;Mamas Mamas ,&nbsp;David Adlam ,&nbsp;Alistair Ring","doi":"10.1016/j.ejso.2025.110432","DOIUrl":"10.1016/j.ejso.2025.110432","url":null,"abstract":"<div><h3>Introduction</h3><div>Women over 70 years of age with operable oestrogen receptor positive (ER positive) breast cancer have worse survival outcomes than younger women. Primary surgery is the optimal treatment with primary endocrine therapy reserved for patients who are unfit or who have multiple co-morbidities. Inferior outcomes in this patient population might be explained by underuse of surgery, the rates of which vary considerably between geographical regions in the UK. We determined the rates of surgery versus primary endocrine therapy in a cohort of women aged over 70 in England, with potentially curable ER positive breast cancer, according to the presence of pre-existing cardiovascular disease (CVD), comorbidities, social deprivation, and by geographical location.</div></div><div><h3>Materials and methods</h3><div>33,235 women aged 70 years or older with stage I to III ER positive breast cancer from the 20 regional NHS Cancers Alliances in England were identified from the cancer registry. Linked hospital records were used to identify patient demographics, tumour and treatment characteristics, resection rates, CVD prevalence and other co-morbidities.</div></div><div><h3>Results</h3><div>25,800 (77.6 %) patients underwent surgery, 6787 (20.4 %) patients received primary endocrine therapy alone, 648 (2 %) patients received no treatment. Both CVD and surgery prevalence varied by geographical location. After adjustment for case mix the differences between Cancer Alliances attenuated and no longer reached statistical significance.</div></div><div><h3>Conclusions</h3><div>We found regional differences in rates of surgery in patients with breast cancer across different centres. After adjustments, the variation is largely attributable to case mix. Under recording of endocrine therapy data in secondary care limits full interpretation.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110432"},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218316","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":"Geographic variation in surgery rates among older patients with early (ER positive HER2 negative) breast cancer: Influence of cardiovascular disease and comorbidities: A national registry dataset analysis","authors":"Emma Crewe ,&nbsp;Freya Tyrer ,&nbsp;John Deanfield ,&nbsp;Mark de Belder ,&nbsp;Jennifer Lai ,&nbsp;Mamas Mamas ,&nbsp;David Adlam ,&nbsp;Alistair Ring","doi":"10.1016/j.ejso.2025.110432","DOIUrl":"10.1016/j.ejso.2025.110432","url":null,"abstract":"<div><h3>Introduction</h3><div>Women over 70 years of age with operable oestrogen receptor positive (ER positive) breast cancer have worse survival outcomes than younger women. Primary surgery is the optimal treatment with primary endocrine therapy reserved for patients who are unfit or who have multiple co-morbidities. Inferior outcomes in this patient population might be explained by underuse of surgery, the rates of which vary considerably between geographical regions in the UK. We determined the rates of surgery versus primary endocrine therapy in a cohort of women aged over 70 in England, with potentially curable ER positive breast cancer, according to the presence of pre-existing cardiovascular disease (CVD), comorbidities, social deprivation, and by geographical location.</div></div><div><h3>Materials and methods</h3><div>33,235 women aged 70 years or older with stage I to III ER positive breast cancer from the 20 regional NHS Cancers Alliances in England were identified from the cancer registry. Linked hospital records were used to identify patient demographics, tumour and treatment characteristics, resection rates, CVD prevalence and other co-morbidities.</div></div><div><h3>Results</h3><div>25,800 (77.6 %) patients underwent surgery, 6787 (20.4 %) patients received primary endocrine therapy alone, 648 (2 %) patients received no treatment. Both CVD and surgery prevalence varied by geographical location. After adjustment for case mix the differences between Cancer Alliances attenuated and no longer reached statistical significance.</div></div><div><h3>Conclusions</h3><div>We found regional differences in rates of surgery in patients with breast cancer across different centres. After adjustments, the variation is largely attributable to case mix. Under recording of endocrine therapy data in secondary care limits full interpretation.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 12","pages":"Article 110432"},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218759","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":"Survival and perioperative outcomes of pelvic exenteration in primary advanced and recurrent endometrial carcinoma: A systematic review and meta-analysis","authors":"Antonio Raffone ,&nbsp;Giulia Pellecchia ,&nbsp;Sara Pregnolato ,&nbsp;Diego Raimondo ,&nbsp;Antonio Travaglino ,&nbsp;Daniele Neola ,&nbsp;Lorenza Driul ,&nbsp;Francesco Fanfani ,&nbsp;Martina Arcieri ,&nbsp;Maria Giovanna Vastarella ,&nbsp;Stefano Restaino ,&nbsp;Luigi Cobellis ,&nbsp;Renato Seracchioli ,&nbsp;Giuseppe Vizzielli","doi":"10.1016/j.ejso.2025.110436","DOIUrl":"10.1016/j.ejso.2025.110436","url":null,"abstract":"<div><h3>Objective</h3><div>To assess survival and perioperative complications and mortality of pelvic exenteration (PE) in recurrent and advanced endometrial carcinoma (EC) patients.</div></div><div><h3>Methods</h3><div>A systematic review and a meta-analysis was performed searching 7 electronic databases from their inception to May 2024 for all peer-reviewed studies that reported as a study outcome at least the 5 years-overall survival (OS) of PE in recurrent and/or advanced EC patients.</div><div>Our outcomes were 5 year-OS from PE as primary outcome, and all extractable outcomes about PE survival [overall OS, 5 year- and overall disease specific survival (DSS), 5 year- and overall progression free survival (PFS)] and perioperative mortality and complications.</div><div>Rates of survival outcomes and perioperative mortality and complications were calculated as individual and pooled estimates, with 95 % confidence intervals (CI).</div><div>Subgroup analyses were planned for all study outcomes based on recurrent or advanced EC, separately.</div></div><div><h3>Results</h3><div>6 studies with 166 patients were included. In women underwent PE for advanced or recurrent EC, pooled rate was: 41.7 % (95 % CI: 25.6–57.8 %) for 5 year-OS; 30.4 % (95 % CI: 14.9–45.8 %) for 5 year-DSS; 26.6 % (95 % CI: 10.6–42.5 %) for overall DSS; 51.8 % (95 % CI: 25.6–78.0 %) for 5 year-PFS; 9.7 % (95 % CI: 5.7–16.1 %) for perioperative mortality; 56.1 % (95 % CI: 32.3–76.4 %) for perioperative complications. Subgroup analyses were suitable exclusively in the “recurrent EC” subgroup and showed even worsened outcomes.</div></div><div><h3>Conclusions</h3><div>In women with advanced or recurrent EC, PE shows not encouraging survival outcomes, with relatively high rates of perioperative mortality and complications. These outcomes further worsened in the subgroup of only recurrent EC. However, they should be confirmed by more updated studies.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110436"},"PeriodicalIF":2.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109528","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 long-term outcomes of 2.5- and 3-field lymph node dissections for esophageal squamous cell carcinoma","authors":"Maohui Chen ,&nbsp;Taidui Zeng ,&nbsp;Yizhou Huang ,&nbsp;Shuliang Zhang ,&nbsp;Chun Chen ,&nbsp;Bin Zheng","doi":"10.1016/j.ejso.2025.110435","DOIUrl":"10.1016/j.ejso.2025.110435","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies demonstrated that the mesoesophageal suspension technique is safe and effective for thoracoscopic lymph node dissection in esophageal squamous cell carcinoma (ESCC), but direct comparison with 3-field dissection is lacking. This study aimed to compare 2.5- and 3-field lymph node dissections in terms of survival benefits, recurrence patterns, and complications in patients with ESCC.</div></div><div><h3>Methods</h3><div>This was a retrospective study of patients with ESCC who underwent 2.5- or 3-field lymph node dissection (FLD). The outcomes included 30-day mortality, postoperative complications, overall survival (OS), disease-free survival (DFS), and recurrence pattern.</div></div><div><h3>Results</h3><div>A total of 353 patients with ESCC were included in this study. After propensity score matching, the frequency of all complications (27.8 % vs. 18.3 %, P = 0.072), recurrent laryngeal nerve injury (5.6 % vs. 0.8 %, P = 0.033) and respiratory complications (19.8 % vs. 11.9 %, P = 0.084) was higher in the 3-field group compared with the 2.5-field group. Smaller number of dissected lymph nodes (median, 31.5 vs. 41, P &lt; 0.001) but comparable number of metastatic lymph nodes (median, 0 vs. 1, P = 0.143) was found in the 2.5-field group compared with the 3-field group. The rate of positive supraclavicular lymph nodes was 1.6 % in the 3-field group. There were no differences OS and DFS between the two groups, with median OS and DFS not reached in both groups. Recurrence pattern of all stage patients was similar between the two groups.</div></div><div><h3>Conclusion</h3><div>The 2.5- and 3-FLD have comparable survival benefits for patients with ESCC, while the 2.5-FLD has a lower risk of complications.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110435"},"PeriodicalIF":2.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043990","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 sarcopenic obesity on postoperative complications and long-term survival in patients with gastric cancer","authors":"Yulong Wang ,&nbsp;Xijuan Liu ,&nbsp;Xianhu Zhang ,&nbsp;Peng Fan ,&nbsp;Yunmeng Zong ,&nbsp;Xiao Feng ,&nbsp;Lili Huang","doi":"10.1016/j.ejso.2025.110437","DOIUrl":"10.1016/j.ejso.2025.110437","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenic obesity (SO), defined as the coexistence of sarcopenia (low muscle mass with impaired function) and obesity, has been linked to adverse outcomes in several cancers, but its impact in gastric cancer (GC) remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 502 GC patients who underwent curative gastrectomy. Body composition was assessed via preoperative CT at the L3 vertebral level. SO is conceptually the coexistence of sarcopenia-low muscle mass with impaired function-and obesity; in this cohort, lacking function tests, SO was operationally defined as low skeletal muscle index (SMI) plus high visceral fat area (VFA). Patients were categorized into four groups: normal composition, obesity, sarcopenia, and SO, with the normal composition group serving as the reference. Complications, overall survival (OS), and disease-free survival (DFS) were assessed via logistic and Cox regression.</div></div><div><h3>Results</h3><div>SO was present in 16.9 % of patients. The median follow-up time was 40 months (interquartile range [IQR]: 20–65 months), and the estimated 5-year OS was 45 %. Compared with the normal composition group, SO was independently associated with higher rates of postoperative complications (odds ratio [OR] = 2.63, 95 % CI: 1.91–4.90, P = 0.002), worse OS (hazard ratio [HR] = 1.88, 95 % CI: 1.32–2.67, P &lt; 0.001), and poorer DFS (HR = 1.75, 95 % CI: 1.22–2.51, P = 0.002). SO outperformed sarcopenia or obesity alone in predicting adverse outcomes.</div></div><div><h3>Conclusions</h3><div>SO is an independent prognostic factor in GC and should be incorporated into preoperative evaluation. Early intervention strategies targeting SO may help improve postoperative and survival outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 11","pages":"Article 110437"},"PeriodicalIF":2.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043985","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}