IF 3.5 2区医学

Ejso Pub Date : 2025-03-05 DOI: 10.1016/j.ejso.2025.109742

Omar Mahmud , Asad Saulat Fatimi , Mahip Grewal , Charles DiMaggio , D. Brock Hewitt , Ammar A. Javed , Christopher L. Wolfgang , Greg D. Sacks

{"title":"Risk of pancreatic cancer and high-grade dysplasia in resected main-duct and mixed-type intraductal papillary mucinous neoplasms: A prevalence meta-analysis","authors":"Omar Mahmud , Asad Saulat Fatimi , Mahip Grewal , Charles DiMaggio , D. Brock Hewitt , Ammar A. Javed , Christopher L. Wolfgang , Greg D. Sacks","doi":"10.1016/j.ejso.2025.109742","DOIUrl":"10.1016/j.ejso.2025.109742","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines recommend the resection of main duct- (MD) and mixed-type (MT) intraductal papillary mucinous neoplasms (IPMN) based on specific risk criteria to prevent or treat pancreatic cancer in selected patients. This paradigm follows high rates of malignancy observed in published surgical series. The aim of this systematic review and meta-analysis was to provide robust, pooled rates of invasive carcinoma (IC) and high-grade dysplasia (HGD) in resected MD- and MT-IPMNs of the pancreas.</div></div><div><h3>Methods</h3><div>The PubMed, Embase, Scopus, Web of Science, and Cochrane CENTRAL databases were systematically searched. Studies that reported rates of IC or HGD, diagnosed by histopathology of surgical specimens, in MD- or MT-IPMNs were included. Pooled prevalence with 95 % confidence interval (95 % CI) was calculated using a random effects model. Galbraith plots were used to evaluate heterogeneity. Risk of bias was assessed using the National Institutes of Health Quality Assessment Tool.</div></div><div><h3>Results</h3><div>Based on 51 studies, 59 % (95 % CI: 54 %, 64 %) of resected MD- and MT-IPMN had IC or HGD, with IC in up to 39 % (95 % CI: 33 %, 44 %) of lesions and HGD in 20 % (95 % CI: 16 %, 25 %). Most studies were deemed to be of good quality and Galbraith plots demonstrated high concordance.</div></div><div><h3>Conclusions</h3><div>These results confirm the rates of IC and HGD in resected MD/MT-IPMNs. However, a significant proportion of patients have benign lesions, and future research is needed to develop precise diagnostics to distinguish between patients with and without high-risk or cancerous disease.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109742"},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673638","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}

引用次数: 0

Comment on “Evaluating the feasibility of repeat sentinel lymph node biopsy in ipsilateral breast tumor recurrence: Technical considerations and oncologic outcomes”

IF 3.5 2区医学

Ejso Pub Date : 2025-03-04 DOI: 10.1016/j.ejso.2025.109741

Mingjuan Xu , Xiaocun Zhu , Juan Zhu , Linlin Zhen

引用次数: 0

P16/HPV-negative oropharyngeal squamous cell carcinoma survival: Comparing primary surgery to primary chemoradiotherapy. A systematic review and meta-analysis

IF 3.5 2区医学

Ejso Pub Date : 2025-03-03 DOI: 10.1016/j.ejso.2025.109739

Bianca Maria Festa , Nancy Schaefer , William Reschly , William M. Mendenhall , Dustin Conrad , Krishna Hanubal , Mohamed Shama , Carolyn O. Dirain , Brian Hughley , Deepa Danan , Peter T. Dziegielewski

{"title":"P16/HPV-negative oropharyngeal squamous cell carcinoma survival: Comparing primary surgery to primary chemoradiotherapy. A systematic review and meta-analysis","authors":"Bianca Maria Festa , Nancy Schaefer , William Reschly , William M. Mendenhall , Dustin Conrad , Krishna Hanubal , Mohamed Shama , Carolyn O. Dirain , Brian Hughley , Deepa Danan , Peter T. Dziegielewski","doi":"10.1016/j.ejso.2025.109739","DOIUrl":"10.1016/j.ejso.2025.109739","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated differences in survival for p16/HPV-negative OPSCC patients treated with primary surgery versus primary (chemo-)radiation therapy (CRT).</div></div><div><h3>Materials and methods</h3><div>PubMed, CINAHL and Web of Science databases and the online Cochrane Library were searched for relevant English language studies describing the survival outcomes of p16/HPV-negative OPSCC patients treated with primary surgery or primary CRT. The primary endpoint was the 5-year OS; the secondary endpoints included 5-year DSS and DFS, and 3- and 2-year OS, DSS and DFS. The pooled survival curves were estimated using a distribution-free approach assuming random effects. Cumulative KM curves for OS, DSS and DFS were built for each treatment group.</div></div><div><h3>Results</h3><div>Twenty-two publications were included in the final analysis. Patients included (n = 1903) were divided according to treatment (“surgery” group, n = 942; “RT/CRT” group, n = 961). For all the endpoints, surgery demonstrated improved short- and long-term survival compared to RT/CRT, although selection bias may have impacted the outcomes. The estimated pooled 5-year OS for the surgery and the RT/CRT group was 54.1 % (95 % CI: 44.4%–65.9 %) and 45.7 % (95 % CI: 41.8%–49.9 %), respectively.</div></div><div><h3>Conclusion</h3><div>Primary surgery and primary CRT for p16/HPV-negative OPSCC both provide acceptable survival outcomes, although in many cases surgery has shown improved survival rates. Further research should focus on when each treatment modality should be used to achieve the goals of treatment completion, survival and functional outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109739"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637433","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}

引用次数: 0

Outcomes following inferior vena cava reconstruction at an advanced surgical unit

IF 3.5 2区医学

Ejso Pub Date : 2025-03-03 DOI: 10.1016/j.ejso.2025.109740

Evonne Z. Younan , Charles W.G. Risbey , Lylee Ye , Sascha Karunaratne , Doruk Seyfi , Daniel Steffens , Peter J. Lee , Jerome Laurence , Charbel Sandroussi

{"title":"Outcomes following inferior vena cava reconstruction at an advanced surgical unit","authors":"Evonne Z. Younan , Charles W.G. Risbey , Lylee Ye , Sascha Karunaratne , Doruk Seyfi , Daniel Steffens , Peter J. Lee , Jerome Laurence , Charbel Sandroussi","doi":"10.1016/j.ejso.2025.109740","DOIUrl":"10.1016/j.ejso.2025.109740","url":null,"abstract":"<div><h3>Background</h3><div>Inferior vena cava (IVC) resection and reconstruction is a viable option for managing complex intra-abdominal tumours. This study evaluates the impact of surgical approach to IVC reconstruction on early oncological, post-operative and short-term survival outcomes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients who underwent IVC reconstruction between January 2015 and June 2024 for any indication, at two tertiary referral hospitals in Sydney, Australia. Data extracted included demographics, anticoagulation, histopathological findings, post-operative complications and short-term survival. Outcomes were compared among patients who received an interposition graft, patch graft or primary repair (non-graft) using nonparametric statistical tests.</div></div><div><h3>Results</h3><div>Seventy-one IVC reconstructions were performed with median age 59 years (IQR 48–69). A bovine pericardium (BP) graft was used in 86% of procedures (n=61). The most common indications for surgery were soft tissue sarcoma (n=17) and renal cell carcinoma (n=16). Post-operatively, there were seven cases of pulmonary embolism (PE), nine cases of graft thrombosis and one case of graft infection. 30-day survival was 99% and 12-month survival was 78%. Tumour size was greater in the interposition graft group (p=0.004), however no differences in post-operative complications or survival were observed between interposition graft, patch graft or primary repairs.</div></div><div><h3>Conclusions</h3><div>IVC reconstruction, particularly using BP, is feasible across a range of tumour types and offers favourable post-operative and short-term survival outcomes, independent of reconstruction technique. BP interposition graft facilitates resection of more extensive disease with similar outcomes to less extensive disease managed with primary repair or patch graft.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 109740"},"PeriodicalIF":3.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic performance of fluorescent lymphography-guided lymph node dissection during minimally invasive gastrectomy following chemotherapy

IF 3.5 2区医学

Ejso Pub Date : 2025-03-02 DOI: 10.1016/j.ejso.2025.109738

Ji Yoon Jeong , Ja Kyung Yoon , Jawon Hwang , Sung Hyun Park , Minah Cho , Yoo Min Kim , Hyoung-Il Kim , Hyunki Kim , Woo Jin Hyung

{"title":"Diagnostic performance of fluorescent lymphography-guided lymph node dissection during minimally invasive gastrectomy following chemotherapy","authors":"Ji Yoon Jeong , Ja Kyung Yoon , Jawon Hwang , Sung Hyun Park , Minah Cho , Yoo Min Kim , Hyoung-Il Kim , Hyunki Kim , Woo Jin Hyung","doi":"10.1016/j.ejso.2025.109738","DOIUrl":"10.1016/j.ejso.2025.109738","url":null,"abstract":"<div><h3>Introduction</h3><div>Fluorescent lymphography-guided lymph node dissection (FL) using indocyanine green (ICG) during radical gastrectomy for gastric cancer has shown enhanced lymph node (LN) retrieval and high sensitivity in detecting LN metastases. However, the impact of FL during gastrectomy following chemotherapy remains uncertain because changes in the ICG injection site due to tumor shrinkage may potentially visualize different lymphatic drainage from the tumor. This study aimed to assess the diagnostic performance of FL during gastrectomy after preoperative chemotherapy.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study included patients who underwent minimally invasive gastrectomy with FL following chemotherapy between January 2013 and February 2024. Patients were categorized according to their tumor response after chemotherapy based on endoscopic, radiologic, and pathological findings.</div></div><div><h3>Results</h3><div>Of 29 patients, 9.4 (range 8–12) LN stations containing 6.9 (range 3–11) fluorescent LN stations, which had 56.3 (range 33–99) LNs including 33.4 (range 11–68) fluorescent LNs, were retrieved per patient. While 52 metastatic LN stations were fluorescent, three non-fluorescent metastatic LN stations were identified in one patient (3.4 %). FL showed 94.5 % (52/55) sensitivity and 95.9 % (70/73) negative predictive value for detecting metastatic LN stations. There was no significant difference in the number of retrieved LNs and the sensitivity for detecting metastatic LN stations between responders and non-responders.</div></div><div><h3>Conclusion</h3><div>Tumor response after chemotherapy did not influence the diagnostic performance of FL. The diagnostic performance of FL during gastrectomy following chemotherapy was acceptable. Similar to upfront surgery, FL can be safely applied even after chemotherapy.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109738"},"PeriodicalIF":3.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550925","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}

引用次数: 0

Long-term survival analysis after radical gastrectomy for Epstein-Barr virus-associated gastric cancer: A multicenter study

IF 3.5 2区医学

Ejso Pub Date : 2025-03-02 DOI: 10.1016/j.ejso.2025.109737

Rong-Zhen Xie , Ze-Ning Huang , Xing-Qi Zhang , Yu-Qin Sun , Jiao-Bao Huang , Qi-Yue Chen , Jian-Wei Xie , Chao-Hui Zheng , Chang-Ming Huang , Jian-Xian Lin , Ping Li

{"title":"Long-term survival analysis after radical gastrectomy for Epstein-Barr virus-associated gastric cancer: A multicenter study","authors":"Rong-Zhen Xie , Ze-Ning Huang , Xing-Qi Zhang , Yu-Qin Sun , Jiao-Bao Huang , Qi-Yue Chen , Jian-Wei Xie , Chao-Hui Zheng , Chang-Ming Huang , Jian-Xian Lin , Ping Li","doi":"10.1016/j.ejso.2025.109737","DOIUrl":"10.1016/j.ejso.2025.109737","url":null,"abstract":"<div><h3>Background</h3><div>The prognosis of Epstein-Barr virus-associated gastric cancer (EBVaGC)needs to be validated by high-quality studies. This study aimed to assess the long-term survival of EBVaGC patients after radical gastrectomy using multicenter data to explore the potential value of EBV infection status as a prognostic predictor.</div></div><div><h3>Methods</h3><div>We analyzed the clinical data of patients with EBVaGC and Epstein-Barr virus-negative gastric cancer (EBVnGC) who underwent radical gastrectomy from January 2013 to July 2020. The Kaplan-Meier method and Cox regression analysis were used to evaluate overall survival (OS) and disease-free survival (DFS). A Random Survival Forest (RSF) model was constructed to predict the prognosis.</div></div><div><h3>Results</h3><div>After propensity score matching, 205 and 410 patients were included in the EBVaGC and EBVnGC groups, respectively. The 3-year OS and DFS rates in the EBVaGC group were significantly higher than those in the EBVnGC group. Multivariate analysis indicated that EBER(Epstein-Barr virus-encoded small RNA) positivity was an independent protective factor for OS and DFS. Among stage II and III EBVaGC patients, those receiving ≥4 cycles of chemotherapy had a 3-year OS significantly better than those receiving <4 cycles. The RSF model based on EBER status outperformed the Cox model and TNM staging system in predicting the 3-year OS and DFS.</div></div><div><h3>Conclusion</h3><div>The prognostic prediction model established based on the EBER status has good clinical application value and can provide a new reference for clinical follow-up management. It is recommended that patients with stage II and III EBVaGC receive at least four cycles of chemotherapy postoperatively to improve survival.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109737"},"PeriodicalIF":3.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550926","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}

引用次数: 0

Reply to letter to the editor: Potential confounding factors in the analysis of postoperative outcomes 回复致编辑的信：术后结果分析中的潜在混杂因素。

IF 3.5 2区医学

Ejso Pub Date : 2025-03-01 DOI: 10.1016/j.ejso.2024.108701

Yizhou Huang , Maohui Chen , Chun Chen, Bin Zheng

引用次数: 0

Potential confounding factors in the analysis of postoperative outcomes 术后结果分析中的潜在干扰因素。

IF 3.5 2区医学

Ejso Pub Date : 2025-03-01 DOI: 10.1016/j.ejso.2024.108702

Senzhong Zheng, Yang Chen

引用次数: 0

Reply to: Vascularized reconstruction following extremity sarcoma resection – More than just a means to close a wound 答复四肢肉瘤切除术后的血管重建--不仅仅是封闭伤口的手段