Gland surgery最新文献

{"title":"Insights on preliminary outcomes of a prospective study examining innervation of deep inferior epigastric perforator flaps in autologous breast reconstruction.","authors":"Joani Christensen, Edward I Chang","doi":"10.21037/gs-24-475","DOIUrl":"10.21037/gs-24-475","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"242-245"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic analysis of N3 locally advanced breast cancer according to the 8th edition of AJCC clinical stage: a propensity-matched SEER analysis.","authors":"Qingyun Li, Yanhua Wu, Sihua Lu, Wenxiong Nong, Zhidong Wu, Wanwang Liang, Yunbo Luo","doi":"10.21037/gs-24-437","DOIUrl":"10.21037/gs-24-437","url":null,"abstract":"<p><strong>Background: </strong>The 8th edition of the American Joint Committee on Cancer (AJCC) clinical staging-including both anatomical and prognostic staging-serves as a valuable tool for predicting the prognosis of N3 locally advanced breast cancer (LABC). This study aims to apply these criteria to analyze changes in staging and evaluate differences in survival outcomes.</p><p><strong>Methods: </strong>Data from the Surveillance, Epidemiology, and End Results (SEER) database were used for patients with newly diagnosed N3 LABC and complete follow-up from 2010 to 2015. Patients were categorized into N3a, N3b, and N3c groups. Chi-squared tests compared differences, while univariate and multivariate Cox analyses assessed breast cancer-specific survival (BCSS) and overall survival (OS). Kaplan-Meier curves and the log-rank test were used to analyze prognostic factors. Propensity score matching (PSM) was applied to reduce baseline differences and enable further comparative validation.</p><p><strong>Results: </strong>Before PSM, a total of 5,096 patients were included in this study. Among these patients were classified 4,080 as N3a, 655 as N3b, and 361 as N3c. Significant differences were observed among the three groups in terms of histological grade, tumour stage, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER2) status (all P<0.001). In Kaplan-Meier survival analysis stratified by anatomical staging, the N3b group had the most favourable prognosis, followed by the N3a and N3c groups (OS, P<0.001; BCSS, P<0.001). In prognostic staging, the N3b group had the most favourable prognosis, followed by N3a and N3c groups, for stages IIIb and IIIc (OS, P<0.005; BCSS, P<0.005). Multivariate Cox regression analysis identified that N-stage were significantly associated with prognosis (P<0.05). After PSM, 200 N3a patients, 118 N3b patients, and 287 N3c patients were included in this study. After PSM, Significant differences were observed among the three groups in terms of histological grade (P=0.04), tumor stage (P<0.001), ER status (P<0.001), and PR status (P<0.001). In Kaplan-Meier analysis stratified by anatomical staging, the N3b group had the best prognosis, followed by the N3a and N3c groups (OS, P=0.02; BCSS, P=0.07). In prognostic staging, for stage IIIb prognostic staging, the N3b group again exhibited the most favourable prognosis, followed by the N3a and N3c groups (OS, P=0.03; BCSS, P=0.12). Multivariate Cox regression analysis revealed that the survival risk in the N3b group is slightly lower than that in the N3a group.</p><p><strong>Conclusions: </strong>In the anatomical and prognostic staging of N3 LABC, the N3b subgroup demonstrates the most promising prognosis. The 8th edition of the AJCC prognostic staging system offers a more detailed framework for assessing prognosis and guiding the diagnosis and treatment of N3 LABC.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"179-195"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The level of estrogen receptor (ER) expression and the length of adjuvant hormonal therapy in ER positive breast cancer.","authors":"Athina Stravodimou, Ioannis A Voutsadakis","doi":"10.21037/gs-24-425","DOIUrl":"10.21037/gs-24-425","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"246-251"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve coaptation in deep inferior epigastric perforator (DIEP) flap breast reconstruction.","authors":"Edward T C Dong, Jérôme Martineau, Carlo M Oranges","doi":"10.21037/gs-24-455","DOIUrl":"10.21037/gs-24-455","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"238-241"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of thyroid surgery-related medical disputes in China.","authors":"Peiliang Zhao, Lin Chen, Zhaoyue Li, Bin Luo","doi":"10.21037/gs-24-448","DOIUrl":"10.21037/gs-24-448","url":null,"abstract":"<p><strong>Background: </strong>Thyroid diseases, particularly thyroid cancer, are becoming increasingly prevalent, with surgery remaining one of the primary treatments. However, thyroidectomy may result in complications and medical disputes, but very little research has examined this subject in the Chinese context. The study aims to conduct a retrospective analysis of thyroid surgery-related medical disputes in China, offering insights into conflict resolution and risk avoidance in both legal and medical contexts.</p><p><strong>Methods: </strong>This retrospective study analyzed thyroid surgery-related medical dispute cases that occurred from 2010 to 2022 via the China Judgments Online website (https://wenshu.court.gov.cn). Before being included in the analysis, each case in the database was examined and carefully read to ensure that it was a dispute event caused by complications from thyroid surgery. Data collected included patient demographics, disease and surgical details, and judicial outcomes. Statistical analysis was performed using GraphPad Prism 9 (GraphPad Software).</p><p><strong>Results: </strong>We identified 198 thyroid surgery disputes, with 74.2% of the patients being female and 58.6% being under 60 years old. Benign disease diagnoses accounted for 52.0% of cases, and traditional open surgery was predominant, occurring in 95.5% of the cases. An increased likelihood of complications and disputes was observed with more extensive surgeries. Tertiary hospitals were the defendants in 84.8% of these cases. The peak period of disputes was from 2011 to 2015, accounting for 51.0% of the total, with a notable concentration of cases in eastern China, accounting for 39.9%. The main causes of disputes were nerve damage (29.8%), parathyroid impairment (29.8%), and disagreements in resection scope (11.5%). Cases of hemorrhage led to the highest mean compensation amount [average Chinese Yuan (CNY) ¥680,000], followed by lymph fistula (CNY ¥524,000) and tracheoesophageal injury (CNY ¥466,000). In 66.7% of cases, the defendants were deemed equally or more responsible than plaintiffs. The average expected compensation was CNY ¥577,000, with the actual compensation being CNY ¥248,000, or 43.0% of the expected amount. Judgments were issued on average of 3.8 years after surgery, and only 10.6% were resolved within the same year and 21.2% after over 5 years, with the longest dispute lasting 45 years.</p><p><strong>Conclusions: </strong>Medical disputes related to thyroid surgery primarily arise from nerve and parathyroid damage, with significant discrepancies between the expected and awarded compensation amounts. Lengthy resolution times highlight the need for enhanced communication related to surgical risk and a more efficient medical dispute resolution process.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"196-206"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in triple-negative breast cancer: insights from the E5103 trial and beyond.","authors":"Mika Nashimoto, Akihiko Ozaki","doi":"10.21037/gs-24-460","DOIUrl":"10.21037/gs-24-460","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"252-256"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepped-wedge clinical trials in pancreatic cancer: a step backward in improving overall survival or a leap forward to enhance quality of care?","authors":"Mauro Daniel Spina Donadio, Victor Hugo Fonseca de Jesus","doi":"10.21037/gs-24-472","DOIUrl":"10.21037/gs-24-472","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"263-267"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Tension-free thyroidectomy (medial thyroidectomy)-a prospective study: surgical technique and results of 259 operations.","authors":"","doi":"10.21037/gs-2024b-5","DOIUrl":"10.21037/gs-2024b-5","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/gs-23-147.].</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"116-117"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights on strength training, during chemotherapy treatment, for breast cancer.","authors":"Rafael Ribeiro Alves, Paulo Gentil, Carlos Alexandre Vieira","doi":"10.21037/gs-24-436","DOIUrl":"10.21037/gs-24-436","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"108-111"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography for predicting pathological complete response to neoadjuvant chemotherapeutic in breast cancer patients.","authors":"Chengchun Ge, Lukai Shi, Zhonghua Tan","doi":"10.21037/gs-2024-568","DOIUrl":"10.21037/gs-2024-568","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Accurately predicting pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) in breast cancer remains a clinical challenge. Current imaging-based models are limited in their ability to integrate key metabolic parameters to enhance prediction accuracy. This study aimed to develop and validate a nomogram using &lt;sup&gt;18&lt;/sup&gt;F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters, including maximum standardized uptake value (SUV&lt;sub&gt;max&lt;/sub&gt;), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), to improve pCR prediction. These parameters, representing both tumor metabolic burden and activity, were hypothesized to collectively provide a robust means of predicting pCR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study enrolled 95 breast cancer (BC) patients who underwent &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT before and after NACT. Patients were categorized into pCR (n=46) and non-pCR (n=49) groups based on postoperative pathological outcomes. Clinical and pathological characteristics, as well as changes in SUV&lt;sub&gt;max&lt;/sub&gt;, MTV, and TLG, were compared between the two cohorts. Logistic regression identified independent predictors of non-pCR. The dataset was then randomly divided into training (n=66) and validation (n=29) cohorts for nomogram construction and validation. The model's performance was evaluated using the area under the receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Relative to the non-pCR cohort, the pCR group exhibited smaller tumor diameters, lower Ki-67 expression, fewer lymph node metastases, and higher proportions of HER2+ molecular subtype (P&lt;0.05). Pretreatment SUV&lt;sub&gt;max&lt;/sub&gt;, MTV, and TLG levels in the pCR group were significantly lower than those in the non-pCR group, and showed a marked decrease after treatment (P&lt;0.05), whereas no significant changes were observed in the non-pCR group (P&gt;0.05). SUV&lt;sub&gt;max&lt;/sub&gt;, MTV, TLG, and molecular subtype were identified as independent predictors of non-pCR through logistic regression analysis. A nomogram constructed using these predictors achieved area under the ROC curve (AUC) of 0.9003 and 0.9363 in the training and validation cohorts, respectively. The model demonstrated good calibration (Hosmer-Lemeshow test, χ&lt;sup&gt;2&lt;/sup&gt;=6.412, P=0.60) and clinical utility through decision curve analysis, effectively stratifying patients at high risk of non-pCR based on a cutoff value of 0.8230.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;&lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT demonstrates significant clinical value in predicting pCR to NACT in BC patients. By integrating metabolic parameters such as SUV&lt;sub&gt;max&lt;/sub&gt;, MTV, and TLG into a nomogram, this approach enables accurate prediction of treatment efficacy, aiding in the early identification of patients unlikely to benefit from NACT. This facilitates timely adjustments to persona","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 1","pages":"48-59"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}