Gland surgery最新文献

{"title":"Frontiers and hotspots of 3D technology in prostatectomy from 1999 to 2024: a bibliometric analysis and visualization.","authors":"Jingke He, Chengcheng Wei, Shuai Su, Yu Luo, Yunfan Li, Kun Han, Lincen Jiang, Jindong Zhang, Delin Wang","doi":"10.21037/gs-2024-483","DOIUrl":"https://doi.org/10.21037/gs-2024-483","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is a major global health issue. Radical prostatectomy is an effective treatment for prostate cancer. The integration of three-dimensional (3D) technology in prostatectomy offers numerous benefits. We intended to perform a bibliometric analysis of the role of 3D technology in prostatectomy.</p><p><strong>Methods: </strong>Articles and review articles related to \"3D\" and \"prostatectomy\" were retrieved from Web of Science Core Collection. Microsoft Office Excel, CiteSpace, and VOSviewer were utilized for analysis and visualization.</p><p><strong>Results: </strong>A total of 441 articles were collected. The annual publication volume and journal distribution were illustrated. Visualizations of collaborations among countries/regions, institutions, and authors were provided. Networks of reference co-citations and keyword co-occurrences, along with their respective clusters were plotted.</p><p><strong>Conclusions: </strong>The number of published papers significantly increased over the last 25 years. The most productive and influential country was the USA, and The University of California System was the most influential institution. The journal with the highest number of publications was <i>BJU International</i>. Among all authors in this field, Wijkstra H has published the most papers. Porpiglia F was the most cited author. Previous hot topics included advanced imaging and clinical trials, whereas augmented reality (AR) and robotics are likely to be hot topics in the future.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"436-450"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004081","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":"Surgery and neoadjuvant therapy in locally advanced pancreatic cancer: an umbrella review of survival, resection outcomes, and cost-effectiveness.","authors":"Yun Zhao, Hwee Leong Tan, Darren Weiquan Chua, Brian Kim Poh Goh, Ye Xin Koh","doi":"10.21037/gs-24-421","DOIUrl":"https://doi.org/10.21037/gs-24-421","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy with a poor prognosis, particularly for patients with locally advanced pancreatic cancer (LAPC). Neoadjuvant therapy (NAT) has emerged as a promising strategy to improve resectability and survival outcomes in LAPC. This umbrella review aimed to synthesize the available evidence on the effectiveness of NAT and surgical interventions in LAPC, focusing on resection and R0 resection rates and overall survival (OS).</p><p><strong>Methods: </strong>This study was registered with PROSPERO (CRD42024565454). A comprehensive literature search was conducted in June 2024 across four databases. Studies reporting on NAT and/or surgery in LAPC were selected, and the methodological quality of each meta-analysis was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) tool. A cost-effectiveness analysis (CEA) was performed comparing FOLFIRINOX (leucovorin calcium, fluorouracil, irinotecan, and oxaliplatin) and gemcitabine/nab-paclitaxel as NAT regimens.</p><p><strong>Results: </strong>Nine systematic reviews with meta-analyses published between 2014 and 2023 were included. They covered a variety of treatment strategies, including NAT followed by resection, induction therapy comparing FOLFIRINOX versus gemcitabine/nab-paclitaxel, and different surgical techniques. FOLFIRINOX demonstrated significantly higher R0 resection rates [risk ratio (RR): 0.77, 95% confidence interval (CI): 0.60-0.97, P<0.05] and improved OS compared to gemcitabine/nab-paclitaxel [hazard ratio (HR): 0.68, 95% CI: 0.46-0.99, P<0.05]. Surgical resection following NAT was associated with significantly better survival outcomes than induction therapy alone or palliative treatments. The CEA revealed that FOLFIRINOX, despite its higher cost, yielded an incremental OS benefit of 5.19 months and maintained a 60-63% probability of being cost-effective within a willingness-to-pay (WTP) threshold of $150,000 per additional month of OS gained.</p><p><strong>Conclusions: </strong>This review highlights the superior efficacy of FOLFIRINOX as a NAT regimen for LAPC, particularly in increasing resectability and R0 resection rates. Combining NAT with surgery offers significant survival benefits, making this strategy a standard of care for eligible LAPC patients.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 3","pages":"529-542"},"PeriodicalIF":1.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003257","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":"Video-assisted submuscular breast reconstruction: evaluating a novel technique in high-risk patients.","authors":"Leonardo Barellini, Simone Miccoli, Benedetta Daicampi, Pietro Susini, Ishith Seth, Mirco Pozzi, Roberto Cuomo, Luca Grimaldi, Gianluca Marcaccini","doi":"10.21037/gs-2024-485","DOIUrl":"10.21037/gs-2024-485","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is one of the most prevalent oncological diseases worldwide, with mastectomy often necessary for treatment. Post-mastectomy breast reconstruction is essential for restoring physical integrity and improving patients' quality of life, especially in high-risk individuals with advanced age, obesity, diabetes, smoking habits, or a history of radiotherapy. Traditional submuscular reconstruction techniques are effective but often associated with higher rates of complications in this patient population. This study aimed to evaluate the efficacy and safety of a novel video-assisted procedure (VAP) for submuscular breast reconstruction, focusing on its ability to reduce complications and enhance outcomes.</p><p><strong>Methods: </strong>A retrospective analysis compared 17 high-risk patients who underwent VAP with 127 patients treated using traditional non-video-assisted procedures (NVAP) between September 2022 and June 2024. Both groups were comparable in age, body mass index (BMI), and risk factors. Data on postoperative complications, including bleeding, wound dehiscence, and infections, were collected and analyzed. Statistical significance was determined using appropriate tests, with a P value <0.05 considered significant.</p><p><strong>Results: </strong>The VAP group demonstrated significant reductions in complications compared to the NVAP group. No cases of postoperative bleeding were reported in the VAP group, while 8.66% of NVAP patients experienced bleeding. Wound dehiscence rates were also lower in the VAP group (5.88%) compared to the NVAP group (10.24%). The minimally invasive nature of VAP allowed for precise dissection and reduced tissue trauma without prolonging surgical times.</p><p><strong>Conclusions: </strong>The findings suggest that VAP is a safer and more effective alternative for high-risk patients requiring submuscular breast reconstruction. By minimizing complications and enhancing both functional and aesthetic outcomes, VAP offers a promising innovation in reconstructive surgery. Larger, randomized trials are necessary to validate these results and establish VAP as a standard of care in diverse clinical settings.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"172-178"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669266","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":"Safety and feasibility of robotic reoperation via a bilateral axillo-breast approach for patients with locally recurrent thyroid cancer: a single-center retrospective study.","authors":"Sijuan Chen, Xianjiao Cao, Gaoyuan Xu, Dan Wang, Dayong Zhuang, Peng Zhou, Tao Yue, Qingqing He, Xiaolei Li","doi":"10.21037/gs-24-477","DOIUrl":"10.21037/gs-24-477","url":null,"abstract":"<p><strong>Background: </strong>For patients with recurrent thyroid cancer, traditional open re-operative surgeries often leave conspicuous cervical scars, significantly impacting patients' long-term quality of life. The potential for robotic surgery to enhance the aesthetic outcomes of re-operative surgery and improve the quality of life for these patients has rarely been studied. This study aimed to assess the feasibility and effectiveness of robotic reoperation for recurrent thyroid cancer following initial surgery, offering a viable surgical alternative tailored to patients with heightened aesthetic concerns.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients with recurrent thyroid cancer who underwent robotic reoperation via the bilateral axillo-breast approach (BABA) at the 960th Hospital of People's Liberation Army between September 2018 and March 2024. The study design involved a comprehensive review of clinical data, including patient demographics, surgical outcomes, and postoperative complications.</p><p><strong>Results: </strong>A cohort of 24 patients (18 females, 6 males) with a mean age of 34.13±10.06 years successfully underwent robotic BABA reoperation without conversion to open surgery. Two patients underwent completion total thyroidectomy (CTT) with central neck node dissection (CND), four underwent CTT with lateral neck dissection (LND), and the remaining 18 patients received LND alone. Histopathological examination revealed papillary thyroid carcinoma (PTC) in 23 patients and medullary thyroid carcinoma (MTC) in one patient. The mean number of lymph nodes retrieved from LND was 14.21±12.30, with 2.74±2.64 nodes harboring metastases. Postoperative complications were transient, including hypoparathyroidism in four patients and temporary vocal cord palsy in one patient, with no permanent complications reported. During an average follow-up period of 29.71±19.29 months, no recurrences were detected. Cosmetic satisfaction was assessed and yielded a median satisfaction score of 9.2.</p><p><strong>Conclusions: </strong>Robotic BABA reoperation emerges as a feasible and safe surgical modality for managing recurrent thyroid cancer, offering effective treatment while catering to patients' high aesthetic demands.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"163-171"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669718","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":"Development and application of primary rat parathyroid cells for transplantation in hypoparathyroidism.","authors":"Ke Ma, Zeyu Yang, Yinde Huang, Supeng Yin, Yizeng Sun, Weihua Wang, Tingjie Yin, Junping Zhu, Chunmeng Shi, Fan Zhang","doi":"10.21037/gs-24-411","DOIUrl":"10.21037/gs-24-411","url":null,"abstract":"<p><strong>Background: </strong>Hypoparathyroidism (HPO) is characterized by deficient secretion of parathyroid hormone (PTH), leading to hypocalcemia and disrupted calcium homeostasis. Current treatments rely on calcium and vitamin D supplementation, which do not adequately mimic physiological PTH function. Cell-based therapies offer a potential solution, but optimal culture conditions to preserve the functional properties of primary parathyroid cells remain unclear. This study aims to develop primary rat parathyroid cell cultures that maintain hormone secretion and calcium-sensing abilities and to evaluate their therapeutic potential in a rat model of HPO.</p><p><strong>Methods: </strong>An HPO model was established in rats through surgical excision of the parathyroid glands. Primary parathyroid cells were isolated from these rats and sorted by flow cytometry using epithelial cell adhesion molecule (EpCAM) and calcium-sensing receptor (CaSR) markers. Four different culture media (CM) were tested to determine optimal conditions for sustaining cell functionality. The most effective CM was supplemented with Sonic Hedgehog (Shh), Activin A, and inhibitors of epithelial-mesenchymal transition (EMT). The cultured cells were then transplanted into HPO rats, and serum calcium and PTH levels were monitored to assess therapeutic efficacy.</p><p><strong>Results: </strong>The optimized CM successfully preserved the hormone-secreting and calcium-sensing functions of primary parathyroid cells over multiple passages. Transplanted cells in HPO rats led to a significant increase in serum calcium and PTH levels compared to untreated controls. The restoration of these levels correlated with the alleviation of hypocalcemic symptoms, indicating effective functional integration of the transplanted cells.</p><p><strong>Conclusions: </strong>Primary rat parathyroid cells cultured under optimized conditions retained essential functional properties and, upon transplantation, effectively restored calcium homeostasis in an HPO rat model. These results highlight the potential of using cultured primary parathyroid cells as a viable cell-based therapy for HPO, offering a promising alternative to conventional treatments.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"139-152"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669752","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":"Ultrasound-guided thermal ablation therapy for papillary thyroid carcinoma: a bibliometric analysis from 2000 to 2023.","authors":"Junping Zhang, Shanshan Li, Mengya Zhu, Wen Chen, Anqi Huo, Yuanyuan Deng, Fang Lu, Ying Liu, Jixiong Xu","doi":"10.21037/gs-24-466","DOIUrl":"10.21037/gs-24-466","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid cancer (PTC) is increasingly treated with procedures. However, there is a lack of relevant systematic evaluation articles. Therefore, this study aims to explore the research landscape of PTC thermal ablation through bibliometric analysis.</p><p><strong>Methods: </strong>We searched publications related to PTC thermal ablation therapy from January 1, 2000 to December 31, 2023, from the Web of Science Core Collection (WoSCC). Subsequently, bibliometric analyses were then performed using the R package \"bibliometrix\", as well as VOSviewer and CiteSpace software, to visualize data on countries, institutions, journals, authors, keywords, and references.</p><p><strong>Results: </strong>A total of 283 publications from 17 countries were retrieved, and the number of publications had shown a steady increase over the past decade, with China, the USA and South Korea being the top three contributing countries. The Chinese People's Liberation Army General Hospital was the most prolific institution, with the <i>International Journal of Hyperthermia</i> being the most frequent publisher. The author with the highest number of publications was Yukun Luo. \"Radiofrequency ablation\" was identified as the most commonly used keyword, indicating a potential research hotspot for the future.</p><p><strong>Conclusions: </strong>This bibliometric study comprehensively analyzed publications on PTC thermal ablation, providing valuable insights into the history and current status of this research field, while also offering guidance for future research directions.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"153-162"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669158","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":"Is adjuvant olaparib standard of care in all high-risk HER2-negative early breast cancer presenting <i>gBRCA1/2</i> mutations?","authors":"Pierre Foidart, Guy Jerusalem","doi":"10.21037/gs-24-467","DOIUrl":"10.21037/gs-24-467","url":null,"abstract":"","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"257-262"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669768","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":"Cohort study comparing volume replacement oncoplastic breast surgery with standard wide local excision for breast cancer.","authors":"Akriti Nanda, Anisha Chopra, Hibatullah Abuelgasim, Pankaj Gupta Roy","doi":"10.21037/gs-24-385","DOIUrl":"10.21037/gs-24-385","url":null,"abstract":"<p><strong>Background: </strong>Volume replacement oncoplastic breast surgery (VR-OPS) allows breast conservation for women who would otherwise undergo mastectomy or compromise cosmetic outcomes with wide local excision (WLE). VR-OPS remains understudied in the literature. The aim of this study was to compare 7-year outcomes of VR-OPS <i>vs.</i> WLE.</p><p><strong>Methods: </strong>This is a single-centre retrospective chart review compared VR-OPS (2012-2016) to WLE (2013-2014), analysing clinicopathological, treatment, surgical, and follow-up data.</p><p><strong>Results: </strong>Eighty patients underwent WLE and 79 VR-OPS. No differences in smoking status, cancer type, or grade were observed between the groups. Women in the VR-OPS group were significantly younger, more likely to be node positive, and had larger tumours. Consequently, they received more neo-adjuvant chemotherapy and axillary surgery. VR-OPS resulted in significantly more clear margins [relative risk (RR) =0.3638; 95% confidence interval (CI): 0.1621 to 0.8162; P=0.01], translating to a decreased need for mastectomy (RR =0.2250; 95% CI: 0.0502 to 1.0089; P=0.06). There was also a significant decrease in the need for further breast surgery for symmetrisation after VR-OPS (RR =0.1266; 95% CI: 0.0162 to 0.9887; P=0.04). Although VR-OPS had slightly more post-op complications (RR =1.8228; 95% CI: 0.8982 to 3.6993; P=0.09), this was not statistically significant. Importantly there was no difference in long-term oncological outcomes specifically local-recurrence (RR =0.7949; 95% CI: 0.1152 to 5.484; P=0.81) and overall-survival (RR =0.6551; 95% CI: 0.2633 to 1.6302; P=0.36).</p><p><strong>Conclusions: </strong>This study observed no significant differences in long-term local recurrence and survival between the VR-OPS and WLE groups. VR-OPS represents an oncologically safe surgical option especially for larger tumours.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"129-138"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669745","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":"DCE-MRI-based machine learning model for predicting axillary lymph node metastasis in breast cancer.","authors":"Qian Zhang, Yang Lou, Xiaofeng Liu, Chong Liu, Wenjuan Ma","doi":"10.21037/gs-2024-495","DOIUrl":"10.21037/gs-2024-495","url":null,"abstract":"<p><strong>Background: </strong>Accurate evaluation of the axillary lymph node (ALN) status is needed for determining the treatment protocol for breast cancer. This study aimed to build an artificial intelligence (AI) model to predict ALN metastasis based on pre-treatment dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) of breast cancer combined with radiomics algorithms.</p><p><strong>Methods: </strong>Pre-treatment DCE-MRI dataset of 166 patients with pathologically confirmed breast cancer diagnosis from January 2017 to August 2020 was collected, and all patients were randomly divided into a training group and test group with a ratio of 7:3. Each patient underwent pre-enhancement as well as post-enhancement 1-6 MRI, and a total of 7,224 two-dimensional (2D) and 9,863 three-dimensional (3D) features were extracted, respectively. Radiomics models based on 2D, 3D, pre-enhancement, and the first post-enhancement images were established using the least absolute shrinkage selection operator (LASSO) algorithm based on machine learning, and the area under the curve (AUC), accuracy, sensitivity, and specificity of the models were calculated.</p><p><strong>Results: </strong>The mean AUC, accuracy, sensitivity, and specificity of the 10-fold cross-validation of the 3D radiomics-based model were 82%, 82%, 83%, and 81%, respectively. The C-index of the combined model with combining radiomics features and clinical features was 90%, the AUC was 90%, the specificity was 91%, the sensitivity was 77% and the accuracy was 84%.</p><p><strong>Conclusions: </strong>The comprehensive prediction model using DCE-MRI image combined with clinical features can accurately predict ALN metastasis in breast cancer.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"228-237"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669748","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":"Efficacy and safety analysis of a docetaxel-plus-trastuzumab regimen in patients with early-stage HER2-positive breast cancer: a retrospective single-arm study.","authors":"Jia Yao, Yaqun Zhang, Mingyi Chen, Toshinari Yamashita, Yu Liu, Shusen Zheng","doi":"10.21037/gs-2024-549","DOIUrl":"10.21037/gs-2024-549","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A regimen of weekly paclitaxel and trastuzumab (WPH) is the standard treatment for patients with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer but has certain limitations. Weekly hospital visits are burdensome for patients and increase healthcare resource use. Docetaxel is currently used in several chemotherapy regimens for HER2-positive breast cancer, such as four cycles of docetaxel and cyclophosphamide plus trastuzumab (TC4H) or THP (paclitaxel, trastuzumab plus pertuzumab), and its safety and efficacy have been well established. Therefore, for patients who cannot visit the hospital for treatment every week, we have implemented a 3-week docetaxel regimen to replace the weekly paclitaxel schedule for these early-stage HER2-positive breast cancer patients. Our retrospective analysis conducted from 2014 to 2019 assessed the efficacy and safety of a docetaxel-and-trastuzumab (TH) regimen in patients with early-stage HER2-positive breast cancer, with the aim of establishing a more accessible and efficient treatment approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a single-arm retrospective study analysis of TH therapy for early-stage HER2-positive breast cancer conducted in The First Affiliated Hospital, School of Medicine, Zhejiang University between January 2015 and December 2019. Patients included were lymph node-negative, aged 50 years or older, and had received TH regimen after surgery, with comprehensive follow-up data available. Patients received six cycles of docetaxel (100 mg/m&lt;sup&gt;2&lt;/sup&gt;) every 3 weeks and trastuzumab (8 mg/kg in cycle 1, followed by 6 mg/kg) every 3 weeks for 1 year. Disease-free survival (DFS), overall survival (OS), and adverse events were evaluated as prognosis outcomes of the TH regimen.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 144 breast cancer patients were enrolled. The median age of the patients was 61.5 years and 80 patients (55.6%) had hormone receptor-positive disease. In the entire study population, 34.7% of patients had tumors 1 cm or smaller. The median follow-up time of the included patients was 7.1 years, the 5-year DFS rate was 96.5%, and the OS rate was 98.6%. Among the five patients who experienced invasive disease events or death, three had local or regional recurrences. Three patients (2.1%) experienced at least one episode of grade 3 neuropathy, and five patients had a significant decrease in ejection fraction, leading to a 3.5% interruption of trastuzumab treatment. None of the patients experienced grade 3 or 4 hypersensitivity reactions to the study treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The TH regimen demonstrated promise as a novel treatment alternative for patients with early-stage HER2-positive breast cancer. It offers a similar degree of efficacy and safety to those of the conventional WPH regimen while requiring fewer hospital visits, which could result in reduced healthcare costs and enhanced patient convenienc","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"219-227"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669759","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}