Gland surgery最新文献

{"title":"Post-treatment patient satisfaction in early-stage breast cancer: comparison of cryoablation versus breast conservation therapy using BREAST-Q.","authors":"Kizuki Matsumoto, Yuko Asano, Hiroki Matsui, Eisuke Fukuma","doi":"10.21037/gs-24-394","DOIUrl":"10.21037/gs-24-394","url":null,"abstract":"<p><strong>Background: </strong>De-escalation of local treatments for breast cancer is progressing, with breast-conserving therapy (BCT) representing approximately 60% of all breast cancer cases in Japan. Nonsurgical therapies have emerged as a novel treatment option. Assessing the health-related quality of life (HRQOL) and patient satisfaction following breast cancer surgery holds significant clinical importance. This study aimed to evaluate satisfaction after cryoablation or BCT in patients with early-stage breast cancer.</p><p><strong>Methods: </strong>Women with stage 0 or 1 breast cancer who underwent cryoablation or BCT between April 1 and June 30, 2022 were included. Exclusion criteria encompassed recurrence, axillary dissection, tumor diameter <15 mm, bilateral breast cancer, or pre-procedure irradiation. This study used the BREAST-Q questionnaire to assess patient HRQOL and satisfaction. The BREAST-Q questionnaire was administered postoperatively, and scores were compared using propensity score matching to adjust for baseline differences between the two groups.</p><p><strong>Results: </strong>Post-operative satisfaction was compared between cryoablation and BCT groups in patients with early-stage breast cancer. Between April 1 and June 30, 2022, a total of 147 Asian female breast cancer patients underwent cryoablation (n=42) or BCT (n=105). Among the 112 patients with stage 0 or 1 disease, 36 were excluded, and the remaining 76 (35 from the cryoablation group and 41 from the BCT group) were included in the analysis. There were no significant differences in observation period, age, or body mass index (BMI) between the groups. All patients received post-operative radiation therapy. While about a quarter of BCT patients received post-operative chemotherapy, none in the cryoablation group did (26.8% <i>vs.</i> 0%, P=0.003). Patients who underwent cryoablation compared to BCT reported significantly higher satisfaction (71.0±18.6 <i>vs.</i> 56.3±16.5) in the primary outcome, with a mean follow-up of 4.2 and 4.0 years, respectively. This trend was consistent across all the other measures. Adjustment for patient characteristics showed higher satisfaction in the cryoablation group, including age, BMI, and follow-up period between surgery and the survey.</p><p><strong>Conclusions: </strong>Cryoablation resulted in greater HRQOL and patient satisfaction than BCT for early-stage breast cancer. Our findings offer valuable insights underpinning treatment options for patients with early-stage, low-grade breast cancer.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"118-128"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669776","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":"Assessing neoadjuvant treatment response through serum human epidermal growth factor receptor 2 (HER2) dynamics.","authors":"Xuliren Wang, Min Xiong, Zhibo Shao, Bingqiu Xiu, Qi Zhang, Douwaner Liu, Weiru Chi, Liyi Zhang, Ming Chen, Hengyu Ren, Zhi-Ming Shao, Jiajian Chen, Jiong Wu","doi":"10.21037/gs-24-432","DOIUrl":"10.21037/gs-24-432","url":null,"abstract":"<p><strong>Background: </strong>Human epidermal growth factor receptor 2 (HER2)-positive invasive breast cancer (BC) accounts for 15-20% of all cases, requiring HER2-targeted neoadjuvant therapy (NAT). Despite the success of trastuzumab and other HER2-targeted treatments, many patients still experience inadequate responses, highlighting the need for more accurate and accessible biomarkers to predict treatment outcomes. Serum HER2 (sHER2) levels, as a non-invasive biomarker, have shown promise in monitoring treatment response; however, the role of sHER2 dynamics during treatment remains underexplored. The aim of this study was to investigate the potential of sHER2 dynamics as a predictor of pathological complete response (pCR) in HER2-positive BC patients undergoing NAT.</p><p><strong>Methods: </strong>This retrospective study analyzed 120 HER2-positive BC patients who underwent standard NAT followed by surgery at Fudan University Shanghai Cancer Center (FUSCC). sHER2 levels were measured at three time points: baseline, after the second cycle of therapy (C2), and at surgery. Logistic regression analysis was used to assess the association between changes in sHER2 levels and the achievement of pCR. The study also examined the influence of other clinicopathological factors such as estrogen receptor (ER) status, Ki67, and tissue HER2 (tHER2) levels on pCR.</p><p><strong>Results: </strong>During NAT, sHER2 levels showed a significant decline, with a more pronounced reduction observed in patients achieving pCR. The greatest reduction in sHER2 levels after C2 was strongly associated with pCR. Both univariate and multivariate analyses identified significant reductions in sHER2 levels after C2 and ER-negative status as independent predictors of pCR. Notably, sHER2 changes from baseline to C2 demonstrated a stronger predictive value for pCR compared to changes observed later in treatment.</p><p><strong>Conclusions: </strong>Our study confirms that reductions in sHER2 levels after C2 are a strong indicator of favorable treatment response in HER2-positive BC patients undergoing NAT. Monitoring sHER2 dynamics early in treatment can serve as a useful, non-invasive biomarker to predict pCR and may guide therapeutic decisions in clinical practice.</p>","PeriodicalId":12760,"journal":{"name":"Gland surgery","volume":"14 2","pages":"207-218"},"PeriodicalIF":1.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669744","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 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":"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":"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":"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":"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}