JAMA surgery最新文献

{"title":"Two Guidelines on Coronary Disease and the Atlantic Divide.","authors":"Faisal Bakaeen, Torsten Doenst","doi":"10.1001/jamasurg.2025.0158","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0158","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Testing and Targeted Therapies in Hepatobiliary Cancers","authors":"Diamantis I. Tsilimigras, Razelle Kurzrock, Timothy M. Pawlik","doi":"10.1001/jamasurg.2025.0242","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0242","url":null,"abstract":"ImportanceHepatobiliary cancers are heterogeneous and molecularly complex. Recent advances in next-generation sequencing (NGS) have enhanced the understanding of their molecular landscape and enabled deployment of biomarker-based gene- and immune-targeted therapies. This review examines the role of molecular testing and targeted therapies in these malignant neoplasms.ObservationsPatients with hepatobiliary cancers have poor outcomes. Precision oncology studies have shown that while many common molecular alterations are not currently targetable in hepatocellular carcinoma (HCC), a large number of actionable alterations characterize biliary tract cancers (BTCs), with several therapies now approved by the US Food and Drug Administration. Immunotherapy is increasingly adopted in clinical practice, either as monotherapy or combined with cytotoxic chemotherapy, for both HCC and BTCs. Moreover, multiple solid cancer tumor-agnostic therapies are approved (larotrectinib, entrectinib, and repotrectinib for <jats:italic>NTRK</jats:italic> fusions; selpercatinib for <jats:italic>RET</jats:italic> fusions; dabrafenib and trametinib combination for <jats:italic>BRAF</jats:italic> V600E mutations; dostarlimab or pembrolizumab for tumors with high microsatellite instability and pembrolizumab for tumor mutation burden ≥10 mutations/megabase), highlighting the need for NGS as well as ERBB2 (formerly HER2) immunohistochemistry (IHC) (with the recent approval of solid tissue–agnostic deruxtecan trastuzumab for ERBB2-positive [IHC 3+] cancer) across cancers. N-of-1 clinical trials using customized drug combinations matched to the tumor’s molecular profile have yielded encouraging results and provide a promising framework for future clinical trial design.Conclusions and RelevanceMolecular testing and gene- and immune-targeted therapies are transforming hepatobiliary cancer treatment. Tumor-agnostic and N-of-1 clinical trials have challenged traditional clinical trial paradigms and provide the foundation for truly personalized oncology for patients with these aggressive cancers. Further work is needed to determine how to leverage these novel approaches into the management of operable disease.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"183 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Results.","authors":"","doi":"10.1001/jamasurg.2025.0539","DOIUrl":"10.1001/jamasurg.2025.0539","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There a Need for Drain Placement After Gastrectomy?-Reply.","authors":"Jacopo Weindelmayer, Giovanni de Manzoni, Giuseppe Verlato","doi":"10.1001/jamasurg.2025.0172","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0172","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Will Care for Esophageal Squamous Cell Carcinoma Change?","authors":"Ernest G Chan, Jessica S Donington","doi":"10.1001/jamasurg.2025.0232","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0232","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JAMA Surgery-The Year in Review 2024.","authors":"Melina R Kibbe","doi":"10.1001/jamasurg.2025.0267","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0267","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable Intraoperative Augmented Reality for Surgery","authors":"Tony Jiang, Philip Edgcumbe, Kathryn V. Isaac","doi":"10.1001/jamasurg.2024.5494","DOIUrl":"https://doi.org/10.1001/jamasurg.2024.5494","url":null,"abstract":"This Surgical Innovation explores the potential that wearable augmented reality devices have for improving intraoperative imaging, patient outcomes, and surgical workflows.","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"128 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143599346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Exercise Effect on Fatigue and Function in Lung Cancer Surgery","authors":"Cornelia M. Ulrich, Caroline Himbert, Christopher A. Barnes, Kenneth M. Boucher, Bailee Daniels, Victoria M. Bandera, Jennifer A. Ligibel, David W. Wetter, Rachel Hess, Jaewhan Kim, Kelly Lundberg, Brian Mitzman, Robin Marcus, Samuel R. G. Finlayson, Paul C. LaStayo, Thomas K. Varghese","doi":"10.1001/jamasurg.2025.0130","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0130","url":null,"abstract":"ImportanceExercise intervention studies have shown benefits for patients with lung cancer undergoing surgery, yet most interventions to date have been resource intensive and have followed a one-size-fits-all approach.ObjectiveTo determine whether a personalized, clinic-aligned perioperative exercise program with remote monitoring and instructions can improve physical function and fatigue among patients undergoing surgery for lung cancer.Design, Setting, and ParticipantsThe Precision-Exercise-Prescription (PEP) randomized clinical trial is a single-center phase 3 trial. Adult patients with primary lung cancer (stages I-IIIa) or oligometastatic disease to the lung (where all disease could be removed) were assessed for eligibility and randomized to either an exercise intervention or standard care. Patients were enrolled between November 2017 and 2021, and the trial continued during the COVID-19 pandemic. Data were analyzed from November 2022 to December 2023.InterventionsThe structured exercise program, personalized based on mobility scores, was a home-based exercise intervention prescribed and monitored remotely by a licensed physical therapist. The program started approximately 2 weeks before surgery and continued after surgery. Standard care included use of incentive spirometer and encouragement to exercise without a formal program.Main Outcomes and MeasuresPhysical function (6-minute walk test [6MWT]), the Short Physical Performance Battery, and cancer-related fatigue (Functional Assessment of Chronic Illness Therapy–Fatigue) were assessed at baseline and 2 months after surgery.ResultsA total of 182 patients (92 receiving exercise intervention, 90 receiving standard care) were assessed in the intention-to-treat population. Patients had a mean (SD) age of 62.7 (13.8) years, 108 (59%) were female, and 89 (49%) had low mobility scores (Activity Measure for Post-Acute Care scores, 1-3). Physical function in the exercise group increased at 2 months after surgery (mean [SE] 6MWT at baseline, 467.9 [13.0] m; at 2 months, 482.2 [14.1] m), compared with a decrease in the standard-care group (mean [SE] 6MWT at baseline, 481.4 [11.1] m; at 2 months, 471.5 [14.0] m). Mean (SE) between-group changes in 6MWT distance for intent to treat from baseline to 2 months were 22.7 (12.7) m (&lt;jats:italic&gt;P&lt;/jats:italic&gt; = .08), with greater effect sizes among women (mean [SE], 37.8 [17.3] m; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .03). Similarly, women showed greater improvements in the Short Physical Performance Battery (mean [SE], 0.9 [0.4]; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .04). Patients in the exercise group maintained stable fatigue scores at 2 months, whereas participants in the standard-care group deteriorated (mean [SD], 3.7 [1.4]; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .009), with greater effect sizes among individuals who were younger, from rural areas, had overweight or obesity, and had primary lung cancer.Conclusions and RelevanceThe PEP intervention, a personalized, clinic-","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":"13 1","pages":""},"PeriodicalIF":16.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143599348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hormone Receptor Status of Second Breast Cancers in Women With Triple-Negative Breast Cancer.","authors":"Claire M Eden, Georgia Syrnioti, Josh Johnson, Anne Moore, Anni Liu, Xi Kathy Zhou, Lisa A Newman","doi":"10.1001/jamasurg.2025.0100","DOIUrl":"10.1001/jamasurg.2025.0100","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescence, Lymph Nodes, and Minimal Invasiveness in Digestive Surgery.","authors":"Mario Morino, Alberto Arezzo","doi":"10.1001/jamasurg.2025.0116","DOIUrl":"https://doi.org/10.1001/jamasurg.2025.0116","url":null,"abstract":"","PeriodicalId":14690,"journal":{"name":"JAMA surgery","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}