Journal of Gastrointestinal Surgery最新文献

{"title":"Is stapled Kono-S anastomosis a protective factor against postoperative endoscopic recurrence in Crohn disease? A single-center, retrospective cohort study","authors":"Tianrun Song ,&nbsp;Yang Chen ,&nbsp;Liqun Wang ,&nbsp;Chunjie Zhang ,&nbsp;Changsheng Zhou ,&nbsp;Yanqing Diao ,&nbsp;Jianfeng Gong ,&nbsp;Lei Cao ,&nbsp;Weiming Zhu ,&nbsp;Ming Duan ,&nbsp;Yi Li","doi":"10.1016/j.gassur.2024.101941","DOIUrl":"10.1016/j.gassur.2024.101941","url":null,"abstract":"<div><h3>Background</h3><div>Handsewn Kono-S anastomosis is safe and associated with a reduction in postoperative recurrence (POR) in Crohn disease (CD). This study aimed to investigate the advantages of stapled Kono-S anastomosis in patients with CD who underwent intestinal anastomosis.</div></div><div><h3>Methods</h3><div>Patients with CD who underwent intestinal anastomosis were reviewed via a prospectively maintained database. Patients who underwent conventional stapled side-to-side anastomosis were classified into the conventional group, and those who underwent stapled Kono-S anastomosis were classified into the Kono-S group. The primary endpoint was modified endoscopic recurrence (mER; ≥i2b). Other endpoints were endoscopic recurrence (ER; ≥i2); severe ER (i3 and i4); intra- and postoperative outcomes, including morbidity and hospital stay; and cross-sectional parameters. Multivariate logistic regression analysis was performed to assess the independent risk factors for mER.</div></div><div><h3>Results</h3><div>Between 2020 and 2023, 199 patients (63 in the Kono-S group) were included in this study. After matching the 63 patients in each group, the overall rates of mER, ER, and severe ER were 19.0%, 24.6%, and 8.7%, respectively. The mER, ER, and severe ER rates were lower in the Kono-S group than in the conventional group (12.7% vs 25.4% [<em>P</em> =.07], 20.6% vs 28.6% [<em>P</em> =.30], and 6.3% vs 11.1% [<em>P</em> =.34], respectively). Multivariate analysis indicated that stapled Kono-S anastomosis (odds ratio [OR], 0.35; 95% CI, 0.12–0.98; <em>P</em> =.047) was an independent protective factor for mER, whereas male gender (OR, 7.75; 95% CI, 1.50–40.00; <em>P</em> =.01) and BMI of &lt;18.5 kg/m² (OR, 3.27; 95% CI, 1.11–9.67; <em>P</em> =.03) were independent risk factors for mER.</div></div><div><h3>Conclusion</h3><div>Stapled Kono-S anastomosis is safe for patients with CD. However, stapled Kono-S anastomosis may not be a protective factor against POR compared with conventional stapled side-to-side anastomosis.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 3","pages":"Article 101941"},"PeriodicalIF":2.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Enhanced Recovery After Surgery protocol in pancreatic surgery: a systematic review and meta-analysis of randomized controlled trials","authors":"Maurício Prätzel Ellwanger ,&nbsp;Manuela Pozza Ellwanger ,&nbsp;Matheus Budahazi Jardine ,&nbsp;Victoria Bramucci ,&nbsp;Stephany Aparecida Pereira Hammes ,&nbsp;Lucca Moreira Lopes ,&nbsp;Antônio Carlos Mattar Munhoz","doi":"10.1016/j.gassur.2024.101939","DOIUrl":"10.1016/j.gassur.2024.101939","url":null,"abstract":"<div><h3>Background</h3><div>The Enhanced Recovery After Surgery (ERAS) protocol represents an advancement in perioperative care to reduce surgical stress and accelerate recovery. This meta-analysis aimed to evaluate the effectiveness of ERAS in pancreatic surgery and to assess the effect of the ERAS protocol vs conventional hospital care on postoperative outcomes, including length of stay (LOS) in the hospital, hospital costs, readmission rates, and infection rates in patients undergoing pancreatic surgery.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Cochrane Central Register of Controlled Trials, and Embase were searched to identify relevant RCTs. Data were extracted and analyzed using a random effects model. Statistical analyses were performed using RStudio.</div></div><div><h3>Results</h3><div>A total of 7 RCTs involving 731 patients were included. The meta-analysis showed a statistically significant reduction in LOS by 2.49 days (mean difference, −2.49; 95% CI, −4.20 to −0.79; <em>P</em> &lt;.01) with considerable heterogeneity (<em>I</em>^<em>2</em> = 86%). Hospital costs were significantly reduced (standardized mean difference, −0.36; 95% CI, −0.65 to −0.06; <em>P</em> =.02) with moderate heterogeneity (<em>I</em>^<em>2</em> = 52%). The readmission and infection rates showed no statistically significant differences between the ERAS and control groups. The Egger test indicated no significant publication bias.</div></div><div><h3>Conclusion</h3><div>The ERAS protocol significantly reduced LOS and hospital costs in patients who underwent pancreatic surgery. Our findings support the implementation of ERAS protocols to enhance recovery and optimize outcomes. To the best of our knowledge, our study is the first to demonstrate these results using an RCT-only meta-analysis approach in pancreatic surgery, highlighting the value of ERAS in improving perioperative care.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 3","pages":"Article 101939"},"PeriodicalIF":2.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring rural-urban differences in the receipt of nonelective cancer-specific gastrointestinal surgery using a multilevel mixed-effects approach","authors":"Crisanto M. Torres ,&nbsp;Sara Myers ,&nbsp;Megan G. Janeway ,&nbsp;Sabrina E. Sanchez ,&nbsp;Dane R. Scantling ,&nbsp;Elizabeth S. Davis ,&nbsp;Sing Chau Ng ,&nbsp;Tracey Dechert ,&nbsp;Teviah E. Sachs ,&nbsp;Kelly M. Kenzik","doi":"10.1016/j.gassur.2024.10.013","DOIUrl":"10.1016/j.gassur.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Rural communities constitute a populace marked by various social challenges influencing health outcomes. As such, nonelective surgeries for cancer may have a disproportionate impact on rural populations. We explored patient and county-level factors contributing to differences in the receipt of nonelective cancer-specific surgery between rural and urban residents.</div></div><div><h3>Methods</h3><div>This retrospective study included adult patients captured in the Surveillance, Epidemiology, and End Results–Medicare data between January 2008 and December 2015 with an incident stage I to IV cancer of the stomach, liver/intrahepatic bile duct, pancreas, gallbladder/other biliary origin, or small intestine who underwent a cancer-specific surgery. The primary outcome was a nonelective cancer-directed surgery among rural vs urban residents. We conducted a multivariable mixed-effects logistic regression model to adjust for confounders while accounting for county-level clustering.</div></div><div><h3>Results</h3><div>The sample included 10,136 patients who underwent a surgical intervention; 2941 (29%) were nonelective. The incidence of nonelective surgery was lower among rural than urban patients (351 [27%] and 2590 [29%]; <em>P</em> = .05). There was no statistically significant difference in the unadjusted and adjusted odds of nonelective surgery between rural and urban residents (odds ratio, 0.88; 95% CI, 0.76–1.03; <em>P</em> = .11; adjusted odds ratio [aOR], 0.86; 95% CI, 0.72–1.02; <em>P</em> = .080). In addition, high social vulnerability index (SVI) counties or Black race was significantly associated with increase odds of nonelective surgery (aOR, 1.33; 95% CI, 1.07–1.65; <em>P</em> = .009; aOR, 1.49; 95% CI, 1.26–1.77; <em>P</em> &lt; .0001, respectively).</div></div><div><h3>Conclusion</h3><div>This study found no difference in the odds of receiving nonelective surgery for gastrointestinal foregut cancers between rural and urban populations. However, Black race and high SVI were associated with higher odds of the receipt of nonelective surgery. Further research is warranted to explore whether disparities in clinical outcomes exist despite the comparable likelihood of receiving nonelective surgery between rural and urban communities.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101858"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: “Multifactorial risk prediction analysis of liver metastasis in colorectal cancer: incorporating programmed cell death ligand 1 combined positive score and other factors”","authors":"Jixuan Wu ,&nbsp;Zili Zhang ,&nbsp;Lei Zhang","doi":"10.1016/j.gassur.2024.10.027","DOIUrl":"10.1016/j.gassur.2024.10.027","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101872"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tunnel anastomosis: a modified flap technique in esophagogastrostomy as a novel antireflux technique after proximal gastrectomy","authors":"Rui Peng ,&nbsp;Yun Shi ,&nbsp;Hao Zhang ,&nbsp;Qing-Yu Xie ,&nbsp;Chao Yue ,&nbsp;Ling-Li Huang ,&nbsp;Liang Chen ,&nbsp;Guang-Li Sun ,&nbsp;Wei-Guo Xu ,&nbsp;Wei Wei ,&nbsp;Rong-Min Gu ,&nbsp;Xue-Zhi Ming ,&nbsp;Huan-Qiu Chen ,&nbsp;Gang Li","doi":"10.1016/j.gassur.2024.10.026","DOIUrl":"10.1016/j.gassur.2024.10.026","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of proximal gastric cancer (PGC) has been increasing rapidly worldwide. Postoperative reflux esophagitis after conventional esophagogastrostomy (EG) is a major problem that haunts surgeons. This study designed a novel antireflux technique called tunnel anastomosis in EG after proximal gastrectomy (PG). This study aimed to present the detailed procedures of tunnel anastomosis and to assess its safety and feasibility by comparing the surgical outcomes, reflux, and nutritional status of patients undergoing tunnel anastomosis and those undergoing double-tract jejunal interposition reconstruction (DTJIR).</div></div><div><h3>Methods</h3><div>A total of 1718 patients undergoing gastrectomy were enrolled in this study. However, only 150 patients undergoing PG were ultimately analyzed, of which 21 patients underwent tunnel anastomosis and 129 patients underwent DTJIR. Propensity score matching (PSM) was used to reduce biases.</div></div><div><h3>Results</h3><div>After 1:1 PSM, there were 21 patients in both groups. No significant differences were observed between the 2 groups regarding surgical approach, blood loss, operative time, reconstruction time, postoperative hospital stay, morbidity, and mortality. The incidence of reflux esophagitis in both groups was 9.5% (2/21) according to the endoscopic examination at the 12-month postoperative follow-up. No patient in the tunnel group was classified as grade B or higher according to the Los Angeles classification. Patients in the tunnel and DTJIR groups exhibited comparable postoperative nutritional status when assessing the body weight, albumin levels and prognostic nutritional index value at 3 and 6 months after surgery.</div></div><div><h3>Conclusion</h3><div>Tunnel anastomosis is a safe technique that offers a robust antireflux effect and can be performed in some suitable patients with PGC.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101871"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568858","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 validation of a machine-learning model for preoperative risk of gastric gastrointestinal stromal tumors","authors":"Shi-Qi Liang ,&nbsp;Yu-Tong Cui ,&nbsp;Guang-Bing Hu ,&nbsp;Hai-Yang Guo ,&nbsp;Xin-Rui Chen ,&nbsp;Ji Zuo ,&nbsp;Zhi-Rui Qi ,&nbsp;Xian-Fei Wang","doi":"10.1016/j.gassur.2024.10.019","DOIUrl":"10.1016/j.gassur.2024.10.019","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal stromal tumors (GISTs) have malignant potential, and treatment varies according to risk. However, no specific protocols exist for preoperative assessment of the malignant potential of gastric GISTs (gGISTs). This study aimed to use machine learning (ML) to develop and validate clinically relevant preoperative models to predict the malignant potential of gGISTs.</div></div><div><h3>Methods</h3><div>This study screened patients diagnosed with gGISTs at the Affiliated Hospital of North Sichuan Medical College. Moreover, this study employed the Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to identify risk factors. Subsequently, an ensemble of ML models was used to determine the optimal classifier. In addition, this study used SHapley Additive exPlanations (SHAP) for tailored risk profiling.</div></div><div><h3>Results</h3><div>This study included 318 patients with gGISTs. Using LASSO regression and multifactorial logistic regression, this study analyzed the training dataset, revealing that the presence of endoscopic ultrasound (EUS) high-risk features, tumor border clarity, tumor diameter, and monocyte-to-lymphocyte ratio (MLR) were significant predictors of high malignancy risk in gGIST. As determined by our ML approach, the logistic classification model demonstrated optimal performance, with area under the receiver operating characteristic curves of 0.919 for the training set and 0.925 for the test set. Furthermore, decision curve analysis confirmed the clinical relevance of the model.</div></div><div><h3>Conclusion</h3><div>High-risk EUS features, ill-defined tumor margins, larger tumor diameters, and elevated MLR independently predicted increased malignant potential in gGIST. This study developed logistic regression models based on these factors, which were further interpreted using the SHAP methodology. This analytical approach facilitated personalized therapeutic decision-making among diverse patient populations.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101864"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501930","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":"Invited commentary: toward a better understanding of recurrence after hepatectomy for metastatic colorectal cancer","authors":"Matthew P. Vivero ,&nbsp;Jason S. Gold","doi":"10.1016/j.gassur.2024.101878","DOIUrl":"10.1016/j.gassur.2024.101878","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101878"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombosis and anticoagulation after portal vein reconstruction during pancreatic surgery: a systematic review","authors":"Max Heckler ,&nbsp;Georgios Polychronidis ,&nbsp;Benedict Kinny-Köster ,&nbsp;Susanne Roth ,&nbsp;Thomas Hank ,&nbsp;Joerg Kaiser ,&nbsp;Christoph Michalski ,&nbsp;Martin Loos","doi":"10.1016/j.gassur.2024.10.007","DOIUrl":"10.1016/j.gassur.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Portal vein (PV) resection and reconstruction, which includes the resection and reconstruction of the PV and superior mesenteric vein, enable surgical removal of borderline resectable and locally advanced pancreatic cancer. Thrombosis of the reconstructed PV represents a major cause of early postoperative and long-term morbidity and mortality. No universally accepted standard for anticoagulation exists. This study aimed to assess early and late thrombosis rates after PV reconstruction with special regard to the type of PV reconstruction and anticoagulation regimen and to comprehensively assess thrombotic events and their clinical effect in patients receiving pancreatic surgery with venous resection and reconstruction.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Studies reporting on PV resection and reconstruction providing data on thrombosis rates were included. The following parameters were assessed: study type, year of publication, number of patients, type/number of PV reconstruction, follow-up period, postoperative mortality, thrombosis rate of the reconstructed PV axis, intraoperative blood loss, and anticoagulation.</div></div><div><h3>Results</h3><div>A total of 23 studies with 2751 patients were included in the final analysis. Of note, 670 patients received tangential resection of the PV with venorrhaphy or patch repair, 1505 patients had segmental resection with end-to-end reconstruction, and 576 patients received reconstruction with an interposition graft/conduit. The pooled overall thrombosis rate was 15%. Reconstruction of tangential defects with either venorrhaphy or patch repair and end-to-end repair of segmental defects resulted in a thrombosis rate of 12%. Subgroup analysis according to the type of graft reconstruction revealed the highest occlusion rates of 55% in patients with allogeneic grafts, followed by up to 27% in patients with synthetic PV conduits. Autologous conduits had a thrombosis rate of 10%. Early thrombotic events were detected in 5% of patients after venorrhaphy/patch reconstruction and end-to-end reconstruction. Early events were most common in the allogeneic graft subgroup (22%), followed by synthetic conduits (15%). There were fewer early events in the autologous graft group (7%). Early PV thrombosis was associated with relevant mortality of up to 26%. Anticoagulation regimens varied between studies.</div></div><div><h3>Conclusion</h3><div>The overall thrombosis rate after PV resection is low. However, among the different reconstruction techniques, allogeneic interposition grafts/conduits had the highest thrombosis rates among the different types of reconstruction after PV resection. No specific anticoagulation strategy can be considered beneficial based on the existing literature.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101852"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467398","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":"Survival outcomes of adjuvant treatment in upstaged clinical T2N0 rectal cancer: are we underutilizing therapy?","authors":"Simran Kripalani ,&nbsp;Caroline Westwood ,&nbsp;Jill S. Hasler ,&nbsp;Vanessa Wookey ,&nbsp;Andrea S. Porpiglia ,&nbsp;Stephanie H. Greco ,&nbsp;Sanjay S. Reddy ,&nbsp;Joshua E. Meyer ,&nbsp;Jeffrey M. Farma ,&nbsp;Anthony M. Villano","doi":"10.1016/j.gassur.2024.10.024","DOIUrl":"10.1016/j.gassur.2024.10.024","url":null,"abstract":"<div><h3>Background</h3><div>Patients with rectal cancer staged as clinical T2N0 (cT2N0) are recommended to undergo upfront resection. However, when the tumor is subsequently upstaged to pathologic T3N0 (pT3N0), there are no clear guidelines for adjuvant treatment. This study aimed to analyze national trends in adjuvant management and to identify differences in morbidity or survival.</div></div><div><h3>Methods</h3><div>Using the National Cancer Database (2004–2020), adult patients with cT2N0 rectal adenocarcinoma that were upstaged to pT3N0 after resection were identified. The treatment groups included (i) surgery alone, (ii) surgery + postoperative (post-op) chemotherapy alone, (iii) surgery + post-op chemoradiation (CRT), and (iv) surgery + chemotherapy + CRT. Cox proportional hazard models and Kaplan-Meier curves (6-month landmark analysis) were used to compare survival outcomes.</div></div><div><h3>Results</h3><div>The analytic cohort included 800 patients who received the following treatments: surgery alone (496 [60%]), surgery + post-op chemotherapy (139 [17%]), surgery + post-op CRT (137 [15%]), and surgery + chemotherapy + CRT (69 [8%]). Patients who underwent post-op chemotherapy or chemotherapy + CRT had higher rates of poor/undifferentiated tumors (15.7% and 15.4%, respectively) than those who underwent surgery alone (8.8%) (<em>P</em> = .047). Over the study period, surgery alone decreased from 86.7% to 65.6%, with concomitant increases in post-op adjuvant therapy. Post-op chemotherapy (hazard ratio [HR], 0.336; 95% CI, 0.196–0.575) and chemotherapy + CRT (HR, 0.447; 95% CI, 0.231–0.866) remained independently associated with improved overall survival. Of note, 5-year survival was the lowest in the surgery-alone group (62.5%).</div></div><div><h3>Conclusion</h3><div>Post-op adjuvant regimens, including chemotherapy, were independently associated with improved survival in patients with cT2N0 rectal cancer upstaged to pT3N0. Adjuvant therapy may be underutilized in this setting.</div></div>","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101869"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited commentary on: Optimal radiation dose intensity: low- vs high-dose in the neoadjuvant treatment of locally advanced esophageal adenocarcinoma","authors":"Puja Gaur Khaitan","doi":"10.1016/j.gassur.2024.101887","DOIUrl":"10.1016/j.gassur.2024.101887","url":null,"abstract":"","PeriodicalId":15893,"journal":{"name":"Journal of Gastrointestinal Surgery","volume":"29 1","pages":"Article 101887"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}