Journal of Surgical Oncology最新文献

{"title":"Less Is More: Risk Factors and Survival Outcomes of Overtreatment for Early-Stage Colorectal Cancer.","authors":"Daniel R S Habib, Matthew Shou, James L Rogers, Kevin Sun, Chen Chia Wang, Aimal Khan","doi":"10.1002/jso.70028","DOIUrl":"https://doi.org/10.1002/jso.70028","url":null,"abstract":"<p><strong>Background and objectives: </strong>After cT1-2N0M0 colorectal cancer (CRC) definitive resection (colectomy/proctectomy) without pathologic upstaging, only observation is recommended given the lack of benefit from adjuvant treatment, which would constitute overtreatment. This study aims to determine risk factors and overall survival (OS) associated with overtreatment in early-stage CRC.</p><p><strong>Methods: </strong>This National Cancer Database study included cT1-T2N0M0 CRC patients who underwent definitive resection between 2010 and 2020. Multivariable logistic regressions were performed to assess overtreatment risk factors. After propensity-matching, Kaplan-Meier survival analyses and multivariable Cox proportional-hazards analyses were performed to assess the association of overtreatment with OS.</p><p><strong>Results: </strong>Of 22 875 colon cancer and 4198 rectal cancer cases, 144 (0.6%) and 82 (2.0%) were overtreated, respectively. Colon cancer overtreatment was associated with younger age (aOR = 0.96, 95% CI = 0.95-0.98), Black race (aOR = 1.94, 95% CI = 1.26-2.99), and pT2 vs. pT1 (aOR = 1.66, 95% CI = 1.19-2.33). Rectal cancer overtreatment was associated with pT2 (aOR = 2.58, 95% CI = 1.59-4.19), poor/undifferentiated grade (aOR = 2.61, 95% CI = 1.44-4.76), and high-risk histology (aOR = 3.20, 95% CI = 1.22-8.40). In the propensity-matched cohorts, overtreatment was associated with worse OS for colon (HR = 1.40, 95% CI = 1.01-1.93) but not rectal cancer (HR = 1.05, 95% CI = 0.66-1.68).</p><p><strong>Conclusions: </strong>Patient and tumor characteristics predicted early-stage CRC overtreatment. Overtreatment was associated with worse OS for colon but not rectal cancer.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567592","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":"The Growing Potential of Thermal Ablation for Colorectal Liver Metastases.","authors":"Toru Beppu, Toshiro Masuda, Tatsunori Miyata, Katsunori Imai, Hiromitsu Hayashi","doi":"10.1002/jso.70021","DOIUrl":"https://doi.org/10.1002/jso.70021","url":null,"abstract":"<p><p>The COLLISION Phase III randomized controlled trial and several propensity-score matching studies have demonstrated that thermal ablation is the standard procedure for patients with small (< 30 mm) and few colorectal liver metastases. Thermal ablation reduces treatment costs, morbidity, and hospitalization while maintaining long-term outcomes. Combination use of thermal ablation during liver resection, and thermal ablation for small recurrent colorectal liver metastases does not compromise outcomes. Thermal ablation should be actively incorporated into the treatment strategy.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567594","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":"Temporospatial Recurrence Patterns and Predictive Factors for Recurrences in 984 Patients With Adult Soft Tissue Sarcomas.","authors":"Svs Deo, Bhawani Pathak, Jyoti Sharma, Sunil Kumar, Sandeep Bhoriwal, Ashutosh Mishra, Amitabha Mandal, Jyoutishman Saikia, Adarsh Barwad, Sanjay Thulkar, D N Sharma, Sameer Bakhshi","doi":"10.1002/jso.70027","DOIUrl":"https://doi.org/10.1002/jso.70027","url":null,"abstract":"<p><strong>Background: </strong>Soft tissue sarcomas recur despite optimal multimodality treatment. Being rare, and heterogeneous, there is no consensus on follow-up protocol and management of recurrences.</p><p><strong>Materials: </strong>This is a retrospective analysis of the adult soft tissue sarcoma database. All the patients undergoing curative surgery between 1993 and 2020 were included. We studied the recurrence patterns in terms of time and anatomical location concerning age, gender, site, size, histology, grade and treatment and identified the predictive factors for local (LR) and systemic recurrences (SR).</p><p><strong>Results: </strong>A total of 984 patients were included. In a median follow-up of 37 months, 31% (305) of patients developed recurrence. Of these, there were 12% LR and 19% SR. The median time to LR and SR was 1.07 years (0.581-2.30) and 1.03 years (0.529-1.80) respectively. The median time to recurrence was least in retroperitoneum, 0.827 years (0.471-2.34), followed by extremity, 1.60 years (0.495-3.73); trunk, 1.95 years (0.696-4.27) and head & neck, 2.21 years (0.909-4.05). Extremity and head & neck STS had more SR, while RP & trunk had a higher rate of LR. Common subtypes associated with LR were extraskeletal chondrosarcoma/osteosarcoma (n = 14, 27.27%), DFSP (n = 5, 26.32%), and leiomyosarcoma (n = 22, 24.44%) and; with SR were rhabdomyosarcoma (n = 4, 50%), angiosarcoma (n = 2, 33.33%), and pleomorphic liposarcoma (n = 23, 27.71%). Recurrence was curatively treated in 32% of patients. The 5-year overall survival in patients with LR and SR were 76.3% and 41.2% respectively. In a multivariate analysis, age > 50 years and extremity site were predictors of local recurrence whereas male sex, high grade, and adjuvant chemotherapy were predictors of systemic recurrence.</p><p><strong>Conclusions: </strong>The study shows a higher incidence of early LR in RP and late LR in the trunk while a higher incidence of early SR in extremities and late SR in the head and neck. The highest risk for SR and LR is associated with synovial sarcoma and liposarcoma respectively. This pattern of recurrence may guide in individualizing the follow-up frequency and imaging modality as well as in doing the timely intervention.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567593","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":"Adjuvant Radiotherapy in Incidental Positive Nodal Disease in Rectal Cancer-A Systemic Review.","authors":"Da Wei Thong, Priyanka Chakraborty, Ruben Rajan, Mary Theophilus","doi":"10.1002/jso.70025","DOIUrl":"https://doi.org/10.1002/jso.70025","url":null,"abstract":"<p><strong>Background: </strong>The optimal adjuvant treatment strategy for incidentally detected node-positive rectal cancer following curative surgery remains uncertain. While preoperative chemoradiotherapy (CRT) is the standard for locally advanced rectal cancer, the role of adjuvant radiotherapy (RT) in early stage node-positive disease (stage IIIA) remains debated. This systematic review evaluates survival outcomes associated with different adjuvant modalities and identifies key prognostic factors influencing disease progression.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, MEDLINE and the Cochrane Library was conducted up to August 2024, following PRISMA guidelines. Retrospective studies assessing oncological outcomes in patients with incidental nodal disease rectal cancer who underwent curative surgery without prior neoadjuvant therapy were included. Risk of bias was assessed using the Newcastle-Ottawa Scale. Due to heterogeneity of studies, a meta-analysis was not performed. This review is registered with PROSPERO (CRD42024596805). No funding was received.</p><p><strong>Results: </strong>Nine studies comprising 5989 patients were analysed. Adjuvant therapy was associated with improved outcomes compared to observation alone. Overall survival (OS) ranged from 61.3% to 92% for adjuvant chemotherapy (CT), 63% to 93% for CRT, and 42% to 82.1% for no adjuvant therapy. Disease-free survival (DFS) ranged from 43% to 90%. Local recurrence (LR) was lowest with CRT (2%-9.1%), while metastatic disease (MD) ranged from 20% to 50%. Poorer outcomes were linked to pN2 disease, positive margins, perineural invasion, high lymph node ratio and low tumour location.</p><p><strong>Conclusion: </strong>Adjuvant CT improves survival in incidental node-positive rectal cancer; RT may benefit high-risk subgroups. Further prospective studies are warranted.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553850","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":"Postoperative Complications in Elderly Patients Undergoing Surgery for Ovarian Cancer: A NSQIP Analysis.","authors":"Lina Salman, Allan Covens, Lilian T Gien, Danielle Vicus","doi":"10.1002/jso.70034","DOIUrl":"https://doi.org/10.1002/jso.70034","url":null,"abstract":"<p><strong>Background and objectives: </strong>Elderly patients with ovarian cancer (OC) commonly receive modified treatment due to the assumption of higher risk. The aim of this study is to evaluate postoperative complications in elderly patients undergoing surgery for OC.</p><p><strong>Methods: </strong>Retrospective cohort study of patients with OC identified in the NSQIP database, (2013-2021). Younger patients included 40-69 years old, and elderly patients were ≥ 70 years old. Major complications included: pulmonary embolism, deep vein thrombosis, acute kidney injury, stroke, cardiac arrest, space surgical site infection, myocardial infarction, sepsis, septic shock, and return to the operating room.</p><p><strong>Results: </strong>Of the 11,108 patients, 8214 (74%) were in the younger patient and 2894 (26%) in the elderly patient group. Elderly patients had higher rates of postoperative pneumonia (2.6% vs. 1.2%), myocardial infarction (1.4% vs. 0.3%), and major complications (3.5% vs. 2.0%), p < 0.0001 for all. Discharge to rehab was higher in elderly patients (3.1% vs. 0.5%, p < 0.001). On multivariate logistic regression, older age was associated with \"major complications\" (aOR 1.79, 95% CI 1.38-2.31, p < 0.0001).</p><p><strong>Conclusions: </strong>In OC patients selected for surgery, elderly patients are at higher risk of Postoperative complications and are less likely to be discharged home. This should be considered when counseling patients pre-operatively and planning for peri-operative care and disposition.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553851","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":"Postoperative Evolution of Health-Related Quality of Life in Patients With Head and Neck Cancer.","authors":"Sara Orozco-Núñez, Natsuki Oishi, Julián Izquierdo, Fernando Martínez-Expósito, Ainhoa García-LLiberós, Enrique Zapater","doi":"10.1002/jso.70022","DOIUrl":"https://doi.org/10.1002/jso.70022","url":null,"abstract":"<p><strong>Background and objectives: </strong>Although there is an abundant international literature evaluating quality of life in patients with head and neck cancer, most of these studies include heterogeneous populations from a therapeutic point of view, without discriminating precisely among therapeutic modalities: whether patients underwent surgery or were treated exclusively with nonsurgical modalities such as radiotherapy (RT) or chemotherapy (CT). Our study focuses on analyzing quality of life in patients undergoing primary surgery.</p><p><strong>Methods: </strong>Prospective study. T2-T4 primary head and neck cancer patients treated in our department in the period from 2000 to 2023 completed the survey EORTC QLQ-C30 and EORTC QLQ-H&N35 on 4 occasions: 1, 3, 6 and 12 months after surgery. Patients were classified in groups according to age, tumor location, adjuvant radiotherapy, and the laryngectomy group underwent a separate analysis.</p><p><strong>Results: </strong>Seventy-seven subjects were included in the present study. The mean age was 59 years, 91% (70 patients) were male. Patients older than 66 years showed better perception, and patients with pharyngeal tumors obtained worse scores than patients with laryngeal tumor.</p><p><strong>Conclusions: </strong>One year after treatment, most patients rate their HRQOL as \"good.\" Acceptance of the new quality of life after treatment improves with increasing age of the patient. Radiotherapy is associated with a significant worsening of HRQOL in the postoperative period, greater intensity towards the sixth month after surgery.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553852","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":"Recurrence in Patients With Chondroblastoma Is Not Associated With Use of Surgical Adjuvants: A Single Center Retrospective Review.","authors":"Brandon S Gettleman, Abigail N Padilla, Adrian Lin, Kian Jeshion-Nelson, Tishya A L Wren, Bruce R Pawel, Vernon T Tolo, Alexander B Christ","doi":"10.1002/jso.70026","DOIUrl":"https://doi.org/10.1002/jso.70026","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chondroblastoma is a rare, benign bone tumor that affects the epiphyses of long bones in young patients. This study describes the incidence of recurrence in our cohort and its association with adjuvants. Secondary objectives include identifying risk factors for recurrence and the development of angular deformity.</p><p><strong>Methods: </strong>A retrospective review from 2004 to 2021 examined pediatric patients surgically treated for chondroblastoma. Eligible patients had at least 6 months of follow-up, initial non-recurrent tumors, and complete chart data. Medical records were reviewed for demographics, tumor location, treatment details, recurrence, and postoperative complications.</p><p><strong>Results: </strong>Thirty-nine patients met inclusion criteria (mean age 13.7 ± 2.5 years, mean follow-up 27.1 ± 12.9 months). Tumors were most common in the femur (43.6%, 17/39). Four individuals experienced recurrence (10.3%, 4/39). There was no significant association between recurrence and mechanical adjuvants (p = 0.464), chemical adjuvants (p = 0.387), and thermal adjuvants (p = 0.078). There was also no significant association with female sex (p = 0.058), age (p = 0.703), or tumor size (p = 0.425). Two patients developed angular deformity (5.1%, 2/39). Location did not affect angular deformity development or growth disturbance.</p><p><strong>Conclusions: </strong>We found no significant link between adjuvant type and recurrence in chondroblastoma treatment. Both angular deformity cases occurred in tibial lesions (16.7%, 2/12). Physicians should consider these findings for patient follow-up and family counseling on long-term outcomes after chondroblastoma treatment.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540622","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":"Impact of Wound Protectors on Complications Following Pancreaticoduodenectomy: A National Surgical Quality Improvement Program Analysis of 20 960 Patients.","authors":"Tyrell Wees, Sukhdeep Jatana, Kevin Verhoeff, A M James Shapiro, David L Bigam, Khaled Dajani, Blaire Anderson","doi":"10.1002/jso.70020","DOIUrl":"https://doi.org/10.1002/jso.70020","url":null,"abstract":"<p><strong>Background: </strong>Wound protectors (WPs) have been shown to decrease postoperative wound complications, yet limited data exist supporting WP for pancreaticoduodenectomies, with limited uptake in practice. We evaluated the effect of WP in pancreaticoduodenectomies on surgical site infections (SSIs) and serious complications.</p><p><strong>Methods: </strong>Utilizing the National Surgical Quality Improvement Program database, we included patients undergoing pancreaticoduodenectomy between 2017 and 2021. Baseline demographics and complications were compared between WP and no WP cohorts. Multivariate logistic regression was performed to identify the effect of WP use on 30-day complications and factors associated with WP use.</p><p><strong>Results: </strong>Of 20 960 patients, 6167 (29.4%) used a WP. WPs were more commonly used in lower ASA classes, more comorbid patients, and preoperative weight loss. WP use was associated with increased operative time but decreased length of stay, SSIs, organ space infection, pancreatic fistula, reoperation, and serious complication. WP was independently associated with decreased serious complication (aOR 0.80, p < 0.001) and SSI (aOR 0.57, p < 0.001). Factors associated with increased likelihood of WP use include preoperative weight loss, broad-spectrum antibiotic use, absence of bleeding disorder and firmer pancreatic texture.</p><p><strong>Conclusion: </strong>WP use during pancreaticoduodenectomy is associated with decreased number of postoperative complications and SSI. Future prospective randomized studies should assess cost-benefit and barriers to use to increase uptake of WP use.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528528","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":"Recurrence After Gallbladder Cancer Resection: Prognostic Impact of CA19-9 and CEA Levels at Baseline and During Surveillance.","authors":"Diamantis I Tsilimigras, Odysseas P Chatzipanagiotou, Andrea Ruzzenente, Federico Aucejo, Hugo P Marques, Joao Bandovas, Tom Hugh, Nazim Bhimani, Shishir K Maithel, Minoru Kitago, Itaru Endo, Timothy M Pawlik","doi":"10.1002/jso.70024","DOIUrl":"https://doi.org/10.1002/jso.70024","url":null,"abstract":"<p><strong>Introduction: </strong>Baseline serum carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) levels may predict prognosis among patients undergoing resection for gallbladder cancer (GBC), yet the prognostic utility of the combination of the two markers has not been well established. In addition, the prognostic significance of elevated preoperative CA19-9 levels that normalize after GBC resection is currently unknown.</p><p><strong>Methods: </strong>Patients undergoing resection of GBC between 2002 and 2021 were identified using an international, multi-institutional database. The association of preoperative CA19-9 and CEA levels with recurrence-free survival (RFS) following GBC resection was assessed. The negative predictive value (NPV) of normal vs. normalized (high preoperative/low postoperative levels) CA19-9 levels relative to the development of recurrence within 1 year after GBC resection was evaluated.</p><p><strong>Results: </strong>Among 194 patients who underwent resection of GBC, median preoperative CA19-9 and CEA levels were 18.8 U/mL (IQR 7.0-88.0) and 2.2 ng/mL (IQR 1.3-3.8), respectively. A total of 92 (47.4%) and 67 (34.5%) patients had elevated CA19-9 (> 20 U/mL) and CEA (> 3 ng/mL) levels before GBC resection, respectively. Individuals with low CA19-9/low CEA had the most favorable 3-year RFS (74.5%) after GBC resection followed by individuals with either high CA19-9 (high CA19-9/low CEA: 41.6%) or high CEA (low CA19-9/high CEA: 60.9%) levels, whereas patients with high CA19-9/high CEA had the worst 3-year RFS (21.5%) following GBC resection (p < 0.001). Patients with normal preoperative CA19-9 levels had better 3-year RFS than patients with high preoperative CA19-9 levels that normalized after resection (74.6% vs. 51.4%, p = 0.03). While the NPV of normal preoperative CA19-9 levels relative to the development of recurrence within 1 year after GBC resection was 94.7%, the NPV of normalized CA19-9 decreased to 70% at 1-year post-resection.</p><p><strong>Conclusion: </strong>Elevation of both preoperative CA19-9 and CEA levels portended poor prognosis following resection of GBC. Normalization of postoperative CA19-9 levels after GBC resection was still associated with elevated risk of recurrence. While preoperative tumor markers can accurately predict prognosis following resection for GBC, evaluation of traditional tumor markers may not be appropriate markers of occult recurrent disease in the postoperative setting. Better markers are needed to monitor for recurrence following resection of GBC.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528466","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":"Local Antibiotic Administration Decreases Surgical Site Infections Following Extremity Sarcoma Surgery.","authors":"Pearce B Haldeman, Liane Chun, Cyril Harfouche, Ricardo Rosales, Conner Trimm, Christopher Reid, James H Flint, Frank Chiarappa","doi":"10.1002/jso.70017","DOIUrl":"https://doi.org/10.1002/jso.70017","url":null,"abstract":"<p><strong>Background and objectives: </strong>The morbidity associated with the treatment of extremity sarcoma resection is significant, and surgical site infection (SSI) remains a prevalent concern. This cohort study compares the outcomes of patients who received local, intra-wound antibiotic powder with those who did not during the resection of extremity sarcomas.</p><p><strong>Methods: </strong>This study included 83 patients. Of these, 25 (30%) patients had received local vancomycin and/or tobramycin antibiotic powder just before wound closure, while 58 (70%) underwent routine closure without administration of local antibiotics. Patient demographics, tumor characteristics, and surgical characteristics were collected.</p><p><strong>Results: </strong>The local antibiotic group consisted of larger tumors (11.50 ± 7.65 vs. 7.79 ± 5.27 cm; p = 0.038) undergoing longer surgeries (594 ± 323 vs. 360 ± 285 min; p = 0.003) with more estimated blood loss (426 ± 399 vs. 177 ± 539 mL; p = 0.023). The postoperative SSI rate was lower in the antibiotic group at 16% versus 40% in the no antibiotic group (p = 0.043). When accounting for possible confounders, the odds ratio of SSI in the antibiotic group versus no antibiotic group was 0.0747 [0.00882, 0.404] (p = 0.0075).</p><p><strong>Conclusion: </strong>Despite the significantly greater tumor burden in the antibiotic group, this study suggests an effective role for local antibiotic powder administration in the prevention of postoperative infections in extremity sarcoma surgery.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528529","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}