Journal of Surgical Oncology最新文献

{"title":"Assessment of Outcome in 198 Patients With Mucinous Appendiceal Adenocarcinoma and Peritoneal Metastases Over 25 Years.","authors":"Paul H Sugarbaker, David Chang","doi":"10.1002/jso.70283","DOIUrl":"https://doi.org/10.1002/jso.70283","url":null,"abstract":"<p><p>A prognostic assessment of mucinous appendiceal adenocarcinoma (MACA) patients with peritoneal metastases in the absence of lymph node metastases needs to be precisely defined. All patients were treated by a complete cytoreductive surgery (CRS) and perioperative chemotherapy. Preoperative clinical features including tumor markers were recorded within 1 week prior to CRS. Data regarding perioperative intraperitoneal chemotherapy, histologic features and reoperative surgery were gathered after CRS. Impact on overall survival of these factors was analyzed by univariant and multivariant analysis. One hundred and ninety-eight patients with mucinous appendiceal adenocarcinoma causing pseudomyxoma peritonei were available for study. They had a median survival of 11 years. Hyperthermic intraperitoneal chemotherapy (HIPEC) with a median survival of 12.0 years was superior to early postoperative intraperitoneal chemotherapy (EPIC) with a median survival of 4.0 years (HR 2.09, p = 0.002). By histopathology, the intermediate type (MACA-Int) was associated with the longest survival and poorly differentiated (MACA-3) the poorest survival. Peritoneal cancer index and tumor marker elevations had no impact on survival. Clinical features and preoperative tumor markers had little or no prognostic value in selection of MACA patients for CRS. Intermediate histologic subtype and use of HIPEC indicated a favorable outcome.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839539","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":"Hospital Volume and Post-Hepatectomy Liver Failure After Major Hepatectomy.","authors":"Xane D Peters, Brian C Brajcich, Bona Ko, Catherine Valukas, Lauren M Janczewski, Clifford Y Ko, Ryan P Merkow, Henry A Pitt, David J Bentrem","doi":"10.1002/jso.70280","DOIUrl":"https://doi.org/10.1002/jso.70280","url":null,"abstract":"<p><strong>Background: </strong>Post-hepatectomy liver failure (PHLF) following major hepatectomy (MH) increases the risk of morbidity and death. The relationship between institutional MH volume, PHLF, and outcomes is not well characterized.</p><p><strong>Methods: </strong>Adults undergoing MH from 2014 to 2021 in the ACS NSQIP hepatectomy-targeted database were included. Rates of PHLF were compared based on hospital-level annual MH volume. Multivariable logistic regression evaluated the association between volume, PHLF grade, and outcomes.</p><p><strong>Results: </strong>Across 11,167 patients, PHLF incidence was 3.7% in low-volume, 5.5% in low-medium volume, 6.9% in medium-high volume, 11.8% in high-volume centers (p < 0.001). The adjusted odds ratio (aOR) for morbidity in grade B/C PHLF compared to those without PHLF was elevated in both lower-volume centers (quartiles 1-3), (11.2 [7.04-17.70]) and in high-volume centers, (8.47 [6.06-11.85]).</p><p><strong>Conclusion: </strong>Higher annual major hepatectomy volume is associated with increased PHLF, which may be a function of complex disease treated at these institutions. PHLF precedes other adverse events affecting both high and low volume institutions. PHLF is an important target for quality improvement.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839490","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":"Comparison of Proximal Tibial Endoprosthetic and Allograft-Prosthetic Reconstruction.","authors":"Marisa N Ulrich, Katherine E Mallett, Samuel E Broida, Mikaela H Sullivan, Amit Zabtani, Matthew T Houdek","doi":"10.1002/jso.70285","DOIUrl":"https://doi.org/10.1002/jso.70285","url":null,"abstract":"<p><strong>Introduction: </strong>The proximal tibia is a common location for bone tumors. Two contemporary reconstruction techniques for limb salvage are endoprosthetic replacement (EPR) and allograft-prosthesis composite (APC). This study aimed to compare the long-term oncologic and functional outcomes of EPR and APC reconstructions.</p><p><strong>Methods: </strong>Thirty-eight (19 APC and 19 EPR) patients underwent oncologic proximal tibia resection and reconstruction were reviewed. Patients undergoing APC reconstruction were younger than the EPR group (31 vs. 44 years, p = 0.049), and patients in the EPR group were more likely to have a diagnosis of metastatic disease (32% vs. 0%, p = 0.019).</p><p><strong>Results: </strong>For all patients, the 10-year disease-specific survival was 63%. With death a competing risk, there was no difference in the 10-year cumulative risk of failure (41% vs. 26%, p = 0.171) or amputation (11% vs. 19%, p = 0.690) between APC or EPR. There was no difference comparing EPR to APC in the proportion of patients with an extensor lag > 10° (42% vs. 26%, p = 0.495) or 10-year knee society scores (85 vs. 85, p = 0.710).</p><p><strong>Conclusion: </strong>EPR and APC have a similar complication profile and functional outcomes following proximal tibial resection and reconstruction.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839516","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":"Omission of Sentinel Lymph Node Biopsy in Breast Cancer: A Real-World Validation of the Patient Populations of the SOUND and INSEMA Trials.","authors":"Tia Puiras, Eeva Juhanoja, Anselm Tamminen","doi":"10.1002/jso.70256","DOIUrl":"https://doi.org/10.1002/jso.70256","url":null,"abstract":"<p><strong>Background: </strong>Treatment guidelines recommending omission of axillary surgery in breast cancer are largely based on the SOUND and INSEMA trials. However, the extent to which their study populations represent real-world patients remains unclear. We aimed to evaluate the real-world applicability and external validity of these trial populations.</p><p><strong>Materials and methods: </strong>All consecutive patients treated for early breast cancer at a single university hospital between 2010 and 2018 were included. Patients with clinically node-negative disease were identified, and eligibility according to the SOUND and INSEMA inclusion criteria was determined. Clinicopathologic characteristics were compared between trial-eligible real-world patients and published trial populations.</p><p><strong>Results: </strong>A total of 2787 consecutive patients with clinically negative axilla were included; 71% (1982/2787) fulfilled the INSEMA and 52% (1461/2787) the SOUND trial eligibility criteria. Patients eligible in the SOUND trial were largely representative of real-world patients in terms of clinicopathologic characteristics. In contrast, the INSEMA trial appeared more selected, with a higher proportion of biologically favorable tumors. Both trials predominantly included patients with small (< 2 cm) luminal breast cancers. Patients with larger tumors and more aggressive subtypes were underrepresented.</p><p><strong>Conclusion: </strong>The SOUND and INSEMA eligibility criteria are broadly applicable to real-world patients with small luminal breast cancers. However, differences between trial populations and real-world patients highlight the need for careful consideration when applying SLNB omission beyond these lower-risk subgroups.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839486","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":"Surgical Management of Recurrent Retroperitoneal Sarcomas: Experience From a High-Volume Sarcoma Centre: Recurrent Retroperitoneal Sarcomas: Outcomes of Multiple Recurrences.","authors":"Abdeali Saif Arif Kaderi, Tanvi M Shah, Shraddha Patkar, Y Aditya Sai Ram, Vinayaka S Bairannavar, M Myvizhi Kannan, Bharat Rekhi, Prabhat Bhargav, Kunal B Gala, Afroj Bagwan, Mukta Ramadwar, Jifmi Jose, Nehal Khanna, Siddhartha Laskar, Mahesh Goel","doi":"10.1002/jso.70264","DOIUrl":"https://doi.org/10.1002/jso.70264","url":null,"abstract":"<p><strong>Background: </strong>Retroperitoneal sarcoma (RPS) is a rare and complex malignancy, requiring specialized multidisciplinary care. While a significant progress has been made in managing a primary RPS, there is a limited literature on the outcomes of recurrent RPS (RecRPS). This study evaluates the oncological outcomes of RecRPS at a leading sarcoma referral center in India.</p><p><strong>Methods: </strong>A retrospective analysis was performed for patients with RecRPS who underwent surgery between January 2011 and December 2024. Clinical outcomes were analyzed using Kaplan-Meier method and compared using log-rank test. Extended Cox regression models were used to account for intra-individual correlation, in cases of multiple recurrence. Prentice, William and Peterson model (PWP) CP model (total time) and PWP Gap time (PWP-GT) models were employed to estimate predictors of multiple recurrences.</p><p><strong>Results: </strong>Out of 285 patients with primary RPS, 160 (56.1%) underwent surgery for a recurrent disease. The median overall survival (OS) was 137.1 months for the entire cohort and 41.92 months in RecRPS. The median OS of patients with 1st recurrence was 38.97 months. For subsequent recurrences, the median OS were 74.94 months (2nd recurrence), 57.4 months (3rd recurrence) and 54.2 months (4th recurrence), respectively. The various clinicopathological parameter associated with multiple recurrences were R+resection or resection with unknown margins, dedifferentiated liposarcoma and leiomyosarcoma, as histopatholologic subtypes; histologic organ invasion (HOI) of the small bowel and vessels, requirement of adjuvant and neoadjuvant therapy, disease progression on neoadjuvant chemotherapy and grade IIIb and IV complications.</p><p><strong>Conclusion: </strong>While the best chance of cure is at the primary presentation, some patients may experience prolonged disease control even with multiple recurrence, if treated optimally.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839465","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":"Correction to \"Comparison of a Risk Calculator With Frailty Indices in Patients Undergoing Lung Cancer Resection\".","authors":"","doi":"10.1002/jso.70140","DOIUrl":"https://doi.org/10.1002/jso.70140","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816626","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":"Correction to \"Comparison of a Risk Calculator With Frailty Indices in Patients Undergoing Lung Cancer Resection\".","authors":"","doi":"10.1002/jso.70137","DOIUrl":"https://doi.org/10.1002/jso.70137","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816668","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":"Pelvic Location Predicts Worse Outcomes in Alveolar Rhabdomyosarcoma: Underuse of Radiotherapy and Missed Survival Benefit.","authors":"Kole Joachim, Ezekiel Dingle, Adrian Lin, Brandon Gettleman, Christopher Hamad, Sumin Jeong, Michael Fice, Lauren E Wessel, Nicholas M Bernthal, Alexander B Christ","doi":"10.1002/jso.70216","DOIUrl":"10.1002/jso.70216","url":null,"abstract":"<p><strong>Introduction: </strong>Alveolar rhabdomyosarcoma (ARMS) is a rare, aggressive soft-tissue malignancy occurring mostly in children. Pelvic presentation poses diagnostic and therapeutic challenges due to proximity to critical structures. This study aims to assess the prognostic treatment factors associated with pelvic ARMS.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database (2000-2021) that included patients with ARMS. Variables included demographics, socioeconomic factors, and treatment modalities. Logistic regression evaluated associations between tumor location and treatment receipt. Cancer-specific mortality was analyzed using Cox proportional hazards regression, with Weibull parametric survival analysis performed to quantify survival time benefits.</p><p><strong>Results: </strong>The study included 678 ARMS patients (585 non-pelvic vs. 93 pelvic). Patients with pelvic tumors had significantly higher mortality risk (hazard ratio [HR] = 1.44, 95%-confidence interval [95% CI]: 1.08-1.94, p = 0.014) and were less likely to undergo resection (45.1% vs. 30.1%, p = 0.007). Weibull parametric analysis demonstrated radiation therapy was associated with improved survival in pelvic tumors, with patients receiving radiation having a predicted median survival of 34.7 months compared to 17.0 months for those not receiving radiation (17.7 month difference, p = 0.039). Both radiation therapy (HR = 0.56, 95% CI: 0.43-0.71, p < 0.001) and surgery (HR = 0.61, 95% CI: 0.48-0.78, p < 0.001) were independently associated with decreased cancer-specific mortality.</p><p><strong>Conclusions: </strong>Radiation therapy demonstrated a significant survival benefit in pelvic ARMS, emphasizing the need for standardized treatment strategies in high-risk sites.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":"785-794"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220226","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":"Does Recurrent Pancreatic Cancer Have Similar Outcomes Compared With Primary Metastatic Pancreatic Cancer?","authors":"Shinya Sakamoto, Motoyasu Tabuchi, Teppei Tokumaru, Sunao Uemura, Shuta Tamura, Rika Yoshimatsu, Manabu Matsumoto, Jun Iwata, Tatsuo Iiyama, Takehiro Okabayashi","doi":"10.1002/jso.70222","DOIUrl":"10.1002/jso.70222","url":null,"abstract":"<p><strong>Background and objectives: </strong>The survival difference between recurrent pancreatic cancer (Rec-PC) and primary metastatic PC (PM-PC) remains inadequately understood.</p><p><strong>Methods: </strong>Eligible participants received combination chemotherapy with either gemcitabine plus nab-paclitaxel (GnP) or FOLFIRINOX. Overall survival (OS) was compared between patients with Rec-PC and those with PM-PC.</p><p><strong>Results: </strong>Data from 147 participants (84 male and 63 female) were retrospectively analyzed. The Rec-PC group demonstrated significantly longer OS (median: 12.7 months) than the PM-PC group (median: 8.4 months) (p = 0.03). On multivariate analysis, Rec-PC (hazard ratio [HR]: 0.51; 95% confidence interval [CI]: 0.31-0.84; p < 0.01), presence of peritoneal dissemination (HR: 2.29; 95% CI: 1.42-3.69; p < 0.01), receipt of second-line chemotherapy (HR: 0.34; 95% CI: 0.21-0.55; p < 0.01), receipt of any local therapy (HR: 0.42; 95% CI: 0.23-0.77; p < 0.01), and prognostic nutritional index < 40 (HR: 2.50; 95% CI: 1.55-4.04; p < 0.01) were identified as independent prognostic factors.</p><p><strong>Conclusions: </strong>Rec-PC was identified as a favorable prognostic factor after adjusting for established prognostic indicators (registration number: NCT06921252).</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":"763-772"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326557","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":"Boost Approaches in Patients Undergoing Postoperative Radiotherapy.","authors":"Abigail Pepin, Neil D Almeida, Simon Fung-Kee-Fung, Megan Kassick, Neil K Taunk, Gary M Freedman","doi":"10.1002/jso.70228","DOIUrl":"10.1002/jso.70228","url":null,"abstract":"<p><p>The use of breast conservation surgery for early-stage breast cancer is common, and adjuvant radiotherapy is often recommended to reduce the risk of ipsilateral breast tumor recurrence. Historical trials have used sequential boost techniques with favorable outcomes with reduction in local recurrence and acceptable cosmetic outcomes. In recent years, there has been renewed interest in incorporating a concurrent tumor bed boost to reduce the number of radiation treatments delivered. This focused review summarizes the literature surrounding the indications, outcomes, and treatment planning considerations for radiation tumor bed boost for early-stage breast cancer patients.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":"773-784"},"PeriodicalIF":1.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13128992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377927","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}