Journal of Surgical Oncology最新文献

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Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Melanoma: A Systematic Review and Meta-Analysis. 中性粒细胞与淋巴细胞比值在黑色素瘤中的预后意义:系统综述和荟萃分析。
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-11 DOI: 10.1002/jso.70039
Yelin Yang, Hao Fang, Zhouhao Cai, Qiang Xu
{"title":"Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Melanoma: A Systematic Review and Meta-Analysis.","authors":"Yelin Yang, Hao Fang, Zhouhao Cai, Qiang Xu","doi":"10.1002/jso.70039","DOIUrl":"https://doi.org/10.1002/jso.70039","url":null,"abstract":"<p><p>The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential prognostic biomarker in melanoma, yet its clinical validity remains incompletely characterized. This study aimed to thoroughly assess the relationship between NLR and clinical outcomes in melanoma patients. We performed a comprehensive literature search in Embase, PubMed, the Cochrane Library, and Web of Science from inception until August 14, 2024. Studies evaluating NLR's prognostic value in melanoma were eligible for inclusion. Primary endpoints were overall survival (OS) and progression-free survival (PFS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted from both univariate and multivariate analyses and pooled using random-effects models. Sensitivity and subgroup analyses were performed to identify potential confounders. All analyses were conducted using Review Manager 5.4.1 and Stata 15.1. Thirty-seven articles met inclusion criteria. Meta-analysis demonstrated that elevated NLR notably correlated with inferior OS (HR = 1.89, 95% CI: 1.68-2.12; p < 0.00001) and shortened PFS (HR = 1.76, 95% CI: 1.49-2.07; p < 0.00001). Subgroup analyses confirmed the consistent association between elevated NLR and adverse outcomes across different treatment modalities, sample sizes, and NLR cut-off values. This meta-analysis establishes elevated NLR as an independent predictor of poor survival outcomes in melanoma patients. These findings support the incorporation of NLR as a cost-effective prognostic biomarker in clinical practice, potentially facilitating risk stratification and treatment optimization.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608658","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}
引用次数: 0
Association Between Mesorectal Grade and Oncologic Outcomes in Rectal Cancer: A Systematic Review and Meta-Analysis. 直肠癌肠系膜分级与肿瘤预后的关系:一项系统综述和荟萃分析。
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-11 DOI: 10.1002/jso.70038
Peter Rogers, Justin Dourado, Sameh Hany Emile, Anjelli Wignakumar, Zachary Delgado, Pauline Aeschbacher, Zoe Garoufalia, Victor Strassmann, Steven D Wexner
{"title":"Association Between Mesorectal Grade and Oncologic Outcomes in Rectal Cancer: A Systematic Review and Meta-Analysis.","authors":"Peter Rogers, Justin Dourado, Sameh Hany Emile, Anjelli Wignakumar, Zachary Delgado, Pauline Aeschbacher, Zoe Garoufalia, Victor Strassmann, Steven D Wexner","doi":"10.1002/jso.70038","DOIUrl":"https://doi.org/10.1002/jso.70038","url":null,"abstract":"<p><p>We aimed to clarify the impact of TME grading on recurrence and survival. PubMed and Scopus were searched. The main outcome measures were local and distant recurrence and overall survival. Ten studies (2002-2023) were analyzed. Patients with incomplete TME exhibited lower overall survival (HR 0.75, p = 0.044) and higher local (RR 3.09, p = 0.001) and distant (RR 1.44, p = 0.005) recurrence rates compared to complete/near-complete TME. Complete and near-complete TME had similar risk of local recurrence, distant metastasis, and overall survival. This meta-analysis supports the crucial role of TME in rectal cancer outcomes.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608656","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}
引用次数: 0
Risk of Open Conversion During Robotic Gastrectomy for Gastric Cancer: Optimizing Patient Selection. 胃癌机器人胃切除术中开放性转换的风险:优化患者选择。
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-10 DOI: 10.1002/jso.70032
Courtney Chen, Tiffany Lim, Annie Yang, Ian Lau, Kelly Mahuron, Ryuhei Aoyama, Michael Sullivan, Bradford Kim, Aaron Lewis, Laleh Melstrom, I Benjamin Paz, Yuman Fong, Yanghee Woo
{"title":"Risk of Open Conversion During Robotic Gastrectomy for Gastric Cancer: Optimizing Patient Selection.","authors":"Courtney Chen, Tiffany Lim, Annie Yang, Ian Lau, Kelly Mahuron, Ryuhei Aoyama, Michael Sullivan, Bradford Kim, Aaron Lewis, Laleh Melstrom, I Benjamin Paz, Yuman Fong, Yanghee Woo","doi":"10.1002/jso.70032","DOIUrl":"https://doi.org/10.1002/jso.70032","url":null,"abstract":"<p><strong>Background and objectives: </strong>Robotic surgery for gastric adenocarcinoma (GC) shows recovery benefits compared to open and laparoscopic approaches. While open conversion (OC) is associated with poorer outcomes, factors influencing robotic gastrectomy (RG) OC are obscure. We identified preoperative and intraoperative risk factors for OC and associated outcomes.</p><p><strong>Methods: </strong>We performed a retrospective analysis of RG using a prospectively maintained GC database from a high-volume comprehensive US cancer center between January 2010 and October 2022. RG standardization began in July 2015, with ongoing expansion of patient selection criteria. Patients who underwent radical resection with biopsy-proved GC were included in the analysis if the operation was initiated robotically. Preoperative documentation of likely to convert to open procedures was identified.</p><p><strong>Results: </strong>Of 289 gastrectomy cases, 133 (46.0%) were RG. Before RG standardization, OC rate was 42.1% (n = 8/19); then decreased to 15.8% (n = 18/114). Factors causing unplanned OC included instability upon insufflation (7.7%), difficult esophagojejunostomy (23.1%), bulky nodes (26.9%), and tumor invasion/fibrosis (38.5%). On multivariate analysis, Preoperative EUS (OR 0.78) decreased OC likelihood, whereas prior abdominal surgeries (OR 1.31) increased OC likelihood (p < 0.05). D2 lymphadenectomy and neoadjuvant treatment did not increase OC likelihood.</p><p><strong>Conclusions: </strong>Pre-operatively identifiable OC factors can guide RG patient selection. Yet, certain intraoperative findings challenge RG and require improved preoperative planning.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600850","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}
引用次数: 0
Socioeconomic Influences on Melanoma Incidence Patterns by Stage in the US. 美国社会经济对黑色素瘤分期发病模式的影响
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-10 DOI: 10.1002/jso.70036
Trisha Lal, Weichuan Dong, Siran M Koroukian, Natalie N Chakraborty, Luke D Rothermel, Richard S Hoehn
{"title":"Socioeconomic Influences on Melanoma Incidence Patterns by Stage in the US.","authors":"Trisha Lal, Weichuan Dong, Siran M Koroukian, Natalie N Chakraborty, Luke D Rothermel, Richard S Hoehn","doi":"10.1002/jso.70036","DOIUrl":"https://doi.org/10.1002/jso.70036","url":null,"abstract":"<p><strong>Background and objectives: </strong>Melanoma is one of the fastest-growing cancers in the United States, with nearly 100% 5-year survival for early-stage disease compared to 35% for late-stage disease. Regional studies suggest that areas with increased early-stage melanoma diagnoses may not experience a reduction in late-stage cases, raising questions about the effectiveness of early detection. We hypothesize that higher socioeconomic status (SES) will correlate with increased early-stage melanoma without a decrease in late-stage disease, with geographic variation across US regions.</p><p><strong>Methods: </strong>This cross-sectional study used SEER data to analyze 829 391 non-Hispanic White patients diagnosed with melanoma between 2004 and 2021, including 725 077 with early-stage (in situ/localized) and 104 314 with late-stage (regional/distant) disease. Regression models evaluated associations between county-level stage-specific melanoma incidence and population characteristics, including SES, ultraviolet exposure, agricultural employment, and rural-urban status.</p><p><strong>Results: </strong>Higher SES counties had higher early-stage melanoma incidence without a reduction in late-stage incidence. Counties in the West and South had increased odds of early-stage melanoma, while rural counties exhibited lower melanoma incidence across stages. Agricultural employment and ultraviolet exposure were not consistently associated with melanoma incidence.</p><p><strong>Conclusion: </strong>Findings suggest early- and late-stage melanoma may represent distinct diseases. Screening may aid in early detection, but its impact on reducing late-stage disease and mortality remains uncertain.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600851","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}
引用次数: 0
The use of ROTEM in Detection of Coagulopathy and Altered Hemostasis in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. ROTEM在细胞减缩手术和腹腔热化疗患者凝血功能障碍和止血改变中的应用。
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-10 DOI: 10.1002/jso.70030
Abdullah Mashat, Kadhim Taqi, Marina Parapini, Julia Chen, Jacqueline Trudeau, Jason Wilson, Trevor D Hamilton, Andrea J MacNeill
{"title":"The use of ROTEM in Detection of Coagulopathy and Altered Hemostasis in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.","authors":"Abdullah Mashat, Kadhim Taqi, Marina Parapini, Julia Chen, Jacqueline Trudeau, Jason Wilson, Trevor D Hamilton, Andrea J MacNeill","doi":"10.1002/jso.70030","DOIUrl":"https://doi.org/10.1002/jso.70030","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) are at risk of coagulopathy. This study aims to evaluate the potential role of rotational thromboelastometry (ROTEM) in detecting alterations in coagulation during and after CRS/HIPEC.</p><p><strong>Methods: </strong>A prospective observational study was conducted at a single tertiary care center. All consecutive patients undergoing CRS/HIPEC from April 2021 to December 2022 were enrolled. Participants were monitored using ROTEM, INR, PTT, and Fibrinogen at four time points (pre-incision, post-HIPEC, and on postoperative days 1 and 3).</p><p><strong>Results: </strong>A total of 35 patients were included. Significant changes were observed from pre-incision to post-HIPEC coagulation parameters: mean fibrinogen decreased from 3.5 g/L to 2.1 g/L and mean INR increased from 1.1 to 2.1, p < 0.05. By postoperative day 3, all parameters had recovered to their pre-incision baselines, with EXTEM ML30 and fibrinogen significantly increased from baseline. Lower pre-incision fibrinogen was significantly associated with increased intra-operative blood loss, p < 0.05. Anesthesiologists reported that intra-operative ROTEM influenced management in 17% of cases (5/30).</p><p><strong>Conclusions: </strong>CRS/HIPEC is associated with significant changes in the coagulation profile that largely normalize by postoperative day 3. Utilizing ROTEM intraoperatively can help identify patients at risk of intra-operative bleeding and guide transfusion strategies.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600852","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}
引用次数: 0
Neoadjuvant Chemotherapy for Retroperitoneal Sarcoma: A Systematic Review and Meta-Analysis. 腹膜后肉瘤的新辅助化疗:系统回顾和荟萃分析。
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-10 DOI: 10.1002/jso.70037
Bernardo Fontel Pompeu, Luiza Soares Guerra, Julia Hoici Brunini, Gabriel Leal Barone, Lucas Monteiro Delgado, Maria Letícia Gobo Silva, Fernando Augusto Batista Campos, Samuel Aguiar Junior
{"title":"Neoadjuvant Chemotherapy for Retroperitoneal Sarcoma: A Systematic Review and Meta-Analysis.","authors":"Bernardo Fontel Pompeu, Luiza Soares Guerra, Julia Hoici Brunini, Gabriel Leal Barone, Lucas Monteiro Delgado, Maria Letícia Gobo Silva, Fernando Augusto Batista Campos, Samuel Aguiar Junior","doi":"10.1002/jso.70037","DOIUrl":"https://doi.org/10.1002/jso.70037","url":null,"abstract":"<p><strong>Introduction: </strong>Retroperitoneal sarcoma is a rare malignancy, and surgical resection remains the primary treatment option. While neoadjuvant radiotherapy has shown limited long-term benefits, the role of neoadjuvant chemotherapy in this setting remains uncertain. This study aimed to evaluate the impact of neoadjuvant chemotherapy on survival outcomes in patients with resectable retroperitoneal sarcoma.</p><p><strong>Methods: </strong>A comprehensive search was performed in PubMed, Scopus, the Central Register of Clinical Trials, and Web of Science for studies published up to December 2024. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model, and heterogeneity was assessed using I² statistics. Statistical analyses were conducted using R Software version 4.4.1 (R Foundation for Statistical Computing).</p><p><strong>Results: </strong>Four retrospective studies were included, comprising a total of 2156 patients with resectable retroperitoneal sarcoma, of whom 361 (16.7%) received neoadjuvant chemotherapy. The analysis showed no significant difference in 5-year overall survival between patients who underwent neoadjuvant chemotherapy and those who did not. A sensitivity analysis, performed after excluding the study contributing most to heterogeneity, revealed a statistically significant 18% higher risk of mortality in patients receiving neoadjuvant chemotherapy (HR 1.18; 95% CI 1.06-1.32). Heterogeneity dropped to I² = 0% in this analysis.</p><p><strong>Conclusion: </strong>These findings suggest that neoadjuvant chemotherapy may be associated with worse survival outcomes, although these results remain exploratory due to the retrospective nature of the included studies and the limited number of available datasets. Ongoing prospective trials, such as the STRASS2 trial, will be critical to further defining the role of neoadjuvant chemotherapy in retroperitoneal sarcoma management.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600849","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}
引用次数: 0
Income and Rurality Impact Overall Survival but not Cause-Specific Survival in Patients With Chondrosarcoma: A Population-Based Study From the SEER Database. 收入和乡村性影响软骨肉瘤患者的总生存率,但不影响病因特异性生存率:来自SEER数据库的一项基于人群的研究
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-09 DOI: 10.1002/jso.70031
Adrian J Lin, Kole Joachim, Brandon Gettleman, Christopher Hamad, Amanda Perrotta, Sumin Jeong, Michael Fice, Lauren E Wessel, Nicholas M Bernthal, Alexander B Christ
{"title":"Income and Rurality Impact Overall Survival but not Cause-Specific Survival in Patients With Chondrosarcoma: A Population-Based Study From the SEER Database.","authors":"Adrian J Lin, Kole Joachim, Brandon Gettleman, Christopher Hamad, Amanda Perrotta, Sumin Jeong, Michael Fice, Lauren E Wessel, Nicholas M Bernthal, Alexander B Christ","doi":"10.1002/jso.70031","DOIUrl":"https://doi.org/10.1002/jso.70031","url":null,"abstract":"<p><strong>Background and objectives: </strong>Previous studies evaluating socioeconomic status (SES) in bone malignancies such as chondrosarcoma used the Cox Proportional Hazards model, which might overestimate risk compared to cause-specific models like the Fine-Gray model. This study aims to evaluate the prognostic significance of income status in chondrosarcoma using both models.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database for patients diagnosed with chondrosarcoma. Patients were stratified by SES indicators, including income levels (low: < $55 000, middle: $55 000-$70 000, high: > $70 000) and rurality (urban vs. rural). Survival analysis was conducted using Cox Proportional Hazards and Fine-Gray models.</p><p><strong>Results: </strong>The inclusion criteria were met by 3678 patients with income distributions as follows: 72.5% high-income, 18.3% middle-income, and 9.2% low-income. Cox analysis identified low-income (hazard ratio [HR] = 1.43, 95%-confidence interval [95%-CI]: 1.10-1.84, p = 0.006) and rurality (HR = 0.71, 95%-CI: 0.55-0.90, p = 0.006) as significant prognostic survival factors. Fine-Gray modeling attenuated the findings for low-income (sub-hazard ratio [SHR] = 1.36, 95%-CI: 0.95-1.94, p = 0.089) and rurality (SHR = 0.76, 95%-CI: 0.54-1.07, p = 0.122).</p><p><strong>Conclusion: </strong>SES influences chondrosarcoma survival, but its effect on cause-specific mortality decreases when competing risks are considered. Fine-gray modeling reveals critical nuances in survival analysis, stressing the need for appropriate statistical methods to interpret SES-related disparities.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591525","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}
引用次数: 0
Bilateral Risk-Reducing Mastectomy With Immediate Breast Reconstruction Lowers Concerns of Breast Cancer in Women With a High-Risk Genetic Predisposition for Breast Cancer Compared With a Radiological Imaging Surveillance Group. 与放射影像监测组相比,双侧降低风险的乳房切除术和立即乳房重建降低了乳腺癌高危遗传易感性妇女的乳腺癌风险。
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-09 DOI: 10.1002/jso.70029
Cecilie Balslev Willert, Pernille Bidstrup, Lene Mellemkjær, Julie Kalstrup, Anne-Marie Axø Gerdes, Niels Kroman, Lene Birk-Sørensen, Rikke Bredgaard, Signe Muus Steffensen, Lena Felicia Carstensen, Lisbet Rosenkrantz Hölmich
{"title":"Bilateral Risk-Reducing Mastectomy With Immediate Breast Reconstruction Lowers Concerns of Breast Cancer in Women With a High-Risk Genetic Predisposition for Breast Cancer Compared With a Radiological Imaging Surveillance Group.","authors":"Cecilie Balslev Willert, Pernille Bidstrup, Lene Mellemkjær, Julie Kalstrup, Anne-Marie Axø Gerdes, Niels Kroman, Lene Birk-Sørensen, Rikke Bredgaard, Signe Muus Steffensen, Lena Felicia Carstensen, Lisbet Rosenkrantz Hölmich","doi":"10.1002/jso.70029","DOIUrl":"https://doi.org/10.1002/jso.70029","url":null,"abstract":"<p><strong>Background and objectives: </strong>Women with a high-risk genetic predisposition for breast cancer are faced with the choice between bilateral risk-reducing mastectomy, often accompanied by immediate breast reconstruction, or radiological imaging surveillance. This study examined changes in mental well-being and health-related quality of life following surgery and compared outcomes with women adhering to surveillance. Additionally, surgical complications and regrets were assessed.</p><p><strong>Methods: </strong>Patients were recruited from multiple clinical departments across Denmark and stratified into surgery or surveillance groups. Patient-reported outcomes were measured using validated questionnaires, including the BREAST-Q, at baseline and 3, 12, and 24 months post-surgery or post-baseline.</p><p><strong>Results: </strong>A total of 35 and 37 patients were included in the surgery and surveillance groups, respectively. Surgery significantly reduced concerns about developing breast cancer but also led to lower physical well-being. Significant between-group differences were found at all post-baseline time points for these outcomes. Surgically and conservatively treated complications occurred in 14% and 23% of patients, respectively. No patients regretted the surgery.</p><p><strong>Conclusions: </strong>Risk-reducing mastectomy with immediate reconstruction effectively reduces breast cancer concerns in high-risk women in the short and long term but at the cost of reduced physical well-being and potential complications. These findings are essential for aligning preoperative expectations.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591524","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}
引用次数: 0
Incomplete Cancer Surgery Correlates With Loss of Immune Surveillance and Hyper-Progression of Disease. 不完全的癌症手术与免疫监视的丧失和疾病的超进展相关
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-09 DOI: 10.1002/jso.70023
Stuart A Fine, Sin Yee Lim, Nicholas M Siena, Alexandra Boix de Jesus, Tracie Goh, Lauren Markus, Tara A Russell, Joseph K Kendal, Serena Y Lofftus, Michael S Shehata, Hy B Dao, Alexander Lee, Kyle D Klingbeil, Brian E Kadera, Bartosz Chmielowski, Scott D Nelson, Sarah M Dry, Nicholas M Bernthal, Arun S Singh, Vishruth K Reddy, Anusha Kalbasi, Lauren E Wessel, Robert M Prins, Frederick R Eilber, Fritz C Eilber, Tyler R McCaw, Joseph G Crompton
{"title":"Incomplete Cancer Surgery Correlates With Loss of Immune Surveillance and Hyper-Progression of Disease.","authors":"Stuart A Fine, Sin Yee Lim, Nicholas M Siena, Alexandra Boix de Jesus, Tracie Goh, Lauren Markus, Tara A Russell, Joseph K Kendal, Serena Y Lofftus, Michael S Shehata, Hy B Dao, Alexander Lee, Kyle D Klingbeil, Brian E Kadera, Bartosz Chmielowski, Scott D Nelson, Sarah M Dry, Nicholas M Bernthal, Arun S Singh, Vishruth K Reddy, Anusha Kalbasi, Lauren E Wessel, Robert M Prins, Frederick R Eilber, Fritz C Eilber, Tyler R McCaw, Joseph G Crompton","doi":"10.1002/jso.70023","DOIUrl":"https://doi.org/10.1002/jso.70023","url":null,"abstract":"<p><strong>Background: </strong>Surgery is potentially curative for solid cancers; however, in cases of incomplete surgery, the impact of surgery on immune surveillance in the residual tumor microenvironment is not known. We sought to understand how surgery impacts immune populations in a residual tumor and correlates with overall survival in patients with primary pleomorphic liposarcoma.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted by searching the UCLA Sarcoma Program database for all patients with a histologic diagnosis of primary pleomorphic liposarcoma from 1995 to 2015. Patient follow-up was carried out through 2021. Patients were stratified by completeness of initial surgery: microscopically complete (R0), microscopically incomplete (R1), and grossly incomplete (R2). Six out of seven patients with an initial R2 resection underwent short-interval re-resection to negative margins within 120 days (R2-to-R0). We used immunofluorescence microscopy to characterize changes in immune populations of the tumor microenvironment.</p><p><strong>Results: </strong>On multivariate analysis of this 32-patient cohort, age, tumor size, and R2-to-R0 resection were significantly associated with mortality. The hazard ratio for mortality after R2-to-R0 resection was 109 (p value < 0.01). The median overall survival for patients with R2-to-R0 resection was 2.0 years compared to 8.5 years for an upfront R0 resection (p value < 0.001). Immunofluorescence on four pairs of initial and re-resected tumors revealed a postoperative accumulation of suppressive myeloid and T regulatory immune populations in the residual microenvironment.</p><p><strong>Discussion: </strong>We found that an initial incomplete surgery correlated with the accumulation of suppressive immune populations in the residual tumor microenvironment and mortality-a phenomenon we call hyper-progression of disease. Our findings have implications for therapeutically targeting immunosuppressive populations in the perioperative period to improve patient survival.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591526","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}
引用次数: 0
Long-Term Urinary Dysfunction and Impact on Quality of Life After Rectal Cancer Surgery: A Prospective Multicenter Observational Study. 直肠癌术后长期尿功能障碍及其对生活质量的影响:一项前瞻性多中心观察性研究。
IF 2 3区 医学
Journal of Surgical Oncology Pub Date : 2025-07-07 DOI: 10.1002/jso.70033
Kohei Ueno, Nobuaki Hoshino, Koya Hida, Akinari Nomura, Tetsuya Shiota, Masahiro Yamada, Ryosuke Okamura, Yoshiro Itatani, Suguru Hasegawa, Kazutaka Obama
{"title":"Long-Term Urinary Dysfunction and Impact on Quality of Life After Rectal Cancer Surgery: A Prospective Multicenter Observational Study.","authors":"Kohei Ueno, Nobuaki Hoshino, Koya Hida, Akinari Nomura, Tetsuya Shiota, Masahiro Yamada, Ryosuke Okamura, Yoshiro Itatani, Suguru Hasegawa, Kazutaka Obama","doi":"10.1002/jso.70033","DOIUrl":"https://doi.org/10.1002/jso.70033","url":null,"abstract":"<p><strong>Background and objectives: </strong>We aimed to examine long-term changes in urinary dysfunction (UD) after rectal cancer surgery, using the three validated assessments: residual urine volume (RUV), International Prostate Symptom Score (IPSS), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).</p><p><strong>Methods: </strong>This prospective multicenter observational study was conducted in eight hospitals, and a total of 103 patients, who underwent radical resection for rectal cancer, were included. UD was evaluated at baseline and at 6, 12, and 24 months postoperatively. Quality of life (QoL) was assessed using the European Organization for Research and Treatment Cancer (EORTC) quality of life questionnaire-core 30 (QLQ-C30).</p><p><strong>Results: </strong>The proportion of patients with UD based on RUV values decreased from 19.3% at baseline to 7.6% at 24 months (p = 0.022). However, UD, based on IPSS remained relatively constant (33.4% to 29.0%, p = 0.398), whereas UD based on ICIQ-SF score increased significantly from 17.5% to 29.0% (p = 0.019). Patients with UD, based on both IPSS and ICIQ-SF, had lower QoL scores at 24 months (mean differences -10.3; p = 0.028 and -15.4; p = 0.001, respectively), whereas RUV values showed no correlation with QoL scores after surgery.</p><p><strong>Conclusions: </strong>RUV values gradually improved postoperatively. However, the impact of higher RUV values on long-term QoL was limited. UD, based on both IPSS and ICIQ-SF, persisted after surgery, and negatively affected long-term QoL.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575724","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}
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