Journal of Surgical Oncology最新文献

{"title":"Risk Factors and Prognostic Significance of Severe Postoperative Complications After Curative Resection for Remnant Gastric Cancer: A Multicenter Retrospective Study.","authors":"Kensuke Kudou, Mitsuhiko Ota, Kippei Ogaki, Yasue Kimura, Yuta Kasagi, Naomichi Koga, Hirofumi Hasuda, Hirotada Tajiri, Tetsuro Kawazoe, Yasuo Tsuda, Tomonori Nakanoko, Koji Ando, Eiji Oki, Tomoharu Yoshizumi","doi":"10.1002/jso.70094","DOIUrl":"https://doi.org/10.1002/jso.70094","url":null,"abstract":"<p><strong>Background: </strong>Remnant gastric cancer (RGC) is associated with higher surgical difficulty and poorer long-term outcomes than primary gastric cancer. However, the impact of postoperative complications on prognosis in RGC remains unclear.</p><p><strong>Methods: </strong>This retrospective, multicenter cohort study included 126 patients who underwent curative surgery for RGC across five institutions between 2007 and 2024. Postoperative complications were evaluated using the Clavien-Dindo (CD) classification. Patients were stratified into two groups based on the presence of severe complications (CD grade ≥ 3a). Logistic regression analysis was used to identify risk factors for complications, and Cox proportional hazards models were applied to determine prognostic factors for overall survival (OS) and recurrence-free survival (RFS).</p><p><strong>Results: </strong>Severe postoperative complications occurred in 15.9% of patients. Multivariate analysis identified smoking (OR = 8.28, p = 0.0048), operative time ≥ 300 min (OR = 3.52, p = 0.0448), and blood transfusion (OR = 4.82, p = 0.0380) as independent risk factors for severe complications. Kaplan-Meier analysis demonstrated significantly poorer 5-year OS (32.0% vs. 65.6%, p = 0.002) and RFS (33.6% vs. 64.3%, p < 0.001) in patients with CD grade ≥ 3a complications. CD grade ≥ 3a and pathological Stage II or higher were independent prognostic factors for both OS and RFS.</p><p><strong>Conclusions: </strong>Severe postoperative complications are associated with poor long-term outcomes in patients undergoing curative surgery for RGC. Identifying and mitigating modifiable risk factors, such as smoking and operative invasiveness, may help improve surgical and oncological outcomes in this challenging population.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064919","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":"Effect of Neoadjuvant Hormonal Therapy on Breast Conservation in Invasive Ductal Versus Lobular Carcinoma of the Breast: A Comparative Analysis.","authors":"Nicole H Goldhaber, Thomas J O'Keefe, Lauren Longo, Sarah L Blair, Sara Grossi","doi":"10.1002/jso.70082","DOIUrl":"https://doi.org/10.1002/jso.70082","url":null,"abstract":"<p><strong>Background: </strong>Comparative efficacy of neoadjuvant hormonal therapy in downstaging invasive ductal carcinoma (IDC) versus invasive lobular carcinoma (ILC) remains an area of uncertainty and may impact primary breast conservation rates.</p><p><strong>Methods: </strong>The National Cancer Database was used to identify women with IDC and ILC who underwent neoadjuvant hormonal therapy alone between 2004 and 2020. Clinical and pathological T-staging were examined and patients that downstaged before surgery were identified. Univariate and multivariate comparison analyses were performed. The effect of duration of neoadjuvant hormonal therapy was also examined.</p><p><strong>Results: </strong>Among women with IDC, 39.5% had lesions that downstaged compared to 30.0% with ILC (p < 0.001). Overall, the duration of neoadjuvant hormonal therapy was longer in patients with downstaged lesions compared to those that did not (mean = 126.9 v 99.4 days; p < 0.001). Of those who downstaged, 43% of patients with IDC and 57.8% of patients with ILC underwent mastectomy following neoadjuvant hormonal therapy.</p><p><strong>Conclusions: </strong>Overall, ILC lesions are less likely to downstage after neoadjuvant hormonal therapy alone compared to IDC lesions. In both histologic subtypes, cancers were more likely to downstage after over 120 days of neoadjuvant hormonal therapy. Clinicians should be mindful when counseling patients that neoadjuvant hormonal therapy alone may not preclude the need for mastectomy in ILC.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064909","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":"Superparamagnetic Iron Oxide Tracer: A Magnetic Match to Gold Standard in Melanoma Sentinel Lymph Node Biopsy-A Systematic Review and Meta-Analysis.","authors":"Kadhim Taqi, Eva Lindell Jonsson, Golpira Elmi Assadzad, Cecily Stockley, Ish Bains, Claire Temple-Oberle","doi":"10.1002/jso.70086","DOIUrl":"https://doi.org/10.1002/jso.70086","url":null,"abstract":"<p><p>Superparamagnetic iron oxide (SPIO) tracer is a potential option for sentinel lymph node biopsy (SLNB), though its application in melanoma remains minimally explored. This systematic review evaluated the use of SPIO tracer compared to the standard approach for SLNB in melanoma. SPIO demonstrated comparable efficacy and detection rate to the gold standard, with a sensitivity of 94%. Reported adverse events included seroma and black staining. Additional research is required to determine its long-term outcomes. Trial Registration: PROSPERO: CRD 42024613648.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030195","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":"Long-Term Functional Outcomes and Modes of Failure of Fresh Frozen Hemicondylar Allografts: A Retrospective Cohort Study.","authors":"Arturo M De Pena, Marcos R Gonzalez, Joseph J Connolly, Santiago A Lozano-Calderon","doi":"10.1002/jso.70081","DOIUrl":"https://doi.org/10.1002/jso.70081","url":null,"abstract":"<p><strong>Background: </strong>Hemicondylar fresh frozen allografts address partial knee defects while preserving native anatomy and bone stock. This study evaluated long-term survival, failure modes, and functional outcomes following hemicondylar reconstruction.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of hemicondylar fresh frozen allograft reconstructions. Allograft failure was assessed using the Henderson classification and osteoarthritis via Kellgren-Lawrence classification. Functional outcomes were evaluated using MSTS scores and patient-reported measures, with radiographic evaluation performed preoperatively and at 1, 2, 5, and 10 years postoperatively.</p><p><strong>Results: </strong>A total of 17 patients (13 femoral, 4 tibial allografts) with a median age of 29 years and a median follow-up of 16.9 years were included. Four patients (24%) experienced allograft failure, including two structural failures, one infection, and one soft-tissue failure. Overall allograft survival was 87.5% at 1 year, 80.8% at 2 years, and 74% at 5-20 years, with a median MSTS score of 21/30. While all patients developed progressive osteoarthritis, only six required total knee arthroplasty for symptomatic arthritis rather than allograft failure.</p><p><strong>Conclusion: </strong>Hemicondylar allografts demonstrate acceptable long-term survival and functional outcomes, with progressive osteoarthritis/chondrolysis representing expected evolution rather than treatment failure. Structural collapse remains the predominant failure mechanism requiring removal. These findings support hemicondylar allografts as viable reconstructive options for selected patients.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023532","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":"Factors and Disease-Specific Outcomes Associated With Treatment Delays in Osteosarcoma: A Population-Based Retrospective Cohort Study.","authors":"Kate S Woods, Ryan T Kauper, Anisha Kohli, Mitchell A Taylor, Alex Gavia, Peter Silberstein","doi":"10.1002/jso.70087","DOIUrl":"https://doi.org/10.1002/jso.70087","url":null,"abstract":"<p><strong>Introduction: </strong>Time to initiation of therapy in oncological care is an influential factor in disease progression and survival outcomes in many cancer types. We aim to identify factors associated with delayed time to treatment (TTT) in high-grade osteosarcoma and its relationship to disease-specific survival (DSS).</p><p><strong>Methods: </strong>The SEER database was queried for biopsy-confirmed cases of high-grade osteosarcoma between 2000 and 2021 using ICD-O-3 histology codes 9180/3-9194/3 and primary site codes C40.0-41.9. χ², Kaplan-Meier with log-rank testing, and stepwise multivariable logistic regression were completed using SPSS, with significance set to p < 0.05.</p><p><strong>Results: </strong>Kaplan-Meier analysis demonstrated significantly reduced 5- and 10-year DSS in patients with TTT over 1 month (p < 0.001). Multivariable analysis identified advanced age groups and tumors of the cranium (aOR 2.48; 95% CI 1.96-3.13), thorax (aOR 1.72; 95% CI 1.13-2.61), and pelvis (aOR 1.71; 95% CI 1.31-2.23) as factors associated with TTT delays over 1 month. Black race and Hispanic ethnicity were also significantly associated with treatment delays in subset analysis of patients < 40 years (aOR 1.74; 95% CI 1.27-2.39 and aOR 1.31; 95% CI 1.01-1.70).</p><p><strong>Conclusion: </strong>These findings reveal disparities in TTT for osteosarcoma patients based on age, race/ethnicity, and tumor location, highlighting the need for equitable access to early care.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023548","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":"Enhanced Functional and Surgical Outcomes With 3D Printing in Orthopedic Oncology: A Comparative Meta-Analysis Against Conventional Techniques.","authors":"Peter Joseph Mounsef, Benjamin Blackman, Ojasvi Sharma, Ahmed Aoude, Anthony Bozzo","doi":"10.1002/jso.70083","DOIUrl":"https://doi.org/10.1002/jso.70083","url":null,"abstract":"<p><strong>Introduction: </strong>Three-dimensional printing (3DP) technology has increasingly gained attention in orthopedic oncology, where complex tumor resections and reconstructions demand high precision. 3DP enables the creation of patient-specific models and prostheses, which can improve postoperative quality of life for patients while assisting surgeons in preoperative planning, enhancing surgical accuracy, and improving outcomes in complex oncologic cases. Despite its potential, comprehensive data on the effectiveness and applications of 3DP in orthopedic oncology are limited. This paper assesses whether using 3DP compared to conventional techniques results in better outcomes in orthopedic oncology.</p><p><strong>Methods: </strong>A comprehensive search of Ovid MEDLINE, Embase, Scopus, and Web of Science was conducted until November 2024. Studies comparing 3D printing to conventional methods in orthopedic oncology and reporting outcomes such as operative time, blood loss, recurrence rates, or functional scores were included. Weighted means and meta-analyses were conducted to compare these outcomes. Statistical heterogeneity was adjusted by using a random-effects model.</p><p><strong>Results: </strong>Fourteen studies comprising 478 patients met the inclusion criteria. Our primary findings were improved MSTS scores (mean difference [MD]: 2.17, p = 0.00) and decreased blood loss (MD: -69.8 mL, p = 0.00) in the 3D printing groups. There was no significant difference in operative time between 3D printing and conventional techniques (MD: -12.2 min, p = 0.32). Tumor recurrence rates did not differ significantly between groups (relative risk: 0.88, p = 0.50). Subgroup analyses indicated that 3D-printed implants showed the greatest benefit in reducing OR time and blood loss, with the other subgroups showing no significant difference in OR time, blood loss, or recurrence rate.</p><p><strong>Conclusion: </strong>The findings suggest that 3D printing in orthopedic oncology may enhance surgical precision by reducing OR time, intraoperative blood loss, and improving postoperative function, without affecting recurrence rates. Substantial heterogeneity limits confidence in these findings.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023589","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 Comprehensive Complication Index in Postoperative Assessment After Head and Neck Reconstruction.","authors":"Takeaki Hidaka, Shimpei Miyamoto, Yutaka Fukunaga, Azusa Oshima, Takeshi Shinozaki, Kazuto Matsuura, Takuya Higashino","doi":"10.1002/jso.70077","DOIUrl":"https://doi.org/10.1002/jso.70077","url":null,"abstract":"<p><strong>Background: </strong>Postoperative complications significantly impact outcomes in head and neck free-flap reconstruction. The comprehensive complication index (CCI) offers a continuous measure of complication burden but is rarely applied in head and neck surgery compared to the Clavien-Dindo Classification (CDC).</p><p><strong>Methods: </strong>This retrospective study analyzed 354 patients who underwent head and neck free-flap reconstruction. Complications were graded using the CDC, and the CCI was calculated. Multivariable linear regression was used to identify risk factors for increased CCI values.</p><p><strong>Results: </strong>A total of 413 complications were observed in 252 patients. Analysis using the CCI identified mandibular reconstruction, diabetes mellitus, and prolonged operative time as significant risk factors for increased complication burden, while analysis using the CDC identified only prolonged operative time.</p><p><strong>Conclusions: </strong>The CCI provides a comprehensive assessment of postoperative morbidity and demonstrates potential for improved evaluation of complication burden in head and neck free-flap reconstruction.</p><p><strong>Level of evidence: </strong>Level IV.</p><p><strong>Clinical trial registration: </strong>This study was registered in the UMIN Clinical Trials Registry as UMIN000055625 (http://www.umin.ac.jp/ctr).</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015650","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":"Safety of Minimally Invasive Sublobar Pulmonary Metastasectomy in the Frail Patient.","authors":"Hannah Sidhu, Li Ding, Graeme M Rosenberg, Takashi Harano, Sean C Wightman, Scott M Atay, Anthony W Kim, Brooks V Udelsman","doi":"10.1002/jso.70078","DOIUrl":"https://doi.org/10.1002/jso.70078","url":null,"abstract":"<p><strong>Background and objectives: </strong>Minimally invasive (MI) pulmonary metastasectomy may improve access in frail patients who are at high-risk for complications after thoracotomy. We compared postoperative complications among frail and non-frail patients undergoing pulmonary metastasectomy.</p><p><strong>Methods: </strong>The Nationwide Readmissions Database (2017-2019) identified adult patients who underwent pulmonary metastasectomy. Frailty was determined using Johns Hopkins Adjusted Clinical Groups indicator. Independent propensity-score matches were performed for the open and MI cohorts. Odds ratio (OR) and incidence rate (IRR) were used to compare morbidity and length of stay (LOS).</p><p><strong>Results: </strong>A total of 8778 patients underwent pulmonary metastasectomy, of which 3.1% (270/8778) were frail. In the open cohort after propensity-score matching (98-matched pairs), frail patients had more complications (OR 2.1; p < 0.0001) and increased LOS (IRR 2.6; p < 0.0001), both of which did not improve with a sublobar resection. In the MI cohort (167-matched pairs), frailty was associated with increased morbidity (OR 2.6; p < 0.001) and increased LOS (IRR 2.8; p < 0.001), but both were mitigated by sublobar resection (morbidity OR 0.44; p = 0.005; LOS IRR 0.66; p < 0.001).</p><p><strong>Conclusions: </strong>A MI sublobar resection significantly mitigates the risk of pulmonary metastasectomy in frail patients. Thoracotomy and lobectomy should be approached cautiously in this population.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000836","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":"Effect of Surgical Margins on Local Recurrence Patterns of Myxofibrosarcomas: A Retrospective Cohort Study From the Stockholm Sarcoma Centre.","authors":"Madeleine N Hoang, Pavlos Doumanidis, Emmy Nyqvist, Jenny Löfgren, Asle C Hesla, Panagiotis Tsagkozis","doi":"10.1002/jso.70076","DOIUrl":"10.1002/jso.70076","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most common subgroups of soft tissue sarcomas are myxofibrosarcomas (MFS), which possess an infiltrative and aggressive growth pattern with a tendency for local recurrence (LR). MFS presents significant management challenges due to difficulties in achieving satisfactory surgical margins. The present study describes the LR pattern of MFS and its association with resection margin, re-excision surgery and adjuvant radiotherapy.</p><p><strong>Method: </strong>This is a registry study conducted at the Sarcoma Centre at Karolinska University Hospital, Stockholm. All patients who underwent surgery with curative aim for MFS in this centre between 2010 and 2023 were included.</p><p><strong>Results: </strong>LR was documented in 17/87 patients. Surgical margin was predictive of LR but not overall patient survival. The cumulative LR incidence at 3.5 years for intralesional, marginal, and wide margins were 80%, 40% and 10% respectively. RT was not shown to confer any suppressive effect on LR. Amputation was needed in five patients for local disease control.</p><p><strong>Conclusion: </strong>Margins are the foremost determinants of LR for MFS. Proactive surgical management should be considered when margins are marginal.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958659","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":"Ultrasound Versus Magnetic Resonance Imaging for Extremity Soft Tissue Sarcoma Surveillance: A Scoping Review.","authors":"Jimmy Smith, David Dallas-Orr, Niket Todi, Danielle Brown, R Lor Randall","doi":"10.1002/jso.70079","DOIUrl":"10.1002/jso.70079","url":null,"abstract":"<p><p>An extensive literature search was conducted using PRISMA-ScR guidelines to evaluate ultrasound and/or MRI for postresection surveillance of soft tissue sarcoma (STS) based on diagnostic accuracy, recurrence detection, cost-effectiveness, and clinical outcomes. Of the 366 articles identified, only 8 studies met the inclusion criteria. This scoping review revealed comparable diagnostic performance between ultrasound and MRI in STS surveillance. Additionally, this study highlights significant cost savings with ultrasound utilization and emerging evidence for hybrid surveillance protocols.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958241","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}