Journal of Surgical Oncology最新文献

{"title":"The Significance of the Morphological Appearance of Peritoneal Lesions on Imaging in Patients With Peritoneal Malignancies-A Report From Phase 1 of the PRECINCT Study.","authors":"Aditi Bhatt,Pascal Rousset,Brendan J Moran,Mudaddal Kazi,Dario Baratti,Amine Souadka,Marcello Deraco,Paolo Sammartino,Armando Sardi,Olivier Glehen,","doi":"10.1002/jso.27869","DOIUrl":"https://doi.org/10.1002/jso.27869","url":null,"abstract":"BACKGROUND AND AIMThis is a report from Phase 1 of the prospective, observational, PRECINCT (Pattern of peritoneal dissemination and REsponse to systemic Chemotherapy IN Common and uncommon peritoneal Tumours) study, in which we studied the incidence of disease at pathological evaluation in different morphological appearances of peritoneal malignancies (PM) on imaging.METHODSRadiological findings were captured in a specific format that included a description of the morphological appearance of PM and a correlation performed with pathological findings.RESULTSIn 630 patients enroled at seven centres (September 2022-December 2023), 24 morphological terms were used. Among prespecified terms (N = 8 used in 6350 [92.2%] regions), scalloping was pathologically positive in 93.5%, confluent disease in 78.8%, tumour nodules in 69.6%, thickening in 66.1%, infiltration in 56.3%. Among unspecified appearances (N = 16) for 540 (7.8%) regions, 'enhancement' was positive in 41.5%, micronodules in 65.3% and nodularity in 60.2%. Hierarchal clustering placed gastric cancer and rare tumours together and colorectal cancer, ovarian cancer and peritoneal mesothelioma in one cluster.CONCLUSIONSThe incidence of disease at pathological evaluation for most morphological appearances was high (> 50%). Morphological description should be provided in routine radiology reports. A set of standardized terms with their description should be developed by a consensus among experienced radiologists.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258262","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":"Comprehensive Geriatric Assessment, Treatment Decisions, and Outcomes in Older Patients Eligible for Pancreatic Surgery","authors":"Marij Hartog, Sara J. E. Beishuizen, Reon Togo, Rozemarijn L. van Bruchem‐Visser, Casper H. J. van Eijck, Francesco U. S. Mattace‐Raso, Chulja J. Pek, Roeland F. de Wilde, Bas Groot Koerkamp, Harmke A. Polinder‐Bos","doi":"10.1002/jso.27862","DOIUrl":"https://doi.org/10.1002/jso.27862","url":null,"abstract":"IntroductionPeriampullary cancer has a poor prognosis. Surgical resection is a potentially curative but high‐risk treatment. Comprehensive geriatric assessment (CGA) can inform treatment decisions, but has not yet been evaluated in older patients eligible for pancreatic surgery.MethodsThis prospective observational study included patients ≥ 70 years of age eligible for pancreatic surgery. Frailty was defined as impairment in at least two of five domains: somatic, psychological, functional, nutritional, and social. Outcomes included postoperative complications, functional decline, and mortality.ResultsOf the 88 patients included, 87 had a complete CGA. Sixty‐five patients (75%) were frail and 22 (25%) were non‐frail. Frail patients were more likely to receive nonsurgical treatment (43.1% vs. 9.1% <jats:italic>p</jats:italic> = 0.004). Fifty‐seven patients underwent surgery, of which 52 (59%) underwent pancreaticoduodenectomy. The incidence of postoperative delirium was three times higher in frail patients (29.7% vs. 0%, <jats:italic>p</jats:italic> = 0.005). The risk of mortality was three times higher in frail patients (HR: 3.36, 95% CI: 1.43–7.89, <jats:italic>p</jats:italic> = 0.006).ConclusionFrailty is common in older patients eligible for pancreatic surgery and is associated with treatment decision, a higher incidence of delirium and a three times higher risk of all‐cause mortality. CGA can contribute to shared decision‐making and optimize perioperative care in older patients.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258265","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":"Is Oncoplastic Surgery Safe in High‐Risk Breast Cancer Phenotypes?","authors":"Gabriel De La Cruz Ku, Carly Wareham, Caroline King, Akash Koul, Anshumi Desai, Sarah M. Persing, Salvatore Nardello, Abhishek Chatterjee","doi":"10.1002/jso.27899","DOIUrl":"https://doi.org/10.1002/jso.27899","url":null,"abstract":"BackgroundOncoplastic surgery (OPS) has increased in popularity over the recent years. It is a form of breast conservation surgery allowing for larger partial mastectomy (PM) resections followed by either volume displacement or volume replacement reconstruction techniques. However, there is a lack of evidence on the effectiveness and safety of OPS with radiotherapy (OPS + RT) in high‐risk breast cancer phenotypes, such as triple negative breast cancer (TNBC) and HER2 positive (HER2+) patients. Our aim was to compare the breast cancer‐specific survival (BCSS) and postoperative surgical complications in OPS + RT compared to PM alone with radiation (PM + RT) and total mastectomy (MTX) without radiotherapy (MTX‐RT).MethodsPatient data were analyzed from the Surveillance, Epidemiology, and End Results (SEER) cancer registries from January 1, 2012 to December 31, 2020. Patients were stratified according to the type of surgery. Cox regression analysis was performed to assess prognostic factors of BCSS.ResultsA total of 24 621 patients with high‐risk breast cancer phenotypes were identified, 180 underwent OPS + RT; 13 402, PM + RT; and 11 039 MTX‐RT. OPS + RT was more frequently performed in younger (mean age of 65.53 years, SD: 9.29, <jats:italic>p</jats:italic> &lt; 0.001), non‐Hispanic White (90.5% vs. 77.7% vs. 76.3%) and single women (17.9% vs. 12.1% vs. 13.3%). MTX‐RT was usually performed in patients with high histological grade, TNBC, and higher stages. Overall complication rates were higher in the MTX‐RT, compared to OPS + RT and PM + RT, 2%, 1.1%, and 0.7%, respectively, <jats:italic>p</jats:italic> &lt; 0.001. Rates of hematoma and surgical site infections were higher in the MTX‐RT group. With a median follow‐up of 46 months, OPS + RT had better BCSS rates at 5 years compared to PM + RT and MTX‐RT (97.1% vs. 94.7% vs. 89.8%, <jats:italic>p</jats:italic> &lt; 0.001). MTX‐RT was found to be an independent prognostic factor of worse BCSS compared to OPS + RT (hazard ratio [HR] = 2.584; 95% confidence interval [CI]: 1.005–7.171), while PM + RT had no difference compared to OPS + RT (HR = 1.670, 95% CI: 0.624–4.469).ConclusionsOPS is a safe breast surgical option in patients with HER2+ and TNBC. Patients with high‐risk phenotypes who underwent OPS + RT and have similar BCSS and complication rates compared to standard breast surgical options. As such, OPS should be considered as an option whenever breast conservation surgery is being discussed.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258267","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 Associated With Prolonged Operative Times in Laparoscopic Right Hemicolectomy and Its Association With Short‐Term Outcomes","authors":"Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Justin Dourado, Giovanna Dasilva, Steven D. Wexner","doi":"10.1002/jso.27872","DOIUrl":"https://doi.org/10.1002/jso.27872","url":null,"abstract":"BackgroundThis study aimed to investigate factors associated with prolonged operative time in laparoscopic right hemicolectomy for colon cancer.MethodsThis was a retrospective review of patients with colon cancer who underwent laparoscopic right hemicolectomy between 2011 and 2021. Linear and binary logistic regression analyses were performed to determine factors associated with prolonged operative time. The association between longer operative times and complications and hospital stay was assessed.ResultsOne hundred and ninety‐seven patients (52.3% female; mean age: 68.8 ± 14.1 years) were included. Factors independently associated with operative time were male sex (<jats:italic>β</jats:italic> = 17.3, 95% CI: 2, 32.5; <jats:italic>p</jats:italic> = 0.026) and extended hemicolectomy (<jats:italic>β </jats:italic>= 67.7, 95% CI: 27.6, 107.9; <jats:italic>p</jats:italic> = 0.001). American Society of Anesthesiologists (ASA) IV classification had a borderline significant association with operative time (<jats:italic>β </jats:italic>= 100.4, 95% CI: −2.05, 202.9; <jats:italic>p</jats:italic> = 0.055). Male sex (<jats:italic>r</jats:italic> = 0.158; <jats:italic>p</jats:italic> = 0.026), body mass index (<jats:italic>r</jats:italic> = 0.205; <jats:italic>p</jats:italic> = 0.004), ASA classification (<jats:italic>r</jats:italic> = 0.232; <jats:italic>p</jats:italic> = 0.001), extended hemicolectomy (<jats:italic>r</jats:italic> = 0.256; <jats:italic>p</jats:italic> &lt; 0.001), and intracorporeal vessel control (<jats:italic>r</jats:italic> = 0.161; <jats:italic>p</jats:italic> = 0.025) had significant positive correlation with operative times. Patients with operative times ≥ 160 min had significantly longer hospital stays (5 vs. 4 days; <jats:italic>p</jats:italic> = 0.043) and similar complication rates to patients with shorter operative times.ConclusionsMale sex, advanced ASA classification, and extended hemicolectomy were independently and significantly associated with longer operative times in laparoscopic right hemicolectomy. Longer operative times were associated with longer hospital stays and similar complication rates.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258266","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":"Development and Validation of a Predictive Risk Score for Blood Transfusion in Patients Undergoing Curative‐Intent Surgery for Intrahepatic Cholangiocarcinoma","authors":"Giovanni Catalano, Laura Alaimo, Yutaka Endo, Odysseas P. Chatzipanagiotou, Andrea Ruzzenente, Luca Aldrighetti, Matthew Weiss, Todd W. Bauer, Sorin Alexandrescu, George A. Poultsides, Shishir K. Maithel, Hugo P. Marques, Guillaume Martel, Carlo Pulitano, Feng Shen, François Cauchy, Bas G. Koerkamp, Itaru Endo, Minoru Kitago, Timothy M. Pawlik","doi":"10.1002/jso.27903","DOIUrl":"https://doi.org/10.1002/jso.27903","url":null,"abstract":"Background and ObjectivesAmong patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC), perioperative bleeding requiring blood transfusion is a common complication, yet preoperative identification of patients at risk for transfusion remains challenging. The objective of this study was to develop a preoperative risk score for blood transfusion requirement during surgery for ICC.MethodsPatients undergoing curative‐intent liver surgery for ICC (1990–2020) were identified from a multi‐institutional database. A predictive model was developed and validated. An easy‐to‐use risk calculator was made available online.ResultsAmong 1420 patients, 300 (21.1%) received an intraoperative transfusion. Independent predictors of transfusion included severe preoperative anemia (OR = 1.65, 95% CI 1.10–2.47), T2 category or higher (OR = 2.00, 95% CI 1.36–3.02), positive lymph nodes (OR = 1.75, 95% CI 1.32–2.32) and major resection (OR = 2.56, 95%CI 1.85–3.58). Receipt of blood transfusion significantly correlated with worse outcomes. The model showed good discriminative ability in both training (AUC = 0.68, 95% CI 0.66–0.72) and bootstrapping validation (C‐index = 0.67, 95% CI 0.65–0.70) cohorts. An online risk calculator of blood transfusion requirement was developed (<jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://catalano-giovanni.shinyapps.io/TransfusionRisk\">https://catalano-giovanni.shinyapps.io/TransfusionRisk</jats:ext-link>).ConclusionsIntraoperative blood transfusion was significantly associated with poor postoperative outcomes among patients undergoing surgery for ICC. The identification of patients at high risk of transfusion could improve perioperative patient care and blood resources allocation.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258269","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":"Review of 2022 PSOGI/RENAPE Consensus on HIPEC","authors":"Shigeki Kusamura, Aditi Bhatt, Kurt van Der Speeten, Vahan Kepenekian, Martin Hübner, Clarisse Eveno, Ignace de Hingh, Jean‐Baptiste Delhorme, Abdelkader Taibi, Laurent Villeneuve, Rea Lo Dico, Brendan Moran, Kim Govaerts, Oliver Zivanovic, Donal Brennan, Cedric Nadeau, Willemien Van Driel, Naoual Bakrin, Pompiliu Piso, Victor J. Verwaal, Santiago González‐Moreno, Mohammad Alyami, Olivia Sgarbura, Beate Rau, Marcello Deraco, Olivier Glehen","doi":"10.1002/jso.27885","DOIUrl":"https://doi.org/10.1002/jso.27885","url":null,"abstract":"The 2022 PSOGI (Peritoneal Surface Oncology Group International) and RENAPE (French Network for Rare Peritoneal Malignancies) consensus on hyperthermic intraperitoneal chemotherapy (HIPEC) was a comprehensive effort aimed at standardizing treatment protocols for various peritoneal malignancies. This initiative is critical due to the wide range of technical variations in HIPEC procedures and the resulting need for standardization to ensure consistent and effective patient care and meaningful audit of multicenter data.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258268","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":"Evaluation of Postoperative Anastomotic Patency in Lymphaticovenular Anastomosis Using Photoacoustic Imaging.","authors":"Yushi Suzuki, Hiroki Kajita, Marika Otaki, Shiho Watanabe, Hayato Nagashima, Keisuke Okabe, Nobuaki Imanishi, Hisashi Sakuma, Kazuo Kishi","doi":"10.1002/jso.27898","DOIUrl":"https://doi.org/10.1002/jso.27898","url":null,"abstract":"<p><strong>Background and objectives: </strong>Lymphaticovenular anastomosis (LVA) is a surgical technique used to alleviate lymphedema by bypassing the lymphatic and venous vessels and facilitating lymphatic fluid drainage. Accurate evaluation of anastomotic patency is crucial for assessing LVA outcomes. Traditional near-infrared fluorescence lymphography has limitations, including fluorescence diffusion in subcutaneous fat and difficulty evaluating areas beneath the dermal backflow. Photoacoustic imaging (PAI) is a potential alternative for high-resolution visualization of lymphatic and blood vessels. We aimed to evaluate the utility of PAI for assessing LVA patency.</p><p><strong>Methods: </strong>Using the LUB0 PAI system, we examined patients who underwent LVA. Imaging was conducted using subcutaneously injected indocyanine green (ICG) to visualize lymphatic vessels.</p><p><strong>Results: </strong>Results showed clear patency in some cases, inability to evaluate it in others, and confirmed occlusion in certain instances.</p><p><strong>Conclusions: </strong>While PAI provides valuable insights, challenges remain, including the potential for ambiguous results from the intermittent nature of lymphatic flow and difficulty visualizing low-ICG-concentration lymphatic vessels. Nonetheless, PAI offers a promising method for detailed 3D evaluation of anastomoses. It may improve surgical outcomes and contribute to future evidence in the field. Further advancements, including real-time video assessment, may enhance the accuracy and reliability of LVA patency evaluation.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289844","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":"Comment on: Analysis of Clinical and Pathological Characteristics of Retroperitoneal Paraganglioma and Associated Prognostic Factors.","authors":"Hua Zhao, Jiayue Xu, Yuejun Zhou","doi":"10.1002/jso.27905","DOIUrl":"https://doi.org/10.1002/jso.27905","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289843","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":"Comment on: “Liver Resection Is Superior to Tumor Ablation in Patients With Multifocal Hepatocellular Carcinoma”","authors":"You‐Fei Wei, Yin‐Feng Xu","doi":"10.1002/jso.27887","DOIUrl":"https://doi.org/10.1002/jso.27887","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142184593","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 Previous Abdominal Surgery and Timing of Peritoneal Metastases on Accuracy of Imaging in Predicting the Surgical PCI: A Report From the PRECINCT Study.","authors":"Aditi Bhatt,Pascal Rousset,Brendan J Moran,Mudaddal Kazi,Dario Baratti,David Morris,Daniel Labow,Armando Sardi,Paolo Sammartino,Olivier Glehen,","doi":"10.1002/jso.27868","DOIUrl":"https://doi.org/10.1002/jso.27868","url":null,"abstract":"BACKGROUND AND AIMIn this report from Phase 1 of the prospective, observational, PRECINCT (Pattern of peritoneal dissemination and REsponse to systemic Chemotherapy IN Common and uncommon peritoneal Tumours) study, a correlation was performed between the radiological PCI (peritoneal cancer index; rPCI) and surgical PCI (sPCI). The impact of timing of peritoneal malignancy (PM) and previous abdominal surgery was also studied.METHODSThe rPCI and sPCI were considered the 'same' if they differed by ≤ 3 points. The agreement was assessed using Bland-Altman analysis and the strength of the agreement was assessed using the concordance correlation coefficient (CCC). The extent of prior surgery was classified according to prior surgical score (PSS).RESULTSIn 707 (79.4%) patients, rPCI and sPCI concurred in 280 (39.6%). In the Bland-Altman analysis, < 40% patients were in the ±3 PCI points limit of acceptable difference. The average difference between the two scores was 4.5 points (95% CI- -5.16 to -3.92). The CCC- was 0.59 for the whole cohort ('moderate' concordance) and was not influenced by imaging modality, timing of PM or PSS.CONCLUSIONSThe rPCI underestimated sPCI by an average of 4.5 points. The role of peritoneal MRI in patients undergoing iterative procedures and the performance of imaging according to sites of recurrence need further evaluation.","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142184603","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}