Journal of Surgical Oncology最新文献

{"title":"Is Aspirin Safe for Thromboprophylaxis After Surgery for Lower Extremity Neoplastic Pathologic Fractures?","authors":"Matthew S Chen, Brandon S Gettleman, Kevin C Liu, Mary K Richardson, Arad Talehakimi, Nathanael D Heckmann, Lawrence Menendez, Alexander B Christ","doi":"10.1002/jso.27997","DOIUrl":"https://doi.org/10.1002/jso.27997","url":null,"abstract":"<p><strong>Background and objectives: </strong>Both malignancy and orthopedic surgery are known risk factors for developing venous thromboembolism (VTE). Therefore, this study aimed to compare VTE rates among patients receiving enoxaparin, apixaban, rivaroxaban, or aspirin (ASA).</p><p><strong>Methods: </strong>The Premier Healthcare Database was utilized to identify all patients who underwent surgery for neoplastic pathologic fractures of the lower extremities from 2015 to 2021. Four cohorts based on receipt of ASA, apixaban, enoxaparin, or rivaroxaban were identified. Propensity matching with the enoxaparin cohort as the comparator was performed. Patient demographics, hospital factors, comorbidities, and 90-day complications were compared.</p><p><strong>Results: </strong>From 2015 to 2021, 3762 patients underwent surgical intervention for neoplastic pathologic fracture of the lower extremities. Enoxaparin recipients showed significantly lower aggregate VTE rates than those on apixaban (p = 0.008) while exhibiting higher VTE occurrence than ASA-treated patients (p = 0.050).</p><p><strong>Conclusion: </strong>Our study demonstrates that the administration of enoxaparin in patients undergoing surgical intervention for neoplastic pathologic fractures of the lower extremities may lead to significantly higher rates of aggregate VTE postoperatively compared to ASA. This data suggests that further research is warranted to determine if surgeons may safely consider using ASA in patients with no other reported risk factors or need for anticoagulation postoperatively, even in active malignancy.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729757","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 Paradox of Wait and Watch after Total Neoadjuvant Therapy in Ugly Rectal Cancers.","authors":"Devesh S Ballal, Avanish P Saklani","doi":"10.1002/jso.28018","DOIUrl":"https://doi.org/10.1002/jso.28018","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716439","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":"Clinical Trial Access in Diverse Populations.","authors":"Tareefe Montaque, John Stewart","doi":"10.1002/jso.28010","DOIUrl":"https://doi.org/10.1002/jso.28010","url":null,"abstract":"<p><p>Despite the disproportionate impact of cancer on minority groups, their participation in oncologic clinical trials remains low. Contributing factors include mistrust of the medical establishment, structural barriers, and implicit bias. Strategies to improve access and representation include pragmatic trial designs, patient navigation programs, financial support, and increasing diversity among medical professionals. Addressing these issues is crucial for ensuring equitable healthcare delivery and improving outcomes for underrepresented populations in clinical research.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716419","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 \"Prognostic Impact of the Cholangiolar Component in Combined Hepatocellular-Cholangiocarcinoma: Insights from a Western Single-Center Study\".","authors":"Taifu You, Yunxia Zhang, Sheng Li","doi":"10.1002/jso.28021","DOIUrl":"https://doi.org/10.1002/jso.28021","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716430","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":"Late Survival and Long-Term Follow-Up After Radical Resection of Advanced Renal Cell Carcinoma With Associated Venous Tumor Thrombus.","authors":"Calvin L Chao, Nidhi K Reddy, Maxime Visa, Shilajit D Kundu, Mark K Eskandari","doi":"10.1002/jso.28020","DOIUrl":"https://doi.org/10.1002/jso.28020","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study evaluates the prognostic value of venous tumor thrombus (VTT) in patients with advanced renal cell carcinoma (RCC) undergoing radical resection and inferior vena cava (IVC) thrombectomy.</p><p><strong>Methods: </strong>Retrospective review of patients with radical nephrectomy for RCC and associated VTT (2000-2024). Patients were dichotomized into Neves 0-II (infrahepatic) and Neves III-IV groups (suprahepatic) IVC involvement for univariate analysis.</p><p><strong>Results: </strong>A total of 64 patients (34 Neves 0-II and 30 Neves III-IV) were analyzed. No significant differences in patient or cancer characteristics. Neves III-IV was associated with greater blood loss (> 2 L) (62.1% vs. 37.9%, p = 0.02), greater intensive care unit length of stay (LOS) (4.4 vs. 1.4 days, p = 0.02), and postoperative LOS (11.0 vs. 6.5 days, p = 0.005). Overall, 30-day mortality was only 1.6% with a mean follow-up of 56.1 months. Local recurrence was 7.8% and IVC patency 96.9%. One-year survival was 82.0%, 5-year survival was 58.4%, and 15-year survival was 42.5% without significant difference between Neves levels.</p><p><strong>Conclusions: </strong>Radical nephrectomy with VTT thrombectomy and primary IVC repair is safe with high early survival and low local recurrence. Extent of IVC tumor thrombus extension is not a poor prognostic factor for early or late survival.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729759","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":"Disparities in Breast Cancer Treatment and Reconstruction Among Native Hawaiian and Pacific Islander Women: Systematic Review and Meta-Analysis.","authors":"Antoinette Nguyen, Emily Duckworth, Danielle Pascua, Brigid Coles, Robert Galiano","doi":"10.1002/jso.27994","DOIUrl":"https://doi.org/10.1002/jso.27994","url":null,"abstract":"<p><strong>Background: </strong>Native Hawaiian and Pacific Islander (NHPI) women experience significant disparities in breast cancer treatment and outcomes, including lower rates of postmastectomy reconstruction, higher refusal rates of radiation therapy, and delays in surgical care. These disparities contribute to poorer survival and increased complications compared to other racial/ethnic groups. This systematic review and meta-analysis aim to quantify these disparities and assess their impact on breast cancer outcomes in NHPI women.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, Scopus, and Embase databases was conducted to identify studies reporting on breast cancer surgery, reconstruction, radiation therapy refusal, and surgical delays for NHPI women. Thirteen studies, encompassing a total of 5 546 918 patients, were included, and meta-analyses were performed to pool odds ratios (OR) and hazard ratios (HR) for key outcomes using random-effects models. Heterogeneity was assessed using I² statistics. Thematic analysis was also conducted to explore cultural and structural factors influencing treatment disparities.</p><p><strong>Results: </strong>NHPI women had significantly lower odds of receiving postmastectomy reconstruction compared to non-Hispanic White women (pooled OR = 2.02, 95% confidence interval [CI]: 1.96-2.08, I² = 99%). Delays in surgical care were more frequent, with NHPI women being 4.51 times more likely to experience delays (OR = 4.51, 95% CI: 3.82-5.32, I² = 99%). Radiation therapy refusal was notably higher, with a pooled hazard ratio of 3.28 (95% CI: 2.99-3.58, I² = 77%) indicating that NHPI women who refused radiation therapy had more than three times the risk of mortality compared to those who accepted it. Thematic analysis revealed that geographic isolation, limited access to specialized care, and cultural perceptions surrounding cancer treatments, including fear of radiation due to historical trauma, contributed significantly to treatment disparities.</p><p><strong>Conclusions: </strong>Native Hawaiian and Pacific Islander women face considerable barriers to receiving equitable breast cancer treatment and reconstruction, resulting in worse outcomes compared to other racial/ethnic groups. Efforts to address these disparities must focus on improving access to care, reducing treatment delays, and implementing culturally sensitive interventions. Targeted policies and healthcare system improvements, especially in geographically isolated areas, are critical to improving survival and treatment outcomes for NHPI women.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710478","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":"A Systematic Review and Meta-Analysis of Oncologic Liver Resections in Low- and Middle-Income Countries: Opportunities to Improve Evidence and Outcomes.","authors":"Adel H Khan, Omar Mahmud, Asad Saulat Fatimi, Shaheer Ahmed, Alyssa A Wiener, Madhuri V Nishtala, Christopher C Stahl, Leslie Christensen, Muhammad Rizwan Khan, Patrick B Schwartz, Syed Nabeel Zafar","doi":"10.1002/jso.27928","DOIUrl":"https://doi.org/10.1002/jso.27928","url":null,"abstract":"<p><strong>Background: </strong>Patients in low- and middle-income countries (LMICs) are disproportionately affected by liver cancers but there is a lack of understanding of their postoperative outcomes. This study aimed to review the current status of research in LMICs regarding outcomes after oncologic hepatectomy and synthesize the data reported in the literature.</p><p><strong>Methods: </strong>The PubMed, Scopus, Embase, Web of Science, and World Health Organization (WHO) Global Index Medicus databases were searched from database inception to May 26th, 2022. Studies that reported outcomes after oncologic hepatectomy in LMIC settings were eligible for inclusion. Two independent reviewers performed record screening and data extraction. Risk of bias assessment was performed using the National Institutes of Health Study Quality Assessment tools. Pooled results with 95% confidence intervals (95% CIs) were calculated using a random effects model.</p><p><strong>Results: </strong>One hundred and thirty-five studies and 16 985 patients were included. Most studies were of a \"fair\" quality. Two studies described pediatric patients. Only one study was from a low-income country and most African regions were not represented. The rates of major and minor complications were 11% and 27%, respectively, while 30- and 90-day mortality rates were 2% and 3% each. Postoperative liver failure (8%), surgical site infections (6%), and bile leaks (6%) were common complications.</p><p><strong>Conclusions: </strong>This review indicates a dearth of data from LMICs on outcomes after hepatectomy, particularly from African regions and low-income countries.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687197","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":"Oncoplastic Surgery: Where Are We Now?","authors":"Patricia Clark, Ashley DiPasquale, Daniela Cocco, Andrew Brown, Ashley Brown","doi":"10.1002/jso.27665","DOIUrl":"https://doi.org/10.1002/jso.27665","url":null,"abstract":"<p><p>In the 1970s, we learned breast conservation therapy (BCT) was not inferior to mastectomy. Early BCT methods could result in deformities that were unacceptable to patients and to their surgeons. By the 1990s, surgeons began to apply the principles of plastic surgery to improve outcomes. The term oncoplastic surgery was first described in the 1990s by Werner Audretsch. We offer a review of principles, techniques, current controversies, and challenges in broadening the utilization of OPS.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence Timing and Risk Following Curative Resection of Colorectal Liver Metastases: Insights From a Hazard Function Analysis.","authors":"Jun Kawashima, Miho Akabane, Yutaka Endo, Selamawit Woldesenbet, Abdullah Altaf, Andrea Ruzzenente, Irinel Popescu, Minoru Kitago, George Poultsides, Kazunari Sasaki, Federico Aucejo, Kota Sahara, Itaru Endo, Timothy M Pawlik","doi":"10.1002/jso.28007","DOIUrl":"https://doi.org/10.1002/jso.28007","url":null,"abstract":"<p><strong>Introduction: </strong>There is no consensus on the optimal surveillance interval for patients undergoing resection of colorectal liver metastases (CRLM). We sought to assess the timing and intensity of recurrence following curative-intent resection of CRLM utilizing a recurrence-free survival (RFS) hazard function analysis.</p><p><strong>Methods: </strong>Patients with CRLM who underwent curative-intent resection were identified from a multi-institutional database. The RFS hazard function was used to plot hazard rates and identify the peak of recurrence over time.</p><p><strong>Results: </strong>Among 1804 patients, the median RFS was 19.9 months. In the analytic cohort, the RFS hazard curve peaked at 5.9 months (peak hazard rate: 0.054) and gradually declined, indicative of early recurrence. In subgroup analyses, patients with high and medium tumor burden scores (TBS) had RFS hazard peaks at 4.9 months (peak hazard rate: 0.060) and 5.8 months (peak hazard rate: 0.054), respectively. In contrast, patients with low TBS had a later peak at 7.5 months, with the lowest peak hazard rate of 0.047.</p><p><strong>Conclusions: </strong>The recurrence peak for CRLM patients occurred approximately 6 months postsurgery, highlighting the need for intensified early postoperative surveillance. Patients with high TBS experienced earlier recurrence, underscoring the importance of close monitoring, particularly during the first 6 months after surgery.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687349","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":"Analysis of Risk Factors, Treatment Patterns, and Survival Outcomes After Emergency Presentation With Colorectal Cancer: A Prospective Multicenter Cohort Study in Nigeria.","authors":"Adeniyi S Aderibigbe, Anna J Dare, Hannah L Kalvin, Olalekan Olasehinde, Funmilola Wuraola, Adewale Adisa, Adeleye Dorcas Omisore, Akinwumi O Komolafe, Oluwatosin Zainab Omoyiola, Chukwuma Eze Okereke, Aba Katung, Adedeji Egberoungbe, Olufemi Ariyibi, Samuel Adegboyega Olatoke, Ademola Adetoyese Adeyeye, Sulaiman Olayide Agodirin, Matthew Olumuyiwa Bojuwoye, James Oluwaleke Fayenuwo, Oluwabusayomi Roseline Ademakinwa, Dapo Osinowo, Abdul-Razak Lawal, Fatimah B Abdulkareem, Debra Goldman, Gregory Knapp, Shilpa Murthy, Rivka Kahn, Mithat Gonen, T Peter Kingham, Olusegun I Alatise","doi":"10.1002/jso.27878","DOIUrl":"https://doi.org/10.1002/jso.27878","url":null,"abstract":"<p><strong>Background and objectives: </strong>Prospective data on presentation and outcomes of colorectal cancer (CRC) in Nigeria are limited; however, emergency presentation with advanced disease is thought common.</p><p><strong>Methods: </strong>Consecutive CRC patients presenting at six sites over 6 years were included. Risk factors for emergency presentation were evaluated using logistic regression methods. Overall survival (OS) was compared between emergent and elective patients using Kaplan-Meier methods and the log-rank test.</p><p><strong>Results: </strong>Of 535 patients, 30.7% presented emergently. Median age was 56 years, 55% were men, and 5.0% reported a cancer family history. Emergency patients had more proximal cancers (42.1% vs. 24.0%), Stage IV disease (61.6% vs. 40.2%; p < 0.001), lower household income (₦35 000/month vs. ₦50 000/month), lower education levels (p = 0.008) and accessed care with nonmotorized transport (50.6% vs. 37.2%; p = 0.005). Median OS was shorter in the emergency group (6.4 vs. 17.4 months; p < 0.001). Across clinical stages, emergency presentation was associated with worse OS (Stage IV median OS 4.8 vs. 9.4 months; p = 0.002). Surgery improved survival in both groups, although emergency patients had higher 30-day postoperative mortality (23.2% vs. 9.1%; p < 0.001).</p><p><strong>Conclusions: </strong>Emergent Nigerian CRC patients have worse OS than elective patients. Cancer control efforts should focus on faster cancer detection, early presentation, diagnosis, and treatment.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687272","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}