Journal of Surgical Oncology最新文献

{"title":"Modified Frailty Index Predicts Prognosis in Patients With Gastric Cancer After Gastrectomy: A Systematic Review and Meta-Analysis.","authors":"Xinyao Zhou, Yunlan Jiang, Heyao Xu, Siyu Lin, Ting Xu, Xiaodi Bai, Shulan Liu","doi":"10.1002/jso.28136","DOIUrl":"https://doi.org/10.1002/jso.28136","url":null,"abstract":"<p><strong>Background: </strong>The predictive ability of the modified frailty index (mFI) for postoperative outcomes and survival in patients with gastric cancer (GC) remains uncertain.</p><p><strong>Methods: </strong>Studies were retrieved from 11 electronic databases. Odds ratio (OR) and 95% confidence intervals (CIs) were used to report surgical outcomes, including overall survival (OS), complications, mortality, readmission, and nonhome discharge. The fixed or random effects model was used depending on the heterogeneity. Subgroup and meta-regression analyses were performed to determine the source of heterogeneity.</p><p><strong>Results: </strong>This meta-analysis of 13 studies, including 15 359 GC patients, showed that high mFI scores were associated with reduced OS (OR = 1.35) and increased risk of poor postoperative outcomes (OR = 2.61). The older patients with higher mFI scores had a higher risk of worse OS after gastrectomy (OR = 1.69).</p><p><strong>Conclusions: </strong>This study demonstrated that high mFI scores were strongly associated with reduced OS and increased risk of poor outcomes following surgery in patients with GC, with a more than two-fold increase in the overall risk of poor outcomes. Compared to other tools, the mFI is easy to operate, making it an effective tool for prognosis assessment and personalized treatment and care planning.</p><p><strong>Trial registration: </strong>PROSPERO (Registration Number: CRD42024613727).</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004925","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":"Indocyanine Green Fluorescence Angiography Versus Visual Assessment for Assessing Perfusion of Gastric Conduit and Esophageal Stump in Post Esophagectomy Patients: A Pilot Randomized Controlled Study.","authors":"Subramanyeshwar Rao Thammineedi, Sujit Chyau Patnaik, Pratap Reddy, Ajesh Raj Saksena, Srijan Shukla, Makayla E Schissel, Lynette M Smith, Chandrakanth Are, Syed Nusrath","doi":"10.1002/jso.28145","DOIUrl":"https://doi.org/10.1002/jso.28145","url":null,"abstract":"<p><strong>Background and objective: </strong>Anastomotic leak (AL) is a serious complication following esophagectomy and is often linked to poor perfusion of the gastric conduit (GC) and esophageal stump (EC). The aim of this study is to compare the efficacy of intraoperative Indocyanine green fluorescence angiography (ICG-FA) versus visual assessment VA) to assess perfusion status and its impact on the rate of AL.</p><p><strong>Methods: </strong>Fifty-eight esophageal or gastroesophageal junction carcinoma patients were randomized to ICG-FA (28) and VA (30) groups. Perfusion status was assessed with VA alone in the VA group and with VA followed by ICG-FA in the ICG-FA group.</p><p><strong>Results: </strong>The ICG-FA group had a lower leak rate of 4% when compared to 27% in the VA group (p = 0.03). ICG-FA identified nine cases where VA misjudged the GC tip vascularity, thereby avoiding unnecessary resections. ICG-FA necessitated revision of the GC tip in one case missed by VA and also identified poor perfusion of ES tip in three cases mandating revision which were deemed well-perfused by VA.</p><p><strong>Conclusion: </strong>ICG-FA demonstrated superiority over VA in assessing perfusion adequacy of the GC and ES, which resulted in a statistically significant decrease in the rate of anastomotic leaks.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026518","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":"Effects of Mobilization Within 24 Hours Based on the ICU Mobility Scale in Cancer Patients: A Randomized Controlled Clinical Trial “Mobilization Based on the ICU Mobility Scale”","authors":"Flaviana Santos de Sousa Silva,&nbsp;Giérisson Brenno Borges Lima,&nbsp;Gabriel Santos de Castro e Lima,&nbsp;Denise Carvalho Torres,&nbsp;Michel Monteiro Macedo,&nbsp;Carlos Eduardo Neves Amorim","doi":"10.1002/jso.28142","DOIUrl":"10.1002/jso.28142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Abdominal cancer surgery leads to loss of functional capacity. The objective was to evaluate the effects of mobilization within 24 h applied to patients with abdominal neoplasms undergoing major surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomized controlled clinical trial was carried out in the Intensive Care Unit. The intervention group performed mobility activities guided by the ICU mobility scale (IMS) in the first 24 h after surgery and the control group performed conventional physiotherapy. Dynamometry was evaluated in the preoperative, 1st POD and postoperative period, as well as the Timed up and go test (TUG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the intervention group had greater initial mobility (IMS Scale intervention group: 6.67 ± 0.69; IMS Scale control group: 2.23 ± 0.52; <i>p</i> = 0.001). There was greater level of mobility until discharge from the ICU in patients in the intervention group compared to the control group (IMS at discharge from the ICU in the intervention group: 8.53 ± 0.33; IMS at discharge from the ICU in the control group: 3 ± 0.64). Both groups showed worsening in the TUG test, but it was significant only in the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Early mobilization in patients with abdominal neoplasms undergoing major surgery proved to be effective in maintaining mobility and functional markers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1583-1590"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.28142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of Deleterious Genetic Mutations in Newly Diagnosed Breast Cancer Patients Over the Age of 65: Is It Time to Expand Testing Parameters?","authors":"Gwendolyn E. Daly,&nbsp;Krystle L. Collins,&nbsp;Susan E. Malone,&nbsp;Jennifer Garreau,&nbsp;Nathalie Johnson","doi":"10.1002/jso.28151","DOIUrl":"10.1002/jso.28151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>National Comprehensive Cancer Network guidelines do not recommend routine genetic testing for women &gt; 65 with newly diagnosed breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective review of data from the Legacy Cancer Institute Tumor Registry of women with a new diagnosis of breast cancer between January 2017 and December 2022. Primary endpoint was the incidence of deleterious mutation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>4548 women with a diagnosis of breast cancer were identified. 2059/4548 (45.3%) were older than 65 at the time of diagnosis. 42.8% of women &gt; 65 (881/2059) received genetic testing compared to 74.1% (1844/2489) who were ≤ 65 (<i>p</i> &lt; 0.0001). In the cohort &gt; 65 who received genetic testing, 107/881 had at least one deleterious mutation (12.1%) compared to 258/1844 women ≤ 65 (14.0%) (<i>p</i> = 0.2). 70/128 (54.7%) patients &gt; 65 with triple negative breast cancer (TNBC) received genetic testing compared to 182/206 ≤ 65 (88.3%) (<i>p</i> &lt; 0.0001). The rate of detection of deleterious mutations in the &gt; 65 group with TNBC was slightly higher than the younger age group (25.7% (18/70) versus 21.4% (39/182), <i>p</i> = 0.45).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions/Discussion</h3>\u0000 \u0000 <p>The incidence of actionable deleterious mutations among women &gt;65 with newly diagnosed breast cancer may be higher than previously reported, warranting consideration of genetic testing for all breast cancer patients regardless of age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1493-1498"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026793","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":"Optimizing Lymphedema Management After Breast Cancer: Predictive Risk Models in Clinical Practice","authors":"Enrique Cano-Lallave,&nbsp;Elisa Frutos-Bernal,&nbsp;María Anciones-Polo,&nbsp;Esther Serrano-Sánchez,&nbsp;Ian Rodríguez-Guerrero,&nbsp;Paula Cuenda-Gamboa,&nbsp;Luis Muñoz-Bellvis,&nbsp;Marta Eguía-Larrea","doi":"10.1002/jso.28146","DOIUrl":"10.1002/jso.28146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Lymphedema secondary to multimodal breast cancer treatment is a relatively common complication that significantly impacts patients' quality of life. Despite identifying several associated risk factors, accurately assessing individual risk remains challenging. This study aims to develop predictive tools integrating patient characteristics, tumor attributes, and treatment modalities to optimize clinical surveillance, enhance prevention, and enable earlier diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were analyzed from 309 patients referred to the Lymphedema Unit of Rehabilitation Service who underwent lymphadenectomy for breast cancer between January 2016 and December 2021. Collected variables included patient demographics, tumor clinicopathological features, and treatment details. A lymphedema incidence study was conducted, complemented by univariate and multivariate regression analyses to identify risk factors. A nomogram was developed to predict high-risk patients, facilitating personalized prevention and management strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cumulative incidence of lymphedema was 18.4%. Independent risk factors included high body mass index, sedentary lifestyle, number of positive nodes (N stage), and radiotherapy, particularly targeting the breast, axilla, and supra-infraclavicular regions. The logistic regression model demonstrated an area under the ROC curve (AUC) of 0.75, with acceptable calibration, validating the predictive model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The predictive tools developed provide healthcare professionals with a means to identify patients at elevated risk of lymphedema, supporting individualized prevention and management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1628-1636"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.28146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Cost-Effective Strategies for Asymptomatic Microhematuria Diagnosis: A Risk-Based Alternative to the American Urological Association Guidelines","authors":"Krishay Sridalla,&nbsp;Hiten D. Patel,&nbsp;Dustin D. French,&nbsp;Joshua J. Meeks,&nbsp;Lili Zhao,&nbsp;Yuying Xing,&nbsp;David J. Bentrem","doi":"10.1002/jso.28148","DOIUrl":"10.1002/jso.28148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>The American Urological Association (AUA) guidelines recommend evaluating asymptomatic microhematuria (MH) at ≥ 3 red blood cells per high powered field (RBCs/hpf), resulting in significant costs with limited bladder cancer detections. This study evaluates alternative diagnostic strategies to improve the cost-effectiveness of asymptomatic MH evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The cost-effectiveness analysis compared three alternative strategies: Strategy 1 (cystoscopy at ≥ 26 RBCs/hpf) was compared to a 3 RBCs/hpf threshold, while Strategy 2 (cystoscopy and renal ultrasound at ≥ 3 RBCs/hpf) and Strategy 3 (cystoscopy and renal ultrasound at ≥ 26 RBCs/hpf) were compared to the AUA guidelines. Total costs, cost per patient evaluated, costs per cancer detected, and incremental cost-effectiveness ratios (ICERs) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Strategy 3 minimized costs without significantly reducing early cancer detection rates. It was cost-effective for females (ICER = $120,649) and the total sample (ICER = $50,648) but not specifically for males (ICER = $23,326). Strategies 1 and 2 yielded lower cost savings and were less efficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Strategy 3—performing cystoscopy and renal ultrasound for higher-risk patients ( ≥ 26 RBCs/hpf)—offers a more cost-effective approach than the AUA guidelines, particularly for women. Future studies should incorporate additional patient variables and diagnostic test characteristics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1661-1669"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.28148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Rates of New Colon Neoplasm in Interval vs. Primary Appendectomies—A Coarsened Exact Matching Analysis","authors":"Anneliese Markus,&nbsp;Rachel Lippman,&nbsp;Adam H. Abbas,&nbsp;Csaba Gajdos,&nbsp;Nader D. Nader","doi":"10.1002/jso.28138","DOIUrl":"10.1002/jso.28138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>While there is low risk of emergent appendectomy patients becoming diagnosed with a neoplasm, the rates are much higher in patients undergoing interval appendectomies. This study compares the incidence rates of new primary right colon neoplasms and postoperative complications between interval and primary appendectomies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study from 2001 to 2020 involving patients from 92 healthcare organizations within TriNetX. Patients' diagnosis and procedure were extracted from ICD and CPT codes. Primary and interval appendectomy (IA) cohorts were defined as having an appendectomy procedure 0–14 and 15–90 days from the initial diagnosis, respectively. Patients in each cohort were matched 1:1 on demographics via Coarsened Exact Matching (CEM). Postoperative complications and oncological outcomes were defined by specific ICD and/or CPT codes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-matching, there were 2803 patients included in each cohort. IA patients were associated with 3.07 times greater incidence rates of malignant neoplasm of the right colon and appendix (<i>p</i> &lt; 0.001). However, IA patients were associated with 2.63 times lower postoperative complication rates (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IA patients are more likely to be diagnosed with new right-sided neoplasms postoperatively. Future studies are necessary to determine appropriate cancer screening methods for IA candidates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1642-1650"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989193","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":"What Are the Long-Term Clinical and Functional Outcomes After Hemicortical Allograft Reconstruction for Primary Bone Tumors?","authors":"Marcos R. Gonzalez,&nbsp;Erhan Okay,&nbsp;Joseph O. Werenski,&nbsp;Joseph J. Connolly,&nbsp;Andrew Pfeiffer,&nbsp;Erik T. Newman,&nbsp;Kevin A. Raskin,&nbsp;Santiago A. Lozano-Calderón","doi":"10.1002/jso.28147","DOIUrl":"10.1002/jso.28147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hemicortical allograft reconstruction is associated with low short-term complication rates and excellent functional outcomes. However, data on their long-term complication profile and patient-reported outcomes is scarce to non-existent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with hemicortical resection and allograft reconstruction for primary bone tumors were included. The Henderson classification for biologic reconstruction was used to classify allograft failures. Functional outcomes at a minimum of 10 years postoperatively were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-four patients with femur hemicortical allograft and 20 with tibia allograft were included. Allograft failure and reoperation occurred in 39% and 52% of patients, respectively. The main causes of allograft failure were infection, soft-tissue failure, and structural failure (9% each). Tibia allografts had a higher rate of failure due to infection (<i>p</i> = 0.02) and nonunion (<i>p</i> = 0.049) compared to femur allografts. There were no differences in allograft failure-free survival based on bone (tibia vs. femur) and osteosynthesis type (plate vs. screw and plates). Median TESS-LE and LEFS scores were 98.8% and 87.5% for tibia allografts, and 98.1% and 97.5% for femur allografts, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Long-term allograft failure-free survival was excellent, with infection and soft-tissue failures as the main failure mechanisms. At last follow-up, patients who still had the hemicortical allograft displayed excellent functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1670-1678"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988966","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":"Neoadjuvant Immunotherapy for Resectable Dedifferentiated Liposarcoma: A National Cohort Analysis","authors":"Mohammad S. Farooq,&nbsp;Neha Shafique,&nbsp;Gracia M. Vargas,&nbsp;Jennifer Guo,&nbsp;John T. Miura,&nbsp;Daniel S. Lefler,&nbsp;Giorgos C. Karakousis","doi":"10.1002/jso.28155","DOIUrl":"10.1002/jso.28155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neoadjuvant immunotherapy (NIT) with checkpoint blockade has been increasingly studied for soft tissue sarcomas, however, survival outcomes data are limited, and dedifferentiated liposarcoma (DDLPS) histology remains underrepresented in recent trial cohorts. We assessed the impact of NIT with or without radiation therapy (RT) on overall survival (OS) for resectable DDLPS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Cancer Database (NCDB) was used to identify patients diagnosed with nonmetastatic DDLPS who received NIT and underwent surgical resection between 2016 and 2022. Primary outcome was 5-year OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3414 patients with DDLPS met the inclusion criteria and NIT was administered to 31 (1%) patients. Factors associated with receipt of NIT were receipt of neoadjuvant RT (NRT, odds ratio [OR]: 5.75, <i>p</i> &lt; 0.001) and male sex (OR: 3.33, <i>p</i> = 0.036). NIT was associated with a hazard ratio (HR) for mortality of 0.89 (<i>p</i> = 0.786). No difference was found in 5-year OS in the overall cohort (NIT 72% vs. 61% no NIT, <i>p</i> = 0.320) or in the propensity-matched cohort (68% vs. 65%, <i>p</i> = 0.848). Subanalysis between NIT with NRT versus NRT-only also did not find any significant difference in 5-year OS (88% vs. 59%, <i>p</i> = 0.331).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this retrospective NCDB analysis of patients with resectable DDLPS, administration of NIT did not significantly affect OS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1683-1691"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.28155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of Additional Liposuction in Lymphatic Reconstructive Surgery","authors":"Lisanne Grünherz,&nbsp;Nick Ferrer,&nbsp;Carlotta Barbon,&nbsp;Carmen Elena Zurfluh,&nbsp;Epameinondas Gousopoulos,&nbsp;Semra Uyulmaz,&nbsp;Pietro Giovanoli,&nbsp;Nicole Lindenblatt","doi":"10.1002/jso.28134","DOIUrl":"10.1002/jso.28134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>The goal of this study was to examine the benefits of immediate adjunctive liposuction in patients undergoing lymphatic reconstructive surgery with a focus on complications, limb volume, and patient-reported outcome measurements (PROMs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center prospective study on patients receiving reconstructive lymphatic surgery at the Department of Plastic Surgery and Hand Surgery of the University Hospital Zurich. Besides patients characteristics and operation details, volume measurements and PROMs were assessed pre- and postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 73 patients with upper extremity lymphedema (UEL) or lower extremity lymphedema (LEL). A total of 41 patients received lymphatic reconstruction only, while in 32 patients, an additional liposuction in case of fat accumulation was performed. Mean percentage volume reduction for all limbs was −10.1% (±10.0%) in UEL and −9.3% (±6.9%) in LEL. Volume reduction in the additional liposuction group was not statistically different from reconstruction only. Although patients with liposuction had a significantly lower hemoglobin postoperatively (<i>p</i> = 0.03), there was no difference in length of rehabilitation. Regardless of the surgical technique, PROMs confirmed improvements in a broad range of different domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Combining reconstructive lymphatic surgery with immediate liposuction is effective for patients with a significant lymphedema-associated fat accumulation without increasing postoperative complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"131 8","pages":"1620-1627"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041333","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}