World Journal of Surgical Oncology最新文献

{"title":"Deciphering pancreatobiliary intraductal oncocytic papillary neoplasms: integrative analysis of histomorphologic patterns, immunophenotypic markers, and emerging molecular biomarkers.","authors":"Yingxian Qian, Shengwei Mo, Xiaoyan Chang","doi":"10.1186/s12957-025-03997-7","DOIUrl":"10.1186/s12957-025-03997-7","url":null,"abstract":"<p><strong>Purpose: </strong>We reviewed recent advancements in the characterization of intraductal oncocytic papillary neoplasm (IOPN) of the pancreas, with a specific focus on developments in immunohistochemical markers, molecular pathology, and pathogenic mechanisms over the past ten years (2015-2024). Through comprehensive analysis of current literature, we aimed to elucidate the evolving understanding of IOPN's biological behavior and diagnostic features, while identifying potential areas for future research in this distinctive pancreatic neoplasm.</p><p><strong>Methods: </strong>English-language articles on IOPN were searched from Pubmed from the first report of IOPN of the pancreas in 2015 to 2024.</p><p><strong>Results: </strong>Significant advancements have been achieved in IOPN research. Molecular investigations discover several immunohistochemical markers which may facilitate the diagnosis of IOPN, including CD117, HepPar-1. Significantly ATP1B1::PRKACA, DNAJB1::PRKACA and ATP1B1::PRKACB gene fusions are identified as molecular hallmarks of IOPN. These genetic alterations are believed to activate the cAMP-PKA signaling pathway, subsequently influencing mitochondrial substrates and contributing to the development of oncocytic features. The molecular signature not only enhances diagnostic specificity but also presents potential therapeutic targets. Furthermore, IOPN exhibits a unique tumor immune microenvironment characterized by elevated PD-L1 expression and substantial inflammatory cell infiltration. The invasive component showed decrease in CD4 + T cells and increase in CD8 + T cells and macrophages suggested the existence of an active immune surveillance, which partially explained why IOPN could have a better prognosis.</p><p><strong>Conclusions: </strong>IOPN exhibits distinct genetic alterations and a unique immune microenvironment. These features not only elucidate the mechanism underlying the relatively favorable prognosis of IOPN and IOPN-derived pancreatic cancers but also offer novel insights into immune regulation strategies for pancreatic cancer.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"333"},"PeriodicalIF":2.5,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008442","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":"Differences in survival outcomes between HER2-low and HER2-zero breast cancer across heterogeneous HR expression patterns: a real-world study.","authors":"Yi Zeng, Pengfei Qian, Guanhong Li, Yu Sun","doi":"10.1186/s12957-025-03962-4","DOIUrl":"10.1186/s12957-025-03962-4","url":null,"abstract":"<p><strong>Introduction: </strong>HER2-negative breast cancers can be further subclassified into HER2-low and HER2-zero subtypes. The DESTINY-Breast04 trial has established HER2-low as a research hotspot, with recent studies indicating superior survival rates in HER2-low patients than HER2-zero patients. The impact of heterogeneous hormone receptor (HR) expression patterns on HER2-negative breast cancer has not been comprehensively investigated. This study explored how varying ER and PR expression patterns affect survival rates in patients with HER2-negative breast cancer.</p><p><strong>Methods: </strong>This retrospective study comprised 648 HER2-negative breast cancer patients treated at our hospital between 2010 and 2023. Six subgroups were compared, including ER+/PR+/HER2-low, ER+/PR+/HER2-zero, single HR+/HER2-low, single HR/HER2-zero, ER-/PR-/HER2-low, and ER-/PR-/HER2-zero.</p><p><strong>Result: </strong>With disease-free survival and overall survival as primary endpoints, the cohort included 648 HER2-negative breast cancer patients. Compared to HER2-zero, HER2-low patients showed a higher proportion of ER positivity (q = 0.016). The ER+/PR + group exhibited a higher proportion of HER2-low, lower N stage, lower histological grade, and lower Ki-67% (p < 0.001), and were also more likely to achieve pCR after neoadjuvant therapy. In the overall population, HER2-low exhibited better survival outcomes. Compared to single HR+/HER2-low, ER+/PR+/HER2-low had longer DFS (p < 0.001). HER2-low is an independent prognostic factor for survival outcomes in HER2-negative patients.</p><p><strong>Conclusion: </strong>Our findings suggest that HER2-low breast cancer is associated with improved survival outcomes compared to HER2-zero breast cancer. HER2-low breast cancer exhibits different survival outcomes across different HR subgroups. These findings may guide future biomarker-driven treatment strategies in HER2-negative breast cancer.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"331"},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001447","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":"Recognition of molecular clusters and a novel prognostic signature based on natural killer cell-related genes in skin cutaneous melanoma.","authors":"Zhan-Yuan Yuan, Dehui Che, Zhiguo Yang, Yang Yang, Dongsheng Cao","doi":"10.1186/s12957-025-03975-z","DOIUrl":"10.1186/s12957-025-03975-z","url":null,"abstract":"<p><strong>Background: </strong>Skin cutaneous melanoma (SKCM) is the third most common type of cutaneous malignant tumor with a poor prognosis. This research aimed to recognize molecular clusters and develop a novel prognostic signature based on natural killer (NK) cell-related genes (NKCRGs) in SKCM.</p><p><strong>Methods: </strong>The data were obtained from public databases, including ImmPort, TCGA, GEO, GTEx and GEPIA2. The crucial NKCRGs in SKCM were determined by using a Venn diagram to intersect NKCRGs, differentially expressed genes and prognosis-related genes. The \"clusterProfiler\" software was employed to perform KEGG and GO analyses of crucial NKCRGs. The molecular subtypes were recognized based on crucial NKCRGs by consensus cluster analysis, and Kaplan-Meier survival curves of samples in different subtypes were performed by the \"survival\" package. Tumor microenvironment, drug sensitivity and somatic mutation analyses were conducted among different subtypes. A prognostic signature was constructed based on crucial NKCRGs by multiple machine learning algorithms. The core NKCRGs were identified by uni- and multi-variate Cox analyses, quantitative real-time PCR experiment, overall survival, immune cell infiltration, single-cell RNA sequencing and pan-cancer analyses.</p><p><strong>Results: </strong>32 crucial NKCRGs were identified in SKCM, and KEGG and GO analyses exhibited that these crucial NKCRGs were primarily related to NK cell-mediated cytotoxicity and immune system process. Two distinct clusters (C1 and C2) in TCGA-SKCM were recognized based on 32 crucial NKCRGs. Compared with C1, C2 presented higher expression levels of 32 crucial NKCRGs and higher overall survival (Log-rank, p < 0.0001). There were significant disparities between two clusters in both drug sensitivity and tumor microenvironment. TTN (78.7%) and MUC16 (72.7%) genes exhibited the highest mutation frequency and the RTK-RAS pathway had the highest proportion of affected samples in C1 and C2. A 12-NKCRG optimal prognostic signature was constructed by 13 combinations of 7 machine learning algorithms utilizing 32 crucial NKCRGs. Two core NKCRGs, CD247 and KIR2DL4, were identified in SKCM.</p><p><strong>Conclusion: </strong>This research demonstrated a novel molecular classification and prognostic signature based on NKCRGs in SKCM, which might be used to forecast the prognosis of SKCM and assist clinicians in making therapeutic strategies, and our results suggested that CD247 and KIR2DL4 might be valuable prognostic biomarkers and potential therapeutic targets for SKCM patients.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"332"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993642","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":"Correction: Knockdown of PVT1 inhibits cell proliferation in luminal and basal-like breast cancer subtypes by activating LATS2/Hippo signaling pathway.","authors":"Hai-Bo Zhang, Ying Zeng, Guo Wang","doi":"10.1186/s12957-025-03995-9","DOIUrl":"https://doi.org/10.1186/s12957-025-03995-9","url":null,"abstract":"","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"328"},"PeriodicalIF":2.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971395","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":"Prognostic significance of tumor spread through air spaces and lymphovascular invasion in stage I non-small cell lung cancer: implications for adjuvant chemotherapy.","authors":"Tai-Huang Lee, Chia-Yu Kuo, Yi-Wen Shen, Shih-Yu Kao, Yu-Wei Liu, Jui-Ying Lee, Cheng-Hao Chuang, Wei-An Lai, Chun-Chieh Wu, Mei-Shuan Lee, Jen-Yu Hung, Inn-Wen Chong, Chih-Jen Yang","doi":"10.1186/s12957-025-03980-2","DOIUrl":"https://doi.org/10.1186/s12957-025-03980-2","url":null,"abstract":"<p><strong>Objective: </strong>Tumor spread through air spaces (STAS) and lymphovascular invasion (LVI) have been associated with poor prognosis in stage I non-small cell lung cancer (NSCLC). This study aimed to evaluate the prognostic significance of STAS and LVI, and to investigate the impact of adjuvant chemotherapy (ACT) on survival outcomes in this patient population.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted including 392 patients with pathological stage I NSCLC who underwent surgical resection at two Kaohsiung Medical University-affiliated hospitals between 2016 and 2019. Patients were stratified into three groups: STAS-positive without LVI (STAS + LVI-), STAS-positive with LVI (STAS + LVI+), and STAS-negative (STAS-). Survival outcomes were analyzed using Kaplan-Meier methods and Cox proportional hazards models. Associations between tumor size, STAS, and LVI were evaluated using chi-square tests.</p><p><strong>Results: </strong>STAS was identified in 101 patients (25.8%), of whom 20 (19.8%) also exhibited LVI. The prevalence of both STAS and LVI increased significantly with tumor size (p < 0.0001 for both). STAS positivity was independently associated with inferior recurrence-free survival (RFS) (hazard ratio [HR] = 2.33, p = 0.021). Overall, ACT did not significantly improve survival in STAS-positive patients (p = 0.63). However, among patients with concurrent STAS and LVI, a trend toward improved 5-year RFS was observed with ACT (54.5% vs. 44.4%; p = 0.43). In contrast, ACT was associated with significantly worse RFS in STAS-negative patients (p = 0.024).</p><p><strong>Conclusions: </strong>STAS represents an independent adverse prognostic factor in stage I NSCLC, and conventional ACT appears to offer limited benefit in this group overall. Patients harboring both STAS and LVI may derive potential benefit from ACT, whereas STAS-negative patients may require careful evaluation to avoid overtreatment. These findings support the need for personalized, risk-adapted postoperative management strategies and warrant further prospective investigation.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"325"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971420","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":"Synovial sarcoma of the abdominal wall with two-stage laced free latissimus dorsi reconstruction of a full-thickness defect: a case report and literature review.","authors":"Fertani Yasmine, Malek Bouhani, Radhi Ben Naceur, Jaidane Olfa, Ghada Sahraoui, Ziadi Jalel, Ben Hassouna Jamel, Ben Dhiab Tarek","doi":"10.1186/s12957-025-03837-8","DOIUrl":"https://doi.org/10.1186/s12957-025-03837-8","url":null,"abstract":"<p><strong>Background: </strong>Sarcomas of the trunk and abdominal wall are rare and present unique challenges in both resection with free margins and reconstruction, particularly when the tissue loss is extensive. These tumors predominantly affect young, active individuals, posing a significant challenge for oncologists and plastic surgeons in preserving the patients' quality of life.</p><p><strong>Case presentation: </strong>We present the case of 23-year-old woman with no significant medical history. She was initially treated at a nonexpert center for a monophasic synovial sarcoma of the abdominal wall. After undergoing three lines of chemotherapy with no response, she was referred to our department, a sarcoma expert center, for debulking surgery in October 2020. Physical examination revealed a large, firm, and painful subcutaneous mass located in the left iliac fossa, extending into the flank. This mass was beneath a linear scar from prior enucleation surgery and measured approximately 25 cm. A full body CT scan confirmed that the mass was attached to the anterior abdominal wall, with no evidence of invasion into internal abdominal organs or metastatic spread. Because of the large size of the tumor and the consequent full-thickness defect of the anterior abdominal wall, surgical resectability depends on the success of the reconstructive surgery. Given the large tumor size and resulting full-thickness defect of the abdominal wall, the success of the surgical resection heavily relies on the effectiveness of the reconstructive surgery. We successfully performed a two-stage intervention, starting with a laced latissimus dorsi (LD) free flap transfer, followed by oncological resection seven days later. While this technique has been described for head and neck reconstruction, it is, to our knowledge, the first reported use in abdominal wall reconstruction.</p><p><strong>Conclusions: </strong>Surgical resection remains the cornerstone of treatment for synovial sarcoma, and the extent of resection should not be limited by concerns about defect restoration. The free latissimus dorsi flap, when utilized with careful surgical planning, is an effective option for reconstructing complex abdominal wall defects. This case highlights the importance of advanced reconstructive techniques in ensuring both oncological control and the preservation of the patient quality of life.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"327"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971486","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":"Clinical management and long-term outcomes in pulmonary inflammatory myofibroblastic tumor: a 12-Year experience with 14 surgically treated adult patients at a single center.","authors":"Wenhao Wang, Xuan Wang, Haoxin Liu, Dong Xu, Kaiheng Gao, Yulong Tan, Zhouyi Lu, Wan Posum, Meng Shi, Huijun Zhang, Xiaofeng Chen","doi":"10.1186/s12957-025-03973-1","DOIUrl":"https://doi.org/10.1186/s12957-025-03973-1","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary inflammatory myofibroblastic tumor (PIMT) is a rare, borderline mesenchymal neoplasm with unclear etiology. It carries recurrence risks but lacks robust data on surgical outcomes in adults. This study analyzes clinicopathological features and long-term results of surgically managed adult PIMT patients at a single center.</p><p><strong>Methods: </strong>A retrospective analysis of 14 adults (9 male, 5 female; mean age 47.6± 14.1 years) undergoing surgical resection for pathologically confirmed PIMT (2012-2023) at a single institution. All patients underwent video-assisted thoracoscopic surgery. Immunohistochemistry was systematically analyzed. The median follow-up for all patients was 53 months (range, 24-122 months).</p><p><strong>Results: </strong>Common presenting symptoms included cough (35.7%) , chest tightness (28.6%), and asymptomatic (28.6%). Mean tumor diameter was 3.1± 0.9 cm. Complete (R0) resection was achieved in all cases. No recurrence or metastasis was observed to the time of writing.</p><p><strong>Conclusion: </strong>PIMT is a rare tumor requiring pathological confirmation. Complete surgical resection (R0) via video-assisted thoracoscopic surgery is the preferred curative approach, demonstrating excellent long-term outcomes in this cohort with no recurrence or metastasis observed, but close surveillance is essential due to potential recurrence risk.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"324"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971428","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":"Revisiting the role of local treatments in the era of targeted therapy and immunotherapy for hepatocellular carcinoma.","authors":"Jia-Jia Du, Fan Yang, Wei Dong, Zun-Yi Zhang, Qi Cheng, Er-Lei Zhang","doi":"10.1186/s12957-025-03963-3","DOIUrl":"https://doi.org/10.1186/s12957-025-03963-3","url":null,"abstract":"<p><p>The advent of targeted therapy and immunotherapy has revolutionised the management of hepatocellular carcinoma (HCC) patients with all stages, dramatically improving their survival outcomes. Currently, radical resection is still the preferred first-line treatment for early-stage HCC, nevertheless, the surgical outcomes remain unsatisfactory due to high recurrence rate of 70% within 5 years after surgery. Moreover, up to two thirds of diagnosed HCC patients are in the advanced stages of the disease, exhibiting intrahepatic or extrahepatic metastases and vascular invasion. In recent years, the combination of surgical and other local treatments with targeted therapy and immunotherapy has dramatically improved the overall survival for HCC patients and also increased the complexity of HCC management, demanding a dynamic adaptation of the available staging-based strategies and flexible therapeutic allocation. In this review, we mainly elaborate the fundamental principles and recent advancements in the surgical management of locally advanced HCC, such as neoadjuvant, adjuvant and conversion therapy, as well as the regulatory effects of local treatments on targeted therapy and immunotherapy. Finally, the value of splenectomy for unresectable HCC patients with hypersplenism is also discussed.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"323"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971514","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":"Impact of intraoperative margin optimization strategies compared to standard breast-conserving surgery on oncologic outcomes: a systematic review and meta-analysis of randomized and prospective trials.","authors":"Wajahat Mirza, Muhammad Moaz, Muhammad Sajeel Turab, Hadi Mohammad Khan, Sundus Dadan, Saeeda Yasmin, Abdullah Khan Tareen, Hamza Hanif","doi":"10.1186/s12957-025-03959-z","DOIUrl":"10.1186/s12957-025-03959-z","url":null,"abstract":"<p><strong>Background: </strong>Achieving optimal surgical margins is critical in breast-conserving surgery (BCS) to reduce local recurrence (LR) and the need for re-excision. This meta-analysis evaluated the impact of intraoperative margin optimization strategies on key surgical and oncologic outcomes in patients who underwent BCS.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to the PRISMA guidelines, including six randomized controlled trials (RCTs). The outcomes assessed included the re-excision rate (primary outcome), positive margin rate, local recurrence (LR), and overall survival (OS). The risk of bias was evaluated using the ROB 2 tool, and the certainty of evidence was assessed using GRADE. The study protocol was prospectively registered in the PROSPERO database ( CRD420251000564 ).</p><p><strong>Results: </strong>Intraoperative margin optimization significantly reduced re-excision rates (OR 0.54, 95% CI 0.32-0.90), corresponding to 169 fewer re-excisions per 1,000 patients. Positive margin rates were also significantly lower (OR 0.40, 95% CI 0.22-0.73), translating to 139 fewer positive margins per 1,000 patients. No statistically significant differences were observed for LR (OR 0.72, 95% CI, 0.16-3.19) or OS (OR 0.87, 95% CI, 0.73-1.03).</p><p><strong>Conclusion: </strong>Intraoperative margin optimization effectively reduces positive margins and re-excisions in BCS without adversely affecting LR or OS. The incorporation of these strategies should be considered a standard practice to enhance surgical quality and patient outcomes.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"322"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971378","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":"Small bowel obstruction and ovarian cancer: insights from a propensity-score matched study in patients with and without hyperthermic intraperitoneal chemotherapy after cytoreductive surgery.","authors":"Luis Felipe Falla-Zuniga, Armando Sardi, Mary Caitlin King, Felipe Lopez-Ramirez, Vladislav Kovalik, Sergei Iugai, Teresa Diaz-Montes, Vadim Gushchin","doi":"10.1186/s12957-025-03968-y","DOIUrl":"https://doi.org/10.1186/s12957-025-03968-y","url":null,"abstract":"<p><strong>Background: </strong>Small bowel obstruction (SBO) affects ~ 30% of ovarian cancer (OC) patients, leading to readmission, debilitating symptoms, and death within one year. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) effectively controls peritoneal disease. We investigated primary CRS/HIPEC's impact on SBO and obstruction-free survival (OFS) in OC patients.</p><p><strong>Methods: </strong>A retrospective single-center cohort study of stage III/IV OC patients treated with primary optimal CRS (2014-2022) was performed. Patients who underwent upfront CRS/HIPEC vs. CRS only were matched for histology, age (> 65 years), extent of disease, FIGO stage, and surgery year, using a propensity scored full matching algorithm. CRS/HIPEC effect on OFS was determined using a weighted cox-regression model. OFS was measured from surgery to SBO/death.</p><p><strong>Results: </strong>Overall, 102 patients were included, 29 underwent CRS/HIPEC and 73 CRS only. CRS/HIPEC had higher median number of upper abdominal procedures (4 [IQR: 3-5] vs. 1 [IQR: 0-4], p < 0.01). Postoperative major morbidity was similar (p = 0.62). After a median follow-up of 88.8 months, SBO occurred in 24.1% (n = 7) CRS/HIPEC vs. 42.0% (n = 34) CRS only (p = 0.12). Most SBOs were partial (CRS/HIPEC: 71.4%, CRS: 55.9%) and managed conservatively (CRS/HIPEC: 71.4%, CRS: 67.6%). Median OFS was 42.9 vs. 20.0 months (HR: 0.50 [95% CI 0.27-0.93], p = 0.028). One-year survival after initial SBO was 85.7% vs. 44.7%, respectively (HR: 0.79 [95% CI 0.39-1.61], p = 0.512).</p><p><strong>Conclusions: </strong>SBO after upfront CRS/HIPEC for OC occurred less frequently, was delayed, and had lower 1-year mortality compared to CRS alone. CRS, which includes upper abdominal exploration/surgery, coupled with HIPEC could enhance long-term peritoneal disease control in OC patients.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"318"},"PeriodicalIF":2.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971458","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}