World Journal of Surgical Oncology最新文献

{"title":"SMARCA4-deficient non-small cell lung cancer with metastasis to the sigmoid colon: a case report.","authors":"Rong Xiao, Guang Fu, Xinglan Li, Tao Lu","doi":"10.1186/s12957-025-03757-7","DOIUrl":"10.1186/s12957-025-03757-7","url":null,"abstract":"<p><strong>Background: </strong>SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily a, member 4-deficient non-small cell lung cancer (SMARCA4-dNSCLC) is a rare subtype of NSCLC whose definitive radiographic characteristics have not yet been fully delineated. Clinically, these tumors often metastasize to distant organs and lymph nodes at an early stage, which is strongly associated with poor clinical prognosis. The common metastatic sites include bone, brain, adrenal glands, liver, and spleen, whereas intestinal metastasis is extremely rare. In this case, we describe a rare instance of SMARCA4-deficient NSCLC with metastasis to the sigmoid colon.</p><p><strong>Case description: </strong>A 59-year-old male presented with hoarseness and shortness of breath. Computed tomography (CT) imaging revealed an irregular mass in the posterior apical segment of the upper lobe of the left lung, with enlarged lymph nodes in the mediastinum and left lung hilum. A biopsy of the lung mass confirmed the diagnosis of NSCLC with SMARCA4 gene deletion. CT also revealed uneven thickening of the sigmoid colon wall, which was proved to be metastases from the lung cancer through surgical pathology. The patient initially underwent chemotherapy combined with immunotherapy and intensity-modulated radiotherapy for the lungs. However, a follow-up CT revealed progression in the sigmoid colon tumor. Consequently, the patient underwent laparoscopic radical sigmoid colectomy with regional lymph node dissection. Two months postoperatively, metastasis to the left adrenal gland was detected. The treatment regimen was adjusted to a combination therapy consisting of gemcitabine, nedaplatin, bevacizumab, and camrelizumab accordingly. The patient demonstrated a favorable response to this treatment, with no evidence of recurrence or further metastasis to date.</p><p><strong>Conclusions: </strong>This case represents the first reported instance of SMARCA4-dNSCLC with metastasis to the sigmoid colon. The atypical clinical and radiological features of this condition pose significant diagnostic challenges, particularly in differentiating metastatic lesions from primary colonic tumors. This case underscores the significance of recognizing rare metastatic patterns in SMARCA4-dNSCLC, enriching the literature on its diverse manifestations and providing a critical reference for clinicians in diagnosing and managing SMARCA4-dNSCLC with sigmoid colon metastasis.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"106"},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744059","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":"Completion of nodal dissection in cutaneous melanoma with metastatic sentinel nodes: Prognostic impact in a population-based cohort study.","authors":"Alessandra Buja, Massimo Rugge, Chiara Trevisiol, Anna Zanovello, Marcodomenico Mazza, Luigi Dall'Olmo, Manuel Zorzi, Antonella Vecchiato, Paolo Del Fiore, Carlo Riccardo Rossi, Simone Mocellin","doi":"10.1186/s12957-025-03762-w","DOIUrl":"10.1186/s12957-025-03762-w","url":null,"abstract":"<p><strong>Background: </strong>In primary cutaneous melanoma (CM) with metastatic sentinel lymph node(s) (SLNB), treatment strategies may include completing a regional lymph node dissection (CLND). The prognostic benefit of this therapeutic approach remains a topic of debate. This retrospective, population-based cohort study explores the prognostic impact of CLND in a real-world clinical setting.</p><p><strong>Methods: </strong>This study analysed 280 incident cases of AJCC stage III CM with metastatic SLNB, as recorded by the Veneto population-based Regional Cancer Registry in 2015, 2017, and 2019. The overall survival and CM-specific survival rates were compared between patients who underwent CLND and those who did not. Kaplan-Meier analysis, Cox regression, and Fine-Gray models for competing risks tested the relationship between lymphadenectomy and overall and CM-specific survival.</p><p><strong>Results: </strong>Among CM patients with metastatic SLNB, 199/280 (71.1%) proceeded with CLND. When compared to those who did not receive treatment, CLND did not demonstrate significant advantages in terms of overall survival and CM-specific survival rates. The cost analysis found no significant differences in treatment choice (estimated costs: €23,695.71 for the treated group and €25,003.55 for the untreated group [p = 0.69]).</p><p><strong>Conclusions: </strong>The present real-world data support omitting CLND in stage III CM with histologically documented sentinel nodal metastasis.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"111"},"PeriodicalIF":2.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744074","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":"Dexmedetomidine alleviates the pro-tumor activity of perioperative stress in tumor-bearing mice: an alternative approach of psycho-physiological intervention.","authors":"Shanqing Xu, Yongzhong Tang, Jianbin Tong","doi":"10.1186/s12957-025-03665-w","DOIUrl":"https://doi.org/10.1186/s12957-025-03665-w","url":null,"abstract":"<p><strong>Background: </strong>The immediate perioperative period (IPP) usually is highly stressful and has significant effects on the postoperative recurrence/metastasis of tumors. Effective methods for limiting the impact of the IPP on postoperative recurrence/metastasis of tumors remain scarce. We aimed to determine the effects of dexmedetomidine (DEX) treatment during the IPP on postoperative recurrence/metastasis of tumors and the stress response.</p><p><strong>Materials and methods: </strong>The clinical perioperative setting was mimicked via tumor resection and perioperative restraint stress in tumor-bearing mice with or without DEX during the IPP. The stress response was assessed using stress hormone and interleukin (IL)-6 levels in peripheral blood. Tumor cell growth was measured via in vivo bioluminescent imaging, cell viability assay, wound-healing assay, and Western blotting.</p><p><strong>Results: </strong>In tumor-bearing mice, DEX during the IPP limited the growth of implanted tumor cells and stress response in a dose-dependent manner. The serum from mice without DEX promoted cultured tumor cell growth, which was alleviated by beta-adrenergic receptor blocker propranolol or IL-6 antibody. Relative to the serum from mice without DEX, the serum from mice with DEX had lower stress hormone and IL-6 levels, as well as weaker effects on tumor growth promotion. Dexmedetomidine supplementation during culture had no significant effects on tumor cells.</p><p><strong>Conclusions: </strong>Dexmedetomidine alleviates the pro-tumor activity of perioperative stress in abdominal tumors.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"103"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744055","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":"Colorectal cancer at the anastomotic site following childhood surgery for hirschsprung disease: a rare case report.","authors":"Matthias Mehdorn, Philipp Rhode, Jan-Hendrik Gosemann, Katja Grunwald, Hans-Jonas Meyer, Martin Lacher, Sigmar Stelzner","doi":"10.1186/s12957-025-03754-w","DOIUrl":"https://doi.org/10.1186/s12957-025-03754-w","url":null,"abstract":"<p><strong>Background: </strong>The present case of a colorectal adenocarcinoma at the anastomotic site of a colorectal anastomosis after childhood surgery for Hirschsprung disease is a rare report of such pathology. Possibly, the altered anatomy after Duhamel procedure may pose a risk for carcinogenesis in those patients. The previously surgically opened plane of the mesorectal fascia, which is usually dissected during total mesorectal excision in rectal cancer, and the impossibility to differentiate from colon or rectal cancer in this case influence oncologic treatment strategies. Furthermore, the case highlights functional aspects of lower anterior resection syndrome before and after rectal cancer surgery with a coloanal anastomosis and how this influences quality of life.</p><p><strong>Case presentation: </strong>We report a rare case of a 54-year-old male with a history of Hirschsprung disease, treated with a Duhamel procedure during childhood, who developed colorectal cancer at the site of the colorectal anastomosis. The Duhamel procedure, a common surgical technique in Hirschsprung disease, involves creating a deep colorectal anastomosis with a retained rectal stump. The tumor, a moderately differentiated adenocarcinoma, was treated with total mesorectal excision and intersphincteric resection with a hand-sewn coloanal anastomosis and a loop ileostomy. Postoperative complications included paralytic ileus and urinary retention, but the ileostomy was successfully reversed. Despite increased LARS (lower anterior resection syndrome) scores postoperatively, the patient adapted well, reporting minimal impact on quality of life. In the short term of 1.5 years post-surgery, the patient is disease-free.</p><p><strong>Conclusion: </strong>This case highlights the need for awareness of potential colorectal cancer development in patients with a history of Hirschsprung disease and emphasizes the importance of individualized management and close surveillance strategies.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"105"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744072","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":"Predicting postoperative recurrence and survival in glioma patients using enhanced MRI-based delta habitat radiomics: an 8-year retrospective pilot study.","authors":"Xiumei Li, Lina Song, Haidong Zhang, Xianqun Ji, Ping Song, Junjie Liu, Peng An","doi":"10.1186/s12957-025-03760-y","DOIUrl":"https://doi.org/10.1186/s12957-025-03760-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop predictive models for postoperative recurrence and overall survival in patients with brain glioma (BG) by integrating preoperative contrast-enhanced MRI-derived delta habitat radiomics features with clinical characteristics.</p><p><strong>Methods: </strong>In this retrospective study, preoperative contrast-enhanced MRI data and clinical records of 187 BG patients were analyzed. Patients were stratified into non-recurrence (n = 100) and recurrence (n = 87) cohorts based on postoperative outcomes. The dataset was randomly divided into training and test sets (7:3 ratio). Delta habitat radiomic features were extracted from intratumoral and peritumoral edema regions. A radiomic score (Radscore) was generated via LASSO regression with ten-fold cross-validation in the training cohort. Clinical variables (gender, IDH1 mutation, 1p19q co-deletion, MRI enhancement patterns) and radiomic features were compared between groups using χ² or Student's t-tests. Multivariate logistic regression models incorporating significant predictors were developed. Model performance was evaluated using AUC comparisons (DeLong test), decision curve analysis (clinical utility), and validated via XGBoost machine learning. Nomograms were constructed to visualize recurrence and survival predictions.</p><p><strong>Results: </strong>The training cohort revealed significant intergroup differences in gender, IDH1 mutation, 1p19q co-deletion, MRI enhancement patterns, and delta habitat radiomic scores (Radscore1/2, p < 0.05). The combined model (clinical + radiomic features) demonstrated superior predictive performance for recurrence [AUC 0.921 (95% CI 0.861-0.961), OR 0.023, sensitivity: 87.18%, specificity: 82.03%] compared to clinical-only [AUC 0.802 (0.745-0.833), OR 0.036] and radiomic-only [AUC 0.843 (0.769-0.900), OR 0.034] models (p < 0.05, DeLong test). Decision curve analysis confirmed greater clinical net benefit for the combined model. These findings were replicated in the test cohort. The survival nomogram incorporated IDH1 mutation status, gender, and Radscore1/2, with Kaplan-Meier analysis verifying their prognostic significance (p < 0.01).</p><p><strong>Conclusion: </strong>Delta habitat radiomics derived from preoperative contrast-enhanced MRI may enhance the accuracy of postoperative recurrence and survival predictions in BG patients. The validated nomograms provide actionable tools for optimizing postoperative surveillance and personalized clinical decision-making.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"104"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744057","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":"A risk stratification model based on ultrasound radiologic features for cervical metastatic lymph nodes in papillary thyroid cancer.","authors":"Hai-Long Tan, Sai-Li Duan, Qiao He, Zhe-Jia Zhang, Peng Huang, Shi Chang","doi":"10.1186/s12957-025-03722-4","DOIUrl":"10.1186/s12957-025-03722-4","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative evaluation for metastatic lesions is significant for PTC patients. However, the stratification systems revealed inconsistencies in the ultrasound (US) features of cervical metastatic lymph nodes (LNs). This study aimed to investigate and develop a risk stratification model based on US radiologic features for cervical metastatic lesions in PTC patients.</p><p><strong>Methods: </strong>This study retrospectively enrolled 1806 LNs from 1665 PTC patients who underwent US-guided fine-needle aspiration biopsy for cervical LNs from January 2010 to December 2022. Univariable and multivariable logistic regression analyses determined and developed the independent risk US features and a risk stratification model for cervical metastatic LNs. The performance of the risk stratification model was assessed and validated by the Korean Society of Thyroid Radiology and the European Thyroid Association.</p><p><strong>Results: </strong>Among the 1806 LNs, 1411 LNs were pathologically diagnosed with malignant. Multivariate analysis indicated that the absence of fatty hilum, cystic components, round shape (SD/LD ≥ 0.5), abundant vascularity, hyperechogenicity (including hyper and hypo-echogenicity, and hyper-echogenicity), and calcifications (include microcalcification, and macrocalcification) were independent risk US features associated with malignant LNs. A risk stratification model for cervical metastatic LNs was developed based on these suspicious US features and showed well-predicted performance (C-index 0.840; 95% CI: 0.840-0.923).</p><p><strong>Conclusion: </strong>Our study proposed a new risk stratification system based on US radiologic features to predict cervical metastatic lymph nodes in PTC patients. We identified several risk factors for lymph node (LN) metastasis from PTC including the absence of fatty hilum, cystic components, round shape (SD/LD ≥ 0.5), abnormal vascularity, hyper-echogenicity, hyper- and hypo-echogenicity, microcalcification, and macrocalcification. These features could serve as valuable indicators for surgeons to accurately assess the status of cervical LNs.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"102"},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711013","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":"Does concomitant ductal carcinoma in situ influence the prognostic outcome after neoadjuvant therapy in triple-negative invasive ductal carcinoma?","authors":"Sicheng Zhou, Li Liang, Zehao Huang, Yue Teng, Wei Xing","doi":"10.1186/s12957-025-03753-x","DOIUrl":"10.1186/s12957-025-03753-x","url":null,"abstract":"<p><strong>Purpose: </strong>Ductal carcinoma in situ (DCIS) is considered a precursor to invasive ductal carcinoma (IDC), and the coexistence of DCIS with IDC is often observed during the diagnosis of breast cancer. The aim of study is to investigated the clinicopathological features and prognosis of triple-negative IDC with DCIS following neoadjuvant therapy (NAT). Additionally, we explored the risk factors for residual DCIS in these patients post-NAT.</p><p><strong>Methods: </strong>This study included patients with stages II-III triple-negative breast cancer with histologically confirmed IDC who underwent radical surgery after NAT between January 2011 and December 2021. Baseline data, clinical features, pathological outcomes, and prognostic information were collected and analyzed.</p><p><strong>Results: </strong>A total of 315 patients were enrolled and categorized into the IDC + DCIS (n = 67) and IDC groups (n = 248) according to the composition of the pre-NAT biopsy. The proportion of patients with histological grade G3 (78.2% vs. 61.2%, p = 0.004) and a Ki-67 index > 20% (98.4% vs. 86.6%, p < 0.001) was significantly higher in the IDC group than in the IDC + DCIS group. Although no significant difference was observed in the 5-year overall survival (OS) (93.4% vs. 90.8%, p = 0.298) between the two groups, the 5-year disease-free survival (DFS) (90.6% vs. 83.5%, p = 0.041) of the IDC + DCIS group was significantly better than that in the IDC group. Multivariate analysis demonstrated that IDC + DCIS (HR: 0.502; 95% CI, 0.284-0.952; p = 0.048) was an independent prognostic factor for DFS. In addition, the clinical T3-T4 stage (OR = 3.891; 95% CI, 1.320-15.219, p = 0.040) and clinical N1-N3 (OR = 4.500; 95% CI, 1.495-13.564, p = 0.012) were independent preoperative predictors of residual DCIS after NAT in patients with IDC and DCIS components.</p><p><strong>Conclusion: </strong>The presence of DCIS component in patients with triple-negative IDC is associated with lower tumor aggressiveness and improved DFS after NAT compared to patients without DCIS. Additionally, clinical T and N stages are risk factors for residual DCIS after NAT in patients with triple-negative IDC and a DCIS component.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"101"},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711114","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":"Modified Charlson comorbidity index of long-term, non-gastric cancer mortality in patients with early gastric cancer: a multicenter retrospective study.","authors":"Xiao Shi, Xiaoyi Shi, Yuxing Yan, Aixia Gong","doi":"10.1186/s12957-025-03741-1","DOIUrl":"10.1186/s12957-025-03741-1","url":null,"abstract":"<p><strong>Purpose: </strong>In patients with early gastric cancer (EGC) who undergo endoscopic submucosal dissection (ESD) with endoscopic curability (eCura) C-2, the risk of non-gastric cancer mortality should be evaluated before receiving further gastrectomy. Charlson comorbidity index (CCI) is often used to estimate prognosis based on patient's background before treatment. We identified the long-term risk of mortality from other causes associated with comorbidities in CCI and applied it to the creation of EGC specific CCI (GCCI).</p><p><strong>Methods: </strong>A total of 1810 patients with EGC from 3 centers were included from January 2015 to February 2023. We used Cox proportional risk models to determine the risk of non-gastric cancer mortality related to comorbidities and used these hazard ratios to reweight the Charlson index to establish GCCI.</p><p><strong>Results: </strong>The Cox model suggested that moderate to severe liver disease, metastatic solid tumors, severe to very severe chronic obstructive pulmonary disease (COPD), and leukemia had the highest risk of non-gastric cancer mortality [hazard ratio (HR) > 5)]. Survival analysis showed that the 5-year non-gastric cancer mortality rates in low-risk group (GCCI score 0-1), medium-risk group (GCCI score 2-4), and high-risk group (GCCI score 5-13) were 3%, 10%, and 52%, respectively.</p><p><strong>Conclusions: </strong>GCCI could identify patients with EGC who have higher non-gastric cancer mortality. The GCCI could be used to help patients with EGC make medical decisions.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"100"},"PeriodicalIF":2.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700974","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":"PDCA cycle and safety culture in nursing safety management of Day Ward chemotherapy.","authors":"Xia Chen","doi":"10.1186/s12957-025-03738-w","DOIUrl":"10.1186/s12957-025-03738-w","url":null,"abstract":"<p><strong>Objective: </strong>The PDCA cycle, also known as the PDCA (Plan-Do-Check-Act) cycle, is a well-established continuous quality improvement framework. This study aimed to evaluate the impact of implementing a nursing safety management strategy grounded in the PDCA cycle and safety culture principles in the context of Day Ward chemotherapy.</p><p><strong>Methods: </strong>This a prospective group comparison study (cohort comparison) based on principles of randomization. A total of 120 patients receiving intravenous chemotherapy at the Day Ward of Nantong First People's Hospital from January 2023 to December 2023 were recruited as research participants. They were randomly assigned to either a control group or a study group, which were managed using the conventional nursing quality management approach and the PDCA cycle-based safety culture management method, respectively. The primary outcomes measured were nursing satisfaction, chemotherapy-related symptom burden, and the incidence of total implantable venous access port catheter (TIVAP)-related adverse events.</p><p><strong>Results: </strong>After three months, the study group showed significantly lower scores on all MSAS-SF subscales (GDI: 1.05 ± 0.33, PHYS: 0.69 ± 0.35, PSYCH: 1.15 ± 0.42, TMSAS: 2.62 ± 0.34) compared to the control group (GDI: 1.22 ± 0.47, PHYS: 0.85 ± 0.32, PSYCH: 1.43 ± 0.73, TMSAS: 2.81 ± 0.36) (all P < 0.05). Nursing satisfaction was higher in the study group (95.00%) than in the control group (78.33%) (P < 0.05). Quality of life scores improved more in the study group (74.9 ± 9.2) than in the control group (68.2 ± 10.5) (P < 0.01). The study group also had fewer TIVAP-related adverse events (6.67%) compared to the control group (24.67%) (P < 0.05).</p><p><strong>Conclusion: </strong>The adoption of a nursing safety management model rooted in the PDCA cycle and safety culture principles can effectively improve nursing quality and satisfaction, alleviate patient symptoms and enhance quality of life in the context of Day Ward chemotherapy. These findings underscore the merit of further disseminating and studying this management approach in nursing practice.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"99"},"PeriodicalIF":2.5,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693513","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":"Safety and efficacy of pancreaticogastrostomy for hepatopancreatoduodenectomy compared to pancreaticojejunostomy for perihilar cholangiocarcinoma.","authors":"Yutaka Nakano, Yuta Abe, Daisuke Udagawa, Minoru Kitago, Yasushi Hasegawa, Shutaro Hori, Masayuki Tanaka, Sho Uemura, Masanori Odaira, Kisyo Mihara, Ryo Nishiyama, Naokazu Chiba, Shigeo Hayatsu, Shigeyuki Kawachi, Yuko Kitagawa","doi":"10.1186/s12957-025-03737-x","DOIUrl":"10.1186/s12957-025-03737-x","url":null,"abstract":"<p><strong>Background: </strong>Hepatopancreatoduodenectomy (HPD) is one of the most challenging surgeries for perihilar cholangiocarcinoma. Postoperative pancreatic fistula (POPF) is a critical and fatal complication. The safety and efficacy of pancreaticogastrostomy (PG) for HPD compared to pancreaticojejunostomy (PJ) remain unclear. In this study, we aimed to investigate and compare the short-term outcomes of PG and PJ for HPD in terms of the POPF rate.</p><p><strong>Methods: </strong>Two groups of patients (PG group vs. PJ group) were retrospectively compared between January 2013 and January 2024. The reconstruction method was changed from PJ to PG in March 2021.</p><p><strong>Results: </strong>A total of 50 patients were enrolled in this study. The PG and PJ groups comprised 15 (30.0%) and 35 (70.0%) patients, respectively. In the PJ group, three (8.6%) patients died after surgery because of clinically relevant POPF (CR-POPF), intraabdominal bleeding, and post-hepatectomy liver failure. The operative time was longer in the PG group (909 min vs. 706 min, P = 0.020); however, the CR-POPF rate was lower in the PG group than in the PJ group (0 [0%] vs. 19 [54.3%], P < 0.001). Moreover, the number of patients who developed massive postoperative ascites (≥ 1,500 mL/day) was lower in the PG group than in the PJ group (3 [20.0%] vs. 16 [45.7%] patients, P = 0.028).</p><p><strong>Conclusions: </strong>Changing the method of pancreatic reconstruction for HPD from PJ to PG improved the short-term outcomes of patients at our institution. PG reconstruction is safe and effective for HPD as it reduces the incidence of CR-POPF.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"97"},"PeriodicalIF":2.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670091","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}