World Journal of Surgical Oncology最新文献

{"title":"The predictive value of multidimensional frailty instruments for postoperative adverse outcomes in cancer patients: a systematic review and meta-analysis.","authors":"Yue Chen, Shulin Song, Ziyan Wang, Yinning Guo, Zhongmin Fu, Ting Xu, Yi Chen, Zhichao Jiang, Lingyu Ding, Qin Xu","doi":"10.1186/s12957-026-04365-9","DOIUrl":"https://doi.org/10.1186/s12957-026-04365-9","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the predictive performance of Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), and Edmonton Frailty Scale (EFS) for adverse outcomes including postoperative complications, unplanned readmission, 30-day mortality, prolonged length of stay among cancer patients.</p><p><strong>Materials and methods: </strong>A comprehensive search was conducted across English and Chinese databases until October 2, 2025. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 tool. Predictive performance was evaluated by pooling sensitivity, specificity, and summary receiver operating characteristic curves.</p><p><strong>Results: </strong>There were 21 studies (4,435 individuals) that were included for the meta-analysis. TFI demonstrated pooled sensitivities of 0.64 (for postoperative complications), 0.77 (for unplanned readmission), and 0.50 (for prolonged hospital stay), with corresponding specificities of 0.67, 0.54, and 0.64 respectively. The areas under the curve (AUC) were 0.70, 0.71, and 0.60. GFI demonstrated sensitivities of 0.59, 0.65, and 0.55 for complications, 30-day mortality, and functional decline, with specificity of 0.73, 0.63, and 0.77, and the AUC of 0.71, 0.68, and 0.74. EFS had sensitivity 0.39, specificity 0.87, and AUC 0.57 for complications. Subgroup analysis revealed that TFI had reasonable predictive value for adverse outcomes with sensitivity 0.61-0.81 and specificity 0.60-0.68 among most gynecological and gastrointestinal cancer subgroups. In most subgroups, GFI showed higher specificity (0.64-0.84) relative to sensitivity (0.43-0.68).</p><p><strong>Conclusion: </strong>TFI and GFI demonstrated moderate predictive validity for adverse outcomes, whereas EFS exhibited poor predictive performance. These findings highlight the necessity for caution interpretation of frailty assessments in clinical practice and underscore the importance of further validating these tools within diverse oncological contexts.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821563","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":"Nomogram predicting outcomes in HCC patients treated with TACE-HAIC, TKIs, and PD-1 inhibitors.","authors":"Jie Chen, Yangdingxin Li, Yong Wang, Yan Li, Junbiao Li, Yuxiang Yuan, Chaoqian Wang, Wei Xu","doi":"10.1186/s12957-026-04342-2","DOIUrl":"https://doi.org/10.1186/s12957-026-04342-2","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop and validate a prognostic nomogram to predict overall survival (OS) in patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) undergoing multimodal therapy, combining transarterial chemoembolization, hepatic arterial infusion chemotherapy, tyrosine kinase inhibitors, and programmed death-1 inhibitors.</p><p><strong>Methods: </strong>A retrospective analysis included 193 patients with BCLC stage C HCC treated at Xuzhou Medical University Affiliated Hospital between February 2021 and February 2024. Patients were randomly divided into a training cohort (n = 135) and a validation cohort (n = 58). Independent prognostic factors were identified via Cox regression analysis. A nomogram was developed and evaluated using the concordance index (C-index), time-dependent receiver operating characteristic curves, calibration plots, and decision curve analysis. Risk stratification was performed using X-tile software.</p><p><strong>Results: </strong>The median OS was 402 days. Multivariate analysis identified ALBI grade (HR [Hazard Ratio] = 10.09-19.63), maximum tumor diameter ≥ 5 cm (HR = 2.69), multiple tumors (HR = 2.59), and vascular invasion (HR = 2.74) as independent predictors of OS. The nomogram demonstrated strong discriminatory performance, with C-indices of 0.788 in the training cohort and 0.805 in the validation cohort. The time-dependent AUCs for 1-year and 1.5-year OS were 0.879 and 0.887 in the training cohort, and 0.923 and 0.832 in the validation cohort, respectively. Calibration curves showed excellent agreement between predicted and observed outcomes. Decision curve analysis supported the clinical utility of the model. Risk stratification based on the nomogram revealed significant survival differences between the low- and high-risk groups (median OS: 566 vs. 454 days; P < 0.001).</p><p><strong>Conclusions: </strong>This novel nomogram, integrating locoregional and systemic therapies, offers an individualized tool for prognostication in patients with BCLC stage C HCC, potentially guiding therapeutic decision-making and patient counseling.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821524","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 FGD5-AS1/miR-142-5p/CDK5 axis promotes ESCC progression by regulating mitochondrial fission and mitophagy: insights from integrative bioinformatics and experimental analyses.","authors":"Min Hou, Shan Chen, Huadong Yang, Qingmei Huang, Hongmei Zhan, Yan Gui","doi":"10.1186/s12957-026-04338-y","DOIUrl":"https://doi.org/10.1186/s12957-026-04338-y","url":null,"abstract":"","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821611","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":"Comparison of survival outcomes between local excision and radical resection in patients with rectal mucosal melanoma.","authors":"Jingyu Zou, Heyuan Zhu, Yongqin Tang, Ying Huang, Pan Chi, Xiaojie Wang","doi":"10.1186/s12957-026-04257-y","DOIUrl":"https://doi.org/10.1186/s12957-026-04257-y","url":null,"abstract":"","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821291","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":"Revolutionizing lung cancer screening: the rise of artificial intelligence integrating circulating tumor markers.","authors":"Honghai Li, Haoning Nan, Yafei Sun, Ming Zhao, Yonghui Qiu, Siyu Chen, Yuqi Wang","doi":"10.1186/s12957-026-04268-9","DOIUrl":"https://doi.org/10.1186/s12957-026-04268-9","url":null,"abstract":"<p><p>Lung cancer persists as the predominant oncological cause of mortality globally, underscoring an imperative public health issue that demands effective screening methodologies to mitigate its impact. The National Lung Screening Trial (NLST) from the National Cancer Institute has established that low-dose computed tomography (LDCT) can detect lung cancer at an early stage and decrease mortality. Nonetheless, concerns such as radiation-induced risks, false positives, overdiagnosis, and medical costs demand attention. The importance of Artificial Intelligence (AI) in lung cancer screening is growing due to its superior capabilities for extracting image data and managing complex models. Circulating tumor markers (CTMs), encompassing circulating tumor DNA (ctDNA), circulating tumor RNA (ctRNA), circulating tumor cells (CTCs), and exosomes, present a non-invasive diagnostic and surveillance strategy for lung cancer. Despite their established utility in treatment and prognostic monitoring, the application of CTMs in early lung cancer screening is less documented. However, recent innovations highlight the potential of AI in conjunction with CTMs to enhance early diagnostic capabilities. This review synthesizes current research on the convergence of AI with CTMs, offering innovative avenues to augment and refine lung cancer screening methodologies.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821578","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":"Optimized sentinel nodes detection in endometrial cancer: intraoperative indocyanine green mapping with postoperative bread-loaf slicing ultrastaging.","authors":"Yu-Sheng Huang, Hao Lin, Yu-Che Ou, Chao-Cheng Huang, Hung-Chun Fu, Szu-Wei Huang, Ying-Wen Wang, Ying-Yi Chen, Chen-Hsuan Wu","doi":"10.1186/s12957-026-04375-7","DOIUrl":"https://doi.org/10.1186/s12957-026-04375-7","url":null,"abstract":"<p><strong>Background: </strong>Accurate lymph node assessment is crucial in early-stage endometrial cancer staging, but traditional lymphadenectomy carries significant morbidity risks. This study evaluates whether indocyanine green (ICG)-based sentinel lymph node (SLN) mapping combined with bread-loaf slicing ultrastaging optimizes lymph node metastasis detection in uterine-confined endometrial cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with early-stage endometrial cancer who underwent surgery with SLN mapping at Kaohsiung Chang Gung Memorial Hospital from November 2021 to December 2024. SLN mapping was performed using either ICG fluorescence imaging or patent blue dye during minimally invasive and open surgical approaches. All retrieved lymph nodes underwent ultrastaging examination using the bread-loaf slicing method.</p><p><strong>Results: </strong>Among 131 patients, the overall SLN mapping success rate was 93.9%, and the overall detection rate was 95.9%. In exploratory subgroup analyses, bilateral mapping success was higher in the ICG group than in the patent blue group (79.2% vs. 27.3%, p < 0.001). Bilateral mapping success was also higher in minimally invasive surgery than in open surgery in the overall cohort (79.1% vs. 43.8%, p = 0.002). Bread-loaf slicing ultrastaging identified lymph node metastases in 4.0% of patients. No recurrence were observed among patients with pathological stage I diseases during follow-up.</p><p><strong>Conclusions: </strong>The combination of intraoperative ICG-based SLN mapping with bread-loaf slicing ultrastaging demonstrated high mapping success rate and detection rate, and supports a feasible, standardized surgical-pathologic workflow for lymph node assessment in uterine-confined endometrial cancer.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782804","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":"Radiomics for predicting microsatellite instability-high status in colorectal cancer: a systematic review and meta-analysis.","authors":"Qitao Gou, Xin He, Xiang Zhang","doi":"10.1186/s12957-026-04381-9","DOIUrl":"https://doi.org/10.1186/s12957-026-04381-9","url":null,"abstract":"<p><strong>Objective: </strong>Microsatellite instability (MSI) has emerged as a key predictive biomarker for chemotherapy and immunotherapy response, and as a prognostic indicator in colorectal cancer (CRC). The current clinical standard for MSI detection relies on polymerase chain reaction (PCR) or immunohistochemical analysis of tumor biopsy specimens. CT, PET-CT, and MRI-based radiomics models present a promising non-invasive alternative for this purpose.</p><p><strong>Materials and methods: </strong>To identify studies assessing the diagnostic efficacy of CT, MRI and PET-CT-based radiomics in detecting MSI status in CRC, a systematic search was performed across PubMed, Embase, the Cochrane Library, and Web of Science. The pooled area under the curve (AUC), sensitivity, and specificity were estimated using a random-effects model in Meta-DiSc 1.4, RevMan 5.4, and Stata 15. Data were visualized through forest plots and a summary receiver operating characteristic (SROC) curve. A comprehensive heterogeneity assessment was conducted via I² statistics, sensitivity analyses, threshold effect evaluation, subgroup analyses, and meta-regression.</p><p><strong>Results: </strong>This meta-analysis included 34 studies with a total of 7,959 patients. The overall model demonstrated a pooled area under the curve (AUC) of 0.90 (95% CI: 0.87-0.93). The pooled sensitivity and specificity were 0.85 (95% CI: 0.79-0.89) and 0.82 (95% CI: 0.78-0.86), respectively, both marked by substantial heterogeneity (I² = 87% and 92%, respectively; P < 0.01).</p><p><strong>Conclusion: </strong>Radiomics holds significant promise as a non-invasive tool for MSI status prediction in CRC. In particular, machine learning and deep learning offer enhanced potential for model performance. These results pave the way for future research to develop and validate more accurate predictive models, thereby improving diagnostic precision, therapeutic decision-making, and prognosis in colorectal cancer.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782895","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":"Surgical management of spinal metastases originating from thyroid cancer.","authors":"Majid Esmaeilzadeh, Harold F Hounchonou, Jörg Andreas Müller, Frank Bengel, Joachim K Krauss","doi":"10.1186/s12957-026-04371-x","DOIUrl":"10.1186/s12957-026-04371-x","url":null,"abstract":"","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782861","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":"Exploration of between-hospital variation and the basis for decision making in management of malignant colorectal polyps- a Danish population-based study.","authors":"Helene Juul Würtz, Lea Lund, Jan Lindebjerg, Karina Dahl Steffensen, Adrian Edwards, Hans B Rahr","doi":"10.1186/s12957-026-04368-6","DOIUrl":"https://doi.org/10.1186/s12957-026-04368-6","url":null,"abstract":"<p><strong>Background: </strong>Finding an unexpected carcinoma in an endoscopically resected colorectal polyp poses a dilemma regarding the subsequent management strategy. Proceeding to surgery with formal segmental bowel resection is associated with a low recurrence risk but substantial morbidity and mortality, whereas surveillance without surgery entails low morbidity but a higher risk of recurrence. Clinical guidelines are based on histopathological risk factors (HRF), but pathology data are often incomplete, and national databases have revealed marked practice variation between hospitals. We aimed to explore between-hospital variation and the basis for treatment decisions after endoscopic resection of malignant colorectal polyps in Denmark.</p><p><strong>Methods: </strong>A national cohort of colorectal cancer patients from 2016-2020 was extracted from national clinical and pathology registers. Patients undergoing local resection only (surveillance group) and local resection followed by subsequent bowel resection (surgery group) were compared in uni- and multivariable analyses stratified by reported HRF. Patient- and hospital-related factors were included as covariates with particular focus on between-hospital variation.</p><p><strong>Results: </strong>Overall, 2,188 patients were analyzed, 1,277 in the surveillance group and 911 in the surgery group. Multivariable analyses showed that male sex, older age, comorbidity, lower performance status and left colon or rectum tumor location were significantly associated with surveillance, most even in the presence of HRF. Long higher education and certain hospitals were significantly associated with bowel resection. Predictors of bowel resection despite absence of HRF were certain hospitals and active smoking. In the surgery group without HRF conclusive information was missing in up to 70% of the pathology reports regarding certain HRF. Preoperative image-based overstaging may have resulted in a higher rate of cancer-free specimens. Overall, 63% of bowel resection specimens were cancer-free.</p><p><strong>Conclusion: </strong>We found marked between-hospital practice variation in management strategy for malignant colorectal polyps, even in adjusted analyses. Among the probable explanations were missing or incomplete pathology data and suspicion of more advanced disease based on clinical staging. Consistency in hospital practice, completeness of the pathology reports and overall better collaboration of the multidisciplinary team are needed to improve the decision-making process in patients with endoscopically removed malignant colorectal polyps.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783209","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":"Integrating single-cell transcriptomics and machine learning to predict breast cancer prognosis and immunotherapy sensitivity: a study based on proliferating T cells.","authors":"Yang Kan, Yupeng Xu, Shengnan Yao, Zhixuan Wu, Danni Zheng, Jiawei Chen","doi":"10.1186/s12957-026-04331-5","DOIUrl":"https://doi.org/10.1186/s12957-026-04331-5","url":null,"abstract":"","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783235","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}