World Journal of Surgical Oncology最新文献

{"title":"Prognostic utility of the Charlson comorbidity index in pancreatic cancer: a systematic review and meta‑analysis.","authors":"Jie Yang, Sijiong Wang, Xiuhua Bai, Hao Song","doi":"10.1186/s12957-026-04517-x","DOIUrl":"10.1186/s12957-026-04517-x","url":null,"abstract":"<p><strong>Objective: </strong>The prognosis of pancreatic cancer is extremely poor, and patients frequently present with multiple comorbidities. The Charlson Comorbidity Index (CCI) and its age-adjusted version (CACI) are widely used to quantify the burden of comorbidity. This systematic review and meta-analysis aimed to evaluate the association between CCI/CACI and survival outcomes in patients with pancreatic cancer.</p><p><strong>Methods: </strong>We systematically searched the Cochrane Library, Embase, PubMed, and Web of Science for relevant literature up to May 2025. Observational studies primarily investigating the association between CCI/CACI and overall survival (OS) in patients with pancreatic cancer were included. Two reviewers independently screened the literature, extracted data, and evaluated the quality of eligible studies using the Newcastle-Ottawa Scale. A random-effects model was employed to pool adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic. Subgroup analysis, sensitivity analysis, and regression analysis were also conducted.</p><p><strong>Results: </strong>This analysis incorporated 28 studies comprising 548,660 participants. Most of the studies were of high quality. The meta-analysis demonstrated that a higher CCI was associated with an inferior OS (pooled HR = 1.26, 95% CI: 1.09-1.47, P = 0.002). A similar association was observed for CACI (pooled HR = 1.40, 95% CI: 1.17-1.67, P < 0.001). Subgroup analyses confirmed that this association was generally consistent across different geographical regions, study designs, sample sizes, treatment modalities, and cut-off values of CCI. However, the assessment of heterogeneity revealed substantial heterogeneity in the analyses involving the CCI (I² = 63.6%, P = 0.005). Due to the limited number of eligible studies, quantitative synthesis could not be conducted for secondary endpoints, including progression-free survival and recurrence-free survival.</p><p><strong>Conclusion: </strong>The current meta-analysis provides quantitative evidence from observational studies to support the CCI and CACI as factors associated with survival in patients with pancreatic cancer. However, given the substantial heterogeneity and observational design of the included studies, these indices should be interpreted as prognostic association markers rather than standalone clinical decision tools. The findings should be cautiously interpreted. Future prospective studies are required for validation. Integrated prediction models combining these indices with molecular markers should be explored.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798598","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":"Bridging the gap: modern pharyngolaryngoesophagectomy techniques and the rise of neoadjuvant/immunotherapy approaches.","authors":"Freideriki Nteka, Tania Triantafyllou, Ioannis Rouvelas, Ioannis Gkoutziotis, Panagiotis Sakarellos, Maria Tolia, Ioannis Karavokyros, Konstantinos Mpallas, Dimitrios Schizas","doi":"10.1186/s12957-026-04519-9","DOIUrl":"10.1186/s12957-026-04519-9","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this review is to outline the evolution and changing role of pharyngolaryngoesophagectomy (PLE) in the organ-preservation era, and to review advances, including minimally invasive techniques, neoadjuvant therapy, and immunotherapy, and their impact on outcomes in advanced laryngeal, hypopharyngeal, and cervical esophageal cancers.</p><p><strong>Main body: </strong>A narrative review of the literature from 2000 to the present was performed, focusing on studies of surgical innovations, oncologic outcomes, quality of life, and combined treatment strategies in PLE. Historically, PLE was associated with high morbidity and mortality. However, advances in surgical techniques, reconstructive methods, and perioperative care have significantly improved its safety and functional outcomes. Minimally invasive and hybrid PLE approaches reduce pulmonary complications and speed recovery without compromising oncologic outcomes. Chemoradiation has become the first-line treatment for many advanced cases, with PLE now reserved for selected cervical esophageal tumors or persistent disease after radiation. Neoadjuvant chemotherapy or chemoradiation can shrink tumors, improve operability, and sometimes allow organ preservation. Immunotherapy before surgery improves pathological response rates and disease-free survival. Recent series report 5-year survival of 20-40% after PLE, and most patients regain swallowing and voice function with rehabilitation.</p><p><strong>Conclusion: </strong>In the organ-preservation era, PLE remains important for certain advanced or treatment-resistant cases. Its role is defined by a multidisciplinary, personalized approach and limited to cases where surgery is essential, often combined with systemic therapy. Ongoing advances in patient selection, minimally invasive techniques, and immunotherapy are expected to further refine PLE's role and improve outcomes.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670523","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":"Diagnostic accuracy of computer-aided detection for colorectal polyps of any size, ≤ 5 mm, and 6-9 mm: a meta-analysis.","authors":"Wen Chen, Simeng Li, Zhenheng Wu, Haifen Tan, Fuqian Yu, Dongmei Wang, Xiaodan Lin, Zhigang Chen","doi":"10.1186/s12957-025-03898-9","DOIUrl":"10.1186/s12957-025-03898-9","url":null,"abstract":"<p><strong>Background: </strong>Although computer-aided detection (CAD) is often used for medical diagnostic purposes, its diagnostic effectiveness in colorectal polyps (CPs) remains uncertain.</p><p><strong>Objective: </strong>To summarize the diagnostic accuracy of CAD in diagnosing CPs, and provide a specific theoretical basis for clinical practice.</p><p><strong>Methods: </strong>From database creation to August 1st 2024, we conducted a comprehensive search of PubMed, Embase, Web of Science (WoS), Scopus, Wanfang, Cochrane Library, and the China National Knowledge Infrastructure (CNKI). The pooled sensitivity, specificity, area under the curve (AUC), diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and Fagan plot analysis were employed to evaluate the overall performance of CAD tests. Furthermore, we assessed publication bias using Deeks' funnel plot asymmetry test.</p><p><strong>Results: </strong>The aggregated diagnostic data from 19 studies (any size), 12 studies (≤ 5 mm polyps) and 2 studies (6-9 mm polyps) were as follows: The sensitivity for polyps of any size, ≤ 5 mm, and 6-9 mm was 0.94 (95% CI, 0.92-0.96), 0.93 (95% CI, 0.89-0.95) and 0.95 (95% CI, 0.92-0.97), respectively. The specificity was 0.91 (95% CI, 0.86-0.95), 0.90 (95% CI, 0.87-0.93) and 0.90 (95% CI, 0.88-0.92), respectively. The AUC was 0.97 (95% CI, 0.96-0.99), 0.96 (95% CI, 0.94-0.98), and 0.92 (95% CI, 0.89-0.94), respectively. Deeks' funnel plot showed that publication bias was not statistically significant in the diagnosis of polyps of any size and ≤ 5 mm CPs (P > 0.05).</p><p><strong>Conclusion: </strong>In summary, CAD is accurate for all types of CPs. Specifically, for polyps of any size and those ≤ 5 mm, CAD was more sensitive and specific for CPs of any size.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631808","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":"Stress-driven reprogramming of plasmacytoid dendritic cells in intrahepatic cholangiocarcinoma defines a reversible targetable immunosuppressive state.","authors":"Mei-Ru Chen, Xiao-Li Xie, Yan-Li Zhou, Jin-Mei Tian, Ying Zhao, Suping Hou, Yuan-Yuan Wang, Ji-Chao Lu, Dong-Qiang Zhao, Zhao-Bo Cui, Li-Xian Zhang","doi":"10.1186/s12957-026-04489-y","DOIUrl":"10.1186/s12957-026-04489-y","url":null,"abstract":"<p><strong>Background: </strong>Plasmacytoid dendritic cells (pDCs) have been implicated in both restraining and promoting intrahepatic cholangiocarcinoma (iCCA), leaving their clinical relevance and therapeutic potential unresolved.</p><p><strong>Methods: </strong>Mendelian randomization was used to assess the causal association between circulating pDC levels and iCCA risk. Bulk and single-cell transcriptomic analyses were performed to characterize pDC-related programs and tumor-conditioned states, and multiplex immunofluorescence was used to define spatial distribution and clinical associations in iCCA tissues. To assess reversibility of stress-associated pDC features, IRE1α RNase activity was pharmacologically inhibited with 4µ8C under tumor-conditioned stress in vitro.</p><p><strong>Results: </strong>Genetically predicted higher circulating pDC levels were associated with lower iCCA risk, consistent with a systemic protective association. In bulk cohorts, higher expression of pDC markers (CLEC4C, NRP1, IL3RA) was associated with an immune-inflamed microenvironment and improved survival in early-stage disease. Single-cell analyses indicated that intratumoral pDCs acquired stress-associated transcriptional programs, including enrichment of endoplasmic reticulum stress and unfolded protein response pathways. In vitro, 4µ8C reduced IRE1α-dependent XBP1 splicing and partially restored type I interferon-linked activation and pDC immunogenic readouts under tumor-conditioned stress. Spatial profiling further showed that higher intratumoral CD303⁺IRF7⁺ pDC activation was associated with advanced stage and poorer overall survival, whereas higher activation in adjacent non-tumor tissues correlated with more favorable outcomes.</p><p><strong>Conclusions: </strong>Together, these findings support a context-dependent, stress-associated pDC program in iCCA and provide a rationale for further evaluating the IRE1α-XBP1 stress axis as a potential approach to modulate pDC-associated immune states within the tumor microenvironment.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002461","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":"An individualized nomogram for survival prediction in intrahepatic cholangiocarcinoma: a population-based analysis.","authors":"Hui Xie, Xiangyu Wang, Lingguang Shen, Fatao Hao, Yong Meng, Jianbin Du","doi":"10.1186/s12957-026-04509-x","DOIUrl":"10.1186/s12957-026-04509-x","url":null,"abstract":"<p><strong>Background: </strong>Intrahepatic cholangiocarcinoma (ICC) is an aggressive malignancy with poor prognosis. Current prognostic systems, including TNM staging system, incompletely incorporate important clinical and pathological factors. This study aims to develop and validate an individualized nomogram for predicting overall survival (OS) in ICC patients.</p><p><strong>Methods: </strong>A total of 1,751 ICC patients diagnosed between 2011 and 2021 were identified from the Surveillance, Epidemiology, and End Results (SEER) database for model development and internal validation. A temporally distinct SEER cohort of 751 ICC patients diagnosed between 2000 and 2010 was used for temporal validation. Twelve candidate predictors were prespecified, and the final nomogram variables were retained from the multivariable Cox model according to a predefined retention threshold. Model performance was evaluated using the concordance index (C-index), time-dependent area under the receiver operating characteristic curve (time-dependent AUC), calibration curves, decision curve analysis (DCA), and integrated discrimination improvement (IDI). Kaplan-Meier analysis was used for risk stratification.</p><p><strong>Results: </strong>The nomogram demonstrated good discriminative ability, with C-indices of 0.761 (training cohort) and 0.732 (validation cohort), and time-dependent AUC values ranging from 0.74 to 0.84 across 1-, 3-, and 5-year predictions. Calibration curves revealed good agreement between predicted and observed survival probabilities in both cohorts. The model outperformed the TNM staging system, with IDI values of 0.197, 0.393, and 0.238 for 1-, 3-, and 5-year predictions, respectively (all P < 0.001). DCA indicated greater net benefit across a range of threshold probabilities. Risk stratification significantly differentiated high-risk from low-risk patients (log-rank P < 0.001).</p><p><strong>Conclusion: </strong>The proposed nomogram provides individualized prediction of 1-, 3-, and 5-year OS in ICC patients and may assist in risk stratification and prognostic assessment.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220920","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":"Primary pulmonary osteosarcoma: a case report, literature review and pooled analysis.","authors":"Jing Zhou, Xing Chen, Kaihang Shi, Gaoxiang Wang, Peng Zuo","doi":"10.1186/s12957-026-04512-2","DOIUrl":"10.1186/s12957-026-04512-2","url":null,"abstract":"<p><strong>Background: </strong>Primary pulmonary osteosarcoma (PPOS) is an exceptionally rare malignant tumor that arises within the lung parenchyma. Fewer than 40 cases of PPOS have been reported to date. Owing to its rarity, the clinical features and prognostic factors of PPOS remain poorly defined.</p><p><strong>Objective: </strong>To report a new case of PPOS and perform a pooled retrospective analysis of published cases to identify clinical profiles and potential prognostic determinants.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted using the PubMed, Medline, and Cochrane Library databases. Thirty-eight reported cases of PPOS were identified. Among these, sufficient clinical and survival data of 25 patients, including one from our institution, were available for analysis. Overall survival (OS) was assessed using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>The median age of the pooled cohort was 64 years. Kaplan-Meier and multivariable Cox analyses demonstrated that older age (> 64 years) was associated with poorer OS and that surgical resection significantly improved survival. Among surgical patients, adjuvant chemotherapy was associated with a trend toward prolonged OS, although the difference was not statistically significant (P = 0.053). Age-stratified analysis revealed a survival benefit of surgery in both the ≤ 64-year age group and the > 64-year age group (P = 0.003 and P < 0.001, respectively), and no significant difference in OS was observed according to tumor size among surgically treated patients (P = 0.89).</p><p><strong>Conclusion: </strong>PPOS is an aggressive malignancy with poor prognosis. Age and surgical resection were found to be crucial prognostic factors. A combination of surgery and chemotherapy may offer additional survival benefits to selected patients. Given that the benefits of surgery were observed across all age groups and that no difference in survival was observed according to tumor size among surgically treated patients, advanced age and larger tumor size alone should not preclude consideration of surgical intervention in patients with adequate performance status. Larger multi-institutional studies are needed to validate these findings.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196894","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 association between myelodysplastic syndrome and de novo bone metastasis in urothelial carcinoma.","authors":"Zhilong Zestel Shen, Gan Xu, Hao Zhang, Pengru Wang, Xin Zhang, Bo Li, Jianru Xiao, Wei Xu","doi":"10.1186/s12957-026-04468-3","DOIUrl":"10.1186/s12957-026-04468-3","url":null,"abstract":"<p><strong>Aim: </strong>To assess the association between myelodysplastic syndrome and de novo bone metastasis of urothelial carcinoma.</p><p><strong>Method: </strong>A cohort of 145,719 patients with MDS and/or UTCA included from the surveillance, epidemiology, and end results (SEER) database was conducted to assess the risk of de novo bone metastasis of UTCA (DNBM-UTCA) in patients with previously diagnosed myelodysplastic syndrome (PD-MDS). The odds ratio for developing DNBM-UTCA between MDS and non-MDS patients was estimated. Weibull accelerated failure time model was applied to evaluate the survival outcomes of patients with UTCA.</p><p><strong>Results: </strong>Our findings suggest that PD-MDS is a powerful risk factor for DNBM-UTCA (adjusted odds ratio, 6.428; 95% CI, 1.866-16.497; p < 0.001) and a poor prognostic factor on survival (adjusted survival time ratio, 0.485; CI, 0.338-0.695; p < 0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that PD-MDS was associated with higher odds of DNBM-UTCA and poorer survival outcomes, which may warrant additional clinical attention during treatment decision-making. However, these findings should be considered hypothesis-generating rather than causal. Further prospective studies and mechanistic investigations are needed to better clarify the biological basis underlying the observed association between PD-MDS and bone metastasis in UTCA.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550669","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":"Frailty in patients undergoing video-assisted thoracoscopic surgery for lung cancer: a narrative review of assessment, outcomes and prehabilitation.","authors":"Yiming Xu, Mingming Cao, Yuting Liu, Xuyang Li, Qiang Zhang","doi":"10.1186/s12957-026-04508-y","DOIUrl":"10.1186/s12957-026-04508-y","url":null,"abstract":"<p><strong>Background: </strong>Older adults with lung cancer are increasingly being considered for video-assisted thoracoscopic surgery (VATS), including segmentectomy or lobectomy with lymph node assessment. Although VATS reduces surgical trauma compared with thoracotomy, it does not eliminate heterogeneity in physiological reserve, treatment tolerance, or postoperative recovery. Frailty may therefore complement conventional preoperative assessment, which is typically based on chronological age, comorbidity burden, pulmonary function, and cardiac risk.</p><p><strong>Methods and main findings: </strong>This narrative review summarises the evidence on frailty assessment, perioperative outcomes, and prehabilitation strategies in patients undergoing lung cancer surgery, with a particular emphasis on VATS. Practical tools, such as the Clinical Frailty Scale and 4-metre gait speed, may support routine screening because they are brief, feasible, and clinically interpretable. More comprehensive approaches, including multidimensional frailty indices, nutritional assessment, sarcopenia evaluation, and comprehensive geriatric assessment, may be useful for selected patients. Available evidence suggests that frailty is associated with postoperative pulmonary complications, prolonged hospitalisation, non-home discharge, increased healthcare utilisation, and mortality after lung resection. However, direct evidence from frail patients with lung cancer undergoing VATS remains limited, and many recommendations are extrapolated from mixed thoracic surgery cohorts, studies of open lung resection, geriatric oncology, and non-thoracic surgical literature.</p><p><strong>Conclusions: </strong>Frailty should be considered an actionable component of perioperative risk stratification, rather than a stand-alone criterion for determining surgical eligibility or the extent of VATS resection. Future studies in thoracic oncology should define optimal frailty assessment pathways and determine whether frailty-guided interventions can improve short-term recovery, long-term functional outcomes, tolerance of adjuvant therapy, and oncological outcomes after minimally invasive lung cancer surgery.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550636","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":"Oncological outcome of endoscopic nipple-sparing mastectomy versus conventional open mastectomy in early breast cancer: a multicenter cohort study.","authors":"Li Zhu, Xin Ye, Zhaoqi Zhang, Yan Fang, Deyue Liu, Shuning Ding, Yanyan Zhu, Qi Wang, Wei Wang, Min Wang","doi":"10.1186/s12957-026-04501-5","DOIUrl":"10.1186/s12957-026-04501-5","url":null,"abstract":"<p><strong>Background: </strong>In recent years, endoscopic nipple-sparing mastectomy (ENM) has been applied in breast cancer treatment, whereas conventional open mastectomy (COM) remains widely adopted in clinical practice. The data about the oncological outcomes of ENM vs. COM was rare, especially the multicenter data.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study enrolled 2,314 early breast cancer patients diagnosed with stage 0-III, and treated with either ENM or COM from September 1st, 2021 to January 30th, 2025 at three institutions. After exclusions, the final cohort consisted of 1,722 patients, of whom 136 were in the ENM group and 1,586 in the conventional group. Demographic data, clinicopathological features, and oncological outcomes were collected and analyzed. Propensity score matching (PSM) was performed to minimize selection bias and balance confounders.</p><p><strong>Results: </strong>Before PSM, the patients in ENM group were significant different from COM group in age, menopausal status, hormone receptor status, HER2 status and molecular subtypes. After PSM, the final analysis cohort comprised 136 patients in the ENM group and 408 patients in the COM group. The median follow-up time was 22 months. No significant differences were observed between the two groups in any of the oncological outcome parameters: local recurrence-free survival between COM and ENM groups (97.8% vs. 97.8%; HR, 0.63; 95%CI, 0.14-2.90; P = 0.50); regional recurrence-free survival between COM and ENM groups (98.8% vs. 99.3%; HR, 1.24; 95%CI, 0.17-9.22; P = 0.84); distant metastasis-free survival between COM and ENM groups(97.3% vs. 98.5%; HR, 1.70; 95%CI, 0.47-6.11; P = 0.48); disease free survival between COM and ENM groups(94.9% vs. 96.3%; HR, 1.24; 95%CI, 0.50-3.10; P = 0.66); overall survival between COM and ENM groups(99.3% vs. 99.3%; HR, 0.76; 95%CI, 0.07-8.72; P = 0.81).</p><p><strong>Conclusions: </strong>In this multicenter cohort study, ENM group showed no different oncological outcomes from COM group. ENM could be used as a viable alternative to COM for eligible breast cancer patients.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536968","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":"Residual tumor deposits after neoadjuvant therapy and 3-year survival outcomes in gastric cancer: a single-center retrospective cohort study.","authors":"Yuanze Wei, Yulong Tian, Xiaodong Liu, Gan Liu, Qi Liu, Kun Wang, Yanbing Zhou","doi":"10.1186/s12957-026-04500-6","DOIUrl":"10.1186/s12957-026-04500-6","url":null,"abstract":"<p><strong>Background: </strong>The prognostic relevance of residual tumor deposits after neoadjuvant therapy (ypTD) in gastric cancer remains insufficiently defined. This study evaluated associations between ypTD positivity and 3-year disease-free survival (DFS) and overall survival (OS) after curative-intent gastrectomy.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 336 patients with locally advanced, clinically lymph node-positive gastric adenocarcinoma who underwent neoadjuvant therapy followed by R0 gastrectomy. Patients were classified by postoperative ypTD status. Survival analyses were restricted to the postoperative 36-month observation window. Kaplan-Meier analysis, log-rank tests, Cox models, exploratory ypN-stratified analyses, and within-cohort model performance comparisons were performed.</p><p><strong>Results: </strong>Fifty-one patients (15.2%) were ypTD-positive. ypTD-positive patients had higher proportions of ypT3-4 disease, ypN2-3 disease, and lymphovascular invasion. The 3-year DFS rate was lower in the ypTD-positive group than in the ypTD-negative group (41.2% vs. 69.8%; log-rank P < 0.001), whereas 3-year OS did not differ significantly (68.6% vs. 77.9%; P = 0.063). In the fully adjusted model, ypTD positivity was associated with increased DFS event risk (HR 1.79, 95% CI 1.08-2.95; P = 0.023), but not OS (HR 0.87, 95% CI 0.46-1.65; P = 0.676). Adding ypTD increased the 36-month time-dependent AUC from 0.598 to 0.645 in within-cohort exploratory comparisons.</p><p><strong>Conclusions: </strong>ypTD positivity was associated with an increased risk of DFS events within 36 months after surgery, whereas no statistically significant association with OS was observed. ypTD may provide potential supplementary prognostic information for recurrence-risk assessment; however, its biological interpretation, potential clinical applicability, and long-term prognostic value require validation in larger multicenter cohorts.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536960","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}