World Journal of Surgical Oncology最新文献

{"title":"Recurrence patterns stratify post-progression survival after early recurrence of colorectal liver metastases following hepatectomy: a single-center retrospective study.","authors":"Taiki Mori, Nozomu Sakai, Tsukasa Takayashiki, Shigetsugu Takano, Isamu Hosokawa, Takanori Konishi, Kensuke Suzuki, Hitoe Nishino, Shinichiro Nakada, Masayuki Ohtsuka","doi":"10.1186/s12957-026-04499-w","DOIUrl":"10.1186/s12957-026-04499-w","url":null,"abstract":"<p><strong>Background: </strong>Early recurrence of colorectal liver metastases (CRLM) after hepatectomy is generally considered high-risk; however, the prognosis may differ depending on whether recurrence is confined to a single site or involves multiple sites. This study evaluated post-progression survival (PPS) according to recurrence pattern at first relapse in patients with early recurrence.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients who underwent initial curative-intent hepatectomy for CRLM at Chiba University Hospital between 2012 and 2022. Patients with recurrence within 12 months were classified as having single-site or multi-site recurrence at first relapse based on the number of involved organs or anatomically distinct compartments. PPS was calculated from the time of first recurrence and analyzed using Kaplan-Meier and Cox regression methods. Post-recurrence treatments, including salvage metastasectomy, were recorded.</p><p><strong>Results: </strong>Among 151 patients, 78 (51.7%) developed recurrence within 12 months: 43 with single-site and 35 with multi-site recurrence at first relapse. PPS was significantly longer in the single-site group than in the multi-site group (log-rank p = 0.016); median PPS was not reached in the single-site group and was 31 months in the multi-site group. On multivariable analysis, multi-site recurrence remained independently associated with poorer PPS (hazard ratio: 1.96, 95% confidence interval: 1.04-3.71; p = 0.037). Salvage metastasectomy was performed in 35 patients (44.9%); the proportion was comparable between the single-site and multi-site groups (46.5% vs. 42.9%, respectively; p = 0.821).</p><p><strong>Conclusions: </strong>Among patients with early recurrence after hepatectomy for CRLM, the anatomical extent of the first relapse further stratified PPS. Multi-site recurrence was independently associated with poorer PPS, suggesting that early recurrence is not a single prognostic entity but comprises clinically heterogeneous subgroups.</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/PMC13673725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536962","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 impact of adjacent organ invasion on cancer-specific mortality in non-metastatic renal cell carcinoma.","authors":"Maximilian Filzmayer, Leonardo Quarta, Michele Petix, Filippo Orlandi, Jordan A Goyal, Alberto Briganti, Luca Carmignani, Salvatore Micali, Shahrokh F Shariat, Matthias J Müller, Clara Humke, Miriam I Traumann, Fred Saad, Felix K-H Chun, Pierre I Karakiewicz","doi":"10.1186/s12957-026-04511-3","DOIUrl":"10.1186/s12957-026-04511-3","url":null,"abstract":"<p><strong>Purpose: </strong>The increase in cancer-specific mortality (CSM) associated with pathologically confirmed adjacent organ invasion (pT4) in non-metastatic (M0) renal cell carcinoma (RCC), relative to limited local invasion (pT3) or no local invasion (pT2) with otherwise same patient and tumor characteristics, is unknown. We addressed this knowledge gap.</p><p><strong>Methods: </strong>Within the Surveillance, Epidemiology, and End Results database (2004-2022), M0 RCC patients treated with radical nephrectomy were identified. Propensity score matching (PSM) was applied, and multivariable competing-risks regression (CRR) models were fitted. Additional sensitivity analyses were performed to evaluate the robustness of the primary findings.</p><p><strong>Results: </strong>Of 27,859 patients, 666 (2.4%) were classified as pT4, 15,343 (55.1%) as pT3, and 11,850 (42.5%) as pT2. After PSM, CSM at 120 months was 63.0% in pT4 versus 43.2% in pT3 and 26.0% in pT2. In multivariable CRR models, pT4 was associated with 1.84-fold higher CSM compared with pT3 (p < 0.001) and 3.31-fold higher CSM compared with pT2 (p < 0.001). In sensitivity analyses restricted to patients with clear-cell RCC, patients diagnosed before approval of adjuvant systemic therapy, and patients without lymph node invasion, corresponding effect estimates ranged from 1.79 to 1.93 for the comparison with pT3 and from 2.96 to 3.47 for the comparison with pT2 (all p < 0.001).</p><p><strong>Conclusion: </strong>In M0 RCC, the presence of adjacent organ invasion (pT4) doubles the rate of CSM relative to pT3 and triples the rate of CSM relative to pT2 when all other tumor and patient characteristics are held constant. These findings quantify the very aggressive nature of pT4 independent of other tumor and patient characteristics and thereby validate contemporary T staging. Accordingly, more frequent follow-up and prioritization of pT4 patients for discussions regarding adjuvant systemic therapy may be warranted compared with their pT3 and pT2 counterparts.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536997","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":"Non-coding RNA-mediated ferroptosis reprogramming in doxorubicin-resistant breast cancer: mechanistic evidence, subtype vulnerabilities, and translational strategies.","authors":"Xiaojie Yu, An Xu, Longdi Yao, Xiao Huang, Jianwen Wang, Chunlian Li, Deyuan Fu","doi":"10.1186/s12957-026-04507-z","DOIUrl":"https://doi.org/10.1186/s12957-026-04507-z","url":null,"abstract":"<p><p>Doxorubicin (DOX) resistance is a major factor limiting the efficacy of chemotherapy in breast cancer. Its development is associated not only with conventional mechanisms, such as enhanced drug efflux, increased DNA damage repair capacity, and evasion of apoptosis, but also with the adaptive escape of tumor cells from ferroptotic stress. Ferroptosis is a form of regulated cell death driven by the accumulation of iron-dependent lipid peroxidation and is coordinately regulated by multiple mechanisms, including the system Xc⁻-GSH-GPX4 axis, the FSP1-CoQ10 pathway, NRF2-mediated antioxidant responses, remodeling of iron metabolism, and regulation of lipid peroxidation. Non-coding RNA (ncRNAs), including miRNAs, lncRNAs, and circRNAs, can act on these ferroptosis defense modules through post-transcriptional regulation, competing endogenous RNA (ceRNA) networks, epigenetic modulation, and extracellular vesicle-mediated intercellular communication, thereby reshaping the sensitivity of breast cancer cells to DOX. This review systematically summarizes the major mechanisms by which ncRNAs regulate ferroptosis and contribute to DOX resistance in breast cancer, and further discusses subtype-specific differences in ncRNA-ferroptosis regulatory circuits among triple-negative, ER-positive, and HER2-positive breast cancers. In addition, this review highlights the potential value of circulating ncRNAs as resistance-associated biomarkers, as well as the translational prospects of miRNA mimics, siRNAs, antisense oligonucleotides (ASOs), and nanodelivery systems targeting the ncRNA-ferroptosis axis. Overall, ncRNA-mediated ferroptosis reprogramming provides a new mechanistic framework and potential therapeutic strategies for understanding and overcoming DOX resistance in breast cancer; however, its clinical application still requires further resolution of key challenges, including validation of causal evidence, insufficient delivery efficiency, off-target effects, and immunological safety.</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":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520961","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":"Pathological subtype dictates survival and failure pattern in laryngeal neuroendocrine neoplasms: a 15-year single-institution experience.","authors":"Feifei Qiao, Na Liu, He Li, Meng Zhang, Shubin Dong","doi":"10.1186/s12957-026-04506-0","DOIUrl":"10.1186/s12957-026-04506-0","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal neuroendocrine neoplasms (LNENs) comprise < 1% of laryngeal malignancies, and evidence-based treatment guidelines remain lacking. We sought to delineate clinicopathological features, therapeutic strategies, and survival determinants in a single-institution cohort of consecutive patients with primary LNEN.</p><p><strong>Methods: </strong>We retrospectively identified 31 consecutive patients with primary LNEN treated between 2010 and 2024. Histology was centrally reviewed by two head-and-neck pathologists and categorized as well-differentiated neuroendocrine tumor (NET, G1-G3) or poorly differentiated neuroendocrine carcinoma (NEC, small-cell/large-cell). All cases underwent immunohistochemistry (Syn, CgA, Ki-67) and multidisciplinary therapy. Survival analyses were performed with Kaplan-Meier and Cox proportional-hazards models.</p><p><strong>Results: </strong>Median age was 60 years, 90.3% were male, and 80.6% had a smoking history. NEC accounted for 71% (22/31) and NET for 29% (9/31). NEC exhibited higher Ki-67 index (85% vs. 10%, P < 0.001), more advanced stage (63.6% vs. 33.3%, P = 0.013), and a predilection for distant metastasis (85.7% vs. 25.0%, P = 0.002). Median overall survival (OS) was 27.0 months for NEC vs. not reached for NET (P < 0.001); 5-year OS was 0% vs. 44.4%. Median disease-free survival (DFS) was 19.0 vs. not reached (P < 0.001). Multivariate analysis identified NEC subtype (HR = 4.23, 95% CI 1.39-12.90), T3-4 stage (HR = 2.61, 95% CI 1.02-6.66), and lymph nodal positivity (HR = 3.12, 95% CI 1.20-8.10) as independent predictors of poor OS; NEC subtype (HR = 3.67, 95% CI 1.15-11.70) and N+ (HR = 3.51, 95% CI 1.22-10.10) predicted inferior DFS. Distant metastasis was the first mode of failure in 68.9% of curative-intent cases.</p><p><strong>Conclusions: </strong>Pathologic subtype (NEC vs. NET) emerges as the dominant independent predictor of survival in this cohort. NEC demonstrates a systemic biological phenotype characterized by early distant metastasis. These findings support the hypothesis that intensified perioperative systemic therapy, rather than locoregional escalation, warrants prospective investigation. Multi-center, molecularly stratified trials are needed to establish a precision-medicine paradigm for this rare disease.</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/PMC13670497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536932","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":"Influencing factors on seroma formation following mastectomy: a retrospective cohort study.","authors":"Karl Hein, Laura Weydandt, Massimiliano Lia, Senol Dogan, Susanne Briest, Ivonne Nel, Bahriye Aktas","doi":"10.1186/s12957-026-04496-z","DOIUrl":"10.1186/s12957-026-04496-z","url":null,"abstract":"<p><strong>Introduction: </strong>Seroma is the most common postoperative complication following mastectomy and may result in additional postoperative interventions and increased treatment burden. However, its etiology and predictive factors remain insufficiently understood. This study aimed to identify predictors of postoperative seroma formation.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of 245 patients (301 breasts) who underwent conventional mastectomy or skin-/nipple-sparing mastectomy, with or without immediate implant reconstruction and axillary surgery, at the University Hospital Leipzig between 2019 and 2023. Variables analyzed included epidemiological characteristics, neoadjuvant chemotherapy, tumor status, perioperative factors, and wound drainage output. Seroma formation was assessed via drains placed in the breast and axilla. Statistical analyses included univariable and multivariable regression and random forest modeling.</p><p><strong>Results: </strong>In univariable analyses, higher body mass index (BMI), longer surgical duration, diabetes mellitus, hypertension, advanced tumor stage, and elevated C-reactive protein levels were associated with increased breast seroma formation. Random forest analysis identified BMI, number of resected lymph nodes, surgical duration, hypertension, and diabetes as key predictors, all of which remained significant in multivariable models. For axillary seroma, BMI, number of resected lymph nodes, and tumor stage were significant in univariable analyses, while BMI and number of resected lymph nodes remained significant in multivariable models.</p><p><strong>Conclusion: </strong>Seroma formation is primarily influenced by BMI, extent of lymph node removal, and surgical duration, with hypertension and diabetes as additional risk factors for breast seroma.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498025","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":"Conversion hepatectomy and survival in initially unresectable hepatocellular carcinoma: a systematic review and meta-analysis with quantitative bias analysis.","authors":"Wenguang Zhao, Xialin Zhang, Ao Zhong, Chenxi Jiang, Ran Cui, Xinlin Yu, Sheng Lin","doi":"10.1186/s12957-026-04498-x","DOIUrl":"10.1186/s12957-026-04498-x","url":null,"abstract":"<p><strong>Background: </strong>Conversion hepatectomy has become feasible for selected patients with initially unresectable hepatocellular carcinoma (HCC), with comparative studies reporting longer survival after surgery. We performed a systematic review, meta-analysis, and quantitative bias analysis (QBA) to assess whether residual selection and time-dependent treatment bias could account for the reported benefit.</p><p><strong>Methods: </strong>We systematically reviewed comparative studies of conversion or salvage hepatectomy versus non-surgical management in initially unresectable HCC and pooled endpoint-specific HRs for OS and PFS/EFS using random-effects models. For each estimate, we extracted the time origin, exposure definition, and adjustment model. Risk of bias and certainty of evidence were assessed using ROBINS-I and GRADE. Robustness to unmeasured confounding, immortal time bias, and small-study effects was evaluated using E-values, tipping-point analysis, probabilistic QBA, timing-bias scenario analyses, and funnel-plot diagnostics.</p><p><strong>Results: </strong>Fourteen studies contributed 24 h: 14 for OS and 10 for PFS/EFS. Hepatectomy was associated with lower hazards of death (HR 0.33, 95% CI 0.22-0.48) and progression or event (HR 0.41, 95% CI 0.28-0.59), although heterogeneity was substantial and both prediction intervals crossed 1.0. E-values suggested robustness to moderate unmeasured confounding, whereas extreme surgical-candidacy confounding attenuated the median bias-adjusted HR to 0.82 for OS and 1.02 for PFS/EFS. Immortal-time bias scenarios did not fully account for the observed associations. OS small-study-effect diagnostics suggested funnel-plot asymmetry, although sample-size-based Peters-type regression was not significant. Certainty of evidence was very low for both endpoints.</p><p><strong>Conclusions: </strong>Conversion hepatectomy was associated with better observed survival outcomes in selected patients with initially unresectable HCC after conversion-intent therapy. The association was robust to moderate, but not extreme, assumptions about unmeasured surgical-candidacy confounding. These findings should be interpreted as a composite post-conversion association reflecting surgical clearance, treatment response, favorable tumor biology, and patient selection rather than as the isolated causal effect of hepatectomy. Future studies should report surgical eligibility landmarks, time zero, time to hepatectomy, and reasons for non-resection to clarify the independent contribution of surgery within conversion pathways.</p><p><strong>Trial registration: </strong>PROSPERO CRD420261382843 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1382843 ).</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472766","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":"Perioperative mortality and survival after lymph node excision in hepatocellular carcinoma: a national cancer database propensity score-matched cohort study.","authors":"Huisong Lee, Kyung Uk Jung, Michael Luu, Kambiz Kosari, Nicholas Nissen, Ju Dong Yang","doi":"10.1186/s12957-026-04497-y","DOIUrl":"10.1186/s12957-026-04497-y","url":null,"abstract":"<p><strong>Background: </strong>The oncologic benefit of lymph node excision (LNE) during hepatectomy for hepatocellular carcinoma (HCC) remains controversial. This study examined the association between LNE, perioperative mortality, and long-term survival following curative-intent liver resection.</p><p><strong>Methods: </strong>The National Cancer Database (2004-2021) was queried to identify patients who underwent curative hepatectomy for HCC. Patients who underwent liver transplantation, palliative surgery, or had distant metastases were excluded. Propensity score matching (PSM) was performed to balance patients undergoing hepatectomy with and without LNE. Multivariable logistic regression was used to identify factors associated with 30- and 90-day mortality. Overall survival (OS) was compared among patients according to LNE.</p><p><strong>Results: </strong>After matching (n = 8,728), all PSM-matched variables achieved standardized mean differences < 0.10, confirming excellent balance. LNE was independently associated with increased perioperative mortality. Removal of 1-3 lymph nodes was associated with increased odds of 30- and 90-day mortality (OR 1.37 and 1.38, respectively), while removal of ≥ 4 nodes conferred higher risk (OR 1.64 and 1.67, respectively). Older age, greater comorbidity burden, and advanced T stage were also associated with increased postoperative mortality. In survival analyses, OS did not differ significantly between No-LNE and pN0 groups (P = 0.151), with comparable 5-year survival rates and median survival.</p><p><strong>Conclusions: </strong>In this national cohort, LNE performed during curative hepatectomy for HCC was associated with increased postoperative mortality, without an apparent long-term survival benefit in patients with node-negative disease. These findings should be interpreted with caution given the observational design and inherent indication bias.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472763","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":"Multimodal magnetic resonance imaging in neuroblastoma chemotherapy: a narrative review.","authors":"Xiao Lu, Zhao Liu, Yuewen Hao","doi":"10.1186/s12957-026-04494-1","DOIUrl":"10.1186/s12957-026-04494-1","url":null,"abstract":"<p><p>Neuroblastoma (NB) is a very heterogeneous childhood cancer with its own problems in both the treatment and the assessment of therapeutical responses. The current study has identified the recent application of multimodal magnetic resonance imaging (MRI) in measuring efficacy of chemotherapy in NB. The typical conventional MRI is based on the alteration in tumor size and signal density, however, it is affected by tissue changes caused by post-chemotherapy processes like necrosis and fibrosis, which degrades its accuracy. Diffusion-weighted imaging (DWI) and intravoxel incoherent motion (IVIM) represent advanced functional MRI techniques that provide quantitative information regarding cellular density, water diffusion, and microcirculation perfusion and, therefore, can be used to early measure tumor responses. The apparent diffusion coefficient (ADC) of diffusion mode is linked to tumor differentiation and tumor therapy outcomes, where increasing values of the ADC following chemotherapy are an indicator of positive response. Dynamic contrast-enhanced MRI (DCE-MRI) further adds value to testing by measuring the changes in hemodynamics. Although these benefits exist, issues still exist such as the necessity to implement uniform imaging guidelines, ensure parameter repeatability and sample size limitations. This narrative review is intended to provide clinicians and researchers with a comprehensive overview of the current evidence and to propose future directions for prospective multicenter studies. Multimodal MRI, as a non-invasive tool, plays a crucial role in assessing the response, stratifying the risk, and individualizing treatment plans for neuroblastoma.Combination of structural, functional, and metabolic MRI information promises to improve the diagnostic accuracy and prognostic accuracy in pediatric cancer.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456804","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":"Progressive elevation of MnSOD and GPX4 expression across the spectrum of pulmonary adenocarcinoma lesions: a digital pathology study.","authors":"Hui-Ting Lee, Chao-Yu Liu, Chia-I Lin, Yung-Hui Li, Wan-Chun Li, Shin-Ting Yeh, Hui-Chen Lin, Chen-Sung Lin","doi":"10.1186/s12957-026-04457-6","DOIUrl":"10.1186/s12957-026-04457-6","url":null,"abstract":"<p><strong>Background: </strong>Manganese superoxide dismutase (MnSOD) and glutathione peroxidase 4 (GPX4) are key components of the mitochondrial redox defense system; however, their clinical associations across lung adenocarcinoma spectrum lesions (ASLs) are insufficiently defined.</p><p><strong>Methods: </strong>We analyzed 67 resected ASLs, comprising 14 preinvasive lesions and 53 invasive adenocarcinomas, from 61 patients who underwent video-assisted thoracoscopic surgery (VATS). Paired nonneoplastic lung tissue adjacent to preinvasive lesions served as normal controls. MnSOD and GPX4 expression levels were assessed through immunohistochemical (IHC) staining, digitized to generate whole slide images (WSIs), and semiquantified using IHC pixelwise H-score (0-300) by employing an ImageJ plugin. The exploratory association of MnSOD and GPX4 expression with clinicopathological variables and overall survival was evaluated.</p><p><strong>Results: </strong>MnSOD and GPX4 IHC pixelwise H-scores increased stepwise from normal lung tissue to preinvasive lesion and further to invasive adenocarcinoma in parallel with higher T-status category. Exploratory analyses demonstrated that a high MnSOD IHC pixelwise H-score (> 154.5) was associated with higher serum carcinoembryonic antigen (CEA) levels (p = 0.001), higher maximum standardized uptake value (SUVmax) on positron emission tomography (p = 0.041), larger tumor size (p = 0.002), M1 status (p = 0.076), spread through air spaces (STAS, p = 0.036), and pleural invasion (p = 0.019). By contrast, a high GPX4 IHC pixelwise H-score (> 165.9) was associated only with pleural invasion (p = 0.014). An exploratory nonlinear inverse association was observed between MnSOD IHC pixelwise H-scores and serum CEA levels (p = 0.004), with a steeper increase at lower CEA levels and a plateau at approximately 5 ng/mL. A high MnSOD IHC pixelwise H-score (> 154.5) exhibited a borderline association with shorter survival (p = 0.052). M status (p = 0.008) and STAS (p = 0.012) were associated with an increased risk of death in exploratory multivariate analysis.</p><p><strong>Conclusions: </strong>In this hypothesis-generating study, MnSOD and GPX4 IHC pixelwise H-scores progressively increase across lung ASLs, and MnSOD is associated with clinicopathological features of tumor aggressiveness. IHC pixelwise H-score analysis may be a feasible semiquantitative approach for evaluating protein expression in lung ASLs.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449609","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 nomogram for predicting 3-month mortality in colorectal cancer patients requiring perioperative ICU admission: a retrospective cohort study.","authors":"Chengcheng Dong, Daiyin Cao, Xiaofei Zhang, Qianxin Luo","doi":"10.1186/s12957-026-04495-0","DOIUrl":"10.1186/s12957-026-04495-0","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer patients requiring perioperative intensive care unit (ICU) admission represent a high-risk subgroup with substantial short-term mortality. This study aimed to develop and internally validate a nomogram for estimating 3-month all-cause mortality in colorectal cancer patients requiring perioperative ICU care.</p><p><strong>Methods: </strong>This single-center retrospective cohort study screened patients hospitalized for colorectal cancer surgery between January 2014 and December 2018. The final cohort included 415 patients requiring perioperative ICU admission. The primary endpoint was all-cause mortality within 3 months after ICU admission. The intended prediction time point was the end of the first 24 h after ICU admission. Candidate predictors were obtained from the preoperative period, the index surgery, and the first 24 h after ICU admission. Multivariable logistic regression was used to identify independent predictors and construct the nomogram. Model performance was evaluated using receiver operating characteristic curve analysis, bootstrap internal validation, calibration analysis, and decision curve analysis.</p><p><strong>Results: </strong>Among 415 included patients, 58 (14.0%) died within 3 months after ICU admission. The final nomogram incorporated preoperative albumin, APACHE II score, CRRT within the first 24 h after ICU admission, mechanical ventilation within the first 24 h after ICU admission, and laparoscopic surgery. Higher albumin level and laparoscopic surgery were associated with lower mortality risk, whereas higher APACHE II score, CRRT, and mechanical ventilation were associated with increased mortality risk. The nomogram showed good discrimination, with an AUC of 0.882 (95% CI, 0.829-0.927) and bootstrap internal validation yielded an optimism-corrected C-index of 0.872. Calibration analysis showed good agreement between predicted and observed risk, and decision curve analysis suggested potential clinical utility across clinically relevant threshold probabilities. The nomogram showed better discrimination than APACHE II alone.</p><p><strong>Conclusions: </strong>We developed and internally validated a nomogram for estimating 3-month mortality at the end of the first 24 h after ICU admission in colorectal cancer patients requiring perioperative ICU care. The model may support early risk stratification in this high-risk population, but external validation is required before routine clinical implementation.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437753","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}