World Journal of Surgical Oncology最新文献

{"title":"Evaluating the prognostic significance of lymph node yield in resected pancreatic adenocarcinoma: a population-based study.","authors":"Chia-Jen Tsai, Pei-Yi Lin, Khaa-Hoo Ong, Chung-Han Ho, Yi-Chen Chen, Chien-Feng Li, Ching-Chieh Yang, Chih-Ying Lu","doi":"10.1186/s12957-026-04475-4","DOIUrl":"10.1186/s12957-026-04475-4","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical resection plays a pivotal role in the management of pancreatic cancer by achieving complete tumor removal and regional lymphadenectomy. Although most clinical guidelines recommend examining at least 15 lymph nodes for accurate staging and better prognostic assessment, the optimal threshold remains uncertain and requires validation across population-based datasets.</p><p><strong>Methods: </strong>Using the Taiwan Cancer Registry and National Health Insurance Research Database, 885 patients with pancreatic adenocarcinoma who underwent curative resection between 2013 and 2019 were identified. Cox proportional hazards regression models were used to evaluate the association between lymph node yield (LNY ≥ 15 vs. <15) and overall survival (OS), adjusting for potential confounders. Several sensitivity analyses were performed to assess the robustness of the findings, including a subgroup analysis restricted to patients with pT1-3 pancreatic head tumors who underwent pancreatoduodenectomy. Stratified analyses were additionally performed according to pathological T and N classifications and treatment modalities.</p><p><strong>Results: </strong>The median LNY was 15, with 474 patients (53.6%) having ≥ 15 nodes retrieved. Patients with adequate LNY were more likely to have tumors located in the pancreatic head, undergo pancreatoduodenectomy, and present with more advanced pT and pN stages as well as a higher number of positive nodes. No significant difference in 1- or 3-year overall survival (OS) was observed between patients with LNY ≥ 15 and those with LNY < 15 in the overall cohort. In the predefined subgroup of patients with pT1-3 pancreatic head tumors undergoing pancreatoduodenectomy, however, retrieval of ≥ 15 lymph nodes was associated with significantly improved 1- and 3-year OS compared with retrieval of < 15 lymph nodes. After adjustment for confounders, LNY ≥ 15 remained associated with improved 1- and 3-year OS in this subgroup, whereas no such association was observed in the overall cohort. Stratified analyses by pathological stage and treatment demonstrated generally consistent findings, with the most pronounced survival benefit of LNY ≥ 15 observed among patients with pT1-2 disease.</p><p><strong>Conclusions: </strong>Retrieval of ≥ 15 lymph nodes were not directly associated with improved survival in the overall cohort but was associated with better survival among patients with pT1-3 pancreatic head tumors undergoing pancreatoduodenectomy. These findings suggest that the prognostic value of the conventional 15-node threshold may vary across clinical subgroups and warrants further validation in larger population-based studies.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319534","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 pathological morphology parameter-based prognostic nomogram for high-risk prostate cancer patients treated with neoadjuvant therapy followed by radical prostatectomy: a retrospective study.","authors":"Hua Liang, Junjie Fan, Ke Xu, Hao Song, Chaosheng Gan, Guojing Wang, Qiyuan Kang, Jianzhou Liu, Dalin He, Jinhai Fan, Kaijie Wu","doi":"10.1186/s12957-026-04442-z","DOIUrl":"10.1186/s12957-026-04442-z","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of these pathological morphology alterations induced by neoadjuvant therapy in high-risk prostate cancer (PCa) patients is still unclear. Hence, this study retrospectively reviewed the data of 124 patients with high-risk PCa who underwent neoadjuvant therapy followed by radical prostatectomy (RP), and aimed to explore the prognostic value of pathological morphology alterations.</p><p><strong>Methods: </strong>Data from 124 patients with high-risk PCa who underwent neoadjuvant therapy followed by RP were retrospectively reviewed. Pathological morphology alterations observed in RP specimens were independently recorded by two uropathologists, and the primary endpoint was biochemical progression-free survival (bPFS). Cox regression analyses were performed to explore independent predictors of bPFS, and a nomogram was developed. The C-index, calibration curves and decision curve analysis (DCA) were used to evaluate the performance of the nomogram.</p><p><strong>Results: </strong>Among 124 patients, 66 patients (53.2%) were treated with neoadjuvant hormonal therapy (NHT), and 58 patients (46.8%) were treated with neoadjuvant chemohormonal therapy (NCHT). Moreover, 11 patients (8.9%) had a complete reduction in glandular density and diameter, and intraductal carcinoma of the prostate (IDC-P) was observed in 8 patients (6.5%). Cox regression revealed that NHT, pelvic lymph node (LN) metastasis, positive surgical margins, negative reduction in glandular density and diameter, and IDC-P were associated with worse bPFS (all P < 0.05), and those factors were subsequently selected to develop a nomogram. The C-index was 0.813 (95% CI: 0.626-0.863), and time-dependent C-index were 0.902 (6 months), 0.882 (12 months), and 0.951 (24 months). The calibration curves showed a high consistency between the predicted and observed bPFS probabilities, and DCA confirmed the nomogram's clinical utility across a range of threshold probabilities.</p><p><strong>Conclusions: </strong>Pelvic LN metastasis, positive surgical margins and IDC-P were independent prognostic factors for high-risk PCa, and NCHT might significantly improve bPFS compared with the NHT. In addition, the degree of reduction in glandular density and diameter was also associated with bPFS, and the nomogram based on pathological morphology parameters-intended for postoperative risk stratification-might be helpful in clinical decision-making.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319543","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":"The crisis of manufactured scholarship: confronting AI-driven \"letter-bombing\" and profile inflation in medical journals.","authors":"Manoj Pandey","doi":"10.1186/s12957-026-04465-6","DOIUrl":"10.1186/s12957-026-04465-6","url":null,"abstract":"<p><p>Post-publication peer review faces a emerging systemic vulnerability from 'letter-bombing'-the proliferation of high-volume, potentially machine-generated critiques that exploit citable correspondence units, creating a plausible risk of academic metric inflation. Driven by the democratization of Large Language Models (LLMs), these automated submissions frequently exploit formatting loopholes to manipulate public indicators like the h-index. The problem is particularly observable in data-intensive specialties like surgical oncology, where abstract-level statistical critiques targeting complex clinical trials risk muddying translational research communication. Drawing on documented bibliometric anomalies and confirmed editorial actions, this piece discusses operational definitions of abnormal correspondence volumes and proposes a multi-layered framework. To protect the scientific record, we propose an enforceable framework for editorial boards: implementing strict metadata labeling to close indexing loopholes, verifying author history, and mandating the \"Right of Simultaneous Reply\" as a universal baseline publishing standard.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319557","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":"Robotic-assisted versus conventional nipple-sparing mastectomy with immediate implant-based breast reconstruction: a GRADE-assessed systematic review and meta-analysis of prospective studies.","authors":"Wajahat Mirza, Hania Iqbal, Mehak Ejaz Khan, Alishbah Khan, Hadi Mohammad Khan","doi":"10.1186/s12957-026-04473-6","DOIUrl":"10.1186/s12957-026-04473-6","url":null,"abstract":"<p><strong>Background: </strong>Robotic nipple-sparing mastectomy with immediate implant-based reconstruction is increasingly adopted to improve cosmetic outcomes and patient experience; however, its comparative perioperative value against conventional or open nipple-sparing mastectomy remains uncertain when restricted to prospective evidence.</p><p><strong>Methods: </strong>We performed a PRISMA-aligned systematic review and random-effects meta-analysis of prospective comparative studies and randomized trials comparing robotic versus conventional or open nipple-sparing mastectomy with immediate implant-based reconstruction. The primary outcome was the total operative time, and the secondary outcomes were major complications, nipple-areolar complex ischemia or necrosis, and length of hospital stay. The risk of bias was assessed using RoB 2 for randomized data and ROBINS-I for nonrandomized data. Leave-one-out sensitivity analyses were conducted for outcomes with substantial heterogeneity, and the certainty of the evidence was graded using GRADE.</p><p><strong>Results: </strong>Three prospective studies were included. Robotic surgery was associated with a significantly longer total operative time (mean difference 64.01 min, 95% confidence interval 8.54-119.47). Major complications did not differ between the approaches (risk ratio 0.63, 95% confidence interval 0.27-1.47), nor did nipple areolar complex ischemia or necrosis (risk ratio 0.56, 95% confidence interval 0.28-1.11) or length of hospital stay (mean difference 0.22 days, 95% confidence interval - 0.26 to 0.70). Heterogeneity was high for operative time and moderate to substantial for length of stay. The certainty of the evidence was low overall, driven by imprecision, heterogeneity, and limitations of the non-randomized design.</p><p><strong>Conclusions: </strong>Robotic nipple-sparing mastectomy is associated with a longer operative time than conventional or open approaches. No statistically significant differences were observed in major complications or nipple-areolar complex viability; however, the current prospective evidence base is limited, heterogeneous, and imprecise, and clinically important differences cannot be excluded. In experienced centers, robotic nipple-sparing mastectomy may be considered for carefully selected patients who prioritize scar concealment and minimally invasive access; however, its broader role in routine practice remains uncertain pending stronger prospective data on safety, patient-reported outcomes, and resource use.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"24 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309726","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":"Triple primary synchronous liver cancer in one patient: the first case report and origin speculation through bioinformatics.","authors":"Zheng Zhou, Shuai Hu, Ting Liu, Danling He, Ting Bu, Lingqiu Mao, Xiyan Zheng, Maoyun Xie, Xianjie Shi","doi":"10.1186/s12957-026-04470-9","DOIUrl":"10.1186/s12957-026-04470-9","url":null,"abstract":"<p><strong>Introduction: </strong>A diagnosis of multiple primary liver tumors is extremely rare. Preoperative diagnosis based on imaging findings is difficult. Moreover, the clinical benefits of treatment strategies for multiple liver cancers remain unclear. Here, we report a case of three synchronous primary liver tumors with three distinct pathological types-hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular-cholangiocarcinoma (cHCC‑CCA)-in a single patient. Bioinformatics analysis supported at least two clonal origins, with cHCC‑CCA and ICC sharing a common lineage based on identical HBV integration sites.</p><p><strong>Case presentation: </strong>A 63-year-old female with a history of hepatitis B for several years presented with three lesions in hepatic segment VIII. Multiphase magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid revealed a diagnosis of multiple lesions, namely, cHCC‑CCA, with multiple intrahepatic metastases. The AFP level was normal, while the CA 19 - 9 level was mildly elevated (normal range ≤ 30.00 U/ml). Hepatectomy was performed, and postoperative assessment confirmed that the large lesion was cHCC‑CCA. However, the small lesions close to the large lesion were HCC and ICC. Gene testing revealed distinct mutational profiles among the three tumors. Similar gene mutations were detected in cHCC‑CCA and ICC. We also found that gene fragments of hepatitis B virus-C (HBV-C) were inserted into the genomes of ICC and cHCC‑CCA rather than that of HCC. The genomic integration site of HBV-C in cHCC‑CCA and ICC was the same.</p><p><strong>Conclusion: </strong>We report an extremely rare case of three synchronous primary liver tumors with three distinct pathological types (HCC, ICC, and cHCC‑CCA) in a single patient. Bioinformatics analysis supported at least two clonal origins, with cHCC‑CCA and ICC sharing a common lineage based on identical HBV integration sites. Hepatectomy represents a potential radical strategy for the treatment of multiple PLCs.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309812","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":"LncRNA ACTA2-AS1 acts as a bladder cancer prognostic biomarker and blocks malignant advance via miR-148b-3p/DNAJB4.","authors":"Xing Chen, Qunfu Tang, Yingjie Wang, Jianbin Zhang, Lei Zhou","doi":"10.1186/s12957-026-04447-8","DOIUrl":"10.1186/s12957-026-04447-8","url":null,"abstract":"<p><strong>Background: </strong>Long non-coding RNA (lncRNA) is crucial in bladder cancer (BCa) development. This research explores the clinical significance and underlying mechanisms of lncRNA ACTA2-AS1 in BCa.</p><p><strong>Methods: </strong>From the GEO database, differentially expressed lncRNAs (DElncRNAs) in BCa were identified, and tumor, along with adjacent non-tumor tissue samples from 132 patients, were collected. RT-qPCR was employed for the quantitative measurement of ACTA2-AS1, miR-148b-3p, and DNAJB4 expression. Chi-square analysis was employed to assess the association of ACTA2-AS1 with clinical features. Kaplan-Meier and Cox regression evaluated ACTA2-AS1's prognostic value. CCK-8, Transwell, and flow cytometry assays evaluated cell proliferation, migration, invasion, apoptosis, and cell cycle arrest. DLR and RIP tests confirmed miR-148b-3p's targeting of ACTA2-AS1 and DNAJB4.</p><p><strong>Results: </strong>ACTA2-AS1 showed significant downregulation in four GEO databases. Moreover, both ACTA2-AS1 and DNAJB4 were notably decreased in BCa tumor tissues, while miR-148b-3p increased significantly. Low ACTA2-AS1 expression correlates with poor tumor differentiation, positive lymph node metastasis, and TNM stage III-IV. Moreover, patients with low ACTA2-AS1 expression are associated with a significantly unfavorable prognosis. Mechanistically, miR-148b-3p targets ACTA2-AS1 and DNAJB4. The suppression impacts of ACTA2-AS1 on BCa cell proliferation, migration, and invasion, and its boost of apoptosis and cell cycle arrest were greatly reversed by miR-148b-3p.</p><p><strong>Conclusion: </strong>Low ACTA2-AS1 expression is a potential biomarker for unfavorable prognosis in BCa patients. Furthermore, ACTA2-AS1 may counteract BCa's malignant biological behaviors via targeting the miR-148b-3p/DNAJB4 axis.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309766","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":"HMGB1 promotes radiotherapy resistance in human cervical cancer HeLa cells through regulating the AMPK/mTOR signaling.","authors":"Youyou Xie, Changhui Yu, Miao Wang, Yaqin Lin, Biyun Wang","doi":"10.1186/s12957-026-04461-w","DOIUrl":"10.1186/s12957-026-04461-w","url":null,"abstract":"<p><p>Cervical cancer (CC) ranks as the third most common malignancy among women worldwide. Radiotherapy (RT) resistance represents a major cause of clinical treatment failure and disease progression. High-mobility group box-1 (HMGB1), a nuclear protein released during RT, has been implicated in the regulation of radiation resistance. This study aimed to establish HeLa RT-resistant (HeLa-R) cells and investigate the effect of HMGB1 on RT resistance and its underlying molecular pathway. HeLa-R cells were established through fractionated X-ray irradiation. Cell viability, proliferation, migration, and invasion were assessed using methyl thiazolyl tetrazolium (MTT), colony formation, Transwell migration, and invasion assays, respectively. HMGB1 expression was analyzed by quantitative RT-PCR, Western blot, and immunofluorescence. A phospho-kinase array was performed to evaluate phosphorylation levels of key kinase sites. Following fractionated X-ray irradiation, we successfully established HeLa-R cells, which exhibited significantly elevated HMGB1 expression compared to parental cells. HMGB1 knockdown suppressed RT resistance in HeLa-R cells, accompanied by increased phosphorylation of AMP-activated protein kinase (p-AMPK). Conversely, AMPK inhibition restored cell viability, colony formation, migration, and invasion in HMGB1-deficient HeLa-R cells. Mechanistically, in HeLa-R cells, mTOR was identified as a downstream effector of AMPK signaling. Separately, clinical analysis revealed that HMGB1 levels were significantly elevated, while p-AMPK levels were markedly reduced in tumor tissues from radioresistant patients compared with radiosensitive patients. In conclusion, our in vitro findings demonstrate that HMGB1 inhibition suppresses RT resistance in HeLa-R cells through activation of the AMPK/mTOR pathway. The clinical correlations between HMGB1, p-AMPK, and radiotherapy response support the potential relevance of this pathway, although further validation in patient tissues is required.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309795","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":"Multi-omics integration and clinical validation identify CKAP2 as a diagnostic biomarker for bladder cancer.","authors":"Xinxin Li, Jinshan Yang, Jiazi Cha, Hao Xie, Changming Dong, Yufan Yang, Yue Li, Jiahao Guo, Chunhua Lin","doi":"10.1186/s12957-026-04464-7","DOIUrl":"10.1186/s12957-026-04464-7","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer (BC) remains a prevalent malignancy with a high recurrence rate; however, the lack of specific biomarkers hinders early detection and effective management. Although Cytoskeleton-Associated Protein 2 (CKAP2) has been implicated in tumorigenesis, its diagnostic value and biological function in BC have not been fully elucidated. This study aimed to identify and rigorously validate CKAP2 as an important diagnostic biomarker using a multi-omics approach integrated with clinical validation.</p><p><strong>Methods: </strong>Differential expression analysis and machine learning-based feature selection were employed to screen for candidate biomarkers, identifying CKAP2 as a key gene of interest. Mendelian randomization (MR) was used to assess the causal relationship between CKAP2 and BC risk. To evaluate clinical utility, a diagnostic model based on logistic regression was established and validated in an independent real-world cohort of 127 tissue samples, including 50 pairs of matched tumor and adjacent normal tissues, 21 independent tumor tissues, and 6 independent adjacent normal tissues. Additionally, single-cell RNA sequencing (scRNA-seq) and cell-cell communication analyses were performed to dissect the role of CKAP2 within the tumor microenvironment.</p><p><strong>Results: </strong>CKAP2 expression was significantly upregulated in BC tissues compared to that in normal tissues (log2FoldChange = 1.53, p < 10⁻⁵). MR analysis provided evidence supporting a potential causal association between elevated CKAP2 expression and increased BC risk. In the external clinical validation, the CKAP2-based model demonstrated exceptional discrimination with an Area Under the Curve (AUC) of 0.931. Calibration curves indicated a high agreement between the predicted and observed probabilities, while Decision Curve Analysis (DCA) confirmed a substantial clinical net benefit. Mechanistically, scRNA-seq localized high CKAP2 expression primarily to cancer cells, and cell-cell communication analysis suggested that CKAP2 may play an important role in modulating tumor-stroma interactions, particularly with fibroblasts.</p><p><strong>Conclusion: </strong>Our integrated analysis supports the potential utility of CKAP2 as a diagnostic biomarker for BC. By integrating multi-omics analysis, causal inference, and validation in an independent clinical cohort, these results consistently point to CKAP2's diagnostic potential and suggest its involvement in BC progression.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309817","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":"Study of phosphorylated ribosomal protein S6 (pS6) in the clinical outcomes of patients undergoing hepatectomy for metastatic colorectal cancer.","authors":"Rafaella Henriques Cavalcanti Torres de Melo, Paulo Goberlianio de Barros Silva, Heladio Feitosa E Castro Neto, Rayane Cardoso de Souza Nunes, José Ricardo de Moura Torres de Melo, Maria Julia Barbosa Bezerra, Conceição Aparecida Dornelas, Carlos Gustavo Hirth","doi":"10.1186/s12957-026-04453-w","DOIUrl":"10.1186/s12957-026-04453-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide, with up to 50% of patients developing metastatic disease, predominantly involving the liver. Hepatectomy remains the gold standard for resectable hepatic metastases; however, recurrence rates remain high and reliable prognostic biomarkers are lacking. Phosphorylated ribosomal protein S6 (pS6), a surrogate marker of PI3K/AKT/mTORC1 pathway activation, has been implicated in tumor aggressiveness across multiple cancer types, but its prognostic role after hepatectomy for metastatic colorectal cancer (mCRC) has not been established.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the prognostic impact of pS6 expression and other molecular markers (BRAF V600E, p53, CERBB2, MSH6, PMS2, FUS, and HSPA9) assessed by immunohistochemistry on tissue microarray (TMA) on the clinical outcomes of patients undergoing hepatectomy for metastatic colorectal cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A retrospective cohort study was conducted including 64 patients who underwent hepatectomy for mCRC between 2012 and 2022 at a high-complexity oncology center in Northeast Brazil. Molecular marker expression was evaluated by immunohistochemistry on TMA constructed from paraffin-embedded hepatic metastasis specimens. Disease-free survival (DFS) at 1, 3, and 5 years and overall survival (OS) were analyzed using Fisher's exact test, Kaplan-Meier curves, and Cox regression multivariate analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Median OS was 23 months (95% CI = 18.33-27.66). Among all molecular markers assessed, only pS6 positivity (20.7% of cases) showed a statistically significant association with worse DFS at 1 year (p = 0.032), 3 years (p = 0.038), and 5 years (p = 0.018). A significant association was also identified between pS6 positivity and FUS positivity (p = 0.014). In multivariate analysis for DFS, pS6 positivity was an independent predictor of recurrence at 3 years (HRa = 9.710; p = 0.028) and 5 years (HRa = 11.857; p = 0.018), as were postoperative complications at 3 years (HRa = 8.671; p = 0.014) and 5 years (HRa = 6.912; p = 0.029). For overall survival, three independent predictors of mortality were identified: adjuvant chemotherapy (HRa = 0.052; p &lt; 0.001), absence of 1-year DFS (HRa = 3.641; p = 0.001), and pS6 positivity (HRa = 4.547; p = 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Median overall survival was 23 months, reflecting the high mortality burden of mCRC after hepatectomy. Among all molecular markers evaluated, pS6 was the only one independently associated with worse disease-free survival and higher mortality risk, consistent with its role as a surrogate marker of PI3K/AKT/mTORC1 pathway activation, though a direct causal relationship cannot be established from the present data. A significant association between pS6 and FUS positivity suggests a possible convergence of oncogenic pathways warranting further investigation. Postoper","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303310","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":"Targeting RELA and STAT3 regulates TNFRSF10A-mediated apoptosis in a novel apoptosis-based prognostic model for clear cell renal cell carcinoma.","authors":"Yuyou Deng, Changzhen Hao, Xiaobing Yang, Chengfan Yu, Ming Xia, Tian Wang","doi":"10.1186/s12957-026-04462-9","DOIUrl":"10.1186/s12957-026-04462-9","url":null,"abstract":"<p><strong>Background: </strong>Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal malignancy and remains a major cause of cancer-related mortality worldwide. Although advances in surgery, targeted therapy, and immunotherapy have improved outcomes for patients, reliable biomarkers for predicting prognosis remain limited. Therefore, robust gene-based prognostic models are urgently needed to improve risk stratification and guide individualized treatment strategies.</p><p><strong>Methods: </strong>We developed a novel prognostic model integrating apoptosis and immune - related genes (AIRGs) to predict overall survival (OS) in patients with ccRCC.</p><p><strong>Result: </strong>Using Gene Set Enrichment Analysis (GSEA) combined with least absolute shrinkage and selection operator (LASSO) Cox regression, we identified 7 key prognostic genes, namely, CCR4, TNFRSF10A, TEK, TGFA, CD14, IFITM1, and SEMA3G, that collectively demonstrated strong predictive performance in TCGA cohort with c-index = 0.711. Functional enrichment analyses revealed that apoptosis, immune regulation, and multiple oncogenic signaling pathways were significantly associated with the risk score, highlighting the critical role of the tumor microenvironment in ccRCC progression. Transcription factor binding analysis based on the JASPAR database suggested that RELA and STAT3 with scores of 0.829 and 0.951, respectively are potential upstream regulators within the prognostic network, particularly influencing TNFRSF10A expression. External validation using the International Cancer Genome Consortium (ICGC) dataset confirmed the robustness of the prognostic model with c-index = 0.612 Furthermore, in vitro experiments demonstrated that RELA and STAT3 regulate TNFRSF10A-mediated apoptotic signaling in ccRCC cells, providing mechanistic support for the bioinformatic findings.</p><p><strong>Conclusion: </strong>This study establishes a biologically informed and clinically relevant prognostic framework for ccRCC. Our findings highlight the therapeutic potential of targeting the RELA/STAT3-TNFRSF10A axis and contribute to the advancement of precision medicine in ccRCC.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296475","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}