World Journal of Surgical Oncology最新文献

{"title":"ALOXE3 expression predicts poor prognosis and modulates immune infiltration in colon adenocarcinoma.","authors":"Liwen Zhao, Liya Zhao, Siyu Ye, Shengnan Jing, Han Yang, Yixin Qi, Zhaofeng Li, Zaiqing Jiang, Xuechuan Yan, Ke Wang, Yong-Jing Gao, Tianzhen He","doi":"10.1186/s12957-025-03939-3","DOIUrl":"10.1186/s12957-025-03939-3","url":null,"abstract":"<p><strong>Background: </strong>Lipoxygenase family proteins (LOXs) are involved in various stages of tumor development, however, their specific roles in tumor-infiltrating lymphocytes (TILs) within colon adenocarcinoma (COAD) remain poorly defined. This study aims to comprehensively examine LOXs expression in COAD and evaluate their potential associations with immune cell infiltration and clinical outcomes.</p><p><strong>Methods: </strong>We analyzed transcriptomic and clinical data from 477 tumor and 41 adjacent normal tissue samples in the TCGA-COAD dataset to evaluate the expression levels of LOX family genes and their associations with overall survival. To validate ALOXE3 expression, we performed RT-qPCR on fresh tumor and the corresponding matched adjacent tissues from six human colon carcinoma patients. Additionally, immune cell infiltration associated with LOX expression was explored using the TIMER and TISIDB databases. For functional validation, ALOXE3 was either overexpressed or silenced via shRNA in colon cancer cell lines, and its effects on tumor progression were assessed through in vitro proliferation assays and in vivo xenograft models.</p><p><strong>Results: </strong>Among all LOX family members, only ALOXE3 expression was significantly associated with survival outcomes in COAD patients (overall survival: HR = 1.56, p < 0.05; disease-specific survival: HR = 2.12, p < 0.01; progression-free interval: HR = 1.55, p < 0.05). Functional assays showed that ALOXE3 overexpression significantly promoted tumor cell proliferation in vitro and enhanced tumor growth in vivo, whereas shRNA-mediated knockdown of ALOXE3 markedly suppressed cell proliferation. KEGG pathway analysis of genes co-expressed with ALOXE3 revealed a remarkable enrichment in mitogen-activated protein kinase (MAPK) signlaing pathway. Consistently, ALOXE3 overexpression resulted in activation of the ERK1/2 signaling pathway, as confirmed by Western blot analysis (p < 0.05). Furthermore, treatment with the ERK inhibitor SCH772984 effectively suppressed ALOXE3-induced tumor cell proliferation, suggesting that ALOXE3 may drive tumor growth via activation of the ERK1/2 signaling pathway.</p><p><strong>Conclusions: </strong>ALOXE3 promotes tumor progression in COAD through activation of the ERK1/2 signaling pathway and exhibits a strong association with the immune cell infiltration of the tumor microenvironment. It may serve as a prognostic biomarker and a potential therapeutic target in COAD. Further studies are warranted to validate its clinical applicability and explore its role in immunotherapeutic approaches.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"296"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691704","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":"Overall survival post secondary cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent colorectal cancer with peritoneal metastases.","authors":"Raymond Hayler, Celine Garrett, Jessica Guo, Shoma Barat, Mina Sarofim, Ruwanthi Wijayawardana, Nima Ahmadi, Winston Liauw, David L Morris","doi":"10.1186/s12957-025-03923-x","DOIUrl":"10.1186/s12957-025-03923-x","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is the third-most common malignancy worldwide. It has the potential to develop peritoneal metastases (CRPM), which can be treated using cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). There is limited literature on outcomes of secondary CRS/HIPEC for CRPM recurrence.</p><p><strong>Methods: </strong>All patients with CRPM who had secondary CRS/HIPEC between 2000 and 2023 were included. Clinical information regarding histological grade, peritoneal cancer index (PCI), completion of cytoreduction (CC), other metastases and their treatments, morbidity grade and demographics including sex, age and death were collected. The outcome of interest was peri-operative morbidity measured using Clavien-Dindo classification comparing with index CRS/HIPEC and survivals (disease-free survival (DFS) and overall survival (OS)). Secondary analyses were conducted to compare concurrent treatments and variables correlated with survivals.</p><p><strong>Results: </strong>Out of 435 patients who underwent CRS/HIPEC for colorectal cancer, 65 underwent secondary CRS/HIPEC. The median PCI score at secondary CRS/HIPEC was 6 (range 0-18) compared to 8 at index CRS/HIPEC (p < 0.01), and the median CC score at secondary CRS/HIPEC was 0 (n = 59, 91%) compared to 0 (n = 65, 100%) at index CRS/HIPEC (mean 0.0 v 0.12, p = 0.02). HIPEC was given in 59/65 patients (90%). Ten patients (15%) had radio- or microwave ablation to lung/liver metastases. Significant Clavien-Dindo morbidity (≥ 3) was similar between index and secondary operation with 13 (23%) of patients and 12 (19%) respectively. Median length of stay was 17 days. Median DFS after secondary CRS/HIPEC was 10.7 months, with an OS of 31.1 months. From index CRS/HIPEC, OS was 65.2 months. There was no difference by histological grade and no difference in DFS or OS in those who had had ablation. PCI at secondary operation was negatively associated with OS (r=-0.32, p = 0.009).</p><p><strong>Conclusion: </strong>Secondary CRS/HIPEC for patients with CRC recurrence has comparable perioperative morbidity and mortality to index CRS/HIPEC, with significant disease-free and overall survival. Ablation of oligometastatic or extra-abdominal disease allows for comparable survival post-secondary CRS/HIPEC. Secondary CRS/HIPEC should be considered in selected patients.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"297"},"PeriodicalIF":2.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699700","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":"7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications.","authors":"Ze Huang, Zhijie Wu, Xiaoyan Fu, Yonghai Guo, Siyuan Lin, Jieying Chen, Zongyan Li, Zuxiao Chen, Haiyan Li","doi":"10.1186/s12957-025-03935-7","DOIUrl":"10.1186/s12957-025-03935-7","url":null,"abstract":"<p><strong>Background: </strong>Single-port endoscopic nipple-sparing mastectomy (E-NSM) with implant-based breast reconstruction (IBBR) represents a promising surgical technique. However, the surgical procedures are complex and lack standardized and systematic surgical protocols. The seven-step method was introduced as a means of simplifying the complex surgical procedures, with detailed descriptions provided of the key points and critical aspects of the surgery.</p><p><strong>Methods: </strong>The medical records of patients who received single-port E-NSM with IBBR guided by the seven-step method from January 2022 to March 2024 were analyzed. The preliminary results were presented.</p><p><strong>Results: </strong>A total of 65 patients were enrolled in the study, who received 93 procedures of single-port E-NSM with IBBR following the seven-step method. The mean age was 41.7 ± 8.2 years, and the mean body mass index (BMI) was 22.81 ± 3.5 kg/m². All patients had breasts of C cup size or smaller. One case required nipple-areola complex (NAC) removal due to tumor involvement, while no involvement of the surgical margins was detected. The mean operative time was 258.6 ± 71.2 min, and the mean intraoperative blood loss was 27.7 ± 20.5 ml. The overall complication rate was 8.6%, with six cases (6.5%) of nipple partial ischemia observed. No case experienced nipple necrosis. All reported complications were classified as minor. In Breast-Q \"Satisfaction with Breasts\" module, the mean score was 65.7 ± 18.0. The \"physical well-being of chest\" score was 73.9 ± 13.6. All four sensory types of the nipple-light touch, temperature, pressure, and pain-as well as erectile function, were preserved at favorable rates following the procedure. As of the last follow-up, no patients experienced local recurrence, distant metastasis, or mortality.</p><p><strong>Conclusions: </strong>Single-port E-NSM with IBBR, guided by the seven-step method, is a safe and feasibility surgical approach. It is associated with a low complication rate, good cosmetic outcomes, and reasonable preservation of nipple sensation and erectile function. This technique appears particularly suitable for patients with breast sizes of C cup or smaller. The proposed seven-step method may provide a valuable framework for clinical practice and serve as a practical reference for peers, thereby contributing to the establishment of standardized and systematic surgical protocols.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"292"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691703","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":"Harnessing organoid technology in urological cancer: advances and applications in urinary system tumors.","authors":"Xiaoting Wang, Danyan Lin, Ninghan Feng","doi":"10.1186/s12957-025-03948-2","DOIUrl":"10.1186/s12957-025-03948-2","url":null,"abstract":"<p><p>The organoid approach preserves the intricate molecular and genetic characteristics of tumor tissues, playing a pivotal role in advancing precision oncology. This preservation enables the exploration of cancer therapies and in vitro validation of drug efficacy. Organoids have emerged as indispensable tools in the study of urological cancers, facilitating research on tumorigenesis, drug testing, and the development of therapeutic combinations. Their superiority over traditional 2D cell cultures and patient-derived xenograft (PDX) models lies in their enhanced ability to more accurately replicate the in vivo environment. Modern organoid platforms integrate 3D bioprinting, co-culture systems, microfluidics, and artificial intelligence to significantly improve the precision, scalability, and efficiency of cancer research. These integrated systems serve as powerful analytical tools, propelling the development of personalized therapies for urological malignancies. This article provides a comprehensive review of the establishment and potential of organoid technologies in treating the three major urogenital system cancers-prostate, bladder, and renal-highlighting their trajectory from basic research to clinical applications and their expanding synergy with bioengineering innovations.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"295"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691706","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":"Intraoperative ultrasound-guided wire(IOUS-wire) localization biopsy versus preoperative fine needle aspiration cytology(FNAC) for early breast cancer with clinically positive nodes, a retrospective cohort study.","authors":"Xue Song, Shijun Tan, Jiafa He, Xiaojie Lin, Lingling Ye, Shengying Chen, Rui Xu, Yan Dai, Qianjun Chen","doi":"10.1186/s12957-025-03925-9","DOIUrl":"10.1186/s12957-025-03925-9","url":null,"abstract":"<p><strong>Background: </strong>The false-negative rate (FNR) of fine needle aspiration (FNA) for clinically positive (suspicious) lymph nodes (LNs) remains excessively high.</p><p><strong>Methods: </strong>We compared the feasibility and diagnostic efficiency of using a novel procedure to FNA for the assessment of clinically positive nodes in patients with early breast cancer. Between 1 January 2015 and 30 September 2023, 198 consecutive patients who consented to undergo axillary biopsy were referred to either the intraoperative ultrasound-guided wire localization group (IOUS-wire) or the ultrasound-guided fine needle aspiration group (US-FNAC). The primary endpoint was the false-negative rate (FNR) and accuracy rates of the two methods. One hundred patients were in the IOUS-wire group, whereas the other 98 patients were in the US-FNAC group.</p><p><strong>Results: </strong>The FNR of clinically positive lymph node biopsies was lower in the IOUS-wire localization group than in the US-FNAC group (16.1% versus 87.5%, p < 0.001). Among the 32 successfully identified metastatic lymph nodes, 26 (81.3%) were detected in the IOUS-wire group. In the US-FNAC group, 42 additional lymph node metastases were identified via SLNB among patients initially classified as FNAC-negative. The accuracy rates for IOUS-wire and US-FNAC were 95% and 57.1%, respectively (p < 0.001). No significant differences were observed in complications or median SLNs harvested between groups.</p><p><strong>Conclusion: </strong>IOUS-wire localization with frozen sections demonstrated superior diagnostic performance compared to preoperative US-FNAC in patients with clinically node-positive early breast cancer. This novel method should be further pursued as a potential biopsy method for evaluating axillary node status, particularly in settings where rapid intraoperative decision-making is prioritized.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"291"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691707","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":"Multiple endocrine neoplasia type 1 with neuroglycopenic symptoms with a novel heterozygous MEN1 gene mutation.","authors":"Xinchen Jiang, Shixiong Tang, Guoqing Yang, Lite Ge, Fan Peng","doi":"10.1186/s12957-025-03942-8","DOIUrl":"10.1186/s12957-025-03942-8","url":null,"abstract":"<p><strong>Background: </strong>Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder caused by mutations in the MEN1 gene located on the long arm of chromosome 11.</p><p><strong>Case presentation: </strong>A 32-year-old male was admitted to the Division of Endocrinology with a three-year history of recurrent episodes of altered consciousness and abnormal mental behavior. Laboratory tests and imaging studies revealed primary hyperparathyroidism (PHPT), multiple pancreatic adenomas, and a pituitary adenoma. Genetic analysis identified a heterozygous germline mutation in exon 2 of the MEN1 gene (NM_130799; c.416A > T, p.(His139Leu)), confirming a diagnosis of Multiple Endocrine Neoplasia Type 1 (MEN1).</p><p><strong>Conclusions: </strong>MEN1 patients should be evaluated for clinical manifestations of neuroglycopenia caused by pancreatic neuroendocrine tumors (pNETs). These neuroglycopenic symptoms (altered consciousness and abnormal mental behavior) should be distinguished from the neuropsychiatric and cognitive symptoms associated with PHPT. Furthermore, our report describes the identification of the first mutation associated with MEN1 as NM_130799.2: c.416A > T, p.(His139Leu). It provides valuable insight into the clinical presentation of multiple endocrine neoplasia type 1.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"294"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691753","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":"Clinicopathologic risk factors for post-operative complications after enucleation of pancreatic neoplasms.","authors":"Isheeta Madeka, Steven Yi, Julia Evans, David Baek, Haresh V Naringrekar, Harish Lavu, Charles J Yeo, Avinoam Nevler, Wilbur B Bowne","doi":"10.1186/s12957-025-03920-0","DOIUrl":"10.1186/s12957-025-03920-0","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic enucleation is a parenchymal-sparing procedure used for highly select patients with pancreatic neoplasms. We aim to utilize a multi-institutional health research network platform (TriNetX) and a single, high-volume center to assess complications and identify risk factors associated with post-operative pancreatic fistulas (POPF) after pancreatic enucleation.</p><p><strong>Methods: </strong>A two-tiered retrospective study was conducted. We identified 423 patients from TriNetX, and 34 patients from a single-institution IRB-approved database who underwent pancreatic enucleation between 2004-2025 and 2012-2023, respectively. Univariate and multivariate analyses were performed to determine risk factors associated with post-operative complications and occurrence of POPFs.</p><p><strong>Results: </strong>In the TriNetX cohort, 128 (30.3%) experienced postoperative complications after pancreatic enucleation. On univariate analysis, hyperlipidemia (HLD) (OR = 2.37), gastroesophageal reflux disease (GERD) (OR = 3.87), acute pancreatitis (OR = 8.28), chronic pancreatitis (OR = 4.76), nicotine dependence (OR = 2.36), ascites (OR = 6.49), deep vein thrombosis (DVT), pulmonary embolism (PE), and thrombophlebitis (OR = 2.95), and body mass index (BMI) ≥ 25 (OR = 1.56) were identified as significant risk factors. On multivariate analysis, acute pancreatitis (HR = 1.64), chronic pancreatitis (HR = 1.78), ascites (HR = 2.96), DVT, PE and thrombophlebitis (HR = 1.74) remained significant. In our single-institution enucleation cohort, 8 patients had a POPF (23.5%). The measured distance from the neoplasm to the main pancreatic duct (MPD) was significantly shorter in patients who developed POPF (2.8 vs 6.5 mm, P < 0.05). ROC analysis determined that shorter distance from the MPD was predictive of POPF occurrence (AUC = 0.79, p < 0.005). Increased estimated blood loss was also associated with POPF (p < 0.01).</p><p><strong>Conclusion: </strong>Our study identifies clinicopathologic risk factors associated with post-operative complications and POPF after pancreatic enucleation. The distance from the neoplasm to the MPD appears to be a key component of decision-making in the development of POPF.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"293"},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691705","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":"Knockdown of PVT1 inhibits cell proliferation in luminal and basal-like breast cancer subtypes by activating LATS2/Hippo signaling pathway.","authors":"Hai-Bo Zhang, Ying Zeng, Guo Wang","doi":"10.1186/s12957-025-03944-6","DOIUrl":"10.1186/s12957-025-03944-6","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer (BC) is a malignant tumor seriously threatening women's health, while current approaches to BC treatment are challenged by the existence of drug resistance. Combination strategies of targeted therapy have been successfully applied in clinical BC treatment. However, whether there exist critical long non-coding RNAs (lncRNAs) responsible for BC pathogenesis and representing promising candidates for combined targeted therapy remains an issue.</p><p><strong>Methods: </strong>Public databases and bioinformatic methods were used to identify lncRNAs abnormally expressed among different subtypes of BC. The expression level of PVT1 was verified in collected clinical samples and representative cell lines. The role of PVT1 in BC cell proliferation was examined using MTS, plate clone formation, EdU and flow cytometry assay after small interfering RNA (siRNA) treatment. RNA sequencing was performed to investigate the potential molecular events regulated by PVT1. Western blot and immunofluorescence experiments were used to verify the activation of LATS2/Hippo signaling pathway after PVT1 knockdown. In addition, its activation was confirmed to mediate PVT1 function through rescue assay. The regulatory effect of PVT1 on LATS2 was investigated using mRNA stability experiments.</p><p><strong>Results: </strong>The expression level of PVT1 in BC tissues of luminal and basal-like subtypes was significantly higher than that in paracancerous tissues. PVT1 knockdown substantially inhibited the proliferation of BC cells in both subtypes. RNA sequencing revealed that Hippo signaling pathway might be the downstream target of PVT1. After PVT1 knockdown, both mRNA and protein levels of LATS2 were elevated which further decreased the distribution of YAP in cell nucleus, indicating the activation of Hippo signaling pathway. The proliferation inhibitory effect of PVT1 could be attenuated by simultaneous knockdown of LATS2. Furthermore, knockdown of PVT1 was demonstrated to significantly slow down the degradation rate of LATS2 mRNA.</p><p><strong>Conclusions: </strong>PVT1 level was significantly elevated in luminal and basal-like BC subtypes. Knockdown of PVT1 could inhibit cell proliferation of these two BC subtypes partly through activating LATS2/Hippo signaling pathway.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"289"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668639","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":"Lesional volume in the prediction of clinically significant prostate cancer.","authors":"Bellamy Brodie, Daniel Yang Yao Peh, Yu Guang Tan, Yan Mee Law, Kae Jack Tay, Christopher Wai Sam Cheng, Henry Sun Sien Ho, John Shyi Peng Yuen, Alvin Yuan Ming Lee, Kenneth Chen","doi":"10.1186/s12957-025-03905-z","DOIUrl":"10.1186/s12957-025-03905-z","url":null,"abstract":"<p><strong>Background: </strong>While MRI has significantly advanced risk stratification in prostate cancer, PIRADS scoring alone is still insufficient to solely determine which patients do not require biopsy. Beyond PIRADS scoring, data regarding lesional volume and number can easily be extracted. This study aims to investigate whether the novel parameter 'Lesional PSAD' is a better predictive biomarker for clinically significant prostate cancer than conventional PSAD.</p><p><strong>Methods: </strong>A retrospective analysis of 433 patients who underwent MRI Prostate followed by MRI-US fusion trans-perineal targeted and systematic biopsy was performed. Prostate and lesional volumes were calculated using the planimetry technique using MRI files. All PIRADS 3-5 lesions were considered significant. Lesional PSAD was calculated as: [Formula: see text] Statistical analysis with Mann-Whitney U and receiver operating curves was performed for prediction of clinically significant prostate cancer.</p><p><strong>Results: </strong>Median PSA at biopsy was 8.5 (6.1-11.64, ng/ml), with a prostate volume of 38.2 (29.2 -54.19, cc), and total lesional volume of 1.49cm² (0.65-2.77). Higher conventional PSAD was associated with higher rates of csPCa (0.173 vs 0.282, p < 0.01). Total lesional volume was found to be significantly higher in csPCa cases (1.205 vs. 1.980, p < 0.001). Lesional PSAD was also found to be significantly higher in the csPCa cohort (LPSAD 0.191 vs 0.561, p < 0.001). ROC analysis showed better discrimination for csPCa with lesional PSAD compared to conventional PSAD (AUC 0.741 vs. 0.733). Subgroup analysis also favoured lesional PSAD over conventional PSAD in patient under 60 years (AUC 0.728 vs. 0.704).</p><p><strong>Conclusion: </strong>Integrating lesional volume with conventional PSAD marginally increases predictive accuracy for csPCa, more so in early-onset prostate cancer, potentially aiding in decision-making for biopsy in high-risk patients.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"290"},"PeriodicalIF":2.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668640","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 safety evaluation of intersphincteric resection combined with rectal eversion and total extra-abdominal resection: a prospective randomized controlled trial.","authors":"Zhanpeng Yang, Aizhen Wang, Hong Liang, Qingwen Fan, Shuaipeng Li, Fuqiang Yao, Mengzhe Li, Xi Wang, Chao Zhang","doi":"10.1186/s12957-025-03952-6","DOIUrl":"10.1186/s12957-025-03952-6","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer remains a significant global health burden, with low rectal tumors posing unique surgical challenges due to their proximity to the anal verge. Traditional abdominoperineal resection (APR) compromises quality of life with permanent colostomy, while sphincter-preserving techniques like laparoscopic intersphincteric resection (L-ISR) face technical limitations. This study evaluates the safety and efficacy of a novel technique - ISR combined with rectal eversion and total extra-abdominal resection (ISRER) - aimed at reducing anastomotic complications, and enhancing anal preservation in anatomically challenging patients.</p><p><strong>Methods: </strong>This was a prospective randomized controlled, unmasked, parallel group trial in Henan Provincial People's Hospital. Intraoperative peritoneal lavage cytology and bacterial culture were performed to assess tumor cell shedding and contamination. Outcomes included distal margin positivity, anal preservation rate, postoperative complications, hospital costs,30-day readmission rates and postoperative stay.</p><p><strong>Results: </strong>All 74 patients with low rectal cancer (3-5 cm from the anal verge) between March 2024 and March 2025. Patients were randomly stratified into ISRER (n = 35) and laparoscopic ISR (L-ISR) (n = 39) groups. No tumor cells or bacterial contamination were detected in peritoneal lavage cytology or cultures. Both groups achieved 100% R0 resection (distal margin negativity). The ISRER group demonstrated a significantly higher anal preservation rate (94.3 vs. 71.8%, P = 0.011) with comparable postoperative complications (2.9 vs. 2.6%, P = 0.735), 30-day readmission rates (2.9 vs. 2.6%, P = 0.938), and hospitalization costs (62,540 vs. 64,937 CNY, P = 0.915). Median postoperative stay was marginally longer in the ISRER group (10 vs. 9 days, P = 0.135), while gastrointestinal recovery and inflammatory markers showed no intergroup differences.</p><p><strong>Conclusion: </strong>ISRER is a safe and technically feasible sphincter-preserving approach for low rectal cancer, offering superior anal retention without compromising oncological safety or increasing complications.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"23 1","pages":"287"},"PeriodicalIF":2.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668642","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}