World Journal of Surgical Oncology最新文献

{"title":"Excessive glutathione intake contributes to chemotherapy resistance in breast cancer: a propensity score matching analysis.","authors":"Zhiyuan Zhang, Jiaru Gao, Linjiao Jia, Shuxin Kong, Maosen Zhai, Shuai Wang, Wenwen Li, Shoukai Wang, Yuqing Su, Wanyue Li, Changzheng Zhu, Wenkang Wang, Yuanxiang Lu, Wentao Li","doi":"10.1186/s12957-024-03626-9","DOIUrl":"10.1186/s12957-024-03626-9","url":null,"abstract":"<p><strong>Background: </strong>We aim to explore the impact of excessive glutathione (GSH) intake on chemotherapy sensitivity in breast cancer.</p><p><strong>Methods: </strong>Clinicopathological data were collected from 460 breast cancer patients who underwent adjuvant chemotherapy from January 2016 to December 2019 from Zhengzhou University People's Hospital. The clinicopathological characteristics following GSH treatment were collected and compared with those in Non-GSH group after 1:2 propensity score matching (PSM). Intracellular GSH levels and the expression of antioxidant enzymes (NRF2, GPX4 and SOD1) were evaluated in tumor tissues in 51 patients receiving neoadjuvant chemotherapy.</p><p><strong>Results: </strong>The recurrence rate after adjuvant chemotherapy was significantly higher in the GSH group (n = 28, 31.8%) than that in the Non-GSH group (n = 39, 22.2%; P = 0.010). Additionally, patients in the HGSH group (high GSH intake, ≥ 16 days) exhibited an elevated recurrence rate compared to that in the LGSH group (low GSH intake, < 16 days) (n = 15 (46.8%) vs. n = 52 (22.4%); P = 0.003). Cox regression revealed that High GSH intake, Ki67 ≥ 30%, Triple negative and Lymphovascular invasion were independent risk factors of progression after adjuvant chemotherapy. Among patients receiving neoadjuvant chemotherapy, intracellular GSH levels and the expression levels of antioxidant enzymes (NRF2, GPX4 and SOD1) in the resistant patients were substantially higher (P < 0.001).</p><p><strong>Conclusions: </strong>Excessive GSH intake may contribute to chemotherapy resistance in breast cancer, and the levels of intracellular GSH and antioxidant enzymes are elevated in resistant patients after neoadjuvant chemotherapy, indicating that the standardization of GSH intake may assist in reducing chemotherapy resistance.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"345"},"PeriodicalIF":2.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872921","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":"Efficacy of adjuvant chemotherapy after curative hepatectomy for patients with colorectal cancer liver metastases: a single-center retrospective study.","authors":"Akira Inoue, Yujiro Nishizawa, Masahiro Hashimoto, Yuki Ozato, Yoshihiro Morimoto, Akira Tomokuni, Masaaki Motoori, Kazumasa Fujitani","doi":"10.1186/s12957-024-03631-y","DOIUrl":"10.1186/s12957-024-03631-y","url":null,"abstract":"<p><strong>Background: </strong>The survival benefit of adjuvant chemotherapy after curative hepatectomy for colorectal cancer (CRC) liver metastases remains controversial. This retrospective study aimed to evaluate the efficacy of adjuvant chemotherapy in improving recurrence-free survival (RFS) and overall survival (OS) in patients who underwent curative hepatectomy for CRC liver metastases at a tertiary medical center.</p><p><strong>Methods: </strong>We retrospectively analyzed clinicopathological factors in 89 patients (surgery alone, n = 63; adjuvant chemotherapy, n = 26) who underwent curative hepatectomy for CRC liver metastases from January 2010 to December 2022. Patients who received neoadjuvant therapy or prior hepatectomy were excluded to minimize patient heterogeneity. Multivariate analysis using Cox proportional hazards regression was conducted to assess the independent effect of adjuvant therapy on RFS and OS.</p><p><strong>Results: </strong>The 3-year RFS rates were 22.6% in the surgery alone group and 29.6% in the adjuvant chemotherapy group (hazard ratio, 0.71; 95% confidence interval, 0.43-1.21; p = 0.102). The 3-year OS rates were 72.3% in the surgery alone group and 88.5% in the adjuvant chemotherapy group (hazard ratio, 0.59; 95% confidence interval, 0.29-1.25; p = 0.17). Univariate analyses showed that the number of liver metastases (> 2) was significantly associated with poorer OS (hazard ratio, 2.44; 95% confidence interval, 1.11-5.37; p = 0.027). Additionally, multivariate analyses showed that the addition of adjuvant chemotherapy was significantly associated with improved OS (hazard ratio, 0.23; 95% confidence interval, 0.07-0.81; p = 0.021).</p><p><strong>Conclusions: </strong>Adjuvant chemotherapy may improve OS after curative hepatectomy for CRC liver metastases, though it did not significantly impact RFS. Larger-scale multicenter prospective studies with stratified analyses are needed to confirm these findings.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"343"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872910","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 lymphovascular invasion in node-negative gastric cancer: a retrospective cohort study.","authors":"Abdullah Ibrahim Alangari, Sojung Kim, Han Hong Lee, Kyo Young Song, Hoseok Seo","doi":"10.1186/s12957-024-03629-6","DOIUrl":"10.1186/s12957-024-03629-6","url":null,"abstract":"<p><strong>Background: </strong>Lymphovascular invasion (LVI) has been identified as a prognostic factor in various cancers, but its significance in node-negative gastric cancer remains unclear. Gastric cancer prognosis is notably affected by lymph node metastasis, with LVI potentially indicating metastatic spread.</p><p><strong>Methods: </strong>A retrospective review was conducted on 5,699 patients who underwent curative radical gastrectomy for gastric cancer between 1989 and 2018. The median follow-up duration was 62 months (0-362 months). Overall, disease-specific, and disease-free survival were compared based on LVI status and stratified by T stage. Additionally, patients with stage IIA or T2N0 were further evaluated to clarify the clinical significance of LVI in the T2N0 group.</p><p><strong>Results: </strong>The T2N0 LVI-positive group exhibited significantly poor prognosis than those in the T2N0 LVI-negative group, with no significant differences observed on comparing the T2N0 LVI-positive group with the T2N1 LVI-negative or LVI-positive groups. Furthermore, although the T2N0 LVI-negative group demonstrated better prognosis compared to the IIA group, the T2N0 LVI-positive group exhibited worse survival. In addition, LVI positivity was an independent risk factor for overall survival in T2N0 patients.</p><p><strong>Conclusions: </strong>LVI in node-negative gastric cancer has clinical significance as a prognostic indicator, indicating an increased risk of disease recurrence and poor survival especially in T2 cohort. This indicates an increased likelihood of lymph node involvement and may influence treatment decisions and follow-up strategies.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"340"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873007","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":"Surgery for patients with endometrioid-type endometrial cancer: is lymphadenectomy above the inferior mesenteric artery necessary?","authors":"Abdurrahman Alp Tokalioglu, Okan Oktar, Mehmet Unsal, Okan Aytekin, Baran Yesil, Huseyin Altas, Ayse Buran, Yesim Ucar, Dilek Yuksel, Gunsu Kimyon Comert, Burak Ersak, Fatih Kilic, Cigdem Kilic, Caner Cakır, Sevgi Koc, Ozlem Moraloglu Tekin, Yaprak Ustun, Taner Turan","doi":"10.1186/s12957-024-03628-7","DOIUrl":"10.1186/s12957-024-03628-7","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study was to identify the risk of metastasis to lymph nodes above the inferior mesenteric artery (IMA) in endometrioid-type endometrial cancer (EC) and the factors that influence metastasis.</p><p><strong>Methods: </strong>The study included patients who had been operated on for endometrioid-type EC in three gynecological oncology centers between 2007 and 2023. The supramesenteric lymph node (SM-LN) is the region between the left renal vein and the IMA, whereas the inframesenteric lymph node (IM-LN) is the region between the IMA and the aortic bifurcation, as determined by the level of the IMA.</p><p><strong>Results: </strong>The study sample comprised 412 patients. The median number of lymph nodes excised per patient was 58. The median count was 37 for pelvic lymph nodes, 21 for para-aortic lymph nodes, 8 for IM-LN, and 13 for SM-LN. In the univariate analysis, the factors that were found to be statistically significant in determining SM-LN metastasis included tumor size, depth of myometrial invasion, uterine serosal invasion, lymphovascular space invasion (LVSI), cervical invasion, peritoneal cytology, adnexal metastasis, omental metastasis, non-nodal extrauterine metastasis, pelvic lymph node metastasis, and IM-LN metastasis. In the multivariate analysis, SM-LN metastasis was independently associated with tumor size, LVSI, pelvic lymph node metastasis, and IM-LN metastasis.</p><p><strong>Conclusion: </strong>In conclusion, in cases of intermediate-high risk EC, it is important to know that the disease spreads to SM-LN in 7.3% of patients. The efficacy of postoperative adjuvant treatment may be inadequate due to a lack of information regarding the SM-LN region.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"344"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873009","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":"Effectiveness of neoadjuvant chemotherapy with a docetaxel, cisplatin, and S-1 (DCS) regimen for T4b gastric cancer.","authors":"Vo Duy Long, Dang Quang Thong, Tran Quang Dat, Doan Thuy Nguyen, Tran Duy Phuoc, Nguyen Viet Hai, Nguyen Lam Vuong, Lam Quoc Trung, Nguyen Hoang Bac","doi":"10.1186/s12957-024-03620-1","DOIUrl":"10.1186/s12957-024-03620-1","url":null,"abstract":"<p><strong>Background: </strong>No studies on neoadjuvant chemotherapy for gastric cancer (GC) with T4b stage were reported. This study aimed to assess the effectiveness of neoadjuvant chemotherapy using DCS regimen (docetaxel, cisplatin, and S-1) for GC with T4b stage.</p><p><strong>Methods: </strong>Forty-three patients diagnosed GC with surgical or clinical T4b stage received three or four preoperative cycles of DCS therapy followed by gastrectomy and lymphadenectomy between Jan-2018 and Dec-2022. Short-tern outcomes including tumor response, completion of neoadjuvant chemotherapy, toxicity and adverse events, rate of treatment-related death, R0 resection, rate of complete adjuvant chemotherapy and short-term surgical results were investigated. The oncologic outcomes comprised 3-year OS and 3-year disease-free survival (DFS).</p><p><strong>Results: </strong>A total of 43 patients with T4b gastric cancer were included in the analysis. Among them, twenty-five patients underwent gastrectomy and lymphadenectomy. The completion rate of neoadjuvant chemotherapy was 88.4%, including 4 cycles of 51.2% and 3 cycles of 37.2%. The disease-control and clinical response rate were 88.4% and 58.1%, respectively. During preoperative chemotherapy, grade 3/4 neutropenia occurred in 20.9%, anemia in 13.9%, hyponatremia in 4.8%, and vomiting in 2.3%. Pathologic complete response was achieved in 8.0%. After surgery, no patient experienced severe complications (Clavien Dindo > = 3). The R0 resection rate was 72.0% and the rate of complete adjuvant chemotherapy was 83.3%. The 3-year OS and DFS rates were 49% and 38%, respectively.</p><p><strong>Conclusions: </strong>Neoadjuvant chemotherapy with DCS regimen demonstrated a high tolerance, high tumor response rate, high complete adjuvant chemotherapy rate and satisfactory 3-year survival outcomes. Three- or four-course of preoperative DCS regimen is a promising approach for GC with T4b stage.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"335"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872900","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 multicenter, randomized, parallel-controlled clinical trial protocol to evaluate the safety and efficacy of irreversible electroporation compared with radiofrequency ablation for the treatment of small hepatocellular carcinoma.","authors":"Chao Cheng, Min Xu, Jinhua Pan, Qiang Chen, Kai Li, Dong Xu, Xiang Jing, Qiang Lu, Hong Yang, Qiyu Zhao, Zhuang Deng, Tian'an Jiang","doi":"10.1186/s12957-024-03614-z","DOIUrl":"10.1186/s12957-024-03614-z","url":null,"abstract":"<p><strong>Background: </strong>At present, the main clinical application of local ablation therapy, such as radiofrequency ablation (RFA), is to heat the tissue to a certain temperature. However, high temperature will cause thermal damage. Irreversible electroporation (IRE) is a novel minimally invasive local ablation technology for tumors. By high-frequency pulse, the tumor cell membrane can be irretrievably perforated, resulting in the destruction of the intracellular environment, which can preserve important structures in the treatment area. However, there are no randomized controlled clinical trials comparing the efficacy of IRE with traditional local ablation in the treatment of liver cancer.</p><p><strong>Aims: </strong>This study aims to conduct a randomized controlled clinical trial comparing the efficacy of IRE with RFA in the treatment of liver cancer.</p><p><strong>Methods: </strong>We will conduct a multicenter, randomized, parallel-controlled non-inferiority clinical trial to compare the efficacy and safety of IRE and RFA for hepatocellular carcinoma (HCC). One hundred and ninety patients with HCC from five academic medical centers will be enrolled. The patients will be randomized into treatment arm (IRE) and control arm (RFA). The primary outcome is the progress -free survival (PFS) and the key secondary outcome is the Overall survival (OS).</p><p><strong>Results: </strong>Forty-eight patients had been recruited from 5 centers, of which, 33 patients (median age, 59.1 years) with 38 tumors had completed the 1-month follow-up and 21 patients have complete the 3-month follow up, with 2.3 months median follow up period. The mean largest tumor diameter is 3.9 cm. No end point was observed for PFS or OS in both groups, and the complete ablation rate was 100% in both groups. The lesions in the IRE group showed obvious shrinkage 1 month after procedure. One major adverse event (AE) was occurred in the control group.</p><p><strong>Conclusion: </strong>This is the first randomized controlled clinical trial to compare the clinical effects of IRE and RFA. The preliminary results suggest that both RFA and IRE are effective in the treatment of HCC, which can provide strong evidence for the use of IRE in HCC and provide more options for the treatment of patients with HCC.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials. gov, identifier NCT05451160.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"332"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872861","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 and clinicopathological role of pretreatment systemic inflammation response index (SIRI) in gastric cancer: a systematic review and meta-analysis.","authors":"Quan Wu, Hui Zhao","doi":"10.1186/s12957-024-03602-3","DOIUrl":"10.1186/s12957-024-03602-3","url":null,"abstract":"<p><strong>Background: </strong>The systemic inflammatory response index (SIRI) is calculated via the following formula: SIRI = monocyte count × neutrophil count/lymphocyte count. The value of the SIRI in predicting the prognosis of gastric cancer (GC) remains controversial. This study revealed the precise effect of the SIRI in predicting GC prognosis through a meta-analysis.</p><p><strong>Methods: </strong>The ability of the SIRI to predict GC prognosis was evaluated by calculating combined hazard ratios (HRs) and 95% confidence intervals (CIs). Furthermore, the combined odds ratios (ORs) and 95% CIs were determined to analyze the associations between the SIRI and the clinicopathological characteristics of patients with GC.</p><p><strong>Results: </strong>Seven publications on a total of 1763 cases were included in this study. The SIRI threshold was between 0.58 and 1.35, and the median value was 0.85. Our pooled findings revealed that a higher SIRI was significantly linked with poor overall survival (OS) (HR = 1.87, 95% CI = 1.59-2.20, p < 0.001) and disease-free survival (DFS; HR = 1.88, 95% CI = 1.50-2.36, p < 0.001) in GC patients. However, the SIRI did not exhibit a significant association with sex (OR = 1.98, 95% CI = 0.82-4.75, p = 0.126), surgery type (OR = 0.96, 95% CI = 0.61-1.51, p = 0.847), tumor differentiation (OR = 0.75, 95% CI = 0.54-1.06, p = 0.099), or TNM stage (OR = 1.25, 95% CI = 0.34-4.62, p = 0.743) in patients with GC.</p><p><strong>Conclusions: </strong>An elevated SIRI was significantly associated with unfavorable OS and DFS in patients with GC. Thus, the SIRI is a reliable biomarker for predicting GC prognosis in clinical practice.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"333"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873006","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":"Role of vascularised fibula graft in the surgical management of radiation-induced midshaft femoral fractures. Case report and literature review.","authors":"Monique Khasin, Genevieve M Darcy, Eldon Mah, Claudia Di Bella","doi":"10.1186/s12957-024-03616-x","DOIUrl":"10.1186/s12957-024-03616-x","url":null,"abstract":"<p><strong>Background: </strong>Post-radiation fractures (PRF) are a recognised complication of radiation treatment for soft tissue sarcomas. They have a low incidence and typically occur up to 5 years following treatment, more commonly affecting the pelvis, ribs and femur. Due to radiation-induced changes in bone, PRFs typically require more complicated intervention compared to post-trauma fractures, however, limited literature exists, particularly in regards to mid-shaft femoral PRFs. We report a case of a mid-shaft femoral PRF managed with a modified onlay free vascularised fibular grafting (FVFG).</p><p><strong>Case presentation: </strong>A 40-year-old male with a history of left quadriceps clear cell sarcoma successfully treated with wide local excision, chemotherapy and radiotherapy 18 years prior presented with a displaced oblique pathological fracture of his left femoral shaft. He was initially treated operatively with intramedullary nailing, however, repeat imaging at the one-year post-operative review demonstrated persistent hypotrophic non-union of the fracture. 16 months following the initial fracture, the patient underwent further surgical intervention with implantation of a modified onlay FVFG to the anterior aspect of the distal femur without nail removal. One-year post-revision, the patient was pain-free with normal mobility and imaging of both the graft and fracture site demonstrated complete union.</p><p><strong>Conclusion: </strong>Despite their operative complexity, we suggest that FVFGs should be considered for treating non-union of mid-shaft femoral PRFs due to their ability to promote healing and bone union in irradiated bone. Here we describe an original technique of a modified onlay FVFG which can be used in PRFs, and we have put this technique in the context of the current literature in FVFG.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"334"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873008","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":"Neoadjuvant immunochemotherapy-a promising strategy for primary pulmonary lymphoepithelioma-like carcinoma.","authors":"Jiawei Chen, Lei Fan, Hongsheng Deng, Liang Li, Shuben Li","doi":"10.1186/s12957-024-03617-w","DOIUrl":"10.1186/s12957-024-03617-w","url":null,"abstract":"<p><strong>Objective: </strong>Neoadjuvant immunochemotherapy has been a promising choice for patients with locally advanced non-small cell cancer (NSCLC). However, whether neoadjuvant immunochemotherapy impacted the subsequent surgical or pathological outcomes of patients with pulmonary lymphoepithelioma-like carcinoma (PLELC) remains relatively unknown. This study aimed to evaluate the safety and efficacy of neoadjuvant immunochemotherapy in PLELC patients.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients who received neoadjuvant immunochemotherapy in combination with chemotherapy followed by surgery between 2019 and 2022. The clinical records of the patients were analyzed.</p><p><strong>Results: </strong>Among the 31 patients with PLELC who underwent neoadjuvant immunochemotherapy followed by surgery, 18 patients (58.0%) experienced tumor downstaging. Nineteen patients (61.5%) achieved a partial response, 2 patients (6.4%) achieved a complete response, and 2 (6.4%) exhibited progressive disease. Pathological evaluation of resected specimens revealed that 8 (25.8%) patients achieved major pathological response (MPR), and 2 (6.4%) pathological complete response (PCR). The mean disease-free survival (DFS) was 17.4 months, which was not significantly different from the value in lung squamous cell carcinoma (LSQ) patients (15.1 months, P = 0.54)).</p><p><strong>Conclusion: </strong>Neoadjuvant immunochemotherapy is a safe and effective approach to reduce the extent of tumor, render unresectable to resectable, and offer an opportunity to receive modified surgery, which may be a promising strategy for patients with PLELC.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"338"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873005","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":"Goal-oriented preoperative biliary drainage is more precise and conducive to seize the opportunity for pancreaticoduodenectomy.","authors":"Hongtao Cao, Tianyu Li, Zeru Li, Bangbo Zhao, Ziwen Liu, Weibin Wang","doi":"10.1186/s12957-024-03615-y","DOIUrl":"10.1186/s12957-024-03615-y","url":null,"abstract":"<p><strong>Background: </strong>Preoperative biliary drainage (PBD) for selected patients with severe juandice has been shown to improve clinical conditions for pancreaticoduodenectomy (PD) and reduce the risk of post-pancreatectomy hemorrhage (PPH). However, the determination of an optimal end-point for PBD remains unclear. The aim of this research is to introduce the concept of goal-oriented biliary drainage, which may serve as a reasonable target and identify the optimal surgery time window.</p><p><strong>Methods: </strong>The clinical data of 194 patients diagnosed with pancreatic cancer and obstructive jaundice were retrospectively analyzed. Serological laboratory examinations including total bilirubin (TBIL) within one week before PBD and PD were recorded and labeled as TBIL-pre and TBIL-post respectively. PBD and PD were performed by experienced medical teams. PPH with grade B and C were enrolled.</p><p><strong>Results: </strong>TBIL-post less than 93.0µmol/L (sensitivity 83.78%, specificity 72.61%) or TBIL decay more than 68.5% (sensitivity 86.49%, specificity 69.43%) identified through ROC curves and multivariate analysis were independent protective factors for reducing the risk of PPH (OR 0.234 and 0.191 retrospectively, P<0.05) and were established as PBD goals. The Kaplan-Meier curves demonstrated the median time to achieve both PBD goals was 3 weeks. Additionally, the proportion of patients achieving both goals failed to increase with the PBD duration over 6 weeks (P > 0.05). The proportion of TBIL-post ≤ 93.0µmol/L (70.8% vs. 51.1%, P<0.05) and TBIL decay ≥ 68.5% (67.0% vs. 50.0%, P<0.05) were higher in EBS group than those in PTCD group.</p><p><strong>Conclusion: </strong>A goal-oriented PBD with the target of TBIL ≤ 93.0µmol/L or TBIL decay ≥ 68.5% can reduce the morbidity of PPH. In general conditions, PBD duration within 3 weeks would be sufficient, while exceeding the duration beyond 6 weeks could not provide additional benefits. Both EBS and PTCD are safe and EBS is more recommended due to its superior performance in achieving the goals.</p>","PeriodicalId":23856,"journal":{"name":"World Journal of Surgical Oncology","volume":"22 1","pages":"331"},"PeriodicalIF":2.5,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872927","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}