Indian Journal of Surgical Oncology最新文献

{"title":"Exceptional Durable Complete Response Following a Single Cycle of Induction Chemotherapy in Supraglottic Laryngeal Cancer.","authors":"Yadav Alka, Kanika Kapur, Pallvi Kaul","doi":"10.1007/s13193-026-02577-9","DOIUrl":"https://doi.org/10.1007/s13193-026-02577-9","url":null,"abstract":"","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"711-712"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Oncological Outcomes between Trimodal Therapy and Radical Cystectomy in Patients with Variant Bladder Cancer.","authors":"Aykut Demirci, Tuncel Uzel","doi":"10.1007/s13193-025-02394-6","DOIUrl":"https://doi.org/10.1007/s13193-025-02394-6","url":null,"abstract":"<p><p>The aim of this study was to assess whether trimodal therapy (TMT) and radical cystectomy (RC) differ in terms of progression and survival outcomes in bladder cancer patients with variant histology (VH). A total of 57 patients diagnosed with VH, treated by either RC or TMT at our clinic between January 2013 and June 2024, were evaluated in this study. Group 1 (<i>n</i> = 44) included patients treated with TMT, while Group 2 (<i>n</i> = 13) consisted of those who underwent RC. The mean age of the patients was 64.43 ± 11.1 years. No statistically significant differences were observed between Group 1 and Group 2 in terms of PFS (<i>p</i> = 0.24), CSS (<i>p</i> = 0.07), or OS (<i>p</i> = 0.85). Patients with clinical stage < T2 demonstrated significantly improved PFS, OS, and CSS outcomes compared to those with stage ≥ T2 (<i>p</i> = 0.006, <i>p</i> = 0.006, and <i>p</i> = 0.001, respectively). Multivariable analysis identified T stage as an independent risk factor for PFS, CSS, and OS, irrespective of age, treatment modality, and VH type (HR: 5.45, <i>p</i> = 0.01; HR: 3.67, <i>p</i> = 0.006; and HR: 2.68, <i>p</i> = 0.01, respectively). While tumor stage remains a key prognostic factor in VH, our findings suggest that TMT may be a viable alternative to RC.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"721-727"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mammographic Breast Density Patterns and Tumor Characteristics in Indian Women with Breast Cancer: A Retrospective Observational Study.","authors":"Kalpana Rai, Prerna Garg, Jitin Goyal, Bharat Gupta, Priyanka Gupta, Vishvak Chanthar, Anila Sharma, Sunil Kumar Puri","doi":"10.1007/s13193-026-02597-5","DOIUrl":"https://doi.org/10.1007/s13193-026-02597-5","url":null,"abstract":"<p><strong>Background: </strong>Mammographic breast density (MBD) is a well-established risk factor for breast cancer and may also reflect underlying tumor biology. Data on MBD patterns and their association with tumor characteristics in Indian women remain limited.</p><p><strong>Methods: </strong>This retrospective, case-only study included 500 women with pathologically proven primary breast cancer diagnosed between January 2022 and December 2023. Original digital mammograms were independently re-reviewed by experienced breast radiologists, and MBD was categorized according to ACR BI-RADS (A-D). Associations between MBD and age, tumor stage, nodal status, histologic grade, hormone receptor status, HER2/neu status, and Ki-67 index were evaluated using univariate analysis and multivariable logistic regression.</p><p><strong>Results: </strong>Most patients were diagnosed between 41 and 60 years of age (median 50 years), and the majority exhibited ACR B or C breast density (93.2%). Mammographic density showed a significant inverse association with age. MBD was not independently associated with tumor stage, nodal status, estrogen or progesterone receptor status, or Ki-67 index. On, multivariate analysis, menopausal status independently predicted hormone receptor positivity (ER: OR 2.19, <i>p</i> < 0.001; PR: OR 1.72, <i>p</i> = 0.003). In contrast, dense breasts (ACR C/D) independently predicted high histologic grade (Grade III) (adjusted OR 1.72, <i>p</i> = 0.003). A univariate association between higher breast density and HER2/neu positivity was observed (<i>p</i> = 0.04) but was attenuated after multivariable adjustment.</p><p><strong>Conclusion: </strong>In this Indian breast cancer cohort, mammographic density was more closely associated with aggressive tumor features than with stage or hormone receptor expression. These findings suggest that MBD may reflect tumor biology beyond tumor masking effects and provide a basis for larger, prospective, population-based studies.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"900-907"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) Versus Intravenous Chemotherapy in Unresectable Peritoneal Metastases Secondary to Platinum-Resistant Ovarian Cancer: Interim Analysis of Randomized Controlled Trial.","authors":"Somashekhar Sp, Rohit Kumar, Priya Kapoor, Esha R Shanbhag, Darshan Patil, Kushal Agrawal, Aaron Marian Fernandes, Channappa Patil, Sai Vivek Velkuru, Vaishnavi Srinarahari, Susmita Rakshit, Sudhir Kumar Kale, Namita Sinha Verma, Dheeraj V N Shyam, Vijay Ahuja, Ashwin Kr","doi":"10.1007/s13193-026-02600-z","DOIUrl":"https://doi.org/10.1007/s13193-026-02600-z","url":null,"abstract":"<p><strong>Introduction: </strong>Platinum-resistant ovarian cancer (PROC) with peritoneal metastasis has limited therapeutic options, with poor response rates and significant toxicity from systemic chemotherapy. PIPAC has emerged as a locoregional strategy to improve intraperitoneal drug delivery.</p><p><strong>Methods: </strong>This randomized study (CTRI REF/2018/08/021223) included patients with unresectable peritoneal metastases secondary to PROC. Patients were randomized to PIPAC or systemic intravenous chemotherapy. The primary endpoint was objective response rate (ORR) assessed by RECIST 1.1. Secondary endpoints included quality of life (EORTC QLQ-C30) and treatment-related morbidity (CTCAE v4.0 and Clavien-Dindo classification).</p><p><strong>Results: </strong>We had Eighty patients (40 per arm) with comparable baseline characteristics. ORR was significantly higher in the PIPAC arm compared to intravenous chemotherapy (62.5% vs. 15%; OR 9.44, 95% CI 3.21-27.77, <i>p</i> < 0.001). Disease control rate was also superior (85% vs. 45%; <i>p</i> < 0.001). Histopathological response (PRGS 1-2) was observed in 60% of patients receiving PIPAC. QOL demonstrated significant improvement in global health scores at Day 120 in the PIPAC group (mean difference 10.5; <i>p</i> < 0.001). Grade ≥ 3 adverse events were lower with PIPAC (12.5% vs. 42.5%; OR 0.19, 95% CI 0.06-0.60, <i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>In this interim analysis, of Indian Randomised Control study, PIPAC demonstrated a consistent signal of improved tumor response, better quality of life, and reduced severe toxicity compared with intravenous chemotherapy. PIPAC is a very useful option in PROC giving good response rate and outcome with better quality of life. In future RCT's it would be interesting to explore bidirectional treatment with concomitant PIPAC and IV Chemotheraphy in recurrent ovarian cancer.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"928-937"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world Compliance to Trimodality Therapy and its Effect on Survival in Esophageal Squamous Cell Carcinoma: Insights from a High-burden Region.","authors":"Jyotiman Nath, Hafizul Islam Pathan, Yanpothung Yanthan, Mouchumee Bhattacharyya, Abhijit Talukdar, Partha Sarathi Roy, Deep Jyoti Kalita, Anupam Sarma","doi":"10.1007/s13193-026-02566-y","DOIUrl":"https://doi.org/10.1007/s13193-026-02566-y","url":null,"abstract":"<p><p>Trimodality treatment (neoadjuvant chemoradiotherapy followed by surgery) improves survival in esophageal squamous cell carcinoma (ESCC). However, patient compliance remains a challenge, particularly in high-burden areas like North-East India. To evaluate the compliance rate for trimodality treatment. To evaluate the reasons for non-compliance and to estimate the overall survival of the study patients. This retrospective study involved 113 patients with locally advanced, resectable ESCC treated at a tertiary care center from January 2021 to December 2022. Compliance with trimodality therapy was assessed. Reasons for non-compliance were categorized based on medical records and telephone interviews. Overall survival (OS) was analyzed using the Kaplan-Meier method and Cox regression. Compliance was calculated as the percentage of patients completing trimodality treatment. Reasons for non-compliance were identified through electronic medical records and phone interviews and shown in a pie chart. Kaplan-Meier and log-rank tests were used to assess survival, while Cox regression identified related factors. SPSS (version 29) and Excel were used for analysis, with significance set at <i>p</i> < 0.05. Only 48 patients (44.03%) completed the planned trimodality treatment. The main reason for non-compliance (66%) was subjective symptom relief after chemoradiotherapy, possibly due to inadequate counseling. Financial issues, disease progression, poor health, and inoperability were other factors. Patients completing treatment showed significantly better survival (1-year OS 83.3% vs. 50.8%; 3-year OS 54.3% vs. 20.3%; <i>p</i><0.001). Cox regression revealed that incomplete treatment was associated with a 3.2-times higher risk of death. Other factors such as age, gender, comorbidities, and nodal status did not significantly affect survival. Compliance with trimodality treatment significantly improves survival in ESCC. Improving patient counselling, financial support, and follow-up may help increase compliance and outcomes in high-burden regions.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"893-899"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Structured Clinical Pathway Derived from Surgical Audit of VATS (Video Assisted Thoracoscopic Surgery) Lung Nodule Localization and Resections in Thoracic Oncology.","authors":"Vijayraj S Patil, Harsih H Kumar, Sujata Sai, Gomathi P Meenakshi, C Srinivas, Raviarjunan, Syed Altaf, Mahesh Bandimegal","doi":"10.1007/s13193-026-02550-6","DOIUrl":"https://doi.org/10.1007/s13193-026-02550-6","url":null,"abstract":"<p><strong>Background: </strong>Lung nodules are commonly encountered in oncology practice, particularly in patients with solid organ tumors. Video-assisted thoracoscopic surgery (VATS) is frequently employed for their resection, but intraoperative localization remains a challenge, especially in resource-constrained settings. This study presents a novel algorithm for localizing and resecting lung nodules using VATS and evaluates its outcomes and validation.</p><p><strong>Methods: </strong>Patients who underwent VATS lung nodule resection by a single surgeon at oncology centers in South India between January 2019 and December 2024 were included. Nodules were classified as surface lesions, central lesions close to the hilum, or central lesions away from the hilum based on CT findings. The algorithm involved manual palpation, mobilization, and resection techniques tailored to nodule location. Outcomes, including sensitivity, accuracy, and resection margins, were analyzed.</p><p><strong>Results: </strong>A total of 42 patients (25 females, 17 males) with a median age of 35 years underwent VATS resection. Nodules were predominantly located in the upper and lower lobes, with a median size of 2 cm. Histology included metastatic (32 cases) and non-metastatic (14 cases) nodules. The algorithm achieved a sensitivity and accuracy of 97.83% (45/46 nodules localized). All nodules were successfully resected with adequate margins, except one case requiring conversion to open surgery. Median procedure duration was 70 minutes, with a mean blood loss of 80 ml and a mean hospital stay of 4 days. Mild hemoptysis occurred in six patients, managed conservatively.</p><p><strong>Conclusion: </strong>Our algorithm for VATS lung nodule localization and resection demonstrates high sensitivity and accuracy, making it a cost-effective and reliable method, particularly in resource- limited settings. It relies on manual palpation and radiological anatomy conceptualization, requiring an experienced surgeon. Further validation and integration with aided localization techniques are recommended to enhance its applicability.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13193-026-02550-6.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"800-806"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single-Centre, Single-Blinded Randomized Control Trial Evaluating the Role of Distraction Therapy in Pain Management Following Major Abdominal Surgeries in Adult Cancer Patients.","authors":"Chandni J Rana, Sumitra G Bakshi, Sonal Tarhane, Sukhada Savarkar, Supriya Salunkhe, Dhanashri Shinde, Ganesh Bakshi, Shraddha Patkar, Mahesh Goel, Mahenadra Pal, Gagan Prakash","doi":"10.1007/s13193-026-02583-x","DOIUrl":"https://doi.org/10.1007/s13193-026-02583-x","url":null,"abstract":"<p><strong>Distract trial: </strong>In the post-operative period, analgesics are complemented with non-pharmacological methods (NPM). However, the evidence is limited.</p><p><strong>Objectives: </strong>Randomised control trial aimed to determine the effectiveness of NPMs of pain management on the need for rescue analgesics following major abdominal oncology surgeries.</p><p><strong>Methodology: </strong>After approval from the hospital ethics board and registration of the trial, consented patients undergoing nephrectomy and hepatobiliary surgeries with planned epidural analgesia (EA) were randomised to the control/ intervention group. The control group had ongoing EA infusion with systemic paracetamol (1 g) thrice a day. Intravenous injection of tramadol (50 mg) was used as a rescue analgesic.</p><p><strong>Intervention: </strong>Encouragement to perform distraction activities of their choice, like reading, listening to music, etc., along with the EA and systemic analgesics. Patient feedback was recorded according to the Revised American Pain Society Outcome Questionnaire (APSOQ). Need for rescue analgesics, along with pain scores, were recorded till discharge. At 1-month post-surgery follow-up, pain assessment was done using the Brief Pain Inventory (BPI).</p><p><strong>Results: </strong>Analysis of 88 patients revealed an increase in time spent by the patient in self-distraction techniques in the intervention group in the immediate post-operative period (35.7% versus 90.4%, <i>P</i> < 0.001); No difference in the requirement of the rescue analgesics was found between the two groups (<i>P</i> = 0.16). The pain scores were comparable in the immediate post-operative period (<i>p</i> > 0.05) and also at the end of 1 month.</p><p><strong>Conclusion: </strong>Self-motivated distraction therapy after major abdominal oncology surgeries did not reduce the perception of pain or the need for rescue analgesics.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"847-854"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Outcomes following Day-Care Mastectomies being Performed for Breast Cancer in a Single Centre in South India.","authors":"Debashri Shankarraman, B Jegadish, Asha Reddy, G Nandini, Geetha Priya, Selvi Radhakrishna","doi":"10.1007/s13193-026-02549-z","DOIUrl":"https://doi.org/10.1007/s13193-026-02549-z","url":null,"abstract":"<p><p>Day-care surgeries aim to optimize healthcare delivery by reducing hospital stays, costs, and improving patient recovery. While widely adopted in other surgical disciplines, breast cancer surgeries-especially mastectomies-are still predominantly managed as inpatient procedures. With advances in anesthesia, pain control, and structured outpatient care, day-care mastectomies are becoming increasingly feasible. This retrospective observational study evaluates clinical and patient-related factors influencing outcomes of day-care mastectomies performed between 2022 and 2024 at Chennai Breast Centre. A total of 302 women with biopsy-proven breast cancer underwent mastectomy, with or without axillary procedures. All patients had preoperative anesthetic evaluation, and surgeries were performed under general or regional anesthesia with pectoral nerve blocks. Postoperative care focused on early mobilization, pain management using multimodal analgesia, and structured discharge protocols. Of the 302 patients, 248 (82.1%) were discharged on the same day, while 54 (17.9%) required overnight stay. Significant factors associated with deferred discharge included presence of multiple comorbidities (p=0.005), higher ASA grades (p=0.016), and recent neoadjuvant chemotherapy (p=0.051). Clinical reasons for overnight stay included high drain output and pain, while patient-related reasons included psychological comfort and long-distance travel. Postoperative complications such as pain and nausea were minimal, with 99.7% reporting no nausea and over 90% reporting mild or no pain. No major readmissions or re-surgeries were recorded. In conclusion, mastectomies can be safely and effectively performed as day-care procedures with appropriate patient selection, structured protocols, and supportive outpatient care. Wider adoption of day-care breast surgeries could enhance resource utilization and patient satisfaction in breast cancer care.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"778-786"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extranodal Follicular Dendritic Cell Sarcomas and their Oligorecurrences: Lessons Learnt at a Single Tertiary Cancer Referral Centre, India.","authors":"Abdeali Saif Arif Kaderi, Mufaddal Kazi, Shraddha Patkar, Bharat Rekhi, Prabhat Bhargav, Tanvi M Shah, Harsh Mohan, Atul Ajith, Gurudutt Varty, Mukta Ramadwar, Jifmi Jose, Nehal Khanna, Mahesh Goel","doi":"10.1007/s13193-026-02537-3","DOIUrl":"https://doi.org/10.1007/s13193-026-02537-3","url":null,"abstract":"<p><strong>Background: </strong>Follicular dendritic cell sarcoma (FDCS) is a rare, aggressive malignant neoplasm usually arising in lymph nodes of the head and neck, but it can also occur at extranodal sites (ENFDCS). Due to its rarity, optimal management is not well defined, underscoring the need for further research.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients with histologically confirmed ENFDCS treated in the gastrointestinal oncology unit of a tertiary cancer center. Clinical features, treatments, and outcomes were reviewed.</p><p><strong>Results: </strong>Fourteen patients (10 males, 4 females; median age 41 years) were included. Primary sites were colon (n = 6), retroperitoneum (n = 3), rectum (n = 2), mesentery (n = 1), liver (n = 1), and pelvis (n = 1). Four tumors (28.6%) were initially misdiagnosed. Final diagnosis was based on morphology and immunohistochemistry for CD21, CD23, and CD35; Epstein-Barr virus testing was not performed. Five patients underwent primary surgery at our center; two patients with metastatic disease at presentation received systemic therapy alone. Among the five primary surgeries, three were preceded by perioperative chemotherapy (n = 1), neoadjuvant chemotherapy (n = 1), or neoadjuvant radiotherapy (n = 1). Seven patients presented with residual or recurrent disease after prior surgery elsewhere; three underwent re-resection following appropriate systemic therapy, and four received only systemic therapy. At a median follow-up of 26 months (range 7-153), median overall survival was not reached, and median disease-free survival was 24 months. Four of five patients primarily operated at our center remained disease free; one recurred at 39 months, was successfully treated with re-resection and systemic therapy, and was alive at 153 months. Of the three patients re-resected at our center, one remained disease free at 17 months, one developed systemic recurrence and eventually received best supportive care at 11 months, and one was disease free until 94 months before being lost to follow-up. Overall, 10 patients were alive, two died of disease progression, and two were lost to follow-up.</p><p><strong>Conclusion: </strong>ENFDCS is frequently misdiagnosed; surgery is the cornerstone of treatment, and multimodality therapy for recurrences can yield durable survival. Outcomes appear better when patients are managed at specialized oncologic centers, highlighting the importance of early recognition and timely referral.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"734-743"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response of Gastric Adenocarcinoma to Neoadjuvant Chemotherapy in Relation to HER2 Overexpression: a Prospective Observational Study.","authors":"Pratap Kumar Deb, Samir Bhattacharyya, Subrata Kumar Sahu, Arnab Gupta","doi":"10.1007/s13193-026-02595-7","DOIUrl":"https://doi.org/10.1007/s13193-026-02595-7","url":null,"abstract":"<p><strong>Background: </strong>Gastric adenocarcinoma remains a significant cause of cancer-related mortality globally. Human epidermal growth factor receptor 2 (HER2) overexpression is identified in a proportion of gastric and gastroesophageal junction adenocarcinomas. Although HER2-targeted therapy is well established in metastatic disease, its role in the neoadjuvant setting is not clearly defined.</p><p><strong>Methods: </strong>In this prospective observational study, 43 patients with resectable gastric or gastroesophageal junction adenocarcinoma (cT2-T4 and/or cN+) were included. All patients received standard neoadjuvant chemotherapy (FLOT, XELOX, or FOLFOX) followed by curative gastrectomy with D2 lymphadenectomy. Pathological response was evaluated using the Becker tumor regression grading (TRG) system. HER2 status was assessed by immunohistochemistry, with fluorescence in situ hybridization performed for equivocal (IHC 2+) cases. The relationship between HER2 expression and pathological response was analyzed.</p><p><strong>Results: </strong>HER2 overexpression was detected in 10 of 43 patients (23.25%). A favorable pathological response (TRG 1-2) occurred significantly less often in HER2-positive tumors compared with HER2-negative tumors (30.0% vs. 84.8%; <i>p</i> = 0.002). In contrast, an unfavorable response (TRG 3) was significantly more frequent among HER2-positive cases (70.0% vs. 15.2%; <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>HER2 overexpression is associated with poorer pathological response to standard neoadjuvant chemotherapy in gastric adenocarcinoma. These findings highlight the potential need for molecularly tailored perioperative treatment strategies in this subgroup.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 4","pages":"888-892"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13096357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}