Indian Journal of Surgical Oncology最新文献

{"title":"From the Desk of Editors: Omission of Surgery in Breast Cancer? Step Forward or Detour.","authors":"Pankaj Kumar Garg, Nita Nair, S P Somashekhar","doi":"10.1007/s13193-025-02369-7","DOIUrl":"10.1007/s13193-025-02369-7","url":null,"abstract":"","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 4","pages":"817-818"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066018","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":"The Outcome and Survival of Locally Advanced Gastric Cancer with Gastric Outlet Obstruction After Upfront Radical Surgery.","authors":"Utpal Anand, Saad Anwar, Kunal Parasar, Basant Narayan Singh, Kislay Kant","doi":"10.1007/s13193-024-02163-x","DOIUrl":"10.1007/s13193-024-02163-x","url":null,"abstract":"<p><strong>Background: </strong>Carcinoma stomach with gastric outlet obstruction (GOO) is generally considered an advanced disease, with a focus on palliative treatment options. But, in the Eastern population, the tumor often originates in the antropyloric region resulting in comparatively early occurrence of GOO. The management of such resectable cases is not clearly defined in literature. In this study, we analyzed the surgical outcome and survival of upfront D2 gastrectomy combined with adjuvant chemotherapy in these cases.</p><p><strong>Methods: </strong>This study enrolled consecutive patients with carcinoma stomach accompanied by GOO from April 2018 to March 2022. The feasibility of radical surgery, clinicopathological profile, and factors affecting postoperative morbidity were analyzed. Two-year overall survival (OS) and associated factors were assessed using Kaplan-Meier survival analysis and the Cox proportional hazard model.</p><p><strong>Results: </strong>Among 119 gastric carcinoma patients, 78 presented with GOO. After excluding metastatic disease (18), locally unresectable disease (5), and neo-adjuvant therapy (3), 52 patients underwent radical gastrectomy. Post-operative morbidity and 90-day mortality were 32.7% and 0%, respectively. Factors affecting morbidity were low hemoglobin levels (<i>p</i> = 0.024) and type of procedure (subtotal vs. total gastrectomy) (<i>p</i> = 0.04). A total of 78.8% patients completed fluoropyrimidine-based adjuvant chemotherapy. The 2-year OS was 59.3% and non-completion of adjuvant chemotherapy (HR 2.68, <i>p</i> = 0.038) and poor tumor differentiation (HR 2.77, <i>p</i> = 0.015) were linked to worse OS.</p><p><strong>Conclusion: </strong>Upfront radical surgery in resectable carcinoma stomach with GOO is a feasible treatment option with acceptable good surgical and oncological outcomes. With combined adjuvant chemotherapy, a reasonable survival rate is observed.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 4","pages":"858-865"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066006","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":"Outcomes of Three-Port Minimally Invasive Transthoracic Esophagectomy in Prone Position for Resectable Esophageal Cancer.","authors":"Kalidindi Venkata Vijaya Narsimha Raju, Madhunarayana Basudhe, Sri Siddhartha Nekkanti, Raghuram Rami Reddy, Yogesh Vashist, Syed Nusrath","doi":"10.1007/s13193-024-02143-1","DOIUrl":"10.1007/s13193-024-02143-1","url":null,"abstract":"<p><p>Esophageal cancer surgery is a complex procedure with significant challenges and high morbidity. This study offers a comprehensive analysis of patients undergoing three-port minimally invasive transthoracic esophagectomy with comprehensive mediastinal lymphadenectomy (3P-MIE) in the prone position, focusing on surgical technique, morbidity, mortality, histological findings, and survival outcomes. Data from 176 patients who underwent 3P-MIE for resectable esophageal cancer in the prone position from January 2010 to March 2023 were analyzed. Most patients underwent a two-field lymphadenectomy (<i>n</i> = 173), while three patients had three-field nodal dissection. Thoracic component was performed thoracoscopically, while abdominal component through laparoscopy or mini laparotomy. Cervical esophagogastric anastomosis was performed in all patients using a semi-mechanical technique. The demographic data showed a median age of 52 years (range 21-73), with 99 females and 77 males. The predominant histology was squamous cell carcinoma (SCC) (86%). Twenty-seven patients underwent upfront surgery (15%), neoadjuvant chemoradiation (NACRT) was delivered to 135 cases (77%), neoadjuvant chemotherapy (NACT) in 11 (7%), and salvage surgery in 3 (2%). Surgical details revealed a median operative time of 370 min (range 90-580) and a median blood loss of 175 mL (range 50-2000 mL). Forty-nine percent (<i>n</i> = 87) of the patients experienced complications of grade 2 or greater according to the Clavien-Dindo classification. Anastomotic leaks occurred in 14.7% of cases, and pneumonia in 17.6%. The median ICU stay was 4 days (range 2-22), and median hospital stay of 9 days (range 5-38). Thirty-day mortality was observed in 5% (<i>n</i> = 9), and 90-day mortality in 6.25% (<i>n</i> = 11). A median of 20 nodes were retrieved, with R0 resection achieved in 96.6% of cases. With a median follow-up of 60 months, the median overall survival (OS) was 62.5%, and the median disease-free survival (DFS) was not reached. Three-port minimally invasive transthoracic esophagectomy in the prone position is a feasible and safe approach, achieving good mediastinal clearance and high R0 resection rates.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 4","pages":"866-875"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066069","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":"Active Surveillance of Papillary Thyroid Cancer-A Feasibility Experience from a Tertiary Care Centre.","authors":"Narmada Nangadda, Hetashvi Gondaliya, Deepali Bhat, Anirudh J Shetty, Kranti S Khadilkar, Shivaprasad Kumbenahalli Siddegowda, Basavaraj G Sooragonda, Vijay Pillai, Vidhya Bhushan Rangappa, Vivek Shetty, Yogesh Madhav Dokhe, Trupti C Kolur, Naveen Bangalore Shivanand, Akhila Lakshmikantha, Vidya Rao, Shaesta Naseem Zaidi, Nisheena Raghavan, Khushboo Mukesh Sahetia, Subramanian Kannan","doi":"10.1007/s13193-024-02129-z","DOIUrl":"https://doi.org/10.1007/s13193-024-02129-z","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The 2015 American Thyroid Association (ATA) guidelines recommend active surveillance (AS) as an alternative for very low-risk papillary thyroid cancer (PTC) based on evidence from observational and cohort studies in Japan and Korea that demonstrated low rates of disease progression. Adopting AS presents unique challenges in India given the need for proper understanding, adequate sonographic expertise, meticulous follow-up and acceptance of the patients and clinicians for active surveillance of diagnosed PTC. We present our data on the feasibility of AS at our centre in the last 7 years. We started adopting AS for patients with PTC or suspected PTC under AS in July 2017. Most of the patients had FNAC category Bethesda V or VI and/or USG category ACR-TIRADS TR4 or TR5 nodules. In all patients, the PTC was discovered incidentally. A baseline CT scan of the neck and chest was performed if indicated and in select patients, serial serum thyroglobulin (Tg) and anti-thyroglobulin (anti-Tg) were done. Patients were followed up semi-annually with neck ultrasound performed by a single operator. We have been following 17 patients with PTC under the AS clinic. The mean (SD) age of the cohort was 45.17 (14.7) years with 13 females and a median follow-up of 40 months (IQR 40-46; range 13-86), and none have undergone thyroid surgery. The PTC was discovered incidentally in 12 patients during a neck sonogram for evaluation of painful swallowing or salivary gland-related symptoms and evaluation of primary hyperparathyroidism; 2 patients on CT chest for pulmonary symptoms and 3 were \"PETomas\" during evaluation of their primary cancer (colon cancer, breast cancer and multiple myeloma). Out of the 3 patients who underwent FDG-PET scan, the SUV max of the PTC was 4, 4.8 and 14.6. All except one were uni-focal PTC with size (largest dimension on USG) ranging from 4.8 to 21 mm and median volume 0.21 mL (IQR 0.21-0.37 mL). The baseline median Tg levels were 12.95 ng/mL (range is 0.07 to 51 ng/mL), and anti-Tg was elevated in 4 patients (132 IU/mL, 156 IU/mL, 696 IU/mL, 4000 IU/mL). Serial Tg and anti Tg levels were measured over time in 4 patients. The patient with the largest PTC (21 mm) who is currently under AS had Eisenmenger syndrome. The longest duration of follow-up in the AS cohort is 86 months. One patient conceived and had a healthy baby during active surveillance with no significant increase in the size of the tumour. On follow-up, the volume change in the nodules ranged from - 44 to 335% with 35% (6/17) showing decrement and 65% (11/17) showing increment. The change in the largest dimension ranged from - 28 to 154% with a decrement of 41% (7/17) and increment of 59% (10/17). However, a significant increase in the volume (&gt; 50%) was noted only in 2 patients, and a significant increase in tumour dimension (&gt; 3 mm) was documented in only 2 patients on follow-up. None of the patients has developed regional or distant metastasis, and none has undergone surger","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 3","pages":"743-752"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676099","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":"Randomised Controlled Trial Evaluating the Impact of Intravenous Iron (ferric carboxymaltose) Supplementation Among Epithelial Ovarian Cancer Patients with Anemia.","authors":"Viral Patel, Anupama Rajanbabu, Keechilat Pavithran, Anandita Anandita","doi":"10.1007/s13193-024-02149-9","DOIUrl":"10.1007/s13193-024-02149-9","url":null,"abstract":"<p><p>The prevalence of anemia is ≥ 50% during treatment (surgery and chemotherapy) in patients with diagnosis of ovarian cancer. The purpose of this study was to assess the effects of intravenous ferric carboxymaltose supplementation on blood transfusion rates and hemoglobin levels in anemic epithelial ovarian cancer patients from intervention to 3 months after the last chemotherapy cycle. Sixty-nine patients with diagnosis of epithelial ovarian cancer with hemoglobin levels ≤ 10 g/dl were randomized in a parallel-group randomized controlled trial conducted at a single institute. All-stage epithelial ovarian cancer patients who were on ≤ 3rd cycle of adjuvant chemotherapy after primary cytoreductive surgery or who underwent interval cytoreductive surgery after receiving ≤ 3 neoadjuvant chemotherapy were included. The intervention group received one 1000-mg dose of ferric carboxymaltose intravenously while the control group received 100 mg ferrous ascorbate orally twice daily for 3 months. The oncologic treatment plan in both groups remained unchanged. Biochemical parameters for iron deficiency anemia (ferritin, total iron binding capacity, iron, and C-reactive protein) were recorded at enrolment. Complete blood count was monitored before intervention and at 3 months of the last chemotherapy cycle. The time frame to evaluate the response of both groups was from inclusion in the study to 3 months from the last chemotherapy cycle. Blood was transfused if hemoglobin was ≤ 8 gm/dl and as per clinical judgement for perioperative blood loss. There were 35 patients in the control group and 32 patients in the intervention group. In total, 22 patients (63%) in the control group and 12 patients (37.5%) in the intervention group received blood transfusion during cancer treatment (<i>p</i> = 0.038). There was no improvement in hemoglobin level in the intervention group vs the control (72% vs. 57%; <i>p</i> 0.208). An intravenous iron supplementation decreased blood transfusion requirements during cancer treatment in patients with diagnosis of epithelial ovarian cancer. The current study is registered with the Clinical Trials Registry- India (CTRI); REF/2019/05/025907, registration date: 27 May 2019. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzQwNzU=&Enc=&userName=.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13193-024-02149-9.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 3","pages":"766-773"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676137","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":"Primary Mucinous Ovarian Carcinoma: Insight into a Rare Histology and Impact of Pattern of Infiltration on Oncological Outcomes.","authors":"Eshwarya Jessy Kaur, Debabrata Barmon, Lopamudra Kakoti, Upasana Baruah, Dimpy Begum, Partha Sarthi Roy, Duncan Khanikar, Mouchumee Bhattacharyya, Shiraj Ahmed, Ratnadeep Sharma","doi":"10.1007/s13193-024-02142-2","DOIUrl":"https://doi.org/10.1007/s13193-024-02142-2","url":null,"abstract":"<p><p>Primary mucinous ovarian carcinomas (pMOCs) are a rare subtype of epithelial ovarian cancer which have a unique biological behaviour. These tumours have been divided into patterns of infiltration, namely expansile and infiltrative types, which in turn have prognostic significance. A hospital-based, retrospective analytical cohort study was conducted at a tertiary cancer center in Northeast India, from September 2019 to September 2023. The objectives were to study the impact of pattern of infiltration on oncological outcomes and to prognosticate them. Histology slides of the diagnosed cases were re-examined according to WHO protocol. Overall incidence of pMOC in our study was 3.3% (32/958 patients). Review of histology slides excluded 8 cases. The expansile pattern was seen in 71.9% (<i>n</i> = 23), and infiltrative pattern in 28.1% (<i>n</i> = 9). The most common presenting stage at diagnosis was IA in both expansile (30.4%, <i>n</i> = 7) and infiltrative (44.4%, <i>n</i> = 9) types. Intraoperative frozen section was used in 7 cases with a concordance rate of 14.2% (<i>n</i> = 1). Recurrence was observed in 11 patients (infiltrative = 55.5%, <i>n</i> = 5; expansile = 26%, <i>n</i> = 6). The median recurrence-free interval (RFI) was 28 months in the expansile group and 21 months in the infiltrative group. All recurrences were intra-peritoneal, most common in the pelvis (45.5%), followed by omento-peritoneal (18.2%). Lymphadenectomy was carried out in 56.2% (<i>n</i> = 18) patients (infiltrative = 88.8%, <i>n</i> = 8; expansile = 43.7%, <i>n</i> = 10); in 1 case of infiltrative type, it was reported as positive. Infiltrative histology was associated with more recurrences and lower median survival. Peritoneal staging adds to the quality of surgery; however, the role of lymphadenectomy needs careful consideration.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 3","pages":"793-798"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676135","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":"Triple Negative Breast Cancer: Immunohistochemistry-Based Sub-Classification and Correlation with Clinico-Demographic Profile and Survival in Indian Patients.","authors":"Rakesh Kumar Gupta, Alok Singh, Siddhartha Nanda, Debajyoti Mohanty, Yashwant Kashyap","doi":"10.1007/s13193-024-02141-3","DOIUrl":"https://doi.org/10.1007/s13193-024-02141-3","url":null,"abstract":"<p><p>In India, breast cancer number is increasing at an alarming pace in younger women. Majority of the patients are presenting in an advanced stage and are frequently showing triple negative phenotype. Additionally, in India, triple negative breast cancer (TNBC) prevalence is much higher in comparison to the western world. We undertook this study with an aim to characterize TNBC based on a panel of immunohistochemical markers to explore their pathogenesis, behavior, treatment response, and outcomes in respect to disease progression, disease-free survival, and death. The study was approved by Institutional Ethics Committee which included 63 TNBC cases for evaluating expression of GATA3 and p53. Basal cell markers were done only in GATA3 negative cases. The IHC markers were correlated with different clinical profile, demographic factors, and outcome. A total of 63 patients were included in the study out of which 37 patients had disease-free survival; 8 patients showed disease progression; and 18 patients died. Among the patients, 29 were GATA positive. Out of those 29 patients, 15 were also p53 positive. Among 34 GATA3 negative cases, 32 showed expression of at least one basal cytokeratin marker, and 13 were also showed p53 expression. Among clinical factors tumor size (<i>OR</i> = 0.37; 0.15-0.81; <i>P</i> = 0.01), and tumors of grade III (<i>OR</i> = 0.02; 0.001-0.22; <i>P</i> = 0.004) showed significant association with reduced survival. BLBC forms a major part of TNBCs in the Indian patients. High tumor grade and large tumor size were significantly associated with reduced disease-free survival. Among immunohistochemistry markers, GATA3 positivity, GATA3 negative with p53 positivity, and CK positive with p53 positive cases showed decreased survival, however, the results were not statistically significant.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13193-024-02141-3.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 3","pages":"784-792"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676140","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":"Editorial: From the Desk of Editor in Chief IJSO-Surgical Oncology Training in India: Broad-Based Versus Organ-Specific Specialisation-What Is the Need of the Hour?","authors":"S P Somashekhar","doi":"10.1007/s13193-025-02364-y","DOIUrl":"10.1007/s13193-025-02364-y","url":null,"abstract":"","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 3","pages":"725-727"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676100","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":"Prognostic Factors for Vulvar Cancer Undergoing Primary Surgery: Case Series from a Single Tertiary Cancer Center.","authors":"T S Shylasree, Ushashree Das, Neha Kumar, Lavanya Naidu, Kedar Deodhar, Supriya Chopra, Pabashi Poddar, Amita Maheshwari","doi":"10.1007/s13193-024-02134-2","DOIUrl":"10.1007/s13193-024-02134-2","url":null,"abstract":"<p><p>To evaluate clinical outcomes in women undergoing primary surgery for vulvar squamous cell carcinoma) (SCC) with an aim to identify surgico-pathological risk factors associated with recurrence and survival. Retrospective cohort analysis was carried out between January 2011 and December 2018 for patients with vulvar SCC who underwent primary surgery. The Kaplan-Meier method was used for the estimation of the probability of disease-free survival (DFS) and overall survival (OS). Univariate and multivariate analyses based on the Cox proportional hazards model were performed to identify factors associated with DFS and OS. A <i>p</i>-value ≤ 0.05 in a two-tailed test was considered statistically significant. The study population included 81 patients; the median follow-up time for the entire cohort was 41 months. Recurrence was noted in 27 cases (33.3%), and the median time to recurrence was 36.14 months. The median overall survival (OS) was 40.8 months, and disease-free survival (DFS) was 36 months. On univariate analysis, depth of invasion (DOI), close margin, presence of lympho-vascular space invasion (LVSI), perineural invasion (PNI), groin metastases, and not receiving adjuvant therapy were significantly associated with increased recurrence rates. Deeper stromal invasion, presence of LVSI, groin node metastases, and recurrent disease were associated with poor OS on univariate analysis. On multivariate analysis, DOI, tumor-free margin (TFM), and PNI were significantly associated with DFS, and a previous history of recurrence was associated with OS. Vulvar cancers are relatively rare tumors with several local tumor factors such as TFM, DOI, LVSI, and lymph node status which may help determine oncological outcomes. Larger studies will definitely help establish more evidence.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 3","pages":"799-806"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676136","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":"Outcome of Multivisceral Resection in Advanced Epithelial Carcinoma Ovary: 5 Years Experience of a Single Institute.","authors":"Kushagra Rahul, Siva Ranjith, Rema P, Suchetha S","doi":"10.1007/s13193-024-02135-1","DOIUrl":"https://doi.org/10.1007/s13193-024-02135-1","url":null,"abstract":"<p><p>Epithelial ovarian cancer (EOC) remains a significant challenge in gynecologic oncology. This study aimed to evaluate the outcomes of multivisceral resection in advanced EOC, focusing on the effect of surgical complexity on post-operative morbidity, time to adjuvant treatment, and overall survival. This single-arm study included 74 patients with advanced EOC who underwent multivisceral resection between January 2018 and December 2021 at the Regional Cancer Centre, Thiruvananthapuram. The study introduced a modified version of Aletti's Surgical Complexity Scoring system to classify surgeries as intermediate or high complexity. Post-operative morbidity was assessed using the Clavien-Dindo scoring system. Time to adjuvant treatment and overall survival were also analyzed. Of the 74 patients, 80% underwent intermediate complexity surgeries, while 20% had high complexity procedures. Major morbidity (Clavien-Dindo grades 3 and 4) occurred in 10.9% of patients, with no significant difference between intermediate and high complexity surgeries (<i>p</i> = 0.86). Adjuvant chemotherapy was initiated within 6 weeks for 89.2% of patients. The overall 12-month and 18-month survival probabilities were 94% and 85%, respectively. Complete cytoreduction (CC-0) was achieved in 93.3% of cases, with significantly lower mortality rates compared to non-CC-0 cases (18.8% vs. 60%). Multivisceral resection in advanced EOC demonstrates favorable outcomes with acceptable morbidity rates, regardless of surgical complexity. The high rate of complete cytoreduction and impressive survival probabilities underscore the potential benefits of aggressive surgical approaches in advanced EOC. Although the subset analysis favored primary cytoreduction, further research with larger sample sizes is needed to confirm these findings and explore the impact of primary versus interval debulking surgery on long-term outcomes.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"16 3","pages":"762-765"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676134","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}