Indian Journal of Surgical Oncology最新文献

{"title":"Lymph Node Metastasis Predicts Early Progression and Castration Resistance in Oligometastatic Prostate Cancer after Cytoreductive Radical Prostatectomy.","authors":"Jieping Hu, Yuyang Yuan, Jianbo Yang, Xinchang Zou, Yifan Tan, Weilin Chen, Xu Hu, Weipeng Liu, Bin Fu","doi":"10.1007/s13193-025-02511-5","DOIUrl":"10.1007/s13193-025-02511-5","url":null,"abstract":"<p><p>To evaluate the association between lymph node metastasis (LNM) and clinicopathological features/survival outcomes in oligometastatic prostate cancer (omPCa) patients undergoing cytoreductive radical prostatectomy (cRP) with pelvic lymph node dissection (LND). We retrospectively analyzed 57 omPCa patients undergoing cytoreductive radical prostatectomy (cRP) with LND between 2015 and 2022. Participants were stratified into lymph node-positive (N1, <i>n</i> = 16) and negative (N0, <i>n</i> = 41) groups based on postoperative pathology. Clinicopathological characteristics and survival outcomes were compared between groups. LNM-positive (pN1, <i>n</i> = 16) patients exhibited significantly higher baseline PSA (<i>p</i> = 0.026), Gleason scores (<i>p</i> = 0.013), and T-stage (<i>p</i> < 0.001) than pN0 patients (<i>n</i> = 41). While PSA99 achievement rates were comparable (<i>p</i> = 0.852), pN1 patients had significantly lower rates of undetectable PSA (<i>p</i> < 0.05), shorter median PSA progression-free survival (21 vs. 53 months, <i>p</i> < 0.05), and shorter median CRPC-free survival (26 months vs. unreached, <i>p</i> < 0.05). LNM in omPCa is associated with aggressive tumor biology and predicts inferior survival outcomes despite multimodal therapy. These findings highlight the critical need for improved preoperative nodal staging and intensified adjuvant strategies in pN1 omPCa patients.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1869-1876"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841629","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":"Indocyanine Green Fluorescence-Guided Surgery for Margin Assessment in Oral Cancer : A Feasibility Study.","authors":"Sreeram Mp, Karthik N Rao, Radhika Kapahtia, Teertha Sadhashiv Shetty, Hari Ps, B S Srinath, Narayana Subramaniam","doi":"10.1007/s13193-025-02488-1","DOIUrl":"10.1007/s13193-025-02488-1","url":null,"abstract":"<p><p>Achieving clear surgical margins in oral cancer surgery is crucial for reducing recurrence rate and improving patient survival. However, intraoperative margin assessment remains challenging due to limitations in visual and tactile evaluation. Indocyanine green (ICG) fluorescence imaging has emerged as a potential adjunct for real-time surgical guidance, though its intraoperative utility in oral cancer is not yet fully established. This prospective, non-randomized feasibility study included 75 patients undergoing surgery for oral cancer. Untagged ICG was administered prior to anesthesia induction. Intraoperative near-infrared imaging was used to delineate tumor margins, which were compared with gross clinical assessment and histopathologic evaluation. The need for intraoperative margin revision, final margin status, and the predictive performance of ICG-derived margins were analyzed. Margin revision was performed in 28% of cases. Final histopathology revealed clear margins in 57.3%, close margins in 30.7%, and involved margins in 12% of patients. ICG-delineated margins differed significantly from both gross and histologic margins (<i>p</i> < 0.01). A deep ICG margin > 4.5 mm predicted the absence of revision with 98.1% sensitivity and 75.5% overall accuracy. ICG fluorescence imaging is not recommended as a standalone modality for intraoperative margin assessment in oral cancer surgery but may be a valuable adjunct to conventional evaluation methods. Standardized protocols and larger validation studies are warranted to confirm its role in surgical oncology practice.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1796-1806"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841521","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 Ewing Sarcoma of the Lung: Integrative Analysis of Clinical, Histopathological, Immunohistochemical, and Cytogenetic Features with Literature Review.","authors":"Ipsita Dhal, Paramita Rudra Pal, Kirti Rajput, Akhil Kapoor, Anuj Gupta, Ankita Pal, Arvind Suresh, Mayank Tripathi, Ajay Choubey","doi":"10.1007/s13193-025-02480-9","DOIUrl":"10.1007/s13193-025-02480-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Ewing sarcoma (ES) is a highly aggressive malignant neoplasm characterized by small, round, undifferentiated cells presumed neural crest origin, accounting for approximately 10-15% of all primary bone tumors. While it predominantly involves the skeletal system, ES can also arise in extraosseous soft tissues, including the retroperitoneum, thoracic wall, paravertebral region, and extremities. Primary pulmonary involvement by Ewing sarcoma is exceedingly uncommon, with fewer than 60 cases documented in the literature over the past decade.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The objective of this study was to analyze the clinicopathological characteristics of primary pulmonary Ewing sarcoma cases diagnosed at our institution, supplemented by a comprehensive review of the existing literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A retrospective study was undertaken to evaluate cases of primary pulmonary Ewing sarcoma (ES) diagnosed at the Department of OncoPathology, MPMMCC, Varanasi, from January 2019 to July 2024. Thirteen histopathologically confirmed cases were identified. Comprehensive demographic and clinical data were retrieved from institutional medical records. Detailed analyses of histomorphological features, and immunohistochemical profiles, and molecular alterations was done. Longitudinal follow-up data were analyzed to assess patient survival and clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The median age of the study cohort was 24 years, ranging from 8 to 63 years. A male predominance was observed, with 69.23% of cases (n=9) occurring in males and 30.76% (n=4) in females. The majority of tumors (92.3%) measured greater than 10 cm in maximum dimension, a finding that was statistically significant (p = 0.001). Immunohistochemically, NKX2.2, FLI-1, and CD99 demonstrated consistent and robust expression across most cases, serving as reliable diagnostic markers. Four out of six patients show EWSR-1 fusion in cytogenetics study. All patients underwent systemic chemotherapy, with one case subsequently managed with surgical resection. Additionally, three patients received adjuvant radiotherapy. Disease progression was documented in three out of thirteen patients. The mean progression-free survival (PFS) was estimated at 19 months (95% confidence interval [CI]: 12.9-26.1 months), while the mean overall survival (OS) was calculated at 13 months (95% CI: 9.7-23.0 months).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Primary pulmonary Ewing sarcoma should be considered in the differential diagnosis of large pulmonary masses, particularly in the absence of a detectable extrathoracic primary lesion and after the exclusion of more common differential diagnoses. Definitive diagnosis relies on histopathological examination supported by immunohistochemistry, with cytogenetic and molecular analyses such as detection of EWSR1 gene rearrangement playing a critical role in confirming the diagnosis. Optimal patient management ne","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1877-1885"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841598","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":"Clinical Outcomes and Prognostic Determinants in Poorly Differentiated Thyroid Cancer: A Surgical Perspective.","authors":"Shambhavi Shukla, Oinam Birjit, Madhukar Upadhyay, Sanjeev Sharma, Bidhan Koirala, Gurucharan Sahu, Prateek V Jain, Kapila Manikantan, Vikram Kekatpure, Pattatheyil Arun","doi":"10.1007/s13193-025-02503-5","DOIUrl":"10.1007/s13193-025-02503-5","url":null,"abstract":"<p><p>Poorly differentiated thyroid cancer (PDTC) is an aggressive malignancy with intermediate characteristics between well-differentiated and anaplastic thyroid carcinoma. It remains a significant cause of thyroid cancer mortality despite its rarity. The absence of standardized treatment guidelines and its heterogeneous nature complicate clinical management. This study aims to identify prognostic determinants influencing surgical outcomes in PDTC, specifically disease-free survival(DFS) and overall survival(OS). This retrospective cohort study analyzed PDTC cases treated at a tertiary cancer center in Eastern India between 2013 and 2021. Patients with histologically confirmed PDTC per the Turin/MSKCC criteria who underwent surgical management were included. Demographic, clinical, and histopathological data were collected to evaluate oncological outcomes, including OS and DFS. Kaplan-Meier survival analysis was performed, and Cox proportional hazards regression was utilized to identify independent prognostic factors. The incidence of PDTC among all thyroid cancers was 1.27% (21/1643), with 15 patients (0.9%) undergoing primary surgical treatment. The cohort comprised 53.3% females, with a median age of 48 years. Lymphovascular invasion(LVI) was observed in 53.3%, perineural invasion (PNI) in 13.3%, extrathyroidal extension(ETE) in 26.7%, and distant metastases (DM) in 26.7%. R0 resection was achieved in 86.67% of cases. Kaplan-Meier analysis estimated two-year OS at 78% and five-year OS at 68%. The predictors of OS included LVI (<i>p</i>=0.02), ETE, and PNI, while DFS was impacted by LVI, PNI (HR=9.83, <i>p</i>=0.023), and DM (HR=13.57, <i>p</i>=0.023). Necrosis and mitotic index >3/hpf had weak correlations with survival outcomes. This study highlights the critical prognostic role of LVI, PNI, ETE, and DM in PDTC outcomes and need for more Indian studies. Despite total thyroidectomy and adjuvant therapies, recurrence remains a challenge, necessitating a multidisciplinary approach. Given the absence of standardized treatment protocols, larger multicenter studies with molecular profiling are needed to refine prognostic models and optimize PDTC management.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1969-1977"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841045","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":"IL-6 Promoter Polymorphisms and Breast Cancer Susceptibility: A Meta-Analysis of 16,499 Cases and 21,186 Controls.","authors":"Alireza Negahi, Hossein Negahban, Soheila Sayad, Mehdi Khosravi-Mashizi, Abolhasan Alijanpour, Amirhossein Rahmani, Amirhossein Shahbazi, Fatemeh Jayervand, Seyed Alireza Dastgheib, Maryam Yeganegi, Hossein Neamatzadeh","doi":"10.1007/s13193-025-02517-z","DOIUrl":"10.1007/s13193-025-02517-z","url":null,"abstract":"<p><p>Interleukin-6 (IL-6) plays a critical role in tumor microenvironment regulation and immune suppression, yet the association between IL-6 promoter polymorphisms and breast cancer risk remains inconsistent across populations. This meta-analysis comprehensively evaluates three major IL-6 promoter variants (rs1800795, rs1800796, and rs1800797) in relation to breast cancer susceptibility while addressing multifactorial genetic and environmental contributions. A systematic search of 18 international and regional databases was performed through July 2025 to identify case-control studies assessing IL-6 promoter polymorphisms and breast cancer risk. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated under five genetic models. Subgroup analyses were performed by ethnicity and study design. Thirty case-control studies from 17 publications involving 33,350 participants (14,488 cases; 18,862 controls) from 13 countries were included. The rs1800796 polymorphism showed significant overall association with increased breast cancer risk in the allelic (OR = 1.193, 95% CI: 1.003-1.431, <i>p</i> = 0.046) and codominant models (OR = 1.339, 95% CI: 1.009-1.779, <i>p</i> = 0.043), with stronger effects in hospital-based cohorts. The rs1800795 variant demonstrated no overall association but exhibited significant Asian-specific effects under the recessive model (OR = 2.111, 95% CI: 1.361-3.274, <i>p</i> = 0.001). The rs1800797 polymorphism showed no association in any genetic model (allelic OR = 1.077, 95% CI: 0.855-1.356, <i>p</i> = 0.531) with negligible heterogeneity (I² = 0%). Substantial heterogeneity was observed for rs1800795 and rs1800796, reflecting differences in ethnicity, genotyping methods, and control recruitment strategies. The rs1800796 polymorphism represents a candidate genetic risk factor for breast cancer, particularly in Asian populations and hospital-based settings. These findings emphasize the necessity of population-stratified analyses, gene-environment interaction studies, and genotype-informed clinical trials before translating genetic associations into personalized therapeutic strategies.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1939-1955"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841527","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":"Clinicopathological Analysis of Orthokeratinized Odontogenic Cyst Aided by a Pilot Molecular Characterization Using Next-Generation Sequencing.","authors":"Chinmay Bhalotia, Deepak Pandiar, S Dharini, Reshma Poothakulath Krishnan","doi":"10.1007/s13193-025-02485-4","DOIUrl":"10.1007/s13193-025-02485-4","url":null,"abstract":"<p><p>To assess the prevalence and detailed clinicopathological features of orthokeratinized odontogenic cysts (OOC) with special emphasis on molecular profiling using next-generation sequencing (NGS). To assess the prevalence and detailed clinicopathological features of orthokeratinized odontogenic cysts (OOC) with special emphasis on molecular profiling using next-generation sequencing (NGS). For radiographic analysis and evaluation of clinicopathological features, we included thirty-nine histologically proven cases of OOC, after obtaining clearance from the institutional ethical clearance board. Furthermore, cases of histopathologically proven OKC were selected for comparison of the radiographic mean surface area. ImageJ software, version 1.53, was used to measure the radiographic mean surface area. The molecular profiling of OKC was performed on formalin-fixed paraffin-embedded tissue from three available cases of OOC and analyzed using a 50-gene NGS panel. The estimated prevalence of OOCs over the past 20 years was 0.55% with a male-to-female ratio of 2:1. The mean age at diagnosis was 33.33 10.74 years (median 33 years). The mandibular molar and ramus region was most frequently affected. OOC had a mean surface area of 113.86 mm2, whereas in OKCs it was found to be 114.87 mm2; the mean difference was not statistically significant. OOC showed a missense mutation in TP53 at exon 6 with loss of function [variant- chr17:7578226 (T>A)] and another NRAS missense mutation at exon 3 [variant- chr1:115256529 (T>C)]. Both mutations were depicted as likely pathogenic. Radiographs were found to be ineffective in differentiating OOC and OKC. In a pioneer study, we genetically analyzed OOC using NGS and found a potential role of TP53 and NRAS mutations in its pathogenesis.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1777-1783"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841427","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":"Intra-Operative Facial-Nerve Monitoring in Total Parotidectomy: A Retrospective Cohort Analysis of Nerve Preservation and Post-Operative Outcomes.","authors":"Sumit Gupta, Sanjeev Puri, Rohit Verma, Sahil Mangi, Manjinder Singh Sidhu, Bhavna Garg, Gurvinder Singh Grewal","doi":"10.1007/s13193-025-02491-6","DOIUrl":"10.1007/s13193-025-02491-6","url":null,"abstract":"<p><p>The research evaluated IONM's impact on postoperative results for patients who underwent total parotidectomy while creating an operational system to detect patients who would experience early facial weakness. The research team analyzed 38 patients who received total parotidectomy surgery at a tertiary cancer center from January 2019 through December 2024. The majority of patients underwent IONM monitoring through a four-channel electromyography system. The House-Brackmann (HB) grading scale evaluated facial nerve function at three time points: 24 h after surgery and at 1 month and 6 months postoperatively. The researchers used logistic regression to identify early facial weakness predictors which they used to develop a three-tier bedside risk score. The patient population had an average age of 45.1 years with a male-to-female ratio of 52%. The initial examination revealed that 42% of patients had HB grade ≥ III weakness but 92% of these patients recovered their strength by the third month and 3 patients (7.9%) maintained palsy. The factors that predicted day-1 paresis included longer nerve identification time and EMG amplitude drop ≥ 0.2 mA and malignant histology. EMG drop emerged as the most significant independent factor that predicted the outcome. The developed score enabled the classification of patients into three risk categories with strong predictive accuracy (AUC 0.84). IONM improves surgical safety but does not eliminate the risk of temporary paresis. The proposed risk score offers a simple tool to guide decisions and patient counseling, especially in resource-limited oncology settings.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1922-1928"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841502","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":"Life Saving Hepatic Resections in Ruptured Pediatric Hepatoblastoma - a Report of 3 Cases.","authors":"Jaihari Ms, Ashwin Krishnamoorthy, Subhash Raveendran, Madhu Muralee","doi":"10.1007/s13193-025-02514-2","DOIUrl":"10.1007/s13193-025-02514-2","url":null,"abstract":"<p><strong>Background: </strong>Hepatoblastoma is the most common primary malignant liver tumor in children, with peak incidence under three years of age. Tumor rupture, though rare, is a life-threatening complication that necessitates urgent intervention due to risks of hemorrhagic shock and peritoneal dissemination. This report highlights the clinical course, surgical management, and outcomes of three pediatric patients with ruptured hepatoblastoma.</p><p><strong>Methods: </strong>We analyzed three cases of ruptured hepatoblastoma in children aged 1-2 years. Diagnosis was based on clinical presentation, imaging, serum alpha-fetoprotein (AFP) levels, and histopathology where required. Management strategies included neoadjuvant chemotherapy with the Super-PLADO regimen, transarterial chemoembolization (TACE) and emergency hepatic resections tailored to tumor extent and vascular involvement.</p><p><strong>Results: </strong>All three patients presented with rupture either before or shortly after initiation of chemotherapy. One case involved a malignant rhabdoid variant with low AFP, necessitating biopsy for diagnosis. TACE was attempted in one case but surgical intervention was ultimately required in all due to worsening hemodynamic instability. Resections included left hepatectomy, non-anatomical segmental resection, and extended right hepatectomy.</p><p><strong>Conclusion: </strong>Ruptured hepatoblastoma is a surgical emergency requiring a multidisciplinary approach. Early recognition, stabilization, and timely surgical intervention are crucial for survival. Despite the high-risk nature of tumor rupture, favorable outcomes can be achieved with individualized, aggressive management combining surgery and other modalities.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1935-1938"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841518","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":"Feasibility, Safety, Efficacy, and Surgical Utility of CO₂ Insufflation-Assisted Peritonectomy Versus Conventional Stripping in Advanced Ovarian Cancer: an Open-Label Phase II Randomized Controlled Trial.","authors":"Nikhil Tiwari, Dharma Ram Poonia, Nivedita Sharma, Jeewan Ram Vishnoi, Lisa Chadha, Richa Todi, P P Sharma, Sanjeev Misra","doi":"10.1007/s13193-025-02510-6","DOIUrl":"10.1007/s13193-025-02510-6","url":null,"abstract":"<p><p>Peritonectomy is a complex and time-intensive component of cytoreductive surgery (CRS) in advanced ovarian cancer. While CO₂ assisted insufflation and dissection is the concept derived from minimally invasive procedures, can potentially impact the surgical outcomes. This trial aims to evaluate the feasibility, safety, and efficacy of CO₂ Insufflation-Assisted Peritonectomy (CIAP) compared to Conventional Stripping (CS) peritonectomy. In this open-label, phase II randomized controlled trial, 64 patients with ovarian cancer undergoing CRS were randomized (1:1) to receive either CIAP or CS. The primary endpoint was the duration of total peritonectomy. Secondary endpoints included operative outcomes, complications, surgeon satisfaction (measured using a newly developed Surgeon Satisfaction Scale and Net Promoter Score NPS. Statistical analysis was performed using SPSS v29.0. CIAP significantly reduced the duration of total peritonectomy compared to CS (149 ± 9.03 vs. 190 ± 11.3 min; <i>p</i> = 0.012). CIAP also demonstrated shorter operative times across individual regions. Postoperative morbidity and complications were comparable between groups. CIAP was rated easy to learn by 84% of surgeons and was perceived to be safe and time-saving. The Net Promoter Score for CIAP was 0.14, reflecting a modest positive inclination among operating surgeons. CIAP is a safe, feasible, and replicable technique that significantly reduces operative time in peritonectomy without increasing surgical morbidity. It holds promise as an adjunct in open CRS, particularly in anatomically complex or adherent regions. Larger multicentric studies are warranted to validate these findings and assess broader clinical applicability.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1852-1860"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841552","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":"Dermatofibroasarcoma Protuberans (DFSP) of the Breast: An Eight Case Series From A Single Institution.","authors":"Shreya Surendra, Shalini Sahu, Santhosh Raj, Nirmal Daniel, Supriya Sen, Thomas Shawn Sam, Meskerem Abera, Rajesh Balakrishnan, Anish Jacob Cherian, Mazhunvanchary Jacob Paul","doi":"10.1007/s13193-025-02504-4","DOIUrl":"10.1007/s13193-025-02504-4","url":null,"abstract":"<p><p>Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing soft tissue sarcoma arising from dermal fibroblasts. Breast involvement is extremely rare, posing diagnostic and therapeutic challenges. We retrospectively reviewed eight cases of breast DFSP managed at our center over a 10-year period. The cohort included seven females and one male with a median age of 39.1 years. Clinical presentations were diverse: one patient had multiple areolar nodules, five presented with breast lumps including three with recurrent lumps, which is an uncommon presentation for DFSP, one had an ulceroproliferative growth with bleeding, and one presented following excision of a recurrent lump elsewhere with histopathology showing positive margins. Histological diagnosis was confirmed via core biopsy or block review. Four patients had classic DFSP, while three had fibrosarcomatous transformation. All cases of DFSP showed CD34 positivity. Wide local excision was performed in seven patients, and one underwent mastectomy. Two patients received adjuvant radiotherapy. No recurrence was observed within six months. Breast DFSP is rare and requires histopathological confirmation. Core biopsy with appropriate histologic features and CD34 immunostaining aids in diagnosis. Wide local excision remains the primary treatment approach. Radiotherapy is recommended in cases with close or positive margins, recurrence, metastatic disease, or when surgery is not feasible. Targeted therapy with Imatinib Mesylate, a tyrosine kinase inhibitor, is reserved for unresectable or metastatic lesions, provided the COL1A1::PDGFB translocation involving chromosomes 17 and 22 [t (17; 22)] is confirmed. Long term stringent follow up is required as recurrence in breast has been noted 26 years following primary treatment in literature.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1909-1916"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841564","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}