Indian Journal of Surgical Oncology最新文献

{"title":"Awareness and Acceptance of Breast Conservation Surgery in Breast Cancer Patients in a Regional Cancer Centre in South India: Knowledge, Attitude and Practice Study (KAP Study).","authors":"Nishtha, Yeshwanth R, Syed Althaf, Ravi Arjunan, Srinivas C, Manjunath K V, Prakash B V","doi":"10.1007/s13193-025-02501-7","DOIUrl":"10.1007/s13193-025-02501-7","url":null,"abstract":"<p><p>There has been a paradigm shift toward breast conservation surgery (BCS) from mastectomy. In our country we face a unique situation of patient population with varied socio-economic background. In our study, we have tried to analyze the knowledge, attitude and practice (KAP) of patients regarding BCS. Hospital based prospective observational study done from August 2023 to August 2024 with 260 patients of non-metastatic breast cancer were assessed using a pre-validated questionnaire to identify the KAP of breast cancer patients with regards to BCS. Majority patients were illiterate, unemployed and from lower middle status. It was observed that only 52% were aware about their diagnosis while 18% knew the stage of the disease. Only 22% were aware of treatment options, while 12% had an idea about BCS. In 90% cases, surgeon was the source of knowledge and despite acquiring the knowledge only 23.7% opted for BCS. The decision regarding the treatment was not taken by the patient in majority of the cases. Our study brings out that there is little to no knowledge about Breast conservation. Awareness programs should target not only the female audience, but also the male counterparts and general surgeons who still cater to a large percentage of breast cancer patients. The awareness programs should emphasize the oncological equivalence of breast conservation and mastectomy among the general surgeons & family physicians.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 8","pages":"1784-1788"},"PeriodicalIF":0.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841693","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":"Partial Muscle-Sparing Islanded PMMC in Head and Neck Reconstruction.","authors":"Rajendra Dhondge, Onkar Kulkarni, Mohsina Hussain, Raj Nagarkar","doi":"10.1007/s13193-025-02438-x","DOIUrl":"10.1007/s13193-025-02438-x","url":null,"abstract":"<p><p>India has a huge burden of head and neck cancer. Microvascular reconstruction is the gold standard currently. But it becomes difficult in each case. The pectoralis major myocutaneous (PMMC) flap has been the workhorse flap of head and neck reconstruction. Here, we describe a partial muscle-sparing islanded modification of the pectoralis major myocutaneous flap. Thirty-two patients with various head and neck defects underwent partial muscle-sparing modification of the pectoralis major myocutaneous flap from January 2022 to January 2023, with a follow-up period of 1 year. All patients did well with the flap, with only 1 partial necrosis, which was managed conservatively. The reach of the flap increased after it was islanded on the pedicle. The bulge in the clavicular region, typically seen with classic PMMC, was also absent, resulting in a symmetrical appearance of the bilateral clavicular region. Partial muscle-sparing modification of the pectoralis major myocutaneous flap is a useful modification which helps to increase the reach of the pedicle, improves aesthetics, is functionally better, and is an easy, repeatable modification with promising results.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1409-1413"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362843","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":"Dead Space Prevention: a Technique for Preventing Pharyngocutaneous Fistula After Salvage Laryngectomy.","authors":"Goran Latif Omer, Othman Hussein Ahmed, Kosar Hama Noori, Sahand Soran Ali, Aland Salih Abdullah, Riccardo Maurizi, Gianluca Velletrani, Beatrice Francavilla, Avar Fuad Ahmed, Stefano Di Girolamo","doi":"10.1007/s13193-025-02407-4","DOIUrl":"10.1007/s13193-025-02407-4","url":null,"abstract":"<p><p>Pharyngocutaneous fistula (PCF) is the most common and challenging complication after salvage total laryngectomy, particularly in patients with prior chemoradiation. This prospective study aimed to evaluate the effectiveness of a novel multilayer closure technique utilizing vascularized muscle flaps designed to obliterate residual pharyngeal dead space and reinforce neopharyngeal healing, with the goal of preventing PCF formation. A prospective single-arm cohort study was conducted on 25 consecutive patients with stage III or IV laryngeal cancer, or recurrent disease following chemoradiation, who underwent total laryngectomy with concurrent neck dissection between 2017 and 2025. The modified technique involved vertical multilayer suturing of the posterior pharyngeal wall combined with tailored vascularized muscle flaps (local, distant, or free) to fill dead space and support the neopharynx. Postoperative care included nutritional optimization, targeted antibiotic prophylaxis, and close monitoring for complications. The primary outcome was the incidence of PCF, compared to the institutional historical baseline rate of 18%. Of the 25 patients (mean age 58 years; 96% male), 60% had prior chemoradiation and 48% were underweight preoperatively. Local muscle flaps, predominantly sternocleidomastoid, were used in 68% of cases; pedicled flaps were used in 88%. Transient hypoalbuminemia occurred in 12% of patients and was corrected with intravenous albumin supplementation. Over a 3-year follow-up, no patient developed PCF or major wound complications. Statistical analysis confirmed a significantly lower PCF rate compared to the institutional baseline (0% vs. 18%, <i>p</i> = 0.007; 95% CI: 0-11.3%). This modified multilayer closure technique with vascularized muscle flap reinforcement demonstrated complete prevention of PCF in a high-risk cohort undergoing salvage laryngectomy. By addressing pharyngeal dead space and employing tension-free vertical closure, this approach aligns with biomechanical principles of improved perfusion and healing. Although promising, these findings warrant validation in larger multicenter controlled trials to confirm its efficacy over standard reconstructive techniques.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1297-1304"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362831","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":"Colorectal Cancer Survival: A single-Centre Experience.","authors":"Emad M N Rezkallah, Benjamin Perakath","doi":"10.1007/s13193-025-02430-5","DOIUrl":"10.1007/s13193-025-02430-5","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is one of the most common malignancies in the UK. Survival rates are known to vary between centres. We report our survival rates for colorectal cancer patients at a district hospital. In addition, we studied the impact of various factors on the outcomes. We conducted a retrospective review for colorectal cancer patients who had curative treatment in our centre during the period from 2017 to 2019. We followed-up our patients for 5 years. We examined the survival rates using the Kaplan-Meier method. The relationship between survival time and other variables was assessed by Cox regression models. Four hundred and five patients were included in our review. Average age was 71.1 ± 10.6 years. There were 237 males (58.5%) and 168 females (41.5%). The 5-year survival rates per stage were 80.9% for stage I, 67.3% for stage II, 55% for stage III, and 10.9% for stage IV. The overall 2-year survival was 78.5% and 5-year survival was 59.3%. We found that male patients, with colon cancer, above the age of 50, who did not have curative resection and received adjuvant therapy, had lower survival rates. Our CRC survival rates are acceptable compared with other studies considering the characteristics of our local population. Different factors such as age, location of the tumour, gender, curative resection, and adjuvant therapy may have a significant effect on the survival rates.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1257-1262"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362885","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":"Pulmonary Metastasectomy for Head and Neck Cancer: Institutional Experience in the Context of Published Surgical Series.","authors":"Ryusei Yoshino, Kengo Takahashi, Nozomi Hatanaka, Akane Ito, Nanami Ujiie, Shunsuke Yasuda, Masahiro Kitada","doi":"10.1007/s13193-026-02540-8","DOIUrl":"10.1007/s13193-026-02540-8","url":null,"abstract":"<p><p>Despite its uncommon occurrence, pulmonary metastasis from head and neck cancer has significant prognostic implications. Although pulmonary metastasectomy is a potential treatment option for select patients, its impact on patient survival remains controversial. This study aimed to describe our institutional experience with pulmonary metastasectomy for head and neck cancer and to contextualize the findings within previously published surgical series. We conducted a retrospective cohort study involving 15 patients with head and neck cancer who underwent pulmonary metastasectomy at our institution. Clinicopathological characteristics, disease-free interval, tumor size, surgical procedures, and postoperative outcomes were descriptively analyzed. The median overall survival time after pulmonary metastasectomy was 36 months. Complete resection was achieved in all patients. Patients with a longer disease-free interval tended to show more favorable survival outcomes, whereas tumor size did not demonstrate a clear association with prognosis in this cohort. Postoperative adjuvant therapy was administered in 60.0% of patients. Pulmonary metastasectomy may be a treatment option for carefully selected patients with head and neck cancer. A longer disease-free interval appears to be an important consideration for patient selection, consistent with previous reports, while tumor size alone may not be sufficient to predict outcomes. Given the retrospective design and small sample size, further multicenter studies are warranted to clarify the role of pulmonary metastasectomy in this setting.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1440-1445"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362839","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 Medical Marvel And Complex Clinical Scenario: The Largest Documented Case of Renal Metastasis from Pleomorphic Adenoma, Weighing 13.5 kg.","authors":"Lalit Kumar, Rohan Shankar, Neha Singh, Tarun Batra","doi":"10.1007/s13193-025-02413-6","DOIUrl":"10.1007/s13193-025-02413-6","url":null,"abstract":"<p><p>Renal masses weighing as much as 13.5 kg are uncommon in the era of radiological imaging. A 52-year-old male presented with a left renal and parotid tumor with a history of parotidectomy 30 years back. He had an open radical nephrectomy followed by total parotidectomy. The patient had an uneventful recovery without any complications. The histopathology report of the renal tumor came as pleomorphic adenoma, while parotidectomy as carcinoma ex pleomorphic adenoma. This case highlights the indolent nature of pleomorphic adenoma presenting as delayed, huge renal metastasis. The thorough evaluation, accurate diagnosis, surgical excision of the tumor, and long-term close surveillance in pleomorphic adenoma are essential.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1237-1240"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362828","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":"Preserving a Functional Foot: Limb-Salvage Surgery with Brachy Mono-Therapy for Soft Tissue Sarcoma.","authors":"Atul Anand, Dharma Ram Poonia, Nivedita Sharma, Jeewan Ram Vishnoi, Bharti Devnani, Deepti Katrolia","doi":"10.1007/s13193-025-02447-w","DOIUrl":"10.1007/s13193-025-02447-w","url":null,"abstract":"<p><p>Soft tissue sarcomas (STS) of the foot are rare, accounting for 2-5% of musculoskeletal sarcomas, and are often associated with higher amputation rates due to limited soft tissue coverage, complex anatomy, and the functional demands of weight-bearing. We report the case of a 70-year-old woman with a myxoinflammatory fibroblastic sarcoma involving the 2nd-4th metatarsals. Limb salvage surgery was performed, consisting of en bloc resection with preservation of the metatarso-phalangeal joints, skeletal fixation with titanium plates, tendon reconstruction using tensor fascia lata, and soft-tissue coverage with an anterolateral thigh free flap. Intraoperative, interstitial brachytherapy catheters were placed, enabling 36 Gy/9 fractions safely without wound or flap complications. At 6 months, the patient was disease-free and ambulatory without disability. This case demonstrates that with multidisciplinary planning, complex reconstruction and adjuvant brachytherapy can achieve durable local control and preserve function in selected patients with foot sarcoma.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1424-1427"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362867","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":"Development of a Competency-Based Curriculum for Surgical Oncology Training in India.","authors":"S V S Deo, Pankaj Kumar Garg, Ashish Jakhetiya, Rahul Kumar, Sunil Kumar, Jeewam Ram Vishnoi, Dillip Kumar Muduly, Madhabanand Kar","doi":"10.1007/s13193-025-02433-2","DOIUrl":"10.1007/s13193-025-02433-2","url":null,"abstract":"<p><p>Cancer care in India is increasingly complex, requiring surgical oncologists with advanced multidisciplinary skills. This article proposes a standardised national curriculum for Surgical Oncology training to ensure consistent training, academic excellence, and improved patient outcomes. The framework integrates surgical expertise, oncologic principles, research aptitude, and holistic care, aligned with global standards yet adapted to India's healthcare realities. Consensus was achieved through online and in-person deliberations among senior surgical oncology leaders from institutes such as AIIMS and other major centres. Several participants have served as subject experts for the National Board of Examinations, the National Medical Commission, and the Indian Council of Medical Research. The framework, informed by global and Indian models, was mapped across cognitive, psychomotor, and affective domains. It incorporated disease-specific competencies, research training, multidisciplinary exposure, and subspecialty rotations. Evaluation strategies included both formative and summative assessments, with inter-institutional exchange where facilities were limited. The three-year curriculum includes academic activities, thesis and database project, logbook maintenance, and rotations in medical oncology, radiation oncology, palliative care, ICU, and basic sciences. Training spans core surgical principles and advanced procedures across organ systems, with emphasis on community health, translational research, digital health, and artificial intelligence. Competency-based progression, structured assessments, and holistic training in ethics, communication, and survivorship are integral features. The proposed curriculum provides a structured, competency-based model for surgical oncology training in India. It strengthens clinical, academic, and research capacities, outlines a roadmap for future organ-based subspecialisation, and offers a framework adaptable to low- and middle-income countries.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s13193-025-02433-2.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1323-1338"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362902","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":"Peri-operative Safety and Complications of Central Venous Access Device in Paediatric-Haemato-Oncology Patients: A Single-Centre Experience of 180 Procedures with Special Focus on Chemoport Insertion.","authors":"Akhil Palod, Vasudeva K Bhat, Roshan George Rajan, Ananth S Mathad, Naveena A N Kumar","doi":"10.1007/s13193-025-02449-8","DOIUrl":"10.1007/s13193-025-02449-8","url":null,"abstract":"<p><p>Reliable long-term central venous access is a cornerstone in the management of paediatric haematology and oncology patients. The use of chemoport in paediatric populations remains limited, primarily due to concerns regarding peri-procedural risks and associated complications. We aim to present our experience of central venous access device (CVAD) in paediatric-haemato-oncology patients with special focus on chemoport insertion, with respect to standardisation of technique, peri-procedural safety, and complications. The paediatric haematology and oncology patients who underwent CVAD insertion between June 2019 and June 2025 were included in the study. The data were retrospectively reviewed from a prospectively maintained department database. The variables included patient demographics, indication, site, route of insertion, technique used, and peri-operative complications. A total of 180 CVAD insertions were performed in paediatric patients between June 2019 and June 2025. Among them, 155 (86.1%) had haematolymphoid malignancies, and 25 (13.9%) had solid tumours. The youngest patient was 4 months old and the eldest was 18 years. Of the 180 CVAD insertions, 140 were chemoport insertions, 29 received Hickman lines, and 11 were subclavian lines. Among the chemoport recipients, six patients (4.3%) had complications, which included: one had a guidewire-associated right atrial rupture, which was managed by emergency thoracotomy; two developed pneumothorax requiring intercostal drainage, and three had minor complications such as port-site erythema and post-procedural fever, managed conservatively. All patients recovered uneventfully and commenced treatment without delay. Totally implantable devices such as chemoports are safe and reliable for paediatric patients with haematological and solid malignancies. Although associated with a learning curve and potential procedural risks, these can be minimised through standardised techniques, protocol-driven care, and continuous personnel training.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1428-1434"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362909","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 Trps-1 Expression in Breast and Urothelial Carcinomas.","authors":"Sheenam Azad, Seema Acharya, Sadaf Khan, Aashna Goel, Shefali Kamboj, Nilkamal Kumar","doi":"10.1007/s13193-025-02431-4","DOIUrl":"10.1007/s13193-025-02431-4","url":null,"abstract":"<p><p>Carcinoma of unknown primary origin is a diverse group of carcinomas that is defined by the presence of metastatic disease with no identified primary tumor at initial presentation. This group comprises 2 to 5% of all carcinoma cases. GATA3 and CK7 are markers which are positive in both breast carcinoma as well as urothelial carcinoma. Trichorhinophalangeal syndrome type 1 (TRPS1), a member of the GATA family, is overexpressed in breast carcinoma. The aim of the study is to compare the expression of TRPS-1 gene in breast carcinoma and urothelial carcinomas for its potential use in differentiating breast carcinoma metastasis from that of urothelial carcinoma in cases of carcinoma of unknown primary, especially when routine markers for breast carcinoma are negative and GATA-3 is positive. The present study was an observational cross-sectional study conducted over a period of 4 years (2020-2023) on 150 cases each of breast and urothelial carcinoma, wherein the expression of TRPS-1 was studied. In the present study, a majority of urothelial carcinoma cases 92.7% (139/150) were negative with a score of 0. Eleven cases were positive (7.3%) with weak to intermediate score while all the cases of breast carcinoma (150/150; 100%) expressed TRPS-1 with intermediate to high scores. It was concluded that TRPS1 is 100% sensitive and 92.66% specific for breast carcinoma and can be included in the panel for search of unknown primary at metastatic site.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"17 6","pages":"1291-1296"},"PeriodicalIF":0.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362919","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}