Surgical Oncology-Oxford最新文献

{"title":"Octogenarians with lower BMI have comparatively poor survival in potentially resectable pancreatic cancer: outcomes over 5-year follow-up","authors":"Hideki Motobayashi,&nbsp;Atsushi Shimizu,&nbsp;Yuji Kitahata,&nbsp;Akihiro Takeuchi,&nbsp;Tomohiro Yoshimura,&nbsp;Masatoshi Sato,&nbsp;Kyohei Matsumoto,&nbsp;Shinya Hayami,&nbsp;Atsushi Miyamoto,&nbsp;Kensuke Nakamura,&nbsp;Manabu Kawai","doi":"10.1016/j.suronc.2025.102248","DOIUrl":"10.1016/j.suronc.2025.102248","url":null,"abstract":"<div><h3>Background</h3><div>The indication and benefit of pancreatectomy for octogenarians with pancreatic cancer remains controversial. This study aims to evaluate prognostic factors in patients with pancreatic cancer after 5-year follow-up.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the 229 patients who underwent pancreatectomy at our hospital between 2005 and 2018 for potentially resectable pancreatic cancer. Of these, 216 patients were divided into three groups based on age: &lt;70 years old (n = 97), 70–79 years old (n = 81), and ≥80 years old (n = 38).</div></div><div><h3>Results</h3><div>Seventy patients (32.4 %) achieved 5-year survival. Median survival time and five-year overall survival in each group were: 37.3 months and 37.1 % for patients &lt;70 years old, 26.0 months and 30.9 % for those 70–79 years old, and 20.2 months and 23.7 % for those ≥80 years old. The patients who were ≥80 years old and had BMI &lt;20 kg/m² had a significantly poorer prognosis than those &lt;80 years old and who had BMI ≥20 kg/m² (<em>P</em> = 0.006). Independent prognostic factors were age ≥80 years and BMI &lt;20 kg/m², preoperative CA19-9 ≥ 500 IU/L, transfusion, tumor size ≥20 mm, positive lymph node, and non-completion of adjuvant therapy. Moreover, age ≥80 years, BMI &lt;20 kg/m², preoperative CA19-9, and severe complications were each associated with non-completion of adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>Octogenarians with lower BMI, which might be attributed to lower completion rate of adjuvant therapy, had especially poorer prognosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102248"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal aortic calcification predicts poor prognosis for patients with gastric cancer who underwent curative gastrectomy","authors":"Naoko Fukushima ,&nbsp;Takahiro Masuda ,&nbsp;Kenei Furukawa ,&nbsp;Kazuto Tsuboi ,&nbsp;Masami Yuda ,&nbsp;Keita Takahashi ,&nbsp;Masaichi Ogawa ,&nbsp;Toru Ikegami ,&nbsp;Fumiaki Yano ,&nbsp;Ken Eto","doi":"10.1016/j.suronc.2025.102247","DOIUrl":"10.1016/j.suronc.2025.102247","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal aortic calcification is a pathological vascular disorder associated with various diseases and has recently been associated with the prognosis of various cancers. This study aimed to investigate the association between abdominal aortic calcification and prognosis in patients who underwent curative gastrectomy for gastric cancer.</div></div><div><h3>Methods</h3><div>We analyzed 251 patients who underwent curative gastrectomy for gastric cancer between January 2014 and February 2020. The volume of abdominal aortic calcification was assessed using routine preoperative computed tomography. The cutoff values were assessed using receiver operating characteristic curve analysis of the survival status at the 3-year follow-up, and set to 585.</div></div><div><h3>Results</h3><div>Higher abdominal aortic calcification volume was identified in 151 patients (60 %). Multivariate analysis showed that abdominal aortic calcification (<em>P</em> = 0.0120, <em>P</em> = 0.0430, respectively), and stage II or III disease (<em>P</em> = 0.0000, <em>P=</em>0.0000, respectively) were independent and significant predictors of the disease-free and cancer-specific survival. Additionally, patients with higher abdominal aortic calcification volume were significantly older and had a higher prevalence of hypertension, diabetes, chronic renal failure, and cardiovascular diseases.</div></div><div><h3>Conclusions</h3><div>Abdominal aortic calcification showed a strong preoperative prognostic indicator in patients undergoing curative gastrectomy for gastric cancer.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102247"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic drain placement versus non-drainage following gastric cancer surgery: A systematic review and meta-analysis of randomized controlled trials","authors":"Ahmed Maher Khalil ,&nbsp;Emtenan Arishi ,&nbsp;Ayman Megahed ,&nbsp;Nouran H. Kamel ,&nbsp;Ahmed W. Hageen ,&nbsp;Najla K. Alzahrani ,&nbsp;Deema Alanzi ,&nbsp;Abdulmalik A. Aiban ,&nbsp;Marwan Farea ,&nbsp;Abdullah Albukhari ,&nbsp;Salem M. Abokhanjar ,&nbsp;Majd Elmahi","doi":"10.1016/j.suronc.2025.102246","DOIUrl":"10.1016/j.suronc.2025.102246","url":null,"abstract":"<div><div>Gastric cancer remains a significant global health burden and a leading cause of cancer-related deaths. Surgical resection is the primary curative treatment, but postoperative complications can negatively impact outcomes. Prophylactic drainage (PD) has been widely used to reduce these complications by facilitating early detection and management of fluid collections. This study evaluates the role of PD following gastric cancer surgery through a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched PubMed, Web of Science, Scopus, and Cochrane databases up to January 15, 2025, and analyzed dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), both with 95 % confidence intervals (CI), using R version 4.3 (PROSPERO ID: CRD42025650045). Four RCTs involving 728 patients were included. The analysis revealed that PD was associated with a significantly lower risk of mortality compared to no drainage (RR: 0.45 [95 % CI: 0.21–0.94]; P = 0.03). However, there were no significant differences between the drainage and non-drainage groups in the incidence of intra-abdominal abscess (RR: 1.23 [95 % CI: 0.49–3.06]; P = 0.66), surgical-site infection (RR: 0.93 [95 % CI: 0.56–1.52]; P = 0.76), pulmonary infection (RR: 0.66 [95 % CI: 0.37–1.18]; P = 0.16), duodenal stump leakage (RR: 1.54 [95 % CI: 0.51–4.71]; P = 0.45), anastomotic leakage (RR: 1.47 [95 % CI: 0.64–3.39]; P = 0.37), or reoperation rates (RR: 0.95 [95 % CI: 0.40–2.27]; P = 0.90). Additionally, no significant differences were observed in the length of hospital stay (MD: 0.10 [95 % CI: −0.39 to 0.58]; P = 0.70) or time to the first soft diet (MD: 0.21 [95 % CI: −0.09 to 0.50]; P = 0.17). In conclusion, PD following gastric cancer surgery is associated with a reduced risk of mortality but does not significantly impact the incidence of perioperative complications or recovery metrics. These findings suggest that while PD may offer a survival benefit, it does not appear to reduce common postoperative complications or accelerate recovery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102246"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is lateral pelvic lymph node dissection necessary for good responder to neoadjuvant chemoradiation in locally advanced rectal cancer?","authors":"Jung Hoon Bae ,&nbsp;Jumyung Song ,&nbsp;Ji Hoon Kim ,&nbsp;Bong-Hyeon Kye ,&nbsp;In Kyu Lee ,&nbsp;Hyeon-Min Cho ,&nbsp;Yoon Suk Lee","doi":"10.1016/j.suronc.2025.102249","DOIUrl":"10.1016/j.suronc.2025.102249","url":null,"abstract":"<div><h3>Background</h3><div>Response to preoperative chemoradiation (CRT) is an important indicator of the possibility of lateral pelvic lymph node (LPN) metastasis. However, the effect of LPN dissection (LPND) in good responders to CRT remains unclear. This study aimed to identify the optimal treatment strategy for patients with rectal cancer who respond well to preoperative CRT.</div></div><div><h3>Methods</h3><div>This multi-institutional retrospective study evaluated patients with locally advanced rectal cancer and clinically suspected LPN metastases who underwent total mesorectal excision with LPND after CRT. The patients were divided into two groups based on the largest lymph node diameter post-CRT (cutoff: 5 mm): good (n = 38) and poor responders (n = 53).</div></div><div><h3>Results</h3><div>LPN metastasis was significantly higher in poor responders (18 patients, 34.0 %) than in good responders (5 patients, 13.2 %) (p = 0.024). All 5 patients in the good responder group had low rectal cancer (i.e., tumors located within 5 cm from the anal verge (AV)). Low rectal cancer was the only significant predictor for LPN metastasis in good responders (p = 0.004). However, LPN size before and after CRT did not predict LPN metastasis in this group (p = 0.947 and 0.910, respectively). When LPND was indicated for all poor responders and for good responders with tumors located ≤5 cm from the AV, the sensitivity for LPN metastasis diagnosis was 100 %.</div></div><div><h3>Conclusion</h3><div>Among rectal cancer patients with good response to preoperative CRT, pathological LPN metastasis occurs in 13.2 %, and tumor height is a significant risk factor for LPN metastasis. LPND might be considered for low rectal tumors, regardless of preoperative CRT response.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102249"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of enhanced recovery after surgery in breast reconstruction: Lessons from a French tertiary center","authors":"Alexandre Vinel ,&nbsp;Florence Babre ,&nbsp;Antoine Dannepond ,&nbsp;Julie Commeny ,&nbsp;Diane Adam ,&nbsp;Anaïs Delgove ,&nbsp;Audrey Michot","doi":"10.1016/j.suronc.2025.102250","DOIUrl":"10.1016/j.suronc.2025.102250","url":null,"abstract":"<div><h3>Introduction</h3><div>Enhanced Recovery After Surgery (ERAS) programs have significantly improved postoperative outcomes across various surgical disciplines. In April 2022, an ERAS protocol tailored for patients undergoing DIEP free flap breast reconstruction was implemented at the Bordeaux Cancer Center, France. This study aimed to assess the impact of this protocol on length of stay (LOS), complication rates, and compliance with protocol items.</div></div><div><h3>Material and methods</h3><div>A retrospective pre-post observational study was conducted, including 56 consecutive patients who underwent DIEP flap reconstruction at the Bergonié Institute between September 2020 and April 2023. Twenty-eight patients received conventional perioperative care, while 28 patients were managed under the ERAS protocol. Outcomes assessed included LOS, early and 90-day postoperative complications, and adherence to the protocol's 20 key items.</div></div><div><h3>Results</h3><div>Median LOS was comparable between groups, at 4.5 days pre-ERAS and 5 days post-ERAS (p = 0.52). Early and 90-day complication rates showed no significant differences. The average compliance with protocol items was 14.2 out of 20 per patient, with 35 % of recommendations followed in less than 66 % of cases.</div></div><div><h3>Conclusion</h3><div>The initial evaluation of the ERAS program showed no significant reduction in LOS or morbidity, primarily due to suboptimal adherence. These findings highlight the importance of optimizing compliance with protocol recommendations to further improve recovery outcomes, reduce LOS and potentially lower overall healthcare costs.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102250"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between the distance from the tumor to major blood vessels and prognosis of deep soft tissue sarcomas","authors":"Tadashi Iwai ,&nbsp;Maria Anna Smolle ,&nbsp;Dominik Kaiser ,&nbsp;Lukas Jud ,&nbsp;Sandro F. Fucentese ,&nbsp;Daniel Andreas Müller","doi":"10.1016/j.suronc.2025.102244","DOIUrl":"10.1016/j.suronc.2025.102244","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent reports show that vascular proximity on magnetic resonance imaging (MRI) increases the risk of local recurrence of thigh soft tissue sarcomas (STS). However, it remains unclear whether the defined radiological distance between the tumor and major blood vessels influences local recurrence-free survival (LRFS), metastasis-free survival (MFS), and overall survival (OS). We aimed to verify this association among patients with deep STS.</div></div><div><h3>Methods</h3><div>Clinical-pathological data of 149 patient's deep STS treated between 2014 and 2023 at a single institution were retrospectively analyzed. Based on MRI findings, the distance between the tumor and major blood vessels was investigated using two groups (“In contact” and “Not in contact”). Sex, age, tumor size, location, grade, AJCC staging, and distance to major blood vessels were evaluated using Cox proportional hazards regression models. Five-year survival rates were assessed using the Kaplan–Meier method.</div></div><div><h3>Results</h3><div>Median follow-up duration was 40 (interquartile range [IQR]: 19–75) months. The five-year OS, LRFS, and MFS rates were 72.5 %, 95.5 %, and 85.2 %, respectively. Multivariate analysis revealed significant associations between poor OS and tumor stage IV as well as “In contact” with major blood vessels. Additionally, the statistical significance between distant metastasis and “In contact” with major blood vessels was clarified.</div></div><div><h3>Conclusions</h3><div>A radiological “In contact” between the tumor and major blood vessels was a significant factor associated with poor prognosis and distant metastasis. Orthopedic oncologists should consider a treatment strategy based on the relationship between the distance from the tumor to major blood vessels on MRI preoperatively.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102244"},"PeriodicalIF":2.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and internal validation of a novel predictive model to guide an individualized risk assessment in prostate cancer patients","authors":"Fabrizio Di Maida ,&nbsp;Luca Lambertini ,&nbsp;Antonio Andrea Grosso ,&nbsp;Daniele Paganelli ,&nbsp;Vincenzo Salamone ,&nbsp;Simone Coco ,&nbsp;Anna Cadenar ,&nbsp;Andrea Marzocco ,&nbsp;Filippo Lipparini ,&nbsp;Matteo Salvi ,&nbsp;Gianni Vittori ,&nbsp;Rino Oriti ,&nbsp;Agostino Tuccio ,&nbsp;Michele Di Dio ,&nbsp;Lorenzo Masieri ,&nbsp;Andrea Mari ,&nbsp;Andrea Minervini","doi":"10.1016/j.suronc.2025.102242","DOIUrl":"10.1016/j.suronc.2025.102242","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To provide a risk-adapted strategy to manage prostate cancer (PCa) patients eligible for curative surgery by developing an individualized risk calculator to predict oncologic outcomes.</div></div><div><h3>Materials and methods</h3><div>Data of consecutive patients treated with robot-assisted radical prostatectomy (RARP) between March 2020 and June 2023 at a single tertiary referral center were prospectively collected and analyzed. Multivariate analysis using Cox proportional hazards model were performed to explore predictors of 3-year biochemical failure (BCF). Both preoperative and postoperative models explored, with key variables including tumor-related features and surgical delay. Based on the significant variables identified, two nomograms were developed to estimate the risk of 3-year BCF. The area under the receiving operator characteristics (ROC) curves (AUC) was used to quantify predictive discrimination. Internal validation using bootstrapping techniques was performed to assess the model's accuracy and calibration.</div></div><div><h3>Results</h3><div>Overall, 2017 patients were enrolled. At the multivariable analysis for preoperative model, cT stage, cN stage, ISUP grade on prostate biopsy, PIRADS of the index lesion on prostate MRI and surgical delay were significant predictive factors of 3-year BCF. At the multivariable analysis for postoperative predictive model, pT stage, pN stage, ISUP grade on final histopathological examination, surgical margins and surgical delay were significant predictive factors of 3-year BCF. The preoperative and postoperative model showed a ROC AUC of 60.7 % and 71.9 %, respectively. The final nomograms for both preoperative and postoperative models were built. Both models underwent internal validation using bootstrapping with 1000 repetitions.</div></div><div><h3>Conclusions</h3><div>To optimize the timing of surgery in PCa patients based on individual risk profile, we finally designed and internally validated two nomograms, which serve complementary roles. The preoperative nomogram offers early, albeit less precise, risk stratification to guide initial treatment planning, while the postoperative nomogram refines BCF predictions using definitive pathological data.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102242"},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical tips on pancreatojejunostomy and gastrojejunostomy during robotic pancreatoduodenectomy with comparison between the internal and external stent for pancreatojejunostomy","authors":"Kyoji Ito ,&nbsp;Yoshikuni Kawaguchi ,&nbsp;Satoru Abe ,&nbsp;Yusuke Seki,&nbsp;Yuichiro Mihara,&nbsp;Yujiro Nishioka,&nbsp;Akihiko Ichida,&nbsp;Takeshi Takamoto,&nbsp;Nobuhisa Akamatsu,&nbsp;Kiyoshi Hasegawa","doi":"10.1016/j.suronc.2025.102239","DOIUrl":"10.1016/j.suronc.2025.102239","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy (PD) is essential for treating periampullary lesions but is often complicated by postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE). This study presents techniques in pancreatojejunostomy (PJ) and gastrojejunostomy (GJ) during robotic PD (RPD) to achieve zero incidence of clinically relevant (CR)–POPF and DGE.</div></div><div><h3>Methods</h3><div>Patients who underwent PD at The University of Tokyo from January 2020 to July 2024 were included in this study. RPD was regularly performed and standardized after January 2022. The following anastomosis techniques were used for RPD: modified Blumgart anastomosis for PJ and side-to-side GJ in a Billroth II fashion using a linear stapler and Braun anastomosis by hand. The outcomes of RPD were compared based by the PJ stent type and with those of open PD (OPD) performed for the same indication during 2020–2022.</div></div><div><h3>Results</h3><div>Of the 34 patients, no patient developed CR–POPF, DGE, or bile leakage. One patient with fluid collection underwent radiographic drainage with the discharge amylase level unelevated. The median (range) length of hospital stay was 8 days (5–17), and none of the patients underwent a 30-day reoperation or showed a 90-day mortality. Patients with PJ short stent placement had significantly shorter median operation times (663 vs. 795 min) and median hospital stays (6.0 vs. 8.5 days) compared to those with external stents. The incidence of POPF (0 % vs. 69.2 %, P &lt; 0.01) and DGE (0 % vs. 23.1 %, P = 0.01) was significantly lower in the RPD group than in the OPD group.</div></div><div><h3>Conclusions</h3><div>The described PJ and GJ techniques and evidence-based perioperative management achieved zero CR–POPF and DGE in RPD, suggesting favorable outcomes. External stents may not improve results in RPD.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102239"},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of conversion surgery in patients with stage IV gastric cancer: A multicenter population-based cohort study","authors":"Hirohito Kakinuma ,&nbsp;Michitaka Honda ,&nbsp;Hidetaka Kawamura ,&nbsp;Soshi Hori ,&nbsp;Teppei Miyakawa ,&nbsp;Satoshi Toshiyama ,&nbsp;Yoshinao Takano ,&nbsp;Shunji Kinuta ,&nbsp;Takahiro Kamiga ,&nbsp;Satoru Shiraso ,&nbsp;Koji Kono","doi":"10.1016/j.suronc.2025.102241","DOIUrl":"10.1016/j.suronc.2025.102241","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of conversion surgery (CS) for stage IV advanced gastric cancer (AGC) remains unclear. This study aimed to provide an overview of the clinical practice for Stage IV AGC and to evaluate the effectiveness of CS.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study. Consecutive patients diagnosed with stage IV AGC between 2008 and 2015 at designated cancer hospitals in Fukushima Prefecture, Japan, were enrolled in this study. We evaluated the relationship between CS and survival time and calculated the adjusted hazard ratios of CS for overall survival.</div></div><div><h3>Results</h3><div>A total of 647 patients were enrolled. CS was performed in 57 (8.8 %) patients. The CS group had fewer metastatic lesions (p = 0.01) and fewer liver metastases (p &lt; 0.01) relative to the non-CS group. The adjusted hazard ratios of CS for overall survival were 0.34 (95 % confidence interval: 0.24–0.48, p &lt; 0.01). The median survival time was 28.0 months in the CS group and 8.2 months in the non-CS group.</div></div><div><h3>Conclusion</h3><div>This study revealed the implementation status of CS for patients with stage IV AGC. CS may improve the patient prognosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102241"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant intraperitoneal chemotherapy in high-risk and cytology positive gastric cancer: a systematic review","authors":"Brendan Desmond ,&nbsp;Lobna Alukaidey ,&nbsp;Zexi Allan ,&nbsp;Carlos Cabalag ,&nbsp;Nicholas J. Clemons ,&nbsp;Michael Michael ,&nbsp;Jeanne Tie ,&nbsp;Niall Tebbutt ,&nbsp;Cuong P. Duong ,&nbsp;David S. Liu","doi":"10.1016/j.suronc.2025.102237","DOIUrl":"10.1016/j.suronc.2025.102237","url":null,"abstract":"<div><h3>Background</h3><div>Gastric cancer has a risk of early transcoelomic spread. Despite perioperative chemotherapy and surgery, peritoneal recurrence is a frequent contributor to mortality. The addition of neoadjuvant normothermic intraperitoneal chemotherapy (IPC) allows early treatment of microscopic disease. Our study aims to systematically evaluate the safety and efficacy of neoadjuvant IPC in patients with gastric cancer who are at high risk of peritoneal recurrence.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to the PRISMA guidelines. Embase, PubMed, Web of Science and Scopus were searched for relevant papers. The primary outcomes were the rates of disease-free (DFS) and overall survival (OS) among patients treated with neoadjuvant IPC. Secondary outcomes focused on adverse effects and toxicity.</div></div><div><h3>Results</h3><div>Overall, 562 manuscripts were screened and 7 papers were included, totalling 158 patients. For cytology-positive patients, the addition of IPC led to a conversion to negative cytology and radical surgery in 78–89 %. This was associated with relatively high DFS and OS. Peritoneal-specific recurrence was higher in cohorts who initially had cytology-positive disease (63–69 %) compared to those who did not (0–29 %). Our data suggest that OS is lower in patients who were initially cytology-positive compared to cytology-negative disease. Importantly, neoadjuvant IPC did not appear to significantly increase treatment-related adverse events.</div></div><div><h3>Conclusion</h3><div>Our results suggest that the neoadjuvant IPC has efficacy and is safe, with high rates of cytology conversion (in cytology-positive disease), low rates of peritoneal recurrence (in locally advanced disease). This was associated with substantial improvements in DFS and OS, compared to current standard treatment regimens.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102237"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}