Surgical Oncology-Oxford最新文献

{"title":"Diagnostic utility of the preoperative cachexia index for malnutrition in colorectal cancer: A prospective cohort study.","authors":"Katarzyna Chawrylak, Wojciech Górski, Katarzyna Sędłak, Radoslaw Mlak, Marta Kaus, Agnieszka Hotloś, Zuzanna Chilimoniuk, Konrad Gładysz, Katarzyna Mielniczek, Magdalena Leśniewska, Zuzanna Pelc, Michał Bednarz, Wiktor Grela, Natalia Gniaź, Aleksandra Górska, Karolina Kasprzak, Damian Wach, Albert Chomątowski, Jakub Stawikowski, S Vincent Grasso, Marcin Kubiak, Andrew Gumbs, Timothy M Pawlik, Wojciech P Polkowski, Karol Rawicz- Pruszyński","doi":"10.1016/j.suronc.2025.102275","DOIUrl":"10.1016/j.suronc.2025.102275","url":null,"abstract":"<p><strong>Background: </strong>Cachexia is a multifactorial syndrome characterized by weight and muscle loss, often linked to malnutrition and inflammation. Malnutrition affects almost 40 % of colorectal cancer (CRC) patients, contributing to worse surgical outcomes, higher morbidity, and increased mortality. This study evaluates the Cachexia Index (CXI) for malnutrition detection in CRC patients.</p><p><strong>Patients and methods: </strong>Seventy patients (54.3 % men; median age 65) underwent bioelectrical impedance analysis, blood tests, and nutritional assessments before surgery. Patients were recruited between November 1, 2023, and October 30, 2024. CXI, calculated as [Skeletal Mass Index × Serum Albumin]/Neutrophil-to-Lymphocyte-Ratio, was compared with the Subjective Global Assessment.</p><p><strong>Results: </strong>The median CXI was 13.7 (range: 1.9-53.8), with malnourished or at-risk patients exhibiting significantly lower median CXI values (9.5 vs. 14.9; p = 0.0262) than well-nourished individuals. Tumor location also influenced CXI; patients with sigmoid colon tumors had the highest median CXI, while those with caecum tumors had the lowest (22.2 vs. 8.2; p = 0.0202). CXI demonstrated 100 % sensitivity and 60 % specificity for malnutrition detection, with a cutoff of ≤12.09 (AUC = 0.80; 95 % CI: 0.69-0.89; p < 0.0001). Malnourished patients had a significantly lower median CXI (9.5 vs. 14.9; p = 0.0262).</p><p><strong>Conclusions: </strong>These findings support CXI as a reliable, non-invasive biomarker for malnutrition in CRC patients, with potential applications in personalized nutritional and therapeutic care.</p>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"102275"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823129","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":"Projected augmented reality and dynamic infrared thermography enhances profunda artery perforator flap perforator mapping.","authors":"E L Meier, H J P Tielemans, R F Pronk, D J O Ulrich, S Hummelink","doi":"10.1016/j.suronc.2025.102274","DOIUrl":"10.1016/j.suronc.2025.102274","url":null,"abstract":"<p><strong>Background: </strong>Preoperative perforator mapping of the Profunda Artery Perforator (PAP) flap is hindered by challenges in aligning preoperative images with the intraoperative lithotomy position of the leg. Dynamic Infrared Thermography (DIRT) is a real-time, quick, and non-invasive imaging modality that is increasingly explored for preoperative perforator mapping. This feasibility study demonstrates the application of Projected Augmented Reality to project thermal images of DIRT directly on the skin for the identification of perforators before PAP flap breast reconstructions.</p><p><strong>Methods: </strong>A portable self-aligning projection device (Anatomy Projector) was integrated with a thermal sensor to obtain thermal information and automatically project thermal images onto the patient's medial thigh before PAP flap dissection. Projected DIRT hotspots were evaluated with hand-held Doppler (HHD) and compared to locations of intraoperative perforators following a Cartesian coordinate system.</p><p><strong>Results: </strong>Preoperative DIRT examination yielded a projection of 127 DIRT hotspots in 20 PAP flaps. All projected hotspots could be verified with Doppler (100 %) and 82.1 % of intraoperative perforators correlated with a projected DIRT hotspot within a 3 cm radius. Notably, 30.4 % of these matches involved the first appearing DIRT hotspot, and 82.6 % of these matches involved a DIRT hotspot within the first 5 appearing hotspots.</p><p><strong>Conclusion: </strong>This feasibility study pioneers the use of Projected Augmented Reality for the display of thermal images of DIRT directly on the skin for the preoperative perforator identification before PAP flap harvest. High resemblance with HHD and intraoperative perforators was found. Future research should examine the further applications in the intraoperative and postoperative setting.</p>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"102274"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805191","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":"A tumor microenvironment-based classification of gastric cancer for more effective diagnosis and treatment.","authors":"Simona O Dima, Andrei Sorop, Shuji Kitahara, Namrata Setia, Mihaela Chivu-Economescu, Lilia Matei, Vlad Herlea, Nicolae C Pechianu, Takenori Inomata, Aya Matsui, Anna Khachatryan, Shuichi Aoki, Gregory Y Lauwers, Irinel Popescu, Dan G Duda","doi":"10.1016/j.suronc.2025.102298","DOIUrl":"10.1016/j.suronc.2025.102298","url":null,"abstract":"<p><p>With approximately one million diagnosed cases and over 700,000 deaths recorded annually, gastric cancer (GC) is the third most common cause of cancer-related deaths worldwide. GC is a heterogeneous tumor. Thus, optimal management requires biomarkers of prognosis, treatment selection, and treatment response. The Cancer Genome Atlas program sub-classified GC into molecular subtypes, providing a framework for treatment personalization using traditional chemotherapies or biologics. We hypothesized that integrating immunohistochemistry markers, tumor gene expression profiles, and serum cytokines would define biologically distinct subtypes of gastric cancer and associate with overall survival independently of clinicopathologic factors and provide incremental prognostic value beyond existing classifications. Here, we report a comprehensive study of GC vascular and immune markers associated with tumor microenvironment (TME) based on stage and molecular subtypes, and their correlation with outcomes. Using tissues and blood circulating biomarkers and a molecular classification, we identified tumor archetypes, which show that the TME evolves with the disease stage and is a determinant of prognosis. Moreover, our TME-based subtyping strategy allowed the identification of archetype-specific prognostic biomarkers such as CDH1-mutant GC and circulating IL-6 that provided information beyond and independent of TMN staging, MSI status, and consensus molecular subtyping. The results show that integrating molecular subtyping with TME-specific biomarkers could contribute to improved patient prognostication and may provide a basis for treatment stratification, including for contemporary anti-angiogenesis and immunotherapy approaches.</p>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":" ","pages":"102298"},"PeriodicalIF":2.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208276","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":"A platform for sharing current research and advancing patient care.","authors":"Vijay P Khatri","doi":"10.1016/j.suronc.2025.102296","DOIUrl":"https://doi.org/10.1016/j.suronc.2025.102296","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":" ","pages":"102296"},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202089","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":"Thirty-Five years of globalizing surgical oncology knowledge: A look into the future - IASGO Cairo 2024.","authors":"Dan G Duda, Mohamed Abdel Wahab, Kyoichi Takaori","doi":"10.1016/j.suronc.2025.102294","DOIUrl":"https://doi.org/10.1016/j.suronc.2025.102294","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":" ","pages":"102294"},"PeriodicalIF":2.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088137","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":"Short-term surgical outcomes for colon adenocarcinoma: Racial-Ethnic comparisons in a universal access health system","authors":"Yvonne L. Eaglehouse ,&nbsp;Sarah Darmon ,&nbsp;Michele M. Gage ,&nbsp;Craig D. Shriver ,&nbsp;Kangmin Zhu","doi":"10.1016/j.suronc.2025.102295","DOIUrl":"10.1016/j.suronc.2025.102295","url":null,"abstract":"<div><h3>Background</h3><div>Access to care has been identified as a contributor to racial-ethnic differences in treatment receipt and survival of colon cancer in the U.S. Less is known about racial-ethnic differences in aspects and outcomes of colon cancer surgery and whether access to care plays a role. We aimed to study colon cancer surgery and short-term postoperative outcomes in the Military Health System (MHS), which provides access to care regardless of patient characteristics.</div></div><div><h3>Methods</h3><div>We used the MilCanEpi database to identify patients aged 18 or older who were diagnosed with stage I-III colon adenocarcinoma between 2001 and 2014 and received colectomy as treatment. Outcomes included positive surgical margins, inadequate lymphadenectomy (&lt;12 nodes examined), 30-day complications (any; general or gastrointestinal), and 30-day hospital readmissions. Multivariable Poisson regression models estimated the adjusted risk ratios (ARRs) and 95 % confidence intervals (CIs) in association with race-ethnicity for each outcome.</div></div><div><h3>Results</h3><div>The study included 157 Asian or Pacific Islander, 258 non-Hispanic Black, 111 Hispanic, and 1131 non-Hispanic White patients. Overall, the risk of measured outcomes did not differ significantly for racial-ethnic minority groups compared to non-Hispanic White (ARRs and their 95 % CIs included 1.00). By complication type, Hispanic patients had significantly lower risk of bowel obstruction (ARR = 0.55, 95 % CI = 0.32, 0.96) compared to non-Hispanic White patients, with no other statistically significant racial-ethnic differences.</div></div><div><h3>Conclusions</h3><div>In the universal access MHS, there were no overall significant racial-ethnic differences in surgical aspects or experience of 30-day outcomes of colectomy for non-metastatic colon cancer.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102295"},"PeriodicalIF":2.4,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088157","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":"Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with peritoneal malignancies: a monocentric, single-arm open-label phase II clinical trial","authors":"Marco Tonello ,&nbsp;Carola Cenzi ,&nbsp;Paola Del Bianco ,&nbsp;Elisa Pizzolato ,&nbsp;Chiara Maria Biatta ,&nbsp;Francesca Bergamo ,&nbsp;Giulia Tasca ,&nbsp;Anna Roma ,&nbsp;Selma Ahcene Djaballah ,&nbsp;Beatrice Bordignon ,&nbsp;Giovanna Magni ,&nbsp;Giacomo Moratello ,&nbsp;Gaetano Ramondo ,&nbsp;Sara Lonardi ,&nbsp;Pierluigi Pilati ,&nbsp;Antonio Sommariva ,&nbsp;Gian Luca De Salvo","doi":"10.1016/j.suronc.2025.102293","DOIUrl":"10.1016/j.suronc.2025.102293","url":null,"abstract":"<div><h3>Introduction</h3><div>Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a promising palliative treatment for patients with peritoneal malignancies who are not candidates for curative surgery. This study aimed to assess the efficacy and feasibility of implementing a PIPAC program at a single cancer center.</div></div><div><h3>Methods</h3><div>An open-label, single-arm, phase II study was conducted, enrolling patients with peritoneal tumors of various origins. Participants received bidirectional chemotherapy (intravenous and PIPAC). The primary endpoint was PIPAC efficacy measured as pathological response, while secondary endpoints included safety and feasibility of the technique, quality of life, and clinical outcomes.</div></div><div><h3>Results</h3><div>From March 2021 to March 2024, 32 patients were screened, and 25 were enrolled, resulting in 58 PIPAC procedures. The complication rate was low, with severe surgical complications occurring in 1.7 % of procedures and CTCAE grade 3 complications in 3.4 %. A major pathological response was observed in 56 % of cases, and seven patients (28.0 %) underwent curative-intent cytoreductive surgery after at least two PIPAC treatments. Both the Peritoneal Cancer Index (PCI) and the Peritoneal Regression Score (PRGS) decreased after repeated PIPAC (p = 0.016 and p = 0.047, respectively). Ascites volume also decreased significantly after the first PIPAC (p = 0.001). The median overall survival (OS) was 9.6 months, with responding patients (PRGS 1–2) showing better clinical outcomes (OS: 21.0 vs. 5.5 months,p &lt; 0.001; PFS: 8.2 vs. 2.4 months,p &lt; 0.001) and quality of life (p = 0.003).</div></div><div><h3>Conclusion</h3><div>PIPAC can be safely combined with systemic chemotherapy in patients with peritoneal malignancies, demonstrating efficacy in controlling ascites and achieving major pathological response. Further studies are necessary to determine its potential survival benefits.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102293"},"PeriodicalIF":2.4,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082172","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":"The utility of preoperative diagnostics in patients undergoing radical nephroureterectomy for suspected upper tract urothelial carcinoma: Can we justify treatment without prior histologic confirmation?","authors":"Vincent Hoffmann,&nbsp;Martina Dellino,&nbsp;Henning Bahlburg,&nbsp;Moritz Reike,&nbsp;Analena Elisa Handke,&nbsp;Peter Bach,&nbsp;Joachim Noldus,&nbsp;Florian Roghmann,&nbsp;Karl Tully","doi":"10.1016/j.suronc.2025.102291","DOIUrl":"10.1016/j.suronc.2025.102291","url":null,"abstract":"<div><h3>Introduction &amp; objectives</h3><div>The main obstacles to the broad application of neoadjuvant chemotherapy for locally advanced upper tract urothelial cancer(UTUC) are uncertainties regarding the accuracy of preoperative diagnostics. This study aimed to examine the predictive value of preoperative diagnostic results regarding the histopathologic findings at the time of radical nephroureterectomy (RNU).</div></div><div><h3>Material &amp; methods</h3><div>An institutional dataset of patients undergoing RNU for suspected UTUC between 01/2018 and 12/2023 was analyzed. We examined the preoperative utilization of different diagnostic means and their predictive value in detecting locally advanced(i.e., ≥T2) disease. Separate uni-and multivariable logistic regression models were employed to examine the association between preoperative findings and final histology.</div></div><div><h3>Results</h3><div>At the time of RNU, 64.4 %(n = 74) of patients were diagnosed with ≥T2 disease. Out of 115 patients, 41.7 % underwent RNU based on cross-sectional imaging findings alone, thirty of whom had undergone a prior endourologic diagnostic workup without evidence of UTUC(62.5 %). There were no false-positive diagnoses of UTUC. On multivariable logistic regression and consecutive receiver operating characteristic(ROC) analysis, only a tumor size ≥1.9 cm during cross-sectional imaging was associated with advanced disease(OR 2.99, 95 %CI 1.65–5.43, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In this cohort of patients undergoing RNU for suspected UTUC, only tumor size during cross-sectional imaging was associated with advanced disease. These results support the notion of tumor size as an independent risk factor, which may, in turn, guide further treatment decisions.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102291"},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082185","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":"Mesenteric caudal right approach to the superior mesenteric artery in robotic pancreaticoduodenectomy","authors":"Yutaka Nakano,&nbsp;Yosuke Uematsu,&nbsp;Minoru Kitago,&nbsp;Yuko Kitagawa","doi":"10.1016/j.suronc.2025.102277","DOIUrl":"10.1016/j.suronc.2025.102277","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102277"},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082237","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":"Safety and perioperative outcomes in extraperitoneal versus transperitoneal robot-assisted radical prostatectomy: A propensity score matching study from a single regional center","authors":"Atsushi Igarashi,&nbsp;Riki Obayashi,&nbsp;Akihiro Yamamoto,&nbsp;Akihiko Nagoshi,&nbsp;Tasuku Fujiwara,&nbsp;Naoki Akagi,&nbsp;Yuto Hattori,&nbsp;Noboru Shibasaki,&nbsp;Mutsushi Kawakita,&nbsp;Toshinari Yamasaki","doi":"10.1016/j.suronc.2025.102292","DOIUrl":"10.1016/j.suronc.2025.102292","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare perioperative outcomes and complications between the transperitoneal approach (Tp) and extraperitoneal approach (Ep) in robot-assisted radical prostatectomy (RARP) at our institution.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed data from 894 patients who underwent RARP between 2014 and 2023, including 539 with Ep and 355 with Tp. Ep was selected for patients who did not require extended lymph node dissection (ELND), whereas Tp was selected for patients who required ELND. Propensity score matching (PSM) was performed, resulting in 326 matched pairs. Primary outcomes included severe complications (Clavien–Dindo grade III or higher). Secondary outcomes included transfusion rates, console time without ELND and postoperative length of stay.</div></div><div><h3>Results</h3><div>Following PSM, severe complications occurred in 0 patients (0 %) in the Ep group and in 14 patients (4.3 %) in the Tp group, with bowel-related complications more frequent in the latter. The transfusion rate was low in both groups (0.6 % [Ep] vs. 0 % [Tp], p = 0.43). Operative parameters showed comparable console time without ELND (185 min [Ep] vs. 179 min [Tp], p = 0.30). Postoperative length of stay was comparable between groups (median, 6 days for both; p = 0.05). Peritoneal injuries occurred in 19 % of patients in the Ep group but did not lead to major complications or conversion to Tp in most cases.</div></div><div><h3>Conclusions</h3><div>This study suggests that both Tp and Ep are feasible approaches for RARP, with Ep potentially associated with fewer bowel complications.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102292"},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050166","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}