Surgical Oncology-Oxford最新文献

{"title":"Individualizing care for patients with gallbladder cancer","authors":"Laura M. Nicolais ,&nbsp;Timothy L. Fitzgerald","doi":"10.1016/j.suronc.2024.102163","DOIUrl":"10.1016/j.suronc.2024.102163","url":null,"abstract":"<div><div>The rarity and lack of Level I Evidence compromise our ability to care for patients with gallbladder cancer.</div></div><div><h3>Methods</h3><div>NCDB cohort study of with resected Stage Groups IB-IVA gallbladder adenocarcinoma between 2004 and 2018. Patients were included.</div></div><div><h3>Results</h3><div>8484 patients were included, median survival was 29.8 (CI 28.6–31.2); Stage IB: 67.0, Stage II: 36.6, and Stage III/IVA 18.4 months. A survival benefit was noted for surgery beyond cholecystectomy (Stage IB 105 vs. 36 months, HR 0.56, p &lt; 0.001; Stage II 56 vs. 20 months, HR 0.72, p &lt; 0.001; and Stage III/IVA 23.8 vs. 9.9 months, HR 0.67, p &lt; 0.001) and chemoradiotherapy (Stage IB 102 vs. 64.8, HR 0.87, CI 0.62–1.23, p = 0.4; ' Stage II 49 vs. 33.5 months, HR 0.78, CI 0.68–0.91, p = 0.002; and Stage III/IVA 31 vs. 12.2 HR 0.60, CI 0.52–0.70, p &lt; 0.001). Adjuvant chemotherapy improved survival in Stage III/IVA (20 vs. 12.2 months, HR 0.74, p &lt; 0.001) but not Stage II and trend toward harm in Stage IB. A nomogram with created with these data.</div></div><div><h3>Conclusion</h3><div>Surgery beyond cholecystectomy provides a benefit to all. Adjuvant chemotherapy (Stage III and IVA) benefits and chemoradiotherapy (II, III, and IVA) only patients with higher stage disease.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578630","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":"Natural history of salivary gland secretory carcinoma: A REFCOR study.","authors":"Marie Magana ,&nbsp;Sebastien Vergez ,&nbsp;Benjamin Verillaud ,&nbsp;Renaud Garrel ,&nbsp;Diane Evrard ,&nbsp;François Mouawad ,&nbsp;Ludovic de Gabory ,&nbsp;Nicolas Fakhry ,&nbsp;Franck Jegoux ,&nbsp;Olivier Malard ,&nbsp;Christine Bach ,&nbsp;Pierre Philouze ,&nbsp;Karine Aubry ,&nbsp;Olivier Mauvais ,&nbsp;Antoine Moya Plana ,&nbsp;Jean Paul Marie ,&nbsp;Bertrand Baujat ,&nbsp;Sarah Atallah","doi":"10.1016/j.suronc.2024.102159","DOIUrl":"10.1016/j.suronc.2024.102159","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Salivary gland Secretory Carcinoma (SC), characterized by Skalova in 2010 is a rare tumor studied within the REFCOR (French Network of experts on Rare Head and Neck Cancers). We conducted a prospective multicentric cohort study of 108 SC cases in the REFCOR database up to July 2021, analyzing diagnostic, therapeutic, and survival data.</div></div><div><h3>Methods</h3><div><em>Data was</em> collected prospectively from diagnosis to the last update. Each patient had two histological readings including one by a REFCORpath pathologist, and all cases underwent molecular testing to confirm diagnosis. Statistical analyses were performed using R software.</div></div><div><h3>Results</h3><div>MRI was not contributive to malignancy diagnosis. After 2 histological readings, 79 % of patients were diagnosed, with 21 % requiring molecular testing to confirm diagnosis. Surgical treatment typically involved tumor excision and lymph node dissection. The tumor exhibited low lymph node involvement, with 95 % of patients being cN0, and no nodal metastases post-dissection. Five-year overall survival and recurrence-free survival were 91.4 % {95 % CI (0.84–1)} and 89 % {95 % CI (0.81; 0.98)} respectively, indicating a favorable prognosis.</div></div><div><h3>Conclusions</h3><div>SC is a rare and newly recognized tumor, with generally favorable outcomes. Our cohort, among the largest to date, provides valuable insights. Future research should refine treatment guidelines.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561209","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":"Tumor necrosis drives prognosis in osteosarcoma: No difference in chemotherapy response and survival between chondroblastic and osteoblastic osteosarcoma","authors":"Neel Patel ,&nbsp;Joseph O. Werenski ,&nbsp;Marcos R. Gonzalez ,&nbsp;Marilee J. Clunk ,&nbsp;Meagan R. McCadden ,&nbsp;Alexis Richard ,&nbsp;Ivan Chebib ,&nbsp;Yin P. Hung ,&nbsp;G. Petur Nielsen ,&nbsp;Santiago A. Lozano-Calderon","doi":"10.1016/j.suronc.2024.102155","DOIUrl":"10.1016/j.suronc.2024.102155","url":null,"abstract":"<div><h3>Introduction</h3><div>The percentage of tumor necrosis is a crucial prognostic factor in osteosarcoma. Many studies adopt a 90 % cutoff based on osteoblastic osteosarcoma, but these findings are generalized to all conventional subtypes, including chondroblastic osteosarcoma. We sought to answer these questions: (1) Is tumor necrosis ≥90 % associated with better overall survival (OS) and disease-free survival (DFS) in osteoblastic and chondroblastic osteosarcoma? (2) Does the osteosarcoma subtype impact tumor necrosis? (3) Does the osteosarcoma subtype in “good” responders (tumor necrosis ≥90 %) affect OS and DFS?.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective study of 156 patients with osteoblastic and chondroblastic osteosarcoma treated at our institution. All patients received a standardized chemotherapy protocol and underwent surgery with the goal of achieving negative margins (R0 resection). Propensity-score matching was performed to adjust for potential confounders. Kaplan-Meier survival analysis and Cox proportional hazards modeling were performed.</div></div><div><h3>Results</h3><div>Patients with osteoblastic osteosarcoma and tumor necrosis ≥90 % had higher 5- and 10-year OS and DFS compared to those with necrosis &lt;90 %. In chondroblastic osteosarcoma, a trend towards higher OS and DFS was seen in patients with tumor necrosis ≥90 %; this, however, was not significant. Chondroblastic osteosarcoma was not a risk factor for either tumor necrosis &lt;90 % (p = 0.89) or tumor necrosis &lt;70 % (p = 0.57). Patients with osteoblastic or chondroblastic osteosarcoma that were deemed “good” responders (tumor necrosis ≥90 %) had similar OS and DFS at the 5- and 10-year marks.</div></div><div><h3>Conclusion</h3><div>Conventional osteosarcoma subtype was not a risk factor for “poor” response<strong>.</strong> Survival outcomes (OS and DFS) were similar for osteoblastic and chondroblastic osteosarcoma with good response to chemotherapy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445297","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 chemoradiotherapy is associated with prolonged relapse free survival in patient with MRI-detected extramural vascular invasion (mrEMVI) positive rectal cancer: A multicenter retrospective cohort study in Japan","authors":"Yusuke Fujita ,&nbsp;Koya Hida ,&nbsp;Daisuke Nishizaki ,&nbsp;Yoshiro Itatani ,&nbsp;Shigeki Arizono ,&nbsp;Takashi Akiyoshi ,&nbsp;Eisuke Asano ,&nbsp;Toshiyuki Enomoto ,&nbsp;Takeshi Naitoh ,&nbsp;Kazutaka Obama ,&nbsp;Japan Society of Laparoscopic Colorectal Surgery","doi":"10.1016/j.suronc.2024.102157","DOIUrl":"10.1016/j.suronc.2024.102157","url":null,"abstract":"<div><h3>Purpose</h3><div>Neoadjuvant chemoradiotherapy (nCRT) is employed for the local control of locally advanced rectal cancer; however, its prognostic impact is limited and often impairs pelvic organ function. Therefore, careful patient selection is essential. This study aimed to investigate the impact of nCRT on relapse-free survival (RFS) by stratifying patients according to MRI detected circumferential resection margin (mrCRM) or extramural vascular invasion (mrEMVI), as the ability of MRI findings to identify patients who will have beneficial outcomes from nCRT is uncertain.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with clinical stage II–III lower rectal cancer who underwent surgical resection with or without nCRT between 2010 and 2011 at 69 hospitals in Japan. The impact of nCRT on RFS was evaluated using multivariable Cox regression models in the entire cohort and in subgroups stratified by mrCRM or mrEMVI status.</div></div><div><h3>Results</h3><div>In the entire cohort (nCRT, n = 172; surgery alone, n = 503), nCRT showed a trend toward improved RFS, although the difference was not statistically significant (HR, 0.74; 95 % CI, 0.54–1.03; P = 0.074). Among mrCRM-negative and mrEMVI-negative patients, there were no significant differences in RFS between the nCRT and surgery-alone groups. Among mrCRM-positive patients, nCRT tended to improve the RFS (HR, 0.70; 95 % CI, 0.46–1.06; P = 0.089). Among mrEMVI-positive patients, nCRT significantly prolonged the RFS (HR, 0.62; 95 % CI, 0.38–1.00; P = 0.048).</div></div><div><h3>Conclusions</h3><div>Compared to surgery alone, nCRT did not significantly improve RFS in the overall population but significantly improved RFS in mrEMVI-positive patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445310","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 impact of demographics and socioeconomic status on the receipt of immunotherapy for stage III melanoma","authors":"Alison C. Coogan ,&nbsp;Paige A. Blinn ,&nbsp;Ethan M. Ritz ,&nbsp;Alan Tan ,&nbsp;Lilia Lunt ,&nbsp;Rachel Akers ,&nbsp;Cristina O'Donoghue","doi":"10.1016/j.suronc.2024.102156","DOIUrl":"10.1016/j.suronc.2024.102156","url":null,"abstract":"<div><h3>Background</h3><div>There is limited data examining potential disparities in the receipt of immunotherapy among patients with stage III melanoma.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort review using the National Cancer Database (NCDB) including adult patients with stage III melanoma between 2004 and 2017. We compared receipt of immunotherapy based on demographic and socioeconomic factors for patients diagnosed 2004–2014 and 2016–2017, before and after FDA approval of immune checkpoint blockade.</div></div><div><h3>Results</h3><div>12,099 patients were included. The proportion of stage III patients who received immunotherapy significantly increased over time, from 24.0 % in 2004–2014 to 43.7 % in 2016–2017 (p &lt; 0.001). There was a significant difference in patients who receive immunotherapy based on age (p &lt; 0.001), insurance (p &lt; 0.001), facility location (p &lt; 0.001).On multivariable analysis, increased odds of immunotherapy receipt were found in patients with diagnosis in 2016–2017 (adjusted odds ratio (aOR) 3.3, 95 % CI 2.9–3.7), younger age (65–80 years aOR 0.43, 95 % CI 0.35–0.52), Hispanic ethnicity (aOR 1.5, 95 % CI 1.1–2.1), and private insurance (not insured aOR 0.67, 95 % CI 0.52–0.85).</div></div><div><h3>Conclusions</h3><div>Although narrowing, gaps persist in the receipt of immunotherapy after FDA approval. Understanding disparities in the receipt of immunotherapy will aid in understanding barriers to treatment and ensuring patients have equitable access to advanced care.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434105","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":"Predictors of malignant transformation in mucinous pancreatic cystic neoplasm: A systemic review and meta-analysis","authors":"Paola Solis- Pazmino ,&nbsp;Camila Pazmino ,&nbsp;Orly Termeie ,&nbsp;Kristina La ,&nbsp;Eduardo Pilatuna ,&nbsp;Belen Tite ,&nbsp;Luis Figueroa ,&nbsp;Magno Guarconi ,&nbsp;Jon Harrison ,&nbsp;Yosef Nasseri ,&nbsp;Joshua Ellenhorn ,&nbsp;Brendan C. Visser","doi":"10.1016/j.suronc.2024.102153","DOIUrl":"10.1016/j.suronc.2024.102153","url":null,"abstract":"<div><h3>Background</h3><div>The presence of ovarian-type stroma defines mucinous cystic neoplasm (MCN). Criteria for surgical resection differ between current consensus guidelines (IAP, AGA, and Europe). This meta-analysis aims to describe pre-surgical clinical parameters that predict malignant transformation of MCN of the pancreas.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of articles published from 2006 to the time of manuscript authorship in December 2022. The electronic databases included English publications in Ovid MEDLINE In-Process &amp; Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, and Scopus.</div></div><div><h3>Results</h3><div>17 studies were identified and included 1058 patients with MCN treated with pancreatectomy. The mean cohort age was 48.2 years (standard deviation [SD] ± 7.9) with an expected female predominance (96 %). The presenting symptom for most was abdominal pain (55.6 %), however, nearly 20 % of patients were asymptomatic. Most patients were treated with distal pancreatectomy (70.5 %), and the mean tumor size was 45 mm. The rate of invasive cancer was 13.8 %. Cysts with mural nodules had a higher risk of developing invasive tumors than those that did not (OR 26.47, 95%CI 12.57–55.74, p &lt; 0.001, I2:0 %). Other clinical factors such as the presence of intramural calcifications or an elevated serum CA 19–9 (&gt;37U/mL) were not predictive of malignancy.</div></div><div><h3>Conclusion</h3><div>The present meta-analysis did not clarify establishing reliable predictors for malignant transformation other than mural modularity, which may represent tumors that have already undergone transformation. It may be used as a criterion in treatment decision-making.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424875","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 modified 5-factor frailty index predicts postoperative outcomes in patients with ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy","authors":"Johanna Kelley ,&nbsp;Gabriella Smith ,&nbsp;Meng Yao ,&nbsp;Laura Chambers ,&nbsp;Robert DeBernardo","doi":"10.1016/j.suronc.2024.102154","DOIUrl":"10.1016/j.suronc.2024.102154","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this research is to compare the ability of mFI5 to the mFI11 to predict frailty, postoperative complications, discharge location for patients with ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) at time of cytoreductive surgery.</div></div><div><h3>Methods</h3><div>This is a single-institution retrospective study in patients with advanced (Stage III, IV) or recurrent ovarian cancer treated with surgical cytoreduction with HIPEC. Logistic regression was used to evaluate frailty as well as factors associated with moderate to severe Accordion postoperative complications and discharge to home. Correlation was calculated between mFI5 and mFI11.</div></div><div><h3>Results</h3><div>Of 141 patients who received HIPEC between 2010 and 2020, 23 patients were classified as frail (mFI5 score ≥2), while 118 were not frail. Frail patients were significantly older with mean age 65.9 compared to non-frail patients who had mean age of 59.1 (p = 0.005), as well as a higher Charlston Comorbidity Index (p &lt; 0.001), and more renal disease (p = 0.025), hypothyroidism (p = 0.005), and hyperlipidemia (p = 0.004). mFI5 and mFI11 scores for frailty were highly correlated (spearman rho 0.98, p &lt; 0.001). Frail patients were more likely to be discharged to a skilled nursing facility (22.7 %) vs. 6.8 % of non-frail patients, or require home services (18.2 % vs 8.5 %, p = 0.025). On multivariable logistic regression, frail patients were more likely to experience moderate or higher Accordion postoperative complications (OR 3.08, p = 0.024).</div></div><div><h3>Conclusions</h3><div>The mFI5, a simpler tool than the mFI11, is also highly associated with postoperative complications and need for postoperative services in patients with ovarian cancer undergoing HIPEC at time of cytoreductive surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401900","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":"Diagnostic accuracy and treatment benefit of PET/CT in staging of colorectal cancer compared to conventional imaging","authors":"Rebecca Engel ,&nbsp;Ken Kudura ,&nbsp;Kwadwo Antwi ,&nbsp;Kris Denhaerynck ,&nbsp;Daniel Steinemann ,&nbsp;Sereina Wullschleger ,&nbsp;Beat Müller ,&nbsp;Martin Bolli ,&nbsp;Marco von Strauss und Torney","doi":"10.1016/j.suronc.2024.102151","DOIUrl":"10.1016/j.suronc.2024.102151","url":null,"abstract":"<div><h3>Background</h3><div>Until recently the use of positron emission tomography (PET) CT for staging in colorectal cancer (CRC) has been limited to the detection of distant metastasis in advanced disease. But with the introduction of neoadjuvant treatments in CRC, accurate pre-treatment staging has become more relevant.</div></div><div><h3>Aims</h3><div>The aim of the study was to assess the staging accuracy for nodal and distant metastasis of PET/CT compared to computed tomography (CT) alone in CRC. Secondary endpoints were overall survival (OS) and cost of CT compared to PET/CT.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 539 cases with CRC staged with PET/CT and or CT between 2015 and 2021 in a Swiss tertiary referral center was performed. In 471 patients for nodal staging and 479 for staging of distant metastasis the clinical stage of both modalities was compared with pathological stage.</div></div><div><h3>Results</h3><div>The distribution of UICC stages (n = 479) was as follows: Stage I 62 cases (12.9 %), Stage II 127 cases (26.5 %), Stage III 199 cases (41.5 %), Stage IV 91 cases (19.0 %).</div><div>CT alone compared to PET was able to predict nodal involvement with a sensitivity of 55.2 % (95%CI 5.7–59.7 %) and 66.7 % (95%CI 62.4–70.9 %), respectively. The specificity was 67.0 % (95%CI 62.8–71.3 %) for CT and 63.6 % (95%CI 59.3–68.0 %) for PET. The positive predictive value was 49.5 % for CT vs. 51.8 % for PET. The sensitivity of metastasis detection was 53.6 % (95%CI 49.1–58.1 %) for CT and 82.5 % (95%CI 79.1–85.9 %) for PET.</div></div><div><h3>Conclusions</h3><div>PET/CT showed higher sensitivity in the detection of lymph node involvement and metastases in CRC patients compared to CT alone.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A ligamentum teres hepatis and falciform ligament ‘belt and braces’ approach in laparoscopic pancreaticoduodenectomy using a modified Blumgart anastomosis to minimize severe pancreatic fistula and post-operative complications","authors":"Wensheng Liu ,&nbsp;Zheng Li ,&nbsp;Chenjie Zhou ,&nbsp;Shunrong Ji ,&nbsp;Wenyan Xu ,&nbsp;Yihua Shi ,&nbsp;Mengqi Liu ,&nbsp;Haidi Chen ,&nbsp;Qifeng Zhuo ,&nbsp;Xianjun Yu ,&nbsp;Xiaowu Xu","doi":"10.1016/j.suronc.2024.102152","DOIUrl":"10.1016/j.suronc.2024.102152","url":null,"abstract":"<div><h3>Background</h3><div>To determine whether ligamentum teres hepatis and falciform ligament, wrapped around the gastroduodenal artery (GDA) and reinforced the posterior wall in pancreatojejunostomy (PJ), protects the GDA stump and other skeletal blood vessels from erosive hemorrhage and reduces the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF) and post-operative complications after laparoscopic pancreaticoduodenectomy (LPD).</div></div><div><h3>Methods</h3><div>We reviewed patients undergone LPD between January 2019 and June 2023. Patients were divided into two groups according to whether the ligamentous flap had been used to wrap the GDA stump (Group A) or to reinforce the posterior wall in PJ, together with the GDA wrapping procedure (Group B). Peri-operative data were reviewed to determine the effectiveness of this approach in preventing CR-POPF, post-pancreatectomy hemorrhage (PPH), and other complications.</div></div><div><h3>Results</h3><div>We enrolled 272 patients (Group A, 154 patients; Group B, 118 patients). Group B patients had significantly fewer ≥ Grade II Clavien–Dindo classification morbidities and CR-POPFs (P &lt; 0.05), and lower length of hospital stay (LOS) and abdominal drainage tube insertion times. Risk factor analysis indicated that main pancreatic duct dilation, the PJ reinforcement procedure, and soft pancreatic tissue were associated with ≥Grade II Clavien–Dindo morbidities and CR-POPF complications.</div></div><div><h3>Conclusions</h3><div>The ligamentous flap application in LPD provided shelter to GDA stump and other skeletal blood vessels under PJ from erosive digestive juices, reinforced the posterior wall in PJ, reduced the incidence of CR-POPF and ≥Grade II Clavien–Dindo classification morbidities. This simple procedure is effective for improving surgical safety of LPD.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424876","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":"Elevating precision: A thorough investigation of multiparametric prostate MRI for prolonged insights into early continence prediction after robot-assisted laparoscopic prostatectomy","authors":"Mehmet Şahin ,&nbsp;Merve Şam Özdemir ,&nbsp;Osman Can ,&nbsp;Emin Taha Keskin ,&nbsp;Harun Özdemir ,&nbsp;Abdülmuttalip Şimşek","doi":"10.1016/j.suronc.2024.102148","DOIUrl":"10.1016/j.suronc.2024.102148","url":null,"abstract":"<div><h3>Background</h3><div>While radical prostatectomy stands out as one of the most effective curative treatments for prostate cancer, it does come with annoying side effects, such as urinary incontinence (UI). We aimed to investigate the predictability of UI using MRI measurements, along with clinical and disease-related variables.</div></div><div><h3>Methods</h3><div>We included 191 patients who underwent robot-assisted laparoscopic radical prostatectomy between July 2020 and October 2022 in the study. Preoperative MRIs of the patients are re-evaluated by an experienced uroradiologist, and membranous urethral length (MUL), urethra wall thickness, levator ani thickness, outer levator distance, Lee's apex shape, intravesical prostate protrusion length, prostate apex depth, and pubic height measurements were made. Additionally, retrospective data on patients' age, BMI, PSA, PSA density, prostate volume, IPSS, clinical stage, and nerve-sparing status were collected. Patients were categorized into two groups based on continence status in the third postoperative month: continent or incontinent. The definition of UI was accepted as the use of one or more pads per day.</div></div><div><h3>Results</h3><div>UI was observed in 38.21 % of the patients in the postoperative third month. Among MRI measurements, only MUL showed a significant relationship with UI (p &lt; 0.001). IPSS (p = 0.004) and Clinical Stage (p &lt; 0.001) were also significantly associated with continence status. Logistic regression analysis identified BMI (p = 0.023; CI 0.73–0.97), IPSS (p = 0.002; CI 1.03–1.17), MUL (p = 0.001; CI 0.66–0.90), and Clinical Stage (p &lt; 0.001; CI 1.53–2.71) as significant predictors. In Multivariable Regression analysis, Clinical Stage emerged as the most powerful predictor of UI (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Except for MUL, MRI measurements may not predict postoperative UI. A combination of IPSS, clinical stage, and MUL effectively informs patients about postoperative outcomes. These findings contribute to enhancing preoperative counseling for patients undergoing radical prostatectomy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331949","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}