Surgical Oncology-Oxford最新文献

{"title":"Advances and considerations in the use of immunotherapies for primary hepato-biliary malignancies","authors":"Leva Gorji ,&nbsp;Zachary J. Brown ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.suronc.2023.102031","DOIUrl":"10.1016/j.suronc.2023.102031","url":null,"abstract":"<div><p>Hepatocellular carcinoma (HCC) and cholangiocarcinoma<span><span><span><span> (CCA) comprise the two most common primary liver malignancies. Curative </span>treatment options often include </span>hepatectomy or </span>liver transplantation<span><span><span><span>; however, many patients present with advanced disease that is not amenable to surgical management. In turn, many patients are treated with systemic or targeted therapy. The </span>tumor microenvironment (TME) is a complex network of </span>immune cells<span> and somatic cells, which can foster an environment for disease development and progression, as well as susceptibility and resistance to systemic therapeutic agents. In particular, the TME is comprised of both immune and non-immune cells. Immune cells such as </span></span>T lymphocytes<span><span>, natural killer (NK) cells, macrophages, and neutrophils reside in the TME and can affect tumorigenesis, </span>disease progression<span>, as well as response to therapy. Given the importance of the immune system, there are many emerging approaches for cancer immunotherapy<span>. We herein provide a review the latest data on immunotherapy<span> for primary HCC and BTC relative to the TME.</span></span></span></span></span></span></p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138741032","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 for quality of life, pain and functional outcomes after surgical treatment of metastatic disease in the spine","authors":"Sebastian G. Walter,&nbsp;Jan Hockmann,&nbsp;Maximilian Weber,&nbsp;Nikolaus Kernich,&nbsp;Peter Knöll,&nbsp;Kourosh Zarghooni","doi":"10.1016/j.suronc.2023.102029","DOIUrl":"10.1016/j.suronc.2023.102029","url":null,"abstract":"<div><h3>Background</h3><p>While predictors for postoperative survival in spine tumour<span> patients have been identified, there is limited evidence for predictors of postoperative Quality of Life (QoL), pain and functional outcome.</span></p></div><div><h3>Methods</h3><p>One hundred and fifty-three consecutive patients, who had undergone surgery for symptomatic spinal metastases<span><span> between June 2016 and April 2019, were interviewed preoperatively and during follow-ups at three, six and 12 months using the EQ-5D-3L, COMI, and ODI questionnaires. Differences in means exceeding the specific </span>Minimal Clinically Important Difference (MCID) values were considered clinically significant.</span></p></div><div><h3>Results</h3><p>Thirty-three percent of the patients were reported dead after 12 months. Only one metastasis compared to multiple metastases has 7.9 the Odds for an improved EQ-5D-3L score at three months. No neoadjuvant metastatic irradiation has 6.8 the Odds for the improvement at that time against performed radiation. A preoperative ODI score between 50.1 and 100 has 22.0 times the odds compared to the range from 0 to 50 for an improved EQ-5D-3L after three months, and 12.5 times the odds in favour of improved COMI after three months, and 13.6 times the odds for improvement of ODI at the three-month follow-up. A preoperative COMI score ranging from 5.0 to 10 has 21 times the odds of a COMI between 0 and 5 for an improved EQ-5D-3L score and 11 times the odds for an improved ODI after 12 months. Other predictors showed no statistically significant improvement.</p></div><div><h3>Conclusion</h3><p>An improvement in QoL, pain and spinal function after 12 months can be predicted by a subjective preoperative poor health condition. Impaired spinal function before surgery, a singular metastasis and no previous irradiation is predictive of improved spinal function and quality of life three months after surgery.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138680992","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":"Evaluating health perceptions of soft-tissue sarcoma patients using the Wilson-Cleary Model to identify key targets for improving outcomes and quality of care","authors":"Nicole J. Andersen ,&nbsp;Kedar K.B. Mate ,&nbsp;Catherine Bergeron ,&nbsp;Robert Turcotte ,&nbsp;Annett Körner","doi":"10.1016/j.suronc.2023.102028","DOIUrl":"10.1016/j.suronc.2023.102028","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Soft-tissue sarcoma (STS) is a rare cancer of the connective tissues requiring invasive treatment. Due to the complexity of treatment, STS patients experience more functional impairment and disability than other oncologic populations. Given that extant literature is unclear and exclusively focused on physical function, the objectives of this study were to use the Wilson-Cleary Model of </span>HRQL to evaluate the extent to which biological function (tumor site, depth and size), symptoms (fatigue, pain, anxiety/depression), and functional status are associated with the health perceptions of soft-tissue sarcoma patients 12 months post-op.</p></div><div><h3>Methods</h3><p><span><span>Data were drawn from an inception cohort study at the McGill University Health Centre. Inclusion criteria included 18 years of age and a biopsy-confirmed diagnosis of STS. Those with evidence of </span>metastasis at diagnosis or less than 12 months of follow-up were excluded. Statistical analyses included T-tests, Pearson correlations, and </span>multiple linear regression.</p></div><div><h3>Results</h3><p>331 patients were included (185 males, 146 females) with mean (SD) ages of 56 (17). Significantly more females reported pain and anxiety/depression. Self-reported function was significantly higher in males. Overall, the regression model explained 53 % of the variance in health perceptions in males, and 48 % in females. Only self-reported function was significantly associated with health perceptions in males (B = 0.34) and females (B = 0.48). Further, compared to females without pain, females with pain perceived their health as significantly worse.</p></div><div><h3>Conclusion</h3><p>Evaluating health perceptions with a multidimensional lens revealed new information about the STS patient experience. Findings suggest that key targets include routine psychosocial distress monitoring and addressing rectifiable disability-related barriers promptly.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138681281","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 involvement of the hepatic artery is a risk factor for unresectability after neoadjuvant treatment in borderline pancreatic adenocarcinoma","authors":"Luis Secanella ,&nbsp;Juli Busquets ,&nbsp;Núria Peláez ,&nbsp;María Sorribas ,&nbsp;Berta Laquente ,&nbsp;Sandra Ruiz-Osuna ,&nbsp;Juan Fabregat","doi":"10.1016/j.suronc.2023.102027","DOIUrl":"10.1016/j.suronc.2023.102027","url":null,"abstract":"<div><h3>Introduction</h3><p>Borderline Resectable Pancreatic Ductal Adenocarcinoma (BR-PDAC) benefits from neoadjuvant treatment (NAT) with the intent of surgical salvage in the absence of disease progression during chemotherapy (CT) or chemoradiotherapy (CRT). Scarce literature exists about prognostic factors of resectability at the time of diagnosis or during neoadjuvant treatment, especially regarding vascular relationships.</p></div><div><h3>Materials</h3><p>We reviewed our prospective BR-PDAC cohort to determine resectability predictors. We collected data about clinical baseline characteristics, vessels’ involvement, type of NAT, CA19-9 evolution, and radiological outcome. We performed a descriptive analysis and a logistic regression model to define resectability predictors; we finally compared overall survival (OS) and progression-free survival (PFS) for those predictors.</p></div><div><h3>Results</h3><p>One hundred patients started NAT, with a resection rate of 44 % (40 pancreaticoduodenectomies, 4 distal pancreatectomies). The most frequent vessel relationship was the abutment of the superior mesenteric artery (44 %), and 26 patients had ≥2 vessels involved. Prognostic factors of resectability were CA19-9 response &gt;10 % (OR 3.07, p = 0.016) and Hepatic Artery involvement (OR 0.21, p = 0.026). Median overall survival was better for CA19-9 responders than for non-responders (20.9 months and 11.8 months respectively, p &lt; 0.001), and similar to normalized CA19-9 (25.0 months, p = 0.48). There were no differences in terms of OS or PFS with the involvement of the HA (17.7 vs 17.1 months, p = 0.367; and 8.7 vs 12.0 months, p = 0.267).</p></div><div><h3>Conclusion</h3><p>The involvement of the Hepatic Artery seems to confer a worse prognosis regarding resectability. A decrease of only &gt;10 % of CA19-9 is a predictive factor for resectability and better overall and progression-free survival.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960740423001275/pdfft?md5=6066b817b027eed085fbeadf2c8a6a0a&pid=1-s2.0-S0960740423001275-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138567321","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":"Collaboration can be successful statewide","authors":"Nicholas Petrelli","doi":"10.1016/j.suronc.2023.102018","DOIUrl":"https://doi.org/10.1016/j.suronc.2023.102018","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138558582","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":"Pleomorphic dermal sarcoma of the scalp - A single-centre experience","authors":"Eyal Mor ,&nbsp;Sarah Lonie ,&nbsp;Catherine Mitchell ,&nbsp;Michael Henderson ,&nbsp;Angela Webb ,&nbsp;David E. Gyorki ,&nbsp;Hayden Snow","doi":"10.1016/j.suronc.2023.102017","DOIUrl":"10.1016/j.suronc.2023.102017","url":null,"abstract":"<div><h3>Background</h3><p><span>Pleomorphic dermal sarcoma (PDS) of the </span>scalp<span> is a rare tumour which is usually slow growing, but occasionally displays rapid growth and has a low rate of local recurrence. Surgical resection is the mainstay of treatment, with or without radiotherapy. The aim of this study is to describe the surgical approach and the additional benefit of radiotherapy to the treatment of these patients.</span></p></div><div><h3>Methods</h3><p>Retrospective, single-centre analysis of patients with PDS of the scalp that underwent surgical resection between 2007 and 2021 (<em>n</em><span> = 24). Treatment variables including depth of resection (superficial or deep to the galea aponeurotica) and adjuvant radiotherapy were investigated.</span></p></div><div><h3>Results</h3><p>Twenty-four patients were included in this study. Median age was 80 (range, 52–95), with a median ASA score of 3 (2–3). Sixteen (66.6 %) patients underwent surgical resection including the galea, while the rest (n = 8) did not or was not known. Radiotherapy was given in 7 (29 %) patients in which only 3 (12.5 %) were in the galeal resection group. Reasons for radiotherapy administration were concomitant SCC found at the same area of resection and close margins. In a median follow-up of was 26.2 months (range, 13.6–102.5) there was only one recurrence event.</p></div><div><h3>Conclusions</h3><p>PDS of the scalp can be safely managed with a surgical resection if clear surgical margins are achieved without radiotherapy with good oncological outcomes.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138567323","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":"Impact of National Accreditation Program for Rectal Cancer guidelines on surgical margin status","authors":"Kevin R. Arndt,&nbsp;Gabrielle E. Dombek,&nbsp;Benjamin G. Allar,&nbsp;Alessandra Storino,&nbsp;Aaron Fleishman,&nbsp;Jeanne Quinn,&nbsp;Anne Fabrizio,&nbsp;Thomas E. Cataldo,&nbsp;Evangelos Messaris","doi":"10.1016/j.suronc.2023.101921","DOIUrl":"10.1016/j.suronc.2023.101921","url":null,"abstract":"<div><h3>Background</h3><p>The American College of Surgeons established the National Accreditation Program for Rectal Cancer (NAPRC) to standardize rectal cancer care. We sought to assess the impact of NAPRC guidelines at a tertiary care center on surgical margin status.</p></div><div><h3>Materials and methods</h3><p>The Institutional NSQIP database was queried for patients with rectal adenocarcinoma undergoing surgery for curative intent two years prior to and following implementation of NAPRC guidelines. Primary outcome was surgical margin status before (pre-NAPRC) versus after (post-NAPRC) implementation of NAPRC guidelines.</p></div><div><h3>Results</h3><p>Surgical pathology in five (5%) pre-NAPRC and seven (8%) post-NAPRC patients had positive radial margins (p = 0.59); distal margins were positive in three (3%) post-NAPRC and six (7%) post-NAPRC patients (p = 0.37). Local recurrence was observed in seven (6%) pre-NAPRC patients, there were no recurrences to date in post-NAPRC patients (p = 0.15). Metastasis was observed in 18 (17%) pre-NAPRC patients and four (4%) post-NAPRC patients (p = 0.55).</p></div><div><h3>Conclusion</h3><p>NAPRC implementation was not associated with a change in surgical margin status for rectal cancer at our institution. However, the NAPRC guidelines formalize evidence-based rectal cancer care and we anticipate that improvements will be greatest in low-volume hospitals which may not utilize multidisciplinary collaboration.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9438747","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":"Consensus statement and clinical pathway for the management of colon cancer with peritoneal metastases in the state of Delaware","authors":"Jesus Esquivel ,&nbsp;Nicholas Petrelli ,&nbsp;James Spellman ,&nbsp;Joseph Bennett ,&nbsp;Suguna Chirla ,&nbsp;Jamil Khatri ,&nbsp;Gregory Masters","doi":"10.1016/j.suronc.2022.101895","DOIUrl":"10.1016/j.suronc.2022.101895","url":null,"abstract":"<div><h3>Background</h3><p><span>Increasing data suggests that the combination of modern systemic therapies and Cytoreductive surgery<span> with or without Hyperthermic Intraperitoneal Chemotherapy (HIPEC) may improve the outcome of patients with </span></span>colon cancer<span> with peritoneal metastases<span>. Patient selection and sequence of treatments remains ill-defined.</span></span></p></div><div><h3>Materials and methods</h3><p>A working group, the State of Delaware Peritoneal Surface Malignancies<span> Task Force (DE-PSM-TF), was created including representatives from medical and surgical oncology from the acute care hospitals in Delaware. An extensive review of all available literature was carried out. Virtual meetings were held, and interpretation and discussion of the data was conducted.</span></p></div><div><h3>Results</h3><p>A clinical pathway that includes a multidisciplinary evaluation at the time of diagnosis of colon cancer with peritoneal metastases and reflects a consensus from the Task Force on 7 key points that suggest the management of these patients based on the severity of their peritoneal metastases and incorporates all currently available therapies was created. The sequence of therapies of this multimodality treatment was determined by the Peritoneal Surface Disease Severity Score (PSDSS) (Fig. 1).</p></div><div><h3>Conclusion</h3><p>The current pathway represents a comprehensive, team effort that should improve the outcome of patients with Colon Cancer with peritoneal metastases in the state of Delaware by having multidisciplinary discussions at the time of diagnosis, selecting the best order of sequence of currently available therapies in order to maximize benefits and minimize morbidity.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10567401","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":"Conquering colon cancer peritoneal metastases one state at a time","authors":"Paul H. Sugarbaker","doi":"10.1016/j.suronc.2023.101969","DOIUrl":"10.1016/j.suronc.2023.101969","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9776677","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":"Editorial comment: Impact of National Accreditation Program for Rectal Cancer guidelines on surgical margin status","authors":"Elizabeth H. Wood,&nbsp;David Shibata","doi":"10.1016/j.suronc.2023.101971","DOIUrl":"10.1016/j.suronc.2023.101971","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827442","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}