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":"Preoperative prediction of severe short-term complications in patients with bladder cancer undergoing radical cystectomy","authors":"Thomas Vetsch ,&nbsp;Markus Huber ,&nbsp;Patrick Y. Wuethrich ,&nbsp;Marc A. Furrer","doi":"10.1016/j.suronc.2025.102253","DOIUrl":"10.1016/j.suronc.2025.102253","url":null,"abstract":"<div><h3>Background and objective</h3><div>Radical cystectomy (RC) is associated with a high risk of postoperative complications. The prediction of individual patient risk for severe complications can facilitate preoperative shared decision-making. Patients with elevated risk may be referred to prehabilitation with the aim to mitigate the risk to improve perioperative outcomes. We developed models to predict severe short-term postoperative complications using preoperatively available clinical variables.</div></div><div><h3>Methods</h3><div>Data from a prospective cohort of 1313 RC patients treated between 1999 and 2021 was used. Preoperative demographic, laboratory, and cancer-related variables were defined as domains to predict severe complications measured by the Comprehensive Complication Index (CCI). Machine-learning models were trained for each postoperative day and predictor domain. The area under the receiver operating characteristic curve (AUROC) was reported as the primary outcome. Clinical utility was examined using Decision Curve Analysis (DCA).</div></div><div><h3>Results</h3><div>The best performing model had an AUROC of 0.69 (95 % CI 0.63–0.75) for severe complications on postoperative day (POD) 14. Mean AUROCs across POD 1–30 were 0.64 for all variables combined, 0.58 for demographics, 0.56 for laboratory values, and 0.53 for cancer-related factors. Model calibration and stability improved from POD 10 onwards. Decision curve analysis indicated the highest net benefit from models incorporating all predictors, with demographic variables contributing most among individual domains.</div></div><div><h3>Conclusions and clinical implications</h3><div>Limited clinical utility of the trained models was observed. The benefit for preoperative clinical decision-making is unclear. Clinical utility may improve by the inclusion of variables related to function in future models (e.g., frailty).</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102253"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335739","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":"Robotic right anterior sectionectomy with Glissonian approach","authors":"Marcel A. Machado ,&nbsp;Micheli F. Domingos ,&nbsp;Eduardo Brommelstroet Ramos","doi":"10.1016/j.suronc.2025.102240","DOIUrl":"10.1016/j.suronc.2025.102240","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102240"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194886","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 phase 1 study of intra-arterial CBL0137 in extremity melanomas and sarcomas","authors":"Joseph J. Skitzki ,&nbsp;Minhyung Kim ,&nbsp;Daniel T. Fisher ,&nbsp;John M. Kane III ,&nbsp;Han Yu ,&nbsp;Kayla Catalfamo ,&nbsp;Garin Tomaszewski ,&nbsp;Michael Petroziello ,&nbsp;Andrei Purmal ,&nbsp;Katerina V. Gurova ,&nbsp;Andrei V. Gudkov","doi":"10.1016/j.suronc.2025.102243","DOIUrl":"10.1016/j.suronc.2025.102243","url":null,"abstract":"<div><h3>Introduction</h3><div>Regional therapies for cancer leverage the ability to isolate the circulation to a diseased extremity or organ and deliver high doses of chemotherapy that would be systemically prohibitive due to toxicity. Virtually all regional therapies utilize the original chemotherapy agent, melphalan, which requires circulatory isolation. CBL0137 is a small molecule with multiple anti-tumor effects when given intra-arterially (IA) that shows similar efficacy to melphalan in preclinical models, but without the need for circulatory isolation.</div></div><div><h3>Materials and methods</h3><div>Patients with advanced, unresectable melanoma or sarcoma (n = 5, sarcoma 60 %, melanoma 40 %) of the extremity entered a rapid dose-escalation phase of a clinical trial of IA CBL0137. CBL0137 was administered via a single IA catheter placed proximal to the site of tumor(s) in the affected extremity and delivered over 15 min. Primary objective was to define dose-limiting toxicities with secondary objectives of assessing response and pharmacokinetics (PK).</div></div><div><h3>Results</h3><div>The treatments were well tolerated with minimal to no toxicity for all patients. PK data showed predictable, dose-dependent drug exposures with rapid tissue uptake and markedly decreased systemic concentrations as compared to matched intravenous dosing data. CBL0137 preferentially accumulated within tumor tissue as compared to surrounding normal tissue in the infused limb without the need for tourniquet. Sixty percent of patients treated in this protocol would not have been eligible for standard regional therapies with one patient demonstrating prolonged disease stability while avoiding major amputation.</div></div><div><h3>Conclusions</h3><div>The historic restrictions of standard regional therapies may be overcome with IA CBL0137, and this treatment is potentially applicable to a wide range of cancers beyond the extremities.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102243"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322073","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":"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":"2025-08-01","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":"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":"2025-08-01","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":"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":"2025-08-01","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":"Delphi for management of N2 non-small cell lung cancer","authors":"Hind Eid ,&nbsp;Elias Karam ,&nbsp;Antoine EL. Kik ,&nbsp;Fadi El Karak ,&nbsp;Ammar Chamaa ,&nbsp;Bassem Habr ,&nbsp;Hampig Raphael Kourie ,&nbsp;Fares Azouri ,&nbsp;Viviane Smayra ,&nbsp;Noel Aoun ,&nbsp;Joseph Kattan ,&nbsp;Georges Chahine ,&nbsp;Marwan Ghosn ,&nbsp;Jad Wakim ,&nbsp;Hussein Nasserddine ,&nbsp;Fadi Nasr ,&nbsp;Georges Khayat ,&nbsp;Joseph Nakad ,&nbsp;Carine Harmouche ,&nbsp;Georges Dabar ,&nbsp;Moussa Riachy","doi":"10.1016/j.suronc.2025.102245","DOIUrl":"10.1016/j.suronc.2025.102245","url":null,"abstract":"<div><div>Mediastinal lymph node involvement is a prognostic factor in patients with localized NSCLC. Both ipsilateral and subcarinal nodal involvement are classified as N2 disease. However, there is no universally agreed-upon approach for diagnosing and treating this condition. The aim of this study is to elaborate an institutional N2 consensus. A multidisciplinary expert panel at Hotel Dieu de France provided informed consent to participate in the modified Delphi process. Twelve basic statements were started by a steering committee of three independent reviewers on the basis of international consensus, medical literature and personal experience. In the first round, physicians answered an open-ended questionnaire that was analyzed thematically. In the second round, the participants rated the generated statements and added their comments. In the third round, the participants rated their agreement via a 6-point Likert scale. Consensus was defined as ≥80 % agreement (A+ or A) with a statement. Nineteen physicians completed the three rounds. A full consensus was reached in eleven statements. Preoperative mediastinal staging is mandatory in patients with resectable N2 disease. It should be considered in patients with a high SUVmax (maximum standardized uptake value) (≥3), proximal or apical tumors and high <em>carcinoembryonic antigen</em> levels. Surgery is performed in the absence of neoadjuvant treatment depending on a single station with nonbulky disease and stage T3 invasive/T4 disease. In patients with N2 disease at several stations, radio chemotherapy is the main treatment, followed by durvalumab in patients with good general status. In pN2 patients, postsurgical treatment is based on the condition of the surgical resection margin. These findings will help physicians in multidisciplinary discussions agree on clinical decisions.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102245"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338368","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":"2025-08-01","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}