Surgical Oncology-Oxford最新文献

{"title":"Preventing futile surgery in Intrahepatic and Perihilar cholangiocarcinomas: Can we identify preoperative factors to improve patient selection and optimize outcomes?","authors":"Mahesh Goel ,&nbsp;Gurudutt P. Varty ,&nbsp;Shraddha Patkar ,&nbsp;Meghana V. ,&nbsp;Mufaddal Kazi ,&nbsp;Kunal Nandy ,&nbsp;Vikas Ostwal ,&nbsp;Anant Ramaswamy ,&nbsp;Kunal B. Gala ,&nbsp;Nitin S. Shetty","doi":"10.1016/j.suronc.2024.102096","DOIUrl":"10.1016/j.suronc.2024.102096","url":null,"abstract":"<div><h3>Background</h3><p>Intraoperative unresectability, postoperative deaths and early recurrences remain devastating futile events in the surgical management of Intrahepatic cholangiocarcinomas (iCCA) and Perihilar cholangiocarcinomas (pCCA). The present study aims to determine the preoperative predictors of futile surgery in cholangiocarcinomas.</p></div><div><h3>Methods</h3><p>Consecutive hepatectomies for iCCA and pCCA, between September 2010 and June 2022 were included. Futility of surgery was defined as either intraoperative unresectability, postoperative 30-day mortality or recurrence within six months of surgery. Multivariable logistic regression was used to identify predictors of futility.</p></div><div><h3>Results</h3><p>One hundred and fifty patients of iCCA and pCCA underwent surgery during the time period. Thirty-seven (38.1 %) out of 97 patients of iCCA and 25(47.16 %) out of 53 patients of pCCA underwent futile resection. The predictive factors of futile surgery for iCCA were tumour number (≥2) (OR, 9.705; 95%CI, 2.378–39.614; p = 0.002), serum aspartate transaminase (OR, 8.31; 95%CI, 2.796–24.703; p &lt; 0.001) and serum CA-19.9 (&gt;37 U/ml) (OR, 2.95; 95%CI, 1.051–8.283; p = 0.04). The predictive factors of futility for pCCA were lymph node involvement (OR, 7.636; 95%CI, 1.824–31.979; p = 0.005) and serum alkaline phosphatase (&gt;562.5 U/L) (OR, 11.211; 95%CI, 1.752–71.750; p = 0.011).</p></div><div><h3>Conclusion</h3><p>Futile surgery was observed in over one third of our patients. Five strong preoperative predictors of futility were identified. Careful analysis of these factors may reduce futile surgical explorations.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"55 ","pages":"Article 102096"},"PeriodicalIF":2.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535931","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":"Outcomes of right sleeve lower lobectomy vs. lower bilobectomy for lung malignancies","authors":"Justin Issard ,&nbsp;Geoffrey Brioude ,&nbsp;Delphine Mitilian ,&nbsp;Dominique Fabre ,&nbsp;Vincent Thomas de Montpreville ,&nbsp;Amir Hanna ,&nbsp;Caroline Caramella ,&nbsp;Cécile Lepechoux ,&nbsp;Benjamin Besse ,&nbsp;Olaf Mercier ,&nbsp;Elie Fadel","doi":"10.1016/j.suronc.2024.102100","DOIUrl":"10.1016/j.suronc.2024.102100","url":null,"abstract":"<div><h3>Objectives</h3><p>Lower bilobectomy (LBL) leaves a residual pleural space potentially associated with adverse postoperative outcomes. In selected patients, right sleeve lower lobectomy (RSLL) with anastomosis between the middle lobe bronchus and intermediate bronchus is feasible. The outcomes of RSLL and LBL have not been compared. The aim of this study was to compare post-operative and long-term outcomes of RSLL and LBL in patients with lung cancer.</p></div><div><h3>Methods</h3><p>We retrospectively included patients managed by RSLL or LBL at our referral chest-surgery institution between 2001 and 2019. Post-operative complications and mortality were compared. Kaplan-Meier curves were plotted to compare overall and disease-free survival rates.</p></div><div><h3>Results</h3><p>We identified 23 patients with RSLL and 96 with LBL. Postoperative mortality was 9 % after RSLL and 5 % after LBL (<em>p</em> = 0.41). Bronchial fistula developed in 3 (13 %) RSLL patients and 6 (6 %) LBL patients (<em>p</em> = 0.23). Pleural space complications were significantly less common after RSLL (4/23 [17 %] vs. 45/96 [47 %], <em>p</em> = 0.03). Long-term vital capacity was significantly higher in the RSLL group (91 % vs. 64 %, <em>p</em> &lt; 0.01). Five-year survival did not differ significantly between groups (84 % vs. 72 %, <em>p</em> = 0.09).</p></div><div><h3>Conclusions</h3><p>RSLL was associated with similar postoperative mortality and long-term survival compared to LBL. However, pleural space complications were less common and lung function was better after RSLL than after LBL. When feasible, RSLL may deserve preference over LBL in patients with lung cancer managed at highly experienced centres.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"56 ","pages":"Article 102100"},"PeriodicalIF":2.3,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638479","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":"Comparative evaluation of continence and potency after radical prostatectomy: Robotic vs. laparoscopic approaches, validating LAP-01 trial","authors":"Alicia López-Abad ,&nbsp;Gerardo Server Gómez ,&nbsp;Juan Pablo Loyola Maturana ,&nbsp;Inés Giménez Andreu ,&nbsp;Argimiro Collado Serra ,&nbsp;Augusto Wong Gutiérrez ,&nbsp;Juan Boronat Catalá ,&nbsp;Pedro de Pablos Rodríguez ,&nbsp;Álvaro Gómez-Ferrer ,&nbsp;Juan Casanova Ramón-Borja ,&nbsp;Miguel Ramírez Backhaus","doi":"10.1016/j.suronc.2024.102098","DOIUrl":"10.1016/j.suronc.2024.102098","url":null,"abstract":"<div><h3>Background</h3><p>Minimally invasive techniques have demonstrated several advantages over the open approach. In the field of prostate cancer, the LAP-01 trial demonstrated the superiority of robotic-assisted radical prostatectomy (RARP) over laparoscopic radical prostatectomy (LRP) when comparing continence at 3-month after surgery, with no statistically significant differences at 6 and 12 months of follow-up.</p></div><div><h3>Objectives</h3><p>Externally validate the LAP-01 study and compare functional outcomes between the two minimally invasive approaches.</p></div><div><h3>Material and methods</h3><p>This retrospective study, conducted by a single surgeon (MRB), utilized data from a prospectively collected database, which included patients who underwent both RARP or LRP. Data regarding baseline characteristics, continence (assessed through the 24-h Pad test and ICIQ questionnaire) and potency were collected at multiple time points: 1 and 6 weeks after catheter removal, 3-, 6-, and 12-months post-surgery.</p></div><div><h3>Results</h3><p>The study encompasses 601 patients, 455 who underwent LRP and 146 RARP. The median age at diagnosis was 64 for LRP and 62 for RARP, while the median PSA levels at diagnosis were 6.7 ng/mL for LRP and 6.5 ng/mL for RARP. Bilateral nerve-sparing procedures were performed in 34.07 % of LRP cases and 51.37 % of RARP cases.</p><p>RARP exhibited a significant advantage over LRP both in continence and potency. Continence rates at 3-, 6- and 9-month after radical prostatectomy (RP) were 36.43 %, 61.86 % and 79.87 % for LRP, compared to 50.98 %, 69.87 % and 91.69 % for RARP. Potency rates at the same intervals were 0.90 %, 3.16 % and 6.39 % for LRP, and 6.19 %, 9.16 % and 18.96 % for RARP. These rates were more pronounced in patients with bilateral nerve-sparing.</p></div><div><h3>Conclusion</h3><p>Our study demonstrates that RARP results in significantly better continence recovery and superior potency outcomes throughout the entire follow-up period compared to LRP, even at the beginning of the robotic approach learning curve.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"55 ","pages":"Article 102098"},"PeriodicalIF":2.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592043","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":"Transvaginal natural orifice transluminal endoscopic surgery (VNOTES) retroperitoneal sentinel lymph node BIOPSY compared with conventional laparoscopy in patients with endometrial cancer","authors":"Cihan Comba ,&nbsp;Sema Karakas ,&nbsp;Sakir Volkan Erdogan ,&nbsp;Omer Demir ,&nbsp;Erkan Şimşek ,&nbsp;Fatma Karasabanoglu ,&nbsp;Gokhan Demirayak ,&nbsp;Isa Aykut Ozdemir","doi":"10.1016/j.suronc.2024.102099","DOIUrl":"10.1016/j.suronc.2024.102099","url":null,"abstract":"<div><h3>Introduction</h3><p>To explore the possibility of treatment with VNOTES sentinel lymph node dissection concept in patients with endometrial cancer.</p></div><div><h3>Methods</h3><p>Patients who underwent VNOTES sentinel lymph node biopsy with the Comba modification were compared to patients who underwent conventional laparoscopic sentinel lymph node biopsy performed by the same surgical team. A total of 38 patients who underwent sentinel lymph node biopsy + total laparoscopic hysterectomy and bilateral salpingo-oophorectomy (BSO) were compared with 19 patients who underwent VNOTES retroperitoneal sentinel lymph node biopsy + hysterectomy and BSO. Surgical steps were described.</p></div><div><h3>Results</h3><p>The average operation time, perioperative blood loss, the number of sentinel lymph nodes, presence of complications, and preoperative-postoperative hemoglobin-hematocrit differences, tumor stages, grades, largest tumor diameter, depths of invasion, and histological subtypes were similar in both the VNOTES and conventional laparoscopy groups. The postoperative pain scores were lower and the hospital stay was shorter in the VNOTES group than in the conventional laparoscopy group. No disease recurrence had been detected in either group at the time of writing.</p></div><div><h3>Conclusion</h3><p>Compared to conventional laparoscopy, sentinel lymph node biopsy with the VNOTES technique provides similar surgical results and is more advantageous in terms of postoperative pain and hospital length of stay.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"55 ","pages":"Article 102099"},"PeriodicalIF":2.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is surgical quality more important than radicality? Long-term outcomes of stage I–III colon cancer (SAKK 40/00)","authors":"Christoph A. Maurer ,&nbsp;Daniel Dietrich ,&nbsp;Martin K. Schilling ,&nbsp;Peter Brauchli ,&nbsp;Katharina Kessler ,&nbsp;Samuel A. Käser","doi":"10.1016/j.suronc.2024.102092","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102092","url":null,"abstract":"<div><h3>Background</h3><p>To prospectively determine the influence of variations of surgical radicality and surgical quality on long-term outcome in patients with stage I-III colon cancer.</p></div><div><h3>Methods</h3><p>From a prospective multicenter cohort study including 1040 patients undergoing surgery for colorectal cancer from 09/2001 to 06/2005 in nine Swiss and one German hospital, 423 patients with stage I-III colon cancer were selected and analyzed. Surgeons and pathologists filled in standardized forms prospectively assessing items of oncosurgical radicality and quality. Patients had standardized follow-up according to national guidelines.</p></div><div><h3>Results</h3><p>Follow-up was median 6.2 years (range 0.3–10.4) showing a 5-year disease-free survival/overall survival of 83 %/87 % in stage I (n = 85), 69 %/77 % in stage II (n = 187), and 53 %/61 % in stage III (n = 151) colon cancer. Despite remarkable variations of oncosurgical radicality and quality, the multivariate model revealed that mainly quality items correlated significantly with disease-free survival (surgical tumor lesion HR 2.12, p = 0.036, perioperative blood transfusion HR 1.67, p = 0.018, emergency resection HR 1.74, p = 0.035) and overall survival (early venous ligation HR 0.66, p = 0.023, surgical tumor lesion HR 2.28, p = 0.027, perioperative blood transfusion HR1.79, p = 0.010, emergency resection HR 1.88, p = 0.026), while radicality parameters (length of specimen, distance of the tumor to nearest bowel resection site, number of lymph nodes, height of resected mesocolon and of central vascular dissection) did not.</p></div><div><h3>Conclusion</h3><p>Surgical quality seems to have a stronger impact on oncologic long-term outcome in stage I – III colon cancer than surgical radicality.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"55 ","pages":"Article 102092"},"PeriodicalIF":2.3,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249956","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":"MRI navigation surgery, including lateral pelvic lymph node dissection following chemoradiotherapy, improves local control and functional preservation of the middle to low rectal cancer","authors":"Madoka Hamada ,&nbsp;Hiroaki Kurokawa ,&nbsp;Toshinori Kobayashi ,&nbsp;Yoshiko Uemura","doi":"10.1016/j.suronc.2024.102093","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102093","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study is to examine the appropriateness of MRI navigation surgery following chemoradiotherapy (CRT), including lateral pelvic lymph node dissection (LLND) for middle to low rectal cancer.</p></div><div><h3>Methods</h3><p>Forty-three consecutive patients with cT2-4b rectal cancer within 10 cm from the anal verge who underwent laparoscopic radical surgery following CRT (45–50.4Gy + S1 80mg/m2) from January 2014 and February 2020 were analyzed. We decided on the operative procedure, including LLND, based on the restaging MRI. We examined the rates of 3-year postoperative local pelvic recurrence, permanent stoma, and recurrent risk factors (Group S). We also compared the results to that of the fourteen patients who enrolled in the previous phase II trial and underwent laparoscopic radical surgery following CRT (40Gy + S-1 (80mg/m2) or UFT (300 mg/m2)) for consecutive cT2-4b rectal cancer below the peritoneal reflection. The operative procedure was decided at the initial MRI diagnosis, and the LLND was not performed (Group P).</p></div><div><h3>Results</h3><p>We had no local pelvic recurrence in Group S, and the three-year local pelvic recurrence-free survival was significantly better in Group S than P (100 % in S 85.1 % in P, p &lt; 0.05). The permanent stoma rate was not different between the Groups, irrespective of the significantly high rate of cCRM(+) in Group S. The Cox proportional hazards model for significant factors of recurrence on the univariate analysis revealed that ycM and ycEMVI scores were independently significant (p &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>MRI navigation surgery, including LLND for rectal cancer following chemoradiotherapy, improves local control and functional preservation.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"55 ","pages":"Article 102093"},"PeriodicalIF":2.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332965","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":"Early and late post-procedural complications in different orthotopic neobladder surgical approaches: A systematic review","authors":"Benito Fabio Mirto ,&nbsp;Biagio Barone ,&nbsp;Raffaele Balsamo ,&nbsp;Marco Abate ,&nbsp;Vincenzo Francesco Caputo ,&nbsp;Antonella Sciarra ,&nbsp;Armando Calogero ,&nbsp;Lorenzo Romano ,&nbsp;Luigi Napolitano ,&nbsp;Carmine Sciorio ,&nbsp;Giuseppe Lucarelli ,&nbsp;Francesco Lasorsa ,&nbsp;Matteo Ferro ,&nbsp;Gian Maria Busetto ,&nbsp;Francesco Del Giudice ,&nbsp;Celeste Manfredi ,&nbsp;Sabin Tătaru ,&nbsp;Benjamin Pradere ,&nbsp;Ciro Imbimbo ,&nbsp;Felice Crocetto","doi":"10.1016/j.suronc.2024.102090","DOIUrl":"10.1016/j.suronc.2024.102090","url":null,"abstract":"<div><p>Bladder cancer (BCa) represents the second most common malignancy of the genitourinary tract. The major risk factors include age, gender, smoking attitude, and occupational exposure, while the exact etiopathogenesis is still uncertain. Patients diagnosed with a BCa showing invasion of the muscle layer below the submucosa must undergo radical cystectomy (RC) with urinary diversion (UD). Many different surgical approaches to UD have been developed. Packaging an orthotopic neobladder (ON) with a bowel tract represents the gold standard when certain patient selection criteria are satisfied. Using PRISMA guidelines, we performed a systematic review assessing early (within 90 days) and late (beyond 90 days) post-procedural complications of different ON surgical approaches. A comprehensive systematic search was conducted in PubMed, Scopus, and Google Scholar databases to identify papers starting from 2012 using dedicated keywords (“neobladder”, “orthotopic neobladder”, “complications'' and “outcomes”). A total of 27 articles were found to satisfy the inclusion criteria and selected. Although the ON is a safe procedure that guarantees the patient the best quality of life (QoL), it is not free from risks. Many complications could occur during and after the surgical time which imposes the necessity of strict follow-up and careful checks over time, which should be properly discussed with patients before.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"55 ","pages":"Article 102090"},"PeriodicalIF":2.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452125","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":"Intraoperative near-infrared fluorescence guided surgery using indocyanine green (ICG) may aid the surgical removal of benign bone and soft tissue tumours","authors":"Marcus J. Brookes ,&nbsp;Corey D. Chan ,&nbsp;Timothy P. Crowley ,&nbsp;Maniram Ragbir ,&nbsp;Kanishka M. Ghosh ,&nbsp;Thomas Beckingsale ,&nbsp;Kenneth S. Rankin","doi":"10.1016/j.suronc.2024.102091","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102091","url":null,"abstract":"<div><h3>Background</h3><p>Benign bone and soft tissue tumours encompass a broad, heterogenous range of tumours with varying clinical characteristics. These are often managed surgically with either curettage or marginal excision, but unfortunately have high rates of local recurrence. Indocyanine green (ICG) is a fluorescent dye which can be used to identify solid malignancies intraoperatively but its use is not yet established in benign bone and soft tissue tumours. This study aims to assess whether these tumours fluoresce when administered with ICG pre-operatively and whether this helps surgeons to identify tumour intra-operatively.</p></div><div><h3>Patients and methods</h3><p>Patients with locally aggressive benign bone and soft tissue tumours were administered with 25–75 mg of ICG preoperatively at the induction of anaesthesia. Fluorescence was imaged intraoperatively using the Stryker SPY-PHI camera.</p></div><div><h3>Results</h3><p>Of the 12 patients included, 11 tumours fluoresced. The surgeons felt the fluorescence guided the procedure in 7 out of the 11 cases which fluoresced. It was felt to be particularly useful in the curettage of bone tumours, in which curettage could be repeated until the absence of fluorescence on imaging. After 12 months, no patients had local recurrence of the tumour. There were no adverse events recorded in this study and surgeons found the technology acceptable.</p></div><div><h3>Conclusions</h3><p>The use of ICG for fluorescence guided surgery is a promising technology to improve outcomes of surgery for benign bone and soft tissue tumours. Further, longer term, study with a control arm is needed to identify whether it results in a reduction in the local recurrence rate.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"55 ","pages":"Article 102091"},"PeriodicalIF":2.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244776","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 pan - COVID - AGICT study. The impact of COVID-19 pandemic on surgically treated pancreatic cancer patients. A multicentric Italian study","authors":"Maria Pia Federica Dorma ,&nbsp;Giuseppe Giuliani ,&nbsp;Francesco Guerra ,&nbsp;Francesco Santelli ,&nbsp;Alessandro Esposito ,&nbsp;Matteo De Pastena ,&nbsp;Giulia Turri ,&nbsp;Corrado Pedrazzani ,&nbsp;Emanuele Federico Kauffmann ,&nbsp;Ugo Boggi ,&nbsp;Leonardo Solaini ,&nbsp;Giorgio Ercolani ,&nbsp;Laura Mastrangelo ,&nbsp;Elio Jovine ,&nbsp;Gregorio Di Franco ,&nbsp;Luca Morelli ,&nbsp;Michele Mazzola ,&nbsp;Giovanni Ferrari ,&nbsp;Serena Langella ,&nbsp;Alessandro Ferrero ,&nbsp;Andrea Coratti","doi":"10.1016/j.suronc.2024.102081","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102081","url":null,"abstract":"<div><h3>Background</h3><p>In this article we aimed to perform a subgroup analysis using data from the COVID-AGICT study, to investigate the perioperative outcomes of patients undergoing surgery for pancreatic cancers (PC) during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>The primary endpoint of the study was to find out any difference in the tumoral stage of surgically treated PC patients between 2019 and 2020. Surgical and oncological outcomes of the entire cohort of patients were also appraised dividing the entire peri-pandemic period into six three-month timeframes to balance out the comparison between 2019 and 2020.</p></div><div><h3>Results</h3><p>Overall, a total of 1815 patients were surgically treated during 2019 and 2020 in 14 Italian surgical Units. In 2020, the rate of patients treated with an advanced pathological stage was not different compared to 2019 (p = 0.846). During the pandemic, neoadjuvant chemotherapy (NCT) has dropped significantly (6.2% vs 21.4%, p &lt; 0.001) and, for patients who didn't undergo NCT, the latency between diagnosis and surgery was shortened (49.58 ± 37 days vs 77.40 ± 83 days, p &lt; 0.001). During 2020 there was a significant increase in minimally invasive procedures (p &lt; 0.001). The rate of postoperative complication was the same in the two years but during 2020 there was an increase of the medical ones (19% vs 16.1%, p = 0.001).</p></div><div><h3>Conclusions</h3><p>The post-pandemic dramatic modifications in healthcare provision, in Italy, did not significantly impair the clinical history of PC patients receiving surgical resection. The present study is one of the largest reports available on the argument and may provide the basis for long-term analyses.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"54 ","pages":"Article 102081"},"PeriodicalIF":2.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902432","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":"Machine learning for predicting colon cancer recurrence","authors":"Erkan Kayikcioglu ,&nbsp;Arif Hakan Onder ,&nbsp;Burcu Bacak ,&nbsp;Tekin Ahmet Serel","doi":"10.1016/j.suronc.2024.102079","DOIUrl":"10.1016/j.suronc.2024.102079","url":null,"abstract":"<div><h3>Introduction</h3><p>Colorectal cancer (CRC) is a global public health concern, ranking among the most commonly diagnosed malignancies worldwide. Despite advancements in treatment modalities, the specter of CRC recurrence remains a significant challenge, demanding innovative solutions for early detection and intervention. The integration of machine learning into oncology offers a promising avenue to address this issue, providing data-driven insights and personalized care.</p></div><div><h3>Methods</h3><p>This retrospective study analyzed data from 396 patients who underwent surgical procedures for colon cancer (CC) between 2010 and 2021. Machine learning algorithms were employed to predict CC recurrence, with a focus on demographic, clinicopathological, and laboratory characteristics. A range of evaluation metrics, including AUC (Area Under the Receiver Operating Characteristic), accuracy, recall, precision, and F1 scores, assessed the performance of machine learning algorithms.</p></div><div><h3>Results</h3><p>Significant risk factors for CC recurrence were identified, including sex, carcinoembryonic antigen (CEA) levels, tumor location, depth, lymphatic and venous invasion, and lymph node involvement. The CatBoost Classifier demonstrated exceptional performance, achieving an AUC of 0.92 and an accuracy of 88 % on the test dataset. Feature importance analysis highlighted the significance of CEA levels, albumin levels, N stage, weight, platelet count, height, neutrophil count, lymphocyte count, and gender in determining recurrence risk.</p></div><div><h3>Discussion</h3><p>The integration of machine learning into healthcare, exemplified by this study's findings, offers a pathway to personalized patient risk stratification and enhanced clinical decision-making. Early identification of individuals at risk of CC recurrence holds the potential for more effective therapeutic interventions and improved patient outcomes.</p></div><div><h3>Conclusion</h3><p>Machine learning has the potential to revolutionize our approach to CC recurrence prediction, emphasizing the synergy between medical expertise and cutting-edge technology in the fight against cancer. This study represents a vital step toward precision medicine in CC management, showcasing the transformative power of data-driven insights in oncology.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"54 ","pages":"Article 102079"},"PeriodicalIF":2.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772296","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}