Surgical Oncology-Oxford最新文献

{"title":"The prognostic outcome of tumor deposit in colorectal cancer beyond stage N staging","authors":"Tanasit Saikeaw,&nbsp;Phadungkiat Tipmanee,&nbsp;Pasut Chareonpornwattana,&nbsp;Gritcharat Watthanasathitarpha,&nbsp;Kanyanat Dasom,&nbsp;Thitithep Limvorapitak","doi":"10.1016/j.suronc.2025.102203","DOIUrl":"10.1016/j.suronc.2025.102203","url":null,"abstract":"<div><h3>Background</h3><div>Tumor deposits (TD) have been shown to have prognostic implications in patients diagnosed with colorectal cancer (CRC), although their impact appears to be modest compared to regional lymph node metastases.</div></div><div><h3>Patients and methods</h3><div>A retrospective analysis was conducted involving patients with colorectal cancer in stages I-III who underwent curative resections between January 2015 and December 2019 in the tertiary care center in Thailand. These patients were divided into two cohorts: TD positive and TD negative. Additionally, the patients were subsequently classified into N0, N1, and N2 groups. Disease-free survival and overall survival were compared.</div></div><div><h3>Results</h3><div>Among the 1015 eligible patients, 176 (17.3 %) had tumor deposits (TD), while 374 patients (36.8 %) had positive lymph nodes (LN). The TD positive group demonstrated a significantly lower 5-year overall survival rate (OS) and 5-year disease-free survival rate (DFS) compared to the TD negative group (73.5 % vs 85.9 %, p &lt; 0.001 and 72.5 % vs 87.9 %, p &lt; 0.001 respectively). Upon stratification by various N stages, the presence of TD was notably associated with DFS in the N1 group (5-year DFS: 84.3 % vs. 89.2 %, p = 0.006). Multivariate logistic analyses shown TD as an independent predictor of disease recurrence [p = 0.02; hazard ratio (HR):1.71 (1.11–2.64)].</div></div><div><h3>Conclusion</h3><div>The presence of TD was significantly correlated with reduced overall survival (OS) and disease-free survival (DFS) in colorectal cancer, especially in patients with nodal metastases.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102203"},"PeriodicalIF":2.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609299","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":"Preserving potential: Surgeons as key partners in establishing a living sarcoma biobank for translational research purposes","authors":"Stefanie Gijsels ,&nbsp;Merlijn Vekeman ,&nbsp;Suzanne Fischer ,&nbsp;David Creytens ,&nbsp;Alexander Ackerman ,&nbsp;Anais Ongenaet ,&nbsp;Laurens Boi ,&nbsp;Eline Segers ,&nbsp;Jens De Temmerman ,&nbsp;Francesca Casteur ,&nbsp;Ruben Van Boxstael ,&nbsp;Herlinde De Waele ,&nbsp;Desirée Dorleijn ,&nbsp;Fleur Cordier ,&nbsp;Lore Lapeire ,&nbsp;Gabriëlle Van Ramshorst ,&nbsp;Olivier De Wever ,&nbsp;Gwen Sys","doi":"10.1016/j.suronc.2025.102209","DOIUrl":"10.1016/j.suronc.2025.102209","url":null,"abstract":"<div><h3>Background</h3><div>Sarcoma is a rare type of cancer, of which over 70 distinct molecular subtypes are known. Because these tumours are so rare and complex, treatment outcomes have remained similar over the past decades and research is progressing slowly. For these rare cancers, personalised medicine and patient-derived models might pose solutions for therapeutic problems, but researchers depend on clinicians to access fresh, viable tumour tissue.</div></div><div><h3>Methods</h3><div>Over the past five years, a bedside-to-bench flow was implemented in Ghent University Hospital for a living biobank of sarcoma tissue to support translational research. All tumour tissue was cryopreserved in cryopreservation medium (90 % foetal bovine serum and 10 % dimethyl sulfoxide) maintaining viability of the tissue.</div></div><div><h3>Results</h3><div>As of July 2024, this biobank houses 217 sarcoma samples available for model development, biomarker discovery and precision medicine initiatives. The samples were collected from 167 patients, with 40 patients of whom we collected several samples throughout the disease course.</div></div><div><h3>Discussion</h3><div>With this article, we aim to incentivise surgeons to engage in biobanking initiatives, as they have a unique position with direct access to fresh tumour tissue. We present our biobank and clinical flow that is implemented in daily clinical practice. The primary aim of the biobank is to advance sarcoma research by creating models and sharing data with fellow researchers.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102209"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579061","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":"Synovial sarcoma: The influence of clinicopathological variables on overall survival in a UK population","authors":"Bill Robertson-Smith ,&nbsp;Jackie Campbell ,&nbsp;Karen Anthony ,&nbsp;Thomas A. McCulloch ,&nbsp;Robert U. Ashford","doi":"10.1016/j.suronc.2025.102204","DOIUrl":"10.1016/j.suronc.2025.102204","url":null,"abstract":"<div><h3>Introduction</h3><div>Synovial sarcoma accounts for 5%–10 % of malignant soft-tissue tumours. Curative treatment includes surgery, with radiotherapy and/or chemotherapy. With no specific treatment regimen for synovial sarcoma, the primary aim of this research was to describe the characteristics of a regional synovial sarcoma population in the UK, and to investigate clinicopathological variables associated with overall survival.</div></div><div><h3>Methods</h3><div>Ninety-four patients with synovial sarcoma from the East Midlands Sarcoma Service database were pseudo anonymised and clinicopathological variables extracted. Kaplan-Meier and Cox regression statistical analyses were used to identify variables affecting overall survival.</div></div><div><h3>Results</h3><div>Mean age at diagnosis was 42 years (range 8–83 years). Over half (n = 50, 53 %) of patients had a tumour in the lower limb. Thirty-seven (39.6 %) had a tumour size of &lt;5 cm. Sixteen (17 %) patients had local recurrence, and under half (n = 40, 43.5 %) developed metastatic disease. Most patients (n = 63, 63 %) were initially treated with surgery. The majority (n = 58, 61.7 %) had a monophasic subtype, and the overall survival of the whole cohort was 83 months (95 % CI 39.1–127.8). Increasing tumour size and distant recurrence (metastasis) had a significantly negative impact on median overall survival (<em>p</em> = 0.0001). Patients who underwent surgery and radiotherapy had a significantly better median overall survival (<em>p</em> = 0.02). Multivariable analysis identified adjuvant radiotherapy (<em>p</em> = 0.039), lower limb tumour (<em>p</em> = 0.033), and tumour size (&lt;5 cm <em>p</em> = 0.006, 5–10 cm <em>p</em> = 0.0001, &gt;10 cm <em>p</em> = 0.013) as significant survival predictors.</div></div><div><h3>Conclusion</h3><div>Adjuvant radiotherapy is a novel independent prognostic marker for synovial sarcoma.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102204"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654469","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":"Do unplanned resections in soft tissue sarcomas of the extremities have an adverse impact on the prognosis? Experience of a Latin-American sarcoma reference center","authors":"Melendez-Fernandez Ana P ,&nbsp;García-Ortega Dorian Y ,&nbsp;Caro-Sanchez Claudia H. ,&nbsp;Villavicencio-Valencia Veronica ,&nbsp;Martinez-Said Hector ,&nbsp;Cuellar-Hubbe Mario","doi":"10.1016/j.suronc.2025.102210","DOIUrl":"10.1016/j.suronc.2025.102210","url":null,"abstract":"<div><h3>Background</h3><div>Soft tissue sarcomas (STS) are rare, heterogeneous neoplasms often not optimally managed by teams without sarcoma expertise. Between 40 % and 50 % of primary resections for extremity sarcomas occur without prior biopsy, resulting in inadequate excisions, termed “unplanned resections” or “whoops surgery.”</div></div><div><h3>Objective</h3><div>To determine the rate of unplanned resections in extremity STS referred to a high-volume sarcoma center and evaluate their impact on oncological outcomes.</div></div><div><h3>Methods</h3><div>A retrospective study of 680 extremity STS patients referred between 2005 and 2020. Of these, 239 (35 %) had unplanned resections. We analyzed the impact of unplanned resections on recurrence, disease-free survival (DFS), and overall survival (OS) after re-excision.</div></div><div><h3>Results</h3><div>Among the 239 patients with unplanned resections, 52 % were male, the median age was 46, and the most common histologies were liposarcoma (24 %) and synovial sarcoma (20 %). The median tumor size was 9 cm. Re-excisions achieved R0 margins of 88.6 %. Recurrence occurred in 26.3 % of cases and progression in 12.9 %, with an overall recurrence or progression rate of 39.2 %. The median DFS was 151 months for R0 resections, compared to 57.1–61.8 months for R1/R2 resections. The median OS was 140 months for R0 resections versus 50.8–52.3 months for R1/R2 resections.</div></div><div><h3>Conclusions</h3><div>Unplanned resections by non-specialized surgeons significantly reduce DFS and OS. Nonetheless, re-excision with negative margins (R0) provides oncological outcomes comparable to those reported in planned surgeries, emphasizing the importance of timely referral to specialized sarcoma centers.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102210"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579063","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 the Impact of Minimally Invasive Surgery on Long-Term Quality of Life in Foregut Cancer Patients","authors":"Edward A. Joseph ,&nbsp;Muhammed Anees ,&nbsp;Muhammad Muntazir Mehdi Khan ,&nbsp;Sricharan Chalikonda ,&nbsp;Casey J. Allen","doi":"10.1016/j.suronc.2025.102207","DOIUrl":"10.1016/j.suronc.2025.102207","url":null,"abstract":"<div><h3>Introduction</h3><div>Compared to open surgery (OS), minimally invasive surgery (MIS) for foregut cancer improves perioperative outcomes. However, the impact of MIS on long-term quality of life (QOL) is unknown. We compare the long-term QOL of patients who underwent MIS and OS for foregut cancer.</div></div><div><h3>Methods</h3><div>Surgically managed esophageal and gastric cancer patients were surveyed globally via online support groups. Physical (P-QOL) and mental (M-QOL) well-being were determined using the Short Form-12 questionnaire and compared based on the surgical approach (MIS vs OS). We defined “long-term” as greater than 3 months from surgery.</div></div><div><h3>Results</h3><div>Out of 100 respondents with esophageal and gastric cancer, 64 survivors underwent surgical management greater than 3 months before the survey. They were 56.6 ± 9.9 years, 46.0% female, and 95.2% White, with a median survival of 33.0 (14.0–63.0) months. The most common diagnosis was esophageal adenocarcinoma (69.8%). Surgical procedures included esophagectomy (56.5%), esophagogastrectomy (29.0%), and gastrectomy (14.5%), of which 45.2% were OS and 48.4% were MIS. The cohort overall exhibited lower P-QOL (40.7 ± 10.4) and M-QOL (44.6 ± 15.2) compared to the general population (50.0 ± 10.0; p &lt; 0.050). There was no difference in age, sex, race, education, income, diagnosis, and adjuvant therapy between OS and MIS cohorts (all p &gt; 0.050). Long-term P-QOL (38.5 ± 11.6 OS vs. 42.8 ± 9.5 MIS, p = 0.123) and M-QOL (44.7 ± 15.3 OS vs. 44.9 ± 14.9 MIS, p = 0.901) was similar between patients who underwent OS and MIS for foregut cancer.</div></div><div><h3>Conclusion</h3><div>MIS is not associated with higher long-term QOL in patients who have undergone surgery for foregut malignancy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102207"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579062","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":"Prediction of early recurrence as a marker of surgical futility in pancreatic adenocarcinoma","authors":"Davide Citterio ,&nbsp;Michele Droz dit Busset ,&nbsp;Carlo Sposito ,&nbsp;Michele Mazzola ,&nbsp;Samuele Grandi ,&nbsp;Andrea Zironda ,&nbsp;Giuseppe Leoncini ,&nbsp;Nicolò Simonotti ,&nbsp;Carlo Battiston ,&nbsp;Maria Flores ,&nbsp;Giovanni Ferrari ,&nbsp;Vincenzo Mazzaferro","doi":"10.1016/j.suronc.2025.102208","DOIUrl":"10.1016/j.suronc.2025.102208","url":null,"abstract":"<div><h3>Background</h3><div>Long-term survival after resection for pancreatic ductal adenocarcinoma (PDAC) is impaired by very high recurrence rates. When recurrence occurs within 6 months (early recurrence: ER) the benefit of surgery is equivalent to palliative chemotherapy in unresectable patients. Therefore, ER is a surrogate of surgical futility in PDAC.</div></div><div><h3>Materials and methods</h3><div>To investigate predictive factors of ER and its impact on survival, a training and a validation cohort of prospectively collected patients who underwent surgery for resectable or borderline-resectable PDAC were analyzed in two independent Pancreas Units during the same period. Logistic regression model on the training cohort identified independent predictors of ER, used to build a prognostic risk-score then tested on the validation cohort.</div></div><div><h3>Results</h3><div>Out of 176 patients in the training cohort, 21.6 % experienced ER, with significant impact on survival (OS: 9.7 months vs. 32.7 months for ER vs. late/no recurrence, respectively). At multivariable analysis, three independent risk factors for ER were identified: Ca19.9 &gt; 100 U/mL, G3 tumors and lack of adjuvant chemotherapy. Based on such features the derived ER-score stratified three prognostic classes at incremental risk of ER (12 %, 35 % and 53 %) with different OS (31.1, 19.7 and 9.3 months, respectively, p &lt; 0.001). The ER predictive score was then tested on a validation cohort of 242 patients, 22.3 % of whom underwent ER. Despite significant differences in tumor-related features, the score was able to discriminate among the predicted ER-risk classes (15 %, 27 % and 53 %, respectively) and forecast significantly different OS (5.8, 19 and 31.1 months, p &gt; 0.001). The discriminative capability of the score in the two cohorts was similar (training AUC = 0.72 vs. validation AUC = 0.68, p = 0.28).</div></div><div><h3>Conclusion</h3><div>An externally validated clinical score, able to identify three prognostic classes at incremental risk of developing ER after resection of PDAC is provided. In patients at high risk of ER, prediction of surgical futility may help in decision-making.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102208"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619204","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":"Metastasis directed therapy in recurrent renal cell carcinoma – Retrospective analysis of a ten-year experience","authors":"R. Himmelsbach,&nbsp;J. Stigler,&nbsp;M. Weishaar,&nbsp;S. Astheimer,&nbsp;A. Sigle,&nbsp;C. Jilg,&nbsp;C. Gratzke,&nbsp;M. Grabbert,&nbsp;M. Glienke","doi":"10.1016/j.suronc.2025.102202","DOIUrl":"10.1016/j.suronc.2025.102202","url":null,"abstract":"<div><h3>Introduction</h3><div>Current guidelines provide a weak recommendation for metastasis directed therapy (MDT) in patients with recurrent renal cell carcinoma (RCC) and is focused on the goal of symptom control and potentially delaying systemic therapy. Especially in light of systemic treatment entailing targeted therapies for metastatic RCC, MDT's role remains undefined. Goal of our study was to evaluate which patients might benefit most from MDT. Our assessed endpoints were time to initiation of systemic therapy and progression-free survival (PFS).</div></div><div><h3>Material &amp; methods</h3><div>We collected data retrospectively and exclusively at our centre; our study included patients with recurrent RCC after initial partial or radical nephrectomy, who subsequently underwent MDT at the University Hospital Freiburg and whose cases were discussed at our interdisciplinary urogenital tumour board between 2011 and 2021.</div></div><div><h3>Results</h3><div>A total of 92 patients were included. Median follow up was 57.6 months (IQR 30.9–89.6). Median age was 65.1 (IQR 59.05–72.36) at the time of first MDT. Lung and lymph nodes were the most frequent locations of recurrence (40.2 % and 20.7 %, respectively). Median PFS after the first MDT was 392 days (IQR 100–855). Median time to the initiation of systemic therapy was 534 days (IQR 142–1707). In multivariate regression analysis, a higher T-stage in the initial pathology was associated with shorter PFS (HR 1.64, 95%-CI 0.98–2.66; p = 0.05). Furthermore, older age lowered the risk of progression after MDT (HR 0.97, 95%CI 0.94–1.00; p = 0.04). According to the non-parametrical log-rank test, patients with early recurrence (within 1 year after initial diagnosis) had significant shorter time to initiation of systemic therapy (p = 0.05). However, this effect was not apparent in multivariable regression analysis.</div></div><div><h3>Conclusion</h3><div>We report on a large cohort of patients who underwent MDT for recurrent RCC within the last ten years at our institution. Within the limitations of a retrospective single-centre analysis, our findings support the concept of MDT for recurrent disease in patients presenting a favourable initial tumour stage and rather late recurrence after initial therapy. However, as mRCC is a very heterogeneous disease, more investigation is needed to refine the definition of predictive parameters that facilitate patient-centred decision-making.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102202"},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562883","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":"Robotic distal pancreatectomy using the hinotori™ surgical system: Differences in surgical techniques from the daVinci™ surgical system","authors":"Yuichiro Uchida ,&nbsp;Takeshi Takahara ,&nbsp;Takahisa Kawase ,&nbsp;Takuya Mizumoto ,&nbsp;Masaya Nakauchi ,&nbsp;Akihiro Nishimura ,&nbsp;Satoshi Mii ,&nbsp;Hirotaka Fukuoka ,&nbsp;Shinichi Taniwaki ,&nbsp;Hideaki Iwama ,&nbsp;Masayuki Kojima ,&nbsp;Ichiro Uyama ,&nbsp;Koichi Suda","doi":"10.1016/j.suronc.2025.102195","DOIUrl":"10.1016/j.suronc.2025.102195","url":null,"abstract":"<div><h3>Background</h3><div>The use of the hinotori™ Surgical System (hinotori) in distal pancreatectomy (DP) is new compared to the da Vinci™ Surgical System (DVSS). The hinotori is equipped with mechanisms distinct from those of DVSS, and comprehensive reports detailing the surgical techniques and outcomes associated with hinotori in DP (hinotori-DP) are lacking. This study aimed to compare the outcomes of DP using the hinotori and DVSS (Xi system), focusing on differences in settings and techniques between the two methods.</div></div><div><h3>Methods</h3><div>This study retrospectively investigated consecutive patients who underwent robotic DP from April 2010 (the introduction of robotic DP at our institute) to July 2024. The analysis excluded patients who underwent spleen-preserving procedures or procedures performed using robotic platform other than hinotori or daVinci Xi. The hinotori-DP cases were compared with those performed using DVSS (DVSS-DP). The techniques used in hinotori-DP were examined in more detail.</div></div><div><h3>Results</h3><div>A total of 75 robotic DP cases (11 with hinotori and 64 with DVSS) were analyzed in this study. Different port configurations and techniques, including a lesser curvature approach, were used in the hinotori-DP compared to DVSS-DP. The operation time was relatively shorter in the hinotori-DP group (299 vs. 366 min, p = 0.095), and the postoperative complication rates were comparable (pancreatic fistula: 27 % vs. 30 %, p = 0.871; Clavien–Dindo Grade ≥3a complications: 18 % vs. 19 %, p = 0.964) between the two groups.</div></div><div><h3>Conclusion</h3><div>The hinotori-DP can be safely performed by focusing on the unique characteristics of the hinotori surgical system.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102195"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430094","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":"Current approaches to breast reconstruction: A scoping review of outcomes and factors influencing core outcome sets","authors":"Dorotea Gašpar ,&nbsp;Iztok Takač ,&nbsp;Monika Sobočan","doi":"10.1016/j.suronc.2025.102191","DOIUrl":"10.1016/j.suronc.2025.102191","url":null,"abstract":"<div><div>Breast cancer is the most common malignancy among women worldwide. Surgery is part of the standard treatment for most new breast cancer patients. Surgical options include breast conserving surgery and mastectomy. Breast reconstruction is commonly offered to patients undergoing mastectomy for breast cancer. The aim of this review was to evaluate current approaches to breast reconstruction and factors influencing core outcome sets for breast reconstruction. This review focused to identify keywords pertaining to the review aim such as: “breast reconstruction” AND “breast cancer” AND “outcomes” through Medline. There were 49 relevant manuscripts identified between the July 2018 to July 2023. Additionally, we identified based on the literature review manuscripts on topics of oncological outcomes after breast reconstruction. Preference was given to the sources published in the last five years. Available research indicates that although general quality of life post-reconstruction is comparable across surgical methods, variations exist in postoperative satisfaction, complications, and recovery. Autologous reconstruction is often associated with higher patient satisfaction and well-being across physical, psychosocial, and aesthetic domains compared to implant-based reconstruction. Key risk factors for complications include diabetes, obesity, and smoking, which impact postoperative recovery and readmission rates. Additionally, postmastectomy radiation therapy to breast cancer management increases risks of infection, necrosis, and aesthetic dissatisfaction. However, autologous techniques are somewhat less affected of this risk than implant based techniques. The review underscores the need for enhanced patient education tools and precision-based approaches that address both aesthetic and oncological concerns, setting a foundation for more informed, data-supported decision-making in breast reconstruction.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"60 ","pages":"Article 102191"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783442","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":"Optimizing oncological and functional outcomes with wide resection techniques in robot-assisted radical prostatectomy for very high-risk prostate cancer: A single-institution retrospective study","authors":"Yu Ozawa,&nbsp;Shin Koike,&nbsp;Keisuke Aoki,&nbsp;Keita Okamoto,&nbsp;Kei Ushijima,&nbsp;Toshiaki Kayaba,&nbsp;Sunao Nohara,&nbsp;Masumi Yamada,&nbsp;Yu Odagaki,&nbsp;Hideo Sakamoto,&nbsp;Kunihiko Yoshioka","doi":"10.1016/j.suronc.2025.102192","DOIUrl":"10.1016/j.suronc.2025.102192","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess our wide resection robot-assisted radical prostatectomy techniques in very high-risk prostate cancer.</div></div><div><h3>Methods</h3><div>Among 600 patients, we identified 63 patients with localized or locally advanced very high-risk prostate cancer (cT3b-T4, primary Gleason pattern 5, multiple high-risk features, or ≥5 positive biopsy cores with Grade Group 4–5 pathology) undergoing wide resection robot-assisted radical prostatectomy following six months of vintage hormonal therapy between 2019 and 2023. Clinical staging included digital rectal exams, magnetic resonance imaging, computed tomography, and bone scintigraphy.</div><div>We assessed the effectiveness of our wide resection techniques in reducing PSM rate by evaluating the perioperative, pathological, and oncological outcomes.</div></div><div><h3>Results</h3><div>The overall PSM rate was 19% (6.7% for pT2, 9.1% for pT3a, and 47% for pT3b). The most frequent site for extracapsular extension was the lateral side (30%), followed by the bladder neck (26%). The bladder neck was the most common location of PSM (59%).</div><div>Over a median follow-up of 18.7 months, patients without PSMs had a 46% higher 2-year prostate-specific antigen-free survival rate than those with PSMs. One patient experienced Clavien–Dindo grade Ⅲa deep vein thrombosis, and 51% achieved immediate continence. A limitation of this study was the use of vintage hormonal therapy and conventional imaging modalities.</div></div><div><h3>Conclusions</h3><div>Our study demonstrated that wider bladder neck dissection, rather than wider apical dissection, can achieve acceptable short-term functional and oncological outcomes. Future studies with longer follow-up are warranted to assess effectiveness of wide resection for local cancer control in very high-risk prostate cancer as a part of a multimodality strategy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102192"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403456","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}