Surgical Oncology-Oxford最新文献

{"title":"Predicting incontinence and erectile function after prostate cancer surgery: International validation of models","authors":"Michael O'Callaghan ,&nbsp;Shahid Ullah ,&nbsp;David Smith ,&nbsp;Stephen Mark ,&nbsp;Jude Clarke ,&nbsp;Darran Rouse ,&nbsp;Rowan David ,&nbsp;Kim Moretti","doi":"10.1016/j.suronc.2025.102194","DOIUrl":"10.1016/j.suronc.2025.102194","url":null,"abstract":"<div><h3>Background</h3><div>Our objective is to externally validate the most accurate, published tools predicting urinary incontinence and erectile dysfunction following prostatectomy. Several models have been developed to predict the risks of adverse events, though most have not been externally validated.</div></div><div><h3>Methods</h3><div>Data were obtained from the Prostate Cancer Outcomes Registry of Australia and New Zealand (PCOR-ANZ). Self-reported urinary incontinence and erectile dysfunction were measured using EPIC-26 at 12 months after radical prostatectomy. Four predictive models were selected for external validation, being the top performing models from a systematic literature review. Two models related to urinary incontinence (Matsushita and Jeong) and two related to sexual function (Alemozaffar and Novara), were examined. Model discrimination was assessed by the Area Under the Received Operator Curve (AUC) and calibration was assessed.</div></div><div><h3>Results</h3><div>We constructed a cohort of 590 patients resident in either New Zealand or South Australia who had received a radical prostatectomy 2007–2019. The average age at diagnosis was 65 years, with most men having few comorbidities (97.1 % Charlson comorbidity index 0) and treated with robotic surgery (93.6 %). In our external validation cohort, the Almozaffar model demonstrated the highest discrimination when predicting erectile dysfunction (AUC 0.73, 95%CI 0.67–0.78). The highest discrimination achieved by a model predicting urinary incontinence was developed by Jeong (AUC 0.69, 95%CI 0.61–0.76).</div></div><div><h3>Conclusions</h3><div>Models predicting erectile dysfunction performed well in external validation and may be suitable for clinical use. Models predicting post-prostatectomy urinary incontinence did not perform as well on validation.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102194"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430059","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":"Comparison between bipolar scissors, monopolar electrocautery, and hydrodissection in nipple-sparing mastectomy","authors":"Khaled E. Barakat ,&nbsp;Mohamed F. Asal ,&nbsp;Ahmed Adham R. Elsayed ,&nbsp;Lindsey Nichols ,&nbsp;Ahmed Abdelkader ,&nbsp;George Maged ,&nbsp;Marc D. Basson","doi":"10.1016/j.suronc.2024.102182","DOIUrl":"10.1016/j.suronc.2024.102182","url":null,"abstract":"<div><h3>Background</h3><div>The common techniques used in nipple-sparing mastectomy (NSM) are hydrodissection (tumescent dissection) and electrocautery. We hypothesized that bipolar scissors (diathermy scissors) would improve surgical outcomes in mastectomy.</div></div><div><h3>Methods</h3><div>We prospectively compared 50 patients undergoing NSM using the bipolar scissor technique to retrospective data from patients who had previously undergone NSM with hydrodissection (n = 50) or electrocautery (n = 50). Operation time, intraoperative bleeding, drainage per day, duration till drain removal, and serious complications were compared.</div></div><div><h3>Results</h3><div>Operation time was significantly better with the bipolar scissors (34.1 ± 4.9 min) and hydrodissection (36.2 ± 6.6 min) compared to monopolar electrocautery (53.7 ± 4.8 min) (p &lt; 0.001). Intraoperative bleeding was significantly less with the bipolar scissors (123.4 ± 27.7 ml) and hydrodissection (126.6 ± 25.1 ml) compared to electrocautery (161.8 ± 25.0 ml) (p &lt; 0.001). Additionally, the drainage per day and the duration till drain removal was 79.7 ± 18.3 ml for 3.22 ± 0.79 days and 92.4 ± 41.3 ml for 3.58 ± 1.23 days for the bipolar scissors and hydrodissection techniques respectively were significantly better compared to 124.8 ± 40.3 ml for 4.58 ± 1.23 days (p &lt; 0.001) for the electrocautery method. Finally, the bipolar scissor technique had the least complications (2 %) compared to hydrodissection (20 %) (p &lt; 0.004).</div></div><div><h3>Conclusion</h3><div>Although hydrodissection was as effective as bipolar scissors in reducing operation time, intraoperative bleeding, postoperative drainage, and the duration of drainage compared with electrocautery, hydrodissection was associated with more serious complications than the bipolar scissors technique.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102182"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883583","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 genomic analysis of patients with musculoskeletal metastases from an unknown origin","authors":"Nicholas Eastley ,&nbsp;Paul Cool ,&nbsp;Mariam Jafri ,&nbsp;Manoj Raghavan ,&nbsp;Jonathan Stevenson","doi":"10.1016/j.suronc.2025.102187","DOIUrl":"10.1016/j.suronc.2025.102187","url":null,"abstract":"<div><h3>Background</h3><div>A subgroup of patients present with musculoskeletal (MSK) metastases but no detectable primary tumour. An inability to employ disease-specific treatment means this cohort's median survival is just 6–10 months. We present a novel, prospective, pilot study investigating the role of targeted Next Generation Sequencing (NGS) of metastases in these ‘Cancer of Unknown Primary’ (CUP) patients, reporting on diagnostic, therapeutic and prognostic benefits.</div></div><div><h3>Materials and methods</h3><div>Patients with an MSK lesion radiologically consistent with a metastases, no previous cancer diagnosis, and no discernible primary tumour were analysed. After biopsy ruled out sarcoma, patients’ tumoural DNA and RNA was analysed using targeted NGS. Data was processed using a custom bioinformatics pipeline and variants classified by biological and clinical significance.</div></div><div><h3>Results</h3><div>19 patients (8F:11M, median age 70 years, range 40–76) were analysed. 18 (95 %) had ≥1 variant with ‘potential’ or ‘strong’ clinical significance. 8 (42 %) patients' variants highlighted them as eligible for an open clinical trial(s). 3 (16 %) had variant(s) with potential therapeutic or prognostic ramifications. Median cohort survival was 15 months (0–41). 5 of the 11 (45 %) patients referred to an appropriate MDT based on their genomic analysis died during follow up (median survival 11 months, 4–32), compared to 7/8 (88 %) managed by a CUP MDT (median survival 9 months, 0–18).</div></div><div><h3>Conclusion</h3><div>Our data suggests the real-time genomic analysis of CUP patients has multiple diagnostic and therapeutic benefits. Larger, prospective trials are needed to characterise the genomics of this vulnerable patient cohort, looking for survival benefits of this analysis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102187"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143262376","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":"Radioembolization prior to liver resection may increase the risk of severe biliary complications: A multicenter, retrospective cohort study performed in France","authors":"Céline Dananai ,&nbsp;Marie Alaux ,&nbsp;Eric Vibert ,&nbsp;Olivier Facy ,&nbsp;Lilian Schwarz ,&nbsp;Emmanuel Boleslawski ,&nbsp;Olivier Scatton ,&nbsp;Antonio Iannelli ,&nbsp;Bertrand Le Roy ,&nbsp;Kayvan Mohkam ,&nbsp;Stéphanie Truant ,&nbsp;Astrid Herrero ,&nbsp;Nour Bou Saleh ,&nbsp;Guillaume Millet","doi":"10.1016/j.suronc.2025.102186","DOIUrl":"10.1016/j.suronc.2025.102186","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102186"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043315","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":"Survival benefit of adjuvant chemotherapy in stage II large (≥5 cm) colonic adenocarcinomas: A propensity-score matched analysis","authors":"Sameh Hany Emile ,&nbsp;Nir Horesh ,&nbsp;Zoe Garoufalia ,&nbsp;Rachel Gefen ,&nbsp;Justin Dourado ,&nbsp;Steven D. Wexner","doi":"10.1016/j.suronc.2025.102190","DOIUrl":"10.1016/j.suronc.2025.102190","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines recommend selective adjuvant chemotherapy for stage II colon cancer with high-risk features. This study aimed to assess survival benefit of adjuvant chemotherapy in patients with stage II colon adenocarcinomas ≥5 cm without high-risk features.</div></div><div><h3>Methods</h3><div>The National Cancer Database was retrospectively reviewed (2010–2019) for all patients with pathologic stage II colonic adenocarcinomas ≥5 cm who underwent colectomy. Patients were divided into adjuvant and control groups that were propensity-score matched for baseline and treatment confounders. The primary outcome was 5-year overall survival (OS).</div></div><div><h3>Results</h3><div>Of 23,937 included patients, adjuvant chemotherapy was given to 2581 (10.8 %). Patient given adjuvant chemotherapy were younger, more often male, Black, had a Charlson score of 0 and private insurance, presented with left-sided cancers and microsatellite stable (MSS) tumors, and more frequently underwent segmental resections and open surgery. 796 patients in the adjuvant group were matched to 1592 patients in the control group. Adjuvant chemotherapy was associated with lower mortality (HR: 0.79; p = 0.022), however, it was not independently associated with improved OS when adjusted for other confounders (HR: 0.84; p = 0.157). The adjuvant group had significantly longer restricted mean OS than the control group (104.9 vs. 100.8 months; p = 0.007). The survival benefit was only noted in patients &gt;50 years, female, White, with non-mucinous adenocarcinomas, MSS tumors, normal CEA levels, and had undergone open and emergency surgery.</div></div><div><h3>Conclusions</h3><div>The study did not demonstrate a clear survival benefit from adjuvant chemotherapy in patients with stage II adenocarcinoma ≥5 cm. A possible potential survival benefit was observed only in a subgroup of patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102190"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349397","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 risk-reducing surgeries in women at high risk for gynaecological cancers: A tertiary center experience","authors":"Danielle Mor-Hadar ,&nbsp;Orla McNally ,&nbsp;Abby Grant ,&nbsp;Niveditha Rajadevan ,&nbsp;Rosemary McBain ,&nbsp;Yael Naaman ,&nbsp;Fiona Chan ,&nbsp;Estefania Vicario ,&nbsp;C David Wrede","doi":"10.1016/j.suronc.2025.102193","DOIUrl":"10.1016/j.suronc.2025.102193","url":null,"abstract":"<div><h3>Objective</h3><div>Ovarian and endometrial carcinomas are the most common gynecologic malignancies, with general population risks of 1.4 % and 2.5 % respectively. Certain genetic factors can raise these risks to 44 % and 60 % respectively. The most effective risk-reduction (RR) method is the removal of the fallopian tubes, ovaries, and/or uterus. This study investigates surgical outcomes and occult cancer rates following RR surgery in high-risk women.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study of all women identified as high-risk for gynaecologic cancer who were referred to a high-volume tertiary centre and underwent RR surgery. All pathology specimens were assessed by sectioning and extensively examining the fimbriated end (SEE-FIM) protocol. The analysis included patients’ demographics, peri- and post-operative evaluation, and final histopathological reports.</div></div><div><h3>Results</h3><div>Between 2008 and 2024, 576 women completed RR surgery in our centre.</div><div>The rates of intra- and post-operative complications were 3.1 % and 4.5 %, respectively.</div><div>The overall occult cancer rate was 3.4 % (<em>n</em> = 20). Of these, 11 (55 %) patients had high-grade serous carcinoma of the ovary/fallopian tube, and seven (35 %) patients were found to have endometrial cancer. Two cases had unexpected metastasis in the ovaries (10 %). Of the whole cohort, 12 (2.1 %) patients were found to have premalignant disease; eight serous tubal intraepithelial carcinoma; two atypical endometrial hyperplasia and two dysplasia of the cervix.</div></div><div><h3>Conclusion</h3><div>RR surgeries are safe with a low complication rate. The incidence of occult cancer at the time of RR surgery is low but significant. Endometrial sampling is to be considered, and all fallopian tubes should be examined with the SEE-FIM protocol.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102193"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427649","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":"Survival outcomes in non-operative cases of localized extremity sarcoma","authors":"Masatake Matsuoka ,&nbsp;Tomohiro Onodera ,&nbsp;Koji Iwasaki ,&nbsp;Masanari Hamasaki ,&nbsp;Taku Ebata ,&nbsp;Yoshiaki Hosokawa ,&nbsp;Eiji Kondo ,&nbsp;Norimasa Iwasaki","doi":"10.1016/j.suronc.2024.102181","DOIUrl":"10.1016/j.suronc.2024.102181","url":null,"abstract":"<div><h3>Background</h3><div>Soft-tissue sarcomas (STSs) are a diverse group of malignancies challenging to treat when surgery is not an option. The aim of this study was to investigate the survival of non-surgical cases in STSs, and to examine the impact of radiation therapy (RT) on survival within this group of cases.</div></div><div><h3>Methods</h3><div>Utilizing the SEER database, we conducted a retrospective cohort study of localized extremity non-small round cell sarcoma diagnosed between 2000 and 2019. A total of 444 non-operative cases were identified and analyzed for cancer-specific survival (CSS) and overall survival (OS) using Kaplan-Meier and Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Among the non-operative cohort, the median age at diagnosis was 72 years. The median survival was 10 months, with AJCC 8th edition clinical stage-specific 5-year CSS rates of 80 % for Stage 1B, 53 % for Stage 2, 47 % for Stage 3A, and 22 % for Stage 3B. The 5-year OS rates were 56 % for Stage 1B, 31 % for Stage 2, 26 % for Stage 3A, and 14 % for Stage 3B. Nearly half of the patients received RT, which was more prevalent in higher clinical stages. RT was associated with improved survival rates for both CSS and OS in patients who are unable to undergo surgical intervention.</div></div><div><h3>Conclusions</h3><div>RT is associated with improved survival in non-operative localized extremity non-small round cell sarcoma patients. These insights are vital for clinical decision-making, emphasizing the need for personalized, non-surgical interventions to improve outcomes for patients where surgery is not feasible.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102181"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856608","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":"Commentary: Wide-field isthmusectomy for localized isthmic thyroid tumors","authors":"Ashok R. Shaha ,&nbsp;Aradhya Nigam ,&nbsp;R. Michael Tuttle","doi":"10.1016/j.suronc.2024.102185","DOIUrl":"10.1016/j.suronc.2024.102185","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102185"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068492","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":"High comorbidity and tumor proliferation predict survival of localized breast cancer patients after curative surgery: A retrospective analysis of real-world data in Finland","authors":"Milla Hollmén ,&nbsp;Eliisa Löyttyniemi ,&nbsp;Eeva Juhanoja ,&nbsp;Pia Vihinen ,&nbsp;Maria Sundvall","doi":"10.1016/j.suronc.2025.102188","DOIUrl":"10.1016/j.suronc.2025.102188","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to analyze the characteristics of breast cancer patients and their impact on real-world treatment and survival outcomes.</div></div><div><h3>Patients and methods</h3><div>We conducted a retrospective study including all patients newly diagnosed with breast cancer during 2019 in the Southwest Finland. We identified 458 patients diagnosed with either localized (n = 435, 95 %) or metastatic (n = 23, 5 %) breast cancer.</div></div><div><h3>Results</h3><div>In localized breast cancer, the five-year overall survival (OS) was 90.9 %, while the five-year disease-free survival (DFS) was 93.5 %. In metastatic breast cancer, the five-year progression-free survival (PFS) was 13.0 % and five-year OS 34.2 %. The median PFS was 10.9 months (95 % CI 2.5–19.4 months) and median OS was 30.6 months (lower 95 % CI 6.9 months – not reached).</div><div>In the univariate analyses, the most important tumor-specific parameters predicting decreased DFS were tumor proliferation index &gt;20 %, low estrogen receptor expression status and tumor size &gt;2 cm. Univariate predictors for decreased OS included Eastern Cooperative Oncology Group (ECOG) performance status ≥2 and Charlson Comorbidity Index (CCI) score ≥3. In the multivariable analyses, CCI score ≥3 and high proliferation index (21–100 % vs. 0–20 %) predicted poorer DFS, while CCI score ≥3 and increased stage (stage 2 vs. 1) predicted poorer OS. The administration of post-operative radiotherapy was significant in the multivariable analyses of both DFS (HR 4.23, 95 % CI 1.85–9.67, p = 0.0006) and OS (HR 6.84, 95 % CI 3.33–14.02, p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>Our results demonstrate that careful clinical evaluation of ECOG and comorbidities, alongside well-established tumor characteristics predict patient survival in a population where overall five-year survival in breast cancer is over 90 %.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102188"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174254","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":"Timing of TS1 adjuvant chemotherapy as a prognostic factor in recurrent pancreatic cancer after surgery","authors":"Kyohei Abe ,&nbsp;Kenei Furukawa ,&nbsp;Mizuki Fukuda ,&nbsp;Takeshi Gocho ,&nbsp;Masashi Tsunematsu ,&nbsp;Ryoga Hamura ,&nbsp;Yoshihiro Shirai ,&nbsp;Koichiro Haruki ,&nbsp;Shuichi Fujioka ,&nbsp;Toru Ikegami","doi":"10.1016/j.suronc.2024.102179","DOIUrl":"10.1016/j.suronc.2024.102179","url":null,"abstract":"<div><h3>Aim</h3><div>Prognosis of pancreatic cancer is improved by combining postoperative adjuvant chemotherapy and preoperative adjuvant chemotherapy with surgery, while the importance of extended dissection surgery has decreased. To better understand prognostic factors of recurrence, we focused on the timing of postoperative adjuvant chemotherapy in patients with pancreatic cancer.</div></div><div><h3>Methods</h3><div>One hundred patients who underwent pancreatectomy or pancreaticoduodenectomy and chemotherapy for pancreatic cancer were classified into early and late postoperative adjuvant therapy initiation groups. Prognosis was evaluated retrospectively using known prognostic factors.</div></div><div><h3>Results</h3><div>On receiver operating characteristic analysis, optimum cut-off between the early (&lt;52 days; n = 60) and late adjuvant initiation groups (≥52 days; n = 40) was 52 days. The two groups were well-matched, except the early initiation group had more surgeries with D2 lymph node dissection (75 % vs 48 %; p = 0.01); fewer postoperative complications (17 % vs 59 %; p = 0.04), including less postoperative pancreatic fistula (13 % vs 35 %; p = 0.03); and longer disease-free survival (0.7 years v 0.5 years; p = 0.02). On multivariate evaluation, early initiation and completion of adjuvant therapy were associated with increased overall survival, while early initiation was associated with prolonged disease-free survival.</div></div><div><h3>Conclusions</h3><div>Prognosis of patients with pancreatic cancer is improved by earlier rather than later initiation of postoperative adjuvant therapy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102179"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856611","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}