Surgical Oncology-Oxford最新文献

{"title":"Updates on molecular targets and clinical trials with targeted therapies for pancreatic cancer.","authors":"Rachael A Safyan, E Gabriela Chiorean","doi":"10.1016/j.suronc.2025.102268","DOIUrl":"https://doi.org/10.1016/j.suronc.2025.102268","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDA) is highly aggressive and has few treatment options. To personalize therapy, it is critical to delineate molecular subtypes and understand inter- and intra-tumoral heterogeneity. KRAS mutations are present in 90 % of PDA, while 10 % are KRAS wild type and are potentially targetable with epidermal growth factor receptor (EGFR) blockade. KRAS^G12C inhibitors have shown activity in G12C mutated cancers, and novel G12D and pan-RAS inhibitors are in clinical trials. Fewer than 1 % of PDA harbor microsatellite instability high (MSI-High) status and are susceptible to immune checkpoint blockade. Albeit rare, and occurring in KRAS wild type PDAs, BRAF V600E mutations, HER2 amplification, and RET, NTRK, and NRG1 fusions are targetable with cancer agnostic FDA approved therapies. In this review, we highlight clinically relevant molecular alterations and clinical trials with focus on targeted therapies that can improve pancreatic cancer patients' outcomes through precision medicine.</p>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":" ","pages":"102268"},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719113","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":"Surgical strategies for locally advanced pancreatic cancer following gemcitabine plus S-1-based chemoradiotherapy.","authors":"Aoi Hayasaki, Shugo Mizuno, Benson Kaluba, Yuki Segi, Haruna Komatsubara, Tatsuya Sakamoto, Koki Maeda, Toru Shinkai, Takahiro Ito, Kazuyuki Gyoten, Takehiro Fujii, Yusuke Iizawa, Akihiro Tanemura, Yasuhiro Murata, Naohisa Kuriyama, Masashi Kishiwada","doi":"10.1016/j.suronc.2025.102269","DOIUrl":"https://doi.org/10.1016/j.suronc.2025.102269","url":null,"abstract":"<p><strong>Background: </strong>In this study, we present our institution's treatment outcomes and surgical strategies for patients with localized pancreatic ductal adenocarcinoma (PDAC).</p><p><strong>Methods: </strong>The study retrospectively reviewed clinical data of 397 patients with localized PDAC who were enrolled in a gemcitabine and S-1 based chemoradiotherapy (GS-CRT) protocol between September 2011 and March 2023. Following GS-CRT, pancreatectomy was performed and concomitant vascular resection with subsequent reconstruction was done, if required, in order to achieve R0 resection margins.</p><p><strong>Result: </strong>From the 397 patients, 366 (92.2 %) completed the GS-CRT. A total of 359 patients were adequately re-evaluated after GS-CRT and categorized as having resectable (R; n = 77), borderline resectable with superior mesenteric vein/portal vein involvement (BR-PV; n = 40), borderline resectable with arterial involvement (BR-A; n = 94), or unresectable locally advanced (UR-LA; n = 148) tumors, respectively. From these, 202 patients with R (n = 63), BR-PV (n = 31), BR-A (n = 56) and UR-LA (n = 52) PDAC underwent curative-intent pancreatectomy. The R0 resection rates and median survival times for disease-specific survival (DSS) according to resectability were favorable: 98.4 %, 93.5 %, 92.9 %, and 80.8 %, and 62.7, 66.1, 41.8, and 36.2 months, respectively. Prognostic factors for DSS among the 202 resected patients included performance status, pre-operative carbohydrate antigen 19-9 and carcinoembryonic antigen serum levels, pre-operative tumor resectability, pathological T factor and receipt of adjuvant chemotherapy. In the resected UR-LA patients, adjuvant chemotherapy was a significant prognostic factor of survival outcomes.</p><p><strong>Conclusions: </strong>GS-CRT followed by pancreatectomy is feasible and a beneficial treatment strategy for PDAC. Therefore, a safe and reliable surgical approach that ensures R0 resection margins and enables subsequent adjuvant chemotherapy is essential.</p>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":" ","pages":"102269"},"PeriodicalIF":2.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692289","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":"Signal heterogeneity in apparent diffusion coefficient map of magnetic resonance imaging in resectable pancreatic cancer: a new prognostic factor for biological borderline resectable pancreatic cancer","authors":"Michinori Matsumoto,&nbsp;Masashi Tsunematsu,&nbsp;Kenei Furukawa,&nbsp;Koichiro Haruki,&nbsp;Yoshihiro Shirai,&nbsp;Shinji Onda,&nbsp;Tadashi Uwagawa,&nbsp;Takeshi Gocho,&nbsp;Mitsuru Yanagaki,&nbsp;Toru Ikegami","doi":"10.1016/j.suronc.2025.102270","DOIUrl":"10.1016/j.suronc.2025.102270","url":null,"abstract":"<div><h3>Background</h3><div>s: This study aimed to identify recurrence and prognostic factors in patients with resectable pancreatic cancer (RPC) that may define biological borderline resectable pancreatic cancer (BRPC).</div></div><div><h3>Methods</h3><div>This retrospective study included 162 patients with R/BRPC who underwent upfront surgery. Univariate and multivariate analyses were performed to assess the relationship between preoperative factors and disease-free survival (DFS) and overall survival (OS) for RPC. The cutoff value for the coefficient of variation of apparent diffusion coefficient (CV_ADC) on preoperative magnetic resonance imaging was determined using receiver operating characteristic curve analysis. Surgical outcomes of patients with RPC were stratified by a score, with each independent prognostic factor assigned 1 point. The outcomes of R/BRPC patients were compared according to the score.</div></div><div><h3>Results</h3><div>Of the patients, 145 had RPC, and 17 had BRPC. In RPC patients, serum CA19-9 &gt;500 U/mL (<em>p</em> = 0.03) and CV_ADC ≥ 0.1 (<em>p</em> = 0.003) were independent recurrence factors, while serum CA19-9 &gt;500 U/mL (<em>p</em> = 0.03), superior mesenteric vein/portal vein contact &lt;180° (<em>p =</em> 0.03), and CV_ADC ≥ 0.1 (<em>p &lt;</em> 0.001) were independent prognostic factors. RPC patients with a score of 0 had significantly better prognoses than those with scores of 1 or 2–3, and BRPC patients (median DFS: 35.0, 9.8, 9.0, and 7.0 months; median OS: 80.7, 26.5, 16.8, and 17.6 months, respectively). No significant difference in prognosis was found between BRPC patients and RPC patients with scores of 1 or 2–3.</div></div><div><h3>Conclusions</h3><div>Preoperative CV_ADC in RPC may be a new recurrence and prognostic factor defining biological BRPC.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102270"},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679290","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":"Shear wave elastography combined with high-frequency ultrasound for predicting the presence of occult carcinoma contralateral to unilateral papillary thyroid cancer","authors":"Shu-ni Jia ,&nbsp;Dong Wang ,&nbsp;Zhe-xia Zhao ,&nbsp;Ting-ting Xue","doi":"10.1016/j.suronc.2025.102267","DOIUrl":"10.1016/j.suronc.2025.102267","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the correlation between high-frequency ultrasound (US) signs and shear wave elastography (SWE) parameters of papillary thyroid carcinoma (PTC) in a unilateral lobe and the contralateral lobe occult PTC, and to evaluate the value of SWE in combination with high-frequency US in predicting contralateral occult carcinoma of the thyroid gland preoperatively, to provide clinicians with assistance in the selection of preoperative surgical approaches.</div></div><div><h3>Methods</h3><div>We collected a total of 552 preoperatively diagnosed patients with unilateral thyroid carcinoma and postoperatively pathologically confirmed PTC. High-frequency US and SWE were performed before surgery. Based on the pathologic findings, they were divided into the contralateral occult PTC positive group and the negative group. To investigate the association between the ultrasonographic features of unilateral PTC and the presence of contralateral occult carcinoma by univariate and multivariate analyses, and comparing the accuracy of high-frequency US alone, SWE alone, and SWE combined with high-frequency US in predicting contralateral occult PTC.</div></div><div><h3>Results</h3><div>Univariate analysis showed that the differences between the two groups of extrathyroidal extension (ETE), ipsilateral multifocality, the combination of Hashimoto's thyroiditis (HT), the combination of lymph node metastasis, and Emax and Emean values of the primary tumors were statistically significant (<em>P</em> &lt; 0.05). The multifactorial binary logistic regression model showed that the differences between the two groups of extrathyroidal extension, ipsilateral multifocality, lymph node metastasis, HT and high Emax value were all independent predictors of contralateral occult PTC. The ROC curve analysis showed no statistically significant difference between high-frequency ultrasound and SWE in predicting the AUC of contralateral occult PTC (0.739 vs 0.699,<em>P</em> = 0.185). The AUC for predicting contralateral occult PTC using high-frequency US combined with SWE was significantly higher than the AUC predicted using high-frequency US and SWE alone (0.794 vs 0.739, <em>P</em> = 0.005; 0.794 vs 0.699,<em>P</em> &lt; 0.001)</div></div><div><h3>Conclusion</h3><div>SWE combined with high-frequency US improves the prediction of contralateral occult PTC, and the presence of contralateral occult PTC is more likely in the presence of extrathyroidal extension of a unilateral lobe lesion of the thyroid gland, ipsilateral multifocality, metastasis to cervical lymph nodes, high Emax, and the combination of HT.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102267"},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665915","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":"Sliced liver hepatectomy: a new type of scaffold-sparing hepatectomy for multiple bilobar colorectal liver metastases.","authors":"Guido Torzilli, Jacopo Galvanin, Giulia Mauri, Guido Costa, Bruno Branciforte, Flavio Milana, Angela Palmisano, Fabio Procopio","doi":"10.1016/j.suronc.2025.102254","DOIUrl":"https://doi.org/10.1016/j.suronc.2025.102254","url":null,"abstract":"<p><strong>Background: </strong>This intention-to-treat study evalutates the feasibility of a new technical solution for patients with multiple bilobar colorectal liver metastases (CLM) characterised by a peculiar intra-organ distribution named Sliced Liver Hepatectomy (SLH).</p><p><strong>Study design: </strong>Patients with CLMs spread in two main clusters were eligible for SLH: an upper cluster involving postero-superior segments (S2-4s-7-8) with at least two hepatic veins contact/invasion at the caval confluence and a lower cluster in S3-4i-5-6 with lesions in contact with the 1st-2nd order glissonean pedicle (Gp).</p><p><strong>Results: </strong>Between 2019 and 2023, 11 patients underwent SLH. 262 CLMs (median 19) were removed: 148 (56 %) in the upper cluster and 114 (44 %) in the lower one. Thirty-six CLM had vascular contact (median 3): 17 with HV (47 %) and 19 with Gp (53 %). 11 (65 %) HV-detachment, five (29 %) HV tangential resection with direct suture reconstruction were performed and one patient (6 %) required the section of HV. All CLM within the lower clusters were detached from Gp. Major complication and mortality were nil. Three patients (27 %) developed a mild postoperative liver failure. After a median follow-up of 21 months, all patients are alive and 7 (63 %) had hepatic recurrence: re-resection in 4 (57 %), percutaneous ablation in one (14 %), and systemic therapy in the remaining 2 (29 %). At six months, median liver-volume growth ratio was 88 % compared with the post-resectional volume.</p><p><strong>Conclusion: </strong>SLH is a new parenchyma-sparing procedure for patients with multiple bilobar CLMs. This first release described the technical clues, showed its feasibility, relative safety, and its related high salvageability in case of relapse.</p>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":" ","pages":"102254"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676444","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":"Effect of antiviral treatment for hepatitis C virus on long-term outcomes in patients undergoing resection for hepatocellular carcinoma","authors":"Hiroyuki Hakoda,&nbsp;Yoshikuni Kawaguchi,&nbsp;Yujiro Nishioka,&nbsp;Yuichiro Mihara,&nbsp;Akihiko Ichida,&nbsp;Takeshi Takamoto,&nbsp;Nobuhisa Akamatsu,&nbsp;Kiyoshi Hasegawa","doi":"10.1016/j.suronc.2025.102255","DOIUrl":"10.1016/j.suronc.2025.102255","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis C virus infection is a risk factor for hepatocellular carcinoma (HCC). The effect of direct-acting antivirals on prognoses remains unclear. We assessed the prognosis of patients receiving direct-acting antiviral and interferon treatment after the initial resection of hepatitis C virus-related HCC.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who underwent initial hepatitis C virus-related HCC resection at The University of Tokyo Hospital between June 2009 and December 2022. Recurrence-free survival (RFS) and overall survival (OS) were assessed using the log-rank test. Cox proportional hazards model analysis was performed to identify the risk factors for RFS and OS.</div></div><div><h3>Results</h3><div>Of 756 patients who underwent HCC resection, 142 had hepatitis C virus-related HCC. Among them, the 5-year OS was significantly better in those receiving antiviral treatment than in those without antiviral treatment (72.2 % vs. 48.9 %, P &lt; 0.001); however, RFS did not differ between the groups (P = 0.35). RFS and OS did not differ significantly between patients who received direct-acting antivirals and those who received interferon (P = 0.09 and P = 0.47, respectively). RFS and OS did not differ significantly between patients receiving antiviral treatment before surgery and those after surgery (P = 0.11 and P = 0.23, respectively).</div></div><div><h3>Conclusions</h3><div>Antiviral treatment improved postoperative prognosis; however, the prognosis did not differ between the types of antiviral treatment in patients with hepatitis C virus-related hepatocellular carcinoma.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102255"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588412","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 Qaly study: Quality of life and lower extremity lymphedema in 174 patients after inguinal lymphadenectomy","authors":"Brett A. Hahn ,&nbsp;Alieske Kleeven ,&nbsp;Milan C. Richir ,&nbsp;Arjen J. Witkamp ,&nbsp;Anke M.J. Kuijpers ,&nbsp;Kristien B.M.I. Keymeulen ,&nbsp;J. Henk Coert ,&nbsp;Shan Shan Qiu ,&nbsp;David D. Krijgh","doi":"10.1016/j.suronc.2025.102257","DOIUrl":"10.1016/j.suronc.2025.102257","url":null,"abstract":"<div><h3>Background</h3><div>Lower extremity lymphedema (LEL) can develop in patients who undergo inguinal lymph node dissection (ILND) in the treatment of gynecologic, genitourinary, and skin and soft tissue malignancies. While LEL can negatively impact quality of life, the poorly documented prevalence and severity of lymphedema-related symptoms complicates the ability to identify high-risk patients and improve the selection of candidates for emerging microsurgical interventions.</div></div><div><h3>Methods</h3><div>This multicenter, cross-sectional study included patients who underwent ILND between 1990 and 2022 across three medical centers in the Netherlands. Retrospective clinical data, including demographic, surgical, and postoperative variables, were abstracted from medical records. Lymphedema prevalence and severity were assessed using the Lymph-ICF-LL questionnaire, while additional patient-reported outcome measures (PROMs) evaluated quality of life and lower extremity function. Statistical analyses included multivariate logistic and linear regression to identify predictors of lymphedema-related symptoms and their impact on PROMs.</div></div><div><h3>Results</h3><div>Among 174 patients who underwent ILND, 77 % reported lymphedema-related symptoms, which were associated with significantly lower quality of life. Multivariable analysis identified that younger age at time of surgery, medical history of cardiovascular disease, and postoperative complications such as surgical site infections (SSI) and prolonged wound healing were significant predictors of developing lymphedema-related symptoms. Additionally, the presence of lymphedema was strongly linked to poorer physical and mental health PROMs, with malignancy type and surgical factors influencing these outcomes.</div></div><div><h3>Conclusion</h3><div>This study emphasizes the significant burden of lymphedema-related symptoms following ILND, while highlighting the potential role of reconstructive microsurgery in reducing morbidity for high-risk patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102257"},"PeriodicalIF":2.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588534","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":"Trend shift from autologous to implant-based breast reconstruction","authors":"Ekaterina Nedeoglo ,&nbsp;Philipp Moog ,&nbsp;Jun Jiang ,&nbsp;Inessa Suhova ,&nbsp;Hans-Günther Machens ,&nbsp;Kai Megerle ,&nbsp;Haydar Kükrek","doi":"10.1016/j.suronc.2025.102256","DOIUrl":"10.1016/j.suronc.2025.102256","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most common type of cancer in women and advances in treatment have shifted the focus towards improving quality of life. Breast reconstruction plays a crucial role in preserving body image for patients undergoing mastectomy. However, significant variations exist in breast reconstruction choices across different countries. Understanding national trends can help optimize patient-centered care.</div></div><div><h3>Methods</h3><div>Using data from quality reports, we analyzed breast reconstruction trends in Germany from 2012 to 2021. The study examined overall reconstruction rates, the distribution of reconstruction methods (implant-based vs. autologous), and differences between surgical departments.</div></div><div><h3>Results</h3><div>Breast reconstruction rates in Germany have steadily increased, with up to 38 % of mastectomy patients undergoing reconstruction. The number of implant-based reconstructions rose significantly by nearly 70 % during this period. Most reconstructions were performed in gynecology departments, where the highest increase in implant-based procedures was observed.</div></div><div><h3>Conclusion</h3><div>The reasons for the shift towards implant-based reconstruction are speculative. The increase in contralateral prophylactic mastectomies, the lack of collaboration with plastic surgery departments and the complexity of autologous breast reconstruction could all be plausible explanations for this observation. Further analysis and critical evaluation of current trends are essential to ensure an individualized, patient-centered approach to breast reconstruction surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102256"},"PeriodicalIF":2.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597180","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":"Does Tilmanocept based lymphoscintigraphy measure up against colloid-based lymphoscintigraphy for sentinel node biopsy in melanoma and early oral squamous cell cancer?","authors":"Giuleta Jamsari ,&nbsp;Eva Wong ,&nbsp;Gopi Elango ,&nbsp;Michael Veness ,&nbsp;Bradley Camden ,&nbsp;David Farlow ,&nbsp;Muzib Abdul-Razak","doi":"10.1016/j.suronc.2025.102258","DOIUrl":"10.1016/j.suronc.2025.102258","url":null,"abstract":"<div><h3>Objective</h3><div>Sentinel lymph node biopsy (SLNB) is crucial in cutaneous melanoma and oral cavity squamous cell carcinoma (OCSCC) as it directs the need for systemic therapy. There has been growing interest in Technetium-99m-labeled Tilmanocept (TL) due to its specific binding capability. This study compares the efficacy of TL to ^99mTc-antimony sulphide colloid (ASC), in these two biologically distinct cancers.</div></div><div><h3>Design</h3><div>In this prospective cross-sectional study, 40 patients were included in each radiotracer group. The primary outcomes measured SN identification rate on lymphoscintigraphy and surgical node retrieval rate. Secondary outcomes include pathological status of lymph nodes, false negative rates (FNR), and nodal recurrence.</div></div><div><h3>Result</h3><div>TL had comparable outcome to ASC with a 100 % SN detection and retrieval rate. Both radiotracers had 100 % lymph nodal tissue specificity with an FNR rate of 0 % for both radiotracers in CM and 25 % for TL in OCSCC. There were significant differences between the SN detection and retrieval rates in ASC in CM and OCSCC but not TL, reflecting its superior binding capability.</div></div><div><h3>Conclusion</h3><div>Our study is the first to demonstrate the superior molecular binding capability of TL with minimal migration to the second echelon nodes.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102258"},"PeriodicalIF":2.3,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597181","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":"Skeletal muscle and visceral fat density are predictive imaging biomarkers for overall survival in patients with pancreatic adenocarcinoma: A retrospective multicenter analysis","authors":"Maike Theis ,&nbsp;Wei Hong ,&nbsp;Belinda Lee ,&nbsp;Sebastian Nowak ,&nbsp;Julian Luetkens ,&nbsp;Stephen Stuckey ,&nbsp;Peter Gibbs ,&nbsp;Benjamin Thomson ,&nbsp;Michael Michael ,&nbsp;Alois Martin Sprinkart ,&nbsp;Hyun Soo Ko","doi":"10.1016/j.suronc.2025.102251","DOIUrl":"10.1016/j.suronc.2025.102251","url":null,"abstract":"<div><h3>Rationale and objectives</h3><div>Utilizing a fully automated AI-generated body composition analysis (BCA) from PDAC staging computed tomography (CT) imaging to discover predictive imaging biomarkers for overall survival (OS).</div></div><div><h3>Material and methods</h3><div>Routine PDAC staging CTs (07/2012–12/2020) and clinicopathological data (Eastern Cooperative Oncology Group (ECOG) performance status, resection status, chemotherapy, age, CA19–9, Charlson Comorbidity Index, BMI) from four tertiary centers were collected retrospectively. Using a 3:1 split (training:holdout), we fitted Cox regression OS using every possible combination of 7 clinicopathological and 9 BCA variables: skeletal muscle index (SMI), area and density of total muscle compartment (TMC), skeletal muscle (SM), subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and selected the combination with the lowest information complexity (ICOMP). The added value of BCA was calculated by comparing the BCA model with the base model (without BCA variables).</div></div><div><h3>Results</h3><div>Analysis included 472 PDAC patients (213 female, mean age 67.9 ± 11.5 years, resectable n = 170, unresectable n = 106, metastatic n = 196). Four clinicopathological (ECOG, resection status, chemotherapy, CA19–9) and 5 BCA variables (SMI, SM density, VAT density, TMC area, VAT area) were selected. Decreased SM density (myosteatosis) and increased VAT density showed strong association with OS (p = 0.0094 and 0.0019, respectively). The BCA model showed superior performance compared to the base model in all subgroups (AUC: resectable 0.76 versus 0.70, unresectable 0.76 versus 0.69, and metastatic 0.80 versus 0.75).</div></div><div><h3>Conclusion</h3><div>BCA-identified myosteatosis and increased VAT density to be predictive imaging biomarkers for OS in all PDAC subgroups, potentially adding value to upfront risk stratification.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102251"},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480295","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}