Surgical Oncology-Oxford最新文献

{"title":"Risk reduction bilateral salpingo-oophorectomy with vNOTES: A new era in cancer prevention strategies","authors":"Maria Pellisé-Tintoré ,&nbsp;Thomas Gaillard ,&nbsp;Enora Laas ,&nbsp;Virginie Fourchotte ,&nbsp;Hélène Didelot ,&nbsp;Lea Pauly ,&nbsp;Jean Guillaume Feron ,&nbsp;Fabien Reyal ,&nbsp;Fabrice Lecuru","doi":"10.1016/j.suronc.2025.102349","DOIUrl":"10.1016/j.suronc.2025.102349","url":null,"abstract":"<div><h3>Introduction</h3><div>Women with BRCA1 and BRCA2 mutations face a significantly increased lifetime risk of developing ovarian and fallopian tube cancer. Minimally invasive techniques are the gold standard access to perform risk-reduction operations. This study aims to evaluate the feasibility and safety of prophylactic bilateral salpingo-oophorectomy using the vaginal natural orifice transluminal endoscopic surgery (vNOTES) technique as a risk-reduction strategy.</div></div><div><h3>Material and methods</h3><div>A prospective study was conducted between October 2023 and December 2024, involving 25 high-risk women at an international, university-affiliated cancer center. All patients underwent prophylactic bilateral salpingo-oophorectomy via transvaginal access using vNOTES. Key data collected included age, BMI, operative time, and blood loss, with primary outcomes focusing on feasibility, complications, and recovery.</div></div><div><h3>Results</h3><div>Twenty-five BRCA-mutated patients underwent prophylactic bilateral adnexectomy via vNOTES. Median age was 48 years (range 41–59) and median BMI 24.1 kg/m² (range 19.1–30.4). All procedures were completed without conversion to laparoscopy or laparotomy, and vNOTES enabled full abdominal exploration. Median operative time was 40 min (IQR 32–44), with minimal blood loss (&lt;100 mL in 96 %) and no intraoperative complications. Postoperative recovery was uneventful, with no pain reported and 96 % of patients discharged the same day. No late complications related to the surgical technique were observed.</div></div><div><h3>Conclusion</h3><div>Prophylactic bilateral salpingo-oophorectomy using the vNOTES technique appears to be a feasible and safe option for reducing the risk of ovarian and fallopian tube cancers in high-risk women. Further studies with larger cohorts are needed to validate these findings.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102349"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936141","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 impact of the timing of adjuvant treatment initiation in patients with upfront resection of pancreatic cancer","authors":"Sydney McManus ,&nbsp;Aimée Galatas ,&nbsp;Sarah Hemelt ,&nbsp;Sanchit Sachdeva ,&nbsp;Kevin Sullivan ,&nbsp;Bolni Marius Nagalo ,&nbsp;Denise Danos ,&nbsp;Omeed Moaven","doi":"10.1016/j.suronc.2025.102329","DOIUrl":"10.1016/j.suronc.2025.102329","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluates the association between timing of adjuvant chemotherapy and overall survival in resectable pancreatic ductal adenocarcinoma (PDAC). It also examines whether the adoption of modern chemotherapy regimens in recent years has influenced this relationship, reflecting evolving treatment practices.</div></div><div><h3>Methods</h3><div>Cases of resectable primary invasive PDAC were identified using the National Cancer Database (NCDB). Overall survival (OS) was visualized using Kaplan Meier survival plots and Cox proportional hazard models. Covariat adjustment and propensity score matched cohort were analyzed. The matched cohort was analyzed with Cox proportional hazard models and logistic models.</div></div><div><h3>Results</h3><div>31,949 patients were included in the study. 26.4 % received no chemotherapy, 66.4 % received chemotherapy within 12 weeks, and 7.2 % received chemotherapy after 12 weeks. There was significant improvement in mOS. Between 2015 and 2019, there was a significant difference in OS for patients receiving chemotherapy within 12 weeks, compared to &gt;12 weeks.</div></div><div><h3>Conclusion</h3><div>While adjuvant chemotherapy in patients with resectable PDAC is associated with improved OS compared to no adjuvant therapy, it is worth considering that those who are well enough to receive chemotherapy inherently have better prognoses. Importantly, the survival association persists regardless of the timing of chemotherapy initiation, suggesting that late administration of adjuvant chemotherapy may still be beneficial in appropriately selected patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102329"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528651","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":"Cranial-to-caudal approach in laparoscopic surgery for left-sided colon cancer: Longer specimens and higher lymph node yield","authors":"Beslen Goksoy ,&nbsp;Cem B. Ofluoglu ,&nbsp;Ibrahim F. Azamat ,&nbsp;Gorkem Uzunyolcu ,&nbsp;Serra Z. Akkoyunlu ,&nbsp;Ilker Ozgur ,&nbsp;Feza Ekiz","doi":"10.1016/j.suronc.2026.102354","DOIUrl":"10.1016/j.suronc.2026.102354","url":null,"abstract":"<div><h3>Background</h3><div>Medial-to-lateral (ML) approach is the standard technique in laparoscopic surgery for left-sided colon cancer. However, it can be technically challenging; such as in patients with intra-abdominal adhesions or during splenic flexure mobilization. To overcome these difficulties, we adopted a cranial-to-caudal (CC) approach as an alternative technique. This study aimed to compare the CC and ML approaches in terms of short-term clinical and mid-term oncological outcomes.</div></div><div><h3>Methods</h3><div>Patients performed laparoscopic surgery for left-sided colon cancer between October 2018 and November 2022 were retrospectively analyzed. Patients were classified into two groups. The primary outcome was the length of the resected specimen. Secondary outcomes were pathological parameters, perioperative outcomes, recurrence-free survival (RFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>Seventy-four patients were included (ML, n = 39; CC, n = 35). The CC group had longer specimen lengths compared with the ML group (32.9 ± 6.8 cm vs 28.9 ± 6.4 cm; p = 0.022), and longer proximal margin (11.8 ± 3.3 cm vs 9.9 ± 2.3 cm; p = 0.004). Lymph node yield was also higher in the CC group (26.4 ± 8.7 vs 22.3 ± 6.5; p = 0.033). On multivariable analysis, specimen length was independently associated with lymph node yield (β = 0.73; 95% CI, 0.47–1.20; p &lt; 0.001). During a mean follow-up of 44 months, RFS (88.6% vs 89.7%; p = 0.84) and OS (88.6% vs 87.2%; p = 0.67) were similar between the groups.</div></div><div><h3>Conclusions</h3><div>In laparoscopic surgery for left-sided colon cancer, the CC approach yielded longer resected specimens and more lymph node counts compared with the ML approach, but did not improve oncologic outcomes.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102354"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127192","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 management of primary hepatic neuroendocrine tumors: A 20-year population-based analysis","authors":"Alexandra H. Helbing ,&nbsp;Tony Boualoy ,&nbsp;Ambria S. Moten","doi":"10.1016/j.suronc.2026.102358","DOIUrl":"10.1016/j.suronc.2026.102358","url":null,"abstract":"<div><h3>Background</h3><div>Primary hepatic neuroendocrine tumors (PHNETs) are rare neoplasms with limited population-level data to guide treatment. We evaluated clinical, pathologic, and treatment factors associated with surgical intervention and survival using a contemporary national cohort.</div></div><div><h3>Methods</h3><div>Patients diagnosed with PHNETs from 2000 to 2021 were identified within the Surveillance, Epidemiology, and End Results (SEER) database. Demographic, tumor, and treatment characteristics were analyzed. Multivariable logistic regression identified predictors of surgical resection. Kaplan-Meier and Cox models evaluated overall survival (OS) and cause-specific survival (CSS).</div></div><div><h3>Results</h3><div>A total of 669 patients met inclusion criteria. Surgical resection was performed in 16.4 % of cases. Compared with localized disease, regional disease was associated with significantly lower odds of surgery (OR 0.25, 95 % CI: 0.14–0.45). Ten-year OS was 21.8 % for localized, 12.5 % for regional, and 4.8 % for distant disease (p &lt; 0.001). Well differentiated tumors were associated with superior 5- and 10-year OS and CSS compared to poorly differentiated tumors (p &lt; 0.001). Among patients with localized or regional disease, surgical resection was associated with a 10-year OS of 44.9 % versus 9.2 % without surgery (p &lt; 0.001). On multivariable analysis, poorly differentiated histology (HR 2.69, 95 % CI: 1.93–3.77) and larger tumor size (HR 1.01, 95 % CI: 1.00–1.01) were associated with increased mortality, while surgical resection remained protective (HR 0.23, 95 % CI: 0.15–0.37).</div></div><div><h3>Conclusions</h3><div>Surgical resection is associated with significantly improved survival in patients with localized or regional PHNETs. Tumor grade, stage, and size remain key prognostic factors in this rare malignancy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102358"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101092","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":"Histologic subtypes and divergent differentiations of urothelial carcinoma: Prognostic implications and clinical insights","authors":"Kadir Can Sahin ,&nbsp;Muhammed Fatih Simsekoglu ,&nbsp;Sami Berk Ozden ,&nbsp;Birgi Ercili ,&nbsp;Ahmet Vural ,&nbsp;Iclal Gurses ,&nbsp;Cetin Demirdag","doi":"10.1016/j.suronc.2025.102344","DOIUrl":"10.1016/j.suronc.2025.102344","url":null,"abstract":"<div><h3>Introduction</h3><div>Bladder cancer is a major global health concern, and urothelial carcinoma (UC) often presents with diverse histologic subtypes and differentiations associated with aggressive behavior and poorer survival with no standardized treatment recommendations. This study aimed to compare clinicopathologic characteristics and survival outcomes between patients with histologic/divergent UC subtypes and those with pure UC at initial presentation.</div></div><div><h3>Patients and methods</h3><div>We retrospectively analyzed 506 patients with de novo UC identified at initial transurethral resection of the bladder (TUR-BT) between 2015 and 2023. Demographic and clinical characteristics, pathologic features, treatment strategies, and survival outcomes were compiled and compared between groups. Treatment strategies, including radical cystectomy and neoadjuvant chemotherapy, were also evaluated to examine how histologic subtypes influenced clinical decision-making.</div></div><div><h3>Results</h3><div>Median follow-up period was 71 months (95 % CI, 68.0–74.0). Patients with histologic subtypes and divergent differentiations demonstrated significantly more aggressive tumor features at diagnosis, including higher rates of muscle invasion (46.1 % vs. 28.8 %, p &lt; 0.001) and lymphovascular invasion (LVI) (38 % vs. 13.5 %, p &lt; 0.001). Both overall survival (OS) and metastasis-free survival (MFS) were significantly worse in the UC with histologic subtype and differentiation group (five-year OS: 48.1 % vs. 73.1 %, p &lt; 0.001; five-year MFS: 58.3 % vs. 87.4 %, p &lt; 0.001). In multivariate analyses, presence of histologic subtypes and LVI were independently associated with poorer OS and MFS across all models. Age remained a significant factor for OS in all categories. ASA score ≥2 and surgical margin positivity were also associated with OS in the overall and muscle invasive patient cohorts.</div></div><div><h3>Conclusion</h3><div>Histologic subtypes of UC are associated with more aggressive clinicopathologic features and significantly worse survival outcomes. Early and accurate recognition of these subtypes and divergent differentiations at initial TUR-BT is critical, highlighting the need for tailored management strategies to improve patient prognosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102344"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883305","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":"Usefulness and safety of salvage surgery with reconstruction for recurrent head and neck cancer with a history of reconstruction surgery and radiation therapy","authors":"Saki Akita ,&nbsp;Masashi Kuroki ,&nbsp;Ryota Iinuma ,&nbsp;Tatsuhiko Yamada ,&nbsp;Ryo Kawaura ,&nbsp;Hiroshi Okuda ,&nbsp;Kousuke Terazawa ,&nbsp;Kenichi Mori ,&nbsp;Hirofumi Shibata ,&nbsp;Natsuko Obara ,&nbsp;Keishi Kohyama ,&nbsp;Hisakazu Kato ,&nbsp;Takenori Ogawa","doi":"10.1016/j.suronc.2025.102340","DOIUrl":"10.1016/j.suronc.2025.102340","url":null,"abstract":"<div><h3>Background</h3><div>Salvage surgery is one of the treatment options for recurrent metastatic head and neck cancer (RMHNC). Salvage surgery with reconstruction for patients with a history of reconstructive surgery and radiation therapy (RT) is especially difficult and carries a high risk of complications.</div></div><div><h3>Methods</h3><div>This study included patients with RMHNC who had a history of reconstructive surgery and RT. The prognosis and complications were evaluated by dividing patients into those who underwent salvage surgery with reconstruction and those who underwent non-surgical treatments.</div></div><div><h3>Results</h3><div>Fifty-seven patients were enrolled. The overall survival (OS) of the salvage surgery with reconstruction group was better than that of the non-surgical treatment groups (median OS; 50.6 months vs. 21.6 months, p = 0.0373), but the progression-free survival (PFS) was similar (median PFS; 14.5 months vs. 12.9 months, p = 0.48). The salvage surgery with reconstruction group also showed a better prognosis than the immune checkpoint inhibitor (ICI) group (median OS; 50.6 months vs. 30.9 months, p = 0.209). In the salvage surgery with reconstruction group, 85.8 % of cases experienced postoperative complications, while in the patients who underwent non-surgical treatments, 58.8 % experienced adverse events (p = 0.0724). There were no cases of Grade IIIb or higher that required general anesthesia.</div></div><div><h3>Conclusion</h3><div>Salvage surgery with reconstruction showed a better prognosis than other non-surgical treatments, including ICI. Furthermore, with careful case selection and thorough postoperative care, salvage surgery with reconstruction can be performed relatively safely without any serious complications.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102340"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795647","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":"Analysis of the clinicopathological relevance and prognostic value of CDK1 in human malignancy: Insights from meta and bioinformatics analysis","authors":"Mehran Pashirzad ,&nbsp;Alexandra E. Butler ,&nbsp;Prashant Kesharwani ,&nbsp;Amirhossein Sahebkar","doi":"10.1016/j.suronc.2025.102339","DOIUrl":"10.1016/j.suronc.2025.102339","url":null,"abstract":"<div><div>We conducted a comprehensive assessment of the prognostic significance of CDK1 expression in patients diagnosed with cancer. Pooled hazard ratios (HRs), odds ratios (ORs), and 95 % confidence interval (CI) were calculated to determine the associations between CDK1 expression and overall survival (OS), disease-free survival (DFS), as well as various clinicopathological characteristics. A total of 20 studies, comprising 2470 patients, were included in this meta-analysis. Elevated CDK1 expression was significantly associated with reduced OS in both univariate and multivariate analyses, with pooled HRs of 1.55 (95 % CI: 1.31–1.81) and 1.89 (95 % CI: 1.52–2.36), respectively. Furthermore, higher CDK1 expression levels correlated significantly with adverse pathological features, including tumor size (OR = 1.50; 95 % CI, 1.08–2.09), lymph node metastasis (LNM; OR = 2.41; 95 % CI, 1.69–3.44), higher histological grade (OR = 2.40; 95 % CI, 1.69–3.39) and advanced tumor stage (OR = 1.76; 95 % CI, 1.25–2.48). These findings suggest that CDK1 over-expression may serve as a robust prognostic biomarker associated with unfavorable clinical outcomes in patients with cancer.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102339"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796661","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":"Perioperative outcomes after robotic repeat hepatectomy: A systematic review","authors":"Gianluca Cassese ,&nbsp;Fabrizio Panaro ,&nbsp;Fabio Giannone ,&nbsp;Mariantonietta Alagia ,&nbsp;Marco Palucci ,&nbsp;Cristina Ciulli ,&nbsp;Alessandro Fogliati ,&nbsp;Mattia Garancini ,&nbsp;Mauro Alessandro Scotti ,&nbsp;Fabio Benedetti ,&nbsp;Fabrizio Romano","doi":"10.1016/j.suronc.2025.102342","DOIUrl":"10.1016/j.suronc.2025.102342","url":null,"abstract":"<div><h3>Background</h3><div>Robotic liver resection has widely spread in hepatopancreatobiliary surgery, with growing evidence even in challenging scenarios. However, the results of robotic hepatectomy in patients who have had previous liver operations (repeat Robotic Liver Resections, r-RLR) have not been deeply investigated so far.</div></div><div><h3>Methods</h3><div>A systematic review of the MEDLINE and SCOPUS databases was performed, including studies published until April 2025.</div></div><div><h3>Results</h3><div>A total of 4 studies including 118 patients met the inclusion criteria. Nineteen patients (16.1 %) had received 2 or more previous liver resections, with 92.4 % (n = 109) of the r-RLR that were performed for malignant lesions. Colorectal liver metastases represented the most common malignant indication (40.7 %), followed by recurrent hepatocellular carcinoma (36.4 %). Tumor size varied between 10 and 33 mm in the largest diameter. The weighted mean operative time was 200.8 min (SD: 112.3), and the weighted mean estimated blood loss was 134.3 mL (SD: 121.9). The weighted mean hospital length of stay was 4.7 days (SD: 4.7). One case of open conversion was reported (0.8 %). Six patients experienced major complications (5 %), with 1 (0.8 %) postoperative death.</div></div><div><h3>Conclusion</h3><div>Few retrospective studies investigating the outcomes of r-RLR are currently available in the literature. From published data, it may be a safe and feasible alternative to open and laparoscopic redo hepatectomy in selected patients in referral HPB centers. Further studies with larger sample sizes are needed to confirm such preliminary findings.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102342"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776510","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 management of breast cancer liver metastases: what indications and results in 2025? A narrative review","authors":"Lucia Paiano ,&nbsp;René Adam ,&nbsp;Nicolas Golse","doi":"10.1016/j.suronc.2025.102330","DOIUrl":"10.1016/j.suronc.2025.102330","url":null,"abstract":"<div><div>Breast cancer liver metastases (BCLM) have historically been treated with chemotherapy and supportive care, and long-term survival in stage IV breast cancer remains rare despite advances in systemic therapies such as chemotherapy, hormonal and targeted therapies. Since the 2000s, many trials comparing surgery and systemic therapy have improved our understanding of the management of BCLM. Prognostic factors influencing outcome include disease-free interval from primary tumor, hormone receptor status, metastatic burden and tumor biology. Molecular profiling (e.g. BRCA1/2, PIK3CA, HER2, ESR1) has further refined the response to systemic therapy, enabling personalized treatment strategies. Recent evidence highlights the prognostic impact of surgery in combination with systemic therapy in highly selected patients, with a 5-year survival rate reaching 53 %. Optimal surgical candidates may include patients with small (&lt;5 cm), solitary or easily resectable metastases, stable disease on neoadjuvant therapy and favorable tumor biology. However, preoperative imaging often underestimates tumor burden, leading to resection cancellation in ∼20 % of cases. Unlike colorectal liver metastases, BCLM rarely become resectable after systemic therapy, which is primarily aimed at disease control and reducing recurrence risk. Non-surgical interventions, including radiofrequency or microwave ablation and radioembolization, are typically reserved for patients who are ineligible for surgery due to frailty, comorbidities or challenging tumor locations. Multidisciplinary planning remains essential to optimize treatment, integrating systemic advances, tumor biology and surgical feasibility to improve long-term outcomes in the management of BCLM.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102330"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623776","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 closure of defunctioning ileostomy after low-pelvic surgery for rectal cancer: Systematic review and meta-analysis of safety and functional outcomes","authors":"Parbatraj Regmi ,&nbsp;Bikash Kumar Sah ,&nbsp;Vijay Pratap Sah ,&nbsp;Bhawani Khanal ,&nbsp;Abhijeet Kumar ,&nbsp;Tomas Janusonis ,&nbsp;Zygimantas Juodeikis ,&nbsp;Darius Cincikas ,&nbsp;Alfredas Kilius ,&nbsp;Narimantas Evaldas Samalavicius ,&nbsp;Rakesh Kumar Gupta","doi":"10.1016/j.suronc.2025.102326","DOIUrl":"10.1016/j.suronc.2025.102326","url":null,"abstract":"<div><h3>Background</h3><div>Preventive defunctioning ileostomy is widely used to prevent leaks in high-risk colorectal anastomosis, but here is no international consensus on the timing of stoma reversal. In this study we aim to evaluate the safety and functional outcomes of early versus late defunctioning ileostomy after low-pelvic surgery for rectal cancer.</div></div><div><h3>Methods</h3><div>Systematic literature search was performed in multiple electronic databases until September 30, 2025. Meta-analysis and trial-sequantial analysis (TSA) were performed using the RevMan 5.4 and Copenhagen Trial Unit TSA software.</div></div><div><h3>Results</h3><div>There was no significant difference in overall postoperative morbidity, major morbidity, operation time, blood loss, incidence of postoperative ileus/bowel obstruction, length of stay (LOS), and reoperation rate between two groups. Functional outcomes like the incidence of major low anterior resection syndrome (LARS) and the minor LARS were also similar in two groups.</div></div><div><h3>Conclusion</h3><div>There is no increased risk of morbidity with early closure of defunctioning ileostomy after colorectal cancer surgery and the functional outcomes were also similar. Therefore, early reversal may be a safe and feasible approach in precisely selected cases when the clinician feels supported in doing so.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102326"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623777","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}