Surgical Oncology-Oxford最新文献

{"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 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":"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}

{"title":"Delayed surgery during the Covid-19 pandemic did not affect long-term outcomes of pancreatic adenocarcinoma","authors":"A. Hamadalnile ,&nbsp;M. Mariathasan ,&nbsp;Mahmud Riad ,&nbsp;A.G. Patel ,&nbsp;S. Atkinson ,&nbsp;A.A. Prachalias ,&nbsp;P. Srinivasan ,&nbsp;L. Jiao ,&nbsp;R.H. Bhogal ,&nbsp;K. Menon ,&nbsp;C. Schneider","doi":"10.1016/j.suronc.2024.102169","DOIUrl":"10.1016/j.suronc.2024.102169","url":null,"abstract":"<div><h3>Background</h3><div>During the Covid-19 pandemic cancer surgery was severely affected due to relocation of healthcare resources and the resulting restructuring of cancer pathways. Although this potentially affected rapidly progressing malignancies like pancreatic cancer the most, little is known about long-term outcomes following pancreatectomy.</div></div><div><h3>Materials and methods</h3><div>Survival data from two pancreatic surgery centres in the UK was analysed with patients being compared across pre-pandemic (C19-) and intra-pandemic (C19+) groups. Demographic, pathological and surgical pathway parameters were evaluated with multivariate analysis and propensity score matching.</div></div><div><h3>Results</h3><div>Out of 123 patients, 60 had surgery during the pandemic. The main strategy to reduce disruptions to pancreatic surgery was relocation of services to private sector facilities without emergency medicine departments. Although time to surgery was delayed by almost 20 days during the pandemic, there were no significant differences in overall survival at 22 months vs. 24 months or disease free survival at 15 months vs. 16 months for the C19+ and C19- groups, respectively. Adjuvant chemotherapy, Charlson comorbidity score, tumour stage and resection margin status were found to be independent predictors for overall survival whereas only adjuvant chemotherapy and Charlson comorbidity score were predictive of disease free survival.</div></div><div><h3>Conclusion</h3><div>This article provides a template for the effective restructuring of pancreatectomy pathways during a pandemic with associated lockdowns and provides the first evidence that the quality of outcomes can be maintained in this difficult environment. It is hoped that these results will provide a framework for addressing surgical oncology challenges in future pandemics.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102169"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy, safety, and oncological outcomes of percutaneous thermal and chemical ablation modalities for recurrent metastatic cervical lymphadenopathy from thyroid cancer","authors":"Eman A. Toraih ,&nbsp;Siva Paladugu ,&nbsp;Rami M. Elshazli ,&nbsp;Mohammad M. Hussein ,&nbsp;Hassan Malik ,&nbsp;Humza Pirzadah ,&nbsp;Ahmed Abdelmaksoud ,&nbsp;Salem I. Noureldine ,&nbsp;Emad Kandil","doi":"10.1016/j.suronc.2024.102180","DOIUrl":"10.1016/j.suronc.2024.102180","url":null,"abstract":"<div><h3>Background</h3><div>Thermal and chemical ablation techniques may consolidate recurrent metastatic cervical lymph nodes as alternatives to repeat neck dissection in thyroid cancer patients. This meta-analysis aims to compare the efficacy and safety across modalities.</div></div><div><h3>Methods</h3><div>Four databases were searched for studies on radiofrequency (RFA), microwave (MWA), laser (LA), and ethanol ablation (EA) treating metastatic cervical nodes from thyroid cancer. The outcomes analyzed included treatment response, oncologic control, and complications. Random effects meta-analytical pooling was conducted.</div></div><div><h3>Results</h3><div>There were 25 studies (n = 1061 nodes) examining the four ablation methods. Patients showed comparable baseline characteristics and initial lymph node sizes ranging from 0.96 to 1.28 cm. All modalities achieved substantial node volume reduction (88.4 %) and disappearance (62.8 %), with significant biochemical decline (from 6.01 to 1.13 ng/ml, <em>p</em> = 0.18 between groups). MWA showed the highest volume reduction (99.4 %) and disappearance rate (87.6 %) versus slower efficacy of RFA (93.0 %, 72.1 %), LA (77.9 %, 62.5 %), and EA (81.8 %, 58.4 %). New malignancy/metastases risks ranged from 0.03 % to 1.3 % without between-group differences (<em>p</em> = 0.52). Major complications were absent; transient voice changes (0.05%–10.6 %) and neck pain (0.0%–5.9 %) were the main overall complaints. However, overall complication rates significantly varied by modality (1.1%–10.6 %; <em>p</em> = 0.003).</div></div><div><h3>Conclusions</h3><div>Thermal and chemical ablation is effective in controlling the metastatic disease burden in patients with thyroid cancer, offering a potentially less morbid and non-surgical alternative to re-operation. Additional prospective data could confirm the long-term equivalent of revision neck dissection and stratify patients based on concomitant Hashimoto's and genomic mutations. Clarifying optimal patient selection and standardizing prognostic indexing could further enhance utilization.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102180"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856605","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":"Impact of structured surveillance of patients with esophageal cancer following surgical resection with curative intent","authors":"Friederike Baehr ,&nbsp;Johanna Teloh-Benger ,&nbsp;Alexander Damanakis ,&nbsp;Florian Gebauer ,&nbsp;Hans Schlößer ,&nbsp;Wolfgang Schroeder ,&nbsp;Christiane J. Bruns ,&nbsp;Alexander Quaas ,&nbsp;Thomas Zander","doi":"10.1016/j.suronc.2024.102184","DOIUrl":"10.1016/j.suronc.2024.102184","url":null,"abstract":"<div><h3>Background</h3><div>Esophageal cancer (EC) is a disease with a poor prognosis. While treatment options have been improved, there is no consensus for surveillance strategies following therapy with curative intent. As the incidence of EC is rising and a large fraction of patients will experience disease recurrence, the need for evidence-based treatment and optimal surveillance is evident.</div></div><div><h3>Study design</h3><div>Included were 1128 patients with esophageal and gastroesophageal junction cancer (squamous cell/adenocarcinoma) that underwent surgical resection at the University Hospital Cologne (UHC) between 2012 and 2021. Patients were retrospectively split into two groups: monitored structured surveillance at the center (n = 635) (MSS) and not monitored surveillance (n = 493) (NMS).</div></div><div><h3>Results</h3><div>In the MSS group, we identified 292 (45.98 %) cases of recurrence while 66 (13.39 %) cases of recurrence were identified in the NMS group. Overall survival (OS) was not significantly longer in MSS than in NMS, yet a positive trend can be seen (p = 0.108). Progression free survival (PFS) was significantly different between groups (p ≤ 0.05). Almost a third of recurrences diagnosed in MSS were limited to a singular location. About 35 % of recurrences in MSS were treated or were intended to be treated with local treatment options like surgery or curative intended radiotherapy, by times in combination with sensitizing chemotherapy. The correlation of time of recurrence and time of death was stronger within NMS than in MSS.</div></div><div><h3>Conclusions</h3><div>Structured surveillance leads to detection of more patients with singular recurrence but no clear sign of prolonged survival. Further prospective trials are warranted to define the clinical benefit of structured surveillance.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102184"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933310","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":"Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases: A pragmatic comparison of oncological outcomes in synchronous versus metachronous disease","authors":"Ignacio Aguirre-Allende ,&nbsp;Fernando Pereira-Pérez ,&nbsp;Israel Manzanedo-Romero ,&nbsp;Paula Fernandez-Briones ,&nbsp;María Muñoz-Martín ,&nbsp;Ángel Serrano-Moral ,&nbsp;Estibalitz Perez-Viejo","doi":"10.1016/j.suronc.2024.102183","DOIUrl":"10.1016/j.suronc.2024.102183","url":null,"abstract":"<div><h3>Background</h3><div>disease burden (PCI), completeness of cytoreduction or histological features, are known to influence survival after CRS-HIPEC for colorectal peritoneal metastases (CPM). However, there is still debate about influence of CPM onset. The aim of this study is to determine the impact of CPM onset on oncological outcomes after CRS-HIPEC.</div></div><div><h3>Methods</h3><div>all patients with CPM scheduled for CRS-HIPEC at one reference center between December 2007 and September 2022 were included. s-PM were defined as those diagnosed at primary disease treatment; m-PM were considered those diagnosed during follow-up. Survival outcomes and recurrence rates were compared using a pragmatic analysis.</div></div><div><h3>Results</h3><div>125 patients with s-CPM and 170 patients with m-CPM were analyzed. Median follow-up was 58.6 and 50.6 months in s-CPM and m-CPM groups(p = 0.11). Complete cytoreduction (CCS-0/-1) rates were comparable: 84 % s-CPM vs. 88.2 % m-CPM(p = 0.190). Overall survival (OS) was significantly shorter in s-CPM: 24.7 vs. 46.6 months (p = 0.024). Conversely, median disease-free survival was similar in both groups, 10 months vs. 11 months(p = 0.155). Patients in the s-CPM group presented more pN+(p = 0.001), higher histologic grade(p = 0.007) and PCI(p = 0.04), and higher rate of concurrent liver metastases(p = 0.004). RAS/BRAF gene mutations and microsatellite instability did not differ significantly. Perioperative chemotherapy regimens and tolerance were also similar.</div></div><div><h3>Conclusions</h3><div>despite s-CPM being associated with impaired OS after CRS-HIPEC, the onset of PM was not found to be an independent determinant for survival. High-risk molecular and histological features strongly influence oncological outcomes after CRS-HIPEC. This is valuable data that could aid in preoperative patient selection process for CRS-HIPEC.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"58 ","pages":"Article 102183"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958376","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}