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Preoperative prediction of severe short-term complications in patients with bladder cancer undergoing radical cystectomy 膀胱癌根治性膀胱切除术患者严重短期并发症的术前预测
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-19 DOI: 10.1016/j.suronc.2025.102253
Thomas Vetsch , Markus Huber , Patrick Y. Wuethrich , Marc A. Furrer
{"title":"Preoperative prediction of severe short-term complications in patients with bladder cancer undergoing radical cystectomy","authors":"Thomas Vetsch ,&nbsp;Markus Huber ,&nbsp;Patrick Y. Wuethrich ,&nbsp;Marc A. Furrer","doi":"10.1016/j.suronc.2025.102253","DOIUrl":"10.1016/j.suronc.2025.102253","url":null,"abstract":"<div><h3>Background and objective</h3><div>Radical cystectomy (RC) is associated with a high risk of postoperative complications. The prediction of individual patient risk for severe complications can facilitate preoperative shared decision-making. Patients with elevated risk may be referred to prehabilitation with the aim to mitigate the risk to improve perioperative outcomes. We developed models to predict severe short-term postoperative complications using preoperatively available clinical variables.</div></div><div><h3>Methods</h3><div>Data from a prospective cohort of 1313 RC patients treated between 1999 and 2021 was used. Preoperative demographic, laboratory, and cancer-related variables were defined as domains to predict severe complications measured by the Comprehensive Complication Index (CCI). Machine-learning models were trained for each postoperative day and predictor domain. The area under the receiver operating characteristic curve (AUROC) was reported as the primary outcome. Clinical utility was examined using Decision Curve Analysis (DCA).</div></div><div><h3>Results</h3><div>The best performing model had an AUROC of 0.69 (95 % CI 0.63–0.75) for severe complications on postoperative day (POD) 14. Mean AUROCs across POD 1–30 were 0.64 for all variables combined, 0.58 for demographics, 0.56 for laboratory values, and 0.53 for cancer-related factors. Model calibration and stability improved from POD 10 onwards. Decision curve analysis indicated the highest net benefit from models incorporating all predictors, with demographic variables contributing most among individual domains.</div></div><div><h3>Conclusions and clinical implications</h3><div>Limited clinical utility of the trained models was observed. The benefit for preoperative clinical decision-making is unclear. Clinical utility may improve by the inclusion of variables related to function in future models (e.g., frailty).</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102253"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335739","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}
引用次数: 0
Survival outcomes and pathologic complete response following neoadjuvant chemoradiotherapy versus chemotherapy alone in locally advanced rectal cancer 局部晚期直肠癌新辅助放化疗与单独化疗后的生存结果和病理完全缓解
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-19 DOI: 10.1016/j.suronc.2025.102252
Metincan Erkaya , Cigdem Benlice , Bilgi Baca , Emre Gorgun
{"title":"Survival outcomes and pathologic complete response following neoadjuvant chemoradiotherapy versus chemotherapy alone in locally advanced rectal cancer","authors":"Metincan Erkaya ,&nbsp;Cigdem Benlice ,&nbsp;Bilgi Baca ,&nbsp;Emre Gorgun","doi":"10.1016/j.suronc.2025.102252","DOIUrl":"10.1016/j.suronc.2025.102252","url":null,"abstract":"<div><h3>Background</h3><div>The management of locally advanced rectal cancer (LARC) continues to evolve, marked by significant advancements in treatment paradigms. Total neoadjuvant therapy (TNT) has emerged as a promising strategy, while de-escalation approaches, such as neoadjuvant chemotherapy (nCT) alone, are gaining traction to mitigate radiation-related toxicities without compromising oncologic efficacy. This study aimed to compare survival outcomes and pathologic complete response (pCR) rates between patients with LARC treated with neoadjuvant chemoradiotherapy (nCRT) and those treated with nCT alone.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed data from the National Cancer Database (NCDB) between 2015 and 2019. The inclusion criteria were non-metastatic clinical T2 node-positive, T3 node-negative, and T3 node-positive rectal adenocarcinoma patients undergoing partial proctectomy with neoadjuvant therapy. The stabilized inverse probability of treatment weighting (IPTW) was applied to balance the baseline characteristics. Overall survival was assessed using Kaplan-Meier curves and multivariable Cox proportional hazards models, while pCR rates were analyzed using logistic regression.</div></div><div><h3>Results</h3><div>Of 6886 patients included, 386 (5.6 %) received nCT alone, and 6500 (94.4 %) received nCRT. After IPTW adjustment, no significant difference in overall survival was observed between nCRT and nCT alone groups (HR: 0.99, 95 % CI: 0.69–1.41, p = 0.936). pCR rates were similar (OR: 1.20, 95 % CI: 0.77–1.98, p = 0.438). Subgroup analysis revealed non-significant trends toward higher pCR rates with nCRT in T3 node-positive patients (OR: 1.44, 95 % CI: 0.77–3.05, p = 0.297). Residual tumor margins (HR: 3.04, 95 % CI: 2.34–3.94, p &lt; 0.001) and incomplete pathological response (HR: 1.68, 95 % CI: 1.22–2.31, p = 0.002) were significant predictors of worse survival outcomes regardless of treatment modality.</div></div><div><h3>Conclusion</h3><div>This large-scale analysis demonstrates comparable overall survival and pCR rates between nCRT and nCT alone in carefully selected with LARC patients, supporting the growing evidence for selective radiation omission strategies. These findings align with those of contemporary de-escalation trials and suggest that nCT alone may be a viable treatment option for specific patient subgroups. Future prospective studies incorporating quality of life assessments and long-term functional outcomes are essential to optimize personalized treatment strategies and refine patient selection criteria for radiation de-escalation in LARC management.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102252"},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480296","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}
引用次数: 0
Octogenarians with lower BMI have comparatively poor survival in potentially resectable pancreatic cancer: outcomes over 5-year follow-up BMI较低的八旬老人在潜在可切除的胰腺癌中生存率相对较低:5年随访结果
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-07 DOI: 10.1016/j.suronc.2025.102248
Hideki Motobayashi, Atsushi Shimizu, Yuji Kitahata, Akihiro Takeuchi, Tomohiro Yoshimura, Masatoshi Sato, Kyohei Matsumoto, Shinya Hayami, Atsushi Miyamoto, Kensuke Nakamura, Manabu Kawai
{"title":"Octogenarians with lower BMI have comparatively poor survival in potentially resectable pancreatic cancer: outcomes over 5-year follow-up","authors":"Hideki Motobayashi,&nbsp;Atsushi Shimizu,&nbsp;Yuji Kitahata,&nbsp;Akihiro Takeuchi,&nbsp;Tomohiro Yoshimura,&nbsp;Masatoshi Sato,&nbsp;Kyohei Matsumoto,&nbsp;Shinya Hayami,&nbsp;Atsushi Miyamoto,&nbsp;Kensuke Nakamura,&nbsp;Manabu Kawai","doi":"10.1016/j.suronc.2025.102248","DOIUrl":"10.1016/j.suronc.2025.102248","url":null,"abstract":"<div><h3>Background</h3><div>The indication and benefit of pancreatectomy for octogenarians with pancreatic cancer remains controversial. This study aims to evaluate prognostic factors in patients with pancreatic cancer after 5-year follow-up.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the 229 patients who underwent pancreatectomy at our hospital between 2005 and 2018 for potentially resectable pancreatic cancer. Of these, 216 patients were divided into three groups based on age: &lt;70 years old (n = 97), 70–79 years old (n = 81), and ≥80 years old (n = 38).</div></div><div><h3>Results</h3><div>Seventy patients (32.4 %) achieved 5-year survival. Median survival time and five-year overall survival in each group were: 37.3 months and 37.1 % for patients &lt;70 years old, 26.0 months and 30.9 % for those 70–79 years old, and 20.2 months and 23.7 % for those ≥80 years old. The patients who were ≥80 years old and had BMI &lt;20 kg/m<sup>2</sup> had a significantly poorer prognosis than those &lt;80 years old and who had BMI ≥20 kg/m<sup>2</sup> (<em>P</em> = 0.006). Independent prognostic factors were age ≥80 years and BMI &lt;20 kg/m<sup>2</sup>, preoperative CA19-9 ≥ 500 IU/L, transfusion, tumor size ≥20 mm, positive lymph node, and non-completion of adjuvant therapy. Moreover, age ≥80 years, BMI &lt;20 kg/m<sup>2</sup>, preoperative CA19-9, and severe complications were each associated with non-completion of adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>Octogenarians with lower BMI, which might be attributed to lower completion rate of adjuvant therapy, had especially poorer prognosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102248"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240794","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}
引用次数: 0
A phase 1 study of intra-arterial CBL0137 in extremity melanomas and sarcomas 动脉内CBL0137治疗四肢黑色素瘤和肉瘤的一期研究
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-07 DOI: 10.1016/j.suronc.2025.102243
Joseph J. Skitzki , Minhyung Kim , Daniel T. Fisher , John M. Kane III , Han Yu , Kayla Catalfamo , Garin Tomaszewski , Michael Petroziello , Andrei Purmal , Katerina V. Gurova , Andrei V. Gudkov
{"title":"A phase 1 study of intra-arterial CBL0137 in extremity melanomas and sarcomas","authors":"Joseph J. Skitzki ,&nbsp;Minhyung Kim ,&nbsp;Daniel T. Fisher ,&nbsp;John M. Kane III ,&nbsp;Han Yu ,&nbsp;Kayla Catalfamo ,&nbsp;Garin Tomaszewski ,&nbsp;Michael Petroziello ,&nbsp;Andrei Purmal ,&nbsp;Katerina V. Gurova ,&nbsp;Andrei V. Gudkov","doi":"10.1016/j.suronc.2025.102243","DOIUrl":"10.1016/j.suronc.2025.102243","url":null,"abstract":"<div><h3>Introduction</h3><div>Regional therapies for cancer leverage the ability to isolate the circulation to a diseased extremity or organ and deliver high doses of chemotherapy that would be systemically prohibitive due to toxicity. Virtually all regional therapies utilize the original chemotherapy agent, melphalan, which requires circulatory isolation. CBL0137 is a small molecule with multiple anti-tumor effects when given intra-arterially (IA) that shows similar efficacy to melphalan in preclinical models, but without the need for circulatory isolation.</div></div><div><h3>Materials and methods</h3><div>Patients with advanced, unresectable melanoma or sarcoma (n = 5, sarcoma 60 %, melanoma 40 %) of the extremity entered a rapid dose-escalation phase of a clinical trial of IA CBL0137. CBL0137 was administered via a single IA catheter placed proximal to the site of tumor(s) in the affected extremity and delivered over 15 min. Primary objective was to define dose-limiting toxicities with secondary objectives of assessing response and pharmacokinetics (PK).</div></div><div><h3>Results</h3><div>The treatments were well tolerated with minimal to no toxicity for all patients. PK data showed predictable, dose-dependent drug exposures with rapid tissue uptake and markedly decreased systemic concentrations as compared to matched intravenous dosing data. CBL0137 preferentially accumulated within tumor tissue as compared to surrounding normal tissue in the infused limb without the need for tourniquet. Sixty percent of patients treated in this protocol would not have been eligible for standard regional therapies with one patient demonstrating prolonged disease stability while avoiding major amputation.</div></div><div><h3>Conclusions</h3><div>The historic restrictions of standard regional therapies may be overcome with IA CBL0137, and this treatment is potentially applicable to a wide range of cancers beyond the extremities.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102243"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322073","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}
引用次数: 0
Abdominal aortic calcification predicts poor prognosis for patients with gastric cancer who underwent curative gastrectomy 腹主动脉钙化预示胃癌行根治性胃切除术患者预后不良
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-07 DOI: 10.1016/j.suronc.2025.102247
Naoko Fukushima , Takahiro Masuda , Kenei Furukawa , Kazuto Tsuboi , Masami Yuda , Keita Takahashi , Masaichi Ogawa , Toru Ikegami , Fumiaki Yano , Ken Eto
{"title":"Abdominal aortic calcification predicts poor prognosis for patients with gastric cancer who underwent curative gastrectomy","authors":"Naoko Fukushima ,&nbsp;Takahiro Masuda ,&nbsp;Kenei Furukawa ,&nbsp;Kazuto Tsuboi ,&nbsp;Masami Yuda ,&nbsp;Keita Takahashi ,&nbsp;Masaichi Ogawa ,&nbsp;Toru Ikegami ,&nbsp;Fumiaki Yano ,&nbsp;Ken Eto","doi":"10.1016/j.suronc.2025.102247","DOIUrl":"10.1016/j.suronc.2025.102247","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal aortic calcification is a pathological vascular disorder associated with various diseases and has recently been associated with the prognosis of various cancers. This study aimed to investigate the association between abdominal aortic calcification and prognosis in patients who underwent curative gastrectomy for gastric cancer.</div></div><div><h3>Methods</h3><div>We analyzed 251 patients who underwent curative gastrectomy for gastric cancer between January 2014 and February 2020. The volume of abdominal aortic calcification was assessed using routine preoperative computed tomography. The cutoff values were assessed using receiver operating characteristic curve analysis of the survival status at the 3-year follow-up, and set to 585.</div></div><div><h3>Results</h3><div>Higher abdominal aortic calcification volume was identified in 151 patients (60 %). Multivariate analysis showed that abdominal aortic calcification (<em>P</em> = 0.0120, <em>P</em> = 0.0430, respectively), and stage II or III disease (<em>P</em> = 0.0000, <em>P=</em>0.0000, respectively) were independent and significant predictors of the disease-free and cancer-specific survival. Additionally, patients with higher abdominal aortic calcification volume were significantly older and had a higher prevalence of hypertension, diabetes, chronic renal failure, and cardiovascular diseases.</div></div><div><h3>Conclusions</h3><div>Abdominal aortic calcification showed a strong preoperative prognostic indicator in patients undergoing curative gastrectomy for gastric cancer.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102247"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255392","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}
引用次数: 0
Prophylactic drain placement versus non-drainage following gastric cancer surgery: A systematic review and meta-analysis of randomized controlled trials 胃癌手术后预防性引流与非引流:随机对照试验的系统回顾和荟萃分析
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-07 DOI: 10.1016/j.suronc.2025.102246
Ahmed Maher Khalil , Emtenan Arishi , Ayman Megahed , Nouran H. Kamel , Ahmed W. Hageen , Najla K. Alzahrani , Deema Alanzi , Abdulmalik A. Aiban , Marwan Farea , Abdullah Albukhari , Salem M. Abokhanjar , Majd Elmahi
{"title":"Prophylactic drain placement versus non-drainage following gastric cancer surgery: A systematic review and meta-analysis of randomized controlled trials","authors":"Ahmed Maher Khalil ,&nbsp;Emtenan Arishi ,&nbsp;Ayman Megahed ,&nbsp;Nouran H. Kamel ,&nbsp;Ahmed W. Hageen ,&nbsp;Najla K. Alzahrani ,&nbsp;Deema Alanzi ,&nbsp;Abdulmalik A. Aiban ,&nbsp;Marwan Farea ,&nbsp;Abdullah Albukhari ,&nbsp;Salem M. Abokhanjar ,&nbsp;Majd Elmahi","doi":"10.1016/j.suronc.2025.102246","DOIUrl":"10.1016/j.suronc.2025.102246","url":null,"abstract":"<div><div>Gastric cancer remains a significant global health burden and a leading cause of cancer-related deaths. Surgical resection is the primary curative treatment, but postoperative complications can negatively impact outcomes. Prophylactic drainage (PD) has been widely used to reduce these complications by facilitating early detection and management of fluid collections. This study evaluates the role of PD following gastric cancer surgery through a systematic review and meta-analysis of randomized controlled trials (RCTs). We searched PubMed, Web of Science, Scopus, and Cochrane databases up to January 15, 2025, and analyzed dichotomous data using risk ratio (RR) and continuous data using mean difference (MD), both with 95 % confidence intervals (CI), using R version 4.3 (PROSPERO ID: CRD42025650045). Four RCTs involving 728 patients were included. The analysis revealed that PD was associated with a significantly lower risk of mortality compared to no drainage (RR: 0.45 [95 % CI: 0.21–0.94]; P = 0.03). However, there were no significant differences between the drainage and non-drainage groups in the incidence of intra-abdominal abscess (RR: 1.23 [95 % CI: 0.49–3.06]; P = 0.66), surgical-site infection (RR: 0.93 [95 % CI: 0.56–1.52]; P = 0.76), pulmonary infection (RR: 0.66 [95 % CI: 0.37–1.18]; P = 0.16), duodenal stump leakage (RR: 1.54 [95 % CI: 0.51–4.71]; P = 0.45), anastomotic leakage (RR: 1.47 [95 % CI: 0.64–3.39]; P = 0.37), or reoperation rates (RR: 0.95 [95 % CI: 0.40–2.27]; P = 0.90). Additionally, no significant differences were observed in the length of hospital stay (MD: 0.10 [95 % CI: −0.39 to 0.58]; P = 0.70) or time to the first soft diet (MD: 0.21 [95 % CI: −0.09 to 0.50]; P = 0.17). In conclusion, PD following gastric cancer surgery is associated with a reduced risk of mortality but does not significantly impact the incidence of perioperative complications or recovery metrics. These findings suggest that while PD may offer a survival benefit, it does not appear to reduce common postoperative complications or accelerate recovery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102246"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270787","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}
引用次数: 0
Is lateral pelvic lymph node dissection necessary for good responder to neoadjuvant chemoradiation in locally advanced rectal cancer? 局部晚期直肠癌新辅助放化疗是否需要骨盆外侧淋巴结清扫?
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-07 DOI: 10.1016/j.suronc.2025.102249
Jung Hoon Bae , Jumyung Song , Ji Hoon Kim , Bong-Hyeon Kye , In Kyu Lee , Hyeon-Min Cho , Yoon Suk Lee
{"title":"Is lateral pelvic lymph node dissection necessary for good responder to neoadjuvant chemoradiation in locally advanced rectal cancer?","authors":"Jung Hoon Bae ,&nbsp;Jumyung Song ,&nbsp;Ji Hoon Kim ,&nbsp;Bong-Hyeon Kye ,&nbsp;In Kyu Lee ,&nbsp;Hyeon-Min Cho ,&nbsp;Yoon Suk Lee","doi":"10.1016/j.suronc.2025.102249","DOIUrl":"10.1016/j.suronc.2025.102249","url":null,"abstract":"<div><h3>Background</h3><div>Response to preoperative chemoradiation (CRT) is an important indicator of the possibility of lateral pelvic lymph node (LPN) metastasis. However, the effect of LPN dissection (LPND) in good responders to CRT remains unclear. This study aimed to identify the optimal treatment strategy for patients with rectal cancer who respond well to preoperative CRT.</div></div><div><h3>Methods</h3><div>This multi-institutional retrospective study evaluated patients with locally advanced rectal cancer and clinically suspected LPN metastases who underwent total mesorectal excision with LPND after CRT. The patients were divided into two groups based on the largest lymph node diameter post-CRT (cutoff: 5 mm): good (n = 38) and poor responders (n = 53).</div></div><div><h3>Results</h3><div>LPN metastasis was significantly higher in poor responders (18 patients, 34.0 %) than in good responders (5 patients, 13.2 %) (p = 0.024). All 5 patients in the good responder group had low rectal cancer (i.e., tumors located within 5 cm from the anal verge (AV)). Low rectal cancer was the only significant predictor for LPN metastasis in good responders (p = 0.004). However, LPN size before and after CRT did not predict LPN metastasis in this group (p = 0.947 and 0.910, respectively). When LPND was indicated for all poor responders and for good responders with tumors located ≤5 cm from the AV, the sensitivity for LPN metastasis diagnosis was 100 %.</div></div><div><h3>Conclusion</h3><div>Among rectal cancer patients with good response to preoperative CRT, pathological LPN metastasis occurs in 13.2 %, and tumor height is a significant risk factor for LPN metastasis. LPND might be considered for low rectal tumors, regardless of preoperative CRT response.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102249"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261525","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}
引用次数: 0
Implementation of enhanced recovery after surgery in breast reconstruction: Lessons from a French tertiary center 提高乳房重建术后恢复的实施:来自法国三级中心的经验教训
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-07 DOI: 10.1016/j.suronc.2025.102250
Alexandre Vinel , Florence Babre , Antoine Dannepond , Julie Commeny , Diane Adam , Anaïs Delgove , Audrey Michot
{"title":"Implementation of enhanced recovery after surgery in breast reconstruction: Lessons from a French tertiary center","authors":"Alexandre Vinel ,&nbsp;Florence Babre ,&nbsp;Antoine Dannepond ,&nbsp;Julie Commeny ,&nbsp;Diane Adam ,&nbsp;Anaïs Delgove ,&nbsp;Audrey Michot","doi":"10.1016/j.suronc.2025.102250","DOIUrl":"10.1016/j.suronc.2025.102250","url":null,"abstract":"<div><h3>Introduction</h3><div>Enhanced Recovery After Surgery (ERAS) programs have significantly improved postoperative outcomes across various surgical disciplines. In April 2022, an ERAS protocol tailored for patients undergoing DIEP free flap breast reconstruction was implemented at the Bordeaux Cancer Center, France. This study aimed to assess the impact of this protocol on length of stay (LOS), complication rates, and compliance with protocol items.</div></div><div><h3>Material and methods</h3><div>A retrospective pre-post observational study was conducted, including 56 consecutive patients who underwent DIEP flap reconstruction at the Bergonié Institute between September 2020 and April 2023. Twenty-eight patients received conventional perioperative care, while 28 patients were managed under the ERAS protocol. Outcomes assessed included LOS, early and 90-day postoperative complications, and adherence to the protocol's 20 key items.</div></div><div><h3>Results</h3><div>Median LOS was comparable between groups, at 4.5 days pre-ERAS and 5 days post-ERAS (p = 0.52). Early and 90-day complication rates showed no significant differences. The average compliance with protocol items was 14.2 out of 20 per patient, with 35 % of recommendations followed in less than 66 % of cases.</div></div><div><h3>Conclusion</h3><div>The initial evaluation of the ERAS program showed no significant reduction in LOS or morbidity, primarily due to suboptimal adherence. These findings highlight the importance of optimizing compliance with protocol recommendations to further improve recovery outcomes, reduce LOS and potentially lower overall healthcare costs.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102250"},"PeriodicalIF":2.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255391","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}
引用次数: 0
Relationship between the distance from the tumor to major blood vessels and prognosis of deep soft tissue sarcomas 肿瘤离大血管的距离与深部软组织肉瘤预后的关系
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-05 DOI: 10.1016/j.suronc.2025.102244
Tadashi Iwai , Maria Anna Smolle , Dominik Kaiser , Lukas Jud , Sandro F. Fucentese , Daniel Andreas Müller
{"title":"Relationship between the distance from the tumor to major blood vessels and prognosis of deep soft tissue sarcomas","authors":"Tadashi Iwai ,&nbsp;Maria Anna Smolle ,&nbsp;Dominik Kaiser ,&nbsp;Lukas Jud ,&nbsp;Sandro F. Fucentese ,&nbsp;Daniel Andreas Müller","doi":"10.1016/j.suronc.2025.102244","DOIUrl":"10.1016/j.suronc.2025.102244","url":null,"abstract":"<div><h3>Introduction</h3><div>Recent reports show that vascular proximity on magnetic resonance imaging (MRI) increases the risk of local recurrence of thigh soft tissue sarcomas (STS). However, it remains unclear whether the defined radiological distance between the tumor and major blood vessels influences local recurrence-free survival (LRFS), metastasis-free survival (MFS), and overall survival (OS). We aimed to verify this association among patients with deep STS.</div></div><div><h3>Methods</h3><div>Clinical-pathological data of 149 patient's deep STS treated between 2014 and 2023 at a single institution were retrospectively analyzed. Based on MRI findings, the distance between the tumor and major blood vessels was investigated using two groups (“In contact” and “Not in contact”). Sex, age, tumor size, location, grade, AJCC staging, and distance to major blood vessels were evaluated using Cox proportional hazards regression models. Five-year survival rates were assessed using the Kaplan–Meier method.</div></div><div><h3>Results</h3><div>Median follow-up duration was 40 (interquartile range [IQR]: 19–75) months. The five-year OS, LRFS, and MFS rates were 72.5 %, 95.5 %, and 85.2 %, respectively. Multivariate analysis revealed significant associations between poor OS and tumor stage IV as well as “In contact” with major blood vessels. Additionally, the statistical significance between distant metastasis and “In contact” with major blood vessels was clarified.</div></div><div><h3>Conclusions</h3><div>A radiological “In contact” between the tumor and major blood vessels was a significant factor associated with poor prognosis and distant metastasis. Orthopedic oncologists should consider a treatment strategy based on the relationship between the distance from the tumor to major blood vessels on MRI preoperatively.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102244"},"PeriodicalIF":2.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240793","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}
引用次数: 0
Delphi for management of N2 non-small cell lung cancer 德尔福治疗N2型非小细胞肺癌
IF 2.3 4区 医学
Surgical Oncology-Oxford Pub Date : 2025-06-03 DOI: 10.1016/j.suronc.2025.102245
Hind Eid , Elias Karam , Antoine EL. Kik , Fadi El Karak , Ammar Chamaa , Bassem Habr , Hampig Raphael Kourie , Fares Azouri , Viviane Smayra , Noel Aoun , Joseph Kattan , Georges Chahine , Marwan Ghosn , Jad Wakim , Hussein Nasserddine , Fadi Nasr , Georges Khayat , Joseph Nakad , Carine Harmouche , Georges Dabar , Moussa Riachy
{"title":"Delphi for management of N2 non-small cell lung cancer","authors":"Hind Eid ,&nbsp;Elias Karam ,&nbsp;Antoine EL. Kik ,&nbsp;Fadi El Karak ,&nbsp;Ammar Chamaa ,&nbsp;Bassem Habr ,&nbsp;Hampig Raphael Kourie ,&nbsp;Fares Azouri ,&nbsp;Viviane Smayra ,&nbsp;Noel Aoun ,&nbsp;Joseph Kattan ,&nbsp;Georges Chahine ,&nbsp;Marwan Ghosn ,&nbsp;Jad Wakim ,&nbsp;Hussein Nasserddine ,&nbsp;Fadi Nasr ,&nbsp;Georges Khayat ,&nbsp;Joseph Nakad ,&nbsp;Carine Harmouche ,&nbsp;Georges Dabar ,&nbsp;Moussa Riachy","doi":"10.1016/j.suronc.2025.102245","DOIUrl":"10.1016/j.suronc.2025.102245","url":null,"abstract":"<div><div>Mediastinal lymph node involvement is a prognostic factor in patients with localized NSCLC. Both ipsilateral and subcarinal nodal involvement are classified as N2 disease. However, there is no universally agreed-upon approach for diagnosing and treating this condition. The aim of this study is to elaborate an institutional N2 consensus. A multidisciplinary expert panel at Hotel Dieu de France provided informed consent to participate in the modified Delphi process. Twelve basic statements were started by a steering committee of three independent reviewers on the basis of international consensus, medical literature and personal experience. In the first round, physicians answered an open-ended questionnaire that was analyzed thematically. In the second round, the participants rated the generated statements and added their comments. In the third round, the participants rated their agreement via a 6-point Likert scale. Consensus was defined as ≥80 % agreement (A+ or A) with a statement. Nineteen physicians completed the three rounds. A full consensus was reached in eleven statements. Preoperative mediastinal staging is mandatory in patients with resectable N2 disease. It should be considered in patients with a high SUVmax (maximum standardized uptake value) (≥3), proximal or apical tumors and high <em>carcinoembryonic antigen</em> levels. Surgery is performed in the absence of neoadjuvant treatment depending on a single station with nonbulky disease and stage T3 invasive/T4 disease. In patients with N2 disease at several stations, radio chemotherapy is the main treatment, followed by durvalumab in patients with good general status. In pN2 patients, postsurgical treatment is based on the condition of the surgical resection margin. These findings will help physicians in multidisciplinary discussions agree on clinical decisions.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102245"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338368","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}
引用次数: 0
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