Surgical Oncology-Oxford最新文献

{"title":"Systemic inflammatory and thyroid markers for predicting malignancy in indeterminate (Bethesda III–IV) thyroid nodules; could thyroglobulin be a clue?","authors":"Aykut Çelik ,&nbsp;Tuğba Matlım Özel ,&nbsp;Sezer Akbulut ,&nbsp;Görkem Yıldız ,&nbsp;Hüseyin Karatay ,&nbsp;Serkan Sarı","doi":"10.1016/j.suronc.2026.102355","DOIUrl":"10.1016/j.suronc.2026.102355","url":null,"abstract":"<div><h3>Background</h3><div>Numerous blood-based markers have been proposed as potential predictors of malignancy, not only in thyroid but also in various cancer types. This study aimed to evaluate the diagnostic utility of these markers for predicting malignancy in indeterminate thyroid nodules.</div></div><div><h3>Method</h3><div>After literature review, we identified a set of markers potentially useful for predicting malignancy. Age, gender, nodule size, platelet count, mean platelet volume, platelet distribution width, lymphocyte/monocyte ratio, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet large cell ratio, immature granulocyte, thyroid-stimulating hormone, thyroglobulin, thyroglobulin-antibody and thyroid peroxidase-antibody levels were prospectively collected from patients who underwent thyroidectomy at our institution. The relationship between these markers and malignancy in indeterminate nodules was evaluated.</div></div><div><h3>Results</h3><div>Among 1392 patients who underwent thyroidectomy between March-2021 and June-2024, 225 were operated for indeterminate thyroid nodules. In these patients, both nodule size ≥4 cm and serum thyroglobulin levels were found to be significantly associated with malignancy in univariate analysis (<em>p</em> &lt; 0.05). ROC curve analysis identified a Tg cut-off value of 299 ng/mL. In multivariate analysis, when a nodule size threshold of 4 cm and a Tg cut-off of 299 ng/mL were applied, the significance of Tg as an independent predictor of malignancy became more pronounced.</div></div><div><h3>Conclusion</h3><div>The relationship between nodule size and malignancy is known, but elevated thyroglobulin levels have been found to be an independent risk factor for malignancy in indeterminate nodules. Although it needs to be generalized with more data, it is an inexpensive and simple diagnostic test that could guide us in patients with indeterminate cytologic findings.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102355"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101087","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":"Robotic extended left hepatectomy and Roux-en-Y hepaticojejunostomy for hilar cholangiocarcinoma after neoadjuvant treatment","authors":"Marcel Autran Machado,&nbsp;Bruno H. Mattos,&nbsp;Murillo M. Lobo Filho,&nbsp;Fábio F. Makdissi","doi":"10.1016/j.suronc.2026.102350","DOIUrl":"10.1016/j.suronc.2026.102350","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102350"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037438","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":"Clinically significant delayed gastric emptying after multivisceral resection for retroperitoneal sarcoma: A retrospective cohort study","authors":"Dorian Yarih Garcia-Ortega ,&nbsp;Luis Antonio Bonilla-Salado ,&nbsp;Ana Paulina Meléndez-Fernández ,&nbsp;Sylvia Veronica Villavicencio-Valencia ,&nbsp;Diyitzia Rosario Irineo-Cerecedo ,&nbsp;Cherilynn Martinez-Valdovinos ,&nbsp;David Aarón Bujanda-Sandoval ,&nbsp;Kuauhyama Luna-Ortiz","doi":"10.1016/j.suronc.2025.102336","DOIUrl":"10.1016/j.suronc.2025.102336","url":null,"abstract":"<div><h3>Background</h3><div>Delayed gastric emptying (DGE) is an underrecognized but clinically impactful complication following multivisceral resection (MVR) for retroperitoneal sarcoma (RPS). This study aimed to determine the incidence, risk factors, and postoperative morbidity of clinically significant DGE in a Latin American tertiary referral sarcoma center.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult patients with primary or recurrent RPS who underwent MVR between January 2020 and December 2024. DGE was defined and graded according to ISGPS criteria, with grades B–C considered clinically significant. Multivariable logistic regression identified independent predictors for DGE. Clinical outcomes were compared by DGE status.</div></div><div><h3>Results</h3><div>Among 142 patients who underwent MVR, the incidence of clinically significant DGE was 8.6 %. Independent risk factors included tumor size &gt;22 cm (OR 2.25; 95 % CI 1.12–4.50; p = 0.023), dedifferentiated liposarcoma histology (OR 3.52; 95 % CI 1.12–11.01; p = 0.031), and multifocal disease (OR 2.78; 95 % CI 1.03–7.49; p = 0.044). DGE was associated with a prolonged hospital stay (22 vs. 10.5 days, p &lt; 0.001) and a higher rate of ICU admission (9.3 % vs. 2.7 %, p = 0.034). No significant associations were found with major complications or reoperation.</div></div><div><h3>Conclusions</h3><div>Clinically significant DGE is an infrequent but high-impact complication after MVR for RPS. Tumor-related features such as large size, high-grade histology, and multifocality contribute to its development. Early identification and standardized perioperative strategies may help reduce the incidence and clinical burden of this condition. These findings provide essential data from a historically underrepresented region and support efforts to optimize postoperative recovery in complex sarcoma surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102336"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679635","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":"Combined retroperitoneal resection with cytoreductive surgery and heated intraperitoneal chemotherapy for metastatic colorectal cancer with retroperitoneal and peritoneal metastases","authors":"Shachar Laks ,&nbsp;Shahar Feiglin ,&nbsp;Gal Schtrechman ,&nbsp;Liog Segev ,&nbsp;Haggai Benvenisti ,&nbsp;Dan Assaf ,&nbsp;Nedaa Mahmeed ,&nbsp;Mohammad Adileh ,&nbsp;Ronen Brenner ,&nbsp;Adam Goldstein ,&nbsp;Almog Ben Yaacov ,&nbsp;Aviram Nissan","doi":"10.1016/j.suronc.2025.102313","DOIUrl":"10.1016/j.suronc.2025.102313","url":null,"abstract":"<div><h3>Introduction</h3><div>Colorectal peritoneal metastases (CRPM) and retroperitoneal lymphatic metastases (RLM) are each considered poor prognostic indicators in colorectal cancer (CRC). Current data suggests that surgery for each including cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC) for CRPM and retroperitoneal resection (RR) for RLM may improve survival. Given the poor prognosis of each finding individually, each condition is generally considered a contraindication to the other. We describe the first series of combined RR and CRS/HIPEC.</div></div><div><h3>Materials and methods</h3><div>Retrospective analysis of a prospectively maintained tertiary institution database comparing perioperative and oncological outcomes of combined RR + CRS/HIPEC to CRS/HIPEC only in CRC.</div></div><div><h3>Results</h3><div>Included 238 CRS/HIPEC and divided to 17 with RR + CRS/HIPEC and 221 with CRS/HIPEC only. Demographic/perioperative characteristics were similar including tumor characteristics and peritoneal cancer index. Longer operative times observed in RR + CRS/HIPEC cohort (5 versus 4 h, <em>p</em> = 0.024). Complications were similar except more postoperative bleeding events and deep vein thrombosis in the RR + CRS/HIPEC cohort (24 % versus 5.0 %, <em>p</em> = 0.024 and 12 % versus 2.3 %, <em>p</em> = 0.026, respectively). This did not translate to longer length of stay, reoperations, or major complications. Median disease free survival was shorter in the RR + CRS/HIPEC cohort (7.3 versus 11.3 months, <em>p</em> = 0.032), but similar overall survival observed (29.5 versus 43.9 months, <em>p</em> = 0.34). Less retroperitoneal recurrences occurred after regional lymphadenectomy (12 %) compared to mass only resection (44 %).</div></div><div><h3>Conclusion</h3><div>Our study demonstrates the safety and oncological efficacy of RR + CRS/HIPEC. We believe that RR + CRS/HIPEC in highly selected patients is a suitable option and hope this leads to larger multi-institutional studies to corroborate these findings.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102313"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398098","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":"Endoscopic management of upper GI anastomotic leaks after oesophagectomy or gastrectomy: Experience from a high-volume centre","authors":"Claudia Sanchez-Gonzalez ,&nbsp;Jose Luis Fernandez Aguilar ,&nbsp;Javier Moreno Ruiz ,&nbsp;Custodia Montiel Casado ,&nbsp;Luis Antonio Vazquez Pedreño ,&nbsp;Ines Cañas Garcia ,&nbsp;Julio Santoyo Santoyo","doi":"10.1016/j.suronc.2026.102353","DOIUrl":"10.1016/j.suronc.2026.102353","url":null,"abstract":"<div><div>Anastomotic leaks after oesophagectomy or gastrectomy represent a major complication in upper gastrointestinal cancer surgery. This study evaluated outcomes of endoscopic management in a high-volume tertiary centre. We retrospectively analysed 29 patients treated between 2016 and 2025. Most leaks (82.8 %) were initially managed with self-expandable metal stents (SEMS), while 17.2 % received a sequential approach with endoscopic vacuum therapy (EVT) followed by SEMS. Clinical success was achieved in 89.7 % of cases, with only two requiring surgical reintervention. One death was attributed to endoscopic treatment. Median time to discharge was 21 days for SEMS and 32 days for EVT-SEMS. These findings support endoscopic therapy as a safe, effective, and organ-preserving first-line option for anastomotic leaks. The sequential use of EVT followed by SEMS is a newly described approach that may offer added benefits in selected patients and warrants further evaluation in specialised centres.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102353"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037437","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":"Sarcomatoid dedifferentiation as a predictor of overall mortality in surgically treated metastatic renal cell carcinoma","authors":"Reha-Baris Incesu ,&nbsp;Lukas Scheipner ,&nbsp;Simone Morra ,&nbsp;Andrea Baudo ,&nbsp;Carolin Siech ,&nbsp;Letizia Maria Ippolita Jannello ,&nbsp;Mario de Angelis ,&nbsp;Anis Assad ,&nbsp;Zhe Tian ,&nbsp;Fred Saad ,&nbsp;Shahrokh F. Shariat ,&nbsp;Alberto Briganti ,&nbsp;Ottavio de Cobelli ,&nbsp;Felix K.H. Chun ,&nbsp;Luca Carmignani ,&nbsp;Nicola Longo ,&nbsp;Sascha Ahyai ,&nbsp;Derya Tilki ,&nbsp;Markus Graefen ,&nbsp;Pierre I. Karakiewicz","doi":"10.1016/j.suronc.2025.102306","DOIUrl":"10.1016/j.suronc.2025.102306","url":null,"abstract":"<div><h3>Background</h3><div>In metastatic clear-cell renal cell carcinoma (ccmRCC), sarcomatoid dedifferentiation is routinely reported in G4 patients, but routine reporting is not recommended in G3 patients. We tested independent predictor status of sarcomatoid dedifferentiation in G4 ccmRCC. Additionally, we explored whether sarcomatoid dedifferentiation may have a role in overall mortality (OM) prediction in G3 ccmRCC.</div></div><div><h3>Methods</h3><div>Within the Surveillance, Epidemiology, and End Results database, univariable and multivariable Cox-regression models assessed cytoreductive nephrectomy (CN)-treated ccmRCC patients (2010–2020).</div></div><div><h3>Results</h3><div>Of 2644 CN-treated ccmRCC patients, 1336 (51 %) harbored G4, of whom 528 (40 %) harbored sarcomatoid dedifferentiation. In G4, median overall survival (OS) according to presence vs. absence of sarcomatoid dedifferentiation was 20 vs. 21 months (p = 0.6) and sarcomatoid dedifferentiation was not independent predictor in multivariable analyses. Of all, 1308 (49 %) harbored G3, of whom 79 (6 %) harbored sarcomatoid dedifferentiation. In G3, median OS according to presence vs. absence of sarcomatoid dedifferentiation was 22 vs. 38 months (p &lt; 0.001) and sarcomatoid dedifferentiation independently predicted higher OM in multivariable analyses (hazard ratio 1.7, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Reporting of sarcomatoid dedifferentiation in G4 RCC is routinely recommended. However, in G4 ccmRCC, presence of sarcomatoid dedifferentiation does not independently predict higher OM and its inclusion is not essential in multivariable considerations in G4 patients. Conversely, despite absence of standard reporting recommendation for sarcomatoid dedifferentiation in G3, presence of sarcomatoid dedifferentiation is associated with significantly higher mortality and achieved independent predictor status. Therefore, it possibly should be routinely reported and routinely included in multivariable analyses addressing G3 ccmRCC patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102306"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446509","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":"Predicting long term survival in myxofibrosarcoma: Development and evaluation of Machine learning models for 2- and 5-year outcomes","authors":"Sanjeev Rampam ,&nbsp;Andrew G. Girgis ,&nbsp;Bishoy M. Galoaa ,&nbsp;Joseph O. Werenski ,&nbsp;Marcos R. Gonzalez ,&nbsp;Santiago A. Lozano-Calderón","doi":"10.1016/j.suronc.2025.102314","DOIUrl":"10.1016/j.suronc.2025.102314","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Myxofibrosarcoma is a rare soft tissue sarcoma with complex growth patterns and variable survival outcomes, making prognosis challenging. Machine learning (ML) offers a promising approach to enhance survival predictions. This study explored key predictive features and assessed ML model performance and generalizability.</div></div><div><h3>Methods</h3><div>We included 3400 patients from the National Cancer Database for model training, and 112 patients from our institutional registry for external validation. We employed a Random Forest algorithm to identify predictive features. These features were used to train four models: Random Forest, single Neural Network, Neural Network Ensemble, and Weighted Ensemble combining all approaches. Model performance was assessed using area under the curve (AUC), F1-scores, and Brier scores.</div></div><div><h3>Results</h3><div>Tumor size, age, and metastatic status were identified as key predictors of survival across models. In internal validation, multiple models showed promise, but the Neural Network Ensemble demonstrated balanced performance for both 2- and 5-year overall survival. In external validation, the Neural Network Ensemble outperformed the Random Forest model, and achieved AUC of 0.965 and 0.934 for 2- and 5-year overall survival, respectively.</div></div><div><h3>Conclusions</h3><div>We successfully developed and validated ML algorithms that accurately predicted survival outcomes in patients with myxofibrosarcoma, with insights for model selection.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102314"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425574","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":"Validation of a prognostic calculator to predict recurrence and mortality in melanoma patients undergoing sentinel lymph node biopsy","authors":"Julia Downey ,&nbsp;Christopher Baliski","doi":"10.1016/j.suronc.2025.102311","DOIUrl":"10.1016/j.suronc.2025.102311","url":null,"abstract":"<div><h3>Background</h3><div>The American Joint Committee on Cancer staging system (AJCC) is currently the gold standard for determining melanoma prognosis. However, it may not accurately reflect survival in certain substages, nor recurrence risk, prompting development of other predictive models. A validated predictive tool has been shown to perform well in two academic centers. We sought to investigate the performance of this nomogram in a regional cancer referral center, with the goal of future use for adjuvant treatment decisions.</div></div><div><h3>Methods</h3><div>A retrospective review of patients with T1b or greater melanomas, undergoing sentinel lymph node biopsy at a tertiary referral center between January 1, 2005, and June 30, 2022, was performed. Those with microsatellites or in-transit metastasis were excluded. Demographic, pathologic and treatment-related factors were linked to recurrence and survival data. The nomogram was assessed for the ability to discriminate recurrence and survival utilizing 6 prognostic factors (Breslow thickness, ulceration, age, tumour location, sentinel lymph node status and maximal lymph node metastasis diameter).</div></div><div><h3>Results</h3><div>486 patients were eligible for inclusion. The median age was 64 years (IQR: 54–73), with a Breslow thickness of 1.8 mm (IQR: 1.2–3.0). 95 patients (19.5 %) had pathologically positive sentinel lymph nodes, with 138 patients (28.4 %) developing recurrent disease. When applying this model to our population, the AUC for recurrence-free survival was 0.75 (95 % CI: 0.66–0.84), while melanoma-specific survival was 0.85 (95 % CI: 0.76–0.94).</div></div><div><h3>Conclusion</h3><div>The melanoma predictive tool performed well at predicting recurrence and survival in our population. The online calculator may assist clinicians advising patients on the merits of adjuvant treatments.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102311"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432979","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":"Strategies of the management of pulmonary metastases in children with Ewing sarcoma- single institution experience of 137 patients","authors":"Krzysztof Bronowicki,&nbsp;Justyna Antoniuk-Majchrzak,&nbsp;Iwona Malesza,&nbsp;Tomasz Walenta,&nbsp;Agnieszka Szymborska,&nbsp;Anna Raciborska","doi":"10.1016/j.suronc.2025.102334","DOIUrl":"10.1016/j.suronc.2025.102334","url":null,"abstract":"<div><h3>Background</h3><div>The role of pulmonary metastasectomy in pediatric Ewing sarcoma remains controversial, with significant treatment selection bias complicating the interpretation of retrospective series.</div></div><div><h3>Objective</h3><div>To evaluate treatment outcomes in isolated pulmonary metastases (PM) using propensity score analysis to control for selection bias.</div></div><div><h3>Methods</h3><div>Retrospective analysis of 137 patients with pulmonary metastases (85 isolated PM, 52 PM with extrapulmonary metastases) treated between 1998 and 2024. Primary comparison focused on thoracotomy alone versus radiotherapy alone in isolated PM patients with primary tumor surgery (n = 30). Propensity score matching was performed to address selection bias.</div></div><div><h3>Results</h3><div>Patients with isolated PM had superior overall survival compared to those with extrapulmonary disease (median OS: 111 vs 66 months, p &lt; 0.001). In isolated PM patients with primary tumor surgery, direct comparison between thoracotomy alone and radiotherapy alone revealed superior survival with surgical resection (median OS: 125 vs 38 months, p = 0.009).</div><div>Stratified analysis by chemotherapy response demonstrated that thoracotomy benefit was primarily evident in patients with poor histologic response (≤10 % viable cells, median OS: 56 vs 27 months, p = 0.017), while patients with good response showed similar outcomes regardless of local treatment approach (p = 0.104).</div><div>After propensity score matching and multivariable adjustment for age and gender, the apparent benefit of thoracotomy was maintained in direct treatment comparisons, though overall comparison against all non-surgical treatments showed no significant difference (HR 0.75, p = 0.343), highlighting the importance of appropriate treatment comparisons and patient selection.</div></div><div><h3>Conclusions</h3><div>Thoracotomy may benefit carefully selected isolated PM patients, particularly those with poor response to chemotherapy. However, significant selection bias complicates the interpretation of retrospective surgical series. The benefit appears limited to specific clinical scenarios rather than representing a general therapeutic advantage. Future studies should focus on developing standardized selection criteria and prospective validation of treatment algorithms.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102334"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693723","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":"Relationship between preoperative inflammatory status and survival in patients undergoing curative surgery for colorectal cancer","authors":"Valerio Argiolas ,&nbsp;Simona Deidda ,&nbsp;Mirko Armas,&nbsp;Luigi Zorcolo,&nbsp;Angelo Restivo","doi":"10.1016/j.suronc.2025.102332","DOIUrl":"10.1016/j.suronc.2025.102332","url":null,"abstract":"<div><h3>Introduction</h3><div>Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. While TNM staging remains the cornerstone for prognostic stratification, growing evidence highlights the role of systemic inflammation and nutritional status in influencing oncologic outcomes. This study aimed to evaluate the prognostic significance of preoperative immunonutritional indices in patients undergoing curative resection for stage I–III CRC.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 616 patients treated between January 2013 and December 2021 at a single tertiary center. Preoperative indices—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), prognostic nutritional index (PNI), and systemic inflammation score (SIS)—were calculated from routine blood tests performed within four weeks prior to surgery. Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-Meier curves and Cox proportional hazard models.</div></div><div><h3>Results</h3><div>After a median follow-up of 61.3 months, 185 deaths (30.0 %) and 74 recurrences (12.0 %) were recorded. All indices demonstrated significant associations with five-year OS and DFS in univariate analysis. In multivariate analysis, PLR&gt;176.9 (HR 1.43; 95 % CI 1.06–1.94; <em>p</em> = 0.02) and LMR≤3 (HR 1.46; 95 % CI 1.8–1.99; p = 0.01) were independently associated with worse OS. For DFS, significant independent predictors of adverse outcomes included NLR&gt;2.95 (HR 1.58; 95 % CI 1.15–2.15; <em>p</em> = 0.004), PLR&gt;176.9 (HR 1.65; 95 % CI 1.20–2.26; <em>p</em> = 0.002), LMR≤3 (HR 1.57; 95 % CI 1.14–2.15; p = 0.006), SII&gt;529.6 (HR 1.46, 95 % CI 1.07–1.99; <em>p</em> = 0.02), and SIS 1–2 (HR 1.43, 95 % CI 1.03–2.06; <em>p</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>Preoperative immunonutritional indices are independent prognostic markers in nonmetastatic colorectal cancer. Their integration with standard staging system could enhance risk stratification and guide personalized treatment.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102332"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579487","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}