Surgical Oncology-Oxford最新文献

{"title":"A ligamentum teres hepatis and falciform ligament ‘belt and braces’ approach in laparoscopic pancreaticoduodenectomy using a modified Blumgart anastomosis to minimize severe pancreatic fistula and post-operative complications","authors":"Wensheng Liu ,&nbsp;Zheng Li ,&nbsp;Chenjie Zhou ,&nbsp;Shunrong Ji ,&nbsp;Wenyan Xu ,&nbsp;Yihua Shi ,&nbsp;Mengqi Liu ,&nbsp;Haidi Chen ,&nbsp;Qifeng Zhuo ,&nbsp;Xianjun Yu ,&nbsp;Xiaowu Xu","doi":"10.1016/j.suronc.2024.102152","DOIUrl":"10.1016/j.suronc.2024.102152","url":null,"abstract":"<div><h3>Background</h3><div>To determine whether ligamentum teres hepatis and falciform ligament, wrapped around the gastroduodenal artery (GDA) and reinforced the posterior wall in pancreatojejunostomy (PJ), protects the GDA stump and other skeletal blood vessels from erosive hemorrhage and reduces the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF) and post-operative complications after laparoscopic pancreaticoduodenectomy (LPD).</div></div><div><h3>Methods</h3><div>We reviewed patients undergone LPD between January 2019 and June 2023. Patients were divided into two groups according to whether the ligamentous flap had been used to wrap the GDA stump (Group A) or to reinforce the posterior wall in PJ, together with the GDA wrapping procedure (Group B). Peri-operative data were reviewed to determine the effectiveness of this approach in preventing CR-POPF, post-pancreatectomy hemorrhage (PPH), and other complications.</div></div><div><h3>Results</h3><div>We enrolled 272 patients (Group A, 154 patients; Group B, 118 patients). Group B patients had significantly fewer ≥ Grade II Clavien–Dindo classification morbidities and CR-POPFs (P &lt; 0.05), and lower length of hospital stay (LOS) and abdominal drainage tube insertion times. Risk factor analysis indicated that main pancreatic duct dilation, the PJ reinforcement procedure, and soft pancreatic tissue were associated with ≥Grade II Clavien–Dindo morbidities and CR-POPF complications.</div></div><div><h3>Conclusions</h3><div>The ligamentous flap application in LPD provided shelter to GDA stump and other skeletal blood vessels under PJ from erosive digestive juices, reinforced the posterior wall in PJ, reduced the incidence of CR-POPF and ≥Grade II Clavien–Dindo classification morbidities. This simple procedure is effective for improving surgical safety of LPD.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102152"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424876","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":"Diagnostic accuracy and treatment benefit of PET/CT in staging of colorectal cancer compared to conventional imaging","authors":"Rebecca Engel ,&nbsp;Ken Kudura ,&nbsp;Kwadwo Antwi ,&nbsp;Kris Denhaerynck ,&nbsp;Daniel Steinemann ,&nbsp;Sereina Wullschleger ,&nbsp;Beat Müller ,&nbsp;Martin Bolli ,&nbsp;Marco von Strauss und Torney","doi":"10.1016/j.suronc.2024.102151","DOIUrl":"10.1016/j.suronc.2024.102151","url":null,"abstract":"<div><h3>Background</h3><div>Until recently the use of positron emission tomography (PET) CT for staging in colorectal cancer (CRC) has been limited to the detection of distant metastasis in advanced disease. But with the introduction of neoadjuvant treatments in CRC, accurate pre-treatment staging has become more relevant.</div></div><div><h3>Aims</h3><div>The aim of the study was to assess the staging accuracy for nodal and distant metastasis of PET/CT compared to computed tomography (CT) alone in CRC. Secondary endpoints were overall survival (OS) and cost of CT compared to PET/CT.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 539 cases with CRC staged with PET/CT and or CT between 2015 and 2021 in a Swiss tertiary referral center was performed. In 471 patients for nodal staging and 479 for staging of distant metastasis the clinical stage of both modalities was compared with pathological stage.</div></div><div><h3>Results</h3><div>The distribution of UICC stages (n = 479) was as follows: Stage I 62 cases (12.9 %), Stage II 127 cases (26.5 %), Stage III 199 cases (41.5 %), Stage IV 91 cases (19.0 %).</div><div>CT alone compared to PET was able to predict nodal involvement with a sensitivity of 55.2 % (95%CI 5.7–59.7 %) and 66.7 % (95%CI 62.4–70.9 %), respectively. The specificity was 67.0 % (95%CI 62.8–71.3 %) for CT and 63.6 % (95%CI 59.3–68.0 %) for PET. The positive predictive value was 49.5 % for CT vs. 51.8 % for PET. The sensitivity of metastasis detection was 53.6 % (95%CI 49.1–58.1 %) for CT and 82.5 % (95%CI 79.1–85.9 %) for PET.</div></div><div><h3>Conclusions</h3><div>PET/CT showed higher sensitivity in the detection of lymph node involvement and metastases in CRC patients compared to CT alone.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102151"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441076","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":"Elevating precision: A thorough investigation of multiparametric prostate MRI for prolonged insights into early continence prediction after robot-assisted laparoscopic prostatectomy","authors":"Mehmet Şahin ,&nbsp;Merve Şam Özdemir ,&nbsp;Osman Can ,&nbsp;Emin Taha Keskin ,&nbsp;Harun Özdemir ,&nbsp;Abdülmuttalip Şimşek","doi":"10.1016/j.suronc.2024.102148","DOIUrl":"10.1016/j.suronc.2024.102148","url":null,"abstract":"<div><h3>Background</h3><div>While radical prostatectomy stands out as one of the most effective curative treatments for prostate cancer, it does come with annoying side effects, such as urinary incontinence (UI). We aimed to investigate the predictability of UI using MRI measurements, along with clinical and disease-related variables.</div></div><div><h3>Methods</h3><div>We included 191 patients who underwent robot-assisted laparoscopic radical prostatectomy between July 2020 and October 2022 in the study. Preoperative MRIs of the patients are re-evaluated by an experienced uroradiologist, and membranous urethral length (MUL), urethra wall thickness, levator ani thickness, outer levator distance, Lee's apex shape, intravesical prostate protrusion length, prostate apex depth, and pubic height measurements were made. Additionally, retrospective data on patients' age, BMI, PSA, PSA density, prostate volume, IPSS, clinical stage, and nerve-sparing status were collected. Patients were categorized into two groups based on continence status in the third postoperative month: continent or incontinent. The definition of UI was accepted as the use of one or more pads per day.</div></div><div><h3>Results</h3><div>UI was observed in 38.21 % of the patients in the postoperative third month. Among MRI measurements, only MUL showed a significant relationship with UI (p &lt; 0.001). IPSS (p = 0.004) and Clinical Stage (p &lt; 0.001) were also significantly associated with continence status. Logistic regression analysis identified BMI (p = 0.023; CI 0.73–0.97), IPSS (p = 0.002; CI 1.03–1.17), MUL (p = 0.001; CI 0.66–0.90), and Clinical Stage (p &lt; 0.001; CI 1.53–2.71) as significant predictors. In Multivariable Regression analysis, Clinical Stage emerged as the most powerful predictor of UI (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Except for MUL, MRI measurements may not predict postoperative UI. A combination of IPSS, clinical stage, and MUL effectively informs patients about postoperative outcomes. These findings contribute to enhancing preoperative counseling for patients undergoing radical prostatectomy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102148"},"PeriodicalIF":2.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331949","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":"Effective factors on postoperative 30–90 and 360-day mortality in non-small cell lung cancer","authors":"Yunus Türk ,&nbsp;Ahmet Üçvet","doi":"10.1016/j.suronc.2024.102149","DOIUrl":"10.1016/j.suronc.2024.102149","url":null,"abstract":"<div><h3>Purpose</h3><div>Postoperative mortality and morbidity are serious problems, and the identification of risky patient groups will reduce mortality and morbidity rates. The aim of our study was to determine the mortality at 30, 90, and 360 days in patients who underwent surgical resection for non-small cell lung cancer (NSCLC).</div></div><div><h3>Methods</h3><div>In this single-center retrospective study, 935 patients who were operated on for NSCLC were included. Demographic characteristics, laboratory data, tumor characteristics, surgical method used, type of resection, postoperative complications, and the relationship between 30, 90, and 360-day mortality were analyzed.</div></div><div><h3>Results</h3><div>In-hospital mortality was observed in 21 (2.2 %) of the 935 patients; the 30-90-360-day mortality rate was respectively 3 %, 4.9 %, and 12.1 %. The 30- and 90-day mortality rates were close (3 %, 4.9 % respectively), and the only difference was the additional surgical procedure. The common factors that increased 30-, 90-, and 360-day mortality were advanced disease stage, additional surgical procedure, length of stay longer than 7 days, low % forced vital capacity (FVC), presence of comorbidities, presence of postoperative complications, and pneumonectomy.</div></div><div><h3>Conclusion</h3><div>In this study, 30-, 90-, and 360-day mortality rates and common and independent risk factors affecting mortality were determined. Although 30-day mortality is the most often utilized time period for assessing postoperative mortality, 90-day mortality can be used to predict postoperative mortality following a major surgical procedure. Preoperative mortality and morbidity are expected to decrease with more detailed preoperative examination of high-risk patients and special follow-up programs in the postoperative period.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102149"},"PeriodicalIF":2.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480136","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":"Treatment strategies for patients over 80 years of age with oral squamous cell carcinoma","authors":"Hideaki Hirai ,&nbsp;Naoya Kinoshita ,&nbsp;Naoto Nishii ,&nbsp;Yu Oikawa ,&nbsp;Takuma Kugimoto ,&nbsp;Takeshi Kuroshima ,&nbsp;Hirofumi Tomioka ,&nbsp;Yasuyuki Michi ,&nbsp;Yoshimasa Sumita ,&nbsp;Kei Tomihara ,&nbsp;Hiroyuki Harada","doi":"10.1016/j.suronc.2024.102146","DOIUrl":"10.1016/j.suronc.2024.102146","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the clinical characteristics of patients with oral squamous cell carcinoma aged ≥80 years, focusing on surgical treatments.</div></div><div><h3>Study design</h3><div>We reviewed patients with oral squamous cell carcinoma aged ≥80 years who underwent surgery between 2005 and 2018. Basic information, comorbidities, multiple primary cancers, initial treatment, complications, and outcomes were evaluated.</div></div><div><h3>Results</h3><div>Of 197 patients aged ≥80 years, 119 patients underwent surgery (50 males, 69 females; mean age: 83.5 years). The gingiva was the most common primary tumor site (63 patients, 52.9 %). The stage classification was stage I in 35 patients (29.4 %), stage II in 44 (37 %), stage III in 16 (13.4 %), stage IVA in 22 (18.5 %), and stage IVB in 2 (1.7 %). Comorbidities were identified in 112 patients (94.1 %). Surgery was the initial treatment in 111 patients (93.3 %). Eight (6.7 %) patients received postoperative adjuvant chemotherapy/radiotherapy; 20 patients (16.8 %) underwent free tissue transplantation. Perioperative complications were observed in 36 patients (30.3 %). The cumulative 5-year and 10-year overall survival rates were 82 % and 68.3 %, respectively; the disease-specific survival rates were 90 %.</div></div><div><h3>Conclusion</h3><div>Good treatment outcomes were obtained with radical surgery. Surgery should be the first choice if quality of life is assured and there are no issues with surgical tolerance, regardless of age.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102146"},"PeriodicalIF":2.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367352","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":"Preoperative multiparametric magnetic resonance imaging based risk stratification system for predicting biochemical recurrence after radical prostatectomy","authors":"Cagri Akpinar ,&nbsp;Digdem Kuru Oz ,&nbsp;Alkan Oktar ,&nbsp;Furkan Ozsoy ,&nbsp;Eriz Ozden ,&nbsp;Nuray Haliloglu ,&nbsp;Muhammed Arif Ibis ,&nbsp;Evren Suer ,&nbsp;Sumer Baltaci","doi":"10.1016/j.suronc.2024.102150","DOIUrl":"10.1016/j.suronc.2024.102150","url":null,"abstract":"<div><h3>Background</h3><div>Multiparametric magnetic resonance imaging (mpMRI) is used as a current marker in preoperative staging and surgical decision-making, but current evidence on predicting post-surgical oncological outcomes based on preoperative mpMRI findings is limited. In this study We aimed to develop a risk classification based on mpMRI and mpMRI-derived biopsy findings to predict early biochemical recurrence (BCR) after radical prostatectomy.</div></div><div><h3>Methods</h3><div>Between January 2017 and January 2023, the data of 289 patients who underwent mpMRI, transrectal ultrasound-guided cognitive and fusion targeted biopsies, and subsequent radical prostatectomy (RP) with or without pelvic lymph node dissection in a single center were retrospectively re-evaluated. BCR was defined as a prostate specific-antigen (PSA) ≥ 0.2 ng/mL at least twice after RP. Multivariate logistic regression models tested the predictors of BCR. The regression tree analysis stratified patients into risk groups based on preoperative mpMRI characteristics. Receiver operating characteristic (ROC)-derived area under the curve (AUC) estimates were used to test the accuracy of the regression tree–derived risk stratification tool.</div></div><div><h3>Results</h3><div>BCR was detected in 47 patients (16.2 %) at a median follow-up of 24 months. In mpMRI based multivariate analyses, the maximum diameter of the index lesion (HR 1.081, 95%Cl 1.015–1.151, p = 0.015) the presence of PI-RADS 5 lesions (HR 2.604, 95%Cl 1.043–6.493, p = 0.04), ≥iT3a stage (HR 2.403, 95%Cl 1.013–5.714, p = 0.046) and ISUP grade ≥4 on biopsy (HR 2.440, 95%Cl 1.123–5.301, p = 0.024) were independent predictors of BCR. In regression tree analysis, patients were stratified into three risk groups: maximum diameter of index lesion, biopsy ISUP grade, and clinical stage on mpMRI. The regression tree–derived risk stratification model had moderate-good accuracy in predicting early BCR (AUC 77 %)</div></div><div><h3>Conclusion</h3><div>Straightforward mpMRI and mpMRI-derived biopsy-based risk stratification for BCR prediction provide an additional clinical predictive model to the currently available pathological risk tools.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102150"},"PeriodicalIF":2.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331950","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 incidence of atypical fibroxanthoma and pleomorphic dermal sarcoma in Denmark from 2002 to 2022","authors":"Olivia Fruergaard,&nbsp;Mathias Ørholt,&nbsp;Peter Viktor Vester-Glowinski,&nbsp;David Hebbelstrup Jensen","doi":"10.1016/j.suronc.2024.102147","DOIUrl":"10.1016/j.suronc.2024.102147","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to assess trends in the incidence rates and overall survival of atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) in the Danish population from 2002 to 2022.</div></div><div><h3>Methods</h3><div>We included all patients diagnosed with AFX or PDS in the Danish National Pathology Register (DNPR) during the study period. We computed the age-adjusted incidence rate (AAIR) per 100,000 and the average annual percent change (AAPC) and developed an age-period-cohort (APC) model of incidence.</div></div><div><h3>Results</h3><div>We included a total of 1118 patients, 78.3 % of whom were men. The median age upon diagnosis for AFX and PDS was 77.6 and 78.4 years, respectively. 84.5 % of the 1118 patients received an AFX diagnosis, while 15.5 % received a PDS diagnosis. The AAIR rose from 0.2 per 100,000 individuals in 2002 to 0.5 per 100,000 by 2022, with a peak increase of 0.75 per 100,000 in 2014. The AAPC for both tumors was 5.3 (95 % CI 2.9 %–7.7 %). We found a significant difference in overall survival between AFX and PDS, with PDS having worse overall survival than AFX.</div></div><div><h3>Conclusion</h3><div>This study, which included the largest non-selected national population to date, found a significant increase in the incidence of AFX and PDS between 2002 and 2015, followed by a decrease.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102147"},"PeriodicalIF":2.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401899","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":"Review of definition and treatment of upper rectal cancer","authors":"Elias Karam ,&nbsp;Fabien Fredon ,&nbsp;Yassine Eid ,&nbsp;Olivier Muller ,&nbsp;Marie Besson ,&nbsp;Nicolas Michot ,&nbsp;Urs Giger-Pabst ,&nbsp;Arnaud Alves ,&nbsp;Mehdi Ouaissi","doi":"10.1016/j.suronc.2024.102145","DOIUrl":"10.1016/j.suronc.2024.102145","url":null,"abstract":"<div><div>While the treatment of locally advanced lower and middle rectal cancer with total mesorectal excision (TME) after neoadjuvant therapy is now well defined, the treatment of locally advanced upper rectal cancer (LAURC) remains controversial. Although most teams and academic societies recommend upfront surgery (US) with partial mesorectal excision (PME), as this appears to be sufficient for these tumors, the literature remains conflicting regarding the additional use of neoadjuvant therapy and TME. Current recommendations for the treatment of LAURC do not reflect actual clinical practice. Notably, there is a paucity of published data specific to the treatment of LAURC since most of the data are from sub-analyses of different cohorts. Another important point responsible for the inconsistent data situation is the fact that the current definition of upper rectal cancer is based on anatomical criteria that are difficult to reproduce and therefore also differ between international professional societies.</div><div>The aim of this review is to provide a deeper insight into the issues surrounding the treatment of LAURC based on an analysis of the current literature, including anatomic and embryologic data.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102145"},"PeriodicalIF":2.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331951","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":"Pancreatoduodenectomy after Ivor-Lewis Santi oesophagectomy with gastric tube reconstruction. An European multicentre experience","authors":"Alessandro D. Mazzotta ,&nbsp;Pietro Addeo ,&nbsp;Benedetto Ielpo ,&nbsp;Michael Ginesini ,&nbsp;Nicolas Regenet ,&nbsp;Ugo Boggi ,&nbsp;Philippe Bachellier ,&nbsp;Olivier Soubrane","doi":"10.1016/j.suronc.2024.102144","DOIUrl":"10.1016/j.suronc.2024.102144","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy (PD) is the standard surgery to treat tumors and other conditions affecting the head of the pancreas. PD involves the division of the gastroduodenal artery (GDA) and its branches, to allow for complete dissection of lymph nodes. However, PD in patients with prior esophageal resection presents challenges due to altered anatomy and risks compromising gastric tube vascularization. GDA preservation becomes crucial to avoid ischemia, although this may pose oncological risks by potentially leaving behind regional lymph nodes. This article reviews European surgical center experiences and techniques for PD in patients with prior esophageal surgery, focusing on short-term outcomes.</div></div><div><h3>Methods</h3><div>We have collected all the experiences carried out in European surgical centers and evaluated the techniques applied for PD in patients who had prior esophageal surgery while analyzing short-term outcomes.</div></div><div><h3>Results</h3><div>Eight patients from 5 European centers were identified. Six patients were diagnosed with pancreatic adenocarcinoma, including one borderline case. Intraoperatively, the gastroduodenal artery (GDA) was preserved in all cases, with portal vein reconstruction required in only one instance due to tumor invasion. No ischemia or venous congestion of the gastric tube was observed during the surgical procedure. Post-operative complications that occurred included POPF type C in 1 (12.5 %), PPH type C in 1 (12.5 %). The median number of harvested lymph nodes was 21 [14–24]. with a median of 1.5 positive lymph nodes. R1 resection was present in 62.5 % of cases.</div></div><div><h3>Conclusion</h3><div>Performing pancreaticoduodenectomy subsequent to Ivor Lewis esophagectomy is a technical challenge, but seems feasiable and safe in selected patients. GDA-preserving pancreaticoduodenectomy emerges as a valuable and time-efficient variation of the conventional procedure, it can be considered oncologically appropriate, but studies confirming its long-term impact on radicality are still needed.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102144"},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367351","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":"Advances in the management of regionally metastatic melanoma","authors":"Caitlyn Balsay-Patel ,&nbsp;Michelle M. Dugan ,&nbsp;Jonathan S. Zager","doi":"10.1016/j.suronc.2024.102143","DOIUrl":"10.1016/j.suronc.2024.102143","url":null,"abstract":"<div><div>Despite numerous developments in systemic therapy, the prognosis for patients with locoregionally advanced melanoma remains poor. By delivering therapy directly to the targeted area via intralesional injections or intra-arterial isolated infusions, systemic side effects are minimized and oncolytic agents are delivered more directly and effectively to the melanoma. There has been significant progress in recent years with intralesional agents such as Talimogene laherparepvec (T-VEC), PV-10 and TAVOkinase/electrocorporation as well as advances in infusional therapies such as percutaneous hepatic perfusion (PHP) for hepatic metastasis of ocular melanoma. This review evaluates advances in intralesional and infusional therapies for melanoma while limiting discussion to those therapies currently approved and on trial.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102143"},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319156","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}