Surgical Oncology-Oxford最新文献

{"title":"Reconsidering upfront surgery for resectable pancreatic ductal adenocarcinoma: The role of risk stratification and neoadjuvant chemotherapy","authors":"Yoshitaro Shindo ,&nbsp;Hidenori Takahashi ,&nbsp;Hiroto Matsui ,&nbsp;Yukio Tokumitsu ,&nbsp;Masao Nakajima ,&nbsp;Yuta Kimura ,&nbsp;Mitsuo Nishiyama ,&nbsp;Yusaku Watanabe ,&nbsp;Shinobu Tomochika ,&nbsp;Yuki Nakagami ,&nbsp;Ryouichi Tsunedomi ,&nbsp;Michihisa Iida ,&nbsp;Tatsuya Ioka ,&nbsp;Hiroaki Nagano","doi":"10.1016/j.suronc.2025.102333","DOIUrl":"10.1016/j.suronc.2025.102333","url":null,"abstract":"<div><h3>Background</h3><div>The optimal treatment strategy for resectable pancreatic ductal adenocarcinoma (R-PDAC) remains controversial. In this study, we aimed to evaluate the impact of neoadjuvant chemotherapy (NAC) using gemcitabine plus nab-paclitaxel (GnP) or modified FOLFIRINOX (mFFX) compared with upfront surgery (UFS) in patients with R-PDAC.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 125 patients diagnosed with R-PDAC at a single institution between 2010 and 2022. The patients were divided into UFS (n = 57) and NAC (n = 68) groups. Survival outcomes, perioperative factors, and prognostic variables were analyzed. Subgroup analysis was performed based on high-risk features, defined as elevated carcinoembryonic antigen (CEA) levels &gt;6 ng/mL and tumor size ≥25 mm.</div></div><div><h3>Results</h3><div>No significant differences were observed in overall survival (OS) and progression-free survival (PFS) between the entire UFS and NAC groups. However, in patients with high-risk features, NAC significantly improved OS compared with UFS (median survival 29.0 months vs. 10.6 months, respectively; P &lt; 0.0001). NAC was associated with reduced intraoperative blood loss and a lower lymph node positivity rate without increasing postoperative morbidity or mortality.</div></div><div><h3>Conclusions</h3><div>While NAC did not universally improve survival outcomes in R-PDAC, it significantly benefitted patients with poor prognostic indicators. These findings support a selective approach to NAC based on biological risk stratification rather than anatomical criteria alone. Future prospective studies are warranted to validate these observations and optimize individualized treatment strategies.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102333"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579572","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":"ERAS pathway adherence and its association with return to intended oncological therapy after gastrectomy","authors":"Ana León Bretscher ,&nbsp;Javier Ripollés Melchor ,&nbsp;María García Nebreda ,&nbsp;Ane Abad Motos ,&nbsp;Carla Iglesias Morales ,&nbsp;José María Tena Guerrero ,&nbsp;Cristina Gil Lapetra ,&nbsp;Francisco José Orts Micó ,&nbsp;Manuel Llácer Pérez ,&nbsp;Patricia Galán Menéndez ,&nbsp;Enrique Alday-Muñoz ,&nbsp;Jorge Puertas Domínguez ,&nbsp;Bakarne Ugarte Sierra ,&nbsp;Ana Maria Pascual Bellosta ,&nbsp;Rosalia Navarro-Perez ,&nbsp;Raquel Risco ,&nbsp;Virginia Moreno Blanco ,&nbsp;Raquel García Álvarez ,&nbsp;Irene Mojarro Zamora ,&nbsp;Alfredo Abad Gurumeta ,&nbsp;Gloria Paseiro Crespo","doi":"10.1016/j.suronc.2025.102346","DOIUrl":"10.1016/j.suronc.2025.102346","url":null,"abstract":"<div><h3>Background</h3><div>Enhanced Recovery After Surgery (ERAS) pathways improve short-term outcomes in abdominal surgery, but their impact on timely initiation of adjuvant chemotherapy (Return to Intended Oncologic Therapy, RIOT) in gastric cancer remains uncertain.</div></div><div><h3>Methods</h3><div>This multicenter, prospective cohort study (POWER4, NCT03865810) analysed 742 patients undergoing gastrectomy across 72 Spanish hospitals (2019–2020). ERAS adherence was assessed by quartiles. Primary outcome: timely RIOT (chemotherapy initiation ≤56 days post-surgery). Secondary outcome: time to RIOT (days). Multivariable logistic and Cox regression models adjusted for clinical/tumour factors.</div></div><div><h3>Results</h3><div>Of 742 patients, 65 % achieved timely RIOT. Quartile-based univariable analysis revealed shorter time to RIOT with higher adherence (Q4 vs. Q1: HR 0.64, 95 % CI 0.42–0.97, *p* = 0.034), but this association disappeared in multivariable models. Advanced TNM stage (e.g., IIIC: HR 18.6, *p* &lt; 0.001) and ASA class were stronger predictors of delayed RIOT.</div></div><div><h3>Conclusions</h3><div>While ERAS pathways may aid recovery, their impact on RIOT depends on high adherence and is overshadowed by tumour-related factors. Future efforts should integrate ERAS with prehabilitation for high-risk patients and target adherence thresholds ≥70 %.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102346"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145883303","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":"Fully robotic Ivor Lewis Esophagectomy with side - to - side linear stapled anastomosis: our standardized 15 - step technique and perioperative outcomes","authors":"Giuseppe Giuliani,&nbsp;Francesco Guerra,&nbsp;Angela Tribuzi,&nbsp;Lorenzo De Franco,&nbsp;Erica Monati,&nbsp;Francesco Matarazzo,&nbsp;Michele Di Marino,&nbsp;Andrea Coratti","doi":"10.1016/j.suronc.2025.102312","DOIUrl":"10.1016/j.suronc.2025.102312","url":null,"abstract":"<div><h3>Backgraund</h3><div>In recent years, robotic surgery for the treatment of esophageal cancer has expanded rapidly. In this study, we report on our standardized steps for RILE, including our perioperative outcomes.</div></div><div><h3>Methods</h3><div>The study includes every single step that we systematically perform during the abdominal and thoracic phases of the RILE. All consecutive patients undergoing RILE by a single surgical team were included in this analysis.</div></div><div><h3>Results</h3><div>A total of 68 patients were included in the analysis. There was one intraoperative complication and no conversion occurred. The rate of major postoperative complications (Clavien and Dindo &gt; II) was 14 %: with anastomotic-related morbidity in particular, 4 (6 %) patients developed anastomotic leakage. The median number of harvested lymph nodes was 41 (range 13–113), while the rate of R0 resection was 97 %.</div></div><div><h3>Conclusions</h3><div>In our opinion our standardisation of RILE could help new surgical teams to start using a robotic approach for two field esophagectomy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102312"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446484","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":"Nationwide field evaluation of early oral intake following gastric cancer surgery","authors":"Tsunehiko Maruyama ,&nbsp;Kazuto Ikezawa ,&nbsp;Hideo Suzuki ,&nbsp;Tomohiro Kurokawa ,&nbsp;Yoshimasa Akashi ,&nbsp;Tatsuya Oda","doi":"10.1016/j.suronc.2026.102352","DOIUrl":"10.1016/j.suronc.2026.102352","url":null,"abstract":"<div><h3>Background</h3><div>Early oral intake (EOI) is a core component of Enhanced Recovery After Surgery (ERAS) protocols. Although EOI after gastrectomy has been shown to improve recovery and reduce postoperative complications, its real-world implementation across Japan remains unclear. This study aimed to evaluate the current status and institutional factors influencing EOI after gastric cancer surgery using a nationwide database.</div></div><div><h3>Methods</h3><div>This retrospective observational study used Japan's nationwide Diagnosis Procedure Combination (DPC) database to analyze 26,097 patients who underwent gastric cancer surgery at 472 institutions from 2017 to 2022. Patients were divided into EOI and non-EOI groups based on oral intake initiation within two days postoperatively. Surgical methods, hospital characteristics, and length of stay were compared.</div></div><div><h3>Results</h3><div>Only 20.8 % of patients initiated EOI. Laparoscopic distal gastrectomy had significantly higher EOI rates compared to open procedures. However, no significant difference was observed for proximal or total gastrectomy. Larger hospitals and designated cancer centers showed higher EOI rates. The EOI group had a significantly shorter postoperative stay (median 9 vs. 12 days, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>EOI following gastrectomy is associated with shorter hospitalization, yet its adoption remains low in Japan. Institutional factors and multidisciplinary collaboration may play crucial roles in promoting EOI. Findings may inform perioperative optimization and ERAS standardization in oncologic gastric surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102352"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076764","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":"Predictive factors and prognostic significance of HER2-low early breast cancer with long-term follow-up","authors":"Yuka Niwa ,&nbsp;Mitsuo Terada ,&nbsp;Yumi Wanifuchi-Endo ,&nbsp;Takashi Fujita ,&nbsp;Tomoko Asano ,&nbsp;Hidetoshi Kawaguchi ,&nbsp;Kazuki Nozawa ,&nbsp;Nana Matsumoto ,&nbsp;Ayaka Isogai ,&nbsp;Hikaru Kawahara ,&nbsp;Marie Mizumoto ,&nbsp;Tatsuya Toyama","doi":"10.1016/j.suronc.2026.102360","DOIUrl":"10.1016/j.suronc.2026.102360","url":null,"abstract":"<div><h3>Background</h3><div>Human epidermal growth factor receptor type2 (HER2)-low breast cancer has emerged as a clinically relevant subtype with novel HER2-targeted therapies. This study aimed to investigate the clinicopathological features and prognostic implications of HER2-low status in patients with early breast cancer undergoing long-term follow-up.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with HER2-negative early breast cancer who underwent surgery between 2003 and 2022. We investigated clinicopathological factors associated with HER2-low status and the clinical impacts of HER2-low/zero status on disease-free survival (DFS), distant DFS (DDFS), and overall survival (OS) according to hormone receptor (HR) status using univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>Among 3663 patients with early breast cancer, we identified 2519 HER2-negative patients (HER2-low 57%, HER2-zero 28%). HER2-low status was associated with high estrogen-receptor (ER) positivity (Allred score 8) and less mucinous histology, but there was no association with progesterone receptor (PgR) expression. HER2-low status also tended to be associated with pre/perimenopausal status and higher nuclear grade (≥2), but not with tumor size or lobular/metaplastic type. Pathological complete response rates after neoadjuvant chemotherapy were comparable between HER2-low (18.9%) and HER2-zero (21.6%), with no survival differences. HER2 status (low vs. zero) was not significantly associated with DFS, DDFS, or OS, and had no prognostic impact in patients with either HR-positive or -negative disease.</div></div><div><h3>Conclusion</h3><div>HER2-low breast cancer was characterized by distinct biological features, including high ER positivity (especially Allred score 8) without PgR association, but did not confer a prognostic advantage over HER2-zero disease. HER2-low status may reflect biological heterogeneity that could be relevant when interpreting treatment response rather than serving as an independent prognostic marker.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102360"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138105","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":"SCOUT® radar localization of non-palpable breast carcinomas versus traditional wire-based localization: a single center retrospective comparison","authors":"Åse Florholmen-Kjær ,&nbsp;Rica Mortensen ,&nbsp;Vegard Heimly Brun","doi":"10.1016/j.suronc.2025.102324","DOIUrl":"10.1016/j.suronc.2025.102324","url":null,"abstract":"<div><h3>Purpose</h3><div>Breast-conserving therapy requires a secure method to localize non-palpable lesions. The traditional and simple metal wire localization (WL) is challenged by more advanced and costly techniques that may have several advantages. We report the first European direct comparison between WL and SCOUT® Radar Localization (RL) comparing oncological and logistical benefits of implementing the new method in the treatment of non-palpable breast carcinomas including in situ lesions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 150 breast cancer surgeries performed immediately before and after WL was replaced by RL in our unit. The last 50 wire-guided surgeries were compared to the initial 50 radar-guided surgeries (cohort I, implementation phase) and to the subsequent 50 radar-guided surgeries (cohort II, routine phase).</div></div><div><h3>Results</h3><div>All lesions and markers were successfully removed in all groups. No procedure-specific complications were registered. Of the 50 patients in the WL group, 8 % needed redo surgery due to positive margins, compared to 4 % in the RL groups (not statistically different). The histological margin was similar between the groups. The median time consumption during surgery was reduced by 26.5 min after establishing the radar localization method (p = 0.022). The resected tissue corresponded better with the marked area in the breast in the RL group (p = 0.026), as evaluated by a more central placement of the marker.</div></div><div><h3>Conclusions</h3><div>Radar localization of breast carcinomas is safe for women with non-palpable breast carcinomas including in situ lesions. The method reduces time consumption in the operating room and may give better surgical precision.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102324"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524296","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 rate of non-sentinel lymph node metastases at axillary dissection in patients with a positive sentinel lymph node after neoadjuvant chemotherapy","authors":"A.M. Zaborowski ,&nbsp;F. Wehrmann ,&nbsp;J. McGarry ,&nbsp;T. Harding ,&nbsp;I. Balasubramanian ,&nbsp;C. Spillane ,&nbsp;L. Nolan ,&nbsp;W. Eljack ,&nbsp;E. Quinn ,&nbsp;M. Corrigan ,&nbsp;A. Lowery ,&nbsp;M. Kerin ,&nbsp;C. Power ,&nbsp;M. Allen ,&nbsp;A. Butt ,&nbsp;A.D.K. Hill ,&nbsp;D. Alazawi ,&nbsp;T. Boyle ,&nbsp;E. Connolly ,&nbsp;A. Heeney ,&nbsp;R.S. Prichard","doi":"10.1016/j.suronc.2026.102351","DOIUrl":"10.1016/j.suronc.2026.102351","url":null,"abstract":"<div><h3>Background</h3><div>Axillary lymph node dissection (ALND) remains the standard of care in patients with a positive sentinel lymph node biopsy (SLNB) following neoadjuvant chemotherapy (NAC). The aim of this study was to determine the rate of non-sentinel lymph node metastases in patients undergoing completion ALND and to identify factors predictive of positive non-sentinel lymph nodes.</div></div><div><h3>Methods</h3><div>A retrospective multicentre study was performed. Patients with node-positive breast cancer who had a positive SLNB after NAC and underwent a completion ALND between 2016 and 2023 were included. Logistic regression analysis was used to identify factors predictive of positive non-sentinel lymph nodes.</div></div><div><h3>Results</h3><div>A total of 106 patients were included. The median age was 48 (29–74). The median number of sentinel lymph nodes (SLNs) removed was 3 (1–6) and the median number of positive SLNs was 2 (1–4). Forty-five patients (43 %) had additional positive lymph nodes at completion ALND. Additional positive nodes were identified in 53 % of patients with SLN metastases ≤2 mm and in 37 % with SLN metastases &gt;2 mm. Final N stage was ypN1 in 81 patients (76.4 %), ypN2 in 16 (15.1 %) and ypN3 in 9 (8.5 %). ALND increased ypN stage in 20.8 % of patients (22/106). Extra-nodal extension (OR 2.34, C.I 1.06–5.20, p = 0.04) was the only factor associated with a higher likelihood of positive non-sentinel nodes.</div></div><div><h3>Conclusion</h3><div>In patients with a positive SLNB after NAC, 43 % had additional positive nodes. Extranodal extension was predictive of additional nodal disease. ALND increased the ypN stage in 21 %, mostly in patients with hormone-receptor positive and triple negative breast cancer which may have treatment implications.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102351"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031476","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":"Molecular profiling of hepatoid adenocarcinoma and adenocarcinoma with enteroblastic differentiation","authors":"Yosuke Matsumoto ,&nbsp;Keiichi Hatakeyama ,&nbsp;Masanori Terashima ,&nbsp;Takeshi Nagashima ,&nbsp;Kenichi Urakami ,&nbsp;Tadakazu Shimoda ,&nbsp;Takashi Sugino ,&nbsp;Etsuro Bando ,&nbsp;Hiroharu Yamashita ,&nbsp;Yukiyasu Okamura ,&nbsp;Ken Yamaguchi","doi":"10.1016/j.suronc.2025.102325","DOIUrl":"10.1016/j.suronc.2025.102325","url":null,"abstract":"<div><div>Hepatoid adenocarcinoma (HAD) and adenocarcinoma with enteroblastic differentiation (ACED) are rare gastric cancer types that produce alpha-fetoprotein (AFP) that morphologically resembles the liver or fetal organ. This study investigated the molecular profiling of HAD and ACED compared with common-type gastric adenocarcinoma (CGA). This study enrolled 496 patients with gastric adenocarcinoma who underwent radical gastrectomy. Whole-exome sequencing and gene expression profiling were conducted to compare HAD/ACED and CGA. Immunohistochemistry was performed in 39 patients with HAD/ACED, including 10 who underwent genomic analysis. <em>TP53</em> (100 %), <em>CSMD3</em> (30 %), <em>LRP1B, FAT3, TG, APOB, CREBBP, PASK, DROSHA</em>, and <em>STK40</em> (20 %) were mutated genes with high frequency (&gt;20 %) in HAD/ACED. Gene expression analysis revealed 15 overexpressed genes in HAD/ACED, many of which were associated with hepatocytes and fetal organs. Furthermore, cancer stemness gene overexpression, including <em>LIN28B</em>, <em>IGF2BP1</em>, and <em>HMGA2</em>, which are related to <em>TP53</em>, was observed. Immunohistochemistry revealed positive staining for LIN28B (82 %), IGF2BP1 (94 %), and HMGA2 (72 %), as well as staining for AFP (69 %), GPC3 (75 %), and SALL4 (94 %). Additionally, positive cancer stemness gene staining was observed in CGA mucosa coexisting with HAD/ACED. HAD/ACED demonstrated higher <em>TP53</em> mutation accumulation and TP53-related cancer stemness gene overexpression, including <em>LIN28B</em>, <em>IGF2BP1</em>, and <em>HMGA2</em>. Therefore, <em>TP53</em> and these cancer stemness genes might be involved in the occurrence of HAD/ACED.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102325"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514667","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":"Prognostic relevance of CT-defined body composition in esophageal cancer patients undergoing curative treatment","authors":"Hannah Götze ,&nbsp;Stefan Niebisch ,&nbsp;Matthias Mehdorn ,&nbsp;Daniel Seehofer ,&nbsp;Gertraud Stocker ,&nbsp;Timm Denecke ,&nbsp;Hans-Jonas Meyer","doi":"10.1016/j.suronc.2025.102278","DOIUrl":"10.1016/j.suronc.2025.102278","url":null,"abstract":"<div><h3>Introduction</h3><div>Body composition including low skeletal muscle mass (LSMM) defined by skeletal muscle index (SMI) and subcutaneous and visceral adipose tissue (SAT and VAT) can be assessed using cross-sectional imaging techniques. Previous studies have shown promising prognostic value for several tumour entities, including esophageal cancer (EC). The aim of this study was to analyse possible associations of body composition parameters in patients with esophageal cancer undergoing curative treatment.</div></div><div><h3>Methods</h3><div>All patients with EC undergoing curative treatment were retrospectively evaluated between 2016 and 2023. A total of 145 patients (17 female, 11.7 %) with a mean age of 65.9 ± 10.2 years were included in the present analysis. For all patients, staging computed tomography (CT) was used to calculate LSMM, VAT, and SAT. The primary study end point was all-cause overall survival. For statistical analysis group differences were calculated using the Mann-Whitney test. Kaplan-Meier curves and multivariable Cox regression analysis was used to test the effect of body composition parameters on mortality.</div></div><div><h3>Results</h3><div>In total, 51 patients (35.2 %) of the patient cohort died within the observation period. According to the sarcopenia threshold of the SMI, 99 patients (68.2 %) were classified as sarcopenic and according to the VAT threshold, 102 patients (70.3 %) were classified as visceral obese. Sarcopenia and visceral obesity were associated with mortality with a hazard ratio (HR) of 2.05 (95%confidence interval (CI) 1.17, 3.57, p = 0.01) and 2.47 (95%CI 1.39, 4.37, p = 0.002) in univariable analysis, respectively. Only the combination of both, sarcopenic obesity was significantly associated in multivariable analysis (HR 2.47, 95 %CI 1.39; 4.37, p = 0.002)</div></div><div><h3>Conclusions</h3><div>The combination of CT-defined sarcopenia and visceral obesity showed a strong prognostic relevance in EC undergoing curative resection. The effect of sarcopenia and visceral obesity considered separately was of lesser prognostic significance. CT-defined body composition may help to better stratify patients with EC at risk of worse outcome in clinical practice.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102278"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989992","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 utility of preoperative diagnostics in patients undergoing radical nephroureterectomy for suspected upper tract urothelial carcinoma: Can we justify treatment without prior histologic confirmation?","authors":"Vincent Hoffmann,&nbsp;Martina Dellino,&nbsp;Henning Bahlburg,&nbsp;Moritz Reike,&nbsp;Analena Elisa Handke,&nbsp;Peter Bach,&nbsp;Joachim Noldus,&nbsp;Florian Roghmann,&nbsp;Karl Tully","doi":"10.1016/j.suronc.2025.102291","DOIUrl":"10.1016/j.suronc.2025.102291","url":null,"abstract":"<div><h3>Introduction &amp; objectives</h3><div>The main obstacles to the broad application of neoadjuvant chemotherapy for locally advanced upper tract urothelial cancer(UTUC) are uncertainties regarding the accuracy of preoperative diagnostics. This study aimed to examine the predictive value of preoperative diagnostic results regarding the histopathologic findings at the time of radical nephroureterectomy (RNU).</div></div><div><h3>Material &amp; methods</h3><div>An institutional dataset of patients undergoing RNU for suspected UTUC between 01/2018 and 12/2023 was analyzed. We examined the preoperative utilization of different diagnostic means and their predictive value in detecting locally advanced(i.e., ≥T2) disease. Separate uni-and multivariable logistic regression models were employed to examine the association between preoperative findings and final histology.</div></div><div><h3>Results</h3><div>At the time of RNU, 64.4 %(n = 74) of patients were diagnosed with ≥T2 disease. Out of 115 patients, 41.7 % underwent RNU based on cross-sectional imaging findings alone, thirty of whom had undergone a prior endourologic diagnostic workup without evidence of UTUC(62.5 %). There were no false-positive diagnoses of UTUC. On multivariable logistic regression and consecutive receiver operating characteristic(ROC) analysis, only a tumor size ≥1.9 cm during cross-sectional imaging was associated with advanced disease(OR 2.99, 95 %CI 1.65–5.43, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In this cohort of patients undergoing RNU for suspected UTUC, only tumor size during cross-sectional imaging was associated with advanced disease. These results support the notion of tumor size as an independent risk factor, which may, in turn, guide further treatment decisions.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102291"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082185","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}