Surgical Oncology-Oxford最新文献

{"title":"The evolution of melanomology: a tale of giants' shoulders and bold hypotheses.","authors":"John F Thompson","doi":"10.1016/j.suronc.2024.102094","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102094","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237451","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":"Early and late post-procedural complications in different orthotopic neobladder surgical approaches: A systematic review","authors":"Benito Fabio Mirto ,&nbsp;Biagio Barone ,&nbsp;Raffaele Balsamo ,&nbsp;Marco Abate ,&nbsp;Vincenzo Francesco Caputo ,&nbsp;Antonella Sciarra ,&nbsp;Armando Calogero ,&nbsp;Lorenzo Romano ,&nbsp;Luigi Napolitano ,&nbsp;Carmine Sciorio ,&nbsp;Giuseppe Lucarelli ,&nbsp;Francesco Lasorsa ,&nbsp;Matteo Ferro ,&nbsp;Gian Maria Busetto ,&nbsp;Francesco Del Giudice ,&nbsp;Celeste Manfredi ,&nbsp;Sabin Tătaru ,&nbsp;Benjamin Pradere ,&nbsp;Ciro Imbimbo ,&nbsp;Felice Crocetto","doi":"10.1016/j.suronc.2024.102090","DOIUrl":"10.1016/j.suronc.2024.102090","url":null,"abstract":"<div><p>Bladder cancer (BCa) represents the second most common malignancy of the genitourinary tract. The major risk factors include age, gender, smoking attitude, and occupational exposure, while the exact etiopathogenesis is still uncertain. Patients diagnosed with a BCa showing invasion of the muscle layer below the submucosa must undergo radical cystectomy (RC) with urinary diversion (UD). Many different surgical approaches to UD have been developed. Packaging an orthotopic neobladder (ON) with a bowel tract represents the gold standard when certain patient selection criteria are satisfied. Using PRISMA guidelines, we performed a systematic review assessing early (within 90 days) and late (beyond 90 days) post-procedural complications of different ON surgical approaches. A comprehensive systematic search was conducted in PubMed, Scopus, and Google Scholar databases to identify papers starting from 2012 using dedicated keywords (“neobladder”, “orthotopic neobladder”, “complications'' and “outcomes”). A total of 27 articles were found to satisfy the inclusion criteria and selected. Although the ON is a safe procedure that guarantees the patient the best quality of life (QoL), it is not free from risks. Many complications could occur during and after the surgical time which imposes the necessity of strict follow-up and careful checks over time, which should be properly discussed with patients before.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452125","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":"Intraoperative near-infrared fluorescence guided surgery using indocyanine green (ICG) may aid the surgical removal of benign bone and soft tissue tumours","authors":"Marcus J. Brookes ,&nbsp;Corey D. Chan ,&nbsp;Timothy P. Crowley ,&nbsp;Maniram Ragbir ,&nbsp;Kanishka M. Ghosh ,&nbsp;Thomas Beckingsale ,&nbsp;Kenneth S. Rankin","doi":"10.1016/j.suronc.2024.102091","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102091","url":null,"abstract":"<div><h3>Background</h3><p>Benign bone and soft tissue tumours encompass a broad, heterogenous range of tumours with varying clinical characteristics. These are often managed surgically with either curettage or marginal excision, but unfortunately have high rates of local recurrence. Indocyanine green (ICG) is a fluorescent dye which can be used to identify solid malignancies intraoperatively but its use is not yet established in benign bone and soft tissue tumours. This study aims to assess whether these tumours fluoresce when administered with ICG pre-operatively and whether this helps surgeons to identify tumour intra-operatively.</p></div><div><h3>Patients and methods</h3><p>Patients with locally aggressive benign bone and soft tissue tumours were administered with 25–75 mg of ICG preoperatively at the induction of anaesthesia. Fluorescence was imaged intraoperatively using the Stryker SPY-PHI camera.</p></div><div><h3>Results</h3><p>Of the 12 patients included, 11 tumours fluoresced. The surgeons felt the fluorescence guided the procedure in 7 out of the 11 cases which fluoresced. It was felt to be particularly useful in the curettage of bone tumours, in which curettage could be repeated until the absence of fluorescence on imaging. After 12 months, no patients had local recurrence of the tumour. There were no adverse events recorded in this study and surgeons found the technology acceptable.</p></div><div><h3>Conclusions</h3><p>The use of ICG for fluorescence guided surgery is a promising technology to improve outcomes of surgery for benign bone and soft tissue tumours. Further, longer term, study with a control arm is needed to identify whether it results in a reduction in the local recurrence rate.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244776","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 pan - COVID - AGICT study. The impact of COVID-19 pandemic on surgically treated pancreatic cancer patients. A multicentric Italian study","authors":"Maria Pia Federica Dorma ,&nbsp;Giuseppe Giuliani ,&nbsp;Francesco Guerra ,&nbsp;Francesco Santelli ,&nbsp;Alessandro Esposito ,&nbsp;Matteo De Pastena ,&nbsp;Giulia Turri ,&nbsp;Corrado Pedrazzani ,&nbsp;Emanuele Federico Kauffmann ,&nbsp;Ugo Boggi ,&nbsp;Leonardo Solaini ,&nbsp;Giorgio Ercolani ,&nbsp;Laura Mastrangelo ,&nbsp;Elio Jovine ,&nbsp;Gregorio Di Franco ,&nbsp;Luca Morelli ,&nbsp;Michele Mazzola ,&nbsp;Giovanni Ferrari ,&nbsp;Serena Langella ,&nbsp;Alessandro Ferrero ,&nbsp;Andrea Coratti","doi":"10.1016/j.suronc.2024.102081","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102081","url":null,"abstract":"<div><h3>Background</h3><p>In this article we aimed to perform a subgroup analysis using data from the COVID-AGICT study, to investigate the perioperative outcomes of patients undergoing surgery for pancreatic cancers (PC) during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>The primary endpoint of the study was to find out any difference in the tumoral stage of surgically treated PC patients between 2019 and 2020. Surgical and oncological outcomes of the entire cohort of patients were also appraised dividing the entire peri-pandemic period into six three-month timeframes to balance out the comparison between 2019 and 2020.</p></div><div><h3>Results</h3><p>Overall, a total of 1815 patients were surgically treated during 2019 and 2020 in 14 Italian surgical Units. In 2020, the rate of patients treated with an advanced pathological stage was not different compared to 2019 (p = 0.846). During the pandemic, neoadjuvant chemotherapy (NCT) has dropped significantly (6.2% vs 21.4%, p &lt; 0.001) and, for patients who didn't undergo NCT, the latency between diagnosis and surgery was shortened (49.58 ± 37 days vs 77.40 ± 83 days, p &lt; 0.001). During 2020 there was a significant increase in minimally invasive procedures (p &lt; 0.001). The rate of postoperative complication was the same in the two years but during 2020 there was an increase of the medical ones (19% vs 16.1%, p = 0.001).</p></div><div><h3>Conclusions</h3><p>The post-pandemic dramatic modifications in healthcare provision, in Italy, did not significantly impair the clinical history of PC patients receiving surgical resection. The present study is one of the largest reports available on the argument and may provide the basis for long-term analyses.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902432","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":"Machine learning for predicting colon cancer recurrence","authors":"Erkan Kayikcioglu ,&nbsp;Arif Hakan Onder ,&nbsp;Burcu Bacak ,&nbsp;Tekin Ahmet Serel","doi":"10.1016/j.suronc.2024.102079","DOIUrl":"10.1016/j.suronc.2024.102079","url":null,"abstract":"<div><h3>Introduction</h3><p>Colorectal cancer (CRC) is a global public health concern, ranking among the most commonly diagnosed malignancies worldwide. Despite advancements in treatment modalities, the specter of CRC recurrence remains a significant challenge, demanding innovative solutions for early detection and intervention. The integration of machine learning into oncology offers a promising avenue to address this issue, providing data-driven insights and personalized care.</p></div><div><h3>Methods</h3><p>This retrospective study analyzed data from 396 patients who underwent surgical procedures for colon cancer (CC) between 2010 and 2021. Machine learning algorithms were employed to predict CC recurrence, with a focus on demographic, clinicopathological, and laboratory characteristics. A range of evaluation metrics, including AUC (Area Under the Receiver Operating Characteristic), accuracy, recall, precision, and F1 scores, assessed the performance of machine learning algorithms.</p></div><div><h3>Results</h3><p>Significant risk factors for CC recurrence were identified, including sex, carcinoembryonic antigen (CEA) levels, tumor location, depth, lymphatic and venous invasion, and lymph node involvement. The CatBoost Classifier demonstrated exceptional performance, achieving an AUC of 0.92 and an accuracy of 88 % on the test dataset. Feature importance analysis highlighted the significance of CEA levels, albumin levels, N stage, weight, platelet count, height, neutrophil count, lymphocyte count, and gender in determining recurrence risk.</p></div><div><h3>Discussion</h3><p>The integration of machine learning into healthcare, exemplified by this study's findings, offers a pathway to personalized patient risk stratification and enhanced clinical decision-making. Early identification of individuals at risk of CC recurrence holds the potential for more effective therapeutic interventions and improved patient outcomes.</p></div><div><h3>Conclusion</h3><p>Machine learning has the potential to revolutionize our approach to CC recurrence prediction, emphasizing the synergy between medical expertise and cutting-edge technology in the fight against cancer. This study represents a vital step toward precision medicine in CC management, showcasing the transformative power of data-driven insights in oncology.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772296","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":"Anastomotic leakage following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer: A clinical cohort study","authors":"Jonas Herzberg ,&nbsp;Miklos Acs ,&nbsp;Salman Yousuf Guraya ,&nbsp;Hans Jürgen Schlitt ,&nbsp;Human Honarpisheh ,&nbsp;Tim Strate ,&nbsp;Pompiliu Piso","doi":"10.1016/j.suronc.2024.102080","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102080","url":null,"abstract":"<div><h3>Background</h3><p>Extended oncological resections for colorectal cancer surgery are associated with a high rate of complications, especially anastomotic leakage (AL). This study determines the incidence of risk factors for postoperative complications following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal cancer (CRC).</p></div><div><h3>Methods</h3><p>In this cohort study, the clinical data of all patients with CRC, treated with CRS and HIPEC, from 2011 to 2021 was analyzed. We considered patients' characteristics, tumor-specific features, postoperative complications, and hospital stay using Chi-Square-test or Fisher's exact test. The Mann-Whitney-U-test was used to measure the probability of differences between two sets of data.</p></div><div><h3>Results</h3><p>Of 1089 HIPEC procedures performed in the study center, 185 patients with CRC and peritoneal metastasis were treated with CRS and HIPEC after formation of at least one anastomosis and therefore included in this study. This included synchronous and metachronous peritoneal metastasis with a mean peritoneal cancer index of 8.67 ± 5.22. In this cohort, AL occurred in 12 (6.5 %) patients. There was no correlation between the number of anastomoses and the occurrence of an AL (p = 0.401).</p></div><div><h3>Conclusion</h3><p>This study reports a low risk of AL after CRS with HIPEC for CRC, comparable to other published data. If a complete cytoreduction seems possible, the risk of anastomotic leakage should not negatively influence the decision to resect. Further studies on this subject are essential to validate our findings.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645229","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":"Repeat cytoreduction with Hyperthermic Intraperitoneal chemotherapy in patients with peritoneal disease: A 5-year retrospective analysis","authors":"João Mendes ,&nbsp;Sónia Marques ,&nbsp;Mariana Peyroteo ,&nbsp;Mercês Lobo ,&nbsp;Fernanda Sousa ,&nbsp;Manuel Fernandes ,&nbsp;José Flávio Videira ,&nbsp;Abreu de Sousa","doi":"10.1016/j.suronc.2024.102078","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102078","url":null,"abstract":"<div><h3>Background</h3><p>Cytoreductive surgery with Hyperthermic Intraperitoneal Chemotherapy (CR-HIPEC) is a locorregional surgical therapy applied in patients with peritoneal-only metastatic disease of primary abdominal malignancies. Integrated in a multimodal treatment, CR-HIPEC is associated with increased overall survival. In cases of peritoneal-site only relapse, it may be carried out more than once.</p></div><div><h3>Methods</h3><p>Patients who received a CR-HIPEC between January 2016 and December 2020 at Instituto Português de Oncologia do Porto, Portugal were included in a unicentric, retrospective, observational study. Short- and long-term outcomes after surgery were analyzed.</p></div><div><h3>Results</h3><p>In this period, 259 CR-HIPEC were performed on 248 patients. Of these, 31 were CR-HIPEC repeats, with 6 being the third HIPEC in the same patient. Of the 31 cases, 15 (48.4 %) had an appendicular origin. Mean PCI in re-HIPEC group was 10.6 (SD ± 7.1). No significant differences in baseline characteristics between the first and re-HIPEC groups were found, except for mean PCI, higher in the 1st HIPEC group (p = 0.047). In re-HIPEC group, major complications rate (CT-CAE 3–4) was 12.9 % (n = 4), without postoperative mortality. The 1st and re-HIPEC group had similar morbidity rates and hospitalization time. With a median follow-up time of 44 months, relapse rate after repeat CR-HIPEC was 45.2 % (n = 14), with a mean overall survival (OS) of 68.7 months and 5-year OS of 78 %.</p></div><div><h3>Conclusions</h3><p>Repeat CR-HIPEC is a safe approach with an acceptable complication rate for its complexity, associated with a survival benefit in selected patients. It should be presented as a valid therapeutic option in recurrent peritoneal disease.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140619977","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":"Adjuvant chemotherapy in stage 1 colon cancer: Patient characteristics and survival analysis from the national cancer database","authors":"Angela Ting-Wei Hsu ,&nbsp;Joshua H. Wolf ,&nbsp;Christopher R. D'Adamo ,&nbsp;Jessica Felton ,&nbsp;Sonal Paul ,&nbsp;Pallavi Kumar ,&nbsp;Arun A. Mavanur","doi":"10.1016/j.suronc.2024.102075","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102075","url":null,"abstract":"<div><h3>Background</h3><p>A subset of patients in ACS-NCDB with stage-1 colon cancer received adjuvant chemotherapy (AC), in contrast to national guidelines. This study aimed to define this population and evaluate associations between AC and survival.</p></div><div><h3>Methods</h3><p>Patients with T1-2N0 colon cancer from 2004 to 2016 were separated into AC and non-AC groups. Adverse pathological features (APF) included T2, poor differentiation, lymphovascular invasion, positive margin, and inadequate lymph nodes (&lt;12). Cox proportional hazard models were used to estimate prognostic factors for overall survival (OS).</p></div><div><h3>Results</h3><p>A total of 1745 of 139,857 patients (1.2 %) received AC. Receiving AC was associated with male sex (p = 0.02), uninsured (p &lt; 0.01), low income (p = 0.02), or having ≥2 APFs (p &lt; 0.001). In the total cohort, AC was associated with increased mortality (HR 1.14 [1.04–1.24] P &lt; 0.01). On subset analysis, AC was associated with improved OS for patients with ≥2 APFs (log-rank P=&lt;0.001), and decreased mortality when adjusted for covariates (HR 0.81 [0.69–0.95] P=&lt;0.01). The most significant predictor of mortality was old age (HR 3.78 [3.67, 3.89] p ≤ 0.01), followed by higher Charlson Comorbidity Index (HR 1.73 [1.69, 1.76] (p ≤ 0.01), and higher APF score (HR 1.46 [1.42, 15.2] p ≤ 0.01).</p></div><div><h3>Conclusion</h3><p>AC was associated with decreased survival in the total cohort of stage 1 colon cancer patients, but was associated with improved survival for patients with multiple APFs.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140607392","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":"Surveillance evaluations in patients with stage I, II, III, or resectable IV melanoma who were treated with curative intent: A systematic review","authors":"Sudha Rajagopal ,&nbsp;Xiaomei Yao ,&nbsp;Wadid Abadir ,&nbsp;Tara D. Baetz ,&nbsp;Alexandra Easson ,&nbsp;Gregory Knight ,&nbsp;Elaine McWhirter ,&nbsp;Carolyn Nessim ,&nbsp;Cheryl F. Rosen ,&nbsp;Alexander Sun ,&nbsp;Frances C. Wright ,&nbsp;Teresa M. Petrella","doi":"10.1016/j.suronc.2024.102077","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102077","url":null,"abstract":"<div><h3>Purpose</h3><p>Appropriate surveillance of patients with melanoma treated with curative intent is vital to improve patient outcomes. A systematic review was conducted to capture locoregional recurrence and metastatic disease, and to evaluate the effectiveness of various surveillance strategies.</p></div><div><h3>Methods</h3><p>MEDLINE, EMBASE, PubMed, Cochrane Database of Systematic Reviews, and National Cancer Institute Clinical Trials Database were searched. Randomized controlled trials (RCTs) and comparative studies reporting at least one patient-related outcome were included. Exclusion criteria included: published in non-English or recruited &gt;20 % or an uncertain percentage of non-target patients without conducting a subgroup analysis for the target patients. This review was registered at PROSPERO (CRD42021246482).</p></div><div><h3>Results</h3><p>Among 17,978 publications from the literature search, one RCT and five non-randomized comparative studies were included and comprised 4016 patients. The aggregate evidence certainty was low for the RCT and very low for the comparative studies, as assessed by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. For patients with stage IA–IIC melanoma, a reduced follow-up schedule with clinical follow-up strategies alone may be safe and cost-effective. For stage IIC–IIIC patients, at least two serial PET/CT or whole-body CT and brain MRI imaging within a median follow-up of 31.2 months may detect 50 % of recurrences that lead to additional management, such as surgery. PET/CT may have a higher positive predictive value and lower false positive rate compared with CT alone in detecting recurrence in stage I–III patients.</p></div><div><h3>Conclusion</h3><p>Surveillance protocols should be based on individual risk of recurrence and established best practices when formulating follow-up strategies, as suggested by the studies reviewed. Future high-quality studies are needed to clarify the frequency of imaging follow-up strategies, especially in patients with high-risk stage II melanoma.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960740424000458/pdfft?md5=0062a63906e03a6e0beb55f6032129ff&pid=1-s2.0-S0960740424000458-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638540","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":"Neoplastic pathologic hip fractures are associated with a higher risk of post-operative bleeding and thromboembolic events","authors":"Marcos R. Gonzalez ,&nbsp;Daniel Karczewski ,&nbsp;Angad DS. Bedi ,&nbsp;Hayley Denwood ,&nbsp;Santiago A. Lozano-Calderon","doi":"10.1016/j.suronc.2024.102076","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102076","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgical treatment of hip fractures leads to significant post-operative complications. Although pathologic fractures (PF) are associated with worse outcomes, most studies do not differentiate between etiology (neoplastic and non-neoplastic PF). We seek to compare 30-day complication rates between <strong>1</strong>) native hip fractures and neoplastic PF, and <strong>2</strong>) neoplastic and non-neoplastic PF.</p></div><div><h3>Materials and methods</h3><p>A total of 127,819 patients with hip fractures and 5104 with PF diagnosed from 2005 to 2021 were retrieved from the NSQIP database. We included 1843 patients with neoplastic PF and 3261 with non-neoplastic PF. Demographics, pre-operative labs and co-morbidities, and post-operative outcomes were analyzed. Propensity-score matching was conducted to control for confounders.</p></div><div><h3>Results</h3><p>Patients with a neoplastic PF had a significantly higher rate of deep venous thrombosis (DVT) (4 % vs 1.2 %, p = 0.001) and pulmonary embolism (PE) (2.4 % vs 0.7 %, p &lt; 0.001), than native hip fractures. Rates of post-operative bleeding were significantly higher in the neoplastic PF group (29.3 % vs 23.9 %, p &lt; 0.001) than non-neoplastic PF. No differences in soft tissue complications were found. When comparing neoplastic and non-neoplastic PF, the former had a higher rate of PE (2.5 % vs 1.0 %, p = 0.015) and post-operative bleeding (27.6 % vs 22.0 %, p = 0.009). Unplanned readmission rates and 30-day mortality rate were also higher in the neoplastic PF group.</p></div><div><h3>Conclusion</h3><p>Neoplastic PF of the hip are associated with higher risk of thromboembolic event rates and post-operative bleeding than both native hip fractures and non-neoplastic PF. No differences in rates of soft tissue complications were found between groups.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140545751","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}