Surgical Oncology-Oxford最新文献

{"title":"The significance of resection margins on R0 results in intrahepatic cholangiocarcinoma","authors":"B.O. Stüben ,&nbsp;S. Ahmadi ,&nbsp;F.H. Saner ,&nbsp;J. Li ,&nbsp;J.P. Neuhaus ,&nbsp;J.W. Treckmann ,&nbsp;D.P. Hoyer","doi":"10.1016/j.suronc.2024.102058","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102058","url":null,"abstract":"<div><h3>Background</h3><p>Intrahepatic cholangiocarcinoma is the second most common primary liver cancer after hepatocellular carcinoma with an increasing incidence worldwide. Surgical resection is still the only potential cure, and survival rates are dismal due to disease relapse after resection and/or metastatic disease. Positive resection margins are associated with recurrence, with conflicting studies regarding the benefits of wide resection margins to reduce recurrence rates.</p></div><div><h3>Methods</h3><p>126 patients with an R0 resection treated with hepatic surgery for intrahepatic cholangiocarcinoma at the Surgical Department at the Medical University Centre Essen, Germany were identified in a database and retrospectively analysed. Patients were grouped into three groups according to margin width, &lt;1 mm (very narrow margin width) 1–5 mm (narrow margin width) and &gt;5 mm (wide margin width). Epidemiological as well as perioperative data was analysed, and a univariate analysis as well as Kaplan-Meier plots carried out to investigate recurrence-free and overall survival.</p></div><div><h3>Results</h3><p>Wider resection margins did not lead to better recurrence-free survival.</p><p>A wider resection margin &gt;5 mm was not significantly associated with improved overall survival.</p><p>Positive lymph nodes (HR 2.50, 95% CI 1.11–5.61, <strong>p=0.027</strong>) and non-anatomic resections (HR 2.06, 95% CI 1.13–3.75, <strong>p=0.019</strong>) are significantly associated with poorer overall survival. Regarding recurrence-free survival, V2 vascular invasion was the only risk factor statistically significantly associated with poorer recurrence-free survival (HR 8.83, 95% CI 0.85–2.83, <strong>p=0.005</strong>).</p></div><div><h3>Conclusion</h3><p>Resection margins did not have a significant impact on disease free survival or overall survival following hepatic resection for intrahepatic cholangiocarcinoma. Non-anatomical resections, lymph node and vascular invasion all significantly impacted oncological outcomes.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960740424000264/pdfft?md5=cf9f9d940081f2a63e68394242a57f12&pid=1-s2.0-S0960740424000264-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140016062","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":"Interpectoral nerve blocks may lower postoperative narcotic use after mastectomy","authors":"Ricardo J. Bello ,&nbsp;Benjamin A. Palleiko ,&nbsp;Kara Kennedy,&nbsp;Lauren Cournoyer,&nbsp;Anne C. Larkin,&nbsp;Kate H. Dinh,&nbsp;Jennifer LaFemina","doi":"10.1016/j.suronc.2024.102055","DOIUrl":"10.1016/j.suronc.2024.102055","url":null,"abstract":"<div><h3>Background</h3><p>Pain management following mastectomy is a significant challenge often requiring opioids. Nonopioid pain management utilizing nerve blocks has been shown in other fields to reduce postoperative opioid use and may be effective for postoperative pain in mastectomy patients. The primary purpose of this study was to compare postoperative opioid use, measured in morphine milligram equivalents (MME), between mastectomy patients who underwent interpectoral nerve block (IPNB) and a historical control group. Secondary outcomes included length of stay (LOS) and postoperative pain scores.</p></div><div><h3>Methods</h3><p>This is a single-center, retrospective cohort study. The charts of women who underwent mastectomy for cancer without immediate reconstruction from 10/2017–12/2019 were reviewed. Wilcoxon rank sum test was used for unadjusted analysis and multiple linear regression for adjusted analysis.</p></div><div><h3>Results</h3><p>There were 105 patients included in this study, of which 37 (35%) underwent IPNB. In unadjusted analysis, median MME use was significantly lower in patients that received IPNB compared to the control group (IPNB = 5, controls = 17, <em>p</em> = 0.03). Patients that received IPNB had an observed reduction in LOS and postoperative pain, though these results failed to reach statistical significance. There were no IPNB-related complications.</p></div><div><h3>Conclusions</h3><p>IPNB may be an effective strategy to decrease postoperative opioid use in mastectomy patients. Larger, prospective studies are needed to further investigate the effectiveness of IPNB.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139921162","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":"Scarless totally implantable venous access port (TIVAP) implantation: Surgical technique, preliminary results, learning curve, and patients-reported outcome in 125 breast cancer patients","authors":"Yi-Lin Chang ,&nbsp;Chayanee Sae-lim ,&nbsp;Shih-Lung Lin ,&nbsp;Hung-Wen Lai ,&nbsp;Hsin-I Huang ,&nbsp;Yuan-Chieh Lai ,&nbsp;Shou-Tung Chen ,&nbsp;Dar-Ren Chen","doi":"10.1016/j.suronc.2024.102048","DOIUrl":"10.1016/j.suronc.2024.102048","url":null,"abstract":"<div><h3>Background</h3><p>Minimal-access (endoscopic or robotic-assisted) breast surgery has been increasingly performed and shown better cosmetic results. However, location of totally implantable venous access port (TIVAP) for systemic treatment at anterior chest may compromise its aesthetic benefits. Therefore, we proposed a new scarless technique for TIVAP implantation, and reported the preliminary results, learning curve, and patients-surveyed outcome.</p></div><div><h3>Methods</h3><p>Surgical technique of the new “scarless” TIVAP implantation was proposed. Patients receiving this procedure in a single institution were included. The preliminary results of the scarless TIVAP implantation, learning curve, and patient-reported outcome were analyzed and reported.</p></div><div><h3>Results</h3><p>A total of 125 breast cancer patients received scarless TIVAP procedures were enrolled. The primary success rate of the scarless TIVAP implantation was 100%. Mean operative time was 46 ± 14 min. Mean amount of blood loss was 8.5 ± 3.2 ml. The cumulative sum plot showed operation time significantly decreased after 24th cases. In the initial learning phase, the mean operative time was 55 ± 17 min, and decreased to 43 ± 12 min in the later mature phase (P = 0.003). There were 5 (4%) complications detected, which included 1 (0.8%) seroma formation, 2 (1.6%) revisions, and 2 (1.6%) unplanned explantations. From patients-evaluated questionnaires, more than 90% of responders were satisfied with aesthetic results, experience during surgery, and application of scarless TIVAP for systemic therapy.</p></div><div><h3>Conclusions</h3><p>The scarless TIVAP implantation is a safe &amp; reliable procedure with high patients-reported aesthetic satisfaction, and could be an alternative TIVAP procedure for patients requiring chemotherapy and desiring a less noticeable scar.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960740424000161/pdfft?md5=504fe3ac73f8b977bf4fd5ef7f153cb5&pid=1-s2.0-S0960740424000161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139816849","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":"Differences in other-cause mortality in metastatic renal cell carcinoma according to partial vs. radical nephrectomy and age: A propensity score matched study","authors":"Carolin Siech ,&nbsp;Reha-Baris Incesu ,&nbsp;Simone Morra ,&nbsp;Lukas Scheipner ,&nbsp;Andrea Baudo ,&nbsp;Letizia Maria Ippolita Jannello ,&nbsp;Mario de Angelis ,&nbsp;Jordan A. Goyal ,&nbsp;Zhe Tian ,&nbsp;Fred Saad ,&nbsp;Shahrokh F. Shariat ,&nbsp;Derya Tilki ,&nbsp;Nicola Longo ,&nbsp;Luca Carmignani ,&nbsp;Ottavio de Cobelli ,&nbsp;Sascha Ahyai ,&nbsp;Alberto Briganti ,&nbsp;Philipp Mandel ,&nbsp;Luis A. Kluth ,&nbsp;Felix K.H. Chun ,&nbsp;Pierre I. Karakiewicz","doi":"10.1016/j.suronc.2024.102047","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102047","url":null,"abstract":"<div><h3>Introduction</h3><p>It is unknown whether the benefit from partial nephrectomy regarding lower other-cause mortality is applicable to older patients with metastatic renal cell carcinoma.</p></div><div><h3>Materials and methods</h3><p>Using Surveillance Epidemiology and End Results database, patients with metastatic renal cell carcinoma, undergoing partial or radical nephrectomy, were stratified according to age (&lt;60, 60–69, and ≥70 years). After propensity score matching, Kaplan-Meier survival analyses and multivariable Cox regression models were used.</p></div><div><h3>Results</h3><p>Of 2,390 patients with metastatic renal cell carcinoma, 885 (37%) were aged &lt;60 years, and 90 (10%) underwent partial nephrectomy; 824 (34%) were aged 60–69 years, and 61 (7%) underwent partial nephrectomy; and 681 (29%) were aged ≥70 years, and 64 (9%) underwent partial nephrectomy. After propensity score matching, in patients aged &lt;60 years, partial nephrectomy was associated with lower other-cause mortality (hazard ratio 0.22; p = 0.02); in patients aged 60–69 years, partial nephrectomy was associated with lower other-cause mortality (hazard ratio 0.38; p = 0.03); but not in patients aged ≥70 years.</p></div><div><h3>Discussion</h3><p>In metastatic renal cell carcinoma, partial nephrectomy is associated with lower other-cause mortality in patients aged &lt;60 years and in patients aged 60–69 years, but not in patients aged ≥70 years. In consequence, consideration of partial nephrectomy might be of great value in younger metastatic renal cell carcinoma patients.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S096074042400015X/pdfft?md5=5b14dad3f6316ce0b2ef86b2584b4e7b&pid=1-s2.0-S096074042400015X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139737762","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":"The impact of methylene blue in colorectal cancer: Systematic review and meta-analysis study","authors":"Alexandre Carvalho ,&nbsp;Nuno Gonçalves ,&nbsp;Pedro Teixeira ,&nbsp;André Goulart ,&nbsp;Pedro Leão","doi":"10.1016/j.suronc.2024.102046","DOIUrl":"10.1016/j.suronc.2024.102046","url":null,"abstract":"<div><h3>Purpose</h3><p>In patients with colorectal cancer (CRC), the most important factor to decide the need of adjuvant chemotherapy is the histological lymph node (LN) evaluation. Our work aimed to give a broad view over the use of methylene blue and its consequences in the number of lymph node harvest.</p></div><div><h3>Methods</h3><p>PUBMED, WEB OF SCIENCE and EMBASE databases were consulted, retrieving clinical trials, which mentioned the used of intra-arterial methylene blue in patients with colorectal cancer.</p></div><div><h3>Results</h3><p>Eighteen clinical trials analyzing the use of intra-arterial methylene blue in specimens of colorectal cancer were selected. The articles show a statistical difference between the use of methylene blue and the classical dissection in both variable at study. The results of the statistical analysis of the lymph node harvest variable demonstrate a significant statistical difference between the group that received methylene blue injection and the group that underwent conventional dissection. There is a significant statistical difference between the experimental and control groups for the ideal lymph node harvest (lymph node harvest count greater than 12).</p></div><div><h3>Conclusion</h3><p>The use of intra-arterial methylene blue revealed a high potential for the quantification of lymph nodes, considering the increase of lymph node harvest and the higher percentage of cases with more than 12 lymph nodes count, albeit the high heterogeneity between the studies in terms of reported results. Future investigations with controlled double blinded studies obtaining better categorized results should be conducted in order to better evaluate this technique and compare it to the current paradigm.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960740424000148/pdfft?md5=8558b276ae115236ea8419fd5025555b&pid=1-s2.0-S0960740424000148-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139878018","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":"Clinical implications of C-reactive protein–albumin–lymphocyte (CALLY) index in patients with esophageal cancer","authors":"Ruiya Ma ,&nbsp;Yoshinaga Okugawa ,&nbsp;Tadanobu Shimura ,&nbsp;Shinji Yamashita ,&nbsp;Yuhki Sato ,&nbsp;Chengzeng Yin ,&nbsp;Ryo Uratani ,&nbsp;Takahito Kitajima ,&nbsp;Hiroki Imaoka ,&nbsp;Mikio Kawamura ,&nbsp;Yuhki Morimoto ,&nbsp;Yoshiki Okita ,&nbsp;Shigeyuki Yoshiyama ,&nbsp;Masaki Ohi ,&nbsp;Yuji Toiyama","doi":"10.1016/j.suronc.2024.102044","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102044","url":null,"abstract":"<div><h3>Purpose</h3><p>The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel inflammatory nutritional biomarker. This study aimed to investigate the potential clinical significance and oncological prognostic role of the preoperative CALLY index in patients with esophageal cancer.</p></div><div><h3>Methods</h3><p>We analyzed the preoperative CALLY index in 146 patients with esophageal cancer. The CALLY index and clinicopathological variables were analyzed by the Mann–Whitney <em>U</em> test, and associations between the CALLY index and survival outcomes were analyzed by Kaplan–Meier analysis and log-rank tests. Univariate and multivariate analyses of prognostic variables were conducted using Cox proportional hazards regression.</p></div><div><h3>Results</h3><p>A lower preoperative CALLY index was significantly correlated with patient age, advanced T stage, presence of lymph node metastasis, neoadjuvant therapy, lymphatic invasion, and advanced stage classification. The preoperative CALLY index decreased significantly in a stage-dependent manner. Patients with esophageal cancer with a low CALLY index had poorer overall survival, disease-free survival than those with a high CALLY index. Multivariate analysis showed that a low CALLY index was an independent prognostic factor for overall survival, disease-free survival and an independent predictor of postoperative surgical site infection.</p></div><div><h3>Conclusions</h3><p>Preoperative CALLY index is a useful marker to guide the perioperative and postoperative management of patients with esophageal cancer.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139709230","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":"Impact of low dose superparamagnetic iron oxide tracer for sentinel node biopsy in breast conserving treatment on susceptibility artefacts on magnetic resonance imaging and contrast enhanced mammography","authors":"Elisabeth R.M. van Haaren ,&nbsp;Merel A. Spiekerman van Weezelenburg ,&nbsp;James van Bastelaar ,&nbsp;Alfred Janssen ,&nbsp;Thiemo van Nijnatten ,&nbsp;Lee H. Bouwman ,&nbsp;Yvonne L.J. Vissers ,&nbsp;Marc B.I. Lobbes","doi":"10.1016/j.suronc.2024.102045","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102045","url":null,"abstract":"<div><h3>Background</h3><p>Residual particles of superparamagnetic iron oxide (SPIO) tracer, used for sentinel node biopsy, cause susceptibility artefacts on breast Magnetic Resonance Imaging (MRI). We investigated the impact of these artefacts on the imaging quality of MRI and explored whether contrast-enhanced mammography (CEM) could be an alternative in the follow-up of breast cancer patients.</p></div><div><h3>Materials and methods</h3><p>Data on patients’ characteristics, injection site, presence, size (mm) of artefacts on full-field digital mammography (FFDM)/CEM, MRI after 1 ml SPIO was recorded. Image quality scored by two breast radiologists using a 4-point Likert system: 0: no artefacts 1: good diagnostic quality 2: impaired but still readable 3: hampered clinical assessment. Continuous variables reported as means and standard deviations (SD), categorical variables as count and percentage.</p></div><div><h3>Results</h3><p>On FFDM/CEM, performed 13 months postoperatively, no iron SPIO particles were detected, with a Likert score of 0. In all MRI (100%) images, executed at 16.6 months after SPIO injection, susceptibility artefacts at the injection sites i.e., retroareolair and lateral quadrant were observed with a mean size of 41.9 ± 9.8 mm (SD) by observer 1, and 44.8 ± 12.5 mm (SD) by observer 2, independent of the injection site. Both observers scored a Likert score of 2: locally impaired on all MRI images and sequences.</p></div><div><h3>Conclusions</h3><p>Even 1 ml SPIO tracer used for sentinel node procedure impairs the evaluation of breast MRI at the tracer injection site beyond one year of follow-up. No impairment was observed on FFDM/CEM, suggesting that CEM might be a reliable alternative to breast MRI if required.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699577","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":"Osteosarcopenia impacts treatment outcomes for Barcelona Cancer Liver Classification stage A hepatocellular carcinoma","authors":"Kyohei Abe,&nbsp;Kenei Furukawa,&nbsp;Michinori Matsumoto,&nbsp;Yasuro Futagawa,&nbsp;Hironori Shiozaki,&nbsp;Shinji Onda,&nbsp;Koichiro Haruki,&nbsp;Yoshihiro Shirai,&nbsp;Tomoyoshi Okamoto,&nbsp;Toru Ikegami","doi":"10.1016/j.suronc.2024.102043","DOIUrl":"10.1016/j.suronc.2024.102043","url":null,"abstract":"<div><h3>Aim</h3><p>To study the effect of preoperative osteosarcopenia (OSP) on the prognosis of treatment (surgery or radiofrequency ablation (RFA)) in patients with Barcelona Cancer Liver Classification stage A hepatocellular carcinoma (BCLC A HCC).</p></div><div><h3>Methods</h3><p>This study enrolled 102 patients with BCLC A HCC who underwent surgical resection (n = 45) and RFA (n = 57); the patients were divided into two groups: OSP (n = 33) and non-OSP (n = 69). Overall survival (OS) and disease-free survival (DFS) curves for both the groups and treatment methods (surgery and RFA) were generated using the Kaplan–Meier method and compared using the log-rank test. Univariate analyses for OS and DFS were performed using log-rank test. Multivariate analyses were performed for factors that were significant at univariate analysis by Cox proportional hazard model.</p></div><div><h3>Results</h3><p>Multivariate analysis showed that OSP (HR 2.44; 95 % CI 1.30–4.55; p &lt; 0.01) and treatment (HR 0.57; 95 % CI 0.31–0.99; p = 0.05) were significant independent predictors of DFS; and treatment (HR, 0.30; 95 % CI 0.10–0.85; p = 0.03) was a significant independent predictor of OS in the non-OSP group, in which the OS rate was significantly lower in patients treated with RFA than in those treated by resection (p = 0.01).</p></div><div><h3>Conclusions</h3><p>OSP is a prognostic factor for BCLC A HCC treatment. Surgical approach was associated with a significantly better prognosis in patients without OSP compared to those who underwent RFA.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139661813","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":"Double hepatic vein reconstruction during extended anatomical resection of segment 8 for colorectal liver metastasis","authors":"Katsuya Sakashita,&nbsp;Shimpei Otsuka,&nbsp;Katsuhiko Uesaka,&nbsp;Teiichi Sugiura","doi":"10.1016/j.suronc.2024.102040","DOIUrl":"10.1016/j.suronc.2024.102040","url":null,"abstract":"<div><h3>Background</h3><p>Hepatic vein reconstruction (HVR) is occasionally necessary for resecting hepatic malignancies to ensure surgical margins while preserving remnant liver function [<span>1</span>]. Reports of multiple HVR are rare due to the highly technical demanding procedure and high risk of morbidity [<span>2</span>]. We introduce our procedure of double HVR for metastatic liver tumors invading the right hepatic vein (RHV) and middle hepatic vein (MHV).</p></div><div><h3>Methods</h3><p>The patient was a 66-year-old man with colorectal liver metastasis in segment 8, invading RHV and MHV. Due to impaired liver function, extended right hemihepatectomy was unsuitable. Thus, extended anatomical resection of segment 8 with double HVR was performed. The liver was completely mobilized and the RHV and MHV were secured. After liver parenchyma dissection, the specimen was connected by RHV and MHV (<span>Fig. 1</span>). The MHV was dissected and reconstructed using a right superficial femoral vein graft while the RHV remained connected [<span>3</span>]. Reconstruction of the MHV was performed on the posterior wall of the proximal side, followed by the anterior wall, using 4-point supporting threads. Anastomosis was performed by the over-and-over suture method. On the distal side, two-point supporting threads were applied. After specimen removal, the RHV was resected and reconstructed in the same manner using a left internal jugular vein graft [<span>4</span>].</p></div><div><h3>Results</h3><p>The patient was discharged on postoperative day 14 with no signs of liver failure. Computed tomography performed six months after surgery revealed no graft occlusion (<span>Fig. 2</span>).</p></div><div><h3>Conclusion</h3><p>In appropriately selected patients, this technique may be a useful option for preserving the remnant liver function.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139661811","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 immune checkpoint proteins and neoadjuvant chemotherapy response in breast cancer","authors":"Umut Kina Kilicaslan ,&nbsp;Basak Aru ,&nbsp;Sibel Aydin Aksu ,&nbsp;Fugen Vardar Aker ,&nbsp;Gulderen Yanikkaya Demirel ,&nbsp;Meryem Gunay Gurleyik","doi":"10.1016/j.suronc.2024.102037","DOIUrl":"10.1016/j.suronc.2024.102037","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Following major developments in cancer immunotherapy<span>, treatments targeting immune checkpoint proteins (ICP) gained interest in breast cancer, though studies mostly focus on patients with </span></span>metastatic disease<span> as well as patients nonresponsive to the conventional treatments. Herein, we aimed to investigate the levels of ICP in tumor stroma<span><span> and tumor infiltrating lymphocytes, and tumor tissue prior to </span>neoadjuvant chemotherapy administration to evaluate the relationship between ICP levels, clinicopathological parameters, and NAC response.</span></span></p></div><div><h3>Materials and methods</h3><p>This study was conducted with 51 patients where PD-1, PD-L1, CTLA-4, TIM-3, CD24 and CD44 levels were investigated in CD45⁺<span> cells while CD326, CD24, CD44 and PD-L1 protein expression levels were investigated in CD45</span>⁻ population. In addition, CD44 and CD24 levels were evaluated in the tumor stroma. TIL levels were investigated according to the TILS Working Group. Treatment responses after NAC were evaluated according to the MD Anderson RCB score.</p></div><div><h3>Results</h3><p>Our results revealed positive correlation between CTLA-4 and CD44 expression in cases with high TIL levels as well as TIL levels and CTLA-4 expression in cases with partial response. Similarly, positive correlation was detected between TIM3 and PD-L1 levels in cases with good response. In addition, a negative correlation between TILs after NAC and PD-1/PD-L1 expression in lymphocytes in cases with partial complete response.</p></div><div><h3>Conclusions</h3><p>Our study provides preliminary data about the correlation between ICP and clinicopathological status and NAC response in breast cancer, in addition to underlining the requirement for further research to determine their potential as therapeutic targets.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589578","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}