Surgical Oncology-Oxford最新文献

{"title":"A platform for sharing current research and advancing patient care","authors":"Vijay P. Khatri MBChB, MBA, FACS, FSSO, FASGO, FICS","doi":"10.1016/j.suronc.2025.102296","DOIUrl":"10.1016/j.suronc.2025.102296","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102296"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202089","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":"Sliced liver hepatectomy: a new type of scaffold-sparing hepatectomy for multiple bilobar colorectal liver metastases","authors":"Guido Torzilli ,&nbsp;Jacopo Galvanin ,&nbsp;Giulia Mauri ,&nbsp;Guido Costa ,&nbsp;Bruno Branciforte ,&nbsp;Flavio Milana ,&nbsp;Angela Palmisano ,&nbsp;Fabio Procopio","doi":"10.1016/j.suronc.2025.102254","DOIUrl":"10.1016/j.suronc.2025.102254","url":null,"abstract":"<div><h3>Background</h3><div>This intention-to-treat study evalutates the feasibility of a new technical solution for patients with multiple bilobar colorectal liver metastases (CLM) characterised by a peculiar intra-organ distribution named Sliced Liver Hepatectomy (SLH).</div></div><div><h3>Study design</h3><div>Patients with CLMs spread in two main clusters were eligible for SLH: an upper cluster involving postero-superior segments (S2-4s-7-8) with at least two hepatic veins contact/invasion at the caval confluence and a lower cluster in S3-4i-5-6 with lesions in contact with the 1st-2nd order glissonean pedicle (Gp).</div></div><div><h3>Results</h3><div>Between 2019 and 2023, 11 patients underwent SLH. 262 CLMs (median 19) were removed: 148 (56 %) in the upper cluster and 114 (44 %) in the lower one. Thirty-six CLM had vascular contact (median 3): 17 with HV (47 %) and 19 with Gp (53 %). 11 (65 %) HV-detachment, five (29 %) HV tangential resection with direct suture reconstruction were performed and one patient (6 %) required the section of HV. All CLM within the lower clusters were detached from Gp. Major complication and mortality were nil. Three patients (27 %) developed a mild postoperative liver failure. After a median follow-up of 21 months, all patients are alive and 7 (63 %) had hepatic recurrence: re-resection in 4 (57 %), percutaneous ablation in one (14 %), and systemic therapy in the remaining 2 (29 %). At six months, median liver-volume growth ratio was 88 % compared with the post-resectional volume.</div></div><div><h3>Conclusion</h3><div>SLH is a new parenchyma-sparing procedure for patients with multiple bilobar CLMs. This first release described the technical clues, showed its feasibility, relative safety, and its related high salvageability in case of relapse.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102254"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676444","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":"Mediastinal staging with video-assisted mediastinoscopic lymphadenectomy after endobronchial ultrasound-guided transbronchial needle aspiration: real-world evidence in 228 patients","authors":"Dominik Herrmann ,&nbsp;Santiago Ewig ,&nbsp;Katharina Greif ,&nbsp;Kolja Milobinski ,&nbsp;Tugba Bas Kaya ,&nbsp;Melanie Oggiano ,&nbsp;Thorsten Walles ,&nbsp;Stefan Welter ,&nbsp;Erich Hecker","doi":"10.1016/j.suronc.2025.102309","DOIUrl":"10.1016/j.suronc.2025.102309","url":null,"abstract":"<div><h3>Background</h3><div>Accurate staging of mediastinal lymph nodes in patients with non-small-cell lung cancer (NSCLC) is essential to determine further management. Current guidelines recommend confirmatory mediastinoscopy for patients with suspicious mediastinal lymph node metastases in image-based staging but negative findings on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). In clinical practice, adherence to these recommendations is low and many physicians omit invasive surgical staging. This study aimed to assess the results of subsequent video-assisted mediastinoscopic lymphadenectomy (VAMLA).</div></div><div><h3>Methods</h3><div>Retrospective single-center cohort analysis of patients who underwent surgery between 2015 and 2019. All patients were diagnosed with potentially resectable lung cancer or FDG-avid pulmonary nodule suspicious for NSCLC and underwent VAMLA following N0-N2 EBUS-TBNA for mediastinal staging.</div></div><div><h3>Results</h3><div>VAMLA was performed in 228 patients. Nodal upstaging after EBUS-TBNA occurred in 17.5 % of the cases (n = 40). During EBUS-TBNA, 1.72 (±1.06) lymph node stations were sampled, compared to 5.59 (±1.1) resected stations in VAMLA (p &lt; 0.001). Clinical nodal status staged by PET/CT was significantly correlated with the occurrence of nodal upstaging by VAMLA, with an odds ratio of 7.69 in cN2 and 5.88 in patients with cN3, compared to cN0. Complications occurred in 8 patients (3.59 %). VAMLA was false negative in 1 patient (0.4 %).</div></div><div><h3>Conclusion</h3><div>Subsequent VAMLA enables the accurate staging of patients after negative EBUS-TBNA. Overall, 17.5 % of cases had nodal upstaging and would otherwise not have received guideline-compliant treatment for NSCLC. These results underline the role of surgical mediastinal staging after negative EBUS-TBNA in patients with suspicious radiologic findings.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102309"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318877","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":"Surgical treatment of liver metastasis from pancreatic cancer","authors":"José Manuel Ramia ,&nbsp;Nuria Blanco-Asensio ,&nbsp;Juan Jesús Rubio ,&nbsp;Víctor López-López ,&nbsp;Ricardo Robles-Campos ,&nbsp;Gerardo Blanco-Fernández ,&nbsp;Angélica Borráez ,&nbsp;Aloia Guerreiro-Camaño ,&nbsp;José Manuel Asencio-Pascual ,&nbsp;Mario Serradilla-Martín ,&nbsp;Fernando Rotellar","doi":"10.1016/j.suronc.2025.102308","DOIUrl":"10.1016/j.suronc.2025.102308","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related mortality, projected to become the second by 2030. Liver metastases from PDAC (LMPC) are typically deemed inoperable, with dismal prognosis and limited surgical roles. However, emerging evidence suggests that liver resection may benefit selected patients. This study evaluates overall survival (OS), disease-free survival (DFS), and prognostic factors following hepatic resection for synchronous and metachronous LMPC.</div></div><div><h3>Methods</h3><div>A retrospective, multicenter cohort study from the REMENOCOR Project included 66 patients who underwent liver resection for LMPC in Spain between 2010 and 2022. Eligible patients were ≥18 years with histologically confirmed PDAC and liver metastases. Survival outcomes, postoperative morbidity (Clavien-Dindo, CCI), and prognostic indicators were analyzed using Kaplan-Meier and univariate and multivariate methods.</div></div><div><h3>Results</h3><div>R0 resection was achieved in 72.7 % of the patients, and major complications occurred in 19.6 %, with 1.5 % mortality. The 5-year OS and DFS were 26.6 % and 12.7 %, respectively. LMPC were metachronic in 65.2 % of patients. Synchronous resection correlated with significantly poorer OS (5 % vs. 38 %, <em>p</em> &lt; 0.05). Synchronous surgery and advanced pancreatic T-stage emerged as independent negative prognostic factors.</div></div><div><h3>Conclusion</h3><div>Liver resection for metachronous LMPC may offer meaningful survival in selected patients, underscoring the importance of individualized surgical strategies and the need for prospective trials.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102308"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325773","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 resected-to-original middle hepatic vein length proportion on posthepatectomy liver failure after right-sided hepatectomy for perihilar cholangiocarcinoma","authors":"Jimin Son ,&nbsp;Se Jin Choi ,&nbsp;Min Kyu Sung ,&nbsp;Woohyung Lee ,&nbsp;Ki Byung Song ,&nbsp;Dae Wook Hwang ,&nbsp;Song Cheol Kim ,&nbsp;Jae Hoon Lee","doi":"10.1016/j.suronc.2025.102302","DOIUrl":"10.1016/j.suronc.2025.102302","url":null,"abstract":"<div><h3>Background</h3><div>Middle hepatic vein (MHV) resection is often required during right-sided hepatectomy for perihilar cholangiocarcinoma (PHCC) to achieve negative margins. However, its resection may compromise hepatic regeneration, potentially increasing the risk of post-hepatectomy liver failure (PHLF).</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study included patients who underwent right-sided hepatectomy for PHCC from 2013 to 2020. Patients who had right trisectionectomy, pancreaticoduodenectomy, or contralateral vascular resection were excluded. The study assessed MHV resection and the proportion of resected-to-original MHV length using CT imaging. The primary outcome was the occurrence of either PHLF (≥ grade B) or 90-day mortality.</div></div><div><h3>Results</h3><div>Among 347 patients, the primary outcome occurred in 9.5 % (33/347). A higher remnant MHV proportion demonstrated a trend toward lower risk of the primary outcome (Odds ratio [OR] 0.989, 95 % confidence interval [CI] 0.978–1.001; p = 0.058). Although any resection of MHV did not remain an independent predictor in multivariable analysis (OR 2.039, 95 % CI 0.883–4.706; p = 0.095), it was significantly associated with the primary outcome in univariable analysis (OR 2.368, 95 % CI 1.115–4.929; p = 0.022).</div></div><div><h3>Conclusions</h3><div>Although not statistically conclusive, MHV resection may increase the risk of PHLF or 90-day mortality in right-sided hepatectomy for PHCC.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102302"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266739","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":"Beyond traditional risk factors: The identification of preoperative serum ferritin as a novel predictor of anastomotic leakage after colonic surgery","authors":"Mohamed Hassin Mohamed Chairi ,&nbsp;Patricia Josefina Madroñal Escribano ,&nbsp;Alicia Ron García ,&nbsp;María José Alonso Sebastián ,&nbsp;Patricia Vílchez Fernández ,&nbsp;Mónica Mogollón González ,&nbsp;Per Anderson ,&nbsp;María Elena Rodríguez-Cabezas ,&nbsp;María del Carmen Olvera Porcel ,&nbsp;José Tomás Torres Alcalá ,&nbsp;Francisco José Huertas Peña","doi":"10.1016/j.suronc.2025.102283","DOIUrl":"10.1016/j.suronc.2025.102283","url":null,"abstract":"<div><h3>Aim</h3><div>To identify predictive risk factors associated with anastomotic leakage (AL) following colon resection surgery.</div></div><div><h3>Method</h3><div>Observational and retrospective cohort study of patients undergoing colon resection with colonic/colorectal anastomosis from January 2018 to December 2023. Demographic, patient, surgery, and outcome data were analysed. Risk factors were identified with both univariate and multivariate analysis.</div></div><div><h3>Results</h3><div>A total of 639 patients who underwent colon resection with anastomosis were included in this study. Among them, 62 patients (9.7 %) developed AL. Univariate analysis identified age, male sex, preoperative serum ferritin levels &gt;51.75 ng/mL, minimally invasive surgical approach, extended resection and preoperative C-reactive protein levels &gt;10 mg/L as factors associated with AL. Multivariate analysis revealed that preoperative serum ferritin (OR 5.55, p = 0.001) and preoperative C-reactive protein levels (OR 54.97, p &lt; 0.001) were independent and significant predictors of AL.</div></div><div><h3>Conclusion</h3><div>Our study has identified preoperative C-reactive protein as a predictor of AL, consistent with findings reported in the literature, and highlights preoperative serum ferritin as a novel predictor of AL following colonic anastomosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102283"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004386","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 impact of tumor microenvironment characteristics in intrahepatic cholangiocarcinoma: A systematic review and meta-analysis","authors":"Zaiba Shafik Dawood ,&nbsp;Mujtaba Khalil ,&nbsp;Arsalan Javid ,&nbsp;Abdul Ali ,&nbsp;Usama Waqar ,&nbsp;Zayan Alidina ,&nbsp;Illiyun Banani ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.suronc.2025.102307","DOIUrl":"10.1016/j.suronc.2025.102307","url":null,"abstract":"<div><h3>Introduction</h3><div>Intrahepatic cholangiocarcinoma (ICC) is a rare and aggressive cancer. Histologic characterization of ICC and the tumor microenvironment (TME) may be associated with prognosis and response to treatment. The objective of the current study was to systematically review and conduct a meta-analysis to identify various elements of the TME that impact prognosis among patients with ICC.</div></div><div><h3>Methods</h3><div>A systematic search was performed using the PubMed, Embase and Scopus databases that employed a Boolean search strategy using Medical Subject Headings (MeSH) terms for: bile duct neoplasms, intrahepatic cholangiocarcinoma and tumor microenvironment. A random effect meta-analysis was conducted to assess the impact of TME elements on overall survival (OS) and disease free survival (DFS).</div></div><div><h3>Results</h3><div>Twenty-five studies (4162 patients, 56.1 % male) met inclusion criteria. On pooled meta-analysis, stromal factors associated with improved patient outcomes included mature stroma (HR = 0.38; 95 %CI, 0.26-0.56-OS). In contrast, alpha-smooth muscle actin fibroblasts in the TME were associated with worse OS (HR = 1.48; 95 %CI, 1.22–1.80); micro vessel density did not correlate with patient prognosis (HR = 0.73; 95 %CI, 0.31–1.70). High peritumoral and intra tumoral CD8⁺ T cells (HR = 0.57; 95 %CI, 0.45–0.71) and CD 4+ T-cells (HR = 0.48; 95 %CI, 0.37–0.62) were associated with improved OS. Epithelial-mesenchymal transition characterized by positive E-Cadherin expression was also associated with improved OS. In contrast, lack of cholangiocellular differentiation and large duct type ICC were associated with a worse OS among patients with ICC.</div></div><div><h3>Conclusion</h3><div>Elements of the TME had a variable impact on the prognosis of patients and may have differential implications for potential treatment of patients with ICC.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102307"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310066","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":"Minor resection for primary hepatocellular carcinoma promotes curative recurrent treatments","authors":"Mei-Pei Huang ,&nbsp;Rey-Heng Hu ,&nbsp;Hou-Ying Cheng ,&nbsp;Chih-Yang Hsiao ,&nbsp;Ming-Chih Ho ,&nbsp;Yao-Ming Wu ,&nbsp;Po-Huang Lee ,&nbsp;Cheng-Maw Ho","doi":"10.1016/j.suronc.2025.102281","DOIUrl":"10.1016/j.suronc.2025.102281","url":null,"abstract":"<div><h3>Background</h3><div>The extent of primary hepatectomy for hepatocellular carcinoma (HCC) may influence long-term outcomes, especially at recurrence. We investigated whether initial minor or major hepatectomy impacts retreatment options and survival following recurrence.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients with primary HCC who underwent either initial major or minor hepatectomy. Outcomes analyzed included overall survival (OS), and post-recurrence overall survival (OS-R). Prognostic factors were analyzed using propensity score matching (PSM).</div></div><div><h3>Results</h3><div>Among 1836 patients experienced recurrence, 873 matched cases were analyzed post-PSM. The crude 5-, 10-, and 15-year OS rates were 86.5 %, 73.9 %, and 61.5 %, respectively, in the minor hepatectomy group, and 76.8 %, 67.6 %, and 62.7 %, respectively, in the major hepatectomy group (p &lt; 0.001). OS-R was comparable between the two groups among the matched cases. The prognostic factors for OS-R included the initial cancer stage, recurrent albumin–bilirubin score, recurrence with vascular invasion or extrahepatic metastases, and the selected recurrent treatment. More patients after primary minor hepatectomy underwent re-resection or local ablation as recurrent treatment, and were able to achieve better outcomes.</div></div><div><h3>Conclusions</h3><div>While recurrence rates and post-recurrence survival were similar between groups, minor hepatectomy may preserve greater liver volume, enabling more patients to receive further curative treatments upon recurrence. Minor hepatectomy offers better retreatment options and potentially better long-term survival.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102281"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144997700","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":"A tumor microenvironment-based classification of gastric cancer for more effective diagnosis and treatment","authors":"Simona O. Dima ,&nbsp;Andrei Sorop ,&nbsp;Shuji Kitahara ,&nbsp;Namrata Setia ,&nbsp;Mihaela Chivu-Economescu ,&nbsp;Lilia Matei ,&nbsp;Vlad Herlea ,&nbsp;Nicolae C. Pechianu ,&nbsp;Takenori Inomata ,&nbsp;Aya Matsui ,&nbsp;Anna Khachatryan ,&nbsp;Shuichi Aoki ,&nbsp;Gregory Y. Lauwers ,&nbsp;Irinel Popescu ,&nbsp;Dan G. Duda","doi":"10.1016/j.suronc.2025.102298","DOIUrl":"10.1016/j.suronc.2025.102298","url":null,"abstract":"<div><div>With approximately one million diagnosed cases and over 700,000 deaths recorded annually, gastric cancer (GC) is the third most common cause of cancer-related deaths worldwide. GC is a heterogeneous tumor. Thus, optimal management requires biomarkers of prognosis, treatment selection, and treatment response. The Cancer Genome Atlas program sub-classified GC into molecular subtypes, providing a framework for treatment personalization using traditional chemotherapies or biologics. We hypothesized that integrating immunohistochemistry markers, tumor gene expression profiles, and serum cytokines would define biologically distinct subtypes of gastric cancer and associate with overall survival independently of clinicopathologic factors and provide incremental prognostic value beyond existing classifications. Here, we report a comprehensive study of GC vascular and immune markers associated with tumor microenvironment (TME) based on stage and molecular subtypes, and their correlation with outcomes. Using tissues and blood circulating biomarkers and a molecular classification, we identified tumor archetypes, which show that the TME evolves with the disease stage and is a determinant of prognosis. Moreover, our TME-based subtyping strategy allowed the identification of archetype-specific prognostic biomarkers such as <em>CDH1</em>-mutant GC and circulating IL-6 that provided information beyond and independent of TMN staging, MSI status, and consensus molecular subtyping. The results show that integrating molecular subtyping with TME-specific biomarkers could contribute to improved patient prognostication and may provide a basis for treatment stratification, including for contemporary anti-angiogenesis and immunotherapy approaches.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102298"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208276","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":"Postoperative complications and their risk factors in breast cancer patients treated with neoadjuvant chemotherapy","authors":"Olga Kähkönen ,&nbsp;Harri Mustonen ,&nbsp;Meri Utriainen ,&nbsp;Laura Niinikoski ,&nbsp;Tuomo Meretoja ,&nbsp;Malin Sund","doi":"10.1016/j.suronc.2025.102303","DOIUrl":"10.1016/j.suronc.2025.102303","url":null,"abstract":"<div><h3>Introduction</h3><div>Although neoadjuvant chemotherapy (NACT) has become established treatment of breast cancer, its impact on postoperative complications varies across studies. Furthermore, association between known risk factors and different kind of complications is unclear. We aimed to characterize the type, rate and risk factors of postoperative complications in a cohort of breast cancer patients treated with NACT.</div></div><div><h3>Materials and methods</h3><div>A retrospective review of breast cancer patients treated with NACT in Helsinki University Hospital between 2020 and 2022 was performed. Complications were graded according to Clavien Dindo classification. Risk factors were identified for overall complications, chronic seroma (defined as a seroma requiring more than five needle aspirations) and hematoma or infection in a multivariable logistic regression model.</div></div><div><h3>Results</h3><div>Out of 4432 patients, 377 met the inclusion criteria. Of these, 216 (57 %) had 314 postoperative complications, commonly seroma (n = 204, 65 %), wound or seroma infection (n = 42, 13 %) and problems with wound healing (n = 19, 6 %). In multivariable analyses, higher age (OR = 1.03, p = 0.003) and undergoing mastectomy (OR = 6.45, p &lt; 0.001) and/or axillary lymph node dissection (ALND) (OR = 2.54, p &lt; 0.001) were independent risk factors of overall complications. Hypertension increased the odds of chronic seroma (OR = 2.26, p = 0.035) and overweight increased the odds of hematoma or infection (OR = 1.06, p = 0.012).</div></div><div><h3>Conclusion</h3><div>Postoperative complications were common yet in most cases treated in an outpatient setting. Patients with higher age and BMI, and those operated with mastectomy and/or ALND were in greater risk of developing postoperative complications. This study also identified that hypertension could have a role in the development of chronic seroma.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102303"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266738","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}