Surgical Oncology-Oxford最新文献

{"title":"Neoadjuvant chemoradiotherapy is associated with prolonged relapse free survival in patient with MRI-detected extramural vascular invasion (mrEMVI) positive rectal cancer: A multicenter retrospective cohort study in Japan","authors":"Yusuke Fujita ,&nbsp;Koya Hida ,&nbsp;Daisuke Nishizaki ,&nbsp;Yoshiro Itatani ,&nbsp;Shigeki Arizono ,&nbsp;Takashi Akiyoshi ,&nbsp;Eisuke Asano ,&nbsp;Toshiyuki Enomoto ,&nbsp;Takeshi Naitoh ,&nbsp;Kazutaka Obama ,&nbsp;Japan Society of Laparoscopic Colorectal Surgery","doi":"10.1016/j.suronc.2024.102157","DOIUrl":"10.1016/j.suronc.2024.102157","url":null,"abstract":"<div><h3>Purpose</h3><div>Neoadjuvant chemoradiotherapy (nCRT) is employed for the local control of locally advanced rectal cancer; however, its prognostic impact is limited and often impairs pelvic organ function. Therefore, careful patient selection is essential. This study aimed to investigate the impact of nCRT on relapse-free survival (RFS) by stratifying patients according to MRI detected circumferential resection margin (mrCRM) or extramural vascular invasion (mrEMVI), as the ability of MRI findings to identify patients who will have beneficial outcomes from nCRT is uncertain.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with clinical stage II–III lower rectal cancer who underwent surgical resection with or without nCRT between 2010 and 2011 at 69 hospitals in Japan. The impact of nCRT on RFS was evaluated using multivariable Cox regression models in the entire cohort and in subgroups stratified by mrCRM or mrEMVI status.</div></div><div><h3>Results</h3><div>In the entire cohort (nCRT, n = 172; surgery alone, n = 503), nCRT showed a trend toward improved RFS, although the difference was not statistically significant (HR, 0.74; 95 % CI, 0.54–1.03; P = 0.074). Among mrCRM-negative and mrEMVI-negative patients, there were no significant differences in RFS between the nCRT and surgery-alone groups. Among mrCRM-positive patients, nCRT tended to improve the RFS (HR, 0.70; 95 % CI, 0.46–1.06; P = 0.089). Among mrEMVI-positive patients, nCRT significantly prolonged the RFS (HR, 0.62; 95 % CI, 0.38–1.00; P = 0.048).</div></div><div><h3>Conclusions</h3><div>Compared to surgery alone, nCRT did not significantly improve RFS in the overall population but significantly improved RFS in mrEMVI-positive patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102157"},"PeriodicalIF":2.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445310","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 impact of demographics and socioeconomic status on the receipt of immunotherapy for stage III melanoma","authors":"Alison C. Coogan ,&nbsp;Paige A. Blinn ,&nbsp;Ethan M. Ritz ,&nbsp;Alan Tan ,&nbsp;Lilia Lunt ,&nbsp;Rachel Akers ,&nbsp;Cristina O'Donoghue","doi":"10.1016/j.suronc.2024.102156","DOIUrl":"10.1016/j.suronc.2024.102156","url":null,"abstract":"<div><h3>Background</h3><div>There is limited data examining potential disparities in the receipt of immunotherapy among patients with stage III melanoma.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort review using the National Cancer Database (NCDB) including adult patients with stage III melanoma between 2004 and 2017. We compared receipt of immunotherapy based on demographic and socioeconomic factors for patients diagnosed 2004–2014 and 2016–2017, before and after FDA approval of immune checkpoint blockade.</div></div><div><h3>Results</h3><div>12,099 patients were included. The proportion of stage III patients who received immunotherapy significantly increased over time, from 24.0 % in 2004–2014 to 43.7 % in 2016–2017 (p &lt; 0.001). There was a significant difference in patients who receive immunotherapy based on age (p &lt; 0.001), insurance (p &lt; 0.001), facility location (p &lt; 0.001).On multivariable analysis, increased odds of immunotherapy receipt were found in patients with diagnosis in 2016–2017 (adjusted odds ratio (aOR) 3.3, 95 % CI 2.9–3.7), younger age (65–80 years aOR 0.43, 95 % CI 0.35–0.52), Hispanic ethnicity (aOR 1.5, 95 % CI 1.1–2.1), and private insurance (not insured aOR 0.67, 95 % CI 0.52–0.85).</div></div><div><h3>Conclusions</h3><div>Although narrowing, gaps persist in the receipt of immunotherapy after FDA approval. Understanding disparities in the receipt of immunotherapy will aid in understanding barriers to treatment and ensuring patients have equitable access to advanced care.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102156"},"PeriodicalIF":2.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434105","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":"Predictors of malignant transformation in mucinous pancreatic cystic neoplasm: A systemic review and meta-analysis","authors":"Paola Solis- Pazmino ,&nbsp;Camila Pazmino ,&nbsp;Orly Termeie ,&nbsp;Kristina La ,&nbsp;Eduardo Pilatuna ,&nbsp;Belen Tite ,&nbsp;Luis Figueroa ,&nbsp;Magno Guarconi ,&nbsp;Jon Harrison ,&nbsp;Yosef Nasseri ,&nbsp;Joshua Ellenhorn ,&nbsp;Brendan C. Visser","doi":"10.1016/j.suronc.2024.102153","DOIUrl":"10.1016/j.suronc.2024.102153","url":null,"abstract":"<div><h3>Background</h3><div>The presence of ovarian-type stroma defines mucinous cystic neoplasm (MCN). Criteria for surgical resection differ between current consensus guidelines (IAP, AGA, and Europe). This meta-analysis aims to describe pre-surgical clinical parameters that predict malignant transformation of MCN of the pancreas.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of articles published from 2006 to the time of manuscript authorship in December 2022. The electronic databases included English publications in Ovid MEDLINE In-Process &amp; Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, and Scopus.</div></div><div><h3>Results</h3><div>17 studies were identified and included 1058 patients with MCN treated with pancreatectomy. The mean cohort age was 48.2 years (standard deviation [SD] ± 7.9) with an expected female predominance (96 %). The presenting symptom for most was abdominal pain (55.6 %), however, nearly 20 % of patients were asymptomatic. Most patients were treated with distal pancreatectomy (70.5 %), and the mean tumor size was 45 mm. The rate of invasive cancer was 13.8 %. Cysts with mural nodules had a higher risk of developing invasive tumors than those that did not (OR 26.47, 95%CI 12.57–55.74, p &lt; 0.001, I2:0 %). Other clinical factors such as the presence of intramural calcifications or an elevated serum CA 19–9 (&gt;37U/mL) were not predictive of malignancy.</div></div><div><h3>Conclusion</h3><div>The present meta-analysis did not clarify establishing reliable predictors for malignant transformation other than mural modularity, which may represent tumors that have already undergone transformation. It may be used as a criterion in treatment decision-making.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102153"},"PeriodicalIF":2.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424875","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 modified 5-factor frailty index predicts postoperative outcomes in patients with ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy","authors":"Johanna Kelley ,&nbsp;Gabriella Smith ,&nbsp;Meng Yao ,&nbsp;Laura Chambers ,&nbsp;Robert DeBernardo","doi":"10.1016/j.suronc.2024.102154","DOIUrl":"10.1016/j.suronc.2024.102154","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this research is to compare the ability of mFI5 to the mFI11 to predict frailty, postoperative complications, discharge location for patients with ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) at time of cytoreductive surgery.</div></div><div><h3>Methods</h3><div>This is a single-institution retrospective study in patients with advanced (Stage III, IV) or recurrent ovarian cancer treated with surgical cytoreduction with HIPEC. Logistic regression was used to evaluate frailty as well as factors associated with moderate to severe Accordion postoperative complications and discharge to home. Correlation was calculated between mFI5 and mFI11.</div></div><div><h3>Results</h3><div>Of 141 patients who received HIPEC between 2010 and 2020, 23 patients were classified as frail (mFI5 score ≥2), while 118 were not frail. Frail patients were significantly older with mean age 65.9 compared to non-frail patients who had mean age of 59.1 (p = 0.005), as well as a higher Charlston Comorbidity Index (p &lt; 0.001), and more renal disease (p = 0.025), hypothyroidism (p = 0.005), and hyperlipidemia (p = 0.004). mFI5 and mFI11 scores for frailty were highly correlated (spearman rho 0.98, p &lt; 0.001). Frail patients were more likely to be discharged to a skilled nursing facility (22.7 %) vs. 6.8 % of non-frail patients, or require home services (18.2 % vs 8.5 %, p = 0.025). On multivariable logistic regression, frail patients were more likely to experience moderate or higher Accordion postoperative complications (OR 3.08, p = 0.024).</div></div><div><h3>Conclusions</h3><div>The mFI5, a simpler tool than the mFI11, is also highly associated with postoperative complications and need for postoperative services in patients with ovarian cancer undergoing HIPEC at time of cytoreductive surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102154"},"PeriodicalIF":2.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401900","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 ligamentum teres hepatis and falciform ligament ‘belt and braces’ approach in laparoscopic pancreaticoduodenectomy using a modified Blumgart anastomosis to minimize severe pancreatic fistula and post-operative complications","authors":"Wensheng Liu ,&nbsp;Zheng Li ,&nbsp;Chenjie Zhou ,&nbsp;Shunrong Ji ,&nbsp;Wenyan Xu ,&nbsp;Yihua Shi ,&nbsp;Mengqi Liu ,&nbsp;Haidi Chen ,&nbsp;Qifeng Zhuo ,&nbsp;Xianjun Yu ,&nbsp;Xiaowu Xu","doi":"10.1016/j.suronc.2024.102152","DOIUrl":"10.1016/j.suronc.2024.102152","url":null,"abstract":"<div><h3>Background</h3><div>To determine whether ligamentum teres hepatis and falciform ligament, wrapped around the gastroduodenal artery (GDA) and reinforced the posterior wall in pancreatojejunostomy (PJ), protects the GDA stump and other skeletal blood vessels from erosive hemorrhage and reduces the incidence of clinically relevant post-operative pancreatic fistula (CR-POPF) and post-operative complications after laparoscopic pancreaticoduodenectomy (LPD).</div></div><div><h3>Methods</h3><div>We reviewed patients undergone LPD between January 2019 and June 2023. Patients were divided into two groups according to whether the ligamentous flap had been used to wrap the GDA stump (Group A) or to reinforce the posterior wall in PJ, together with the GDA wrapping procedure (Group B). Peri-operative data were reviewed to determine the effectiveness of this approach in preventing CR-POPF, post-pancreatectomy hemorrhage (PPH), and other complications.</div></div><div><h3>Results</h3><div>We enrolled 272 patients (Group A, 154 patients; Group B, 118 patients). Group B patients had significantly fewer ≥ Grade II Clavien–Dindo classification morbidities and CR-POPFs (P &lt; 0.05), and lower length of hospital stay (LOS) and abdominal drainage tube insertion times. Risk factor analysis indicated that main pancreatic duct dilation, the PJ reinforcement procedure, and soft pancreatic tissue were associated with ≥Grade II Clavien–Dindo morbidities and CR-POPF complications.</div></div><div><h3>Conclusions</h3><div>The ligamentous flap application in LPD provided shelter to GDA stump and other skeletal blood vessels under PJ from erosive digestive juices, reinforced the posterior wall in PJ, reduced the incidence of CR-POPF and ≥Grade II Clavien–Dindo classification morbidities. This simple procedure is effective for improving surgical safety of LPD.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102152"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy and treatment benefit of PET/CT in staging of colorectal cancer compared to conventional imaging","authors":"Rebecca Engel ,&nbsp;Ken Kudura ,&nbsp;Kwadwo Antwi ,&nbsp;Kris Denhaerynck ,&nbsp;Daniel Steinemann ,&nbsp;Sereina Wullschleger ,&nbsp;Beat Müller ,&nbsp;Martin Bolli ,&nbsp;Marco von Strauss und Torney","doi":"10.1016/j.suronc.2024.102151","DOIUrl":"10.1016/j.suronc.2024.102151","url":null,"abstract":"<div><h3>Background</h3><div>Until recently the use of positron emission tomography (PET) CT for staging in colorectal cancer (CRC) has been limited to the detection of distant metastasis in advanced disease. But with the introduction of neoadjuvant treatments in CRC, accurate pre-treatment staging has become more relevant.</div></div><div><h3>Aims</h3><div>The aim of the study was to assess the staging accuracy for nodal and distant metastasis of PET/CT compared to computed tomography (CT) alone in CRC. Secondary endpoints were overall survival (OS) and cost of CT compared to PET/CT.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 539 cases with CRC staged with PET/CT and or CT between 2015 and 2021 in a Swiss tertiary referral center was performed. In 471 patients for nodal staging and 479 for staging of distant metastasis the clinical stage of both modalities was compared with pathological stage.</div></div><div><h3>Results</h3><div>The distribution of UICC stages (n = 479) was as follows: Stage I 62 cases (12.9 %), Stage II 127 cases (26.5 %), Stage III 199 cases (41.5 %), Stage IV 91 cases (19.0 %).</div><div>CT alone compared to PET was able to predict nodal involvement with a sensitivity of 55.2 % (95%CI 5.7–59.7 %) and 66.7 % (95%CI 62.4–70.9 %), respectively. The specificity was 67.0 % (95%CI 62.8–71.3 %) for CT and 63.6 % (95%CI 59.3–68.0 %) for PET. The positive predictive value was 49.5 % for CT vs. 51.8 % for PET. The sensitivity of metastasis detection was 53.6 % (95%CI 49.1–58.1 %) for CT and 82.5 % (95%CI 79.1–85.9 %) for PET.</div></div><div><h3>Conclusions</h3><div>PET/CT showed higher sensitivity in the detection of lymph node involvement and metastases in CRC patients compared to CT alone.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102151"},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevating precision: A thorough investigation of multiparametric prostate MRI for prolonged insights into early continence prediction after robot-assisted laparoscopic prostatectomy","authors":"Mehmet Şahin ,&nbsp;Merve Şam Özdemir ,&nbsp;Osman Can ,&nbsp;Emin Taha Keskin ,&nbsp;Harun Özdemir ,&nbsp;Abdülmuttalip Şimşek","doi":"10.1016/j.suronc.2024.102148","DOIUrl":"10.1016/j.suronc.2024.102148","url":null,"abstract":"<div><h3>Background</h3><div>While radical prostatectomy stands out as one of the most effective curative treatments for prostate cancer, it does come with annoying side effects, such as urinary incontinence (UI). We aimed to investigate the predictability of UI using MRI measurements, along with clinical and disease-related variables.</div></div><div><h3>Methods</h3><div>We included 191 patients who underwent robot-assisted laparoscopic radical prostatectomy between July 2020 and October 2022 in the study. Preoperative MRIs of the patients are re-evaluated by an experienced uroradiologist, and membranous urethral length (MUL), urethra wall thickness, levator ani thickness, outer levator distance, Lee's apex shape, intravesical prostate protrusion length, prostate apex depth, and pubic height measurements were made. Additionally, retrospective data on patients' age, BMI, PSA, PSA density, prostate volume, IPSS, clinical stage, and nerve-sparing status were collected. Patients were categorized into two groups based on continence status in the third postoperative month: continent or incontinent. The definition of UI was accepted as the use of one or more pads per day.</div></div><div><h3>Results</h3><div>UI was observed in 38.21 % of the patients in the postoperative third month. Among MRI measurements, only MUL showed a significant relationship with UI (p &lt; 0.001). IPSS (p = 0.004) and Clinical Stage (p &lt; 0.001) were also significantly associated with continence status. Logistic regression analysis identified BMI (p = 0.023; CI 0.73–0.97), IPSS (p = 0.002; CI 1.03–1.17), MUL (p = 0.001; CI 0.66–0.90), and Clinical Stage (p &lt; 0.001; CI 1.53–2.71) as significant predictors. In Multivariable Regression analysis, Clinical Stage emerged as the most powerful predictor of UI (p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Except for MUL, MRI measurements may not predict postoperative UI. A combination of IPSS, clinical stage, and MUL effectively informs patients about postoperative outcomes. These findings contribute to enhancing preoperative counseling for patients undergoing radical prostatectomy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102148"},"PeriodicalIF":2.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective factors on postoperative 30–90 and 360-day mortality in non-small cell lung cancer","authors":"Yunus Türk ,&nbsp;Ahmet Üçvet","doi":"10.1016/j.suronc.2024.102149","DOIUrl":"10.1016/j.suronc.2024.102149","url":null,"abstract":"<div><h3>Purpose</h3><div>Postoperative mortality and morbidity are serious problems, and the identification of risky patient groups will reduce mortality and morbidity rates. The aim of our study was to determine the mortality at 30, 90, and 360 days in patients who underwent surgical resection for non-small cell lung cancer (NSCLC).</div></div><div><h3>Methods</h3><div>In this single-center retrospective study, 935 patients who were operated on for NSCLC were included. Demographic characteristics, laboratory data, tumor characteristics, surgical method used, type of resection, postoperative complications, and the relationship between 30, 90, and 360-day mortality were analyzed.</div></div><div><h3>Results</h3><div>In-hospital mortality was observed in 21 (2.2 %) of the 935 patients; the 30-90-360-day mortality rate was respectively 3 %, 4.9 %, and 12.1 %. The 30- and 90-day mortality rates were close (3 %, 4.9 % respectively), and the only difference was the additional surgical procedure. The common factors that increased 30-, 90-, and 360-day mortality were advanced disease stage, additional surgical procedure, length of stay longer than 7 days, low % forced vital capacity (FVC), presence of comorbidities, presence of postoperative complications, and pneumonectomy.</div></div><div><h3>Conclusion</h3><div>In this study, 30-, 90-, and 360-day mortality rates and common and independent risk factors affecting mortality were determined. Although 30-day mortality is the most often utilized time period for assessing postoperative mortality, 90-day mortality can be used to predict postoperative mortality following a major surgical procedure. Preoperative mortality and morbidity are expected to decrease with more detailed preoperative examination of high-risk patients and special follow-up programs in the postoperative period.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102149"},"PeriodicalIF":2.3,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment strategies for patients over 80 years of age with oral squamous cell carcinoma","authors":"Hideaki Hirai ,&nbsp;Naoya Kinoshita ,&nbsp;Naoto Nishii ,&nbsp;Yu Oikawa ,&nbsp;Takuma Kugimoto ,&nbsp;Takeshi Kuroshima ,&nbsp;Hirofumi Tomioka ,&nbsp;Yasuyuki Michi ,&nbsp;Yoshimasa Sumita ,&nbsp;Kei Tomihara ,&nbsp;Hiroyuki Harada","doi":"10.1016/j.suronc.2024.102146","DOIUrl":"10.1016/j.suronc.2024.102146","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the clinical characteristics of patients with oral squamous cell carcinoma aged ≥80 years, focusing on surgical treatments.</div></div><div><h3>Study design</h3><div>We reviewed patients with oral squamous cell carcinoma aged ≥80 years who underwent surgery between 2005 and 2018. Basic information, comorbidities, multiple primary cancers, initial treatment, complications, and outcomes were evaluated.</div></div><div><h3>Results</h3><div>Of 197 patients aged ≥80 years, 119 patients underwent surgery (50 males, 69 females; mean age: 83.5 years). The gingiva was the most common primary tumor site (63 patients, 52.9 %). The stage classification was stage I in 35 patients (29.4 %), stage II in 44 (37 %), stage III in 16 (13.4 %), stage IVA in 22 (18.5 %), and stage IVB in 2 (1.7 %). Comorbidities were identified in 112 patients (94.1 %). Surgery was the initial treatment in 111 patients (93.3 %). Eight (6.7 %) patients received postoperative adjuvant chemotherapy/radiotherapy; 20 patients (16.8 %) underwent free tissue transplantation. Perioperative complications were observed in 36 patients (30.3 %). The cumulative 5-year and 10-year overall survival rates were 82 % and 68.3 %, respectively; the disease-specific survival rates were 90 %.</div></div><div><h3>Conclusion</h3><div>Good treatment outcomes were obtained with radical surgery. Surgery should be the first choice if quality of life is assured and there are no issues with surgical tolerance, regardless of age.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102146"},"PeriodicalIF":2.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative multiparametric magnetic resonance imaging based risk stratification system for predicting biochemical recurrence after radical prostatectomy","authors":"Cagri Akpinar ,&nbsp;Digdem Kuru Oz ,&nbsp;Alkan Oktar ,&nbsp;Furkan Ozsoy ,&nbsp;Eriz Ozden ,&nbsp;Nuray Haliloglu ,&nbsp;Muhammed Arif Ibis ,&nbsp;Evren Suer ,&nbsp;Sumer Baltaci","doi":"10.1016/j.suronc.2024.102150","DOIUrl":"10.1016/j.suronc.2024.102150","url":null,"abstract":"<div><h3>Background</h3><div>Multiparametric magnetic resonance imaging (mpMRI) is used as a current marker in preoperative staging and surgical decision-making, but current evidence on predicting post-surgical oncological outcomes based on preoperative mpMRI findings is limited. In this study We aimed to develop a risk classification based on mpMRI and mpMRI-derived biopsy findings to predict early biochemical recurrence (BCR) after radical prostatectomy.</div></div><div><h3>Methods</h3><div>Between January 2017 and January 2023, the data of 289 patients who underwent mpMRI, transrectal ultrasound-guided cognitive and fusion targeted biopsies, and subsequent radical prostatectomy (RP) with or without pelvic lymph node dissection in a single center were retrospectively re-evaluated. BCR was defined as a prostate specific-antigen (PSA) ≥ 0.2 ng/mL at least twice after RP. Multivariate logistic regression models tested the predictors of BCR. The regression tree analysis stratified patients into risk groups based on preoperative mpMRI characteristics. Receiver operating characteristic (ROC)-derived area under the curve (AUC) estimates were used to test the accuracy of the regression tree–derived risk stratification tool.</div></div><div><h3>Results</h3><div>BCR was detected in 47 patients (16.2 %) at a median follow-up of 24 months. In mpMRI based multivariate analyses, the maximum diameter of the index lesion (HR 1.081, 95%Cl 1.015–1.151, p = 0.015) the presence of PI-RADS 5 lesions (HR 2.604, 95%Cl 1.043–6.493, p = 0.04), ≥iT3a stage (HR 2.403, 95%Cl 1.013–5.714, p = 0.046) and ISUP grade ≥4 on biopsy (HR 2.440, 95%Cl 1.123–5.301, p = 0.024) were independent predictors of BCR. In regression tree analysis, patients were stratified into three risk groups: maximum diameter of index lesion, biopsy ISUP grade, and clinical stage on mpMRI. The regression tree–derived risk stratification model had moderate-good accuracy in predicting early BCR (AUC 77 %)</div></div><div><h3>Conclusion</h3><div>Straightforward mpMRI and mpMRI-derived biopsy-based risk stratification for BCR prediction provide an additional clinical predictive model to the currently available pathological risk tools.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"57 ","pages":"Article 102150"},"PeriodicalIF":2.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}