Surgical Oncology-Oxford最新文献

{"title":"Introduction to “Legends in oncology: Expert commentary”","authors":"Vijay P. Khatri","doi":"10.1016/j.suronc.2024.102041","DOIUrl":"10.1016/j.suronc.2024.102041","url":null,"abstract":"","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":"139589584","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":"Repeated pancreatic resection for pancreatic metastases from renal cell Carcinoma: A Spanish multicenter study (PANMEKID)","authors":"Adela Rojas-Holguín ,&nbsp;Constantino Fondevila-Campo ,&nbsp;Alfonso Sanjuanbenito ,&nbsp;Joan Fabregat-Prous ,&nbsp;Luís Secanella-Medayo ,&nbsp;Fernando Rotellar-Sastre ,&nbsp;Fernando Pardo-Sánchez ,&nbsp;Mikel Prieto-Calvo ,&nbsp;Héctor Marín-Ortega ,&nbsp;Santiago Sánchez-Cabús ,&nbsp;Luis Diez-Valladares ,&nbsp;Óscar Alonso-Casado ,&nbsp;Carmen González-Serrano ,&nbsp;Juan Carlos Rodríguez-Sanjuan ,&nbsp;Gabriel García-Plaza ,&nbsp;Isabel Jaén-Torrejimeno ,&nbsp;Miguel Ángel Suárez-Muñoz ,&nbsp;Antonio Becerra-Massare ,&nbsp;Paula Senra-del Rio ,&nbsp;Elizabeth Pando ,&nbsp;Gerardo Blanco-Fernández","doi":"10.1016/j.suronc.2024.102039","DOIUrl":"10.1016/j.suronc.2024.102039","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Recurrent isolated pancreatic metastasis from Renal Cell Carcinoma (RCC) after pancreatic resection is rare. The purpose of our study is to describe a series of cases of relapse of pancreatic metastasis from renal cancer in the pancreatic remnant and its surgical treatment with a repeated pancreatic resection, and to analyse the results of both overall and disease-free survival.</p></div><div><h3>Methods</h3><p>Multicenter retrospective study of patients undergoing pancreatic resection for RCC pancreatic metastases, from January 2010 to May 2020. Patients were grouped into two groups depending on whether they received a single pancreatic resection (SPS) or iterative pancreatic resection. Data on short and long-term outcome after pancreatic resection were collected.</p></div><div><h3>Results</h3><p>The study included 131 pancreatic resections performed in 116 patients. Thus, iterative pancreatic surgery (IPS) was performed in 15 patients. The mean length of time between the first pancreatic surgery and the second was 48.9 months (95 % CI: 22.2–56.9). There were no differences in the rate of postoperative complications. The DFS rates at 1, 3 and 5 years were 86 %, 78 % and 78 % vs 75 %, 50 % and 37 % in the IPS and SPS group respectively (p = 0.179). OS rates at 1, 3, 5 and 7 years were 100 %, 100 %, 100 % and 75 % in the IPS group vs 95 %, 85 %, 80 % and 68 % in the SPS group (p = 0.895).</p></div><div><h3>Conclusion</h3><p>Repeated pancreatic resection in case of relapse of pancreatic metastasis of RCC in the pancreatic remnant is justified, since it achieves OS results similar to those obtained after the first resection.</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":"https://www.sciencedirect.com/science/article/pii/S0960740424000070/pdfft?md5=becc7339e8739539ff7ba847f297ee7e&pid=1-s2.0-S0960740424000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589585","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":"A systematic review and meta-analysis of mediastinoscopy-assisted transhiatal esophagectomy (MATHE)","authors":"Yoshio Masuda ,&nbsp;Eugene Kwong Fei Leong ,&nbsp;Jimmy Bok Yan So ,&nbsp;Asim Shabbir ,&nbsp;Timothy Lam Jia Wei ,&nbsp;Daryl Kai Ann Chia ,&nbsp;Guowei Kim","doi":"10.1016/j.suronc.2024.102042","DOIUrl":"10.1016/j.suronc.2024.102042","url":null,"abstract":"<div><h3>Background</h3><p>Transhiatal esophagectomy (THE) avoids thoracotomy but sacrifices mediastinal lymphadenectomy. Mediastinoscopy-assisted transhiatal esophagectomy (MATHE) allows for visualisation and en-bloc dissection of mediastinal lymph nodes while retaining the benefits of THE. However, given its novel inception, there is a paucity of literature. This study aimed to conduct the first meta-analysis to explore the efficacy of MATHE and clarify its role in the future of esophagectomy.</p></div><div><h3>Methods</h3><p>Four databases (PubMed, EMBASE, Scopus, and Cochrane Library) were searched from inception to May 1, 2023. Studies were included if they reported outcomes for patients with esophageal cancer who underwent MATHE. Meta-analyses of proportions and pooled means were performed for the outcomes of intraoperative blood loss, lymph node (LN) harvest, mean hospital length of stay (LOS), mean operative time, R0 resection, conversion rates, 30-day mortality rate, 5-year OS, and surgical complications (anastomotic leak, cardiovascular [CVS] and pulmonary complications, chyle leak and recurrent laryngeal nerve palsy [RLN]). Sensitivity analyses were performed for outcomes with substantial statistical heterogeneity.</p></div><div><h3>Results</h3><p>The search yielded 223 articles; 28 studies and 1128 patients were included in our analysis. Meta-analyses of proportions yielded proportion rates: 30-day mortality (0 %, 95 %CI 0-0), 5-year OS (60.5 %, 95 %CI 47.6–72.7), R0 resection (100 %, 95 %CI 99.3–100), conversion rate (0.1 %, 95 %CI 0–1.2). Among surgical complications, RLN palsy (14.6 %, 95 %CI 9.5–20.4) were most observed, followed by pulmonary complications (11.3 %, 95 %CI 7–16.2), anastomotic leak (9.7 %, 95 %CI 6.8–12.8), CVS complications (2.3 %, 95 %CI 0.9–4.1) and chyle leak (0.02 %, 95 %CI 0–0.8). Meta-analysis of pooled means yielded means: LN harvest (18.6, 95 %CI 14.3–22.9), intraoperative blood loss (247.1 ml, 95 %CI 173.6–320.6), hospital LOS (18.1 days, 95 %CI 14.4–21.8), and operative time (301.5 min, 95 %CI 238.4–364.6). There was moderate-to-high statistical heterogeneity. Findings were robust to sensitivity analyses.</p></div><div><h3>Conclusion</h3><p>MATHE is associated with encouraging post-operative mortality and complication rates, while allowing for radical mediastinal lymphadenectomy with reasonable lymph node harvest.</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":"139661825","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":"Clinical outcomes of total femoral replacement. First Latin American experience","authors":"Jorge Cabrolier ,&nbsp;Oscar Ceballos ,&nbsp;Fabiola Rieloff ,&nbsp;Francisco Hardoy ,&nbsp;Ricardo Tolosa ,&nbsp;Orlando Wevar","doi":"10.1016/j.suronc.2024.102038","DOIUrl":"10.1016/j.suronc.2024.102038","url":null,"abstract":"<div><h3>Introduction</h3><p><span>The femur is frequently affected by primary and metastatic bone tumors. In cases with substantial </span>bone loss, Total Femur Replacement (TFR) remains the only viable limb preservation option. This study investigates the clinical outcomes of TFR patients in a Latin American setting, with a minimum 3-year follow-up.</p></div><div><h3>Methods</h3><p>Retrospective review identifying cases of TFR at a single center from 2009 to 2020. Patients who had TFR either due to oncological indications or complications arising from oncology-related surgeries were included. Data on the indications for surgery and post-operative complications were recorded. To assess functional status, the Musculoskeletal Tumor Society (MSTS) score and the Toronto Extremity Salvage Score (TESS) were used.</p></div><div><h3>Results</h3><p>Fourteen patients met the inclusion criteria. Diagnoses included eight osteosarcomas<span>, four chondrosarcomas<span>, one Ewing sarcoma<span>, and one giant cell tumor. Ten patients had undergone prior surgeries. Indication for TFR was a complication of a previous surgery in 78.6 % of cases. Post-TFR complications were experienced by 35.7 % of patients, requiring further surgeries. At the 3-year mark, average MSTS and TESS scores were 67.4 % and 70.8 %, respectively.</span></span></span></p></div><div><h3>Conclusion</h3><p>Total femur replacement serves as a valuable limb salvage solution for patients with significant femoral defects in oncological scenarios, however, there is a significant risk of complications. Given its potential benefits, it is essential for developing countries to consider incorporating TFR into their healthcare systems.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589695","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":"Improving accuracy in nodal staging of oral cancer: Proposal of a new system","authors":"Narayana Subramaniam ,&nbsp;Gillian Heller ,&nbsp;Jonathan Robert Clark ,&nbsp;Ruta Gupta ,&nbsp;David Goldstein ,&nbsp;John R. de Almeida ,&nbsp;Ali Hosni ,&nbsp;Deepak Balasubramanian ,&nbsp;Krishnakumar Thankappan ,&nbsp;Subramania Iyer ,&nbsp;Martin Batstone ,&nbsp;N. Gopal Iyer ,&nbsp;Robert I. Smee ,&nbsp;Naveen Hedne Chandrasekhar ,&nbsp;Vijay Pillai ,&nbsp;Vivek Shetty ,&nbsp;Vidyabhushan Rangappa ,&nbsp;Michael Veness ,&nbsp;Tsu-Hui (Hubert) Low","doi":"10.1016/j.suronc.2024.102033","DOIUrl":"10.1016/j.suronc.2024.102033","url":null,"abstract":"<div><h3>Background</h3><p>Despite introduction of extranodal extension (ENE) into the AJCC 8th edition of oral cancer staging, previous criticisms persist, such as limited discrimination between sub-stages and doubtful prognostic value of contralateral<span> nodal disease. The purpose of this study was to compare our novel nodal staging system, based on the number of positive nodes and ENE, to the AJCC staging system in surgically treated patients.</span></p></div><div><h3>Methods</h3><p>Retrospective analysis of 4710 patients with oral squamous cell carcinoma<span> (OSCC) treated with surgery±adjuvant therapy in 8 institutions in Australia, North America and Asia. With overall survival (OS) and disease specific survival (DSS) as endpoint, the prognostic performance of AJCC 8th and 7th editions were compared using hazard consistency, hazard discrimination, likelihood difference and balance.</span></p></div><div><h3>Results</h3><p>Our new nodal staging system (PN) a progressive and linear increase in hazard ratio (HR) from pN0 to pN3, with good separation of Kaplan Meier curves. Using the predetermined criteria for evaluation of a staging system, our proposed staging model outperformed AJCC 8th and 7th editions in prediction of OS and DSS.</p></div><div><h3>Conclusion</h3><p>PN was the lymph node staging system that provided the most accurate prediction of OS and DSS for patients in our cohort of OSCC. Additionally, it can be easily adopted, addresses the shortcomings of the existing systems and should be considered for future editions of the TNM staging system.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393681","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 prognosis-based classification model in resectable pancreatic cancer","authors":"Norimitsu Okui,&nbsp;Masashi Tsunematsu,&nbsp;Kenei Furukawa,&nbsp;Yoshihiiro Shirai,&nbsp;Koichiro Haruki,&nbsp;Taro Sakamoto,&nbsp;Tadashi Uwagawa,&nbsp;Shinji Onda,&nbsp;Takeshi Gocho,&nbsp;Toru Ikegami","doi":"10.1016/j.suronc.2024.102035","DOIUrl":"10.1016/j.suronc.2024.102035","url":null,"abstract":"<div><h3>Aim</h3><p>Pancreatic ductal adenocarcinoma<span> treatment is mainly based on the anatomical resectability classification. However, prognosis-based classification may be more reasonable. In this study, we stratified resectable pancreatic ductal adenocarcinoma according to preoperative factors and reconsidered treatment strategies.</span></p></div><div><h3>Methods</h3><p>We retrospectively evaluated 131 patients who underwent upfront surgery for resectable pancreatic ductal adenocarcinoma between 2007 and 2019. Recurrence within 1 year after surgery was defined as early recurrence, and the risk factors for early recurrence were identified using preoperative factors. Subsequently, we calculated the scores and stratified the participant groups.</p></div><div><h3>Results</h3><p>Fifty-five (42 %) patients who relapsed within 1 year showed significantly poorer survival than those without recurrence (median overall survival, 14.0 vs. 80.6 months; <em>p</em><span> &lt; 0.01). Multivariate analysis revealed that a tumor diameter of ≥24 mm (</span><em>p</em> &lt; 0.01) and preoperative serum carbohydrate antigen 19-9 level of ≥380 U/mL (<em>p</em> = 0.04) were the independent risk factors for early recurrence. Early recurrence score was created using these factors, stratifying the participant group into three groups of 0–2 points, and the prognosis was significantly different (median overall survival, 49.3 vs. 31.2 vs. 16.0 months; <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>We stratified the upfront surgical cases of resectable pancreatic ductal adenocarcinoma. The group with a score of 0 had a good prognosis, and upfront surgery was possibly not futile on patients in poor general condition. The group with a score of 2 had a poor prognosis and may require stronger preoperative treatment.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374962","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 outcomes and predictors of overall survival of stage I-III appendiceal adenocarcinoma: Retrospective cohort analysis of the national cancer database","authors":"Sameh Hany Emile ,&nbsp;Nir Horesh ,&nbsp;Michael R. Freund ,&nbsp;Emanuela Silva-Alvarenga ,&nbsp;Zoe Garoufalia ,&nbsp;Rachel Gefen ,&nbsp;Steven D. Wexner","doi":"10.1016/j.suronc.2024.102034","DOIUrl":"10.1016/j.suronc.2024.102034","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to determine predictors of overall survival (OS) after surgical treatment of stage I-III appendiceal adenocarcinoma and compare the outcomes of partial colectomy and hemicolectomy.</p></div><div><h3>Methods</h3><p><span>A retrospective analysis of the U.S. National Cancer Database (NCDB) including patients who underwent surgery for stage I-III appendiceal adenocarcinoma between 2005 and 2019 was conducted. A propensity-score matched analysis was undertaken to compare the outcomes of partial and hemicolectomy and multivariate analysis was performed to determine </span>predictive factors of OS. The main outcome was OS and its independent predictors.</p></div><div><h3>Results</h3><p>2607 patients (51.6 % male) with a mean age of 61.6 ± 13.9 years were included. 61.7 % of patients underwent hemicolectomy while 31.7 % underwent partial colectomy. After matching, partial colectomy, and hemicolectomy had similar OS (117.3 vs 117.2 months; p = 0.08), positive resection margins, short-term mortality, and 30-day readmission. The hemicolectomy group was associated with more examined lymph nodes and longer hospital stays. Older age (HR: 1.047, p &lt; 0.0001), rural residence area (HR: 3.6, p = 0.025), higher Charlson score (HR: 1.6, p = 0.016), signet-ring cell carcinoma (HR: 2.37, p = 0.009), adjuvant systemic treatment (HR: 1.55, p = 0.015), positive surgical margins (HR: 1.83, p = 0.017), positive lymph nodes number (HR: 1.09, p &lt; 0.0001), and examined lymph nodes number (HR: 0.962, p = 0.001) were independent predictors of OS.</p></div><div><h3>Conclusions</h3><p>Partial colectomy and hemicolectomy had similar OS and clinical outcomes. Older age, rural residence, higher Charlson score, signet-ring pathology, adjuvant systemic treatment, positive surgical margins, positive lymph node number, and examined lymph node number were independent predictors of OS.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374909","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":"Hybrid technique has lower stricture rates than Wallace and Bricker","authors":"Osman Can ,&nbsp;Eyyüp Danış ,&nbsp;Eren Görkem Kutlutürk ,&nbsp;Emre Can Polat ,&nbsp;Alper Ötünçtemur","doi":"10.1016/j.suronc.2024.102036","DOIUrl":"10.1016/j.suronc.2024.102036","url":null,"abstract":"<div><h3>Introduction</h3><p><span>A clear consensus has not yet been reached on the optimal ureteroenteric anastomosis<span> technique for ileal conduit urinary diversion following </span></span>radical cystectomy. This study aims to determine the incidence of strictures and their management associated with these anastomosis techniques.</p></div><div><h3>Methods</h3><p><span>We conducted a retrospective, single-center study of patients who underwent radical cystectomy and urinary diversion between March 2014 and August 2022. Patients were categorized based on the ureteroenteric anastomosis technique used: Wallace, Bricker, or Hybrid. Strictures were identified through antegrade </span>pyelography<span> following nephrostomy placement.</span></p></div><div><h3>Results</h3><p>A total of 141 patients were included in the study, with 60 patients in the Wallace group (42 %), 42 patients in the Bricker group (30 %), and 39 patients in the Hybrid group (28 %). The overall incidence of ureteroenteric strictures was 15 %, with 7 patients in the Wallace group, 11 patients in the Bricker group, and 3 patients in the Hybrid group experiencing strictures. There was no statistically significant difference in stricture rates between the Wallace and Bricker groups (11 % vs. 26 %, p = 0.09) or between the Wallace and Hybrid groups (11 % vs. 7 %, p = 0.73). However, a statistically significant difference was observed between the Bricker and Hybrid groups (26 % vs. 7 %, p = 0.03). The mean time to stricture development was 9.2 ± 3.3 months for the Wallace group, 9.5 ± 3.7 months for the Bricker group, and 12.6 ± 5 months for the Hybrid group (p = 0.407).</p></div><div><h3>Conclusion</h3><p>The Hybrid ureteroenteric anastomosis technique exhibits a lower stricture rate compared to the Bricker and Wallace techniques. It represents a safe and feasible alternative technique.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394359","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 use of thyroid isthmusectomy for management of well differentiated thyroid carcinoma - A systematic review and meta-analysis","authors":"Moon Usman ,&nbsp;Peter Yao ,&nbsp;Kathleen Luckett ,&nbsp;Katerina Andreadis ,&nbsp;Remil Thomas ,&nbsp;Andy Hickner ,&nbsp;Paul J. Christos ,&nbsp;Andrew Tassler ,&nbsp;David Kutler ,&nbsp;William Kuhel ,&nbsp;Victoria Banuchi","doi":"10.1016/j.suronc.2023.102032","DOIUrl":"10.1016/j.suronc.2023.102032","url":null,"abstract":"<div><h3>Objective</h3><p><span>With the growing global incidence of thyroid carcinomas, there is an increasing need for distinct guidelines for isthmus-confined carcinomas. Here, we performed the first </span>systematic review<span> on the topic to date, aiming to provide understanding to isthmusectomy as surgical management for well-differentiated thyroid carcinoma of the isthmus.</span></p></div><div><h3>Methods</h3><p><span>We conducted a systematic review following the PRISMA guidelines, analyzing English-language studies from the past decade that report on thyroid isthmusectomy. Exclusion criteria included isthmusectomy performed alongside full thyroidectomy or partial </span>thyroid lobectomy, lack of data on tumor characteristics or survival outcomes, and non-English publications where a translation was unavailable. Our review identified a total of 227 patients from seven studies.</p></div><div><h3>Results</h3><p><span>The average 5-year overall survival and disease-free survival rates for patients with isthmus-confined PTC who underwent isthmusectomy were 100 % and 93.1 %, respectively. Similar to that of total thyroidectomy. 3.1 % of patients required completion thyroidectomy. Furthermore, isthmusectomy resulted in fewer </span>surgical complications than total thyroidectomy.</p></div><div><h3>Conclusions</h3><p>The scarcity of studies providing detailed tumor characteristics and patient outcomes limits our ability to fully evaluate the safety and efficacy of isthmusectomy for isthmus-confined PTC. Additionally, the variable sample sizes and restricted geographic distribution of the included studies calls into questions the generalizability of their findings. Despite these limitations, the data suggest that isthmusectomy may be a viable surgical option for select patients with small, isthmus-confined PTC. In the absence of a randomized controlled trial on the noninferiority of isthmusectomy, significantly more publications are needed before strong conclusions can be drawn.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139055627","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":"What is the diagnostic accuracy of fluorescence-guided surgery for margin assessment in appendicular bone and soft tissue tumors? - A systematic review of clinical studies","authors":"Erhan Okay ,&nbsp;Marcos R. Gonzalez ,&nbsp;Joseph O. Werenski ,&nbsp;Alisha Sodhi ,&nbsp;Korhan Ozkan ,&nbsp;Marcus Brookes ,&nbsp;Maniram Ragbir ,&nbsp;Kenneth Rankin ,&nbsp;Anand TN. Kumar ,&nbsp;Santiago A. Lozano-Calderon","doi":"10.1016/j.suronc.2023.102030","DOIUrl":"10.1016/j.suronc.2023.102030","url":null,"abstract":"<div><h3>Background</h3><p><span>Fluorescence-guided surgery (FGS) is a novel technique to successfully assess surgical margins intraoperatively. Investigation and adoption of this technique in orthopaedic </span>oncology remains limited.</p></div><div><h3>Methods</h3><p>The PRISMA<span> guidelines were followed for this manuscript. Our study was registered on PROSPERO (380520). Studies describing the use of FGS for resection of bone and soft tissue sarcomas (STS) on humans were included. Diagnostic performance metrics (sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV] and accuracy) and margin positivity rate were the outcomes assessed.</span></p></div><div><h3>Results</h3><p>Critical appraisal using the Joanna Brigs Institute checklists showed significant concerns for study quality. Sensitivity of FGS ranged from 22.2 % to 100 % in three of the four studies assessing his metrics; one study in appendicular tumors in the pediatric population reported 0 % sensitivity in the three cases included. Specificity ranged from 9.38 % to 100 %. PPV ranged from 14.6 % to 70 % while NPV was between 53.3 % and 100 %. The diagnostic accuracy ranged from 21.62 % to 92.31 %. Margin positivity rate ranged from 2 % to 50 %, with six of the seven studies reporting values between 20 % and 50 %.</p></div><div><h3>Conclusions</h3><p>FSG is a feasible technique to assess tumor margins in bone and STS. Reported performance metrics and margin positivity rates vary widely between studies due to low study quality and high heterogeneity in dying protocols.</p></div><div><h3>Level of evidence</h3><p>Level III, diagnostic study.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139020412","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}