American Surgeon最新文献_第2页

The Association of Social Vulnerability and Area Deprivation With Open Versus Laparoscopic Partial Colectomy for Colon Cancer. 社会脆弱性和区域剥夺与开放与腹腔镜部分结肠切除术结肠癌的关系。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-07-29 DOI: 10.1177/00031348251363498

John D Salvemini, Kelly Brister, Wayne Shannon Orr, Wade O Christopher

{"title":"The Association of Social Vulnerability and Area Deprivation With Open Versus Laparoscopic Partial Colectomy for Colon Cancer.","authors":"John D Salvemini, Kelly Brister, Wayne Shannon Orr, Wade O Christopher","doi":"10.1177/00031348251363498","DOIUrl":"10.1177/00031348251363498","url":null,"abstract":"IntroductionComparisons between open and laparoscopic partial colectomy for colon cancer are well documented. Social vulnerability (SVI) and area deprivation (ADI) indices reflect social determinants of health, often associated with worse surgical outcomes. Here we examine the association of SVI and ADI with partial colectomy approach.MethodsData came from the Epic Cosmos database for patients with colon cancer who underwent partial colectomy between 2013 and 2022. Only patients with documented SVI were included. Descriptive statistics and binary logistic regression were performed.ResultsThis study included 41,158 patients with colon cancer, of which 18,446 patients underwent open and 22,712 patients underwent laparoscopic partial colectomy. White patients were more likely to undergo laparoscopic colectomy than Black patients (OR: 1.11, 95% CI 1.05-1.17, P < .001). Thirty-day and 12-month mortality were higher in the open (4.7% and 14.5%) than laparoscopic group (1.0% and 4.9%). Upper quartile SVI and ADI had higher odds of open surgery (OR: 1.24, 95% CI 1.18-1.30, P < .001; OR: 1.45, 95% CI 1.39-1.52, P < .001, respectively).ConclusionUpper quartile SVI and ADI had higher odds of open partial colectomy for colon cancer. Clinical presentation and stage at diagnosis largely dictate the approach. Increasing CRC awareness and screenings while promoting laparoscopic partial colectomy would benefit populations with high social vulnerability and area deprivation.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1840-1844"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740986","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}

引用次数: 0

Presentation Patterns and Treatment Outcomes in Appendix Cancer Patients Traveling to a High-Volume Peritoneal Surface Malignancy Center. 阑尾癌患者前往大容量腹膜表面恶性肿瘤中心的表现模式和治疗结果。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-05-05 DOI: 10.1177/00031348251337155

Vladislav Kovalik, Armando Sardi, Mary Caitlin King, Sergei Iugai, Luis Felipe Falla-Zuniga, Carol Nieroda, Vadim Gushchin

{"title":"Presentation Patterns and Treatment Outcomes in Appendix Cancer Patients Traveling to a High-Volume Peritoneal Surface Malignancy Center.","authors":"Vladislav Kovalik, Armando Sardi, Mary Caitlin King, Sergei Iugai, Luis Felipe Falla-Zuniga, Carol Nieroda, Vadim Gushchin","doi":"10.1177/00031348251337155","DOIUrl":"10.1177/00031348251337155","url":null,"abstract":"IntroductionMucinous appendix cancer (MAC) treatment is centralized at peritoneal surface malignancy centers (PSMCs), requiring patients to travel for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). We compared presentation patterns and outcomes for patients accessing a high-volume PSMC from in-state (I-S) vs out-of-state (O-S).MethodsThis cohort study of MAC patients with peritoneal metastases treated with CRS/HIPEC (1998-2023) used a prospective database. Travel distance, presentation (time from diagnosis [TFD], peritoneal cancer index [PCI], prior surgery score [PSS], and systemic chemotherapy [SCh]), quality (complete cytoreduction [CC-0/1] and grade III/IV Clavien-Dindo complications), and overall survival (OS) were compared between O-S and I-S patients. A hazard ratio (HR) with 95% confidence interval (CI) for 10-year OS was evaluated using Cox regression for O-S travel, adjusting for age, histology, PCI, and prior treatment.ResultsOverall, 369 patients were included: 223 (60.4%) O-S and 146 (39.6%) I-S, with median travel distances of 180 [IQR: 83-729] and 29 [IQR: 14-59] miles, respectively. Compared to I-S, O-S had longer TFD (median: 4.6 vs 2.8 months, P < 0.001), higher PCI (median: 32 vs 24, P = 0.001), and higher rates of PSS-2/3 (40.4% vs 28.6%, P = 0.023) and SCh (31.8% vs 19.2%, P = 0.007). CC-0/1 (84.8% vs 91.4%, P = 0.063) and major complication (15.2% vs 21.4%, P = 0.132) rates were comparable. O-S travel did not affect OS (HR: 1.08 [95% CI: 0.73, 1.61]).ConclusionTraveling to a PSMC is associated with delayed presentation, more advanced disease, and prior treatments. However, quality and survival outcomes remain unaffected. Early referral and support for travel are essential.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1889-1897"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952698","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}

引用次数: 0

Breast Tall Cell Carcinoma With Reversed Polarity: Insights Into Clinical Management. 极性倒置的乳腺高细胞癌：临床管理的见解。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-06-04 DOI: 10.1177/00031348251346526

Cecilia M Pesavento, Melinda Sanders, Cara C Connolly, Rachel L McCaffrey

{"title":"Breast Tall Cell Carcinoma With Reversed Polarity: Insights Into Clinical Management.","authors":"Cecilia M Pesavento, Melinda Sanders, Cara C Connolly, Rachel L McCaffrey","doi":"10.1177/00031348251346526","DOIUrl":"10.1177/00031348251346526","url":null,"abstract":"Tall Cell Carcinoma with Reversed Polarity (TCCRP) is a rare type of invasive breast cancer. Most available literature focuses on histopathology and gene-sequencing, while few studies offer insights into clinical management. This report provides a comprehensive review of available literature including 2 new clinical cases to offer insights into the diagnosis, treatment, and outcomes of TCCRP. A systematic literature review was conducted using PubMed with collation of all cases with appropriate clinicopathologic data available. Two TCCRP cases with complete clinicopathologic data were identified at our institution and included in the analysis. Clinical, radiographic, and pathological characteristics were analyzed. Literature review identified 46 relevant studies, with 88 prior cases reported. Data was extracted from 14 studies with complete data, and 67 unique cases analyzed. All patients were female, with a median age of 62 (40-85). Clinical data included tumor size, receptor status, surgery management, adjuvant therapy, recurrence, and overall survival. Most cases demonstrate triple-negative status, yet almost all cases behave indolently with excellent prognosis after surgery and little/no adjuvant therapy. Improved understanding of the clinical behavior of this disease will promote appropriate management and avoid overtreatment.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1959-1965"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214694","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}

引用次数: 0

Comparison of the Ivor-Lewis vs McKeown Procedure in Esophageal Cancers: An Updated Meta-Analysis and Systematic Review. Ivor-Lewis和McKeown手术治疗食管癌的比较：最新的荟萃分析和系统评价。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-06-10 DOI: 10.1177/00031348251346537

Branden Tejada, Eric S Giannaris, Sulaiman Hashemi, Dionisia M Fountos, Mahmoud M Ali, Jake A Mathew, Daniel E German

{"title":"Comparison of the Ivor-Lewis vs McKeown Procedure in Esophageal Cancers: An Updated Meta-Analysis and Systematic Review.","authors":"Branden Tejada, Eric S Giannaris, Sulaiman Hashemi, Dionisia M Fountos, Mahmoud M Ali, Jake A Mathew, Daniel E German","doi":"10.1177/00031348251346537","DOIUrl":"10.1177/00031348251346537","url":null,"abstract":"BackgroundThe Ivor Lewis and McKeown techniques are two established approaches for esophagectomy in the treatment of esophageal cancer. Despite their widespread use, limited direct comparisons exist to assess the efficacy of these techniques across key intraoperative and postoperative outcomes. We performed an updated pooled pairwise meta-analysis to discern the relative benefits and risks associated with each approach.MethodsA systematic search of PubMed, Embase, MEDLINE, and the Cochrane Library through September 2024 was conducted. Eligible studies compared Ivor Lewis and McKeown techniques for esophagectomy. Primary outcomes were 12-month mortality and anastomotic complications; secondary outcomes were number of lymph nodes resected, recurrent laryngeal nerve palsy, pulmonary complications, and chyle-leaked complications.ResultsA total of 9 studies comprising 15 341 patients were included. There were no significant differences in terms of 12-month mortality (OR .89, 95% CI .65 to 1.22, P = .48), the number of lymph nodes resected (MD -1.18, 95% CI -4.51 to 2.16, P = .49), and pulmonary complications (OR .87, 95% CI .61 to 1.24, P = .27). However, Ivor Lewis significantly reduced the incidence of anastomotic leakage (OR .42, 95% CI .18 to .98, P = .050), recurrent laryngeal nerve palsy (OR .13, 95% CI .06 to .27, P < .00001), and chyle-related complications (OR .63, 95% CI .39 to 1.04, P = .05) compared to the McKeown technique.ConclusionThis meta-analysis reveals certain significant advantages in Ivor Lewis, while both maintain similarities in other areas.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1974-1982"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257155","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}

引用次数: 0

Association Between Social Determinants of Health and Severity of Traumatic Brain Injury in Children: A Retrospective Cohort Study. 儿童创伤性脑损伤严重程度与健康的社会决定因素之间的关系：一项回顾性队列研究

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-05-17 DOI: 10.1177/00031348251341951

Justin C Wilburn, Abbas H Zaidi, Lori A Gurien, Md Jobayer Hossain, Babu Balagopal

{"title":"Association Between Social Determinants of Health and Severity of Traumatic Brain Injury in Children: A Retrospective Cohort Study.","authors":"Justin C Wilburn, Abbas H Zaidi, Lori A Gurien, Md Jobayer Hossain, Babu Balagopal","doi":"10.1177/00031348251341951","DOIUrl":"10.1177/00031348251341951","url":null,"abstract":"BackgroundTraumatic brain injury (TBI) is a leading cause of morbidity and mortality among children in the United States (US), with severity and outcomes linked to social determinants of health (SDOH) and regional differences. Data on the impact of SDOH including race, sex, and Child Opportunity Index (COI) level on TBI severity in southeastern US are sparse in children.MethodsWe analyzed data retrospectively in 1063 children with TBI, admitted at a Level I Pediatric Trauma Center in the Southeast US between January 2017-June 2023. TBI severity was categorized using the Glasgow Coma Scale (GCS). Outcomes were length of hospital stay (LOHS), intensive care unit stay (LOICUS), and craniotomy frequency. Patients were classified by race (white, Black, non-Black people of color [NBPOC]), COI (low, moderate, high), and sex (male, female). Statistical analyses included chi-square tests, one-way analysis of variance (ANOVA), and post-hoc comparisons.ResultsSignificant disparities were observed by race and COI. Black children and children with low COI had lower GCS scores (P < 0.01), longer LOHS and LOICUS (P < 0.01) compared to white children and those with high COI. Additionally, Black and NBPOC children were more likely to undergo craniotomies than white children (P < 0.05). No sex-based differences in TBI severity or outcomes were found.DiscussionThis study highlights the significant impact of SDOH, particularly race and COI, on pediatric TBI severity, surgical interventions, and outcomes. These findings underscore the need for targeted interventions to address health care disparities in vulnerable pediatric populations.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1935-1941"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085541","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}

引用次数: 0

South Asian Immigration to the US: From Collective Farms to High-Tech Cities Through H-1B Visas. 南亚移民到美国：通过H-1B签证从集体农场到高科技城市。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-03-12 DOI: 10.1177/00031348251323856

Don K Nakayama

{"title":"South Asian Immigration to the US: From Collective Farms to High-Tech Cities Through H-1B Visas.","authors":"Don K Nakayama","doi":"10.1177/00031348251323856","DOIUrl":"10.1177/00031348251323856","url":null,"abstract":"With origins in the conscripted labor system of nineteenth century European colonies, the South Asian diaspora began in the early twentieth. Migrants faced racial hostility, their foreignness identifiable by skin color, physiognomy, languages unintelligible to Anglophone ears, and customs and religions that confirmed them as heathens in a Christian country. More threatening was their capacity for hard work at substandard wages. Driven out of the Pacific Northwest by mob violence, Sikhs from Punjab brought the intensive farming practices of their native Indus Valley to the agricultural districts of California. Prohibited by statute from owning land, they formed farming collectives to pool their modest plots and capital into larger acreages that were competitive with the industrial farms of the Central and Imperial Valleys. Prejudice and economic competition drove laws and policies that prohibited Asian naturalization (Barred Zone Act, 1917). In 1924, the Johnson-Reed Act set quotas that barred migration from India. Unable to establish second generations, by the 1940s Sikh agricultural settlements were threatened with extinction. Anti-Asian policies unwound in the last half of the twentieth century. Prohibitions against Asian immigration were lifted in 1965. Preferred were those trained in science, technology, and medicine. In 1990 the H-1B visa system added workers in the nascent fields of information technology and computer science, fields where the Indian educational system was robust. After a half-century of immigration policies that favored the highly schooled in science and technology, South Asian communities were created that were intellectually, financially, and socially accomplished, transforming American society.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1997-1999"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143612745","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}

引用次数: 0

Biological and Molecular Mechanisms of Wound Healing: Emerging Therapeutic Strategies and Future Directions. 伤口愈合的生物学和分子机制：新兴的治疗策略和未来的方向。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-06-10 DOI: 10.1177/00031348251350983

Jun Xiong, Li Liu, Xuebing Zhang

引用次数: 0

Results of Open and Endovascular Repair of Complex Aortic, Iliac, and Femoral Anastomotic Aneurysms. 血管内切开修复复杂的主动脉、髂、股吻合动脉瘤的结果。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-07-28 DOI: 10.1177/00031348251363809

Shyamal Pansuriya, Sachinder Hans

{"title":"Results of Open and Endovascular Repair of Complex Aortic, Iliac, and Femoral Anastomotic Aneurysms.","authors":"Shyamal Pansuriya, Sachinder Hans","doi":"10.1177/00031348251363809","DOIUrl":"10.1177/00031348251363809","url":null,"abstract":"Anastomotic aneurysms (AA) manifest as late complications of aortic-iliac-femoral reconstruction with a prosthetic graft. We studied open and endovascular repair of complex aortic iliac and femoral AA was performed for (A) Rupture, (B) Large symptomatic aneurysms, (C) Recurrent, (D) Femoral AA requiring simultaneous arterial reconstruction for critical limb ischemia in two teaching hospitals. Between 1990 and 2024, 100 aorto-femoral-iliac AA were repaired with 32 representing complex AA involving aorta (n = 6), iliac (n = 3), femoral (n = 23). Aortic and iliac anastomotic aneurysms underwent endovascular repairs in 5 patients and open repair in 4 patients with satisfactory outcomes in all. All 23 patients presenting with complex femoral anastomotic aneurysms were repaired via open technique, including five presenting with rupture with mortality in two, and one mortality among those presenting with large aneurysms. Complex femoral AA take longer to present after index operative, showed greater operative time, intra-operative blood loss but had similar mortality to patients with non-complex AAs. Most aortic and iliac AA can be repaired with endovascular and open techniques with satisfactory results, while complex femoral AA required open repair.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1871-1875"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726502","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}

引用次数: 0

Increasing Tube Thoracostomy Output Threshold to Less Than 300 mL Per Day is Not Associated With Increased Complications after Removal in Trauma Patients. 增加胸腔插管输出阈值至每天小于300 mL与创伤患者切除后并发症的增加无关。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-07-28 DOI: 10.1177/00031348251363533

Lee C Givens, Chase A Jordan, James W Herrin, Yann-Leei L Lee, Steven G Miller, Thomas Capasso, Maryann Mbaka, Christopher M Kinnard, Andrew C Bright, Ashley Y Williams, Nathan M Polite, Jon D Simmons, Charles C Butts

{"title":"Increasing Tube Thoracostomy Output Threshold to Less Than 300 mL Per Day is Not Associated With Increased Complications after Removal in Trauma Patients.","authors":"Lee C Givens, Chase A Jordan, James W Herrin, Yann-Leei L Lee, Steven G Miller, Thomas Capasso, Maryann Mbaka, Christopher M Kinnard, Andrew C Bright, Ashley Y Williams, Nathan M Polite, Jon D Simmons, Charles C Butts","doi":"10.1177/00031348251363533","DOIUrl":"10.1177/00031348251363533","url":null,"abstract":"BackgroundTube thoracostomy (TT) is a life-saving intervention that has a high complication rate. While many institutions continue drainage until <200 mL/day, there is little data on removal with higher output. This study aimed to determine whether TT removal with higher output on the day of removal is associated with complication of tube thoracostomy (CTT).Materials and MethodsThis was a retrospective study of patients who underwent TT due to traumatic hemothorax/pneumothorax. Data on demographics, admission vital signs, injury details, treatment course, and output on day of removal was collected. Output was classified as HIGH (200-299 mL at removal) or LOW (<200 mL). The primary outcome variable was development of CTT, which was defined as re-accumulation of HTX/PTX, development of an empyema, subsequent TT, or need for thoracic surgery following tube removal.ResultsAfter applying exclusion criteria, we identified 315 patients for analysis. The average age was 41 years old, and 74% (233) were male. The mean duration of treatment with TT was 5 days. The mean output on the day of removal was 80 mL, with 10% having a volume between 200-299 mL on day of removal. Overall, 16% developed CTT. There was no difference in the rate of CTT after removal between HIGH and LOW groups. Multiple variable logistic regression showed only chest AIS was statistically significantly associated with CTT.DiscussionComplications after tube thoracostomy are common (16%), but patients with higher output were not more likely to develop a complication. Chest tubes can be safely removed with an output <300 mL/day.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1828-1833"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726497","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}

引用次数: 0

Neoadjuvant Chemotherapy vs Surgery First in a Rural Population With Resectable Pancreatic Cancer: Oncologic, Biologic, and Socioeconomic Implications. 农村可切除胰腺癌患者的新辅助化疗vs手术：肿瘤学、生物学和社会经济意义

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-04-29 DOI: 10.1177/00031348251339535

Annmarie F Butare, Emmanuel E Zervos

{"title":"Neoadjuvant Chemotherapy vs Surgery First in a Rural Population With Resectable Pancreatic Cancer: Oncologic, Biologic, and Socioeconomic Implications.","authors":"Annmarie F Butare, Emmanuel E Zervos","doi":"10.1177/00031348251339535","DOIUrl":"10.1177/00031348251339535","url":null,"abstract":"BackgroundThe role of neoadjuvant chemotherapy (NAT) in patients with resectable pancreatic cancer is being studied in ongoing multicenter randomized trials. The primary aim of this study is to compare survival between NAT and up-front surgery (UFS) in a non-selected population of patients presenting with resectable cancer of the head of the pancreas. Patient and tumor-related factors impacting receipt of NAT and survival were also analyzed.MethodsA single institution prospective database was queried to identify patients who underwent pancreaticoduodenectomy for resectable pancreatic adenocarcinoma from 2019 to 2023. Patient demographic and clinical oncologic factors were compared between those who received NAT and those who underwent UFS. Area Deprivation Index (ADI) and distance traveled were used as surrogate indicators for socioeconomic disparity and rurality, respectively. Overall survival was compared using Kaplan-Meier and Cox Regression analyses.ResultsOf the 83 patients included, one third received NAT. There was no significant difference in 1 yr, 3 yr, or overall survival between patients who received NAT vs up-front surgery. ADI and distance traveled did not impact whether a patient received NAT or survival. On Multivariate Cox Regression analysis, age and performance status were the only factors significantly associated with survival.ConclusionsThere was no significant difference in early mortality and overall survival between NAT and UFS groups.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1882-1888"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958761","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}

引用次数: 0