Annals of Gastroenterological Surgery最新文献

{"title":"Osteopenic occult vertebral fracture is associated with poor oncological outcome in patients with hepatocellular carcinoma after hepatic resection","authors":"Koichiro Haruki,&nbsp;Kenei Furukawa,&nbsp;Munetoshi Akaoka,&nbsp;Masashi Tsunematsu,&nbsp;Michinori Matsumoto,&nbsp;Tomohiko Taniai,&nbsp;Yoshihiro Shirai,&nbsp;Shinji Onda,&nbsp;Ryoga Hamura,&nbsp;Toru Ikegami","doi":"10.1002/ags3.12912","DOIUrl":"https://doi.org/10.1002/ags3.12912","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although osteopenia has been associated with poor outcomes in patients with hepatocellular carcinoma (HCC), the oncological impact of occult vertebral fracture (OVF) has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study comprised 235 patients who had undergone primary hepatic resection for hepatocellular carcinoma between 2008 and 2019. Osteopenia was evaluated with computed tomographic measurement of pixel density in the midvertebral core of the 11th thoracic vertebra. OVF was defined if the ratios of central/anterior or central/posterior heights of the vertebrae, measured using sagittal computed tomography reconstruction between 11th thoracic vertebra to 5th lumber vertebrae, &lt;0.8. Multivariate Cox proportional hazard models were conducted to assess disease-free and overall survival adjusting for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Occult vertebral fracture was identified in 93 patients (40%), while osteopenia in 65 patients (28%). Osteopenic OVF was identified in 27 patients (12%). In multivariate analysis, gender (<i>p</i> &lt; 0.001), serum PIVKA-II level ≥ 200 mAU/ml (<i>p</i> = 0.005), C-reactive protein-to-albumin ratio ≥0.04 (<i>p</i> = 0.03), multiple tumors (<i>p</i> &lt; 0.001), type of resection (<i>p</i> &lt; 0.001), low skeletal muscle index (<i>p</i> = 0.002), and osteopenic OVF (HR 3.07, 95% CI 1.78–5.28, <i>p</i> &lt; 0.001) were independent and significant predictors of cancer recurrence, while gender (<i>p</i> = 0.002), Child–Pugh grade B (<i>p</i> = 0.009), C-reactive protein-to-albumin ratio ≥0.04 (<i>p</i> = 0.03), multiple tumors (<i>p</i> = 0.005), low skeletal muscle index (<i>p</i> &lt; 0.001), and osteopenic OVF (HR 4.75, 95% CI 2.41–9.39, <i>p</i> &lt; 0.001) were independent predictors of overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Osteopenic OVF is associated with poor oncological outcomes in patients with hepatocellular carcinoma after hepatic resection. Our findings provide a compelling rationale for the further investigation of the interplay between tumor and bone metabolism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"804-813"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of preoperative Glasgow prognostic score in patients with colorectal cancer and synchronous peritoneal metastases","authors":"Kosuke Fujimoto,&nbsp;Fumikazu Koyama,&nbsp;Hirotoshi Kobayashi,&nbsp;Kenjiro Kotake,&nbsp;Masayasu Kawasaki,&nbsp;Yukihide Kanemitsu,&nbsp;Yusuke Kinugasa,&nbsp;Hideki Ueno,&nbsp;Kotaro Maeda,&nbsp;Takeshi Suto,&nbsp;Michio Itabashi,&nbsp;Kimihiko Funahashi,&nbsp;Heita Ozawa,&nbsp;Shingo Noura,&nbsp;Hideyuki Ishida,&nbsp;Masayuki Ohue,&nbsp;Tomomichi Kiyomatsu,&nbsp;Soichiro Ishihara,&nbsp;Keiji Koda,&nbsp;Hideo Baba,&nbsp;Kenji Kawada,&nbsp;Yojiro Hashiguchi,&nbsp;Takanori Goi,&nbsp;Yuji Toiyama,&nbsp;Naohiro Tomita,&nbsp;Eiji Sunami,&nbsp;Fumihiko Fujita,&nbsp;Jun Watanabe,&nbsp;Kenichi Hakamada,&nbsp;Goro Nakayama,&nbsp;Kenichi Sugihara,&nbsp;Yoichi Ajioka","doi":"10.1002/ags3.12918","DOIUrl":"https://doi.org/10.1002/ags3.12918","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chemotherapy is the typical choice for treating colorectal cancer with synchronous peritoneal metastases. Nonetheless, surgical resection may be chosen if the metastases are resectable. Unfortunately, there is no reliable preoperative or intraoperative prognostic indicator. This study aimed to determine the prognostic significance of the preoperative Glasgow prognostic score (GPS) in colorectal cancer patients with synchronous peritoneal metastases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective study on 143 patients with colorectal cancer and concurrent peritoneal metastases. Our analysis included prognostic factors, such as the GPS, using data from the institutional observational study by the Japanese Society for Cancer of the Colon and Rectum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 3-year survival rates for the GPS0 or 1 and GPS2 groups were 32.7% and 14.3%, respectively, with a significantly worse prognosis in the GPS2 group (<i>p</i> = 0.003). Multivariate analysis identified GPS2 (<i>p</i> = 0.006) and the peritoneal cancer index (PCI) (<i>p</i> = 0.029) or the Japanese surgical peritoneal metastasis grade (<i>p</i> = 0.009) as independent poor prognostic factors. Additionally, the GPS0 or 1 group with total resection of peritoneal metastases had a significantly better prognosis than the non-resection group (<i>p</i> &lt; 0.001); however, there was no difference between the GPS2 group with total peritoneal resection and the non-resection group (<i>p</i> = 0.713).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preoperative GPS2 is an independent poor prognostic factor in patients with colorectal cancer and synchronous peritoneal metastases, and surgical resection does not improve prognosis in patients with GPS2. Preoperative GPSs may be used as indicators for surgical resection of synchronous peritoneal metastases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"750-760"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520245","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":"Impact of primary tumor clinicopathological factors on prognosis after hepatic resection for rectal liver metastases","authors":"Tomofumi Uotani,&nbsp;Takeshi Takamoto,&nbsp;Satoshi Nara,&nbsp;Daisuke Ban,&nbsp;Takahiro Mizui,&nbsp;Konosuke Moritani,&nbsp;Shunsuke Tsukamoto,&nbsp;Yukihide Kanemitsu,&nbsp;Tsutomu Fujii,&nbsp;Minoru Esaki","doi":"10.1002/ags3.12917","DOIUrl":"https://doi.org/10.1002/ags3.12917","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment of liver metastases from rectal cancer has been considered based on research data on liver metastases from colorectal cancer. This study aimed to clarify the impact of clinicopathological factors of the primary lesion, including rectal cancer-specific factors such as lateral lymph node metastasis, on the prognosis after liver resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center retrospective study of patients undergoing curative surgical treatment for resectable liver metastases from rectal cancer from January 2010 to June 2023. Prognostic factors were investigated using univariable and multivariable analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort consisted of 113 males and 44 females, with a median age of 60 years. Lateral lymph node dissection was performed in 48 patients, of which 11 had positive nodes. Multivariable analysis revealed lateral lymph node metastasis (HR 5.86; 95% CI 2.40–14.2; <i>p</i> = 0.0001) and perineural invasion (HR 2.83; 95% CI 1.36–5.88; <i>p</i> = 0.005) as independent prognostic factors. After curative hepatectomy, 73.3% of patients with these two factors showed early recurrence within 6 months, requiring nonsurgical treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lateral lymph node metastasis and perineural invasion of the primary tumor were prognostic factors after resection of rectal liver metastases. Patients with these factors required nonsurgical treatment in the early postoperative period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"814-821"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520247","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":"Impact of body mass index as a continuous variable on short- and long-term outcomes in patients undergoing laparoscopic surgery for colon cancer","authors":"Takayuki Aiba,&nbsp;Tomonori Akagi,&nbsp;Hidefumi Shiroshita,&nbsp;Kentaro Nakajima,&nbsp;Tetsuji Ohyama,&nbsp;Tatsuya Kinjo,&nbsp;Akiyoshi Kanazawa,&nbsp;Nobuaki Suzuki,&nbsp;Takuya Tokunaga,&nbsp;Manabu Yamamoto,&nbsp;Nobuki Ichikawa,&nbsp;Shungo Endo,&nbsp;Yutaka Kojima,&nbsp;Takatoshi Nakamura,&nbsp;Shuji Saito,&nbsp;Yoshinori Kagawa,&nbsp;Shinobu Ohnuma,&nbsp;Seiichiro Yamamoto,&nbsp;Takeshi Naitoh,&nbsp;Masafumi Inomata","doi":"10.1002/ags3.12916","DOIUrl":"https://doi.org/10.1002/ags3.12916","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of obesity on colon cancer remains unclear. Very few studies of colon cancer surgery have analyzed body mass index (BMI) as a continuous variable, with no such reports from Japan. This study examined the association between BMI as a continuous variable and short- and long-term outcomes of laparoscopic surgery for obese colon cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Obese (BMI ≥25 kg/m²) patients who underwent laparoscopic radical surgery for Stage II/III colon cancer at 46 participating centers from 2009 to 2013 were included. Associations between short- and long-term outcomes and BMI as a continuous variable were analyzed by univariate and multivariate regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among patients meeting the study criteria, 1036 were examined. BMI as a continuous variable correlated with log-transformed operative time (regression coefficient: 0.02, 95% confidence interval [CI]: 0.012–0.028, <i>p</i> &lt; 0.05) and blood loss (odds ratio: 1.089, 95% CI: 1.032–1.149, <i>p</i> &lt; 0.05). There was no association between BMI continuous variables and 3-year relapse-free survival (RFS) and overall survival. However, 3-year RFS was possibly better in patients with BMI ≥28.5 kg/m² versus those with BMI &lt;28.5 kg/m² (hazard ratio: 0.682, 95% CI: 0.462–1.008, <i>p</i> = 0.055).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study showed that BMI as a continuous variable correlated with operative time and blood loss. RFS was possibly better in the severely obese patients (BMI ≥28.5 kg/m²), suggesting that the prognosis for highly obese colon cancer patients appears to follow the obesity paradox.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"392-400"},"PeriodicalIF":2.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950528","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":"Short-term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi-institutional cohort study in Japan (ICAN study)","authors":"Tomohiro Yamaguchi,&nbsp;Keitaro Tanaka,&nbsp;Jun Watanabe,&nbsp;Hiroki Hamamoto,&nbsp;Atsushi Nishimura,&nbsp;Fumihiko Fujita,&nbsp;Hirokazu Suwa,&nbsp;Masaaki Ito,&nbsp;Kazushige Kawai,&nbsp;Junichiro Hiro,&nbsp;Seiichiro Yamamoto,&nbsp;Sho Nambara,&nbsp;Masato Ota,&nbsp;Yuri Ito,&nbsp;Junji Okuda,&nbsp;Masafumi Inomata,&nbsp;Masahiko Watanabe,&nbsp;Takeshi Naitoh,&nbsp;ICAN Collaborative Study Group of the Japan Society of Laparoscopic Colorectal Surgery","doi":"10.1002/ags3.12915","DOIUrl":"https://doi.org/10.1002/ags3.12915","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several randomized controlled trials and meta-analyses have demonstrated the potential advantages of intracorporeal over extracorporeal anastomosis. However, the heterogeneity and small samples of these studies complicate drawing clear conclusions regarding such advantages. In this nationwide, multicenter, retrospective cohort study, we aimed to clarify the benefits of intracorporeal over extracorporeal anastomosis in patients undergoing laparoscopic colectomy for colon cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 46 institutions. Patients with clinical stage 0–III colon adenocarcinoma who underwent laparoscopic colectomy between January 2020 and December 2021 were evaluated. The effect of intracorporeal anastomosis on short-term outcomes compared to extracorporeal anastomosis was assessed using propensity score matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1245 patients (intracorporeal, <i>n</i> = 615; extracorporeal, <i>n</i> = 630) were included in the final analysis. The operative time was longer (228 vs. 207 min, <i>p</i> &lt; 0.001), but blood loss was also lower (5.0 vs. 10.0 mL, <i>p</i> &lt; 0.001) and the incidence of intraoperative vascular injury appeared lower (0.5% vs. 1.6%, <i>p</i> = 0.091) in the intracorporeal group than those in the extracorporeal group. The time to first passage of stool (2.9 vs. 3.5 days, <i>p</i> &lt; 0.001) and length of hospital stay (9.3 vs. 10.2 days, <i>p</i> = 0.008) were shorter in the intracorporeal group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intracorporeal anastomosis showed advantages over extracorporeal anastomosis in terms of blood loss, intraoperative vascular injury (potentially), bowel recovery, and length of hospital stay, despite the longer operative time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"739-749"},"PeriodicalIF":2.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520163","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":"Prognostic factors for patients with esophageal cancer who achieve pathological complete response in the primary tumor after upfront chemotherapy or chemoradiotherapy","authors":"Masaaki Motoori,&nbsp;Koji Tanaka,&nbsp;Hiroshi Miyata,&nbsp;Makoto Yamasaki,&nbsp;Osamu Shiraishi,&nbsp;Atsushi Takeno,&nbsp;Tomoki Makino,&nbsp;Keijiro Sugimura,&nbsp;Takushi Yasuda,&nbsp;Yuichiro Doki","doi":"10.1002/ags3.12914","DOIUrl":"https://doi.org/10.1002/ags3.12914","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Upfront chemotherapy (uCT) or upfront chemoradiotherapy (uCRT) followed by surgery is generally accepted as the standard treatment for patients with locally advanced esophageal cancer. A substantial proportion of patients achieve a pathological complete response (pCR) of the primary tumor with upfront treatment. This retrospective study aimed to clarify the prognostic factors of patients with esophageal cancer who achieve pCR in the primary tumor after upfront treatment and whether the prognosis of patients with pCR who receive uCT differs from that of patients who receive uCRT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 121 patients who achieved pCR of the primary tumor after uCT and 40 patients after uCRT. Univariate and multivariate survival analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariate analysis of overall survival demonstrated that gender, upfront treatment, and pathological lymph node metastasis were independent prognostic factors (<i>p</i> = 0.0086, 0.011, and 0.031, respectively). Multivariate analysis of relapse-free survival demonstrated that gender, cM status, and pathological lymph node metastasis were independent prognostic factors (<i>p</i> = 0.033, 0.014, and 0.0010, respectively). Among patients without pathological lymph node metastasis, the uCT group showed significantly better both overall and relapse-free survival than the uCRT group (<i>p</i> = 0.014 and 0.037, respectively). Recurrence occurred in 24 patients in the uCT group and 9 in the uCRT group. All of local treatment (chemoradiotherapy and surgery) for recurrent lesions was performed in the uCT group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Male genders and pathological lymph node metastasis are independent poor prognostic factors in patients with esophageal cancer who receive upfront treatment followed by surgery and achieved pCR of the primary tumor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"678-686"},"PeriodicalIF":2.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12914","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of delayed adjuvant chemotherapy on survival in gastric cancer patients with and without preoperative chemotherapy","authors":"Masataka Shimonosono,&nbsp;Takaaki Arigami,&nbsp;Daisuke Matsushita,&nbsp;Yusuke Tsuruda,&nbsp;Ken Sasaki,&nbsp;Kenji Baba,&nbsp;Takao Ohtsuka","doi":"10.1002/ags3.12911","DOIUrl":"https://doi.org/10.1002/ags3.12911","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Adjuvant chemotherapy (AC) is the standard treatment for patients with advanced gastric cancer (GC), yet the optimal timing for its initiation remains unclear. Besides, no studies have definitively established when AC should begin in patients receiving preoperative chemotherapy (PC). This study aimed to determine the optimal timing for initiating AC in patients with GC who underwent curative gastrectomy, either with or without PC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 446 patients who underwent curative gastrectomy were evaluated, including 140 who received AC: 72 without PC and 68 with PC. Patients were categorized into two groups based on when they began AC: the early initiation group (within 8 weeks post-surgery), and the late initiation group (8 weeks or later post-surgery).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the non-PC cohort, the 3-year relapse-free survival (RFS) rates were 71% in the early group versus 56% in the late group (<i>p</i> = 0.49), while the 3-year overall survival (OS) rates were 94% versus 73% (<i>p</i> = 0.003). Similar trends were observed in the PC cohort; the 3-year RFS rates were 59% versus 19% (<i>p</i> = 0.002), and the 3-year OS rates were 69% versus 48% (<i>p</i> = 0.02). Multivariate analysis identified pretherapeutic distant metastasis (<i>p</i> &lt; 0.001) and delayed AC initiation (≥8 weeks) (<i>p</i> = 0.001) as independent predictors of worse prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delayed initiation of AC is associated with significantly poorer postoperative survival in patients with GC, irrespective of whether PC was administered. These findings emphasize the importance of timely AC initiation to improve long-term outcomes in this patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"668-677"},"PeriodicalIF":2.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12911","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520046","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":"Prognostic significance of six autoantibodies in esophageal squamous cell carcinoma: A prospective multi-institutional study","authors":"Fumiaki Shiratori,&nbsp;Naoto Fujiwara,&nbsp;Yasuaki Nakajima,&nbsp;Koji Otsuka,&nbsp;Masahiko Murakami,&nbsp;Satoru Matsuda,&nbsp;Hirofumi Kawakubo,&nbsp;Keita Takahashi,&nbsp;Yuichiro Tanishima,&nbsp;Daiji Oka,&nbsp;Shunichi Ito,&nbsp;Kosuke Narumiya,&nbsp;Osamu Aramaki,&nbsp;Tadatoshi Takayama,&nbsp;Takashi Suzuki,&nbsp;Satoshi Yajima,&nbsp;Hideaki Shimada","doi":"10.1002/ags3.12910","DOIUrl":"https://doi.org/10.1002/ags3.12910","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Serum autoantibodies have been reported to react with tumor-associated antigens in various cancers. This study evaluated the diagnostic and prognostic significance of six autoantibody panels in esophageal squamous cell carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, 193 patients with esophageal squamous cell carcinoma and 78 healthy controls were enrolled. Serum antibodies were detected using originally developed enzyme-linked immunosorbent assays to detect autoantibodies against the following tumor antigens: c-myc, p62, RalA, p53, Sui1, and NY-ESO-1. The positive rates of the six-autoantibody panel were compared with those of SCC antigen (SCC-Ag). The prognostic significance of these autoantibodies was also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall positive rate was significantly higher in the six-autoantibody panel than in SCC-Ag (72% vs. 28%; <i>p</i> &lt; 0.01). The positive rates of the six-autoantibody panel were 71% in stage 0/I, 73% in stage II, and 71% in stage III. No clinicopathological factors were associated with autoantibodies. Although the difference was not significant, the overall survival of the autoantibody-positive group was worse than that of the autoantibody-negative group (<i>p</i> = 0.14).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The six-autoantibody panel was useful for detecting esophageal squamous cell carcinoma, particularly in stage 0/I; however, it showed limited prognostic significance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"658-667"},"PeriodicalIF":2.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520138","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":"Cost-effectiveness analysis of postoperative surveillance for stage IV colorectal cancer in Japan: An economic modeling study","authors":"Fumio Tsukamoto,&nbsp;Shunsuke Tsukamoto,&nbsp;Takeharu Kato,&nbsp;Hiroshi Nagata,&nbsp;Yasuyuki Takamizawa,&nbsp;Konosuke Moritani,&nbsp;Yusuke Kinugasa,&nbsp;Minoru Esaki,&nbsp;Yukihide Kanemitsu,&nbsp;Ataru Igarashi","doi":"10.1002/ags3.12906","DOIUrl":"https://doi.org/10.1002/ags3.12906","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal postoperative surveillance strategy after curative resection in patients with stage IV colorectal cancer remains unclear. The present study aimed to assess the cost-effectiveness of postoperative surveillance strategies recommended by the various academic societies for stage IV colorectal cancer after curative resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This economic evaluation used a Markov state-transition model to compare the cost-effectiveness of postoperative surveillance programs proposed in guidelines published by the American Society of Clinical Oncology, American Society of Colon and Rectal Surgeons, European Society for Medical Oncology, National Comprehensive Cancer Network, and Japanese Society for Cancer of the Colon and Rectum. Model parameters were extracted from our retrospective data for patients with colorectal cancer who had synchronous liver and/or lung metastases and underwent curative resection. Cost-effectiveness was assessed using an incremental cost-effectiveness ratio for quality-adjusted life years, with a maximum acceptable value of 5 000 000–6 000 000 JPY/33333–40 000 USD. Uncertainty in the model was assessed by probabilistic sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For patients with stage IV colorectal cancer after curative resection, the JSCCR-strategy was the most cost-effective, with an incremental cost-effectiveness ratio of 2 888 628 JPY/19256 USD compared with the next most cost-effective program. Probabilistic sensitivity analysis showed that the JSCCR-strategy was most likely to be selected as the most cost-effective (76.1%–77.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This modeling analysis found that the JSCCR-strategy was the most cost-effective strategy for stage IV colorectal cancer. Our findings suggest that intensive postoperative surveillance is acceptable for stage IV colorectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"730-738"},"PeriodicalIF":2.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519899","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":"Effectiveness of advanced dressings in preventing surgical site infections compared to that of standard dressings in gastrointestinal surgery: A systematic review and meta-analysis for guideline revision by the Japanese Society for Surgical Infection","authors":"Keita Kouzu,&nbsp;Hironori Tsujimoto,&nbsp;Seiichi Shinji,&nbsp;Hiroji Shinkawa,&nbsp;Koji Tamura,&nbsp;Yukio Sato,&nbsp;Koji Munakata,&nbsp;Yasunari Fukuda,&nbsp;Daisuke Koike,&nbsp;Hiromu Miyake,&nbsp;Yohei Hosoda,&nbsp;Motoi Uchino,&nbsp;Hiroki Ohge,&nbsp;Junzo Shimizu,&nbsp;Seiji Haji,&nbsp;Yasuhiko Mohri,&nbsp;Chizuru Yamashita,&nbsp;Yuichi Kitagawa,&nbsp;Motomu Kobayashi,&nbsp;Yuki Hanai,&nbsp;Hiroshi Nobuhara,&nbsp;Masahiro Yoshida,&nbsp;Toru Mizuguchi,&nbsp;Toshihiko Mayumi,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12909","DOIUrl":"https://doi.org/10.1002/ags3.12909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This is a systematic review and meta-analysis of the efficacy of wound coverage using advanced dressings specifically for the prevention of surgical site infections (SSI) in gastrointestinal surgery, as part of the update of the SSI prevention guidelines of the Japan Society for Surgical Infection (JSSI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After searching CENTRAL, PubMed, and ICHUSHI-Web in July 2024, we included randomized controlled trials (RCTs) comparing advanced dressings and standard dressings for surgical wounds in gastrointestinal surgery (PROSPERO No. CRD42024569084). Three authors independently screened the RCTs. We assessed the risk of bias and certainty of the body of evidence for the extracted data. The primary outcome was superficial SSI, and the secondary outcomes were length of postoperative hospital stay, costs, and allergy. This study was partially supported by the JSSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of seven RCTs and 927 patients were included. The use of advanced dressings significantly lowered the risk of SSI compared to that associated with standard dressings (risk ratio: 0.54, 95% confidence intervals: 0.34–0.88). The certainty of the evidence was rated as moderate. According to the subgroup analysis, advanced dressings reduced the risk of SSI in colorectal surgery. Advanced dressings did not reduce the length of postoperative hospital stay or costs compared to that of standard dressings. Allergies were reported in only one patient using silver-impregnated dressings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of advanced dressings for primary wounds in gastrointestinal surgery was associated with a significantly lower risk of SSI than that associated with standard dressings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"408-417"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950173","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}