Yi Ting Lin, Tiing Foong Siow, Alvin Yong Hui Tan, Ian Chik, Kuo Hsin Chen
{"title":"Laparoscopic Parenchymal-Sparing Hepatectomy with Middle Hepatic Vein Resection and Reconstruction for Colorectal Liver Metastases: A Video Case Report.","authors":"Yi Ting Lin, Tiing Foong Siow, Alvin Yong Hui Tan, Ian Chik, Kuo Hsin Chen","doi":"10.1245/s10434-024-16063-5","DOIUrl":"10.1245/s10434-024-16063-5","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"9168-9169"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abraham J Matar, Kailey M Oppat, Frances J Bennett, Emilie A K Warren, Chase J Wehrle, Zhihao Li, Luckshi Rajendran, Zachary P Rokop, Chandrashekhar Kubal, Ben E Biesterveld, David P Foley, Mayumi Maeda, Mindie H Nguyen, Beth Elinoff, Abhinav Humar, Dimitrios Moris, Debra Sudan, John Klein, Juliet Emamaullee, Vatche Agopian, Parsia A Vagefi, Shukri H A Dualeh, Christopher J Sonnenday, Gonzalo Sapisochin, Federico N Aucejo, Shishir K Maithel
{"title":"ASO Author Reflections: Hepatic Resection as the Primary Treatment Modality for Hepatocellular Carcinoma After Orthotopic Liver Transplantation.","authors":"Abraham J Matar, Kailey M Oppat, Frances J Bennett, Emilie A K Warren, Chase J Wehrle, Zhihao Li, Luckshi Rajendran, Zachary P Rokop, Chandrashekhar Kubal, Ben E Biesterveld, David P Foley, Mayumi Maeda, Mindie H Nguyen, Beth Elinoff, Abhinav Humar, Dimitrios Moris, Debra Sudan, John Klein, Juliet Emamaullee, Vatche Agopian, Parsia A Vagefi, Shukri H A Dualeh, Christopher J Sonnenday, Gonzalo Sapisochin, Federico N Aucejo, Shishir K Maithel","doi":"10.1245/s10434-024-16237-1","DOIUrl":"10.1245/s10434-024-16237-1","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"9223-9224"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carolin Siech, Mario de Angelis, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A Goyal, Zhe Tian, Fred Saad, Shahrokh F Shariat, Stefano Puliatti, Nicola Longo, Alberto Briganti, Séverine Banek, Philipp Mandel, Luis A Kluth, Felix K H Chun, Pierre I Karakiewicz
{"title":"Adult Prostate Sarcoma: Demographics, Treatment Patterns, and Survival.","authors":"Carolin Siech, Mario de Angelis, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A Goyal, Zhe Tian, Fred Saad, Shahrokh F Shariat, Stefano Puliatti, Nicola Longo, Alberto Briganti, Séverine Banek, Philipp Mandel, Luis A Kluth, Felix K H Chun, Pierre I Karakiewicz","doi":"10.1245/s10434-024-16258-w","DOIUrl":"10.1245/s10434-024-16258-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine clinicopathologic characteristics, treatment patterns, and survival rates in a contemporary population-based cohort of adult prostate sarcoma patients.</p><p><strong>Methods: </strong>In the Surveillance, Epidemiology, and End Results database (2004-2020), adult patients with prostate sarcoma were identified. Descriptive statistics, Kaplan-Meier analyses, smoothed cumulative incidence plots, and Cox regression models were used.</p><p><strong>Results: </strong>Of 125 patients, 45 (36%) harbored leiomyosarcoma, 17 (14%) had rhabdomyosarcoma, 15 (12%) had stromal sarcoma, 17 (14%) had sarcoma not otherwise specified (NOS), and 31 (25%) had other sarcoma subtypes. Metastatic stage was most common in the rhabdomyosarcoma patients (44%) and least common in the leiomyosarcoma (21%) and stromal sarcoma (20%) patients. Most of the rhabdomyosarcoma patients received the combination of systemic and radiation therapy with (24%) or without radical surgery (35%), whereas most of the leiomyosarcoma and stromal sarcoma patients underwent radical surgery with (22 and 13%) or without (22 and 47%) radiation. In the overall population, the median overall survival was 27 months. The 5-years overall versus cancer-specific versus other-cause mortality rates were respectively 71 versus 58 versus 13%. In the multivariable Cox regression models, the highest overall mortality was exhibited by the patients with metastatic disease (hazard ratio [HR] 2.87; 95% confidence interval [CI] 1.55-5.31; p < 0.001) or unknown disease stage (HR 2.94; 95% CI 2.20-7.21; p = 0.019). Conversely, of all the histologic subtypes, only stromal sarcoma distinguished itself by lower overall mortality (HR 0.41; 95% CI 0.18-0.96; p = 0.039).</p><p><strong>Conclusions: </strong>Four major histologic subtypes were identified. Among most adult sarcoma patients, treatment patterns vary according to histology, from multimodal therapy to radical prostatectomy alone. These treatment differences reflect equally important heterogeneity in survival patterns.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8993-9001"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jincong Q Freeman, Dezheng Huo, Frederick M Howard
{"title":"ASO Author Reflections: Breast-Conserving Surgery After Neoadjuvant Systemic Therapy for Early-Stage Breast Cancer: Quantitative Biomarkers and Disparities in the Precision-Medicine Era.","authors":"Jincong Q Freeman, Dezheng Huo, Frederick M Howard","doi":"10.1245/s10434-024-16265-x","DOIUrl":"10.1245/s10434-024-16265-x","url":null,"abstract":"<p><p>In this era of precision medicine, incorporating quantitative measures of estrogen receptor (ER)/progesterone receptor (PR)/Ki-67 expressions and genomic assays could more precisely identify neoadjuvant systemic therapy with the highest likelihood of response and tumor downstaging. In our recent study, we quantified the likelihood of achieving breast-conserving surgery (BCS vs. mastectomy) after neoadjuvant chemotherapy or endocrine therapy as a function of demographics, quantitative ER/PR/Ki-67 expressions, 21-gene recurrence scores, or 70-gene risk scores in early-stage, hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Using the 2010-2020 National Cancer Database, we found that the BCS rate after neoadjuvant chemotherapy was higher among patients with high 21-gene recurrence scores, lower ER/PR expression, or higher Ki-67 expression. Most patients who received neoadjuvant endocrine therapy underwent BCS, which was mostly dependent on ER expression. Asian women were less likely than white women to undergo BCS after neoadjuvant treatments. Lack of health insurance was associated with lower odds of BCS in both neoadjuvant settings. Although our study provides insight into the associations of BCS with quantitative biomarkers at a single time point, several questions remain unanswered. With the evolving landscape of neoadjuvant therapies in development for HR-positive/HER2-negative breast cancer, ongoing work using quantitative biomarkers and genomic assay scores is needed to select the right neoadjuvant systemic therapy for the right patient. Given the increasing amount of data available at the time of breast cancer diagnosis, novel computational approaches are needed to integrate patient demographic and tumor-specific factors to predict the optimal treatment strategy and likelihood of BCS.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8904-8905"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"ASO Author Reflections: Can Adequate Surgical Margin Rates after Mastectomy Be Improved?","authors":"Nicolás Ajkay","doi":"10.1245/s10434-024-16312-7","DOIUrl":"10.1245/s10434-024-16312-7","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8900-8901"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142405969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hengxi Chen, Yali Chen, Ai Zheng, Xin Tan, Ling Han
{"title":"Clinical Outcomes Between Completion and Abandonment of Radical Hysterectomy in Early-Stage Cervical Cancer Patients with Lymph Nodal Involvement Identified During Surgery: A Systematic Review and Meta-Analysis.","authors":"Hengxi Chen, Yali Chen, Ai Zheng, Xin Tan, Ling Han","doi":"10.1245/s10434-024-16326-1","DOIUrl":"10.1245/s10434-024-16326-1","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to summarize the clinical outcomes of early-stage cervical cancer patients with lymph node metastasis found during surgery who completed radical hysterectomy, or abandoned surgery and switched to chemoradiotherapy, in hopes of providing evidence for clinical treatment.</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), and ClinicalTrials.gov databases were searched from inception to 20 November 2023. The analysis was conducted using STATA 16.0.</p><p><strong>Results: </strong>A total of eight studies with 2105 early-stage cervical cancer patients were included in this review. Meta-analysis found no significant difference between the completing radical hysterectomy surgery (CRS) group and the abandoning radical surgery (ARS) group regarding overall survival (OS; hazard ratio [HR] 1.35, 95% confidence interval [CI] 0.93-1.97; I<sup>2 </sup>= 27.2%, p = 0.221), progression-free survival (PFS; HR 0.39, 95% CI 0.14-1.07; I<sup>2 </sup>= 0.0%, p = 0.625) and disease-free survival (DFS; HR 0.61, 95% CI 0.13-2.84; I<sup>2 </sup>= 0.0%, p = 0.574). Meta-analysis found the total recurrence (risk ratio [RR] 0.49, 95% CI 0.30-0.79; I<sup>2 </sup>= 0.0%, p = 0.810) and pelvic recurrence (RR 0.39, 95% CI 0.17-0.91; I<sup>2 </sup>= 12.4%, p = 0.320) in the CRS group were less than those in the ARS group. Meta-analysis found that compared with the ARS group, the CRS group had fewer grade 3/4 adverse effects (RR 0.58, 95% CI 0.41-0.82; I<sup>2 </sup>= 0.0%, p = 0.591).</p><p><strong>Conclusions: </strong>Current evidence suggests that for early-stage cervical cancer patients with positive lymph nodes detected during surgery, CRS and ARS have similar survival outcomes, but completing radical surgery results in a lower incidence of pelvic recurrence.</p><p><strong>Protocol registration: </strong>CRD42023480118.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8954-8960"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic Duodenum and Spleen-Preserving Subtotal or Total Pancreatectomy: A Parenchyma-Sparing Strategy for Main Duct Intraductal Papillary Mucinous Neoplasms (with Video).","authors":"Zheng Li, Yihua Shi, Wenjie Tang, Chen Chen, Wensheng Liu, Qifeng Zhuo, Shunrong Ji, Chenjie Zhou, Xianjun Yu, Xiaowu Xu","doi":"10.1245/s10434-024-16244-2","DOIUrl":"10.1245/s10434-024-16244-2","url":null,"abstract":"<p><strong>Background: </strong>For premalignant main duct intraductal papillary mucinous neoplasms (MD-IPMN), laparoscopic duodenum and spleen-preserving subtotal or total pancreatectomy (LDSP-STP/TP) seems to be a viable option for parenchyma-sparing pancreatectomy.</p><p><strong>Patients and methods: </strong>On the basis of the imaging features, family history, genomic alterations, intraoperative ultrasound examination, and frozen section evaluation, we have proposed patient selection strategies for the LDSP-STP/TP technique for the first time. Additionally, a comprehensive step-by-step overview of this technique has been provided. To date, we have performed five LDSP-STP procedures and one LDSP-TP procedure.</p><p><strong>Results: </strong>We successfully performed selective resection of the affected pancreatic parenchyma while preserving the duodenum, common bile duct (CBD), spleen, and splenic artery and vein. The operation time ranged from 295 to 495 min, with blood loss ranging from 100 to 300 mL. Postoperative pathological results revealed low-grade dysplasia in the resected pancreatic samples and margins. The patients resumed eating within 3-5 days after surgery, and all postoperative complications were classified as grade I according to the Clavien-Dindo classification. At the 3-month follow-up, there were no cases of CBD ischemic stenosis, splenic ischemia, or pseudocyst formation observed. For patients who received LDSP-STP, the longitudinal diameter of the remaining pancreatic tail ranged from 2.2 to 4.6 cm, and they demonstrated satisfactory long-term blood glycemic control.</p><p><strong>Conclusions: </strong>LDSP-STP/TP demonstrates technical feasibility and safety. It allows for the selective resection of the affected pancreatic parenchyma, thereby minimizing the impact of pancreatic functional impairment. However, it is crucial to validate this technique through long-term prospective observations.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8734-8740"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Szabo Yamashita, Andres Tame-Elorduy, Catherine M Skefos, Jeena M Varghese, Mouhammed Amir Habra, Sarah B Fisher, Paul H Graham, Elizabeth G Grubbs, Steven G Waguespack, Camilo Jimenez, Nancy D Perrier
{"title":"SDHB-Associated Pheochromocytomas: What is Their Clinical Behavior?","authors":"Thomas Szabo Yamashita, Andres Tame-Elorduy, Catherine M Skefos, Jeena M Varghese, Mouhammed Amir Habra, Sarah B Fisher, Paul H Graham, Elizabeth G Grubbs, Steven G Waguespack, Camilo Jimenez, Nancy D Perrier","doi":"10.1245/s10434-024-16120-z","DOIUrl":"10.1245/s10434-024-16120-z","url":null,"abstract":"<p><strong>Introduction: </strong>Germline pathogenic variants in succinate dehydrogenase subunit B (SDHB) cause paraganglioma/pheochromocytoma syndrome type 4 (PGL-4). SDHB-associated pheochromocytomas (PCC) are thought to be rare and little data exist about their clinical behavior.</p><p><strong>Patients and methods: </strong>Retrospective review of patients treated (1993-2023) at a tertiary cancer center for SDHB-associated PCC. Clinical and demographic variables were retrieved to characterize disease-free survival, disease progression, and overall survival.</p><p><strong>Results: </strong>In total, 90 SDHB-carriers were identified, 18% had PCC (n = 16). Median age at diagnosis of was 40 (19-76) years, 50% (n = 8) of patients were male, 25% (n = 4) had distant metastasis (DM) at diagnosis, and 13% (n = 2) had synchronous PGL. No patients had bilateral disease, and 94% of patients underwent surgery as initial treatment with a curative intent in 75%. Overall, 64% of patients underwent open resection. Recurrence occurred in 77% of patients (n = 10), 75% in minimally invasive surgery (MIS) versus 77% open, p = 0.63. Bone was the most common site of DM (100%, n = 13). Metaidobenzyleguanidine (MIBG) imaging was performed in 69% of patients, 91% of which were positive. Median time from surgery until recurrence was 36 months (1-295 months). Radiation therapy was the most common adjuvant treatment (44%) followed by Iobenguane I-131 (31%) and systemic therapy (31%). Median follow-up time was 56 months (1-408 months). Overall, 33% of patients were alive, 19% of patients were disease-free, and 50% of the patients with DM had stable disease at last follow-up.</p><p><strong>Conclusions: </strong>Overall, 18% of germline SDHB mutation-carriers were diagnosed with PCC, all of which were unilateral. SDHB-associated PCC was associated with advanced and recalcitrant disease and was often MIBG positive. More studies are needed to better understand the clinical behavior of PCC in PGL-4.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"9007-9013"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Junhong Liu, Bingji Cao, ZhiHua Shi, Xinbo Liu, Junfeng Liu
{"title":"Correlation Between the Number of Pathological Risk Factors and Postoperative Prognosis in Patients with Stage I Lung Adenocarcinoma.","authors":"Junhong Liu, Bingji Cao, ZhiHua Shi, Xinbo Liu, Junfeng Liu","doi":"10.1245/s10434-024-16045-7","DOIUrl":"10.1245/s10434-024-16045-7","url":null,"abstract":"<p><strong>Background: </strong>Although visceral pleural invasion, lymphovascular invasion, tumor spread through air spaces, and poor differentiation are pathological risk factors associated with unfavorable prognosis in patients with lung adenocarcinoma, the cumulative impact of these factors on prognosis remains unclear.</p><p><strong>Methods: </strong>We enrolled 1532 patients with stage I lung adenocarcinoma. Patients were divided according to the number of risk factors as follows: Group A (without risk factors), Group B (one risk factor), and Group C (multiple risk factors). Moreover, we stratified patients into two subgroups based on tumor size (≤ 3 cm, 3-4 cm). Kaplan-Meier analysis was used to evaluate 5-year disease-free survival (DFS) and overall survival (OS).</p><p><strong>Results: </strong>Overall, 949, 404, and 179 patients were included in Groups A, B, and C, respectively. Group C had a larger tumor size and more cases of extrathoracic recurrence than the other groups. The 5-year DFS and OS gradually decreased across Groups A to C (DFS: 94.3%, 80.6%, and 64.3%, respectively, p < 0.001; OS: 97.2%, 92.7%, and 77%, respectively, p < 0.001). A similar trend was observed for tumors ≤ 3 cm in size (DFS: 95.2%, 83.2%, and 68.5%, respectively, p < 0.001; OS: 97.6%, 94.1%, and 79.6%, respectively, p < 0.001), but a less pronounced trend was observed for tumors between 3 and 4 cm in size (DFS: 72.1, 60.8, and 43.3%, respectively, p = 0.054; OS: 85.7, 82.1, and 64.7%, respectively, p = 0.16).</p><p><strong>Conclusions: </strong>Postoperative survival worsened with increasing pathological risk factors in patients with stage I lung adenocarcinoma, especially those with tumor size ≤ 3 cm.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"9310-9320"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}