Annals of Surgical Oncology最新文献

{"title":"Breast Cancer Recurrence in Initially Clinically Node-Positive Patients Undergoing Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in the NEOSENTITURK-Trials MF18-02/18-03.","authors":"Neslihan Cabioglu, Hasan Karanlik, Abdullah Igci, Mahmut Muslumanoglu, Mehmet Ali Gulcelik, Cihan Uras, Havva Belma Kocer, Didem Can Trabulus, Enver Ozkurt, Guldeniz Karadeniz Cakmak, Mustafa Tukenmez, Suleyman Bademler, Nilufer Yildirim, Gökhan Giray Akgul, Ebru Sen, Kazim Senol, Selman Emiroglu, Bulent Citgez, Yeliz Emine Ersoy, Ahmet Dag, Baha Zengel, Gul Basaran, Halil Kara, Ece Dilege, M Umit Ugurlu, Atilla Celik, Serkan Ilgun, Yasemin Bolukbasi, Niyazi Karaman, Gürhan Sakman, Serdar Ozbas, Halime Gul Kilic, Ayfer Kamali Polat, Ibrahim Ali Ozemir, Berkay Kilic, Ayse Altınok, Ecenur Varol, Lutfi Dogan, Alper Akcan, Beyza Ozcinar, Leyla Zer, Aykut Soyder, Mehmet Velidedeoglu, Fazilet Erozgen, Berk Goktepe, Mutlu Dogan, Abut Kebudi, Banu Yigit, Burak Celik, Serdar Yormaz, Cumhur Arici, Orhan Agcaoglu, Ali Ibrahim Sevinc, M Kemal Atahan, Vafa Valiyeva, Elif Baran, Israa Aljorani, Zafer Utkan, Levent Yeniay, Taner Kivilcim, Atilla Soran, Adnan Aydiner, Kamuran Ibis, Vahit Ozmen","doi":"10.1245/s10434-024-16472-6","DOIUrl":"10.1245/s10434-024-16472-6","url":null,"abstract":"<p><strong>Background: </strong>This study aims to identify factors predicting recurrence and unfavorable prognosis in cN+ patients who have undergone sentinel lymph node biopsy (SLNB) following neoadjuvant chemotherapy (NAC).</p><p><strong>Methods: </strong>The retrospective multi-centre \"MF18-02\" and the prospective multi-centre cohort registry trial \"MF18-03\" (NCT04250129) included patients with cT1-4N1-3M0 with SLNB+/- axillary lymph node dissection (ALND) post-NAC.</p><p><strong>Results: </strong>A total of 2407 cN+ patients, who later achieved cN0 status after NAC and subsequently underwent SLNB, were studied. The majority had cT1-2 (79.1%) and N1 (80.7%). After a median follow-up time of 41 months, the rates of locoregional recurrence and axillary recurrence (AR) were 1.83% and 0.37%, respectively. No significant difference in locoregional recurrence or AR rates was observed between the SLNB/targeted axillary dissection-only (n = 1470) and ALND (n = 937) groups. Factors significantly linked with AR included age younger than 45 years, nonpathological complete response (non-pCR) in the breast, and nonluminal pathology. Locoregional recurrences were associated with nonluminal or HER2(+) pathology, non-pCR in the breast, and ALND. Poor prognostic factors for disease-free survival (DFS) included having cT3-T4, no breast pCR (non-pCR), ypN(+), and nonluminal pathology. No significant difference was found in DFS or disease-specific survival (DSS) rates among ypN0, ypN-isolated tumour cells, ypNmic, and ypN1. However, significant decreases in DFS and DSS rates were observed when comparing ypN2 or ypN3 disease with ypN0.</p><p><strong>Conclusions: </strong>The present large registry data indicate that younger patients (<45), those with nonluminal pathology, and those who only partially respond in the breast are more susceptible to axillary and locoregional recurrences.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"952-966"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765820","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":"Prognostic Significance of Recurrence and Timing of Recurrence on Survival Among Patients with Early-Stage Hepatocellular Carcinoma in U.S. Clinical Practice.","authors":"Shishir K Maithel, Rongrong Wang, Joanna Harton, Adam Yopp, Shimul A Shah, Flavio G Rocha, Sairy Hernandez, Spencer Cheng, Sarika Ogale, Ruoding Tan","doi":"10.1245/s10434-024-16476-2","DOIUrl":"10.1245/s10434-024-16476-2","url":null,"abstract":"<p><strong>Background: </strong>Many patients with hepatocellular carcinoma (HCC) experience recurrence after curative-intent resection or ablation, with a poor prognosis. Real-world patterns of recurrence and the prognostic significance of early recurrence in U.S. clinical practice have not been well characterized.</p><p><strong>Methods: </strong>This retrospective observational study was designed to evaluate the impact of recurrence on overall survival (OS) among patients with HCC following initial curative-intent resection or ablation. We used the Surveillance, Epidemiology, and End Results cancer registry linked with Medicare claims (January 1, 2010-December 31, 2019). Eligible patients (≥66 years) diagnosed with HCC (2010-2017) had liver resection or ablation within 180 days of diagnosis. Patients were stratified by recurrence status using diagnosis- and treatment-based definitions of recurrence. Early or late recurrence was defined as within 1 year or after 1 year, respectively. Adjusted OS analyses used multivariable Cox regression models.</p><p><strong>Results: </strong>A total of 1,146 patients were included. During a median overall follow-up of 35.2 months, 736 (64%) patients had a recurrence, of whom 380 (52%) had early recurrence (within 1 year). In the adjusted analysis, patients with recurrence had a 2.24-fold higher risk of death (95% confidence interval 1.85, 2.71; P < 0.001). Patients with early recurrence had a 1.39-fold higher risk of death (95% confidence interval 1.14, 1.68; P < 0.001) than those with late recurrence.</p><p><strong>Conclusions: </strong>Recurrence and the timing of recurrence are significant predictors of increased mortality risk for patients with HCC following initial curative-intent resection or ablation, highlighting the need for effective adjuvant therapies that may delay or avoid recurrences.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"1054-1062"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765637","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":"Histopathological Prognostic Factors of Surgically Treated HPV-Associated Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-analysis.","authors":"Branden Qi Yu Chua, Vanessa Wei Shan Chong, Hanis Binte Abdul Kadir, Brian Sheng Yep Yeo, Pei Yuan Fong, Isabelle Jia Hui Jang, Chwee Ming Lim","doi":"10.1245/s10434-024-16362-x","DOIUrl":"10.1245/s10434-024-16362-x","url":null,"abstract":"<p><strong>Background: </strong>Human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is rising in prevalence and is associated with better survival than HPV-negative OPSCC. In surgically treated HPV-negative OPSCCs, adverse pathologic features such as positive surgical margins, extra-nodal extension (ENE) and perineural invasion are well described to portend worse clinical outcomes. These adverse pathological features, however, are not validated prognostic markers among surgically treated HPV-positive OPSCCs. To that end, we pooled all available evidence to address the prognostic significance of these histologic features.</p><p><strong>Patients and methods: </strong>This meta-analysis was performed according to PRISMA guidelines. PubMed, Web of Science and Embase databases were systematically searched for articles evaluating 13 known adverse histopathological prognostic factors of surgically treated HPV-associated OPSCC. Data analysis was done using R v4.0.5.</p><p><strong>Results: </strong>A total of 32 studies (n = 31,535) fulfilled the inclusion criteria. ENE and advanced pT stage were associated with poorer overall survival (OS) [hazard ratio (HR):1.80, 95% confidence interval (CI) [1.59-2.03], p < 0.0001, HR: 3.28, 95% CI [2.20-4.87], p = 0.0025]; disease-specific survival (DSS) (HR: 3.14, 95% CI [1.20-8.26], p = 0.0327, HR: 3.49, 95% CI [2.45-4.96], p = 0.0043) and disease-free survival (DFS) (HR: 2.03, 95% CI [1.05-3.94], p = 0.0397, HR: 3.66, 95% CI [2.81-4.77], p = 0.0001) respectively. The presence of lymphovascular invasion (HR: 1.46, 95% CI [1.22-1.75], p = 0.0018) and positive margins (HR: 1.50, 95% CI [1.185-1.899], p = 0.0069) significantly worsen OS.</p><p><strong>Conclusion: </strong>ENE, advanced pT stage, positive margins and lymphovascular invasion were adverse histologic prognostic marker among surgically treated HPV-positive OPSCC. The presence of these factors should be carefully evaluated in order to select the optimal patients for surgical treatment.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"1280-1300"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563914","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: Nodal Recurrence Is Rare in Patients with cN+/ycN0 Breast Cancer after Neoadjuvant Chemotherapy Regardless of the Extent of Axillary Surgery or Nodal Pathology in the NEOSENTITURK-Trials MF18-02/18-03 Provided Regional Nodal Irradiation Is Administered.","authors":"Neslihan Cabioglu, Hasan Karanlik, Abdullah Igci, M Muslumanoglu, Mehmet Ali Gulcelik, Cihan Uras, H Belma Kocer, Atilla Soran, Kamuran Ibis, Vahit Ozmen","doi":"10.1245/s10434-024-16651-5","DOIUrl":"10.1245/s10434-024-16651-5","url":null,"abstract":"<p><p>The combined analysis of the retrospective multicentre and prospective multicenter cohort registry trial NEOSENTITURK MF18-02/18-03 (NCT04250129) investigated the outcomes and factors associated with recurrence in patients with cT1-4N1-3M0 who underwent a succesful sentinel lymph node biopsy or targeted axillary dissection (n = 1470), with or without axillary lymph node dissection (n = 937) after neoadjuvant chemotherapy. The present large registry data suggest that axillary recurrences (AR) can be detected at exceedingly low rates (< 0.5%) within 3 years after surgery. This is regardless of the extent of axillary surgery or nodal pathology, provided that regional nodal irradiation is administered. Factors associated with increased risk for AR included age under 45 years, nonpathologic complete response (non-pCR) in the breast, and nonluminal pathology. Similarly, having cT3-4, a non-pCR in the breast or axilla, and nonluminal pathology were identified as poor prognostic factors.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"971-972"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799299","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":"Hierarchically Positioning Laparoscopic Microwave Ablation in the Therapeutic Span of Early Hepatocellular Carcinoma: A Real-Life Comparative Analysis.","authors":"Umberto Cillo, Silvia Caregari, Matteo Barabino, Ilaria Billato, Andrea Marchini, Alessandro Furlanetto, Sara Lazzari, Marco Brolese, Mattia Ballo, Elisabetta Biasini, Ciro Celsa, Angelo Sangiovanni, Francesco Giuseppe Foschi, Claudia Campani, Gianpaolo Vidili, Carlo Saitta, Fabio Piscaglia, Maurizia Rossana Brunetto, Alberto Masotto, Fabio Farinati, Franco Trevisani, Marco Antonio Zappa, Alessandro Vitale, Roberto Santambrogio","doi":"10.1245/s10434-024-16462-8","DOIUrl":"10.1245/s10434-024-16462-8","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic microwave ablation (LMWA) has yet to gain a specific place in treatment guidelines for early hepatocellular carcinoma (HCC). This study compared the outcomes of LMWA and trans-arterial chemoembolization (TACE) for early non-resectable patients with HCC, taking percutaneous radiofrequency ablation (PRFA) as the reference treatment.</p><p><strong>Methods: </strong>A retrospective multicenter observational study was conducted, enrolling non-transplantable, non-resectable patients who had early HCC treated with LMWA (n = 658) from Padua and Milan centers, and with PRFA (n = 844), and TACE (n = 425) from the ITA.LI.CA multicenter database. The matching-adjusted indirect comparison (MAIC) method was used to obtain weighted LMWA and TACE populations similar to the reference PRFA population.</p><p><strong>Results: </strong>Laparoscopic ablation showed an excellent safety profile, and MAIC-weighted early postoperative deaths were comparable among the groups. The MAIC-weighted overall survival was similar between the LMWA (1-, 3-, and 5 year survival of 91.0 %, 67.9 %, 47.0 %, respectively) and PRFA (1-, 3- and 5 year survivals of 90.0 %, 64.7 %, 46.6 %, respectively) groups (p = 0.678) and significantly better for the LMWA group than for the TACE group (1-, 3- and 5 year survivals of 84.7 %, 48.8 %, 33.6 %, respectively) (p < 0.001). Weighted multivariate overall survival analysis and competing risk/subgroup analyses confirmed the non-inferiority of LMWA to PRFA and its superiority to TACE. The LMWA- and PRFA-treated patients had a significantly lower risk of HCC-related death (p = 0.004) than the TACE-treated patients (p = 0.001). Conversely, the groups did not differ significantly in terms of non-HCC-related deaths.</p><p><strong>Conclusions: </strong>The non-inferiority of LMWA to PRFA, its superiority to TACE, and its applicability to a wide range of presentations with few contraindications support its inclusion among radical therapies for treating early-HCC patients.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"1063-1072"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799302","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 Subtotal Splenectomy: A Feasible Option in the Treatment of Splenic Metastasis.","authors":"Cristina Izquierdo, Alberto García-Picazo, Juan Pablo Rodríguez, Anna Navarro, Greta Donisi, Eduardo Luque, Benedetto Ielpo, Fernando Burdío, Patricia Sánchez-Velázquez","doi":"10.1245/s10434-024-16549-2","DOIUrl":"10.1245/s10434-024-16549-2","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic subtotal splenectomy (LSS) is a procedure that helps avoid the consequences of asplenia. Given the spleen's importance and functionality, there may be specific indications and patient conditions in which partial splenectomy is beneficial. This case report aims to clarify the indications for LSS and outline the surgical technique.</p><p><strong>Methods: </strong>This multimedia article provides a comprehensive overview of the surgical procedure, emphasizing key steps to avoid postoperative bleeding and complications.</p><p><strong>Results: </strong>The patient was hospitalized for 3 days without any complications observed. Postoperative hemoglobin levels were 11.2 g/dL, with no signs of anemia. The patient was discharged with a follow-up visit after 2 weeks, showing no evidence of postoperative complications. The anatomopathological study revealed a nodular area with extensive tumoral necrosis.</p><p><strong>Discussion: </strong>LSS is a safe surgical option that might help to mitigate the consequences of total splenectomy. Innovative technology in hemostasis, such as COOLINGBIS^© (a monopolar electrosurgical electrode designed for hemostatic sealing and coagulation) can help manage this risk. Identifying the vascular pedicle via computed tomography scan is crucial to prevent unexpected bleeding.</p><p><strong>Conclusions: </strong>In selected cases, LSS is a feasible and safe procedure when performed with appropriate laparoscopic equipment and by experienced surgeons.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"1232-1235"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685709","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}

{"title":"CEA Rebound After Discontinuation of Pre-Hepatectomy Chemotherapy Predicts Worse Outcomes After Resection of Colorectal Cancer Liver Metastases.","authors":"Antony Haddad, Mateo Lendoire, Abhineet Uppal, Harufumi Maki, Ian Folkert, Yifan Wang, Reed I Ayabe, Timothy E Newhook, Yun Shin Chun, Ching-Wei D Tzeng, Jean-Nicolas Vauthey, Hop S Tran Cao","doi":"10.1245/s10434-024-16370-x","DOIUrl":"10.1245/s10434-024-16370-x","url":null,"abstract":"<p><strong>Background: </strong>Carcinoembryonic antigen (CEA) levels may vary with administration and discontinuation of pre-hepatectomy chemotherapy in patients undergoing resection of colorectal cancer liver metastases (CLM). The prognostic significance of these changes, termed CEA dynamics, is unclear.</p><p><strong>Patients and methods: </strong>Consecutive patients undergoing hepatectomy for CLM (2001-2021) at a comprehensive cancer center were included. CEA dynamics were classified as CEA normal (CEA < 5 ng/mL before, during, and after chemotherapy), CEA decrease (elevated CEA levels that drop during and after chemotherapy), and CEA rebound (elevated CEA levels that drop during chemotherapy but rebound upon discontinuation). Recurrence-free (RFS), hepatic-specific disease-free (hDFS), and overall survival (OS) were compared across CEA dynamics groups.</p><p><strong>Results: </strong>Of 903 patients, 254 (28%) were CEA normal, 423 (47%) were CEA decrease, and 226 (25%) were CEA rebound. Median RFS was 15.9 months, median hDFS was not reached, and median OS was 11.9 years for CEA normal patients. By comparison, CEA decrease and CEA rebound patients had shorter median RFS (12.2 months, P = 0.002 and 7.4 months, P < 0.001, respectively), shorter median hDFS (29.1 months, P = 0.003 and 14.8 months, P < 0.001, respectively), and shorter median OS (7.1 years, P = 0.131, and 4.9 years, P < 0.001, respectively). On multivariable analysis, CEA rebound was an independent predictor of worse RFS [hazard ratio (HR) 1.50, 95% confidence interval (CI) 1.16-1.93], hDFS (HR 1.39, 95% CI 1.03-1.88), and OS (HR 1.79, 95% CI 1.18-2.73). Among patients with CEA rebound, RAS-BRAF/TP53 comutation and multiple tumors predicted worse OS while APC mutation predicted improved OS.</p><p><strong>Conclusion: </strong>CEA rebound between pre-hepatectomy chemotherapy discontinuation and CLM resection is associated with worse oncologic outcomes, particularly in patients with aggressive tumor biology, and may help frame patient and surgeon expectations ahead of CLM resection.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"1021-1032"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613881","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":"Significance of Residual Nodal Disease in Clinically Node-Negative Breast Cancer After Neoadjuvant Chemotherapy.","authors":"Alycia So, Min Yi, Janine M Simons, Henry M Kuerer, Abigail Caudle, Sarah M DeSnyder, Isabelle Bedrosian, Kevin T Nead, Mariana Chavez-MacGregor, Mediget Teshome, Kelly K Hunt","doi":"10.1245/s10434-024-16382-7","DOIUrl":"10.1245/s10434-024-16382-7","url":null,"abstract":"<p><strong>Background: </strong>Trials evaluating omission of axillary dissection (ALND) in patients with cN0 breast cancer with positive sentinel lymph nodes (SLNs) have excluded neoadjuvant chemotherapy (NACT). It remains unclear whether the data can be extrapolated to cN0 patients undergoing NACT. This study sought to identify factors associated with positive SLNs and additional disease on ALND in cT1-2N0 disease after NACT.</p><p><strong>Methods: </strong>The authors queried their database for cT1-2N0 patients treated with NACT followed by SLN biopsy from 1996 to 2022. Physical examination and ultrasound determined clinical nodal status. Multivariable logistic regression identified factors associated with positive SLNs and disease on ALND.</p><p><strong>Results: </strong>Of 1930 patients, 234 (12.1%) had positive SLNs. Positive SLNs were predicted by hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) status (odds ratio [OR] 2.5; p < 0.0001), lobular histology (OR 1.8; p = 0.007), multifocality (OR 2; p = 0.001), grade 1 tumors (OR 2.5; p = 0.002), and cT2 category (OR 1.9; p = 0.004). Of the 234 patients with positive SLNs and known SLN metastasis size, 148 (63.2%) underwent ALND, and 39 (26.4%) had additional positive nodes. Increasing patient age predicted disease on ALND (OR 1.03; p = 0.02). No additional positive nodes on ALND were identified in patients with only isolated tumor cells compared with 12.3% who had micrometastases and 37.6% who had macrometastases (p = 0.01). During a 5-year median follow-up period of the SLN-positive patients, three (1.3%) experienced axillary recurrence and two of the three underwent ALND at the initial surgery with no additional positive nodes.</p><p><strong>Conclusions: </strong>In cT1-2N0 breast cancer, HR+/HER2- status, lobular histology, multifocality and cT2 category predicted positive SLNs after NACT. Older age predicted positive nodes on ALND. Patients with positive SLNs had low axillary recurrence rates. These findings support investigation into omission of ALND in cN0 breast cancer and a low volume of SLN disease after NACT.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"922-930"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493626","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}

{"title":"Effect of Early Postoperative Mobilization on Functional Recovery, Hospital Length of Stay, and Postoperative Complications After Immediate Internal Pudendal Artery Perforator Flap Reconstruction for Irradiated Abdominoperineal Resection Defects: A Prospective, Randomized Controlled Trial.","authors":"Caio Augusto Lima de Araujo, Fabio de Freitas Busnardo, Victor Augusto Thome Grillo, Carlos Henrique Chirnev Felício, Luciana Alexandra Antônia de Almeida, Carlos Frederico Sparapan Marques, Caio Sérgio Nahas, Antonio Rocco Imperialle, Guilherme Cutait de Castro Cotti, Rolf Gemperli, Ulysses Ribeiro","doi":"10.1245/s10434-024-16497-x","DOIUrl":"10.1245/s10434-024-16497-x","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing perineal defect reconstruction with the internal pudendal artery perforator (IPAP) flap traditionally face 5 days of postoperative bed rest (BR) to minimize surgical risks. However, prolonged BR can exacerbate postoperative physiologic changes such as increased fatigue, reduced body mass, and declining lung function, while also leading to complications such as pneumonia, delirium, deep vein thrombosis, and pressure injuries. This study assessed the effectiveness, feasibility, and safety of an adapted early mobilization (EM) program for these patients.</p><p><strong>Methods: </strong>This prospective, randomized, controlled clinical study involved 51 patients assigned to adapted EM (n = 25) or BR (n = 26). Whereas EM included core exercises, orthostasis training, gait training, muscle strengthening, and aerobic exercises after surgery, BR followed standard bed rest protocols. The primary outcome was independent ambulation for 3 m on postoperative day 5. The secondary outcomes included 6-min walk test (6MWT) distances on days 5 and 30, hospital length of stay, healing time, postoperative complications, fatigue prevalence, and quality of life.</p><p><strong>Results: </strong>On day 5, EM improved ambulation significantly compared with BR (68.0% vs 38.5%; P = 0.035) and achieved greater 6MWT distances on days 5 (108.78 vs 47.73 m; P = 0.041) and 30 (243.8 vs 166.29 m; P = 0.018). The EM patients were discharged earlier (66.7% by day 10 vs 33.3% of the BR patients; P = 0.043), with comparable healing times (P = 0.06) and postoperative complication rates (68% vs 80.8%; P = 0.296). Fatigue prevalence and quality of life did not differ significantly between the two groups.</p><p><strong>Conclusion: </strong>Early mobilization after IPAP flap reconstruction is safe and feasible, promoting early ambulation and recovery and facilitating earlier discharge without increasing complications.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"993-1004"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666956","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: Enhancing Return to Intended Oncologic Therapy in Gastric Cancer-The Role of Minimally Invasive Gastrectomy.","authors":"Parit T Mavani, Andee Koo, David A Kooby, Mihir M Shah","doi":"10.1245/s10434-024-16517-w","DOIUrl":"10.1245/s10434-024-16517-w","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"1257-1258"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646246","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}