Annals of Surgical Oncology最新文献

{"title":"The Impact of Preoperative Colonoscopy for Appendiceal Mucinous Neoplasms.","authors":"Giancarlo Sticca, Maria Abou-Khalil, Mikael Soucisse, Jean-François Tremblay, Mai-Kim Gervais, Pierre Dubé, Lucas Sideris","doi":"10.1245/s10434-025-18424-0","DOIUrl":"https://doi.org/10.1245/s10434-025-18424-0","url":null,"abstract":"<p><strong>Background: </strong>Preoperative colonoscopy is recommended for colorectal cancers to exclude synchronous tumors. However, data are lacking regarding this recommendation for appendiceal mucinous neoplasms. This study evaluated whether preoperative colonoscopy in patients with appendiceal mucinous lesions would reveal a significant finding, modify the operative plan, or be associated with adverse events.</p><p><strong>Methods: </strong>This mixed-methods retrospective cohort study included all mucinous appendiceal neoplasms between 2017 and 2024 at a tertiary care hospital.</p><p><strong>Results: </strong>Overall, 100 patients were included: 15% presented with acute appendicitis, 31% presented with an appendiceal mucinous lesion, and 54% presented with pseudomyxoma peritonei. Preoperative colonoscopy was performed in 83% of patients, 73.4% of which were normal, 19.3% showed benign polyps, 3.6% demonstrated caecal base invasion, 2.4% showed appendicular orifice invasion, and 1.2% had extrinsic caecal compression. No synchronous colorectal tumors were identified. When caecal invasion was demonstrated on colonoscopy, it had already been identified on preoperative computed tomography scan. The operative approach was never modified based on the colonoscopy results. There was no difference in discovery of tumor perforation between patients who underwent colonoscopy and those who did not (85% vs. 75%; p = 0.286). Longer time to surgery for those undergoing preoperative colonoscopy (325.9 vs. 116.1 days; p = 0.034) reflected the need for thorough work-up, neoadjuvant therapy, specialist consultations, and tertiary-care center referrals for patients with advanced appendiceal mucinous neoplasms.</p><p><strong>Conclusions: </strong>Preoperative colonoscopy demonstrated a low yield, a limited capacity to modify operative management, and was not associated with a higher probability of tumor perforation. Colonoscopy may be safely postponed postoperatively in select patients.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205488","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":"Incident Dark-Field (IDF) Illumination Microscopy as a Novel Tool for Real-Time, Dye-Free Parathyroid Perfusion Assessment in Thyroid Surgery.","authors":"Ting-Chun Kuo, Kuen-Yuan Chen, Yu-Chang Yeh, Chieh-Wen Lai, Ming-Tsan Lin, Chin-Hao Chang, Ming-Hsun Wu","doi":"10.1245/s10434-025-17746-3","DOIUrl":"10.1245/s10434-025-17746-3","url":null,"abstract":"<p><strong>Background: </strong>Postsurgical hypoparathyroidism is a frequent complication in thyroid surgery. Visual inspection to assess parathyroid gland (PG) viability is subjective and inconsistent. Although indocyanine green (ICG) angiography can improve perfusion assessment, it introduces workflow disruptions and carries a risk of allergic reactions.</p><p><strong>Methods: </strong>This pilot study investigated the feasibility of incident dark-field (IDF) microscopy as a dye-free, real-time imaging method for assessing PG perfusion during thyroidectomy. Thyroidectomy patients were prospectively enrolled at a tertiary referral hospital. Parathyroid glands were visually identified and confirmed with near-infrared autofluorescence (NIRAF). Imaging was recorded using three techniques: gross inspection (GI), IDF microscopy, and ICG angiography. Perfusion status was evaluated and classified into three categories (devascularized, compromised, and well-vascularized) and reviewed by three independent, blinded observers. Statistical analyses included interobserver reliability and inter-evaluation correlation assessments.</p><p><strong>Results: </strong>Among 41 NIRAF-confirmed PGs, IDF microscopy demonstrated rapid assessment, requiring 2.41 ± 1.01 min per PG evaluation compared with 5.40 ± 1.53 min for ICG angiography. For PG viability evaluation, IDF showed higher correlation with ICG than GI (weighted kappa, 0.75 vs 0.60; both P < 0.001). Surpassing GI's moderate agreement (weighted kappa, 0.44-0.47; P < 0.001), IDF microscopy exhibited moderate to substantial inter-evaluation agreement (weighted kappa 0.51-0.66; P < 0.001).</p><p><strong>Conclusions: </strong>Incident dark-field microscopy offers a rapid, reliable, and dye-free method for real-time assessment of PG perfusion, demonstrating diagnostic performance on par with ICG angiography while providing notable workflow advantages. This technique has the potential to reduce hypoparathyroidism by enhancing PG preservation in thyroid surgery. Further studies are needed to validate these findings and refine quantification methods.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7524-7531"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574739","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":"The Impact of RAS/BRAF Mutation on Pathological Complete Response After Total Neoadjuvant Therapy in Rectal Cancer.","authors":"Sara Aboelmaaty, Ibrahim A Gomaa, Annaclara Sileo, Richard Sassun, Jyi Cheng Ng, Nouran O Keshk, Nicholas P McKenna, William R Perry, David W Larson","doi":"10.1245/s10434-025-17804-w","DOIUrl":"10.1245/s10434-025-17804-w","url":null,"abstract":"<p><strong>Introduction: </strong>Kirsten rat sarcoma viral oncogene (KRAS) mutations account for 86% of all RAS mutations and 30-50% of colorectal cancer mutations (CRC). The KRAS mutation may have prognostic implications in CRC. The impact of RAS/BRAF mutations on pathological complete response (pCR) after total neoadjuvant therapy (TNT) in patients with rectal cancer is unclear. This study aims to assess pCR rates following TNT in RAS/BRAF mutant rectal cancer.</p><p><strong>Methods: </strong>Adult patients with rectal cancer who underwent TNT and curative surgery at a large academic institution between 2018 and 2023 were retrospectively reviewed. Patients were divided into two groups based on RAS/BRAF mutation status: mutant RAS/BRAF (RAS+) and wild-type RAS/BRAF (RAS-). Patients with other or concurrent mutations were excluded.</p><p><strong>Results: </strong>Of 146 patients, 69 (47.3%) were RAS+, whereas 77 (52.7%) were RAS-. In the RAS+ group, five patients (7.2%) were BRAF mutants. There was no significant difference in magnetic resonance imaging rate between groups. However, RAS mutation status was significantly associated with differences in pCR; specifically, a higher proportion of RAS- patients achieved pCR (20.8% vs. 8.7%; p = 0.042). Subgroup analysis revealed that RAS+ (20.8%, 8.7%; p = 0.042) and codons 12 and 13 (20.8%, 7.3%; p = 0.033) were associated with a less pathologic complete response rate. Three-year disease-free survival was significantly associated with RAS mutation status, being higher in the RAS- group compared with the RAS+ group (80% vs. 65%; p = 0.038).</p><p><strong>Conclusions: </strong>In the era of TNT and nonoperative management strategies, RAS/BRAF mutations are more likely associated with a lower pCR rate in locally advanced rectal cancer patients. Moreover, these mutations are associated with worse disease-free survival.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7326-7332"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658123","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: Prognostic Significance of Tumor-Cell-Derived SIRPα in Intrahepatic Cholangiocarcinoma.","authors":"Katsuya Toshida, Shinji Itoh, Tomoharu Yoshizumi","doi":"10.1245/s10434-025-17889-3","DOIUrl":"10.1245/s10434-025-17889-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8066-8067"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658198","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: Hypothetical Interventions on Frailty Heterogeneous Trajectories of Older Patients with Gastric Cancer Using Parametric g-Formula.","authors":"Yinning Guo, Xinyi Xu, Qin Xu","doi":"10.1245/s10434-025-18082-2","DOIUrl":"10.1245/s10434-025-18082-2","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7660-7661"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844279","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":"Clinical Characteristics and Outcomes of Oncologic Surgical Emergencies: A Retrospective Study.","authors":"Ling Chen, Lingqiang Min, Qiangjun Gan, Botian Ye, Guochao Zhao, Dansong Wang","doi":"10.1245/s10434-025-18031-z","DOIUrl":"10.1245/s10434-025-18031-z","url":null,"abstract":"<p><strong>Background: </strong>Oncologic surgical emergencies (OSEs) are increasing, with rising cancer incidences and prolonged patient survival. However, prior OSEs studies have been limited by a narrow focus. This study aimed to determine whether a five-category classification for OSEs can effectively guide clinical decision-making based on patient outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study used prospectively collected data from 1 May 2015 to 31 December 2023 at Zhongshan Hospital, Fudan University. Among in-patients undergoing emergency general surgery, 2908 patients with OSEs were included. The OSEs were classified into five categories based on the tumor course: (1) emergency as the initial symptom, (2) emergency due to tumor progression or recurrence, (3) complications from non-invasive treatments, (4) complications from invasive treatments, and (5) emergencies unrelated to tumors but with a history of malignancy. The primary outcome was in-hospital mortality.</p><p><strong>Results: </strong>Obstruction was the most common emergency (58.0%), and gastrointestinal tumors were the primary source (79.8%). Category 1 emergencies were the most frequent (42.8%), followed by categories 2 (16.4%), 4 (16.0%), 5 (19.5%), and 3 (5.5%). The patients with OSEs had a higher in-hospital mortality rate than those with other types of emergencies (4.0% vs. 1.5%; p < 0.001). Perforation, age ≥ 65 years, and male sex were independent risk factors for in-hospital mortality.</p><p><strong>Conclusions: </strong>The comprehensive five-category classification system for OSEs provided a valuable framework that may enhance clinical decision-making and guide management strategies for this patient population. Thus, it has potential to be integrated into clinical practice.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7652-7659"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940271","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":"The Hidden Burden: Impact of Allostatic Load on Colorectal Cancer Surgery Outcomes.","authors":"Mujtaba Khalil, Selamawit Woldesenbet, Zayed Rashid, Abdullah Altaf, Shahzaib Zindani, Emily Huang, Syed Husain, Matthew Kalady, Samilia Obeng-Gyasi, Timothy M Pawlik","doi":"10.1245/s10434-025-17711-0","DOIUrl":"10.1245/s10434-025-17711-0","url":null,"abstract":"<p><strong>Background: </strong>Allostatic load (AL) is a composite measure of the physiological damage caused by socioenvironmental stressors. We sought to investigate the association between AL, social vulnerability index (SVI), and postoperative outcomes following colorectal cancer (CRC) surgery.</p><p><strong>Patients and methods: </strong>Individuals who underwent surgery for CRC between 2022 and 2024 were identified using the Epic Cosmos database. AL is calculated on the basis of ten biomarkers from four physiological systems (cardiovascular, metabolic, renal, immune). Multivariable regression models were utilized to examine the association between AL and postoperative outcomes.</p><p><strong>Results: </strong>Among 40,520 individuals, mean patient age was 67.7 years (SD ±13.9), roughly half of the patients were male (n = 20,573; 50.8%), and patients generally had a high Charlson comorbidity index score (CCI > 2; n = 33,132; 81.8%). Overall, 7.1% (n = 2897) of patients had a high AL. Notably, AL increased with increasing SVI (ref: low; medium: 1.10 [95% CI 1.01-1.20]; high: 1.17 [95% CI 1.07-1.28]). High AL was associated with a 48% increased risk of postoperative complications (OR 1.48; 95% CI 1.38-1.58), a 79% increased risk of an extended length of stay (OR 1.79; 95% CI 1.67-1.90), and a twofold (OR 2.13; 95% CI 1.90-2.37) increase in the risk of mortality within 30 days of surgery.</p><p><strong>Conclusions: </strong>Individuals with CRC living in socially vulnerable neighborhoods experience high physiological damage and are at a higher risk of postoperative complications and mortality. Therefore, patients from socially vulnerable neighborhoods may require preoperative screening and optimization to mitigate disparities in surgical outcomes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7723-7730"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339792","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":"ASO Author Reflections: The Hidden Burden: Impact of Allostatic Load on Colorectal Cancer Surgery Outcomes.","authors":"Mujtaba Khalil, Timothy M Pawlik","doi":"10.1245/s10434-025-17754-3","DOIUrl":"10.1245/s10434-025-17754-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7780-7781"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551716","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":"ASO Author Reflections: Impact of Historical Redlining and Neighborhood Trajectories on Gastrointestinal Cancer Care.","authors":"Mujtaba Khalil, Timothy M Pawlik","doi":"10.1245/s10434-025-17880-y","DOIUrl":"10.1245/s10434-025-17880-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7662-7663"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673819","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":"Natural History of Primary Retroperitoneal Extra-Visceral Perivascular Epithelioid Cell Tumors (PEC): A Study from Transatlantic and Australasian Retroperitoneal Sarcoma Working Group (TARPSWG).","authors":"Eyal Mor, Sameer Apte, Catherine Mitchell, Carolyn Nessim, Max Almond, Bruno Vincenzi, Jose Antonio Gonzalez Lopez, Lee Cranmer, Michael J Wagner, Aviram Nissan, Miguel Henriques Abreu, Markus Albertsmeier, Mathilda Knoblauch, Adam Barlow, Emily Z Keung, Giovanni Grignani, Jason L Hornick, Alessandro Gronchi, David E Gyorki","doi":"10.1245/s10434-025-17787-8","DOIUrl":"10.1245/s10434-025-17787-8","url":null,"abstract":"<p><strong>Background: </strong>Perivascular epithelioid cell tumors (PEComa) are a rare family of mesenchymal tumors that include several subtypes. There are very limited data describing the natural history of patients with extra-visceral retroperitoneal PEComas of the retroperitoneum. The aim of this study is to describe the clinical features, treatment patterns, outcomes, and diagnostic challenges of primary extra-visceral retroperitoneal or abdominopelvic PEComa over the past decade.</p><p><strong>Patients and methods: </strong>This is a retrospective analysis of all extra-visceral, non-renal, retroperitoneal, or abdominopelvic PEComas treated at participating centers over the past 10 years.</p><p><strong>Results: </strong>A total of 77 patients from 13 centers were included. The median age at diagnosis was 56 years (range 18-81 years); 73% were female. The median size was 9 cm. The tumor was classified as a PEComa not otherwise specified (NOS) in 55 (71%), sclerosing PEComa in 11 (15%), and angiomyolipoma (AML) in 11 (15%). Treatment intent was curative in 59 (77%) patients. Adjuvant radiation was given in five (8%) patients, and (neo)adjuvant systemic therapy was given to six (10%). Of those who did not undergo curative intent treatment, four (22%) patients had metastatic disease and three (17%) had primary unresectable disease. With a median follow-up of 26 months (2.3-147 months), 24 (40%) of the 59 patients having curative treatment had recurred. Recurrence rates differed by subtype, with 20 (37%) of the PEComa NOS group, 3 (27%) of the sclerosing PEComa group, and 1 (9%) of the AML group developing recurrence. The estimated 5-year OS of the whole cohort was 63% and 75% for the curative intent group.</p><p><strong>Conclusions: </strong>Retroperitoneal and abdominopelvic PEComas show distinct behaviors by subtype. PEComa NOS had the highest recurrence and mortality, sclerosing PEComa showed intermediate risk, and AML was indolent. Histological classification is essential for prognosis and management.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7817-7828"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636043","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}