Annals of Surgical Oncology最新文献

{"title":"Surgical Site Infections in Simultaneous Colorectal and Liver Resections for Metastatic Colorectal Adenocarcinoma.","authors":"Lauren E Schleimer, Lynn Hakki, Kenneth Seier, Susan K Seo, Nina Cohen, Shauna Usiak, Tiffany Romero, Mini Kamboj, Crisanta Ilagan, Lily V Saadat, Remo Alessandris, Kevin C Soares, Jeffrey Drebin, Alice C Wei, Maria Widmar, Iris H Wei, J Joshua Smith, Emmanouil P Pappou, Philip B Paty, Garrett M Nash, William R Jarnagin, Julio Garcia-Aguilar, Mithat Gonen, T Peter Kingham, Martin R Weiser, Michael I D'Angelica","doi":"10.1245/s10434-024-16489-x","DOIUrl":"https://doi.org/10.1245/s10434-024-16489-x","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) are a major driver of morbidity after combined liver and colorectal surgery for metastatic colorectal cancer. Available literature is inadequate to characterize risk factors and benchmarks for quality improvement.</p><p><strong>Methods: </strong>Consecutive cases of simultaneous liver and colorectal surgery for colorectal adenocarcinoma from November 2013 through September 2022 were reviewed for SSIs per National Surgical Quality Improvement Program (NSQIP) and National Healthcare Safety Network (NHSN) criteria. Univariable and multivariable logistic regression evaluated associations with NSQIP 30-day organ-space SSIs.</p><p><strong>Results: </strong>In 580 procedures, the rate of 30-day organ-space SSIs was 16% (n = 94) using NSQIP criteria and 11% (n = 64) using NHSN criteria; 4% (n = 24) had incisional SSIs by both criteria. Most organ-space SSIs were perihepatic, and a minority were associated with bile (26%) or anastomotic (15%) leak. Independent risk factors for organ-space SSIs included major liver resection, upper abdominal (compared with lower abdominal/pelvic) colorectal procedure, and ostomy reversal. Organ-space SSI rates increased over time by approximately 16% per calendar year (p = 0.02) despite a declining rate of major liver resection; incisional SSI rates remained low. Overall, major morbidity was 22%, with 7-day median length of stay (interquartile range 6-9) and 0.3% 90-day mortality.</p><p><strong>Conclusion: </strong>Organ-space SSIs are a significant driver of postoperative morbidity in simultaneous liver and colorectal resections for metastatic colorectal adenocarcinoma. Our findings confirm simultaneous resection remains safe and interventions to mitigate the risk of perihepatic organ-space SSIs in high-risk patients are warranted.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680774","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":"Preoperative Radiation Therapy is Not Associated with Postoperative Complications in Patients with Retroperitoneal Sarcoma.","authors":"Luc M Berclaz, Saveli I Goldberg, Sonia Cohen, Shannon MacDonald, Thomas F Delaney, Yen-Lin Chen, John T Mullen","doi":"10.1245/s10434-024-16584-z","DOIUrl":"https://doi.org/10.1245/s10434-024-16584-z","url":null,"abstract":"<p><strong>Background: </strong>The role of preoperative radiation therapy (RT) in the management of retroperitoneal sarcomas (RPS) remains controversial. A legitimate concern is the potential for worse outcomes after surgery for RPS with preoperative RT.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the impact of preoperative (± intraoperative) RT on postoperative complications in patients undergoing surgery for RPS.</p><p><strong>Methods: </strong>A total of 99 patients who underwent curative-intent surgery for primary RPS of any histology after preoperative RT from 2003 to 2021 were analyzed. Univariate and multivariate logistic regression analyses were performed to identify factors associated with postoperative morbidity and mortality.</p><p><strong>Results: </strong>The median preoperative RT dose was 57.4 Gy, and 17 patients received intraoperative RT to a median dose of 10 Gy. The median number of organs resected was two. Postoperative complications within 30 days of surgery occurred in 47% of patients, including severe complications (Clavien-Dindo grades ≥IIIa) in 20% of patients. The 90-day mortality rate was 2%. On multivariate analysis, concomitant vascular resection was the only significant predictor of severe postoperative complications (odds ratio 8.76; p = 0.0069). Despite increasing median preoperative RT doses from 50.4 Gy in 2003-2012 to 63 Gy (on a clinical trial) in 2013-2021, severe postoperative morbidity rates actually decreased from 26.3% to 16.1% (p = 0.303).</p><p><strong>Conclusion: </strong>The administration of preoperative (± intraoperative) RT to patients with RPS resulted in similar postoperative complications as reported after surgery alone. Continuous advances in surgical and radiotherapeutic expertise resulted in lower complication rates over time despite increasing radiation doses.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680768","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":"National Trends and Outcomes in Cytoreductive Surgery for Colorectal Cancer with Peritoneal Metastases Before and After PRODIGE 7.","authors":"Rhami Khorfan, Shaina Sedighim, David Caba-Molina, Thuy B Tran, Maheswari Senthil, Michael P O'Leary, Oliver S Eng","doi":"10.1245/s10434-024-16539-4","DOIUrl":"https://doi.org/10.1245/s10434-024-16539-4","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685711","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: Predictors of Recurrence in Non-metastatic Appendiceal Epithelial Cancers-The Role of Staging Right Colectomy.","authors":"Nicole Aguirre, Garrett Nash, Georgios Karagkounis","doi":"10.1245/s10434-024-16479-z","DOIUrl":"https://doi.org/10.1245/s10434-024-16479-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680724","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: Organoid Model to Aid the Decision of Hyperthermic Intraperitoneal Chemotherapy for Colorectal Cancer.","authors":"Duo Liu, Keli Yang, Jian Cai","doi":"10.1245/s10434-024-16555-4","DOIUrl":"https://doi.org/10.1245/s10434-024-16555-4","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675129","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 Visual Abstract: A Novel Curriculum for Surgical Oncology Fellowship Training in West Africa.","authors":"Sulaiman Nanji, Emanuel Ezeome, Olusegun Alatise, Shaila Merchant, Florence Dedey, Matthew Jalink, Sidy Ka, Klodiana Kolomitro, Clement Osime, Nazik Hammad, Nicholas Cofie, Faizal Haji, Serigne Magueye Gueye","doi":"10.1245/s10434-024-16486-0","DOIUrl":"https://doi.org/10.1245/s10434-024-16486-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675131","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: Evolving Paradigms in the Management of Peritoneal Metastases Recurrences: Repeat Cytoreductive Surgery with HIPEC or Not-Insights from French Expert Centers.","authors":"Catherine Arvieux, Anne-Cécile Ezanno, Isabelle Sourrouille, Frédéric Marchal, Marc Pocard, Olivier Glehen, Fatah Tidadini","doi":"10.1245/s10434-024-16563-4","DOIUrl":"https://doi.org/10.1245/s10434-024-16563-4","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680618","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: Lymph Node Yield and Long-Term Survival in Colon Cancer-Insights from a 20-Year National Study.","authors":"Velia Men, James Z Jin","doi":"10.1245/s10434-024-16565-2","DOIUrl":"https://doi.org/10.1245/s10434-024-16565-2","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680620","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":"Perioperative and Oncologic Outcomes of Hepatic Arterial Infusion (HAI) Pump Chemotherapy for Patients with Unresectable Colorectal Liver Metastases at an Expanding HAI Program.","authors":"Annie Liu, Melissa Lowe, Donna Niedzwiecki, Kristen E Rhodin, Jeremy Sharib, Benjamin Wildman-Tobriner, Terence Z Wong, Charles Y Kim, Julie Thacker, Christopher Mantyh, John Migaly, Billy Y Lan, John H Strickler, S David Hsu, Daniel Nussbaum, Sabino Zani, Hope Uronis, Peter J Allen, Michael E Lidsky","doi":"10.1245/s10434-024-16488-y","DOIUrl":"https://doi.org/10.1245/s10434-024-16488-y","url":null,"abstract":"<p><strong>Background: </strong>Hepatic arterial infusion (HAI) is an established treatment for patients with unresectable colorectal liver metastases (uCRLM). Until recently, HAI was only performed at a limited number of centers. We previously reported early outcomes suggesting that implementation of a new HAI program is safe and feasible. Here, we report perioperative and oncologic outcomes from an expanded series of patients with uCRLM treated with HAI.</p><p><strong>Methods: </strong>We analyzed outcomes from consecutive patients with uCRLM who underwent HAI pump (HAIP) placement at Duke University Hospital from 2018 to 2023. Demographics, prior treatment, and perioperative and oncologic outcomes were assessed.</p><p><strong>Results: </strong>Overall, 102 patients underwent HAIP placement for uCRLM; 62% were male and median age was 51 years. Most patients (97%) received a median of 12 (range 0-66) prior chemotherapy cycles. Postoperative HAI-specific complications occurred in 23% of patients, including biliary sclerosis in 6%, and the 90-day mortality rate was 3%. 20% converted to resection, 4% underwent transplant, and 2% achieved complete response at 6 months after floxuridine initiation. Median hepatic and extrahepatic progression-free survival (PFS) was 15.7 months and 11.6 months, respectively. Median overall survival (OS) was 38 months from the time of pump implantation (median follow-up time: 30 months).</p><p><strong>Conclusions: </strong>HAI for uCRLM is safe, feasible, and effective at a new center, with outcomes that recapitulate those previously reported by established centers. Future analysis of our institutional data, which includes mutation status, primary tumor sidedness, and extent of prior therapy could inform selection and treatment strategies for new HAI programs.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675137","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":"Letter to The Editor in Relation to 'Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer: The Largest Systematic Reviews of 68,755 Patients and Meta-analysis'.","authors":"Matthew G Davey, Noel E Donlon","doi":"10.1245/s10434-024-16543-8","DOIUrl":"https://doi.org/10.1245/s10434-024-16543-8","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680762","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}