Annals of Surgical Oncology最新文献

{"title":"Patient-Derived Organoids for Predicting Chemotherapy Response in Bladder Cancer: A Multicenter, Real-world Validation Study.","authors":"Yihao Zhao, Shijie Zhang, Yiming Wang, Zhe Shen, Junchao Feng, Jiaorui Zou, Jiqian Hou, Xiaoyi Zhang, Zhongze Zhou, Na Yu, Sifeng Qu, Jun Chen","doi":"10.1245/s10434-026-20781-3","DOIUrl":"https://doi.org/10.1245/s10434-026-20781-3","url":null,"abstract":"<p><strong>Background: </strong>Responses to chemotherapeutic agents vary substantially among patients with bladder cancer. The lack of preclinical models that accurately predict the clinical efficacy of intravesical chemotherapy remains a major barrier to precision oncology.</p><p><strong>Methods: </strong>In this prospective multicenter study (NCT06662071), 63 patients with bladder cancer were enrolled at four medical centers. Patient-derived organoids (PDOs) were established using specimens obtained by transurethral resection of bladder tumor. A total of 35 PDOs underwent high-throughput screening with a panel of eight clinically relevant chemotherapeutic agents. To identify the optimal classification strategy, we evaluated six distinct approaches by combining two statistical methods (the Jenks natural breaks method and the tertile method) with three sensitivity indicators (viability, nAUC, and IC₅₀) and assessed the concordance between drug sensitivity profiles and real-world clinical follow-up data.</p><p><strong>Results: </strong>We successfully established 41 PDOs. Comparative analysis indicated that post-digestion cell viability and total cell count may influence the success of PDO establishment. The PDOs showed high morphological and molecular concordance with the primary tumors. Among the six candidate strategies, IC₅₀-Jenks showed the highest numerical concordance with clinical outcomes, with accuracy of 88.2% (95% CI, 63.6-98.5%) and specificity of 93.3% (95% CI, 68.1-99.8%). Representative case studies confirmed the utility of PDOs in identifying therapeutic futility and supporting the feasibility of bladder-sparing strategies.</p><p><strong>Conclusions: </strong>This multicenter feasibility study suggests that bladder cancer PDOs may support exploratory assessment of chemotherapy sensitivity. The proposed classification approach requires validation in larger, prospectively designed, clinically homogeneous cohorts before it can inform routine treatment decisions.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261297","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: The Appropriate Extent of Lymphadenectomy for Gallbladder Cancer: Is Extended Lymphadenectomy Useful?","authors":"Tianhao Chen, Rongxing Zhou, Yanwen Jin, Jie Zhang, Qianbin Jia, Fuyu Li, Wenjie Ma","doi":"10.1245/s10434-026-20798-8","DOIUrl":"https://doi.org/10.1245/s10434-026-20798-8","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261207","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":"Recommendations for the Multimodal Management of Malignant Bowel Obstructions: Results of a North American Multidisciplinary Delphi Consensus.","authors":"Farhana Shariff, Jessica Bogach, Apishanthi Sriskandarajah, Ashlie Nadler","doi":"10.1245/s10434-026-20614-3","DOIUrl":"https://doi.org/10.1245/s10434-026-20614-3","url":null,"abstract":"<p><strong>Background: </strong>Malignant bowel obstruction (MBO) is a challenging clinical problem requiring teams to balance complex oncologic disease, limited treatment options, and patient prognosis and values as they approach end of life. Presently, there is limited high-quality evidence to guide decision-making for MBO patients.</p><p><strong>Objective: </strong>A multidisciplinary modified Delphi process was undertaken to create guidance and support clinical decision-making in the medical and surgical care of this patient population.</p><p><strong>Methods: </strong>Multidisciplinary experts from all specialties regularly caring for MBO in Canada and the United States were invited for participation, including Acute Care Surgery, Surgical Oncology, Gynecologic Oncology, Gastroenterology, Radiology, Medical Oncology, and Palliative Care. Statements were evaluated through two rounds of surveys and a consensus meeting, with an a priori threshold of 80% agreement for approval.</p><p><strong>Results: </strong>Forty-nine final evidence-informed statements were included following expert consensus review pertaining to Patient Assessment, Medical Management, Surgical Management, and Palliative Management, in addition to a unifying definition of MBO. Consensus statements address aspects of complex MBO care, including but not limited to, optimal preoperative evaluation and multidisciplinary review; timing and use of steroids, motility, and antisecretory agents; contraindications to surgery; key facets of consent and perioperative decision making; framework for the nuanced use of gastrostomies and IV fluids in the end-of-life setting.</p><p><strong>Conclusions: </strong>This Modified Delphi consensus provides multidisciplinary evidence-based recommendations for the care of patients with this challenging problem. These expert approved statements provide much-needed clinical guidance to support best care balanced with patient values and avoidance of undue harm.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261287","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":"Tailored Strategy for Laparoscopic Anatomical Extended Right Posterior Sectionectomy Including the Dorsal Right Anterior Section.","authors":"Jimin Son, Ji Hoon Kim","doi":"10.1245/s10434-026-20764-4","DOIUrl":"https://doi.org/10.1245/s10434-026-20764-4","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic extended right posterior sectionectomy (eRPS), including the dorsal segment of the right anterior section (RAS), is a technically demanding but parenchyma-preserving alternative to right hepatectomy. Its success depends on accurate identification of the anatomically variable intersegmental plane. This study describes a tailored Glissonean approach according to the presence or absence of the anterior fissure vein (AFV).</p><p><strong>Patients and methods: </strong>Between December 2020 and July 2023, six consecutive patients underwent laparoscopic eRPS including the dorsal RAS. Preoperative three-dimensional (3D) reconstruction was used to evaluate the right anterior Glissonean pedicle (RAG) branching pattern and presence of a definite AFV. When an AFV was identified, an AFV-guided transfissural approach was used; when absent, an intrahepatic Glissonean approach using the RAG as an intraparenchymal landmark was performed. Indocyanine green (ICG) fluorescence confirmed the ischemic boundary after target pedicle ligation.</p><p><strong>Results: </strong>Median operative duration was 260 min and median blood loss was 175 mL, with no transfusions. A definite AFV was identified in five of six patients (83.3%). Median tumor size was 31 mm (range 15-52 mm), and all cases achieved R0 resection. Median hospital stay was 6.5 days (range 5-21 days). One patient (16.7%) experienced postoperative ileus, with no perioperative mortality.</p><p><strong>Conclusions: </strong>A tailored Glissonean approach guided by preoperative 3D reconstruction and complemented by ICG fluorescence provides a practical framework for laparoscopic eRPS. Careful case selection remains essential.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261354","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":"Predictors of Immediate Therapeutic Lymph Node Dissection Instead of Index Lymph Node After Neoadjuvant Checkpoint Inhibitors: Lessons Learned from the PRADO Trial.","authors":"Marieke T Goodijk, Anke M J Kuijpers, Lotte L Hoeijmakers, Dirk J Grünhagen, Yvonne M Schrage, Michel W J M Wouters, Charlotte L Zuur, Willem M C Klop, Jos A van der Hage, Arjen J Witkamp, Bart A van de Wiel, Robyn P M Saw, Thomas E Pennington, Kerwin F Shannon, Andrew J Spillane, Richard A Scolyer, Robert V Rawson, Alexander M Menzies, Georgina V Long, Christian U Blank, Alexander C J van Akkooi, Winan J van Houdt","doi":"10.1245/s10434-026-20632-1","DOIUrl":"https://doi.org/10.1245/s10434-026-20632-1","url":null,"abstract":"<p><strong>Background: </strong>In the PRADO trial, a multicenter phase II study, patients with macroscopic stage III melanoma received neoadjuvant ipilimumab and nivolumab followed by resection of the marked index lymph node (ILN). Patients without a major pathological response (MPR) underwent therapeutic lymph node dissection (TLND), although some required TLND for other indications. We investigated whether baseline clinicopathological and preoperative response parameters identify patients benefiting from immediate TLND rather than ILN resection followed by potential secondary TLND.</p><p><strong>Methods: </strong>Data were collected from PRADO case report forms. Group differences were assessed using Fisher's exact, chi-square, or Mann-Whitney U tests. Logistic regression identified predictors of TLND, with a subgroup analysis restricted to pathology-positive TLND. Model performance was assessed using (cross-validated) area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>Ninety-nine patients were included; 36 underwent TLND: 20 (56%) with pathological nonresponse, eight (22%) with partial response, and eight (22%) for other indications (nodal recurrence after MPR, n = 3; extranodal extension, n = 1; suspicious nodes on imaging, n = 2; or infeasible ILN resection due to immune-related adverse events, n = 2). Age < 40 years (odds ratio 7.91, 95% confidence interval 1.35-46.30; P = 0.022) and radiographic increase in tumor size (odds ratio 1.15; 95% confidence interval 1.07-1.24; P < 0.001) were associated with TLND.</p><p><strong>Conclusions: </strong>Age younger than 40 years and unfavorable radiological response to neoadjuvant immunotherapy were associated with TLND, suggesting these parameters may identify patients at risk of residual nodal disease and subsequent need for TLND.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149261343","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: Where You Live and Where You're Treated: Addressing Disparities in Esophageal Adenocarcinoma.","authors":"Megan E Campany, Song Kim, Allison Welton, Paul L Linsky, Jinny S Ha, Jacob A Klapper, Matthew G Hartwig, Britton B Donato","doi":"10.1245/s10434-026-20619-y","DOIUrl":"https://doi.org/10.1245/s10434-026-20619-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242651","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":"Symptom Structure, Heterogeneity, and Network Features on Postoperative Day 3 After Oesophagectomy: A Multisite, Cross-sectional, Multimethod Analysis.","authors":"Shaoxue Li, Yiting Luo, Siying Wu, Yuen-Shan Ho, Naomi Takemura, Janelle Yorke, Jiaying Li, Shuwen Li, Zengjie Ye","doi":"10.1245/s10434-026-20727-9","DOIUrl":"https://doi.org/10.1245/s10434-026-20727-9","url":null,"abstract":"<p><strong>Background: </strong>The acute inpatient symptom state following oesophagectomy is multidimensional and heterogeneous. However, the structure, between-patient heterogeneity, and network features of symptoms remain incompletely characterised.</p><p><strong>Method: </strong>We analysed 1047 postoperative patients with oesophageal cancer from four hospitals in Anhui Province, China, in the \"Be Resilient to Oesophageal Cancer\" program. We applied principal component analysis to summarise symptom dimensions and latent profile analysis to derive patient groups of symptom burden. Symptom networks were estimated and centrality computed to identify candidate targets. We then performed in silico node-perturbation simulations to estimate potential system-level effects of alleviating versus aggravating individual symptoms.</p><p><strong>Results: </strong>Four symptom dimensions emerged from the principal component analysis: somatic discomfort and fatigue, psychological distress, social functioning impairment, and gastrointestinal/appetite-related symptoms. A low-burden group (80.2%) and a high-burden group (19.8%) were identified. The overall network's most central symptom was \"reduced social interaction\" (r = 2.52). Within groups, \"worry\" was most central in the low-burden group (r = 2.08), whereas \"incision pain\" was most central in the high-burden group (r=2.56). Computer simulations revealed that, within alleviating interventions, somatic symptoms accounted for the highest proportion across all symptom types (incision pain: -20.68% to -9.17%). Conversely, within aggravating interventions, psychosocial symptoms constituted the largest share in both the overall symptom network and the low-burden group (helplessness: 24.13% to 30.27%), whereas somatic symptoms dominated the high-burden group (incision pain: 9.17%).</p><p><strong>Conclusion: </strong>A multimethod pipeline identified reduced social interaction, worry, and incision pain as profile-specific, structurally prominent symptoms within the postoperative day 3 symptom networks. These findings highlight distinct psychosocial and somatic features across symptom-burden profiles and provide hypotheses for subsequent longitudinal and interventional studies.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242678","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":"Smoking Status and Response to Total Neoadjuvant Therapy for Rectal Cancer: A National Cohort Study.","authors":"Janet S Lee, Miranda Considine, Julia Frebault, Sarah L Mott, Catherine Tran, Cyrus Jahansouz, Imran Hassan, Paolo Goffredo","doi":"10.1245/s10434-026-20769-z","DOIUrl":"https://doi.org/10.1245/s10434-026-20769-z","url":null,"abstract":"<p><strong>Background: </strong>Tobacco smoking is prevalent among patients with rectal cancer, yet its effect on pathologic response to total neoadjuvant therapy (TNT) remains unknown. This study evaluated the association between smoking status and pathologic response to TNT in locally advanced rectal cancer, using the neoadjuvant rectal (NAR) score and pathologic complete response (pCR) rate.</p><p><strong>Methods: </strong>This retrospective cohort study used the National Cancer Database to identify adults diagnosed in 2023 with clinical stage Ⅱ-Ⅲ rectal adenocarcinoma who received TNT followed by proctectomy. Smoking status at diagnosis was categorized as never, current, or former. Primary outcomes were favorable NAR score (< 8) and pCR (ypT0N0).</p><p><strong>Results: </strong>Among 1767 patients, 49.7% were never smokers, 30.5% former, and 19.8% current smokers. Rates of favorable NAR score and pCR were highest among never smokers (33.4 and 21.7%), intermediate among former smokers (28.8 and 19.9%), and lowest among current smokers (25.5 and 16.3%). On multivariable analysis, current smoking was associated with lower odds of favorable NAR score than was never smoking (odds ratio 0.59; 95% confidence interval 0.40-0.86). A similar trend was seen for pCR, though this did not reach statistical significance (odds ratio 0.58; 95% confidence interval 0.34-1.00). Former smoking was not significantly different from never smoking in terms of a favorable NAR score or pCR.</p><p><strong>Conclusions: </strong>Current smoking status was independently associated with lower rates of response to TNT in locally advanced rectal cancer, whereas former smoking was not when compared with never smoking. These findings identify active tobacco exposure as a potential modifiable risk factor.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242691","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: Patient-Reported Outcomes Following Pegulicianine Fluorescence-Guided Surgery.","authors":"Logan R Holt, Barbara L Smith","doi":"10.1245/s10434-026-20712-2","DOIUrl":"https://doi.org/10.1245/s10434-026-20712-2","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242575","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":"Cancer Statistics 2026-A Shout-out and Challenge to the Source!","authors":"Frederick L Greene","doi":"10.1245/s10434-026-20784-0","DOIUrl":"https://doi.org/10.1245/s10434-026-20784-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149242599","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}