Christopher D Vetter, Tanya Hoskin, Carrie Olson, Karthik Giridhar, Judy C Boughey
{"title":"ASO Visual Abstract: Validation of the Performance of the Novel Prognostic Staging System for Overall Survival in De Novo Metastatic Breast Cancer and Demonstration of Performance for Cancer-Specific Outcomes.","authors":"Christopher D Vetter, Tanya Hoskin, Carrie Olson, Karthik Giridhar, Judy C Boughey","doi":"10.1245/s10434-025-18350-1","DOIUrl":"https://doi.org/10.1245/s10434-025-18350-1","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342942","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":"Surgical Optimization in Preoperatively Low-risk cN1a PTC: A Predictive Model for High-Volume Central Lymph Node Metastasis.","authors":"Yi Zhou, Zhixin Guo, Jianyan Long, Heyang Xu, Mingwei Liang, Yuan Hu, Ruixia Li, Zhenbang Ke, Wanna Chen, Xiangdong Xu","doi":"10.1245/s10434-025-18569-y","DOIUrl":"https://doi.org/10.1245/s10434-025-18569-y","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative identification of high-volume central lymph node metastasis (hv-CLNM; defined as more than 5 central lymph node metastases) is critical for guiding surgical decisions-lobectomy or total thyroidectomy-in patients with papillary thyroid carcinoma (PTC) clinically diagnosed with central neck lymph node metastasis (cN1a). Total thyroidectomy is generally preferred for patients with hv-CLNM. In contrast, lobectomy may be sufficient for patients with low-volume metastasis (5 or fewer lymph node metastases). This study aimed to identify predictors of hv-CLNM in preoperatively low-risk cN1a and to develop a predictive model to estimate the risk of hv-CLNM, thereby optimizing surgical decision-making.</p><p><strong>Methods: </strong>A total of 707 patients with pathologically confirmed PTC and classified as preoperatively low-risk cN1a were retrospectively enrolled. Clinical and ultrasound features were collected. Variables were selected using least absolute shrinkage and selection operator regression, followed by multivariate logistic regression to construct a predictive model. Internal validation was performed. Recurrence-free survival was compared between lobectomy and total thyroidectomy groups using propensity score matching.</p><p><strong>Results: </strong>Hv-CLNM occurred in 13.4% (96/707) of patients. Independent predictors of hv-CLNM included age, sex, tumor size, tumor location, and lymph node calcification. The nomogram demonstrated good discrimination (area under the plasma concentration-time curve = 0.75) and calibration. After adjustment, recurrence-free survival did not significantly differ between surgical groups.</p><p><strong>Conclusions: </strong>This nomogram, based on readily available clinical and ultrasound features, effectively predicts the risk of hv-CLNM in preoperatively low-risk cN1a PTC. This tool may facilitate individualized surgical planning. Lobectomy appears to be a safe and appropriate option for most patients in this subgroup.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342852","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: Defining the Role of PIPAC in Ovarian Cancer - Results from a U.S. Phase 1 Clinical Trial.","authors":"Brad Nakamura, Tri A Dinh, Thanh H Dellinger","doi":"10.1245/s10434-025-18588-9","DOIUrl":"https://doi.org/10.1245/s10434-025-18588-9","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342897","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":"Artificial-Intelligence-based Surgical Phase Recognition in Robot-Assisted Radical Prostatectomy and Cross-Surgeon Validation.","authors":"Yuichiro Konnai, Keishiro Fukumoto, Masashi Takeuchi, Rei Takeuchi, Shinnosuke Fujiwara, Yota Yasumizu, Nobuyuki Tanaka, Toshikazu Takeda, Kazuhiro Matsumoto, Takeo Kosaka, Hirofumi Kawakubo, Yuko Kitagawa, Mototsugu Oya","doi":"10.1245/s10434-025-18590-1","DOIUrl":"https://doi.org/10.1245/s10434-025-18590-1","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has shown potential in various fields; however, its practical application in surgery remains limited. We developed an AI system capable of automatically recognizing surgical phases in robot-assisted radical prostatectomy (RARP) and confirmed its accuracy through cross-surgeon validation.</p><p><strong>Materials and methods: </strong>We analyzed clinical data from 102 patients who underwent RARP, including 81 consecutive patients operated on by one surgeon (surgeon A) and 21 operated on by five other surgeons (surgeons B-F). In total, 65 of the 81 patients were used for AI development, while the remaining 16, in addition to the 21 patients operated on by surgeons B-F, were used for AI validation. We classified surgical operations into nine phases. Well-trained surgeons annotated the time corresponding to each surgical phase for each video. We used Temporal Convolutional Networks for the Operating Room (TeCNO) to develop the AI model and evaluated its precision.</p><p><strong>Results: </strong>In AI development, 919,231 frames were utilized. Testing involved 216,357 frames from surgeon A and 249,553 frames from surgeons B-F. When the developed AI was used to analyze surgical videos from surgeon A, precision reached 0.94. In contrast, when the AI was applied to videos from surgeons B-F, precision was 0.83.</p><p><strong>Conclusions: </strong>The AI we developed not only showed high accuracy, but also demonstrated generalizability across different surgeons. By comprehensively evaluating surgical videos, our AI may be used to assess the quality of surgeries, thereby providing valuable feedback to surgeons and enhancing the effectiveness of surgical education.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342915","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}
Alice Boilève, Franck Audemar, Eric Dupont-Bierre, Samuel Le Sourd, Ayhan Ulusakarya, Marion Chauvenet, Asmahame Benmaziame, Mathilde Wagner, Diane Goere, Clarisse Dromain, Maximiliano Gelli, Veronica Pezzella, Baptiste Bonnet, Marie-Laure Tanguy, Valérie Boige
{"title":"Treatment Intensification with Hepatic Arterial Infusion Chemotherapy in Patients with Liver-Only Colorectal Metastases Still Unresectable After Systemic Induction Chemotherapy: Exploratory Findings From a Prematurely Closed Multicenter Randomized Phase II Study: SULTAN UCGI 30/PRODIGE 53 (NCT03164655).","authors":"Alice Boilève, Franck Audemar, Eric Dupont-Bierre, Samuel Le Sourd, Ayhan Ulusakarya, Marion Chauvenet, Asmahame Benmaziame, Mathilde Wagner, Diane Goere, Clarisse Dromain, Maximiliano Gelli, Veronica Pezzella, Baptiste Bonnet, Marie-Laure Tanguy, Valérie Boige","doi":"10.1245/s10434-025-18570-5","DOIUrl":"https://doi.org/10.1245/s10434-025-18570-5","url":null,"abstract":"<p><strong>Background: </strong>Hepatic arterial infusion (HAI) oxaliplatin represents a promising treatment option in patients with unresectable liver-only colorectal metastases (CRLM).</p><p><strong>Methods: </strong>In this randomized phase II study, we evaluated the efficacy of an intensification strategy based on HAI oxaliplatin combined with systemic chemotherapy (sys-CT) as a salvage treatment in patients with CRLM still unresectable after first-line induction sys-CT. The primary objective was conversion to resection/ablation (CTR). A real-life retrospective cohort of consecutive patients treated with HAI oxaliplatin + sys-CT in the same setting was also analyzed.</p><p><strong>Results: </strong>The study was stopped prematurely because of slow enrollment. Among 26 patients (13 men [50%]; median age 60 years) enrolled in 2018-2021, 11 were randomized in arm A (HAI + sys-CT, percutaneously placed catheters) and nine in arm B (sys-CT). CRLM were synchronous in 89% of patients, and 55% had RAS mutations. The CTR was 64% (7/11) in arm A and 22% (2/9) in arm B (odds ratio 0.16; 95% confidence interval 0.02-1.2; p = 0.09). Objective tumor response was 80% (8/10) in arm A and 11% (1/9) in arm B. Median overall survival was not reached in arm A versus 16.6 months in arm B (p = 0.008). Progression-free survival was significantly longer in arm A (12.6 vs. 4.37 months, p = 0.002). In the retrospective cohort of 35 patients, objective tumor response and CTR were 64% and 34%, respectively. Overall, HAI-related toxicity was manageable.</p><p><strong>Conclusions: </strong>Because the number of enrolled patients was lower than expected, our study could not confirm that salvage HAI combined with sys-CT improved CTR and survival outcomes compared with Sys-CT alone. However, these encouraging exploratory results warrant further prospective studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, (NCT03164655). Trial registration date: 11th May 2017. https://clinicaltrials.gov/ct2/show/NCT03164655.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336256","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}
Naita M Wirsik, Thomas Schmidt, Christiane J Bruns
{"title":"ASO Author Reflections: The Treatment Challenge of cT2cN0 Staged Adenocarcinoma of the Esophagus and the Gastroesophageal Junction.","authors":"Naita M Wirsik, Thomas Schmidt, Christiane J Bruns","doi":"10.1245/s10434-025-18520-1","DOIUrl":"https://doi.org/10.1245/s10434-025-18520-1","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336258","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":"Personalized Surgical Decision-Making Model for Clinical Stage IA Pure-Solid Non-small Cell Lung Cancer.","authors":"Haoji Yan, Takahiro Niimi, Takeshi Matsunaga, Mariko Fukui, Aritoshi Hattori, Kazuya Takamochi, Kenji Suzuki","doi":"10.1245/s10434-025-18610-0","DOIUrl":"https://doi.org/10.1245/s10434-025-18610-0","url":null,"abstract":"<p><strong>Background: </strong>Making an optimal surgical procedure decision (lobar or sublobar resections) remains challenging for some early-stage non-small cell lung cancer (NSCLC). This study aimed to evaluate the feasibility of developing a personalized model exclusively for surgical decision-making in early-stage NSCLC.</p><p><strong>Methods: </strong>Propensity score matching was performed to diminish the influence of the surgeon's surgical procedure decision. Clinical and radiomic covariates were modified by the surgical procedure to reflect the interaction between the surgical procedure and covariates. The least absolute shrinkage and selection operator, Cox regression, was used for model development. Patients were divided into positive-score and negative-score groups based on a predicted score threshold of 0.</p><p><strong>Results: </strong>After matching, 369 patients with clinical stage IA pure-solid NSCLC were included. Of the 248 modified covariates, 14 were selected, including four clinical and ten radiomic covariates. The surgical decision-making model generated a score for each patient (mean -0.43; standard deviation 0.97). In the positive-score group, sublobar resection was associated with significantly worse recurrence-free survival (RFS) than lobar resection (hazard ratio [HR], 4.15; 95% confidence interval [CI], 1.47, 11.7; P = 0.004). In contrast, sublobar resection was superior to lobar resection in terms of RFS (HR, 0.4; 95% CI, 0.22, 0.73; P = 0.002) for the negative-score group patients. For overall survival, lobar resection was favored in the positive-score group (P < 0.001), while sublobar resection was favored in the negative-score group (P < 0.04).</p><p><strong>Conclusions: </strong>The personalized surgical decision-making model potentially helps to decide the optimal surgical procedure for early-stage NSCLC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342884","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}
Gemma Bosch, Greta Donisi, Fernando Burdio, Patricia Sánchez-Velázquez, Alberto García-Picazo, Benedetto Ielpo
{"title":"Robotic-Assisted Anatomical Caudate Lobe Resection with Glissonean Pedicle Approach. A Step-by-Step Surgical Technique (with Video).","authors":"Gemma Bosch, Greta Donisi, Fernando Burdio, Patricia Sánchez-Velázquez, Alberto García-Picazo, Benedetto Ielpo","doi":"10.1245/s10434-025-18530-z","DOIUrl":"https://doi.org/10.1245/s10434-025-18530-z","url":null,"abstract":"<p><p>Minimally invasive surgery (MIS) has transformed hepatobiliary procedures, providing significant advantages over traditional open techniques. However, challenges remain, especially in major hepatectomies and posterior segment resections due to the inherent limitations of laparoscopy. The caudate lobe (segment I), located deep within the liver and adjacent to critical vascular structures, presents unique technical difficulties, making it one of the most challenging segments to access laparoscopically. Robot-assisted surgery has emerged as a promising alternative, offering enhanced precision and control, allowing for more precise suturing and ligation of retrohepatic vessels and bile ducts. While there are still hurdles related to liver mobilization and hemostasis, these can be effectively managed through careful preoperative planning and intraoperative techniques, such as three-dimensional (3D) reconstructions and counterstaining with indocyanine green, which improve the safety and efficacy of anatomical caudate lobe resections. Therefore, this study aims to explore the safety and feasibility of robot-assisted complete caudectomy, detailing the technical aspects step-by-step through a case video example of an anatomical resection for hepatocarcinoma with Glissonean pedicle access.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336301","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}