Annals of Surgical Oncology最新文献

{"title":"Association of the Number of Concurrent Metabolic Syndrome Risk Factors with Textbook Outcomes Following Liver Resection for Patients with Hepatocellular Carcinoma: A Multicenter Study.","authors":"Zhan-Cheng Qiu, Jun-Long Dai, Yu Zhang, Fei Xie, Yu Yu, Shu-Sheng Leng, Tian-Fu Wen, Chuan Li","doi":"10.1245/s10434-024-16343-0","DOIUrl":"10.1245/s10434-024-16343-0","url":null,"abstract":"<p><strong>Background: </strong>There is little information regarding the impact of the number of concurrent metabolic syndrome (MetS) risk factors on the textbook outcomes (TO) in patients with hepatocellular carcinoma (HCC) following liver resection.</p><p><strong>Patients and methods: </strong>Data from patients who underwent liver resection between 2015 and 2023 in a multicenter database were retrospectively reviewed (N = 3156). According to the guidelines, MetS risk factors include obesity, hypertension, diabetes, and dyslipidemia.</p><p><strong>Results: </strong>In this study, 2056 (65.1%) patients achieved TO. The incidence of TO was 63.1% in patients with ≥ 1 MetS risk factor, which was lower than that in patients without any MetS risk factors (67.5%, P = 0.011). As the number of MetS risk factors increased, the probability of not achieving TO gradually increased. The non-TO rates in patients with no, 1, 2, and ≥ 3 MetS risk factors were 32.5%, 35.9%, 37.6% and 40.2%, respectively (P_trend = 0.005). Multivariate logistic regression confirmed that the number of MetS risk factors (0 as a reference; 1, OR 1.220, 95% CI 1.029-1.447, P = 0.022; 2, OR 1.397, 95% CI 1.113-1.755, P = 0.004; ≥ 3, OR 1.647, 95% CI 1.197-2.264, P = 0.002) independently contributed to non-TO in patients with HCC after liver resection. Both the 5-year recurrence-free survival (TO: 50.7% versus non-TO: 43.9%, P < 0.001) and overall survival rates (TO: 71.0% versus non-TO: 58.7%, P < 0.001) of TO patients were significantly better than those of non-TO patients.</p><p><strong>Conclusions: </strong>Concurrent MetS risk factors can adversely impact TO achievement in patients with HCC after liver resection. The more risk factors patients have, the less likely they are to achieve TO.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"399-407"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379936","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":"Portal Vein Arterialization as a Lifesaving Strategy for Hepatic Artery Injury in Robotic Hepatectomy.","authors":"Yan Li, Anlan Zhang, Zhongchuan Tian, Jie Ma, Ming Li, Baoyong Zhou","doi":"10.1245/s10434-024-16342-1","DOIUrl":"10.1245/s10434-024-16342-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Robotic vascular resection and reconstruction is a challenging procedure. Portal vein arterialization (PVA) can offer an efficient solution in those cases in which the hepatic artery cannot be reconstructed.1.Can J Surg 64:e173-e182;2.The Paul Brousse Hospital Experience. HPB (Oxford) 16:723-738;3.J Am Coll Surg 207:e1-6; PVA increases oxygen supply to the remaining part of the liver, promotes liver regeneration, and prevents liver failure.Majlesara A, Golriz M, Ramouz A, et al. Portal vein arterialization as a salvage method in advanced hepatopancreatobiliary surgery. Br J Surg. 2024;111. In this multimedia article, we describe a patient who was treated with PVA for a robotic hepatic artery injury during robotic left-liver-first anterior radical modular orthotopic right hemihepatectomy (Rob-Larmorth).5.Ann Surg Oncol 31:5636-5637 METHODS: A 52-year-old male patient was admitted with epigastric pain. Further imaging showed intrahepatic cholangiocarcinoma involving the root of the right anterior branch of the portal vein. Following multidisciplinary consultation, surgical resection was recommended as the primary approach. The robotic technique was chosen in this operation, with preoperative anticipation of needing Rob-Larmorth. Unfortunately, the left hepatic artery sustained unintended damage during skeletonization of the duodenal ligaments. Anastomosis could not be performed due to severe damage to the distal end intima. We utilized PVA technology to anastomose the hepatic artery to the portal vein. Finally, Rob-Larmorth and PVA were successfully performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The surgery took 490 min and the estimated blood loss was approximately 300 mL. No blood transfusion was performed. Postoperatively, the patient recovered smoothly without liver failure, although percutaneous drainage was required due to bile leakage. Pathological examination revealed moderately to poorly differentiated bile duct cell carcinoma (T2N0M0, stage II). No recurrence was observed during the 12-month follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;PVA can be an effective solution when no other revascularization options are available. Implementing PVA as a bridging procedure increases oxygen delivery to the remnant liver, facilitating regeneration and reducing the risk of liver failure. The development of arterial collaterals is a significant concern for individuals undergoing PVA. Complications reported after PVA include early shunt thrombosis, portal hypertension, and a notable 90-day mortality rate.1.Can J Surg 64:e173-e182 However, Majlesara and colleagues found no evidence of postoperative liver damage associated with PVA. They also reported low morbidity rates and no associated mortality for both one- and two-stage embolization of the arterioportal shunt.Majlesara A, Golriz M, Ramouz A, et al. Portal vein arterialization as a salvage method in advanced hepatopancreatobiliary surgery. Br J Surg. 2024;111.&lt;/p&gt;&lt;p&gt;&lt;stron","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"424-425"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399212","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":"Exploring the Potential of Robotic Single-Port Surgery for Gallbladder Cancer: Initial Insights and Future Prospects.","authors":"Eun Jeong Jang, Kwan Woo Kim","doi":"10.1245/s10434-024-16252-2","DOIUrl":"10.1245/s10434-024-16252-2","url":null,"abstract":"<p><strong>Background: </strong>Robotic surgery has demonstrated outcomes comparable or superior to open and laparoscopic surgeries for extended cholecystectomy.^1-8 Despite its advantages, the minimally invasive robotic single-port (SP) system remains underutilized in complex hepatobiliary pancreatic surgery due to instrument limitations and retraction issues.^9,10 This study evaluated the feasibility, safety, and effectiveness of the da Vinci SP system in gallbladder cancer surgery. The study was approved by the Ethics Committee of OOO University Hospital (IRB no. DAUH IRB-24-081) and conducted in accordance with the principles of the Declaration of Helsinki. The requirement for informed consent was waived due to the study's retrospective design.</p><p><strong>Methods: </strong>A 62-year-old woman with a diagnosis of gallbladder cancer was referred for surgery. Preoperative computed tomography (CT) scans showed no evidence of metastasis (T2N0). Therefore, a robotic SP extended cholecystectomy was planned. Figure 1 shows a 30-mm SP port and a 1-mm assistant port inserted for the procedure. Due to the absence of an energy device for the liver wedge resection, Maryland bipolar forceps were used, mimicking the Kelly clamp crushing technique. A monopolar cautery hook was used for lymph node resection of stations 7, 8, 12, and 13 (Fig. 2). Fig. 1 Port placement for robotic extended cholecystectomy using the da Vinci Xi system Fig. 2 Demonstration of full lymph node dissection RESULTS: The total duration of the operation was 226 min, with an estimated blood loss of 200 ml. The CT scan on day 5 showed no abnormalities, and the patient was discharged routinely on day 7 (Fig. 3). The pathologic examination confirmed adenocarcinoma (T2a) with clear resection, and all six lymph nodes tested negative for malignancy. Fig. 3 The wound 2 weeks after surgery CONCLUSIONS: This study underscores the adequacy of robotic surgeries and emphasizes the potential of the da Vinci SP system in hepatobiliary surgery. Despite current challenges related to instrument limitations, the authors are confident that the SP system will evolve into a crucial asset for hepatobiliary surgical practices in the foreseeable future.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"440-442"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456745","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":"Neoadjuvant Treatment with Changes in Chemotherapy Regimens According to Carbohydrate Antigen 19-9 Level for Resectable/Borderline Resectable Pancreatic Ductal Adenocarcinoma.","authors":"Daisuke Hashimoto, Sohei Satoi, So Yamaki, Shinji Nakayama, Nobuhiro Shibata, Kazuki Matsumura, Hidetaka Miyazaki, Yuki Matsui, Denys Tsybulskyi, Nguyen Thanh Sang, Tsukasa Ikeura, Masashi Kanai, Mitsugu Sekimoto","doi":"10.1245/s10434-024-16361-y","DOIUrl":"10.1245/s10434-024-16361-y","url":null,"abstract":"<p><strong>Background: </strong>The response of carbohydrate antigen (CA) 19-9 to neoadjuvant therapy (NAT) for pancreatic ductal adenocarcinoma (PDAC) may contribute to outcomes. This study aimed to investigate the effect of changes in NAT regimens based on CA19-9 level.</p><p><strong>Methods: </strong>This single-center retrospective study included patients with resectable/borderline resectable (R/BR)-PDAC undergoing NAT from 2008 to 2022. A CA19-9 level lower than 150 IU/mL after NAT was the criterion for resection. If the level did not decrease, the chemotherapy regimen was changed to satisfy the criterion. The patient cohort was divided into group A (satisfied criterion without changing chemotherapy), group B (did not receive chemotherapy change, could not satisfy the criterion), group C (received chemotherapy change, satisfied the criterion), and group D (received chemotherapy change, could not satisfy the criterion).</p><p><strong>Results: </strong>The study cohort included 283 patients. After first-line chemotherapy, 112 (39.6%) patients did not satisfy the criterion (groups B [n = 64], C [n = 32], and D [n = 16]). Of the 283 patients, 48 (17%) received a chemotherapy change (groups C and D). The patients in groups C and D showed significantly better overall survival (OS, 35.9 months) than the group B patients (25.7 months) (P = 0.035). The OS of the group C patients (63.8 months) was similar to the OS of the group A patients (n = 171: 56.3 months; P = 0.430). Multivariate analysis of the patients in groups B, C, and D identified chemotherapy change as an independent prognostic factor for OS and progression-free survival.</p><p><strong>Conclusion: </strong>Changing the chemotherapy targeting the CA19-9 level can improve the outcome of R/BR-PDAC patients with poor biologic response to first-line NAT.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"517-528"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456751","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: Biological Contraindications to Surgery in Colorectal Liver Metastasis.","authors":"Kazunari Sasaki, Timothy M Pawlik, Georgios Antonios Margonis","doi":"10.1245/s10434-024-16412-4","DOIUrl":"10.1245/s10434-024-16412-4","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"450-451"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493598","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: Liver Metastasectomy for Gastric Adenocarcinoma.","authors":"Ioannis A Ziogas, Benedetto Mungo","doi":"10.1245/s10434-024-16378-3","DOIUrl":"10.1245/s10434-024-16378-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"446-447"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520783","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":"Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer: The Largest Systematic Reviews of 68,755 Patients and Meta-analysis.","authors":"Rui Du, Yue Wan, Yulong Shang, Guofang Lu","doi":"10.1245/s10434-024-16371-w","DOIUrl":"10.1245/s10434-024-16371-w","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis aimed to compare the efficacy of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) in treating gastric cancer (GC).</p><p><strong>Patients and methods: </strong>A comprehensive literature search across PubMed, MEDLINE, and Web of Science identified 86 eligible studies, including 68,755 patients (20,894 in the RG group and 47,861 in the LG group).</p><p><strong>Results: </strong>The analysis revealed that RG was associated with superior outcomes in several areas: more lymph nodes were harvested, intraoperative blood loss was reduced, postoperative hospital stays were shorter, and the time to first flatus and oral intake was shortened (all p < 0.001). Additionally, RG resulted in lower incidences of conversion to open surgery (OR = 0.62, p = 0.004), reoperation (OR = 0.68, p = 0.010), overall postoperative complications (OR = 0.82, p < 0.001), severe complications (OR = 0.65, p < 0.001), and pancreatic complications (OR = 0.60, p = 0.004). However, RG had longer operative times and higher costs (both p < 0.001). No significant differences were found between RG and LG in terms of resection margin distance, mortality, anastomotic leakage, or recurrence rates.</p><p><strong>Conclusions: </strong>RG is a safe and effective surgical option for patients of GC, but further improvements in operative duration and costs are needed.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"351-373"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456760","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: Advancing Gastric Cancer Treatment Through HIPEC-Current Insights and Future Directions.","authors":"Ying Chen, Yang Zhou, Huaping Xiong, Zhen Wei, Dong Zhang, Shoushan Li","doi":"10.1245/s10434-024-16372-9","DOIUrl":"10.1245/s10434-024-16372-9","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"252-253"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520781","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: Can Conversion Therapy be an Option for Advanced Esophageal Cancer with Distant Metastases?","authors":"Takayuki Tsuji, Satoru Matsuda, Yuta Sato, Koji Tanaka, Ken Sasaki, Masaya Watanabe, Yoichi Hamai, Motomi Nasu, Zenichiro Saze, Yuichiro Nakashima, Motoo Nomura, Shun Yamamoto, Eisuke Booka, Koshiro Ishiyama, Takeo Bamba, Katsuyuki Sakanaka, Takahiro Tsushima, Hiroya Takeuchi, Ken Kato, Hirofumi Kawakubo","doi":"10.1245/s10434-024-16310-9","DOIUrl":"10.1245/s10434-024-16310-9","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"325-326"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360871","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 Role of Metastasectomy in Patients with Liver-Only Metastases from Gastric Adenocarcinoma.","authors":"Ioannis A Ziogas, Otto N Thielen, Sumaya Abdul Ghaffar, Elliott J Yee, Andrii Khomiak, Jakob A Durden, Sunnie Kim, Richard D Schulick, Ana L Gleisner, Martin D McCarter, Benedetto Mungo","doi":"10.1245/s10434-024-16318-1","DOIUrl":"10.1245/s10434-024-16318-1","url":null,"abstract":"<p><strong>Background: </strong>The role of metastasectomy in patients with liver-only metastases from gastric adenocarcinoma remains under investigation. Therefore, we performed a national registry analysis comparing surgical treatment options for patients with gastric adenocarcinoma and liver-only metastases.</p><p><strong>Patients and methods: </strong>In this retrospective National Cancer Database (2010-2019) study, adults (≥ 18 years) with gastric adenocarcinoma and liver-only metastases (no brain, bone, or lung metastases) were included. Patients were stratified into four groups: no surgical treatment, primary tumor resection (PTR), liver metastasectomy, and PTR with liver metastasectomy. Survival was evaluated using the Kaplan-Meier method, log-rank test, and Cox regression.</p><p><strong>Results: </strong>Of 10,977 included patients, 93.6% underwent no surgical treatment, 4.6% PTR alone, 0.8% liver metastasectomy alone, and 1.0% both PTR and liver metastasectomy. The median OS after no surgical treatment was 6.5 months, after PTR alone 10.9 months, after liver metastasectomy alone 9.9 months, and after PTR and liver metastasectomy 18.6 months. In multivariable analysis, when adjusting for age, sex, race/ethnicity, insurance status, Charlson-Deyo score, chemotherapy, and radiation, PTR and liver metastasectomy was associated with superior OS compared with no surgical treatment (HR 2.17, 95% CI 1.76-2.69, p < 0.001), PTR alone (HR 1.42, 95% CI 1.12-1.79, p = 0.003), and liver metastasectomy alone (HR 1.96, 95% CI 1.45-2.64, p < 0.001).</p><p><strong>Conclusions: </strong>These data suggest that, in highly selected patients with gastric adenocarcinoma and synchronous liver-only metastases and favorable biology, surgical resection might grant a survival advantage.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"391-398"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340053","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}