Annals of Surgical Oncology最新文献

{"title":"Real-World Evidence of Porto-Mesenteric Vein Resections with Pancreatectomy and the Development of Predictive Clinical Nomograms for Postoperative Outcomes-An Analysis of 389 Cases: The \"Porto-Mesenteric Vein Resection-Indian MulticentrE\" (PRIME) Study.","authors":"Deeksha Kapoor, Manish S Bhandare, Agam Sharma, Raja Kalayarasan, Monish Karunakaran, Sree Kumar Balasubramanian, Aishwarya Pal, Nagaraj Palankar, D S Darshanik, Subhash Soni, Sreenivas Reddy Biravely, ArunKumar Namachivayam, Rajneesh Kumar Singh, Vaibhav Varshney, Adarsh Chaudhary, Sadiq Sikora, Rajesh Gupta, Sanjay Govil, Pradeep Rebala, Biju Pottakkat, Hariharan Ramesh, Vikram A Chaudhari, Shailesh V Shrikhande","doi":"10.1245/s10434-025-17702-1","DOIUrl":"10.1245/s10434-025-17702-1","url":null,"abstract":"<p><strong>Background: </strong>With better surgery and chemotherapeutic agents, borderline resectable or locally advanced pancreatobiliary tumours are being treated with curative intent. This study presents real-world evidence of porto-mesenteric vein resections (PVR) with pancreatectomy and generates predictive nomograms for postoperative mortality (POM) and major complications (MC).</p><p><strong>Methods: </strong>A retrospective multicentre study, including 11 high-volume centres, evaluated patients undergoing PVR. Factors affecting 90-day POM and MC (Clavien-Dindo grades ≥ 3a) were assessed, and predictive nomograms were generated. Overall survival (OS) and disease-free survival (DFS) were estimated for patients with pancreatic ductal adenocarcinoma (PDAC). Cox regression analysis was performed to ascertain factors affecting OS and DFS.</p><p><strong>Results: </strong>Among 389 patients, POM was 6.4%, and MCs were 32.6%. Charlson comorbidity index > 4, preoperative biliary drainage, preoperative radiotherapy (PRT), segmental PVR, and additional organ resection (AOR) were predictive of POM. The independent predictors of MCs were American Society of Anesthesiologists status 3/4, PRT, and AOR. The generated model had an area under the curve (AUC) of 0.757, cutoff > 1.79 to predict POM, and AUC of 0.669, cutoff > 0.678 for MCs. In the 263 patients with PDAC, the median OS was 25.01 months (95% confidence interval [CI] 21.9-28.11), and DFS was 16.72 months (95% CI 14.56-18.89). Perineural invasion, segmental PVR, and margin positivity predicted worse survival, while completing multi-modality treatment was protective.</p><p><strong>Conclusions: </strong>The POM and MCs of PVR with pancreatectomy were at par with the world standards. The generated predictive nomograms for POM and MC revealed a good predictive potential. In patients with PDAC, completion of multimodality treatment offers better long-term survival.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7410-7421"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144566942","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: Vascular Resection in Perihilar Cholangiocarcinoma Surgery.","authors":"Edoardo Poletto, Pim B Olthof, Andrea Ruzzenente, Bas Groot Koerkamp","doi":"10.1245/s10434-025-18455-7","DOIUrl":"https://doi.org/10.1245/s10434-025-18455-7","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197787","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":"Correction: Robotic Right Anterior Sectionectomy with Extraglissonean Approach for HCC.","authors":"Simone Conci, Giuseppe Calderone, Edoardo Poletto, Andrea Ruzzenente","doi":"10.1245/s10434-025-18500-5","DOIUrl":"https://doi.org/10.1245/s10434-025-18500-5","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205458","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 Relevance of High-Grade Pancreatic Intraepithelial Neoplasia at the Pancreatic Transection Margin in Patients with Pancreatic Ductal Adenocarcinoma.","authors":"Kei Kobayashi, Yu Sawada, Kota Sahara, Yutaro Kikuchi, Kentaro Miyake, Yasuhiro Yabushita, Yuki Homma, Takafumi Kumamoto, Ryusei Matsuyama, Itaru Endo","doi":"10.1245/s10434-025-17400-y","DOIUrl":"10.1245/s10434-025-17400-y","url":null,"abstract":"<p><strong>Background: </strong>The clinical relevance of high-grade pancreatic intraepithelial neoplasia (PanIN) at the pancreatic transection margin (PTM) during resection of pancreatic ductal adenocarcinoma (PDAC) remains unclear.</p><p><strong>Patients and methods: </strong>A total of 358 patients who underwent R0 resection for PDAC between January 2010 and December 2022 were included. The permanent sections used for the intraoperative frozen section diagnosis of PTM were evaluated for the PanIN grade.</p><p><strong>Results: </strong>Among 358 patients, 35 patients had low-grade PanIN (9.8%), and 17 had high-grade PanIN (4.7%) at the PTM. The 2-year overall survival (OS), disease-free survival (DSS), and relapse-free survival (RFS) did not differ markedly among patients with normal epithelium, low-grade PanIN, or high-grade PanIN at the margin. As the clinical features differed between patients with high-grade PanIN at the PTM and those without, we adjusted the patients' background factors using propensity score matching. The 2-year OS, DSS, and RFS rates were not significantly different between the groups. In addition, we investigated the details of 17 cases of high-grade PanIN in the PTM. The analysis revealed that 11 patients experienced recurrence after surgery. Among them, two cases of T1N0 showed recurrence in the remnant pancreas more than 2 years after surgery, while nine cases exhibited recurrence outside the remnant pancreas, such as the liver and lungs, within 2 years.</p><p><strong>Conclusions: </strong>Patients with high-grade PanIN at the PTM did not show a significantly different prognosis than those without; however, recurrence in the remnant pancreas was observed in long-term survivors. Therefore, rigorous long-term follow-up is essential for such patients.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7372-7381"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974425","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":"Comment on \"Comparative Outcomes of Ileocolon Graft Versus Gastric Conduit Reconstruction in Esophageal Cancer: A Propensity-Matched Analysis of Survival, Quality of Life, and Perioperative Risks\".","authors":"Wajid Memon, Saraswati Sah, Renu Sah","doi":"10.1245/s10434-025-17770-3","DOIUrl":"10.1245/s10434-025-17770-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7952-7953"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526184","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 of Annals of Surgical Oncology Concerning \"Dissecting Tumor Size Underestimation in Pancreatic Cancer: A Comparative Analysis of Preoperative Treatments\".","authors":"Heyue Zhang, Jin Xu, Yinping Jiang, Xudong Zhu, Hailin Tang","doi":"10.1245/s10434-025-17743-6","DOIUrl":"10.1245/s10434-025-17743-6","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7485-7486"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526187","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":"Right Kidney Preservation During Resection of the Infrarenal Inferior Vena Cava for Paragangliomas.","authors":"Pietro Addeo, Raphael Moog, Chloe Paul, Alessio Imperiale, Philippe Baltzinger, Pierre de Mathelin","doi":"10.1245/s10434-025-17639-5","DOIUrl":"10.1245/s10434-025-17639-5","url":null,"abstract":"<p><strong>Background: </strong>In the case of tumors involving the infrarenal inferior vena cava (IVC), reimplantation of both renal veins is recommended to preserve renal function. The left renal vein can be ligated because of the collateral circulation through the gonadal and/or lumbar veins. On the contrary, right nephrectomy or reconstruction of the right renal vein (when not invaded) is mostly performed because the right kidney has no collateral vein circulation ^1,2.</p><p><strong>Patients and methods: </strong>The patient had a paracaval paraganglioma infiltrating the infrarenal IVC. The confluence of both renal veins was infiltrated, and incomplete surgery had been performed previously. Preoperative imaging showed that the right renal vein was free from tumoral infiltration at the renal hilum. Surgery was performed via a midline incision. To avoid venous congestion a temporary venous shunt between the right renal vein and the portal vein was used². The IVC was resected en-bloc with the both renal veins and reconstructed by a 10 cm long, 20 mm diameter, ringed Goretex® tube. The right renal vein was reimplanted directly over the IVC tube. The left renal vein was anastomosed on the IVC tube by interposing a 5 cm long, 10 mm diameter, ringed Goretex® tube.</p><p><strong>Results: </strong>The postoperative course was uneventful. Long-term imaging showed permeability of the IVC and right renal vein reconstruction, but obstruction of the conduit used to replace the left renal vein, which was drained via the left gonadal vein. No tumoral recurrence was detected.</p><p><strong>Conclusions: </strong>Resection of the infrarenal IVC with preservation of both renal veins can be feasible in selected cases. To avoid venous congestion, a temporary venous shunt between the right renal vein and the portal vein can be useful.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7832-7833"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282269","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":"Overcoming the Challenges of Uncinate Process Oncologic Management: The Left-Side Approach in Minimally Invasive Pancreatoduodenectomy: Step-by-Step Technique and Video.","authors":"Alessia Fassari, Vito De Blasi, Alexandru Amariutei, Edoardo Rosso","doi":"10.1245/s10434-025-17704-z","DOIUrl":"10.1245/s10434-025-17704-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The uncinate process (UP) represents one of the greatest challenges in laparoscopic pancreatoduodenectomy (LPD) due to its deep anatomic location and proximity to major vascular structures. Ensuring complete resection of the UP and mesopancreas is crucial for achieving negative surgical margins and adequate lymphadenectomy with tumors of this region. The standard approach from the right-side of the superior mesenteric artery (SMA) often requires significant tension on mesenteric vessels, increasing the risk of vascular injury. This video describes a step-by-step, left-side approach to UP that minimizes these risks and enhances surgical safety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 79-year-old woman underwent LPD for an intraductal papillary mucinous neoplasm (IPMN) of the pancreatic head. Preoperative imaging showed three key anatomic variants that significantly impacted surgical planning. The first variant was a lateral deviation of the abdominal aorta, altering usual retroperitoneal landmarks. The second variant was an aberrant right hepatic artery arising from the SMA, running behind the pancreas and requiring careful preservation during uncinate dissection. The third variant was a rare inferior pancreaticoduodenal artery originating from the posterior aspect of the SMA, posing a challenge during retroperitoneal dissection. The left-side approach begins with an incision of the left duodenomesocolic fold and longitudinal opening of the retroperitoneum. The pancreatic head and duodenum are mobilized from the anterior face of the inferior vena cava. By shifting the lower pancreatic head and third portion of the duodenum leftward, the SMA and superior mesenteric vein (SMV) are exposed. The SMV is fully skeletonized. The first jejunal loop is sectioned at the Treitz ligament, allowing a clear vision of the UP, which is dissected from the SMA with minimal traction on the mesenteric vessels. The SMA then is skeletonized in a left-to-dorsal direction. The small bowel is finally transposed to the right, and the UP is mobilized by careful division of its remaining attachments to the mesenteric vessels. Resection concludes with division of the retro-portal lamina along the SMA's right border.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In this case, the operative time was 300 min, with an estimated blood loss of 200 ml, an uneventful recovery, and discharge on postoperative day 14. Histology confirmed IPMN without involvement of the lymph nodes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although this video illustrates a case of IPMN that typically requires less extensive lymphadenectomy, the principles demonstrated remain relevant and translatable to more aggressive pathologies. By reducing vascular tension and improving surgical visibility, the left-side approach minimizes complications and ensures complete retroportal lamina resection, achieving the best oncologic results even in challenging cases. A key advantage is the early identification ","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7450-7451"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339790","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":"Activated Hippo Pathway is Associated with a Worse Response to Trastuzumab and Worse Survival in HER2-Positive Breast Cancer.","authors":"Masanori Oshi, Farhad Ghasemi, Akimitsu Yamada, Li Yan, Jianmin Zhang, Scott I Abrams, Itaru Endo, Kazuaki Takabe","doi":"10.1245/s10434-025-17657-3","DOIUrl":"10.1245/s10434-025-17657-3","url":null,"abstract":"<p><strong>Background: </strong>The Hippo signaling pathway is an evolutionarily conserved network that regulates cell proliferation, apoptosis, and stemness. It also plays an important role in tumorigenesis and cancer progression, and previous studies have indicated that Hippo signaling promotes trastuzumab resistance in breast cancer (BC). However, its clinical relevance in patients with BC remains unclear.</p><p><strong>Patients and methods: </strong>Clinical and transcriptomics data from two large cohorts, METABRIC and TCGA, were analyzed. A Hippo pathway score was calculated by applying Gene Set Variation Analysis to the curated Kyoto Encyclopedia of Genes and Genomes (KEGG) Hippo pathway gene set (43 genes). Patients were stratified into high and low groups based on the top tertile of Hippo pathway scores in each cohort.</p><p><strong>Results: </strong>High Hippo pathway scores were significantly associated with worse disease-specific survival (DSS) in HER2-positive BC. In both cohorts, the Hippo pathway score showed the largest hazard ratio (HR) for DSS in HER2-positive BC compared with YAP1 or TAZ, transcription co-activators that are key components in the Hippo pathway (HR = 2.47, p = 0.04, and HR = 41.8, p = 0.03). Breast cancers with high Hippo pathway activity were associated with enrichment of cell proliferation and metastasis-related gene sets, including epithelial-mesenchymal transition, Notch, Hedgehog, and TGF-β signaling. Moreover, high Hippo pathway scores correlated with lower infiltration of anti-cancer immune cells (Th1 cells, dendritic cells, and M1-macrophages). Notably, low Hippo pathway scores were linked to a higher pathological complete response following trastuzumab-based neoadjuvant chemotherapy (p = 0.035).</p><p><strong>Conclusions: </strong>Enhanced Hippo pathway activity in HER2-positive BC is associated with worse prognoses, metastasis-related gene enrichment, and reduced anti-cancer immune cell infiltration, potentially contributing to trastuzumab resistance.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7959-7969"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339785","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":"Expression of Signal Regulatory Protein Alpha in Tumor Cells is the Key Factor in Intrahepatic Cholangiocarcinoma.","authors":"Katsuya Toshida, Shinji Itoh, Yuki Nakayama, Kyohei Yugawa, Takuma Ishikawa, Yuriko Tsutsui, Takahiro Tomiyama, Norifumi Iseda, Sunao Fujiyoshi, Takashi Motomura, Takeo Toshima, Takeshi Iwasaki, Yoshinao Oda, Tomoharu Yoshizumi","doi":"10.1245/s10434-025-17813-9","DOIUrl":"10.1245/s10434-025-17813-9","url":null,"abstract":"<p><strong>Background: </strong>Signal-regulatory protein alpha (SIRPα) has recently garnered attention for its role in the immune system, commonly referred to as the \"don't eat me\" signal. However, the relationship between SIRPα expression in tumor cells and prognosis in patients undergoing hepatectomy for intrahepatic cholangiocarcinoma (ICC) has been scarcely reported.</p><p><strong>Patients and methods: </strong>A total of 117 patients who underwent hepatectomy for ICC were enrolled in this study. Immunohistochemical staining was performed to evaluate SIRPα, programmed cell death-ligand 1 (PD-L1), and cluster of differentiation 8 (CD8). The relationships between SIRPα expression, clinicopathological characteristics, and patient outcomes were analyzed.</p><p><strong>Results: </strong>The macrophage-SIRPα-positive group exhibited a higher rate of lymph node metastasis (p = 0.0013). The tumor-cell-SIRPα-positive group showed lower carcinoembryonic antigen levels (p = 0.0068) and fewer cases of the perihilar type (p = 0.0165). In multivariate analysis, SIRPα positivity in tumor cells was identified as an independent prognostic factor for both disease-free survival (p = 0.0198) and overall survival (p = 0.0089). Notably, SIRPα positivity in tumor cells showed no significant correlation with PD-L1 expression or CD8-positive tumor-infiltrating T cells in ICC.</p><p><strong>Conclusions: </strong>Our findings demonstrate that SIRPα expression in tumor cells is more critical than its expression in macrophages for predicting the prognosis of patients with ICC following hepatic resection.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"8037-8045"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616040","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}