Annals of Surgical Oncology最新文献

{"title":"β-Blockers Influence Oncological Outcomes in Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Based on the Pathological Subtype: A Retrospective Cohort Study.","authors":"Nerma Crnovrsanin, Sarah Zumsande, Ingmar Florin Rompen, Sabine Schiefer, Sarah Zimmer, Wenjun Hu, Johanna Arnscheidt, Fritz Brinkmann, Thomas Longerich, Georg Martin Haag, Thomas Schmidt, Mohammed Al-Saeedi, Leila Sisic, Henrik Nienhüser","doi":"10.1245/s10434-025-17233-9","DOIUrl":"10.1245/s10434-025-17233-9","url":null,"abstract":"<p><strong>Introduction: </strong>Preclinical studies suggest that β-blockers (BBs), traditionally used for cardiovascular diseases, may improve cancer outcomes. This study assessed the effect of BB intake on oncological outcomes and response to chemotherapy in gastric cancer (GC) patients and the influence of ß2-adrenergic receptor (ADRB2) expression on local tumor innervation.</p><p><strong>Methods: </strong>We retrospectively analyzed the BB intake of 361 patients who underwent surgery with curative intent for GC after neoadjuvant chemotherapy at the University Hospital of Heidelberg. Resection specimens were analyzed and immunohistochemical stainings were performed to evaluate ADRB2 expression and neuronal markers (protein gene product 9 [PGP.9]). Survival rates were estimated using Kaplan-Meier curves, and multivariable Cox regression analysis was performed to control for confounding variables.</p><p><strong>Results: </strong>In patients with diffuse GC (DGC), BB users demonstrated improved overall survival (OS) and significantly improved recurrence-free survival (RFS) compared with non-users (median OS: not reached vs. 34 months [p = 0.072]; median RFS: not reached vs. 16 months [p = 0.031]). BB intake emerged as an independent prognostic factor in multivariable analysis for this subgroup (OS: hazard ratio [HR] 0.36, 95% confidence interval [CI] 0.17-0.76; RFS: HR 0.41, 95% CI 0.20-0.87). In contrast, BB use was associated with worse OS in intestinal subtype GC (median OS: 30 months vs. not reached; p = 0.044), an effect that diminished after adjusting for cardiovascular risk profiles. Higher ADRB2 expression was associated with less lymph node involvement in the DGC subtype (p = 0.030).</p><p><strong>Conclusion: </strong>This study suggests a differential impact of BB use on GC subtypes and underscores the importance of considering cancer subtypes and patient comorbidities when evaluating the potential benefits of BBs in cancer therapy.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5142-5153"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708159","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":"Positive Margin Rates After Breast-Conserving Surgery by Histologic Subtype: A Systematic Review and Meta-analysis Evaluating the Impact of Oncoplastic Surgery.","authors":"Kayla M Switalla, Israel O Falade, Astrid Quirarte, Molly Baxter, Mandeep Kaur, Rita A Sakr, Giovanni Corso, Rita A Mukhtar","doi":"10.1245/s10434-025-17329-2","DOIUrl":"10.1245/s10434-025-17329-2","url":null,"abstract":"<p><strong>Background: </strong>Invasive lobular carcinoma (ILC), the second most common histologic subtype of breast cancer, has a higher risk of positive surgical margins than invasive ductal carcinoma (IDC). Whether this risk persists for patients undergoing breast-conserving surgery (BCS) with oncoplastic approaches remains unclear. We conducted a systematic review and meta-analysis to assess positive margins following oncoplastic BCS by histologic subtype and evaluate the impact of oncoplastic surgery on positive margins in ILC.</p><p><strong>Methods: </strong>We systematically searched the literature for articles reporting positive margin rates after oncoplastic BCS in ILC patients. Relative risks (RR) were log transformed and displayed with forest plots.</p><p><strong>Results: </strong>Eight studies, encompassing 754 ILC patients undergoing BCS (338 with oncoplastic surgery), were included. The pooled positive margin rate for ILC patients undergoing oncoplastic surgery was 31% (95% confidence interval [CI] 21-40%). Patients with ILC had a significantly higher RR for positive margins after oncoplastic BCS compared with IDC (RR 3.4, 95% CI 1.5-7.4). However, for ILC patients with larger tumors, oncoplastic BCS was associated with a significantly lower RR for positive margins compared with standard BCS (RR 0.5, 95% CI 0.3-0.9).</p><p><strong>Conclusions: </strong>Invasive lobular carcinoma patients undergoing oncoplastic BCS have higher positive margin risks than IDC patients, underscoring the need for improved preoperative imaging and systemic therapies. However, the addition of oncoplastic surgery to BCS reduces positive margin rates compared with standard BCS in ILC patients, particularly for larger tumors. These findings highlight the role of oncoplastic surgery as an important technique to optimize outcomes for those at high risk of positive margins.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4899-4909"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959685","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: Sentinel Lymph Node Biopsy Performance Rates in Cutaneous Melanoma.","authors":"Lindy Davis, Amelia Stapleton Van Doren","doi":"10.1245/s10434-025-17094-2","DOIUrl":"10.1245/s10434-025-17094-2","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5315-5316"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143530939","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":"Patients with Upper Third of Esophageal Squamous Cell Carcinoma Have Better Tumor Regression After Neoadjuvant Immunochemotherapy.","authors":"Yan He, Jun Yu, Tao Bao, Xian-Dong He, Xian-Feng Xie, Xu Chen, Xiang-Shu Pu, Kun-Kun Li, Chang-Feng Li, Ming-Fang Xu, Yu Pu, Yu-Zhu Jiang, Ying-Jian Wang, Wei Guo","doi":"10.1245/s10434-025-17175-2","DOIUrl":"10.1245/s10434-025-17175-2","url":null,"abstract":"<p><strong>Background: </strong>Several high-quality clinical trials have shown promising results compared with neoadjuvant chemotherapy (NCT) or chemoradiotherapy, further supporting the efficacy of neoadjuvant immunochemotherapy (NICT) for locally advanced esophageal cancer (AEC). This study evaluated the efficacy of NICT in different segments of esophageal squamous cell carcinoma (ESCC) and aimed to identify potential prognostic factors.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed 248 patients. Before undergoing radical surgery, the patients received two to four cycles of NICT. The relationship between different segments of ESCC and both clinical and pathologic characteristics were evaluated.</p><p><strong>Results: </strong>The patients with tumors in the upper thoracic esophagus had a higher proportion of lower tumor regression grade (TRG) scores. A significantly higher proportion of patients with TRG 0-1 was observed in the upper and middle thoracic tumor groups than in the lower thoracic group (P = 0.001). In esophageal cancer, TRG 2-3 was significantly associated with lower thoracic tumor location (odds ratio [OR], 3.298; P = 0.003), clinical T3 stage (OR, 2.834; P < 0.001), and clinical N2 stage (OR, 2.557; P = 0.045).</p><p><strong>Conclusions: </strong>The patients with upper-third ESCC appeared to derive greater clinical benefits from NICT than those with tumors located in the lower third of the esophagus in this post hoc analysis. This could potentially serve as a predictor of NICT efficacy.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4670-4680"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717774","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":"Circulating Tumor DNA in High-Risk Stage II/III Cutaneous Melanoma: A Feasibility Study.","authors":"Kristen E Rhodin, Margaret H O'Connor, Aaron Therien, Shayna Hollander, Viviana Geron, Uma Nair, Emily Rakestraw, April K Salama, Riddhishkumar Shah, Douglas S Tyler, Georgia M Beasley","doi":"10.1245/s10434-025-17194-z","DOIUrl":"10.1245/s10434-025-17194-z","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant therapies reduce recurrence in patients with clinical stage IIB/IIC/III melanoma; however, better risk stratification and patient selection are needed. Circulating tumor DNA (ctDNA) as a marker of micrometastatic residual disease is being explored for such purposes in other malignancies. We aimed to explore the feasibility of serial ctDNA monitoring in patients with stage II/III melanoma, as well as the association of ctDNA elevation with disease burden and outcomes.</p><p><strong>Methods: </strong>A single-institution prospective study was conducted on patients with clinical stage IIB/IIC/III melanoma. Primary tumor was sent to Natera for generation of a tumor-informed mPCR-NGS assay (Signatera™). Peripheral blood was collected for analysis at pre-specified timepoints. Patients were stratified by ctDNA elevations both pre- and postoperatively to compare tumor characteristics and recurrence-free survival (RFS).</p><p><strong>Results: </strong>Overall, 30 patients were enrolled. The median Breslow depth was 4.4 mm and 70% were ulcerated. Signatera™ assays were successfully created for all 30 patients. Median follow-up from the time of surgery was 16 months and 13 patients recurred with median RFS of 19 months. Eight of these 13 patients (62%) had detectable ctDNA levels predating their clinical or radiographic recurrence. Elevated ctDNA at the first post-operative timepoint was associated with worse RFS.</p><p><strong>Conclusions: </strong>ctDNA monitoring is feasible for patients with high-risk cutaneous melanoma. Our findings suggest that detectable ctDNA post-operatively may be associated with worse outcomes. Elevations during surveillance may predict subsequent clinical recurrence; however, the role of ctDNA in adjuvant therapy decision-making and surveillance is not yet ready for broad application.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5292-5299"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727058","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":"Modified Technique in Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA).","authors":"Duy Quoc Ngo, Duong The Le, Quy Xuan Ngo, Quang Van Le","doi":"10.1245/s10434-025-17429-z","DOIUrl":"10.1245/s10434-025-17429-z","url":null,"abstract":"<p><strong>Background: </strong>Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is becoming increasingly popular in thyroid surgery.^1-4 following its introduction at Vietnam National Cancer Hospital in 2018,^5,6 we developed modifications to optimize surgical efficiency and patient outcomes.</p><p><strong>Patients and methods: </strong>We present the case of a 23-year-old female with right thyroid lobe carcinoma (cT1N0M0). A modified TOETVA technique was employed for right lobectomy. Key modifications included: (1) direct working space creation without epinephrine-saline solution injection or Angkoon's retractor and (2) strategic repositioning of the 5-mm trocar and minimized vestibular trauma during 10-mm trocar placement to reduce mental nerve injury risk.</p><p><strong>Results: </strong>The operative duration for right lobectomy was 55 min. The postoperative course was uneventful, with no cervical edema, minimal pain, and preserved cervical mobility on day one. No complications (vocal cord dysfunction, hypoparathyroidism, hemorrhage, or seroma) were observed. The patient was discharged on postoperative day 2.</p><p><strong>Conclusions: </strong>Our technical modifications demonstrated reduced operative time, diminished postoperative discomfort, and decreased temporary mental nerve injury incidence. The simplified approach using standard laparoscopic instrumentation has enhanced the procedure's accessibility across global healthcare facilities.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4804"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952561","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":"Risk Classification of Oral Cancer Surgical Margins: Margin to Depth of Invasion Ratio Analysis.","authors":"Chun-Yang Hung, Li-Jen Liao, Yu-Ping Cheng, Wan-Lun Hsu, Chun-Ju Chiang, Chun-Wei Chang, Wen-Chung Lee, Cheng-Ping Wang, Pei-Jen Lou, Yih-Leong Chang, Tseng-Cheng Chen","doi":"10.1245/s10434-025-17286-w","DOIUrl":"10.1245/s10434-025-17286-w","url":null,"abstract":"<p><strong>Background: </strong>A high-risk margin is a recurrence risk factor in oral squamous cell carcinoma (OSCC), but its exact definition is debated. The effectiveness of the margin-to-depth-of-invasion ratio (MDR) in identifying high-risk margin remains to be determined.</p><p><strong>Methods: </strong>Patients who had a diagnosis of pT1-4N0 OSCC with negative margins (margin > 1 mm) recorded in the Taiwan Cancer Registry between January 2018 and December 2021 were reviewed. All patients were categorized into two groups: MDR < 0.5 and MDR ≥ 0.5.</p><p><strong>Results: </strong>The study analyzed 7420 OSCC patients without a positive margin. Of these 7420 patients, 4669 (62.92%) had an MDR ≥ 0.5, and 2751 (37.08%) had an MDR < 0.5. The group with an MDR < 0.5 exhibited significantly poorer 3-year disease-free survival (DFS, 74% vs 86%) and overall survival (OS, 79% vs 89%) than the group with an MDR ≥ 0.5. Despite a higher rate of postoperative radiotherapy (PORT) in the group with an MDR < 0.5, multivariate Cox analysis showed that patients with a margin < 5 mm and an MDR ≥ 0.5 had a significantly better DFS than those with a margin < 5 mm and an MDR < 0.5 (p = 0.001). Treatment with PORT improved DFS and OS for the patients with an MDR < 0.5, but worsened outcomes for the patients with an MDR ≥ 0.5.</p><p><strong>Conclusion: </strong>For OSCC patients without positive margin, an MDR < 0.5 was associated with worse survival and higher locoregional recurrence risk. The patients with an MDR < 0.5 may benefit from PORT, whereas those with an MDR ≥ 0.5 could experience worse outcomes. An MDR < 0.5 could serve as a criterion for high-risk OSCC margin.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5230-5242"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967807","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":"Great Debate: Does Breast-Conserving Surgery with Radiotherapy Offer Better Survival than Mastectomy in Early-Stage Breast Cancer?","authors":"Sasha R Douglas, Julie A Margenthaler, Kandace P McGuire, E Shelley Hwang","doi":"10.1245/s10434-025-17333-6","DOIUrl":"10.1245/s10434-025-17333-6","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4590-4596"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969370","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":"Recurrence-Free Survival as a Surrogate for Overall Survival Among Patients with Intrahepatic Cholangiocarcinoma Following Upfront Surgery: An International Multi-institutional Analysis.","authors":"Jun Kawashima, Yutaka Endo, Selamawit Woldesenbet, Mujtaba Khalil, Miho Akabane, François Cauchy, Feng Shen, Shishir Maithel, Irinel Popescu, Minoru Kitago, Matthew J Weiss, Guillaume Martel, Carlo Pulitano, Luca Aldrighetti, George Poultsides, Andrea Ruzzente, Todd W Bauer, Ana Gleisner, Hugo Marques, Bas Groot Koerkamp, Itaru Endo, Timothy M Pawlik","doi":"10.1245/s10434-025-17156-5","DOIUrl":"10.1245/s10434-025-17156-5","url":null,"abstract":"<p><strong>Introduction: </strong>The role of recurrence-free survival (RFS) as a validated surrogate endpoint for overall survival (OS) among patients undergoing upfront surgery for intrahepatic cholangiocarcinoma (ICC) has not been defined. We sought to evaluate the correlation between RFS and OS after surgical resection for ICC. We hypothesized that RFS was a reliable surrogate endpoint for OS among patients with ICC.</p><p><strong>Methods: </strong>Patients who underwent upfront curative-intent surgery for ICC between 2000 and 2023 were identified from an international, multi-institutional database. The correlation between RFS and OS was assessed using rank correlation. Landmark analysis evaluated concordance between survival at 5 years and recurrence status at 6, 12, 24, 36, 48, and 54 months postoperatively.</p><p><strong>Results: </strong>Among 1541 patients who underwent curative-intent hepatic resection, the median RFS and OS were 22.6 months and 41.5 months, respectively. A moderately strong correlation between RFS and OS was identified (ρ = 0.79, 95% CI 0.76 to 0.82). In the landmark analysis, the concordance between 5-year OS after surgery and recurrence status at different time points (6, 12, 24, 36, 48, and 54 months) was 60.7%, 72.0%, 81.4%, 83.1%, 83.0%, and 82.5%, respectively. Restricted cubic spline analysis indicated that the prediction of OS based on RFS increased with time and plateaued 3 years after surgery.</p><p><strong>Conclusions: </strong>Among patients undergoing curative-intent resection of ICC, there was a moderately strong correlation between RFS and OS. Three-year RFS may be a reliable surrogate endpoint to predict 5-year OS and should be considered in future trial design.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4967-4975"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676706","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":"The Landmark Series: Neoadjuvant Therapy for Locally Advanced Rectal Cancer.","authors":"Zachary Bunjo, Tarik Sammour","doi":"10.1245/s10434-025-17299-5","DOIUrl":"10.1245/s10434-025-17299-5","url":null,"abstract":"<p><p>The management of locally advanced rectal cancer (LARC) has seen much development over recent decades. Neoadjuvant radiotherapy combined with high-quality total mesorectal excision saw improvements in locoregional control. With the advent of several key trials, neoadjuvant therapy for LARC has seen a shift toward total neoadjuvant therapy, with corresponding improvements in tumor response and survival outcomes. The collective pool of evidence has allowed for increasingly personalized treatment of LARC, with organ-preservation now an option for many. The aims of the review are to summarize the evolution of neoadjuvant therapy for LARC, highlight key studies informing contemporary best practices, navigate the complexity of options available, and present areas of ongoing development.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4935-4944"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957316","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}