Annals of Surgical Oncology最新文献

{"title":"National Survey on Attitudes of Brazilian Breast Surgeons Regarding Oncoplastic Surgery: Success of a Training Model.","authors":"Francisco Pimentel Cavalcante, Vilmar Marques de Oliveira, Patrícia Klarmann Ziegelmann, Fabrício Palermo Brenelli, Régis Resende Paulinelli, Augusto Tufi Hassan, Guilherme Garcia Novita, Eduardo Camargo Millen, Felipe Pereira Zerwes, André Mattar, Marcelo Antonini, Antônio Luiz Frasson, Cícero de Andrade Urban, Eduardo Carvalho Pessoa, Carlos Alberto Ruiz, Jorge Villanova Biazus, Ruffo Freitas-Junior, Rene Aloisio da Costa Vieira","doi":"10.1245/s10434-025-17435-1","DOIUrl":"10.1245/s10434-025-17435-1","url":null,"abstract":"<p><strong>Background: </strong>Historically, breast reconstruction was performed by plastic surgeons. The Brazilian Society of Mastology (SBM) implemented initiatives to improve breast surgeons' training in oncoplastic techniques; however, the current proportion of surgeons performing these techniques remained unknown. This study aimed to determine the proportion of Brazilian breast surgeons performing oncoplastic surgery, their previous training, the complexity of procedures performed, and factors influencing adoption of techniques.</p><p><strong>Methods: </strong>In this survey, a structured questionnaire was sent to all SBM-affiliated breast surgeons between July and December 2023. Outcome proportions were estimated using binomial distribution. Adjusted proportion ratios (aPR) were calculated using robust Poisson regression.</p><p><strong>Results: </strong>A 60.2% valid response rate was achieved (n = 1059/1759). Almost half of the respondents performed oncoplastic surgery, with most being young (< 40 years) (aPR: 1.66; 1.31-1.10; p < 0.001), male (aPR: 1.39; 1.22-1.59; p < 0.001), southern residents (aPR: 1.39; 1.18-1.63; p < 0.001), with a specialist degree in breast disease (aPR: 1.19; 1.00-1.42; p < 0.004), primarily trained in general surgery (aPR: 1.32; 1.16-1.51; p < 0.001) and secondarily in breast surgery (aPR: 1.41; 1.08-1.85; p = 0.01), and performing > 100 surgeries/year (aPR: 1.72; 1.49-1.99; p < 0.001). The techniques most commonly mastered were simple displacement (88.7%), therapeutic mammoplasty or contralateral symmetrization (96.4%), reconstruction with implants or tissue expanders (93.6%), extreme oncoplasty (81%), skin- and nipple-sparing (99%) or skin-reducing mastectomy (84.2%), and thoracoabdominal flaps (71.7%).</p><p><strong>Conclusions: </strong>A high proportion of Brazilian mastologists perform oncoplastic surgery. These findings provide key insights to further enhance training and improve outcomes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5489-5499"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963271","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":"Predicting Outcomes of Breast-Conserving Surgery in Patients with Breast Cancer Using the Modified 5-Item Frailty Index: A Retrospective Cohort Study.","authors":"Samuel Knoedler, Jun Jiang, Philipp Moog, Julius M Wirtz, Thomas Schaschinger, Horacio Mayer, Hans-Guenther Machens, Sören Könneker, Gabriel Hundeshagen, Bong-Sung Kim, Dennis P Orgill, Adriana C Panayi","doi":"10.1245/s10434-025-17438-y","DOIUrl":"10.1245/s10434-025-17438-y","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most common malignancy among women worldwide, with breast-conserving surgery (BCS) being a key treatment. The modified 5-item frailty index (mFI-5), a well-validated tool for assessing frailty, has shown predictive utility in other surgical contexts but remains under-explored in BCS.</p><p><strong>Patients and methods: </strong>Using the American College of Surgeons National Surgical Quality Improvement Program database (2008-2021), we identified adult female patients with breast cancer who underwent BCS. Frailty was assessed using the mFI-5 and scored from 0 to 5, with higher scores indicating greater frailty. Multivariable logistic regression was employed to evaluate associations between mFI-5 scores and postoperative outcomes.</p><p><strong>Results: </strong>A total of 96,586 patients were included. Higher mFI-5 scores were significantly associated with older age, higher body mass index (BMI), and increased ASA scores. Multivariate analysis showed greater frailty was linked to higher risks of any (mFI = 1: OR 1.06; mFI = 2: OR 1.26; mFI ≥ 3: OR 2.45), surgical (mFI = 1: OR 1.18; mFI = 2: OR 1.65; mFI ≥ 3: OR 3.17), and medical complications (mFI = 1: OR 1.72; mFI = 2: OR 2.56; mFI ≥ 3: OR 6.05). Similarly, frail patients had significantly higher odds of mortality (mFI = 1: OR 2.27; mFI = 2: OR 4.3; mFI ≥ 3: OR 11.05) and unplanned readmission (mFI = 1: OR 1.38; mFI = 2: OR 2.25; mFI ≥ 3: OR 6.05). Reoperation risk decreased with higher mFI-5 scores (mFI = 1: OR 0.92; mFI = 2: OR 0.73; mFI ≥ 3: OR 0.92).</p><p><strong>Conclusions: </strong>The mFI-5 is strongly associated with postoperative outcomes after BCS and serves as a valuable tool for risk stratification. Our findings reinforce its role as a critical preoperative index to identify high-risk patients and guide surgical planning.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5528-5539"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075599","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: Minimally Invasive Approach for Bilateral Sentinel Node Using Indocyanine Green in Vulvar Cancer: Not Only a Technical Issue.","authors":"Nicolò Bizzarri, Filippo Maria Capomacchia, Giacomo Guidi, Simona Fragomeni, Giorgia Garganese, Anna Fagotti, Giovanni Scambia, Angelica Naldini","doi":"10.1245/s10434-025-17339-0","DOIUrl":"10.1245/s10434-025-17339-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5626-5627"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967173","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":"Characterization of the Germline Pathogenic Mutational Landscape and Oncologic Outcomes Among 877 Patients with Invasive Lobular Carcinoma.","authors":"Victoria D Huynh, Jason Mouabbi, Henry M Kuerer, Kerollos Nashat Wanis, Hiam M Abdel-Salam, Angelica M Gutierrez, Helen M Johnson, Anthony Lucci, Kelly K Hunt, Banu K Arun","doi":"10.1245/s10434-025-17366-x","DOIUrl":"10.1245/s10434-025-17366-x","url":null,"abstract":"<p><strong>Purpose: </strong>There is a paucity of literature on germline pathogenic variants (gPVs) in patients with invasive lobular carcinoma (ILC). This study characterizes the landscape and compares clinicopathologic variables and treatment outcomes between those with and without gPVs.</p><p><strong>Methods: </strong>A prospectively maintained institutional database was used to identify all patients diagnosed with nonmetastatic ILC who had germline genetic testing. Clinicopathologic characteristics and time to recurrence, contralateral cancer, and death were compared for patients with and without gPVs. Conditional hazard ratios, computed by Cox proportional hazards models, described associations between clinicopathologic factors, including gPV status, and cancer events.</p><p><strong>Results: </strong>Of 4398 patients with nonmetastatic ILC seen between 1989 and 2024, 1170 patients were evaluated by genetic counselors; 877 underwent genetic testing. 10% (83/877) had gPVs, of whom 87% (72/83) had gPVs in known breast cancer predisposition genes; 13% had gPVs in preliminary evidence genes or genes not previously known to be breast cancer associated. Patients with gPVs were more likely to be younger than 40 years, be premenopausal, have high grade and triple-negative receptor status, and undergo mastectomy compared with those without gPV (p < 0.01). At median follow-up of 80 months (interquartile range, IQR 38-135 years), there was no significant difference in the time to contralateral breast cancer, distant or local-regional recurrence, and survival among patients with and without gPVs.</p><p><strong>Conclusion: </strong>In this large single-institutional analysis, patients with ILC had a distinct landscape of gPVs in breast cancer and non-breast cancer predisposition genes. A significant proportion of patients with ILC have gPVs, and these findings have potentially actionable implications.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5477-5488"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967799","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-Specific Mortality of Partial Cystectomy Versus Radical Cystectomy in T2N0M0 Urothelial Bladder Cancer.","authors":"Mattia Longoni, Andrea Marmiroli, Fabian Falkenbach, Quynh Chi Le, Michele Nicolazzini, Calogero Catanzaro, Federico Polverino, Zhe Tian, Jordan A Goyal, Matteo Ferro, Markus Graefen, Felix K H Chun, Alessandro Volpe, Riccardo Schiavina, Nicola Longo, Fred Saad, Shahrokh F Shariat, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz","doi":"10.1245/s10434-025-17488-2","DOIUrl":"10.1245/s10434-025-17488-2","url":null,"abstract":"<p><strong>Background: </strong>The authors hypothesized that for T2N0M0 urothelial carcinoma of urinary bladder (UCUB) patients, partial cystectomy (PC) does not differ from radical cystectomy (RC) regarding cancer-specific mortality (CSM).</p><p><strong>Methods: </strong>Within the Surveillance, Epidemiology and End Results (SEER) database (2004-2021), rates of PC versus RC for T2N0M0 UCUB patients were tabulated. Nearest-neighbor 1:1 propensity score-matching (PSM) for age, sex, tumor size and site, race/ethnicity, chemotherapy, and pelvic lymph node dissection status was applied. Poisson-smoothed cumulative incidence plots depicted 5-year CSM and other-cause mortality (OCM) rates. Uni- and multivariable competing-risks regression (CRR) models were fitted. Sensitivity analyses were performed for patients with tumors ≤ 3 cm, tumors amenable to segmental resection (outside trigone, ureteric orifices, or bladder neck), or both.</p><p><strong>Results: </strong>Of 5425 T2N0M0 UCUB patients, 412 (7.6%) received PC versus 5013 (92.4%) who received RC. The PC rates decreased from 12.1% in 2004 to 6.2% in 2021 (p < 0.001). After PSM, the 5 year CSM rate was 26.7% for PC versus 28.4% for RC, and after ultivariable CRR, PC was unrelated to CSM rates (multivariable hazard ratio [mHR], 0.9; p = 0.2). In separate sensitivity analyses of 3187 (58.7%) patients with tumors ≤ 3 cm, 2521 (46.5%), patients with tumors amenable to segmental resection, and 1416 (26.1%) patients with both, after reapplication of PSM and additional multivariable adjustment, virtually the same results were observed.</p><p><strong>Conclusion: </strong>A small proportion of T2N0M0 UCUB patients underwent PC instead of RC. However, for well-selected patients, PC was not associated with worse cancer control outcomes than RC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"6133-6140"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155957","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":"Precision Robotic Glissonean Approach for High-Branching G8 Pedicles in Hepatocellular Carcinoma.","authors":"Taiga Wakabayashi, Jonathan Seak Chen Ken, Yusuke Nie, Yu Teshigahara, Rodrigo Antonio Gasque, Kazuharu Igarashi, Go Wakabayashi","doi":"10.1245/s10434-025-17445-z","DOIUrl":"10.1245/s10434-025-17445-z","url":null,"abstract":"<p><strong>Background: </strong>Anatomical liver resection benefits from controlling Glissonean pedicles before parenchymal transection to ensure accurate anatomical boundaries. In segment 8, high-branching Glissonean anatomy can hinder identification of the targeted pedicle, increasing the risk of misidentification. A hilum-first, stepwise intrahepatic approach facilitates safe and precise isolation of each ramification. We present a case of robotic S8 segmentectomy for hepatocellular carcinoma (HCC), using a strategy adapted to this anatomical variation.</p><p><strong>Methods: </strong>An 83-year-old male with HCC in S8 underwent robotic segmentectomy. Preoperative imaging revealed high-branching of G5 from G8 branches. The anterior Glissonean pedicle was first encircled. (1) G5d + G8d and (2) G5v were isolated, enabling identification of G8v and G8d by subtraction. These branches were selectively clamped, and ICG-negative staining guided precise anatomical resection. The robotic system's enhanced dexterity and magnified 3D vision enabled atraumatic handling of these fine branches.</p><p><strong>Results: </strong>This approach allowed more distal pedicle division than initially planned, preserving 104 mL (10%) of functional liver. Blood loss was 10 mL/kg, and no complications occurred. The patient was discharged on postoperative day 6. Pathology confirmed moderately differentiated HCC (T2N0M0, UICC 8th) with negative margins and no microvascular invasion.</p><p><strong>Conclusions: </strong>Robotic liver resection enables precise and atraumatic intrahepatic Glissonean dissection, particularly in cases with high-branching Glissonean anatomy. A hilum-first, stepwise approach-combined with real-time ICG fluorescence imaging-offers a reliable method for safely isolating targeted pedicles, thereby enhancing oncological precision and preserving functional liver volume in challenging segment 8 resections.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5710"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092627","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 Value of Sentinel Node Biopsy in Patients With Higher-Risk (T3, T4) Primary Cutaneous Melanomas: Insights Provided by a Stage II Risk Calculator.","authors":"Thomas E Pennington, John F Thompson, Robyn P M Saw, David J Coker, Serigne N Lo, Alex H R Varey","doi":"10.1245/s10434-024-16699-3","DOIUrl":"10.1245/s10434-024-16699-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5382-5386"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962963","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":"Prognostic Value of Tumor Regression Grade After Chemotherapy Versus Chemoradiotherapy in Patients Undergoing Neoadjuvant Treatment for Locally Advanced Esophageal Adenocarcinoma.","authors":"Giovanni Capovilla, Elisa Sefora Pierobon, Lucia Moletta, Alessia Scarton, Maria Elisa Sciuto, Evangelos Tagkalos, Eren Uzun, Carlo Alberto De Pasqual, Cecilia Turolo, Gianpietro Zanchettin, Federica Riccio, Luca Provenzano, Renato Salvador, Felix Berlth, Jacopo Weindelmayer, Sara Lonardi, Sara Galuppo, Simone Giacopuzzi, Giovanni De Manzoni, Peter Grimminger, Michele Valmasoni","doi":"10.1245/s10434-025-17264-2","DOIUrl":"10.1245/s10434-025-17264-2","url":null,"abstract":"<p><strong>Background: </strong>The higher rate of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) is an argument to support this treatment. However, previous studies have not demonstrated a survival benefit of NACRT for adenocarcinoma (ADC) compared with neoadjuvant chemotherapy (NACT) and the correlation between pathological tumor response (pTR) and survival is unclear. We aimed to verify whether the prognostic value of pTRis influenced by the type of neoadjuvant treatment performed.</p><p><strong>Methods: </strong>Patients with ADC who underwent NACT or NACRT and surgery between 2015 and 2020 were included. The correlation between pTR and overall survival (OS) and disease-free survival (DFS) after both treatments was evaluated by using Kaplan-Meier analysis. pTR was assessed by using the Mandard tumor regression grade (TRG).</p><p><strong>Results: </strong>Overall, 563 patients were included; 278 received NACT, and 285 NACRT. The incidence of pCR was significantly higher after NACRT (24.6% vs. 11.2%, p < 0.0001). The TRG of both node-negative (pN0) and node-positive (pN+) patients significantly correlated with the 5 years OS after NACT (pN0 p = 0.03, pN+ p = 0.01). The same result was not detected in NACRT patients (pN0 p = 0.98, pN+ p = 0.23). The 5-year DFS of the patients with pCR was higher in the NACT group (84% vs. 66.5%, p = 0.05). The proportion of patients showing distant recurrences was significantly higher in the NACRT group (35.4% vs. 23.8%, p = 0.009).</p><p><strong>Conclusions: </strong>Tumor regression grade was significantly associated with survival after NACT, but not with NACRT. Despite a lower rate of pCR, both OS and, especially, DFS of patients with pCR improved after NACT compared with NACRT.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5909-5918"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963401","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: Blood Group as a Guide for Adjuvant Chemotherapy in Pancreatic Cancer.","authors":"Yosuke Inoue, Manabu Takamatsu, Yohei Masugi, Tsuyoshi Hamada","doi":"10.1245/s10434-025-17381-y","DOIUrl":"10.1245/s10434-025-17381-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5428-5429"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062056","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":"Augmenting the Future Liver Remnant Prior to Major Hepatectomy: A Review of Options on the Menu.","authors":"Paul Wong, Peter Vien, Jonathan Kessler, Kelly Lafaro, Alice Wei, Laleh G Melstrom","doi":"10.1245/s10434-025-17607-z","DOIUrl":"10.1245/s10434-025-17607-z","url":null,"abstract":"<p><p>The optimization of the future liver remnant (FLR) is paramount in improving outcomes for patients undergoing liver surgery, as post-hepatectomy liver failure remains a major source of postoperative morbidity and mortality. A wide collection of techniques has been introduced with the goal of augmenting the FLR prior to hepatectomy for primary and secondary liver malignancies, and these modalities include portal vein embolization (PVE), portal vein ligation (PVL), liver venous deprivation (LVD), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), and radioembolization (e.g., Y-90). There are advantages and drawbacks for each of these methods regarding the capacity for FLR hypertrophy sufficient for resection, perioperative morbidity/mortality, and long-term oncologic outcomes. In the context of technical variations when performing the procedures, there have been comparative studies between the various methods of FLR optimization, however, not many in a controlled fashion. Results from ongoing and future randomized controlled trials will help refine these techniques, directly compare outcomes, and personalize strategies based on patient-specific factors. In this review, the benefits of the various FLR augmentation approaches are summarized and the current literature and trials are reviewed.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5694-5709"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246173","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}