Annals of Surgical Oncology最新文献

{"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":"National Variation in Implementation of Sentinel Lymph Node Biopsy for Clinically Node-Positive Patients Undergoing Neoadjuvant Therapy.","authors":"Crystal D Taylor, Ton Wang, Brandy R Sinco, Melissa Pilewskie, Tasha M Hughes, Lesly A Dossett","doi":"10.1245/s10434-025-17293-x","DOIUrl":"10.1245/s10434-025-17293-x","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) is feasible in women with clinically node-positive breast cancer following neoadjuvant chemotherapy and a nodal pathologic complete response. Acceptable false negative rates are achieved through technical considerations such as removing three or more sentinel lymph nodes (SLNs); however, the variation that exists in adherence to this technique is unclear.</p><p><strong>Objective: </strong>This study aimed to evaluate recent trends in axillary surgery in women with cN1-cN2 disease who received neoadjuvant chemotherapy, adherence to removing three or more SLNs, and variation in SLN yield.</p><p><strong>Methods: </strong>We performed a cohort study using the National Cancer Database of women aged ≥18 years with cN1-cN2 disease who received neoadjuvant chemotherapy, including those without a pathologic complete response, from 2012 to 2020. Trends in axillary surgery and lymph node yield obtained during SLNB were evaluated.</p><p><strong>Results: </strong>The cohort included 67,365 women (median age 54 years). The number of patients receiving SLNB alone increased from 14 to 39%; SLNB with completion axillary lymph node dissection (ALND) increased from 17 to 30%; and ALND alone decreased from 69 to 27%. The rates of obtaining three or more SLNs during SLNB remained the same over time at 66%, while facility-level variation in obtaining three or more nodes ranged from 40 to 86%.</p><p><strong>Conclusions: </strong>There has been de-escalation of axillary surgery with fewer patients undergoing ALND; however, overall there has been no significant change in the rates of obtaining three or more lymph nodes during SLNB following neoadjuvant chemotherapy, with significant facility-level variation observed.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4874-4882"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966829","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":"Fluorescence Laparoscopic Local Resection of Pancreatic Head Tumor with End-to-End Pancreatic Anastomosis: A New Surgical Strategy for Pancreatic Head Tumor Resection.","authors":"Jianlin Lai, Haoxiang Zhang, Long Huang, Yifeng Tian, Shi Chen","doi":"10.1245/s10434-025-17246-4","DOIUrl":"10.1245/s10434-025-17246-4","url":null,"abstract":"<p><strong>Background: </strong>With the application of new technologies such as three-dimensional and fluorescent staining, laparoscopic surgery is more comprehensive, accurate, and safe.^1-3 For specific borderline or benign pancreatic head tumors that are small, well-differentiated, and have an intact capsule, laparoscopic local enucleation of the pancreatic head tumor is the preferred surgical approach;^4,5 however, when the tumor involves the pancreatic duct, it is often necessary to resect the pancreatic duct and reconstruct it. This paper introduces a local resection of the pancreatic head tumor with end-to-end anastomosis of the pancreatic duct under fluorescence laparoscopy. According to literature review, there are no reports regarding end-to-end anastomosis of the pancreatic head duct under laparoscopy. PATIENT AND METHODS: Using magnetic resonance imaging (MRI) examination, a 35-year-old female was found to have a solid pseudopapillary neoplasm in the pancreatic head sized 5.4 × 3.8 × 4.2 cm. We performed fluorescence laparoscopic local resection of the pancreatic head tumor. During the operation, the tumor involved the main pancreatic duct, and Takada's end-to-end anastomosis of the pancreatic duct was performed.</p><p><strong>Results: </strong>The duration of the operation was 180 min and blood loss was 100 mL. The patient recovered smoothly and was discharged on the eighth day after operation. Postoperative pathology suggested a solid pseudopapillary neoplasm. There was no dilation of the pancreatic duct 3 months after surgery.</p><p><strong>Conclusion: </strong>Laparoscopic local tumor enucleation has been widely accepted in the treatment of small, well-encapsulated, well-differentiated benign tumors of the pancreatic head. When the pancreatic head tumor involves the main pancreatic duct, Takada's end-to-end anastomosis of the pancreatic duct provides a new surgical strategy.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5106-5107"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762865","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":"Cartilage Resection in the Surgical Management of Ear Melanoma.","authors":"Elan Novis, Joyce Tan, Danielle Vignati, Terence Wong, Robert V Rawson, Jonathan R Stretch, Serigne N Lo, Thomas E Pennington, Sydney Ch'ng, Kerwin F Shannon, Andrew J Spillane, Omgo E Nieweg, John F Thompson, Michael Rtshiladze, Richard A Scolyer, Robyn P M Saw","doi":"10.1245/s10434-025-17294-w","DOIUrl":"10.1245/s10434-025-17294-w","url":null,"abstract":"<p><strong>Background: </strong>Melanoma of the ear accounts for approximately 1% of cutaneous melanomas. Management recommendations are based on small retrospective series and case reports. Resection of melanoma of the ear requires a delicate balance between disease clearance, preservation of function, and aesthetics. The role of cartilage resection in the wide excision of melanoma of the ear remains unclear. We aimed to compare outcomes in patients having wide excision of ear melanoma who had cartilage resected with those who had a cartilage-sparing approach.</p><p><strong>Methods: </strong>Data were obtained from the Melanoma Institute Australia (MIA) prospectively maintained database. All patients diagnosed with invasive melanoma involving the ear between 1990 and 2022 were included. Data analysis was performed to assess the association between cartilage resection and recurrence-free survival (RFS), melanoma-specific survival (MSS), and overall survival (OS).</p><p><strong>Results: </strong>Overall, 411 patients were included in the study, of whom 330 (80%) had cartilage resected and 81 (20%) had a cartilage-sparing resection. The cartilage resection group had a higher mean Breslow thickness (1.9 vs. 1.4 mm; p = 0.0002), whereas the cartilage-sparing group had a higher proportion of stage IA disease (60.5 vs. 39.7%; p = 0.041). Five (1.2%) patients had melanoma invading into perichondrium but not deeper. Cartilage resection had no impact on RFS {hazard ratio [HR] 0.82 (0.52-1.29); p = 0.39} or MSS (HR 0.89 (0.30-2.62); p = 0.83).</p><p><strong>Conclusion: </strong>The decision to resect cartilage as part of the wide excision of invasive ear melanoma should be tailored to the needs of the individual patient, however a cartilage-sparing approach does not appear to compromise MSS outcomes, particularly in early-stage disease.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5306-5314"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959238","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":"Advancing Robotic Liver Resection: The Sling Technique for Improved Hepatic Retraction.","authors":"Belkacem Acidi, Antony Haddad, Timothy E Newhook, Naruhiko Ikoma, Ching-Wei D Tzeng, Yun Shin Chun, Jean Nicolas Vauthey, Hop S Tran Cao","doi":"10.1245/s10434-025-17229-5","DOIUrl":"10.1245/s10434-025-17229-5","url":null,"abstract":"<p><p>Hepatic surgery, including laparoscopic liver resection, is well codified with difficulty scales on the basis of lesion position, particularly in the posterior segments, lesion size, and underlying liver disease.^1,2 These scores are transposable to robotic hepatic surgery.³ Tumors in segment 7 are particularly challenging to expose and are classified as difficult to access.⁴ Various techniques are used, such as mobilizing the liver with the gallbladder or the round ligament and employing a range of liver retractors. However, these retractors can be traumatic to the liver, are difficult to maneuver, and occupy an assistant's arm. Our team decided to utilize the \"sling\" technique, involving rolled surgical sponges shaped into a cylinder. This sling is placed behind the liver and gently retracted to mobilize it, bringing difficult-to-access areas into view for easier resection. The technique is atraumatic, easily manipulable, and frees up the assistant's arm for other tasks. It also aligns the transection plane with the camera, enhancing visualization during robotic liver surgery. This method is demonstrated through two surgical videos. The sling technique is a cost-efficient, easily reproducible, and effective method for hepatic retraction in robotic liver surgery. It overcomes the limitations of traditional retractors, offering enhanced exposure with minimal trauma to the liver. The described technique, demonstrated through surgical videos, highlights its practical application and benefits in minimally invasive hepatic surgery.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5021"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699573","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":"Rare but Complex: Outcomes and Challenges in Managing Composite Follicular-Anaplastic Thyroid Cancer.","authors":"Dilay Aykan, Hala Al Asadi, Anjani Turaga, Lutske Lodewijk, Brendan M Finnerty, Thomas J Fahey, Inne H M Borel Rinkes, Menno R Vriens, Rasa Zarnegar","doi":"10.1245/s10434-025-17208-w","DOIUrl":"10.1245/s10434-025-17208-w","url":null,"abstract":"<p><strong>Background: </strong>A subset of follicular thyroid cancers (FTC) can dedifferentiate into anaplastic thyroid cancer (ATC), forming composite FTC/ATC tumors. The effect of this dedifferentiation on survival outcomes remains unclear. This study aimed to characterize the clinicopathologic features of composite FTC/ATC tumors and assess their disease-specific survival (DSS).</p><p><strong>Patients and methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database (2000-2020) was used to identify patients with FTC, composite FTC/ATC, and ATC. Propensity score matching (PSM) was performed on the basis of age, sex, race, and histologic subtype. Clinicopathologic characteristics, DSS, and treatment outcomes were compared.</p><p><strong>Results: </strong>A total of 60 patients with composite FTC/ATC were matched to 180 patients with FTC and 180 patients with ATC. Compared with FTC, composite tumors were associated with larger size (p < 0.001), extra-thyroidal extension (ETE) (p < 0.001), lymph node (p < 0.001) and distant metastases (p = 0.002), more external beam radiation (p < 0.001), and chemotherapy (p < 0.001), but less radioactive iodine (RAI) (p < 0.001). Compared with ATC, composite tumors showed less ETE (p = 0.01), fewer lymph node metastases (p = 0.01), less chemotherapy (p = 0.002), and more RAI (p = 0.002). The median survival of patients with co-FTC/ATC was 7 months (p < 0.001). Advanced age (hazard ratio, HR 1.05; 95% confidence intervals, CI 1.02-1.08) and incomplete thyroidectomy (HR 2.58, 95% CI 1.20-5.56) predicted worse DSS.</p><p><strong>Conclusions: </strong>Composite FTC/ATC tumors have survival outcomes that fall between those of FTC and ATC. Total thyroidectomy is a key component of treatment, as incomplete thyroidectomy is linked to poorer survival. Further research is needed to explore how the proportion of ATC within composite tumors influences survival outcomes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4754-4759"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708073","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":"A Deep Learning Survival Model for Evaluating the Survival Prognosis of Papillary Thyroid Cancer: A Population-Based Cohort Study.","authors":"Guibin Zheng, Peng Wei, Danxia Li, Xinna Li, Mark Zafereo, Chao Li, Wenbin Yu, Xiaohong Chen, Haitao Zheng, Xicheng Song, Guojun Li","doi":"10.1245/s10434-025-17290-0","DOIUrl":"10.1245/s10434-025-17290-0","url":null,"abstract":"<p><strong>Background: </strong>Deep learning can assess the individual survival prognosis in sizeable datasets with intricate underlying processes. However, studies exploring the performance of deep learning survival in papillary thyroid cancer (PTC) are lacking. This study aimed to construct a deep learning model based on clinical risk factors for survival prediction in patients with PTC.</p><p><strong>Methods: </strong>A Cox proportional hazards deep neural network (DeepSurv) was developed and validated by using consecutive patients with PTC from 17 US Surveillance, Epidemiology, and End Results Program (SEER) cancer registries (2000-2020). The performance of the DeepSurv model was further validated on two external test datasets from the University of Texas MD Anderson Cancer Center (MDACC) and The Cancer Genome Atlas (TCGA). Using the survival risk scores at 10 years predicted by the DeepSurv model, we classified patients with PTC into low-risk and high-risk groups and explored their overall survival (OS).</p><p><strong>Results: </strong>The concordance index of the DeepSurv model for predicting OS was 0.798 in the SEER test dataset, 0.893 in the MDACC dataset, and 0.848 in the TCGA dataset. The DeepSurv model was capable of classifying patients with PTC into low-risk and high-risk groups according to the survival risk scores at 10 years. Patients in the high-risk group had significantly worse OS than patients in the low-risk group in all three test datasets (all P < 0.001).</p><p><strong>Conclusion: </strong>The DeepSurv model was capable of classifying patients with PTC into low-risk and high-risk groups, which may provide important prognostic information for personalized treatment in patients with PTC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4780-4789"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967577","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 Esophagojejunostomy: Reflecting on the Evolution of Nasogastric Tube Techniques.","authors":"Xinhua Chen, Huilin Huang, Jiang Yu","doi":"10.1245/s10434-025-17341-6","DOIUrl":"10.1245/s10434-025-17341-6","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5200-5201"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959892","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":"EGFR Mutation Rates Correlate with Age at Diagnosis and Tumor Characteristics in Patients with Pulmonary Ground-Glass Opacities.","authors":"Wen-Fang Tang, Zhen-Bin Qiu, Xiang-Peng Chu, Yu-Mei Zeng, Yi-Bin Hu, Xuan Tang, Ye-Feng Yu, Wen-Hao Li, Wen-Zhao Zhong, Wei-Zhao Huang, Yi Liang","doi":"10.1245/s10434-024-16730-7","DOIUrl":"10.1245/s10434-024-16730-7","url":null,"abstract":"<p><strong>Background: </strong>To clearly reveal the correlations between tumor characteristics, age at diagnosis, and epidermal growth factor receptor (EGFR) mutation rates in patients with pulmonary ground-glass opacities (GGOs).</p><p><strong>Methods: </strong>We retrospectively reviewed 1473 patients with GGOs between January 2015 and May 2020 from two cancer centers. The tumor characteristics and EGFR mutation rates were compared between different age groups. Multivariate logistic regression was fitted to analyze the relationship between age, tumor characteristics, and EGFR mutation rates.</p><p><strong>Results: </strong>The older patients had more large tumors, mixed GGOs with a consolidation-to-tumor ratio (CTR) of >0.5, and invasive adenocarcinoma (IAC) and pathologic stage IA2-IB. Overall, the rate of EGFR mutations in GGOs was 57.3% and the main subtypes were L858R and 19del mutations. The distribution of EGFR subtypes varied in different age and GGO diameter groups. Age (p = 0.036), GGO types (p = 0.005), tumor diameter (p = 0.039), and pathological types (p < 0.001) were significant predictors for EGFR mutation status. Importantly, significant differences in EGFR mutation rates between age groups were mainly observed in the GGO ≤2 cm diameter (p < 0.001), pure GGOs (p = 0.001), and IAC (p = 0.039) cohorts. Overall, those diagnosed at >50 years of age had a 47.0% increased likelihood of harboring EGFR mutations. Compared with the older group, the increased chance of harboring EGFR mutations for patients with larger tumors, mixed GGOs, and IAC was greater in the younger group.</p><p><strong>Conclusions: </strong>The EGFR mutation rates were varied among different tumor characteristics and age at diagnosis. These findings provide new insights into the treatment of GGOs.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4641-4649"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891695","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: Redefining Prognostic Endpoints in Intrahepatic Cholangiocarcinoma-The Role of Recurrence-Free Survival.","authors":"Jun Kawashima, Miho Akabane, Timothy M Pawlik","doi":"10.1245/s10434-025-17212-0","DOIUrl":"10.1245/s10434-025-17212-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5024-5025"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633316","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}