Annals of Surgical Oncology最新文献

{"title":"Survival After Orbital Exenteration for Primary Cutaneous Squamous Cell Carcinoma: A Retrospective Cohort Study.","authors":"Alexander Murray-Douglass, Lachlan Crawford, Justin Hunt, Darryl Dunn, Brett G M Hughes, Charles Lin, Carly Fox","doi":"10.1245/s10434-024-16854-w","DOIUrl":"10.1245/s10434-024-16854-w","url":null,"abstract":"<p><strong>Background: </strong>Locally advanced periorbital cutaneous squamous cell carcinoma (cSCC) may require orbital exenteration, which is highly morbid. As immunotherapy develops, orbit preservation may become widespread, and data benchmarking survival with current standard-of-care surgery and radiotherapy are essential to the integration of this emerging method into modern treatment paradigms. This study aimed to determine the survival of patients after orbital exenteration for cSCC and investigate contributing factors. It was hypothesized that postoperative radiotherapy would be associated with improved survival.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients with T3 and T4 cSCC undergoing orbital exenteration. Survival analysis was performed using Cox proportional hazards.</p><p><strong>Results: </strong>The study enrolled 40 patients with a median age of 61.5 years who met the criteria. None of the patients had received preoperative radiotherapy. Age (hazard ratio [HR], 1.09; p = 0.019) and residual disease (HR, 9.00; p = 0.003) were associated with worse survival. Postoperative radiotherapy (HR, 0.003; p < 0.001) was associated with improved survival. Perineural, lymphovascular, and bony invasion and T and N stage were not associated with survival. Survival with postoperative radiotherapy was 94 % at 1 year, 87 % at 2 years, and 84 % at 5 years.</p><p><strong>Conclusions: </strong>The oncologic outcomes of orbital exenteration with postoperative radiotherapy for locally advanced head and neck cSCC are good. However, amelioration of the morbidity caused by resection of the eye would be ideal. Data to support immunotherapy as a sole therapy are currently limited, but a combination of neoadjuvant immunotherapy and surgical treatment may facilitate orbit-preserving treatment in the future.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2725-2731"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977371","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: Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC) of Extraperitoneal Abdominal Disease, a Likely Common Practice but Infrequently Reported.","authors":"Christopher W Mangieri, Edward A Levine","doi":"10.1245/s10434-025-16968-9","DOIUrl":"10.1245/s10434-025-16968-9","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2932-2933"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122012","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: Eroding Utility of Prognostic Tools for Melanoma Sentinel Lymph Node Metastasis During Two Decades.","authors":"Harrison M Drebin, Nicholas R Kurtansky, Michael A Marchetti, Edmund K Bartlett","doi":"10.1245/s10434-024-16771-y","DOIUrl":"10.1245/s10434-024-16771-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2767-2768"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891684","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":"Peritoneal Cancer Index Correlates with Radiographic Assessment of Colorectal Carcinomatosis.","authors":"Eleanor A Fallon, Muhammad O Awiwi, Neal Bhutiani, Beth Helmink, Chris P Scally, Paul Mansfield, Keith Fournier, Raghunandan Vikram, Abhineet Uppal, Michael G White","doi":"10.1245/s10434-024-16737-0","DOIUrl":"10.1245/s10434-024-16737-0","url":null,"abstract":"<p><strong>Background: </strong>The Peritoneal Cancer Index (PCI), calculated intraoperatively, has previously yielded mixed results when correlated with computed tomography. This study aimed to quantify variation in this scoring method comparing radiologists' and surgeons' radiologic PCI (rPCI) assessment.</p><p><strong>Methods: </strong>The rPCI of 104 patients treated at a single institution for peritoneal carcinomatosis was calculated by an abdominal radiologist and a surgeon. An additional 36-patient cohort was studied to compare preoperative rPCI with intraoperative gold standard PCI. Agreement was compared using kappa statistics.</p><p><strong>Results: </strong>The rPCI of the 104 patients studied ranged from 2 to 39 (median, 12; interquartile range [IQR], 6-23) by the radiologist's analysis and 2 to 37 (median, 9; IQR, 6-15) by the surgeon's analysis. There was good agreement for PCI cutoffs of 15 (77.48%; kappa, 0.40) and 20 (78.63%; kappa, 0.24). The 36-patient cohort undergoing surgical exploration showed a median rPCI of 4 (IQR, 2-5.75) and a median intraoperative PCI of 11 (IQR, 6-12), with a significant difference in score by method (p < 0.001, Wilcoxon signed-rank test).</p><p><strong>Conclusions: </strong>For rPCI cutoffs greater than 15 and 20, the surgeon's and radiologist's rPCI showed strong concordance, denoting the interobserver reproducibility of rPCI. Moreover, concordance with intraoperative PCI translated to radiographic assessment. The rPCI consistently underestimated intraoperative PCI, suggesting that rPCI may be a useful conservative tool for assessing peritoneal burden. Although surgical exploration is needed to \"rule in\" patients as candidates for CRS, the authors suggest that rPCI can be used to \"rule out\" patients as CRS candidates based on institutional PCI cutoffs.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2923-2931"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891702","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: Nipple-Sparing Mastectomy with Single Axillary Incision: A Safe Approach to Hide the Scar.","authors":"Ruoh-Yun Gau, Hsu-Huan Chou, Shin-Cheh Chen","doi":"10.1245/s10434-025-16883-z","DOIUrl":"10.1245/s10434-025-16883-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2595-2596"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021907","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: Personal Insights and Reflections on the Burden of Breast Cancer Among Adolescents and Young Adults.","authors":"Min Zhang, Linlin Yuan, Meimei Cui, Jiayi Chen, Jingjing Jia, Ming Zhao, Dan Zhou, Liling Zhu, Limei Luo","doi":"10.1245/s10434-024-16858-6","DOIUrl":"10.1245/s10434-024-16858-6","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2601-2602"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254352","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":"Lumpectomy Patients are at Highest Risk for Opioid Overprescription: A Comparison Between Practice Patterns and OPEN National Guidelines.","authors":"Emily P Swafford, Sadhana Anantha, Jenna Davis, Rainya Heath, Allison Draper, Sarah Tevis, Neha Goel, Susan B Kesmodel, Kristin E Rojas","doi":"10.1245/s10434-024-16823-3","DOIUrl":"10.1245/s10434-024-16823-3","url":null,"abstract":"<p><strong>Background: </strong>Nearly 25% of opioid-related deaths are from prescribed opioids, and the exacerbation of the opioid epidemic by the coronavirus disease 2019 (COVID-19) pandemic underscores the urgent need to address superfluous prescribing. Therefore, we sought to align local opioid prescribing practices with national guidelines in postoperative non-metastatic breast cancer patients.</p><p><strong>Methods: </strong>A single-institution analysis included non-metastatic breast surgery patients treated between April 2020 and July 2021. 'Overprescription' was defined as a discharge prescription quantity of oral morphine equivalents (OMEs) greater than the upper limit of the procedure-specific Michigan Opioid Prescribing Engagement Network (OPEN) recommendations. Univariable and multivariate analyses identified risk factors associated with opioid prescribing.</p><p><strong>Results: </strong>Overall, 464 patients met the inclusion criteria: 280 patients underwent lumpectomy, and 184 patients underwent mastectomy. 52% of patients were overprescribed opioids, including 74% of lumpectomy patients (p < 0.001) and 90% of patients undergoing lumpectomy with axillary surgery (p < 0.001). Mastectomy patients were overprescribed less frequently (< 25%). The quantity of opioids prescribed at discharge did not correlate to inpatient opioid requirements (r = 0.024, p = 0.604). Increased age, tobacco use, and long surgery duration were associated with higher quantities of opioids prescribed at discharge.</p><p><strong>Conclusion: </strong>Patients undergoing less aggressive breast surgery are at very high risk of overprescription, and real-life prescribing patterns do not correlate to national guidelines or inpatient need. Future work will optimize adherence to procedure-specific guidelines and implement tailored discharge protocols.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2585-2593"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969010","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: Arterial Divestment: A Viable and Safe Option for Resection of Locally Advanced Pancreatic Cancer.","authors":"Manish S Bhandare, Shravan Nadkarni, Vikram A Chaudhari, Shailesh V Shrikhande","doi":"10.1245/s10434-025-16924-7","DOIUrl":"10.1245/s10434-025-16924-7","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2872-2873"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363428","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: CD45RO-Positive Memory T Cell Density in the Tumoral Core and Invasive Margin as an Immune-Related Prognostic Marker in Esophageal Squamous Cell Carcinoma.","authors":"Toshiki Noma, Tomoki Makino, Yuichiro Doki","doi":"10.1245/s10434-024-16754-z","DOIUrl":"https://doi.org/10.1245/s10434-024-16754-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":"32 4","pages":"2702-2703"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571925","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":"Association Between Delayed/Forgone Medical Care and Resource Utilization Among Women with Breast Cancer in the United States.","authors":"Kriyana P Reddy, Kathleen Jarrell, Cara Berkowitz, Sarah Hulse, Leisha C Elmore, Rebecca Fishman, Rachel A Greenup, Alina M Mateo, Jami D Rothman, Dahlia M Sataloff, Julia C Tchou, S Yousuf Zafar, Oluwadamilola M Fayanju","doi":"10.1245/s10434-024-16586-x","DOIUrl":"10.1245/s10434-024-16586-x","url":null,"abstract":"<p><strong>Background: </strong>Although high treatment costs of breast cancer care are well documented, the relationship between delayed/forgone (D/F) care and resource utilization among patients with breast cancer is unknown. This study sought to investigate the relationship between D/F care, resource use, and healthcare expenditures among patients with breast cancer.</p><p><strong>Methods: </strong>Data on adult female patients with breast cancer were obtained from the Medical Expenditure Panel Survey to assess resource utilization and expenditures in the United States from 2007 to 2017. Weighted proportions of patients with ≥ 1 emergency department, ≥ 1 inpatient, ≥ 1 outpatient, and > 5 office-based encounters were compared between those experiencing D/F care versus those who did not using Rao-Scott adjusted chi-squared tests. Annual, per capita total, out-of-pocket, emergency department, inpatient, outpatient, office-based visit, and prescription medication expenditures were compared by using two-part econometric models.</p><p><strong>Results: </strong>Five percent of patients with breast cancer experienced D/F care, and 42.9% of patients cited financial barriers as the primary reason for D/F care. In unweighted estimates, there were higher proportions of patients with ≥ 1 hospitalizations (37% vs. 16%, P < 0.001) among those experiencing D/F care versus those who did not. Patients with D/F care had $5372 (95% CI $35-$10,709, P = 0.04) higher per capita inpatient expenditures than patients without D/F care.</p><p><strong>Conclusions: </strong>Delayed/forgone care is associated with increased resource utilization and healthcare spending among breast cancer patients. Further work is needed to address the root causes of D/F breast cancer care, with a view to mitigating disparate outcomes and increasing costs.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2534-2544"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852142","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}