Annals of Surgical Oncology最新文献

{"title":"Melanoma 2.0: Time to Move Beyond Breslow Thickness?","authors":"Alexander C J van Akkooi","doi":"10.1245/s10434-025-18591-0","DOIUrl":"https://doi.org/10.1245/s10434-025-18591-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336270","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":"Robotic Portal Tumor Thrombectomy during Pancreatoduodenectomy for Acinar Cell Carcinoma.","authors":"Marcel Autran C Machado, Bruno V Mattos, Murillo Macedo Lobo Filho, Fabio Makdissi","doi":"10.1245/s10434-025-18566-1","DOIUrl":"https://doi.org/10.1245/s10434-025-18566-1","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336334","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":"Tubularized Bovine Pericardium Graft for Inferior Vena Cava Reconstruction in Abdominal Malignant Tumor.","authors":"Ryota Ito, Yoshihiro Ono, Taiga Fujii, Atsuhi Takahashi, Kosuke Kobayashi, Atsushi Oba, Hiromichi Ito, Yosuke Inoue, Akio Saiura, Yu Takahashi","doi":"10.1245/s10434-025-18545-6","DOIUrl":"https://doi.org/10.1245/s10434-025-18545-6","url":null,"abstract":"<p><strong>Background: </strong>Abdominal malignant tumors sometimes involve the inferior vena cava (IVC).^1-4 In such cases, radical resection, including IVC resection and reconstruction, is a critical component of curative treatment.^3,4 Although patch repair or synthetic tube grafts are used for IVC reconstruction, synthetic grafts may carry risks of infection and thrombosis.^5-7 Although tubularized bovine pericardium grafts have shown favorable outcomes, the technical details are not well documented.^1,8-11 CASE PRESENTATION: IVC patch reconstruction using bovine pericardial grafts was performed in three cases. In one, the patch extended over more than two-thirds of the circumference, and the reconstruction was carried out in an irregular shape to preserve the branch of the left renal vein. By using a tubularized bovine pericardium graft, a smooth shape enabled easier reconstruction of the branches. A 33-year-old woman presented with an initially unresectable large leiomyosarcoma invading the IVC and hepatic veins. After chemotherapy shrank the tumor, surgical resection, including right nephrectomy, partial hepatectomy, and IVC resection, was performed. A 14 cm tube graft was created in the operating room using bovine pericardium, and this was anastomosed to the IVC. Elevated left renal vein pressure indicated side-to-end anastomosis. Postoperative computed tomography confirmed graft patency, and the patient was discharged uneventfully on postoperative day 10.</p><p><strong>Conclusions: </strong>We present the technical details of IVC resection and reconstruction using a tubularized bovine pericardium graft, along with left renal vein reconstruction.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318145","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 Visual Abstract: Real-world Application of Alliance ACOSOG Z11102: How Many Patients can be Spared Mastectomy?","authors":"Frances Phang, Brian Finkelman, Jessica Gooch, Ann Olzinski-Kunze, Kristin ASkinner, Daniel Kim, Kimberly Gergelis, Bradley Turner, Anna Weiss","doi":"10.1245/s10434-025-18508-x","DOIUrl":"https://doi.org/10.1245/s10434-025-18508-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318202","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 Features, Microbial Epidemiology, and Recurrence Risk of Cellulitis in Breast Cancer-Related Lymphedema.","authors":"Benjamin D Wagner, Jonathan Rubin, I-Hsin Lin, Jilmil Raina, Maryam Abul, Bracha L Pollack, Arielle N Roberts, Andrea V Barrio, Raghu P Kataru, Babak J Mehrara, Anna Kaltsas","doi":"10.1245/s10434-025-18598-7","DOIUrl":"https://doi.org/10.1245/s10434-025-18598-7","url":null,"abstract":"<p><strong>Background: </strong>Cellulitis, resulting from impaired lymphatic function, is a debilitating complication of breast cancer-related lymphedema (BCRL) that contributes to lymphedema progression. However, the clinical presentation and microbiologic profile of BCRL-associated cellulitis remain poorly defined. This study investigated the prevalence, clinical features, and treatment outcomes of cellulitis in BCRL, aiming to identify risk factors for recurrence and inform evidence-based treatment strategies.</p><p><strong>Methods: </strong>A retrospective review was conducted of cellulitis episodes among 2920 patients with BCRL treated at a single institution between 2000 and 2024. Demographic, clinical, microbiologic, and treatment data were analyzed. Univariate and multivariable Cox proportional hazards models were used to evaluate risk factors associated with recurrent cellulitis.</p><p><strong>Results: </strong>A total of 418 cellulitis episodes were documented among 231 patients with BCRL, indicating a prevalence of 7.9% (231/2920) and a recurrence rate of 39.0% (90/231). Blood cultures were obtained in 255 (61.7%) episodes, of which 33 (12.9%) were positive. Streptococcus agalactiae was the most frequently isolated pathogen (8/33; 24.2%). Risk factors independently associated with recurrence included any radiotherapy (hazard ratio [HR] 2.15; 95% confidence interval [CI] 1.24-3.72; P < 0.01), axillary lymph node dissection (HR 1.96; 95% CI 1.05-3.68; P < 0.05), and shorter time from BCRL diagnosis to the initial cellulitis episode (HR 0.99; 95% CI 0.99-0.99; P < 0.01).</p><p><strong>Conclusions: </strong>Cellulitis is a significant complication of BCRL with a high recurrence rate. Radiotherapy, axillary lymph node dissection, and early cellulitis onset are associated with recurrence. These findings support proactive surveillance and risk-stratified prevention strategies to reduce infection burden and improve outcomes in this high-risk population.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318157","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":"Preoperative Anemia, Transfusion, and Long-Term Oncologic Outcomes after Gastrectomy: Findings from the POWER4 Cohort.","authors":"Javier Ripollés-Melchor, Ane Abad-Motos, José A García-Erce, Carlos Jericó, Ángel V Espinosa, María J Colomina, Alfredo Abad-Gurumeta, Margarita Logroño-Ejea, Patricia Galán-Menéndez, Andrés Zorrilla-Vaca, Astrid Batalla, Raquel Fernández-García, Gloria Paseiro-Crespo, Raquel García-Álvarez, Nekari de-Luis-Cabezón, Ana León-Brescher, María García-Nebreda, Héctor Bergés-Gutierrez, Alicia Ruiz-Escobar, José L Rábago-Moriyón, Leticia Gómez-Viana, Lucía Gil-Gómez, Silvia Gil-Trujillo, María J Maroño-Boe, César Aldecoa","doi":"10.1245/s10434-025-18528-7","DOIUrl":"https://doi.org/10.1245/s10434-025-18528-7","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anemia and transfusion are common in gastric cancer surgery and have been associated with adverse short-term outcomes. Their impact on long-term oncologic prognosis remains unclear. We aimed to assess the association between preoperative anemia, perioperative red blood cell transfusion, and disease-free survival (DFS) after gastrectomy.</p><p><strong>Patients and methods: </strong>This was a prespecified long-term analysis of the prospective POWER4 multicenter cohort conducted across 72 Spanish hospitals. Patients undergoing elective gastrectomy for gastric cancer between 2019 and 2020 were followed for ≥ 36 months. DFS was defined as time from surgery to recurrence or death. Primary exposures were preoperative anemia (World Health Organization criteria) and perioperative transfusion (within 72 h). Analyses included Kaplan-Meier estimates, multivariable Cox regression, logistic regression for delayed or omitted adjuvant chemotherapy (RIOT), and causal mediation analysis. Generalized additive models (GAMs) explored nonlinear associations between hemoglobin and DFS.</p><p><strong>Results: </strong>Among 386 patients, 47% had anemia and 28% received transfusion. In 368 with complete follow-up, DFS event rates ranged from 13% (no anemia/no transfusion) to 38% (anemia + transfusion) (p < 0.001). Both exposures were associated with DFS in univariable models but lost significance after adjustment. No hemoglobin threshold was identified. Among 149 eligible patients, RIOT was delayed or omitted in 41%, with neither exposure as independent predictors. Mediation analysis suggested transfusion explained 26% of the effect of anemia on DFS, though not significantly.</p><p><strong>Conclusions: </strong>Anemia and transfusion were associated with adverse unadjusted outcomes, but not independently. This supports interpreting anemia as a marker of vulnerability rather than a modifiable risk factor for recurrence.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318132","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":"Outcomes of First Versus Second-Line Hepatic Artery Infusion Chemotherapy in Unresectable Intrahepatic Cholangiocarcinoma.","authors":"Naaz Nasar, Misha Armstrong, Joanne F Chou, Mithat Gonen, Kevin C Soares, Vinod P Balachandran, Jeffrey A Drebin, T Peter Kingham, Alice C Wei, Michael I D'Angelica, Remo Alessandris, Andrea Cercek, James Harding, Eileen M O'Reilly, Ghassan K Abou-Alfa, Wungki Park, Louise Connell, Nancy Kemeny, William R Jarnagin","doi":"10.1245/s10434-025-18544-7","DOIUrl":"https://doi.org/10.1245/s10434-025-18544-7","url":null,"abstract":"<p><strong>Background: </strong>Hepatic artery infusion chemotherapy (HAIC) has shown survival benefits in unresectable intrahepatic cholangiocarcinoma (IHC). The optimal timing of HAIC remains uncertain. This study compares outcomes with HAIC when used as first-line treatment compared with as second-line treatment in patients with advanced IHC.</p><p><strong>Methods: </strong>A total of 722 patients with biopsy-proven IHC treated from 2000 to 2018 were evaluated. Patients undergoing upfront resection or with metastatic disease beyond regional lymph nodes were excluded. Overall survival (OS) was calculated from the date of diagnosis using Kaplan-Meier methods. To assess the impact of timing of HAIC on survival, multi-state models using parametric Cox regression and separate cause-specific hazard models were used to estimate mean survival time from diagnosis.</p><p><strong>Results: </strong>A total of 336 patients eligible for HAIC were analyzed: 137 received first-line HAIC and 199 received first-line systemic chemotherapy (SYS). The median OS of all patients was 22 months (95% confidence interval [CI] 20-25), and HAIC given at any time was associated with reduced all-cause mortality by 34% (hazard ratio [HR] 0.66; 95% CI 0.52-0.84). Of 199 patients who received first-line SYS, 59 received second-line HAIC, 73 received second-line SYS, and 67 did not receive further treatment. Multi-states analyses revealed that first-line HAIC was associated with a mean survival time of 33 months, compared with 36 months for second-line HAIC and 22 months for those who received second-line SYS.</p><p><strong>Conclusion: </strong>HAIC is associated with a survival benefit whether administered in the first-line or second-line setting, supporting its use as an effective treatment option in unresectable IHC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318185","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 Visual Abstract: Disaggregating Asian American and Pacific Islander Subpopulations in Esophageal Cancer-Stage, Histology, and Survival.","authors":"Shawn M Doss, Vatsala Kapoor, Ryan Brownlee, Luke Guy, Daniel Milgrom, Steven Colquhoun, Alicia H Arnold, Danny Yakoub","doi":"10.1245/s10434-025-18578-x","DOIUrl":"https://doi.org/10.1245/s10434-025-18578-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318131","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":"Robotic Left Hepatectomy with Hilar Dissection and Portal Lymphadenectomy Following Preoperative Gemcitabine, Cisplatin, and Pembrolizumab for Intrahepatic Cholangiocarcinoma.","authors":"Juan Felipe Salazar Gonzalez, Daniel Aliseda, Jon Michael Harrison, Brendan Christopher Visser","doi":"10.1245/s10434-025-18515-y","DOIUrl":"https://doi.org/10.1245/s10434-025-18515-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The historic management of resectable intrahepatic cholangiocarcinoma (ICC) included open resection and portal lymphadenectomy.&lt;sup&gt;1&lt;/sup&gt; In the modern era of effective perioperative systemic and immunotherapies, more locally advanced tumors are being converted to resectable disease.&lt;sup&gt;2&lt;/sup&gt; As the surgical limits of safe oncologic resection continue to expand at experienced centers, minimally invasive approaches have also gained traction given the superior intraoperative optics, improved dexterity, and expedited recovery of patients.&lt;sup&gt;3&lt;/sup&gt; As such, we report a successful robotic resection of a locally advanced left-sided ICC pre-treated with induction chemoimmunotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient and methods: &lt;/strong&gt;A 40-year-old male patient was found to have a left-sided liver mass during workup for right-sided abdominal pain. Dedicated triphasic computed tomography (CT) revealed a 10 cm mass with two possible ipsilobar daughter satellite lesions as well as tumor thrombus emanating from the left portal vein and bulky periportal lymphadenopathy. Biopsy confirmed ICC without targetable mutations. CA19-9 was elevated at 400 U/mL. After multidisciplinary tumor board review of this patient's locally advanced case, induction therapy with gemcitabine, cisplatin, and pembrolizumab was initiated. After five treatment cycles (roughly 4 months), the patient underwent restaging imaging, which demonstrated a robust radiographic response, including withdrawal of the tumor thrombus deeper into the left portal system as well as reduction in CA19-9 levels. Given the patient's young age, good performance status, and impressive treatment response, we reviewed the risks and benefits of proceeding with robotic left hepatectomy and portal lymphadenectomy. Note that several contingencies were discussed preoperatively, including open conversion and a more extensive resection should the tumor be understaged or progressed off therapy. To ensure sufficient liver remnant, we routinely spare the caudate in left hepatectomies for ICC unless there is compelling evidence of preoperative radiographic involvement. Finally, we planned to address the receding tumor thrombus with intraoperative ultrasound and using intraoperative frozen section. Should this return positive, we discussed with the patient a venous resection and reconstruction to achieve a negative margin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Operative time was 4 h with an estimated blood loss of 150 cc. Cumulative Pringle time was 30 min. The patient had an uneventful postoperative recovery and was discharged home on postoperative day 3. Final pathology revealed a single 5.7 cm ICC with complete pathologic response and negative margins. Notably, 4 of 11 lymph nodes were involved with tumor for a final TNM staging of T1bN1. After multidisciplinary re-review of this patient's pathology, the patient resumed their preoperative systemic regimen. At most recent 4-month follow-up, ther","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318169","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 Visual Abstract: Rurality and Use of Metastasis-Directed Therapies in Medicare Beneficiaries with Metastatic Colon Cancer: A Retrospective Cohort Study.","authors":"Vrushabh P Ladage, Niveditta Ramkumar, Qianfei Wang, A James O'Malley, Carrie H Colla, Sandra L Wong, Anna N A Tosteson, Gabriel A Brooks","doi":"10.1245/s10434-025-18586-x","DOIUrl":"https://doi.org/10.1245/s10434-025-18586-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318117","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}