Annals of Surgical Oncology最新文献

{"title":"Survival of Open Versus Thoracoscopic Esophagectomy for Esophageal Squamous Cell Cancer by Tumor Location: An Energy Balancing Weights Analysis.","authors":"Yishuo Gao, Yongli Yang, Tongtong Ren, Nana Wang, Peinan Chen, Funa Yang, Xiaocan Jia","doi":"10.1245/s10434-025-18562-5","DOIUrl":"https://doi.org/10.1245/s10434-025-18562-5","url":null,"abstract":"<p><strong>Background: </strong>The survival impact of open esophagectomy (OE) versus thoracoscopic esophagectomy (TE) in patients with esophageal squamous cell carcinoma (ESCC) based on tumor location remains debated. This study employs energy balancing weights (EBW) to compare long-term survival between OE and TE across tumor locations.</p><p><strong>Patients and methods: </strong>This ambispective cohort study analyzed 1778 patients with ESCC undergoing OE or TE at a tertiary hospital between January 2015 and December 2016. Primary endpoints were 5-year overall survival (OS) and disease-free survival (DFS); secondary endpoints included operative safety. EBW-adjusted Cox regression was used to compare long-term survival, with sensitivity analyses via inverse probability of treatment weighting and matching weight methods.</p><p><strong>Results: </strong>The median survival times for upper, middle, and lower tumor locations were 60.06, 60.48, and 64.35 months, respectively. Compared with OE, the Cox regression analysis of TE showed that in the upper group, the HR was 0.45 (95% CI 0.27-0.75) for OS and the HR was 0.55 (0.34-0.89) for DFS. In the middle group, theHR was 0.64 (0.48-0.85) for OS and the HR was 0.70 (0.53-0.91) for DFS. And in the lower group, the HR was 0.70 (0.44-1.11) for OS and the HR was 0.67 (0.43-1.04) for DFS. Additionally, TE was associated with reduced blood loss and increased lymph node yield but had longer operative times and higher costs (P < 0.05).</p><p><strong>Conclusions: </strong>TE improved survival and safety in upper/middle ESCC, while lower tumor locations require individualized approaches. EBW enhanced confounder control, supporting reliable clinical decisions.</p>","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":"145318118","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":"Underutilization of Staging Laparoscopy Prior to Neoadjuvant Systemic Therapy in Gastric Cancer.","authors":"Arsha Ostowari, Kathryn T Chen, Bima J Hasjim, Stefania Montero, Shaina Sedighim, Fatemeh Tajik, Melanie Roman, Farshid Dayyani, Shaun Daly, Brian R Smith, Ninh T Nguyen, Oliver S Eng, Michael P O'Leary, Maheswari Senthil","doi":"10.1245/s10434-025-18547-4","DOIUrl":"https://doi.org/10.1245/s10434-025-18547-4","url":null,"abstract":"<p><strong>Background: </strong>Radiographically occult peritoneal carcinomatosis (PC) is a major concern in gastric cancer; hence staging laparoscopy (SL) is recommended prior to initiating treatment, particularly neoadjuvant systemic therapy (NST). However, compliance may vary and could result in understaging. We sought to evaluate the utilization of SL in patients with gastric cancer referred to academic institutions.</p><p><strong>Patients and methods: </strong>This is a multi-institution retrospective study of patients with a diagnosis of gastric/gastroesophageal junction (GEJ) Siewert 3 adenocarcinoma who received treatment between 2010 and 2022. Demographics, tumor characteristics, treatment, and recurrence data were collected. Descriptive statistics and multivariate analysis were performed.</p><p><strong>Results: </strong>A total of 280 patients with gastric/GEJ cancer were identified, of which 75 (26.8%) had clinical stage IV disease and were excluded. Of the remaining 205 patients, 74 (36.1%) underwent upfront surgery and 131 (63.1%) underwent NST. Only 39 (29.8%) patients in the NST group underwent SL, of whom 15(38.4%) were found to have peritoneal metastases; 12 (80%) had gross PC and 3 (20%) had positive cytology. Among patients who underwent surgical resection after NST (n = 77), 26 (33.7%) experienced disease recurrence with a median time to recurrence of 11.6 months. The peritoneum (n = 10/26, 38.5%) was the most common site of recurrence.</p><p><strong>Conclusions: </strong>Compliance with SL prior to NST is poor (29.8%), and in the group that underwent SL, 38% of patients were upstaged due to presence of peritoneal metastases. These findings are significant, as the management and prognosis of peritoneal metastases are drastically different. Various factors could lead to poor compliance with SL, hence better compliance and alternate approaches to reliably detect PC are needed.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312113","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: Survival Benefit of Adjuvant S-1 Chemotherapy in Patients Aged ≥ 80 Years with Gastric Cancer after Curative Resection-A Multicenter Cohort Study.","authors":"Shutaro Sumiyoshi, Takeshi Kubota, Hiroyuki Inoue, Kazuya Takabatake, Keiji Nishibeppu, Junichi Hamada, Toshiya Ochiai, Yosuke Ariyoshi, Atsushi Toma, Kenji Watanabe, Nobuki Yamaoka, Soujin Sai, Shozo Ide, Tomoya Hatakeyama, Yoshiki Itokawa, Fumiaki Ochi, Hirotaka Konishi, Hitoshi Fujiwara, Miho Sekimoto, Satoru Shikata, Atsushi Shiozaki","doi":"10.1245/s10434-025-18577-y","DOIUrl":"https://doi.org/10.1245/s10434-025-18577-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306929","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: Robotic Segmental Hepatic Resection Associated to Pancreatoduodenectomy for Gallbladder Cancer and Extrahepatic Cholangiocarcinoma.","authors":"Guanyu Wang, Zhuzeng Yin","doi":"10.1245/s10434-025-18565-2","DOIUrl":"https://doi.org/10.1245/s10434-025-18565-2","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312177","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: Improving Preoperative Risk Stratification for Esophagectomy: Insights from Cardiopulmonary Exercise Testing.","authors":"Watson Hua-Sheng Tseng, Shu-Chun Huang","doi":"10.1245/s10434-025-18564-3","DOIUrl":"https://doi.org/10.1245/s10434-025-18564-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306928","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: The Survival for Pneumonectomy After Neoadjuvant Therapy in Non-Small Cell Lung Cancer.","authors":"Sikai Wu, Xiaowei Chen, Ershu Bo, Haixiao Diao, Zhenlin Yang, Shugeng Gao","doi":"10.1245/s10434-025-18576-z","DOIUrl":"https://doi.org/10.1245/s10434-025-18576-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312128","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":"Minimally Invasive Gastrectomy for Borrmann Type IV Gastric Cancer: An Oncologically Sound Alternative to Open Surgery.","authors":"Jawon Hwang, Ki-Yoon Kim, Sung Hyun Park, Minah Cho, Yoo Min Kim, Hyoung-Il Kim, Woo Jin Hyung","doi":"10.1245/s10434-025-18573-2","DOIUrl":"https://doi.org/10.1245/s10434-025-18573-2","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have validated the oncologic safety of minimally invasive surgery (MIS) for advanced gastric cancer, but the feasibility of applying MIS to treat Borrmann type IV gastric cancer remains unclear. Given its distinct clinicopathological features, poor prognosis, and technical complexities in surgery, further investigation is needed. This study aimed to compare the surgical and oncological outcomes between open surgery and MIS in patients with Borrmann type IV gastric cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 1025 patients who underwent open (n = 888) or minimally invasive (n = 137) gastrectomy for Borrmann type IV gastric cancer between 2003 and 2021. Propensity score matching was performed to balance baseline characteristics, and short- and long-term outcomes were compared between the matched groups.</p><p><strong>Results: </strong>After propensity score matching, each group included 112 matched patients. The MIS group had longer operative times (p < 0.001) but shorter hospital stays (p < 0.001) than the open surgery group. Other perioperative outcomes showed no significant differences. Overall and recurrence-free survival were comparable between the two groups (p = 0.741 and p = 0.707, respectively). Adjusted hazard ratios for death and recurrence following MIS compared with open surgery were 1.20 (95% confidence interval 0.78-1.85, p = 0.396) and 1.22 (95% confidence interval 0.83-1.79, p = 0.308), respectively.</p><p><strong>Conclusion: </strong>Our findings suggest that MIS for Borrmann type IV gastric cancer may offer long-term oncologic outcomes comparable to those with open surgery while preserving the inherent benefits of MIS.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306877","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 Multidisciplinary Breast Cancer Clinic Improves Time to Treatment at an Urban, Safety Net Hospital.","authors":"Anna J Kobzeva-Herzog, Sarvesh Palaniappan, Yilan Jiangliu, Emma Kraus, Heba Elassar, Andrea Merrill, Lauren Oshry, Jose Acevedo, Naomi Ko, Michael R Cassidy","doi":"10.1245/s10434-025-18497-x","DOIUrl":"https://doi.org/10.1245/s10434-025-18497-x","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomically vulnerable patients experience significant breast cancer care treatment disparities. Our aim was to examine how multidisciplinary breast cancer clinic (MBCC) implementation affected time to treatment at a safety net hospital.</p><p><strong>Methods: </strong>This was a retrospective cohort study of female patients (≥18 years) with new breast cancer diagnoses from January 2019-September 2022. Time to treatment from biopsy-confirmed diagnosis was compared between patients seen in MBCC and those in a traditional discipline-based serial episodic clinic model.</p><p><strong>Results: </strong>Among 734 patients (mean age 58.5 years), 45.8% identified as Black and 48.4% were insured by Medicaid. MBCC patients (28.9%) were younger (55.7 vs. 59.6 years, P<0.001), less likely to be Hispanic (18.4% vs. 27.6%, P=0.01), more likely to have invasive cancer (86.8% vs. 60.3%, P<0.001), had shorter time to treatment (35.0 vs. 46.9 days, P<0.001), and were more likely to receive chemotherapy first (48.6% vs. 11.5%, P<0.001) compared to non-MBCC patients. In patients who received chemotherapy first, MBCC was associated with reduced time to initial appointment (10.2 vs. 18.1 days, P=0.011) and treatment initiation (27.1 vs. 42.6 days, P<0.001). Multivariable analysis showed invasive histology was associated with MBCC participation (OR 4.29, P<0.0001), while Hispanic ethnicity (OR 0.55, P=0.014) and older age (OR 0.98, P=0.021) were less associated with MBCC.</p><p><strong>Conclusions: </strong>Implementation of a MBCC in a safety net hospital improved time to initial breast cancer treatment for vulnerable patients. Moving forward, MBCC can serve as a model to reduce disparities in vulnerable patient populations.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312049","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 Fragmentation of Care and Delivery of Adjuvant Chemotherapy in Patients Traveling to High-Volume Hospitals for Pancreatic Adenocarcinoma.","authors":"Alexa J Hughes, Kristen N Kaiser, Emma Holler, Brian M Ruedinger, Anita A Turk, Cary Jo R Schlick, Michael G House, Karl Y Bilimoria, Ryan J Ellis","doi":"10.1245/s10434-025-18539-4","DOIUrl":"https://doi.org/10.1245/s10434-025-18539-4","url":null,"abstract":"<p><strong>Background: </strong>Surgical care for pancreatic ductal adenocarcinoma (PDAC) is increasingly centralized to high-volume hospitals (HVHs), prompting many patients to travel farther for resection. While surgery is centralized, adjuvant chemotherapy is often delivered locally, resulting in care fragmentation. The implications of this separation on chemotherapy receipt and survival are unclear. This study evaluated associations between travel distance, care fragmentation, and receipt of adjuvant chemotherapy in patients undergoing upfront PDAC resection at HVHs and assessed how these factors influenced overall survival.</p><p><strong>Methods: </strong>Patients with non-metastatic PDAC who underwent upfront resection at HVHs (≥20 pancreatectomies/year) were identified from the National Cancer Database (2007-2021). The cohort was stratified by adjuvant chemotherapy receipt, travel distance (deciles D1-D10), and care fragmentation. Multivariable logistic regression assessed factors associated with chemotherapy receipt; Cox proportional hazards models evaluated survival.</p><p><strong>Results: </strong>Among 17,807 patients treated at 97 HVHs, 10,200 (57%) received adjuvant chemotherapy. Patients traveling ≥14 miles (≥D4) were less likely to receive adjuvant chemotherapy (D4 odds ratio [OR] 0.85; 95% confidence interval [CI] 0.73-0.99; P=0.04). Patients experiencing care fragmentation were more likely to receive adjuvant therapy (64.3% vs. 54.4%, OR 1.51; 95% CI 1.35-1.69; P<0.001). Travel ≥20 miles (≥D5) was associated with higher mortality (hazards ratio [HR] 1.12; 95% CI 1.02-1.23; P=0.01). Conversely, receipt of adjuvant chemotherapy (HR 0.77; 95% CI 0.73-0.81; P<0.001) and fragmented care (HR 0.89; 95% CI 0.84-0.93; P<0.001) were associated with improved survival.</p><p><strong>Conclusions: </strong>Longer travel distance was associated with lower chemotherapy receipt and worse survival. Care fragmentation was linked to improved treatment access and survival, underscoring the need for coordinated cross-institutional care.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298283","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":"Perineural Invasion Worsens Long-Term Outcomes of Pancreatic Neuroendocrine Tumors Following Surgical Resection.","authors":"Hui Xu, Jing-Jing Hou, Jun-Xi Xiang, Alexandra G Lopez-Aguiar, George Poultsides, Flavio Rocha, Sharon Weber, Ryan Fields, Kamran Idrees, Cliff Cho, Shishir K Maithel, Yi Lv, Xu-Feng Zhang, Timothy M Pawlik","doi":"10.1245/s10434-025-18561-6","DOIUrl":"https://doi.org/10.1245/s10434-025-18561-6","url":null,"abstract":"<p><strong>Background: </strong>To define the impact of perineural invasion (PNI) on long-term survival of patients following curative-intent resection of pancreatic neuroendocrine tumors (pNETs).</p><p><strong>Patients and methods: </strong>Patients with pNETs who underwent curative-intent resection (R0/R1) between 2000 and 2020 were identified from a multi-institutional database. The impacts of PNI on overall survival (OS) and disease-free survival (DFS) were analyzed.</p><p><strong>Results: </strong>Among 700 patients, 171 (n = 24.4%) had a pNET with PNI. The presence of PNI was associated with higher tumor grade (G3, 8.2% vs. 2.5%, p < 0.001), more advanced AJCC T disease (T3-T4, 58.5% vs. 15.9%, p < 0.001), and a higher incidence of nodal metastasis (52.6% vs. 21.2%, p < 0.001) versus patients with no PNI. Patients with PNI had a worse OS (median, with PNI 115.9 months vs. no PNI not reached, p < 0.001) and DFS (median, with PNI 51.9 vs. no PNI 115.4 months, p < 0.001) versus patients with no PNI. On multivariable analysis PNI was an independent risk factor associated with worse OS (HR = 2.624, 95%CI 1.475-4.668, p = 0.001), as well as DFS (HR = 1.972, 95%CI 1.396-2.786, p < 0.001). Among 256 patients with very early staged tumors (G1N0) who underwent an R0 resection, PNI remained a strong independent factor associated with worse long-term survivals (OS, HR = 3.892, 95%CI 1.196-12.662, p = 0.024; DFS, HR = 2.530, 95%CI 1.010-6.339, p = 0.048).</p><p><strong>Conclusions: </strong>PNI was an independent adverse prognostic factor among patients undergoing curative-intent resection of pNETs, even among individuals with early-stage disease. The presence of PNI should be routinely assessed and considered in the prognostic stratification of patients following resection of pNETs.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145306864","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}