Annals of Surgical Oncology最新文献

{"title":"ASO Author Reflections: Adding Radiotherapy to Neoadjuvant Chemoimmunotherapy Improves Pathological Response but not Short‑Term Survival in Esophageal Squamous Cell Carcinoma.","authors":"Xin Xiao, Pinhao Fang, Yong Yuan","doi":"10.1245/s10434-026-20486-7","DOIUrl":"10.1245/s10434-026-20486-7","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10405-10406"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811873","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":"Definitive Chemoradiotherapy for Adenocarcinoma of the Esophagus or Esophago-Gastric Junction: A Dutch Population-Based Cohort Study.","authors":"S S G Gangaram Panday, O Khoma, H W M van Laarhoven, L van Doorn, J Nuyttens, P S N van Rossum, R H A Verhoeven, B P L Wijnhoven, B Mostert, S M Lagarde","doi":"10.1245/s10434-026-20428-3","DOIUrl":"10.1245/s10434-026-20428-3","url":null,"abstract":"<p><strong>Background: </strong>Locally advanced esophageal adenocarcinoma has a poor prognosis and limited treatment options when surgery is not possible or desired. Although definitive chemoradiotherapy (dCRT) is currently administered as a curatively intended treatment, limited data exist regarding its efficacy for patients with adenocarcinoma of the esophagus, necessitating further evaluation of survival outcomes.</p><p><strong>Methods: </strong>Patients with a diagnosis of adenocarcinoma of the esophagus or esophago-gastric junction who had undergone dCRT (defined as a radiation dose of > 41.4 Gy and ≤ 50.4 Gy, respectively) were identified from the nationwide Netherlands Cancer Registry (2015-2022). Overall survival (OS) was analyzed, and multivariable Cox regression analysis was performed to evaluate prognostic factors. Progression-free survival (PFS) was estimated for the subgroup of patients with detailed follow-up data from 2015 to 2017.</p><p><strong>Results: </strong>The study analyzed 926 patients, including 263 patients with data on recurrence patterns. Of these patients, 77% had a diagnosis of stage III/IVa disease, and 72% had a WHO performance status of 0 to 1. The 90-day mortality rate was 7.1%. The median OS was 19.6 months (95% confidence interval [CI], 18.6-21.2 months), and the 3-year OS was 28%. The median PFS was 12.1 months (95% CI, 9.7-14.0 months). Clinical T3-T4 category, cN+ category, WHO performance status, and tumor length were linked to worse survival, although the multivariable model had limited discriminatory power.</p><p><strong>Conclusion: </strong>Real-world OS and PFS for patients with adenocarcinoma of the esophagus or esophago-gastric junction who received dCRT were poor, and 90-day mortality was substantial. These outcomes highlight the need for optimal patient selection, well-informed shared decision-making, and the development of improved treatment strategies.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10375-10383"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811901","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":"Clinical Outcomes of Neoadjuvant Chemoimmunotherapy Versus Chemoradiation Combined with Immunotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis.","authors":"Xin Xiao, Pinhao Fang, Chengyi Mao, Jianfeng Zhou, Yushang Yang, Siyuan Luan, Xiaokun Li, Haowen Zhang, Yong Yuan","doi":"10.1245/s10434-026-20415-8","DOIUrl":"10.1245/s10434-026-20415-8","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoimmunotherapy (NCIT) has emerged as a promising strategy for patients with esophageal squamous cell carcinoma (ESCC). However, whether neoadjuvant chemoradiation-immunotherapy (NCRI) can further improve therapeutic efficacy remains uncertain.</p><p><strong>Methods: </strong>This study prospectively enrolled and retrospectively analyzed 557 consecutive patients with locally advanced ESCC who underwent neoadjuvant therapy between December 2019 and January 2025. The participants were stratified into two treatment cohorts: those receiving NCIT and those undergoing NCRI. To mitigate potential selection bias and ensure balanced baseline characteristics between groups, a 1:1 propensity score-matching (PSM) protocol was implemented incorporating multiple clinically relevant covariates to assess short-term pathologic outcomes and long-term survival.</p><p><strong>Results: </strong>After PSM, these baseline characteristics were well balanced, with 124 patients in each group. The NCRI group demonstrated superior pathologic outcomes, with a significantly higher pathologic complete response (pCR) rate (41.1% vs 19.4%; P < 0.001) and a lower tumor regression score (TRS; P < 0.001), but also a higher incidence of postoperative pulmonary complications (37.1% vs 16.9%; P < 0.001). Despite these differences, no significant variation in overall survival (OS; P = 0.837) or disease-free survival (DFS; P = 0.429) was observed between the two groups during the follow-up period.</p><p><strong>Conclusions: </strong>The addition of radiotherapy to NCIT significantly improved pCR rates compared with NCIT alone, but was associated with a higher incidence of postoperative pulmonary complications. However, this pathologic benefit did not translate into superior long-term survival outcomes in either OS or DFS.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10356-10365"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787588","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: Proximal Gastrectomy After Neoadjuvant Therapy: Function-Preserving Surgery for Gastroesophageal Junction Cancer.","authors":"Ze-Lin Wen, Hu Ren, Diliyaer Adili, He Fei, Peng-Hui Niu, Ze-Feng Li, Hong-Xu Nie, Dong-Bing Zhao","doi":"10.1245/s10434-026-20571-x","DOIUrl":"10.1245/s10434-026-20571-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10736-10737"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987906","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":"Oncological Outcomes of Segmentectomy for Centrally Located Small-Sized Non-small-cell Lung Cancer: A Multicenter Study (CReGYT-02 Study).","authors":"Kazuki Takada, Takamasa Koga, Kotaro Nomura, Taichi Matsubara, Takamitsu Hayakawa, Ryo Fujikawa, Akira Hamada, Kosuke Fujino, Shinya Katsumata, Hikaru Watanabe, Jun Suzuki, Fumihiko Kinoshita, Naoki Haratake, Miyuki Abe, Shinkichi Takamori, Shinya Tane, Hironobu Hoshino, Hiroyuki Tsuchida, Satoshi Muto, Makoto Endo, Tomoyoshi Takenaka, Tomoharu Yoshizumi, Mototsugu Shimokawa, Junichi Soh, Yasuhisa Ohde","doi":"10.1245/s10434-026-20379-9","DOIUrl":"10.1245/s10434-026-20379-9","url":null,"abstract":"<p><strong>Background: </strong>The oncologic appropriateness of segmentectomy for centrally located small-sized non-small-cell lung cancer (NSCLC) remains unclear. This study evaluated the outcomes of segmentectomy compared with lobectomy for centrally located clinical stage IA NSCLC.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study used the CReGYT-02 database from 17 Japanese institutions. Patients with clinical stage IA NSCLC (8th edition), tumor ≤3 cm, and consolidation-to-tumor ratio > 0.5 who underwent segmentectomy or lobectomy between 2012 and 2016 were included. Tumors located in the outer one-third of the lung parenchyma were excluded. Outcomes included recurrence-free survival, overall survival, recurrence patterns, and performance status and treatment at recurrence or diagnosis of other cancers. Kaplan-Meier analysis and Cox proportional hazards models were performed before and after inverse probability of treatment weighting.</p><p><strong>Results: </strong>Among 479 eligible patients, 26 underwent segmentectomy and 453 lobectomy. After inverse probability of treatment weighting, segmentectomy was not associated with inferior recurrence-free survival (hazard ratio 0.71; 95% confidence interval 0.31-1.67) or overall survival (hazard ratio 1.12; 95% confidence interval 0.46-2.70). Recurrence occurred in 7.7% after segmentectomy and 21.0% after lobectomy; no locoregional recurrences occurred after segmentectomy. All patients in the segmentectomy group maintained performance status 0-1 and received treatment at recurrence or diagnosis of other cancers.</p><p><strong>Conclusions: </strong>Segmentectomy was not associated with worse oncologic outcomes or increased locoregional failure compared with lobectomy among highly selected patients with centrally located small-sized NSCLC. However, because the segmentectomy cohort was very small, these findings should be interpreted cautiously and require validation in larger prospective studies.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10326-10334"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705297","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":"Log Odds of Positive Lymph Nodes Improves Risk Stratification for Early Recurrence and Survival After Radical Esophagectomy for cT3 Esophageal Squamous Cell Carcinoma.","authors":"Byung Jo Park, Tae Hee Hong, Young Ho Yang, Ha Eun Kim, Chang Young Lee, Jin Gu Lee, Dae Joon Kim","doi":"10.1245/s10434-026-20288-x","DOIUrl":"10.1245/s10434-026-20288-x","url":null,"abstract":"<p><strong>Background: </strong>Early recurrence after curative resection for cT3 esophageal squamous cell carcinoma (ESCC) is strongly associated with poor long-term survival. Identifying patients at high risk of early recurrence may improve postoperative risk stratification and inform tailored surveillance or adjuvant therapy.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed patients who underwent en bloc esophagectomy with three-field lymphadenectomy. The log odds of positive lymph nodes (LODDS) were calculated as log([number of positive nodes + 0.5]/[number of negative nodes + 0.5]). Early recurrence was defined using maximally selected rank statistics. Independent risk factors for early recurrence were identified using multivariable Firth logistic regression, followed by decision tree analysis to establish hierarchical risk stratification.</p><p><strong>Results: </strong>Among 121 patients, 109 (90.1%) achieved R0 resection. The median numbers of dissected and metastatic lymph nodes were 67.0 and 2.0, respectively, with a median LODDS of - 3.46. Early recurrence was defined as recurrence within 16.6 months after surgery. Multivariable analysis identified higher LODDS, upper thoracic location, and resectability status (resectable or borderline resectable) as independent predictors of early recurrence. In the complementary tree-based analysis, early recurrence risk was primarily stratified by LODDS using a cut-off of - 2.69. Patients with LODDS > - 2.69 had significantly worse 5-year overall survival than those with LODDS ≤ -2.69 (30.0% versus 66.1%, p < 0.001). Among patients with LODDS ≤ - 2.69, tumor location further refined risk stratification.</p><p><strong>Conclusions: </strong>LODDS provides a robust and clinically applicable metric for postoperative risk stratification of early recurrence in patients undergoing radical esophagectomy for cT3 ESCC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10292-10300"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590324","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: Expanding the Boundaries of Breast Conservation with Chest Wall Perforator Flaps.","authors":"Ljuba Morando, Jenny-Claude Millochau, Claude Nos, Benoit Couturaud, Alejandro Martin Sanchez, Isabelle Sarfati, Krishna B Clough","doi":"10.1245/s10434-026-20189-z","DOIUrl":"10.1245/s10434-026-20189-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10816-10817"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434853","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":"Exploring the Limits of Perigastric Surgery in Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Pseudomyxoma Peritonei: A Functional Burden with Preserved Oncologic Outcomes.","authors":"Matteo Aulicino, Carlo Abatini, Claudio Lodoli, Giorgio D'Annibale, Lorenzo Barberis, Rossella Sepe, Maria Alessandra Calegari, Sergio Alfieri, Fabio Pacelli, Francesco Santullo","doi":"10.1245/s10434-026-19711-0","DOIUrl":"10.1245/s10434-026-19711-0","url":null,"abstract":"<p><strong>Introduction: </strong>Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard treatment for pseudomyxoma peritonei (PMP), and complete cytoreduction remains essential for prognosis. While gastrectomy has traditionally represented a major threshold of surgical aggressiveness, the functional impact of increasingly extensive perigastric dissection is not well defined.</p><p><strong>Methods: </strong>We retrospectively analyzed 110 consecutive patients who underwent CRS and HIPEC for appendiceal PMP between 2016 and 2024. Perigastric procedures were categorized into five Gastric Cytoreductive Levels (GCLs) based on the extent of vascular sacrifice. Postoperative gastrointestinal recovery was compared among stomach-preserving procedures (GCL1-4), whereas morbidity and oncologic outcomes were evaluated across all five groups. Independent predictors of delayed oral refeeding were assessed through multivariable logistic regression, and a predictive nomogram was developed.</p><p><strong>Results: </strong>Gastrointestinal recovery worsened with increasing extent of stomach-preserving perigastric dissection. Patients in GCL4 experienced delayed oral intake, longer dependence on parenteral nutrition, and prolonged hospitalization compared with those undergoing less extensive procedures; nasogastric tube removal was also delayed. Major morbidity, 30 day mortality, and long-term survival were similar across all groups. Female sex, longer operative duration, and GCL4 independently predicted delayed oral refeeding. The nomogram demonstrated good discrimination and calibration.</p><p><strong>Conclusions: </strong>Increasingly extensive perigastric cytoreduction is associated with impaired postoperative gastric recovery while maintaining acceptable morbidity and oncologic outcomes. The predictive nomogram-although exploratory-may help to anticipate postoperative nutritional needs and support tailored recovery strategies after extensive CRS and HIPEC for PMP.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10184-10194"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855792","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":"Decreasing Time to Definitive Breast Reconstruction: National Trends and Patient-Level Predictors.","authors":"Chanel R Varney, Tara Pillai, Nicholas C Oleck, Yue Jiang, Neill Y Li, Ash Patel, Brett T Phillips","doi":"10.1245/s10434-026-20384-y","DOIUrl":"10.1245/s10434-026-20384-y","url":null,"abstract":"<p><strong>Background: </strong>The time interval between mastectomy and breast reconstruction reflects the speed of care delivery and has been associated with patient quality of life. This study evaluates 2010-2020 trends in the reconstructive interval and additional metrics of care delivery, including length-of-stay and outpatient setting utilization.</p><p><strong>Patients and methods: </strong>A retrospective cohort study of 2010-2020 mastectomy patients was conducted using national insurance claims data. Trends in the reconstructive interval were analyzed for recipients of nonimmediate breast reconstructions via linear regression. Multivariable analysis was used to identify predictors of interval durations. Trends in inpatient length-of-stay and outpatient surgery utilization were assessed via linear regression for nonimmediate reconstructions, immediate reconstructions, and mastectomy-only surgeries.</p><p><strong>Results: </strong>350,243 patients (median age, 59.0) were included. From 2010 to 2020, the median reconstructive interval decreased from 187 to 168 days for nonimmediate implant reconstructions (β = - 1.92; p < 0.001) and from 337 to 288 days for nonimmediate autologous reconstructions (β = - 5.00; p = 0.002). Predictors of prolonged reconstructive intervals were interval radiation therapy (β = 130.87; p < 0.001), interval chemotherapy (β = 70.30; p < 0.001), autologous reconstruction technique (β = 38.33; p < 0.001), and Medicaid insurance (β = 28.84; p < 0.001). From 2010 to 2020, mean inpatient length-of-stay decreased for four of the six surgery types, including immediate implant reconstructions (2.00 to 1.65 nights; β = - 0.03; p = 0.009) and immediate autologous reconstructions (4.00 to 3.06 nights; β = - 0.08; p = 0.006). Outpatient utilization increased for all nonautologous surgeries, accounting for 82.2-98.0% of such cases in 2020.</p><p><strong>Conclusions: </strong>Nationally, decreasing reconstructive intervals coincided with decreasing inpatient length-of-stay and increasing outpatient surgery utilization. Collectively, these trends reflect a dramatic acceleration in breast reconstruction care delivery over the past decade.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10564-10573"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787550","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: From Fluorescence to Action: Standardizing Intraoperative Mastectomy Flap Assessment.","authors":"Yizhuo Shen, Lauren Valentine, Renee Gao, Stav Brown, Felix J Klimitz, Samira Glaeser-Khan, Meera Nair, Rohan Kumaran, Geronimo Salcedo, Nikita Singh, Luccie Wo, Siba Haykal","doi":"10.1245/s10434-026-20438-1","DOIUrl":"10.1245/s10434-026-20438-1","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"10584-10585"},"PeriodicalIF":3.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787582","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}