Annals of Surgical Oncology最新文献

{"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}

{"title":"Risk-Prediction Models for Clinical Decision-Making in Sarcoma Care: An International Survey Among Soft-Tissue Sarcoma Clinicians.","authors":"Anouk A Kruiswijk, Lisa A E Vlug, Ibtissam Acem, Ellen G Engelhardt, Alessandro Gronchi, Dario Callegaro, Rick L Haas, Robert J P van de Wal, Michiel A J van de Sande, Leti van Bodegom-Vos","doi":"10.1245/s10434-024-16849-7","DOIUrl":"10.1245/s10434-024-16849-7","url":null,"abstract":"<p><strong>Introduction: </strong>Risk prediction models (RPMs) are statistical tools that predict outcomes on the basis of clinical characteristics and can thereby support (shared) decision-making. With the shift toward personalized medicine, the number of RPMs has increased exponentially, including in multimodal sarcoma care. However, their integration into routine soft-tissue sarcoma (STS) care remains largely unknown. Therefore, we inventoried RPM use in sarcoma care during tumor board discussions and patient consultations as well as the attitudes toward the use of RPMs to support (shared) decision-making among STS clinicians.</p><p><strong>Materials and methods: </strong>A 29-item survey was disseminated online to members of international sarcoma societies.</p><p><strong>Results: </strong>This study enrolled 278 respondents. Respectively, 68% and 65% of the clinicians reported using RPMs during tumor board discussions and/or patient consultations. During tumor board discussions, RPMs were used primarily to assess the potential benefits of (neo)adjuvant chemotherapy. During patient consultations, RPMs were used to predict patient prognosis upon request and to assist in decision-making regarding (neo)adjuvant therapies. The reliability of patient risk predicted by RPMs and the absence of guidelines regarding the use of RPMs were identified as barriers. Additionally, some clinicians questioned the applicability of estimates from RPMs to individual patients and expressed concerns about causing unnecessary anxiety when discussing prognostic outcomes.</p><p><strong>Conclusions: </strong>Responding STS clinicians frequently use RPMs to support decision-making about (neo)adjuvant therapies. However, they expressed concerns about the applicability of RPM estimates to individual patients and reported challenges in communicating prognostic outcomes with patients. These findings highlight the difficulties clinicians face when integrating RPMs into patient consultations.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2958-2970"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073730","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":"Robot-Assisted Surgery in Endometrial Cancer: A Dual Benefit for Patients and Surgeons.","authors":"Claire Delage De Luget, Houssein El Hajj, Eric Lambaudie","doi":"10.1245/s10434-025-17277-x","DOIUrl":"https://doi.org/10.1245/s10434-025-17277-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762879","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: Sentinel Lymph Node Biopsy for Patients with a Non-classic Lobular Carcinoma In Situ Breast Biopsy.","authors":"Pieter J Westenend, Claudia J C Meurs, Sabine Siesling, Marian B E Menke-Pluijmers","doi":"10.1245/s10434-024-16863-9","DOIUrl":"10.1245/s10434-024-16863-9","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2597-2598"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999097","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":"Challenges, Treatment Strategies, and Surgical Techniques in the Management of Spermatic Cord Sarcomas.","authors":"Luca Improta, Roberto Passa, Chiara Pagnoni, Michela Angelucci, Rossana Alloni, Sergio Valeri","doi":"10.1245/s10434-024-16748-x","DOIUrl":"10.1245/s10434-024-16748-x","url":null,"abstract":"<p><p>Spermatic cord sarcomas (SCS) are a group of mesenchymal tumors whose rarity and anatomical location often lead to clinical misdiagnosis such as inguinal hernia, testicular tumor, or other conditions. Any inguinoscrotal mass with suspicious characteristics should prompt clinicians to perform imaging assessments (such as ultrasound or, in uncertain cases, magnetic resonance imaging (MRI)) and refer the patient promptly to a specialized center. Histological characterization of all suspicious masses via percutaneous biopsy is recommended, with staging completed through computed tomography (CT) scan for confirmed cases. Optimal management is multidisciplinary and should consider both the tumor's histological subtype and specific characteristics of the tumor and patient. Radiotherapy and chemotherapy, while awaiting more robust data in the literature, are valuable adjuncts to surgery, which remains the cornerstone of treatment. Surgery should also be proposed for patients who initially underwent nonspecialist procedures, as a completion approach. The surgical strategy involves en bloc resection through radical orchifunicolectomy, ipsilateral hemiscrotectomy, ligation of the spermatic cord at the internal inguinal ring, and, where necessary, resection of the inguinal canal. Reconstruction may employ mesh or pedicled flaps. The prognosis of SCS, when treated at referral centers, is superior to that of mesenchymal tumors at other sites, underscoring the need for early recognition and prompt multidisciplinary care.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2971-2978"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885195","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: Feasibility of Robotic Liver and Diaphragm Resection Using Robotic Platform-Evolution of Surgical Approach for Multiorgan Abdominal Cancer Resection.","authors":"Parisa Y Kenary, Sharona Ross, Iswanto Sucandy","doi":"10.1245/s10434-024-16813-5","DOIUrl":"10.1245/s10434-024-16813-5","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2489-2490"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909001","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":"The Age-Old Question in Nipple-Sparing Mastectomy: Is Older Age a Contraindication?","authors":"Francys C Verdial, Kyle J Anderman, Abigail E Daly, Tolga Ozmen, Rebecca Kwait, Tawakalitu S Oseni, Amy S Colwell, Michelle C Specht, Michele A Gadd, Barbara L Smith","doi":"10.1245/s10434-024-16741-4","DOIUrl":"10.1245/s10434-024-16741-4","url":null,"abstract":"<p><strong>Background: </strong>Nipple-sparing mastectomy (NSM) is infrequently performed in older women, at least in part owing to concerns regarding age-related complications. We describe postoperative outcomes of NSM in older women and risk factors for complications, with the goal of informing patient selection and decision-making.</p><p><strong>Patients and methods: </strong>Cases of NSM with immediate implant-based reconstruction were identified from an institutional database (2009-2019). Patient characteristics and postoperative complications were compared between women 45-54 years, 55-64 years, and  ≥ 65 years. Regression models were used to identify risk factors for serious complications and reconstruction failure.</p><p><strong>Results: </strong>Of 1998 NSMs in 1197 women, 1296 were in women 45-54 years, 521 in women 55-64 years, and 181 in women ≥ 65 years. Women ≥ 65 years had higher rates of comorbidities and more frequently incurred early postoperative complications (11% versus 7.3% in 55-64 years and 5.2% in 45-54 years, p = 0.005), particularly hematoma (5.0% versus 1.5% in 55-64 years and 1.2% in 45-54 years, p < 0.001). On univariate analysis, unadjusted rates of infection, necrosis, serious complications, and reconstruction failure did not differ significantly by age. Permanent reconstruction failure occurred in eight (4.4%) women ≥ 65 years. On multivariable analysis, age was not an independent predictor of serious complications or reconstruction failure, though current smoking, in addition to factors more common in older women (diabetes, hypertension, anticoagulation, prior radiotherapy), emerged as independent risk factors.</p><p><strong>Conclusions: </strong>After adjusting for patient factors, older age did not increase risk of complications after NSM. Studies on functional and quality-of-life outcomes may help further refine patient selection and facilitate decision-making.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2569-2577"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920649","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: Leveraging Machine Learning for Early Recurrence Prediction in Gastric Cancer: Insights from a Multicenter Real-World Study.","authors":"Xing-Qi Zhang, Ze-Ning Huang, Yan-Bing Zhou, Jian-Xian Lin, Chang-Ming Huang","doi":"10.1245/s10434-024-16772-x","DOIUrl":"10.1245/s10434-024-16772-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2663-2664"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926270","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":"Significance of Tumor Microvasculature in the Tumor Microenvironment in Adenocarcinoma with EGFR Common Mutations.","authors":"Kyoto Matsudo, Kazuki Takada, Asato Hashinokuchi, Taichi Nagano, Fumihiko Kinoshita, Takaki Akamine, Mikihiro Kohno, Tomoyoshi Takenaka, Mototsugu Shimokawa, Yoshinao Oda, Tomoharu Yoshizumi","doi":"10.1245/s10434-024-16806-4","DOIUrl":"10.1245/s10434-024-16806-4","url":null,"abstract":"<p><strong>Background: </strong>Tumor microvasculature is an important component of the tumor microenvironment (TME), and it has been reported that tumor microvasculature induces TME to become immunosuppressive via vascular endothelial growth factor. However, the significance of this in adenocarcinoma with epidermal growth factor receptor (EGFR) common mutations has not been fully investigated.</p><p><strong>Methods: </strong>We analyzed 262 patients with adenocarcinoma harboring EGFR common mutations who underwent surgery at Kyushu University Hospital between 2006 and 2021. Microvessel density (MVD) was calculated by CD34 immunohistochemistry. Patients were categorized into high and low MVD status, which was compared with the clinicopathological characteristics.</p><p><strong>Results: </strong>A total of 136 (51.9%) patients had L858R mutation, and 126 (48.1%) had Exon 19 Del. Regarding MVD status; 133 patients (50.8%) were classified as high and 129 (49.2%) as low. Fisher's exact test revealed a significant association of high MVD status with high CD8+ tumor infiltrating lymphocytes (TILs) (p = 0.0187), low GZMB+ TILs (p = 0.0019), and high Foxp3+ TILs (p = 0.0003). On multivariate analysis, MVD status was significantly associated with Foxp3+ TILs and GZMB+ TILs. Fisher's exact test also revealed that tumors with L858R mutation had a high MVD status (p = 0.0136) compared with tumors with deletions of exon 19 (Exon 19 Del), and multivariate analysis revealed that L858R mutation was significantly associated with high MVD status.</p><p><strong>Conclusions: </strong>In adenocarcinomas harboring EGFR common mutations, abundant tumor microvasculature might induce the TME to be immunosuppressive. Tumors with L858R mutation compared with Exon 19 Del might be more likely to form an immunosuppressive TME owing to the abundance of tumor microvasculature.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"3031-3039"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982124","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}