Annals of Surgical Oncology最新文献

{"title":"ASO Author Reflections: Combining Two Easily Available Parameters Can Help to Individualize Lymph Node Surgery in Medullary Thyroid Cancer (MTC) Without Compromising Cure Rates.","authors":"Martin B Niederle, Teresa Binter, Philipp Riss, Bruno Niederle, Christian Scheuba","doi":"10.1245/s10434-025-17088-0","DOIUrl":"10.1245/s10434-025-17088-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4805-4807"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522537","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":"Comparison of Targeted Axillary Dissection with Sentinel Node Biopsy Alone on Nodal Recurrence for Patients who have Node-Positive Breast Cancer Treated with Neoadjuvant Chemotherapy.","authors":"Marissa K Boyle, Farin Amersi, Alice Chung, Joshua Tseng, Armando E Giuliano","doi":"10.1245/s10434-025-17197-w","DOIUrl":"10.1245/s10434-025-17197-w","url":null,"abstract":"<p><strong>Background: </strong>For patients with node-positive breast cancer whose axilla is clinically downstaged after neoadjuvant chemotherapy (NAC), targeted axillary dissection (TAD) has been adopted at several institutions. This study compared axillary nodal recurrence between TAD and sentinel lymph node biopsy (SLNB) alone.</p><p><strong>Methods: </strong>Consecutive patients with stage II or III biopsy-proven node-positive breast cancer treated with NAC from August 2018 to June 2022 were identified. Patients who became clinically node-negative after NAC and had tumor-free SLNB were evaluated. The patients were divided into two groups: the TAD and SLNB-alone groups.</p><p><strong>Results: </strong>Of the 377 patients treated with NAC, 143 (38 %) had stage II or III node-positive breast cancer, 105 (73 %) were converted to ycN0, and 44 (42 %) had tumor-free SLNB and avoided an axillary lymph node dissection (ALND). Of the 44 patients, 25 (57 %) had TAD, and 19 (43 %) had SLNB alone. The TAD and SLNB-alone groups were clinically similar. The median tumor size was 2.7 cm (range, 1.9-3.4 cm). The SLNB-alone approach was less likely to retrieve the biopsy-proven clipped node (clipped node retained: overall [n = 5/37], TAD [n = 1], SLNB alone [n = 4]; p = 0.03). Adjuvant radiotherapy (RT) was administered to 40 patients (91 %) and regional nodal RT to 32 patients (73 %). During a median follow-up period of 28 months, no axillary nodal recurrences were found in either group.</p><p><strong>Conclusions: </strong>For the patients with stage II or III node-positive breast cancer who became cN0 after NAC, with tumor-free sentinel nodes, axillary nodal recurrence rates were low after both TAD and SLNB alone despite rates of higher non-retrieval of the clipped node in the SLNB-alone group. These findings suggest that either method affords excellent staging and regional control.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4847-4854"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708111","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":"An Open-label, Randomized Study of Melphalan/Hepatic Delivery System Versus Best Alternative Care in Patients with Unresectable Metastatic Uveal Melanoma.","authors":"Jonathan S Zager, Marlana Orloff, Pier Francesco Ferrucci, Junsung Choi, David J Eschelman, Evan S Glazer, Aslam Ejaz, J Harrison Howard, Erika Richtig, Sebastian Ochsenreither, Sunil A Reddy, Michael C Lowe, Georgia M Beasley, Anja Gesierich, Armin Bender, Martin Gschnell, Reinhard Dummer, Michel Rivoire, Ana Arance, Stephen William Fenwick, Joseph J Sacco, Sebastian Haferkamp, Carsten Weishaupt, Johnny John, Matthew Wheater, Christian H Ottensmeier","doi":"10.1245/s10434-025-17231-x","DOIUrl":"10.1245/s10434-025-17231-x","url":null,"abstract":"<p><strong>Background: </strong>Metastatic uveal melanoma (mUM) has a poor prognosis, with liver metastases typically presenting a therapeutic challenge. Melphalan/Hepatic Delivery System (Melphalan/HDS) is a drug/medical device combination used for liver-directed treatment of unresectable mUM patients. This study assessed efficacy and safety of Melphalan/HDS versus best alternative care (BAC).</p><p><strong>Methods: </strong>Eligible patients with unresectable mUM were randomized (1:1) to receive Melphalan/HDS (3 mg/kg ideal body weight) once every 6 to 8 weeks for a maximum of 6 cycles or BAC. Due to slow enrollment and patient reluctance to receive BAC treatment, the study design was amended to a single-arm Melphalan/HDS study, and all efficacy analyses of the randomized study were treated as exploratory.</p><p><strong>Results: </strong>The study enrolled 85 patients. Eligible patients were randomized to receive Melphalan/HDS (n = 43) or BAC (n = 42), and 72 patients received study treatment (Melphalan/HDS [n = 40]; BAC [n = 32]). Exploratory analyses of efficacy endpoints showed numerical differences consistently favoring the Melphalan/HDS arm versus BAC (median overall survival: 18.5 vs. 14.5 months; median progression-free survival: 9.1 vs. 3.3 months; objective response rate: 27.5% vs. 9.4%; and disease control rate: 80.0% vs. 46.9%). Serious adverse events (SAEs) occurred in 51.2% of Melphalan/HDS and in 21.9% of BAC patients. The most common (>5%) SAEs included thrombocytopenia (19.5%), neutropenia (9.8%), leukopenia (9.8%) and febrile neutropenia (7.3%) in Melphalan/HDS patients and cholecystitis, nausea and vomiting (6.3% each) in BAC patients. No treatment-related deaths were observed.</p><p><strong>Conclusion: </strong>Treatment with Melphalan/HDS shows clinically meaningful efficacy and demonstrates a favorable benefit-risk profile in patients with unresectable mUM as compared to BAC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4976-4988"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794368","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":"Changing Clinical Meaning of Resection Margin Status According to the Treatment Paradigm and the Potential Role of Perioperative Radiotherapy for Patients with Pancreatic Ductal Adenocarcinoma: An Updated Multicenter Retrospective Cohort Study.","authors":"Won-Gun Yun, Wooil Kwon, Hee Ju Sohn, Youngmin Han, Yoon Soo Chae, Hye-Sol Jung, Young Jae Cho, Chang-Sup Lim, Yoo-Seok Yoon, Jin-Young Jang","doi":"10.1245/s10434-025-17389-4","DOIUrl":"10.1245/s10434-025-17389-4","url":null,"abstract":"<p><strong>Background: </strong>Surgeons have focused on obtaining microscopically negative margins and developing perioperative treatment strategies for pancreatic head cancer. However, the clinical significance of resection margin and radiotherapy remains unclear, particularly in neoadjuvant chemotherapy (NAC) settings. Therefore, this study aimed to evaluate the prognostic impact of margin status and perioperative radiotherapy.</p><p><strong>Methods: </strong>Between 2014 and 2019, the study enrolled 307 patients with pancreatic head cancer who underwent upfront pancreaticoduodenectomy (PD) and 97 patients who underwent NAC followed by PD at three tertiary referral hospitals. The margin status was divided into a three-tier system as follows: R0-wide (tumor-free margin, ≥ 1 mm), R0-narrow (0 mm < margin < 1 mm), and R1 (margin = 0 mm).</p><p><strong>Results: </strong>In the upfront surgery setting, the groups were arranged in descending order of the 5-year overall survival (OS) rates as follows: R0-wide (39.1%), R0-narrow (25.6%), and R1 (12.5%). In the NAC setting, the groups also could be arranged in descending order of 5-year OS rates as follows: R0-wide (52.2%), R0-narrow (45.5%), and R1 (8.3%). However, the differences in OS between the R0-wide and R0-narrow groups did not reach statistical significance (P = 0.587), in contrast to the upfront surgery setting. In the multivariate analyses, concurrent chemo-radiotherapy after surgery was significantly associated with a decreased risk of locoregional recurrence in both treatment settings.</p><p><strong>Conclusions: </strong>Obtaining a wide margin could enhance prognosis in upfront surgery settings, and obtaining only a narrow margin could be appropriate in NAC settings. In addition, adjuvant radiotherapy could be considered, particularly for patients with margin involvement.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5110-5121"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969369","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":"Differential Effects of Endocrine Therapy Type on Quality of Life in Older (≥70 Years) Women with Early-Stage Breast Cancer.","authors":"Keva Li, Erin Moshier, Theresa Shao, Barry S Rosenstein, Manjeet Chadha","doi":"10.1245/s10434-024-16482-4","DOIUrl":"10.1245/s10434-024-16482-4","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on health-related quality of life (HRQoL) in older breast cancer (BC) patients. This study examines patient-reported outcomes (PROs) by type of endocrine therapy (ET) prescribed, aromatase inhibitors (AI), or tamoxifen (Tam) to estrogen receptor-positive BC patients aged ≥70 years.</p><p><strong>Methods: </strong>This retrospective review includes 1052 women diagnosed with early-stage BC from the REQUITE study database, who underwent breast conservation surgery (BCS), and received adjuvant breast radiation therapy (RT), and ET as the only systemic therapy. Among them, 201 women were aged ≥70 years. The PROs were assessed by using EORTC-QLQ-C30, BR23, and Multidimensional Fatigue Inventory measures obtained at baseline after BCS, post-RT, and at 1, 2, and 3 years follow-up. Statistical analysis involves mixed model analysis of variance and propensity score weights.</p><p><strong>Results: </strong>Among the 201 women, 131 received AI, and 70 received Tam. The overall mean age of this cohort is 75.3 years. Compared with Tam, AI-treated patients experience worse insomnia and general and physical fatigue. Tam-treated patients experienced more physical and cognitive functioning decline than the AI-treated patients. The Tam-treated patients also reported more mental fatigue and reduced sexual enjoyment compared to the AI-treated patients.</p><p><strong>Conclusions: </strong>This study suggests a differential impact by type of ET on distinct HRQoL domains experienced by older postmenopausal women. Furthermore, larger prospective clinical trials are necessary to inform treatment decisions for older ER-positive BC patients, considering patient preferences and understanding trade-offs between disease outcomes and HRQoL.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4815-4828"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967278","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":"The Landmark Series: Therapeutic Cancer Vaccine Strategies for Cold Tumors.","authors":"Alex B Blair, Lei Zheng, Kevin C Soares","doi":"10.1245/s10434-025-17281-1","DOIUrl":"10.1245/s10434-025-17281-1","url":null,"abstract":"<p><p>Immunologically cold tumors present a significant challenge in cancer treatment due to their limited baseline immune infiltration and resistance to immunotherapy. Cancer vaccines offer a promising strategy to overcome this barrier by introducing high-quality, tumor-relevant antigens that can stimulate an effective anti-tumor immune response. Therapeutic cancer vaccines are being explored in the neoadjuvant, adjuvant, and minimal residual disease contexts to enhance immune activation and promote immune cell infiltration and function, with the goal to eradicate malignant cells and improve patient survival. Critical hurdles remain in optimizing antigen selection, determining the most effective vaccine formulations, and defining the ideal clinical setting for vaccine use. Moreover, rational combinations of cancer vaccines with other immune modulators (e.g., adjuvants, immune checkpoint inhibitors, and cytokines) may hold the key to enhancing vaccine efficacy and expanding therapeutic options for difficult-to-treat malignancies. This review examines current advancements in cancer vaccines and their utilization for immunologically cold tumors in the perioperative setting, highlighting ongoing challenges and future directions in this evolving field.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4957-4966"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959873","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":"Response to Comment on Prevalence and Association of Sarcopenia with Mortality in Patients with Head and Neck Cancer: A Systematic Review and Meta-analysis.","authors":"Jin Hean Koh, Claire Yi Jia Lim, Lucas Tze Peng Tan, Andrew Makmur, Esther Yan Xin Gao, Jamie Sin Ying Ho, Angel Justina Tan, Anna See, Benjamin Kye Jyn Tan, Benjamin Yong Qiang Tan, Li Feng Tan","doi":"10.1245/s10434-025-17201-3","DOIUrl":"10.1245/s10434-025-17201-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5281-5282"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656085","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: Enhancing Safety in Minimally Invasive Left Pancreatectomy with Polyglycolic Acid Mesh Wrapping.","authors":"Hayato Baba, Atsushi Oba, Yosuke Inoue, Kosuke Kobayashi, Yoshihiro Ono, Takafumi Sato, Hiromichi Ito, Yu Takahashi","doi":"10.1245/s10434-025-17263-3","DOIUrl":"10.1245/s10434-025-17263-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5124-5125"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771174","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":"Adjusting for Population Differences in the National Cancer Database to Better Represent United States Cancer Cases: A Reference Tool for Researchers.","authors":"Anays Murillo, Kelsey S Romatoski, Sophie H Chung, Elizabeth S Davis, Veer S Sawhney, Kelly Kenzik, Sing Chau Ng, Jennifer F Tseng, Teviah E Sachs","doi":"10.1245/s10434-025-17285-x","DOIUrl":"10.1245/s10434-025-17285-x","url":null,"abstract":"<p><strong>Background: </strong>The National Cancer Database (NCDB) is widely used in US cancer outcomes research, but its reliance on Commission on Cancer-approved hospitals can underrepresent certain populations, skew data, and limit generalizability of findings. Current literature is representative up through 2014. We sought to adjust NCDB cancer cases to better reflect total US cancer population in a useful way for cancer outcomes research.</p><p><strong>Methods: </strong>Incident cancer cases in the NCDB from 2016-2020 were compared with the US Cancer Statistics (USCS) database, which contains nearly 100% of new cancer cases. NCDB case coverage was defined as percentage of cases the NCDB represents of USCS cases. Coverage was determined for the entire cohort (age 20+ years), and sub-analyses were performed for age, sex, race/ethnicity, residence location, and cancer sites.</p><p><strong>Results: </strong>From 2016-2020, 6,515,675 cancer cases were diagnosed in the NCDB and 9,311,593 in the USCS, yielding 70% NCDB case coverage over 5 years, which increased from 68 to 73%. The lowest case coverage was among men, 85+-year-olds, American Indian/Alaskan Native people, and Hispanic/Latino individuals (65%, 59%, 42%, and 55%). The Mountain region was the least represented (49%) as was nonmetropolitan residence (64%). Similar underrepresentation was seen among top cancers. Missingness of data was also captured.</p><p><strong>Conclusions: </strong>Though NCDB's representation of US cancer cases is improving, gaps remain, including age, sex, race/ethnicity, and residence location, further exacerbated by missing variables. We provide investigators using the NCDB with a way to represent cancer case data to better tailor research questions and frame outcomes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4604-4615"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953588","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":"Landmark Studies in Differentiated Thyroid Cancer.","authors":"Sarah B Fisher, Tracy S Wang","doi":"10.1245/s10434-025-17419-1","DOIUrl":"10.1245/s10434-025-17419-1","url":null,"abstract":"<p><p>Surgical resection remains the mainstay of curative intent therapy for patients with differentiated thyroid cancer, with radioactive iodine ablation and/or TSH suppression commonly employed in the adjuvant setting. Alternative strategies such as active surveillance and ablation are potentially available for patients with very low risk disease, although data regarding long term oncologic outcomes are limited. While only a small subset of patients with DTC will require systemic therapy, an increased understanding of tumor mutation profiles and available targeted therapies may facilitate multidisciplinary treatment of patients with locally advanced and/or unresectable DTC. This landmark series will summarize key studies that shape current guidelines in the surgical management of DTC and its adjuncts, with particular attention to current controversies and novel therapeutics that impact surgical management.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4729-4741"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966071","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}