Annals of Surgical Oncology最新文献

{"title":"A Novel Method for Hemorrhage Control During Laparoscopic Distal Pancreatectomy with Splenic Vessel Preservation: Triple Occlusion.","authors":"Yongbin Li, Yu Cai, Jun Xu, Lingwei Meng, Bing Peng","doi":"10.1245/s10434-024-16846-w","DOIUrl":"10.1245/s10434-024-16846-w","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic distal pancreatectomy (LDP) has the advantages of reduced blood loss, shorter hospital stays, and a better postoperative quality of life compared with open distal pancreatectomy (ODP).<sup>1</sup> Meanwhile, spleen-preserving laparoscopic distal pancreatectomy is the preferred technique for low-grade malignant and benign tumors located in pancreatic body and tail, since it preserves the immune function of the spleen. The splenic-vessel-preserving (SVP) Kimura technique and splenic vessel resection Warshaw technique are the two primary procedures. Although the Kimura procedure and the Warshaw procedure were comparable in most postoperative outcomes, the former was superior to the latter in reducing the risk of gastric varices and splenic infarction.<sup>2,3</sup> However, in cases of large tumors in the distal pancreas or those with tight adhesions of the tumor to the splenic vessels, laparoscopic Kimura procedure is technically challenging because of the higher risk of intraoperative hemorrhage.<sup>4</sup> Herein, we present an effective surgical approach to laparoscopic SVP that minimizes the chances of vascular injury and maximizes the chances of a successful splenic preservation-triple occlusion strategy.</p><p><strong>Methods: </strong>A 46-year-old woman was admitted to our department owing to vague pain in the upper abdomen lasting for 6 months. Enhanced computed tomography (CT) scan revealed a 3.9 ✕ 4.3 cm cystic tumor in the distal pancreas, which has a smooth cystic wall without wall nodules; despite poor demarcation of the tumor from the splenic vein, tumor markers were all within normal limits (CA19-9, 5.78 U/ml; CEA, 1.14 ng/ml), so a benign tumor was considered. We present the triple-occlusion strategy during laparoscopic Kimura operation. This approach, as demonstrated in the video, includes triple occlusion of the proximal splenic artery, proximal splenic vein, and splenic pedicle; In addition, we use cold scissors to carefully dissect the tumor from the splenic vein, which minimizes the possibility of splenic vein injury and tumor rupture caused by thermal damage of ultrasonic scalpel, thus improving the safety of the surgery and the chances of spleen preservation.</p><p><strong>Results: </strong>The operation lasted for 136 min with 10 ml of estimated blood loss. Multiple sites of the cystic wall were sampled (including the margins of the splenic vein), and intraoperative freezing was conducted to consider mucinous tumors, with no cancer cells detected. The amylase in the drainage fluid on postoperative day (POD) 3 was 1410 U/l, and the drainage tube was removed on POD 4. The patient showed an uneventful recovery and was discharged on POD 5. Finally, mucinous cystadenoma with mild atypical hyperplasia was diagnosed by pathological examination.</p><p><strong>Conclusion: </strong>The laparoscopic triple-occlusion strategy may be helpful for selected patients with tumors located at the","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2854-2855"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999089","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":"Re: The Effects of Various Approaches to Lobectomies on Respiratory Muscle Strength, Diaphragm Thickness, and Exercise Capacity in Lung Cancer Re: Enhancing Respiration Function Evaluation and Recovery in Lung Cancer: The Interdisciplinary Approach to Postoperative Management.","authors":"Funda Sirakaya, Ebru Calik Kutukcu, Mehmet Ruhi Onur, Erkan Dikmen, Ulas Kumbasar, Serkan Uysal, Riza Dogan","doi":"10.1245/s10434-024-16865-7","DOIUrl":"10.1245/s10434-024-16865-7","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2712"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999122","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":"Resection of Primary Leiomyosarcoma of the Inferior Vena Cava and Reconstruction with a Cadaveric Homograft.","authors":"M Baia, A Drohan, S Radaelli, D Callegaro, C Colombo, A Borghi, S Pasquali, R Sanfilippo, C Sangalli, C Morosi, M Fiore, A Gronchi","doi":"10.1245/s10434-025-16911-y","DOIUrl":"10.1245/s10434-025-16911-y","url":null,"abstract":"<p><strong>Background: </strong>Leiomyosarcoma (LMS) is a rare malignancy arising from the smooth muscle, which affects the inferior vena cava (IVC) in 30-40% of cases; the cure relies on complete surgical resection,¹ demanding meticulous oncological and vascular planning. The efficacy of preoperative chemotherapy is currently under investigation.² Restoration of vessel continuity and blood flow must be tailored to each individual case. This video presents an IVC LMS case, in which the retroperitoneal sarcoma (RPS) six-stage procedure³ was customized for LMS, with IVC flow restored using a cadaveric aortic homograft.</p><p><strong>Patients and methods: </strong>A 64-year-old woman presented with a 6 cm IVC mass with neoplastic thrombosis and intense PET uptake. Suspecting an IVC LMS, the tumor board recommended up-front surgery.</p><p><strong>Results: </strong>An en bloc resection of the tumor and the involved IVC segment II-III with homograft interposition was performed. The procedure involved division of the right gonadal, caudate lobe, lumbar and left adrenal veins; isolation of the IVC and renal veins; followed by cross-clamping and resection under vascular control with hemodynamic stability and no need for veno-venous bypass. Frozen margins on the IVC and renal veins were negative. Blood flow was restored using a cryopreserved cadaveric aortic homograft, trimmed to the appropriate length and implanted end-to-end on the IVC. The right renal vein was anastomosed end-to-side on the graft, while the left renal vein was reconnected using a jump graft crafted from the remaining portion of the cadaveric graft.</p><p><strong>Conclusions: </strong>Resection of retroperitoneal leiomyosarcoma requires both oncological and vascular expertise to achieve optimal curative outcomes and restore physiological vascular flow when necessary.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2979-2980"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254360","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":"Pancreatoduodenectomy with En Bloc Superior Mesenteric Artery and Vein Resection Under Temporary Mesenterico-Portal Venous Shunt: The Strasbourg Technique.","authors":"Philippe Bachellier, Pierre de Mathelin, Pietro Addeo","doi":"10.1245/s10434-025-17271-3","DOIUrl":"https://doi.org/10.1245/s10434-025-17271-3","url":null,"abstract":"<p><strong>Background: </strong>Pancreatectomies with superior mesenteric artery (SMA) resection are technically challenging.¹ With the advent of FOLFIRNOX chemotherapy, resection of the SMA is performed in selected patients with locally advanced pancreatic cancer (LAPC),^2-10 in centers of excellence by highly skilled pancreatic-vascular surgeons treating a large volume of LAPCs.^4-10 METHODS: The patient was a 64-year-old female with an LAPC treated with 11 cycles of FOLFIRINOX induction chemotherapy. The SMA, the superior mesenteric vein (SMV), and a replaced right hepatic artery (r-RHA) were encased. A temporary mesenterico-portal shunt (TMPS), using a 25 cm Goretex tube between the origin of the SMV and the right side of the portal vein,¹¹ was used. This TMPS (1) lessens portal hypertension in case of SMV obstruction; (2) maintains adequate liver venous perfusion during dissection; (3) gives the mesentery enough mobility to avoid graft for SMA resection; and (4) avoids simultaneous venous and arterial clamping. A mesenteric approach was performed to isolate the SMA.¹² Upon heparin bolus, the r-RHA was re-implanted on the gastroduodenal artery stump, the SMA on the aorta, the SMV on the portal vein, and the splenic vein on the left renal vein.</p><p><strong>Results: </strong>Postoperative course was uneventful. Pathology showed pT4N0R1 pancreatic adenocarcinomas. Three years later, the patient recurred on the left adrenal gland and was treated by external radiotherapy. Five years later, the patients is alive under chemotherapy.</p><p><strong>Conclusions: </strong>Pancreaticoduodenectomy with SMA and SMV using a transitory mesentericoportal shunt (The Strasbourg technique) is a standardized technique used to manage patients with LAPC at our unit.</p>","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":"143762855","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":"Short-term Patient-Reported Outcomes Following Bilateral Risk-Reducing Mastectomy for Patients at a High Risk for Breast Cancer: A Systematic Review.","authors":"Koumani W Ntowe, Michael S Lee, Victoria N Yi, Samantha J Kaplan, Brett T Phillips, Akiko Chiba, Jennifer K Plichta","doi":"10.1245/s10434-024-16805-5","DOIUrl":"10.1245/s10434-024-16805-5","url":null,"abstract":"<p><strong>Background: </strong>Bilateral risk-reducing mastectomies (RRMs) have been proven to decrease the risk of breast cancer in patients at high risk owing to family history or having pathogenic genetic mutations. However, few resources with consolidated data have detailed the patient experience following surgery. This systematic review features patient-reported outcomes for patients with no breast cancer history in the year after their bilateral RRM.</p><p><strong>Methods: </strong>The databases MEDLINE, Embase, and Scopus were used to identify studies. Studies were then evaluated by multiple authors, and their quality was assessed by using the Methodological Index for Non-Randomized Studies score.</p><p><strong>Results: </strong>Our search identified 1858 unique studies, of which 11 met our inclusion criteria. Only two of these studies included patients who did not receive postmastectomy reconstruction. The included studies were either retrospective cohort studies or prospective studies. General satisfaction with the outcome of RRM and the decision to undergo RRM was high across many of the studies, with low levels of regret. There was also a noticeable trend of improved psychosocial outcomes following RRM. For postoperative sexual well-being, body image, aesthetic satisfactions, and somatosensory function, there were a mix of positive and negative outcomes.</p><p><strong>Conclusions: </strong>The patients who elected to manage their breast cancer risk with bilateral RRM (mostly with reconstruction) tend to be satisfied with their decision and the surgical outcomes. This may be related to decreased cancer-related anxiety. Postmastectomy psychosocial well-being tends to improve while physical health after surgery varies by patient.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2510-2525"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926298","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":"Tumor Spread Through Air Spaces Predicts Survival in Resected Pulmonary Lymphoepithelial Carcinoma.","authors":"Pei-Hsing Chen, Chin Chen, Chao-Wen Lu, Tzu-Pin Lu, Yi-Hsuan Lee, Min-Shu Hsieh, Hsao-Hsun Hsu, Jin-Shing Chen","doi":"10.1245/s10434-024-16401-7","DOIUrl":"10.1245/s10434-024-16401-7","url":null,"abstract":"<p><strong>Background: </strong>Tumor spread through air spaces (STAS) has been recognized as a prognostic factor for several types of lung cancers. However, information regarding its clinical significance in pulmonary lymphoepithelial carcinoma is limited. Therefore, this study investigated effects of STAS on the clinical outcomes for patients with pulmonary lymphoepithelial carcinoma.</p><p><strong>Methods: </strong>This study retrospectively reviewed 56 surgically resected pulmonary lymphoepithelial carcinomas. The study defined STAS as the presence of tumor cells within air spaces in lung parenchyma beyond the tumor edge. Artifacts were excluded. Recurrence-free survival (RFS) was analyzed using the log-rank test and Cox proportional hazards model.</p><p><strong>Results: </strong>In 18 patients (32.1%), STAS was observed and found to be associated with larger tumor size (>3 cm) (p = 0.009), higher pathologic stage (p = 0.026), and tumor necrosis (p = 0.046). Patients with STAS had a significantly lower 5-year RFS rate (p = 0.025). Multivariate analysis showed that STAS was an independent predictor of worse RFS (hazard ratio, 3.395; p = 0.038). Patients with STAS had a significantly increased risk of locoregional recurrence (p = 0.049).</p><p><strong>Conclusions: </strong>The study findings suggest that STAS is an independent predictor of poor RFS. Based on these findings, a new three-tier grading system based on the patterns of tumor border and STAS was proposed for effective prediction of 5-year RFS in pulmonary lymphoepithelial carcinoma.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2675-2686"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567037","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":"Prognostic Factors of Long-Term Survival and Conditional Survival Analysis in MPM Patients Treated with CRS+HIPEC: A Retrospective Study of Two Centers.","authors":"Xin-Li Liang, Yan-Dong Su, Xin-Bao Li, Yu-Bin Fu, Ru Ma, Rui Yang, He-Liang Wu, Yu-Run Cui, Yan Li","doi":"10.1245/s10434-024-16485-1","DOIUrl":"10.1245/s10434-024-16485-1","url":null,"abstract":"<p><strong>Objectives: </strong>This study was designed to explore the survival benefit factors of malignant peritoneal mesothelioma (MPM) patients after cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) and to make dynamic survival prediction by conditional survival (CS).</p><p><strong>Methods: </strong>Data of 212 patients with MPM who underwent CRS+HIPEC were retrospectively analyzed. Patients were divided into long-term survival (LTS) group (≥48.0 months) and short-term survival (STS) group (≤16.0 months) according to OS. Conditional survival is the probability of surviving y years after already survived for x years. Univariate and multivariate analyses were performed to explore the favorable factors of LTS. Conditional survival and Kaplan-Meier were applied to assess the postoperative survival probability.</p><p><strong>Results: </strong>Ninety patients were enrolled: 53 (58.9%) were LTS, and 37 (41.1%) were STS. Univariate analysis revealed 14 meaningful factors (P < 0.05): age, surgery history, Karnofsky performance status, pathological types, tumor vascular emboli, lymphatic metastasis, Ki-67 index, preoperative CA125 level, peritoneal cancer index (PCI), completeness of cytoreduction, bleeding, red blood cell (RBC) transfusion, ascites, and severe adverse events (SAEs). Multivariate analysis identified that PCI ≤ 20, less RBC transfusion and no SAEs were independent prognostic factors for LTS. Five-year CS increased from 27% at 0 years to 84% at 4 years with the increasing number of survival years. The survival curve flattens at postoperative 5 years.</p><p><strong>Conclusions: </strong>The key factors in CRS+HIPEC for MPM patients to achieve LTS are lower tumor burden, less intraoperative RBC transfusion, and prevention of SAEs. Malignant peritoneal mesothelioma patients demonstrated a substantial increase in CS over time. Some patients may achieve clinical cure 5 years after surgery.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2912-2922"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613907","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":"Predictive Biomarkers for the Efficacy of Conversion Therapy in Gastric Cancer are Expected to be a Prominent Research Focus.","authors":"Ying-Xuan Ye, Shi-Rui Chen, Chu-Ying Wu, Kai Ye","doi":"10.1245/s10434-024-16710-x","DOIUrl":"10.1245/s10434-024-16710-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2673-2674"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142833784","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":"Impact of Routine Follow-Ups After Curative Gastrectomy in Elderly Patients with Early Gastric Cancer.","authors":"Juno Yoo, Chang Seok Ko, Seong-A Jeong, Seul-Gi Oh, Ba Ool Seong, Jeong Hwan Yook, Moon-Won Yoo, Beom Su Kim, In-Seob Lee, Chung Sik Gong, Sa-Hong Min, Jung-Bok Lee","doi":"10.1245/s10434-024-16713-8","DOIUrl":"10.1245/s10434-024-16713-8","url":null,"abstract":"<p><strong>Introduction: </strong>Elderly patients with early gastric cancer exhibit a relatively shorter life expectancy and lower recurrence risk, prompting consideration of whether the regular follow-up strategy should apply to this demographic. This study was designed to determine the effect of routine postoperative follow-up on the elderly patients, specifically those pathologically diagnosed with stage I gastric cancer.</p><p><strong>Methods and materials: </strong>This retrospective analysis was conducted at a single tertiary center and enrolled patients aged ≥ 75 years who underwent curative gastrectomy for stage I gastric cancer between January of 2007 and December of 2016. The patients were divided into routine and nonroutine follow-up groups, depending on whether the recommended follow-up examinations (endoscopy, CT, and blood tests) were complete. Propensity score matching was performed to compare the overall survival (OS) and disease-specific survival (DSS) between the two study groups.</p><p><strong>Results: </strong>Among 385 patients enrolled, 301 (78.2%) were routine and 84 (21.8%) were nonroutine follow-up patients. After propensity score matching, each study group consisted of 83 patients. There was no significant difference in OS (85.5% vs. 83.1%, p = 0.47) and DSS (98.6% vs. 98.3%, p = 0.57) between the two study groups. There were six (1.5%) recurrences in the entire cohort: four in the routine and two in the nonroutine follow-up group.</p><p><strong>Conclusions: </strong>Regular follow-up of elderly patients with stage I gastric cancer did not significantly impact the OS and DSS rates.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2629-2636"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909118","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":"Surgery for Classic, Pleomorphic and Non-classic Lobular Carcinoma In Situ: Surgery Rate, Risk of Upstaging and Short-Term Follow-Up.","authors":"Claudia J C Meurs, Crystal Kerkhoven, Sabine Siesling, Marian B E Menke-Pluijmers, Pieter J Westenend","doi":"10.1245/s10434-024-16686-8","DOIUrl":"10.1245/s10434-024-16686-8","url":null,"abstract":"<p><strong>Background: </strong>The Dutch breast cancer guideline recommends surveillance for classic lobular carcinoma in situ (LCIS), unless there is a discrepancy with mammographic findings, and surgery for pleomorphic and non-classic LCIS.</p><p><strong>Objective: </strong>The aim of this study was to assess adherence to the guideline in daily practice, as well as the surgery rate, risk of upstaging, and events during follow-up.</p><p><strong>Methods: </strong>Selection of patients from a nationwide cohort diagnosed between 2011 and 2020. Patients with a history of in situ or invasive breast cancer or concomitant atypical ductal hyperplasia were excluded. Analyses comprised univariable analysis.</p><p><strong>Results: </strong>Of 1178 diagnoses, 1018 (86%) were classic LCIS, 129 (11%) were pleomorphic LCIS, and 31 (3%) were non-classic (florid or unspecified non-classic) LCIS. Surgery was performed in 323 patients. The surgery rate for classic LCIS was 19%, 83% for pleomorphic LCIS, and 84% for non-classic LCIS. The upstage rate for both classic and pleomorphic LCIS was 32%, and 31% for non-classic LCIS. LCIS was upstaged in 103 patients (32%); 24 (7%) to DCIS and 79 (25%) to invasive breast cancer. Follow-up of the 859 non-operated patients showed fewer than 4% with ipsilateral DCIS or invasive breast cancer.</p><p><strong>Conclusion: </strong>The surgery rates for classic, pleomorphic, and non-classic LCIS indicate that the guideline is well adhered to in daily practice. Given the high upstage rates and low number of subsequent DCIS and invasive breast cancer events in patients with classic LCIS, these patients appear to be well-selected for surgery versus surveillance. The results support the recommendation to operate on patients with pleomorphic/non-classic LCIS.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"2545-2553"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909231","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}