Annals of Surgical Oncology最新文献

{"title":"ASO Author Reflections: The Landmark Series: Minimally Invasive Pancreatic Resection-Past, Present, and Future.","authors":"Adrian Diaz, Sarah Hays, Melissa E Hogg","doi":"10.1245/s10434-025-17595-0","DOIUrl":"10.1245/s10434-025-17595-0","url":null,"abstract":"<p><p>Minimally invasive pancreatic resection (MIPR) has emerged as a safe and effective approach for select patients with pancreatic ductal adenocarcinoma (PDAC), particularly for distal pancreatectomy. Ongoing randomized trials such as DIPLOMA 2 × 2 and PORTAL will further clarify its role in pancreatoduodenectomy, especially with robotic assistance. However, widespread adoption depends not only on evidence but also on access to technology and structured training programs. Expanding dedicated training, simulation-based education, and institutional support will be essential to ensure safe implementation. At the same time, emerging technologies such as augmented reality and next-generation robotics may help lower technical thresholds, lower prices, and accelerate adoption. The continued convergence of high-quality evidence, advanced surgical tools, and equitable implementation strategies will be critical to making MIPR a broadly accessible standard for PDAC, improving outcomes without compromising oncologic rigor. Barriers will need to be overcome to continue growth, such as limited availability of robotic platforms, high costs, and disparities in care.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5423-5425"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207512","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":"Postoperative Recurrence Pattern of Clinical Stage I Esophageal Cancer After Esophagectomy with Two- or Three-Field Lymph Node Dissection: Supplementary Analysis from JCOG0502.","authors":"Takeo Bamba, Ken Kato, Hiroyuki Daiko, Yoshinori Ito, Takeshi Kajiwara, Takeo Fujita, Hiroshi Miyata, Ryunosuke Machida, Keita Sasaki, Hiroya Takeuchi, Yuko Kitagawa","doi":"10.1245/s10434-025-17420-8","DOIUrl":"10.1245/s10434-025-17420-8","url":null,"abstract":"<p><strong>Background: </strong>Although recurrence after curative surgery for cT1bN0M0 clinical stage I (cStage I) esophageal squamous cell carcinoma (ESCC) is not rare, reports of recurrence analyses are sparse. Detailed data on optimal postoperative follow-up evaluation of cStage I ESCC are lacking. This study aimed to evaluate the frequency, characteristics, and predictors of postoperative recurrence in patients with cT1bN0M0 cStage I ESCC.</p><p><strong>Methods: </strong>The study analyzed 210 patients who underwent surgery for cT1bN0M0 cStage I ESCC and a follow-up computed tomography (CT) examination in the prospective multicenter study, JCOG0502. The study categorized the characteristics of postoperative recurrences such as the recurrence sites and whether regional/non-regional lymph nodes (LNs) and single/multiple organs were involved. Backward elimination was applied (p < 0.2) to identify postoperative recurrence predictors and obtained hazard ratios (HRs) based on Fine and Gray's model.</p><p><strong>Results: </strong>Postoperative recurrence was experienced by 31 patients (14.8%) at one or more of the following sites: regional LNs (n = 18), non-regional LNs (n = 10), lung (n = 2); bone (n = 2), and liver, local recurrence, skin, pleura, pericardium, and other (n = 1 each). In four patients, the first recurrence developed in multiple organs. The median interval between trial registration and the first recurrence was 18.6 months. In multivariable analyses, pathologic nodal metastasis (hazard ratio [HR], 3.29; p = 0.003), tumor location in the upper-thoracic esophagus versus lower-thoracic esophagus (HR, 6.71; p = 0.013), and two-field lymphadenectomy (HR, 4.31; p = 0.001) were independently associated with the development of postoperative recurrence.</p><p><strong>Conclusion: </strong>The main postoperative recurrence sites of cT1bN0M0 ESCC are the LNs, but recurrence in non-regional LNs or distant organs is also quite common, indicating the importance of post-surgery systemic follow-up evaluation.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5928-5935"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953021","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":"Does Size Outweigh Number in Predicting Survival After Pulmonary Metastasectomy for Soft Tissue Sarcoma? Insights from a Retrospective Multicenter Study.","authors":"Anton Burkhard-Meier, Matthias Grube, Vindi Jurinovic, Abbas Agaimy, Markus Albertsmeier, Luc M Berclaz, Dorit Di Gioia, Hans Roland Dürr, Rüdiger von Eisenhart-Rothe, Chukwuka Eze, Katja Fechner, Emma Fey, Sinan E Güler, Judith S Hecker, Anne Hendricks, Felix Keil, Alexander Klein, Carolin Knebel, Julia R Kovács, Wolfgang G Kunz, Ulrich Lenze, Alisa M Lörsch, Mathias Lutz, Norbert Meidenbauer, Carolin Mogler, Sebastian Schmid, Nina-Sophie Schmidt-Hegemann, Christian Schneider, Sabine Semrau, Wulf Sienel, Martin Trepel, Johannes Waldschmidt, Armin Wiegering, Lars H Lindner","doi":"10.1245/s10434-025-17450-2","DOIUrl":"10.1245/s10434-025-17450-2","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary metastasectomy (PM) is the most frequently performed local ablative therapy for leiomyosarcoma (LMS), synovial sarcoma (SyS), and undifferentiated pleomorphic sarcoma (UPS). This study aimed to assess surgical feasibility, outcome, and clinical prognostic factors, as well as the value of a peri-interventional systemic therapy.</p><p><strong>Methods: </strong>This multicenter retrospective study enrolled 77 patients with LMS, SyS, or UPS who underwent first-time complete resection of isolated lung metastases between 2009 and 2021. Disease-free survival (DFS), overall survival (OS), and clinical prognostic factors were analyzed.</p><p><strong>Results: </strong>After the first PM, the median DFS was 7.4 months, and the median OS was 58.7 months. A maximal lesion diameter greater than 2 cm was associated with reduced DFS in both the univariable (hazard ratio [HR], 2.29; p = 0.006) and multivariable (HR, 2.60; p = 0.005) analyses. The univariable analysis identified a maximal lesion diameter greater than 2 cm as an adverse prognostic factor for OS (HR, 5.6; p < 0.001), whereas a treatment-free interval longer than 12 months was associated with improved OS (HR, 0.42; p = 0.032). The addition of systemic therapy was associated with a trend toward improved DFS for patients with lesions larger than 2 cm (HR, 0.29; p = 0.063). Severe postoperative complications (grade ≥IIIa) occurred in 2 % of the patients.</p><p><strong>Conclusion: </strong>The size of resected lung metastases might be a more relevant prognostic factor than their number for patients with LMS, SyS, or UPS. For patients with lung metastases larger than 2 cm in maximal diameter, additional systemic therapy may be warranted.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5948-5956"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075594","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":"Repeat Diagnostic Laparoscopy After Chemotherapy is Useful in Patient Selection for Conversion to Cytoreductive Surgery for Initially Unresectable Colorectal and Appendiceal Peritoneal Metastases: A Retrospective Cohort Study.","authors":"Yoshimasa Gohda, Hideaki Yano, Ryuichiro Suda, Alex Mirnezami, Nobuyuki Takemura, Yasushi Kojima, Naoyoshi Nagata, Takashi Kawai, Norihiro Kokudo","doi":"10.1245/s10434-025-17106-1","DOIUrl":"10.1245/s10434-025-17106-1","url":null,"abstract":"<p><strong>Background: </strong>Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) enable effective management of colorectal and appendiceal peritoneal metastases (CAPM) despite high morbidity. This study aimed to evaluate the role of repeat diagnostic laparoscopy (rDL) after systemic ± intraperitoneal chemotherapy in the management of initially unresectable CAPM.</p><p><strong>Methods: </strong>This retrospective cohort study included 70 consecutive patients with CAPM who underwent initial diagnostic laparoscopy (iDL). Patients with inoperable or equivocal CAPM underwent chemotherapy followed by rDL to assess the treatment response and possibility of conversion to CRS and HIPEC.</p><p><strong>Results: </strong>Cytoreductive surgery was deemed feasible for 29 patients and unlikely or equivocal for 41 patients based on iDL. Of the 29 resectable patients, 24 successfully underwent CRS and HIPEC after neoadjuvant chemotherapy. Among the 41 patients initially considered unresectable, 16 were deemed operable based on rDL after chemotherapy, and CRS and HIPEC were achieved for 14 patients (conversion). The median peritoneal cancer index was significantly reduced after chemotherapy for the 14 \"conversion\" patients, from 16 based on iDL to 11 based on rDL (p < 0.05). The conversion rate was 34% (14/41), with a 5-year survival rate of 14%. Treatment with CRS and HIPEC was achieved for 38 of 45 patients deemed operable based on either iDL or rDL (worst-case estimated positive predictive value, 84%).</p><p><strong>Conclusion: </strong>Diagnostic laparoscopy is useful in predicting the likelihood of achieving CRS for patients with CAPM. Despite inoperability based on iDL, patients should be considered for rDL after chemotherapy to assess the possibility of conversion to CRS and HIPEC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5774-5783"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633321","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":"ncRNAs as Key Regulators in Gastric Cancer: From Molecular Subtyping to Therapeutic Targets.","authors":"Chen Gu, Zhenni ChenLiu, Qihang Wu, Dong Tang","doi":"10.1245/s10434-025-17368-9","DOIUrl":"10.1245/s10434-025-17368-9","url":null,"abstract":"<p><p>Gastric cancer (GC) poses a major global health challenge, underscoring the need for advanced diagnostic and therapeutic approaches. Non-coding RNAs (ncRNAs), including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), have emerged as pivotal regulators in GC, with their dysregulated expression driving key processes such as tumorigenesis, metastasis, immune evasion, and chemoresistance. The functional diversity of ncRNAs across different GC molecular subtypes highlights their potential as biomarkers for improved subtype classification and patient stratification. Beyond their diagnostic value, ncRNAs demonstrate critical regulatory functions in tumor biology, establishing these RNA molecules as promising targets for therapeutic development. Strategies based on RNA hold considerable promise for addressing critical challenges such as immune escape and drug resistance by modulating key signaling pathways. These approaches can enhance immune responses, reprogram the tumor microenvironment, and reverse resistance mechanisms that compromise treatment efficacy, thereby improving clinical outcomes. Although ncRNAs represent a promising frontier in GC precision medicine, further research is required to fully harness their clinical potential.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"6080-6097"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953078","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: Thoracic Duct Resection in Esophageal Squamous Cell Carcinoma: To Resect or Not?","authors":"Boyao Yu, Cong Qi, Zhichao Liu, Chunguang Li","doi":"10.1245/s10434-025-17492-6","DOIUrl":"10.1245/s10434-025-17492-6","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5967-5968"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141234","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: Artificial Intelligence in Bladder Cancer-Transforming Diagnosis and Treatment Paradigms.","authors":"Qingyuan Zheng","doi":"10.1245/s10434-025-17538-9","DOIUrl":"10.1245/s10434-025-17538-9","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"6189-6190"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172541","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":"Sentinel Node Biopsy Utilization in Wisconsin Women Undergoing Breast-Conserving Surgery for DCIS.","authors":"Chandler S Cortina, Jessica R Schumacher, Randi S Cartmill, Manasa Venkatesh, Elise H Lawson, Amanda L Kong, Meeghan A Lautner","doi":"10.1245/s10434-025-17590-5","DOIUrl":"10.1245/s10434-025-17590-5","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5446-5448"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191378","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":"ASO Author Reflections: Contralateral Axillary Lymph Node Metastasis of Breast Cancer: Time to Re-evaluate Conventional Thinking.","authors":"Astrid Botty van den Bruele, Laura H Rosenberger, Stephanie Downs-Canner, Meghan R Flanagan","doi":"10.1245/s10434-025-17535-y","DOIUrl":"10.1245/s10434-025-17535-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5578-5579"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198107","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":"Evaluating Variations in Indocyanine Green Administration and Its Impact on Nodal Yield in Oesophagogastric Cancer Surgery.","authors":"Michael Bozin, Shaun Chew, Carlos Cabalag, Cuong Duong","doi":"10.1245/s10434-025-17235-7","DOIUrl":"10.1245/s10434-025-17235-7","url":null,"abstract":"<p><strong>Background: </strong>Indocyanine green (ICG), a near-infrared fluorescent dye, has the potential to improve oncological outcomes by increasing lymph node yield in oesophagogastric (OG) cancer. There is no consensus regarding the dose, timing, and method of injection. This study was designed to evaluate the variation in ICG administration and its potential impact on nodal yield in OG cancer surgery for the purpose of translation in Western patients.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The primary outcome of this review was nodal yield, and the secondary outcome was the diagnostic accuracy of ICG in detecting metastatic lymph nodes. A meta-analysis of diagnostic accuracy data was performed by using a random-effects model.</p><p><strong>Results: </strong>A total of 38 studies (12,138 patients) were included in the analysis. Nodal yield was significantly increased in the ICG groups by 7.6 nodes (95% confidence interval [CI] 5.9-9.4; P = 0.0001) compared with control. Trends towards greater nodal yield were observed when ICG was administered at doses less than 2.75 mg, on the day before surgery, and via subserosal injection, although these did not reach statistical significance. Of the 17 studies with diagnostic accuracy data, the pooled sensitivity and specificity of ICG were 0.81 (95% CI 0.67-0.90) and 0.41 (95% CI 0.29-0.53), I² 90.5%.</p><p><strong>Conclusions: </strong>Indocyanine green-assisted lymphadenectomy significantly increased lymph node yield, which may translate into improved survival in patients with OG cancer. The ICG dose, timing, and method of injection warrant standardisation to maximise its potential benefits in Western patients.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5860-5876"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960467","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}