Annals of Surgical Oncology最新文献

{"title":"ASO Visual Abstract: Prognosis of Patients with Breast Cancer Following Delayed Diagnosis During the COVID-19 Pandemic: A Real-World Cohort Study.","authors":"Jae Pak Yi, Chang Ik Yoon, Su Hyun Lim, Hoon Choi, Se Jeong Oh, Hyobin Kim, Dae Sun Park, Jong Min Baek, Yong-Seok Kim, Ye Won Jeon, Jiyoung Rhu, Young-Joon Kang","doi":"10.1245/s10434-025-16870-4","DOIUrl":"https://doi.org/10.1245/s10434-025-16870-4","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999108","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: What the Eye Cannot See.","authors":"Eleanor A Fallon, Michael G White","doi":"10.1245/s10434-024-16862-w","DOIUrl":"https://doi.org/10.1245/s10434-024-16862-w","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999101","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 Disability on Postoperative Outcomes After Gastrointestinal Cancer Surgery.","authors":"Shahzaib Zindani, Mujtaba Khalil, Selamawit Woldesenbet, Zayed Rashid, Abdullah Altaf, Jun Kawashima, Austin Schenk, Timothy M Pawlik","doi":"10.1245/s10434-025-16904-x","DOIUrl":"https://doi.org/10.1245/s10434-025-16904-x","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 61 million individuals in the United States have a disability and face unique challenges, resulting in healthcare disparities.</p><p><strong>Objective: </strong>We aimed to evaluate the impact of disability on postoperative outcomes and number of healthy days at home (HDAH).</p><p><strong>Methods: </strong>Patients who underwent surgery for gastrointestinal (GI) cancer between 2017 and 2020 were identified using the Medicare database. Multivariable regression models were used to examine the association between disability and postoperative complications, discharge disposition, and the number of HDAH.</p><p><strong>Results: </strong>A total of 72,452 individuals underwent GI cancer surgery (pancreas: n = 7614, 10.5%; hepatobiliary: n = 4994, 6.9%; colorectal: n = 59,844, 82.6%). Median patient age was 75 years (interquartile range 71-81) with most patients being female (n = 37,167, 51.3%). Overall, 5432 individuals (7.2%) had a disability. Following surgery, patients with a disability were more likely to experience complications (4.6% vs. 3.3%), be discharged to a skilled nursing facility (SNF; 26.6% vs. 12.3%), and experience hospital readmission (20.0% vs. 13.5%) [all p < 0.001]. Consequently, individuals with disabilities were more likely to spend fewer (<20th percentile) HDAH (33% vs. 19.2%) [all p < 0.001]. On multivariable analysis, disability was associated with higher odds of complications (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.19-1.56) and hospital readmission (OR 1.55, 95% CI 1.44-1.66). Additionally, disability was associated with higher odds of spending fewer HDAH (OR 1.88, 95% CI 1.77-1.99).</p><p><strong>Conclusion: </strong>Following GI cancer surgery, individuals with disabilities had a higher risk of complications and spent fewer HDAH. There is a need for targeted interventions to improve the care of patients with disabilities and ensure equitable oncological and surgical outcomes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999117","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":"Associations of KRAS Point Mutations with Survival of Patients Who Underwent Curative-Intent Resection of Colorectal Liver Metastases.","authors":"Harufumi Maki, Reed I Ayabe, Antony Haddad, Yujiro Nishioka, Timothy E Newhook, Hop S Tran Cao, Yun Shin Chun, Ching-Wei D Tzeng, Jean-Nicolas Vauthey","doi":"10.1245/s10434-024-16822-4","DOIUrl":"https://doi.org/10.1245/s10434-024-16822-4","url":null,"abstract":"<p><strong>Background: </strong>The oncologic significance of specific KRAS point mutations for patients with colorectal liver metastases (CLM) is uncertain. This study aimed to assess the prognostic impact of KRAS point mutations on patients who underwent surgery for CLM.</p><p><strong>Methods: </strong>Patients who underwent curative-intent surgery for CLM from 2001 to 2020 were selected for the study. In the study, KRAS point mutations and other clinicopathologic variables were examined for association with survival.</p><p><strong>Results: </strong>The study classified 798 patients into five groups by KRAS mutation status as follows: wild-type (n = 412, 51.6%), G12D (n = 123, 15.4%), G12V (n = 88, 11.0%), G13D (n = 61, 7.6%), and \"Other\" mutations (n = 114, 14.3%). For the patients with G12V substitutions, TP53 mutation was associated with worse overall survival (OS) (hazard ratio [HR], 2.64; 95% confidence interval [CI], 1.04-6.66; P = 0.041), but was not associated with a survival difference for the other four groups. The patients with co-occurring KRAS G12V and TP53 had a median OS of 4.4 years and a 5-year OS rate of 39.8%. In contrast, the patients with KRAS G12V mutation and wild-type TP53 had a median OS of 7.3 years and a 5-year OS rate of 75.9%, similar to the corresponding values for the patients with wild-type KRAS. Co-occurring KRAS G12V and TP53 mutations were independently associated with worse OS in the entire cohort (HR, 2.08; 95% CI, 1.15-3.76; P = 0.015).</p><p><strong>Conclusions: </strong>This study showed that KRAS G12V mutation is associated with worse OS for patients undergoing curative-intent CLM resection, but only those with co-occurring TP53 mutation. Prognosis after surgery for CLM should not be stratified by KRAS mutation site alone.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999111","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":"https://doi.org/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":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","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}

{"title":"Phase I/II Study of Neoadjuvant Chemoradiotherapy Consisting of S-1 and Cisplatin for Patients with Clinically Resectable Type 4 or Large Type 3 Gastric Cancer (OGSG1205).","authors":"Masayuki Shinkai, Motohiro Imano, Masaki Yokokawa, Ryo Tanaka, Jin Matsuyama, Toshio Shimokawa, Hisato Kawakami, Taroh Satoh, Takushi Yasuda, Hiroshi Furukawa","doi":"10.1245/s10434-024-16845-x","DOIUrl":"https://doi.org/10.1245/s10434-024-16845-x","url":null,"abstract":"<p><strong>Background: </strong>To improve the prognosis of clinically resectable type 4 or large type 3 gastric cancer (GC), we performed a phase I/II study of neoadjuvant-radiotherapy combined with S-1 plus cisplatin.</p><p><strong>Patients and methods: </strong>Phase I, with a standard 3 + 3 dose-escalation design, was performed to define the recommended phase II dose. Efficacy and safety were evaluated in phase II. The three dose levels were as follows: level 0, S-1 60 mg/m² on days 1-14 plus cisplatin 60 mg/m² on day 1; level 1, S-1 80 mg/m² on days 1-14 plus cisplatin 60 mg/m² on day 1; and level 2, S-1 80 mg/m² on days 1-14 and 22-35, plus cisplatin 60 mg/m² on days 1 and 22. The starting dose was level 1. Radiotherapy was delivered at a total dose of 40 Gy in fractions for 4 weeks.</p><p><strong>Results: </strong>A total of six patients were enrolled in the phase I study. Dose-limiting toxicity was observed at level 2; level 1 was established as the recommended phase II dose. In phase II, 20 patients were enrolled from November 2012 to April 2018. Grade 3/4 leukopenia and nonhematologic adverse events occurred in 35% and 5% of the patients, respectively. In total, 19 patients underwent the protocol surgery; 2 (10.5%) achieved a pathological complete response. There were no treatment-related deaths; 3- and 5-year overall survival rates were 70.0 and 50.0%, respectively.</p><p><strong>Conclusions: </strong>Neoadjuvant chemoradiotherapy with S-1 plus cisplatin is a safe and promising treatment for clinically resectable type 4 or large type 3 GC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982572","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 Landmark Series: The Future of Pancreatic Cancer Clinical Trials.","authors":"Yongwoo David Seo, Matthew H G Katz, Rebecca A Snyder","doi":"10.1245/s10434-024-16840-2","DOIUrl":"https://doi.org/10.1245/s10434-024-16840-2","url":null,"abstract":"<p><p>Pancreatic cancer has a poor prognosis despite ongoing advances in systemic and multimodal therapies. This review analyzes recent progress and future directions in pancreatic cancer clinical trials, emphasizing the evolution from traditional approaches to a more personalized and biologically-driven treatment paradigm. While improvements in overall survival have been achieved through perioperative therapies, gaps remain in our understanding of optimal treatment strategies. Key questions include selection of specific chemotherapeutic agents, duration of preoperative therapy, the role of radiotherapy, and accurate and real-time assessment of response to therapy. Historically, pancreatic cancer clinical trials have been designed based on anatomic criteria, failing to account for the inherent biologic heterogeneity of this disease. The field is now moving towards a precision oncology approach, leveraging genomic and transcriptomic data to identify predictive biomarkers and personalize treatment selection. Novel clinical trial designs, such as platform and basket trials, are accelerating the evaluation of new therapeutic strategies and facilitating efficient patient selection, particularly in the context of new emerging targeted therapies such as KRAS inhibitors. Furthermore, implementation of dynamic response assessment techniques, such as circulating tumor DNA and radiomics, may inform treatment decision-making and improve prediction of long-term outcomes. By integrating these evolving strategies, the emerging clinical trial landscape has the potential to transform the treatment of pancreatic cancer and yield meaningful improvements in patient outcomes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142997781","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":"Patients with DCIS Seen at a Specialized High-Risk Breast Clinic Run by Surgical Advanced Practice Providers Have High Rates of Preventive Medication Uptake.","authors":"Kathryn Paschalis, Chelsea Marin, Kendall Miller, Crystal Regis, Katie Bates, Jessica Gooch, Marilyn Ling, Jan Dombrowski, Brian Yirinec, Alissa Huston, Anna Weiss","doi":"10.1245/s10434-024-16857-7","DOIUrl":"https://doi.org/10.1245/s10434-024-16857-7","url":null,"abstract":"<p><strong>Background: </strong>Preventative medication (PM) uptake is low among patients at an elevated risk of breast cancer, largely due to fears of intolerance. This study aimed to investigate whether a new, surgical advanced practice provider (APP)-run clinic was effectively prescribing PM. We hypothesized equivalent rates of PM uptake compared to consultation with medical oncologists (MD).</p><p><strong>Patients and methods: </strong>The APP-run clinic and accompanying database were initiated 01/2023, including patients with benign breast complaints and/or an elevated risk of invasive breast cancer. A historic single-institution surgical database and this prospective database were queried for patients with ductal carcinoma in situ between 04/2007-05/2023 and 01/2023-01/2024, respectively. Patients with invasive breast cancer within the prior 5 years were excluded. Chart review abstracted PM type/dose. Chi square analysis compared PM uptake rates and dose.</p><p><strong>Results: </strong>A total of 523 patients met study criteria; the MD sample and APP sample were relatively well balanced except fewer hormone receptor positive patients in the MD sample (266/309 [86.1%] versus 202/214 [94.4%] APP, p < 0.01). PM uptake was lower in the MD sample (96/309 [31.1%] compared to the APP sample (86/214 [40.2%], p = 0.03). There was significantly more tamoxifen prescribed among the APP sample (58.2% vs. 35.6% among MD, p = 0.02), and low-dose tamoxifen prescribing increased significantly (47.3% vs. 9.8% MD, p < 0.01).</p><p><strong>Conclusions: </strong>Our surgical APP-run breast health clinic has demonstrated equivalent PM uptake as compared to patients seen previously by medical oncologists. This model should be considered broadly. Additionally, low-dose tamoxifen has become the prescription of choice; thus, long-term studies of tamoxifen 5 mg are warranted.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999119","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: Is There an Extra Benefit of Adding Neoadjuvant Radiotherapy to Chemotherapy in Patients with (Borderline) Resectable Pancreatic Cancer?","authors":"Won-Gun Yun, Jin-Young Jang","doi":"10.1245/s10434-024-16829-x","DOIUrl":"https://doi.org/10.1245/s10434-024-16829-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982571","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":"Predictors of Bilateral Disease in Low-Risk Papillary Thyroid Cancer: Histopathologic Insights and Preoperative Ultrasonography.","authors":"P M Rodriguez Schaap, A Papachristos, H Serrao-Brown, A Aniss, E J M Nieveen van Dijkum, A J Gill, L Delbridge, A F Engelsman, S Sidhu, M Sywak","doi":"10.1245/s10434-024-16352-z","DOIUrl":"https://doi.org/10.1245/s10434-024-16352-z","url":null,"abstract":"<p><strong>Background: </strong>With the current shift toward de-escalation of surgical management in low-risk papillary thyroid cancer (PTC), understanding predictors and the clinical significance of additional tumors in the contralateral lobe is important. This study investigated the histopathologic predictors of bilateral disease in low-risk PTC patients and the utility of preoperative ultrasonography in guiding completion thyroidectomy decisions.</p><p><strong>Methods: </strong>Patients treated with total thyroidectomy (TT) for low-risk PTCs (< 4 cm) at the Endocrine Surgical Unit of the Royal North Shore Hospital, University of Sydney from 2013 to 2020 were identified from a prospectively maintained database. The primary objective was to evaluate whether specific histopathologic factors can reliably predict the likelihood of bilateral disease in low-risk PTC patients after hemithyroidectomy. The secondary objective was to assess the accuracy of preoperative ultrasonography for patients with bilateral disease.</p><p><strong>Results: </strong>Of the 737 patients in this study, 194 (26.3%) had bilateral disease. The multivariate analysis showed that larger median tumor size (odds ratio [OR] 1.043 per mm; 95 % confidence interval [CI] 1.025-1.062; P < 0.001), ipsilateral multifocal disease (MFD) (OR 2.010; 95% CI 1.338-3.020; P < 0.001), and venous invasion (OR 1.693; 95% CI 1.058-2.707) had a significant association with bilateral disease. However, in the prediction of clinically significant contralateral disease (≥ 10 mm), median tumor size (OR 1.104 per mm; 95% CI 1.059-1.152; P < 0.001) and venous invasion (OR 2.815; 95% CI 1.044-7.589; P = 0.041) were significantly correlated, whereas ipsilateral MFD lost its significance. These significant contralateral tumors were identified preoperatively and associated with higher Thyroid Imaging, Reporting and Data System (TIRADS) and/or Bethesda cytology classifications in 94% of cases.</p><p><strong>Conclusion: </strong>In low-risk PTC patients, larger tumor size, venous invasion, and ipsilateral MFD are significantly associated with disease in the contralateral thyroid lobe.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977369","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}