Idam de Oliveira-Junior, Marina Ignácio Gonzaga, Chrissie Casella Amarati, Natachia Moreira Vilela, Durval Renato Wonharth, René Aloisio da Costa Vieira
{"title":"ASO Visual Abstract: Primary Breast Implant-Associated Squamous Cell Carcinoma: A Proposal for a Better Surgical Approach and Clinical Staging System Based on Tumor Characteristics.","authors":"Idam de Oliveira-Junior, Marina Ignácio Gonzaga, Chrissie Casella Amarati, Natachia Moreira Vilela, Durval Renato Wonharth, René Aloisio da Costa Vieira","doi":"10.1245/s10434-025-18502-3","DOIUrl":"https://doi.org/10.1245/s10434-025-18502-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285445","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}
Elizabeth M Fish, Ian Whittall, Walker Lyons, Richard J Bleicher, Rebecca M Shulman, Cecilia Chang, Alycia L So, Andrea S Porpiglia, Allison A Aggon, Austin D Williams
{"title":"Axillary Management Trends and Survival in Men Undergoing Mastectomy with Positive Sentinel Nodes.","authors":"Elizabeth M Fish, Ian Whittall, Walker Lyons, Richard J Bleicher, Rebecca M Shulman, Cecilia Chang, Alycia L So, Andrea S Porpiglia, Allison A Aggon, Austin D Williams","doi":"10.1245/s10434-025-18501-4","DOIUrl":"https://doi.org/10.1245/s10434-025-18501-4","url":null,"abstract":"<p><strong>Background: </strong>Men are often diagnosed with node-positive breast cancer and treated with mastectomy because of a lack of screening and an unfavorable tumor-to-breast ratio. The AMAROS trial showed no difference in outcomes between axillary lymph node dissection (ALND) and axillary radiation in women with cT1-2N0 breast cancer with positive sentinel lymph nodes (+SLNs). Axillary management in men remains unstandardized, so we assessed current trends and outcomes.</p><p><strong>Methods: </strong>Males with cT1-2N0M0 breast cancer undergoing mastectomy with one to two +SLNs were identified from the National Cancer Database (2018-2021). Patients were stratified by axillary management. Postmastectomy radiotherapy (PMRT) included chest wall and axillary fields. Management strategies and overall survival were analyzed.</p><p><strong>Results: </strong>Among 445 patients, 25% had no further axillary treatment, 22% underwent ALND, 29% PMRT, and 24% ALND+PMRT. Patients with two +SLNs more often underwent ALND+PMRT (43% vs. 19%, p < 0.001). The use of PMRT rose over time (23-36%), whereas ALND alone declined (27-12%). Additional positive nodes were found in 31% of ALND cases, with no difference between ALND and ALND+PMRT. Performance of ALND delayed PMRT (194 vs. 133 days from diagnosis, p < 0.001). On multivariable analysis, two +SLNs predicted ALND+PMRT (odds ratio 2.5, p = 0.006). Older age (p < 0.001) and two +SLNs (p = 0.03) were linked to worse overall survival, whereas axillary management was not (p = 0.23).</p><p><strong>Conclusion: </strong>Although axillary strategies are proven safe and effective in women, their extrapolation to men is inconsistent. Half of men undergoing mastectomy are undertreated or overtreated, underscoring the need for multidisciplinary consensus and prospective male-specific data to guide care and reduce morbidity.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285515","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}
Helen Kemprecos, Kathryn Tsai, Daniel S Cheah, Fumihiro Kawano, Oscar Salirrosas, Annie Tigranyan, Aaron Anderson, Gregory Polites, Mark Cohen, Onur Kutlu, Claudius Conrad
{"title":"ASO Visual Abstract: Missingness in NCDB: A Novel Surrogate for Hepatobiliary Cancers Outcomes.","authors":"Helen Kemprecos, Kathryn Tsai, Daniel S Cheah, Fumihiro Kawano, Oscar Salirrosas, Annie Tigranyan, Aaron Anderson, Gregory Polites, Mark Cohen, Onur Kutlu, Claudius Conrad","doi":"10.1245/s10434-025-18483-3","DOIUrl":"https://doi.org/10.1245/s10434-025-18483-3","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285465","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}
Grace R Thompson, Fahong Yu, Song Han, Gerik Tushoski-Aleman, Jordan A McKean, Steven J Hughes, Aditya S Shirali
{"title":"Age-Associated Alterations in Cytokine and Extracellular Matrix Remodeling in the Papillary Thyroid Cancer Tumor Microenvironment.","authors":"Grace R Thompson, Fahong Yu, Song Han, Gerik Tushoski-Aleman, Jordan A McKean, Steven J Hughes, Aditya S Shirali","doi":"10.1245/s10434-025-18473-5","DOIUrl":"https://doi.org/10.1245/s10434-025-18473-5","url":null,"abstract":"<p><strong>Background: </strong>Age related changes in the tumor microenvironment (TME) may contribute to cancer progression in older adults. Changes in gene expression with age were analyzed to identify differences in cytokine activity and the extracellular matrix (ECM) in papillary thyroid cancer (PTC).</p><p><strong>Patients and methods: </strong>RNA sequencing data of PTC samples were obtained from The Cancer Genome Atlas (TCGA) and divided into four groups: G1 (22-55 years), G2 (55-64 years), G3 (65-74 years), and G4 (≥ 75 years). Disease stages were defined as local (T<sub>1</sub>-<sub>3</sub>N<sub>0</sub>M<sub>0</sub>), nodal (T<sub>1-3</sub>N<sub>1ab</sub>M<sub>0</sub>), and advanced (T<sub>4</sub>N<sub>X</sub>M<sub>0-1</sub>). Differentially expressed genes (DEGs) identified from DESeq2 RNA-seq analysis were subjected to gene set enrichment analysis (GSEA) and ingenuity pathway analysis (IPA).</p><p><strong>Results: </strong>Overall, 476 PTC samples were retrieved: G1 (n = 329), G2 (n = 71), G3 (n = 49), and G4 (n = 27). Advanced disease occurred more frequently in older patients (2% in G1 versus 10% in G4, p < 0.0001). Comparing G1 versus G2, G1 versus G3, and G1 versus G4 identified 179, 153, and 254 DEGs, respectively (p<sub>adj</sub> < 0.01). GSEA identified 23 ECM-associated DEGs and 11 cytokine receptor binding-associated DEGs that showed increasing transcription from G1 to G4. A subgroup analysis performed on only patients with conventional PTC found a larger number of DEGs from G1 to G4 than in the overall cohort (85% versus 73%, respectively).</p><p><strong>Conclusions: </strong>Expression of genes associated with the ECM and cytokine receptor binding changed significantly with advanced age, suggesting that age related changes in the TME may contribute to cancer progression.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285484","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":"Kimura or Warshaw? Development and Validation of a Preoperative Prediction Model Based on 3D Reconstruction Technology.","authors":"Hongliang Liu, Qisheng Hao, Lunan Wu, Mengxing Cheng, Fabo Qiu, Chuandong Sun, Hao Zou, Bin Zhou","doi":"10.1245/s10434-025-18548-3","DOIUrl":"https://doi.org/10.1245/s10434-025-18548-3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the risk factors for splenic vessel preservation in laparoscopic Kimura procedure and to establish and validate a nomogram model for predicting the failure of splenic vessel preservation.</p><p><strong>Patients and methods: </strong>Clinical data of 169 patients who underwent spleen-preserving distal pancreatectomy for benign or low-grade malignant tumors of the distal pancreas at the Affiliated Hospital of Qingdao University from July 2018 to April 2024 were retrospectively collected. Among them, there were 55 male and 114 female individuals, with an average age of 48.24 ± 14.62 years. All patients were planned to undergo laparoscopic Kimura procedure on the basis of preoperative discussions. A total of 118 patients (69.82%) were randomly assigned to the modeling group, and 51 patients (30.18%) to the validation group. No significant differences were observed in baseline characteristics between the two groups (all P > 0.05). On the basis of data from the modeling group, independent risk factors for splenic vessel preservation were identified using rank sum test and multivariate logistic regression analysis. R software was used to establish a nomogram model for predicting the failure of splenic vessel preservation, and external validation was performed using data from the validation group.</p><p><strong>Results: </strong>On the basis of data from the modeling group, the cutoff values of tumor volume, ratio of splenic vein (SV) circumference embedded in pancreas, and pancreas-SV contact area were determined using receiver operating characteristic curves as follows: 9828.8 mm<sup>3</sup> [area under the curve (AUC) = 0.745, 95% confidence interval (CI) 0.654-0.835], 0.45 (AUC = 0.751, 95% CI 0.610-0.893), and 501 mm<sup>2</sup> (AUC = 0.715, 95% CI 0.588-0.903), respectively. The AUC for tumor location was 0.733 (95% CI 0.622-0.874). Univariate and multivariate logistic regression analyses showed that tumor volume, tumor location, ratio of SV circumference embedded in pancreas, and pancreas-SV contact area were valuable preoperative indicators for predicting the failure of splenic vessel preservation (P < 0.05). The nomogram prediction model established using R software on the basis of these four indicators exhibited good predictive performance, with C-indices of 0.747 in the modeling group and 0.756 in the validation group. Decision curve analysis indicated that the nomogram model had favorable clinical benefits.</p><p><strong>Conclusions: </strong>Tumor volume, tumor location, ratio of SV circumference embedded in pancreas, and pancreas-SV contact area are valuable preoperative indicators for predicting the risk of splenic vessel preservation failure. The nomogram model established on the basis of these indicators has certain clinical practical value. As a representative of the integration of medicine and engineering, three-dimensional medical reconstruction can provide ","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285425","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}
Naita M Wirsik, Thomas Schmidt, Cezanne D Kooij, Niall Dempster, Nerma Crnovrsanin, Noel E Donlon, Eren Uzun, Kunal Bhanot, Henrik Nienhüser, Daniela Polette, Kammy Kewani, Peter Grimminger, Daniel Reim, Florian Seyfried, Hans F Fuchs, Suzanne S Gisbertz, Christoph-Thomas Germer, Jelle P Ruurda, Fredrik Klevebro, Wolfgang Schröder, Magnus Nilsson, John V Reynolds, Mark I Van Berge Henegouwen, Sheraz Markar, Richard Van Hillegersberg, Christiane J Bruns
{"title":"Comparison of Pretreatment Strategies for cT2cN0 Staged Adenocarcinoma of the Esophagus and the Gastroesophageal Junction: A European High-Volume Center Cohort Analysis.","authors":"Naita M Wirsik, Thomas Schmidt, Cezanne D Kooij, Niall Dempster, Nerma Crnovrsanin, Noel E Donlon, Eren Uzun, Kunal Bhanot, Henrik Nienhüser, Daniela Polette, Kammy Kewani, Peter Grimminger, Daniel Reim, Florian Seyfried, Hans F Fuchs, Suzanne S Gisbertz, Christoph-Thomas Germer, Jelle P Ruurda, Fredrik Klevebro, Wolfgang Schröder, Magnus Nilsson, John V Reynolds, Mark I Van Berge Henegouwen, Sheraz Markar, Richard Van Hillegersberg, Christiane J Bruns","doi":"10.1245/s10434-025-18311-8","DOIUrl":"https://doi.org/10.1245/s10434-025-18311-8","url":null,"abstract":"<p><strong>Background: </strong>After the ESOPEC trial showed a survival benefit for fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT)-treated adenocarcinomas of the esophagus (EAC) and the gastroesophageal junction (GEJ) compared with Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS), a European, high-volume center study for stage cT2cN0 EAC and GEJ was undertaken, as it has been published that a third of these patients are understaged and could benefit from a multimodal approach PATIENTS AND METHODS: Retrospective analysis of prospective databases from ten high-volume European centers was performed. Inclusion criteria were GEJ Siewert type I/II or EAC with cT2cN0 status at diagnosis undergoing multimodal treatment with FLOT or CROSS. Primary endpoint was overall survival (OS) RESULTS: Between 2012 and 2023, 133 patients met the inclusion criteria, of whom 73 (54.9%) received CROSS and 60 (45.1%) underwent treatment with FLOT. In both groups, patients were mainly male (p = 0.08), older than 70 years (p = 0.24), and had American Society of Anesthesiologists (ASA) II classification (p = 0.45). Regarding surgical treatment, more patients underwent gastrectomy in the FLOT than in the CROSS cohort (23.3% versus 6.8%, p = 0.007). There were no differences regarding pT, pN, and pM category (p > 0.05). Median survival was not reached, while mean survival was 74.6 months (95% CI 60.5-88.7 months) for CROSS versus 100.8 months (95% CI 72.5-94.5 months, p = 0.028) for FLOT. The 3-year survival was 87% in the FLOT group versus 59% in the CROSS group. In multivariable analyses, FLOT was independent factor for survival (p < 0.001) CONCLUSIONS: For cT2cN0 staged EAC and GEJ type I /II patients FLOT chemotherapy showed a survival benefit and should be the preferred treatment in a multimodal approach.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285475","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}
Mengran Chen, Wenwen Yang, Xuan Mai, Zhenxue Mao, Yifei Du, Sansan Jia, Xiangyu Ding, Xiaoxia Xu
{"title":"ASO Author Reflections: Risk Factors for Surgical Site Infection in Patients with Oral Cancer: A Systematic Review.","authors":"Mengran Chen, Wenwen Yang, Xuan Mai, Zhenxue Mao, Yifei Du, Sansan Jia, Xiangyu Ding, Xiaoxia Xu","doi":"10.1245/s10434-025-18440-0","DOIUrl":"https://doi.org/10.1245/s10434-025-18440-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285424","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}
Judy Li, Giacomo Waller, Yunyun Qin, Allen T Yu, Thomas Li, Deborah Li, Rami Srouji, Camilo Correa-Gallego, Spiros Hiotis, Ganesh Gunasekaran, Joshua Leinwand, Neha L Lad, James Oh Park, Noah A Cohen
{"title":"Worse Survival in Co-Altered RAS-TP53 Patients With Resected Colorectal Liver Metastases.","authors":"Judy Li, Giacomo Waller, Yunyun Qin, Allen T Yu, Thomas Li, Deborah Li, Rami Srouji, Camilo Correa-Gallego, Spiros Hiotis, Ganesh Gunasekaran, Joshua Leinwand, Neha L Lad, James Oh Park, Noah A Cohen","doi":"10.1245/s10434-025-18533-w","DOIUrl":"https://doi.org/10.1245/s10434-025-18533-w","url":null,"abstract":"<p><strong>Background: </strong>Next-generation sequencing provides valuable information about mutations within colorectal liver metastases (CRLMs) that impact survival. Existing data focus on prognostic implications of single gene mutations. This study assessed the impact of co-alterations on KRAS/NRAS and TP53 after CRLM resection.</p><p><strong>Methods: </strong>A retrospective analysis was performed for patients with CRLM who underwent surgical management and had next-generation sequencing (NGS) performed to assess associations with clinical outcomes. Groups were stratified by the presence or absence of RAS-TP53 co-alterations (RTC).</p><p><strong>Results: </strong>The study cohort consisted of 155 patients with NGS data, with 42 patients (27%) harboring RTC. The baseline characteristics were similar between the groups. The RTC patients had more right-side primary tumors (45% vs. 26%; P = 0.028), presented more frequently with synchronous CRLM (91% vs. 72%; P = 0.017), and were more often deemed initially unresectable (26% vs. 12%; P = 0.038). Medical and surgical management were comparable between the groups, with the majority of the patients receiving systemic therapy (97% overall) and undergoing wedge partial hepatectomies (59% overall). The RTC patients had worse recurrence-free and overall survival, and experienced extrahepatic recurrences sooner (median, 9 vs 14 months; P = 0.014). In the multivariate analyses, RTC (hazard ratio [HR, 2.076; 95% confidence interval [CI], 1.054-4.088; P = 0.035) and post-recurrence locoregional treatments (HR, 0.446; 95% CI 0.222-0.896; P = 0.023) were independently associated with survival.</p><p><strong>Conclusions: </strong>The RTC patients presented more often with synchronous CRLM, and RTC also was associated with worse oncologic outcomes, suggestive of more aggressive tumor biology. Integration of genome-sequencing data beyond single gene mutations may provide important prognostic information for patients with CRLM to guide management decisions.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285466","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: Validation of a New Patient-Reported Outcome Surgery for Patients with Upper Gastrointestinal Cancer: MDASI-UGI-Surg.","authors":"Paula Marincola Smith, Naruhiko Ikoma","doi":"10.1245/s10434-025-18524-x","DOIUrl":"https://doi.org/10.1245/s10434-025-18524-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285494","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}