Annals of Surgical Oncology最新文献

{"title":"ASO Author Reflections: Histology and Nodal Status Reframe Risk After Neoadjuvant Therapy.","authors":"Yongqiang Ao, Zheng Han, Mingyu Xia, Jiazhe Wen, Caiying Wang, Fei Liang, Bei Xu, Hai Kun Wang, Shuai Wang, Jian Gao, Jiahao Jiang, Jianyong Ding","doi":"10.1245/s10434-026-20752-8","DOIUrl":"https://doi.org/10.1245/s10434-026-20752-8","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226992","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":"Analysis of the Safety and Efficacy of Cryoablation in Patients with Locally Advanced Pancreatic Cancer.","authors":"Shutong Shao, Li Wang, Feng Tan, Shengzhong Hou, Kang Xue, Xing Huang, Dan Cao, Junjie Xiong, Bole Tian","doi":"10.1245/s10434-026-20731-z","DOIUrl":"https://doi.org/10.1245/s10434-026-20731-z","url":null,"abstract":"<p><strong>Background: </strong>Cryoablation is emerging as a potential treatment option for locally advanced pancreatic cancer (LAPC). The aim of this study was to retrospectively evaluate the safety and efficacy of cryoablation in patients with LAPC. The study has been prospectively registered in the Chinese Clinical Trial Registry (ID: ChiCTR2300068376).</p><p><strong>Patients and methods: </strong>Adult patients with LAPC were stratified based on the treatment modality (cryoablation versus systemic therapy). The cryoablation was performed using a single cryoprobe under ultrasound guidance. The Kaplan-Meier method was utilized to evaluate and compare overall survival (OS) among the groups. Cox proportional hazards regression analysis was employed to identify independent predictors of overall survival.</p><p><strong>Results: </strong>Of 186 enrolled patients with LAPC between August 2022 and December 2024, 142 were in the cryoablation group and 44 in the systemic therapy alone group. The median OS was 17.8 months with systemic therapy alone and 18.7 months with cryoablation alone. Combined cryoablation and systemic therapy yielded a median OS of 22.1 months. Among patients receiving cryoablation combined with chemotherapy median OS was 19.8 months, and for combination systemic therapy group (chemotherapy + immunotherapy ± targeted therapy), it was 25.4 months. Multivariate analysis identified age, tumor location, treatment type, and jaundice as independent OS predictors. Additionally, nearly all patients experienced marked pain relief after cryoablation treatment.</p><p><strong>Conclusions: </strong>When combined with systemic therapy, cryoablation has a more significant survival advantage than systemic therapy alone. However, due to the heterogeneity of the cohort and potential immortal time bias, these survival outcomes should be interpreted with caution. Additionally, cryoablation offers effective benefits for relieving cancer pain and preserving functional quality of life in patients with LAPC.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227022","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":"Effect of Extended-Duration Venous Thromboprophylaxis After Cancer Surgery.","authors":"Xing Wang, Wuqian Chen, Lu Ma, Chao You","doi":"10.1245/s10434-026-20700-6","DOIUrl":"https://doi.org/10.1245/s10434-026-20700-6","url":null,"abstract":"<p><strong>Background: </strong>Cancer patients undergoing surgery are at significantly increased risk of venous thromboembolism (VTE). Although extended thromboprophylaxis is recommended, the optimal anticoagulant type and duration remain unclear. This study aimed to evaluate the comparative efficacy and safety of different extended thromboprophylaxis in this population.</p><p><strong>Methods: </strong>A Bayesian network meta-analysis of randomized controlled trials (RCTs) was performed to evaluate various thromboprophylaxis strategies for patients undergoing cancer-related surgery. We conducted both three-node and five-node network analyses to evaluate extended-duration versus standard-duration thromboprophylaxis strategies. Outcomes included venous thromboembolism, major bleeding, and all-cause mortality. Net clinical benefit and risk-benefit assessments were additionally performed to determine the overall impact of prolonged anticoagulant therapy. Treatment effects were summarized as risk ratios (RRs) with corresponding 95% credible intervals (CrIs).</p><p><strong>Results: </strong>A total of 14 randomized controlled trials involving 4,331 participants were included. Compared with placebo, extended-duration prophylaxis with direct oral anticoagulants (DOACs) (RR 0.12, 95% CrI 0.05-0.27) and low-molecular-weight heparin (LMWH) (RR 0.17, 95% CrI 0.05-0.55) significantly reduced the incidence of venous thromboembolism without a corresponding increase in major bleeding. In net clinical benefit analyses, both prolonged DOAC therapy (RR 0.27, 95% CrI 0.14-0.49) and LMWH (RR 0.36, 95% CrI 0.17-0.76) demonstrated favorable overall outcomes. Risk-benefit evaluation suggested that prolonged DOACs provided a more advantageous balance than LMWH, with an NNH/NNT ratio of 4.17.</p><p><strong>Conclusions: </strong>Extended thromboprophylaxis is effective and safe for cancer patients undergoing surgery. Besides, DOACs appears to be the optimal anticoagulant for extended thromboprophylaxis, providing the greatest net clinical benefit.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227038","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":"Advanced Nodal Disease is Not a Single Stratum: Refining Eligibility for Targeted Axillary Dissection After Neoadjuvant Therapy.","authors":"Miriam C Obeid, Omar Layth Qassid, Kefah Mokbel","doi":"10.1245/s10434-026-20708-y","DOIUrl":"https://doi.org/10.1245/s10434-026-20708-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227071","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":"Performance of⁶⁸Ga-PSMA-11 PET/CT for Diagnosing Tumor Thrombus and Predicting Response to Pembrolizumab and Axitinib in Patients with Renal Cell Carcinoma: A Pilot, Retrospective Study.","authors":"Bo-Han Lin, Cheng-Long Zeng, Xiao-Hui Wu, Rui-Cheng Gao, Qian-Ren-Shun Qiu, Ye-Hui Chen, Xue-Yi Xue, Qing-Shui Zheng, Shao-Hao Chen, Yong Wei, Ning Xu","doi":"10.1245/s10434-026-20772-4","DOIUrl":"https://doi.org/10.1245/s10434-026-20772-4","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the performance of ⁶⁸Ga-PSMA-11 PET/CT for diagnosing tumor thrombus (TT) and predicting response to pembrolizumab and axitinib in renal cell carcinoma (RCC) with TT.</p><p><strong>Methods: </strong>We reviewed RCC patients who underwent contrast-enhanced CT, mpMRI, and ⁶⁸Ga-PSMA-11 PET/CT. Diagnostic performance for detecting TT was analyzed, with TT confirmed by experienced pathologists. We further analyzed clear cell RCC (ccRCC) patients with TT who received pembrolizumab and axitinib and evaluated imaging features for predicting therapeutic efficacy by using receiver operating characteristic analysis. Internal validation was performed using bootstrap resampling (1000 iterations). Model calibration was assessed with the Hosmer-Lemeshow test.</p><p><strong>Results: </strong>A total of 166 RCC patients were initially included, of whom 56 had TT. ⁶⁸Ga-PSMA-11 PET/CT showed higher overall diagnostic performance for TT than contrast-enhanced CT and mpMRI, with incremental detection primarily observed for Mayo level 0-I TT. The sensitivity and specificity of PET/CT in diagnosing TT were 0.96 (95% CI 0.88-0.99) and 0.97 (95% CI 0.92-0.99), respectively. Then, 35 ccRCC patients with TT underwent an average of 5 cycles of pembrolizumab and axitinib, followed by surgery. Following neoadjuvant therapy, 21 patients exhibited a partial response, while 14 showed nonresponse. TT SUVmax demonstrated significant predictive value for response to neoadjuvant therapy, with an AUC of 0.80 (95% CI 0.63-0.92; bootstrap-corrected, 0.79). The Hosmer-Lemeshow test indicated adequate calibration (P > 0.05).</p><p><strong>Conclusions: </strong>⁶⁸Ga-PSMA-11 PET/CT may provide incremental value for detecting low-level TT and shows potential for predicting response to pembrolizumab plus axitinib in RCC. However, the clinical significance of detecting early TT remains uncertain.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227013","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":"Androgen Receptor (AR) Expression is Associated with an Immune-Cold Phenotype and Reduced Response to Immune Checkpoint Inhibitors in ER-Positive/HER2-Negative Breast Cancer.","authors":"Jun Arima, Kohei Chida, Rongrong Wu, Takafumi Shima, Toru Kuramoto, Hiroki Hamamoto, Kohei Taniguchi, Zunairah Shah, Kenichi Hakamada, Takashi Ishikawa, Seita Hagihara, Kosei Kimura, Mitsuhiko Iwamoto, Sang-Woong Lee, Kazuaki Takabe","doi":"10.1245/s10434-026-20685-2","DOIUrl":"https://doi.org/10.1245/s10434-026-20685-2","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have limited efficacy in estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2-) breast cancer, and the mechanisms underlying immune resistance remain unclear. The androgen receptor gene (AR), expressed in a substantial proportion of ER-positive tumors, has been implicated in tumor biology; however, its role in the tumor immune microenvironment and immunotherapy response is not well understood.</p><p><strong>Methods: </strong>We investigated the association between AR expression, transcriptome-derived immune cell-associated signatures, and response to ICIs in 4046 patients with breast cancer across five cohorts with bulk transcriptomic data and two cohorts with single-cell transcriptomic data.</p><p><strong>Results: </strong>High AR expression was consistently associated with reduced transcriptome-derived tumor-infiltrating leukocyte scores across multiple ER+/HER2- cohorts. Specifically, signatures associated with cluster of differentiation (CD)-8+ T-cell subsets, dendritic cells, and M1 macrophages were significantly reduced in AR-high tumors, indicating a transcriptionally immune-suppressed tumor microenvironment. In the I-SPY2 cohort, AR-high tumors demonstrated significantly lower pathological complete response rates after neoadjuvant ICI therapy. Furthermore, AR expression showed a predictive performance for ICI response that was superior to that with programmed cell death protein-1 and programmed cell death ligand-1 (area under the curve 0.82 vs. 0.73 and 0.60, respectively). Interestingly, single-cell analysis revealed that AR expression across multiple cell types, including epithelial, endothelial, and myeloid, was associated with reduced ICI responsiveness. Additionally, AR inhibition using enzalutamide was associated with increased signatures associated with CD8+ T cells, dendritic cells, and M1 macrophages.</p><p><strong>Conclusions: </strong>These findings suggest that AR expression is associated with an immunosuppressive tumor microenvironment and reduced response to ICIs in ER+/HER2- breast cancer.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227062","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: Para-aortic Lymph Node Metastasis in Colorectal Cancer.","authors":"Andreas Denys, Amanda Verstraete, Karen Geboes, Gabrielle H van Ramshorst","doi":"10.1245/s10434-026-20803-0","DOIUrl":"https://doi.org/10.1245/s10434-026-20803-0","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223298","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":"Real-World Adoption of Adjuvant Immune Checkpoint Inhibition in Stage IIB/IIC Melanoma Following FDA Approval.","authors":"James W Jakub, Bently P Doonan, Courtney N Day, Jeffrey E Johnson, Arkadiusz Z Dudek, Mahesh Seetharam, Barbara Pockaj, Ahmed Yahya, Roxana S Dronca","doi":"10.1245/s10434-026-20378-w","DOIUrl":"https://doi.org/10.1245/s10434-026-20378-w","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant immune checkpoint inhibition (ICI) for stage IIB/IIC melanoma was approved in December 2021 based on recurrence-free survival benefit without mature overall survival data. Given uncertainty regarding the risk-benefit balance in this population, we evaluated real-world utilization of adjuvant ICI in the first year following FDA approval and compared uptake with historical patterns observed in stage III melanoma.</p><p><strong>Methods: </strong>The National Cancer Database (NCDB) and Mayo Clinic Cancer Registry were queried for patients with stage IIB/IIC melanoma diagnosed in 2019-2020 (pre-approval) and 2022 (post-approval). Utilization was compared with historical patterns for stage III melanoma surrounding its December 2017 FDA approval. Multivariable logistic regression identified factors associated with receipt of adjuvant ICI.</p><p><strong>Results: </strong>Among 7039 patients with stage IIB/IIC melanoma in NCDB, adjuvant ICI use increased from 5% pre-approval to 32% post-approval (P < .0001), with higher utilization in stage IIC (40%) than IIB (27%). Younger age was the only consistent patient-level factor associated with treatment. Within our tertiary care system, 21% of eligible patients received adjuvant ICI post-approval. By comparison, stage III utilization at NCDB sites increased from 27 to 58% in the first year following its FDA approval.</p><p><strong>Conclusions: </strong>Adjuvant ICI use for stage IIB/IIC melanoma increased following FDA approval; however, most eligible patients did not receive therapy, and overall utilization remained lower than historical patterns observed for stage III disease, suggesting selective adoption driven by risk-benefit considerations.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223293","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: Rethinking Adjuvant Chemotherapy in Resected ALK-Positive Lung Cancer.","authors":"Akira Hamada, Shinkichi Takamori, Asato Hashinokuchi, Mototsugu Shimokawa, Yasuhiro Tsutani","doi":"10.1245/s10434-026-20787-x","DOIUrl":"https://doi.org/10.1245/s10434-026-20787-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223254","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":"Recent National Trends in Time to Breast Cancer Surgery Before and After the COVID-19 Pandemic Onset and Predictors of Failure to Receive Timely Surgery.","authors":"Supriya Sullivan, Sarah Mott, M Muska Nataliansyah, Erin M Mobley, Ingrid M Lizarraga","doi":"10.1245/s10434-026-20719-9","DOIUrl":"https://doi.org/10.1245/s10434-026-20719-9","url":null,"abstract":"<p><strong>Background: </strong>Time to surgery (TTS) for breast cancer has been increasing for decades, with delays associated with worse survival. A 2022 Commission on Cancer (CoC) quality measure requires upfront surgery within 60 days after diagnosis (BCSdx). The long-term effects of the COVID-19 pandemic on TTS and compliance with BCSdx are unknown.</p><p><strong>Methods: </strong>Using the National Cancer Database, the study identified 520,967 women with a diagnosis of clinical stages I to III invasive breast cancer from 2014 to 2023 who underwent upfront surgery. Time to surgery was defined as days from diagnosis to definitive surgery. Diagnosis year was modeled continuously and categorically (pre-pandemic 2014-2019, pandemic onset 2020, post-pandemic onset 2021-2023). Linear and logistic regression were used to identify factors associated with TTS and odds of not having surgery in ≤ 60 days.</p><p><strong>Results: </strong>Between 2014 and 2023, the mean TTS increased from 37 to 50 days (+ 13 days). Compared with 2014-2019, the 2021-2023 period was associated with + 7.51 mean days (95% confidence interval [CI], 7.35-7.67 days) and 1.90 times (95% CI, 1.87-1.94 times) increased odds of not meeting BCSdx in the multivariable analysis. Longer TTS also was associated with immediate reconstruction (β = + 8.27 days), uninsured status (β = + 7.99 days), and diagnosis at another facility (β = + 6.55 days). The proportion of patients with a TTS of ≤ 60 days declined from 88% to 74%. The strongest predictors of noncompliance were uninsured status (odds ratio [OR], 2.10), diagnosis at another facility (OR, 1.81), immediate reconstruction (OR, 1.81), black race (OR, 1.72), and Hispanic ethnicity (OR, 1.70).</p><p><strong>Conclusions: </strong>The increase in TTS for breast cancer accelerated after the onset of the COVID-19 pandemic, with a concomitant decrease in BCSdx compliance. Strategies to improve care coordination, particularly for at-risk populations, are needed to address this quality measure.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223256","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}