Annals of Surgical Oncology最新文献

{"title":"The Five-Item Modified Frailty Index Predicts Adverse Surgical Outcomes in Patients Undergoing Mastectomy.","authors":"Laetitia S Chiarella, Lioba Huelsboemer, Fortunay Diatta, Felix J Klimitz, Alexander J Kammien, Alejandro Kochen, Sam Boroumand, Omar Allam, Martin Kauke-Navarro, Bohdan Pomahac","doi":"10.1245/s10434-025-17105-2","DOIUrl":"10.1245/s10434-025-17105-2","url":null,"abstract":"<p><strong>Background: </strong>The 5-item modified Frailty Index (mFI-5) is a clinical tool to predict adverse outcomes in surgical patients by assessing five comorbidities: diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and dependent functional status. It helps to evaluate postoperative complication risks, recovery time, and overall survival, particularly in frail patients undergoing oncological and gynecological surgeries.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed American College of Surgeons, National Surgical Quality Improvement Program data from adult female patients undergoing mastectomy procedures without reconstruction between 2017 and 2022. Patients were selected based on Current-Procedural-Terminology codes, excluding incomplete or non-breast-related cases. Preoperative, perioperative, and 30-day postoperative data were analyzed using logistic and linear regression models, with the mFI-5 cutoff set at 2.</p><p><strong>Results: </strong>Between 2017 and 2022, 860 patients underwent mastectomies at Yale Healthcare Network; 19% (n = 163) had mFI score ≥2. High-risk patients (mFI ≥2) were significantly older (66.32 ± 10.83 years) and had a higher body mass index (33.69 ± 7.73, both p < 0.001). Surgical complications occurred in 11.98% of patients, with a higher rate in the high-risk group (22.7% vs. 9.5%, p < 0.001). Adjusted multivariate logistic regression showed an increased risk of complications in frail patients (aOR 2.66; [1.60-4.43], p < 0.001). Although slight reductions in hospital stay and surgery duration were observed for high-risk patients, these differences were not significant. Sensitivity analysis confirmed higher odds of complications, including acute kidney failure (odds ratio [OR] 9.01) and pneumonia (OR 4.10).</p><p><strong>Conclusions: </strong>The mFI-5 is a robust tool for predicting surgical complications in patients undergoing mastectomy, particularly those with multiple comorbidities.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4829-4837"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952563","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":"Neoadjuvant Chemotherapy Response and Genetic Susceptibility in Recently Parous Women with Breast Cancer: A Retrospective Analysis.","authors":"Saya Dennis, Takahiro Tsukioki, Masha Kocherginsky, Andrea Keya Qi, Sarah DeHorn, Michael Gurley, Erica Wrubel, Yuan Luo, Seema Ahsan Khan","doi":"10.1245/s10434-025-17204-0","DOIUrl":"10.1245/s10434-025-17204-0","url":null,"abstract":"<p><strong>Background: </strong>Women with recent parity are at increased short-term breast cancer (BC) risk and face a worse prognosis. The effect of parity on response to neoadjuvant chemotherapy (NAC) is unstudied, and the influence of inherited susceptibility on parity-related short-term risk remains unclear.</p><p><strong>Methods: </strong>A retrospective case-cohort study analyzed women age 50 years or younger with non-metastatic BC diagnosed between 2010 and 2020 who underwent genetic testing and were treated at Northwestern Medicine. Associations between NAC response and recency of parity were evaluated using multivariate logistic regression, stratified by tumor biologic subtypes. Relationships between germline mutations, recency of parity, and BC were explored via multi-state modeling and linear regression.</p><p><strong>Results: </strong>Among 1080 eligible women, 231 received NAC. Treatment response was poorer in parous women with triple-negative tumors than in nullipara women regardless of the recency of parity (P < 0.03). Among 122 women (11.3%) with detectable pathogenic mutations, adjusted analyses with both modeling approaches showed no indications that BRCA1/2 carriers had a greater hazard of a BC diagnosis in the decade after recent parity than nulliparous mutation carriers. For BRCA2 and PALB2 carriers, BC diagnosis occurred less frequently in the postpartum intervals.</p><p><strong>Conclusion: </strong>This study showed a poor response to NAC in parous triple-negative BC (TNBC) patients than in nullipara patients. The effects of immunotherapy-based regimens deserve evaluation in the context of parity. Postpartum BC occurrence is not increased in BRCA1/2 carriers. The effects of rarer susceptibility genes may differ. These important effects of parity on BC in young women and those at genetic risk warrant larger prospective studies.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4855-4864"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959143","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":"Great Debate: Molecular Testing and Extent of Surgery in Well-Differentiated Thyroid Cancer.","authors":"Cord Sturgeon, Ashok R Shaha, Linwah Yip","doi":"10.1245/s10434-025-17348-z","DOIUrl":"10.1245/s10434-025-17348-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4597-4603"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954348","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":"Comparison of Voice and Swallowing Changes After Thyroidectomy Using the Gasless Transaxillary, Transoral, and Conventional Transcervical Approaches: A Network Meta-analysis.","authors":"Van Cuong Nguyen, Chang Myeon Song, Yong Bae Ji, Dong Won Lee, Jin Hyeok Jeong, Kyung Tae","doi":"10.1245/s10434-025-17276-y","DOIUrl":"10.1245/s10434-025-17276-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated voice and swallowing outcomes following thyroidectomy by using the gasless transaxillary (GTAA) and transoral (TOA) approaches compared with the conventional transcervical approach (CTA).</p><p><strong>Methods: </strong>A comprehensive search of the PubMed, EMBASE, and Cochrane Library databases was conducted through September 2024. Network meta-analyses were performed on 14 comparative studies, encompassing 1723 patients.</p><p><strong>Results: </strong>Voice handicap index (VHI)-10 scores, highest frequency, and frequency range deteriorated after surgery in all three methods. However, the postoperative voice outcomes of the GTAA and TOA were superior to the conventional approach at all follow-up points up to 3 months after the operation. Specifically, the VHI-10 scores of the GTAA and TOA were significantly lower than those of the CTA at 3 months postoperation. Other acoustic parameters, such as jitter, shimmer, noise-to-harmonic ratio, and intensity range, did not differ among the three methods. The postoperative swallowing impairment score (SIS)-6 of the GTAA and TOA were lower than that of the CTA. Specifically, the SIS-6 of the GTAA was significantly lower than those of the TOA and CTA at 3 months postoperation.</p><p><strong>Conclusions: </strong>The postoperative voice and swallowing outcomes, especially VHI-10, highest frequency, frequency range, and SIS-6, following remote-access thyroidectomy using the GTAA and TOA were superior to those observed with the conventional approach. Given the limited number of studies included, further research is needed to confirm these findings as new studies emerge, especially those with larger sample sizes, diverse populations, different approaches, and extended follow-up periods.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5256-5268"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966034","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":"Near Complete Response: An Opportunity for Organ Preservation in Rectal Cancer.","authors":"Wini Zambare, J Joshua Smith","doi":"10.1245/s10434-025-17310-z","DOIUrl":"10.1245/s10434-025-17310-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4582-4585"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964596","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":"Anaplastic Thyroid Cancer: A Rare, Rapidly Progressive, and Lethal Malignancy.","authors":"Marie W Su, Christopher R McHenry","doi":"10.1245/s10434-025-17311-y","DOIUrl":"10.1245/s10434-025-17311-y","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4578-4579"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962817","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 Practice Guidelines Series: Multidisciplinary Management of Retroperitoneal Sarcomas.","authors":"Catherine Sarre Lazcano, Kenneth Cardona, Dario Callegaro","doi":"10.1245/s10434-025-17284-y","DOIUrl":"10.1245/s10434-025-17284-y","url":null,"abstract":"<p><p>Retroperitoneal sarcomas (RPS) represent a rare and biologically diverse group of malignancies, distinct from soft tissue sarcomas arising in other anatomic regions. Their deep-seated location, large size at presentation and proximity to critical structures contribute to diagnostic delays, treatment challenges, and variable oncologic outcomes, particularly when managed outside high-volume referral centers. Current international guidelines emphasize the importance of preoperative biopsy, review by a sarcoma pathologist, management in a referral center, multidisciplinary case discussion, consideration for clinical trials enrollment, and prospective database inclusion as standards of care. Given that the quality of the initial surgical resection-achieving complete macroscopic resection with margins tailored to the histologic type-remains the most important modifiable prognostic factor, adherence to international best practices in surgical and multimodal treatment is crucial to optimize patient outcomes. This article reviews contemporary management strategies for adult-type RPS, emphasizing the importance of multidisciplinary expertise.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5343-5355"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974029","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":"Radiologic and Pathologic Response Evaluation After Neoadjuvant Chemotherapy for Primary Retroperitoneal Sarcoma: A Transatlantic Australasian Retroperitoneal Sarcoma Working Group (TARPSWG) Collaboration.","authors":"Stijn J C van der Burg, Marco Fiore, Piotr Rutkowski, Markus Albertsmeier, Sylvie Bonvalot, Valerie P Grignol, Chandrajit P Raut, Ferdinando C M Cananzi, John E Mullinax, David E Gyorki, Elisabetta Pennacchioli, Samuel J Ford, Carolyn Nessim, Kenneth Cardona, Dario Callegaro, Jacek Skoczylas, Lars H Lindner, Alessandro Gronchi, Winan J Van Houdt","doi":"10.1245/s10434-025-17306-9","DOIUrl":"10.1245/s10434-025-17306-9","url":null,"abstract":"<p><strong>Background: </strong>Comsplete resection is the primary treatment for retroperitoneal sarcomas (RPS). The role of neoadjuvant chemotherapy (NACT) in improving oncologic outcomes is currently under investigation in the STRASS 2 trial. This study assessed the association between change in tumor size or pathologic response and oncologic outcomes.</p><p><strong>Methods: </strong>Data were retrieved from the international Retroperitoneal Sarcoma Registry and included patients who had RPS treated with NACT between January 2017 and October 2020. The correlation between radiologic response (RECIST1.1), change in tumor size, pathologic response, and oncologic outcomes was evaluated. Binary logistic, Cox, and polynomial spline regression and log-rank tests were performed as statistical analyses.</p><p><strong>Results: </strong>The study enrolled 141 patients from 14 medical centers. The most common histologies were dedifferentiated liposarcoma (36.9 %) and leiomyosarcoma (34 %). At completion of NACT, 14.5 % of the patients, had a partial response (PR), 63.3 % had stable disease (SD), and 22.2 % had progressive disease (PD). The hazard ratio of PD after NACT for overall survival (OS) was 1.9 (95 % confidence interval [CI], 0.9-4.1). A linear trend was observed between tumor growth and death rate. At early radiologic evaluation during NACT, PD was significantly associated, with worse OS (HR, 5.4; 95 % CI, 1.1-25.3). Partial response was significantly correlated with ≥20 % fibrosis/hyalinization (odds ratio [OR], 5.6; 95 % CI, 1.1-29.0).</p><p><strong>Conclusion: </strong>Progression in RPS on an early evaluation scan is associated with worse OS, and radiologic response is correlated with pathologic response based on fibrosis/hyalinization. A larger cohort is necessary for more significant associations between radiologic or pathologic response and oncologic outcomes.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5359-5366"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075603","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":"An Evaluation of Sentinel Lymph Node Biopsy Guideline Adherence in Melanoma.","authors":"Amelia Stapleton Van Doren, Hemali Shah, Ashar Ata, Lindy Davis","doi":"10.1245/s10434-025-16971-0","DOIUrl":"10.1245/s10434-025-16971-0","url":null,"abstract":"<p><strong>Background: </strong>Regional lymph nodes are a common first site of metastasis in patients diagnosed with invasive melanoma. Knowledge of sentinel lymph node status provides strong prognostic information in melanoma and is important for staging and treatment decisions. The National Comprehensive Cancer Network^® (NCCN) recommends performance of sentinel lymph node biopsy (SLNB) for melanoma patients with a T category of ≥T2a. This study aims to assess our academic institution's guideline adherence to improve quality of care.</p><p><strong>Methods: </strong>Retrospective review of medical records from 2017 to 2023 identified 628 patients referred to our institution for invasive melanoma treatment. Adherence to guidelines was assessed using Chi-square analyses and Fisher's exact tests.</p><p><strong>Results: </strong>In total, 8.2% of cases did not follow the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for SLNB. When justification provided within the medical record was considered adherent to guidelines, our rate of discordance was 1.6%. Head and neck melanomas were more likely to have guideline-discordant SLNB management, regardless of whether or not a justification was provided.</p><p><strong>Conclusion: </strong>Greater than 98% of melanoma cases at our institution aligned with the SLNB NCCN Guidelines^®. We outlined the complex justifications physicians and patients may use to pursue care that is nonadherent to guidelines. Employment of SLNB may be limited by medical comorbidities, surgical risks, and when the management would not change based on the result. Our study provides a blueprint for institutional assessment of guideline adherence and highlights the importance of documentation and guideline dissemination.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"5283-5291"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370336","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":"Adenocarcinoma Presenting as Pulmonary Ground Glass Opacities (GGOs): Every GGO Has Its Own Story.","authors":"Vittorio Aprile, Maria Giovanna Mastromarino, Stylianos Korasidis, Marcello Carlo Ambrogi, Marco Lucchi","doi":"10.1245/s10434-025-17116-z","DOIUrl":"10.1245/s10434-025-17116-z","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"4572-4574"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603695","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}