Annals of Surgical Oncology最新文献

{"title":"Short- and Long-Term Outcomes After Hepatectomy in Patients Receiving Triplet Versus Doublet Preoperative Chemotherapy for Colorectal Liver Metastases.","authors":"Agostino M De Rose, Elena Panettieri, Mateo Lendoire, Yosuke Nakao, Eleanor A Fallon, Caterina Mele, Marc-Antoine Allard, Timothy E Newhook, Francesco Ardito, René Adam, Jean-Nicolas Vauthey, Felice Giuliante","doi":"10.1245/s10434-025-18413-3","DOIUrl":"https://doi.org/10.1245/s10434-025-18413-3","url":null,"abstract":"<p><strong>Background: </strong>FOLFOXIRI is associated with better response and higher resection rates than doublet regimens for colorectal liver metastases (CLM); however, irinotecan and oxaliplatin may cause liver injury, increasing the risk of hepatectomy. This study compared outcomes between patients receiving FOLFOXIRI versus FOLFOX/FOLFIRI before undergoing CLM resection.</p><p><strong>Methods: </strong>This multicenter retrospective study included consecutive patients undergoing CLM resection during 2010-2021 after preoperative FOLFOXIRI or FOLFOX/FOLFIRI as first-line chemotherapy. Patients receiving multiple lines of therapy were excluded.</p><p><strong>Results: </strong>Of 1711 patients included, 160 (9.4%) received FOLFOXIRI and 1551 (90.6%) received FOLFOX/FOLFIRI. Patients receiving FOLFOXIRI were younger (median age 55 vs. 59 years; p < 0.001), had a higher rate of synchronous CLM (93.7% vs. 78.7%; p < 0.001), and had a higher median tumor burden score (TBS; 5.6 vs. 4.1; p < 0.001). In both groups, a median of six cycles of preoperative chemotherapy were administered. Outcomes after FOLFOXIRI (vs. FOLFOX/FOLFIRI) were as follows: major hepatectomy, 44.4% of patients (vs. 35.3%; p = 0.024), median estimated blood loss, 300 mL (vs. 200 mL; p = 0.006), rate of intraoperative blood transfusion, 8.1% (vs. 4.4%; p = 0.034), 90-day major complication rate, 13.3% (vs. 10.0%; p = 0.193), 90-day mortality rate, 1.2% (vs. 0.6%; p = 0.324), and 5-year overall survival (OS) rate, 66.6% (vs. 56.4%; p = 0.072). Medium-high TBS, synchronous extrahepatic disease, positive resection margin, and RAS mutation were independent risk factors for poor OS. Patients with medium-high TBS had a significantly better 5-year OS rate after FOLFOXIRI than after FOLFOX/FOLFIRI (67.6% vs. 50.1%; p = 0.004).</p><p><strong>Conclusion: </strong>In patients with CLM with higher disease burden, FOLFOXIRI may be preferable to FOLFOX/FOLFIRI for preoperative chemotherapy.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197948","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: Lost in Transition: Addressing Preventable Attrition after Neoadjuvant Chemotherapy.","authors":"Jaspinder Sanghera, Michelle Holland, Ioannis Liapis, Annabelle L Fonseca","doi":"10.1245/s10434-025-17887-5","DOIUrl":"10.1245/s10434-025-17887-5","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7784-7785"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673820","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":"Short-Term Outcomes of Breast Cancer Surgery by Race-Ethnicity in the Military Health System.","authors":"Yvonne L Eaglehouse, Sarah Darmon, Matthew Nealeigh, Tracey Koehlmoos, Craig D Shriver, Kangmin Zhu","doi":"10.1245/s10434-025-17449-9","DOIUrl":"10.1245/s10434-025-17449-9","url":null,"abstract":"<p><strong>Background: </strong>Racial-ethnic differences in breast cancer treatment in the United States are well documented. Few studies have evaluated racial-ethnic differences in short-term outcomes following breast cancer surgery. This study compared postoperative outcomes following breast cancer surgery between racial-ethnic groups in the U.S. Military Health System.</p><p><strong>Methods: </strong>We identified a cohort of women aged 18 and older diagnosed with stage I-III breast cancer between 2001 and 2014 who received partial (i.e., breast conserving, lumpectomy), total, or radical mastectomy without reconstruction in the MilCanEpi database. Multivariable Poisson regression estimated the adjusted risk ratios (ARRs) with 95% confidence intervals (CIs) in association with race-ethnicity for 30-day complications, reoperation, and hospital readmission.</p><p><strong>Results: </strong>The study included 7527 women with mean age 56.2 (±12.8) years. The risk of 30-day complications was statistically significantly lower for Asian or Pacific Islander (n = 886; ARR = 0.67, 95% CI = 0.51, 0.89) and not statistically different for non-Hispanic Black (n = 1246; ARR = 0.81, 95% CI = 0.65, 1.02) and Hispanic (n = 497; ARR = 0.97, 95% CI = 0.73, 1.29) compared with Non-Hispanic White (n = 4,898) women. The risk of reoperation was not statistically different between the racial-ethnic groups. Hispanic women had a statistically significantly higher risk of 30-day readmission (ARR = 1.46, 95% CI = 1.08, 1.98). The risk was not statistically different for Asian and Black compared with White women.</p><p><strong>Conclusions: </strong>In the Military Health System, the risk of 30-day complications and hospital readmissions varied between women of different race-ethnicity following surgery without reconstruction for nonmetastatic breast cancer. This suggests that factors other than availability and affordability of care in the differences and warrants further research.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7693-7706"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118603","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":"Six Surgical Stages in the Resection of Primary Left Retroperitoneal Liposarcoma: A Standardized Comprehensive Approach.","authors":"M Baia, F Dossa, S Radaelli, D Callegaro, C Colombo, A Borghi, S Pasquali, C Morosi, C Sangalli, R Sanfilippo, M Fiore, A Gronchi","doi":"10.1245/s10434-025-17739-2","DOIUrl":"10.1245/s10434-025-17739-2","url":null,"abstract":"<p><strong>Background: </strong>Surgery at high-volume centers remains the cornerstone of retroperitoneal sarcoma (RPS) treatment, requiring en bloc resection of the tumor with adjacent organs when appropriate.^1-5 This video illustrates a standardized six-stage surgical approach for primary left-sided retroperitoneal liposarcoma, modeled on the same concept of the six-stage technique previously described for right retroperitoneal liposarcoma.⁶ PATIENT AND METHODS: A 73-year-old man presented with a 13-cm primary left retroperitoneal high-grade dedifferentiated liposarcoma. The tumor displaced the descending colon and abutted the pancreatic tail and psoas muscle. Following Tumor-Board evaluation, the patient received preoperative chemotherapy (three cycles of epirubicin-ifosfamide), resulting in disease stability upon restaging.</p><p><strong>Results: </strong>The patient underwent en bloc resection of the left retroperitoneal mass, including the ipsilateral kidney, adrenal gland, and colon. A healthy plane was identified between the tumor and the pancreatic tail. Given the patient's age, prior chemotherapy, and high-risk of pancreatic fistula, the distal pancreas and spleen were dissected free and preserved. On the posterior side, the psoas muscle was tightly adherent to the tumor and was resected to ensure oncological adequacy. This structured medial-to-lateral approach allows early vascular control and safe identification of critical structures.</p><p><strong>Conclusions: </strong>Resecting a left RPS is a complex procedure that demands a diverse set of surgical skills. This six-stage approach, developed over two decades in a high-volume center, provides a reproducible and oncologically sound benchmark, applicable virtually in all cases while ensuring a resection adherent to the principles of surgical oncology.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7836-7837"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537845","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: From Downstaging to Cure-Conversion Surgery after Trastuzumab-Based Chemo-Immunotherapy for Stage IV HER2-Positive Gastric Cancer.","authors":"Liying Zhao, Huayuan Liang","doi":"10.1245/s10434-025-17760-5","DOIUrl":"10.1245/s10434-025-17760-5","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7668-7669"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574736","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":"Simultaneous Vaginoplasty with Acellular Dermal Matrix and Pedicled Omental Flap and Pull-Through Colon-Anal Anastomosis for Low Rectal Cancer with Vaginal Invasion.","authors":"Anqi Wang, Jun Ying, Jian Zhang, Xiaohai Zhu, Haiyang Zhou","doi":"10.1245/s10434-025-17818-4","DOIUrl":"10.1245/s10434-025-17818-4","url":null,"abstract":"<p><strong>Background: </strong>In distal locally advanced rectal cancer with vaginal invasion, simultaneous bowel and vaginal reconstruction is technically challenging.¹ Here, we describe a technique of simultaneous vaginoplasty and colon-anal anastomosis.</p><p><strong>Methods: </strong>A 64-year-old woman was diagnosed with rectal mucinous adenocarcinoma 5 months ago. Colonoscopy showed that the tumor was located on the anterior rectal wall, with its lower edge adjacent to the dentate line. Pelvic MRI revealed that the tumor involved the posterior vaginal wall. The patient expressed a strong desire for sphincter preservation. Following a series of multidisciplinary team discussions for oncological feasibility, neoadjuvant chemotherapy (CapeOx, ycT4bN0M0, partial response) and subsequent radical sphincter-preserving surgery were conducted. The surgery mainly included laparoscopic-assisted intersphincteric dissection and extensive resection of posterior vaginal wall with partial external anal sphincter.² Sphincteroplasty was performed to restore anal function, followed by a pull-through colon-anal anastomosis.^{3, 4} Vaginoplasty was performed using a human acellular dermal matrix, which worked by promoting fibroblasts to migrate and proliferate, and stimulating the growth of endothelial and epithelial cells.⁵ Tissue healing was further supported by pedicled greater omental transplantation.</p><p><strong>Results: </strong>The operative time was 250 min. The blood loss was 150 ml. Postoperative course was uneventful, and the patient was discharged 8 days after surgery. The pulled-through bowel was resected 3 weeks after surgery. Postoperative pathology confirmed a rectal mucinous adenocarcinoma with vaginal invasion (ypT4bN0M0). All margins were clear.</p><p><strong>Conclusion: </strong>We describe a feasible technique of simultaneous bowel and vaginal reconstruction for low rectal cancer with vaginal invasion.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7351-7352"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616055","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":"Reply to: Letter to the Editor of Annals of Surgical Oncology Concerning \"Dissecting Tumor Size Underestimation in Pancreatic Cancer: A Comparative Analysis of Preoperative Treatments\" by Zhu, Xudong et al.","authors":"Kazuki Kobayashi, Yoji Kishi","doi":"10.1245/s10434-025-17816-6","DOIUrl":"10.1245/s10434-025-17816-6","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7487-7488"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648400","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: Resistance of Lateral Lymph Nodes to NCRT: An Ongoing Clinical Challenge.","authors":"Zixuan Zhuang, Xuyang Yang, Yang Zhang, Xiangbing Deng, Mingtian Wei, Ziqiang Wang","doi":"10.1245/s10434-025-17881-x","DOIUrl":"10.1245/s10434-025-17881-x","url":null,"abstract":"","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7355"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673821","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":"Machine Learning-Driven SERS Analysis Platform for Accurate and Rapid Diagnosis of Peritoneal Metastasis from Gastric Cancer.","authors":"Bowen Shi, Sheng Lu, Luke Zhang, Xinran Wang, Yu Chen, Feng Bian, Zhong Zhang, Yongkang Xu, Hexia Luo, Huan Zhang, Weiwu Yao, Chao Yan","doi":"10.1245/s10434-025-17894-6","DOIUrl":"10.1245/s10434-025-17894-6","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal metastasis (PM) is the most common form of distant metastasis in gastric cancer and is a major cause of mortality. Current diagnostic approaches suffer from low sensitivity, time-consuming procedures, and cannot provide real-time diagnostic information. Surface-enhanced Raman spectroscopy (SERS) combined with machine learning algorithms has emerged as a promising tool for cancer diagnosis.</p><p><strong>Patients and methods: </strong>Raman spectra were collected from the peritoneal lavage fluid (PLF) of 120 patients with gastric cancer and analyzed using three machine learning models: principal component analysis-linear discriminant analysis (PCA-LDA), random forest (RF), and support vector machine (SVM). The sensitivity, specificity, accuracy, false positive rate, false negative rate, positive predictive value, and negative predictive value were calculated. Receiver operating characteristic curve analysis was used to assess the diagnostic performance.</p><p><strong>Results: </strong>The accuracy, sensitivity, and specificity of SERS analysis to determine PM with PCA-LDA were 95.7%, 87.0%, and 95.5%; with RF were 95.4%, 91.3%, and 96.0%; with SVM were 95.5%, 91.3%, and 96.0%. For exfoliative cytology, these parameters were 72.0%, 40.0%, and 100%. For computed tomography (CT) scan, these parameters were 72.5%, 57.9%, and 85.7%. In addition, the performance of these models (PCA-LDA, RF, and SVM) demonstrated high diagnostic accuracy, with area under the curve values of 96.9%, 92.1%, and 93.4%, respectively. The diagnostic performance of all models in diagnosing PM is significantly better than those of exfoliative cytology and CT imaging.</p><p><strong>Conclusions: </strong>The integration of SERS with machine learning models provides a simple, convenient, and cost-effective tool for PLF, offering significant potential for improving the diagnosis of PM.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7604-7614"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717258","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":"A CT-Based Deep Learning Radiomics Nomogram for Early Recurrence Prediction in Pancreatic Cancer: A Multicenter Study.","authors":"Xiao Guan, Jinsong Liu, Lei Xu, Wenwen Jiang, Chengfeng Wang","doi":"10.1245/s10434-025-17748-1","DOIUrl":"10.1245/s10434-025-17748-1","url":null,"abstract":"<p><strong>Background: </strong>Early recurrence (ER) following curative-intent surgery remains a major obstacle to improving long-term outcomes in patients with pancreatic cancer (PC). The accurate preoperative prediction of ER could significantly aid clinical decision-making and guide postoperative management.</p><p><strong>Patients and methods: </strong>A retrospective cohort of 493 patients with histologically confirmed PC who underwent resection was analyzed. Contrast-enhanced computed tomography (CT) images were used for tumor segmentation, followed by radiomics and deep learning feature extraction. In total, four distinct feature selection algorithms were employed. Predictive models were constructed using random forest (RF) and support vector machine (SVM) classifiers. The model performance was evaluated by the area under the receiver operating characteristic curve (AUC). A comprehensive nomogram integrating feature scores and clinical factors was developed and validated.</p><p><strong>Results: </strong>Among all of the constructed models, the Inte-SVM demonstrated superior classification performance. The nomogram, incorporating the Inte-feature score, CT-assessed lymph node status, and carbohydrate antigen 19-9 (CA19-9), yielded excellent predictive accuracy in the validation cohort (AUC = 0.920). Calibration curves showed strong agreement between predicted and observed outcomes, and decision curve analysis confirmed the clinical utility of the nomogram.</p><p><strong>Conclusions: </strong>A CT-based deep learning radiomics nomogram enabled the accurate preoperative prediction of early recurrence in patients with pancreatic cancer. This model may serve as a valuable tool to assist clinicians in tailoring postoperative strategies and promoting personalized therapeutic approaches.</p>","PeriodicalId":8229,"journal":{"name":"Annals of Surgical Oncology","volume":" ","pages":"7567-7576"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574735","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}