Cancers最新文献

{"title":"Peptide Receptor Radionuclide Therapy in Patients with Advanced, Recurrent or Progressive Meningioma: An Updated Systematic Review and Meta-Analysis.","authors":"Barbara Muoio, Cesare Michele Iacovitti, Davide Giovanni Bosetti, Maddalena Sansovini, Marco Cuzzocrea, Gaetano Paone, Giorgio Treglia","doi":"10.3390/cancers17122039","DOIUrl":"10.3390/cancers17122039","url":null,"abstract":"<p><strong>Background: </strong>Peptide receptor radionuclide therapy (PRRT) could be a therapeutic option for patients with advanced, recurrent or progressing meningiomas overexpressing somatostatin receptors. The aim of this study is to perform an updated meta-analysis to establish the disease control rate of PRRT in these patients.</p><p><strong>Methods: </strong>A comprehensive literature search of studies on PRRT in patients with advanced, recurrent or progressing meningioma was carried out. Four different databases (PubMed/MEDLINE, EMBASE, Cochrane library, Google Scholar) were screened until April 2025. Only original articles about PRRT in advanced, progressive or refractory meningiomas were selected. Case reports were excluded. Three review authors independently performed the literature search, the article selection and the data extraction. Main findings of eligible studies were summarized and a proportion meta-analysis on the disease control rate was carried out using a random-effects model.</p><p><strong>Results: </strong>In total, 18 studies (269 patients) published from 2006 to 2025 were included in the analysis. In most of the included studies, PRRT was performed using [¹⁷⁷Lu]Lu-DOTATATE. The pooled disease control rate was 67.7% (95% confidence interval values: 59.6-75.7%). PRRT was well-tolerated in most patients with advanced, recurrent or progressive meningioma. Moderate statistical heterogeneity was found in the meta-analysis (I-square: 53%).</p><p><strong>Conclusions: </strong>PRRT is an effective and well-tolerated treatment in patients with advanced, progressive or recurrent meningiomas, showing a significant disease control rate (in about two-thirds of patients). Even if well-designed clinical trials are needed to corroborate these findings, evidence-based data seem to support the clinical use of PRRT for this indication.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494864","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":"Validation of the Updated Porto Proposal in Papillary Thyroid Microtumors: Analysis of Cases at a University Hospital in Catalonia, Spain.","authors":"Karmele Saez de Gordoa, Elias Tasso, Alexandre Rei, Martin Ramonda, Belinda Salinas, Sandra Cobo-Lopez, Aida Orois, Amparo Cobo, Marti Manyalich-Blasi, Teresa Ramón Y Cajal, Mireia Mora, Felicia Hanzu, Oscar Vidal Pérez, Maria Teresa Rodrigo-Calvo","doi":"10.3390/cancers17122021","DOIUrl":"10.3390/cancers17122021","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Given the high incidence and generally favorable prognosis of papillary thyroid microcarcinomas (PTMs), the Porto Proposal aims to refine the management of these tumors. It designates tumors lacking certain risk factors as papillary microtumors (PMTs) to avoid overtreatment and reduce patient stress. The updated Porto Proposal (uPp) suggests criteria for reclassifying incidental PTMs as PMTs. This study seeks to validate these criteria using data from a university hospital in Catalonia, Spain, and assess the clinical and pathological characteristics of PTMs. <b>Methods</b>: This retrospective study analyzed patients diagnosed with PTM (≤1 cm) at a university hospital from 2000 to 2024. The study examined variables, including lymph node positivity, incidental diagnosis, tumor location, histological type, treatment, multifocality, age at diagnosis, tumor size, and survival. The uPp criteria were applied to reclassify PTMs into PMTs or PMCs (true papillary microcarcinomas). Student's <i>t</i>-test and chi-square tests were used to evaluate the associations between these variables and the uPp classification. <b>Results</b>: The cohort comprised 107 patients, with 77 (72%) women and 30 men. The mean age at diagnosis was 54.5 years. Out of the total, 77 (72%) cases were reclassified as PMTs and 30 (28%) as PMCs according to the uPp criteria. PMC tumors were larger (mean size 4.5 mm vs. 3.3 mm for PMT, <i>p</i> = 0.014) and were significantly associated with multifocality (52.2%; <i>p</i> = 0.004). Most lymph node-positive cases were classified as PMCs (69.2%; <i>p</i> < 0.001) and were multifocal and bilateral more commonly. However, no significant differences in outcomes between PMCs and PMTs were found (<i>p</i> = 0.188). Follicular histology was significantly more common in PMTs (87.0%, <i>p</i> < 0.001) and rarely had lymph node metastases (4.6%; <i>p</i> = 0.047). <b>Conclusions</b>: The updated Porto Proposal (uPp) effectively identifies PTMs with minimal malignant potential, distinguishing between PMT and PMC. The findings support the protocol's use in reducing unnecessary treatments and psychological stress for patients. The study highlights significant clinical and pathological differences between PTM subtypes, reinforcing the protocol's applicability in daily pathological practice.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494889","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":"Targeting S-Nitrosylation to Overcome Therapeutic Resistance in NRAS-Driven Melanoma.","authors":"Jyoti Srivastava, Sanjay Premi","doi":"10.3390/cancers17122020","DOIUrl":"10.3390/cancers17122020","url":null,"abstract":"<p><p>NRAS-mutant melanoma represents a clinically challenging subset of melanoma with limited effective therapies and intrinsic resistance to targeted MEK inhibition. Recent findings highlight protein S-nitrosylation, a redox-dependent post-translational modification as a critical modulator of MEK-ERK signaling and immune evasion in this context. In this commentary, we discuss how S-nitrosylation of MAPK components, including MEK and ERK, sustains oncogenic signaling and attenuates immunogenic cell death. Targeting this modification with nitric oxide synthase (NOS) inhibitors such as L-NAME, L-NMMA and 1400w restore sensitivity of MEK inhibitor, promotes dendritic cell activation, and enhances CD8+ T cell infiltration in preclinical models such as immunogenic mouse models and individual patient derived, primary melanoma cells. We also explore the emerging role of S-nitrosylation in regulating macrophage-mediated immune surveillance and propose translational strategies for combining redox modulation with targeted and immune therapies. These insights offer a compelling framework for overcoming therapeutic resistance and reprogramming the tumor immune microenvironment to activate the cytotoxic T-cells and enhance the responses to immunotherapy in NRAS-driven cancers.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494806","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":"Comparison of Stereotactic Body Radiotherapy and Surgery for Stage I Lung Cancer: A Multidisciplinary Cohort Study Utilizing Propensity Score Overlap Weighting and AI-Based CT Imaging Analysis.","authors":"Eun Hye Lee, Young Joo Suh, Jong Won Park, Jisu Moon, Sangjoon Park, Chang Geol Lee, Hong In Yoon, Byung Jo Park, Jin Gu Lee, Dae Joon Kim, Seung Hyun Yong, Sang Hoon Lee, Chang Young Lee, Jaeho Cho, Eun Young Kim","doi":"10.3390/cancers17122015","DOIUrl":"10.3390/cancers17122015","url":null,"abstract":"<p><p><b>Background:</b> With rising life expectancy and widespread lung cancer screening, early-stage non-small cell lung cancer (NSCLC) incidence has increased. While surgery is the standard treatment for operable stage I NSCLC, many patients are ineligible due to age or comorbidities. Stereotactic body radiotherapy (SBRT) has achieved good primary tumor control rates and overall survival. This study compares the outcomes of SBRT and surgery for stage I NSCLC using propensity score overlap-weighted dataset. <b>Methods:</b> This retrospective study analyzed clinical stage I NSCLC patients treated at a tertiary hospital from 2012 to 2021. Baseline differences between SBRT and surgery groups were adjusted using overlap weighting. AI-based CT analysis (CT AI-CAD) assessed tumor characteristics, verified by radiologists. Primary outcomes were 5-year cumulative incidence of recurrence and overall survival, with subgroup analyses based on tumor features. <b>Results:</b> Of 1474 patients, 1258 underwent surgery, and 216 received SBRT. After overlap weighting, baseline characteristics were well balanced. The 5-year cumulative incidence of recurrence and OS showed no statistically significant differences between SBRT and surgery groups (recurrence: 16.2% vs. 16.1%; OS: 80.5% vs. 82.9%). Further AI-based CT subgroup analysis showed no significant differences in recurrence rates across tumor features. A solid tumor diameter associated with a significant increase in recurrence was identified as 16.6 mm for SBRT and 18.6 mm for surgery. <b>Conclusions:</b> After overlap weighting, SBRT and surgery showed no statistically significant differences in treatment outcomes in stage I NSCLC. These findings may help guide the timing and selection of safe and effective treatment approaches.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494691","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":"Statins Are Not Associated with Improved Bladder Cancer Outcomes in Patients with Early-Stage Bladder Cancer Treated with BCG Immunotherapy.","authors":"Estelle Ndukwe, Paz Lotan, Michael Risk, Elizabeth L Koehne, Daniel D Shapiro, Robert P Tyllo, Glenn O Allen, E Jason Abel, David F Jarrard, Kyle A Richards","doi":"10.3390/cancers17122027","DOIUrl":"10.3390/cancers17122027","url":null,"abstract":"<p><p><b>Background</b>: Statins are commonly used cholesterol-lowering drugs with evidence of additional chemoprotective and immunomodulatory effects resulting from the inhibition of DNA replication, cell proliferation, and TH1-cell inhibition. There are conflicting reports regarding the potential benefit of concurrent statin treatment on non-muscle invasive bladder cancer (NMIBC) and specifically on intravesical Bacillus Calmette-Guerin (BCG) outcomes. We therefore aimed to analyze the effects of concurrent BCG and statin use in patients with NMIBC. <b>Methods</b>: National Veterans Affairs databases were used to retrospectively identify men with NMIBC between 2000 and 2010 who were treated with BCG. Pharmacy data was interrogated, and patients were divided according to statin therapy status. Statins had to be given at the beginning of BCG treatments and continued for at least 6 months. Cox proportional hazard ratios after inverse propensity score-weighted and competing risks adjustments were calculated for recurrence, secondary events (e.g., progression), cancer-specific survival, and overall survival. <b>Results</b>: Among 8814 patients, with a median follow-up of 11.3 years, statins were used by 38% of the patients. Patients taking statins were older (71 vs. 68, <i>p</i> < 0.0001), had more comorbidities (Charlson Comorbidity Index (CCI > 2; 38.6% vs. 31.4%, <i>p</i> < 0.0001), and had a higher-grade disease (40.2% vs. 34.3%, <i>p</i> < 0.0001) compared to those not on statins. After adjusting for stage, grade, age, race, CCI, agent orange exposure, and year of diagnosis, Cox proportional hazard analysis revealed no association with recurrence (HR 1.05, 95% CI 0.97-1.15, <i>p</i> = 0.23), secondary events (HR 0.91, 95% CI 0.80-1.05, <i>p</i> = 0.189), or bladder cancer specific survival (HR 0.88, 95% CI 0.76-1.02, <i>p</i> = 0.09) of statin use. However, statins were associated with improved overall survival (HR 0.89, 95% CI 0.83-0.96, <i>p</i> = 0.002). <b>Conclusions</b>: Concurrent statin and BCG use in patients with NMIBC was associated with improved overall survival, but not recurrence, secondary events, or bladder cancer-specific survival. These results confirm the real-world well-established cardiovascular benefit of statin treatment and primary preventive care. However, this large population study did not find any association between statins and the outcomes of patients with NMIBC treated with BCG immunotherapy.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494801","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":"Neutrophil to Lymphocyte Ratio as a Biomarker for the Prediction of Cancer Outcomes and Immune-Related Adverse Events in a CTLA-4-Treated Population.","authors":"Michael M Cunningham, Rachel Romero, Carolina Alvarez, Shruti Saxena Beem, Todd A Schwartz, Rumey C Ishizawar","doi":"10.3390/cancers17122011","DOIUrl":"10.3390/cancers17122011","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Immune-related adverse events (irAEs) triggered by immune checkpoint inhibitor therapy (ICI) have been paradoxically associated with both significant morbidity and improved cancer outcomes. While predictive markers for irAEs have been studied in the PD-1 blockade, less is known for their role in CTLA-4 inhibition. This study aims to fill this gap by evaluating NLR and irAE incidence in a CTLA-4-treated population. <b>Methods:</b> This study is a single-center retrospective cohort study investigating 111 patients treated with CTLA-4 inhibition (ipilimumab) to assess associations for baseline low NLR values with cancer outcomes and irAE type and incidence. Patient charts were manually reviewed by a single physician, and unclear clinical events were assessed by a second physician reviewer. <b>Results:</b> In this cohort, the occurrence of more than one irAE presentation was associated with an improved cancer outcome, OR 1.48 (1.02, 2.15). When stratified by organ-specific manifestation, only endocrinologic irAEs were associated with improved cancer outcome, OR 2.82 (1.19, 6.67). A low baseline NLR was statistically significantly associated with an increased incidence of irAEs of any type, OR 4.34 (1.73, 10.9). <b>Conclusions:</b> These data show that irAE occurrence in cancer patients treated with CTLA-4 inhibition is associated with improved cancer outcomes, similar to that previously seen with PD-1 inhibition. It also suggests that the NLR may serve as a practical peripheral biomarker to predict both cancer response and odds of irAEs in patients treated with CTLA-4 inhibition. This low-cost and widely available tool could provide additional information for modeling cancer outcomes.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494858","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":"Impact of HPV Testing Based on the 2020 Update of the German Cervical Cancer Screening Program-Data from a Retrospective Monocentric Study.","authors":"Leonard Jung, Gilbert Georg Klamminger, Meletios P Nigdelis, Elke Eltze","doi":"10.3390/cancers17122024","DOIUrl":"10.3390/cancers17122024","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Since 2020, Germany has replaced its annual cytological screening for cervical cancer in women aged 35 and older with a combination screening program. This updated protocol, conducted every three years, includes both a cervical Pap smear and an HPV (human papillomavirus) test. In addition, the 2020 update of the German Cervical Cancer Screening Program mandates a more timely follow-up for certain abnormal findings compared to the previous approach. <b>Methods</b>: Results of cytologic, colposcopic, and histologic examinations between 2018 and 2021 were retrospectively retrieved from the electronic patient records of the Institute of Pathology Saarbrücken Rastpfuhl in order to present relevant findings within the years 2018-2019 and 2020-2021. The present study included all women who received appropriate follow-up based on the corresponding underlying screening modality. <b>Results</b>: Our reporting considered data from 30,715 women in 2018/19 (prior screening modality group) and 25,924 women in 2020/21 (updated screening modality group). In 2018/19, a total of 93 histological examinations were performed, compared to 237 in 2020/21. In 2018/19, 52 cases of CIN III and 12 cases of CIN II were identified, while in 2020/21, 78 cases of CIN III and 31 cases of CIN II were detected. In contrast, while women with negative cytological findings in 2018/19 were typically not referred for further colposcopic or histological evaluation, the updated program enabled earlier detection and treatment of cases with diagnosed high-grade dysplasia based solely on a positive HPV test. Notably, 31 women who were diagnosed at an earlier stage based solely on a positive HPV test initially presented with a cytological Pap I result (negative for intraepithelial lesion or malignancy; NILM). <b>Conclusions</b>: Additional HPV co-testing within the updated German cervical cancer screening program resulted not only in high rates of high-grade dysplasia detection but also a rise in the number of colposcopic procedures. While negative follow-up HPV findings regularly showed remission of the original finding, incidence of high-grade dysplasia was usually linked to a positive HPV test.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494815","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":"Safety and Efficacy Outcomes of Robotic, Laparoscopic, and Laparotomic Surgery in Severe Obese Endometrial Cancer Patients: A Network Meta-Analysis.","authors":"Carlo Ronsini, Mario Fordellone, Eleonora Braca, Mariano Catello Di Donna, Maria Cristina Solazzo, Giuseppe Cucinella, Cono Scaffa, Pasquale De Franciscis, Vito Chiantera","doi":"10.3390/cancers17122018","DOIUrl":"10.3390/cancers17122018","url":null,"abstract":"<p><strong>Background: </strong>The surgical management of endometrial cancer in severely obese patients (BMI ≥ 40) presents unique challenges. This study evaluates the outcomes of various surgical approaches in terms of safety and efficacy in lymph node retrieval.</p><p><strong>Methods: </strong>A systematic review and network meta-analysis focused on intra-operative complications, post-operative complications, severe complications, and complete surgical staging rates. The analysis included 1163 patients, following a pre-specified methodology based on the PRISMA-NMA guidelines. The study was registered on PROSPERO with protocol number CRD 395959.</p><p><strong>Results: </strong>Intra-operative complications: No significant difference was found between minimally invasive surgery (MIS, 233 patients) and laparotomy (LPT) (OR 0.68 [95% CI 0.21-2.26], <i>p</i> = 0.18). However, robotic surgery showed a significantly lower risk (OR 0.28 [0.10-0.74]). Post-operative complications: The MIS group (457 patients) had a lower risk compared to LPT (OR 0.41 [0.26-0.64]). Network analysis: Robotic surgery had a 70.7% probability of reducing intra-operative complications compared to laparoscopy (LPS) and a 99.2% probability compared to LPT. Laparoscopy was the safest option for post-operative complications, with a 74.3% probability. Robotic surgery had an 82.4% probability of achieving complete surgical staging compared to LPT.</p><p><strong>Conclusions: </strong>Robotic surgery shows superior outcomes for complete lymph nodal staging in obese endometrial cancer patients, while LPS is favorable for post-operative complications. Further studies are needed to optimize strategies.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494879","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":"Comment on Gentile et al. Superior Survival and Lower Recurrence Outcomes with Breast-Conserving Surgery Compared to Mastectomy Following Neoadjuvant Therapy in 607 Breast Cancer Patients. <i>Cancers</i> 2025, <i>17</i>, 766.","authors":"Wiebren A Tjalma","doi":"10.3390/cancers17122008","DOIUrl":"10.3390/cancers17122008","url":null,"abstract":"<p><p>The article by Gentile et al [...].</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12190353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494721","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":"Iterative Cytoreductive Surgery and HIPEC for Peritoneal Metastases from Primary Appendiceal and Colorectal Cancers: An Observational Study.","authors":"Andrew M Fleming, Owen M Clark, Jaewon J Lee, Kristen Dougherty, Leah E Hendrick, Jordan Raine, Ian Solsky, Paxton V Dickson, Evan S Glazer, David Shibata, Elizabeth Gleeson, Gitonga Munene, Jeremiah L Deneve","doi":"10.3390/cancers17122014","DOIUrl":"10.3390/cancers17122014","url":null,"abstract":"<p><p><b>Background</b>: Peritoneal relapse after cytoreduction and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is common. Repeat CRS/HIPEC offers the potential for long-term survival in the appropriately selected patient. <b>Methods</b>: We performed a retrospective review of a single institution database to assess perioperative outcomes after repeat CRS/HIPEC for appendiceal (pAC) and colorectal (pCRC) cancers. Kaplan-Meier and Cox estimates were used to assess survival. <b>Results</b>: Of 157 patients, 103 patients underwent initial CRS/HIPEC for pAC (<i>n</i> = 67) or pCRC (<i>n</i> = 36) histologies. Twenty-seven pAC patients (27/67, 40%) and 23/36 pCRC patients (63%) developed disease recurrence. Relapsed patients had a higher burden of disease (PCI), operative length and blood loss and received adjuvant chemotherapy (all <i>p</i> < 0.05). Nine of the 27 relapsed pAC patients and 5 of the 13 relapsed pCRC patients underwent repeat CRS/HIPEC. The median time to repeat CRS/HIPEC was 18 months (4-26 months), and a CCR-0 and CCR-1 were achieved in 79% and 21%, respectively. The 1-, 3- and 5-year OS for pAC patients who underwent repeat CRS/HIPEC was 88.9%, 88.9% and 77.8%, and the 1- and 3-year OS for pCRC patients was 100% and 25%, respectively. Repeat CRS/HIPEC for pAC was associated with significant improvement in OS (<i>p</i> = 0.03), while for pCRC, no significant difference was observed (<i>p</i> = 0.99). <b>Conclusions</b>: Repeat CRS/HIPEC for isolated peritoneal recurrence is safe and offers the potential for long-term survival. Patient selection is key to ensure optimal cytoreduction when considering repeat CRS/HIPEC.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 12","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494837","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}