Clinical Surgical Oncology最新文献_第2页

The clinical application of A new DSA-Guided axillary vein puncture technique for venous infusion port 一种新的dsa引导下腋静脉穿刺技术在静脉输注口的临床应用

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100098

Liu Mei , Xu Yue , Mu Ning, Li Feng'e, Wu Shengnan, Lv Huan, Wang Xinyi, Ma Chunhua

Objective

To explore the feasibility of a new guidance method for axillary vein puncture, a totally implantable venous access port (TIVAP) was implanted via axillary vein puncture guided by a 30-degree contralateral oblique view of digital subtraction angiography (DSA).

Methods

This retrospective study reviewed clinical data of 275 patients who underwent TIVAP implantation at the Oncology Treatment Center of Tianjin Union Medical Center (February 2022–November 2024). The success rate of puncture, puncture-related complications, and short-term follow-up outcomes in patients undergoing TIVAP implantation via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA were analyzed.

Results

57 patients were implanted with TIVAP via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA. The right axillary vein approach was used in 53 cases (93.0 %), and the left axillary vein approach was used in 4 cases (7.0 %), among which 2 cases were switched to the left side due to venous anomalies on the right side. The puncture success rate was 100 %. Two cases (3.5 %) had accidental puncture of the subclavian artery, but no local hematoma occurred after compression. There were no puncture-related complications such as pneumothorax, air embolism, arrhythmia, or nerve damage. All patients completed a 1-month follow-up, during which no delayed hematoma, venous thrombosis, or port infection was detected.

Conclusion

TIVAP implantation via axillary vein puncture guided by a 30-degree contralateral oblique view of DSA demonstrated high technical success and acceptable short-term safety and serves as a feasible alternative in selected patients.

目的探讨一种新的腋静脉穿刺引导方法的可行性，在30度对侧斜位数字减影血管造影（DSA）引导下，经腋静脉穿刺植入全植入式静脉通路（TIVAP）。方法回顾性分析天津协和医院肿瘤治疗中心（2022年2月- 2024年11月）行TIVAP植入术的275例患者的临床资料。分析30度对侧斜位DSA引导下腋静脉穿刺行TIVAP植入术的穿刺成功率、穿刺相关并发症及近期随访结果。结果57例患者均在对侧30度斜位DSA引导下经腋窝静脉穿刺植入TIVAP。53例（93.0%）采用右腋窝静脉入路，4例（7.0%）采用左腋窝静脉入路，其中2例因右侧静脉异常而切换到左侧。穿刺成功率100%。2例（3.5%）意外穿刺锁骨下动脉，压迫后未出现局部血肿。无穿刺相关并发症，如气胸、空气栓塞、心律失常或神经损伤。所有患者完成了1个月的随访，期间未发现迟发性血肿、静脉血栓形成或端口感染。结论30度对侧DSA斜位位引导下经腋窝静脉穿刺植入tivap具有较高的技术成功率和短期安全性，在特定患者中是一种可行的替代方法。

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引用次数: 0

The gut microbiota and colorectal cancer: Molecular insights and translational implications 肠道微生物群和结直肠癌：分子见解和翻译意义

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100107

Jinmiao Chen , Xiuqi Du , Minke Shao , Yifan Sun , Xinyu Shi , Songbing He

In recent years, the gut microbiota have identified as a modifiable key environmental factor influencing the development and progression of colorectal cancer (CRC). Molecular epidemiological studies, including cross-sectional and prospective cohort designs, have consistently identified distinct microbial dysbiosis in CRC patients, characterized by an enrichment of pro-inflammatory and genotoxin-producing bacteria, alongside a reduction in protective commensals. Mendelian randomization analyses further support a causal role for specific microbial taxa in CRC pathogenesis. Mechanistically, gut microbes contribute to tumorigenesis through direct genotoxic effects (e.g., DNA damage), activation of inflammatory pathways, and metabolite-mediated interactions—exhibiting dual roles, as seen with short-chain fatty acids versus secondary bile acids. These processes often interact with host genetic backgrounds, forming complex gene-environment interactions. These findings the potential of microbiota-derived signatures as biomarkers for early detection and prognostic prediction. Furthermore, microbiota-targeted strategies—such as dietary interventions, probiotics, pharmaceuticals, and nanotechnology-based approaches—are being actively explored for precision prevention and treatment of CRC.

近年来，肠道微生物群已被确定为影响结直肠癌（CRC）发生和进展的一个可改变的关键环境因素。包括横断面和前瞻性队列设计在内的分子流行病学研究一致发现，CRC患者中存在明显的微生物生态失调，其特征是促炎和产生基因毒素的细菌富集，同时保护性共生菌减少。孟德尔随机化分析进一步支持特定微生物类群在结直肠癌发病机制中的因果作用。从机制上讲，肠道微生物通过直接的基因毒性作用（如DNA损伤）、炎症途径的激活和代谢物介导的相互作用促进肿瘤的发生，表现出双重作用，如短链脂肪酸和次级胆汁酸。这些过程经常与宿主遗传背景相互作用，形成复杂的基因-环境相互作用。这些发现表明微生物群衍生特征作为早期检测和预后预测的生物标志物的潜力。此外，针对微生物群的策略-如饮食干预，益生菌，药物和基于纳米技术的方法-正在积极探索用于精确预防和治疗结直肠癌。

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引用次数: 0

Metastatic sites and surgical management in stage IV ovarian cancer: Is there a place for debulking surgery in FIGO stage IVB patients? A retrospective study from the ESME national cohort IV期卵巢癌的转移部位和手术治疗：FIGO IVB期患者是否有切除手术的余地？来自ESME国家队列的回顾性研究

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100113

Navid Mokarram Dorri , Laura Foulhioux , Christophe Zemmour , Quentin Dominique Thomas , Hélène Costaz , Fabrice Narducci , Thierry Petit , Cécile Loaec , Enora Laas , Frédéric Guyon , François Cherifi , Aude-Marie Savoye , Domenico Ferraioli , Rossi Lea , Thibault de la Motte Rouge , Frederic Marchal , Marie Gosset , Christophe Pomel , Anne-Laure Martin , Eric Lambaudie

Objectives

To evaluate the surgical management and oncologic outcomes of patients with FIGO stage IV ovarian cancer, using data from the French national ESME cohort.

Methods

This retrospective multicenter study included patients diagnosed with FIGO stage IV ovarian cancer between January 2011 and December 2016, treated in 18 French Comprehensive Cancer Centers participating in the ESME-OVR program. Clinical characteristics, treatment strategies, metastatic site patterns, and survival outcomes (overall survival [OS], progression-free survival [PFS]) were analyzed and compared between FIGO IVA and IVB stages.

Results

A total of 159 patients were identified, of whom 107 (67.3 %) had FIGO stage IVB disease. Regardless of metastatic stage, surgical strategies and were comparable. Complete debulking surgery was achieved in 75 % of cases. Most of FIGO stage IVB patients (88.8 %) presented a single metastatic site including extra-abdominal lymph nodes (50.5 %), liver (20.6 %), and lungs (10.3 %); 15.9 % of patient with distant metastases underwent local treatment and predominantly targeted nodal disease. Complete debulking surgery was significantly associated with improved OS and PFS (p = 0.002 and p < 0.001, respectively), while local treatment of metastases did not provide survival benefit. The number of metastatic sites did not significantly influence prognosis.

Conclusions

Complete debulking surgery is the critical factor from a progronostic point of view, whether in FIGO stage IVA or IVB. Feasibility of local treatment for distant metastases is observed, its impact on oncologic outcomes remains unclear and we need further prospective investigation. Surgical strategies should be integrated into a personalized approach to optimize management in advanced-stage disease.

目的利用法国国家ESME队列的数据，评估FIGO IV期卵巢癌患者的手术治疗和肿瘤预后。方法本回顾性多中心研究纳入2011年1月至2016年12月期间诊断为FIGO IV期卵巢癌的患者，这些患者在参与ESME-OVR计划的18个法国综合癌症中心接受治疗。分析和比较FIGO IVA和IVB分期的临床特征、治疗策略、转移部位模式和生存结果（总生存期[OS]、无进展生存期[PFS]）。结果共发现159例患者，其中107例（67.3%）为FIGO期IVB。无论转移阶段如何，手术策略与其他方法具有可比性。75%的病例完成了完全的减脂手术。大多数FIGO期IVB患者（88.8%）表现为单一转移部位，包括腹外淋巴结（50.5%）、肝脏（20.6%）和肺部（10.3%）；15.9%的远处转移患者接受了局部治疗，主要是靶向淋巴结疾病。完全减容手术与OS和PFS的改善显著相关（分别为p = 0.002和p <； 0.001），而局部转移治疗没有提供生存益处。转移部位的数量对预后无显著影响。结论无论是FIGO期IVA还是IVB，完全减容手术是影响预后的关键因素。局部治疗远处转移的可行性观察，其对肿瘤预后的影响尚不清楚，我们需要进一步的前瞻性研究。手术策略应与个性化的方法相结合，以优化晚期疾病的管理。

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引用次数: 0

Immunofluorescence and targeted removal of the axillary sentinel lymph node in early-stage breast cancer: a simple, safe and effective anatomical approach 免疫荧光和靶向切除早期乳腺癌腋窝前哨淋巴结：一种简单、安全、有效的解剖方法

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100109

Stéphane Lantheaume , Sandrine Soler , Isabelle Ben Taàrit , Anne Le Hémon-Lepaul , Sophie Lantheaume , Céline Lenck , François Sensenbrenner

Introduction

The reference technique for axillary sentinel lymph node (SLN) detection in women with breast cancer uses the radioactive marker, technetium (Tc99m), which makes ambulatory surgery difficult and carries a risk of irradiation to the patient and the medical teams. The aim of this study was to investigate the feasibility of using immunofluorescence (IF), a new non-radioactive technique, for SLN detection in women with early-stage breast cancer (ESBC).

Materials and methods

Patients were included if they were suffering from ESBC (T1/T2 N0) or ductal carcinoma in situ. The SLN was first detected using IF with indocyanine green and was then confirmed using Tc99m.

Results

A total of 268 women with ESBC were included (median age: 61.4 years). Tumour location in the breast correlated with SLN location according to the anatomic classification ABCD, with >75 % of tumours located in the outer quadrants of the breast. IF was positive in 96 % of cases and allowed precise anatomic location of the SLN. The SLN was located in zone A in 87.7 % of patients and zone B in 10.1 %, which corresponds to the path of the lateral thoracic vein. Only 2.2 % of tumours were in zone C and none were in zone D. Rate of failure of detection by IF alone was 4.1 %, associated with a mean BMI of 26.8 kg/m².

Conclusion

IF is an economic, non-invasive, non-radioactive technique for SLN detection in ESBC. Surgeons should be aware of this new, alternative procedure so that it can be used more widely in the future.

乳腺癌女性腋窝前哨淋巴结（SLN）检测的参考技术使用放射性标记物锝（Tc99m），这使得门诊手术变得困难，并且对患者和医疗团队有照射的风险。本研究的目的是探讨利用免疫荧光（IF）这一新的非放射性技术检测早期乳腺癌（ESBC）妇女SLN的可行性。材料和方法纳入ESBC （T1/T2 N0）或导管原位癌患者。首先用吲哚菁绿IF检测SLN，然后用Tc99m确认。结果共纳入268例ESBC患者（中位年龄：61.4岁）。根据解剖学分类ABCD，肿瘤在乳腺中的位置与SLN的位置相关，75%的肿瘤位于乳腺外象限。在96%的病例中，IF呈阳性，可以精确定位SLN的解剖位置。87.7%的患者SLN位于A区，10.1%的患者位于B区，与胸外侧静脉路径一致。只有2.2%的肿瘤位于C区，没有肿瘤位于d区。单靠IF检测的失败率为4.1%，与平均BMI为26.8 kg/m2相关。结论if是一种经济、无创、无放射性的ESBC SLN检测技术。外科医生应该意识到这种新的替代手术，以便在未来得到更广泛的应用。

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引用次数: 0

Delayed diagnosis May lead to giant cell tumor of bone progression 延迟诊断可能导致骨巨细胞瘤进展

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100106

M.J.C. Duivenvoorden , R. Hemke , G.G.J. Krebbekx , J.A.M. Bramer , N.P. Denswil , G.M.M.J. Kerkhoffs , F.G.M. Verspoor

Introduction

Giant Cell Tumor of Bone is an intermediate, locally aggressive tumor that is often diagnosed at an advanced stage due to diagnostic delays. Hypothetically, diagnostic delays may result in advanced disease, necessitating more invasive surgery and causing significant lifelong burden. This systematic review explores the available literature on diagnostic and treatment delays in Giant Cell Tumor of Bone.

Methods

A systematic review was conducted using the Medline, Embase, and Cochrane databases on February 9, 2023. A total of 15 studies representing 34 cases (32 cases analyzed) were included after thorough review and critical appraisal.

Results

Fifteen articles representing 32 cases were included. The median age of the included cases was 29 years (IQR 24–41). Tumor locations included the foot (22 %), spine (19 %), distal ulna (16 %), and other sites (43 %). Campanacci grades 2 and 3 (used to assess tumor severity) were reported in 16 % and 81 % of cases, respectively. Primary GCTB accounted for 88 % of cases, while 12 % involved local recurrence. The median diagnostic delay was 5.5 months (IQR 3.0–13.5). Patient-related delays (13 cases) had a median of 6 months (IQR 3–35), referral delays (19 cases) had a median of 4 months (IQR 3–12), and diagnostic delays (4 cases) had a median of 2.5 months (IQR 1–4).

Conclusion

Diagnostic delays in Giant Cell Tumor of Bone were identified, and were often associated with advanced disease. Further research involving a larger number of cases is essential to assess the impact of these delays on clinical outcomes and disease progression.

骨巨细胞瘤是一种中度的局部侵袭性肿瘤，由于诊断延迟，通常在晚期才被诊断出来。假设，诊断延迟可能导致疾病晚期，需要更多的侵入性手术，并造成重大的终身负担。本系统综述探讨了骨巨细胞瘤的诊断和治疗延迟的现有文献。方法于2023年2月9日使用Medline、Embase和Cochrane数据库进行系统评价。经过全面审查和批判性评价，共纳入15项研究34例（分析32例）。结果共纳入文献15篇，32例。纳入病例的中位年龄为29岁（IQR 24-41）。肿瘤部位包括足部（22%）、脊柱（19%）、尺骨远端（16%）和其他部位（43%）。Campanacci 2级和3级（用于评估肿瘤严重程度）分别在16%和81%的病例中报道。原发性GCTB占88%，而12%涉及局部复发。中位诊断延迟为5.5个月（IQR 3.0-13.5）。患者相关延迟（13例）的中位数为6个月（IQR 3-35），转诊延迟（19例）的中位数为4个月（IQR 3-12），诊断延迟（4例）的中位数为2.5个月（IQR 1-4）。结论骨巨细胞瘤的诊断延迟是可以确定的，并且通常与疾病晚期相关。为了评估这些延迟对临床结果和疾病进展的影响，有必要开展涉及更多病例的进一步研究。

{"title":"Delayed diagnosis May lead to giant cell tumor of bone progression","authors":"M.J.C. Duivenvoorden , R. Hemke , G.G.J. Krebbekx , J.A.M. Bramer , N.P. Denswil , G.M.M.J. Kerkhoffs , F.G.M. Verspoor","doi":"10.1016/j.cson.2025.100106","DOIUrl":"10.1016/j.cson.2025.100106","url":null,"abstract":"<div><h3>Introduction</h3><div>Giant Cell Tumor of Bone is an intermediate, locally aggressive tumor that is often diagnosed at an advanced stage due to diagnostic delays. Hypothetically, diagnostic delays may result in advanced disease, necessitating more invasive surgery and causing significant lifelong burden. This systematic review explores the available literature on diagnostic and treatment delays in Giant Cell Tumor of Bone.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using the Medline, Embase, and Cochrane databases on February 9, 2023. A total of 15 studies representing 34 cases (32 cases analyzed) were included after thorough review and critical appraisal.</div></div><div><h3>Results</h3><div>Fifteen articles representing 32 cases were included. The median age of the included cases was 29 years (IQR 24–41). Tumor locations included the foot (22 %), spine (19 %), distal ulna (16 %), and other sites (43 %). Campanacci grades 2 and 3 (used to assess tumor severity) were reported in 16 % and 81 % of cases, respectively. Primary GCTB accounted for 88 % of cases, while 12 % involved local recurrence. The median diagnostic delay was 5.5 months (IQR 3.0–13.5). Patient-related delays (13 cases) had a median of 6 months (IQR 3–35), referral delays (19 cases) had a median of 4 months (IQR 3–12), and diagnostic delays (4 cases) had a median of 2.5 months (IQR 1–4).</div></div><div><h3>Conclusion</h3><div>Diagnostic delays in Giant Cell Tumor of Bone were identified, and were often associated with advanced disease. Further research involving a larger number of cases is essential to assess the impact of these delays on clinical outcomes and disease progression.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reappraising the prognostic role of liver resection as part of extended cholecystectomy for T2 gallbladder cancer 重新评估肝切除作为T2胆囊癌扩大胆囊切除术一部分的预后作用

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100112

Hirotoshi Noda, Yoshiyasu Kato, Ryo Ashida, Katsuhisa Ohgi, Shimpei Otsuka, Hideyuki Dei, Katsuhiko Uesaka, Teiichi Sugiura

Background

The role of liver resection (LR) as extended cholecystectomy for T2 gallbladder cancer (GBC) remains controversial.

Methods

100 patients with pathological (p) T2 GBC who underwent curative surgery between 2003 and 2023 were retrospectively analyzed. Prognostic outcomes were compared between patients who underwent LR (LR+) and those who did not (LR–), with subgroup analyses by T2 substage. To assess the accuracy of preoperative T staging, 72 additional pT1/3 patients who underwent surgical resection during the same study period were evaluated.

Results

The LR+ (n = 78) and LR– (n = 22) groups showed no differences in overall survival (OS, P = 0.552) or recurrence-free survival (RFS, P = 0.538). Subgroup analyses showed no survival advantage with LR in both T2a and T2b cases. A multivariable analysis identified lymph node metastasis, elevated CA19-9, and tumor location (neck) as independent predictors of OS, but not LR (P = 0.806). Similarly, LR was not a risk factor for RFS (P = 0.677). Local recurrence occurred in one patient (LR + group). Diagnostic accuracy of T2 was 64.5 %. 2 cases of clinical T2b cases were upstaged to pT3.

Conclusions

LR did not provide clear oncological benefits in T2 GBC when adequate preoperative and intraoperative assessment was ensured. For T2a tumors, LR is likely to be omitted without compromising oncological outcomes. For even T2b cases, omission may be considered when hepatic invasion is carefully excluded.

背景肝切除（LR）作为扩展胆囊切除术治疗T2胆囊癌（GBC）的作用仍然存在争议。方法回顾性分析2003 ~ 2023年间行根治性手术治疗的病理性(p) T2 GBC患者100例。比较LR患者（LR+）和未接受LR -患者（LR -）的预后结果，并按T2分期进行亚组分析。为了评估术前T分期的准确性，在同一研究期间对另外72例接受手术切除的pT1/3患者进行了评估。结果LR+组（n = 78）和LR -组（n = 22）的总生存期（OS, P = 0.552）和无复发生存期（RFS, P = 0.538）差异无统计学意义。亚组分析显示，在T2a和T2b病例中，LR没有生存优势。多变量分析发现淋巴结转移、CA19-9升高和肿瘤位置（颈部）是OS的独立预测因素，但不是LR （P = 0.806）。同样，LR也不是RFS的危险因素（P = 0.677）。局部复发1例（LR +组）。T2诊断正确率为64.5%。2例临床T2b被抢到pT3。结论在术前和术中充分评估的情况下，slr对T2型GBC没有明显的肿瘤学益处。对于T2a肿瘤，可以在不影响肿瘤预后的情况下省略LR。即使是T2b病例，当仔细排除肝脏侵犯时，也可以考虑遗漏。

{"title":"Reappraising the prognostic role of liver resection as part of extended cholecystectomy for T2 gallbladder cancer","authors":"Hirotoshi Noda, Yoshiyasu Kato, Ryo Ashida, Katsuhisa Ohgi, Shimpei Otsuka, Hideyuki Dei, Katsuhiko Uesaka, Teiichi Sugiura","doi":"10.1016/j.cson.2025.100112","DOIUrl":"10.1016/j.cson.2025.100112","url":null,"abstract":"<div><h3>Background</h3><div>The role of liver resection (LR) as extended cholecystectomy for T2 gallbladder cancer (GBC) remains controversial.</div></div><div><h3>Methods</h3><div>100 patients with pathological (p) T2 GBC who underwent curative surgery between 2003 and 2023 were retrospectively analyzed. Prognostic outcomes were compared between patients who underwent LR (LR+) and those who did not (LR–), with subgroup analyses by T2 substage. To assess the accuracy of preoperative T staging, 72 additional pT1/3 patients who underwent surgical resection during the same study period were evaluated.</div></div><div><h3>Results</h3><div>The LR+ (n = 78) and LR– (n = 22) groups showed no differences in overall survival (OS, <em>P</em> = 0.552) or recurrence-free survival (RFS, <em>P</em> = 0.538). Subgroup analyses showed no survival advantage with LR in both T2a and T2b cases. A multivariable analysis identified lymph node metastasis, elevated CA19-9, and tumor location (neck) as independent predictors of OS, but not LR (<em>P</em> = 0.806). Similarly, LR was not a risk factor for RFS (<em>P</em> = 0.677). Local recurrence occurred in one patient (LR + group). Diagnostic accuracy of T2 was 64.5 %. 2 cases of clinical T2b cases were upstaged to pT3.</div></div><div><h3>Conclusions</h3><div>LR did not provide clear oncological benefits in T2 GBC when adequate preoperative and intraoperative assessment was ensured. For T2a tumors, LR is likely to be omitted without compromising oncological outcomes. For even T2b cases, omission may be considered when hepatic invasion is carefully excluded.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 4","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Establishment and development of minimally invasive surgery for nasopharyngeal carcinoma 鼻咽癌微创手术的建立与发展

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100111

Tao Jiang, Ming-yuan Chen

Recurrent nasopharyngeal carcinoma (rNPC) is insensitive to radiotherapy, and re-irradiation lead to severe adverse reactions. Studies have confirmed that endoscopic nasopharyngectomy(ENPG) combined with vascularized nasal mucosal flap repair is superior to re-irradiation with intensity-modulated radiation therapy (IMRT) in terms of survival rate, quality of life and medical costs. This surgical approach has been widely recognized and shows advantages in early-stage rNPC, marking minimally invasive surgery (MIS) for rNPC as an important treatment option. However, the efficacy of surgery for patients with de novo early-stage nasopharyngeal carcinoma(NPC) and advanced rNPC remains controversial. With the standardization and popularization of surgical procedures for NPC, the improvement of surgical staging, the perioperative management of the internal carotid artery(ICA), the advancement of skull base defect repair technology, the implementation of reasonable postoperative treatment and follow-up, as well as the innovation of lymph node dissection technology, MIS for NPC will play an increasingly important role in the treatment of NPC. Evidence-based medical evidence have confirmed that MIS offers definite survival benefits and safety advantages rNPC, serving as the core treatment option for resectable rNPC. Meanwhile, its preliminary application in de novo early-stage NPC has demonstrated potential in avoiding radiotherapy-induced injuries, opening up a new direction for disease treatment. Nevertheless, the surgical treatment of NPC still requires more multi-center and clinical studies for further validation and improvement.

复发性鼻咽癌（rNPC）对放疗不敏感，再照射会导致严重的不良反应。研究证实，内镜下鼻咽切除术（ENPG）联合带血管的鼻黏膜瓣修复术在生存率、生活质量和医疗费用方面都优于调强放疗（IMRT）再照射。这种手术方式在早期rNPC中得到广泛认可并显示出优势，标志着微创手术（MIS）作为rNPC的重要治疗选择。然而，手术治疗新发早期鼻咽癌（NPC）和晚期鼻咽癌（rNPC）的疗效仍存在争议。随着鼻咽癌手术程序的规范化和普及，手术分期的完善，颈内动脉围手术期管理的完善，颅底缺损修复技术的进步，术后合理治疗和随访的实施，以及淋巴结清扫技术的创新，鼻咽癌MIS将在鼻咽癌治疗中发挥越来越重要的作用。循证医学证据证实，MIS具有明确的生存效益和安全性优势，可作为可切除的rNPC的核心治疗方案。同时，其在新生早期鼻咽癌中的初步应用显示出避免放疗性损伤的潜力，为疾病治疗开辟了新的方向。然而，鼻咽癌的手术治疗仍需要更多的多中心和临床研究来进一步验证和改进。

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引用次数: 0

Corrigendum to “Outpatient revisits associated with three sentinel lymph node detection techniques for breast cancer: A propensity score weighted analysis” [Clin. Surg. Oncol. 4 (2025)100087] “与乳腺癌三种前哨淋巴结检测技术相关的门诊复诊：倾向评分加权分析”的勘误表[临床。中华外科杂志4 (2025)100087 [j]

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100114

Michelle P. Sosa , Deirdre G. McNicholas , Arbelina B. Bebla , Seth Emont , Zhun Cao , Manu Tyagi , Craig Lipkin , Sommer Gunia

引用次数: 0

Automated CT-based sarcopenia assessment for risk stratification of patients undergoing colorectal cancer resection 基于ct的肌肉减少症自动评估结直肠癌切除术患者的风险分层

Clinical Surgical Oncology

Pub Date : 2025-12-01 DOI: 10.1016/j.cson.2025.100105

Johannes Vogelsang , Gernot Pucher , Fabian Hörst , René Hosch , Johannes Haubold , Philipp Keyl , Christopher M. Sauer , David Albers , Peter Markus , Jan P. Neuhaus , Andreas D. Rink , Jürgen Treckmann , Ulf P. Neumann , Kai Nassenstein , Michael Forsting , Hideo A. Baba , Jan Egger , Stefan Kasper , Martin Schuler , Felix Nensa , Julius Keyl

Despite the prognostic relevance of sarcopenia in colorectal cancer, it has not yet been incorporated into routine clinical patient assessment. This study investigates the potential of automatically CT-derived muscle-to-bone ratio (MBR) for preoperative stratification of colorectal cancer patients.

We retrospectively analyzed CT images of 117 colorectal cancer patients undergoing surgical resection. A deep learning model was used to assess the abdominal MBR as a measure of sarcopenia. Univariable and multivariable analyses were performed to analyze the association between MBR and overall survival (OS), in-hospital mortality, length of stay (LOS), and postoperative C-reactive protein (CRP) levels.

In univariable analysis, preoperative MBR was significantly associated with OS (hazard ratio (HR) 0.29, 95 % CI: 0.13–0.64, p < 0.005). In multivariable analysis adjusted for age, sex, and UICC stage, higher MBR remained independently associated with improved OS (HR 0.28, 95 % CI: 0.10–0.79, p = 0.017) and reduced in-hospital mortality (coefficient (β) = -2.58, p = 0.031). Subgroups based on MBR showed significantly different OS in Kaplan-Meier analysis (p < 0.005). Furthermore, patients with low preoperative MBR exhibited significantly higher postoperative CRP values (p = 0.039). No significant association was observed between MBR and LOS.

Our study demonstrates the potential of deep learning-derived MBR for automated sarcopenia assessment and patient stratification in colorectal cancer surgery.

尽管结直肠癌中肌肉减少症与预后相关，但尚未纳入常规临床患者评估。本研究探讨了自动ct衍生的肌骨比（MBR）在结直肠癌患者术前分层中的潜力。我们回顾性分析117例结直肠癌手术切除患者的CT图像。使用深度学习模型评估腹部MBR作为肌肉减少症的测量。进行单变量和多变量分析，分析MBR与总生存期（OS）、住院死亡率、住院时间（LOS）和术后c反应蛋白（CRP）水平之间的关系。单变量分析中，术前MBR与OS显著相关（风险比0.29,95% CI: 0.13-0.64, p < 0.005）。在调整了年龄、性别和UICC分期的多变量分析中，较高的MBR仍然与改善的OS （HR 0.28, 95% CI: 0.10-0.79, p = 0.017）和降低的住院死亡率（系数(β) = -2.58, p = 0.031）独立相关。Kaplan-Meier分析显示，基于MBR的亚组OS差异显著（p < 0.005）。此外，术前MBR较低的患者术后CRP值明显较高（p = 0.039）。MBR和LOS之间没有明显的关联。我们的研究证明了基于深度学习的MBR在结肠直肠癌手术中用于自动肌肉减少症评估和患者分层的潜力。

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引用次数: 0

The role of artificial intelligence in emergency general surgery: Trends, advances, and future directions 人工智能在急诊普外科中的作用：趋势、进展和未来方向

Clinical Surgical Oncology

Pub Date : 2025-11-02 DOI: 10.1016/j.cson.2025.100103

Lasitha B. Samarakoon , Elon Correa , Wen Y. Chung

Artificial intelligence (AI) is increasingly integrated into emergency general surgery (EGS), offering advances in diagnosis, decision support, operative planning, intraoperative guidance, and postoperative management. This review synthesises current evidence on AI applications in EGS, drawing on meta-analyses, large-scale datasets, and landmark studies. Key domains include risk prediction, intraoperative assistance, surgical video analysis, training, prehabilitation, and operational coordination. Evidence shows AI can improve diagnostic accuracy, streamline workflows, and enhance patient outcomes, though benefits vary by setting, resource availability, and clinical domain. Adoption is accelerating, supported by rising global funding, yet constrained by regulatory, ethical, and implementation challenges. Addressing these barriers, standardising evaluation metrics, and expanding high-quality, multicentre trials will be essential to realise AI's full potential in EGS.

人工智能（AI）越来越多地融入急诊普通外科（EGS），在诊断、决策支持、手术计划、术中指导和术后管理方面提供了进步。本文综合了人工智能在EGS中应用的现有证据，利用了荟萃分析、大规模数据集和里程碑式的研究。关键领域包括风险预测、术中辅助、手术视频分析、培训、康复和操作协调。有证据表明，人工智能可以提高诊断准确性，简化工作流程，并改善患者的治疗效果，尽管益处因环境、资源可用性和临床领域而异。在全球资金不断增加的支持下，采用正在加速，但仍受到监管、道德和实施方面挑战的制约。解决这些障碍，标准化评估指标，扩大高质量的多中心试验，对于实现人工智能在EGS中的全部潜力至关重要。

引用次数: 0