Clinical Surgical Oncology最新文献_第3页

Neoadjuvant therapy for patients with advanced colon cancer: Analysis of the National Cancer Database (NCDB) 晚期结肠癌患者的新辅助治疗：国家癌症数据库（NCDB）分析

Clinical Surgical Oncology

Pub Date : 2025-09-01 DOI: 10.1016/j.cson.2025.100097

Guanming Chen , Jesus C. Fabregas , Zhigang Xie , Ilyas Sahin , Girish Mishra , Jiamin Hu , Rachel E. Liu-Galvin , Young-Rock Hong

Background

Few real-world studies have characterized the utilization pattern and overall survival (OS) benefits associated with neoadjuvant therapy (NAT) among patients diagnosed with colon cancer.

Patients and methods

In this retrospective cohort study, we identified adult patients diagnosed with stages II-IV colon cancer from 2015 to 2020 using the US National Cancer Database. Patients were grouped based on treatment modality and sequence: NAT and those treated by upfront surgery followed by adjuvant therapy (ADT). We examined utilization pattern of NAT by patients’ sociodemographic, medical, and facility characteristics. We then used Kaplan Meier method and Cox proportional hazards models to compare OS across cancer stages between two groups.

Results

Of the 116,905 patients who met inclusion criteria, 8110 (6.9 %) received NAT. Overall, patients underwent NAT were generally younger (age ≤64 years), privately insured, diagnosed with stage IV colon cancer, and with liver metastasis. Receipt of NAT was associated with significantly improved OS among patients with stage IV colon cancer after adjusting for covariates (hazard ratio, 0.79; 95 % CI: 0.76–0.83, p < 0.001). Subgroup analysis results showed that NAT was associated with better OS compared to those received ADT regardless of age, liver metastasis status, comorbidity score, and KRAS mutation status. For patients with stages II or III colon cancer, NAT was not associated with improved OS.

Conclusion

Neoadjuvant therapy was significantly associated with improved OS among patients with stage IV colon cancer. Future investigations are needed to understand the role of NAT in locally advanced colon cancer.

背景：很少有现实世界的研究描述了结肠癌患者新辅助治疗（NAT）的使用模式和总生存期（OS）获益。患者和方法在这项回顾性队列研究中，我们使用美国国家癌症数据库，确定了2015年至2020年诊断为II-IV期结肠癌的成年患者。患者根据治疗方式和顺序进行分组：NAT和术前手术后辅助治疗（ADT）。我们根据患者的社会人口学、医学和设施特征检查了NAT的使用模式。然后，我们使用Kaplan Meier方法和Cox比例风险模型来比较两组癌症分期的OS。结果在符合纳入标准的116,905例患者中，8110例（6.9%）接受了NAT治疗。总体而言，接受NAT治疗的患者通常较年轻（年龄≤64岁），有私人保险，诊断为IV期结肠癌，并有肝转移。调整协变量后，接受NAT治疗与IV期结肠癌患者的OS显著改善相关（风险比0.79;95% CI: 0.76-0.83, p < 0.001）。亚组分析结果显示，无论年龄、肝转移情况、合并症评分和KRAS突变状态如何，与接受ADT的患者相比，NAT与更好的OS相关。对于II期或III期结肠癌患者，NAT与改善OS无关。结论新辅助治疗可显著改善IV期结肠癌患者的OS。需要进一步的研究来了解NAT在局部晚期结肠癌中的作用。

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引用次数: 0

Assessing the quality and readability of AI chatbot responses to frequently asked questions about basal cell carcinoma 评估人工智能聊天机器人对基底细胞癌常见问题的回答的质量和可读性

Clinical Surgical Oncology

Pub Date : 2025-09-01 DOI: 10.1016/j.cson.2025.100094

Rickvir S. Sidhu , Arrane Selvamogan

引用次数: 0

Risk factors for anastomotic fistula after total mesorectal excision: A monocentric retrospective study of 78 patients 全直肠系膜切除术后吻合口瘘的危险因素：78例患者的单中心回顾性研究

Clinical Surgical Oncology

Pub Date : 2025-09-01 DOI: 10.1016/j.cson.2025.100096

Amine Majdoubi , Anass El Aachi , Mohammed El Hammouti , Haïtam Aabalou , Ayoub Kharkhach , Tariq Bouhout , Badr Serji

Introduction

Anastomotic fistulas remain one of the most feared complications following rectal surgery, particularly after Total Mesorectal Excision (TME). They compromise prognosis, prolong hospitalization, and increase costs due to the additional interventions they necessitate.

Aims

To identify predictive factors for the occurrence of anastomotic fistulas, with the goal of personalizing and optimizing surgical management—particularly to guide decisions regarding the use of defunctioning stomas.

Materials and methods

We conducted a retrospective observational study on 78 patients who underwent TME with low rectal anastomosis for rectal adenocarcinoma at Hassan II University Hospital in Oujda, between December 2017 and May 2024.

Results

Of the 78 patients, 21 developed anastomotic fistulas, yielding an incidence rate of 26.9 %. Late-onset cases were predominant (16 cases, 76.19 %) compared to early-onset cases (five cases, 23.81 %). In univariate analysis, diabetes (p = 0.002), intraoperative incidents (p = 0.014) - particularly blood loss exceeding 150 cc (p = 0.001) - and smoking (p = 0.005) were significant risk factors for fistula development. In multivariate analysis, diabetes (OR = 10.87; p = 0.003) and intraoperative blood loss >150 ml (OR = 7.38; p = 0.030) emerged as independent predictors of fistula development. Active smoking showed a borderline association (OR = 6.46; p = 0.056), suggesting a potential but not statistically confirmed impact on anastomotic fistula. These findings are consistent with the existing literature. In contrast, other factors commonly reported in the literature, such as male sex (p = 0.530), ASA score (p = 0.612), anemia (p = 0.324), and preoperative (p = 0.781) and postoperative albumin levels (p = 0.119), did not show a significant association in our study.

Discussion and conclusion

While the identified risk factors are relevant, they alone are insufficient to warrant major modifications in our surgical strategy, particularly regarding the decision to perform a defunctioning stoma. Further studies are necessary to validate these findings.

吻合口瘘是直肠手术后最可怕的并发症之一，特别是在全肠系膜切除术（TME）后。它们损害预后，延长住院时间，并由于需要额外干预而增加费用。目的确定吻合口瘘发生的预测因素，以实现个性化和优化手术治疗的目标，特别是指导关于使用功能障碍造口的决定。材料与方法我们对2017年12月至2024年5月在Oujda Hassan II大学医院行TME低位直肠吻合治疗直肠腺癌的78例患者进行了回顾性观察研究。结果78例患者中发生吻合口瘘21例，发生率26.9%。晚发病例16例（76.19%），早发病例5例（23.81%）。在单因素分析中，糖尿病（p = 0.002）、术中事件（p = 0.014）——特别是失血量超过150cc （p = 0.001）——和吸烟（p = 0.005）是瘘管发生的重要危险因素。在多因素分析中，糖尿病（OR = 10.87; p = 0.003）和术中出血量>；150 ml （OR = 7.38; p = 0.030）成为瘘发生的独立预测因素。积极吸烟呈边缘相关性（OR = 6.46; p = 0.056），提示对吻合口瘘有潜在的影响，但未得到统计学证实。这些发现与现有文献一致。相比之下，文献中常见的其他因素，如男性（p = 0.530）、ASA评分（p = 0.612）、贫血（p = 0.324）、术前（p = 0.781）和术后白蛋白水平（p = 0.119）等，在我们的研究中并没有显示出显著的相关性。讨论和结论虽然确定的危险因素是相关的，但它们本身不足以保证我们对手术策略进行重大修改，特别是在决定进行功能缺损时。需要进一步的研究来验证这些发现。

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引用次数: 0

Prophylactic stoma in robotic radical surgery for low-to-intermediate rectal cancer 低至中度直肠癌机器人根治术中的预防性造口

Clinical Surgical Oncology

Pub Date : 2025-08-13 DOI: 10.1016/j.cson.2025.100091

Zhekun Huang , Songbin Lin , Peiwen Zhou , Yang Lv , Guodong He , Ye Wei , Jianmin Xu , Wentao Tang

Background

Anastomotic leakage are common and serious complications after surgery for low and intermediate rectal cancers; a prophylactic stoma is thought to reduce the incidence of anastomotic leakage and alleviate its serious complications. However, it also comes with numerous risks. This study will investigate the value of prophylactic stomas in robot-assisted radical surgery for low and intermediate rectal cancers.

Methods

We included 670 patients with low-to-intermediate rectal cancer who underwent robot-assisted radical resection at two hospitals within Fudan University from June 2016 to October 2022 (77 underwent prophylactic stoma and 593 did not have prophylactic stoma). The clinical data of the patients were collected and analyzed using a propensity score matching method that matched the groups at a 1:1 ratio based on sex, diabetes mellitus, body mass index, neoadjuvant chemoradiotherapy, distance of the lower edge of the tumor from the anal verge, maximum diameter of the tumor, and preoperative incomplete obstruction.

Results

Patients in the prophylactic stoma group had a significantly lower incidence of symptomatic anastomotic leakage than the non-stoma group. There were no significant differences in the overall postoperative complication, unplanned readmission, or 30-day postoperative reoperation rates between the groups; however, the prophylactic stoma group had a lower number of postoperative hospital days and lower average hospital costs. Preoperative bowel obstruction was an independent risk factor for postoperative anastomotic leakage in the prophylactic stoma group.

Conclusions

Prophylactic stomas based on a robotic platform are beneficial for some high-risk patients with low-to-intermediate rectal cancer.

背景：吻合口瘘是低、中度直肠癌术后常见且严重的并发症；预防性造口术被认为可以减少吻合口瘘的发生率，减轻其严重的并发症。然而，它也带来了许多风险。本研究将探讨预防造口在机器人辅助的低、中度直肠癌根治术中的价值。方法纳入2016年6月至2022年10月在复旦大学两家医院行机器人辅助根治性切除术的670例低至中度直肠癌患者，其中77例行预防性造口术，593例未行预防性造口术。收集患者的临床资料，根据性别、糖尿病、体重指数、新辅助放化疗、肿瘤下缘距肛缘距离、肿瘤最大直径、术前不完全性梗阻等因素，采用倾向评分匹配法，按1:1比例进行分组匹配。结果预防造瘘组有症状性吻合口瘘发生率明显低于非造瘘组。两组患者术后总体并发症、非计划再入院或术后30天再手术率无显著差异；然而，预防性造口组术后住院天数较低，平均住院费用较低。术前肠梗阻是预防性造口组术后吻合口漏的独立危险因素。结论基于机器人平台的预防性造口术对部分中低危直肠癌患者是有益的。

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引用次数: 0

Unusual lymphangioleiomyomatosis presenting as a pure perivascular growth pattern 不寻常的淋巴管平滑肌瘤病表现为纯粹的血管周围生长模式

Clinical Surgical Oncology

Pub Date : 2025-08-11 DOI: 10.1016/j.cson.2025.100089

Maria Angela D. Magpantay , Corine Astroth , Alfred Garcia , Dong Ren , Oliver Eng , Michael P. O'Leary

Introduction

Lymphangioleiomyomatosis (LAM) is a rare disease mainly affecting women of child-bearing age that primarily involves lung parenchyma smooth muscles with resulting cystic changes. This disease can present symptomatically as shortness of breath or as a recurrent pneumothorax. Rare instances of extrapulmonary manifestations involving the kidneys and other visceral organs have been reported. Herein, we describe an unusual case of LAM in a patient with a retroperitoneal mass showing pure perivascular growth pattern.

Case presentation

We report a case of a 41-year-old female who presented with abdominal pain and was found to have a left para-aortic mass. This was at the aortic bifurcation and concerning for a paraganglioma; however, laboratory analysis excluded a functional mass. The patient was lost to follow-up due to complications from the COVID-19 pandemic and established care 4 years later, at which time biopsy revealed the diagnosis of LAM. She ultimately underwent surgical resection.

Conclusion

This is a unique presentation of non-pulmonary, para-aortic LAM. This case reviews the relevant literature and presents a methodical histologic work up of this unusual mass.

摘要淋巴管平滑肌瘤病（LAM）是一种罕见的疾病，主要影响育龄妇女，主要累及肺实质平滑肌，并伴有囊性改变。这种疾病的症状表现为呼吸短促或复发性气胸。罕见的肺外表现累及肾脏和其他内脏器官的病例已被报道。在此，我们描述了一例不寻常的LAM病例，患者腹膜后肿块显示纯粹的血管周围生长模式。我们报告一个41岁女性的病例，她表现为腹痛，并被发现有一个左侧主动脉旁肿块。这是在主动脉分叉处与副神经节瘤有关；然而，实验室分析排除了功能性肿块。由于COVID-19大流行的并发症，患者失去了随访，并在4年后建立了护理，当时活检显示LAM的诊断。她最终接受了手术切除。结论：这是一种独特的非肺主动脉旁LAM的表现。本病例回顾了相关文献，并对这种不寻常的肿块进行了系统的组织学研究。

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引用次数: 0

AI-driven surgical oncology: Innovations, challenges, and the path ahead 人工智能驱动的外科肿瘤学：创新、挑战和未来的道路

Clinical Surgical Oncology

Pub Date : 2025-07-11 DOI: 10.1016/j.cson.2025.100088

Wen Yuan Chung

引用次数: 0

Bibliometric and visualized analysis of fertility preservation in patients with gynecological malignancies from 2014 to 2023 2014 - 2023年妇科恶性肿瘤患者生育能力保存文献计量及可视化分析

Clinical Surgical Oncology

Pub Date : 2025-06-27 DOI: 10.1016/j.cson.2025.100085

Zhanghuan Li , Wenqi Du , Yufei Qin , Yinghui Yang , Yuxia Gao , Jing Yang , Xiaojie Feng , Wenqiang Fan , Wenxiang Wang

Objective

Fertility preservation in patients with gynecological malignancies (FP-GM) has gained increasing attention. This study conducts a bibliometric analysis of FP-GM research, aiming to identify key themes, influential publications, major contributors, and emerging trends that have shaped the field over the last decade.

Methods

Data were sourced from the Web of Science Core Collection (WOSCC). Tools such as CiteSpace and VOSviewer were utilized to conduct a detailed bibliometric analysis, focusing on keyword co-occurrence, citation bursts, collaboration networks, and clusters of influential references.

Results

A total of 2029 original articles were identified, involving 11446 authors from 342 countries and 8693 institutions, and published across 417 academic journals. Annual Publication generally shows an increasing trend. The USA is leading much of the advancement in this field. The International Journal of Gynecological Cancer published the most articles, and the journal with the most citations was Fertility and Sterility. Grynberg, Michael was the author with the most publications, and Donnez, J was the author with the most citations. The most frequently occurring keywords were “fertility preservation”, “cancer”, “women” and “chemotherapy”. Clusters of references including “cryopreservation techniques”, “ovarian cancer”, “cervical cancer”, “endometrial cancer” and so on. Citation bursts underscored the impact of guidelines and experimental research on the evolution of FP-GM.

Conclusion

Research on FP-GM is dominated by cryopreservation techniques and the reproductive consequences of cancer treatments. Influential guidelines and experimental research have shaped the field, with emerging interest in fertility-sparing treatments and hormonal preservation strategies, indicating a continuous evolution in clinical practices.

目的保存妇科恶性肿瘤患者的生育能力已受到越来越多的关注。本研究对FP-GM研究进行了文献计量分析，旨在确定在过去十年中塑造该领域的关键主题、有影响力的出版物、主要贡献者和新兴趋势。方法数据来源于Web of Science Core Collection （WOSCC）。利用CiteSpace和VOSviewer等工具进行详细的文献计量分析，重点关注关键词共现、引文爆发、协作网络和有影响力的参考文献集群。结果共发现原创文章2029篇，作者11446人，来自342个国家8693个机构，发表于417种学术期刊。年度出版物总体呈增长趋势。美国在这一领域处于领先地位。发表文章最多的是《国际妇科癌症杂志》，被引用次数最多的是《生育与不育》。格林伯格，迈克尔是发表文章最多的作者，Donnez， J是被引用最多的作者。出现频率最高的关键词是“保留生育能力”、“癌症”、“女性”和“化疗”。参考文献簇包括“冷冻保存技术”、“卵巢癌”、“宫颈癌”、“子宫内膜癌”等。大量引用强调了指南和实验研究对FP-GM进化的影响。结论FP-GM的研究主要集中在冷冻保存技术和肿瘤治疗对生殖的影响。有影响力的指导方针和实验研究塑造了这一领域，对保留生育能力的治疗和激素保存策略的兴趣日益浓厚，表明临床实践在不断发展。

{"title":"Bibliometric and visualized analysis of fertility preservation in patients with gynecological malignancies from 2014 to 2023","authors":"Zhanghuan Li , Wenqi Du , Yufei Qin , Yinghui Yang , Yuxia Gao , Jing Yang , Xiaojie Feng , Wenqiang Fan , Wenxiang Wang","doi":"10.1016/j.cson.2025.100085","DOIUrl":"10.1016/j.cson.2025.100085","url":null,"abstract":"<div><h3>Objective</h3><div>Fertility preservation in patients with gynecological malignancies (FP-GM) has gained increasing attention. This study conducts a bibliometric analysis of FP-GM research, aiming to identify key themes, influential publications, major contributors, and emerging trends that have shaped the field over the last decade.</div></div><div><h3>Methods</h3><div>Data were sourced from the Web of Science Core Collection (WOSCC). Tools such as CiteSpace and VOSviewer were utilized to conduct a detailed bibliometric analysis, focusing on keyword co-occurrence, citation bursts, collaboration networks, and clusters of influential references.</div></div><div><h3>Results</h3><div>A total of 2029 original articles were identified, involving 11446 authors from 342 countries and 8693 institutions, and published across 417 academic journals. Annual Publication generally shows an increasing trend. The USA is leading much of the advancement in this field. <em>The International Journal of Gynecological Cancer</em> published the most articles, and the journal with the most citations was <em>Fertility and Sterility</em>. Grynberg, Michael was the author with the most publications, and Donnez, J was the author with the most citations. The most frequently occurring keywords were “fertility preservation”, “cancer”, “women” and “chemotherapy”. Clusters of references including “cryopreservation techniques”, “ovarian cancer”, “cervical cancer”, “endometrial cancer” and so on. Citation bursts underscored the impact of guidelines and experimental research on the evolution of FP-GM.</div></div><div><h3>Conclusion</h3><div>Research on FP-GM is dominated by cryopreservation techniques and the reproductive consequences of cancer treatments. Influential guidelines and experimental research have shaped the field, with emerging interest in fertility-sparing treatments and hormonal preservation strategies, indicating a continuous evolution in clinical practices.</div></div>","PeriodicalId":100278,"journal":{"name":"Clinical Surgical Oncology","volume":"4 3","pages":"Article 100085"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867119","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

Artificial intelligence and machine learning in thoracic surgery- A scoping review 胸外科中的人工智能和机器学习-范围综述

Clinical Surgical Oncology

Pub Date : 2025-06-24 DOI: 10.1016/j.cson.2025.100086

K. Kutywayo , K. Chandarana , I. Das , S. Rathinam

Artificial intelligence (AI) and machine learning (ML) are rapidly transforming thoracic surgery, offering innovative solutions to enhance patient care, improve surgical outcomes, improve surgical training, and increase efficiency. This scoping review provides a comprehensive overview of the current applications, challenges, and future directions of AI and ML in thoracic surgery.

Key applications of AI in thoracic imaging include lung nodule detection and characterisation, with deep learning algorithms demonstrating performance comparable to or exceeding that of human radiologists. Radiomics combined with ML techniques show promise in tumour characterisation and classification of non-small cell lung cancer subtypes. In preoperative planning, AI-powered 3D reconstruction and virtual reality systems enable detailed surgical simulation and risk assessment.

Augmented reality and computer-assisted navigation systems are being developed to enhance surgical precision intraoperatively. While fully autonomous robotic surgery remains a distant goal, AI-enhanced robotic platforms are advancing rapidly. Postoperatively, AI algorithms show potential for predicting outcomes, interpreting pulmonary function tests, and guiding rehabilitation strategies.

Despite these advancements, several challenges persist, including data quality and quantity issues, algorithm interpretability, and the need for rigorous clinical validation. Ethical considerations surrounding AI implementation in healthcare also require careful attention.

Future directions include integrating multimodal data, developing real-time intraoperative guidance systems, and creating adaptive AI models capable of continuous learning. As these technologies mature, they have the potential to revolutionise thoracic surgical practice, ultimately improving patient outcomes.

人工智能（AI）和机器学习（ML）正在迅速改变胸外科手术，提供创新的解决方案，以加强患者护理，改善手术结果，改善手术培训并提高效率。本文综述了人工智能和机器学习在胸外科中的当前应用、挑战和未来方向。人工智能在胸部成像中的关键应用包括肺结节检测和表征，其深度学习算法的表现与人类放射科医生相当或超过。放射组学结合ML技术在非小细胞肺癌亚型的肿瘤特征和分类方面显示出希望。在术前规划中，人工智能支持的3D重建和虚拟现实系统可以进行详细的手术模拟和风险评估。正在开发增强现实和计算机辅助导航系统，以提高术中手术的精度。虽然完全自主的机器人手术仍然是一个遥远的目标，但人工智能增强的机器人平台正在迅速发展。术后，人工智能算法显示出预测结果、解释肺功能测试和指导康复策略的潜力。尽管取得了这些进步，但仍存在一些挑战，包括数据质量和数量问题、算法可解释性以及严格的临床验证需求。在医疗保健中实施人工智能的伦理考虑也需要仔细关注。未来的方向包括整合多模态数据，开发实时术中引导系统，以及创建能够持续学习的自适应人工智能模型。随着这些技术的成熟，它们有可能彻底改变胸外科手术实践，最终改善患者的治疗效果。

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引用次数: 0

Outpatient revisits associated with three sentinel lymph node detection techniques for breast cancer: A propensity score weighted analysis 与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

Clinical Surgical Oncology

Pub Date : 2025-06-23 DOI: 10.1016/j.cson.2025.100087

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

Introduction

This study evaluates whether near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) is associated with a lower outpatient (OP) revisit rate compared to isosulfan blue (IB) or methylene blue (MB) when combined with technetium-99m (Tc99m) for sentinel lymph node (SLN) mapping of breast cancer.

Materials and methods

This retrospective observational study included adult female patients with a breast cancer diagnosis who underwent SLN mapping and had an index OP discharge between July 1, 2017 and August 31, 2022 at a U.S. hospital contributing to the Premier Healthcare Database. Patients were grouped by SLN mapping method: IB + Tc99m, MB + Tc99m, and ICG + Tc99m. The primary outcome was OP revisit rates at 30, 60, and 90 days post-discharge. Propensity score weighting adjusted for differences in baseline characteristics.

Results

5.6 % (n = 60,068) of the 1,067,677 adult female patients with a breast cancer diagnosis underwent SLN mapping, and 54.9 % (n = 32,970) met the inclusion criteria. In the propensity-weighted sample (n = 2002), the ICG + Tc99m cohort had the lowest OP revisit rates at all time points compared to IB + Tc99m and MB + Tc99m: at 30 days, 36.4 % vs. 43.1 % vs. 43.2 %; at 60 days, 50.9 % vs. 55.8 % vs. 56.2 %; and at 90 days, 55.9 % vs. 59.7 % vs. 60.0 % (all p < .05). Adjusted odds ratios (aORs) confirmed the ICG + Tc99m cohort's reduced OP revisits: 30-day aOR, 0.74 (0.63–0.88); 60-day aOR, 0.80 (0.68–0.94); and 90-day aOR, 0.84 (0.71–0.99) (all p < .05).

Conclusion

NIRF with ICG + Tc99m was associated with significantly fewer OP revisits, suggesting that this method may improve patient outcomes and the continuum of care for breast cancer patients.

本研究评估近红外荧光（NIRF）成像与吲哚菁绿（ICG）相比，与异硫丹蓝（IB）或亚甲基蓝（MB）联合锝-99m （Tc99m）进行乳腺癌前哨淋巴结（SLN）定位时，是否与较低的门诊（OP）重访率相关。材料和方法本回顾性观察性研究纳入了2017年7月1日至2022年8月31日期间在美国一家医院接受SLN定位并有指数OP出院的乳腺癌成年女性患者，这些患者为Premier医疗数据库提供了资料。采用SLN作图法对患者进行分组：IB + Tc99m、MB + Tc99m、ICG + Tc99m。主要结果是出院后30,60和90天的OP重访率。结果在1,067,677例诊断为乳腺癌的成年女性患者中，5.6% （n = 60,068）进行了SLN定位，54.9% （n = 32,970）符合纳入标准。在倾向加权样本（n = 2002）中，与IB + Tc99m和MB + Tc99m相比，ICG + Tc99m队列在所有时间点的OP重访率最低：在30天，36.4%比43.1%比43.2%；60天，50.9% vs. 55.8% vs. 56.2%；在第90天，55.9% vs. 59.7% vs. 60.0% (p <；. 05)。调整后的优势比（aORs）证实ICG + tc9900万组的OP复诊次数减少：30天的aOR为0.74 (0.63-0.88)；60天aOR为0.80 (0.68-0.94)；90天aOR为0.84(0.71-0.99)(均p <；. 05)。结论ICG + Tc99m的nirf与OP复诊次数显著减少相关，提示该方法可改善患者预后和乳腺癌患者的持续护理。

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引用次数: 0

Application of large models in imaging diagnosis and prognostic analysis in hepatocellular carcinoma 大模型在肝细胞癌影像学诊断及预后分析中的应用

Clinical Surgical Oncology

Pub Date : 2025-06-01 DOI: 10.1016/j.cson.2025.100083

Jiapei Lin , Yilin Li , Dongrui Li , Liyong Zhuo , Jian Wei , Jingwei Wei

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, with high incidence and death rates. Despite significant progress in conventional diagnostic methods such as imaging studies and biomarkers, inherent limitations hinder their effectiveness. The rapid development of large model techniques has unveiled considerable potential for improving imaging-based diagnosis and prognostic evaluation of HCC. This review highlights recent advances in applying large models to HCC, emphasizing developments in deep neural network architecture and multimodal data integration. It examines how these models enhance early diagnosis accuracy through automated feature extraction and explores their role in integrating clinical variables, radiomics, genomics, and pathology data, offering novel perspectives for prognosis assessment. Despite their promise, challenges such as data quality, model interpretability, and generalization capacity remain. The review concludes by discussing the future potential of large models in HCC diagnosis and prognosis, addressing key challenges and ethical considerations for clinical adoption.

肝细胞癌（HCC）仍然是世界范围内癌症相关死亡的主要原因，具有高发病率和死亡率。尽管成像研究和生物标志物等传统诊断方法取得了重大进展，但固有的局限性阻碍了它们的有效性。大模型技术的快速发展揭示了改善基于影像学的HCC诊断和预后评估的巨大潜力。本文综述了大型模型应用于HCC的最新进展，强调了深度神经网络架构和多模态数据集成的发展。研究了这些模型如何通过自动特征提取来提高早期诊断的准确性，并探讨了它们在整合临床变量、放射组学、基因组学和病理数据方面的作用，为预后评估提供了新的视角。尽管前景看好，但数据质量、模型可解释性和泛化能力等挑战依然存在。综述最后讨论了大型模型在HCC诊断和预后方面的未来潜力，解决了临床采用的关键挑战和伦理考虑。

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引用次数: 0