Surgical Oncology Insight最新文献

{"title":"Selective use of post-lumpectomy mammography after breast-conserving surgery","authors":"Carolyn A. Schnurr ,&nbsp;Danielle J. Hurst ,&nbsp;Kristin E. LeMarbe ,&nbsp;Sevasti A. Vergis ,&nbsp;Thomas J. Quinn ,&nbsp;Joshua T. Dilworth ,&nbsp;Sayee Kiran ,&nbsp;Nayana Dekhne","doi":"10.1016/j.soi.2026.100228","DOIUrl":"10.1016/j.soi.2026.100228","url":null,"abstract":"<div><h3>Objectives</h3><div>Post-lumpectomy mammography (PLM) may detect suspicious residual calcifications after breast-conserving surgery (BCS). However, PLM may lead to patient anxiety, delays in initiating adjuvant treatment, and increased costs. We aimed to identify predictors of suspicious residual calcifications that may be used to select patients for whom PLM may be avoided.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of patients with non-metastatic breast cancer who underwent BCS and PLM between May 2016 to June 2023 at a single institution. We recorded patient characteristics, the presence of suspicious calcifications on pre-operative mammography and PLM, pathology from initial biopsy and lumpectomy specimen, and whether additional biopsy, re-excision, or mastectomy was performed. Wilcoxon Ranked-Sum and Fisher’s Exact tests were used to compare outcomes between cohorts. Univariate (UVA) and multivariable analyses (MVA) identified potential predictors of suspicious residual calcifications on PLM and the need for an additional procedure following PLM.</div></div><div><h3>Results</h3><div>Among 463 patients with pure DCIS (56 %), invasive ductal carcinoma (39.5 %), or invasive lobular carcinoma (4.5 %), 76 (16.4 %) had suspicious residual calcifications on PLM, of whom 70 (41.7 %) underwent an additional procedure, of which 43 (61.4 %) had positive pathology. On MVA, clinical tumor size was a significant predictor of residual calcifications on PLM (odds ratio [OR], 2.38, <em>p</em> = 0.008) and residual calcifications on PLM strongly predicted the likelihood of an additional procedure (odds ratio [OR], 64.9, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that patients with clinically small tumors and clear margins may represent a low-risk group in whom routine PLM could potentially be avoided.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077449","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}

{"title":"Commentary on “Supporting the PACT Act: Top cancers diagnosed in young veterans who deployed to Iraq and Afghanistan”","authors":"Erin M. Bayley,&nbsp;Haley Moss,&nbsp;Akiko Chiba,&nbsp;Sarah Colonna,&nbsp;Karen M. Goldstein,&nbsp;Megan Shepherd-Banigan,&nbsp;Anna Jo Smith,&nbsp;Michael J. Kelley,&nbsp;Leah L. Zullig","doi":"10.1016/j.soi.2026.100215","DOIUrl":"10.1016/j.soi.2026.100215","url":null,"abstract":"","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037954","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}

{"title":"Association between area deprivation index (ADI) and initial treatment among patients with desmoid tumors","authors":"Alexandra G. Lopez-Aguiar ,&nbsp;Menglin Xu ,&nbsp;Han Gil Kim ,&nbsp;David Liebner ,&nbsp;Valerie P. Grignol ,&nbsp;Gabriel Tinoco","doi":"10.1016/j.soi.2026.100216","DOIUrl":"10.1016/j.soi.2026.100216","url":null,"abstract":"<div><h3>Introduction</h3><div>Desmoid fibromatosis is a locally aggressive, non-metastasizing soft tissue tumor associated with substantial morbidity. Management has shifted away from routine surgical resection toward surveillance and systemic therapies. Socioeconomic disadvantage may influence treatment selection even among patients evaluated at tertiary referral centers. This study evaluated the association between neighborhood-level socioeconomic disadvantage, measured by the area deprivation index (ADI), and initial treatment strategy among patients with desmoid tumors.</div></div><div><h3>Methods</h3><div>Adults evaluated for desmoid fibromatosis at The Ohio State University between January 1, 2010, and January 1, 2021, were included in this retrospective cohort. Residential addresses were mapped to national ADI scores using the Neighborhood Atlas, and initial management was categorized as surgery, systemic therapy, or radiation. Associations between ADI and treatment selection were examined using prespecified univariate regression analyses.</div></div><div><h3>Results</h3><div>Among 151 patients, initial treatment included surgery (72 %), systemic therapy (24 %), or radiation (4 %). Patients residing in higher-ADI neighborhoods had significantly higher ADI scores when treated with systemic therapy compared with surgery (mean ADI 65 vs 50, P = 0.013), and higher ADI was associated with selection of systemic therapy rather than upfront surgery.</div></div><div><h3>Conclusion</h3><div>In this single-institution cohort, higher neighborhood socioeconomic disadvantage was associated with selection of non-surgical initial management for desmoid fibromatosis. These findings reflect treatment patterns during a transitional era in desmoid care and suggest that socioeconomic factors may influence management decisions even among patients accessing specialized care. Further multi-institutional studies in contemporary cohorts are needed to clarify how socioeconomic disadvantage affects treatment selection and outcomes.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977190","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}

{"title":"Insights to multidisciplinary care in early onset colorectal cancer","authors":"Casidhe-Nicole Bethancourt ,&nbsp;David Cohen ,&nbsp;Yoanna Pumpalova ,&nbsp;Joel Gabre ,&nbsp;Beatrice Dionigi","doi":"10.1016/j.soi.2025.100214","DOIUrl":"10.1016/j.soi.2025.100214","url":null,"abstract":"<div><div>Early onset colorectal cancer (EO-CRC) is growing steadily, despite increased efforts in screening and early detection. Although genomically similar to average-onset colorectal cancer (AO-CRC), younger patients face distinct clinical, psychosocial and economic challenges. While the general guidelines for detection and treatment are the same across age groups, we aim here to describe some of the unique challenges faced by younger patients. These include diagnostic delays, fertility concerns, and unique emotional and financial burdens. In this review, we explore the multidimensional needs of EO-CRC patients, including barriers to early detection, the impact of treatment on reproductive health and relationships, and the long-term financial and psychological toll. Addressing these challenges requires a tailored, multidisciplinary approach that goes beyond standard oncologic care.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977191","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}

{"title":"Robotic right hemicolectomy with complete mesocolic excision and D3 lymphadenectomy: Perioperative complications and oncologic outcomes","authors":"Matthew B. Hill ,&nbsp;Thikhamporn Tawantanakorn ,&nbsp;Mithat Gonen ,&nbsp;Julio Garcia-Aguilar ,&nbsp;Martin R. Weiser","doi":"10.1016/j.soi.2025.100213","DOIUrl":"10.1016/j.soi.2025.100213","url":null,"abstract":"<div><h3>Background</h3><div>Hemicolectomy with complete mesocolic excision and D3 lymphadenectomy is associated with high lymph node yield and favorable oncologic outcomes; however, there are concerns over the safety of the procedure given the extent of dissection required.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the rates of complications and disease-free survival in patients with cancer in the ascending colon, terminal ileum, or appendix who underwent a robotic right hemicolectomy with complete mesocolic excision and D3 lymphadenectomy at our comprehensive cancer center between 2014 and 2024.</div></div><div><h3>Results</h3><div>For the 631 patients included in the analysis, median operative time was 165 (IQR 140–188) min, with median blood loss of 25 (IQR 25–50) ml. Complications of Clavien-Dindo grade ≥III occurred in 15 patients (2.4 %), including 7 patients (1.1 %) with anastomotic leak. Median hospital stay was 4 (IQR 3–5) days, with 38 patients (6.0 %) readmitted and 2 deaths (0.3 %) within 30 days. For 536 patients with colon adenocarcinoma, the median number of lymph nodes harvested was 30.5 (IQR 23–42); with median follow-up of 42.8 months, 2 patients had a local (anastomotic) recurrence and 61 had a distant recurrence. Disease-free survival at 5 years in patients treated for stage I, II, or III colon cancer was 98.5 %, 89.9 %, and 68.6 %, respectively.</div></div><div><h3>Conclusions</h3><div>Robotic right hemicolectomy with complete mesocolic excision and D3 lymphadenectomy can be performed with low morbidity by experienced surgeons. Outcomes compare favorably to the outcomes of standard colectomy and are similar to the outcomes of open and laparoscopic D3 colectomies.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938510","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}

{"title":"Predictive value of preoperative TSH levels for thyroid hormone supplementation post-thyroid lobectomy: A 200-patient retrospective cohort study","authors":"Andres Tame-Elorduy ,&nbsp;Nicholas Druar ,&nbsp;Amanda Tibbels ,&nbsp;Omair Shariq ,&nbsp;Jace P. Landry ,&nbsp;Amblessed Onuma ,&nbsp;Anita K. Ying ,&nbsp;Yi-Ju Chiang ,&nbsp;Paul H. Graham ,&nbsp;Sarah B. Fisher ,&nbsp;Elizabeth G. Grubbs ,&nbsp;Nancy D. Perrier","doi":"10.1016/j.soi.2025.100212","DOIUrl":"10.1016/j.soi.2025.100212","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;A thyroid lobectomy is a commonly indicated procedure for a wide variety of thyroid pathologies; however, the decisions between a total thyroidectomy vs a lobectomy requires counseling of lifelong dependence on thyroid hormone supplementation. However, the need for thyroid supplementation following lobectomy can vary significantly among patients. This study aims to evaluate whether preoperative Thyroid-Stimulating Hormone (TSH) levels can help predict the requirement for thyroid hormone replacement therapy (THRT) postoperatively in patients undergoing thyroid lobectomy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;1281 patients who received thyroid lobectomies for benign and malignant disease at MD Anderson Cancer Center from 2016 to February 2024 were screened. The exclusion criteria were a hyperactive nodule, undifferentiated thyroid carcinoma, age &lt; 18 years-old, no follow up at 6 months, and preoperative hypothyroidism. Post-operative TSH values were obtained early in the post-op period (6–8 weeks) and late in the post-op period (6–12 months). The primary outcome was the requirement for THRT at their follow up at 6–12 months post-op, using logistic regression analysis and ROC curve analysis to evaluate the predictive value of preoperative TSH levels.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 1281 patients screened, 200 met the inclusion criteria with a gender distribution of distribution of 74.37 % female and 25.63 % male with a median age of 50 ranging from 18 to 86 years old. Preoperative TSH levels varied among patients. Logistic regression analysis demonstrated that pre-op TSH levels were a significant predictor of the need for levothyroxine supplementation at 6–12 months post-op (Odds Ratio [OR] = 3.65, 95 % Confidence Interval [CI] = 2.25–5.93, P &lt; 0.001). Higher preoperative TSH levels increased the risk of needing THRT in the postoperative setting. Early post-op TSH (6–8 weeks post-op) (OR = 2.00, 95 % CI = 1.48–2.70, P &lt; 0.001) and late post-op TSH (6–12 months post-op) (OR = 1.21, 95 % CI = 1.04–1.41, P = 0.016) were also significant predictors.&lt;/div&gt;&lt;div&gt;A pre-op TSH cut-off value of 1.5 mIU/L was identified as the optimal threshold, with sensitivity and specificity at this cut-off being 66 % and 75 %, respectively. The Negative Predictive Value (NPV) was 63.5 while the Positive Predictive Value (PPV) was 76.8 %.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The study demonstrates a significant correlation between preoperative TSH levels and the necessity for postoperative thyroid hormone supplementation. Patients with preoperative TSH levels above 1.5 mIU/L were more likely to require THRT at 6–12 months. These findings suggest that preoperative TSH could serve as a predictive marker for post-op thyroid function, aiding in preoperative patient counseling and management planning. This information is crucial for better counseling patients on the potential outcomes of thyroid lobectomy versus total thyroidec","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938511","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}

{"title":"The association of lymph node ratio to survival in gastric adenocarcinoma patients following radical gastrectomy","authors":"Liliana Cuevas López ,&nbsp;Carlos E. Diaz-Castrillón ,&nbsp;Francisco Javier Henao ,&nbsp;Elio Fabio Sánchez","doi":"10.1016/j.soi.2025.100211","DOIUrl":"10.1016/j.soi.2025.100211","url":null,"abstract":"<div><h3>Objective</h3><div>The TNM staging system offers prognostic insights, but its effectiveness is often limited by inadequate lymph node retrieval. The lymph node ratio (LNR) offers a more comprehensive assessment. This study aimed to evaluate the association between LNR and survival outcomes in Colombia, a country with a high prevalence of gastric cancer.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients with gastric adenocarcinoma who underwent oncologic resection at a single center between 2015 and 2018. The LNR was calculated as the ratio of affected lymph nodes to the total number dissected during gastrectomy. Perioperative characteristics were assessed based on LNR quartiles: LNR0 (0), LNR1 (&gt;0–0.16), LNR2 (&gt;0.16–0.4), and LNR3 (&gt;0.4). Kaplan-Meier survival curves and multivariable Cox regression models were used to evaluated the association between LNR and survival outcomes.</div></div><div><h3>Results</h3><div>157 patients were included, with a median age of 64 years; 63.1 % (n = 99) were men, and 74.5 % (n = 117) had an ECOG 1. The median number of lymph nodes collected was 24, with 77 % (n = 122) having more than 15 nodes resected. Significant differences in overall survival (OS) and disease-free survival (DFS) were observed among the LNR groups (p = 0.0010). As LNR increased, both OS and DFS declined. Patients with 40 % LNR involvement had twice the mortality hazard (HR 2.13, 95 % CI 1.02–4.48) and patients with 10 % LNR involvement had three times the recurrence risk (HR 3.12, 95 % CI 1.1–8.82).</div></div><div><h3>Conclusions</h3><div>LNR is an independent prognostic factor for survival following radical gastrectomy. This highlights the need for careful lymph node evaluation and its integration into risk stratification and patient management.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884431","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}

{"title":"Optimal duration of neoadjuvant chemotherapy prior to CRS±HIPEC for colorectal cancer: An assessment of survival and postoperative outcomes","authors":"Frances J. Bennett ,&nbsp;Kailey M. Oppat ,&nbsp;Mohammad Y. Zaidi ,&nbsp;Joshua Winer ,&nbsp;Maria C. Russell ,&nbsp;Charles Staley ,&nbsp;Shishir K. Maithel ,&nbsp;Seth J. Concors","doi":"10.1016/j.soi.2025.100210","DOIUrl":"10.1016/j.soi.2025.100210","url":null,"abstract":"<div><h3>Background</h3><div>Cytoreductive surgery (CRS) with or without heated intraperitoneal chemotherapy (HIPEC) represents a viable therapy for select patients with colorectal cancer (CRC) peritoneal metastases. Given recurrence rates, challenges returning to oncologic treatment postoperatively, and desire to assess tumor biology, neoadjuvant chemotherapy (NAC) is common. Evidence-based guidance regarding NAC duration is limited.</div></div><div><h3>Methods</h3><div>A single institution database (2009–2024) of patients with CRC that underwent CRS±HIPEC was reviewed. Patients undergoing curative intent CRS±HIPEC with known NAC duration were stratified by NAC duration (0–3 vs &gt;3 months). Primary outcomes were recurrence-free survival (RFS) and overall survival (OS). Secondary outcome was clinically significant postoperative complications.</div></div><div><h3>Results</h3><div>From 2009–2024, 87 patients underwent curative intent CRS±HIPEC (&gt;3 months NAC: 58 patients, 0–3 months NAC: 29 patients). Median peritoneal cancer index score was similar between cohorts (&gt;3 months: 11 vs 0–3 months: 12; p = 0.98). RFS and OS were not statistically different based on NAC duration (RFS: &gt;3 months: 8 months vs 0–3 months: 15 months, p = 0.28) (OS: &gt;3 months: 26 months vs 0–3 months: 35 months; p = 0.33). &gt; 3 months of NAC was associated with increased median length of stay (&gt;3 months: 10 days vs 0–3 months: 8 days; p = 0.04). Even when controlling for other perioperative variables on multivariable analysis, &gt; 3 months of NAC was associated with increased risk of clinically significant complications (HR 3.47, 95 % CI 1.11–10.88; p = 0.03).</div></div><div><h3>Conclusion</h3><div>Greater duration of NAC prior to CRS±HIPEC is not associated with improved RFS or OS, and, rather, is associated with higher complication rate and longer hospital stay.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840591","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}

{"title":"Perioperative outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy following neoadjuvant systemic therapy for high-volume peritoneal mesothelioma","authors":"Yun Song ,&nbsp;Joelle Allam ,&nbsp;Karen A. Beaty ,&nbsp;Anneleis F. Willett ,&nbsp;Melissa W. Taggart ,&nbsp;Anais Malpica ,&nbsp;Richard E. Royal ,&nbsp;Paul F. Mansfield ,&nbsp;Ryan W. Huey ,&nbsp;Kanwal P.S. Raghav ,&nbsp;Keith F. Fournier ,&nbsp;Beth A. Helmink","doi":"10.1016/j.soi.2025.100209","DOIUrl":"10.1016/j.soi.2025.100209","url":null,"abstract":"<div><h3>Background</h3><div>The role and optimal sequencing of systemic therapy in patients with high-volume peritoneal mesothelioma (PeM) undergoing curative-intent cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) remains unclear. We compared perioperative outcomes in patients undergoing upfront CRS/HIPEC (U-CRS) versus those receiving neoadjuvant therapy (NAT).</div></div><div><h3>Methods</h3><div>This single-institution retrospective study included patients with PeM (2009–2023) who underwent CRS/HIPEC with a peritoneal carcinomatosis index (PCI) &gt; 20. Primary outcomes were prolonged operative time (OT), defined as &gt; 75th percentile for the study cohort, and 90-day postoperative complications. Secondary outcomes included complete cytoreduction with CC-0 score, recurrence-free survival (RFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>Of 45 patients, 14 (31 %) underwent U-CRS and 31 (69 %) received NAT. Most NAT patients (94 %) were treated with a platinum agent and pemetrexed, with or without bevacizumab, for a median of 6 cycles. Median PCI was similar between groups (U-CRS: 28; NAT: 27; <em>p</em> = 0.73). Median OT was 572 min (U-CRS) vs. 645 min (NAT; <em>p</em> = 0.17). Grade III–V complications occurred in 50 % of U-CRS vs. 32 % of NAT patients (<em>p</em> = 0.42). NAT was not independently associated with prolonged OT or severe complications on multivariable analyses. Rates of CC-0 resection, RFS, and OS were similar between groups.</div></div><div><h3>Conclusions</h3><div>NAT is feasible and safe in patients with high-volume PeM undergoing CRS/HIPEC, without negatively affecting perioperative outcomes. The neoadjuvant setting offers a valuable platform for investigating novel therapies aimed at improving long-term outcomes in PeM.</div></div><div><h3>Synopsis</h3><div>Neoadjuvant systemic therapy before CRS/HIPEC for high-volume peritoneal mesothelioma is feasible and safe with similar operative times and complication rates as upfront surgery, supporting its use as a platform to evaluate novel therapies to improve long-term outcomes in peritoneal mesothelioma.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840590","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}

{"title":"The role of multivisceral resection on outcomes in primary retroperitoneal sarcoma: A systematic review by the Australian and New Zealand Sarcoma Association Clinical Practice Guidelines Working Party","authors":"David J. Coker ,&nbsp;David Gyorki ,&nbsp;Deborah Zhou ,&nbsp;Anna Lawless ,&nbsp;Joanna Connor ,&nbsp;Peter S. Grimison ,&nbsp;Stephen R. Thompson ,&nbsp;Iain Ward ,&nbsp;Elizabeth A. Connolly ,&nbsp;Jasmine Mar ,&nbsp;Smaro Lazarakis ,&nbsp;Scott Venter ,&nbsp;Jean Wong ,&nbsp;Daniel Steffens ,&nbsp;Peter Lee ,&nbsp;Angela M. Hong","doi":"10.1016/j.soi.2025.100208","DOIUrl":"10.1016/j.soi.2025.100208","url":null,"abstract":"<div><h3>Background</h3><div>Retroperitoneal sarcoma (RPS) has high local recurrence rates and poor outcomes, with complete surgical resection being the only curative treatment. Over the past two decades, there has been a trend towards multivisceral resection (MVR). This systematic review sought to evaluate the role of MVR compared with simple resection in patients with primary RPS.</div></div><div><h3>Methods</h3><div>A systematic review was conducted following PICO methodology. Adult patients with primary localized RPS undergoing MVR were compared to those receiving simple resection. Primary outcomes included abdominal recurrence-free survival, overall survival, and perioperative morbidity.</div></div><div><h3>Results</h3><div>Twenty-three retrospective studies were identified, with patient cohorts ranging from 23 to 1007 participants. Results demonstrated conflicting evidence regarding MVR's impact on survival outcomes. The highest quality study showed MVR significantly reduced 3-year abdominal recurrence rates (10 % vs 47 %, HR 1.99, p = 0.04) compared to simple resection. However, MVR did not significantly improve overall survival across most studies. Analysis of perioperative morbidity consistently demonstrated that MVR does not significantly increase complications compared to simple resection.</div></div><div><h3>Conclusions</h3><div>Current evidence suggests MVR may reduce abdominal recurrence in primary RPS without significantly increasing perioperative morbidity, though overall survival benefits remain unproven. MVR could be considered for RPS subtypes at high risk of local recurrence, particularly liposarcoma, to maximize local control without significantly increasing perioperative morbidity. Given that complete surgical resection remains the only curative therapy for RPS, the decision for MVR should be individualized with input from a sarcoma multidisciplinary team.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799726","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}