Pub Date : 2025-12-05DOI: 10.1016/j.soi.2025.100204
Adam Awe , Chris B. Agala , Anne Worth , Ellie R. Lee , Susan Maygarden , Jen Jen Yeh
Introduction
Pre-operative thyroid ultrasound (TUS) helps risk-stratify patients with thyroid nodules. We evaluated the association between TUS size, pathologic papillary thyroid cancer (PTC) size, and extent of surgery pursued.
Methods
A single-institution retrospective analysis was performed on patients > 18 years of age with a pre-operative TUS from 2017 to 2022. Size comparisons were assessed using intra-class correlation (ICC).
Results
In total, 252 patients with 261 nodules were included. Two-hundred and twenty-one (84.7 %) nodules were PTC. The average maximum diameter of nodules was 0.77 cm (+/- 0.14 cm) on TUS and 1.40 cm (+/- 1.84 cm) on pathology for PTC < 1 cm (p-value 0.31); ICC 0.0. The average maximum diameter of nodules was 2.03 cm (+/- 0.78 cm) on TUS and 1.67 cm (+/- 1.13 cm) on pathology for PTC 1 – 4 cm (p = 0.001); ICC 0.30 (95 % CI 0.15 – 0.46). The average maximum diameter of nodules was 5.29 cm (+/- 1.21 cm) on TUS and 3.58 cm (+/- 2.36 cm) on pathology for PTC > 4 cm (p < 0.001); ICC 0.05 (95 % CI - 0.40 – 0.51). Fifteen patients (45.5 %) with a TUS nodule > 4 cm and pathological PTC less than or equal to 4 cm underwent a total thyroidectomy.
Conclusions
Pre-operative TUS of PTC > 1 cm overestimated the pathologic size of PTC. Nearly half of patients with a TUS nodule > 4 cm with pathologic PTC less than or equal to 4 cm underwent a total thyroidectomy. The size of nodules on pre-operative TUS should not dictate extent of thyroid resection alone.
{"title":"Size of thyroid cancers does not correlate well with pre-operative thyroid nodule size on ultrasound","authors":"Adam Awe , Chris B. Agala , Anne Worth , Ellie R. Lee , Susan Maygarden , Jen Jen Yeh","doi":"10.1016/j.soi.2025.100204","DOIUrl":"10.1016/j.soi.2025.100204","url":null,"abstract":"<div><h3>Introduction</h3><div>Pre-operative thyroid ultrasound (TUS) helps risk-stratify patients with thyroid nodules. We evaluated the association between TUS size, pathologic papillary thyroid cancer (PTC) size, and extent of surgery pursued.</div></div><div><h3>Methods</h3><div>A single-institution retrospective analysis was performed on patients > 18 years of age with a pre-operative TUS from 2017 to 2022. Size comparisons were assessed using intra-class correlation (ICC).</div></div><div><h3>Results</h3><div>In total, 252 patients with 261 nodules were included. Two-hundred and twenty-one (84.7 %) nodules were PTC. The average maximum diameter of nodules was 0.77 cm (+/- 0.14 cm) on TUS and 1.40 cm (+/- 1.84 cm) on pathology for PTC < 1 cm (p-value 0.31); ICC 0.0. The average maximum diameter of nodules was 2.03 cm (+/- 0.78 cm) on TUS and 1.67 cm (+/- 1.13 cm) on pathology for PTC 1 – 4 cm (p = 0.001); ICC 0.30 (95 % CI 0.15 – 0.46). The average maximum diameter of nodules was 5.29 cm (+/- 1.21 cm) on TUS and 3.58 cm (+/- 2.36 cm) on pathology for PTC > 4 cm (p < 0.001); ICC 0.05 (95 % CI - 0.40 – 0.51). Fifteen patients (45.5 %) with a TUS nodule > 4 cm and pathological PTC less than or equal to 4 cm underwent a total thyroidectomy.</div></div><div><h3>Conclusions</h3><div>Pre-operative TUS of PTC > 1 cm overestimated the pathologic size of PTC. Nearly half of patients with a TUS nodule > 4 cm with pathologic PTC less than or equal to 4 cm underwent a total thyroidectomy. The size of nodules on pre-operative TUS should not dictate extent of thyroid resection alone.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799728","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}
Pub Date : 2025-12-05DOI: 10.1016/j.soi.2025.100205
Bhavya Bansal , Ahmed Younos , Sharona Ross , Iswanto Sucandy
Introduction
Minimally invasive robotic technique is gaining popularity due to its technical advantages when compared with conventional laparoscopy. Minimally invasive major hepatic lobectomy, especially for the right side, however, remains a technically demanding procedure and requires extensive training to ensure safety and efficacy.1, 2, 3, 4 Herein, we describe our standardized technical approach for anatomical right hepatectomy using robotic platform.
Methods
An 81-year-old woman presented with a single 9 cm urothelial carcinoma liver metastasis to the right hepatic lobe. PET scan shows a large-sized hypermetabolic tumor with no evidence of other lesion or extrahepatic disease. After confirmation of tumor resectability, a right anatomical hepatic lobectomy is needed to gain oncological clearance. Hepatic inflow control was obtained by ligation of right hepatic artery and portal vein. Detailed technical operative steps are shown in the multimedia video attached to this paper.
Results
Total operative time was 240 min, with an estimated blood loss of 75 mL. The patient had an uneventful postoperative recovery and she was discharged on postoperative day 4. Pathologic evaluation revealed a 9.0 cm metastatic urothelial carcinoma with negative resection margins. Currently, she is two years from the operation without any evidence of disease recurrence.
Conclusion
This video highlights safe and effective practical steps in performing robotic anatomical right hepatic lobectomy.
{"title":"Robotic anatomical right hepatectomy for metastatic clear cell carcinoma. Standardized approach using robotic platform","authors":"Bhavya Bansal , Ahmed Younos , Sharona Ross , Iswanto Sucandy","doi":"10.1016/j.soi.2025.100205","DOIUrl":"10.1016/j.soi.2025.100205","url":null,"abstract":"<div><h3>Introduction</h3><div>Minimally invasive robotic technique is gaining popularity due to its technical advantages when compared with conventional laparoscopy. Minimally invasive major hepatic lobectomy, especially for the right side, however, remains a technically demanding procedure and requires extensive training to ensure safety and efficacy.<span><span>1</span></span>, <span><span>2</span></span>, <span><span>3</span></span>, <span><span>4</span></span> Herein, we describe our standardized technical approach for anatomical right hepatectomy using robotic platform.</div></div><div><h3>Methods</h3><div>An 81-year-old woman presented with a single 9 cm urothelial carcinoma liver metastasis to the right hepatic lobe. PET scan shows a large-sized hypermetabolic tumor with no evidence of other lesion or extrahepatic disease. After confirmation of tumor resectability, a right anatomical hepatic lobectomy is needed to gain oncological clearance. Hepatic inflow control was obtained by ligation of right hepatic artery and portal vein. Detailed technical operative steps are shown in the multimedia video attached to this paper.</div></div><div><h3>Results</h3><div>Total operative time was 240 min, with an estimated blood loss of 75 mL. The patient had an uneventful postoperative recovery and she was discharged on postoperative day 4. Pathologic evaluation revealed a 9.0 cm metastatic urothelial carcinoma with negative resection margins. Currently, she is two years from the operation without any evidence of disease recurrence.</div></div><div><h3>Conclusion</h3><div>This video highlights safe and effective practical steps in performing robotic anatomical right hepatic lobectomy.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749875","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}
Minimally invasive robotic technique is gaining popularity due to its technical advantages when compared with conventional laparoscopy. Major hepatic lobectomy, however, remains a technically demanding procedure and requires extensive training to ensure safety and efficacy, especially when undertaken using minimally invasive approach.1, 2, 3, 4 With focus on robotic surgery techniques, in this video we describe our standardized technical approach of robotic anatomical left hepatectomy with enbloc caudate lobe resection.
Methods
A 78-year-old man presented with a caudate lobe cholangiocarcinoma infiltrating the caudate lobe and dorsal aspect of segment 4 with a very close proximity to the base of umbilical fissure. No evidence of extrahepatic metastasis is seen. Left anatomical hepatic lobectomy enbloc with caudate resection is needed to oncologically remove the tumor, in addition to radical portal abdominal lymphadenectomy. Technical operative steps are shown in the multimedia video.
Results
Total operative time was 270 min, with an estimated blood loss of 100 mL. The patient had an uneventful postoperative recovery and he was discharged on postoperative day 6. Pathologic evaluation revealed a 6.7 cm moderately differentiated cholangiocarcinoma with negative margins.
Conclusion
This case highlights the safety, feasibility, and technical steps of robotic anatomical left hepatic lobectomy with enbloc caudate resection.
{"title":"Robotic anatomical left hepatectomy with enbloc caudate resection for intrahepatic cholangiocarcinoma","authors":"Bhavya Bansal , Parisa Yazdankhan Kenary , Sharona Ross , Iswanto Sucandy","doi":"10.1016/j.soi.2025.100207","DOIUrl":"10.1016/j.soi.2025.100207","url":null,"abstract":"<div><h3>Introduction</h3><div>Minimally invasive robotic technique is gaining popularity due to its technical advantages when compared with conventional laparoscopy. Major hepatic lobectomy, however, remains a technically demanding procedure and requires extensive training to ensure safety and efficacy, especially when undertaken using minimally invasive approach.<span><span>1</span></span>, <span><span>2</span></span>, <span><span>3</span></span>, <span><span>4</span></span> With focus on robotic surgery techniques, in this video we describe our standardized technical approach of robotic anatomical left hepatectomy with enbloc caudate lobe resection.</div></div><div><h3>Methods</h3><div>A 78-year-old man presented with a caudate lobe cholangiocarcinoma infiltrating the caudate lobe and dorsal aspect of segment 4 with a very close proximity to the base of umbilical fissure. No evidence of extrahepatic metastasis is seen. Left anatomical hepatic lobectomy enbloc with caudate resection is needed to oncologically remove the tumor, in addition to radical portal abdominal lymphadenectomy. Technical operative steps are shown in the multimedia video.</div></div><div><h3>Results</h3><div>Total operative time was 270 min, with an estimated blood loss of 100 mL. The patient had an uneventful postoperative recovery and he was discharged on postoperative day 6. Pathologic evaluation revealed a 6.7 cm moderately differentiated cholangiocarcinoma with negative margins.</div></div><div><h3>Conclusion</h3><div>This case highlights the safety, feasibility, and technical steps of robotic anatomical left hepatic lobectomy with enbloc caudate resection.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799694","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}
Pub Date : 2025-12-04DOI: 10.1016/j.soi.2025.100206
Daniel Markus Düx , Bennet Hensen , Julian Glandorf , Simon Schröer , Othmar Belker , Dominik Horstmann , Moritz Gutt , Kristina Imeen Ringe , Frank Wacker , Marcel Gutberlet
Purpose
Evaluating safety and efficacy of magnetic resonance-guided microwave ablation (MRgMWA) for small subdiaphragmatic and pericardial hepatic malignancies (HM).
Methods
This single-center study retrospectively reviewed MRgMWA for lesions ≤ 2 cm within 1 cm of the diaphragm from 02/2017–05/2025. Complications were classified according to “Cardiovascular and Interventional Radiological Society of Europe” guidelines. Technical efficacy, local tumor progression (LTP), local tumor recurrence (LTR), non-target progression (NTP), and time to progression were assessed. Data is presented as mean ± standard deviation.
Results
Twenty-three patients (64.8 ± 10.2 years; 15 males, 8 females) with 25 HM (17 hepatocellular carcinoma, 1 cholangiocarcinoma, 7 metastases) were treated. Lesion size was 13.1 ± 4.4 mm, with proximity to diaphragm of 3.1 ± 3.2 mm. Total procedure duration was 2 h 14 min ± 51 min. The complication rate was 33.3 %, including pain (N = 3), fever (N = 2), hematoma (N = 1), bilioma (N = 1), and reactive cholecystitis (N = 1). All complications resolved - two with pain medication and one with antibiotics. Technical efficacy was 100 %. No tumor recurrence was observed at ablation sites (LTP and LTR = 0 %) at 32.5 ± 29.0 months, but one seeding metastasis occurred. NTP occurred in 14 patients (60.9 %) at 13.6 ± 10.8 months. Three patients died 7, 32 and 48 months post-ablation. One patient underwent liver transplantation post-ablation.
Conclusions
MRgMWA for small subdiaphragmatic and pericardial HM may be safe and effective, demonstrating no LTR at 32.5 ± 29.0 months follow-up.
Synopsis
This study highlights the potential of MR-guided microwave ablation as minimally-invasive treatment option for small subdiaphragmatic (N = 20) or pericardial (N = 5) liver tumors. Complications seem relatively low compared to existing studies with excellent local tumor control.
{"title":"Safety and efficacy of MRI-fluoroscopic guided microwave ablation of small subdiaphragmatic and pericardial liver tumors","authors":"Daniel Markus Düx , Bennet Hensen , Julian Glandorf , Simon Schröer , Othmar Belker , Dominik Horstmann , Moritz Gutt , Kristina Imeen Ringe , Frank Wacker , Marcel Gutberlet","doi":"10.1016/j.soi.2025.100206","DOIUrl":"10.1016/j.soi.2025.100206","url":null,"abstract":"<div><h3>Purpose</h3><div>Evaluating safety and efficacy of magnetic resonance-guided microwave ablation (MRgMWA) for small subdiaphragmatic and pericardial hepatic malignancies (HM).</div></div><div><h3>Methods</h3><div>This single-center study retrospectively reviewed MRgMWA for lesions ≤ 2 cm within 1 cm of the diaphragm from 02/2017–05/2025. Complications were classified according to “Cardiovascular and Interventional Radiological Society of Europe” guidelines. Technical efficacy, local tumor progression (LTP), local tumor recurrence (LTR), non-target progression (NTP), and time to progression were assessed. Data is presented as mean ± standard deviation.</div></div><div><h3>Results</h3><div>Twenty-three patients (64.8 ± 10.2 years; 15 males, 8 females) with 25 HM (17 hepatocellular carcinoma, 1 cholangiocarcinoma, 7 metastases) were treated. Lesion size was 13.1 ± 4.4 mm, with proximity to diaphragm of 3.1 ± 3.2 mm. Total procedure duration was 2 h 14 min ± 51 min. The complication rate was 33.3 %, including pain (N = 3), fever (N = 2), hematoma (N = 1), bilioma (N = 1), and reactive cholecystitis (N = 1). All complications resolved - two with pain medication and one with antibiotics. Technical efficacy was 100 %. No tumor recurrence was observed at ablation sites (LTP and LTR = 0 %) at 32.5 ± 29.0 months, but one seeding metastasis occurred. NTP occurred in 14 patients (60.9 %) at 13.6 ± 10.8 months. Three patients died 7, 32 and 48 months post-ablation. One patient underwent liver transplantation post-ablation.</div></div><div><h3>Conclusions</h3><div>MRgMWA for small subdiaphragmatic and pericardial HM may be safe and effective, demonstrating no LTR at 32.5 ± 29.0 months follow-up.</div></div><div><h3>Synopsis</h3><div>This study highlights the potential of MR-guided microwave ablation as minimally-invasive treatment option for small subdiaphragmatic (N = 20) or pericardial (N = 5) liver tumors. Complications seem relatively low compared to existing studies with excellent local tumor control.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840592","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}
Pub Date : 2025-12-01DOI: 10.1016/j.soi.2025.100199
D. Skubleny, S. Jatana, Z. Czarnecka, A. Rouhi, M. McCall, GR Rayat, D.E. Schiller
Introduction
Molecular classification in gastric cancer has identified relevant disease heterogeneity with prognostic implications. However, limited comparative analysis of molecular classification systems has occurred. We assessed the effect of the Tumour Microenvironment Score (TME), the Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG) classification systems on disease-free interval (DFI) and disease-specific survival (DSS) in Stage I-III gastric cancer.
Methods
Previously characterized machine learning models were used to assign TCGA, ACRG and TME molecular classes to stage I-III patients in the ACRG and TCGA datasets (n = 523). DFI and DSS was assessed using univariable and multivariable Cox Proportional Hazards models.
Results
A multivariable Cox model including TCGA, ACRG and TME subtypes showed that only a high TME score was associated with improved DFI (HR 0.22 [95 % CI 0.10, 0.49]; p < 0.001) and DSS (HR 0.2 [95 % CI 0.09–0.43]; p < 0.001). The significant effect of TME High score was maintained after sensitivity analysis that adjusted for stage, age, sex, chemotherapy, radiation, tumour location, and study (DFI: TME High HR 0.33 [95 % CI 0.15, 0.73)]; p < 0.01 and DSS: TME High HR 0.21 [95 % CI 0.08, 0.52)]; p < 0.001).
Conclusions
In an integrated analysis comparing TCGA, ACRG and TME scores, a high TME score is the only independent molecular prognostic factor for DFI and DSS in non-metastatic gastric cancer. Additional investigation into implications of the heterogeneity of the TME score relative to the TCGA and ACRG classifications may yield additional insight into gastric cancer biology and treatment.
Synopsis
We compared the prognostic relevance of multiple molecular classification methods in gastric cancer using a previously developed machine learning model. The Tumour Microenvironment Score, which indicates an active immune microenvironment, was the only significant independent prognostic factor for disease-free interval and disease-specific survival.
胃癌的分子分类已经确定了与预后相关的疾病异质性。然而，分子分类系统的比较分析很少。我们评估了肿瘤微环境评分（TME）、癌症基因组图谱（TCGA）和亚洲癌症研究小组（ACRG）分类系统对I-III期胃癌无病间期（DFI）和疾病特异性生存期（DSS）的影响。方法采用先前表征的机器学习模型对ACRG和TCGA数据集中的I-III期患者进行TCGA、ACRG和TME分子分类（n = 523）。采用单变量和多变量Cox比例风险模型评估DFI和DSS。结果包括TCGA、ACRG和TME亚型的多变量Cox模型显示，只有高TME评分与DFI （HR 0.22[95 % CI 0.10, 0.49]; p <； 0.001）和DSS （HR 0.2[95 % CI 0.09-0.43]; p <； 0.001）改善相关。经调整分期、年龄、性别、化疗、放疗、肿瘤部位和研究的敏感性分析后，TME High评分的显著效果仍保持不变（DFI: TME High HR 0.33[95 % CI 0.15, 0.73）]；p <； 0.01,DSS: TME High HR 0.21[95 % CI 0.08, 0.52)]；p & lt; 0.001)。结论在TCGA、ACRG和TME评分的综合分析中，TME评分高是非转移性胃癌DFI和DSS的唯一独立分子预后因素。对TME评分相对于TCGA和ACRG分类的异质性的进一步研究可能会对胃癌生物学和治疗产生更多的见解。摘要：我们使用先前开发的机器学习模型比较了多种分子分类方法在胃癌中的预后相关性。肿瘤微环境评分（tumor Microenvironment Score）显示活跃的免疫微环境，是无病期和疾病特异性生存的唯一重要独立预后因素。
{"title":"The tumour microenvironment score outperforms established molecular classifiers as a prognostic factor for disease-free interval and disease-specific survival in non-metastatic gastric cancer","authors":"D. Skubleny, S. Jatana, Z. Czarnecka, A. Rouhi, M. McCall, GR Rayat, D.E. Schiller","doi":"10.1016/j.soi.2025.100199","DOIUrl":"10.1016/j.soi.2025.100199","url":null,"abstract":"<div><h3>Introduction</h3><div>Molecular classification in gastric cancer has identified relevant disease heterogeneity with prognostic implications. However, limited comparative analysis of molecular classification systems has occurred. We assessed the effect of the Tumour Microenvironment Score (TME), the Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG) classification systems on disease-free interval (DFI) and disease-specific survival (DSS) in Stage I-III gastric cancer.</div></div><div><h3>Methods</h3><div>Previously characterized machine learning models were used to assign TCGA, ACRG and TME molecular classes to stage I-III patients in the ACRG and TCGA datasets (n = 523). DFI and DSS was assessed using univariable and multivariable Cox Proportional Hazards models.</div></div><div><h3>Results</h3><div>A multivariable Cox model including TCGA, ACRG and TME subtypes showed that only a high TME score was associated with improved DFI (HR 0.22 [95 % CI 0.10, 0.49]; p < 0.001) and DSS (HR 0.2 [95 % CI 0.09–0.43]; p < 0.001). The significant effect of TME High score was maintained after sensitivity analysis that adjusted for stage, age, sex, chemotherapy, radiation, tumour location, and study (DFI: TME High HR 0.33 [95 % CI 0.15, 0.73)]; p < 0.01 and DSS: TME High HR 0.21 [95 % CI 0.08, 0.52)]; p < 0.001).</div></div><div><h3>Conclusions</h3><div>In an integrated analysis comparing TCGA, ACRG and TME scores, a high TME score is the only independent molecular prognostic factor for DFI and DSS in non-metastatic gastric cancer. Additional investigation into implications of the heterogeneity of the TME score relative to the TCGA and ACRG classifications may yield additional insight into gastric cancer biology and treatment.</div></div><div><h3>Synopsis</h3><div>We compared the prognostic relevance of multiple molecular classification methods in gastric cancer using a previously developed machine learning model. The Tumour Microenvironment Score, which indicates an active immune microenvironment, was the only significant independent prognostic factor for disease-free interval and disease-specific survival.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 4","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617843","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}
Pub Date : 2025-11-29DOI: 10.1016/j.soi.2025.100202
Lily V. Saadat , Bridget Kelly , Micah J. Brainerd , Marissa K. Boyle , Brian K. Sparkman , Kelly L. Koch , Julia M. Selfridge , Christopher P. Childers , Robin Schmitz , on behalf of the Fellows and Young Attendings Committee of the Society of Surgical Oncology (SSO)
The goal of this primer is to educate the future generation of surgeons and prepare trainees for their clinical rotations in the operating room and with patient care. This primer will introduce medical students and trainees to the diagnosis and management of benign and malignant hepatopancreatobiliary (HPB) oncology for their surgical oncology rotations.
{"title":"Society of surgical oncology medical student & trainee primer for hepatopancreatobiliary surgical oncology","authors":"Lily V. Saadat , Bridget Kelly , Micah J. Brainerd , Marissa K. Boyle , Brian K. Sparkman , Kelly L. Koch , Julia M. Selfridge , Christopher P. Childers , Robin Schmitz , on behalf of the Fellows and Young Attendings Committee of the Society of Surgical Oncology (SSO)","doi":"10.1016/j.soi.2025.100202","DOIUrl":"10.1016/j.soi.2025.100202","url":null,"abstract":"<div><div>The goal of this primer is to educate the future generation of surgeons and prepare trainees for their clinical rotations in the operating room and with patient care. This primer will introduce medical students and trainees to the diagnosis and management of benign and malignant hepatopancreatobiliary (HPB) oncology for their surgical oncology rotations.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694612","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}
Pub Date : 2025-11-29DOI: 10.1016/j.soi.2025.100200
Judy Li , Ryan Wang , Joshua A. Leinwand , Noah A. Cohen , Umut Sarpel
Background
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an important treatment modality in the management of peritoneal surface malignancies. The effect of elevated core body temperature (CBT) during HIPEC on clinical outcomes is unclear.
Methods
A retrospective review of patients who underwent HIPEC at a tertiary care institution between 2006 and 2019 with complete perfusion and anesthesia records was conducted. The cohort was stratified into two groups according to mean CBT recorded during HIPEC. Elevated CBT was defined as core temperature ≥ 38 °C. A supplemental analysis was performed with a higher threshold of 39.5 °C.
Results
147 patients were identified, with 100 (68 %) having elevated CBTs during HIPEC. Baseline characteristics were similar. The majority had peritoneal disease of colorectal and appendiceal origin. Peritoneal cancer index (PCI) scores and operative characteristics were similar between groups. HIPEC parameters such as perfusion flow rates, and inflow and outflow temperatures were comparable. Average CBT in both groups did not exceed 40 °. Postoperative course, 30-day complication rates and disease-free (median 7 months in normal CBT vs 18 months in elevated CBT, P = 0.116) and overall survival (median 50 months in normal CBT vs 76 months in elevated CBT, P = 0.569) were similar.
Conclusion
Despite inflow temperatures of 43 °C, average CBT did not exceed 40 °C, demonstrating that HIPEC does not cause equivalent systemic hyperthermia. Patients experiencing elevated CBT during HIPEC have similar postoperative morbidity, mortality, and oncologic outcomes compared to those with normal CBT, suggesting that patients may be more tolerant of hyperthermia than previously reported.
Synopsis
Research about hyperthermic intraperitoneal chemotherapy (HIPEC) has focused previously on chemotherapy agents and perfusion parameters, but there is a lack of data investigating the effect of core body temperatures (CBT) on clinical outcomes. The majority of patients have an elevated CBT during HIPEC, but on average do not exceed 40 °C. These patients have similar postoperative and oncologic outcomes, suggesting that patients are more tolerant of elevated CBTs than previously reported.
{"title":"Elevated core body temperature during hyperthermic intraperitoneal chemotherapy does not impact postoperative outcomes","authors":"Judy Li , Ryan Wang , Joshua A. Leinwand , Noah A. Cohen , Umut Sarpel","doi":"10.1016/j.soi.2025.100200","DOIUrl":"10.1016/j.soi.2025.100200","url":null,"abstract":"<div><h3>Background</h3><div>Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is an important treatment modality in the management of peritoneal surface malignancies. The effect of elevated core body temperature (CBT) during HIPEC on clinical outcomes is unclear.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent HIPEC at a tertiary care institution between 2006 and 2019 with complete perfusion and anesthesia records was conducted. The cohort was stratified into two groups according to mean CBT recorded during HIPEC. Elevated CBT was defined as core temperature ≥ 38 °C. A supplemental analysis was performed with a higher threshold of 39.5 °C.</div></div><div><h3>Results</h3><div>147 patients were identified, with 100 (68 %) having elevated CBTs during HIPEC. Baseline characteristics were similar. The majority had peritoneal disease of colorectal and appendiceal origin. Peritoneal cancer index (PCI) scores and operative characteristics were similar between groups. HIPEC parameters such as perfusion flow rates, and inflow and outflow temperatures were comparable. Average CBT in both groups did not exceed 40 °. Postoperative course, 30-day complication rates and disease-free (median 7 months in normal CBT vs 18 months in elevated CBT, P = 0.116) and overall survival (median 50 months in normal CBT vs 76 months in elevated CBT, P = 0.569) were similar.</div></div><div><h3>Conclusion</h3><div>Despite inflow temperatures of 43 °C, average CBT did not exceed 40 °C, demonstrating that HIPEC does not cause equivalent systemic hyperthermia. Patients experiencing elevated CBT during HIPEC have similar postoperative morbidity, mortality, and oncologic outcomes compared to those with normal CBT, suggesting that patients may be more tolerant of hyperthermia than previously reported.</div></div><div><h3>Synopsis</h3><div>Research about hyperthermic intraperitoneal chemotherapy (HIPEC) has focused previously on chemotherapy agents and perfusion parameters, but there is a lack of data investigating the effect of core body temperatures (CBT) on clinical outcomes. The majority of patients have an elevated CBT during HIPEC, but on average do not exceed 40 °C. These patients have similar postoperative and oncologic outcomes, suggesting that patients are more tolerant of elevated CBTs than previously reported.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694611","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}
Pub Date : 2025-11-29DOI: 10.1016/j.soi.2025.100201
Hideo Takahashi , Micah J. Brainerd , Natalie Bath , Brian K. Sparkman , Kelly L. Koch , Ricardo J. Bello , Raja R. Narayan , Marissa K. Boyle , Julia M. Selfridge , Christopher P. Childers , on behalf of the Fellows and Young Attendings Committee of the Society of Surgical Oncology (SSO)
The goal of this primer is to educate the future generation of surgeons and prepare trainees for their clinical rotations in the operating room and with patient care. This primer will introduce medical students and trainees to the diagnosis and management of benign and malignant non-hepatopancreatobiliary (HPB) gastrointestinal (GI) oncology for their surgical oncology rotations.
{"title":"Society of surgical oncology medical student & trainee primer for non-HPB GI oncology","authors":"Hideo Takahashi , Micah J. Brainerd , Natalie Bath , Brian K. Sparkman , Kelly L. Koch , Ricardo J. Bello , Raja R. Narayan , Marissa K. Boyle , Julia M. Selfridge , Christopher P. Childers , on behalf of the Fellows and Young Attendings Committee of the Society of Surgical Oncology (SSO)","doi":"10.1016/j.soi.2025.100201","DOIUrl":"10.1016/j.soi.2025.100201","url":null,"abstract":"<div><div>The goal of this primer is to educate the future generation of surgeons and prepare trainees for their clinical rotations in the operating room and with patient care. This primer will introduce medical students and trainees to the diagnosis and management of benign and malignant non-hepatopancreatobiliary (HPB) gastrointestinal (GI) oncology for their surgical oncology rotations.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694619","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}
Pub Date : 2025-11-28DOI: 10.1016/j.soi.2025.100203
Danielle Graham , Andrew Francis , Micah Brainerd , Ian Garbarine , Nicole Rademacher , Kelly L. Koch , Julia M. Selfridge , Christopher P. Childers , Marissa K. Boyle , Brian K. Sparkman , Natalie M. Bath , on behalf of the Fellows and Young Attendings Committee of the Society of Surgical Oncology (SSO)
The goal of this primer is to educate the future generation of surgeons and prepare trainees for their clinical rotations in the operating room and in the clinic. This primer will introduce medical students and trainees to the diagnosis and management of skin, soft tissue, and endocrines cancers for their surgical oncology rotations.
{"title":"Society of surgical oncology medical student & trainee primer for skin, soft tissue, and endocrine surgical oncology","authors":"Danielle Graham , Andrew Francis , Micah Brainerd , Ian Garbarine , Nicole Rademacher , Kelly L. Koch , Julia M. Selfridge , Christopher P. Childers , Marissa K. Boyle , Brian K. Sparkman , Natalie M. Bath , on behalf of the Fellows and Young Attendings Committee of the Society of Surgical Oncology (SSO)","doi":"10.1016/j.soi.2025.100203","DOIUrl":"10.1016/j.soi.2025.100203","url":null,"abstract":"<div><div>The goal of this primer is to educate the future generation of surgeons and prepare trainees for their clinical rotations in the operating room and in the clinic. This primer will introduce medical students and trainees to the diagnosis and management of skin, soft tissue, and endocrines cancers for their surgical oncology rotations.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799727","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}
Pub Date : 2025-11-27DOI: 10.1016/j.soi.2025.100197
Trisha Lal , Christine O. Kang , Fangzhou Liu , Alexander Cabulong , Richard S. Hoehn , Johnie Rose , Siran M. Koroukian
The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee. Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law.
{"title":"National trends in emergency and non-emergency colorectal cancer resections across the COVID-19 pandemic","authors":"Trisha Lal , Christine O. Kang , Fangzhou Liu , Alexander Cabulong , Richard S. Hoehn , Johnie Rose , Siran M. Koroukian","doi":"10.1016/j.soi.2025.100197","DOIUrl":"10.1016/j.soi.2025.100197","url":null,"abstract":"<div><div>The enclosed information is STRICTLY CONFIDENTIAL and is intended for the use of the addressee only. University Hospitals and its affiliates disclaim any responsibility for unauthorized disclosure of this information to anyone other than the addressee. Federal and Ohio law protect patient medical information, including psychiatric_disorders, (H.I.V) test results, A.I.Ds-related conditions, alcohol, and/or drug_dependence or abuse disclosed in this email. Federal regulation (42 CFR Part 2) and Ohio Revised Code section 5122.31 and 3701.243 prohibit disclosure of this information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"3 1","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646072","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}
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