Surgical Oncology Insight最新文献

{"title":"Characterization of ultrarare sarcomas in a high-volume referral center in Latin America","authors":"Dorian Yarih Garcia-Ortega ,&nbsp;José Antonio Ortega-Jiménez ,&nbsp;Itzel Elizabeth Vidal-Sanchez ,&nbsp;Ana Paulina Meléndez-Fernández ,&nbsp;Claudia Haydee Sarai Caro-Sanchez ,&nbsp;Sylvia Veronica Villavicencio-Valencia ,&nbsp;Gabriela Concepción Alamilla-García ,&nbsp;Kuauhyama Luna-Ortiz","doi":"10.1016/j.soi.2025.100156","DOIUrl":"10.1016/j.soi.2025.100156","url":null,"abstract":"<div><h3>Background</h3><div>Ultrarare sarcomas are a diverse group of malignancies with an incidence of less than 1 % of all sarcomas. Due to their rarity, knowledge about their biology and treatment is limited. Most data come from high-income countries, with little representation from Latin America. This study characterizes ultrarare sarcomas’ clinical and pathological features in a Latin American referral center.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at a high-volume sarcoma center, including patients diagnosed between 2000 and 2020. Histopathological diagnoses were defined by expert pathologists. Demographic, clinical, and treatment data were collected. Statistical analyses included descriptive statistics and Kaplan-Meier survival analysis.</div></div><div><h3>Results</h3><div>We included 148 patients (median age: 42 years, 54.7 % female). The most common histological subtypes were epithelioid sarcoma (19.6 %), myxo-inflammatory fibroblastic sarcoma (12.8 %), and alveolar soft part sarcoma (9.5 %). Most tumors (77.7 %) were high-grade, and 22.3 % had metastases at diagnosis. Surgery was performed in 77.7 % of cases, achieving R0 resection in 51.4 %. Adjuvant radiotherapy was used in 39.9 %, and chemotherapy in 26.4 %. Overall survival was 48.2 months. Metastatic disease, high-grade tumors, and positive margins were associated with worse survival (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This study highlights the heterogeneity of ultrarare sarcomas and the importance of multidisciplinary management in Latin America. Further research and collaboration are needed to improve outcomes.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212436","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":"Surgical cancer patients’ attitudes and beliefs about cannabis at a midwest comprehensive cancer center","authors":"Kenneth F. Newcomer ,&nbsp;Erica K. Barnell ,&nbsp;Felicia Zhang ,&nbsp;Joel Vetter ,&nbsp;Evan M. Bagley ,&nbsp;Marvin Petty ,&nbsp;Kerri A. Ohman ,&nbsp;William G. Hawkins","doi":"10.1016/j.soi.2025.100154","DOIUrl":"10.1016/j.soi.2025.100154","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal (GI) cancer and its treatments often cause physical (e.g., pain, weight loss, vomiting) and neuropsychiatric symptoms (e.g., anxiety, poor sleep, depressed mood). Despite increasing availability of cannabis, regional patterns of use among cancer patients remain unclear, and surgeons often lack insight into patient attitudes regarding cannabis for symptom management.</div></div><div><h3>Methods</h3><div>Patients with GI cancer were recruited from a Midwest Comprehensive Cancer Center. The cohort included patients who had undergone surgery during treatment. A confidential survey assessed symptoms, cannabis use history, and attitudes toward cannabis for palliation. Survey methods followed the Theory of Planned Behavior, with responses measured using a Likert scale.</div></div><div><h3>Results</h3><div>Of the 64 survey respondents, 66 % had undergone surgery. Cancer distribution included 25 colorectal cases, 20 pancreatic cases, 8 esophagogastric cases, and 11 other cancer types. Within 30 days of survey completion, severe physical and neuropsychiatric symptoms were reported by 39 % and 24 % patients, respectively. Active cannabis use was reported by 19 %, with 90 % citing symptom relief as the primary motivation. Only half of cannabis users disclosed their use to physicians. Use barriers included cost and accessibility. Among nonusers, 67 % were interested in medicinal cannabis. Favorable views of cannabis were reported by 74 %, with younger patients reporting significantly increased positive attitudes.</div></div><div><h3>Conclusions</h3><div>Cannabis use among cancer patients is common. Most patients believe cannabis improves cancer-related symptoms, yet many do not discuss its use with healthcare providers. Enhanced communication could improve quality of life for patients benefiting from cannabis.</div></div><div><h3>Synopsis</h3><div>Cannabis use among gastrointestinal cancer patients is common, with most seeking symptom relief. Despite favorable attitudes, many patients do not disclose use to physicians. Improved communication may enhance quality of life through symptom management.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205786","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":"Outcomes following diagnostic laparoscopy in patients with peritoneal carcinomatosis deemed ineligible for cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) due to disease burden","authors":"Paula Marincola Smith ,&nbsp;Ashlee Seldomridge ,&nbsp;Yi-Ju Chiang ,&nbsp;Michael G. White ,&nbsp;Yun Song ,&nbsp;Christopher Scally ,&nbsp;Paul F. Mansfield ,&nbsp;Keith F. Fournier ,&nbsp;Beth A. Helmink","doi":"10.1016/j.soi.2025.100150","DOIUrl":"10.1016/j.soi.2025.100150","url":null,"abstract":"<div><h3>Introduction</h3><div>While cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) can improve overall survival (OS) for patients with peritoneal carcinomatosis from appendiceal or colorectal cancer, some patients are ineligible for CRS/HIPEC due to disease burden. This paper characterizes outcomes for patients who are evaluated by diagnostic laparoscopy (DL) and deemed ineligible for CRS/HIPEC.</div></div><div><h3>Methods</h3><div>Medical records were retrospectively reviewed for patients who underwent DL and deemed ineligible for CRS/HIPEC (1/1/2009–1/1/2024). Date of death was confirmed using public obituaries. Treatment course/causes of death are summarized by descriptive statistics and OS by Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>124 patients were included. Median Peritoneal Cancer Index (PCI) score was 25. Median follow-up was 1.14 and median OS 1.29 years. 58 (46.8 %) died of their malignancy, 42 (33.9 %) died of unknown cause, and 24 (19.4 %) were alive at last follow-up. The most common causes of death were bowel obstruction (29, 23.4 %), multifactorial/failure to thrive (21, 16.9 %), and malignant ascites (15, 12.1 %). Patients who underwent some form of additional therapy after DL (1.43 versus 0.48 years, p &lt; 0.001) or who enrolled in a clinical trial (1.91 versus 1.21 years, p = 0.030) had prolonged OS.</div></div><div><h3>Conclusions</h3><div>OS for patients with peritoneal carcinomatosis from appendiceal or colorectal cancer who are deemed ineligible for CRS/HIPEC after DL is 1.29 years without significant variation by primary pathology, PCI, peritoneal cytology, or presence of hematogenous metastases. Patients who get some form of additional therapy following their DL have prolonged OS. The most common causes of death are bowel obstruction, failure to thrive, and malignant ascites.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 2","pages":"Article 100150"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089494","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":"Advancements in the surgical management of pancreatic masses: A comprehensive review","authors":"Cara Mohammed ,&nbsp;Patricio Xavier Duran S ,&nbsp;Hugh Kolomar ,&nbsp;Tanmay Thirth ,&nbsp;Simcha Bulmash ,&nbsp;Sharvari Vikram Joshi ,&nbsp;Tannia Payan Serrano ,&nbsp;Greeshma Reddy ,&nbsp;Turimula Arpan ,&nbsp;Deepika Palegar Thuli ,&nbsp;Areehah Zafar Masood ,&nbsp;Manju Rai","doi":"10.1016/j.soi.2025.100147","DOIUrl":"10.1016/j.soi.2025.100147","url":null,"abstract":"<div><div>Pancreatic masses encompass a heterogeneous group of neoplasms, ranging from benign lesions like serous cystadenomas to malignant entities such as pancreatic ductal adenocarcinoma (PDAC). Timely and accurate differentiation between these masses is critical for tailoring optimal therapeutic strategies. This narrative review highlights the evolving landscape of surgical management for pancreatic masses, emphasizing the advancements in diagnostic modalities, surgical techniques, and perioperative care. Imaging modalities, including contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), and endoscopic ultrasound (EUS), have enhanced the precision of diagnosis and staging. Histopathological evaluation remains indispensable for definitive diagnosis. Surgical interventions, including partial and total pancreatectomy, are explored based on tumor type and staging, with resection offering the only curative option for PDAC. Minimally invasive approaches, such as laparoscopic and robotic-assisted surgeries, have demonstrated reduced morbidity, quicker recovery, and comparable oncological outcomes to open procedures. The role of neoadjuvant therapy is discussed for resectable and borderline resectable tumors, with evidence suggesting improved surgical outcomes and overall survival. The review also addresses postoperative challenges, including pancreatic fistulas, delayed gastric emptying, and the management of endocrine and exocrine insufficiencies. Palliative strategies, such as biliary bypass and endoscopic stenting, are detailed for non-resectable tumors, prioritizing symptom relief and quality of life. Emerging technologies like intraoperative imaging, artificial intelligence, and precision medicine are reshaping the surgical approach, enabling personalized treatment plans. This comprehensive overview underscores the importance of a multidisciplinary approach in optimizing outcomes for patients with pancreatic neoplasms.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830319","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 of neighborhood socioeconomic status and ethnic diversity with receipt of adjuvant chemotherapy in stage III colon cancer: A population-based cohort study","authors":"Adom Bondzi-Simpson ,&nbsp;Ramy Behman ,&nbsp;Tiago Ribeiro ,&nbsp;Sheron Perera ,&nbsp;Aisha Lofters ,&nbsp;Rinku Sutradhar ,&nbsp;Vivian Aghanya ,&nbsp;Andrea Covelli ,&nbsp;Rebecca A. Snyder ,&nbsp;Callisia N. Clarke ,&nbsp;Natalie G. Coburn ,&nbsp;Julie Hallet","doi":"10.1016/j.soi.2025.100148","DOIUrl":"10.1016/j.soi.2025.100148","url":null,"abstract":"<div><h3>Background</h3><div>Adjuvant chemotherapy reduces cancer recurrence and improves survival in eligible patients. Barriers to care may contribute to inequities in outcomes. We examined the association between neighborhood socioeconomic status (SES) and ethnic diversity with receipt of adjuvant chemotherapy in stage III colon cancer patients.</div></div><div><h3>Methods</h3><div>A population-based retrospective cohort study was conducted on adults undergoing surgery for stage III colon cancer (2007–2020). SES and ethnic diversity, defined by quintiles from census data, were the primary exposures. Outcomes were receipt of medical oncology consultation and adjuvant chemotherapy within 3 months post-surgery. Logistic regression measured the association between each exposure and outcome combination adjusting for confounders. A sub-group analysis was performed on patients who received a medical oncology consultation.</div></div><div><h3>Results</h3><div>Of 14,511 patients, 10,973 (76.5 %) received medical oncology consultation and 8814 (61.4 %) recieved adjuvant chemotherapy. SES and ethnic diversity were not associated with medical oncology consultation after adjusting for age, sex, surgical approach, and comorbidities. However, living in both the lowest SES and highest ethnically diverse neighborhoods were associated with lower odds of adjuvant chemotherapy (OR 0.70; 95 % CI 0.62–0.80 and OR 0.72; 95 % CI 0.64–0.82, respectively). These associations persisted at 6 months post-surgery. Among patients who had a medical oncology consultation, living in both the lowest SES and highest ethnically diverse neighborhoods were associated with lower odds of adjuvant chemotherapy.</div></div><div><h3>Conclusion</h3><div>Living in lower SES and higher ethnically diverse neighborhoods were independently associated with lower odds of adjuvant chemotherapy but not medical oncology consultation, highlighting disparities in outcomes for marginalized patients within a universal healthcare system.</div></div><div><h3>Synopsis</h3><div>We examined the association between neighborhood socioeconomic status (SES) and ethnic diversity with receipt of adjuvant chemotherapy in patients with stage III colon cancer in Ontario, Canada. Patients from the lowest SES or most diverse neighborhoods had a 30 % and 28 % lower odds of receiving chemotherapy, highlighting disparities within a universal healthcare system.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 2","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072744","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":"Collateral vessel formation affects long-term patency of artificial vessels: Insights from 60 cases of superior vena cava reconstruction combined with thymic tumor resection","authors":"Yongqiang Ao ,&nbsp;Jiahao Jiang ,&nbsp;Shuai Wang ,&nbsp;Jian Gao ,&nbsp;Yuansheng Zheng ,&nbsp;Lijie Tan ,&nbsp;Junzhen Liu ,&nbsp;Jianyong Ding","doi":"10.1016/j.soi.2025.100151","DOIUrl":"10.1016/j.soi.2025.100151","url":null,"abstract":"<div><h3>Background</h3><div>Superior vena cava (SVC) reconstruction combined with total thymic tumor resection is the standard treatment for thymic tumors invading the SVC. Long-term graft patency is a critical to surgical success and patient prognosis. This study evaluates the durability of artificial grafts and identifies factors affecting their long-term patency.</div></div><div><h3>Methods</h3><div>We retrospectively included 60 patients who underwent extended resection of thymic tumors combined with SVC reconstruction between March 2017 and May 2024. Graft patency and collateral vessel formation were assessed using contrast-enhanced CT or magnetic resonance venography every 3–6 months. Clinical characteristics were compared between patients with and without graft occlusion.</div></div><div><h3>Results</h3><div>Among the 60 patients, 43 underwent left brachiocephalic vein-to-right atrial appendage reconstruction, 13 had right brachiocephalic vein-to-right atrial appendage reconstruction, and 4 had bilateral reconstruction. The 1-, 3-, and 5-year survival rates were 91.6 %, 87.0 %, and 79.1 %, respectively. Of 51 patients with graft assessment, the graft patency rate was 88.2 %, with occlusion in six patients occurring 8–20 months postoperatively. Preoperative SVC syndrome and elevated internal jugular venous pressure during SVC clamping were significant predictors of occlusion (p = 0.031, p = 0.0002) and remained independent risk factors (p = 0.046, p = 0.014). Postoperatively observed collateral circulation was significantly associated with graft occlusion (p = 0.0075), particularly newly formed collateral vessels (p = 0.0016). Imaging revealed extensive collateral vessel development, including azygos vein and chest wall veins.</div></div><div><h3>Conclusions</h3><div>Total thymic tumor resection combined with SVC reconstruction provides favorable long-term survival and graft patency. Collateral vessel formation over time may compromise graft patency and eventually lead to graft occlusion.</div></div><div><h3>Synopsis</h3><div>This study evaluates the long-term patency of artificial grafts in SVC reconstruction for thymic tumors, identifying preoperative SVC syndrome, elevated IJVP, and newly developed collateral circulation as key factors predicting or influencing graft occlusion.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 2","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070613","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":"Unseen burden: Exploring caregiver experiences, barriers, and facilitators in foregut cancer care","authors":"Ioannis Liapis ,&nbsp;Jaspinder Sanghera ,&nbsp;Michelle Holland ,&nbsp;Ivan Herbey ,&nbsp;Katie West ,&nbsp;Martin J. Heslin ,&nbsp;Krista Mehari ,&nbsp;Larry Hearld ,&nbsp;Smita Bhatia ,&nbsp;Annabelle L. Fonseca","doi":"10.1016/j.soi.2025.100153","DOIUrl":"10.1016/j.soi.2025.100153","url":null,"abstract":"<div><h3>Introduction</h3><div>Caregivers play a pivotal role in supporting foregut cancer patients, yet their experiences and the challenges they face are overlooked. Understanding caregivers’ experiences and the barriers and facilitators they encounter can inform interventions to improve their well-being and, ultimately, patient outcomes. This study focuses on the lived experiences and the interpersonal factors that shape the caregivers’ journeys.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with caregivers of patients with foregut cancer receiving treatment at a safety-net hospital in the Deep South. Interviews were recorded, transcribed and qualitatively analyzed using NVivo 14 software. Grounded theory methodology was used to guide analysis. Three co-authors independently coded the data, with intercoder agreement of above 90 %.</div></div><div><h3>Results</h3><div>Of the 15 caregivers interviewed, the majority were female, spouses of the patients, and resided in areas of high socioeconomic deprivation. Three theme categories emerged: caregiver experiences, individual/interpersonal level barriers, and individual/interpersonal level facilitators. Caregivers expressed self-sacrifice and a strong sense of duty, describing caregiving as a priority despite personal hardships. Barriers included psychological distress, financial strain, competing responsibilities, transportation challenges, social isolation, and patient denial. Conversely, facilitators included support from family and friends, religious and spiritual practices, and engagement in support groups.</div></div><div><h3>Conclusion</h3><div>Caregivers of patients with foregut cancer face significant psychological and financial burden, compounded by competing responsibilities and limited social support. Interventions aimed at reducing caregiver burden and enhancing support mechanisms will improve both caregiver well-being and patient outcomes. Future research should focus on strategies that promote these facilitators and address barriers to caregiving.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 2","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098388","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":"Single versus multiagent chemotherapy for ampullary carcinoma: A propensity matched multivariate analysis of the NCDB","authors":"Ethan A. Warshowsky ,&nbsp;Dorothy Wakefield ,&nbsp;Ryan Z. Swan ,&nbsp;Michael Minarich","doi":"10.1016/j.soi.2025.100149","DOIUrl":"10.1016/j.soi.2025.100149","url":null,"abstract":"<div><h3>Introduction</h3><div>Pancreatoduodenectomy remains the standard of care for ampullary carcinoma, however the role of adjuvant chemotherapy remains unclear. We investigated the survival benefits of single vs. multi-agent chemotherapy regimens.</div></div><div><h3>Methods</h3><div>The National Cancer Database (NCDB) was queried to identify patients ≥ 18 years old diagnosed with stage II or III carcinoma of the ampulla of Vater between years 2013–2020. Multi-agent usage increased dramatically in 2017, so we categorized by years 2013–2016 vs. 2017–2020. Propensity score matching was performed separately for stage II and III disease using age, race, number of comorbidities and year. Kaplan-Meier (K-M) analysis compared overall survival by single vs. multi-agent chemotherapy for 2013–2016 and 2017–2020. Cox regression analysis examined differences by number of agents while controlling for age, race, number of comorbidities, and year.</div></div><div><h3>Results</h3><div>1207 patients were included in the propensity-matched cohort: 477 who received single vs. 730 who received multi-agent chemotherapy. K-M analyses demonstrated that for 2013–2016, multi-agent therapy showed a significantly longer average survival for both stage II (55.99 vs. 51.43 months) and III (55.90 vs. 50.78 months) disease (p &lt; 0.01). Follow up for the 2017 – 2020 cohort was inadequate for accurate survival reporting. Upon multivariate analysis, a significant advantage in survival with multi-agent chemotherapy was maintained for stage II (HR: 1.44, 95 % CI: 1.14–1.82, p &lt; 0.01) and stage III (HR: 1.41, 95 % CI: 1.09–1.83<strong>,</strong> p = 0.01) disease.</div></div><div><h3>Conclusion</h3><div>For resected, locally advanced ampullary cancer, multi-agent chemotherapy was found to have a significant improvement in overall survival compared to single agent chemotherapy for stage II and III disease.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 2","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070614","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":"Prognostic impact of positive peritoneal cytology (POPEC) in gastric cancer: Multi-centre European retrospective cohort study","authors":"Richard Owen ,&nbsp;Swathikan Chidambaram ,&nbsp;Khalid Shamiyah ,&nbsp;Jessie A Elliott ,&nbsp;Jakob Hedberg ,&nbsp;Sivesh Kamarajah ,&nbsp;Frederik Klevebro ,&nbsp;Marcel Andre Schneider ,&nbsp;Lana Fourie ,&nbsp;Christian Gutschow ,&nbsp;Magnus Nilsson ,&nbsp;Ewen Griffiths ,&nbsp;Ricardo Rosati ,&nbsp;Javed Sultan ,&nbsp;Manuel Pera ,&nbsp;Peter Grimminger ,&nbsp;Guillaume Piessen ,&nbsp;Clarisse Eveno ,&nbsp;Jelle Ruurda ,&nbsp;Richard van Hillegersberg ,&nbsp;John Saunders","doi":"10.1016/j.soi.2025.100145","DOIUrl":"10.1016/j.soi.2025.100145","url":null,"abstract":"<div><h3>Objective</h3><div>Positive peritoneal cytology is traditionally viewed as representative of metastatic disease and a poor prognostic factor. The objective of this multi-center study was to define the prognostic role of peritoneal cytology in curative gastrectomy, evaluate international variation in cytology sampling, and assess the impact on positive peritoneal cytology yields.</div></div><div><h3>Methods</h3><div>This was a multi-center international retrospective cohort study of 16 tertiary gastric cancer centers. Adult patients who underwent peritoneal lavage cytology at staging laparoscopy and subsequent gastrectomy between 2009 and 2023 were included. The primary outcome measure was overall survival at five years. Multivariable Cox regression provided hazard ratios (HRs) with 95 % CIs, adjusted for relevant confounding factors.</div></div><div><h3>Results</h3><div>837 patients with no radiological or macroscopic M1 disease were included, with a mean age of 66 (IQR 58–73) and 71 % were male. Non-distal gastric cancer was most common (47 %), with 59 % and 43 % of tumors staged pT3/4 and pN2/3, respectively. 66 patients (7.9 %) had positive cytology. Positive cytology was not associated with overall survival in multivariable analysis, controlled for stage and neoadjuvant treatment (HR=1.0; 95 %CI 0.51–2.0). Higher T and N stages were associated with positive cytology (p &lt; 0.001). The proportion of patients with positive cytology was variable, depending on how many quadrants were sampled.</div></div><div><h3>Conclusion</h3><div>Positive peritoneal cytology with otherwise M0 disease was not associated with decreased survival after curative intent gastrectomy in this study, meaning prospective study is needed. The technique of performing peritoneal washings influenced cytology yield and thus must be standardized in a much-needed prospective evaluation of peritoneal cytology.</div></div><div><h3>Synopsis</h3><div>The POPEC multicenter international retrospective cohort study included 837 patients receiving curative gastrectomy. This study showed the technique of performing peritoneal washings influenced cytology yield, however positive peritoneal cytology was not associated with decreased survival. Therefore, positive peritoneal cytology should not be considered an absolute contradiction to curatively intended gastrectomy.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307707","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":"Survival in stage IV colorectal cancer at diagnosis","authors":"Jeremy Chang ,&nbsp;Carine Dornbush ,&nbsp;Sarah L. Mott ,&nbsp;Bradley Loeffler ,&nbsp;Kristina Guyton ,&nbsp;Jennifer Hrabe ,&nbsp;Irena Gribovskaja-Rupp","doi":"10.1016/j.soi.2025.100144","DOIUrl":"10.1016/j.soi.2025.100144","url":null,"abstract":"<div><h3>Background</h3><div>It is well established that the primary tumor anatomic location of colorectal cancer (CRC) affects tumor biology and disease course, however, there exist few large-scale studies investigating oncologic outcomes of metastatic CRC at diagnosis based on anatomic location of primary tumor and metastasis.</div></div><div><h3>Methods</h3><div>A retrospective analysis of the National Cancer Database (NCDB) from 2016 to 2019 was performed identifying patients with metastatic colorectal cancer at diagnosis based on ICD-10 codes divided into left colon, right colon, and rectal primary. Patient demographic, tumor characteristic, treatment and outcomes data were obtained. The primary outcome measure was overall survival. Multivariable Cox regression was performed.</div></div><div><h3>Results</h3><div>Intra-abdominal metastases are the most common metastases for all primary tumor locations, however, rectal cancer more frequently metastasizes to extra-abdominal organs. Regardless of primary tumor location, lung metastasis has improved overall survival compared with liver or M1b/1c disease. Compared with left colon and rectal primary, metastatic right sided colon cancer had the worst median overall survival. Receipt of any surgical management, radiation, or oncologic treatment to primary site or metastasis was associated with improved overall survival.</div></div><div><h3>Conclusions</h3><div>These findings underpin the heterogeneity of colorectal cancer tumor biology and highlight the importance of understanding primary tumor location and metastasis location for appropriate patient education and prognostication. Appropriate patients had improved survival and low mortality with surgery.</div></div>","PeriodicalId":101191,"journal":{"name":"Surgical Oncology Insight","volume":"2 3","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580683","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}