Ejso最新文献

英文中文

The growing precision of diagnostic pathways in thyroid nodule evaluation 甲状腺结节评估中的诊断路径越来越精确。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-11-08 DOI: 10.1016/j.ejso.2024.109374

Jasper Bekker, Volkert B. Wreesmann

引用次数: 0

Impact of surgical intervention on overall survival in malignant pleural mesothelioma: A population-based cohort study with propensity score matching 手术干预对恶性胸膜间皮瘤总生存期的影响：基于人群的队列研究与倾向评分匹配。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-11-07 DOI: 10.1016/j.ejso.2024.109372

Ting Zhang , Zhaotong Wang , Yuanhang Zuo , Shuoxin Yin , Ning Wang

Background

Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer with limited treatment options. This study aims to assess the impact of surgical intervention on overall survival (OS) in patients with MPM and to identify prognostic factors influencing survival outcomes.

Methods

Data from the SEER-17 Database between 2000 and 2019 were analyzed. Patients were categorized into surgery and no-surgery groups. Survival analyses were conducted using Kaplan-Meier curves and Cox proportional hazards models. Propensity score matching (PSM) was applied to reduce biases.

Results

The study included a total of 3901 MPM patients, with 1190 in the surgery group and 2711 in the no-surgery group. The median OS for the entire cohort was 10 months. The surgery group had a median OS of 15 months compared to 8 months in the no-surgery group (p < 0.001). The 1-year and 5-year OS rates for surgery patients were 56.9 % and 11.2 %, respectively, while for no-surgery patients, they were 34.9 % and 3.7 % (p < 0.001). Multivariate analysis indicated that no-surgery was an independent risk factor for worse OS (HR 1.38, 95 % CI 1.21–1.39, p < 0.001). After PSM, no-surgery remained an independent risk factor influencing OS. Subgroup analysis indicated that surgery benefited most groups except those aged ≥80 years, bilateral disease, N3 stage, and certain histological grades.

Conclusion

Surgical intervention significantly improves survival in patients with MPM. However, benefits vary across subgroups, and careful consideration of patient-specific factors is essential.

背景：恶性胸膜间皮瘤（MPM）是一种罕见的侵袭性癌症，治疗方案有限。本研究旨在评估手术干预对MPM患者总生存期（OS）的影响，并确定影响生存结果的预后因素：方法：分析2000年至2019年期间SEER-17数据库中的数据。患者分为手术组和非手术组。使用Kaplan-Meier曲线和Cox比例危险模型进行生存分析。采用倾向评分匹配（PSM）以减少偏倚：研究共纳入 3901 名 MPM 患者，其中手术组 1190 人，非手术组 2711 人。整个组群的中位OS为10个月。手术组的中位生存期为 15 个月，而不手术组为 8 个月：手术干预能明显提高 MPM 患者的生存率。然而，不同亚组的获益情况各不相同，因此必须仔细考虑患者的特异性因素。

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引用次数: 0

Reproductive, obstetrical and oncological outcomes of fertility-sparing treatment for cervical cancer according to the FIGO 2018 staging system: A systematic review 根据 FIGO 2018 分期系统对宫颈癌进行保胎治疗的生殖、产科和肿瘤学结果：系统综述。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-11-07 DOI: 10.1016/j.ejso.2024.109359

Cristina Taliento , Gennaro Scutiero , Ginevra Battello , Alessia Sala , Giulia Pellecchia , Rita Trozzi , Martina Arcieri , Matteo Pavone , Nicolò Bizzarri , Pantaleo Greco , Lorenza Driul , Frédéric Amant , Anna Fagotti , Giovanni Scambia , Giuseppe Vizzielli , Stefano Restaino

Objective

We assessed reproductive, obstetrical, and oncological outcomes in patients who underwent fertility-sparing treatment by including studies that adhere to the FIGO 2018 staging system.

Methods

Data on recurrence, mortality, pregnancy rate, live birth rate, and preterm delivery rate were collected.

Results

In patients with stages IA1, IA2, and IB1, the recurrence rate was 4.7 % and the death rate was 0.6 %. For patients with stage IB2, the recurrence rate was 12.1 % and the death rate was 3.2 %. Pregnancy rates for conization/simple trachelectomy and radical trachelectomy were 61.7 % and 50 %, respectively. A higher live birth rate (84.4 % vs 58.6 %), and lower preterm birth rate (18.3 % vs 33.3 %) were observed in patients undergoing conization compared to radical trachelectomy.

Conclusion

We found a recurrence rate of 4.7 % in patients with stage less than or equal to IB1 and 12.1 % in those with stage IB2. A higher rate of preterm delivery was observed in patients who underwent radical trachelectomy.

目的我们通过纳入遵循 FIGO 2018 分期系统的研究，评估了接受保胎治疗患者的生殖、产科和肿瘤结局：收集了复发率、死亡率、妊娠率、活产率和早产率等数据：IA1、IA2和IB1期患者的复发率为4.7%，死亡率为0.6%。IB2 期患者的复发率为 12.1%，死亡率为 3.2%。锥切/简单气管切除术和根治性气管切除术的妊娠率分别为61.7%和50%。与根治性气管切除术相比，锥切术患者的活产率更高（84.4% 对 58.6%），早产率更低（18.3% 对 33.3%）：我们发现，IB1 期以下患者的复发率为 4.7%，IB2 期患者的复发率为 12.1%。接受根治性气管切除术的患者早产率较高。

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引用次数: 0

Women in Surgical Oncology: What I, as a female surgeon, have contributed to the sarcoma community? 肿瘤外科中的女性：作为一名女外科医生，我为肉瘤界做出了哪些贡献？

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-11-05 DOI: 10.1016/j.ejso.2024.109363

Sylvie Bonvalot

引用次数: 0

Curative-intent surgery for solitary bone metastasis from extremity and trunk wall sarcoma: What are the outcomes and complications? 四肢和躯干壁肉瘤单发骨转移的治愈性手术：疗效和并发症如何？

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-11-05 DOI: 10.1016/j.ejso.2024.109369

Liuzhe Zhang , Jean-Camille Mattei , Anthony M. Griffin , Kim Tsoi , Peter C. Ferguson , Jay S. Wunder

Introduction

Approximately 40–50 % of sarcoma patients will develop lung metastasis, but only 10 % will develop bone metastasis. The survival benefit of surgery for solitary bone metastasis remains unclear.

Methods

From 1987 to 2019, 47 patients who underwent curative-intent treatment for localized bone or soft tissue sarcoma in the extremities or trunk wall developed solitary bone metastases as the first distant recurrence. Of them, 51 % (24/47) received curative-intent metastasectomy. We compared the clinicopathologic characteristics of the metastasectomy versus non-metastasectomy patients and evaluated the prognostic impact of solitary bone metastasectomy. The primary outcome measure was disease-specific survival (DSS) after developing solitary bone metastasis.

Results

The post-metastasis DSS was worse with larger primary tumour size (HR 1.09; 95 % CI 1.02–1.16; p = 0.01) and bone metastasis in the pelvis or spine versus other bones (HR 3.79, 95 % CI 1.46–9.87; p = 0.01), and better with curative-intent surgery for the solitary bone metastasis (HR 0.14; 95 % CI 0.06–0.34; p < 0.001). The median DSS was 43 (95 % CI, 24–69) months for the metastasectomy group vs. 13 (95 % CI, 7–19) months for the non-metastasectomy group (p < 0.001). The metastasectomy group had fewer patients with metastasis in the spine or pelvis and longer metastasis-free interval. In the multivariate analysis, curative-intent surgery for solitary bone metastasis was associated with better survival (HR 0.21; 95 % CI 0.08–0.53; p = 0.001).

Conclusions

Curative-intent surgery for solitary bone metastasis from sarcoma is associated with a better prognosis and is a reasonable treatment strategy whenever feasible.

简介大约 40-50% 的肉瘤患者会发生肺转移，但只有 10% 的患者会发生骨转移。手术治疗单发骨转移瘤的生存获益仍不明确：从1987年到2019年，47名四肢或躯干壁局部骨或软组织肉瘤患者接受了治愈性治疗，首次远处复发为单发骨转移。其中，51%（24/47）的患者接受了根治性转移切除术。我们比较了转移瘤切除术与非转移瘤切除术患者的临床病理特征，并评估了单发骨转移瘤切除术对预后的影响。主要结果指标是发生单发骨转移后的疾病特异性生存率（DSS）：结果：原发肿瘤体积越大（HR 1.09；95 % CI 1.02-1.16；P = 0.01），骨盆或脊柱骨转移相对于其他骨骼骨转移（HR 3.79，95 % CI 1.46-9.87；P = 0.01），转移后 DSS 越低；单发骨转移治愈性手术后 DSS 越高（HR 0.14；95 % CI 0.06-0.34；P 结论：单发骨转移治愈性手术后 DSS 越高：肉瘤单发骨转移的根治性手术与较好的预后相关，在可行的情况下是一种合理的治疗策略。

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引用次数: 0

Prospective evaluation of MRI artefacts following breast conserving surgery and sentinel lymph node dissection with the magnetic technique 使用磁技术对保乳手术和前哨淋巴结清扫术后的磁共振成像伪影进行前瞻性评估。

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-11-05 DOI: 10.1016/j.ejso.2024.109368

Allan Jazrawi , Eirini Pantiora , Shahin Abdsaleh , Chin Lian Ng , Athanasios Zouzos , Tanja Gagliardi , Fredrik Wärnberg , Staffan Eriksson , Andreas Karakatsanis

Introduction

Superparamagnetic Iron Oxide (SPIO) nanoparticles serve as a promising tracer for sentinel lymph node (SLN) detection in breast cancer. Concerns exist regarding artefacts on postoperative Magnetic Resonance Imaging (MRI), especially following breast conservation (BCS).

Materials and methods

In this prospective observational study, 97 women with DCIS or invasive breast cancer underwent BCS and SLN detection with peritumoral SPIO injection administered up to four weeks before surgery. Postoperatively, patients were followed with MRI and mammograms, and imaging outcomes were evaluated by four, independent breast radiologists, blinded to clinical data, using a predefined, standardized questionnaire.

Results

In 97 patients included, there was inter-rater discordance in the prevalence of “any artefact” (range: 24.1–74.4 %; weighted average: 32.4 %) and “SPIO specific artefact” (range: 12.0–49.4 %; weighted average: 20.9 %). The median area of “any artefact” was 9.24 cm² (iqr 4.72, 15.50) and SPIO specific artefact 9.88 (iqr 5.32, 15.5). Likert scores indicated higher difficulty interpreting MRI if artefacts were present (OR: 2.295, 95 % CI 1.028, 5.123; p = 0.043), but this was reduced if intravenous contrast was administered (OR: 0.177, 95 % CI 0.091, 0.342; p < 0.001). Multivariable analysis identified free-hand SPIO administration as a risk factor (OR 8.929, 95 % CI 2.849, 27.778; p < 0.001). All six patients with local recurrence were successfully diagnosed on MRI by all raters.

Conclusion

This prospective cohort study suggests that a targeted peritumoral SPIO injection can result in the removal of SPIO during lumpectomy and address the concerns for artefacts on postoperative MRI follow-up, in the selected patients that MRI may be warranted.

导言：超顺磁性氧化铁（SPIO）纳米粒子是检测乳腺癌前哨淋巴结（SLN）的一种很有前途的示踪剂。人们对术后磁共振成像（MRI）的伪影存在担忧，尤其是在保乳手术（BCS）之后：在这项前瞻性观察研究中，97 名患有 DCIS 或浸润性乳腺癌的女性接受了 BCS 和 SLN 检测，并在手术前四周进行了瘤周 SPIO 注射。术后，对患者进行核磁共振成像和乳房X光检查，由四位独立的乳腺放射科医生使用预定义的标准化问卷对成像结果进行评估，他们对临床数据保密：结果：在纳入的97名患者中，"任何伪影"（范围：24.1%-74.4%；加权平均值：32.4%）和 "SPIO特异性伪影"（范围：12.0%-49.4%；加权平均值：20.9%）的发生率存在评分者之间的不一致。任何人工痕迹 "的中位面积为 9.24 平方厘米（IQR 4.72，15.50），SPIO 特殊人工痕迹的中位面积为 9.88 平方厘米（IQR 5.32，15.5）。李克特评分显示，如果存在伪影，磁共振成像的解读难度会更高（OR：2.295，95 % CI 1.028，5.123；p = 0.043），但如果静脉注射造影剂，难度会降低（OR：0.177，95 % CI 0.091，0.342；p 结论：这项前瞻性队列研究表明，有针对性的瘤周 SPIO 注射可在肿瘤切除术中清除 SPIO，并解决术后 MRI 随访中的伪影问题，适用于可能需要进行 MRI 检查的特定患者。

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引用次数: 0

Development and validation of a cross-modality tensor fusion model using multi-modality MRI radiomics features and clinical radiological characteristics for the prediction of microvascular invasion in hepatocellular carcinoma 利用多模态磁共振成像放射组学特征和临床放射学特征开发和验证用于预测肝细胞癌微血管侵犯的跨模态张量融合模型

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2024-11-04 DOI: 10.1016/j.ejso.2024.109364

Ao Meng , Yinping Zhuang , Qian Huang , Li Tang , Jing Yang , Ping Gong

Objectives

To develop and validate a cross-modality tensor fusion (CMTF) model using multi-modality MRI radiomics features and clinical radiological characteristics for the prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC).

Materials and methods

This study included 174 HCC patients (47 MVI-positive and 127 MVI-negative) confirmed by postoperative pathology. The synthetic minority over-sampling technique was used to augment MVI-positive samples. The amplified dataset of 254 samples (127 MVI-positive and 127 MVI-negative) was randomly divided into training and test cohorts in a 7:3 ratio. Radiomics features were respectively extracted from arterial phase, delayed phase, diffusion-weighted imaging, and fat-suppressed T2-weighted imaging. The least absolute shrinkage and selection operator was used for feature selection. Univariate and multivariate logistic regression analyses were employed to identify clinical and radiological independent predictors. The selected multi-modality MRI radiomics features, clinical and radiological characteristics were used to construct the CMTF model, single modality (SM) model, early fusion (EF) model.

Results

The CMTF model demonstrated superior performance in predicting MVI compared to the SM and EF models. When integrating four MRI modalities, the CMTF model achieved a high area under the curve (AUC) with 95 % confidence interval (95 % CI) of 0.894 (0.820–0.968). Additionally, incorporating clinical and radiological characteristics further enhanced the predictive performance of CMTF model, the AUC (95 % CI) value increased to 0.945 (0.892–0.998).

Conclusion

The CMTF model showed promising performance in preoperative MVI prediction, providing a more effective non-invasive detection tool for HCC patients.

目的利用多模态磁共振成像放射组学特征和临床放射学特征，开发并验证用于预测肝细胞癌（HCC）微血管侵犯（MVI）的跨模态张量融合（CMTF）模型：本研究纳入了 174 例经术后病理证实的 HCC 患者（47 例 MVI 阳性，127 例 MVI 阴性）。采用合成少数过度取样技术扩增 MVI 阳性样本。将 254 个样本（127 个 MVI 阳性样本和 127 个 MVI 阴性样本）的扩增数据集按 7:3 的比例随机分为训练组和测试组。分别从动脉期、延迟期、弥散加权成像和脂肪抑制 T2 加权成像中提取放射组学特征。特征选择采用最小绝对收缩和选择算子。采用单变量和多变量逻辑回归分析来确定临床和放射学独立预测因素。选定的多模态磁共振成像放射组学特征、临床和放射学特征被用于构建CMTF模型、单模态（SM）模型和早期融合（EF）模型：结果：CMTF模型在预测MVI方面的表现优于SM和EF模型。整合四种磁共振成像模式后，CMTF 模型的曲线下面积（AUC）很高，95% 置信区间（95% CI）为 0.894（0.820-0.968）。此外，结合临床和放射学特征进一步提高了 CMTF 模型的预测性能，AUC（95 % CI）值增至 0.945（0.892-0.998）：CMTF模型在术前MVI预测方面表现良好，为HCC患者提供了更有效的无创检测工具。

{"title":"Development and validation of a cross-modality tensor fusion model using multi-modality MRI radiomics features and clinical radiological characteristics for the prediction of microvascular invasion in hepatocellular carcinoma","authors":"Ao Meng , Yinping Zhuang , Qian Huang , Li Tang , Jing Yang , Ping Gong","doi":"10.1016/j.ejso.2024.109364","DOIUrl":"10.1016/j.ejso.2024.109364","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop and validate a cross-modality tensor fusion (CMTF) model using multi-modality MRI radiomics features and clinical radiological characteristics for the prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC).</div></div><div><h3>Materials and methods</h3><div>This study included 174 HCC patients (47 MVI-positive and 127 MVI-negative) confirmed by postoperative pathology. The synthetic minority over-sampling technique was used to augment MVI-positive samples. The amplified dataset of 254 samples (127 MVI-positive and 127 MVI-negative) was randomly divided into training and test cohorts in a 7:3 ratio. Radiomics features were respectively extracted from arterial phase, delayed phase, diffusion-weighted imaging, and fat-suppressed T2-weighted imaging. The least absolute shrinkage and selection operator was used for feature selection. Univariate and multivariate logistic regression analyses were employed to identify clinical and radiological independent predictors. The selected multi-modality MRI radiomics features, clinical and radiological characteristics were used to construct the CMTF model, single modality (SM) model, early fusion (EF) model.</div></div><div><h3>Results</h3><div>The CMTF model demonstrated superior performance in predicting MVI compared to the SM and EF models. When integrating four MRI modalities, the CMTF model achieved a high area under the curve (AUC) with 95 % confidence interval (95 % CI) of 0.894 (0.820–0.968). Additionally, incorporating clinical and radiological characteristics further enhanced the predictive performance of CMTF model, the AUC (95 % CI) value increased to 0.945 (0.892–0.998).</div></div><div><h3>Conclusion</h3><div>The CMTF model showed promising performance in preoperative MVI prediction, providing a more effective non-invasive detection tool for HCC patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 1","pages":"Article 109364"},"PeriodicalIF":3.5,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Letter to the editor: “Validation of a supplementary condition of eighth AJCC staging system for stage II hepatocellular carcinoma” 致编辑的信："第八届 AJCC 分期系统 II 期肝细胞癌补充条件的验证"。

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Pub Date : 2024-11-01 DOI: 10.1016/j.ejso.2024.108419

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Reply to: Critical Appraisal of multidisciplinary treatment outcomes in young-onset colorectal cancer with synchronous liver metastases: A retrospective analysis and methodological Considerations 答复对伴有同步肝转移的年轻结直肠癌多学科治疗结果的批判性评估：回顾性分析和方法学考虑。

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