Ejso最新文献

英文中文

Development and validation of a new prognostic tool for hepatocellular carcinoma undergoing resection: The Weighted Alpha-Fetoprotein Tumor Burden Score (WATS)

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-07 DOI: 10.1016/j.ejso.2025.109677

Tonghui Lu , Kailing Xie , Yan Chen , Mingxiu Ma , Yaming Guo , Tianqiang Jin , Chaoliu Dai , Feng Xu

Purpose

This study aimed to develop and validate a novel prognostic index, the Weighted Alpha-Fetoprotein Tumor Burden Score (WATS), for predicting outcomes in hepatocellular carcinoma (HCC) patients undergoing resection.

Materials and methods

A total of 772 resected HCC patients were included. WATS was developed and validated using an 8:2 cohort split. The score was derived from multivariate Cox regression, resulting in the formula: WATS = 0.73 × tumor number +0.17 × tumor size +0.1 × ln AFP. The time-dependent ROC curve assessed the score's predictive ability, while restricted cubic splines evaluated the dose-response relationship between WATS and prognostic outcomes. Kaplan–Meier curves and multivariate Cox regression further validated the prognostic accuracy.

Results

In the training cohort, AUCs for progression-free survival (PFS) at 1, 2, 3, 4, and 5 years were 0.683, 0.664, 0.661, 0.633, and 0.620, respectively; for overall survival (OS), they were 0.757, 0.732, 0.703, 0.672, and 0.670, respectively. In the validation cohort, AUCs for PFS were 0.711, 0.654, 0.671, 0.662, and 0.684, respectively; for OS, they were 0.724, 0.688, 0.642, 0.698, and 0.721, respectively. WATS outperformed other complex indicators and staging systems. RCS analysis showed a linear relationship between WATS and outcomes. The nomogram based on WATS demonstrated excellent discrimination, calibration, and clinical benefit.

Conclusion

WATS is a novel, reliable prognostic tool for HCC post-resection, offering enhanced patient stratification and risk assessment, thereby improving clinical management.

{"title":"Development and validation of a new prognostic tool for hepatocellular carcinoma undergoing resection: The Weighted Alpha-Fetoprotein Tumor Burden Score (WATS)","authors":"Tonghui Lu , Kailing Xie , Yan Chen , Mingxiu Ma , Yaming Guo , Tianqiang Jin , Chaoliu Dai , Feng Xu","doi":"10.1016/j.ejso.2025.109677","DOIUrl":"10.1016/j.ejso.2025.109677","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to develop and validate a novel prognostic index, the Weighted Alpha-Fetoprotein Tumor Burden Score (WATS), for predicting outcomes in hepatocellular carcinoma (HCC) patients undergoing resection.</div></div><div><h3>Materials and methods</h3><div>A total of 772 resected HCC patients were included. WATS was developed and validated using an 8:2 cohort split. The score was derived from multivariate Cox regression, resulting in the formula: WATS = 0.73 × tumor number +0.17 × tumor size +0.1 × ln AFP. The time-dependent ROC curve assessed the score's predictive ability, while restricted cubic splines evaluated the dose-response relationship between WATS and prognostic outcomes. Kaplan–Meier curves and multivariate Cox regression further validated the prognostic accuracy.</div></div><div><h3>Results</h3><div>In the training cohort, AUCs for progression-free survival (PFS) at 1, 2, 3, 4, and 5 years were 0.683, 0.664, 0.661, 0.633, and 0.620, respectively; for overall survival (OS), they were 0.757, 0.732, 0.703, 0.672, and 0.670, respectively. In the validation cohort, AUCs for PFS were 0.711, 0.654, 0.671, 0.662, and 0.684, respectively; for OS, they were 0.724, 0.688, 0.642, 0.698, and 0.721, respectively. WATS outperformed other complex indicators and staging systems. RCS analysis showed a linear relationship between WATS and outcomes. The nomogram based on WATS demonstrated excellent discrimination, calibration, and clinical benefit.</div></div><div><h3>Conclusion</h3><div>WATS is a novel, reliable prognostic tool for HCC post-resection, offering enhanced patient stratification and risk assessment, thereby improving clinical management.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109677"},"PeriodicalIF":3.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488112","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}

引用次数: 0

Reply to: Comment on "Effects of enteral immunonutrition in laparoscopic versus open resections in colorectal cancer surgery: A meta-analysis of randomised controlled trials".

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-06 DOI: 10.1016/j.ejso.2025.109655

Chee Siong Wong, Shafquat Zaman, Koushik Siddiraju, Archana Sellvaraj, Tariq Ghattas, Yegor Tryliskyy

引用次数: 0

Comment on “Effects of enteral immunonutrition in laparoscopic versus open resections in colorectal cancer surgery: A meta-analysis of randomized controlled trials”

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-06 DOI: 10.1016/j.ejso.2025.109656

Jun Chen, Xiaoyu Liu

引用次数: 0

Human factors application, decision making, team working and leadership in Surgical Oncology

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-06 DOI: 10.1016/j.ejso.2025.109679

Elizabeth S. Brennan , Umar Rehman , Mohammad Sohaib Sarwar , Kirsten A. Bekker , Jake Cowen , Jasper Bekker , Peter A. Brennan

As humans we are fallible, and make mistakes both at work and in our personal lives on a regular basis. The operating theatre is one of the most dangerous areas of the hospital with many preventable errors occurring in this setting. Understanding, recognising and applying human factors (HF) in surgical practice can help reduce the chances of error. While HF is gaining ever increasing traction and profile across healthcare, sadly some colleagues do not think these factors apply to them, and for example, feel able to operate for countless hours without taking a break.

In this review, we explore some of the many human factors that are relevant to surgical oncology, gained from our experiences in the British National Health System (NHS). We focus on the sometimes overlooked factors that can be utilised to improve both personal performance and enhance team working. We also discuss decision making, thinking processes, situation awareness, surgical personality, leadership and other factors. The importance of a just culture in surgery is also discussed, whereby incidents are investigated to learn why something has happened, rather than who was to blame. Finally, the potential adverse effects of burnout on surgical error and patient safety are also considered.

{"title":"Human factors application, decision making, team working and leadership in Surgical Oncology","authors":"Elizabeth S. Brennan , Umar Rehman , Mohammad Sohaib Sarwar , Kirsten A. Bekker , Jake Cowen , Jasper Bekker , Peter A. Brennan","doi":"10.1016/j.ejso.2025.109679","DOIUrl":"10.1016/j.ejso.2025.109679","url":null,"abstract":"<div><div>As humans we are fallible, and make mistakes both at work and in our personal lives on a regular basis. The operating theatre is one of the most dangerous areas of the hospital with many preventable errors occurring in this setting. Understanding, recognising and applying human factors (HF) in surgical practice can help reduce the chances of error. While HF is gaining ever increasing traction and profile across healthcare, sadly some colleagues do not think these factors apply to them, and for example, feel able to operate for countless hours without taking a break.</div><div>In this review, we explore some of the many human factors that are relevant to surgical oncology, gained from our experiences in the British National Health System (NHS). We focus on the sometimes overlooked factors that can be utilised to improve both personal performance and enhance team working. We also discuss decision making, thinking processes, situation awareness, surgical personality, leadership and other factors. The importance of a just culture in surgery is also discussed, whereby incidents are investigated to learn why something has happened, rather than who was to blame. Finally, the potential adverse effects of burnout on surgical error and patient safety are also considered.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109679"},"PeriodicalIF":3.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550924","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}

引用次数: 0

Ultrasound for skeletal muscle assessment in surgical oncology: A scoping review

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-05 DOI: 10.1016/j.ejso.2025.109676

Wariya Vongchaiudomchoke , Ah-Reum Cho , Ibtisam Mahmoud , Francesco Carli

Background

Skeletal muscle wasting in cancer patients is associated with adverse outcomes. Ultrasound offers a non-invasive muscle assessment, but no previous review has focused on its application during perioperative period. This scoping review aims to map the current literature on the ultrasound use for skeletal muscle assessment in cancer patients during the perioperative period and identify knowledge gaps for future research.

Methods

A systematic literature search was conducted in the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Embase, Medline, and Web of Science. Two independent reviewers screened studies for eligibility and extracted relevant data, including study characteristics, population, ultrasound protocols, and outcomes. Inclusion criteria were primary studies involving adults undergoing cancer surgery with ultrasound used for skeletal muscle assessment during the perioperative period.

Results

Thirteen studies were included. The majority assessed quantitative parameters, with the rectus femoris muscle being the most evaluated. Muscle thickness and cross-sectional area were the most frequently reported parameters. Studies validated ultrasound parameters against established tools and clinical indicators, including sarcopenia, frailty, muscle strength, and biomarker. Ultrasound was also used to predict postoperative outcomes and assess perioperative interventions. However, variability in ultrasound protocols highlights the need for standardized practices, and the lack of consensus on cutoffs warrants future research.

Conclusions

This review demonstrated the validity and the applications of ultrasound for skeletal muscle assessment in cancer patients during the perioperative period. Significant variability in ultrasound protocols and the absence of standardized cutoffs highlight the need for further research.

{"title":"Ultrasound for skeletal muscle assessment in surgical oncology: A scoping review","authors":"Wariya Vongchaiudomchoke , Ah-Reum Cho , Ibtisam Mahmoud , Francesco Carli","doi":"10.1016/j.ejso.2025.109676","DOIUrl":"10.1016/j.ejso.2025.109676","url":null,"abstract":"<div><h3>Background</h3><div>Skeletal muscle wasting in cancer patients is associated with adverse outcomes. Ultrasound offers a non-invasive muscle assessment, but no previous review has focused on its application during perioperative period. This scoping review aims to map the current literature on the ultrasound use for skeletal muscle assessment in cancer patients during the perioperative period and identify knowledge gaps for future research.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, Embase, Medline, and Web of Science. Two independent reviewers screened studies for eligibility and extracted relevant data, including study characteristics, population, ultrasound protocols, and outcomes. Inclusion criteria were primary studies involving adults undergoing cancer surgery with ultrasound used for skeletal muscle assessment during the perioperative period.</div></div><div><h3>Results</h3><div>Thirteen studies were included. The majority assessed quantitative parameters, with the rectus femoris muscle being the most evaluated. Muscle thickness and cross-sectional area were the most frequently reported parameters. Studies validated ultrasound parameters against established tools and clinical indicators, including sarcopenia, frailty, muscle strength, and biomarker. Ultrasound was also used to predict postoperative outcomes and assess perioperative interventions. However, variability in ultrasound protocols highlights the need for standardized practices, and the lack of consensus on cutoffs warrants future research.</div></div><div><h3>Conclusions</h3><div>This review demonstrated the validity and the applications of ultrasound for skeletal muscle assessment in cancer patients during the perioperative period. Significant variability in ultrasound protocols and the absence of standardized cutoffs highlight the need for further research.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109676"},"PeriodicalIF":3.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative decline in isometric knee extension force is a predictor of unplanned readmission within 1 year in patients with colorectal cancer

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-04 DOI: 10.1016/j.ejso.2025.109673

Takuya Yanagisawa , Noriatsu Tatematsu , Shiho Asano , Mioko Horiuchi , Saki Migitaka , Shotaro Yasuda , Keita Itatsu , Tomoyuki Kubota , Hideshi Sugiura

Introduction

Exploring the relationship between perioperative physical function and unplanned readmission (UR) in patients with colorectal cancer (CRC) can aid in rehabilitation interventions. In this study, we aimed to determine whether perioperative physical function is associated with UR within 1 year in patients with CRC.

Materials and methods

This retrospective cohort study included 155 consecutive patients with CRC who underwent surgery. The outcome was UR within 1 year. Physical function was evaluated through isometric knee extension force (IKEF) and 6-min walk distance. Additionally, the decline ratio of physical function was calculated using the following formula: the decline ratio (%) = ([before discharge - before surgery]/before surgery) × 100. The propensity score-matching strategy was used to adjust for confounders in the relationship between perioperative physical function and UR. Subsequently, the association between perioperative physical function and UR was assessed using the log-lank test and Cox proportional hazards model analysis.

Results

Of 155 patients, 120 were included in the analysis. A significant difference in the decline ratio of IKEF was observed between patients with and without UR (p = 0.007). After propensity score-matching, 52 patients were matched. In matched patients, the decline in IKEF (decline ratio of IKEF ≤ −18.8 %) was significantly correlated with UR in the log-rank test (p = 0.003) and Cox proportional hazards model analysis (hazard ratio, 9.26; 95 % confidence interval, 1.15, 74.12; p = 0.035).

Conclusion

A decline in IKEF was associated with UR within 1 year in patients with CRC.

{"title":"Perioperative decline in isometric knee extension force is a predictor of unplanned readmission within 1 year in patients with colorectal cancer","authors":"Takuya Yanagisawa , Noriatsu Tatematsu , Shiho Asano , Mioko Horiuchi , Saki Migitaka , Shotaro Yasuda , Keita Itatsu , Tomoyuki Kubota , Hideshi Sugiura","doi":"10.1016/j.ejso.2025.109673","DOIUrl":"10.1016/j.ejso.2025.109673","url":null,"abstract":"<div><h3>Introduction</h3><div>Exploring the relationship between perioperative physical function and unplanned readmission (UR) in patients with colorectal cancer (CRC) can aid in rehabilitation interventions. In this study, we aimed to determine whether perioperative physical function is associated with UR within 1 year in patients with CRC.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study included 155 consecutive patients with CRC who underwent surgery. The outcome was UR within 1 year. Physical function was evaluated through isometric knee extension force (IKEF) and 6-min walk distance. Additionally, the decline ratio of physical function was calculated using the following formula: the decline ratio (%) = ([before discharge - before surgery]/before surgery) × 100. The propensity score-matching strategy was used to adjust for confounders in the relationship between perioperative physical function and UR. Subsequently, the association between perioperative physical function and UR was assessed using the log-lank test and Cox proportional hazards model analysis.</div></div><div><h3>Results</h3><div>Of 155 patients, 120 were included in the analysis. A significant difference in the decline ratio of IKEF was observed between patients with and without UR (p = 0.007). After propensity score-matching, 52 patients were matched. In matched patients, the decline in IKEF (decline ratio of IKEF ≤ −18.8 %) was significantly correlated with UR in the log-rank test (p = 0.003) and Cox proportional hazards model analysis (hazard ratio, 9.26; 95 % confidence interval, 1.15, 74.12; p = 0.035).</div></div><div><h3>Conclusion</h3><div>A decline in IKEF was associated with UR within 1 year in patients with CRC.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109673"},"PeriodicalIF":3.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488258","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}

引用次数: 0

Prognostic value of preoperative serum C-reactive protein level for survival in mucinous appendix cancer treated with complete CRS/HIPEC

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-03 DOI: 10.1016/j.ejso.2025.109675

Andrei Nikiforchin, Armando Sardi, Mary Caitlin King, Sergei Iugai, Ekaterina Baron, Felipe Lopez-Ramirez, Vladislav Kovalik, Luis Felipe Falla-Zuniga, Philipp Barakat, Carol Nieroda, Vadim Gushchin

Background

The role of systemic inflammation, a significant prognostic factor in various malignancies, is underexplored in mucinous appendix cancer (MAC). We assessed how inflammation, expressed by preoperative serum C-reactive protein (CRP), correlates with survival across MAC histopathologies managed with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC).

Methods

This retrospective cohort study included MAC patients with peritoneal dissemination, who had complete CRS/HIPEC (CC-0/1) (1998–2023). Preoperative serum CRP cut-off was defined with the minimum p-value approach and time-dependent receiver operating characteristic analysis. Survival was analyzed using the Kaplan-Meier method and Cox regression.

Results

Of 273 patients, 163 had low-grade and 110 had high-grade MAC. CRP cut-off was 2.00 mg/dL. Among low-grade, 132 patients had CRP<2 and 31 had CRP≥2. In high-grade, 87 patients had CRP<2 and 23 had CRP≥2. Median follow-up was 86 (95%CI: 48–124) months. In low-grade MAC, 5-year progression-free survival (PFS) was 88.5 % in CRP<2 and 53.9 % in CRP≥2 (p < 0.001), while 5-year overall survival (OS) was 89.2 % and 85.4 %, respectively (p = 0.018). In high-grade tumors, 5-year PFS was 46.5 % in CRP<2 and 19.3 % in CRP≥2 (p = 0.011), while 5-year OS was 56.5 % and 45.3 %, respectively (p = 0.291). Multivariate Cox regression showed a strong association of CRP≥2 with worse PFS (HR 5.10; 95%CI: 2.46–10.58) and OS (HR 3.18; 95%CI: 1.22–8.28) in low-grade MAC only.

Conclusions

Elevated pre-CRS/HIPEC serum CRP was associated with worse PFS and OS in low-grade, but not in high-grade MAC. These findings highlight CRP's utility in prognosis assessment and can be useful in identifying target MAC subgroups for studying anti-inflammatory agents.

{"title":"Prognostic value of preoperative serum C-reactive protein level for survival in mucinous appendix cancer treated with complete CRS/HIPEC","authors":"Andrei Nikiforchin, Armando Sardi, Mary Caitlin King, Sergei Iugai, Ekaterina Baron, Felipe Lopez-Ramirez, Vladislav Kovalik, Luis Felipe Falla-Zuniga, Philipp Barakat, Carol Nieroda, Vadim Gushchin","doi":"10.1016/j.ejso.2025.109675","DOIUrl":"10.1016/j.ejso.2025.109675","url":null,"abstract":"<div><h3>Background</h3><div>The role of systemic inflammation, a significant prognostic factor in various malignancies, is underexplored in mucinous appendix cancer (MAC). We assessed how inflammation, expressed by preoperative serum C-reactive protein (CRP), correlates with survival across MAC histopathologies managed with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included MAC patients with peritoneal dissemination, who had complete CRS/HIPEC (CC-0/1) (1998–2023). Preoperative serum CRP cut-off was defined with the minimum p-value approach and time-dependent receiver operating characteristic analysis. Survival was analyzed using the Kaplan-Meier method and Cox regression.</div></div><div><h3>Results</h3><div>Of 273 patients, 163 had low-grade and 110 had high-grade MAC. CRP cut-off was 2.00 mg/dL. Among low-grade, 132 patients had CRP<2 and 31 had CRP≥2. In high-grade, 87 patients had CRP<2 and 23 had CRP≥2. Median follow-up was 86 (95%CI: 48–124) months. In low-grade MAC, 5-year progression-free survival (PFS) was 88.5 % in CRP<2 and 53.9 % in CRP≥2 (p < 0.001), while 5-year overall survival (OS) was 89.2 % and 85.4 %, respectively (p = 0.018). In high-grade tumors, 5-year PFS was 46.5 % in CRP<2 and 19.3 % in CRP≥2 (p = 0.011), while 5-year OS was 56.5 % and 45.3 %, respectively (p = 0.291). Multivariate Cox regression showed a strong association of CRP≥2 with worse PFS (HR 5.10; 95%CI: 2.46–10.58) and OS (HR 3.18; 95%CI: 1.22–8.28) in low-grade MAC only.</div></div><div><h3>Conclusions</h3><div>Elevated pre-CRS/HIPEC serum CRP was associated with worse PFS and OS in low-grade, but not in high-grade MAC. These findings highlight CRP's utility in prognosis assessment and can be useful in identifying target MAC subgroups for studying anti-inflammatory agents.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 5","pages":"Article 109675"},"PeriodicalIF":3.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510229","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}

引用次数: 0

Oncological outcomes after vaginal and robotic-assisted radical trachelectomy in patients with cervical cancer - A single-center prospective cohort study

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-02 DOI: 10.1016/j.ejso.2025.109671

Sinor Soltanizadeh, Signe Frahm Bjørn, Ligita Paskeviciute Frøding, Berit Jul Mosgaard, Claus Høgdall

Objective

The aims of this study are to evaluate the oncological outcomes of robotic-assisted radical trachelectomy (RART) compared with radical vaginal trachelectomy (RVT) for localized early-stage cervical cancer in a national cohort.

Methods

RVT was introduced in 2003 in Denmark and nationally centralized to Copenhagen Univeristy Hospital. In 2014 the procedure advanced to a robotic-assisted approach. Perioperative and oncological data has been prospectively reported to the Danish Gynecological Cancer Database (DGCD) which is continuously developed and updated. All patients undergoing radical trachelectomy were included in this prospective cohort study. Data was extracted from DGCD and manually validated through electronic medical journals and The Danish Pathology Registry.

Results

A total of 206 patients underwent radical trachelectomy, with 78 patients undergoing RART and 128 patients undergoing RVT. No significant differences were observed in the microscopic free margins of the trachelectomy specimens. A total of seven (5.5%) patients undergoing RVT and two (2.6%) patients undergoing RART had recurrences (p = 0.403). No significant differences in recurrence-free survival were found between the groups, both in the unadjusted (HR 0.51 (0.11–2.47)) and adjusted analyses (HR 0.80 (0.16–3.96)).

Conclusions

In this large single-center cohort, oncological safety of RART is equal to RVT for patients with localized cervical cancer and a fertility desire.

{"title":"Oncological outcomes after vaginal and robotic-assisted radical trachelectomy in patients with cervical cancer - A single-center prospective cohort study","authors":"Sinor Soltanizadeh, Signe Frahm Bjørn, Ligita Paskeviciute Frøding, Berit Jul Mosgaard, Claus Høgdall","doi":"10.1016/j.ejso.2025.109671","DOIUrl":"10.1016/j.ejso.2025.109671","url":null,"abstract":"<div><h3>Objective</h3><div>The aims of this study are to evaluate the oncological outcomes of robotic-assisted radical trachelectomy (RART) compared with radical vaginal trachelectomy (RVT) for localized early-stage cervical cancer in a national cohort.</div></div><div><h3>Methods</h3><div>RVT was introduced in 2003 in Denmark and nationally centralized to Copenhagen Univeristy Hospital. In 2014 the procedure advanced to a robotic-assisted approach. Perioperative and oncological data has been prospectively reported to the Danish Gynecological Cancer Database (DGCD) which is continuously developed and updated. All patients undergoing radical trachelectomy were included in this prospective cohort study. Data was extracted from DGCD and manually validated through electronic medical journals and The Danish Pathology Registry.</div></div><div><h3>Results</h3><div>A total of 206 patients underwent radical trachelectomy, with 78 patients undergoing RART and 128 patients undergoing RVT. No significant differences were observed in the microscopic free margins of the trachelectomy specimens. A total of seven (5.5%) patients undergoing RVT and two (2.6%) patients undergoing RART had recurrences (p = 0.403). No significant differences in recurrence-free survival were found between the groups, both in the unadjusted (HR 0.51 (0.11–2.47)) and adjusted analyses (HR 0.80 (0.16–3.96)).</div></div><div><h3>Conclusions</h3><div>In this large single-center cohort, oncological safety of RART is equal to RVT for patients with localized cervical cancer and a fertility desire.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 5","pages":"Article 109671"},"PeriodicalIF":3.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Survival benefit of adjuvant chemotherapy in high-risk patients with colon cancer regardless of microsatellite instability

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-02 DOI: 10.1016/j.ejso.2025.109674

Sung Uk Bae , Jong Lyul Lee , Chun-Seok Yang , Eun Jung Park , Soo Yeun Park , Chang Woo Kim , Woong Bae Ji , Gyung Mo Son , Yoon Dae Han , So Hyun Kim , Min Sung Kim , Youn Young Park , Kyung Ha Lee , Chang Hyun Kim , Gi Won Ha , JaeIm Lee , Kyeong Eui Kim , Woon Kyung Jeong , Duck-Woo Kim , Seong Kyu Baek

Introduction

The predictive utility of high-risk features (HRFs) and microsatellite instability (MSI) status for adjuvant chemotherapy (ACT) in patients with stage II colon cancer remains unclear. We examined the impact of HRFs and MSI in predicting the benefits of adjuvant ACT in patients with stage II colon cancer.

Materials and methods

We included 1801 patients with resected stage II colon cancer who underwent ACT (5-fluorouracil [FU] and oxaliplatin) or surgery alone between January 2010 and December 2017. The primary outcomes were overall survival (OS) and disease-free survival (DFS).

Results

Among MSI-high patients with HRFs, patients who received 5- FU and oxaliplatin-based ACT had significantly higher OS and DFS than patients who did not, with no significant difference between those who received 5-FU and oxaliplatin as ACT. Among MSI-low/microsatellite stable patients with HRFs, patients who received 5-FU and oxaliplatin as ACT had significantly higher OS and DFS than patients who did not, with no significant differences between those who received 5-FU and oxaliplatin as ACT. Among patients who did not receive ACT, OS and DFS were 95.0 % and 91.2 % for patients without HRFs, respectively, and 84.4 % and 75.0 % for patients with HRFs, respectively. ACT improved the survival rates of patients with HRFs (OS: 84.4 %→95.9 %, DFS: 75.0 %→88.9 %).

Conclusions

ACT can be recommended for patients having stage II colon cancer with one or more HRF(s) for recurrence, regardless of the MSI status. In patients with HRFs, we observed no significant difference regarding survival between those who received 5-FU and oxaliplatin-based ACT.

{"title":"Survival benefit of adjuvant chemotherapy in high-risk patients with colon cancer regardless of microsatellite instability","authors":"Sung Uk Bae , Jong Lyul Lee , Chun-Seok Yang , Eun Jung Park , Soo Yeun Park , Chang Woo Kim , Woong Bae Ji , Gyung Mo Son , Yoon Dae Han , So Hyun Kim , Min Sung Kim , Youn Young Park , Kyung Ha Lee , Chang Hyun Kim , Gi Won Ha , JaeIm Lee , Kyeong Eui Kim , Woon Kyung Jeong , Duck-Woo Kim , Seong Kyu Baek","doi":"10.1016/j.ejso.2025.109674","DOIUrl":"10.1016/j.ejso.2025.109674","url":null,"abstract":"<div><h3>Introduction</h3><div>The predictive utility of high-risk features (HRFs) and microsatellite instability (MSI) status for adjuvant chemotherapy (ACT) in patients with stage II colon cancer remains unclear. We examined the impact of HRFs and MSI in predicting the benefits of adjuvant ACT in patients with stage II colon cancer.</div></div><div><h3>Materials and methods</h3><div>We included 1801 patients with resected stage II colon cancer who underwent ACT (5-fluorouracil [FU] and oxaliplatin) or surgery alone between January 2010 and December 2017. The primary outcomes were overall survival (OS) and disease-free survival (DFS).</div></div><div><h3>Results</h3><div>Among MSI-high patients with HRFs, patients who received 5- FU and oxaliplatin-based ACT had significantly higher OS and DFS than patients who did not, with no significant difference between those who received 5-FU and oxaliplatin as ACT. Among MSI-low/microsatellite stable patients with HRFs, patients who received 5-FU and oxaliplatin as ACT had significantly higher OS and DFS than patients who did not, with no significant differences between those who received 5-FU and oxaliplatin as ACT. Among patients who did not receive ACT, OS and DFS were 95.0 % and 91.2 % for patients without HRFs, respectively, and 84.4 % and 75.0 % for patients with HRFs, respectively. ACT improved the survival rates of patients with HRFs (OS: 84.4 %→95.9 %, DFS: 75.0 %→88.9 %).</div></div><div><h3>Conclusions</h3><div>ACT can be recommended for patients having stage II colon cancer with one or more HRF(s) for recurrence, regardless of the MSI status. In patients with HRFs, we observed no significant difference regarding survival between those who received 5-FU and oxaliplatin-based ACT.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109674"},"PeriodicalIF":3.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534078","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}

引用次数: 0

Periventricular gliomas: Evaluation of the risks associated with ventricular opening in two cohorts—one prospective with TachoSil® for ventricular sealing and the other without it retrospective

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2025-02-02 DOI: 10.1016/j.ejso.2025.109670

Pilar Teixidor-Rodríguez , Ferran Brugada-Bellsolà , Sebastián Menéndez-Girón , Luisa Parada-Arias , Cristina Hostalot-Panisello , Roser Garcia-Armengol , Sara Castañer-Llanes , Sílvia Comas-Anton , Marta Domenech-Viñolas , Cristina Carrato , Cristina Izquierdo , Jordi Busquets-Bonet , Carlos Javier Domínguez-Alonso , Eva Montané

Introduction

Historically, ventricular opening (VO) has been associated with a greater risk of postoperative complications and a risk of leptomeningeal spread (LMS) in periventricular gliomas especially high grade gliomas. There are no specific products on the market for ventricular sealing with registered studies. TachoSil® is widely used for supportive sealing of the dura mater. We wanted to assess the effectiveness and safety of TachoSil® as a ventricular sealant for periventricular gliomas surgery with VO.

Methods

A single-center, analytical, and observational study was conducted. Two cohorts of patients with gliomas and VO were compared. A prospective cohort treated with TachoSil® (2020–2024) and a retrospective control cohort without TachoSil® (2017–2023). We recorded epidemiological, clinical, radiological, and surgical variables and the percentage of complications attributable to the VO: CSF leak, pseudomeningocele, infection, hydrocephalus, or leptomeningeal spread (LMS).

Results

We included 68 patients: the prospective cohort treated with TachoSil® consisted of 37 patients and the control group of 31. The demographic, clinical, and radiologic characteristics of two cohorts were statistically homogeneous. Ventricular sealing with TachoSil® had wider resections (1.54cm3 ± SD 1.92 residual tumor volume vs. 3.71 cm3 ± SD 5.64, p = 0.032) and fewer postoperative complications related to VO (2 vs. 9 patients, p = 0.008).

Conclusion

This study demonstrates that the use of TachoSil® for sealing glioma patients with VO is safe and effective, reducing complications related to VO, increase the degree of resection and reduces readmissions and reinterventions resulting from complications arising from VO. A randomized clinical trial should be conducted.

{"title":"Periventricular gliomas: Evaluation of the risks associated with ventricular opening in two cohorts—one prospective with TachoSil® for ventricular sealing and the other without it retrospective","authors":"Pilar Teixidor-Rodríguez , Ferran Brugada-Bellsolà , Sebastián Menéndez-Girón , Luisa Parada-Arias , Cristina Hostalot-Panisello , Roser Garcia-Armengol , Sara Castañer-Llanes , Sílvia Comas-Anton , Marta Domenech-Viñolas , Cristina Carrato , Cristina Izquierdo , Jordi Busquets-Bonet , Carlos Javier Domínguez-Alonso , Eva Montané","doi":"10.1016/j.ejso.2025.109670","DOIUrl":"10.1016/j.ejso.2025.109670","url":null,"abstract":"<div><h3>Introduction</h3><div>Historically, ventricular opening (VO) has been associated with a greater risk of postoperative complications and a risk of leptomeningeal spread (LMS) in periventricular gliomas especially high grade gliomas. There are no specific products on the market for ventricular sealing with registered studies. TachoSil® is widely used for supportive sealing of the dura mater. We wanted to assess the effectiveness and safety of TachoSil® as a ventricular sealant for periventricular gliomas surgery with VO.</div></div><div><h3>Methods</h3><div>A single-center, analytical, and observational study was conducted. Two cohorts of patients with gliomas and VO were compared. A prospective cohort treated with TachoSil® (2020–2024) and a retrospective control cohort without TachoSil® (2017–2023). We recorded epidemiological, clinical, radiological, and surgical variables and the percentage of complications attributable to the VO: CSF leak, pseudomeningocele, infection, hydrocephalus, or leptomeningeal spread (LMS).</div></div><div><h3>Results</h3><div>We included 68 patients: the prospective cohort treated with TachoSil® consisted of 37 patients and the control group of 31. The demographic, clinical, and radiologic characteristics of two cohorts were statistically homogeneous. Ventricular sealing with TachoSil® had wider resections (1.54cm3 ± SD 1.92 residual tumor volume vs. 3.71 cm3 ± SD 5.64, p = 0.032) and fewer postoperative complications related to VO (2 vs. 9 patients, p = 0.008).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that the use of TachoSil® for sealing glioma patients with VO is safe and effective, reducing complications related to VO, increase the degree of resection and reduces readmissions and reinterventions resulting from complications arising from VO. A randomized clinical trial should be conducted.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 6","pages":"Article 109670"},"PeriodicalIF":3.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488150","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Ejso

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀