IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-01-07 DOI: 10.1016/j.ejso.2026.111387

Yukihiro Watanabe, Masayasu Aikawa, Takuya Oba, Yumiko Kageyama, Yoshiki Murase, Kenichiro Takase, Yuichiro Watanabe, Hiroaki Ono, Katsuya Okada, Kojun Okamoto, Isamu Koyama

Introduction

Renal dysfunction is a known surgical risk factor, yet the influence of procedure type on this risk remains unclear. We examined whether the impact of non-dialysis and dialysis-dependent chronic kidney disease (CKD) on outcomes after liver resection for hepatocellular carcinoma (HCC) differs according to resection type.

Materials and methods

We retrospectively reviewed 877 HCC patients who underwent liver resection between 2007 and 2024 and categorized them into three groups: normal renal function, non-dialysis CKD (estimated glomerular filtration rate of <45 mL/min/1.73 m²), and dialysis-dependent CKD. Short- and long-term outcomes were analyzed using multivariable logistic and Cox regression analyses. Propensity score matching and subgroup analyses stratified by procedure type (anatomical vs. non-anatomical) were performed to validate the findings.

Results

Compared with normal renal function, non-dialysis CKD was independently associated with increased postoperative complications (overall: odds ratio [OR] 2.14; 95 % confidence interval [CI], 1.19–3.83; p = 0.011; major: OR, 2.60; 95 % CI, 1.28–5.31; p = 0.008), but not with worse survival. Dialysis-dependent CKD was not significantly linked to complications or prognosis. Propensity score matching confirmed a higher complication rate in the non-dialysis CKD group (27 % vs. 14 %, p = 0.047). In subgroup analyses, non-dialysis CKD increased postoperative complications after non-anatomical resection (OR 2.31; p = 0.022), but not after anatomical resection (OR 1.95; p = 0.233), suggesting a procedure-dependent effect.

Conclusion

Non-dialysis CKD independently increases surgical risk without affecting long-term outcomes, with a procedure-dependent risk pattern. Dialysis is not a contraindication to surgery. Tailored operative strategies are essential for HCC patients with CKD.

肾功能不全是已知的手术危险因素，但手术类型对这种危险的影响尚不清楚。我们研究了非透析和透析依赖性慢性肾脏疾病（CKD）对肝细胞癌（HCC）肝切除术后预后的影响是否因切除术类型而异。材料和方法我们回顾性分析了2007年至2024年间接受肝切除术的877例HCC患者，并将其分为三组：肾功能正常、非透析性CKD（估计肾小球滤过率为45 mL/min/1.73 m2）和透析依赖性CKD。使用多变量逻辑分析和Cox回归分析对短期和长期结果进行分析。进行倾向评分匹配和按手术类型（解剖与非解剖）分层的亚组分析来验证研究结果。结果与正常肾功能相比，非透析性CKD与术后并发症增加独立相关（总体：优势比[OR] 2.14； 95%可信区间[CI] 1.19-3.83; p = 0.011；主要：优势比[OR] 2.60; 95% CI, 1.28-5.31; p = 0.008），但与较差的生存率无关。透析依赖性CKD与并发症或预后无显著相关性。倾向评分匹配证实非透析CKD组的并发症发生率更高（27% vs. 14%, p = 0.047）。在亚组分析中，非透析性CKD增加了非解剖性切除后的术后并发症（OR 2.31; p = 0.022），但在解剖性切除后没有增加（OR 1.95; p = 0.233），提示手术依赖效应。结论非透析CKD独立增加手术风险，不影响长期预后，具有手术依赖的风险模式。透析不是手术的禁忌症。量身定制的手术策略对于HCC合并CKD患者至关重要。

{"title":"Procedure-dependent impact of non-dialysis chronic kidney disease on outcomes after liver resection for hepatocellular carcinoma","authors":"Yukihiro Watanabe, Masayasu Aikawa, Takuya Oba, Yumiko Kageyama, Yoshiki Murase, Kenichiro Takase, Yuichiro Watanabe, Hiroaki Ono, Katsuya Okada, Kojun Okamoto, Isamu Koyama","doi":"10.1016/j.ejso.2026.111387","DOIUrl":"10.1016/j.ejso.2026.111387","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal dysfunction is a known surgical risk factor, yet the influence of procedure type on this risk remains unclear. We examined whether the impact of non-dialysis and dialysis-dependent chronic kidney disease (CKD) on outcomes after liver resection for hepatocellular carcinoma (HCC) differs according to resection type.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed 877 HCC patients who underwent liver resection between 2007 and 2024 and categorized them into three groups: normal renal function, non-dialysis CKD (estimated glomerular filtration rate of <45 mL/min/1.73 m<sup>2</sup>), and dialysis-dependent CKD. Short- and long-term outcomes were analyzed using multivariable logistic and Cox regression analyses. Propensity score matching and subgroup analyses stratified by procedure type (anatomical vs. non-anatomical) were performed to validate the findings.</div></div><div><h3>Results</h3><div>Compared with normal renal function, non-dialysis CKD was independently associated with increased postoperative complications (overall: odds ratio [OR] 2.14; 95 % confidence interval [CI], 1.19–3.83; p = 0.011; major: OR, 2.60; 95 % CI, 1.28–5.31; p = 0.008), but not with worse survival. Dialysis-dependent CKD was not significantly linked to complications or prognosis. Propensity score matching confirmed a higher complication rate in the non-dialysis CKD group (27 % vs. 14 %, p = 0.047). In subgroup analyses, non-dialysis CKD increased postoperative complications after non-anatomical resection (OR 2.31; p = 0.022), but not after anatomical resection (OR 1.95; p = 0.233), suggesting a procedure-dependent effect.</div></div><div><h3>Conclusion</h3><div>Non-dialysis CKD independently increases surgical risk without affecting long-term outcomes, with a procedure-dependent risk pattern. Dialysis is not a contraindication to surgery. Tailored operative strategies are essential for HCC patients with CKD.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111387"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914926","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

Extended thromboprophylaxis in enhanced recovery after surgery for colorectal cancer: a multicentre retrospective cohort study 扩大血栓预防在促进大肠癌术后恢复：一项多中心回顾性队列研究

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-01-03 DOI: 10.1016/j.ejso.2025.111378

S.T. Glazemakers , S.H.J. Ketelaers , H.B. Cornelisse , F. de Wit , I.T.A. Pereboom , G. van der Sluis , H. Smid-Nanninga , H.D. de Boer , I. Nielen , S.W. Polle , R. Bretveld , E.B. van Duyn , J. Tolenaar , J.W.A. Burger , J.G. Bloemen

Introduction

The value of continuing thromboprophylaxis after hospital discharge (extended prophylaxis) following colorectal cancer surgery is uncertain in modern surgical practices.

Methods

A multicentre, retrospective cohort study was conducted across 6 ERAS-adherent centres in the Netherlands, including 2409 patients who underwent elective colorectal cancer surgery between January 2018 and August 2023. Patients were categorized based on their hospital's thromboprophylaxis regimen: thromboprophylaxis until discharge or extended prophylaxis continued after discharge. The primary outcome was 90-day cumulative incidence of symptomatic VTE, with log-rank tests for group comparisons. Secondary outcomes included major bleeding complications (Clavien-Dindo grade ≥ III), and factors associated with occurence of postoperative VTE or major bleeding complications.

Results

The median duration of thromboprophylaxis was 4 (IQR 2–6) days in the until-discharge group (n = 1260) and 28 (IQR 18–28) days in the extended-prophylaxis group (n = 1149). The overall incidence of symptomatic VTE was 0.2 %, with no significant difference observed between the two groups (0.2 % vs. 0.2 %; p = 0.925). Major bleeding complications occurred more frequently in the extended-prophylaxis group (1.0 % vs. 2.0 %; p = 0.049). Multivariate analysis demonstrated that extended thromboprophylaxis was independently associated with major bleeding complications (OR2.002, 95 %CI 1.007–3.980), but not with VTE incidence.

Conclusion

The overall incidence of symptomatic VTE following elective colorectal cancer surgery within ERAS protocols was low. Thromboprophylaxis regimens continued after discharge were not associated with lower incidence of postoperative VTE, but were associated with a higher frequency of postoperative major bleeding complications. These findings suggest that routine extended thromboprophylaxis may be reconsidered in modern colorectal cancer surgery.

Clinical trial registration

registration number W22.176.

在现代外科实践中，结直肠癌手术后出院后继续血栓预防（延长预防）的价值尚不确定。方法在荷兰的6个eras附属中心进行了一项多中心、回顾性队列研究，包括2409名在2018年1月至2023年8月期间接受选择性结直肠癌手术的患者。根据医院的血栓预防方案对患者进行分类：在出院前进行血栓预防或在出院后继续进行延长预防。主要终点为90天症状性静脉血栓栓塞的累积发生率，采用对数秩检验进行组间比较。次要结局包括主要出血并发症（Clavien-Dindo分级≥III），以及与术后静脉血栓栓塞或主要出血并发症发生相关的因素。结果血栓预防的中位持续时间在出院组（n = 1260）为4 （IQR 2 ~ 6）天，在延长预防组（n = 1149）为28 （IQR 18 ~ 28）天。症状性静脉血栓栓塞的总发生率为0.2%，两组间差异无统计学意义（0.2% vs. 0.2%; p = 0.925）。大出血并发症在扩展预防组发生率更高（1.0% vs 2.0%; p = 0.049）。多因素分析表明，扩大血栓预防与大出血并发症独立相关（OR2.002, 95% CI 1.007-3.980），但与静脉血栓栓塞发生率无关。结论ERAS方案下择期结直肠癌手术后出现症状性静脉血栓栓塞的总体发生率较低。出院后继续进行血栓预防治疗与较低的术后静脉血栓栓塞发生率无关，但与较高的术后大出血并发症发生率相关。这些发现提示常规延长血栓预防在现代结直肠癌手术中可能被重新考虑。临床试验注册注册号W22.176。

{"title":"Extended thromboprophylaxis in enhanced recovery after surgery for colorectal cancer: a multicentre retrospective cohort study","authors":"S.T. Glazemakers , S.H.J. Ketelaers , H.B. Cornelisse , F. de Wit , I.T.A. Pereboom , G. van der Sluis , H. Smid-Nanninga , H.D. de Boer , I. Nielen , S.W. Polle , R. Bretveld , E.B. van Duyn , J. Tolenaar , J.W.A. Burger , J.G. Bloemen","doi":"10.1016/j.ejso.2025.111378","DOIUrl":"10.1016/j.ejso.2025.111378","url":null,"abstract":"<div><h3>Introduction</h3><div>The value of continuing thromboprophylaxis after hospital discharge (extended prophylaxis) following colorectal cancer surgery is uncertain in modern surgical practices.</div></div><div><h3>Methods</h3><div>A multicentre, retrospective cohort study was conducted across 6 ERAS-adherent centres in the Netherlands, including 2409 patients who underwent elective colorectal cancer surgery between January 2018 and August 2023. Patients were categorized based on their hospital's thromboprophylaxis regimen: thromboprophylaxis until discharge or extended prophylaxis continued after discharge. The primary outcome was 90-day cumulative incidence of symptomatic VTE, with log-rank tests for group comparisons. Secondary outcomes included major bleeding complications (Clavien-Dindo grade ≥ III), and factors associated with occurence of postoperative VTE or major bleeding complications.</div></div><div><h3>Results</h3><div>The median duration of thromboprophylaxis was 4 (IQR 2–6) days in the until-discharge group (n = 1260) and 28 (IQR 18–28) days in the extended-prophylaxis group (n = 1149). The overall incidence of symptomatic VTE was 0.2 %, with no significant difference observed between the two groups (0.2 % vs. 0.2 %; p = 0.925). Major bleeding complications occurred more frequently in the extended-prophylaxis group (1.0 % vs. 2.0 %; p = 0.049). Multivariate analysis demonstrated that extended thromboprophylaxis was independently associated with major bleeding complications (OR2.002, 95 %CI 1.007–3.980), but not with VTE incidence.</div></div><div><h3>Conclusion</h3><div>The overall incidence of symptomatic VTE following elective colorectal cancer surgery within ERAS protocols was low. Thromboprophylaxis regimens continued after discharge were not associated with lower incidence of postoperative VTE, but were associated with a higher frequency of postoperative major bleeding complications. These findings suggest that routine extended thromboprophylaxis may be reconsidered in modern colorectal cancer surgery.</div></div><div><h3>Clinical trial registration</h3><div>registration number W22.176.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111378"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914929","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

Locally advanced breast cancers: the EUSOMA experience 局部晚期乳腺癌：EUSOMA的经验。

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2025-11-25 DOI: 10.1016/j.ejso.2025.111303

Peter van Dam , Mariano Tomatis , Antonio Ponti , Lorenza Marotti , Julie Verhaegen , Cynthia Aristei , Maria Joao Cardoso , Kwok Leung Cheung , Giuseppe Curigliano , Jakob De Vries , Donatella Santini , Francesco Sardanelli , Isabel T. Rubio

Background

The aim of this study was to assess clinicopathologic characteristics, treatment modalities used and outcome of patients with locally advanced breast cancer (LABC).

Materials and methods

we searched the European Society of Breast Cancer Specialists (EUSOMA) data warehouse for clinically LABC cT4a-d – in the 2013–2022 timeframe.

Results

Of a total of 132269 patients, we identified 2427 patients with cT4abc BC (1.83 %) and 977 with inflammatory (T4d) BCs (0.74 %), of whom 542/2427 (20.1 %) and 251/977 (25.6 %), respectively, had metastatic disease at presentation (p = 0.054. Ninety percent of patients with cT4abcM0 and 88.8 % of patients with cT4dM0 disease had surgery (p = 0.369) and 90.9 % and 88.7 % (p = 0.187) endocrine therapy. Neoadjuvant chemotherapy (CT), adjuvant CT, biological drugs and radiotherapy were given in 33.2 %, 47.0 %, 67.1 % and 61.1 % of cT4abcM0 cases compared to 77.3 %, 80.4 %, 87.7 % and 80.2 % of cT4dM0 cases (all p < 0.001). Multivariable analysis showed that age <70 years, luminal A and HER-2 pure subtype, surgical treatment, radiotherapy, and systemic treatment (all p ≤ 0.034) were determinants of better overall survival (OS). Local recurrence rate (LRR) was significantly lower in patients receiving radiotherapy or endocrine therapy (p ≤ 0.012). Cox analyses showed no difference in OS or LRR between patients with cT4abc and those with T4d BCs, neither at univariable or multivariable analysis.

Conclusions

The current study confirms well-known features of cLABCs and underscores the importance of multimodal treatment, which is often underused in these patients.

背景：本研究的目的是评估局部晚期乳腺癌（LABC）患者的临床病理特征、治疗方式和预后。材料和方法：我们在欧洲乳腺癌专家协会（EUSOMA）数据仓库中检索2013-2022年期间的临床LABC cT4a-d -。结果：在132269例患者中，我们确定了2427例cT4abc BC（1.83%）和977例炎性（T4d） BC(0.74%)，其中分别有542/2427（20.1%）和251/977（25.6%）患者在就诊时患有转移性疾病（p = 0.054）。90%的cT4abcM0患者和88.8%的cT4dM0患者接受手术治疗（p = 0.369）， 90.9%和88.7% （p = 0.187）接受内分泌治疗。cT4abcM0患者接受新辅助化疗（CT）、辅助CT、生物药物和放疗的比例分别为33.2%、47.0%、67.1%和61.1%，而cT4dM0患者接受新辅助化疗、辅助CT、生物药物和放疗的比例分别为77.3%、80.4%、87.7%和80.2%（均为p）结论：本研究证实了cLABCs众所周知的特点，强调了多模式治疗的重要性，但这些患者往往未充分利用这种治疗方法。

{"title":"Locally advanced breast cancers: the EUSOMA experience","authors":"Peter van Dam , Mariano Tomatis , Antonio Ponti , Lorenza Marotti , Julie Verhaegen , Cynthia Aristei , Maria Joao Cardoso , Kwok Leung Cheung , Giuseppe Curigliano , Jakob De Vries , Donatella Santini , Francesco Sardanelli , Isabel T. Rubio","doi":"10.1016/j.ejso.2025.111303","DOIUrl":"10.1016/j.ejso.2025.111303","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to assess clinicopathologic characteristics, treatment modalities used and outcome of patients with locally advanced breast cancer (LABC).</div></div><div><h3>Materials and methods</h3><div>we searched the European Society of Breast Cancer Specialists (EUSOMA) data warehouse for clinically LABC cT4a-d – in the 2013–2022 timeframe.</div></div><div><h3>Results</h3><div>Of a total of 132269 patients, we identified 2427 patients with cT4abc BC (1.83 %) and 977 with inflammatory (T4d) BCs (0.74 %), of whom 542/2427 (20.1 %) and 251/977 (25.6 %), respectively, had metastatic disease at presentation (<em>p</em> = 0.054. Ninety percent of patients with cT4abcM0 and 88.8 % of patients with cT4dM0 disease had surgery (p = 0.369) and 90.9 % and 88.7 % (p = 0.187) endocrine therapy. Neoadjuvant chemotherapy (CT), adjuvant CT, biological drugs and radiotherapy were given in 33.2 %, 47.0 %, 67.1 % and 61.1 % of cT4abcM0 cases compared to 77.3 %, 80.4 %, 87.7 % and 80.2 % of cT4dM0 cases (all <em>p</em> < 0.001). Multivariable analysis showed that age <70 years, luminal A and HER-2 pure subtype, surgical treatment, radiotherapy, and systemic treatment (all p ≤ 0.034) were determinants of better overall survival (OS). Local recurrence rate (LRR) was significantly lower in patients receiving radiotherapy or endocrine therapy (p ≤ 0.012). Cox analyses showed no difference in OS or LRR between patients with cT4abc and those with T4d BCs, neither at univariable or multivariable analysis.</div></div><div><h3>Conclusions</h3><div>The current study confirms well-known features of cLABCs and underscores the importance of multimodal treatment, which is often underused in these patients.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111303"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755609","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

Advert ESSO course on Artificial Intelligence in Healthcare-Interactive Workshop for Surgeons and Radiologists 医疗保健中的人工智能ESSO课程-为外科医生和放射科医生举办的互动研讨会

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-03-07 DOI: 10.1016/S0748-7983(26)00093-4

引用次数: 0

52.03 ESSO announcements 52.03它是一个符号

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-02-25 DOI: 10.1016/j.ejso.2026.111486

引用次数: 0

Real-world outcomes of uncertain resection in surgically resected pN2 Non-Small Cell Lung Cancer 手术切除pN2非小细胞肺癌不确定切除的实际结果。

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI: 10.1016/j.ejso.2026.111444

Pietro Bertoglio , Vittorio Aprile , Filippo Lococo , Filippo Antonacci , Marco Chiappetta , Dania Nachira , Alessandra Lenzini , Marco Lucchi , Enrico Ruffini , Stefano Margaritora , Piergiorgio Solli , Jury Brandolini , Francesco Guerrera

Objective

In addition to the standard R classification for assessing radicality in Non-Small Cell Lung Cancer (NSCLC), the concept of uncertain resection [R (un)] has been introduced. This study aimed to evaluate the prognostic impact of R (un) in a cohort of surgically resected pN2 NSCLC patients and to analyze outcome of a possible change in the R (un) description.

Methods

We retrospectively analyzed data from prospective databases of four institutions. All consecutive patients with R0 pN2 NSCLC treated between 2016 and 2021 were included. Each case was re-evaluated and classified as either R0 or R (un). We also assessed a modified R (un) classification considering station 7 as hierarchically superior to stations 5 and 6.

Results

Among 230 patients, 98 (42.6 %) were female. Forty-six patients (20 %) received neoadjuvant therapy, and 178 (77.4 %) underwent lobectomy.

Single station pN2 was observed in 143 patients (62.2 %), and 130 (56.5 %) were reclassified as R (un). Adjuvant therapy was administered to 135 patients (58.7 %).

Patients classified as R0 had significantly better overall survival (OS, p = 0.044) and disease-free survival (DFS, p = 0.050) compared to those with R (un). However, in multivariable analysis, only adjuvant therapy remained an independent prognostic factor for OS.

When applying the modified R (un) definition, R (un) remained associated with worse OS (p = 0.007) and DFS (p < 0.001) and was confirmed as an independent prognostic factor in multivariable analysis.

Conclusions

Our findings confirm the prognostic relevance of the R classification, including R (un). We propose a possible refinement of the R (un) definition potentially improving its prognostic accuracy.

目的：除了用于评估非小细胞肺癌（NSCLC）根治性的标准R分类外，还引入了不确定切除的概念[R (un)]。本研究旨在评估手术切除的pN2 NSCLC患者R （un）对预后的影响，并分析R （un）描述可能发生变化的结果。方法：我们回顾性分析来自四家机构前瞻性数据库的数据。所有在2016年至2021年间连续接受R0 pN2 NSCLC治疗的患者均被纳入研究。每个病例重新评估并分类为R0或R （un）。我们还评估了一个改进的R （un）分类，认为7号站在等级上优于5号和6号站。结果：230例患者中，女性98例（42.6%）。46例（20%）患者接受了新辅助治疗，178例（77.4%）患者接受了肺叶切除术。143例（62.2%）出现单站pN2, 130例（56.5%）被重新分类为R （un）。辅助治疗135例（58.7%）。R0组患者的总生存期（OS, p = 0.044）和无病生存期（DFS, p = 0.050）明显优于R组（un）。然而，在多变量分析中，只有辅助治疗仍然是OS的独立预后因素。当应用修改后的R （un）定义时，R （un）仍然与较差的OS （p = 0.007）和DFS (p)相关。结论：我们的研究结果证实了R分类与预后的相关性，包括R （un）。我们提出了一种可能的R （un）定义的改进，可能会提高其预测准确性。

{"title":"Real-world outcomes of uncertain resection in surgically resected pN2 Non-Small Cell Lung Cancer","authors":"Pietro Bertoglio , Vittorio Aprile , Filippo Lococo , Filippo Antonacci , Marco Chiappetta , Dania Nachira , Alessandra Lenzini , Marco Lucchi , Enrico Ruffini , Stefano Margaritora , Piergiorgio Solli , Jury Brandolini , Francesco Guerrera","doi":"10.1016/j.ejso.2026.111444","DOIUrl":"10.1016/j.ejso.2026.111444","url":null,"abstract":"<div><h3>Objective</h3><div>In addition to the standard R classification for assessing radicality in Non-Small Cell Lung Cancer (NSCLC), the concept of uncertain resection [R (un)] has been introduced. This study aimed to evaluate the prognostic impact of R (un) in a cohort of surgically resected pN2 NSCLC patients and to analyze outcome of a possible change in the R (un) description.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from prospective databases of four institutions. All consecutive patients with R0 pN2 NSCLC treated between 2016 and 2021 were included. Each case was re-evaluated and classified as either R0 or R (un). We also assessed a modified R (un) classification considering station 7 as hierarchically superior to stations 5 and 6.</div></div><div><h3>Results</h3><div>Among 230 patients, 98 (42.6 %) were female. Forty-six patients (20 %) received neoadjuvant therapy, and 178 (77.4 %) underwent lobectomy.</div><div>Single station pN2 was observed in 143 patients (62.2 %), and 130 (56.5 %) were reclassified as R (un). Adjuvant therapy was administered to 135 patients (58.7 %).</div><div>Patients classified as R0 had significantly better overall survival (OS, p = 0.044) and disease-free survival (DFS, p = 0.050) compared to those with R (un). However, in multivariable analysis, only adjuvant therapy remained an independent prognostic factor for OS.</div><div>When applying the modified R (un) definition, R (un) remained associated with worse OS (p = 0.007) and DFS (p < 0.001) and was confirmed as an independent prognostic factor in multivariable analysis.</div></div><div><h3>Conclusions</h3><div>Our findings confirm the prognostic relevance of the R classification, including R (un). We propose a possible refinement of the R (un) definition potentially improving its prognostic accuracy.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111444"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104313","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

Transarterial chemoembolization combined with immune checkpoint inhibitors and anti-VEGF agents for intermediate HCC: a multicenter study 经动脉化疗栓塞联合免疫检查点抑制剂和抗vegf药物治疗中度HCC：一项多中心研究

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-01-15 DOI: 10.1016/j.ejso.2026.111407

Wei-Yi Jiang , Jin-Kai Feng , Bin Zhou , Si-Si Ren , Yu-Chao Hou , Fang-Fang Zhang , Yan-Jun Xiang , Zong-Han Liu , Rong-Chen Chen , Yun-Feng Shan , Chao Liang , Hong-Kun Zhou , Lin Gong , Shu-Qun Cheng

Purpose

To compare the clinical outcomes and safety profiles of immune checkpoint inhibitors (ICIs) and anti-vascular endothelial growth factor (VEGF) agents alone versus transarterial chemoembolization (TACE) combined with ICI and anti-VEGF agents in patients with intermediate hepatocellular carcinoma (HCC).

Methods

Patients were stratified into two groups: the triple-therapy (TACE combined with ICI and anti-VEGF agents) and dual-therapy groups (ICI plus anti-VEGF agents). Stabilized inverse probability of treatment weighting (sIPTW) was applied to balance baseline characteristics. Study endpoints included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate (DCR). Univariate and multivariate Cox regression analyses were employed to identify independent prognostic factors. Safety was evaluated per CTCAE v5.0.

Results

After sIPTW adjustment, the triple-therapy group demonstrated significantly longer median PFS (20.0 vs. 14.0 months; P < 0.0001) and median OS (26.0 vs. 19.0 months; P < 0.0001) compared to the dual-therapy group. Tumor response was also superior in the triple-therapy group, with higher ORR (63.3 % vs. 39.4 %; P = 0.015) and DCR (85.0 % vs. 60.6 %; P < 0.001). IPTW-weighted Cox regression identified AFP, tumor response, and up-to-7 criteria as independent prognostic factors for PFS, while AFP, up-to-7 criteria, and cirrhosis were independent factors for OS. The safety profile was manageable in both groups, with no new safety signals identified.

Conclusion

This study demonstrates that combining TACE with ICIs and anti-VEGF agents significantly improves PFS, OS, ORR and DCR in intermediate-stage HCC patients compared to dual ICI and anti-VEGF agents therapy, with manageable toxicity.

目的比较免疫检查点抑制剂（ICIs）和抗血管内皮生长因子（VEGF）药物单独治疗与经动脉化疗栓塞（TACE）联合ICI和抗VEGF药物治疗中重度肝癌（HCC）的临床疗效和安全性。方法将患者分为三组（TACE联合ICI和抗vegf药物）和双组（ICI +抗vegf药物）。采用稳定处理加权逆概率（sIPTW）来平衡基线特征。研究终点包括无进展生存期（PFS）、总生存期（OS）、客观缓解率（ORR）和疾病控制率（DCR）。采用单因素和多因素Cox回归分析确定独立预后因素。按照CTCAE v5.0进行安全性评估。结果经sIPTW调整后，三联治疗组的中位PFS（20.0个月vs. 14.0个月；P < 0.0001）和中位OS（26.0个月vs. 19.0个月；P < 0.0001）明显长于双联治疗组。三联治疗组的肿瘤反应也更佳，ORR（63.3%比39.4%,P = 0.015）和DCR（85.0%比60.6%,P < 0.001）更高。iptw加权Cox回归发现，AFP、肿瘤反应和7级以上标准是PFS的独立预后因素，而AFP、7级以上标准和肝硬化是OS的独立预后因素。两组的安全状况都是可控的，没有发现新的安全信号。结论本研究表明，与ICI和抗vegf药物双药治疗相比，TACE联合ICIs和抗vegf药物治疗可显著改善中期HCC患者的PFS、OS、ORR和DCR，且毒性可控。

{"title":"Transarterial chemoembolization combined with immune checkpoint inhibitors and anti-VEGF agents for intermediate HCC: a multicenter study","authors":"Wei-Yi Jiang , Jin-Kai Feng , Bin Zhou , Si-Si Ren , Yu-Chao Hou , Fang-Fang Zhang , Yan-Jun Xiang , Zong-Han Liu , Rong-Chen Chen , Yun-Feng Shan , Chao Liang , Hong-Kun Zhou , Lin Gong , Shu-Qun Cheng","doi":"10.1016/j.ejso.2026.111407","DOIUrl":"10.1016/j.ejso.2026.111407","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the clinical outcomes and safety profiles of immune checkpoint inhibitors (ICIs) and anti-vascular endothelial growth factor (VEGF) agents alone versus transarterial chemoembolization (TACE) combined with ICI and anti-VEGF agents in patients with intermediate hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>Patients were stratified into two groups: the triple-therapy (TACE combined with ICI and anti-VEGF agents) and dual-therapy groups (ICI plus anti-VEGF agents). Stabilized inverse probability of treatment weighting (sIPTW) was applied to balance baseline characteristics. Study endpoints included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate (DCR). Univariate and multivariate Cox regression analyses were employed to identify independent prognostic factors. Safety was evaluated per CTCAE v5.0.</div></div><div><h3>Results</h3><div>After sIPTW adjustment, the triple-therapy group demonstrated significantly longer median PFS (20.0 vs. 14.0 months; P < 0.0001) and median OS (26.0 vs. 19.0 months; P < 0.0001) compared to the dual-therapy group. Tumor response was also superior in the triple-therapy group, with higher ORR (63.3 % vs. 39.4 %; P = 0.015) and DCR (85.0 % vs. 60.6 %; P < 0.001). IPTW-weighted Cox regression identified AFP, tumor response, and up-to-7 criteria as independent prognostic factors for PFS, while AFP, up-to-7 criteria, and cirrhosis were independent factors for OS. The safety profile was manageable in both groups, with no new safety signals identified.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that combining TACE with ICIs and anti-VEGF agents significantly improves PFS, OS, ORR and DCR in intermediate-stage HCC patients compared to dual ICI and anti-VEGF agents therapy, with manageable toxicity.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111407"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024137","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

Iron deficiency restrains short-term recovery in patients undergoing surgery for advanced ovarian cancer 缺铁抑制晚期卵巢癌手术患者的短期恢复

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-01-05 DOI: 10.1016/j.ejso.2026.111390

Anna Norbeck , Mihaela Asp , Susanne Malander , Päivi Kannisto

Background

Patients with advanced ovarian cancer (AOC) who undergo primary and interval debulking surgery are often anemic at diagnosis, with iron deficiency being the most common cause. The aim was to investigate whether preoperative anemia and iron deficiency impact short-term recovery.

Methods

This retrospective cohort study included 262 patients with AOC who underwent surgery at Skane University Hospital Lund, Sweden, between January 2020 and December 2023. Patients were divided into four groups, according to preoperative anemia and iron deficiency. Iron deficiency was defined as transferrin saturation (TSAT) < 0.20. Severe complications were defined as Clavien–Dindo (CD) grade ≥3. Logistic regression analyses were used to investigate the difference between patients with and without iron deficiency.

Results

Among patients with iron deficiency anemia, 24 % of patients had more than 1 cm of residual tumor at the end of surgery, compared to 6–8 % of patients with no anemia and/or no iron deficiency, (p 0.005). The rate of severe complications (CD ≥ 3) was higher for patients with iron deficiency, odds ratio 2.47 (95 % CI 1.11–5.50), than for patients with no iron deficiency, adjusted for the Aletti score, operating time and hemoglobin (Hb) level. There was no difference between groups regarding length of hospital stay.

Conclusion

Patients with iron deficiency anemia, were less likely to undergo radical or optimal surgery. Severe postoperative complications were more common in patients with iron deficiency, with or without anemia. These analyses indicate that iron deficiency is associated with more advanced disease and complex surgical procedures.

背景：晚期卵巢癌（AOC）患者在接受原发性和间断性减癌手术时，通常在诊断时贫血，缺铁是最常见的原因。目的是研究术前贫血和缺铁是否影响短期恢复。方法本回顾性队列研究纳入了2020年1月至2023年12月在瑞典隆德斯科纳大学医院接受手术的262例AOC患者。根据术前贫血和缺铁情况将患者分为四组。缺铁定义为转铁蛋白饱和（TSAT） & 0.20。严重并发症定义为Clavien-Dindo （CD）分级≥3级。采用Logistic回归分析探讨缺铁患者与非缺铁患者之间的差异。结果在缺铁性贫血患者中，24%的患者手术结束时肿瘤残留大于1cm，而无贫血和/或无缺铁患者的这一比例为6 - 8%，（p 0.005）。经Aletti评分、手术时间和血红蛋白（Hb）水平调整后，缺铁患者的严重并发症（CD≥3）发生率高于无缺铁患者，优势比为2.47 （95% CI 1.11-5.50）。在住院时间方面，两组之间没有差异。结论缺铁性贫血患者接受根治性或最佳手术治疗的可能性较小。严重的术后并发症在缺铁、伴或不伴贫血的患者中更为常见。这些分析表明，铁缺乏与更严重的疾病和复杂的外科手术有关。

{"title":"Iron deficiency restrains short-term recovery in patients undergoing surgery for advanced ovarian cancer","authors":"Anna Norbeck , Mihaela Asp , Susanne Malander , Päivi Kannisto","doi":"10.1016/j.ejso.2026.111390","DOIUrl":"10.1016/j.ejso.2026.111390","url":null,"abstract":"<div><h3>Background</h3><div>Patients with advanced ovarian cancer (AOC) who undergo primary and interval debulking surgery are often anemic at diagnosis, with iron deficiency being the most common cause. The aim was to investigate whether preoperative anemia and iron deficiency impact short-term recovery.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 262 patients with AOC who underwent surgery at Skane University Hospital Lund, Sweden, between January 2020 and December 2023. Patients were divided into four groups, according to preoperative anemia and iron deficiency. Iron deficiency was defined as transferrin saturation (TSAT) < 0.20. Severe complications were defined as Clavien–Dindo (CD) grade ≥3. Logistic regression analyses were used to investigate the difference between patients with and without iron deficiency.</div></div><div><h3>Results</h3><div>Among patients with iron deficiency anemia, 24 % of patients had more than 1 cm of residual tumor at the end of surgery, compared to 6–8 % of patients with no anemia and/or no iron deficiency, (<em>p 0.005</em>). The rate of severe complications (CD ≥ 3) was higher for patients with iron deficiency, odds ratio 2.47 (95 % CI 1.11–5.50), than for patients with no iron deficiency, adjusted for the Aletti score, operating time and hemoglobin (Hb) level. There was no difference between groups regarding length of hospital stay.</div></div><div><h3>Conclusion</h3><div>Patients with iron deficiency anemia, were less likely to undergo radical or optimal surgery. Severe postoperative complications were more common in patients with iron deficiency, with or without anemia. These analyses indicate that iron deficiency is associated with more advanced disease and complex surgical procedures.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111390"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915100","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

Impact of postoperative infectious complications on survival outcomes after minimally invasive esophagectomy for esophageal cancer 食管癌微创食管切除术后感染并发症对生存结果的影响

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.ejso.2025.111363

Eigo Akimoto, Shotaro Horonushi, Ryuta Kakuta, Ryoko Nozaki, Shota Igaue, Daichi Utsunomiya, Kentaro Kubo, Daisuke Kurita, Koshiro Ishiyama, Junya Oguma, Yasuyuki Seto, Hiroyuki Daiko

Background

Postoperative infectious complications (PIC) adversely affect survival outcomes in patients with esophageal cancer; however, previous reports have investigated this complication only in thoracotomy. This adverse effect is expected less often with less invasive surgery, such as thoracoscopic/robot-assisted approaches, by maintaining immune function.

Methods

This study included 631 patients with esophageal cancer who underwent minimally invasive curative surgery between 2018 and 2023. Patients who underwent salvage surgery (n = 30) or two-stage surgery (n = 6) were excluded. We divided the patients into two groups by the presence (PIC group, n = 168) or absence (non-PIC group, n = 428) of PIC of Clavien–Dindo grade ≥ II. Survival outcomes were compared in propensity score-matched cohorts to evaluate the impact of PIC.

Results

The incidence of Clavien–Dindo ≥ grade II PIC was 28.1 % (168/596). After propensity score matching, data for 159 patients in each group were extracted for analysis. The 3-year overall survival rates were equivalent between the PIC and non-PIC groups (78.4 % vs. 81.6 %, respectively; log-rank p = 0.53). The 3-year disease-specific survival rates were also similar between the PIC and non-PIC groups (87.3 % vs. 85.0 %, respectively; log-rank p = 0.63).

Conclusions

In minimally invasive esophagectomy for esophageal cancer, PIC may not be a poor prognostic factor. Further evaluation using larger datasets is necessary before reaching definitive conclusions.

食管癌术后感染并发症（PIC）对患者的生存结果有不利影响；然而，先前的报道仅在开胸手术中调查了这一并发症。通过微创手术，如胸腔镜/机器人辅助入路，通过维持免疫功能，预期这种不良反应较少发生。方法本研究纳入2018年至2023年631例食管癌微创治疗手术患者。排除了接受挽救性手术（n = 30）或两期手术（n = 6）的患者。我们将患者分为存在（PIC组，n = 168）或不存在（非PIC组，n = 428） Clavien-Dindo分级≥II级PIC两组。在倾向评分匹配的队列中比较生存结果，以评估PIC的影响。结果Clavien-Dindo≥II级PIC发生率为28.1%（168/596）。倾向评分匹配后，每组抽取159例患者资料进行分析。PIC组和非PIC组的3年总生存率相等（分别为78.4%和81.6%;log-rank p = 0.53）。PIC组和非PIC组的3年疾病特异性生存率也相似（分别为87.3%和85.0%;log-rank p = 0.63）。结论在食管癌微创食管切除术中，PIC可能不是预后不良的因素。在得出明确结论之前，需要使用更大的数据集进行进一步评估。

{"title":"Impact of postoperative infectious complications on survival outcomes after minimally invasive esophagectomy for esophageal cancer","authors":"Eigo Akimoto, Shotaro Horonushi, Ryuta Kakuta, Ryoko Nozaki, Shota Igaue, Daichi Utsunomiya, Kentaro Kubo, Daisuke Kurita, Koshiro Ishiyama, Junya Oguma, Yasuyuki Seto, Hiroyuki Daiko","doi":"10.1016/j.ejso.2025.111363","DOIUrl":"10.1016/j.ejso.2025.111363","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative infectious complications (PIC) adversely affect survival outcomes in patients with esophageal cancer; however, previous reports have investigated this complication only in thoracotomy. This adverse effect is expected less often with less invasive surgery, such as thoracoscopic/robot-assisted approaches, by maintaining immune function.</div></div><div><h3>Methods</h3><div>This study included 631 patients with esophageal cancer who underwent minimally invasive curative surgery between 2018 and 2023. Patients who underwent salvage surgery (n = 30) or two-stage surgery (n = 6) were excluded. We divided the patients into two groups by the presence (PIC group, n = 168) or absence (non-PIC group, n = 428) of PIC of Clavien–Dindo grade ≥ II. Survival outcomes were compared in propensity score-matched cohorts to evaluate the impact of PIC.</div></div><div><h3>Results</h3><div>The incidence of Clavien–Dindo ≥ grade II PIC was 28.1 % (168/596). After propensity score matching, data for 159 patients in each group were extracted for analysis. The 3-year overall survival rates were equivalent between the PIC and non-PIC groups (78.4 % vs. 81.6 %, respectively; log-rank <em>p</em> = 0.53). The 3-year disease-specific survival rates were also similar between the PIC and non-PIC groups (87.3 % vs. 85.0 %, respectively; log-rank <em>p</em> = 0.63).</div></div><div><h3>Conclusions</h3><div>In minimally invasive esophagectomy for esophageal cancer, PIC may not be a poor prognostic factor. Further evaluation using larger datasets is necessary before reaching definitive conclusions.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111363"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074687","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

Real-world outcomes of stage III NSCLCs managed by surgery or definitive radiation therapy in the era of immunotherapy 在免疫治疗时代，III期非小细胞肺癌通过手术或最终放射治疗的实际结果

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso

Pub Date : 2026-03-01 Epub Date: 2026-01-10 DOI: 10.1016/j.ejso.2026.111401

Etienne Abdelnour-Berchtold , Louis-Emmanuel Chriqui , Laetitia Zermatten , Sotirios Papadopoulos , Celine Forster , Arpad Hasenauer , Benoit Bedat , Matthieu Zellweger , Remy Kinj , Nuria Mederos , Michel Christodoulou , Alfredo Addeo , Frederic Triponez , Wolfram Karenovics , Michel Gonzalez , Thorsten Krueger , Solange Peters , Hasna Bouchaab , Jean Yannis Perentes

Objectives

Immunotherapy (IO) has been associated with better outcomes in locally advanced non-small cell lung cancers (NSCLCs). In 2017, our center introduced compassionate use of immunotherapy for stage III NSCLC as follows: neoadjuvant chemotherapy combined to perioperative immunotherapy and surgery for resectable NSCLCs (PERIOPERATIVE) and chemo-radiation therapy followed by immunotherapy (PACIFIC) for non-resectable NSCLCs. We report the outcomes and complications of 78 patients.

Methods

IWe reviewed all stage III NSCLC patients treated in the Center or Thoracic Surgery of Romandie (CURCT) between 2017 and 2023 with chemo-immunotherapy and surgery and radiation therapy using our prospectively collected database. We compared groups using Stata®.

Results

Intention to treat population consisted in 52 PERIOPERATIVE and 26 PACIFIC patients. PERIOPERATIVE patients were significantly younger (64 [60–71]vs73 [67–80], p = 0.0001) and had better lung diffusion capacity compared to PACIFIC patients (%predicted DLCO: 74 ± 18vs48 ± 26, p = 0.0008). Complications over the course of therapy occurred in more than 50 % of patients but remained manageable in both groups. Forty-two of 52 PERIOPERATIVE (81 %) and 18 of 26 (69 %) PACIFIC patients completed the entire treatment plan. There was no 30-day mortality. Complete pathological response (pCR) occurred in 11 of the 50 operated PERIOPERATIVE patients (22 %) and was associated with a 100 % 5-year survival. Overall, 5-year survival was of 78 % and 30 % in the PERIOPERATIVE and PACIFIC groups respectively.

Conclusion

The inclusion of immunotherapy in the management of stage III NSCLC has been associated with improved patient outcomes. Real life data suggests that patient complications are frequent but manageable and that patient dropout is low.

免疫治疗（IO）与局部晚期非小细胞肺癌（nsclc）的更好预后相关。2017年，我中心对III期非小细胞肺癌开展了富有同情心的免疫治疗，可切除的非小细胞肺癌（围手术期）采用新辅助化疗联合围手术期免疫治疗，不可切除的非小细胞肺癌（围手术期）采用化疗+放疗+免疫治疗（PACIFIC）。我们报告了78例患者的结果和并发症。方法：我们回顾了2017年至2023年间在罗曼迪胸外科中心（CURCT）接受化疗免疫治疗、手术和放疗的所有III期NSCLC患者，使用我们前瞻性收集的数据库。我们使用Stata®进行组间比较。结果意向治疗人群围手术期52例，太平洋期26例。围手术期患者明显更年轻（64 [60-71]vs73 [67-80], p = 0.0001），与太平洋患者相比，肺弥散能力更好（预测DLCO百分比：74±18vs48±26，p = 0.0008）。超过50%的患者在治疗过程中出现并发症，但在两组中都是可控的。52例围手术期患者中有42例（81%）和26例太平洋患者中有18例（69%）完成了整个治疗计划。没有30天死亡率。50例围手术期患者中有11例（22%）出现完全病理反应（pCR）， 5年生存率为100%。总的来说，围手术期和太平洋组的5年生存率分别为78%和30%。结论：在III期NSCLC的治疗中纳入免疫治疗与改善患者预后相关。现实生活中的数据表明，患者并发症频繁但可控，患者退学率很低。

{"title":"Real-world outcomes of stage III NSCLCs managed by surgery or definitive radiation therapy in the era of immunotherapy","authors":"Etienne Abdelnour-Berchtold , Louis-Emmanuel Chriqui , Laetitia Zermatten , Sotirios Papadopoulos , Celine Forster , Arpad Hasenauer , Benoit Bedat , Matthieu Zellweger , Remy Kinj , Nuria Mederos , Michel Christodoulou , Alfredo Addeo , Frederic Triponez , Wolfram Karenovics , Michel Gonzalez , Thorsten Krueger , Solange Peters , Hasna Bouchaab , Jean Yannis Perentes","doi":"10.1016/j.ejso.2026.111401","DOIUrl":"10.1016/j.ejso.2026.111401","url":null,"abstract":"<div><h3>Objectives</h3><div>Immunotherapy (IO) has been associated with better outcomes in locally advanced non-small cell lung cancers (NSCLCs). In 2017, our center introduced compassionate use of immunotherapy for stage III NSCLC as follows: neoadjuvant chemotherapy combined to perioperative immunotherapy and surgery for resectable NSCLCs (PERIOPERATIVE) and chemo-radiation therapy followed by immunotherapy (PACIFIC) for non-resectable NSCLCs. We report the outcomes and complications of 78 patients.</div></div><div><h3>Methods</h3><div>IWe reviewed all stage III NSCLC patients treated in the Center or Thoracic Surgery of Romandie (CURCT) between 2017 and 2023 with chemo-immunotherapy and surgery and radiation therapy using our prospectively collected database. We compared groups using Stata®.</div></div><div><h3>Results</h3><div>Intention to treat population consisted in 52 PERIOPERATIVE and 26 PACIFIC patients. PERIOPERATIVE patients were significantly younger (64 [60–71]vs73 [67–80], p = 0.0001) and had better lung diffusion capacity compared to PACIFIC patients (%predicted DLCO: 74 ± 18vs48 ± 26, p = 0.0008). Complications over the course of therapy occurred in more than 50 % of patients but remained manageable in both groups. Forty-two of 52 PERIOPERATIVE (81 %) and 18 of 26 (69 %) PACIFIC patients completed the entire treatment plan. There was no 30-day mortality. Complete pathological response (pCR) occurred in 11 of the 50 operated PERIOPERATIVE patients (22 %) and was associated with a 100 % 5-year survival. Overall, 5-year survival was of 78 % and 30 % in the PERIOPERATIVE and PACIFIC groups respectively.</div></div><div><h3>Conclusion</h3><div>The inclusion of immunotherapy in the management of stage III NSCLC has been associated with improved patient outcomes. Real life data suggests that patient complications are frequent but manageable and that patient dropout is low.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111401"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074763","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

Ejso最新文献

Introduction

Materials and methods

Results

Conclusion

Introduction

Methods

Results

Conclusion

Clinical trial registration

Background

Materials and methods

Results

Conclusions

Objective

Methods

Results

Conclusions

Purpose

Methods

Results

Conclusion

Background

Methods

Results

Conclusion

Background

Methods

Results

Conclusions

Objectives

Methods

Results

Conclusion