Ejso最新文献

{"title":"Real-world outcomes of stage III NSCLCs managed by surgery or definitive radiation therapy in the era of immunotherapy","authors":"Etienne Abdelnour-Berchtold ,&nbsp;Louis-Emmanuel Chriqui ,&nbsp;Laetitia Zermatten ,&nbsp;Sotirios Papadopoulos ,&nbsp;Celine Forster ,&nbsp;Arpad Hasenauer ,&nbsp;Benoit Bedat ,&nbsp;Matthieu Zellweger ,&nbsp;Remy Kinj ,&nbsp;Nuria Mederos ,&nbsp;Michel Christodoulou ,&nbsp;Alfredo Addeo ,&nbsp;Frederic Triponez ,&nbsp;Wolfram Karenovics ,&nbsp;Michel Gonzalez ,&nbsp;Thorsten Krueger ,&nbsp;Solange Peters ,&nbsp;Hasna Bouchaab ,&nbsp;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}

{"title":"Surgery for Colorectal Peritoneal Metastases in non-expert centers is strongly associated with tumor persistence or early recurrence: a bicentric study of 106 patients","authors":"Barbara Noiret ,&nbsp;Vahan Kepenekian ,&nbsp;Maxime Leroy ,&nbsp;Marie Provost ,&nbsp;Pascal Rousset ,&nbsp;Guillaume Piessen ,&nbsp;Olivier Glehen ,&nbsp;Clarisse Eveno","doi":"10.1016/j.ejso.2026.111397","DOIUrl":"10.1016/j.ejso.2026.111397","url":null,"abstract":"<div><h3>Background</h3><div>Complete cytoreductive surgery (CRS) performed in expert centers is a key determinant of outcome in patients with colorectal peritoneal metastases (CRPM). In the contemporary context of ongoing debate regarding the role of HIPEC following the PRODIGE 7 trial, the impact of initial management outside expert centers on outcomes remains insufficiently characterized. This study evaluates the value of systematic second-look surgeries in expert centers after CRS in non-expert centers.</div></div><div><h3>Methods</h3><div>Patients with histologically confirmed CRPM who initially underwent surgery in non-expert centers followed by systematic second-look surgery in two expert centers were included between 2010 and 2022.</div></div><div><h3>Statistical analysis</h3><div>Perioperative outcomes were evaluated in both surgeries. Preoperative imaging (CT-scan/MRI) were conducted before second-look surgeries and reviewed by expert radiologists. Survival outcomes were performed by Kaplan-Meier method.</div></div><div><h3>Results</h3><div>Among 106 patients (50.9 % male, mean age 58.9 ± 10.8 years), all tumors were classified as pT3-4, with 87 % having synchronous CRPM. Initial CRS in non-expert centers was performed urgently in 35 % of cases, primarily due to occlusion or perforation (62.1 %). Complete cytoreduction (CC0) was declared in 63 % of initial CRS. Reassessment (CT/MRI) before second-look was highly predictive of intraoperative and histological presence of CRPM, but intraoperative CRPM detection occurred in 61 % (CT-negative) and 81 % (MRI-negative) with histological confirmation in 53 % and 42 %. During second-look surgery, CRPM was observed in 88 % of cases (median PCI score:6) and 11.3 % were unresectable. Median overall survival (OS) was 43 months with 1- and 5-year OS of 95 % and 34.3 %, respectively. Prognostic factors of lower OS included poorly cohesive histology, emergency surgery and incomplete cytoreduction during first surgery in non-expert centers.</div></div><div><h3>Conclusions</h3><div>In patients with CRPM initially managed in non-expert centers, expert-center reassessment, including consideration of second-look surgery, identifies persistent or recurrent peritoneal disease in a substantial proportion of patients, even in the absence of radiological evidence. These findings support the importance of early referral to expert centers for comprehensive evaluation and multidisciplinary decision-making. The impact of second-look strategies on survival outcomes warrants further prospective investigation.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111397"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074764","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}

{"title":"Virtual patient modeling for generative-AI-assisted treatment decision-making in lymphedema care: AI tends to favor more aggressive treatment","authors":"Yuki Tsujimoto ,&nbsp;Makoto Shiraishi ,&nbsp;Hiroki Yamanaka ,&nbsp;Haesu Lee ,&nbsp;Mutsumi Okazaki ,&nbsp;Naoki Morimoto","doi":"10.1016/j.ejso.2026.111391","DOIUrl":"10.1016/j.ejso.2026.111391","url":null,"abstract":"<div><h3>Background</h3><div>The rapid advancement of generative artificial intelligence (gen-AI) has prompted interest in whether it can recognize and respond to individual clinical backgrounds in treatment decision-making. To explore this, we developed a virtual patient model for lymphedema and conducted an observational study to examine what treatments AI would recommend, whether the recommendations were individualized, and what tendencies the AI exhibited.</div></div><div><h3>Methods</h3><div>A virtual cohort of 100 patients with secondary upper extremity lymphedema following breast cancer surgery was constructed using generative pre-trained transformer-4 omni (GPT-4o). For each virtual patient, six clinical questions, based on the Japanese Lymphedema Guidelines 2024, were submitted to the AI to elicit individualized recommendations. The answers obtained were compared with guidelines-defined recommendation levels to assess concordance, deviation, and treatment tendencies, analyzed by patient factors.</div></div><div><h3>Results</h3><div>Multivariate analysis demonstrated that GPT-4o-generated recommendations were tailored to individual patient characteristics. They showed high concordance with guideline-defined recommendations for conservative care but greater variability and bias toward invasive options in surgical contexts.</div></div><div><h3>Conclusion</h3><div>The preference of gen-AI for invasive treatments may reflect an overestimation of the benefits of performing treatments rather than withholding them, especially in invasive treatments. This bias shows a limitation of current gen-AI in complex decisions. Our reproducible simulation framework identified this bias and variability, clarifying both strengths and limitations of gen-AI. This type of AI-on-AI observational study may help improve the accuracy of AI and support its future role in clinical care.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 3","pages":"Article 111391"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017786","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}

{"title":"Comparative analysis between peristaltic and syringe nebulization systems: Advancing high-pressure drug delivery for pressurized intraperitoneal aerosol chemotherapy (PIPAC).","authors":"Qiming Fan, Renjie Li, Xiaosong Lin, Ruijian Chen, Bingcong Luo, Zifeng Yang, Yong Li","doi":"10.1016/j.ejso.2026.111494","DOIUrl":"https://doi.org/10.1016/j.ejso.2026.111494","url":null,"abstract":"<p><strong>Background: </strong>The high-pressure syringe pump (HP-SP) is the most widely applied device for PIPAC. However, HP-SP systems exhibited several limitations: relatively more drug assembly procedures and significant start-up delays. Herein, the performance of a high-pressure peristaltic pump (HP-PP) was compared to the existing HP-SP for PIPAC.</p><p><strong>Methods: </strong>Mechanical and ex vivo experiments were conducted to compare the performance of the HP-PP and HP-SP for PIPAC. The evaluated parameters included (1) particle size distribution, operational pressure, and its influence on particle size distribution in the initial phase; (2) drug assembly time (DAT); (3) dead volume; (4) spray cone angle and deposition areas; and (5) doxorubicin (DOX) penetration depth and spatial distribution in a box model.</p><p><strong>Results: </strong>Both systems produced aerosols with comparable median particle sizes (≈25 μm) and spray cone angles (≈70°). The HP-PP demonstrated significantly shorter start-up time (5 s vs. 34.7 ± 2.9 s) and DAT (15.1 ± 1.3 s vs. 54.8 ± 3.1 s for a 150 mL setup). The original dead volume of HP-PP was 2.4 ± 0.3 mL but was reduced to 0.44 ± 0.03 mL after optimization. Spray coverage was similar for both pumps across different nozzle heights. DOX penetration depths were similar between groups, except for marginally deeper penetration at obstructed (B) and lateral (C) positions for HP-PP (p < 0.01).</p><p><strong>Conclusion: </strong>The HP-PP performs comparably to the HP-SP in key aerosol and distribution parameters, while offering faster initiation and a simplified drug assembly process. This indicates its potential application for clinical PIPAC, despite no therapeutic advantage being observed at this stage.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 5","pages":"111494"},"PeriodicalIF":2.9,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480147","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}

{"title":"Breast cancer: A success story for women.","authors":"V Suzanne Klimberg","doi":"10.1016/j.ejso.2026.111491","DOIUrl":"https://doi.org/10.1016/j.ejso.2026.111491","url":null,"abstract":"<p><p>For women, breast cancer is a huge success story; many survivors go on to lead long, happy, and sometimes even better lives following treatment. Two-thirds of patients with invasive breast cancer have a Stage I diagnosis, meaning that the 5-year relative survival rate in the Western world is close to 90%. This is in stark contrast to the lack of screening and outcomes in low-resource countries.(1) Achieving favorable results requires early detection and efficient treatments, such as radiation therapy, surgery, and targeted medicines. Multidisciplinary care and an emphasis on patient-reported outcomes have been championed by the increasing number of women surgeons. The advent of the \"breast surgeon\" has changed the face of breast cancer care and paved the way for many innovations in breast cancer treatment.</p>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 5","pages":"111491"},"PeriodicalIF":2.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473007","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}

{"title":"Ethnicity and breast cancer incidence in over 329 500 women in England in 2011–2019","authors":"Gathani T. ,&nbsp;Kan S.W. ,&nbsp;Sweetland S. ,&nbsp;Reeves G.K.","doi":"10.1016/j.ejso.2025.109585","DOIUrl":"10.1016/j.ejso.2025.109585","url":null,"abstract":"<div><h3>Introduction</h3><div>Previous studies have reported an overall lower breast cancer incidence in women from Asian and Black backgrounds compared with white women. Age standardised and age specific incidence rates in the largest specific ethnicities within Asian and Black groups are not reported.</div></div><div><h3>Materials and methods</h3><div>Data on population size and the age distribution of women in five ethnic groups of interest (white British, Black African, Black Caribbean, Indian and Pakistani) were extracted from the Office for National Statistics 2001, 2011 and 2021 census data for England.</div><div>Cancer registrations for invasive breast cancer (ICD-10 C50) in women in England aged ≥25 years during 2011–2019 with a recorded ethnicity were extracted from the National Cancer Registration and Analysis Service.</div><div>Age standardised (ASIRs) and age specific (ASRs) incidence rates in five ethnic groups of interest were calculated.</div></div><div><h3>Results</h3><div>329 655 women who were aged ≥25 years and in one of the five ethnic groups of interest had a record of an incident C50 cancer registration during 2011–2019. The ASIR was highest for white women (199.6 (95 % CI 198.9–200.3)), and lowest for Black African women (118.2 (95 % CI 111.6–125.1)). The ASRs for invasive breast cancer were generally lower in women from minority ethnic groups compared to white women in all age groups examined except for younger Black Caribbean women.</div></div><div><h3>Conclusions</h3><div>There are significant differences in breast cancer incidence rates between women from specific ethnicities. This requires further investigation in large scale prospective studies considering potential differences by ethnicity in known risk factors for breast cancer.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 2","pages":"Article 109585"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002250","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}

{"title":"Alteration in estrogen receptor status in metachronous contralateral breast cancer among unilateral early breast cancer patients with BRCA 1/2 mutations","authors":"Ki Jo Kim ,&nbsp;Eunhye Kang ,&nbsp;Seung Ho Baek ,&nbsp;Han-Byoel Lee ,&nbsp;Sung Gwe Ahn ,&nbsp;Woong Ki Park ,&nbsp;Dong Seung Shin ,&nbsp;Hyunwoo Lee ,&nbsp;Seok Jin Nam ,&nbsp;Seok Won Kim ,&nbsp;Jong Han Yu ,&nbsp;Byung Joo Chae ,&nbsp;Se Kyung Lee ,&nbsp;Jeong Eon Lee ,&nbsp;Jai Min Ryu","doi":"10.1016/j.ejso.2025.111332","DOIUrl":"10.1016/j.ejso.2025.111332","url":null,"abstract":"<div><h3>Background</h3><div><em>BRCA1/2</em> mutations significantly increase the risk of contralateral breast cancer (CBC). However, their influence on estrogen receptor (ER) status changes between primary breast cancer and metachronous CBC remains unclear. This study investigates ER status alterations in CBC patients with <em>BRCA1/2</em> mutations to clarify their clinical implications.</div></div><div><h3>Methods</h3><div>In this multicenter retrospective study (2004–2020), patients with unilateral early breast cancer who underwent <em>BRCA1/2</em> testing and developed metachronous CBC were grouped by <em>BRCA1/2</em> mutation status. ER status of primary and CBC tumors was compared using Fisher's exact test and logistic regression to assess the relationship between <em>BRCA1/2</em> mutations and ER alterations.</div></div><div><h3>Results</h3><div>Among 423 CBC patients, those with <em>BRCA1</em> mutation had a higher likelihood of ER negative primary tumors maintaining ER negative disease in CBC (70.7 %) compared to <em>BRCA1/2</em> negative patients (odds ratio [OR] 3.8, p &lt; 0.001). Similarly, ER negative primary tumors were more likely to remain ER negative in CBC among <em>BRCA1 or BRCA2</em> mutation carriers (64.8 %, OR 2.9, p = 0.002). These findings demonstrate a strong association between <em>BRCA1</em> mutations and development of ER negative CBC in ER negative primary breast cancer. Among patients with primary ER negative breast cancer, those who received adjuvant chemotherapy for both primary and CBCs showed a higher rate of ER negative CBC (OR 4.23, p = 0.001).</div></div><div><h3>Conclusion</h3><div><em>BRCA1</em> mutation carriers face a higher risk of developing ER negative metachronous CBC, in ER negative primary tumor. These results support genetic counseling and risk-reducing strategies, including prophylactic mastectomy, for <em>BRCA1</em> mutation carriers.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 2","pages":"Article 111332"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683369","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}

{"title":"Post-mastectomy radiotherapy negatively impacts short-term patient-reported outcomes in patients with and without immediate breast reconstruction – a retrospective cohort study","authors":"Lea Zehnpfennig ,&nbsp;Nadia Maggi ,&nbsp;Jeremy Levy ,&nbsp;Julie M. Loesch ,&nbsp;Rama Kiblawi ,&nbsp;Marie Louise Frevert ,&nbsp;Fabienne D. Schwab ,&nbsp;Martin D. Haug ,&nbsp;Christian Kurzeder ,&nbsp;Walter P. Weber ,&nbsp;Martin Heidinger","doi":"10.1016/j.ejso.2025.111305","DOIUrl":"10.1016/j.ejso.2025.111305","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite prior demonstration of a detrimental effect of post-mastectomy radiotherapy (PMRT) on patient reported outcomes (PROs) in patients with breast cancer (BC) undergoing breast reconstruction, the impact of PMRT on patients without reconstruction remains less clear. The objective of this study was to assess the association between PMRT and patient-reported outcomes (PROs).</div></div><div><h3>Materials and methods</h3><div>Patients with stage 0-III BC who underwent mastectomy (including total mastectomy, nipple-sparing mastectomy, and skin-sparing mastectomy) at a Swiss university hospital between 01/2013-12/2023, who completed at least one postoperative BREAST-Q questionnaire, were identified from a prospectively maintained institutional database. Outcomes included the identification of differences in PROs relative to receipt of PMRT.</div></div><div><h3>Results</h3><div>Of 243 eligible patients, 30.9 % (75/243) underwent PMRT. The median time to last PRO assessment was 30.4 months, without differences between the groups (p = 0.100). The frequency and type of breast reconstruction were comparable between the groups, with 41.2 % of patients not undergoing breast reconstruction. Physical well-being and psychosocial well-being were reduced following PMRT. In the multivariate analysis, PMRT was identified as a predictor of worse short-term (0–2 years postoperatively) physical well-being (estimated difference [ED] −7.9, 95 %CI -15.4 to −0.4) and showed a trend towards worse psychosocial well-being (ED -9.1, 95 %CI -18.3 – 0.1) irrespective of breast reconstruction.</div></div><div><h3>Conclusion</h3><div>In conclusion, PMRT negatively impacts short-term PROs, regardless of whether breast reconstruction is performed or not.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 2","pages":"Article 111305"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617526","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}

{"title":"Women as surgical leaders: from fixing women to fixing systems","authors":"I.T. Rubio ,&nbsp;L. Pitoni","doi":"10.1016/j.ejso.2025.110433","DOIUrl":"10.1016/j.ejso.2025.110433","url":null,"abstract":"<div><div>Advancing women in surgical leadership has traditionally focused on individual adaptation, mentorship, resilience, and personal skills rather than addressing systemic barriers. Despite improvements in awareness, representation, and support networks, meaningful change remains limited due to persistent institutional biases, structural constraints, and cultural norms. Female surgeons face additional challenges related to recruitment, mentorship, research access, and work-life integration, particularly around motherhood, which can penalize career progression even in supportive systems. Leadership programs and sponsorship opportunities remain unevenly available, and formal recognition of mentorship and informal leadership roles is often lacking. True transformation requires shifting from “fixing women” to “fixing systems” through formal leadership curricula, institutional accountability, and measurable outcomes. By empowering women to actively shape culture rather than merely navigate it, surgery can achieve female leadership that is inclusive, effective, and equitable. Addressing these challenges demands a collective responsibility of surgical societies, academic centers, and hospital leadership to foster structural reform, recognize diverse career trajectories, and cultivate visible female role models.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 2","pages":"Article 110433"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039371","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}

{"title":"Subsequent risk of death from sepsis among over 6 million cancer patients: A population-based cohort study","authors":"Hang Yi ,&nbsp;Xu Ou-Yang ,&nbsp;Mingzhong Wan ,&nbsp;Boyuan Wen ,&nbsp;Jiale Li ,&nbsp;Yan Wang ,&nbsp;Yinyan Gao ,&nbsp;Qihao Leng ,&nbsp;Guochao Zhang ,&nbsp;Shujun Li ,&nbsp;Yousheng Mao","doi":"10.1016/j.ejso.2025.111373","DOIUrl":"10.1016/j.ejso.2025.111373","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis, a severe systemic inflammatory response to infection, remains a leading cause of morbidity and mortality among cancer patients, particularly due to the immunosuppressive effects of both malignancy and its treatments. This study aims to assess the risk of sepsis-related mortality in cancer patients, identify the effects of various cancer types and demographic factors, and provide insights for developing targeted preventive strategies.</div></div><div><h3>Methods</h3><div>A population-based cohort study was conducted using data from the Surveillance, Epidemiology, and End Results (SEER) database, which includes approximately 26.5 % of the U.S. population. The analysis covered 6,891,191 cancer patients diagnosed from 2000 to 2021. Standardized mortality ratios (SMRs) and absolute excess risks (AERs) were calculated to compare sepsis-related mortality risk in cancer patients with the general population. Key variables included cancer type, age, gender, race, and marital status.</div></div><div><h3>Results</h3><div>Of the 6,891,191 cancer patients included, 25,232 (0.37 %) died from sepsis. The overall SMR was 1.52 (95 % CI: 1.50–1.54), with an AER of 2.15 (95 % CI: 2.05–2.25) per 10,000 person-years. Patients with brain and other nervous system cancers (SMR = 5.74, 95 % CI: 4.95–6.61), respiratory system cancers (SMR = 3.52, 95 % CI: 3.38–3.66), and hematologic malignancies such as myeloma (SMR = 3.25, 95 % CI: 2.97–3.55) exhibited high sepsis-related mortality risks. Disparities were observed, with elevated risks in female patients (SMR = 1.64, 95 % CI: 1.61–1.67), American Indian/Alaska Native patients (SMR = 4.23, 95 % CI: 3.50–5.07), and single (never married) individuals (SMR = 2.50, 95 % CI: 2.42–2.58). Mortality risk was most pronounced within the first two months following cancer diagnosis, with an SMR of 7.37 (95 % CI: 7.14–7.61).</div></div><div><h3>Conclusions</h3><div>The findings suggest a significantly increased risk of sepsis-related mortality among cancer patients, highlighting the need for improved infection prevention, early interventions, and tailored strategies. Multidisciplinary care and enhanced support for high-risk groups are essential to mitigate sepsis-related complications and improve outcomes.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"52 2","pages":"Article 111373"},"PeriodicalIF":2.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145880111","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}