Journal of Surgical Oncology最新文献_第10页

A Seer-Based Analysis of Survival Predictors in Stage I Colorectal Adenocarcinomas 基于先知的I期结直肠癌生存预测因素分析。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-21 DOI: 10.1002/jso.70111

Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Marcus Oosenbrug, Marylise Boutros, Steven D. Wexner

Background

We assessed predictors of overall (OS) and cancer-specific survival (CSS) in stage I colorectal cancer (CRC).

Methods

Retrospective analysis of patients with stage I colon or rectal adenocarcinomas from the SEER database (2010–2020) Survival was assessed using Kaplan-Meier statistics and multivariable Cox regression analyses. The primary outcomes were 5-year OS and CSS.

Results

40,001 patients (51.3% male; mean age: 65.1 ± 12.6 years) were included. Colon and rectal cancers accounted for 75.8% and 24.2%, respectively. Five-year OS and CSS were 83.1% (95% CI: 82.6–83.5%) and 93.2% (95% CI: 92.9–93.5%), respectively. Factors independently associated with worse OS were age (HR: 1.07; p < 0.001), male sex (HR:1.48; p < 0.001), Black race (HR: 1.25; p < 0.001), single, divorced, or widowed status (HR: 1.49, 1.46, and 1.43; p < 0.001), tumor size (HR: 1.001; p = 0.008), poorly differentiated carcinomas (HR: 1.32; p < 0.001), undifferentiated carcinomas (HR:1.44; p = 0.026), perineural invasion (HR: 1.84; p < 0.001), elevated CEA levels (HR: 1.68; p < 0.001), and systemic therapy (neoadjuvant: HR: 1.3; p = 0.032, adjuvant: HR: 2.2; p < 0.001, both: HR: 1.97; p < 0.001). Factors independently associated with worse CSS were age (HR: 1.05; p < 0.001), male sex (HR: 1.32; p < 0.001), Black race (HR: 1.43; p < 0.001), marital status (HR: 1.44, 1.28, and 1.68; p < 0.001), tumor size (HR: 1.003; p < 0.001), poorly differentiated carcinomas (HR: 1.77; p < 0.001), perineural invasion (HR: 2.29; p < 0.001), elevated CEA levels (HR: 2.24; p < 0.001), and systemic therapy (neoadjuvant: HR: 2.53; p = 0.032, adjuvant: HR: 4.22; p < 0.001, both: HR: 3.83; p < 0.001).

Conclusions

Although patients with stage I CRC had excellent survival, single, older, Black, male patients with large, high-grade tumors associated with perineural invasion and elevated CEA levels had a higher mortality risk.

背景：我们评估了I期结直肠癌（CRC）总生存率（OS）和癌症特异性生存率（CSS）的预测因素。方法：回顾性分析来自SEER数据库（2010-2020）的I期结肠或直肠腺癌患者，采用Kaplan-Meier统计和多变量Cox回归分析评估生存率。主要结局为5年OS和CSS。结果：纳入40001例患者，其中男性51.3%，平均年龄65.1±12.6岁。结肠癌和直肠癌分别占75.8%和24.2%。5年OS和CSS分别为83.1% （95% CI: 82.6-83.5%）和93.2% （95% CI: 92.9-93.5%）。与OS恶化独立相关的因素是年龄（HR: 1.07; p）。结论：尽管I期CRC患者有很好的生存率，但单个、年龄较大、黑人、男性的大、高级别肿瘤伴神经周围浸润和CEA水平升高的患者有更高的死亡风险。

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引用次数: 0

Complete Cytoreduction of Colorectal Liver Metastases: Evolving Systemic Therapy and Liver Transplantation 结肠直肠癌肝转移的完全细胞减少：不断发展的全身治疗和肝移植。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-16 DOI: 10.1002/jso.70112

Viet Le, Jan Franko, Yuman Fong

Approximately 50%–60% of patients with colorectal cancer develop metastases, of which most have unresectable metastatic liver disease. Several recent studies highlight the progress of systemic therapy in converting patients with high burden of colorectal liver metastases (CRLM) from unresectable to resectable disease, resulting in median overall survival improvements. The improvement of systemic therapy and the evolving spectrum of surgical techniques is allowing multidisciplinary treatment teams an increasing ability to achieve complete cytoreduction of CRLM and offering an increasing number of patients a chance for long-term survival.

约50%-60%的结直肠癌患者发生转移，其中大多数为不可切除的转移性肝病。最近的几项研究强调了全身治疗在将高负担的结直肠癌肝转移（CRLM）患者从不可切除转移到可切除疾病方面的进展，从而提高了中位总生存期。全身治疗的改进和外科手术技术的不断发展，使多学科治疗团队越来越有能力实现CRLM的完全细胞减少，并为越来越多的患者提供长期生存的机会。

引用次数: 0

The Melanoma Divide: Hispanic Health Disparities From Peru to the United States 黑色素瘤的鸿沟：从秘鲁到美国的西班牙裔健康差异。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-14 DOI: 10.1002/jso.70110

Gabriel De la Cruz Ku, Gonzalo Ziegler-Rodriguez, Anshumi Desai, Luis Piedra Delgado, Jessica Farzan, Jiddu Guart, Michael Mallouh, Camila Franco, Sheila Diaz-Mora, Sandro Casavilca-Zambrano, Jose Cotrina-Concha, Mecker G. Möller

Introduction

Melanoma is a heterogeneous malignancy, the incidence of which has increased by 20% in the Hispanic population over the past two decades. We aimed to compare the clinical, pathological, and outcome-related characteristics of Hispanic patients with melanoma in Peru (HPP) versus the United States (HPUS).

Methods

Two retrospective cohorts were evaluated: HPP diagnosed with melanoma at a tertiary institution in Lima-Peru and HPUS with melanoma registered in the Surveillance, Epidemiology, and End Results Program during the period 2010–2019.

Results

A total of 1136 HPP and 5302 HPUS were included. HPP patients were older (61.17 vs. 56.63 years, p < 0.001), more likely to be male (51.5% vs. 39.6%, p < 0.001), and resided in nonmetropolitan areas (49.6% vs. 3.5%, p < 0.001). HPP had a higher prevalence of primary lesions in the lower extremities (75.5% vs. 36.9%, p < 0.001) and ulceration (65.3% vs. 21.3%, p < 0.001). Histologically, HPP most commonly presented with acral lentiginous melanoma (38.1%), while HPUS had a more superficial spreading type (30.8%, p < 0.001). HPP showed greater Breslow depth (mean: 7.66 vs. 1.51 mm, p < 0.001) and mitotic activity and were diagnosed at more advanced stages: stage III (36.5% vs. 15.0%, p < 0.001). With a median follow-up of 74 months, HPP exhibited worse 5-year overall survival (OS) rates across all stages versus HPUS.

Conclusions

HPP with melanoma exhibit more aggressive pathological features than their HPUS counterparts and are diagnosed at more advanced stages, resulting in poorer OS rates across all stages, and being HPP is a prognostic factor of a worse OS. These findings emphasize the need for further research to deepen our understanding of the molecular factors influencing this diverse biological presentation in Hispanic populations.

简介：黑色素瘤是一种异质性恶性肿瘤，在过去二十年中，其发病率在西班牙裔人群中增加了20%。我们的目的是比较秘鲁（HPP）和美国（HPUS）西班牙裔黑色素瘤患者的临床、病理和结局相关特征。方法：对两个回顾性队列进行评估：在利马-秘鲁的一所高等院校诊断为黑色素瘤的HPP和2010-2019年期间在监测、流行病学和最终结果项目中登记的患有黑色素瘤的HPUS。结果：共纳入HPP 1136例，hpu 5302例。HPP患者年龄较大（61.17岁vs. 56.63岁）。结论：HPP合并黑色素瘤患者比hpu患者表现出更具侵袭性的病理特征，并且在更晚期被诊断出来，导致所有阶段的OS率更低，HPP是更差OS的预后因素。这些发现强调了进一步研究的必要性，以加深我们对影响西班牙裔人群这种不同生物学表现的分子因素的理解。

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引用次数: 0

Excision Depth and Prognosis in T1–T3 Plantar Melanoma: Is Complete Excision of Plantar Fat Pad Necessary? T1-T3足底黑色素瘤的切除深度和预后：足底脂肪垫完全切除是必要的吗？

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-13 DOI: 10.1002/jso.70108

Kyeong-Tae Lee, Sungjin Kim, Goo-Hyun Mun

Background

While peripheral excision margins in cutaneous melanoma are well established, the optimal excision depth remains unclear. In plantar melanoma, the fat pad plays a key functional role, raising concerns about whether full excision is necessary for thin and intermediate-thickness lesions. This study evaluated the association between excision depth and oncologic outcomes in T1–T3 plantar melanoma.

Methods

Patients with primary T1–T3 plantar melanoma who underwent wide excision between 2008 and 2022 were reviewed. They were grouped by excision depth: intra-adiposal (partial fat pad preservation) and suprafascial (complete removal). Oncologic and functional outcomes, assessed via the Foot Function Index (FFI), were compared.

Results

Ninety-four patients (40 intra-adiposal, 54 suprafascial) were analyzed (median follow-up, 43 months). Tumor-free margins were achieved in all cases. Baseline characteristics were similar, except for lesion location. Recurrence rates were comparable, and excision depth was not significantly associated with recurrence-free survival. FFI scores from 26 patients (13 per group) tended to be better in the intra-adiposal group, though not statistically significant.

Conclusions

In thin to intermediate-thickness plantar melanoma, intra-adiposal excision may be oncologically safe if tumor-free margins are achieved, potentially offering functional benefits without compromising oncologic outcomes.

背景：虽然皮肤黑色素瘤的外周切除边缘已经确定，但最佳切除深度尚不清楚。在足底黑色素瘤中，脂肪垫起着关键的功能作用，这引起了人们对薄和中厚病变是否需要完全切除的关注。本研究评估了T1-T3足底黑色素瘤切除深度与肿瘤预后之间的关系。方法：回顾2008年至2022年间接受广泛切除的原发性T1-T3足底黑色素瘤患者。他们按切除深度分组：脂肪内（部分脂肪垫保留）和筋膜上（完全切除）。通过足功能指数（FFI）评估肿瘤和功能结果进行比较。结果：分析了94例患者（40例脂肪内，54例筋膜上）（中位随访43个月）。所有病例均获得无瘤边缘。基线特征相似，除了病变位置不同。复发率具有可比性，且切除深度与无复发生存率无显著相关性。26例患者（每组13例）的FFI评分倾向于脂肪内组更好，但无统计学意义。结论：在薄到中厚的足底黑色素瘤中，如果达到无瘤边缘，脂肪内切除可能是肿瘤安全的，潜在地提供功能益处而不影响肿瘤预后。

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引用次数: 0

Predictive Factors for Failed Sentinel Lymph Node Mapping in Endometrial Cancer: A Retrospective Multicenter Study 子宫内膜癌前哨淋巴结定位失败的预测因素：一项回顾性多中心研究。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-11 DOI: 10.1002/jso.70106

Cristina Taliento, Gennaro Scutiero, Giuseppe Cucinella, Vito Chiantera, Giovanni Pontrelli, Marko Klaric, Dragan Belci, Martin Steinkasserer, Stefano Restaino, Ruby Martinello, Orsola Brasile, Martina Arcieri, Sara Pregnolato, Giulia Pellecchia, Giulia Soraci, Rosa Taratufolo, Carmelia Milano, Marcello Desgro, Francesca Davià, Mariano Catello Di Donna, Dino Becic, Sara Notaro, Giuseppe Vizzielli, Pantaleo Greco

Background and Objectives

This study aims to evaluate the predictive factors associated with failed sentinel lymph node (SLN) mapping in a large, retrospective cohort of patients with early-stage endometrial cancer (EC).

Methods

We retrospectively evaluated a series of EC patients who underwent laparoscopic SLN mapping with intracervical indocyanine green (ICG) injection in five referred oncological centers from January 2019 to March 2024. We compared the clinical and pathological features of bilateral and failed SLN mapping, which was defined as either unilateral mapping or no SLN mapping. Logistic regression was used to identify predictors of failure.

Results

Among 623 analyzed patients, 437 (70.14%) had a successful bilateral procedure. On univariate analysis, age (p = 0.03), non-endometrioid histology (p = 0.02) and previous vaginal delivery (p = 0.015) were significant associated with failed SLN mapping. On multivariable analysis, only increasing age (OR 1.03; 95% CI, 1.01–1.04, p = 0.03) and non-endometrioid histology (OR 1.81; 95% CI, 1.01–3.19) were independently associated with unsuccessful procedure. No significant differences were observed for BMI, enlarged lymph nodes, intraoperative lysis of adhesion, LVSI, grade 3, and FIGO stage.

Conclusions

Increasing age and non-endometrioid histology are independent predictors of bilateral SLN mapping failure in EC patients undergoing SLN mapping with cervical ICG injection.

背景和目的：本研究旨在评估与早期子宫内膜癌（EC）患者前哨淋巴结（SLN）定位失败相关的预测因素。方法：我们回顾性评估了2019年1月至2024年3月在五个转诊肿瘤中心接受腹腔镜宫颈内注射吲哚青绿（ICG） SLN定位的一系列EC患者。我们比较了双侧和SLN标测失败的临床和病理特征，定义为单侧SLN标测或无SLN标测。使用逻辑回归来确定失败的预测因素。结果：623例患者中，437例（70.14%）双侧手术成功。单因素分析显示，年龄（p = 0.03）、非子宫内膜样组织学（p = 0.02）和阴道分娩史（p = 0.015）与SLN定位失败有显著相关性。在多变量分析中，只有年龄增加（OR 1.03; 95% CI, 1.01-1.04, p = 0.03）和非子宫内膜样组织学（OR 1.81; 95% CI, 1.01-3.19）与手术失败独立相关。BMI、淋巴结肿大、术中粘连溶解、LVSI、3级和FIGO分期均无显著差异。结论：年龄增长和非子宫内膜样组织学是宫颈ICG注射SLN定位的EC患者双侧SLN定位失败的独立预测因素。

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引用次数: 0

Liquid Biopsy in Metastatic Breast Cancer: Adoption Lags Despite Growing Evidence 转移性乳腺癌的液体活检：尽管证据越来越多，但采用滞后。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-10 DOI: 10.1002/jso.70107

Kadri Altundag

引用次数: 0

Protocols, Complications, and Outcomes of Pressurized Intraperitoneal Aerosol Chemotherapy for Patients With Peritoneal Metastasis: A Systematic Review of the Literature 腹膜转移患者的加压气雾化疗方案、并发症和结果：文献系统综述。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-10 DOI: 10.1002/jso.70109

Ian S. Reynolds, William P. Duggan, Nicholas P. McKenna, Amit Merchea, Jürgen Mulsow

Background

The use of pressurized intraperitoneal aerosol chemotherapy (PIPAC) is becoming more frequent for patients with unresectable peritoneal metastases. This systematic review explores the indications, protocols, feasibility, safety, oncological outcomes, patient reported outcomes and quality of life outcomes for patients being treated with PIPAC.

Methods

A review of PubMed, Embase and the Cochrane Library was undertaken to identify studies pertaining to patients undergoing treatment with PIPAC. Clinicopathological characteristics, treatment protocols, safety data, treatment response data and outcome data were extracted from relevant studies and included in the analysis.

Results

Data from 1980 patients undergoing 4454 PIPAC procedures for peritoneal metastases from a range of primary cancers was extracted. The treatment protocols identified were relatively homogenous across all studies. Grade 3/4 complications, grade 3/4 toxicity and procedure related mortality occurred infrequently. At least partial histological response was seen in 61.8% of patients. Overall survival for studies presenting data for mixed primary tumors ranged from 8 to 25 months. Quality of life and function were relatively stable throughout treatment.

Conclusions

PIPAC is a safe and feasible treatment option for patients with peritoneal metastases. Ongoing studies are required to evaluate how it compares to best option standard of care chemotherapy.

背景：对于无法切除的腹膜转移患者，使用加压腹腔内气溶胶化疗（PIPAC）越来越常见。本系统综述探讨了PIPAC治疗患者的适应症、方案、可行性、安全性、肿瘤预后、患者报告的预后和生活质量预后。方法：对PubMed、Embase和Cochrane图书馆进行综述，以确定与接受PIPAC治疗的患者有关的研究。从相关研究中提取临床病理特征、治疗方案、安全性数据、治疗反应数据和结局数据并纳入分析。结果：我们提取了1980例接受4454次PIPAC手术治疗各种原发癌症腹膜转移的患者的数据。所有研究确定的治疗方案相对均匀。3/4级并发症、3/4级毒性和手术相关死亡率很少发生。61.8%的患者至少有部分组织学反应。混合原发肿瘤的总体生存期为8至25个月。在整个治疗过程中，患者的生活质量和功能相对稳定。结论：PIPAC是腹膜转移患者安全可行的治疗方案。需要进行的研究来评估它与最佳选择标准治疗化疗的比较。

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引用次数: 0

The Role of Anesthesia in Surgical Oncology: Insights From the Literature and Clinical Considerations 麻醉在外科肿瘤中的作用：来自文献和临床考虑的见解。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-08 DOI: 10.1002/jso.70105

Roberta Oliveira de Almeida, Eduardo Soares Rodrigues, Maria Thereza Palmieri Barbosa, Fabrício Tavares Mendonça, Ana Cristina Pinho Mendes Pereira, Catia Sousa Govêia, Larissa Goveia Moreira, Bruno Luís de Castro Araujo, Mauro Pereira de Azevedo, Alexandre Ferreira Oliveira, Rodrigo Nascimento Pinheiro

Anesthetic technique affects surgical outcomes and oncological prognosis. Recognizing the critical role of surgery in cancer treatment, this narrative review aims to improve anesthesiology practices for cancer patients by evaluating actions that positively influence outcomes. Anesthesiologist experience helps guide technique choice in complex cases. Decisions should be customized based on the type of surgery and patient condition, as different techniques can significantly impact results. The expertise of the entire team at specialized centers further enhances outcomes.

麻醉技术影响手术效果和肿瘤预后。认识到手术在癌症治疗中的关键作用，这篇叙述性综述旨在通过评估积极影响结果的行动来改善癌症患者的麻醉实践。麻醉师的经验有助于指导复杂病例的技术选择。决定应根据手术类型和患者情况定制，因为不同的技术会显著影响结果。专业中心的整个团队的专业知识进一步提高了结果。

引用次数: 0

Marginal Resection Is Appropriate for Radical Surgery for Solitary Fibrous Tumours of the Pelvis: A High Volume Pelvic Exenteration Centre Experience 边缘切除是骨盆孤立性纤维性肿瘤根治性手术的合适选择：大容量盆腔切除中心的经验。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-10-02 DOI: 10.1002/jso.70103

Evonne Z. Younan, Kilian G. M. Brown, David J. Coker, Lylee Ye, Kirk K. S. Austin, Peter J. Lee, Chris Byrne, Michael J. Solomon

Solitary fibrous tumours (SFTs) are rare soft-tissue neoplasms with variable metastatic potential and a tendency to exhibit more aggressive behaviour in the pelvis. This study evaluated the outcomes of pelvic SFT resections using a marginal resection approach at a specialist sarcoma and pelvic oncology centre. Eighteen patients underwent resection of pelvic SFTs between 1994 and 2025. Fifteen (83%) cases required resection of adjacent pelvic structures, of which three (17%) patients underwent total pelvic exenteration to achieve complete resection or to facilitate surgical access. Clear (R0) margins were achieved in 69% of cases, although most were ≤ 1 mm (IQR: 0.30–4.75). Major complications occurred in two patients (11%), and there was no inpatient or 30-day mortality. After a median follow-up of 42 months, 14 of 15 surviving patients were disease-free and only 2 patients experienced recurrence. These findings suggest that pelvic SFTs may be safely resected with low recurrence using a marginal resection approach.

孤立性纤维性肿瘤（SFTs）是一种罕见的软组织肿瘤，具有不同的转移潜力，并倾向于在骨盆中表现出更具侵略性的行为。本研究评估了在专科肉瘤和盆腔肿瘤中心采用边缘切除方法进行盆腔SFT切除术的结果。1994年至2025年间，18例患者接受了盆腔SFTs切除术。15例（83%）患者需要切除邻近盆腔结构，其中3例（17%）患者接受全盆腔切除以实现完全切除或方便手术进入。69%的病例边缘清晰（R0），尽管大多数≤1 mm （IQR: 0.30-4.75）。2例患者（11%）出现主要并发症，无住院或30天死亡。中位随访42个月后，15例存活患者中有14例无病，仅有2例复发。这些结果表明盆腔SFTs可以采用边缘切除方法安全、低复发率切除。

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引用次数: 0

Redefining Precision: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Comparing Robotic-Assisted Versus Laparoscopic Surgery in Colorectal Cancer 重新定义精确度：一项比较机器人辅助手术与腹腔镜手术在结直肠癌中的随机对照试验的系统评价和荟萃分析。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-09-29 DOI: 10.1002/jso.70098

Marcílio de Oliveira Filho, Miguel Chaves Lenzi, Pedro Emanuel Carneiro de Lima, Marina Azevedo Amaral, Phillip Anderson Silva Avelino, Pedro Laguardia Almeida, Altair Pereira de Melo Neto, Dante L. S. Souza, Eurico Cleto Ribeiro de Campos

Minimally invasive approaches such as laparoscopic surgery (LS) and robotic-assisted surgery (RAS) have transformed colorectal cancer (CRC) management. This systematic review and meta-analysis evaluated nine randomized controlled trials encompassing 2,758 patients to compare RAS and LS regarding perioperative, oncological, and long-term outcomes. RAS showed longer operative time but yielded benefits such as reduced conversion rates, greater lymph node retrieval, and lower circumferential resection margin (CRM) positivity. Both techniques demonstrated comparable safety, mortality, and overall complication rates. While RAS presents certain advantages, further research is required to determine its cost-effectiveness and long-term oncological impact.

Trial Registration: PROSPERO CRD420251025102.

微创方法，如腹腔镜手术（LS）和机器人辅助手术（RAS）已经改变了结直肠癌（CRC）的治疗。本系统综述和荟萃分析评估了包含2758例患者的9项随机对照试验，比较RAS和LS在围手术期、肿瘤和长期预后方面的差异。RAS显示较长的手术时间，但也有好处，如降低转换率，更大的淋巴结回收，更低的环切缘（CRM）阳性。两种技术均显示出相当的安全性、死亡率和总并发症发生率。虽然RAS具有一定的优势，但需要进一步的研究来确定其成本效益和长期肿瘤影响。试验注册：PROSPERO CRD420251025102。

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引用次数: 0