William W Tseng, Francesco Barretta, Francesco Tucci, Marta Barisella, Stefano Radaelli, Chiara Colombo, Dario Callegaro, Carlo Morosi, Roberta Sanfilippo, Chiara Fabbroni, Silvia Stacchiotti, Steven H Sun, Paola Collini, Marco Fiore, Alessandro Gronchi
Background: Pleomorphic liposarcoma (PLPS) is an ultra-rare malignancy distinct from well-differentiated/dedifferentiated and myxoid liposarcoma. In this study, we sought to (1) assess outcomes after surgery for primary, non-metastatic PLPS and (2) explore potential indications for multimodality therapy.
Methods: Clinicopathologic data were retrospectively collected for patients treated from 2002 to 2019 at our sarcoma referral center. Descriptive data were summarized and Kaplan-Meier plots were constructed for overall survival (OS) and crude cumulative incidences (CCI) of disease-specific death (DSD), local recurrence (LR), and distant metastasis (DM). Univariable models were performed to assess the association of specific variables of interest on outcome.
Results: Forty-four pathology-verified PLPS cases were included in this study. Median tumor size was 8.5 cm; 75% were FNCLCC Grade 3. All patients underwent complete resection, including 15 patients (34%) who required re-excision to secure microscopic negative margins. Radiation therapy was given to 75% of patients, chemotherapy in 36%. At 5 years, OS was 75.3%; CCI of DSD, LR, and DM were 17.5%, 2.3%, and 32.5%. Larger tumor size was strongly associated with worse OS (p = 0.028) and DSD (p ≤ 0.001). A subgroup of patients (n = 10, 23%) with smaller, predominantly Grade 2 tumors underwent surgery alone without any LR or DM event at a median follow-up of 7.9 years.
Conclusions: In PLPS, aggressive surgery and when appropriate, radiation therapy, results in excellent local control. Chemotherapy can be considered for larger tumors. Patients with smaller, Grade 2 tumors may be potentially cured with surgery alone.
{"title":"Pleomorphic Liposarcoma of the Extremity and Trunk: Multimodality Therapy for Some but Not All?","authors":"William W Tseng, Francesco Barretta, Francesco Tucci, Marta Barisella, Stefano Radaelli, Chiara Colombo, Dario Callegaro, Carlo Morosi, Roberta Sanfilippo, Chiara Fabbroni, Silvia Stacchiotti, Steven H Sun, Paola Collini, Marco Fiore, Alessandro Gronchi","doi":"10.1002/jso.27884","DOIUrl":"https://doi.org/10.1002/jso.27884","url":null,"abstract":"<p><strong>Background: </strong>Pleomorphic liposarcoma (PLPS) is an ultra-rare malignancy distinct from well-differentiated/dedifferentiated and myxoid liposarcoma. In this study, we sought to (1) assess outcomes after surgery for primary, non-metastatic PLPS and (2) explore potential indications for multimodality therapy.</p><p><strong>Methods: </strong>Clinicopathologic data were retrospectively collected for patients treated from 2002 to 2019 at our sarcoma referral center. Descriptive data were summarized and Kaplan-Meier plots were constructed for overall survival (OS) and crude cumulative incidences (CCI) of disease-specific death (DSD), local recurrence (LR), and distant metastasis (DM). Univariable models were performed to assess the association of specific variables of interest on outcome.</p><p><strong>Results: </strong>Forty-four pathology-verified PLPS cases were included in this study. Median tumor size was 8.5 cm; 75% were FNCLCC Grade 3. All patients underwent complete resection, including 15 patients (34%) who required re-excision to secure microscopic negative margins. Radiation therapy was given to 75% of patients, chemotherapy in 36%. At 5 years, OS was 75.3%; CCI of DSD, LR, and DM were 17.5%, 2.3%, and 32.5%. Larger tumor size was strongly associated with worse OS (p = 0.028) and DSD (p ≤ 0.001). A subgroup of patients (n = 10, 23%) with smaller, predominantly Grade 2 tumors underwent surgery alone without any LR or DM event at a median follow-up of 7.9 years.</p><p><strong>Conclusions: </strong>In PLPS, aggressive surgery and when appropriate, radiation therapy, results in excellent local control. Chemotherapy can be considered for larger tumors. Patients with smaller, Grade 2 tumors may be potentially cured with surgery alone.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aos Karim, Alexander Troester, Sarah L Mott, Elliot Arsoniadis, Christine Jensen, Imran Hassan, Pridvi Kandagatla, Paolo Goffredo
Background and objectives: The staging system for anal squamous cell carcinoma (ASCC) was recently revised, downstaging selected node-positive patients and upstaging some with larger tumors. We aimed to validate this staging system using a population-based cohort.
Methods: The Surveillance, Epidemiology, and End Results database was analyzed to identify adult ASCC patients. Patients were staged according to the American Joint Committee on Cancer (AJCC) 8th and 9th edition systems. Survival probabilities were estimated using Kaplan-Meier curves. Cox regression models were utilized to estimate the effect of stage on overall (OS) and cancer-specific survival (CSS).
Results: A total of 2117 patients were identified and staged based on the two AJCC classifications. At 24 months when comparing stage IIB versus stage IIIA, the 8th edition revealed an improved OS (79% vs. 88%) and CSS (84% vs. 91%) for stage IIIA disease, while the 9th edition restored the hierarchical OS (IIB 88% vs. IIIA 78%) and CSS (91% vs. 82%) order.
Conclusions: The hierarchical increase of the OS HRs, and nearly all CSS HRs, across disease stages validated the updated edition of the AJCC classification. Although this change may not have significant implication on the management of ASCC, it does provide better prognostication.
背景和目的:最近对肛门鳞状细胞癌(ASCC)的分期系统进行了修订,降低了部分结节阳性患者的分期,提高了部分肿瘤较大患者的分期。我们的目的是通过基于人群的队列来验证这一分期系统:方法:我们对监测、流行病学和最终结果数据库进行了分析,以确定成年 ASCC 患者。根据美国癌症联合委员会(AJCC)第 8 版和第 9 版系统对患者进行分期。采用卡普兰-梅耶曲线估算生存概率。利用 Cox 回归模型估算分期对总生存期(OS)和癌症特异性生存期(CSS)的影响:结果:共确定了 2117 名患者,并根据 AJCC 的两种分类进行了分期。在24个月时,比较IIB期和IIIA期,第8版显示IIIA期患者的OS(79% vs. 88%)和CSS(84% vs. 91%)均有所改善,而第9版则恢复了OS(IIB 88% vs. IIIA 78%)和CSS(91% vs. 82%)的分级顺序:结论:各疾病分期的 OS HRs 和几乎所有 CSS HRs 的分级增加验证了 AJCC 分类法的更新版。虽然这一变化对 ASCC 的管理可能没有重大影响,但它确实提供了更好的预后。
{"title":"A Population-Level Validation of the New 9th Edition of the American Joint Commission on Cancer Staging System for Anal Squamous Cell Carcinoma.","authors":"Aos Karim, Alexander Troester, Sarah L Mott, Elliot Arsoniadis, Christine Jensen, Imran Hassan, Pridvi Kandagatla, Paolo Goffredo","doi":"10.1002/jso.27926","DOIUrl":"https://doi.org/10.1002/jso.27926","url":null,"abstract":"<p><strong>Background and objectives: </strong>The staging system for anal squamous cell carcinoma (ASCC) was recently revised, downstaging selected node-positive patients and upstaging some with larger tumors. We aimed to validate this staging system using a population-based cohort.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results database was analyzed to identify adult ASCC patients. Patients were staged according to the American Joint Committee on Cancer (AJCC) 8th and 9th edition systems. Survival probabilities were estimated using Kaplan-Meier curves. Cox regression models were utilized to estimate the effect of stage on overall (OS) and cancer-specific survival (CSS).</p><p><strong>Results: </strong>A total of 2117 patients were identified and staged based on the two AJCC classifications. At 24 months when comparing stage IIB versus stage IIIA, the 8th edition revealed an improved OS (79% vs. 88%) and CSS (84% vs. 91%) for stage IIIA disease, while the 9th edition restored the hierarchical OS (IIB 88% vs. IIIA 78%) and CSS (91% vs. 82%) order.</p><p><strong>Conclusions: </strong>The hierarchical increase of the OS HRs, and nearly all CSS HRs, across disease stages validated the updated edition of the AJCC classification. Although this change may not have significant implication on the management of ASCC, it does provide better prognostication.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lauren M Janczewski, Dominic J Vitello, Xane Peters, Catherine Valukas, Ryan P Merkow, David J Bentrem
Introduction: Regionalizing hepatic resections to high-volume hospitals (HVH) has improved outcomes, yet widened disparities in access. We sought to evaluate the association of hospital volume with quality care outcomes and overall survival (OS) between minor and major hepatectomy for primary liver cancer.
Methods: The National Cancer Database identified patients with primary liver cancer who underwent minor/major hepatectomy (2009-2019). HVHs were defined by the top quartile in annual case volume (vs. the bottom three quartiles). Quality care outcomes (time to resection, margin status, length of stay, 30-day readmission, 30-day mortality, 90-day mortality) and OS were assessed using multivariable regression.
Results: Overall, 6,988 patients underwent minor hepatectomy and 4880 major hepatectomy. No differences in quality care outcomes or OS based on hospital volume for minor hepatectomy were observed (all p > 0.05). Treatment at HVHs for major hepatectomy was associated with decreased odds of 30-day and 90-day mortality events (all p < 0.05). Median OS was 40.2 months [IQR 21.7-66.6] at HVHs versus 33.5 [IQR 17.0-58.7] at low-volume hospitals which remained independently predictive of improved OS on multivariable analysis (HR 0.86, 95% CI 0.79-0.93).
Conclusion: These results support regionalization to HVHs for major hepatectomy; however, minor hepatectomy can be safely performed at hospitals regardless of volume.
{"title":"Association of Hospital Volume With Quality Care Outcomes Following Minor and Major Hepatectomy for Primary Liver Cancer.","authors":"Lauren M Janczewski, Dominic J Vitello, Xane Peters, Catherine Valukas, Ryan P Merkow, David J Bentrem","doi":"10.1002/jso.27819","DOIUrl":"https://doi.org/10.1002/jso.27819","url":null,"abstract":"<p><strong>Introduction: </strong>Regionalizing hepatic resections to high-volume hospitals (HVH) has improved outcomes, yet widened disparities in access. We sought to evaluate the association of hospital volume with quality care outcomes and overall survival (OS) between minor and major hepatectomy for primary liver cancer.</p><p><strong>Methods: </strong>The National Cancer Database identified patients with primary liver cancer who underwent minor/major hepatectomy (2009-2019). HVHs were defined by the top quartile in annual case volume (vs. the bottom three quartiles). Quality care outcomes (time to resection, margin status, length of stay, 30-day readmission, 30-day mortality, 90-day mortality) and OS were assessed using multivariable regression.</p><p><strong>Results: </strong>Overall, 6,988 patients underwent minor hepatectomy and 4880 major hepatectomy. No differences in quality care outcomes or OS based on hospital volume for minor hepatectomy were observed (all p > 0.05). Treatment at HVHs for major hepatectomy was associated with decreased odds of 30-day and 90-day mortality events (all p < 0.05). Median OS was 40.2 months [IQR 21.7-66.6] at HVHs versus 33.5 [IQR 17.0-58.7] at low-volume hospitals which remained independently predictive of improved OS on multivariable analysis (HR 0.86, 95% CI 0.79-0.93).</p><p><strong>Conclusion: </strong>These results support regionalization to HVHs for major hepatectomy; however, minor hepatectomy can be safely performed at hospitals regardless of volume.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Eduardo Santa Ritta Barreira, Luiz Paulo Kowalski, Fernando Luiz Dias, Terence Pires D E Farias, Izabella Costa Santos, José Guilherme Vartanian, André Maurício Ferrari Beltrão, Heládio Feitosa, Ruy Gomes Neto, Alexandre Ferreira Oliveira, Reitan Ribeiro, Felipe Augusto Brasileiro Vanderlei, Felipe Henning Gaia Duarte, Pedro Eder Portari Filho, Rodrigo Nascimento Pinheiro
The risk of hypoparathyroidism and hypocalcemia is a critical concern in thyroid surgery. Preserving parathyroid gland vascularization during surgery is essential for effective prevention. Preoperative and postoperative management, including calcium and Vitamin D supplementation, is paramount. Measurement of parathyroid hormone levels after surgery is the best predictor of hypoparathyroidism. This guideline offers recommendations for the prevention, diagnosis, and treatment of acute hypoparathyroidism and hypocalcemia after thyroid surgery.
{"title":"Guideline From the Brazilian Society of Surgical Oncology and Brazilian College of Surgeons in Preventing and Managing Acute Hypoparathyroidism After Thyroid Surgery.","authors":"Carlos Eduardo Santa Ritta Barreira, Luiz Paulo Kowalski, Fernando Luiz Dias, Terence Pires D E Farias, Izabella Costa Santos, José Guilherme Vartanian, André Maurício Ferrari Beltrão, Heládio Feitosa, Ruy Gomes Neto, Alexandre Ferreira Oliveira, Reitan Ribeiro, Felipe Augusto Brasileiro Vanderlei, Felipe Henning Gaia Duarte, Pedro Eder Portari Filho, Rodrigo Nascimento Pinheiro","doi":"10.1002/jso.27910","DOIUrl":"https://doi.org/10.1002/jso.27910","url":null,"abstract":"<p><p>The risk of hypoparathyroidism and hypocalcemia is a critical concern in thyroid surgery. Preserving parathyroid gland vascularization during surgery is essential for effective prevention. Preoperative and postoperative management, including calcium and Vitamin D supplementation, is paramount. Measurement of parathyroid hormone levels after surgery is the best predictor of hypoparathyroidism. This guideline offers recommendations for the prevention, diagnosis, and treatment of acute hypoparathyroidism and hypocalcemia after thyroid surgery.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alyne O Tokarski, Rafaella S Bernardelli, Julia R Bruscato, Claudio R Lucena, Jose C Linhares, Audrey T Tsunoda
Introduction: The assessment of quality of life (QoL) in women with cervical cancer is crucial due to the profound changes they undergo during and after treatment. Often, the significance of sexual factors is underestimated, likely due to societal taboos surrounding such discussions.
Objective: This study aimed to determine the long-term QoL outcomes, particularly focusing on sexuality, among three therapeutic approaches for cervical cancer: chemotherapy, radiotherapy, and brachytherapy; isolated hysterectomy; and hysterectomy combined with radiotherapy.
Methods: Conducted from November 2022 to July 2023, this cross-sectional study involved 131 cervical cancer patients. Their QoL was assessed using the MDASI, FACIT-Cx, and risk factor questionnaires. Results were compared across the three treatment groups, revealing notable differences.
Results: Patients undergoing chemo/radio/brachytherapy showed significantly lower QoL scores compared to those undergoing isolated hysterectomy. This was evident in reduced scores across FACIT-Cx subscales for physical well-being, specific concerns, and FACIT-total (p < 0.05). The MDASI results similarly indicated greater symptoms and interference in daily activities for the chemo/radio/brachytherapy group.
Conclusion: In conclusion, isolated hysterectomy, demonstrated superior QoL outcomes compared to chemo/radio/brachytherapy. Furthermore, the study underscored the importance of addressing sexual concerns in QoL assessments of cervical cancer survivors, emphasizing the need for comprehensive care to enhance overall well-being posttreatment.
简介由于宫颈癌患者在治疗期间和治疗后经历了深刻的变化,因此对她们的生活质量(QoL)进行评估至关重要。通常情况下,性因素的重要性被低估,这可能是由于围绕此类讨论的社会禁忌所致:本研究旨在确定宫颈癌三种治疗方法(化疗、放疗和近距离放疗;孤立的子宫切除术;子宫切除术联合放疗)的长期QoL结果,尤其关注性生活:这项横断面研究于 2022 年 11 月至 2023 年 7 月进行,涉及 131 名宫颈癌患者。使用 MDASI、FACIT-Cx 和风险因素问卷对他们的 QoL 进行了评估。对三个治疗组的结果进行了比较,发现了明显的差异:结果:接受化疗/放疗/近距离放疗的患者的 QoL 得分明显低于接受单独子宫切除术的患者。这表现在 FACIT-Cx 分量表中身体健康、特定关注和 FACIT 总分的降低(p 结论:化疗/放疗/近距离放射治疗患者的 QoL 得分明显低于孤立子宫切除术患者:总之,与化疗/放疗/近距离放射治疗相比,孤立子宫切除术的 QoL 效果更佳。此外,该研究还强调了在宫颈癌幸存者的 QoL 评估中解决性问题的重要性,并强调需要提供全面的护理以提高治疗后的整体健康水平。
{"title":"Quality of Life Post Cervical Cancer Treatment: A Comparison Between Radical Surgery Approach and Radiotherapy and Chemotherapy.","authors":"Alyne O Tokarski, Rafaella S Bernardelli, Julia R Bruscato, Claudio R Lucena, Jose C Linhares, Audrey T Tsunoda","doi":"10.1002/jso.27911","DOIUrl":"https://doi.org/10.1002/jso.27911","url":null,"abstract":"<p><strong>Introduction: </strong>The assessment of quality of life (QoL) in women with cervical cancer is crucial due to the profound changes they undergo during and after treatment. Often, the significance of sexual factors is underestimated, likely due to societal taboos surrounding such discussions.</p><p><strong>Objective: </strong>This study aimed to determine the long-term QoL outcomes, particularly focusing on sexuality, among three therapeutic approaches for cervical cancer: chemotherapy, radiotherapy, and brachytherapy; isolated hysterectomy; and hysterectomy combined with radiotherapy.</p><p><strong>Methods: </strong>Conducted from November 2022 to July 2023, this cross-sectional study involved 131 cervical cancer patients. Their QoL was assessed using the MDASI, FACIT-Cx, and risk factor questionnaires. Results were compared across the three treatment groups, revealing notable differences.</p><p><strong>Results: </strong>Patients undergoing chemo/radio/brachytherapy showed significantly lower QoL scores compared to those undergoing isolated hysterectomy. This was evident in reduced scores across FACIT-Cx subscales for physical well-being, specific concerns, and FACIT-total (p < 0.05). The MDASI results similarly indicated greater symptoms and interference in daily activities for the chemo/radio/brachytherapy group.</p><p><strong>Conclusion: </strong>In conclusion, isolated hysterectomy, demonstrated superior QoL outcomes compared to chemo/radio/brachytherapy. Furthermore, the study underscored the importance of addressing sexual concerns in QoL assessments of cervical cancer survivors, emphasizing the need for comprehensive care to enhance overall well-being posttreatment.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Impact of Early Follow-Up on Readmission After Gastrointestinal Cancer Surgery: Correspondence.","authors":"Yizhuo Jiang, Ziqi Zhao, Yuliang Liu","doi":"10.1002/jso.27916","DOIUrl":"https://doi.org/10.1002/jso.27916","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marco Schiavon, Giorgio Cannone, Luca Bertolaccini, Filippo Tommaso Gallina, Federica Pezzuto, Giulia Lorenzoni, Francesco Facciolo, Lorenzo Spaggiari, Fiorella Calabrese, Federico Rea, Giulia Pasello
Objective: In advanced non-small cell lung cancer (NSCLC), immune-checkpoint inhibitors (ICIs) can achieve significant clinical responses. This raises the question of whether to consider salvage surgery as a curative treatment option. Few case series reported encouraging results in terms of pathological response. However, intraoperative risk and postoperative morbidity have been highlighted. This study aims to assess the safety and feasibility of surgery after ICIs administration and to evaluate its effectiveness on the final pathological examination.
Methods: We retrospectively identified stages III-IVA NSCLC consecutive patients who underwent surgery with radical intent after ICIs at three National Centers (2016-2022). Before treatment, all patients were considered unresectable by a multidisciplinary discussion. After surgery, pathological response was evaluated according to the International Association for the Study of Lung Cancer (IASLC) recommendation.
Results: Thirty-one patients were included; pretreatment clinical stage was: IIIA in 4 patients (10%), IIIB in 13 (42%), IIIC in 3 (13%), and IVA in 11 (35%). Median treatment duration was four cycles. Only anatomical resections were performed, with lobectomy that represent the main type of resection (22 patients, 74%). A minimally invasive approach was performed in 10 patients (32%), with a conversion rate of 0%. Postoperative complications were observed in eight patients (25%). Complete pathologic response (CPR) and major pathologic response (MPR) were 48% and 16%, respectively. Two and 3-years survival were 88%.
Conclusions: Based on our experience, salvage surgery of advanced NSCLC treated with ICIs confirm his feasibility and safety in responder patients. Moreover, it is associated with low morbidity, high CPR rate, and satisfying medium-term survival.
{"title":"Safety and Efficacy of Salvage Surgery after Treatment With Immune-Checkpoint Adjuvant Inhibitors for Advanced Non-Small Cell Lung Cancer: A Multicentric Study.","authors":"Marco Schiavon, Giorgio Cannone, Luca Bertolaccini, Filippo Tommaso Gallina, Federica Pezzuto, Giulia Lorenzoni, Francesco Facciolo, Lorenzo Spaggiari, Fiorella Calabrese, Federico Rea, Giulia Pasello","doi":"10.1002/jso.27920","DOIUrl":"https://doi.org/10.1002/jso.27920","url":null,"abstract":"<p><strong>Objective: </strong>In advanced non-small cell lung cancer (NSCLC), immune-checkpoint inhibitors (ICIs) can achieve significant clinical responses. This raises the question of whether to consider salvage surgery as a curative treatment option. Few case series reported encouraging results in terms of pathological response. However, intraoperative risk and postoperative morbidity have been highlighted. This study aims to assess the safety and feasibility of surgery after ICIs administration and to evaluate its effectiveness on the final pathological examination.</p><p><strong>Methods: </strong>We retrospectively identified stages III-IVA NSCLC consecutive patients who underwent surgery with radical intent after ICIs at three National Centers (2016-2022). Before treatment, all patients were considered unresectable by a multidisciplinary discussion. After surgery, pathological response was evaluated according to the International Association for the Study of Lung Cancer (IASLC) recommendation.</p><p><strong>Results: </strong>Thirty-one patients were included; pretreatment clinical stage was: IIIA in 4 patients (10%), IIIB in 13 (42%), IIIC in 3 (13%), and IVA in 11 (35%). Median treatment duration was four cycles. Only anatomical resections were performed, with lobectomy that represent the main type of resection (22 patients, 74%). A minimally invasive approach was performed in 10 patients (32%), with a conversion rate of 0%. Postoperative complications were observed in eight patients (25%). Complete pathologic response (CPR) and major pathologic response (MPR) were 48% and 16%, respectively. Two and 3-years survival were 88%.</p><p><strong>Conclusions: </strong>Based on our experience, salvage surgery of advanced NSCLC treated with ICIs confirm his feasibility and safety in responder patients. Moreover, it is associated with low morbidity, high CPR rate, and satisfying medium-term survival.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Environmental determinants of health refer to external factors in our surroundings that influence health outcomes. It is estimated that healthier environments could prevent almost one-quarter of the global burden of disease. Additionally, environmental factors, including lifestyle factors, air pollution, chemical exposures, and natural exposures, are responsible for a significant incidence of cancers and premature cancer deaths. Minority populations, low-income populations, children, and older adults are at increased risk for oncologic risks secondary to environmental factors.
{"title":"The Impact of Environmental Health Determinants in Surgical Oncology.","authors":"Shaneeta Johnson, Sasha Corbin, Chevar South, Shamir Cawich","doi":"10.1002/jso.27889","DOIUrl":"https://doi.org/10.1002/jso.27889","url":null,"abstract":"<p><p>Environmental determinants of health refer to external factors in our surroundings that influence health outcomes. It is estimated that healthier environments could prevent almost one-quarter of the global burden of disease. Additionally, environmental factors, including lifestyle factors, air pollution, chemical exposures, and natural exposures, are responsible for a significant incidence of cancers and premature cancer deaths. Minority populations, low-income populations, children, and older adults are at increased risk for oncologic risks secondary to environmental factors.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Santiago González-Moreno, Marcello Deraco, Shigeki Kusamura, Lana Bijelic, Laura A Lambert, Clarisse Dromain, Frédéric Bibeau, Winston Liauw, Artur Reis, Ana Galan, Paul H Sugarbaker
Peritoneal surface oncology (PSO) is a novel field dealing with the knowledge of peritoneal neoplasms, primary or secondary, and their clinical management. As a specific treatment with curative intent for peritoneal neoplasms developed over the years, there is a growing need to comprehensively educate and train surgical oncologists worldwide in this discipline, a recognized unmet need. The European School of Peritoneal Surface Oncology (ESPSO) emerged in 2014 to provide an answer to this need.
{"title":"Education and Training in Peritoneal Surface Oncology.","authors":"Santiago González-Moreno, Marcello Deraco, Shigeki Kusamura, Lana Bijelic, Laura A Lambert, Clarisse Dromain, Frédéric Bibeau, Winston Liauw, Artur Reis, Ana Galan, Paul H Sugarbaker","doi":"10.1002/jso.27833","DOIUrl":"https://doi.org/10.1002/jso.27833","url":null,"abstract":"<p><p>Peritoneal surface oncology (PSO) is a novel field dealing with the knowledge of peritoneal neoplasms, primary or secondary, and their clinical management. As a specific treatment with curative intent for peritoneal neoplasms developed over the years, there is a growing need to comprehensively educate and train surgical oncologists worldwide in this discipline, a recognized unmet need. The European School of Peritoneal Surface Oncology (ESPSO) emerged in 2014 to provide an answer to this need.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tedy Sawma, Ahmer Sultan, Samer Abdulmoneim, Travis Grotz, Charles B Rosen, Timucin Taner, Julie K Heimbach, Susanne G Warner, Brittany L Siontis, Thanh P Ho, Steven I Robinson, Cornelius A Thiels
Background and objectives: Hepatic epithelioid hemangioendothelioma (HEHE) is an uncommon vascular neoplasm characterized by variable clinical behavior. Our aim was to describe the therapeutic approach for HEHE at diagnosis and define clinicopathological characteristics associated with tumor progression and long-term survival.
Methods: This is a retrospective study that includes patients with HEHE who received treatment at Mayo Clinic Rochester between 1984 and 2023.
Results: Eighty patients were included in the study (median age: 44 years; 62.5% female), 24 underwent liver transplantation, 26 underwent liver resection, and 30 were managed medically. The 3-year overall survival rates were 86.7%, 80.9%, and 51.1%, respectively. Notably, 26 patients had extrahepatic metastases at the time of diagnosis, four (16.7%) in the transplantation group, four (15.4%) in the resection group, and 18 (69.2%) in the nonsurgical group. On multivariable modeling, bone metastasis was independently associated with long-term mortality (HR 6.3, p < 0.001) while lung metastasis and surgical intervention were not associated with long-term mortality (HR 0.8, p = 0.8; HR 1.1, p = 0.9, respectively).
Conclusion: Bone metastasis emerged as a strong predictor of poor survival. Hence, aggressive surgical intervention may not be advantageous in patients with skeletal metastases but can still be offered for those with other extrahepatic metastases.
{"title":"Management and Long-Term Outcomes of Patients With Hepatic Epithelioid Hemangioendothelioma.","authors":"Tedy Sawma, Ahmer Sultan, Samer Abdulmoneim, Travis Grotz, Charles B Rosen, Timucin Taner, Julie K Heimbach, Susanne G Warner, Brittany L Siontis, Thanh P Ho, Steven I Robinson, Cornelius A Thiels","doi":"10.1002/jso.27807","DOIUrl":"https://doi.org/10.1002/jso.27807","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hepatic epithelioid hemangioendothelioma (HEHE) is an uncommon vascular neoplasm characterized by variable clinical behavior. Our aim was to describe the therapeutic approach for HEHE at diagnosis and define clinicopathological characteristics associated with tumor progression and long-term survival.</p><p><strong>Methods: </strong>This is a retrospective study that includes patients with HEHE who received treatment at Mayo Clinic Rochester between 1984 and 2023.</p><p><strong>Results: </strong>Eighty patients were included in the study (median age: 44 years; 62.5% female), 24 underwent liver transplantation, 26 underwent liver resection, and 30 were managed medically. The 3-year overall survival rates were 86.7%, 80.9%, and 51.1%, respectively. Notably, 26 patients had extrahepatic metastases at the time of diagnosis, four (16.7%) in the transplantation group, four (15.4%) in the resection group, and 18 (69.2%) in the nonsurgical group. On multivariable modeling, bone metastasis was independently associated with long-term mortality (HR 6.3, p < 0.001) while lung metastasis and surgical intervention were not associated with long-term mortality (HR 0.8, p = 0.8; HR 1.1, p = 0.9, respectively).</p><p><strong>Conclusion: </strong>Bone metastasis emerged as a strong predictor of poor survival. Hence, aggressive surgical intervention may not be advantageous in patients with skeletal metastases but can still be offered for those with other extrahepatic metastases.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}