Journal of Surgical Oncology最新文献

英文中文

Comparison of Presentation and Management in Skeletal and Extraskeletal Ewing Sarcoma in Children. 儿童骨骼与骨骼外尤文氏肉瘤的表现与治疗比较。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-18 DOI: 10.1002/jso.70153

Charbel Chidiac, Caitlyn Ramdat, Katherine M McDermott, Adam S Levin, Kathryn M Lemberg, Daniel S Rhee

Objective: Extraskeletal Ewing sarcoma (EES) is a variant of Ewing sarcoma that originates from soft tissues rather than bones. Our study aims to characterize the differences between EES and skeletal ES (SES) in the pediatric population.

Methods: We conducted a retrospective review of children ≤ 18 years with ES recorded in the National Cancer Data Base (NCDB) from 2004 to 2022. Kaplan-Meier curves and Cox proportional hazards regression analysis were used to identify risk factors associated with survival.

Results: Among 7446 identified patients, 1016 (20.9%) had EES and 6430 (79.1%) had SES. EES patients were older (median 14 vs. 13 years, p = 0.007), more often female (46.9% vs. 41.2%, p = 0.0009), and had smaller tumors (7.5 vs. 8.0 cm, p = 0.003). Tumor distribution differed significantly, with EES was most frequent in the thorax (49.8%) and head and neck (11.8%), while SES more common in the lower limbs (30.2%) and pelvis (25.3%) (p < 0.0001). EES patients were more likely to receive surgery alone (4.2% vs. 1.8%) or a combination of surgery, chemotherapy, and radiation (25.9% vs. 20.7%) but less likely to receive chemotherapy and radiation without surgery (19.4% vs. 29.3%, p < 0.05). Five-year overall survival was similar between SES (72.2%) and EES (73.7%) (p = 0.70). Multivariable analysis confirmed EES was not an independent predictor of survival (aHR 0.94; 95% CI 0.81-1.10). Factors independently associated with mortality were older age, metastasis at diagnosis, and positive surgical margins.

Conclusions: Demographic, treatment characteristics, and prognostic factors differ between pediatric patients with SES and EES. However, survival is similar between the two groups.

目的：骨外尤文氏肉瘤（EES）是尤文氏肉瘤的一种变体，起源于软组织而非骨骼。我们的研究旨在描述EES和骨骼ES （SES）在儿科人群中的差异。方法：我们对2004年至2022年国家癌症数据库（NCDB）中记录的≤18岁ES儿童进行了回顾性研究。Kaplan-Meier曲线和Cox比例风险回归分析用于确定与生存相关的危险因素。结果：7446例患者中，EES 1016例（20.9%），SES 6430例（79.1%）。EES患者年龄较大（中位年龄14岁vs. 13岁，p = 0.007），多为女性（46.9% vs. 41.2%, p = 0.0009），肿瘤较小（7.5 cm vs. 8.0 cm, p = 0.003）。肿瘤分布差异显著，EES最常见于胸腔（49.8%）和头颈部（11.8%），而SES多见于下肢（30.2%）和骨盆（25.3%）(p)。结论：小儿SES和EES患者的人口学、治疗特点和预后因素存在差异。然而，两组患者的生存率相似。

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引用次数: 0

Comment on “Noncolorectal Cancer-Related Deaths in Patients With Early-Onset Colorectal Cancer: A Population-Based Study” 《早发性结直肠癌患者的非结直肠癌相关死亡：一项基于人群的研究》

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-09 DOI: 10.1002/jso.70160

Jilong Feng

引用次数: 0

Development of a Multivariable Machine Learning Model for the Prediction of Postoperative Ileus After Radical Cystectomy 根治性膀胱切除术后肠梗阻多变量机器学习预测模型的建立。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-09 DOI: 10.1002/jso.70161

Murugesan Manoharan, Mohamed Javid Raja Iyub, Yanjia Zhang, Pushan Prabhakar, Arjun Pon Avudaiappan, Mahmoud Eldefrawy, Sai Raghavendra Sridhar, Deerush Kannan Sakthivel

Background and Objectives

Postoperative Ileus (POI) is a common complication after Radical Cystectomy (RC) that delays recovery and extends hospital stay. Our objective was to develop machine learning (ML) models that can predict patients at a high risk of developing POI after RC.

Methods

Data of patients who underwent RC for bladder cancer at our institution were retrospectively extracted for analysis and model creation. Data pre-processing and variable selection were applied. Several ML models were developed, evaluated, and compared using the area under the curve (AUC), F1 score, precision, sensitivity, and specificity.

Results

Three hundred and seven patients were included in the analysis, and of these, 30 patients (9.8%) developed POI. Overall, 78.2% of patients were male and 91.2% were White. Of the various ML models, logistic regression demonstrated the highest AUC (0.98), followed by random forest (0.97), Support Vector Machine (0.97), XGBoost (0.95), simple neural network (0.87), and decision tree (0.84). Furthermore, the first two models also displayed higher specificity (0.94 and 0.93) and F1 scores (0.78 and 0.75). All models except for the decision tree and neural network achieved 100% sensitivity. Features such as age, body mass index (BMI), American Society of Anaesthesiologists (ASA) class status, surgical approach, potassium level, and the placement of a nasogastric tube were identified as key predictors of the outcome.

Conclusion

Based on our data, ML models can effectively predict POI after RC, especially with logistic regression and random forest. The identification of relevant predictors may contribute meaningfully to potential applications in risk stratification and personalized care.

背景和目的：术后肠梗阻（POI）是根治性膀胱切除术（RC）后常见的并发症，可延迟恢复并延长住院时间。我们的目标是开发机器学习（ML）模型，以预测RC后发生POI的高风险患者。方法：回顾性提取本院膀胱癌行RC的患者资料进行分析和模型创建。采用数据预处理和变量选择。使用曲线下面积（AUC）、F1评分、精度、灵敏度和特异性，开发、评估和比较了几种ML模型。结果：307例患者纳入分析，其中30例（9.8%）发展为POI。总体而言，78.2%的患者为男性，91.2%为白人。在各种ML模型中，逻辑回归显示出最高的AUC(0.98)，其次是随机森林（0.97），支持向量机（0.97），XGBoost(0.95)，简单神经网络（0.87）和决策树（0.84）。此外，前两种模型也显示出更高的特异性（0.94和0.93）和F1评分（0.78和0.75）。除决策树和神经网络外，所有模型的灵敏度均达到100%。年龄、体重指数（BMI）、美国麻醉医师协会（ASA）分类状态、手术入路、钾水平和鼻胃管放置等特征被确定为预后的关键预测因素。结论：基于我们的数据，ML模型可以有效地预测RC后的POI，特别是与逻辑回归和随机森林相结合。相关预测因子的识别可能对风险分层和个性化护理的潜在应用有意义。

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引用次数: 0

Treatment and Outcomes for Patients With Inadequate Lymphadenectomy After Resection of Stage II Small Bowel Adenocarcinoma II期小肠腺癌切除术后淋巴结切除不充分患者的治疗和结果。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-09 DOI: 10.1002/jso.70151

Jackson A. Baril, Karl Y. Bilimoria, Eugene P. Ceppa, Michael G. House, Thomas K. Maatman, Alexandra M. Roch, Anthony D. Yang, C. Max Schmidt, Ryan J. Ellis

Background and Objectives

Adjuvant chemotherapy (AC) is considered for patients with stage II small bowel adenocarcinoma (SBA) with an inadequate lymphadenectomy; however, the prognostic role of additional high-risk features (T4 primary, positive resection margin, poorly differentiated tumor, or lymphovascular invasion) is unknown. The objectives were to describe utilization of AC among patients with stage II SBA with inadequate lymphadenectomy, identify factors associated with receipt of AC, and examine the association between AC and survival stratified by presence of additional high-risk features.

Methods

Patients with stage II SBA were identified using the National Cancer Database from 2004 to 2021. Inadequate lymphadenectomy was defined < 5 lymph nodes duodenal tumors and < 8 lymph nodes other sites.

Results

Of 1765 patients with stage II SBA and an inadequate lymphadenectomy, 525 (29.8%) received AC. T4 primary, poor grade tumor, and positive resection margin were associated with receiving AC. Receipt of AC was associated with improved 5-year survival in patients with additional high-risk features (49.9% vs 31.4%; HR 0.62, 95%CI 0.48–0.79) but not in patients without additional high-risk features (67.1% vs. 53.2%; HR 0.83, 95%CI 0.55–1.24).

Conclusions

Receipt of AC was associated with improved survival in patients with inadequate lymphadenectomy and any additional high-risk feature. Multiple variables may be considered in decisions regarding AC.

背景和目的：考虑辅助化疗（AC）用于淋巴结切除术不充分的II期小肠腺癌（SBA）患者；然而，其他高危特征（T4原发、切除边缘阳性、低分化肿瘤或淋巴血管侵袭）的预后作用尚不清楚。目的是描述淋巴结切除术不充分的II期SBA患者AC的使用情况，确定与AC接受相关的因素，并通过存在额外的高风险特征来检查AC与生存率之间的关系。方法：从2004年到2021年，使用国家癌症数据库确定II期SBA患者。结果：在1765例II期SBA和不充分的淋巴结切除术患者中，525例（29.8%）接受了AC。T4原发、恶性肿瘤和阳性切除缘与接受AC相关。接受AC与具有额外高风险特征的患者的5年生存率相关（49.9% vs 31.4%; HR 0.62, 95%CI 0.48-0.79），但与没有额外高风险特征的患者无关（67.1% vs 53.2%; HR 0.83, 95%CI 0.55-1.24）。结论：接受AC与淋巴结切除术不充分和任何其他高风险特征的患者的生存率提高相关。在有关AC的决策中可能要考虑多个变量。

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引用次数: 0

Severe Complications in Remnant Gastric Cancer: An Epiphenomenon of Tumor Biology and Surgical Complexity? 残胃癌的严重并发症：肿瘤生物学和手术复杂性的附带现象？

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-09 DOI: 10.1002/jso.70165

Yong Zhang

引用次数: 0

Comment on “A SEER-Based Analysis of Survival Predictors in Stage I Colorectal Cancer” “基于seer的I期结直肠癌生存预测因子分析”评论

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-07 DOI: 10.1002/jso.70156

Ahmet Necati Sanli, Deniz Esin Tekcan Sanli

引用次数: 0

Comment on: Predictive Factors for Failed Sentinel Lymph Node Mapping in Endometrial Cancer: A Retrospective Multicenter Study—Missing Data on Indocyanine Green Injection Timing Relative to Adhesiolysis Warrants Retrospective Subgroup Extraction 评论：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-吲哚菁绿注射时间与粘连溶解相关的缺失数据需要回顾性亚组提取。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-07 DOI: 10.1002/jso.70157

Shuang Xiao

引用次数: 0

Risk Prediction of Postoperative Pancreatic Fistula After Open Pancreatoduodenectomy Using Objective Indicators Obtained From Preoperative Images 利用术前图像客观指标预测胰十二指肠切除术后胰瘘的风险。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-07 DOI: 10.1002/jso.70155

Shota Kuwabara, Yuta Ishizuka, Hiroyasu Tojima, Yuma Aoki, Kazuyuki Yamamoto, Yasuhito Shoji, Akira Fukunaga, Tatsunosuke Ichimura, Hiroto Manase, Satoshi Hirano

Background and Objectives

Postoperative pancreatic fistula (POPF) is a serious complication following Pancreatoduodenectomy (PD). Accurate prediction of clinically relevant POPF (CR-POPF) is essential to reduce morbidity. Identifying objective, easily measurable preoperative risk factors may improve patient outcomes. Therefore, we aimed to identify significant predictive risk factors for CR-POPF.

Methods

We retrospectively analyzed data from 143 patients who underwent PD. Preoperative computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) was used to measure the main pancreatic duct (MPD) diameter, the distance from the peritoneum to the anterior surface of the pancreas (PTP), and the abdominal wall thickness (AWT). The PTP/AWT ratio was calculated as a surrogate marker for the visceral-to-subcutaneous fat ratio (V/S ratio). The liver-to-pancreas mean CT attenuation ratio (late/early phase; L/E ratio) was also assessed. Univariate and multivariable analyses were performed to identify risk factors for CR-POPF.

Results

CR-POPF occurred in 33 (23.1%) patients. Multivariable analysis identified V/S ratio ≥ 3.5 (OR: 3.55, p = 0.041), and L/E ratio < 1.2 (OR: 6.07, p = 0.004) as independent risk predictors of CR-POPF.

Conclusions

Simple, objective parameters from preoperative CT or MRCP images may help predict CR-POPF. Accurate risk assessment and early intervention may reduce complications and improve postoperative outcomes.

背景与目的：胰瘘（POPF）是胰十二指肠切除术（PD）后的严重并发症。准确预测临床相关POPF （CR-POPF）对于降低发病率至关重要。确定客观的、容易测量的术前危险因素可以改善患者的预后。因此，我们旨在确定CR-POPF的重要预测危险因素。方法：我们回顾性分析143例PD患者的资料。术前采用计算机断层扫描（CT）或磁共振胰胆管造影（MRCP）测量主胰管（MPD）直径、腹膜到胰腺前表面的距离（PTP）和腹壁厚度（AWT）。计算PTP/AWT比率作为内脏与皮下脂肪比率（V/S比率）的替代指标。同时评估肝脏与胰腺的平均CT衰减比（晚期/早期；L/E比）。进行单变量和多变量分析以确定CR-POPF的危险因素。结果：发生CR-POPF 33例（23.1%）。多变量分析确定V/S比≥3.5 (OR: 3.55, p = 0.041)， L/E比。结论：术前CT或MRCP图像中简单、客观的参数可能有助于预测CR-POPF。准确的风险评估和早期干预可以减少并发症，改善术后预后。

{"title":"Risk Prediction of Postoperative Pancreatic Fistula After Open Pancreatoduodenectomy Using Objective Indicators Obtained From Preoperative Images","authors":"Shota Kuwabara, Yuta Ishizuka, Hiroyasu Tojima, Yuma Aoki, Kazuyuki Yamamoto, Yasuhito Shoji, Akira Fukunaga, Tatsunosuke Ichimura, Hiroto Manase, Satoshi Hirano","doi":"10.1002/jso.70155","DOIUrl":"10.1002/jso.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Postoperative pancreatic fistula (POPF) is a serious complication following Pancreatoduodenectomy (PD). Accurate prediction of clinically relevant POPF (CR-POPF) is essential to reduce morbidity. Identifying objective, easily measurable preoperative risk factors may improve patient outcomes. Therefore, we aimed to identify significant predictive risk factors for CR-POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data from 143 patients who underwent PD. Preoperative computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) was used to measure the main pancreatic duct (MPD) diameter, the distance from the peritoneum to the anterior surface of the pancreas (PTP), and the abdominal wall thickness (AWT). The PTP/AWT ratio was calculated as a surrogate marker for the visceral-to-subcutaneous fat ratio (V/S ratio). The liver-to-pancreas mean CT attenuation ratio (late/early phase; L/E ratio) was also assessed. Univariate and multivariable analyses were performed to identify risk factors for CR-POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CR-POPF occurred in 33 (23.1%) patients. Multivariable analysis identified V/S ratio ≥ 3.5 (OR: 3.55, <i>p</i> = 0.041), and L/E ratio < 1.2 (OR: 6.07, <i>p</i> = 0.004) as independent risk predictors of CR-POPF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Simple, objective parameters from preoperative CT or MRCP images may help predict CR-POPF. Accurate risk assessment and early intervention may reduce complications and improve postoperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"133 2","pages":"170-176"},"PeriodicalIF":1.9,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701281","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}

引用次数: 0

Correction to “A Comparative Analysis of Open Versus Minimally Invasive Pancreatoduodenectomies” 对“开放式与微创胰十二指肠切除术的比较分析”的更正。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-07 DOI: 10.1002/jso.70138

Valukas, C.S., Zaza, N.M., Vitello, D., Odell, D.D., Merkow, R. and Bentrem, D.J. (2025), A Comparative Analysis of Open Versus Minimally Invasive Pancreatoduodenectomies. Journal of Surgical Oncology, 131: 816-826. https://doi.org/10.1002/jso.27992

D. Bentrem was the Editor-in-Chief of the Journal of Surgical Oncology and simultaneously a coauthor of this article. Measures to manage this potential conflict of interest during the peer review process were not taken. Subsequently, both the peer review process and the content of the article were independently re-evaluated by the publisher's research integrity team. Despite any perceived conflict of interest, the publisher considers the results presented in this article to be reliable.

Valukas, c.s., Zaza, n.m., Vitello， D, Odell, d.d., Merkow， R.和Bentrem， D.J.(2025)，开放与微创胰十二指肠切除术的比较分析。中华外科杂志，31:816-826。https://doi.org/10.1002/jso.27992D。Bentrem是《外科肿瘤学杂志》的主编，同时也是这篇文章的合著者。在同行评审过程中没有采取措施来管理这种潜在的利益冲突。随后，同行评议过程和文章内容都由出版商的研究诚信团队独立重新评估。尽管存在明显的利益冲突，但出版商认为本文提供的结果是可靠的。

引用次数: 0

Correction to “Trends in Immunotherapy (Io) Use and Survival Among Patients With High-Incidence Stage IV Cancers Across the United States” 对“美国高发病率IV期癌症患者免疫治疗使用和生存趋势”的修正。

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology

Pub Date : 2025-12-07 DOI: 10.1002/jso.70141

Warwar, S. C., L. M. Janczewski, G. M. Rodriguez, J. D. Wayne, and D. J. Bentrem (2025), “Trends in Immunotherapy (IO) Use and Survival Among Patients With High-Incidence Stage IV Cancers Across the United States,” Journal of Surgical Oncology 131 (10): 1455–1466, https://doi.org/10.1002/jso.28084.

Warwar， S. C.， L. M. Janczewski， G. M. Rodriguez， J. D. Wayne和D. J. Bentrem(2025)，“免疫治疗（IO）在美国高发病率IV期癌症患者中的使用和生存趋势，外科肿瘤杂志131 (10):1455-1466,https://doi.org/10.1002/jso.28084.D。Bentrem是《外科肿瘤学杂志》的主编，同时也是这篇文章的合著者。在同行评审过程中没有采取措施来管理这种潜在的利益冲突。随后，同行评议过程和文章内容都由出版商的研究诚信团队独立重新评估。尽管存在明显的利益冲突，但出版商认为本文提供的结果是可靠的。

引用次数: 0

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