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。
{"title":"Marginal Resection Is Appropriate for Radical Surgery for Solitary Fibrous Tumours of the Pelvis: A High Volume Pelvic Exenteration Centre Experience","authors":"Evonne Z. Younan, Kilian G. M. Brown, David J. Coker, Lylee Ye, Kirk K. S. Austin, Peter J. Lee, Chris Byrne, Michael J. Solomon","doi":"10.1002/jso.70103","DOIUrl":"10.1002/jso.70103","url":null,"abstract":"<div>\u0000 \u0000 <p>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.</p>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1296-1300"},"PeriodicalIF":1.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206408","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}
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.
{"title":"Redefining Precision: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Comparing Robotic-Assisted Versus Laparoscopic Surgery in Colorectal Cancer","authors":"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","doi":"10.1002/jso.70098","DOIUrl":"10.1002/jso.70098","url":null,"abstract":"<div>\u0000 \u0000 <p>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.</p>\u0000 <p><b>Trial Registration:</b> PROSPERO CRD420251025102.</p>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1224-1234"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186072","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}
Milee Patel, Kristen Limbach, Elizabeth Martin, Matthew Burow, Kevin M. Sullivan
Peritoneal metastasis is a significant source of morbidity and mortality for patients with cancer from gastrointestinal origin such as gastric, colorectal, and appendiceal cancers, and treatment options are limited. Cross-sectional imaging is limited in sensitivity and specificity, and treating peritoneal metastases is limited by the bioavailability of systemic cytotoxic chemotherapy and metastatic burden. Within this review, we specifically explore the pathophysiology underlying peritoneal metastasis while emphasising the contributions of the tumour microenvironment and immune system.
{"title":"Peritoneal Metastases in Gastrointestinal Malignancies: A Review of the Pathophysiology of Metastasis and the Tumour Microenvironment","authors":"Milee Patel, Kristen Limbach, Elizabeth Martin, Matthew Burow, Kevin M. Sullivan","doi":"10.1002/jso.70090","DOIUrl":"10.1002/jso.70090","url":null,"abstract":"<div>\u0000 \u0000 <p>Peritoneal metastasis is a significant source of morbidity and mortality for patients with cancer from gastrointestinal origin such as gastric, colorectal, and appendiceal cancers, and treatment options are limited. Cross-sectional imaging is limited in sensitivity and specificity, and treating peritoneal metastases is limited by the bioavailability of systemic cytotoxic chemotherapy and metastatic burden. Within this review, we specifically explore the pathophysiology underlying peritoneal metastasis while emphasising the contributions of the tumour microenvironment and immune system.</p>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1190-1196"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186117","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}
Impaired health-related quality of life (HRQoL) and psychological symptoms after melanoma surgery are common, but research often focuses on specific stages, older patients, or clinical trial settings. This study aims to identify sub-groups of surgically treated melanoma patients in a real-world setting by examining associations between clinical and sociodemographic factors and psychosocial well-being.
Methods
Patients attending follow-up at the Department of Plastic Surgery, Herlev and Gentofte Hospital, were invited to this cross-sectional, questionnaire-based study. Eight validated patient-reported outcome measures assessed HRQoL, psychological symptoms, work ability, and patient activation. A study-specific questionnaire evaluated satisfaction and follow-up experiences.
Results
251/489 patients (51%) completed the questionnaires. Over one-third had high fear of cancer recurrence, and one in five reported high distress. Stage IV patients had the highest psychological symptom burden and lowest HRQoL, work ability, and patient activation. Younger age was linked to more psychological symptoms, and female gender to lower work ability. Stage IV disease and low income were associated with lower patient activation. About 20% felt more anxious before follow-ups.
Conclusion
Findings highlight the need for follow-up that supports psychosocial well-being after melanoma surgery, particularly in younger patients and those with advanced melanoma.
{"title":"Identification of Sub-Groups of Patients Surgically Treated for Melanoma With Affected Health-Related Quality of Life and Psychosocial Well-Being","authors":"Sara Mølgaard Hansen, Morten Berg Jensen, Pernille Envold Bidstrup, Christoffer Johansen, Lisbet Rosenkrantz Hölmich","doi":"10.1002/jso.70104","DOIUrl":"10.1002/jso.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Impaired health-related quality of life (HRQoL) and psychological symptoms after melanoma surgery are common, but research often focuses on specific stages, older patients, or clinical trial settings. This study aims to identify sub-groups of surgically treated melanoma patients in a real-world setting by examining associations between clinical and sociodemographic factors and psychosocial well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients attending follow-up at the Department of Plastic Surgery, Herlev and Gentofte Hospital, were invited to this cross-sectional, questionnaire-based study. Eight validated patient-reported outcome measures assessed HRQoL, psychological symptoms, work ability, and patient activation. A study-specific questionnaire evaluated satisfaction and follow-up experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>251/489 patients (51%) completed the questionnaires. Over one-third had high fear of cancer recurrence, and one in five reported high distress. Stage IV patients had the highest psychological symptom burden and lowest HRQoL, work ability, and patient activation. Younger age was linked to more psychological symptoms, and female gender to lower work ability. Stage IV disease and low income were associated with lower patient activation. About 20% felt more anxious before follow-ups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings highlight the need for follow-up that supports psychosocial well-being after melanoma surgery, particularly in younger patients and those with advanced melanoma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1266-1277"},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicole J. Andersen, Catherine Bergeron, Robert Turcotte, Annett Körner
Introduction
It is increasingly apparent that the most used patient-reported outcome measure in health-related quality of life (HRQL) soft-tissue sarcoma research (Toronto Extremity Salvage Score) is limited by its exclusive focus on physical function. It is now recommended that it only be used in combination with other global outcome measures, such as the Reintegration to Normal Living Index (RNLI) and Euroqol-5D-3L (EQ-5D-3L). We assessed the measurement properties of the RNLI and EQ-5D using the Wilson-Cleary Model and sought to better understand health perceptions and HRQL at 12 months post-op.
Methods
Data for this secondary analysis were drawn from an inception cohort of people receiving care for soft-tissue sarcoma at our institution. Inclusion criteria were being ≥ 18 years old and a diagnosis of localized soft-tissue sarcoma (biopsy-confirmed). Measures included the MSTS-87 (pain), RNLI (health perceptions), and EQ-5D-3L (HRQL). RStudio was used to calculate descriptive statistics, assess internal consistency, and evaluate the measurement and structural models.
Results
The study sample (n = 276) was 45% female with a mean age of 56 (18). Internal consistency was high with the RNLI (α = 0.91) and acceptable with EQ-5D-3L (α = 0.74). Findings suggested good model fit with the measurement model (CFI = 0.98, RMSEA = 0.37, SRMR = 0.0) and structural model (CFI = 0.98, RMSEA = 0.37, SRMR = 0.08). Moreover, HRQL appeared most impacted by the ability to engage in daily activities (work/study, home maintenance, family affairs, and leisure).
Conclusion
The RNLI (health perceptions) and EQ-5D (HRQL) appeared to be reliable and valid with this patient group. Findings suggest targets for optimizing soft-tissue sarcoma outcomes are maximizing functional restoration, encouraging participation in fulfilling activities throughout recovery (even if adapted), and routine psychosocial distress monitoring.
{"title":"Health Perceptions and HRQL With Soft-Tissue Sarcoma at 12 Months Post-Op: Using the Wilson-Cleary Model to Evaluate the Measurement Properties of the RNLI and EQ-5D-3L","authors":"Nicole J. Andersen, Catherine Bergeron, Robert Turcotte, Annett Körner","doi":"10.1002/jso.70101","DOIUrl":"10.1002/jso.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>It is increasingly apparent that the most used patient-reported outcome measure in health-related quality of life (HRQL) soft-tissue sarcoma research (<i>Toronto Extremity Salvage Score</i>) is limited by its exclusive focus on physical function. It is now recommended that it only be used in combination with other global outcome measures, such as the Reintegration to Normal Living Index (RNLI) and Euroqol-5D-3L (EQ-5D-3L). We assessed the measurement properties of the RNLI and EQ-5D using the Wilson-Cleary Model and sought to better understand health perceptions and HRQL at 12 months post-op.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data for this secondary analysis were drawn from an inception cohort of people receiving care for soft-tissue sarcoma at our institution. Inclusion criteria were being ≥ 18 years old and a diagnosis of localized soft-tissue sarcoma (biopsy-confirmed). Measures included the MSTS-87 (pain), RNLI (health perceptions), and EQ-5D-3L (HRQL). RStudio was used to calculate descriptive statistics, assess internal consistency, and evaluate the measurement and structural models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study sample (<i>n</i> = 276) was 45% female with a mean age of 56 (18). Internal consistency was high with the RNLI (<i>α</i> = 0.91) and acceptable with EQ-5D-3L (<i>α </i>= 0.74). Findings suggested good model fit with the measurement model (CFI = 0.98, RMSEA = 0.37, SRMR = 0.0) and structural model (CFI = 0.98, RMSEA = 0.37, SRMR = 0.08). Moreover, HRQL appeared most impacted by the ability to engage in daily activities (work/study, home maintenance, family affairs, and leisure).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The RNLI (health perceptions) and EQ-5D (HRQL) appeared to be reliable and valid with this patient group. Findings suggest targets for optimizing soft-tissue sarcoma outcomes are maximizing functional restoration, encouraging participation in fulfilling activities throughout recovery (even if adapted), and routine psychosocial distress monitoring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1288-1295"},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metincan Erkaya, Salih Karahan, Mustafa Oruc, Sudha R. Amarnath, Jacob A. Miller, Ali Alipouriani, Brogan Catalano, Scott Steele, Emre Gorgun
Purpose
Intraoperative radiotherapy (IORT) is utilized as an adjunctive treatment in advanced rectal cancer, particularly in cases with threatened surgical margins. Although IORT has shown benefits in enhancing local tumor control, its impact on overall survival (OS) remains unclear. This study assesses the effect of IORT on survival outcomes using a large cohort from the National Cancer Database (NCDB) and examines factors influencing its application in clinical practice across the United States.
Methods
The National Cancer Database was retrospectively reviewed (2006–2019) to identify patients with pathological T3–T4, M0 rectal cancer who underwent surgery following neoadjuvant chemotherapy. Patients with microscopically residual margin-positive were included and categorized into two groups: those who received neoadjuvant radiotherapy (RT) and those treated with intraoperative radiotherapy (IORT) combined with adjuvant/neoadjuvant RT. Groups were propensity score–matched (1:4) to balance baseline characteristics. The primary outcome was 5-year overall survival (OS), assessed using Kaplan–Meier analysis and Cox proportional hazards modeling.
Results
Among 1,788 patients with margin-positive rectal cancer, IORT was administered to 119 patients (6.7%) while 1,669 patients (93.3%) received neoadjuvant RT. Patients receiving IORT were younger, more likely to have private insurance, more frequently treated at academic/research programs, and more commonly underwent pelvic exenteration and Multiagent chemotherapy. After propensity score matching, 119 IORT patients were compared with 476 neoadjuvant RT patients. IORT was associated with lower mortality in univariate analysis (HR: 0.63; p < 0.001); however, this benefit was attenuated after adjusting for confounders (HR: 0.84; p = 0.07). The 5-year overall survival rates were 58.4% for IORT versus 54.9% for neoadjuvant RT alone (p = 0.18).
Conclusion
This nationwide analysis suggests that adding IORT to treatment does not significantly improve overall survival in margin-positive rectal cancer patients. However, due to heterogeneity in patient selection and dosing, further prospective trials are warranted to clarify its clinical role.
{"title":"The Impact of Intraoperative Radiotherapy on Margin Positive Locally Advanced Rectal Cancer: A Propensity-Matched Analysis of The National Cancer Database","authors":"Metincan Erkaya, Salih Karahan, Mustafa Oruc, Sudha R. Amarnath, Jacob A. Miller, Ali Alipouriani, Brogan Catalano, Scott Steele, Emre Gorgun","doi":"10.1002/jso.70102","DOIUrl":"10.1002/jso.70102","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Intraoperative radiotherapy (IORT) is utilized as an adjunctive treatment in advanced rectal cancer, particularly in cases with threatened surgical margins. Although IORT has shown benefits in enhancing local tumor control, its impact on overall survival (OS) remains unclear. This study assesses the effect of IORT on survival outcomes using a large cohort from the National Cancer Database (NCDB) and examines factors influencing its application in clinical practice across the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Cancer Database was retrospectively reviewed (2006–2019) to identify patients with pathological T3–T4, M0 rectal cancer who underwent surgery following neoadjuvant chemotherapy. Patients with microscopically residual margin-positive were included and categorized into two groups: those who received neoadjuvant radiotherapy (RT) and those treated with intraoperative radiotherapy (IORT) combined with adjuvant/neoadjuvant RT. Groups were propensity score–matched (1:4) to balance baseline characteristics. The primary outcome was 5-year overall survival (OS), assessed using Kaplan–Meier analysis and Cox proportional hazards modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1,788 patients with margin-positive rectal cancer, IORT was administered to 119 patients (6.7%) while 1,669 patients (93.3%) received neoadjuvant RT. Patients receiving IORT were younger, more likely to have private insurance, more frequently treated at academic/research programs, and more commonly underwent pelvic exenteration and Multiagent chemotherapy. After propensity score matching, 119 IORT patients were compared with 476 neoadjuvant RT patients. IORT was associated with lower mortality in univariate analysis (HR: 0.63; <i>p</i> < 0.001); however, this benefit was attenuated after adjusting for confounders (HR: 0.84; <i>p</i> = 0.07). The 5-year overall survival rates were 58.4% for IORT versus 54.9% for neoadjuvant RT alone (<i>p</i> = 0.18).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This nationwide analysis suggests that adding IORT to treatment does not significantly improve overall survival in margin-positive rectal cancer patients. However, due to heterogeneity in patient selection and dosing, further prospective trials are warranted to clarify its clinical role.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1257-1265"},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matteo Redaelli, Jessica A. Steadman, Tanya L. Hoskin, Tina J. Hieken
Background and Objectives
Neoadjuvant chemoimmunotherapy (NACI) for node-positive breast cancer may induce immune cell activation in regional lymph nodes (LN), confounding post-NACI imaging. Here we evaluated RECIST 1.1 criteria to predict post-NACI pathologic LN status.
Methods
We studied patients with biopsy-proven cN+ non-distant metastatic breast cancer receiving NACI operated on 03/2020–09/2024 with both pre- and post-NACI cross-sectional imaging. Per RECIST 1.1, LN short axis diameter (SAD) was measured in target (defined as SAD ≥ 15 mm) and nontarget (SAD 10–14.9 mm) LNs. Groups were compared using Fisher′s exact test.
Results
75 patients, median age 53 years, were studied: 61% cN1, 12% cN2, and 27% cN3. Baseline median number of imaging-suspicious LN was 4 (IQR 2-5). Post-NACI, 64% had a nodal pathologic complete response (pCR/ypN0). 55% met RECIST 1.1 LN assessment criteria. 21 of 32 (66%) with an imaging CR (iCR) were ypN0, while 8 of 9 (89%) without an iCR were ypN0. Neither target (p = 0.24) nor combined target/nontarget LN iCR (p = 0.76) predicted ypN status. Nodal pCR rates were higher in those with ≤ 1 versus > 1 suspicious LN post-NACI (71% vs. 42%, p = 0.03).
Conclusions
RECIST 1.1 criteria did not predict nodal pCR for NACI-treated node-positive breast cancer patients. Other post-NACI imaging assessment strategies are needed.
{"title":"Does RECIST 1.1 Predict Nodal Response to Neoadjuvant Chemo-Immunotherapy in Breast Cancer?","authors":"Matteo Redaelli, Jessica A. Steadman, Tanya L. Hoskin, Tina J. Hieken","doi":"10.1002/jso.70096","DOIUrl":"10.1002/jso.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Neoadjuvant chemoimmunotherapy (NACI) for node-positive breast cancer may induce immune cell activation in regional lymph nodes (LN), confounding post-NACI imaging. Here we evaluated RECIST 1.1 criteria to predict post-NACI pathologic LN status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied patients with biopsy-proven cN+ non-distant metastatic breast cancer receiving NACI operated on 03/2020–09/2024 with both pre- and post-NACI cross-sectional imaging. Per RECIST 1.1, LN short axis diameter (SAD) was measured in target (defined as SAD ≥ 15 mm) and nontarget (SAD 10–14.9 mm) LNs. Groups were compared using Fisher′s exact test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>75 patients, median age 53 years, were studied: 61% cN1, 12% cN2, and 27% cN3. Baseline median number of imaging-suspicious LN was 4 (IQR 2-5). Post-NACI, 64% had a nodal pathologic complete response (pCR/ypN0). 55% met RECIST 1.1 LN assessment criteria. 21 of 32 (66%) with an imaging CR (iCR) were ypN0, while 8 of 9 (89%) without an iCR were ypN0. Neither target (<i>p</i> = 0.24) nor combined target/nontarget LN iCR (<i>p</i> = 0.76) predicted ypN status. Nodal pCR rates were higher in those with ≤ 1 versus > 1 suspicious LN post-NACI (71% <i>vs.</i> 42%, <i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RECIST 1.1 criteria did not predict nodal pCR for NACI-treated node-positive breast cancer patients. Other post-NACI imaging assessment strategies are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1218-1223"},"PeriodicalIF":1.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131105","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}
The objective of this study was to examine patterns of recurrence and presentation of ovarian cancer (OC) patients.
Methods
This was a retrospective review of all patients at a single academic institution diagnosed with OC between January 1, 2014, and December 31, 2022. Demographic and clinical characteristics were extracted. Cox proportional hazards models were utilized to compare these characteristics, while the Kaplan-Meier method was employed to determine overall survival (OS).
Results
During our study, 437 patients were diagnosed with OC, and 173 (39.6%) were diagnosed with recurrence. For those diagnosed with recurrence, 68 (39.3%) were symptomatic. Forty-eight (72.7%) symptomatic patients had abdominal pain or increased abdominal girth, 5 (7.6%) had shortness of breath, 1 (1.5%) had vaginal bleeding, and 12 (18.1%) had nonspecific symptoms. Among the 105 (60.7%) asymptomatic patients, 57 (54.3%) had increasing CA-125 levels. Four (2.32%) patients with recurrence were diagnosed on a routine pelvic exam, and only one (0.5%) patient was asymptomatic and incidentally diagnosed.
Conclusions
The majority of patients were asymptomatic at the time of diagnosis, and the pelvic exam was not the primary means of detecting OC recurrence. Guidelines for surveillance visits for OC patients and the utility of a pelvic exam should be examined.
{"title":"Surveillance Visits for Ovarian Cancer: Is It Time to Reconsider?","authors":"Sharonne Holtzman, Caroline Gellman, Isabel Chess, Riva Letchinger, Lily McCarthy, Alexis Zachem, Guillaume Stoffels, Stephanie V. Blank, Valentin Kolev","doi":"10.1002/jso.70099","DOIUrl":"10.1002/jso.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>The objective of this study was to examine patterns of recurrence and presentation of ovarian cancer (OC) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective review of all patients at a single academic institution diagnosed with OC between January 1, 2014, and December 31, 2022. Demographic and clinical characteristics were extracted. Cox proportional hazards models were utilized to compare these characteristics, while the Kaplan-Meier method was employed to determine overall survival (OS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During our study, 437 patients were diagnosed with OC, and 173 (39.6%) were diagnosed with recurrence. For those diagnosed with recurrence, 68 (39.3%) were symptomatic. Forty-eight (72.7%) symptomatic patients had abdominal pain or increased abdominal girth, 5 (7.6%) had shortness of breath, 1 (1.5%) had vaginal bleeding, and 12 (18.1%) had nonspecific symptoms. Among the 105 (60.7%) asymptomatic patients, 57 (54.3%) had increasing CA-125 levels. Four (2.32%) patients with recurrence were diagnosed on a routine pelvic exam, and only one (0.5%) patient was asymptomatic and incidentally diagnosed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The majority of patients were asymptomatic at the time of diagnosis, and the pelvic exam was not the primary means of detecting OC recurrence. Guidelines for surveillance visits for OC patients and the utility of a pelvic exam should be examined.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1278-1287"},"PeriodicalIF":1.9,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131102","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}
CMTM4 (CKLF-like MARVEL transmembrane domain containing 4), a member of chemokine-like factor gene super-family, has been identified as a potential tumor suppressor gene in several malignancies and is implicated in biological processes such as tumor cell proliferation, adhesion, and migration. However, the role of CMTM4 in colorectal cancer remains unspecified.
Methods
The expression level of CMTM4 in colorectal malignant tissues were analyzed, and correlations between CMTM4 expression and clinicopathological features were analyzed in individuals with colorectal cancer. Bioinformatic analysis of CMTM4 expression in colorectal cancer and adjacent normal tissues was conducted using Oncomine and GenomicScape. Correlation analyses between CMTM4 and the genes MYC and CDKN2A were conducted using The Cancer Genome Atlas (TCGA) data set. The relationship between CMTM4 expression and overall survival in individuals with colorectal cancer was analyzed using TCGA and Gene Expression Omnibus datasets. Immunohistochemical images of CMTM4 protein expression were obtained from the Human Protein Atlas database.
Results
CMTM4 expression was significantly downregulated in colorectal cancer tissues compared to normal tissues. A positive correlation was observed between CMTM4 and CDKN2A expression, whereas a negative correlation was observed between CMTM4 and MYC expression. Higher CMTM4 expression levels were associated with improved survival time in individuals diagnosed with colorectal cancer, indicating its tumor-suppressive role within the CMTM family.
Conclusions
CMTM4 is often downregulated in colorectal cancer and exhibits tumor-suppressive properties. These findings indicate that CMTM4 may serve as a potential therapeutic target for colorectal cancer.
背景：CMTM4 （CKLF-like MARVEL transmembrane domain containing 4）是趋化因子样因子基因超家族的成员之一，在多种恶性肿瘤中被认为是一种潜在的肿瘤抑制基因，参与肿瘤细胞增殖、粘附和迁移等生物学过程。然而，CMTM4在结直肠癌中的作用仍未明确。方法：分析CMTM4在结直肠癌恶性组织中的表达水平，分析CMTM4表达与结直肠癌患者临床病理特征的相关性。应用Oncomine和GenomicScape对CMTM4在结直肠癌及邻近正常组织中的表达进行生物信息学分析。使用the Cancer Genome Atlas （TCGA）数据集对CMTM4与MYC和CDKN2A基因进行相关性分析。使用TCGA和Gene expression Omnibus数据集分析结直肠癌患者CMTM4表达与总生存率的关系。CMTM4蛋白表达的免疫组化图像来自Human protein Atlas数据库。结果：与正常组织相比，CMTM4在结直肠癌组织中的表达明显下调。CMTM4与CDKN2A表达呈正相关，而CMTM4与MYC表达呈负相关。较高的CMTM4表达水平与结直肠癌患者的生存时间延长相关，表明其在CMTM家族中具有肿瘤抑制作用。结论：CMTM4在结直肠癌中经常下调，并表现出肿瘤抑制特性。这些发现表明CMTM4可能作为结直肠癌的潜在治疗靶点。
{"title":"Downregulation of CMTM4 and Its Tumor-Suppressive Role in Colorectal Cancer: Insights From Expression and Survival Analyses","authors":"Guoquan Jin, Gang Zhao, Jiangjun You, Miao Li","doi":"10.1002/jso.70089","DOIUrl":"10.1002/jso.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>CMTM4</i> (CKLF-like MARVEL transmembrane domain containing 4), a member of chemokine-like factor gene super-family, has been identified as a potential tumor suppressor gene in several malignancies and is implicated in biological processes such as tumor cell proliferation, adhesion, and migration. However, the role of <i>CMTM4</i> in colorectal cancer remains unspecified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The expression level of <i>CMTM4</i> in colorectal malignant tissues were analyzed, and correlations between <i>CMTM4</i> expression and clinicopathological features were analyzed in individuals with colorectal cancer. Bioinformatic analysis of <i>CMTM4</i> expression in colorectal cancer and adjacent normal tissues was conducted using Oncomine and GenomicScape. Correlation analyses between <i>CMTM4</i> and the genes <i>MYC</i> and <i>CDKN2A</i> were conducted using The Cancer Genome Atlas (TCGA) data set. The relationship between <i>CMTM4</i> expression and overall survival in individuals with colorectal cancer was analyzed using TCGA and Gene Expression Omnibus datasets. Immunohistochemical images of CMTM4 protein expression were obtained from the Human Protein Atlas database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>CMTM4</i> expression was significantly downregulated in colorectal cancer tissues compared to normal tissues. A positive correlation was observed between <i>CMTM4</i> and <i>CDKN2A</i> expression, whereas a negative correlation was observed between <i>CMTM4</i> and <i>MYC</i> expression. Higher <i>CMTM4</i> expression levels were associated with improved survival time in individuals diagnosed with colorectal cancer, indicating its tumor-suppressive role within the <i>CMTM</i> family.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>CMTM4</i> is often downregulated in colorectal cancer and exhibits tumor-suppressive properties. These findings indicate that <i>CMTM4</i> may serve as a potential therapeutic target for colorectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1243-1249"},"PeriodicalIF":1.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113598","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}
Rathin Gosavi, Raymond Yap, Stephen Bell, Simon Wilkins, Mohammad Asghari-Jafarabadi, Paul McMurrick
Background
Anastomotic leak (AL) is a serious complication following colon cancer resection, but its long-term impact on survival and recurrence remains uncertain.
Objective
To evaluate the association between AL and postoperative outcomes, including overall survival (OS), replase-free survival (RFS), and cancer-specific survival (CSS), and to identify factors associated with increased risk of leak.
Methods
This retrospective cohort study included 2217 patients with histologically confirmed Stage I–III colon adenocarcinoma who underwent curative-intent resection with primary anastomosis across three tertiary centres (2009–2025). Patients with benign pathology, carcinoma in situ (Stage 0), metastatic disease, or missing follow-up data were excluded. ALs were defined as clinically and/or radiologically confirmed disruptions occurring within 30 days postoperatively. No leaks were observed beyond this period. Outcomes were compared using Kaplan–Meier estimates and Cox regression models.
Results
ALs, either clinical or radiological, occurred in 2.0% of patients (n = 44). Leaks were associated with significantly increased 30-day mortality (6.8% vs. 0.4%, p < 0.001), reoperation (86.4% vs. 3.4%, p < 0.001), and hospital stay (median 21 vs. 7 days, p < 0.001). In multivariable analysis, AL independently predicted 30-day mortality (AOR 13.6, 95% CI 9.9–18.6) and return to theatre (AOR 396.2, 95% CI 218.8–717.4). AL was associated with worse OS and DFS, but not CSS (p = 0.66).
Conclusions
AL is an independent predictor of postoperative morbidity and long-term nononcologic mortality in colon cancer patients. While OS and DFS were significantly reduced, CSS remained unaffected, a unique finding that challenges assumptions about leak-related oncologic progression. These results suggest that excess mortality stems from systemic complications and care disruption rather than cancer recurrence. Preventive strategies and early leak detection in high-risk patients are essential to improving outcomes.
背景：吻合口漏（AL）是结肠癌切除术后的严重并发症，但其对远期生存和复发的影响尚不确定。目的：评估AL与术后预后的关系，包括总生存期（OS）、无置换生存期（RFS）和癌症特异性生存期（CSS），并确定与泄漏风险增加相关的因素。方法：本回顾性队列研究纳入了2217例组织学证实的I-III期结肠腺癌患者，这些患者在三个三级中心接受了治愈性切除和一级吻合（2009-2025）。排除良性病理、原位癌（0期）、转移性疾病或缺少随访资料的患者。ALs被定义为术后30天内发生的经临床和/或放射学证实的神经中断。在此之后，没有发现任何泄漏。使用Kaplan-Meier估计和Cox回归模型对结果进行比较。结果：临床或放射学的ALs发生率为2.0% （n = 44）。泄漏与显著增加的30天死亡率相关（6.8% vs. 0.4%, p）。结论：AL是结肠癌患者术后发病率和长期非肿瘤死亡率的独立预测因子。虽然OS和DFS显著降低，但CSS未受影响，这一独特的发现挑战了有关泄漏相关肿瘤进展的假设。这些结果表明，过高的死亡率源于系统性并发症和护理中断，而不是癌症复发。高危患者的预防策略和早期泄漏检测对于改善预后至关重要。
{"title":"Anastomotic Leak Following Colon Cancer Resection: An Independent Predictor of Non-Oncologic Mortality and Morbidity","authors":"Rathin Gosavi, Raymond Yap, Stephen Bell, Simon Wilkins, Mohammad Asghari-Jafarabadi, Paul McMurrick","doi":"10.1002/jso.70100","DOIUrl":"10.1002/jso.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Anastomotic leak (AL) is a serious complication following colon cancer resection, but its long-term impact on survival and recurrence remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the association between AL and postoperative outcomes, including overall survival (OS), replase-free survival (RFS), and cancer-specific survival (CSS), and to identify factors associated with increased risk of leak.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 2217 patients with histologically confirmed Stage I–III colon adenocarcinoma who underwent curative-intent resection with primary anastomosis across three tertiary centres (2009–2025). Patients with benign pathology, carcinoma in situ (Stage 0), metastatic disease, or missing follow-up data were excluded. ALs were defined as clinically and/or radiologically confirmed disruptions occurring within 30 days postoperatively. No leaks were observed beyond this period. Outcomes were compared using Kaplan–Meier estimates and Cox regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ALs, either clinical or radiological, occurred in 2.0% of patients (<i>n</i> = 44). Leaks were associated with significantly increased 30-day mortality (6.8% vs. 0.4%, <i>p</i> < 0.001), reoperation (86.4% vs. 3.4%, <i>p</i> < 0.001), and hospital stay (median 21 vs. 7 days, <i>p</i> < 0.001). In multivariable analysis, AL independently predicted 30-day mortality (AOR 13.6, 95% CI 9.9–18.6) and return to theatre (AOR 396.2, 95% CI 218.8–717.4). AL was associated with worse OS and DFS, but not CSS (<i>p</i> = 0.66).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>AL is an independent predictor of postoperative morbidity and long-term nononcologic mortality in colon cancer patients. While OS and DFS were significantly reduced, CSS remained unaffected, a unique finding that challenges assumptions about leak-related oncologic progression. These results suggest that excess mortality stems from systemic complications and care disruption rather than cancer recurrence. Preventive strategies and early leak detection in high-risk patients are essential to improving outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":"132 7","pages":"1250-1256"},"PeriodicalIF":1.9,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jso.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号