World Journal of Surgical Oncology最新文献

Background: Tumor initiation and progression are dynamically regulated by multiple programmed cell death (PCD) pathways. In recent years, beyond apoptosis, novel cell death modalities including necroptosis, pyroptosis, ferroptosis, autophagy cell death, and cuproptosis have been shown to exhibit dual pro-tumorigenic and anti-tumorigenic effects.

Main body: Earlier research primarily focused on their anti-cancer potential through tumor cell elimination; however, emerging evidence reveals that under specific tumor microenvironmental (TME) conditions or genetic contexts, these cell death modalities may indirectly promote immune evasion, metastatic dissemination, and therapeutic resistance. These effects are mediated through the release of damage-associated molecular patterns, which activate inflammatory responses, recruit immunosuppressive cells, and remodel stromal components, thereby accelerating malignant tumor progression.

Conclusion: This review highlights the translational potential of inhibitors targeting novel cell death modalities, such as the necroptosis inhibitor necrostatin-1, the pyroptosis inhibitor dimethyl fumarate, and the ferroptosis inhibitor ferrostatin-1, in anti-tumor therapy, providing theoretical foundations and novel perspectives for improving patient prognosis.

Background: This systematic review and meta-analysis aimed to investigate the association between preoperative multiparametric MRI-defined prostatic apex shapes (categorized as Lee types A, B, C, and D) and the recovery of urinary continence following radical prostatectomy (RP).

Methods: A comprehensive literature search was conducted up to November 1, 2025, across four electronic databases: MEDLINE, Cochrane Library, Web of Science, and Embase. Comparative studies reporting hazard ratios (HRs) with 95% confidence intervals (CIs) for continence recovery relative to a reference apex type were included. Pooled hazard ratios were calculated using appropriate statistical models.

Results: Seven cohort studies, comprising a total of 4,669 patients, were included in the quantitative synthesis. Meta-analysis revealed that a Lee type D apex was significantly associated with earlier recovery of urinary continence post-RP compared to other types (pooled HR = 1.31, 95% CI: 1.16-1.48, p < 0.001). In contrast, no significant associations were found for type B (HR = 0.94, 95% CI: 0.81-1.09, p = 0.411) or type C (HR = 1.01, 95% CI: 0.85-1.20, p = 0.897) when each was compared against type A. The significant advantage of type D remained consistent across all pre-specified subgroup analyses. Within study design subgroups, significant results were observed in both retrospective (HR = 1.27, 95% CI: 1.12-1.44) and prospective studies (HR = 1.94, 95% CI: 1.23-3.07). Similarly, geographic subgroup analyses confirmed this association in cohorts from Italy (HR = 1.28, 95% CI: 1.11-1.49), Germany (HR = 1.28, 95% CI: 1.03-1.61), and Korea (HR = 2.18, 95% CI: 1.56-4.11).

Conclusion: Preoperative MRI-based identification of a Lee type D prostatic apex is a significant and reproducible predictor for faster recovery of urinary continence after RP. This morphological feature may serve as a valuable preoperative imaging biomarker for patient counseling and surgical planning.

Head and neck cancers (HNCs) are common malignancies with generally unfavorable prognoses worldwide, among which squamous cell carcinoma (SCC) represents the predominant histological type. The Combined Positive Score (CPS), a key metric for evaluating PD-L1 expression, has demonstrated predictive value for response to immunotherapy across various solid tumors. However, its distribution patterns and clinical significance among tumors originating from different anatomical subsites within the head and neck region remain unclear.This retrospective study included 591 patients with malignant head and neck tumors treated at Beijing Tongren Hospital between January 2022 and November 2024, comprising 316 hypopharyngeal, 202 laryngeal, 45 oropharyngeal, and 28 nasal cavity and paranasal sinus carcinoma. PD-L1 expression was assessed using the PD-L1 IHC 22C3 pharmDx assay, and CPS was calculated accordingly. Results showed that the CPS was significantly lower in hypopharyngeal carcinoma (18.89 ± 21.65) compared to oropharyngeal carcinoma (24.71 ± 25.97; P < 0.05). Furthermore, CPS was negatively correlated with tumor differentiation in hypopharyngeal cancer (r = -0.1434, P = 0.018), with a similar trend observed in laryngeal cancer (P = 0.054), whereas no significant correlation was found in oropharyngeal or nasal cavity and paranasal sinus carcinoma.Survival analysis in the immunotherapy-treated subgroup revealed no statistically significant differences in overall survival (OS) or progression-free survival (PFS) between patients with CPS ≥ 20 and those with CPS < 20. However, in hypopharyngeal cancer, the CPS < 20 group exhibited a hazard ratio (HR) for death of 4.55 (95% CI: 1.019-20.31), suggesting a potential clinically relevant difference.This study highlights significant heterogeneity in the immune microenvironment across different subsites of head and neck squamous cell carcinoma. The relationship between CPS and tumor differentiation is site-specific, indicating that the value of CPS as a biomarker for immunotherapy response should be interpreted in the context of tumor location.

Background: Sentinel lymph node biopsy (SLNB) guided by indocyanine green is an innovative technique with a high detection rate in breast cancer; however, Latin American reports are scarce. This study describes the first series of patients in Peru who underwent this technique and evaluates the relationships between clinicopathological factors and lymph node positivity.

Methods: A retrospective study was conducted on breast cancer patients who underwent SLNB guided by indocyanine green between 2021 and 2024. Clinical and pathological variables were analyzed, and their associations with lymph node positivity were evaluated via bivariate and multivariate statistical tests.

Results: Sixty-nine patients were analyzed, and a detection rate of 100% was achieved with the indocyanine green technique. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.9% (CI: 90.8%-99.9%), 97.3% (CI: 92.1%-99.9%), 96.9% (CI: 90.8%-99.9%), and 97.3% (CI: 92.0 - 99.9%), respectively, with 95% confidence intervals (CIs). SLN positivity was significantly associated with a larger preoperative ultrasound tumor size (25.4 ± 9.0 vs. 20.7 ± 9.2 mm; p = 0.018), pT stage (65.6% vs. 37.8%; p = 0.023), and the presence of lymphovascular invasion (p < 0.001). No significant differences were found in terms of age, body mass index, menopausal status, comorbidities, laterality, or histological grade.

Conclusions: Tumor size, pT stage, and lymphovascular invasion were the main predictors of lymph node positivity in this Peruvian cohort. This study constitutes the first Peruvian series evaluating indocyanine green-guided SLNB, providing relevant evidence for its implementation in Latin America and supporting its use as a safe and effective technique for the treatment of breast cancer.