World Journal of Surgical Oncology最新文献

Colorectal cancer is one of the common malignant tumors with poor prognosis, which is partly due to the lack of an effective biomarker. The purpose of this study is to explore the impact of membrane palmitoylated protein (MPP2) on the prognosis of colorectal cancer patients. We obtained transcriptome data and DNA methylation data of 380 colorectal cancer patients from the Cancer Genome Atlas (TCGA). Then we used a series of bioinformatics analysis methods to reveal the relationship between MPP2 expression, DNA methylation sites, prognosis, immune checkpoint and clinical characteristics of patients. Finally, in vitro experiment and the meta-analysis of thousands of patients further confirmed the impact of MPP2 on the prognosis of colorectal cancer patients and cell migration and proliferation. The expression level of MPP2 is negatively regulated by its DNA methylation sites, which leads to its low expression in colorectal cancer. High expression of MPP2 is an independent prognostic risk factor, which may be a biomarker for colorectal cancer. Moreover, the expression of MPP2 shows a close relationship with immune checkpoint or immune cells infiltration, especially CD4⁺T cells. In addition, meta-analysis involving 1584 patients from four different data further confirmed that MPP2 was a risk factor for colorectal cancer. Finally, knockdown of MPP2 could significantly inhibit the proliferation of SW480 cells via mTOR signaling pathway. This study was the first to suggest that MPP2 may become a promising biomarker, and has an important role in immune checkpoint or immune cell infiltration in colorectal cancer.

A response to the case report by Zhang et al. and supplement another case of giant peritoneal loose body discovered due to abdominal pain. A 68-year-old man was admitted to the hospital with abdominal pain. CT revealed an ovoid mass in the pelvis measuring approximately 11.5 × 8.6 × 7.4 cm. During laparotomy, yellowish-white mass was identified within the pelvis. Histological examination revealed that the mass was hyalinized fibrous connective tissue with focal calcification. We report an extremely rare and interesting case.

Background: The current treatment strategies for borderline resectable esophageal squamous cell carcinoma remain controversial. This study aimed to evaluate the efficacy and safety of programmed cell death 1 inhibitors combined with chemotherapy, followed by conversion surgery, for borderline resectable esophageal squamous cell carcinoma.

Methods: Patients with borderline resectable esophageal squamous cell carcinoma treated with induction immunochemotherapy from January 1, 2020 to July 1, 2023 at our hospital were retrospectively analyzed. The primary study outcome was the R0 resection rate. Secondary study outcomes included progression-free survival (PFS), overall survival (OS), pathological complete remission (pCR) rate, and safety.

Results: Forty patients with borderline resectable esophageal squamous cell carcinoma were included in the analysis. The R0 resection rate was 23/40 (57.5%); the conversion success rate was 27/40 (67.5%), and the pCR rate was 11/40 (27.5%). The median follow-up was 23.6 months (95% CI, 19.1-28.2). One-year OS and PFS rates were 77.7% and 71.8%, respectively. The incidence rate of Grade 3-4 adverse events was 10%. There was a significant difference in PFS between patients who underwent surgery and those who did not (P = 0.008, HR: 0.144 95%CI: 0.034-0.606). However, the difference in OS was not significant (P = 0.128, HR: 0.299 95%CI: 0.063-1.416). Patients who achieved clinical downstaging after induction therapy had significantly better OS (P = 0.004 h: 0.110 95%CI: 0.025-0.495) and PFS (P = 0.0016, HR: 0.106 95%CI: 0.026-0.426) compared to those who did not.

Conclusions: Conversion surgery after induction immunochemotherapy is a promising new strategy with a high conversion rate, inspiring R0 resection rate, significant pathological remission rate, and mild toxicity for borderline resectable esophageal squamous cell carcinoma.

Background: The Cholangiocarcinoma Screening and Care Program (CASCAP) has been launched since 2013 to detect early-stage cholangiocarcinoma and reduce the disease death. However, the clinical utility of the CASCAP remains unclear. To compare survival outcomes between two time periods: before and after 2013, when significant changes in treatment strategies were implemented, and to evaluate the efficacy of the ultrasound-based screening program, in an Asian region endemic for cholangiocarcinoma.

Methods: A single-center retrospective review was conducted in curative-intended resection cholangiocarcinoma from 2002 to 2021. Patents characteristics and survival outcomes were compared between 2002 and 2013 (early period) and 2014 to 2021 (later period).

Results: A total of 1091 patients with intrahepatic (n = 624) or perihilar (n = 467) cholangiocarcinoma was included (early period, n = 658; later period, n = 433). Of 66 (15.2%) patients in the later period were referred by the CASCAP. The incidence of early-staged disease (Stage 0 and 1) was lower in early period compared to later period 16.0% versus 29.1% (p < 0.001); that of positive surgical margin was higher in early period 53.7% versus 40.0% (p < 0.001). A median survival time (MST) was 14 months in early and 40 months in later period (p < 0.001). Subgroup analysis by tumor location, the MST was 13 versus 60 months in early and late periods for intrahepatic tumor (p < 0.001), respectively. While MST in perihilar tumor was 18 versus 31 months in early and late periods(p < 0.001), respectively. By presentation, the MST was 51 vs. 38 months, respectively, with screening and usual presentation (p = 0.06).

Conclusion: Postoperative survival in CCA patients improved more than doubled during the study period. Moreover, the late period demonstrated enhanced early-stage detection, a higher rate of negative surgical margins, and improved survival outcomes.

Background: Sentinel lymph node biopsy (SLNB) is widely used in patients who receive neoadjuvant chemotherapy (NAC). Still, axillary lymph node dissection (ALND) is recommended for patients with any axillary residual disease after NAC. The necessity of ALND in patients with minimal axillary disease is unclear. We aim to investigate regional recurrence rates in patients with limited axillary residual disease after NAC underwent SLNB + image-tailored axillary surgery and adjuvant radiotherapy (RT).

Methods: Patients with clinical stages were T1-3 and N1 at the time of diagnosis, clinically good or complete axillary response after NAC, and limited axillary residue (≤ 3 pathological lymph nodes) with favorable response to NAC in the final pathological examination were included in the study. All patients underwent SLNB + image-tailored axillary surgery. Peripheral lymphatic radiotherapy was applied, and no further surgery was performed in patients with compatible radiology and pathology results.

Results: Our study, which evaluated 139 patients with a median age of 47 years, found that the median number of excised lymph nodes was 4. Notably, 46% of patients had between 1 and 3 lymph nodes excised, while 45% had between 4 and 6. Only 9% of patients had ≥ 7 lymph nodes. 83(60%) of the patients underwent breast-conserving surgery (BCS), and 56(40%) underwent mastectomy. The study's median follow-up period was 44 months. During this duration, one breast recurrence (0.7%), one supraclavicular recurrence (0.7%), and six systemic recurrences (4.3%) were observed. No axillary recurrence occurred within the follow-up period.

Conclusions: Patients presenting with pathological-suspicious ≤ 3 lymph nodes on imaging and showing a good response to NAC can be considered suitable candidates for SLNB + image-tailored axillary surgery, followed by adjuvant RT instead of ALND.

Introduction: Urine-derived exosomes could potentially be biomarkers for bladder cancer (BC) diagnosis. This study aimed to systematically evaluate the diagnostic worth of urine-derived exosomes in BC patients through a meta-analysis of diverse studies.

Methods: A systematic search was carried out in PubMed, Web of Science, Embase, Cochrane, and CNKI databases to obtain the literature concerning the diagnosis of BC via urine-derived exosomes. A literature retrieval strategy was devised to pick articles and extract needed data from the literature. QUADS-2 was used to evaluate the quality of the included literatures, and the aggregated diagnostic effect was assessed by calculating the area under the aggregated SROC curve. All statistical analyses and plots were conducted with STATA 14.0 and RevMan5.3.

Results: A total of 678 articles were retrieved by means of the search strategy of the online database. Through screening, 21 articles were obtained, involving 3348 participants and 77 studies. The meta-analysis of the results indicated that urinary exosomes had a combined sensitivity of 0.75, a specificity of 0.77, and a combined AUC of 0.83 for the diagnosis of BC, suggesting that urine-derived exosomes have a relatively satisfactory diagnostic effect in the detection of BC. Among the subgroups classified by biomarker, long non-coding RNAs (lncRNAs) had the highest comprehensive sensitivity (SEN = 0.78), and miRNAs had the highest comprehensive specificity (SPN = 0.81). In other subgroup analyses, the biomarker panel for multiple exosomes combined diagnosis demonstrated the best diagnostic efficacy, with a combined the area under the curve ( AUC) of 0.87.

Conclusions: As a novel biomarker, urine-derived exosomes have significant diagnostic prospects in the diagnosis of BC. Nevertheless, their application in clinical settings still demands a considerable number of clinical trials to confirm their clinical feasibility and practicability.

Background: This study aims to elucidate the significance of the preoperative fibrinogen to pre-albumin ratio (FPR) in predicting the prognosis of pancreatic ductal adenocarcinoma (PDAC), a correlation not extensively explored previously.

Methods: A cohort of 563 patients diagnosed with PDAC and subjected to radical surgical resection was examined. We meticulously documented a range of inflammatory markers, clinical-pathological features, and oncological outcomes. The prognostic value of preoperative FPR was assessed using Kaplan-Meier survival analysis and Cox proportional hazards regression modeling. Furthermore, the predictive accuracy of FPR was evaluated through time-dependent receiver operating characteristic (ROC) curves and decision curve analyses (DCA).

Results: The determined optimal threshold for FPR was 14.77, which facilitated the stratification of patients into groups with low and high FPR levels. Notably, patients in the high FPR cohort exhibited significantly reduced recurrence-free survival (RFS) and overall survival (OS) rates compared to their low FPR counterparts. Multivariate Cox regression analysis underscored FPR as an independent prognostic indicator for both RFS and OS. In comparison to the neutrophil-to-lymphocyte ratio (NLR), FPR demonstrated superior prognostic accuracy and clinical utility.

Conclusion: The preoperative fibrinogen to pre-albumin ratio serves as an independent prognostic marker for RFS and OS among PDAC patients undergoing radical resection. Our findings suggest that FPR could be a valuable addition to the current prognostic models, potentially guiding therapeutic decision-making and patient management strategies in PDAC.

Objective: To investigate contralateral central lymph node metastasis (CCLNM) in patients with unilateral papillary thyroid carcinoma (UPTC). To provide a reference for clinical decision-making, a prediction model for the probability of CCLNM was established.

Method: The clinicopathological data of 221 UPTC patients who underwent surgical treatment were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for CCLNM according to clinicopathological characteristics, construct a prediction model to construct a visual nomogram, and evaluate the model.

Results: According to univariate and multivariate logistic regression analyses, sex (P = 0.01, OR: 3.790, 95% CI: 1.373-10.465), extrathyroidal tumor extension (ETE) (P = 0.040, OR: 6.364, 95% CI: 1.083-37.381), tumor diameter (P = 0.010, OR: 3.674, 95% CI: 1.372-9.839) and ipsilateral central lymph node metastasis (ICLNM) (P < 0.001, OR: 38.552, 95% CI: 2.675-27.342) were found to be independent risk factors for CCLNM and were used to construct a nomogram for internal verification. The ROC curve had an AUC of 0.852 in the training group and an AUC of 0.848 in the verification group, and the calibration curve indicated that the prediction probability of the model was consistent with the actual probability. Finally, the analysis of the decision curve showed that the model has good application value in clinical decision-making.

Conclusion: Sex, ETE, tumor size, and ICLNM emerged as independent risk factors for CCLNM in UPTC patients. A predictive model was therefore developed, harnessing these variables to enable an objective, personalized estimation of CCLNM risk. This tool offers valuable insights to inform surgical planning and optimize treatment strategies for UPTC management.

Background: To investigate the clinicopathologic characteristics, therapeutic methods, and prognosis of secretory carcinoma of salivary gland (SCSG).

Methods: The clinicopathologic data of 13 patients with SCSG admitted to Shanxi Cancer Hospital from January 2018 to June 2023 were retrospectively analyzed, and a literature review was performed.

Results: A total of eight males and five females aged 22-78 years old were enrolled, and they commonly presented with painless masses in the parotid or submandibular gland. They all underwent surgical treatment, accompanied by typical pathological examinations postoperatively. Fluorescence in situ hybridization (FISH) was conducted in seven cases, the results were all positive, and no gene fusion other than ETV6-NTRK3 was found. Two patients developed local relapse during follow-up, both of which were in the surgical area. By the end of the follow-up, 12 patients survived and one patient died.

Conclusions: SCSG is a rare low-grade malignancy with a good prognosis. Pathological and immunohistochemical characteristics are the key to secretory carcinoma (SC) diagnosis, and surgical excision is the major treatment means for SCSG. Whether to perform simultaneous cervical lymph node dissection and other adjuvant therapies should be determined based on the pathological stage and the presence or absence of high-risk factors.