World Journal of Surgical Oncology最新文献

Background: Neoadjuvant chemotherapy (NAC) combined with gastrectomy has been a standard therapeutic strategy for resectable gastric cancer (GC). However, it remains unclear whether postoperative adjuvant chemotherapy (AC) brings better survival in ypTNM stage I GC patients.

Methods: Data on ypTNM stage I GC patients with or without AC following systemic NAC and radical gastrectomy were retrospectively retrieved from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2021. Inverse probability of treatment weighting (IPTW) was used to balance covariates. Overall survival (OS) and cancer-specific survival (CSS) were assessed through Kaplan-Meier and Cox proportional hazards models. Two nomograms were developed to predict OS and CSS of patients with ypTNM stage I GC who received AC.

Results: 661 patients met the inclusion criteria, 230 received AC and 431 were AC nonuser. AC was significantly associated with improved OS (weighted HR = 0.63, 95% CI: 0.43-0.92) but not statistically significant for CSS (weighted HR = 0.73, 95% CI: 0.46-1.17) after IPTW adjustment. Age, tumor diameter, and primary site were also independent predictors of survival. Subgroup analysis revealed that patients with non-proximal GC benefitted more from AC. The survival prediction models demonstrated good calibration and discrimination, with the C-indexes for OS were 0.75 and 0.79 for CSS.

Conclusion: Patients with ypTNM stage I GC might benefit from postoperative AC compared with non-AC. Nomograms showed better predictive value for evaluating the prognosis of ypTNM stage I GC patients who received AC.

Background: Advanced colorectal cancer (CRC) predisposes to peritoneal metastases (PM), leading to a decreased survival rate. Advanced CRC includes CRC with PM (CRC-PM) and locally advanced high-risk CRC without PM. The effectiveness of hyperthermic intraperitoneal chemotherapy (HIPEC) in prolonging survival and in treating or preventing PM after surgery for advanced CRC is still uncertain.

Methods: A search of PubMed, Cochrane, Embase, and Web of science databases for relevant studies prior to April 2024 was performed. Data were analyzed using Stata/MP 17.0 software. The primary outcomes included overall survival (OS) and disease-free survival (DFS). Secondary outcomes were overall recurrence rate (ORR), PM rate, and complications. The quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).

Results: A total of ten high-quality cohort studies and four randomized controlled trials (RCTs) were included, encompassing 2851 patients. HIPEC improved 1-year DFS (odds ratio (OR) = 1.64, 95%Cl: 1.09-2.46) and 5-year OS (OR = 1.49, 95%Cl: 1.10-2.03) in advanced CRC. HIPEC also reduced the overall PM rate (OR = 0.66, 95%Cl: 0.49-0.90). For advanced high-risk CRC without prior PM, HIPEC reduced the PM rate and had a preventive effect (OR = 0.71, 95%Cl: 0.52-0.97). In terms of complications, HIPEC increased the incidence of thrombopenia (OR = 5.77, 95%Cl: 1.65-20.09) and neutropenia (OR = 3.21, 95%Cl: 1.74-5.90). The quality of evidence ranged from high to very low.

Conclusion: The use of HIPEC in treating advanced CRC may result in improved survival rates and a reduction in peritoneal recurrence or metastasis, although complications should be considered. Further investigation is required to clarify the role of HIPEC in more high-quality RCTs.

Introduction: Extra-axial chordomas are extremely rare tumours that are characterised by slow growth and local aggressiveness and can potentially metastasise during follow-up.

Materials and methods: This is the case of a 37-year-old woman with a bone lesion in the distal third of her fibula, with mild symptoms at that site consisting of a mass and mild pain. After local and distant staging, a percutaneous core needle biopsy was performed and a diagnosis of malignant bone tumour with cartilage differentiation was made, although the diagnosis and lesion grade could not be specified.

Results: After evaluation by the sarcoma committee, and given the biopsy diagnosis and negative distant extension, wide resection and reconstruction of the tibio-fibular reconstruction complex were performed. The definitive diagnosis was a well-differentiated extra-axial chondroid bone chordoma in the cortex of the fibula. Four years after the procedure, the patient is disease free, with good ankle function and independent in her activities of daily living. An AOFAS score of 62 points, an MSTS-ISOLS score of 18 points (60%) and SF-12 scores of 35.56 on the PCS and 24.58 on the MCS were recorded.

Conclusion: Bone and soft tissue neoplasms require local and distant staging prior to biopsy. For a suspected diagnosis, clinical, anatomical and radiological correlation must be maintained. Treatment can proceed after the case has been reviewed by a multidisciplinary sarcoma committee. In chordoma cases, extra-axial locations are extremely rare. Reconstruction of the ankle presents major anatomical difficulties, with multiple techniques having been described. In such cases, a careful pre-surgical anatomical study must be performed to obtain wide margins and plan the reconstruction based on the type of patient, anatomical structures after resection and the multiple techniques described for the lateral ankle region, in order to maintain maximum function without limiting the patient's quality of life.

Objective: This study aims to analyze global trends in cancer deaths and disability-adjusted life years (DALYs) attributable to smoking from 1990 to 2021 using the Global Burden of Disease (GBD) database, and to predict trends over the next 20 years.

Methods: This study utilized the 2021 GBD database to extract annual mortality, DALYs, and age-standardized rates for cancer attributable to smoking across 204 countries from 1990 to 2021. Joinpoint regression assessed temporal trends, calculating average annual percentage change (AAPC). Autoregressive Integrated Moving Average (ARIMA) modeling forecasted future disease burden for 20 years.

Results: From 1990 to 2021, global cancer attributable to smoking deaths and DALYs increased, with deaths rising from 1,328.88 to 2,012.85 thousand and DALYs from 35,581.64 to 47,976.55 thousand, despite declining age-standardized mortality (ASMR) from 33.76 to 23.31 per 100,000 (AAPC: -1.19) and DALYs (ASDR) from 863.94 to 546.86 per 100,000 (AAPC: -1.47). Males exhibited a higher burden, with ASMR at 42.68 and ASDR at 978.15 per 100,000 in 2021, compared to females (7.01 and 161.30). High Socio-demographic Index (SDI) regions showed the steepest ASMR decline (AAPC: -1.80). Tracheal, bronchus, and lung, esophageal, and stomach cancers dominated the burden. In 2021, specific regions within Greenland, Eastern Europe, Central Asia, East Asia, and the Middle East demonstrated notably higher compared to other regions. The ARIMA model predicts that the ASMR and ASDR for cancer attributable to smoking in both males and females will continue to decline from 2022 to 2041.

Conclusion: This study reveals a rising global burden of cancer attributable to smoking deaths and DALYs. However, ASMR and ASDR have decreased, with males bearing a higher burden, indicating a relative reduction in disease burden. High SDI regions exhibit steeper declines in the burden of cancer attributable to smoking. Tracheal, bronchus, and lung, esophageal, and stomach cancers dominate, with ARIMA forecasts predicting continued reductions through 2041. It remains imperative to enhance tobacco control, especially in low SDI regions, to sustain this declining trend.

Background: Laryngeal and hypopharyngeal squamous cell carcinomas are among the most common head and neck malignancies, presenting a dual clinical challenge of achieving tumor eradication while preserving laryngeal function. This study evaluated the efficacy and preservation of laryngeal function effects of different neoadjuvant treatment regimens in patients.

Methods: This retrospective study analyzed data from 110 patients with loco-regionally advanced laryngeal and hypopharyngeal cancer. Patients were categorized into three groups based on the neoadjuvant treatment regimens administered: TP chemotherapy group (albumin-bound paclitaxel plus cisplatin), camrelizumab plus TP chemotherapy group, and cetuximab plus TP chemotherapy group. To make a Kaplan-Meier survival curve plot for 3 groups and do a log-rank test on these groups. We executed receiver operation capability (ROC) curve examination and a multivariate Coxproportional dangers regression to recognize separate prognostic determinants for 2-year overall survival (OS).

Results: Compared with TP chemotherapy alone, camrelizumab plus TP chemotherapy demonstrated significant improvements in multiple endpoints (all P < 0.05). The objective response rate (ORR) in the camrelizumab plus TP chemotherapy group was 90.0%, the 2-year progression-free survival (PFS) rate was 75.0%, and the 2-year laryngectomy-free survival (LFS) rate was 67.5%. However, the 2-year OS rate was 80.0%, indicating no significant improvement (P > 0.05). The cetuximab plus TP chemotherapy group did not demonstrate significant improvements in any of the above three endpoints (all P > 0.05). No significant difference was observed in the incidence of major adverse events among the three groups (P > 0.05). Cox regression analysis revealed that the systemic immunoinflammatory index (SII), neutrophil-lymphocyte ratio (NLR), and N stage were independent prognostic factors. ROC curve analysis demonstrated that the areas under the curve (AUC) for SII and NLR in predicting prognosis were 0.839 (95% confidence interval [CI]: 0.755-0.923) and 0.853 (95% CI: 0.772-0.934), respectively.

Conclusion: In patients with loco-regionally advanced laryngeal and hypopharyngeal carcinoma, combining camrelizumab with TP chemotherapy demonstrates favorable short-term efficacy and laryngeal preservation rates while maintaining an acceptable safety profile. The inflammatory immune markers SII and NLR have valuable predictive utility in this patient population.

Background: Triple-negative breast cancer (TNBC) is one of the most malignant subtypes of breast cancer with a high recurrence rate and adverse prognosis. Due to the lack of reliable molecular targets, improving patients' outcomes is still a challenge in the clinic. The clinical significance of miR-4326 and its potential in mediating tumor progression were investigated in this study, aiming to explore a novel biomarker for TNBC.

Methods: A total of 108 patients diagnosed with TNBC were included in the present study, and the tissue samples were collected. The expression of miR-4326 was evaluated using PCR, while its clinical significance was assessed from the perspectives of disease severity and 5-year prognosis. In vitro, the regulation of TNBC cell growth and motility by miR-4326 was evaluated by CCK8 and Transwell assays with the help of cell transfection.

Results: Upregulation of miR-4326 was observed in tumor tissues of TNBC patients, which indicates advanced TNM stage, the occurrence of lymph node metastasis, and poorer prognosis. In TNBC cells, miR-4326 was also upregulated, its knockdown significantly suppressed cell proliferation, migration, and invasion. MED13 showed opposite dysregulation and was negatively regulated by miR-4326. Silencing MED13 could reverse the suppressive effect of miR-4326 knockdown on TNBC cells.

Conclusions: miR-4326 could serve as a prognostic biomarker for TNBC and regulate tumor progression via targeting MED13.