World Journal of Surgical Oncology最新文献

Introduction: Solid cancers and their surgical treatment are both major sources of oxidative stress (OS), which contributes to adverse clinical outcomes. This study aimed to explore the impact of major solid cancer surgery on plasma OS concentrations by assessing key biomarkers.

Methods: We conducted an exploratory, prospective study including 36 patients undergoing elective major cancer surgery. Pre- and postoperative plasma concentrations of adenosine deaminase (ADA), xanthine oxidase (XO), ischemia-modified albumin (IMA), redox potential (RP), and high-sensitivity troponin T (hs-TnT) were measured. Thirty matched healthy controls were used for comparison.

Results: Preoperative plasma concentrations of ADA, XO, IMA, and RP were significantly elevated in patients, as compared to controls, indicating high baseline oxidative stress. Postoperatively, plasma concentrations of XO, IMA, and RP decreased significantly (p < 0.05) but remained higher than those of controls, while ADA concentrations showed no significant postoperative decrease. The plasma concentration of hs-TnT increased modestly but significantly after surgery (p = 0.003). A negative correlation between preoperative ADA and XO concentration was observed (r = -0.46; p = 0.006).

Conclusion: Solid cancers were associated with elevated plasma expression of OS, which significantly decreased after surgery. However, major surgery itself induces a residual oxidative burden, reflected by an elevation in myocardial biomarkers. The increased levels of OS levels before surgery could fit the cancer-driven "priming/second-hit" framework. The negative correlation between ADA and XO suggests a potential feedback mechanism. These findings bring new insights regarding OS modulation during major solid cancer surgery and warrant further investigation in larger studies.

Purpose: Mitoxantrone hydrochloride injection for tracing (MHI) is a novel lymphatic tracer recommended for sentinel lymph node (SLN) biopsy (SLNB) in breast cancer. However, whether MHI can be detected under near-infrared fluorescence and the optimal MHI concentration and injection timing for SLNB remain unclear. This study characterized the fluorescent properties of MHI and explored its optimal application conditions for SLNB.

Methods: A total of 103 patients with clinically lymph node (LN)-negative breast cancer were enrolled who underwent mastectomy with SNLB followed by completion axillary lymph node dissection (ALND) were enrolled. Specifically, 32 patients (cohort I) were randomly allocated into four groups (undiluted, 1:2 dilution, 1:5 dilution, and 1:10 dilution) to determine the optimal concentration for fluorescence imaging, which was further confirmed in an additional 31 patients (cohort II). Subsequently, 40 patients (cohort III) were intraoperatively injected with either methylene blue (MB) or MHI/indocyanine green (ICG), and their lymphatic drainage imaging results were compared.

Results: Undiluted MHI was identified as the optimal concentration for both visible dye and near-infrared fluorescence imaging. In all 39 patients (eight patients from cohort I and all the patients in cohort II) injected with undiluted MHI, lymphatic vessels were visible on the body surface, along with an SLN detection rate of 94.9% and a false-negative rate (FNR) of 5.26%. A waiting time of 5 min was recommended as the optimal dyeing time before skin incision for SLNB. Furthermore, MHI demonstrated comparable SLN detection rate and lymphatic vessel imaging rate to those of MB and ICG with high specificity and operational convenience.

Conclusion: MHI is a feasible fluorescence tracer for SLNB, with its dual advantages of visual clarity (like MB) and lymphatic specificity (like ICG). These combined advantages may enhance the accuracy and practicality of SLNB in breast cancer.

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.