Pub Date : 2026-01-28DOI: 10.1016/j.ciresp.2025.800277
Antonio Ríos , Beatriz Mahíllo , Beatriz Domínguez-Gil
The transmission of diseases through organ transplantation is an inherent risk to the transfer of biological material between individuals. This risk must be minimized, while also avoiding the unnecessary loss of organs suitable for transplantation obtained from donors with a history of a condition that may affect organ function or may be transmitted to the recipient—such donors are referred to as non-standard risk donors. The final decision to transplant organs from these donors must be made following a thorough risk/benefit assessment.
To this end, the approach in Spain has been based on the provision of targeted support to transplant teams through the development and adoption of reference documents, a second-opinion system, and the generation of evidence through the prospective follow-up of recipients of organs trasplanted from this type of donors.
{"title":"Definiendo límites de seguridad en la donación de órganos: el donante de riesgo no estándar","authors":"Antonio Ríos , Beatriz Mahíllo , Beatriz Domínguez-Gil","doi":"10.1016/j.ciresp.2025.800277","DOIUrl":"10.1016/j.ciresp.2025.800277","url":null,"abstract":"<div><div>The transmission of diseases through organ transplantation is an inherent risk to the transfer of biological material between individuals. This risk must be minimized, while also avoiding the unnecessary loss of organs suitable for transplantation obtained from donors with a history of a condition that may affect organ function or may be transmitted to the recipient—such donors are referred to as non-standard risk donors. The final decision to transplant organs from these donors must be made following a thorough risk/benefit assessment.</div><div>To this end, the approach in Spain has been based on the provision of targeted support to transplant teams through the development and adoption of reference documents, a second-opinion system, and the generation of evidence through the prospective follow-up of recipients of organs trasplanted from this type of donors.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 3","pages":"Article 800277"},"PeriodicalIF":1.3,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16DOI: 10.1016/j.ciresp.2025.800283
Pablo Lozano Lominchar , Paula Muñoz , Cristina Ballester , Cristobal Muñoz Casares , Daniel Díaz , Vicente Olivares-Ripoll , Patricia Marrero , Lorena Cambeiro , Irene López , Hugo Vasques , Jose Manuel Asencio , on behalf of the Spanish Society of Surgeons, the Portuguese Sarcoma Group (Society of Surgeons)
Background
Retroperitoneal sarcoma (RPS) is a rare malignancy requiring complex surgical management. While Enhanced Recovery After Surgery (ERAS®) protocols have improved outcomes in various surgical specialties, their implementation in RPS remains inconsistent.
Objective
This study aimed to evaluate current perioperative care practices for RPS surgery across Spain and Portugal, identifying gaps in protocol standardization and assessing the feasibility of consensus-based approaches.
Methods
A structured online survey was distributed to members of the Spanish and Portuguese Societies of Surgeons. The questionnaire encompassed five domains: demographics, preoperative, intraoperative, and postoperative practices, and attitudes toward perioperative consensus.
Results
Among 266 survey accesses, 37 complete responses were analyzed. Only 27% of respondents reported having a dedicated ERAS® protocol for RPS, though 89.2% employed ERAS® pathways for other surgeries. Prehabilitation elements —such as smoking cessation (21.6%), nutritional support (73%), and supervised physical therapy (37.8%)— were inconsistently applied. Intraoperatively, goal-directed fluid therapy was used by 51.4%, while 97.3% adhered to restrictive transfusion thresholds. Postoperative variability was notable in diet resumption, mobilization, and nasogastric tube use. All respondents supported the creation of an RPS-specific perioperative care consensus.
Conclusions
There is marked heterogeneity in perioperative care for RPS across Iberian centers. Standardized, evidence-based guidelines are urgently needed to improve consistency and optimize patient outcomes.
腹膜后肉瘤（RPS）是一种罕见的恶性肿瘤，需要复杂的手术治疗。虽然ERAS （Enhanced Recovery After Surgery）方案改善了各种外科专科的预后，但其在RPS中的实施仍然不一致。目的本研究旨在评估目前西班牙和葡萄牙RPS手术的围手术期护理实践，确定方案标准化方面的差距，并评估基于共识的方法的可行性。方法对西班牙和葡萄牙外科医师协会会员进行结构化的在线调查。调查问卷包括五个方面：人口统计学，术前，术中，术后实践，以及对围手术期共识的态度。结果在266条调查通道中，分析了37条完整回复。只有27%的受访者报告有专门的ERAS®RPS方案，尽管89.2%的受访者采用ERAS®途径进行其他手术。戒烟（21.6%）、营养支持（73%）和有监督的物理治疗（37.8%）等康复要素的应用不一致。术中，51.4%的患者使用目标导向的液体治疗，而97.3%的患者坚持限制性输血阈值。术后在饮食恢复、活动和鼻胃管使用方面的差异是显著的。所有的应答者都支持建立一个特定于rps的围手术期护理共识。结论伊比利亚各中心RPS围手术期护理存在明显的异质性。迫切需要标准化的、以证据为基础的指南，以提高一致性并优化患者的预后。
{"title":"Cuidados perioperatorios en la cirugía del sarcoma retroperitoneal primario: una encuesta hispano-lusa sobre prácticas actuales","authors":"Pablo Lozano Lominchar , Paula Muñoz , Cristina Ballester , Cristobal Muñoz Casares , Daniel Díaz , Vicente Olivares-Ripoll , Patricia Marrero , Lorena Cambeiro , Irene López , Hugo Vasques , Jose Manuel Asencio , on behalf of the Spanish Society of Surgeons, the Portuguese Sarcoma Group (Society of Surgeons)","doi":"10.1016/j.ciresp.2025.800283","DOIUrl":"10.1016/j.ciresp.2025.800283","url":null,"abstract":"<div><h3>Background</h3><div>Retroperitoneal sarcoma (RPS) is a rare malignancy requiring complex surgical management. While Enhanced Recovery After Surgery (ERAS®) protocols have improved outcomes in various surgical specialties, their implementation in RPS remains inconsistent.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate current perioperative care practices for RPS surgery across Spain and Portugal, identifying gaps in protocol standardization and assessing the feasibility of consensus-based approaches.</div></div><div><h3>Methods</h3><div>A structured online survey was distributed to members of the Spanish and Portuguese Societies of Surgeons. The questionnaire encompassed five domains: demographics, preoperative, intraoperative, and postoperative practices, and attitudes toward perioperative consensus.</div></div><div><h3>Results</h3><div>Among 266 survey accesses, 37 complete responses were analyzed. Only 27% of respondents reported having a dedicated ERAS® protocol for RPS, though 89.2% employed ERAS® pathways for other surgeries. Prehabilitation elements —such as smoking cessation (21.6%), nutritional support (73%), and supervised physical therapy (37.8%)— were inconsistently applied. Intraoperatively, goal-directed fluid therapy was used by 51.4%, while 97.3% adhered to restrictive transfusion thresholds. Postoperative variability was notable in diet resumption, mobilization, and nasogastric tube use. All respondents supported the creation of an RPS-specific perioperative care consensus.</div></div><div><h3>Conclusions</h3><div>There is marked heterogeneity in perioperative care for RPS across Iberian centers. Standardized, evidence-based guidelines are urgently needed to improve consistency and optimize patient outcomes.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800283"},"PeriodicalIF":1.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16DOI: 10.1016/j.ciresp.2025.800256
Marina Garcés Albir , Francisco García García , Isabel Mora Oliver , Elena Muñoz Forner , Luis Sabater Orti , Dimitri Dorcaratto , GRUPO 3D-PANC Integrantes Grupo 3D-PANC
Neoadjuvant chemotherapy followed by surgery represents the treatment of choice for patients with borderline and locally advanced pancreatic adenocarcinoma (PAC). Despite being the diagnostic technique of choice for PAC staging, computed tomography (CT) has very low accuracy in identifying patients who may benefit from surgical resection after neoadjuvant therapy. Consequently, the study of new image processing technologies is gaining significant importance. However, no prospective validation studies of these new technologies currently exist. The 3D-PANC study is a multicenter prospective study that will include patients with borderline or locally advanced PAC undergoing neoadjuvant chemotherapy and surgical exploration with curative intent. The objective is to compare the accuracy of the 3D-MSP (Model for Surgery Planning) model versus conventional CT for preoperative diagnosis of vascular involvement after neoadjuvant treatment (NAT) in patients with borderline or locally advanced PAC. This will be achieved by analyzing the accuracy variables of both techniques against the gold standard (surgical outcomes and histopathological analysis).
{"title":"Protocolo del estudio 3D-PANC: ¿es la tecnología de imagen en tres dimensiones superior a la tomografía computarizada para evaluar la respuesta al tratamiento neoadyuvante en los pacientes con adenocarcinoma de páncreas borderline o localmente avanzado?","authors":"Marina Garcés Albir , Francisco García García , Isabel Mora Oliver , Elena Muñoz Forner , Luis Sabater Orti , Dimitri Dorcaratto , GRUPO 3D-PANC Integrantes Grupo 3D-PANC","doi":"10.1016/j.ciresp.2025.800256","DOIUrl":"10.1016/j.ciresp.2025.800256","url":null,"abstract":"<div><div>Neoadjuvant chemotherapy followed by surgery represents the treatment of choice for patients with borderline and locally advanced pancreatic adenocarcinoma (PAC). Despite being the diagnostic technique of choice for PAC staging, computed tomography (CT) has very low accuracy in identifying patients who may benefit from surgical resection after neoadjuvant therapy. Consequently, the study of new image processing technologies is gaining significant importance. However, no prospective validation studies of these new technologies currently exist. The 3D-PANC study is a multicenter prospective study that will include patients with borderline or locally advanced PAC undergoing neoadjuvant chemotherapy and surgical exploration with curative intent. The objective is to compare the accuracy of the 3D-MSP (Model for Surgery Planning) model versus conventional CT for preoperative diagnosis of vascular involvement after neoadjuvant treatment (NAT) in patients with borderline or locally advanced PAC. This will be achieved by analyzing the accuracy variables of both techniques against the gold standard (surgical outcomes and histopathological analysis).</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800256"},"PeriodicalIF":1.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-16DOI: 10.1016/j.ciresp.2025.800249
Juli Busquets , Núria Peláez , Luis Secanella , Maria Sorribas , Elena Iborra
The resection of locally advanced adenocarcinoma of the pancreatic head with occlusion of the superior mesenteric vein and involvement of the splenomesentericportal confluent (EMP) sometimes requires prolonged venous clamping with risk of intestinal ischemia. The use of intraoperative venous shunts has been published by reference groups to allow successful resection. In our center we performed a total pancreatoduodenectomy for locally advanced pancreatic head adenocarcinoma with superior mesenteric vein occlusion (SMV) and splenomesentericportal confluent. The use of a transient ileo-caval shunt via a venous graft allowed resection of the tumor without repercussion on the bowel. The surgery ended with closure of the shunt, anastomosis of the graft to the portal vein and digestive reconstruction. The patient presented good tolerance to surgery and was discharged on the 7 th postoperative day. The pathology report described pancreatic adenocarcinoma ypT1N0(R0) regression grade GRT2/IIa, with 0/30 affected adenopathies.
{"title":"Shunt íleo-cava intraoperatorio transitorio en la resección de adenocarcinoma de cabeza de páncreas localmente avanzado: ¿rompiendo un techo?","authors":"Juli Busquets , Núria Peláez , Luis Secanella , Maria Sorribas , Elena Iborra","doi":"10.1016/j.ciresp.2025.800249","DOIUrl":"10.1016/j.ciresp.2025.800249","url":null,"abstract":"<div><div>The resection of locally advanced adenocarcinoma of the pancreatic head with occlusion of the superior mesenteric vein and involvement of the splenomesentericportal confluent (EMP) sometimes requires prolonged venous clamping with risk of intestinal ischemia. The use of intraoperative venous <em>shunt</em>s has been published by reference groups to allow successful resection. In our center we performed a total pancreatoduodenectomy for locally advanced pancreatic head adenocarcinoma with superior mesenteric vein occlusion (SMV) and splenomesentericportal confluent. The use of a transient ileo-caval <em>shunt</em> via a venous graft allowed resection of the tumor without repercussion on the bowel. The surgery ended with closure of the <em>shunt</em>, anastomosis of the graft to the portal vein and digestive reconstruction. The patient presented good tolerance to surgery and was discharged on the 7<!--> <!-->th postoperative day. The pathology report described pancreatic adenocarcinoma ypT1N0(R0) regression grade GRT2/IIa, with 0/30 affected adenopathies.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800249"},"PeriodicalIF":1.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-15DOI: 10.1016/j.ciresp.2025.800270
Andrea Boscà Robledo , Eva M. Montalvá Orón , Ana Navío Seller , Javier Maupoey Ibáñez , Ana Hernando Sanz , David Calatayud Mizrahi , Francisco J. Orbis Castellanos , Rafael López Andújar
Background
There is abundant scientific literature on the use of haemostatics and sealants in liver surgery, but there is a lack of evidence due to the difficulty to apply adequate methodologies without conflicts of interest.
This prospective randomized study with the main objective is to determine the efficacy of the local haemostatic Hemopatch® in the incidence of bleeding and biliary fistula in patients undergoing elective liver resection.
Methods
This was a single-center study where 222 patients were analyzed: 115 patients had been randomized to the control group and 107 to the experimental group. The patients after liver resection are randomized to place Hemopatch® or not on the transection liver surface. Patients with all types of liver resections and with laparotomic and laparoscopic approaches were included. During postoperative follow-up, an abdominal drain is placed, and hemoglobin and bilirubin are analyzed during the first three days.
Results
Clinically postoperative bleeding occurred in 3.5% of the patients in the control group and in 2.8% of the experimental group (P = .409). The incidence of postoperative biliary fistula was 17.4% in the control group and 23.4% in the experimental group (P = .269). There were also no differences in the rest of the parameters analyzed.
Conclusions
The results on the use of Hemopatch® in liver resection to prevent hemorrhage and biliary fistula are inconclusive. It cannot be routinely recommended and surgeons should be more demanding with the scientific evidence to justify the systematic use of haemostatics agents.
{"title":"Evidencia clínica del uso de Hemopatch® en la reducción del sangrado y fístula biliar tras resección hepática. Estudio prospectivo aleatorizado en cirugía programada","authors":"Andrea Boscà Robledo , Eva M. Montalvá Orón , Ana Navío Seller , Javier Maupoey Ibáñez , Ana Hernando Sanz , David Calatayud Mizrahi , Francisco J. Orbis Castellanos , Rafael López Andújar","doi":"10.1016/j.ciresp.2025.800270","DOIUrl":"10.1016/j.ciresp.2025.800270","url":null,"abstract":"<div><h3>Background</h3><div>There is abundant scientific literature on the use of haemostatics and sealants in liver surgery, but there is a lack of evidence due to the difficulty to apply adequate methodologies without conflicts of interest.</div><div>This prospective randomized study with the main objective is to determine the efficacy of the local haemostatic Hemopatch® in the incidence of bleeding and biliary fistula in patients undergoing elective liver resection.</div></div><div><h3>Methods</h3><div>This was a single-center study where 222 patients were analyzed: 115 patients had been randomized to the control group and 107 to the experimental group. The patients after liver resection are randomized to place Hemopatch® or not on the transection liver surface. Patients with all types of liver resections and with laparotomic and laparoscopic approaches were included. During postoperative follow-up, an abdominal drain is placed, and hemoglobin and bilirubin are analyzed during the first three days.</div></div><div><h3>Results</h3><div>Clinically postoperative bleeding occurred in 3.5% of the patients in the control group and in 2.8% of the experimental group (<em>P</em> <!-->=<!--> <!-->.409). The incidence of postoperative biliary fistula was 17.4% in the control group and 23.4% in the experimental group (<em>P</em> <!-->=<!--> <!-->.269). There were also no differences in the rest of the parameters analyzed.</div></div><div><h3>Conclusions</h3><div>The results on the use of Hemopatch® in liver resection to prevent hemorrhage and biliary fistula are inconclusive. It cannot be routinely recommended and surgeons should be more demanding with the scientific evidence to justify the systematic use of haemostatics agents.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 2","pages":"Article 800270"},"PeriodicalIF":1.3,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ciresp.2025.800262
Corrado P. Marini , Patrizio Petrone , Francesca Izzo , David A. Lieb II , Srinivas H. Reddy , John McNelis
Background
This study assessed whether there is a correlation between the grade of splenic injury and the semiquantitative assessment of the amount of the hemoperitoneum (HP) by a modified Federle score (mFS), and which of the 2 factors is more predictive of the need for intervention in adult patients with isolated blunt splenic injury (iBSI).
Methods
Retrospective cohort study of patients admitted (1/1/2019−12/31/2022) with iBSI. Continuous data are presented as means ± standard deviation and non-parametric data as frequencies with percentages. A test-retest analysis for intra- and inter-class reliability of HP assessment was done in a 10-patient subgroup.
Results
Among the 62 patients, 47 (75.8%) were managed nonoperatively (23 observation, 24 splenic artery embolization [SAE]), and 15 underwent splenectomy. The grade of splenic injury and mFS scores were 3.6 ± 1.3 and 4.1 ± 1.9, respectively. The 22 patients who underwent SAE were more severely injured in terms of grade of splenic injury (4.0 ± 1.2 vs 2.6 ± 1.1), amount of HP by mFS (4.1 ± 1.8 vs 3.1 ± 1.7) and ISS (21 ± 11 vs 15 ± 12) compared to the observed patients (P < .05). Mortality was 8%. SAE and splenectomy groups differed only by the quantity of HP (4.1 ± 1.8 vs 5.5 ± 1.3). While there was a correlation between AAST grade and mFS, only mFS was predictive of splenectomy.
Conclusion
The quantity of HP as assessed by mFS may be more predictive than the grade of splenic injury regarding the need for splenectomy in patients with iBSI.
背景：本研究评估脾脏损伤等级与改良Federle评分（mFS）半定量评估腹腔积血（HP）量之间是否存在相关性，以及这两个因素中哪一个更能预测成人孤立性钝性脾损伤（iBSI）患者是否需要干预。方法对2019年1月1日至2022年12月31日住院的iBSI患者进行回顾性队列研究。连续数据以平均值±标准差表示，非参数数据以频率和百分比表示。在10例患者亚组中，对HP评估的类内和类间可靠性进行了重测分析。结果62例患者中，非手术治疗47例（75.8%），其中观察23例，脾动脉栓塞24例，脾切除术15例。脾损伤分级和mFS评分分别为3.6±1.3分和4.1±1.9分。22例SAE患者在脾损伤等级（4.0±1.2 vs 2.6±1.1）、mFS HP（4.1±1.8 vs 3.1±1.7）和ISS（21±11 vs 15±12）方面均较观察患者损伤更严重（P < 0.05）。死亡率为8%。SAE组和脾切除术组仅在HP数量上有差异（4.1±1.8 vs 5.5±1.3）。虽然AAST分级与mFS之间存在相关性，但只有mFS可预测脾切除术。结论mFS评价的HP值可能比脾损伤程度更能预测iBSI患者是否需要脾切除术。
{"title":"A modified Federle score is superior to injury grade in predicting the need for splenectomy in patients with isolated blunt splenic trauma","authors":"Corrado P. Marini , Patrizio Petrone , Francesca Izzo , David A. Lieb II , Srinivas H. Reddy , John McNelis","doi":"10.1016/j.ciresp.2025.800262","DOIUrl":"10.1016/j.ciresp.2025.800262","url":null,"abstract":"<div><h3>Background</h3><div>This study assessed whether there is a correlation between the grade of splenic injury and the semiquantitative assessment of the amount of the hemoperitoneum (HP) by a modified Federle score (mFS), and which of the 2 factors is more predictive of the need for intervention in adult patients with isolated blunt splenic injury (iBSI).</div></div><div><h3>Methods</h3><div>Retrospective cohort study of patients admitted (1/1/2019−12/31/2022) with iBSI. Continuous data are presented as means ± standard deviation and non-parametric data as frequencies with percentages. A test-retest analysis for intra- and inter-class reliability of HP assessment was done in a 10-patient subgroup.</div></div><div><h3>Results</h3><div>Among the 62 patients, 47 (75.8%) were managed nonoperatively (23 observation, 24 splenic artery embolization [SAE]), and 15 underwent splenectomy. The grade of splenic injury and mFS scores were 3.6 ± 1.3 and 4.1 ± 1.9, respectively. The 22 patients who underwent SAE were more severely injured in terms of grade of splenic injury (4.0 ± 1.2 vs 2.6 ± 1.1), amount of HP by mFS (4.1 ± 1.8 vs 3.1 ± 1.7) and ISS (21 ± 11 vs 15 ± 12) compared to the observed patients (<em>P</em> < .05). Mortality was 8%. SAE and splenectomy groups differed only by the quantity of HP (4.1 ± 1.8 vs 5.5 ± 1.3). While there was a correlation between AAST grade and mFS, only mFS was predictive of splenectomy.</div></div><div><h3>Conclusion</h3><div>The quantity of HP as assessed by mFS may be more predictive than the grade of splenic injury regarding the need for splenectomy in patients with iBSI.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 1","pages":"Article 800262"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ciresp.2025.800272
Ozgur Ekinci , Ataturk Nurullayev , Muhammet Ali Aydemir , Aysegul Ergun , Tunc Eren , Orhan Alimoglu
Aim
This study aimed to explore the clinical and pathological differences between microsatellite instability-high (MSI-H) and microsatellite stable (MSS) tumors in right-sided colon cancer patients, as well as to evaluate the prognostic significance of MSI status on survival outcomes.
Methods
Historical records of patients who underwent surgery for right-sided colon cancer between 2016 and 2024 were evaluated retrospectively. Immunohistochemistry was used for the determination of MSI status, and data on tumor characteristics, lymph node metastasis, carcinoembryonic antigen (CEA) levels, and survival outcomes were analyzed. Comparisons were performed to assess differences between the MSI-H and MSS groups, where P < .05 was considered statistically significant.
Results
The study included 100 patients, consisting of 52 men and 48 women with a median age of 72 (range: 63–79). Tumors with MSI-H status were significantly larger (median: 6.50 cm vs 4.50 cm; P < .001) and demonstrated higher rates of mucinous carcinoma (52.9% vs 24.2%; P = .008) compared to MSS tumors. Poor differentiation was more common in MSI-H tumors (20.6% vs 3.03%: P = .003). Overall survival (OS) and disease-free survival (DFS) did not differ significantly between MSI-H and MSS groups (P = .466 and P = .337, respectively). Elevated postoperative CEA levels at 6, 12, 18 and 24 months were significantly associated with poorer survival outcomes (P < .01).
Conclusion
Right-sided colon cancers with MSI-H status were associated with larger tumor size, mucinous histology, and poor differentiation but did not significantly affect survival outcomes. Postoperative CEA monitoring provides critical prognostic information. Further large-scale studies are required to confirm these findings and refine therapeutic approaches.
目的探讨右侧结肠癌患者微卫星不稳定-高（MSI- h）与微卫星稳定（MSS）肿瘤的临床及病理差异，并评价MSI状态对生存结局的预后意义。方法回顾性分析2016年至2024年间右侧结肠癌手术患者的历史资料。采用免疫组织化学方法测定MSI状态，并分析肿瘤特征、淋巴结转移、癌胚抗原（CEA）水平和生存结果等数据。比较MSI-H组和MSS组之间的差异，其中P <； 0.05被认为具有统计学意义。结果纳入100例患者，男性52例，女性48例，中位年龄72岁（63-79岁）。与MSS肿瘤相比，MSI-H状态的肿瘤明显更大（中位数：6.50 cm vs 4.50 cm; P < 0.001），并且粘液癌的发生率更高（52.9% vs 24.2%; P = 0.008）。分化差在MSI-H肿瘤中更为常见（20.6% vs 3.03%: P = 0.003）。总生存期（OS）和无病生存期（DFS）在MSI-H组和MSS组之间无显著差异（P = 0.466和0.337）。术后6、12、18和24个月CEA水平升高与较差的生存结果显著相关（P < 0.01）。结论MSI-H状态的右侧结肠癌肿瘤体积较大，黏液组织学和分化差，但对生存结果无显著影响。术后CEA监测提供了重要的预后信息。需要进一步的大规模研究来证实这些发现并改进治疗方法。
{"title":"The impact of microsatellite instability and tumor characteristics on survival of patients with right-sided colon cancer","authors":"Ozgur Ekinci , Ataturk Nurullayev , Muhammet Ali Aydemir , Aysegul Ergun , Tunc Eren , Orhan Alimoglu","doi":"10.1016/j.ciresp.2025.800272","DOIUrl":"10.1016/j.ciresp.2025.800272","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to explore the clinical and pathological differences between microsatellite instability-high (MSI-H) and microsatellite stable (MSS) tumors in right-sided colon cancer patients, as well as to evaluate the prognostic significance of MSI status on survival outcomes.</div></div><div><h3>Methods</h3><div>Historical records of patients who underwent surgery for right-sided colon cancer between 2016 and 2024 were evaluated retrospectively. Immunohistochemistry was used for the determination of MSI status, and data on tumor characteristics, lymph node metastasis, carcinoembryonic antigen (CEA) levels, and survival outcomes were analyzed. Comparisons were performed to assess differences between the MSI-H and MSS groups, where <em>P</em> < .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The study included 100 patients, consisting of 52 men and 48 women with a median age of 72 (range: 63–79). Tumors with MSI-H status were significantly larger (median: 6.50 cm vs 4.50 cm; <em>P</em> < .001) and demonstrated higher rates of mucinous carcinoma (52.9% vs 24.2%; <em>P</em> = .008) compared to MSS tumors. Poor differentiation was more common in MSI-H tumors (20.6% vs 3.03%: <em>P</em> = .003). Overall survival (OS) and disease-free survival (DFS) did not differ significantly between MSI-H and MSS groups (<em>P</em> = .466 and <em>P</em> = .337, respectively). Elevated postoperative CEA levels at 6, 12, 18 and 24 months were significantly associated with poorer survival outcomes (<em>P</em> < .01).</div></div><div><h3>Conclusion</h3><div>Right-sided colon cancers with MSI-H status were associated with larger tumor size, mucinous histology, and poor differentiation but did not significantly affect survival outcomes. Postoperative CEA monitoring provides critical prognostic information. Further large-scale studies are required to confirm these findings and refine therapeutic approaches.</div></div>","PeriodicalId":50690,"journal":{"name":"Cirugia Espanola","volume":"104 1","pages":"Article 800272"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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