Surgical Oncology-Oxford最新文献

{"title":"Delphi for management of N2 non-small cell lung cancer","authors":"Hind Eid ,&nbsp;Elias Karam ,&nbsp;Antoine EL. Kik ,&nbsp;Fadi El Karak ,&nbsp;Ammar Chamaa ,&nbsp;Bassem Habr ,&nbsp;Hampig Raphael Kourie ,&nbsp;Fares Azouri ,&nbsp;Viviane Smayra ,&nbsp;Noel Aoun ,&nbsp;Joseph Kattan ,&nbsp;Georges Chahine ,&nbsp;Marwan Ghosn ,&nbsp;Jad Wakim ,&nbsp;Hussein Nasserddine ,&nbsp;Fadi Nasr ,&nbsp;Georges Khayat ,&nbsp;Joseph Nakad ,&nbsp;Carine Harmouche ,&nbsp;Georges Dabar ,&nbsp;Moussa Riachy","doi":"10.1016/j.suronc.2025.102245","DOIUrl":"10.1016/j.suronc.2025.102245","url":null,"abstract":"<div><div>Mediastinal lymph node involvement is a prognostic factor in patients with localized NSCLC. Both ipsilateral and subcarinal nodal involvement are classified as N2 disease. However, there is no universally agreed-upon approach for diagnosing and treating this condition. The aim of this study is to elaborate an institutional N2 consensus. A multidisciplinary expert panel at Hotel Dieu de France provided informed consent to participate in the modified Delphi process. Twelve basic statements were started by a steering committee of three independent reviewers on the basis of international consensus, medical literature and personal experience. In the first round, physicians answered an open-ended questionnaire that was analyzed thematically. In the second round, the participants rated the generated statements and added their comments. In the third round, the participants rated their agreement via a 6-point Likert scale. Consensus was defined as ≥80 % agreement (A+ or A) with a statement. Nineteen physicians completed the three rounds. A full consensus was reached in eleven statements. Preoperative mediastinal staging is mandatory in patients with resectable N2 disease. It should be considered in patients with a high SUVmax (maximum standardized uptake value) (≥3), proximal or apical tumors and high <em>carcinoembryonic antigen</em> levels. Surgery is performed in the absence of neoadjuvant treatment depending on a single station with nonbulky disease and stage T3 invasive/T4 disease. In patients with N2 disease at several stations, radio chemotherapy is the main treatment, followed by durvalumab in patients with good general status. In pN2 patients, postsurgical treatment is based on the condition of the surgical resection margin. These findings will help physicians in multidisciplinary discussions agree on clinical decisions.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102245"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338368","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}

{"title":"Development and internal validation of a novel predictive model to guide an individualized risk assessment in prostate cancer patients","authors":"Fabrizio Di Maida ,&nbsp;Luca Lambertini ,&nbsp;Antonio Andrea Grosso ,&nbsp;Daniele Paganelli ,&nbsp;Vincenzo Salamone ,&nbsp;Simone Coco ,&nbsp;Anna Cadenar ,&nbsp;Andrea Marzocco ,&nbsp;Filippo Lipparini ,&nbsp;Matteo Salvi ,&nbsp;Gianni Vittori ,&nbsp;Rino Oriti ,&nbsp;Agostino Tuccio ,&nbsp;Michele Di Dio ,&nbsp;Lorenzo Masieri ,&nbsp;Andrea Mari ,&nbsp;Andrea Minervini","doi":"10.1016/j.suronc.2025.102242","DOIUrl":"10.1016/j.suronc.2025.102242","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To provide a risk-adapted strategy to manage prostate cancer (PCa) patients eligible for curative surgery by developing an individualized risk calculator to predict oncologic outcomes.</div></div><div><h3>Materials and methods</h3><div>Data of consecutive patients treated with robot-assisted radical prostatectomy (RARP) between March 2020 and June 2023 at a single tertiary referral center were prospectively collected and analyzed. Multivariate analysis using Cox proportional hazards model were performed to explore predictors of 3-year biochemical failure (BCF). Both preoperative and postoperative models explored, with key variables including tumor-related features and surgical delay. Based on the significant variables identified, two nomograms were developed to estimate the risk of 3-year BCF. The area under the receiving operator characteristics (ROC) curves (AUC) was used to quantify predictive discrimination. Internal validation using bootstrapping techniques was performed to assess the model's accuracy and calibration.</div></div><div><h3>Results</h3><div>Overall, 2017 patients were enrolled. At the multivariable analysis for preoperative model, cT stage, cN stage, ISUP grade on prostate biopsy, PIRADS of the index lesion on prostate MRI and surgical delay were significant predictive factors of 3-year BCF. At the multivariable analysis for postoperative predictive model, pT stage, pN stage, ISUP grade on final histopathological examination, surgical margins and surgical delay were significant predictive factors of 3-year BCF. The preoperative and postoperative model showed a ROC AUC of 60.7 % and 71.9 %, respectively. The final nomograms for both preoperative and postoperative models were built. Both models underwent internal validation using bootstrapping with 1000 repetitions.</div></div><div><h3>Conclusions</h3><div>To optimize the timing of surgery in PCa patients based on individual risk profile, we finally designed and internally validated two nomograms, which serve complementary roles. The preoperative nomogram offers early, albeit less precise, risk stratification to guide initial treatment planning, while the postoperative nomogram refines BCF predictions using definitive pathological data.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102242"},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185039","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}

{"title":"Technical tips on pancreatojejunostomy and gastrojejunostomy during robotic pancreatoduodenectomy with comparison between the internal and external stent for pancreatojejunostomy","authors":"Kyoji Ito ,&nbsp;Yoshikuni Kawaguchi ,&nbsp;Satoru Abe ,&nbsp;Yusuke Seki,&nbsp;Yuichiro Mihara,&nbsp;Yujiro Nishioka,&nbsp;Akihiko Ichida,&nbsp;Takeshi Takamoto,&nbsp;Nobuhisa Akamatsu,&nbsp;Kiyoshi Hasegawa","doi":"10.1016/j.suronc.2025.102239","DOIUrl":"10.1016/j.suronc.2025.102239","url":null,"abstract":"<div><h3>Background</h3><div>Pancreaticoduodenectomy (PD) is essential for treating periampullary lesions but is often complicated by postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE). This study presents techniques in pancreatojejunostomy (PJ) and gastrojejunostomy (GJ) during robotic PD (RPD) to achieve zero incidence of clinically relevant (CR)–POPF and DGE.</div></div><div><h3>Methods</h3><div>Patients who underwent PD at The University of Tokyo from January 2020 to July 2024 were included in this study. RPD was regularly performed and standardized after January 2022. The following anastomosis techniques were used for RPD: modified Blumgart anastomosis for PJ and side-to-side GJ in a Billroth II fashion using a linear stapler and Braun anastomosis by hand. The outcomes of RPD were compared based by the PJ stent type and with those of open PD (OPD) performed for the same indication during 2020–2022.</div></div><div><h3>Results</h3><div>Of the 34 patients, no patient developed CR–POPF, DGE, or bile leakage. One patient with fluid collection underwent radiographic drainage with the discharge amylase level unelevated. The median (range) length of hospital stay was 8 days (5–17), and none of the patients underwent a 30-day reoperation or showed a 90-day mortality. Patients with PJ short stent placement had significantly shorter median operation times (663 vs. 795 min) and median hospital stays (6.0 vs. 8.5 days) compared to those with external stents. The incidence of POPF (0 % vs. 69.2 %, P &lt; 0.01) and DGE (0 % vs. 23.1 %, P = 0.01) was significantly lower in the RPD group than in the OPD group.</div></div><div><h3>Conclusions</h3><div>The described PJ and GJ techniques and evidence-based perioperative management achieved zero CR–POPF and DGE in RPD, suggesting favorable outcomes. External stents may not improve results in RPD.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102239"},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189890","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}

{"title":"Prognostic impact of conversion surgery in patients with stage IV gastric cancer: A multicenter population-based cohort study","authors":"Hirohito Kakinuma ,&nbsp;Michitaka Honda ,&nbsp;Hidetaka Kawamura ,&nbsp;Soshi Hori ,&nbsp;Teppei Miyakawa ,&nbsp;Satoshi Toshiyama ,&nbsp;Yoshinao Takano ,&nbsp;Shunji Kinuta ,&nbsp;Takahiro Kamiga ,&nbsp;Satoru Shiraso ,&nbsp;Koji Kono","doi":"10.1016/j.suronc.2025.102241","DOIUrl":"10.1016/j.suronc.2025.102241","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of conversion surgery (CS) for stage IV advanced gastric cancer (AGC) remains unclear. This study aimed to provide an overview of the clinical practice for Stage IV AGC and to evaluate the effectiveness of CS.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study. Consecutive patients diagnosed with stage IV AGC between 2008 and 2015 at designated cancer hospitals in Fukushima Prefecture, Japan, were enrolled in this study. We evaluated the relationship between CS and survival time and calculated the adjusted hazard ratios of CS for overall survival.</div></div><div><h3>Results</h3><div>A total of 647 patients were enrolled. CS was performed in 57 (8.8 %) patients. The CS group had fewer metastatic lesions (p = 0.01) and fewer liver metastases (p &lt; 0.01) relative to the non-CS group. The adjusted hazard ratios of CS for overall survival were 0.34 (95 % confidence interval: 0.24–0.48, p &lt; 0.01). The median survival time was 28.0 months in the CS group and 8.2 months in the non-CS group.</div></div><div><h3>Conclusion</h3><div>This study revealed the implementation status of CS for patients with stage IV AGC. CS may improve the patient prognosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102241"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138004","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}

{"title":"Neoadjuvant intraperitoneal chemotherapy in high-risk and cytology positive gastric cancer: a systematic review","authors":"Brendan Desmond ,&nbsp;Lobna Alukaidey ,&nbsp;Zexi Allan ,&nbsp;Carlos Cabalag ,&nbsp;Nicholas J. Clemons ,&nbsp;Michael Michael ,&nbsp;Jeanne Tie ,&nbsp;Niall Tebbutt ,&nbsp;Cuong P. Duong ,&nbsp;David S. Liu","doi":"10.1016/j.suronc.2025.102237","DOIUrl":"10.1016/j.suronc.2025.102237","url":null,"abstract":"<div><h3>Background</h3><div>Gastric cancer has a risk of early transcoelomic spread. Despite perioperative chemotherapy and surgery, peritoneal recurrence is a frequent contributor to mortality. The addition of neoadjuvant normothermic intraperitoneal chemotherapy (IPC) allows early treatment of microscopic disease. Our study aims to systematically evaluate the safety and efficacy of neoadjuvant IPC in patients with gastric cancer who are at high risk of peritoneal recurrence.</div></div><div><h3>Methods</h3><div>A systematic review was conducted according to the PRISMA guidelines. Embase, PubMed, Web of Science and Scopus were searched for relevant papers. The primary outcomes were the rates of disease-free (DFS) and overall survival (OS) among patients treated with neoadjuvant IPC. Secondary outcomes focused on adverse effects and toxicity.</div></div><div><h3>Results</h3><div>Overall, 562 manuscripts were screened and 7 papers were included, totalling 158 patients. For cytology-positive patients, the addition of IPC led to a conversion to negative cytology and radical surgery in 78–89 %. This was associated with relatively high DFS and OS. Peritoneal-specific recurrence was higher in cohorts who initially had cytology-positive disease (63–69 %) compared to those who did not (0–29 %). Our data suggest that OS is lower in patients who were initially cytology-positive compared to cytology-negative disease. Importantly, neoadjuvant IPC did not appear to significantly increase treatment-related adverse events.</div></div><div><h3>Conclusion</h3><div>Our results suggest that the neoadjuvant IPC has efficacy and is safe, with high rates of cytology conversion (in cytology-positive disease), low rates of peritoneal recurrence (in locally advanced disease). This was associated with substantial improvements in DFS and OS, compared to current standard treatment regimens.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102237"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168204","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}

{"title":"Robotic right anterior sectionectomy with Glissonian approach","authors":"Marcel A. Machado ,&nbsp;Micheli F. Domingos ,&nbsp;Eduardo Brommelstroet Ramos","doi":"10.1016/j.suronc.2025.102240","DOIUrl":"10.1016/j.suronc.2025.102240","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"61 ","pages":"Article 102240"},"PeriodicalIF":2.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194886","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}

{"title":"Current evidence for robotic and laparoscopic liver resections: Results from the international study group","authors":"Hwee-Leong Tan ,&nbsp;Darren W.Q. Chua ,&nbsp;Brian K.P. Goh","doi":"10.1016/j.suronc.2025.102238","DOIUrl":"10.1016/j.suronc.2025.102238","url":null,"abstract":"<div><div><span>Minimally-invasive liver resection<span> (MILR) has been increasingly adopted across the world with improvements in surgical technique and instrumentation. While MILR has been shown to confer several perioperative benefits compared to open liver resection, the steep learning curve associated with MILR remains a significant hurdle. Robotic liver resection (RLR) leverages on inherent technical advantages the robotic platform has over conventional </span></span>laparoscopy, holding the potential for RLR to achieve the perioperative advantages of MILR while overcoming the limitations of laparoscopic liver resection (LLR). In this review, we summarize the current evidence comparing the outcomes of RLR and LLR from the International Robotic and Laparoscopic Liver Resection Study Group.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102238"},"PeriodicalIF":2.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188512","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}

{"title":"Risk factors for postoperative evisceration after cytoreductive surgery and HIPEC. A comparative study of open and closed abdominal techniques","authors":"Fatah Tidadini ,&nbsp;Jade Fawaz ,&nbsp;Jean-Louis Quesada ,&nbsp;Julio Abba ,&nbsp;Brice Malgras ,&nbsp;Bertrand Trilling ,&nbsp;Pierre-Yves Sage ,&nbsp;Juliette Fischer ,&nbsp;Marc Pocard ,&nbsp;Catherine Arvieux ,&nbsp;Anne-Cécile Ezanno","doi":"10.1016/j.suronc.2025.102229","DOIUrl":"10.1016/j.suronc.2025.102229","url":null,"abstract":"<div><h3>Background</h3><div>Standard treatment for resectable peritoneal metastasis (PM) includes the combination of cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Postoperative evisceration is a rare but major complication after CRS and HIPEC. This study aimed to identify the risk factors associated with evisceration after HIPEC, comparing outcomes between open and closed abdominal HIPEC.</div></div><div><h3>Methods</h3><div>We conducted a retrospective multi-center study analyzing data of 233 patients with PM who underwent CRS/HIPEC between 2014 and 2023. Patients were categorized based on the HIPEC technique: Open (OPEN_HIPEC), n = 110; Closed abdominal technique (CLOSED_HIPEC), n = 123). We aimed to identify patient factors associated with evisceration within 30 days of CRS/HIPEC, using multivariate analysis.</div></div><div><h3>Results</h3><div>Among 233 patients included, 129 (55.4 %) were women. The median age was 60 [51; 67] years. The OPEN_HIPEC group was significantly younger than the CLOSED_HIPEC group (median 57 [47; 62] vs 63 [54; 70] years; p ≤ 0.001) with a higher PCI score (median 9.5 [5; 17] vs 6 [2; 11]; p ≤ 0.001). Severe complications were similar between OPEN and CLOSED_HIPEC: 17 (15.5 %) vs 15 (12.2 %); p = 0.471 with no mortality. Eight (3.4 %) patients had postoperative evisceration with significantly more occurrences in the OPEN_HIPEC than in the CLOSED_HIPEC group (7/110 (6.4 %) vs 1/123 (0.8 %); p = 0.028). Univariate analysis identified chronic obstructive pulmonary disease (COPD)/respiratory pathology (HR = 7.02 [1.76–28.1]) and PCI score category of 11–15 (HR = 5.09 [1.03–25.2] as risk factors. Multivariate analysis identified a history of COPD/respiratory pathology (HR = 7.39 [1.85–29.6], p = 0.005) and OPEN_HIPEC (HR = 8.37 [1.03–68.1], p = 0.047) as risk factors of postoperative evisceration. Although suture material was not identified as a significant factor by the analysis, all eviscerations in the OPEN_HIPEC group were observed following musculoaponeurotic closures using Vicryl 1 sutures.</div></div><div><h3>Conclusions</h3><div>Following CRS/HIPEC treatment, 3.4 % patients had evisceration by day 30. A history of COPD/respiratory pathology and OPEN_HIPEC technique were identified as independent risk factors associated with evisceration, necessitating reintervention. It should also be noted that in the OPEN_HIPEC group there were no eviscerations after the change to PDS sutures.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"60 ","pages":"Article 102229"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943020","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}

{"title":"Perioperative morbidity of open retroperitoneal lymph node dissection for testicular germ cell tumors: an in-depth single center analysis according to European Association of Urology guidelines of complication reporting and a scoping literature review","authors":"Jakob Klemm ,&nbsp;Roland Dahlem ,&nbsp;Michael Hartmann ,&nbsp;Markus von Deimling ,&nbsp;Robert J. Schulz ,&nbsp;David Klemm ,&nbsp;Florian Janisch ,&nbsp;Shahrokh F. Shariat ,&nbsp;Margit Fisch ,&nbsp;Malte W. Vetterlein","doi":"10.1016/j.suronc.2025.102228","DOIUrl":"10.1016/j.suronc.2025.102228","url":null,"abstract":"<div><h3>Introduction</h3><div>Retroperitoneal lymph node dissection (RPLND) is crucial in managing metastatic germ cell tumors (GCTs), particularly post-chemotherapy. Given the long-term survival of these patients, perioperative morbidity is a significant concern. However, data on RPLND morbidity using predefined reporting standards are scarce. This study aims to address this gap by utilizing updated European Association of Urology (EAU) guidelines for standardized complication reporting.</div></div><div><h3>Patients and methods</h3><div>A retrospective analysis was conducted on patients who underwent RPLND for GCTs between 2010 and 2022. 30-day complications were extracted from digital charts using a predefined procedure-specific catalog. Complications were graded using the Clavien-Dindo classification (CDC), and the Comprehensive Complication Index (CCI) was calculated for each patient.</div></div><div><h3>Results</h3><div>Sixty-nine men underwent RPLND at a median age of 32 years (IQR 25–38). Chemotherapy was administered to 64 patients (93 %), with 48 (70 %) having negative tumor markers. Median tumor diameter was 52 mm (IQR 35–83), and median operative time was 197 min (IQR 128–262). Unilateral template removal was performed in 55 patients (80 %). A total of 157 complications were reported in 66 patients (96 %), with anemia (33 %) and gastrointestinal issues (24 %) being the most common. Five patients (7.2 %) had “major” complications (CDC grade ≥ IIIa), and the median CCI was 12 (IQR 9–23). Using the CCI, the proportion of patients with a “major” complication burden increased to 14 %, compared to 8.5 % by CDC alone. The primary limitation of this study is its retrospective design and the limited 30-day follow-up period.</div></div><div><h3>Conclusion</h3><div>Most patients experience postoperative complications after RPLND, though severe complications are rare. These findings could improve patient counseling when discussing testicular cancer therapy options.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"60 ","pages":"Article 102228"},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069983","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}

{"title":"Quantity of lower muscle as a promising prognostic factor for overall survival in patients with bone and soft tissue sarcoma","authors":"Tadashi Iwai ,&nbsp;Maria Anna Smolle ,&nbsp;Dominik Kaiser ,&nbsp;Lukas Jud ,&nbsp;Sandro F. Fucentese ,&nbsp;Daniel Andreas Müller","doi":"10.1016/j.suronc.2025.102227","DOIUrl":"10.1016/j.suronc.2025.102227","url":null,"abstract":"<div><h3>Introduction</h3><div>Various prognostic factors of bone sarcoma (BS) and soft tissue sarcoma (STS) have been investigated in the past. Recent reports indicate that muscle quantity is related to prognosis of older cancer patients. However, to the best of our knowledge, there are no reports on the relationship between femoral muscle volume and overall survival (OS), local recurrence-free survival (LRFS), or metastasis-free survival (MFS) in patients with BS and STS aged ≥18 years.</div></div><div><h3>Methods</h3><div>Clinicopathological data of 119 patients with BS and STS treated between 2014 and 2023 at a single institution were retrospectively analyzed. Based on positron emission tomography–computed tomography information, the quantity of femoral muscles, psoas muscle index at the L3 level, and triceps surae muscle were investigated in four age groups (19–39, 40–59, 60–74, &gt;75 years). Sex, age, tumor size, location, grade, American Joint Committee on Cancer stage, history of chemotherapy, history of radiation therapy, American Society of Anesthesiologists–Physical Status, and muscle volumes were evaluated using Cox proportional hazards regression models. Five-year survival rates were assessed using the Kaplan–Meier method.</div></div><div><h3>Results</h3><div>Median follow-up was 34 months (interquartile range, 17–64). Five-year OS, LRFS, and MFS rates were 73.7 %, 86.6 %, and 76.7 %, respectively. In multivariate analysis, tumor stage IV and decreased all-femoral muscle volume were significantly associated with poor OS.</div></div><div><h3>Conclusions</h3><div>Decreased femoral muscle volume is a significant factor associated with poor OS. Therefore, it may be important for adult patients to maintain postoperative all-femoral muscle volume as much as possible.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"60 ","pages":"Article 102227"},"PeriodicalIF":2.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898862","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}