Surgical Oncology-Oxford最新文献_第10页

Extended pelvic lymphadenectomy and rectal cancer: An umbrella review 盆腔淋巴结切除术与直肠癌：综述

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-20 DOI: 10.1016/j.suronc.2025.102215

Valentina Villanova , Alessandro Martinino , Emilia Stanzani , Paola Pastena , Laura Lorenzon , Francesco Giovinazzo , on behalf of the SMAGEICS Group

Extended pelvic lymph node dissection (EPLND) for rectal cancer is common in Asian countries to reduce local recurrence and improve survival. This umbrella review investigates the benefit of adding extended lymphadenectomy to the standard total mesorectal excision (TME) practice. We conducted a comprehensive search of PubMed, Scopus, and Web of Science to identify systematic reviews and meta-analyses examining the role of EPLND in rectal cancer surgery. Primary outcomes were local recurrence and overall survival; secondary outcomes included: operation time, blood loss, urinary dysfunction, and sexual dysfunction. Of the 953 articles screened, 12 met the inclusion criteria. The median follow-up time was 52 months. In terms of overall survival, 10 studies found no statistically significant difference in the EPLND group; only two showed a significant improvement in 5-year survival. Nine studies found no significant benefit of EPLND in preventing local recurrence, while two suggested benefits for patients with locally advanced cancer after neoadjuvant chemoradiotherapy. In most studies, operation time and blood loss were higher in the EPLND group. EPLND was associated with increased odds of urinary and sexual dysfunction, with four out of six studies reporting higher rates for both outcomes. Our analysis concludes that EPLND offers no additional benefit over TME alone in terms of local recurrence, overall survival, or secondary outcomes, including increased risks of urinary and sexual dysfunction, longer operation times, and greater blood loss.

扩大盆腔淋巴结清扫术（EPLND）治疗直肠癌在亚洲国家很常见，以减少局部复发和提高生存率。本综述调查了在标准全肠系膜切除术（TME）实践中增加扩大淋巴结切除术的益处。我们对PubMed、Scopus和Web of Science进行了全面的检索，以确定EPLND在直肠癌手术中的作用的系统综述和荟萃分析。主要结局为局部复发和总生存期；次要结果包括：手术时间、出血量、尿功能障碍和性功能障碍。在筛选的953篇文章中，有12篇符合纳入标准。中位随访时间为52个月。在总生存率方面，有10项研究发现EPLND组无统计学差异；只有两名患者的5年生存率有显著提高。9项研究发现EPLND在预防局部复发方面没有显著的益处，而2项研究表明局部晚期癌症患者在新辅助放化疗后有益处。在大多数研究中，EPLND组的手术时间和出血量更高。EPLND与泌尿和性功能障碍的几率增加有关，六项研究中有四项报告了这两种结果的较高发生率。我们的分析得出结论，EPLND在局部复发、总体生存或次要结局（包括泌尿和性功能障碍风险增加、手术时间延长和出血量增加）方面没有比单独的TME有额外的好处。

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引用次数: 0

LogODDS as a prognostic factor in oral cavity squamous cell carcinoma LogODDS作为口腔鳞状细胞癌的预后因素。

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-14 DOI: 10.1016/j.suronc.2025.102213

Giada A. Beltramini , Edoardo F. Montrasio , Filippo Da Pozzo , Alessandro Cherchi , Domenico Sfondrini , Andrea Sacconi

The objective of the study is to estimate the role of LogODDS as a prognostic factor in patients affected by oral cavity squamous cell carcinoma, in terms of overall survival (OS) and disease-free survival (DFS), looking for a cut-off value that allows to stratify them in high and low risk of recurrency, implementing the informations given by Lymph Node Ratio (LNR) and TNM 8th.

Seventyfour patients affected by oral cavity squamous cell carcinoma with metastatic lymph nodes who have undergone surgery at Maxillofacial Surgery Unit of the Fondazione IRCCS Cà Granda Ospedale Policlinico di Milano, in which a restaging according to TNM 8th was possible and LNR and LogODDS could have been calculated, were enrolled.

Multivariate analysis for OS was statistically relevant for both LogODDS and LNR, where N alone didn't reach the same result. No one of the previous parameters has a statistically relevant meaning in DFS prediction.

LogODDS as a prognostic factor has a statistically compelling meaning in order to predict overall survival in oral squamous cell carcinoma.

该研究的目的是评估LogODDS作为口腔鳞状细胞癌患者的预后因素的作用，在总生存期（OS）和无病生存期（DFS）方面，寻找一个临界值，允许将他们分为高复发风险和低复发风险，实现淋巴结比（LNR）和TNM 8给出的信息。74例口腔鳞状细胞癌伴淋巴结转移的患者在米兰国立高等医院颌面外科接受了手术，其中可以根据TNM 8进行再分期，并且可以计算LNR和LogODDS。OS的多变量分析对于LogODDS和LNR都具有统计学意义，其中单独使用N不能达到相同的结果。上述参数在DFS预测中均不具有统计相关意义。LogODDS作为一种预后因素在预测口腔鳞状细胞癌的总生存率方面具有统计学上令人信服的意义。

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引用次数: 0

Comparative analysis of hepatectomy for HCC with PVTT: Insights from a 30-year single-center experience 肝切除术与PVTT治疗HCC的比较分析：来自30年单中心经验的见解

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-12 DOI: 10.1016/j.suronc.2025.102211

Zhicheng Yao , Yupeng Ren , Mingbo Cao , Yuxuan Li , Xiaorui Su , Ziyi Hu , Pei Han , Ho Kam Yuen , Tan To Cheung

Background and aim

Portal vein tumor thrombosis (PVTT) is frequent in hepatocellular carcinoma (HCC). Although hepatectomy is the primary treatment for HCC, no consensus exists on its role in PVTT between Eastern and Western clinicians. This study aims to assess the efficacy of hepatectomy in HCC patients with PVTT by analyzing perioperative outcomes and prognosis.

Methods

This retrospective, single-center study reviewed HCC patient data from Queen Mary Hospital, Hong Kong (1989–2020). Propensity score matching (PSM) was applied to match patients with and without PVTT undergoing hepatectomy, comparing perioperative and survival outcomes between groups.

Results

Among 3981 HCC patients, 1842 had PVTT and were not operated (not-operated group), while 2139 underwent hepatectomy. Of the operated patients, 156 had PVTT (PVTT group) and 1983 did not (no-PVTT group). Median overall survival (mOS) in the not-operated group was 2.7 months, compared to 13.0 months in the PVTT group. After 1:3 PSM, the no-PVTT group (n = 468) had longer mOS (47.0 vs. 13.0 months, p < 0.001) and disease-free survival (10.6 vs. 4.2 months, p < 0.001). The PVTT group had longer operative times (449 vs. 390 min, p < 0.001), higher complication rates (37.8 % vs. 28.2 %, p = 0.024), and closer surgical margins (0.6 vs. 1.0 cm, p = 0.036), but similar hospital mortality (p = 0.898). mOS for low-AFP (<17400 ng/ml) and high-AFP (≥17400 ng/ml) patients was 16.2 vs. 8.2 months, respectively (p < 0.001).

Conclusion

Aggressive treatment of PVTT is necessary. For certain PVTT patients, hepatectomy may be potentially effective, with acceptable perioperative safety and seemingly no technical barriers.

背景与目的门静脉肿瘤血栓形成（PVTT）是肝细胞癌（HCC）的常见病。虽然肝切除术是HCC的主要治疗方法，但东西方临床医生对其在PVTT中的作用尚未达成共识。本研究旨在通过分析肝切除术对肝细胞癌合并PVTT患者围手术期预后的影响，评价肝切除术对肝细胞癌合并PVTT患者的疗效。方法本回顾性单中心研究回顾了香港玛丽医院1989-2020年HCC患者资料。采用倾向评分匹配（PSM）对行肝切除术的PVTT患者和不PVTT患者进行匹配，比较两组患者的围手术期和生存结果。结果3981例HCC患者中，1842例行PVTT且未行手术（非手术组），2139例行肝切除术。手术患者中有PVTT 156例（PVTT组），无PVTT 1983例（无PVTT组）。未手术组的中位总生存期（mOS）为2.7个月，而PVTT组为13.0个月。1:3 PSM后，无pvtt组（n = 468）的mOS延长(47.0 vs 13.0个月，p <；0.001)和无病生存期(10.6个月vs. 4.2个月，p <；0.001)。PVTT组手术时间更长(449 vs 390 min, p <；0.001)，更高的并发症发生率（37.8%对28.2%,p = 0.024），手术切缘更近（0.6对1.0 cm, p = 0.036），但医院死亡率相似（p = 0.898）。低afp （<17400 ng/ml）和高afp（≥17400 ng/ml）患者的最小生存时间分别为16.2个月和8.2个月(p <；0.001)。结论积极治疗PVTT是必要的。对于某些PVTT患者，肝切除术可能具有潜在的有效性，具有可接受的围手术期安全性，似乎没有技术障碍。

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引用次数: 0

Complete pathological response to neoadjuvant chemoradiotherapy is associated with improved long-term survival after surgical treatment for rectal cancer 新辅助放化疗的完全病理反应与直肠癌手术治疗后长期生存率的提高有关

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-12 DOI: 10.1016/j.suronc.2025.102206

Elias Khajeh , Sanam Fakour , Constanze Zeh-Ressel , Marzieh Jafari , Rajan Nikbakhsh , Ali Ramouz , Arianeb Mehrabi , Markus W. Büchler , Yakup Kulu

Background

Tumor regression after neoadjuvant chemoradiotherapy can improve the long-term outcomes of rectal cancer. However, it is unclear how the tumor regression grade (TRG) relates to long-term outcomes. We evaluated how the TRG affects overall survival in patients with rectal cancer who underwent neoadjuvant chemoradiotherapy prior to radical surgery.

Methods

All patients who underwent low anterior resection for rectal cancer after chemoradiotherapy over a 13-year period were included in this study. Perioperative and histopathological data of patients, including the TRG (categorized as no regression, minimal regression, moderate regression, near complete regression and complete regression) were evaluated. The correlation of TRG with overall survival was assessed using the log-rank test and Cox proportional hazards regression analysis.

Results

During the study period,193 patients underwent low anterior rectal resection after neoadjuvant chemoradiotherapy. The 90-day mortality rate was 1.5 % and the median follow up was 69.5 months. The 5-year and 10-year overall survival rates were 85.0 % and 69.8 %, respectively. Patients with complete regression had a significantly higher 10-year overall survival rate than other patients (87.3 % vs. 66.5 %, p = 0.031). Multivariate analysis revealed that older age (hazard ratio [HR] = 2.4,95 % confidence interval [95 % CI] = 1.3–4.6, p = 0.007) and complete pathological response (HR = 0.23, 95 % CI = 0.06–0.96, p = 0.044) were independent predictors of overall survival.

Conclusion

Complete pathological response after neoadjuvant therapy for rectal cancer improves overall survival after surgery. Further studies are needed to determine the factors that predict complete TRG to identify patients who would benefit most from neoadjuvant chemoradiotherapy.

背景：新辅助放化疗后肿瘤消退可以改善直肠癌的长期预后。然而，目前尚不清楚肿瘤消退等级（TRG）与长期预后的关系。我们评估了TRG如何影响根治性手术前接受新辅助放化疗的直肠癌患者的总生存率。方法本研究纳入13年以上化疗后行直肠癌低位前切除术的患者。评估患者围手术期和组织病理学数据，包括TRG（分为无回归、最小回归、中度回归、接近完全回归和完全回归）。采用log-rank检验和Cox比例风险回归分析评估TRG与总生存率的相关性。结果在研究期间，193例患者在新辅助放化疗后行低位直肠前切除术。90天死亡率为1.5%，中位随访69.5个月。5年和10年总生存率分别为85.0%和69.8%。完全消退患者的10年总生存率明显高于其他患者（87.3%比66.5%,p = 0.031）。多因素分析显示，年龄（风险比[HR] = 2.4, 95%可信区间[95% CI] = 1.3 ~ 4.6, p = 0.007）和完全病理反应（HR = 0.23, 95% CI = 0.06 ~ 0.96, p = 0.044）是总生存率的独立预测因素。结论直肠癌新辅助治疗后病理完全缓解可提高术后总生存率。需要进一步的研究来确定预测完全TRG的因素，以确定从新辅助放化疗中获益最多的患者。

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引用次数: 0

Life after oncoplastic surgery (IRONY) trial: Preliminary results 肿瘤整形手术后生活（IRONY）试验：初步结果

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-08 DOI: 10.1016/j.suronc.2025.102205

Paolo Orsaria , Antonella Grasso , Lorenza Caggiati , Edy Ippolito , Francesco Pantano , Claudia Piccolo , Vittorio Altomare

Background

Today partial reconstruction in breast cancer (BC) surgery involves displacement or replacement procedures to improve cosmesis without compromising safety. However, patient satisfaction should be compared among several options, in order to get additional criteria for a personalized approach. The aim is evaluate oncological, aesthetic and functional results after monolateral (reshaping or replacement) or bilateral (mammoplasty with contralateral pexy or reduction) conserving strategies.

Materials and methods

The protocol provides for the enrollment of a prospective sample of 250 patients in a time frame of 3 years. The first 108 cases (range 18–85 years) with BC diagnosis, and suitable for type 1–2 oncoplastic surgery who gave informed consent, were selected Data analysis was focused on radicality, complications, cosmetic and functional results related to quality of life, comparing monolateral (ML) and bilateral (BL) groups.

Results

Tumor size (p = 0.01), multifocality (p = 0.05), multicentricity (p = 0.01) and estimated resection volume (p = 0.000) were higher in the BL group. There was a comparable re-excision rate for positive margins (p = 0.72), and after 2.3 years, no difference in local recurrences were recorded. No early (p > 0.05), but late complications were more common in the BL (p = 0.07). The overall satisfaction with cosmesis and well-being were characterized by similar proportions of good results (p>0.05), with some details more related to each procedure.

Conclusion

The proposed techniques represent effective solutions for reshaping that follows BC excision, achieving comparable early complications, low re-interventions with good aesthetic results and social functioning. However, is crucial a careful patient selection and surgical plan while predicting any sequel or delayed complication during follow-up.

目前，乳腺癌（BC）手术中的部分重建包括置换或置换手术，以在不影响安全性的情况下改善美观。然而，患者满意度应该在几个选项之间进行比较，以便获得个性化方法的额外标准。目的是评估单侧（重塑或置换）或双侧（对侧乳房成形或复位）保存策略后的肿瘤学，美学和功能结果。材料和方法该方案规定在3年的时间框架内纳入250例患者的前瞻性样本。选择前108例（18-85岁）确诊为BC，并同意进行1-2型肿瘤整形手术的患者（范围18-85岁）。数据分析的重点是根治性、并发症、与生活质量相关的美容和功能结果，比较单侧（ML）组和双侧（BL）组。结果BL组肿瘤大小（p = 0.01）、多灶性（p = 0.05）、多中心性（p = 0.01）和估计切除体积（p = 0.000）均高于BL组。阳性切缘的再切除率相当（p = 0.72）， 2.3年后，局部复发没有记录差异。不早(p >；0.05)，但晚期并发症在BL中更为常见（p = 0.07）。对美容和健康的总体满意度的特征是良好结果的比例相似（p>0.05），与每个程序相关的一些细节更多。结论所提出的技术是BC切除术后整形的有效解决方案，具有相似的早期并发症，低再干预率，良好的美学效果和社会功能。然而，在随访期间预测任何后续或延迟并发症时，谨慎的患者选择和手术计划是至关重要的。

{"title":"Life after oncoplastic surgery (IRONY) trial: Preliminary results","authors":"Paolo Orsaria , Antonella Grasso , Lorenza Caggiati , Edy Ippolito , Francesco Pantano , Claudia Piccolo , Vittorio Altomare","doi":"10.1016/j.suronc.2025.102205","DOIUrl":"10.1016/j.suronc.2025.102205","url":null,"abstract":"<div><h3>Background</h3><div>Today partial reconstruction in breast cancer (BC) surgery involves displacement or replacement procedures to improve cosmesis without compromising safety. However, patient satisfaction should be compared among several options, in order to get additional criteria for a personalized approach. The aim is evaluate oncological, aesthetic and functional results after monolateral (reshaping or replacement) or bilateral (mammoplasty with contralateral pexy or reduction) conserving strategies.</div></div><div><h3>Materials and methods</h3><div>The protocol provides for the enrollment of a prospective sample of 250 patients in a time frame of 3 years. The first 108 cases (range 18–85 years) with BC diagnosis, and suitable for type 1–2 oncoplastic surgery who gave informed consent, were selected Data analysis was focused on radicality, complications, cosmetic and functional results related to quality of life, comparing monolateral (ML) and bilateral (BL) groups.</div></div><div><h3>Results</h3><div>Tumor size (p = 0.01), multifocality (p = 0.05), multicentricity (p = 0.01) and estimated resection volume (p = 0.000) were higher in the BL group. There was a comparable re-excision rate for positive margins (p = 0.72), and after 2.3 years, no difference in local recurrences were recorded. No early (p > 0.05), but late complications were more common in the BL (p = 0.07). The overall satisfaction with cosmesis and well-being were characterized by similar proportions of good results (p>0.05), with some details more related to each procedure.</div></div><div><h3>Conclusion</h3><div>The proposed techniques represent effective solutions for reshaping that follows BC excision, achieving comparable early complications, low re-interventions with good aesthetic results and social functioning. However, is crucial a careful patient selection and surgical plan while predicting any sequel or delayed complication during follow-up.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102205"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619205","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}

引用次数: 0

Disparities in disease presentation among patients with papillary thyroid cancer: A retrospective cohort study 甲状腺乳头状癌患者疾病表现的差异：一项回顾性队列研究

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-07 DOI: 10.1016/j.suronc.2025.102212

Nina Rodriguez , Dragan Vujovic , Mathilda Alsen , Eric Genden , Maaike van Gerwen

Purpose

Prior research suggests that racial and ethnic minorities present with advanced papillary thyroid cancer (PTC), traditionally defined using surgical pathology. However, marginalized populations are more likely to experience delays in surgical treatment, raising concerns that surgical staging may misrepresent the extent of disease at initial presentation. This study investigates disparities in disease presentation using cytology from Fine Needle Aspiration (FNA), which is performed at first evaluation and precedes surgery, in an institutional cohort of PTC patients.

Methods

A single-site retrospective review of 405 patients with PTC from 2018 to 2019 evaluated the association between sociodemographic variables and the likelihood of presenting with cytologically-confirmed malignancy using FNA. Patients with malignant cytology (Bethesda VI) were compared to those with unconfirmed malignancy (Bethesda III-V). To validate the clinical significance of the Bethesda VI classification, we conducted an additional analysis examining whether these patients presented with more advanced disease.

Results

Patients classified as Bethesda VI on FNA were younger and more likely to present with advanced disease features, compared to Bethesda III-V patients. On multivariable analysis, patients in the lowest income group were significantly more likely to present with Bethesda VI compared to those in the highest income group.

Conclusion

Differences in initial presentation were observed in our institutional cohort of PTC patients. Lower median household income was independently associated with presenting with Bethesda VI, even after adjusting for race/ethnicity. This analysis highlights the clinical relevance of considering factors beyond race and ethnicity alone to better tailor early detection efforts and strategic resource allocation, thereby addressing disparities more effectively.

目的先前的研究表明，少数民族和种族存在晚期甲状腺乳头状癌（PTC），传统上用外科病理学来定义。然而，边缘人群更有可能经历手术治疗的延误，这引起了人们的关注，即手术分期可能错误地反映了最初表现时的疾病程度。本研究在PTC患者的机构队列中，使用细针穿刺（FNA）细胞学调查疾病表现的差异，FNA是在首次评估和手术前进行的。方法对2018年至2019年405例PTC患者进行单点回顾性分析，评估社会人口学变量与FNA显示细胞学证实的恶性肿瘤可能性之间的关系。恶性细胞学（Bethesda VI）患者与未确诊的恶性（Bethesda III-V）患者进行比较。为了验证Bethesda VI分类的临床意义，我们进行了一项额外的分析，检查这些患者是否表现出更晚期的疾病。结果与Bethesda III-V级患者相比，FNA分类为Bethesda VI级的患者更年轻，更有可能出现晚期疾病特征。在多变量分析中，与最高收入组相比，最低收入组的患者更有可能出现Bethesda VI。结论：在我们的机构队列PTC患者中观察到初始表现的差异。即使在调整了种族/民族因素后，较低的家庭收入中位数与出现Bethesda VI独立相关。该分析强调了仅考虑种族和民族以外的因素以更好地定制早期检测工作和战略资源分配的临床相关性，从而更有效地解决差异。

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引用次数: 0

The prognostic outcome of tumor deposit in colorectal cancer beyond stage N staging 结直肠癌N期后肿瘤沉积的预后分析

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-06 DOI: 10.1016/j.suronc.2025.102203

Tanasit Saikeaw, Phadungkiat Tipmanee, Pasut Chareonpornwattana, Gritcharat Watthanasathitarpha, Kanyanat Dasom, Thitithep Limvorapitak

Background

Tumor deposits (TD) have been shown to have prognostic implications in patients diagnosed with colorectal cancer (CRC), although their impact appears to be modest compared to regional lymph node metastases.

Patients and methods

A retrospective analysis was conducted involving patients with colorectal cancer in stages I-III who underwent curative resections between January 2015 and December 2019 in the tertiary care center in Thailand. These patients were divided into two cohorts: TD positive and TD negative. Additionally, the patients were subsequently classified into N0, N1, and N2 groups. Disease-free survival and overall survival were compared.

Results

Among the 1015 eligible patients, 176 (17.3 %) had tumor deposits (TD), while 374 patients (36.8 %) had positive lymph nodes (LN). The TD positive group demonstrated a significantly lower 5-year overall survival rate (OS) and 5-year disease-free survival rate (DFS) compared to the TD negative group (73.5 % vs 85.9 %, p < 0.001 and 72.5 % vs 87.9 %, p < 0.001 respectively). Upon stratification by various N stages, the presence of TD was notably associated with DFS in the N1 group (5-year DFS: 84.3 % vs. 89.2 %, p = 0.006). Multivariate logistic analyses shown TD as an independent predictor of disease recurrence [p = 0.02; hazard ratio (HR):1.71 (1.11–2.64)].

Conclusion

The presence of TD was significantly correlated with reduced overall survival (OS) and disease-free survival (DFS) in colorectal cancer, especially in patients with nodal metastases.

肿瘤沉积（TD）已被证明对诊断为结直肠癌（CRC）的患者具有预后影响，尽管与区域淋巴结转移相比，它们的影响似乎不大。患者和方法回顾性分析了2015年1月至2019年12月期间在泰国三级医疗中心接受治愈性切除术的I-III期结直肠癌患者。这些患者被分为两组：TD阳性和TD阴性。并将患者分为N0、N1、N2组。比较无病生存期和总生存期。结果1015例患者中，176例（17.3%）有肿瘤沉积（TD）， 374例（36.8%）有淋巴结（LN）阳性。与TD阴性组相比，TD阳性组的5年总生存率（OS）和5年无病生存率（DFS）显著降低(73.5% vs 85.9%, p <；0.001和72.5% vs 87.9%, p <；0.001分别)。根据不同的N分期进行分层，N1组TD的存在与DFS显著相关（5年DFS: 84.3%对89.2%,p = 0.006）。多因素logistic分析显示，TD是疾病复发的独立预测因子[p = 0.02；风险比（HR）：1.71（1.11-2.64）。结论TD的存在与结直肠癌患者总生存期（OS）和无病生存期（DFS）的降低显著相关，尤其是结直肠癌淋巴结转移患者。

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引用次数: 0

Preserving potential: Surgeons as key partners in establishing a living sarcoma biobank for translational research purposes 保留潜力：外科医生是建立用于转化研究目的的活肉瘤生物库的关键合作伙伴

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-05 DOI: 10.1016/j.suronc.2025.102209

Stefanie Gijsels , Merlijn Vekeman , Suzanne Fischer , David Creytens , Alexander Ackerman , Anais Ongenaet , Laurens Boi , Eline Segers , Jens De Temmerman , Francesca Casteur , Ruben Van Boxstael , Herlinde De Waele , Desirée Dorleijn , Fleur Cordier , Lore Lapeire , Gabriëlle Van Ramshorst , Olivier De Wever , Gwen Sys

Background

Sarcoma is a rare type of cancer, of which over 70 distinct molecular subtypes are known. Because these tumours are so rare and complex, treatment outcomes have remained similar over the past decades and research is progressing slowly. For these rare cancers, personalised medicine and patient-derived models might pose solutions for therapeutic problems, but researchers depend on clinicians to access fresh, viable tumour tissue.

Methods

Over the past five years, a bedside-to-bench flow was implemented in Ghent University Hospital for a living biobank of sarcoma tissue to support translational research. All tumour tissue was cryopreserved in cryopreservation medium (90 % foetal bovine serum and 10 % dimethyl sulfoxide) maintaining viability of the tissue.

Results

As of July 2024, this biobank houses 217 sarcoma samples available for model development, biomarker discovery and precision medicine initiatives. The samples were collected from 167 patients, with 40 patients of whom we collected several samples throughout the disease course.

Discussion

With this article, we aim to incentivise surgeons to engage in biobanking initiatives, as they have a unique position with direct access to fresh tumour tissue. We present our biobank and clinical flow that is implemented in daily clinical practice. The primary aim of the biobank is to advance sarcoma research by creating models and sharing data with fellow researchers.

肉瘤是一种罕见的癌症类型，已知超过70种不同的分子亚型。由于这些肿瘤非常罕见和复杂，在过去的几十年里，治疗结果一直保持相似，研究进展缓慢。对于这些罕见的癌症，个性化药物和病人衍生的模型可能为治疗问题提供解决方案，但是研究人员依赖于临床医生获取新鲜的、有活力的肿瘤组织。方法在过去的五年中，根特大学医院实施了从床到台的流程，以支持肉瘤组织的活生物库的转化研究。所有肿瘤组织在冷冻保存培养基（90%胎牛血清和10%二甲亚砜）中冷冻保存，保持组织活力。截至2024年7月，该生物库拥有217个肉瘤样本，可用于模型开发、生物标志物发现和精准医学计划。样本来自167名患者，其中40名患者在整个病程中采集了多次样本。在这篇文章中，我们的目的是鼓励外科医生参与生物银行的倡议，因为他们有直接接触新鲜肿瘤组织的独特地位。我们介绍了在日常临床实践中实施的生物库和临床流程。生物银行的主要目标是通过创建模型和与其他研究人员共享数据来推进肉瘤研究。

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引用次数: 0

Synovial sarcoma: The influence of clinicopathological variables on overall survival in a UK population 滑膜肉瘤：临床病理变量对英国人群总生存率的影响

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-05 DOI: 10.1016/j.suronc.2025.102204

Bill Robertson-Smith , Jackie Campbell , Karen Anthony , Thomas A. McCulloch , Robert U. Ashford

Introduction

Synovial sarcoma accounts for 5%–10 % of malignant soft-tissue tumours. Curative treatment includes surgery, with radiotherapy and/or chemotherapy. With no specific treatment regimen for synovial sarcoma, the primary aim of this research was to describe the characteristics of a regional synovial sarcoma population in the UK, and to investigate clinicopathological variables associated with overall survival.

Methods

Ninety-four patients with synovial sarcoma from the East Midlands Sarcoma Service database were pseudo anonymised and clinicopathological variables extracted. Kaplan-Meier and Cox regression statistical analyses were used to identify variables affecting overall survival.

Results

Mean age at diagnosis was 42 years (range 8–83 years). Over half (n = 50, 53 %) of patients had a tumour in the lower limb. Thirty-seven (39.6 %) had a tumour size of <5 cm. Sixteen (17 %) patients had local recurrence, and under half (n = 40, 43.5 %) developed metastatic disease. Most patients (n = 63, 63 %) were initially treated with surgery. The majority (n = 58, 61.7 %) had a monophasic subtype, and the overall survival of the whole cohort was 83 months (95 % CI 39.1–127.8). Increasing tumour size and distant recurrence (metastasis) had a significantly negative impact on median overall survival (p = 0.0001). Patients who underwent surgery and radiotherapy had a significantly better median overall survival (p = 0.02). Multivariable analysis identified adjuvant radiotherapy (p = 0.039), lower limb tumour (p = 0.033), and tumour size (<5 cm p = 0.006, 5–10 cm p = 0.0001, >10 cm p = 0.013) as significant survival predictors.

Conclusion

Adjuvant radiotherapy is a novel independent prognostic marker for synovial sarcoma.

滑膜肉瘤占软组织恶性肿瘤的5% - 10%。治愈性治疗包括手术、放射治疗和/或化疗。由于滑膜肉瘤没有特定的治疗方案，本研究的主要目的是描述英国区域滑膜肉瘤人群的特征，并调查与总生存率相关的临床病理变量。方法对来自East Midlands肉瘤服务数据库的94例滑膜肉瘤患者进行伪匿名，提取临床病理变量。Kaplan-Meier和Cox回归统计分析用于确定影响总生存率的变量。结果平均诊断年龄42岁（范围8 ~ 83岁）。超过一半（n = 50,53 %）的患者在下肢有肿瘤。37例（39.6%）肿瘤大小为5cm。16例（17%）患者出现局部复发，不到一半（n = 40, 43.5%）患者出现转移性疾病。大多数患者（n = 63,63 %）最初接受手术治疗。大多数患者（n = 58, 61.7%）为单相亚型，整个队列的总生存期为83个月（95% CI 39.1-127.8）。增大肿瘤大小和远处复发（转移）对中位总生存期有显著的负面影响（p = 0.0001）。接受手术和放疗的患者的中位总生存期明显更好（p = 0.02）。多变量分析发现辅助放疗（p = 0.039）、下肢肿瘤（p = 0.033）和肿瘤大小（<5 cm p = 0.006, 5 - 10 cm p = 0.0001, >10 cm p = 0.013）是显著的生存预测因素。结论辅助放疗是滑膜肉瘤新的独立预后指标。

{"title":"Synovial sarcoma: The influence of clinicopathological variables on overall survival in a UK population","authors":"Bill Robertson-Smith , Jackie Campbell , Karen Anthony , Thomas A. McCulloch , Robert U. Ashford","doi":"10.1016/j.suronc.2025.102204","DOIUrl":"10.1016/j.suronc.2025.102204","url":null,"abstract":"<div><h3>Introduction</h3><div>Synovial sarcoma accounts for 5%–10 % of malignant soft-tissue tumours. Curative treatment includes surgery, with radiotherapy and/or chemotherapy. With no specific treatment regimen for synovial sarcoma, the primary aim of this research was to describe the characteristics of a regional synovial sarcoma population in the UK, and to investigate clinicopathological variables associated with overall survival.</div></div><div><h3>Methods</h3><div>Ninety-four patients with synovial sarcoma from the East Midlands Sarcoma Service database were pseudo anonymised and clinicopathological variables extracted. Kaplan-Meier and Cox regression statistical analyses were used to identify variables affecting overall survival.</div></div><div><h3>Results</h3><div>Mean age at diagnosis was 42 years (range 8–83 years). Over half (n = 50, 53 %) of patients had a tumour in the lower limb. Thirty-seven (39.6 %) had a tumour size of <5 cm. Sixteen (17 %) patients had local recurrence, and under half (n = 40, 43.5 %) developed metastatic disease. Most patients (n = 63, 63 %) were initially treated with surgery. The majority (n = 58, 61.7 %) had a monophasic subtype, and the overall survival of the whole cohort was 83 months (95 % CI 39.1–127.8). Increasing tumour size and distant recurrence (metastasis) had a significantly negative impact on median overall survival (<em>p</em> = 0.0001). Patients who underwent surgery and radiotherapy had a significantly better median overall survival (<em>p</em> = 0.02). Multivariable analysis identified adjuvant radiotherapy (<em>p</em> = 0.039), lower limb tumour (<em>p</em> = 0.033), and tumour size (<5 cm <em>p</em> = 0.006, 5–10 cm <em>p</em> = 0.0001, >10 cm <em>p</em> = 0.013) as significant survival predictors.</div></div><div><h3>Conclusion</h3><div>Adjuvant radiotherapy is a novel independent prognostic marker for synovial sarcoma.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"59 ","pages":"Article 102204"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating the Impact of Minimally Invasive Surgery on Long-Term Quality of Life in Foregut Cancer Patients 评估微创手术对前肠癌患者长期生活质量的影响

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford

Pub Date : 2025-03-05 DOI: 10.1016/j.suronc.2025.102207

Edward A. Joseph , Muhammed Anees , Muhammad Muntazir Mehdi Khan , Sricharan Chalikonda , Casey J. Allen

Introduction

Compared to open surgery (OS), minimally invasive surgery (MIS) for foregut cancer improves perioperative outcomes. However, the impact of MIS on long-term quality of life (QOL) is unknown. We compare the long-term QOL of patients who underwent MIS and OS for foregut cancer.

Methods

Surgically managed esophageal and gastric cancer patients were surveyed globally via online support groups. Physical (P-QOL) and mental (M-QOL) well-being were determined using the Short Form-12 questionnaire and compared based on the surgical approach (MIS vs OS). We defined “long-term” as greater than 3 months from surgery.

Results

Out of 100 respondents with esophageal and gastric cancer, 64 survivors underwent surgical management greater than 3 months before the survey. They were 56.6 ± 9.9 years, 46.0% female, and 95.2% White, with a median survival of 33.0 (14.0–63.0) months. The most common diagnosis was esophageal adenocarcinoma (69.8%). Surgical procedures included esophagectomy (56.5%), esophagogastrectomy (29.0%), and gastrectomy (14.5%), of which 45.2% were OS and 48.4% were MIS. The cohort overall exhibited lower P-QOL (40.7 ± 10.4) and M-QOL (44.6 ± 15.2) compared to the general population (50.0 ± 10.0; p < 0.050). There was no difference in age, sex, race, education, income, diagnosis, and adjuvant therapy between OS and MIS cohorts (all p > 0.050). Long-term P-QOL (38.5 ± 11.6 OS vs. 42.8 ± 9.5 MIS, p = 0.123) and M-QOL (44.7 ± 15.3 OS vs. 44.9 ± 14.9 MIS, p = 0.901) was similar between patients who underwent OS and MIS for foregut cancer.

Conclusion

MIS is not associated with higher long-term QOL in patients who have undergone surgery for foregut malignancy.

与开放手术（OS）相比，微创手术（MIS）可以改善前肠癌的围手术期预后。然而，MIS对长期生活质量的影响尚不清楚。我们比较了前肠癌行MIS和OS患者的长期生活质量。方法通过在线支持小组对全球手术治疗的食管癌和胃癌患者进行调查。身体（P-QOL）和精神（M-QOL）幸福感使用短表格12问卷确定，并基于手术入路（MIS vs OS）进行比较。我们将“长期”定义为手术后超过3个月。结果100例食管癌和胃癌患者中，有64例在调查前3个月以上接受了手术治疗。患者年龄为56.6±9.9岁，女性46.0%，白人95.2%，中位生存期为33.0（14.0 ~ 63.0）个月。最常见的诊断为食管腺癌（69.8%）。手术方式包括食管切除术（56.5%）、食管胃切除术（29.0%）和胃切除术（14.5%），其中45.2%为OS， 48.4%为MIS。总体而言，该队列的P-QOL（40.7±10.4）和M-QOL（44.6±15.2）低于普通人群(50.0±10.0；p & lt;0.050)。OS组和MIS组在年龄、性别、种族、教育程度、收入、诊断和辅助治疗方面没有差异(p >；0.050)。前肠癌行OS和MIS患者的长期p - qol（38.5±11.6 OS比42.8±9.5 MIS, p = 0.123）和M-QOL（44.7±15.3 OS比44.9±14.9 MIS, p = 0.901）相似。结论前肠恶性肿瘤手术患者的mis与较高的长期生活质量无关。

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引用次数: 0