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Development and internal validation of a novel predictive model to guide an individualized risk assessment in prostate cancer patients 一种新的预测模型的开发和内部验证,以指导前列腺癌患者的个体化风险评估
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-28 DOI: 10.1016/j.suronc.2025.102242
Fabrizio Di Maida , Luca Lambertini , Antonio Andrea Grosso , Daniele Paganelli , Vincenzo Salamone , Simone Coco , Anna Cadenar , Andrea Marzocco , Filippo Lipparini , Matteo Salvi , Gianni Vittori , Rino Oriti , Agostino Tuccio , Michele Di Dio , Lorenzo Masieri , Andrea Mari , Andrea Minervini

Introduction and objectives

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.

Materials and methods

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.

Results

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.

Conclusions

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.
前言和目的通过开发个体化风险计算器来预测肿瘤预后,为符合根治性手术条件的前列腺癌(PCa)患者提供一种风险适应策略。材料与方法前瞻性收集2020年3月至2023年6月在某三级转诊中心连续接受机器人辅助根治性前列腺切除术(RARP)治疗的患者数据并进行分析。采用Cox比例风险模型进行多因素分析,探讨3年生化衰竭(BCF)的预测因素。探讨了术前和术后模型,关键变量包括肿瘤相关特征和手术延迟。基于所确定的显著变量,我们开发了两个nomogram来估计3年BCF的风险。采用接收算子特征(ROC)曲线下面积(AUC)来量化预测判别。使用自举技术进行内部验证,以评估模型的准确性和校准。结果共纳入2017例患者。在术前模型的多变量分析中,cT分期、cN分期、前列腺活检ISUP分级、前列腺MRI指数病变PIRADS、手术延迟是3年BCF的显著预测因素。在术后预测模型的多变量分析中,pT分期、pN分期、最终组织病理学检查ISUP分级、手术切缘、手术延迟是3年BCF的重要预测因素。术前和术后模型的ROC AUC分别为60.7%和71.9%。建立术前和术后模型的最终形态图。两个模型都使用1000次重复的bootstrapping进行内部验证。结论:为了根据个体风险状况优化PCa患者的手术时机,我们最终设计并内部验证了两种互补作用的nomographic。术前nomographic提供早期(尽管不太精确)的风险分层来指导初始治疗计划,而术后nomographic使用明确的病理数据来完善BCF预测。
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引用次数: 0
Technical tips on pancreatojejunostomy and gastrojejunostomy during robotic pancreatoduodenectomy with comparison between the internal and external stent for pancreatojejunostomy 机器人胰十二指肠切除术中胰空肠吻合术和胃空肠吻合术的技术要点及胰空肠吻合术内、外支架的比较
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-28 DOI: 10.1016/j.suronc.2025.102239
Kyoji Ito , Yoshikuni Kawaguchi , Satoru Abe , Yusuke Seki, Yuichiro Mihara, Yujiro Nishioka, Akihiko Ichida, Takeshi Takamoto, Nobuhisa Akamatsu, Kiyoshi Hasegawa

Background

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.

Methods

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.

Results

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 < 0.01) and DGE (0 % vs. 23.1 %, P = 0.01) was significantly lower in the RPD group than in the OPD group.

Conclusions

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.
背景胰十二指肠切除术(PD)是治疗壶腹周围病变的必要方法,但常并发术后胰瘘(POPF)和胃排空延迟(DGE)。本研究介绍了机器人PD (RPD)过程中胰空肠吻合术(PJ)和胃空肠吻合术(GJ)的技术,以实现临床相关(CR) -POPF和DGE的零发生率。方法2020年1月至2024年7月在东京大学接受PD治疗的患者纳入本研究。2022年1月以后,RPD定期执行并标准化。RPD采用以下吻合技术:改良Blumgart吻合PJ和侧对侧GJ,采用Billroth II型线性吻合器,手工Braun吻合。在2020-2022年期间,RPD的结果根据PJ支架类型与相同适应症的开放式PD (OPD)进行比较。结果在34例患者中,没有患者发生CR-POPF、DGE或胆汁漏。1例有液体收集的患者行放射线引流,排出的淀粉酶水平未升高。住院时间的中位数(范围)为8天(5-17天),没有患者在30天内再次手术或出现90天死亡率。与外部支架相比,PJ短支架置入患者的中位手术时间(663 vs 795分钟)和中位住院时间(6.0 vs 8.5天)显著缩短。POPF的发生率(0% vs. 69.2%, P <;RPD组的DGE(0 %比23.1%,P = 0.01)明显低于OPD组。结论所描述的PJ和GJ技术以及循证围手术期管理使RPD的CR-POPF和DGE为零,提示良好的预后。外部支架可能不会改善RPD的结果。
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引用次数: 0
Prognostic impact of conversion surgery in patients with stage IV gastric cancer: A multicenter population-based cohort study 转化手术对IV期胃癌患者预后的影响:一项多中心人群队列研究
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-23 DOI: 10.1016/j.suronc.2025.102241
Hirohito Kakinuma , Michitaka Honda , Hidetaka Kawamura , Soshi Hori , Teppei Miyakawa , Satoshi Toshiyama , Yoshinao Takano , Shunji Kinuta , Takahiro Kamiga , Satoru Shiraso , Koji Kono

Background

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.

Methods

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.

Results

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 < 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 < 0.01). The median survival time was 28.0 months in the CS group and 8.2 months in the non-CS group.

Conclusion

This study revealed the implementation status of CS for patients with stage IV AGC. CS may improve the patient prognosis.
背景:IV期晚期胃癌(AGC)转化手术(CS)的疗效尚不清楚。本研究旨在概述IV期AGC的临床实践,并评估CS的有效性。方法回顾性队列研究。本研究纳入了2008 - 2015年在日本福岛县指定癌症医院连续诊断为IV期AGC的患者。我们评估了CS与生存时间之间的关系,并计算了CS对总生存的校正风险比。结果共纳入647例患者。57例(8.8%)患者行CS。CS组转移灶较少(p = 0.01),肝转移灶较少(p <;0.01),相对于非cs组。CS对总生存率的校正风险比为0.34(95%置信区间:0.24-0.48,p <;0.01)。CS组中位生存时间为28.0个月,非CS组中位生存时间为8.2个月。结论本研究揭示了IV期AGC患者CS的实施情况。CS可改善患者预后。
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引用次数: 0
Neoadjuvant intraperitoneal chemotherapy in high-risk and cytology positive gastric cancer: a systematic review 新辅助腹腔化疗在高危和细胞学阳性胃癌中的应用:系统综述
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-23 DOI: 10.1016/j.suronc.2025.102237
Brendan Desmond , Lobna Alukaidey , Zexi Allan , Carlos Cabalag , Nicholas J. Clemons , Michael Michael , Jeanne Tie , Niall Tebbutt , Cuong P. Duong , David S. Liu

Background

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.

Methods

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.

Results

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.

Conclusion

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.
背景:胃癌具有早期跨结肠扩散的风险。尽管围手术期化疗和手术,腹膜复发是一个常见的死亡因素。新辅助常温腹腔化疗(IPC)的加入使显微镜下疾病的早期治疗成为可能。本研究旨在系统评价新辅助IPC在腹膜复发高危胃癌患者中的安全性和有效性。方法根据PRISMA指南进行系统评价。检索了Embase、PubMed、Web of Science和Scopus等相关论文。主要结局是接受新辅助IPC治疗的患者的无病率(DFS)和总生存率(OS)。次要结局集中于不良反应和毒性。结果共筛选论文562篇,纳入论文7篇,共158例患者。对于细胞学阳性的患者,添加IPC导致78 - 89%的患者转化为细胞学阴性并进行根治性手术。这与相对较高的DFS和OS相关。在最初患有细胞学阳性疾病的队列中,腹膜特异性复发率(63 - 69%)高于未患有细胞学阳性疾病的队列(0 - 29%)。我们的数据表明,与细胞学阴性的疾病相比,最初细胞学阳性的患者的OS较低。重要的是,新辅助IPC似乎没有显著增加治疗相关不良事件。结论新辅助IPC有效且安全,细胞学转换率高(细胞学阳性疾病),腹膜复发率低(局部晚期疾病)。与目前的标准治疗方案相比,这与DFS和OS的显著改善有关。
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引用次数: 0
Robotic right anterior sectionectomy with Glissonian approach Glissonian入路的机器人右前切开术
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-22 DOI: 10.1016/j.suronc.2025.102240
Marcel A. Machado , Micheli F. Domingos , Eduardo Brommelstroet Ramos
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引用次数: 0
Current evidence for robotic and laparoscopic liver resections: Results from the international study group 目前机器人和腹腔镜肝切除术的证据:来自国际研究小组的结果。
IF 2.4 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-22 DOI: 10.1016/j.suronc.2025.102238
Hwee-Leong Tan , Darren W.Q. Chua , Brian K.P. Goh
Minimally-invasive liver resection (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 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.
随着手术技术和器械的改进,微创肝切除术(MILR)在世界范围内越来越多地被采用。虽然与开放肝切除术相比,MILR已被证明具有一些围手术期的益处,但MILR相关的陡峭学习曲线仍然是一个重大障碍。机器人肝切除术(Robotic liver resection, RLR)利用机器人平台相对于传统腹腔镜固有的技术优势,在克服腹腔镜肝切除术局限性的同时,具有实现MILR围手术期优势的潜力。在这篇综述中,我们总结了目前比较国际机器人和腹腔镜肝脏切除术研究小组RLR和LLR结果的证据。
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引用次数: 0
Risk factors for postoperative evisceration after cytoreductive surgery and HIPEC. A comparative study of open and closed abdominal techniques 细胞减少手术和HIPEC术后内脏切除的危险因素。开腹术与闭腹术的比较研究
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-09 DOI: 10.1016/j.suronc.2025.102229
Fatah Tidadini , Jade Fawaz , Jean-Louis Quesada , Julio Abba , Brice Malgras , Bertrand Trilling , Pierre-Yves Sage , Juliette Fischer , Marc Pocard , Catherine Arvieux , Anne-Cécile Ezanno

Background

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.

Methods

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.

Results

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.

Conclusions

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.
背景:可切除腹膜转移(PM)的标准治疗包括细胞减少手术(CRS)和腹腔高温化疗(HIPEC)的结合。术后内脏切除是CRS和HIPEC术后罕见但主要的并发症。本研究旨在确定HIPEC术后内脏取出的相关危险因素,比较开放式和闭合式腹部HIPEC的结果。方法对2014 - 2023年间233例接受CRS/HIPEC治疗的PM患者进行回顾性多中心研究。根据HIPEC技术对患者进行分类:Open (OPEN_HIPEC), n = 110;闭腹术(CLOSED_HIPEC), n = 123)。我们旨在通过多变量分析确定与CRS/HIPEC术后30天内内脏切除相关的患者因素。结果233例患者中,女性129例(55.4%)。中位年龄为60岁[51岁;67)年。OPEN_HIPEC组明显比CLOSED_HIPEC组年轻(中位数57 [47;62] vs . 63 [54];70年;p≤0.001),PCI评分较高(中位9.5 [5;17] vs . 6 [2;11);p≤0.001)。OPEN和close_hipec的严重并发症相似:17例(15.5%)vs 15例(12.2%);P = 0.471,无死亡率。8例(3.4%)患者发生了术后内脏切除,OPEN_HIPEC组的发生率明显高于CLOSED_HIPEC组(7/110 (6.4%)vs 1/123 (0.8%);p = 0.028)。单因素分析发现慢性阻塞性肺疾病(COPD)/呼吸系统病理(HR = 7.02[1.76-28.1])和PCI评分类别11-15 (HR = 5.09[1.03-25.2])为危险因素。多因素分析发现COPD/呼吸病理史(HR = 7.39 [1.85-29.6], p = 0.005)和OPEN_HIPEC (HR = 8.37 [1.03-68.1], p = 0.047)是术后内脏取出的危险因素。虽然缝合材料在分析中没有被确定为重要因素,但在OPEN_HIPEC组中,所有的内脏都是在使用Vicryl 1缝线闭合肌肉腱膜后观察到的。结论CRS/HIPEC治疗后,3.4%的患者在第30天出现内脏切除。COPD/呼吸病理史和OPEN_HIPEC技术被确定为与内脏切除相关的独立危险因素,需要再次干预。还应注意的是,在OPEN_HIPEC组中,改用PDS缝合后没有出现内脏穿孔。
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引用次数: 0
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 开放性腹膜后淋巴结清扫术治疗睾丸生殖细胞肿瘤的围手术期发病率:根据欧洲泌尿外科协会并发症报告指南和范围文献综述进行深入的单中心分析
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-05-09 DOI: 10.1016/j.suronc.2025.102228
Jakob Klemm , Roland Dahlem , Michael Hartmann , Markus von Deimling , Robert J. Schulz , David Klemm , Florian Janisch , Shahrokh F. Shariat , Margit Fisch , Malte W. Vetterlein

Introduction

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.

Patients and methods

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.

Results

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.

Conclusion

Most patients experience postoperative complications after RPLND, though severe complications are rare. These findings could improve patient counseling when discussing testicular cancer therapy options.
腹膜后淋巴结清扫(RPLND)是治疗转移性生殖细胞肿瘤(gct)的关键,尤其是化疗后。考虑到这些患者的长期生存,围手术期的发病率是一个重要的问题。然而,使用预定义报告标准的RPLND发病率数据很少。本研究旨在利用最新的欧洲泌尿外科协会(EAU)标准化并发症报告指南来解决这一差距。患者和方法回顾性分析了2010年至2022年间因gct接受RPLND的患者。使用预定义的特定程序目录从数字图表中提取30天并发症。采用Clavien-Dindo分级(CDC)对并发症进行分级,并计算每位患者的综合并发症指数(CCI)。结果69名男性接受了RPLND,中位年龄32岁(IQR 25-38)。64例(93%)患者接受化疗,其中48例(70%)肿瘤标志物阴性。中位肿瘤直径52 mm (IQR 35 ~ 83),中位手术时间197 min (IQR 128 ~ 262)。55例(80%)患者行单侧模板切除。66例患者(96%)共报告157例并发症,其中贫血(33%)和胃肠道问题(24%)最为常见。5例(7.2%)患者出现“严重”并发症(CDC分级≥IIIa),中位CCI为12 (IQR 9-23)。使用CCI,有“主要”并发症负担的患者比例增加到14%,而单独使用CDC的比例为8.5%。本研究的主要局限性是其回顾性设计和有限的30天随访期。结论RPLND术后并发症多,严重并发症少见。这些发现可以在讨论睾丸癌治疗方案时改善患者咨询。
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引用次数: 0
Quantity of lower muscle as a promising prognostic factor for overall survival in patients with bone and soft tissue sarcoma 骨和软组织肉瘤患者的下肌数量是一个有希望的预后因素
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-04-28 DOI: 10.1016/j.suronc.2025.102227
Tadashi Iwai , Maria Anna Smolle , Dominik Kaiser , Lukas Jud , Sandro F. Fucentese , Daniel Andreas Müller

Introduction

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.

Methods

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, >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.

Results

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.

Conclusions

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.
骨肉瘤(BS)和软组织肉瘤(STS)的各种预后因素已被研究。最近的报道表明,肌肉量与老年癌症患者的预后有关。然而,据我们所知,在年龄≥18岁的BS和STS患者中,没有关于股肌体积与总生存期(OS)、局部无复发生存期(LRFS)或无转移生存期(MFS)之间关系的报道。方法回顾性分析2014 - 2023年在同一医院治疗的119例BS和STS患者的临床病理资料。基于正电子发射断层扫描和计算机断层扫描信息,研究了4个年龄组(19-39岁、40-59岁、60-74岁和75岁)的股骨肌数量、腰大肌指数和肱三头肌表面肌。使用Cox比例风险回归模型评估患者的性别、年龄、肿瘤大小、位置、分级、美国癌症分期联合委员会、化疗史、放疗史、美国麻醉医师协会-身体状况和肌肉体积。采用Kaplan-Meier法评估5年生存率。结果中位随访时间为34个月(四分位数间距17-64)。5年OS、LRFS和MFS率分别为73.7%、86.6%和76.7%。在多变量分析中,肿瘤分期和全股肌体积减小与不良OS显著相关。结论股肌体积减小是导致OS不良的重要因素。因此,成年患者术后尽可能保持全股肌容量是很重要的。
{"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}
引用次数: 0
Corrigendum for “Radiofrequency ablation with four electrodes as a building block for matrix radiofrequency ablation: Ex vivo liver experiments and finite element method modelling. Influence of electric and activation mode on coagulation size and geometry” by Stefaan Mulier, Ricardo Possebon, Yansheng Jiang, Jacques Jamart, Chong Wang, Yi Miao, Tongfu Yu, Kuirong Jiang, Yuanbo Feng, Guy Marchal, Luc Michel, Yicheng Ni, published in [Surgical Oncol. 33 (2020) 145–157] “射频消融与四个电极作为构建块的矩阵射频消融:离体肝脏实验和有限元方法建模”的勘误表。作者:Stefaan Mulier, Ricardo Possebon,蒋彦生,Jacques Jamart,王冲,缪毅,余同富,蒋kuirong,冯元波,Guy Marchal, Luc Michel,倪一成,发表于[外科杂志]. 33(2020)145-157。
IF 2.3 4区 医学 Q3 ONCOLOGY Pub Date : 2025-04-13 DOI: 10.1016/j.suronc.2025.102226
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引用次数: 0
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Surgical Oncology-Oxford
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