Surgical Oncology-Oxford最新文献

{"title":"Risk factors for postoperative malignant progression of lower-grade gliomas: a systematic review and meta-analysis","authors":"Zhengmao Ge ,&nbsp;Guyu Jin ,&nbsp;Hongkang Wang ,&nbsp;Shimin Wang ,&nbsp;Xiaowei Fei ,&nbsp;Shuyang Li ,&nbsp;Lei Zhang ,&nbsp;Xiaofan Jiang ,&nbsp;Yanyu Zhang","doi":"10.1016/j.suronc.2025.102327","DOIUrl":"10.1016/j.suronc.2025.102327","url":null,"abstract":"<div><h3>Objectives</h3><div>The primary aim was to evaluate the risk factors for postoperative malignant progression of lower-grade glioma (LGG) in patients.</div></div><div><h3>Data sources</h3><div>PubMed, EMBASE, Web of Science and Cochrane Library were searched from database inception to August 2024.</div></div><div><h3>Eligibility criteria</h3><div>Quantitative and original studies reporting risk factors for postoperative malignant progression of LGGs were included.</div></div><div><h3>Results</h3><div>17 observational studies with 3810 glioma patients met the inclusion criteria. Factors including advanced age (HR 1.011, p = 0.042), contrast enhancement (HR 1.540, p = 0.001), rapid expanding speed (HR 4.525, p &lt; 0.001), location in insular lobe (HR 1.514, p = 0.020), eloquence involved (HR 2.413, p &lt; 0.001) and corpus callosum involved (HR 1.695, p = 0.002) were identified as risk factors of postoperative malignant progression of LGGs. High Karnofsky Performance Status (KPS) score (HR 0.955, p = 0.001), oligodendroglioma (HR 0.603, p &lt; 0.001), oligoastrocytoma (HR 0.693, p = 0.016), isocitrate dehydrogenase (IDH) mutation (HR 0.406, p = 0.004), 1p19q codeletion (HR 0.534, p &lt; 0.001), O⁶-methylguanine-DNA methyltransferase promoter (MGMTP) methylation (HR 0.539, p = 0.007), resection operation (HR 0.277, p &lt; 0.001) and high extent of resection (EOR) (HR 0.972, p = 0.038) were identified as factors that decreased the risk of postoperative malignant progression of LGGs.</div></div><div><h3>Conclusion</h3><div>This review identified multiple factors associated with the risk of postoperative malignant progression of LGGs, with moderate to high certainty of evidence supporting several key risk and protective factors. Surgeons should be aware of these factors and consider implementing more active treatment and surveillance measures for high-risk patients to improve prognosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102327"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534854","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":"Survival benefit of resectability determined by multiple surgeons in BCLC-C Stage: A single-center cohort study","authors":"Kyung Chul Yoon ,&nbsp;Sanggyun Suh ,&nbsp;YoungRok Choi ,&nbsp;Jeong-Moo Lee ,&nbsp;Minseob Kim ,&nbsp;Jaewon Lee ,&nbsp;Jae-Yoon Kim ,&nbsp;Jiyoung Kim ,&nbsp;Won-Gun Yun ,&nbsp;Chang-Sup Lim ,&nbsp;Su young Hong ,&nbsp;Suk Kyun Hong ,&nbsp;Nam-Joon Yi ,&nbsp;Kwang-Woong Lee ,&nbsp;Kyung-Suk Suh","doi":"10.1016/j.suronc.2025.102328","DOIUrl":"10.1016/j.suronc.2025.102328","url":null,"abstract":"<div><h3>Background</h3><div>Systemic therapy remains the standard treatment for Barcelona Clinic Liver Cancer Stage C (BCLC C). However, the heterogeneity of this patient cohort has prompted investigation into alternative or additional therapeutic approaches. Potential bias exists in previous comparisons among treatment groups. Therefore, we compared survival outcomes between resectable and unresectable groups, as determined by four experienced surgeons.</div></div><div><h3>Methods</h3><div>We used data from patients who were initially diagnosed with liver cancer and treated at Seoul National University Hospital from January 2015 to December 2017. Four experienced liver surgeons participated, and each patient was classified as 'resectable' only when the two reviewing surgeons agreed that it was 'resectable’ based on medical records and imaging.</div></div><div><h3>Results</h3><div>The cohort included 1351 patients, of whom 212 had BCLC C. Among them, 162 were classified as resectable and 50 as unresectable. Portal vein tumor thrombus was present in 92.6 % and 86 % in the unresectable and resectable groups, respectively. The resectable group had better survival rates than the unresectable group, with 1-, 3-, and 5-year survival rates of 75.4, 52.3, and 45.1 % vs. 47 %, 22.2 %, and 13 %, respectively (P &lt; 0.01). In the resectable group, 21 patients underwent resection and 28 received transarterial chemoembolization. The resection subgroup demonstrated superior 1-, 3-, and 5-year survival rates: 90.2 %, 75.2 %, and 64.4 %, vs. 63.1 %, 33.4 %, and 28.7 %, respectively (P &lt; 0.01). Bile duct invasion (HR: 0.6477 [1.309–32.05], P = 0.02) and resection (HR: 0.247 [0.072–0.854], P = 0.02) were significant factors for OS.</div></div><div><h3>Conclusions</h3><div>Determining resectability at the BCLC-C stage and performing resection may improve survival.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102328"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514691","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":"Identification of TRACP 5b as a local recurrence biomarker in giant cell tumor of bone","authors":"Yu Toda,&nbsp;Koichi Ogura,&nbsp;Shintaro Iwata,&nbsp;Eisuke Kobayashi,&nbsp;Shuhei Osaki,&nbsp;Suguru Fukushima,&nbsp;Akira Kawai","doi":"10.1016/j.suronc.2025.102331","DOIUrl":"10.1016/j.suronc.2025.102331","url":null,"abstract":"<div><h3>Background</h3><div>Giant cell tumor of bone (GCTB) has a high potential for local recurrence after surgical treatment. It is characterized by the histological proliferation of osteoclast-like multinucleated giant cells. Tartrate-resistant acid phosphatase 5b (TRACP5b) is a reliable serum marker of bone resorption. This study aimed to investigate the impact of TRACP5b levels on the local recurrence of GCTB following surgical treatment.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from 47 primary GCTB patients who underwent serum TRACP5b testing and surgical treatment between 2015 and 2022. We statistically evaluated the correlation between TRACP5b levels and clinical characteristics. Patients were stratified into two groups based on TRACP5b levels, and the association between TRACP5b and local recurrence was assessed across various clinical parameters.</div></div><div><h3>Results</h3><div>The mean TRACP5b level in male patients (2062 ± 2289 mU/dL) was significantly higher than in female patients (976 ± 487 mU/dL; p = 0.048). A moderate positive correlation was observed between tumor size and TRACP5b levels (r = 0.586, p &lt; 0.001). Gender, tumor location (trunk, lower extremity, and upper extremity), tumor size, and TRACP5b levels were significantly associated with local recurrence-free survival (p values were 0.037, 0.0006, 0.048, and 0.004, respectively).</div></div><div><h3>Conclusions</h3><div>This study identified preoperative TRACP5b levels as a prognostic factor for local recurrence in GCTB patients, highlighting its potential utility in risk stratification and personalized management.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102331"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579571","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 bona fide right hepatectomy with ICG-guided detachment technique","authors":"Taiga Wakabayashi,&nbsp;Sara Pepe,&nbsp;Muhammad Naeem,&nbsp;Go Wakabayashi","doi":"10.1016/j.suronc.2025.102338","DOIUrl":"10.1016/j.suronc.2025.102338","url":null,"abstract":"<div><h3>Background</h3><div>Anatomic liver resection (ALR) requires precise transection along the true intersegmental/sectional plane while preserving vascular integrity of the remnant liver. Conventional approaches often rely on ischemic demarcation or venous landmarks, which may not perfectly match anatomical boundaries. Robotic platforms and indocyanine green (ICG) fluorescence have enabled refined visualization and dexterity, supporting the concept of bona fide ALR—defined as anatomical resection that exactly follows the Glissonean territory while preserving remnant inflow and outflow integrity. The “detachment technique” denotes a robotic ICG-guided approach that achieves natural parenchymal separation along the demarcated plane through controlled traction–countertraction dynamics, ensuring anatomical precision without unnecessary vessel sacrifice. Conceptually, this principle applies to any segmental or subsegmental unit of the liver representing the smallest anatomical territory supplied by a Glissonean pedicle.</div></div><div><h3>Methods</h3><div>We report robotic right hepatectomy in a woman in her 50s with abdominal fullness due to a giant hepatic hemangioma. Using the Da Vinci Xi system, cystic plate cholecystectomy was performed, and the right hepatic artery was ligated to reduce tumor tension. After encirclement of the hepatoduodenal ligament, the right Glissonean pedicle was isolated using an extrahepatic approach. Intravenous injection of 0.25 mg ICG enabled negative staining, which delineated the transection plane. Parenchymal transection was carried out with a Maryland bipolar dissector under robotic countertraction, facilitating natural detachment along the Main Portal Fissure. Firefly mode provided real-time visualization, and the anterior and posterior Glissonean pedicles and the right hepatic vein were divided with staplers.</div></div><div><h3>Results</h3><div>The procedure was completed in 407 minutes with an estimated blood loss of 116 mL. The postoperative course was uneventful, and the patient was discharged on postoperative day 7.</div></div><div><h3>Conclusion</h3><div>Robotic right hepatectomy with a Glissonean approach and ICG-guided negative staining illustrates the feasibility of bona fide anatomic liver resection (ALR). While demonstrated in a single case of hemangioma, this technique requires expertise in the extrahepatic Glissonean approach and should be validated in multicentric cohorts to assess its generalizability and long-term outcomes.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102338"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145693724","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":"Comprehensive guide to the diagnosis, management, and treatment of metastatic spinal cord compression syndrome","authors":"Daniel Alejandro Vega Moreno ,&nbsp;Gervith Reyes Soto ,&nbsp;Julio Cesar Lopez-Valdes ,&nbsp;Alfonso Arellano-Mata ,&nbsp;Henar Galicia Palacios ,&nbsp;Miguel Agustín Amador Hernandez ,&nbsp;Manuel de Jesús Encarnación-Ramirez","doi":"10.1016/j.suronc.2025.102341","DOIUrl":"10.1016/j.suronc.2025.102341","url":null,"abstract":"<div><div>Spinal metastases are the most common tumors found in the neuraxis. They correspond to 90 % of all tumors at this level. The thoracic region is the most frequently affected area, followed by the lumbar region, with the cervical region being the least frequently affected place. Back pain is the most common symptom, appearing in up to 95 % of patients who present with spinal cord compression syndrome. The evaluation of patients with spinal cord compression syndrome is complex and requires an entire multidisciplinary team for diagnosis, management, and treatment. In the medical part, treatment is based on pain control with analgesic medications and the use of steroids, mainly dexamethasone, which has demonstrated efficacy and safety in the context of patients with spinal cord compression syndrome for functional recovery. Radiotherapy treatment is essential both as a definitive treatment and as a complementary treatment to surgery and although to date there are several treatment schemes, doses and fractions must be individualized based on the clinical context of each patient. On the other hand, metastatic spinal surgery is considered part of the definitive treatment, and although in a palliative context there are multiple approaches and indications for it. The importance of considering surgery is in those patients who are unstable since surgery, although it is not curative, poses a substantial improvement in symptoms as well as in pain recovery. We propose a diagnosis and treatment algorithm for patients with metastatic spinal cord compression syndrome in which decision-making is based on individualization and joint management by a multidisciplinary team.</div></div><div><h3>Clinical trial number</h3><div>not applicable.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102341"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783657","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":"Cavity shave technique for safe resection margins in breast cancer conserving surgery: a randomized clinical trial","authors":"Gianluca Vanni ,&nbsp;Marco Pellicciaro ,&nbsp;Marco Materazzo ,&nbsp;Alice Bertolo ,&nbsp;Denisa Eskiu ,&nbsp;Alessia Petricca ,&nbsp;Michele Treglia ,&nbsp;Benedetto Longo ,&nbsp;Valerio Cervelli ,&nbsp;Oreste Claudio Buonomo","doi":"10.1016/j.suronc.2025.102315","DOIUrl":"10.1016/j.suronc.2025.102315","url":null,"abstract":"<div><h3>Background/aim</h3><div>In the modern era, breast surgery aims to adopt conservative strategies that ensure both oncological safety and aesthetic outcomes. However, one of the major challenges is the risk of positive margins, which may require a second surgery. Various strategies have been adopted to minimize this risk. The most commonly used strategies include the selective resection of suspicious margins after intraoperative evaluation and the routine circumferential resection of additional tissue around the cavity left by a lumpectomy, known as the Cavity-Shave (CS) Technique.</div></div><div><h3>Methods</h3><div>A blind randomized clinical trial was conducted, in which standard selective margin resections were compared to the CS technique, in a 1:1 ratio, comparing oncological outcomes, aesthetic results, and surgical time.</div></div><div><h3>Results</h3><div>A total of 185 patients were enrolled in the study, with a mean age of 62.04 ± 14.02. The sample was randomly assigned to two groups: 91(49.2 %) were allocated to the cavity shave (CS) Group and 94 (50.8 %) to the no-CS-Group. The rate of positive margins was 20.9 % versus 18.1 %, p-value:0.631 vs p-value:0.577. The re-excision rate was 12.1 % vs 14.9 %, in the CS-group and in the no-Cs-Group respectively. The mean operating room occupancy time was 77.9 ± 23.5 min in the CS-group versus 95.6 ± 34.9 min in the no-Cs-Group, with a p-value&lt;0.001. Aesthetic outcomes were comparable between the two groups (p-value:0.706), despite a statistically significant difference in the total volume excised, 67.2 ± 16.4 cm³ in the CS-Group versus 51.5 ± 17.2 cm³ in the no-CS-Group, p-value:0.021.</div></div><div><h3>Conclusion</h3><div>CS and selective margin resection with intraoperative histopathological evaluation showed similar oncological and aesthetic outcomes; however, CS was associated with a statistically significant reduction in surgical time.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102315"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460312","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":"Impact of minimally invasive surgical approach on oncological completeness of resection in lung cancer surgery","authors":"Clara Forcada ,&nbsp;María Teresa Gómez-Hernández ,&nbsp;Cristina E. Rivas ,&nbsp;Marta G. Fuentes ,&nbsp;Óscar Colmenares ,&nbsp;Mario Manama ,&nbsp;José Luis Aranda ,&nbsp;Marta Rodríguez ,&nbsp;Mercedes Sánchez ,&nbsp;Marcelo F. Jiménez","doi":"10.1016/j.suronc.2025.102310","DOIUrl":"10.1016/j.suronc.2025.102310","url":null,"abstract":"<div><h3>Objectives</h3><div>Oncological radicality, defined as complete resection, is essential in lung cancer surgery. This study aimed to compare the oncological quality of anatomical lung resections performed via video-assisted thoracoscopic surgery (VATS) versus robotic-assisted thoracic surgery (RATS), focusing on completeness of resection. Secondary objectives included lymphadenectomy quality, nodal upstaging, residual disease, and the number of dissected lymph node stations and retrieved lymph nodes.</div></div><div><h3>Methods</h3><div>A prospective single-center study included consecutive patients undergoing minimally invasive anatomical lung resection for lung cancer (September 2023–April 2025). Overlap weighting based on propensity scores—calculated using histology, clinical T and N stage, and extent of resection—was applied. Outcomes related to oncological radicality were compared between the VATS and RATS groups using appropriate statistical tests based on variable type and distribution.</div></div><div><h3>Results</h3><div>Of 358 patients, 255 met the inclusion criteria (84 RATS, 171 VATS). The rates of complete, incomplete, and uncertain resection were 62.0 %, 3.5 %, and 34.5 %, respectively. After overlap weighting, no significant differences were observed between RATS and VATS in complete resection (66.5 % vs. 60 %, p = 0.557), residual disease (2.17 % vs. 1.92 %, p = 0.802), adequate lymphadenectomy (70.7 % vs. 61.8 %, p = 0.181), or nodal upstaging (19.7 % vs. 11.3 %, p = 0.087). However, RATS yielded a higher number of mediastinal nodal stations dissected (median: 4 vs. 3, p &lt; 0.001) and lymph nodes retrieved (median: 9 vs. 7, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>RATS and VATS achieved similar oncological radicality. However, RATS was associated with more extensive lymphadenectomy, potentially improving staging accuracy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102310"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446554","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":"The impact of the timing of adjuvant treatment initiation in patients with upfront resection of pancreatic cancer","authors":"Sydney McManus ,&nbsp;Aimée Galatas ,&nbsp;Sarah Hemelt ,&nbsp;Sanchit Sachdeva ,&nbsp;Kevin Sullivan ,&nbsp;Bolni Marius Nagalo ,&nbsp;Denise Danos ,&nbsp;Omeed Moaven","doi":"10.1016/j.suronc.2025.102329","DOIUrl":"10.1016/j.suronc.2025.102329","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluates the association between timing of adjuvant chemotherapy and overall survival in resectable pancreatic ductal adenocarcinoma (PDAC). It also examines whether the adoption of modern chemotherapy regimens in recent years has influenced this relationship, reflecting evolving treatment practices.</div></div><div><h3>Methods</h3><div>Cases of resectable primary invasive PDAC were identified using the National Cancer Database (NCDB). Overall survival (OS) was visualized using Kaplan Meier survival plots and Cox proportional hazard models. Covariat adjustment and propensity score matched cohort were analyzed. The matched cohort was analyzed with Cox proportional hazard models and logistic models.</div></div><div><h3>Results</h3><div>31,949 patients were included in the study. 26.4 % received no chemotherapy, 66.4 % received chemotherapy within 12 weeks, and 7.2 % received chemotherapy after 12 weeks. There was significant improvement in mOS. Between 2015 and 2019, there was a significant difference in OS for patients receiving chemotherapy within 12 weeks, compared to &gt;12 weeks.</div></div><div><h3>Conclusion</h3><div>While adjuvant chemotherapy in patients with resectable PDAC is associated with improved OS compared to no adjuvant therapy, it is worth considering that those who are well enough to receive chemotherapy inherently have better prognoses. Importantly, the survival association persists regardless of the timing of chemotherapy initiation, suggesting that late administration of adjuvant chemotherapy may still be beneficial in appropriately selected patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102329"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528651","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":"Cranial-to-caudal approach in laparoscopic surgery for left-sided colon cancer: Longer specimens and higher lymph node yield","authors":"Beslen Goksoy ,&nbsp;Cem B. Ofluoglu ,&nbsp;Ibrahim F. Azamat ,&nbsp;Gorkem Uzunyolcu ,&nbsp;Serra Z. Akkoyunlu ,&nbsp;Ilker Ozgur ,&nbsp;Feza Ekiz","doi":"10.1016/j.suronc.2026.102354","DOIUrl":"10.1016/j.suronc.2026.102354","url":null,"abstract":"<div><h3>Background</h3><div>Medial-to-lateral (ML) approach is the standard technique in laparoscopic surgery for left-sided colon cancer. However, it can be technically challenging; such as in patients with intra-abdominal adhesions or during splenic flexure mobilization. To overcome these difficulties, we adopted a cranial-to-caudal (CC) approach as an alternative technique. This study aimed to compare the CC and ML approaches in terms of short-term clinical and mid-term oncological outcomes.</div></div><div><h3>Methods</h3><div>Patients performed laparoscopic surgery for left-sided colon cancer between October 2018 and November 2022 were retrospectively analyzed. Patients were classified into two groups. The primary outcome was the length of the resected specimen. Secondary outcomes were pathological parameters, perioperative outcomes, recurrence-free survival (RFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>Seventy-four patients were included (ML, n = 39; CC, n = 35). The CC group had longer specimen lengths compared with the ML group (32.9 ± 6.8 cm vs 28.9 ± 6.4 cm; p = 0.022), and longer proximal margin (11.8 ± 3.3 cm vs 9.9 ± 2.3 cm; p = 0.004). Lymph node yield was also higher in the CC group (26.4 ± 8.7 vs 22.3 ± 6.5; p = 0.033). On multivariable analysis, specimen length was independently associated with lymph node yield (β = 0.73; 95% CI, 0.47–1.20; p &lt; 0.001). During a mean follow-up of 44 months, RFS (88.6% vs 89.7%; p = 0.84) and OS (88.6% vs 87.2%; p = 0.67) were similar between the groups.</div></div><div><h3>Conclusions</h3><div>In laparoscopic surgery for left-sided colon cancer, the CC approach yielded longer resected specimens and more lymph node counts compared with the ML approach, but did not improve oncologic outcomes.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102354"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127192","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 reduction bilateral salpingo-oophorectomy with vNOTES: A new era in cancer prevention strategies","authors":"Maria Pellisé-Tintoré ,&nbsp;Thomas Gaillard ,&nbsp;Enora Laas ,&nbsp;Virginie Fourchotte ,&nbsp;Hélène Didelot ,&nbsp;Lea Pauly ,&nbsp;Jean Guillaume Feron ,&nbsp;Fabien Reyal ,&nbsp;Fabrice Lecuru","doi":"10.1016/j.suronc.2025.102349","DOIUrl":"10.1016/j.suronc.2025.102349","url":null,"abstract":"<div><h3>Introduction</h3><div>Women with BRCA1 and BRCA2 mutations face a significantly increased lifetime risk of developing ovarian and fallopian tube cancer. Minimally invasive techniques are the gold standard access to perform risk-reduction operations. This study aims to evaluate the feasibility and safety of prophylactic bilateral salpingo-oophorectomy using the vaginal natural orifice transluminal endoscopic surgery (vNOTES) technique as a risk-reduction strategy.</div></div><div><h3>Material and methods</h3><div>A prospective study was conducted between October 2023 and December 2024, involving 25 high-risk women at an international, university-affiliated cancer center. All patients underwent prophylactic bilateral salpingo-oophorectomy via transvaginal access using vNOTES. Key data collected included age, BMI, operative time, and blood loss, with primary outcomes focusing on feasibility, complications, and recovery.</div></div><div><h3>Results</h3><div>Twenty-five BRCA-mutated patients underwent prophylactic bilateral adnexectomy via vNOTES. Median age was 48 years (range 41–59) and median BMI 24.1 kg/m² (range 19.1–30.4). All procedures were completed without conversion to laparoscopy or laparotomy, and vNOTES enabled full abdominal exploration. Median operative time was 40 min (IQR 32–44), with minimal blood loss (&lt;100 mL in 96 %) and no intraoperative complications. Postoperative recovery was uneventful, with no pain reported and 96 % of patients discharged the same day. No late complications related to the surgical technique were observed.</div></div><div><h3>Conclusion</h3><div>Prophylactic bilateral salpingo-oophorectomy using the vNOTES technique appears to be a feasible and safe option for reducing the risk of ovarian and fallopian tube cancers in high-risk women. Further studies with larger cohorts are needed to validate these findings.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102349"},"PeriodicalIF":2.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936141","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}