Surgical Oncology-Oxford最新文献

{"title":"Molecular profiling of hepatoid adenocarcinoma and adenocarcinoma with enteroblastic differentiation","authors":"Yosuke Matsumoto ,&nbsp;Keiichi Hatakeyama ,&nbsp;Masanori Terashima ,&nbsp;Takeshi Nagashima ,&nbsp;Kenichi Urakami ,&nbsp;Tadakazu Shimoda ,&nbsp;Takashi Sugino ,&nbsp;Etsuro Bando ,&nbsp;Hiroharu Yamashita ,&nbsp;Yukiyasu Okamura ,&nbsp;Ken Yamaguchi","doi":"10.1016/j.suronc.2025.102325","DOIUrl":"10.1016/j.suronc.2025.102325","url":null,"abstract":"<div><div>Hepatoid adenocarcinoma (HAD) and adenocarcinoma with enteroblastic differentiation (ACED) are rare gastric cancer types that produce alpha-fetoprotein (AFP) that morphologically resembles the liver or fetal organ. This study investigated the molecular profiling of HAD and ACED compared with common-type gastric adenocarcinoma (CGA). This study enrolled 496 patients with gastric adenocarcinoma who underwent radical gastrectomy. Whole-exome sequencing and gene expression profiling were conducted to compare HAD/ACED and CGA. Immunohistochemistry was performed in 39 patients with HAD/ACED, including 10 who underwent genomic analysis. <em>TP53</em> (100 %), <em>CSMD3</em> (30 %), <em>LRP1B, FAT3, TG, APOB, CREBBP, PASK, DROSHA</em>, and <em>STK40</em> (20 %) were mutated genes with high frequency (&gt;20 %) in HAD/ACED. Gene expression analysis revealed 15 overexpressed genes in HAD/ACED, many of which were associated with hepatocytes and fetal organs. Furthermore, cancer stemness gene overexpression, including <em>LIN28B</em>, <em>IGF2BP1</em>, and <em>HMGA2</em>, which are related to <em>TP53</em>, was observed. Immunohistochemistry revealed positive staining for LIN28B (82 %), IGF2BP1 (94 %), and HMGA2 (72 %), as well as staining for AFP (69 %), GPC3 (75 %), and SALL4 (94 %). Additionally, positive cancer stemness gene staining was observed in CGA mucosa coexisting with HAD/ACED. HAD/ACED demonstrated higher <em>TP53</em> mutation accumulation and TP53-related cancer stemness gene overexpression, including <em>LIN28B</em>, <em>IGF2BP1</em>, and <em>HMGA2</em>. Therefore, <em>TP53</em> and these cancer stemness genes might be involved in the occurrence of HAD/ACED.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102325"},"PeriodicalIF":2.4,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514667","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":"2025-11-08","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":"Early closure of defunctioning ileostomy after low-pelvic surgery for rectal cancer: Systematic review and meta-analysis of safety and functional outcomes","authors":"Parbatraj Regmi ,&nbsp;Bikash Kumar Sah ,&nbsp;Vijay Pratap Sah ,&nbsp;Bhawani Khanal ,&nbsp;Abhijeet Kumar ,&nbsp;Tomas Janusonis ,&nbsp;Zygimantas Juodeikis ,&nbsp;Darius Cincikas ,&nbsp;Alfredas Kilius ,&nbsp;Narimantas Evaldas Samalavicius ,&nbsp;Rakesh Kumar Gupta","doi":"10.1016/j.suronc.2025.102326","DOIUrl":"10.1016/j.suronc.2025.102326","url":null,"abstract":"<div><h3>Background</h3><div>Preventive defunctioning ileostomy is widely used to prevent leaks in high-risk colorectal anastomosis, but here is no international consensus on the timing of stoma reversal. In this study we aim to evaluate the safety and functional outcomes of early versus late defunctioning ileostomy after low-pelvic surgery for rectal cancer.</div></div><div><h3>Methods</h3><div>Systematic literature search was performed in multiple electronic databases until September 30, 2025. Meta-analysis and trial-sequantial analysis (TSA) were performed using the RevMan 5.4 and Copenhagen Trial Unit TSA software.</div></div><div><h3>Results</h3><div>There was no significant difference in overall postoperative morbidity, major morbidity, operation time, blood loss, incidence of postoperative ileus/bowel obstruction, length of stay (LOS), and reoperation rate between two groups. Functional outcomes like the incidence of major low anterior resection syndrome (LARS) and the minor LARS were also similar in two groups.</div></div><div><h3>Conclusion</h3><div>There is no increased risk of morbidity with early closure of defunctioning ileostomy after colorectal cancer surgery and the functional outcomes were also similar. Therefore, early reversal may be a safe and feasible approach in precisely selected cases when the clinician feels supported in doing so.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102326"},"PeriodicalIF":2.4,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623777","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":"2025-10-30","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":"Validation of a prognostic calculator to predict recurrence and mortality in melanoma patients undergoing sentinel lymph node biopsy","authors":"Julia Downey ,&nbsp;Christopher Baliski","doi":"10.1016/j.suronc.2025.102311","DOIUrl":"10.1016/j.suronc.2025.102311","url":null,"abstract":"<div><h3>Background</h3><div>The American Joint Committee on Cancer staging system (AJCC) is currently the gold standard for determining melanoma prognosis. However, it may not accurately reflect survival in certain substages, nor recurrence risk, prompting development of other predictive models. A validated predictive tool has been shown to perform well in two academic centers. We sought to investigate the performance of this nomogram in a regional cancer referral center, with the goal of future use for adjuvant treatment decisions.</div></div><div><h3>Methods</h3><div>A retrospective review of patients with T1b or greater melanomas, undergoing sentinel lymph node biopsy at a tertiary referral center between January 1, 2005, and June 30, 2022, was performed. Those with microsatellites or in-transit metastasis were excluded. Demographic, pathologic and treatment-related factors were linked to recurrence and survival data. The nomogram was assessed for the ability to discriminate recurrence and survival utilizing 6 prognostic factors (Breslow thickness, ulceration, age, tumour location, sentinel lymph node status and maximal lymph node metastasis diameter).</div></div><div><h3>Results</h3><div>486 patients were eligible for inclusion. The median age was 64 years (IQR: 54–73), with a Breslow thickness of 1.8 mm (IQR: 1.2–3.0). 95 patients (19.5 %) had pathologically positive sentinel lymph nodes, with 138 patients (28.4 %) developing recurrent disease. When applying this model to our population, the AUC for recurrence-free survival was 0.75 (95 % CI: 0.66–0.84), while melanoma-specific survival was 0.85 (95 % CI: 0.76–0.94).</div></div><div><h3>Conclusion</h3><div>The melanoma predictive tool performed well at predicting recurrence and survival in our population. The online calculator may assist clinicians advising patients on the merits of adjuvant treatments.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102311"},"PeriodicalIF":2.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432979","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":"2025-10-28","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":"Combined retroperitoneal resection with cytoreductive surgery and heated intraperitoneal chemotherapy for metastatic colorectal cancer with retroperitoneal and peritoneal metastases","authors":"Shachar Laks ,&nbsp;Shahar Feiglin ,&nbsp;Gal Schtrechman ,&nbsp;Liog Segev ,&nbsp;Haggai Benvenisti ,&nbsp;Dan Assaf ,&nbsp;Nedaa Mahmeed ,&nbsp;Mohammad Adileh ,&nbsp;Ronen Brenner ,&nbsp;Adam Goldstein ,&nbsp;Almog Ben Yaacov ,&nbsp;Aviram Nissan","doi":"10.1016/j.suronc.2025.102313","DOIUrl":"10.1016/j.suronc.2025.102313","url":null,"abstract":"<div><h3>Introduction</h3><div>Colorectal peritoneal metastases (CRPM) and retroperitoneal lymphatic metastases (RLM) are each considered poor prognostic indicators in colorectal cancer (CRC). Current data suggests that surgery for each including cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC) for CRPM and retroperitoneal resection (RR) for RLM may improve survival. Given the poor prognosis of each finding individually, each condition is generally considered a contraindication to the other. We describe the first series of combined RR and CRS/HIPEC.</div></div><div><h3>Materials and methods</h3><div>Retrospective analysis of a prospectively maintained tertiary institution database comparing perioperative and oncological outcomes of combined RR + CRS/HIPEC to CRS/HIPEC only in CRC.</div></div><div><h3>Results</h3><div>Included 238 CRS/HIPEC and divided to 17 with RR + CRS/HIPEC and 221 with CRS/HIPEC only. Demographic/perioperative characteristics were similar including tumor characteristics and peritoneal cancer index. Longer operative times observed in RR + CRS/HIPEC cohort (5 versus 4 h, <em>p</em> = 0.024). Complications were similar except more postoperative bleeding events and deep vein thrombosis in the RR + CRS/HIPEC cohort (24 % versus 5.0 %, <em>p</em> = 0.024 and 12 % versus 2.3 %, <em>p</em> = 0.026, respectively). This did not translate to longer length of stay, reoperations, or major complications. Median disease free survival was shorter in the RR + CRS/HIPEC cohort (7.3 versus 11.3 months, <em>p</em> = 0.032), but similar overall survival observed (29.5 versus 43.9 months, <em>p</em> = 0.34). Less retroperitoneal recurrences occurred after regional lymphadenectomy (12 %) compared to mass only resection (44 %).</div></div><div><h3>Conclusion</h3><div>Our study demonstrates the safety and oncological efficacy of RR + CRS/HIPEC. We believe that RR + CRS/HIPEC in highly selected patients is a suitable option and hope this leads to larger multi-institutional studies to corroborate these findings.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102313"},"PeriodicalIF":2.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398098","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":"Predicting long term survival in myxofibrosarcoma: Development and evaluation of Machine learning models for 2- and 5-year outcomes","authors":"Sanjeev Rampam ,&nbsp;Andrew G. Girgis ,&nbsp;Bishoy M. Galoaa ,&nbsp;Joseph O. Werenski ,&nbsp;Marcos R. Gonzalez ,&nbsp;Santiago A. Lozano-Calderón","doi":"10.1016/j.suronc.2025.102314","DOIUrl":"10.1016/j.suronc.2025.102314","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Myxofibrosarcoma is a rare soft tissue sarcoma with complex growth patterns and variable survival outcomes, making prognosis challenging. Machine learning (ML) offers a promising approach to enhance survival predictions. This study explored key predictive features and assessed ML model performance and generalizability.</div></div><div><h3>Methods</h3><div>We included 3400 patients from the National Cancer Database for model training, and 112 patients from our institutional registry for external validation. We employed a Random Forest algorithm to identify predictive features. These features were used to train four models: Random Forest, single Neural Network, Neural Network Ensemble, and Weighted Ensemble combining all approaches. Model performance was assessed using area under the curve (AUC), F1-scores, and Brier scores.</div></div><div><h3>Results</h3><div>Tumor size, age, and metastatic status were identified as key predictors of survival across models. In internal validation, multiple models showed promise, but the Neural Network Ensemble demonstrated balanced performance for both 2- and 5-year overall survival. In external validation, the Neural Network Ensemble outperformed the Random Forest model, and achieved AUC of 0.965 and 0.934 for 2- and 5-year overall survival, respectively.</div></div><div><h3>Conclusions</h3><div>We successfully developed and validated ML algorithms that accurately predicted survival outcomes in patients with myxofibrosarcoma, with insights for model selection.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102314"},"PeriodicalIF":2.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425574","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":"Fully robotic Ivor Lewis Esophagectomy with side - to - side linear stapled anastomosis: our standardized 15 - step technique and perioperative outcomes","authors":"Giuseppe Giuliani,&nbsp;Francesco Guerra,&nbsp;Angela Tribuzi,&nbsp;Lorenzo De Franco,&nbsp;Erica Monati,&nbsp;Francesco Matarazzo,&nbsp;Michele Di Marino,&nbsp;Andrea Coratti","doi":"10.1016/j.suronc.2025.102312","DOIUrl":"10.1016/j.suronc.2025.102312","url":null,"abstract":"<div><h3>Backgraund</h3><div>In recent years, robotic surgery for the treatment of esophageal cancer has expanded rapidly. In this study, we report on our standardized steps for RILE, including our perioperative outcomes.</div></div><div><h3>Methods</h3><div>The study includes every single step that we systematically perform during the abdominal and thoracic phases of the RILE. All consecutive patients undergoing RILE by a single surgical team were included in this analysis.</div></div><div><h3>Results</h3><div>A total of 68 patients were included in the analysis. There was one intraoperative complication and no conversion occurred. The rate of major postoperative complications (Clavien and Dindo &gt; II) was 14 %: with anastomotic-related morbidity in particular, 4 (6 %) patients developed anastomotic leakage. The median number of harvested lymph nodes was 41 (range 13–113), while the rate of R0 resection was 97 %.</div></div><div><h3>Conclusions</h3><div>In our opinion our standardisation of RILE could help new surgical teams to start using a robotic approach for two field esophagectomy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102312"},"PeriodicalIF":2.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446484","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":"Sarcomatoid dedifferentiation as a predictor of overall mortality in surgically treated metastatic renal cell carcinoma","authors":"Reha-Baris Incesu ,&nbsp;Lukas Scheipner ,&nbsp;Simone Morra ,&nbsp;Andrea Baudo ,&nbsp;Carolin Siech ,&nbsp;Letizia Maria Ippolita Jannello ,&nbsp;Mario de Angelis ,&nbsp;Anis Assad ,&nbsp;Zhe Tian ,&nbsp;Fred Saad ,&nbsp;Shahrokh F. Shariat ,&nbsp;Alberto Briganti ,&nbsp;Ottavio de Cobelli ,&nbsp;Felix K.H. Chun ,&nbsp;Luca Carmignani ,&nbsp;Nicola Longo ,&nbsp;Sascha Ahyai ,&nbsp;Derya Tilki ,&nbsp;Markus Graefen ,&nbsp;Pierre I. Karakiewicz","doi":"10.1016/j.suronc.2025.102306","DOIUrl":"10.1016/j.suronc.2025.102306","url":null,"abstract":"<div><h3>Background</h3><div>In metastatic clear-cell renal cell carcinoma (ccmRCC), sarcomatoid dedifferentiation is routinely reported in G4 patients, but routine reporting is not recommended in G3 patients. We tested independent predictor status of sarcomatoid dedifferentiation in G4 ccmRCC. Additionally, we explored whether sarcomatoid dedifferentiation may have a role in overall mortality (OM) prediction in G3 ccmRCC.</div></div><div><h3>Methods</h3><div>Within the Surveillance, Epidemiology, and End Results database, univariable and multivariable Cox-regression models assessed cytoreductive nephrectomy (CN)-treated ccmRCC patients (2010–2020).</div></div><div><h3>Results</h3><div>Of 2644 CN-treated ccmRCC patients, 1336 (51 %) harbored G4, of whom 528 (40 %) harbored sarcomatoid dedifferentiation. In G4, median overall survival (OS) according to presence vs. absence of sarcomatoid dedifferentiation was 20 vs. 21 months (p = 0.6) and sarcomatoid dedifferentiation was not independent predictor in multivariable analyses. Of all, 1308 (49 %) harbored G3, of whom 79 (6 %) harbored sarcomatoid dedifferentiation. In G3, median OS according to presence vs. absence of sarcomatoid dedifferentiation was 22 vs. 38 months (p &lt; 0.001) and sarcomatoid dedifferentiation independently predicted higher OM in multivariable analyses (hazard ratio 1.7, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Reporting of sarcomatoid dedifferentiation in G4 RCC is routinely recommended. However, in G4 ccmRCC, presence of sarcomatoid dedifferentiation does not independently predict higher OM and its inclusion is not essential in multivariable considerations in G4 patients. Conversely, despite absence of standard reporting recommendation for sarcomatoid dedifferentiation in G3, presence of sarcomatoid dedifferentiation is associated with significantly higher mortality and achieved independent predictor status. Therefore, it possibly should be routinely reported and routinely included in multivariable analyses addressing G3 ccmRCC patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"64 ","pages":"Article 102306"},"PeriodicalIF":2.4,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446509","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}