Surgical Oncology-Oxford最新文献

{"title":"Surgical treatment of liver metastasis from pancreatic cancer","authors":"José Manuel Ramia ,&nbsp;Nuria Blanco-Asensio ,&nbsp;Juan Jesús Rubio ,&nbsp;Víctor López-López ,&nbsp;Ricardo Robles-Campos ,&nbsp;Gerardo Blanco-Fernández ,&nbsp;Angélica Borráez ,&nbsp;Aloia Guerreiro-Camaño ,&nbsp;José Manuel Asencio-Pascual ,&nbsp;Mario Serradilla-Martín ,&nbsp;Fernando Rotellar","doi":"10.1016/j.suronc.2025.102308","DOIUrl":"10.1016/j.suronc.2025.102308","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related mortality, projected to become the second by 2030. Liver metastases from PDAC (LMPC) are typically deemed inoperable, with dismal prognosis and limited surgical roles. However, emerging evidence suggests that liver resection may benefit selected patients. This study evaluates overall survival (OS), disease-free survival (DFS), and prognostic factors following hepatic resection for synchronous and metachronous LMPC.</div></div><div><h3>Methods</h3><div>A retrospective, multicenter cohort study from the REMENOCOR Project included 66 patients who underwent liver resection for LMPC in Spain between 2010 and 2022. Eligible patients were ≥18 years with histologically confirmed PDAC and liver metastases. Survival outcomes, postoperative morbidity (Clavien-Dindo, CCI), and prognostic indicators were analyzed using Kaplan-Meier and univariate and multivariate methods.</div></div><div><h3>Results</h3><div>R0 resection was achieved in 72.7 % of the patients, and major complications occurred in 19.6 %, with 1.5 % mortality. The 5-year OS and DFS were 26.6 % and 12.7 %, respectively. LMPC were metachronic in 65.2 % of patients. Synchronous resection correlated with significantly poorer OS (5 % vs. 38 %, <em>p</em> &lt; 0.05). Synchronous surgery and advanced pancreatic T-stage emerged as independent negative prognostic factors.</div></div><div><h3>Conclusion</h3><div>Liver resection for metachronous LMPC may offer meaningful survival in selected patients, underscoring the importance of individualized surgical strategies and the need for prospective trials.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102308"},"PeriodicalIF":2.4,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of tumor microenvironment characteristics in intrahepatic cholangiocarcinoma: A systematic review and meta-analysis","authors":"Zaiba Shafik Dawood ,&nbsp;Mujtaba Khalil ,&nbsp;Arsalan Javid ,&nbsp;Abdul Ali ,&nbsp;Usama Waqar ,&nbsp;Zayan Alidina ,&nbsp;Illiyun Banani ,&nbsp;Timothy M. Pawlik","doi":"10.1016/j.suronc.2025.102307","DOIUrl":"10.1016/j.suronc.2025.102307","url":null,"abstract":"<div><h3>Introduction</h3><div>Intrahepatic cholangiocarcinoma (ICC) is a rare and aggressive cancer. Histologic characterization of ICC and the tumor microenvironment (TME) may be associated with prognosis and response to treatment. The objective of the current study was to systematically review and conduct a meta-analysis to identify various elements of the TME that impact prognosis among patients with ICC.</div></div><div><h3>Methods</h3><div>A systematic search was performed using the PubMed, Embase and Scopus databases that employed a Boolean search strategy using Medical Subject Headings (MeSH) terms for: bile duct neoplasms, intrahepatic cholangiocarcinoma and tumor microenvironment. A random effect meta-analysis was conducted to assess the impact of TME elements on overall survival (OS) and disease free survival (DFS).</div></div><div><h3>Results</h3><div>Twenty-five studies (4162 patients, 56.1 % male) met inclusion criteria. On pooled meta-analysis, stromal factors associated with improved patient outcomes included mature stroma (HR = 0.38; 95 %CI, 0.26-0.56-OS). In contrast, alpha-smooth muscle actin fibroblasts in the TME were associated with worse OS (HR = 1.48; 95 %CI, 1.22–1.80); micro vessel density did not correlate with patient prognosis (HR = 0.73; 95 %CI, 0.31–1.70). High peritumoral and intra tumoral CD8⁺ T cells (HR = 0.57; 95 %CI, 0.45–0.71) and CD 4+ T-cells (HR = 0.48; 95 %CI, 0.37–0.62) were associated with improved OS. Epithelial-mesenchymal transition characterized by positive E-Cadherin expression was also associated with improved OS. In contrast, lack of cholangiocellular differentiation and large duct type ICC were associated with a worse OS among patients with ICC.</div></div><div><h3>Conclusion</h3><div>Elements of the TME had a variable impact on the prognosis of patients and may have differential implications for potential treatment of patients with ICC.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102307"},"PeriodicalIF":2.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310066","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":"Ten-year outcomes of 3D-conformal accelerated partial vs. whole breast irradiation after breast-conserving surgery: A randomized study from India","authors":"Budhi Singh Yadav ,&nbsp;Sofia Loganathan ,&nbsp;Divya Dahiya ,&nbsp;Arun Singh Oinam","doi":"10.1016/j.suronc.2025.102305","DOIUrl":"10.1016/j.suronc.2025.102305","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;To compare long term clinical outcomes after accelerated partial breast irradiation (APBI) versus whole breast irradiation (WBI) using 3-dimensional conformal external beam radiation therapy in women with breast cancer after breast conservation surgery (BCS).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;Women &gt;35 years of age with invasive or noninvasive breast cancer ≤4 cm treated by BCS were randomized to 3D-CRT APBI (34 Gy/10 fractions/5 days) or WBI (40 Gy/16 fractions/3 weeks ± boost irradiation). The primary outcome was ipsilateral breast tumor recurrence. Important secondary outcomes were late toxicities using Radiation Therapy Oncology Group scores, Late Effects Normal Tissue Task Force and Subjective, Objective, Management, Analytic scales, adverse cosmetic outcome and distant metastases. The secondary endpoints of radiation toxicities and cosmesis were published in an interim analysis. Here we present the primary outcome and the late toxicities data. Patient and tumor characteristics, local recurrence and rates of adverse cosmetic outcomes were compared using Fisher exact tests. Locoregional recurrence free survival (LRRFS), disease free survival (DFS) and overall survival (OS) was calculated using Kaplan-Meier curves. All statistical tests were 2 sided, with &lt;em&gt;p&lt;/em&gt; &lt; 0.05 considered statistically significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Between June 2011 and December 2015, 132 women with breast cancer were randomized to 3D-CRT APBI or WBI. Patient and tumor characteristics were balanced between the two arms. Median follow-up was 10.8 years (range, 3.2–13.6 years). Local recurrence was observed in 3 (4.6 %) and 2 (3 %) patients in APBI and WBI arms (p = 0.62), respectively. Distant metastases occurred in 5 (7.6 %) and 3 (4.4 %) patients in APBI and WBI arms (p = 0.35), respectively. The HR for locoregional recurrence was 1.62 (95 % CI, 0.27–9.67, p = 0.60) for APBI (65 patients, 3 local recurrences) vs. WBI (67 patients, 2 local recurrences). The 10-year LRRFS rates (95 % CIs) were 97 % (88–99 %) and 95 % (86–98 %), respectively.&lt;/div&gt;&lt;div&gt;The HR for disease-recurrence (local or distant) was 1.47 (95 % CI, 0.51–4.25, p = 0.47) for APBI (65 patients, 8 recurrences) vs. WBI (67 patients, 6 recurrences). The 10-year DFS rates (95 % CIs) were 92 % (83–97 %) and 88 % (77–94 %), respectively. The HR for death was 1.14 (95 % CI, 0.23–5.67, p = 0.87) for APBI (65 patients, 3 deaths) vs. WBI (67 patients, 3 deaths). The 10-year OS rates (95 % CIs) were 97 % (87–99 %) and 95 % (85–98 %), respectively. Adverse cosmesis was significantly higher in patients treated with WBI: 18 (30 %) compared with 3 (5 %) with APBI (&lt;em&gt;p&lt;/em&gt; &lt; 0.001). Late arm edema was observed in 1 (1.5 %) patients in APBI arm as compared to 4 (6 %) in WBI arm (p = 0.72).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In women with breast cancer after BCS, APBI was comparable to WBI in terms of LRRFS, DFS and OS. Cosmetic outco","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102305"},"PeriodicalIF":2.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314058","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":"Overall survival improvement with locoregional control in patients with metastatic breast cancer. Single-institution experience","authors":"María Tereza Nieto-Coronel ,&nbsp;Nancy Reynoso-Noveron ,&nbsp;Ariana Tabares-Yañez ,&nbsp;Claudia Haydee Arce- Salinas","doi":"10.1016/j.suronc.2025.102304","DOIUrl":"10.1016/j.suronc.2025.102304","url":null,"abstract":"<div><h3>Background</h3><div>The benefit of local control on the overall survival of patients with metastatic breast cancer remains controversial. This study aimed to evaluate the impact of locoregional treatment of the primary tumor (surgery and/or radiotherapy) in Mexican patients diagnosed with de novo metastatic breast cancer.</div></div><div><h3>Materials and methods</h3><div>This retrospective study evaluated 671 patients with de novo metastatic breast cancer, diagnosed between the years 2007–2015, using data from a local database of breast cancer patients. The decision for locoregional treatment was made by the attending physician.</div></div><div><h3>Results</h3><div>Among 671 patients, the median follow-up was 26.83 months. Patients who underwent locoregional control (surgery and/or radiotherapy) had a median survival of 41.57 months compared to 21.3 months in those without locoregional control (p &lt; 0.001). Median survival was 51.5 months in patients treated with surgery versus 25,53 months in those without surgery (p &lt; 0.001) and 40.1 months versus 25.23 months in patients receiving chemoradiotherapy (p &lt; 0.001). Multivariate analysis confirmed that surgery significantly improved overall survival (HR 0.50; 95 % CI:0.32–0.77; p = 0.002). However, after adjusting for potential confounders using propensity score matching, the survival benefit associated with surgery did not reach statistical significance.</div></div><div><h3>Conclusions</h3><div>Our retrospective analysis shows no survival benefit from locoregional control after adjustment for potential confounders. However, given the observed survival differences, it is important to identify which patient subgroups may derive benefit in prospective studies.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102304"},"PeriodicalIF":2.4,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318727","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":"Rectal cancer surgery timing after neoadjuvant therapy: balancing downstaging and perioperative outcomes","authors":"Giacomo Calini ,&nbsp;Alice Gori ,&nbsp;Claudio Isopi ,&nbsp;Antonino Spinelli ,&nbsp;Gianluca Pellino ,&nbsp;Matteo Fiore ,&nbsp;Alessandro Bianconi ,&nbsp;Stefano Cardelli ,&nbsp;Davide Ferrari ,&nbsp;Emanuele Rausa ,&nbsp;Gilberto Poggioli ,&nbsp;Matteo Rottoli ,&nbsp;the COVID-CRC Study Group.","doi":"10.1016/j.suronc.2025.102299","DOIUrl":"10.1016/j.suronc.2025.102299","url":null,"abstract":"<div><h3>Aim of the study</h3><div>Neoadjuvant therapy (NAT) and Total Mesorectal Excision (TME) improves oncological outcomes in locally advanced rectal cancer (LARC). We aimed to define the optimal timing for rectal resection and TME after NAT, balancing pathologic Complete Response (pCR) and downstaging with the fewest complications.</div></div><div><h3>Methods</h3><div>Stage I-III rectal cancer surgery preceded by NAT were retrieved from a retrospective collaborative of 81 centers in Italy 2018–2021. Logistic regression (LR) examined the independent association between postoperative outcomes (pCR, downstaging, intra- and postoperative complications, incomplete resection) and NAT protocols: chemoradiotherapy (nCRT) and short-course radiotherapy (S-CRT) stratified for timing (&lt;8w; 8-12w; &gt;12w) between NAT completion and surgery.</div></div><div><h3>Results</h3><div>Overall, 1428 patients were included: 1042 received nCRT, 187 SCRT, 125 long-course RT, and 74 others. Different timing of nCRT were not associated with any of the outcomes. Time interval &gt;12w for S-CRT was significantly and independently associated with pCR (OR 4.99, 95 %CI 1.4–18), but with similar downstaging, intra- and post-operative complications, and incomplete resection. LR predicting for pCR found a significant association with ASA≥3 (OR 0.67, 95 %CI 0.5–0.9) and with S-CRT &lt;8 weeks (OR 0.31, 95 %CI 0.13–0.74), while no variables were found to be associated with downstaging and intraoperative complications. Postoperative complications were associated with male, ASA≥3, and medium-low rectal cancer, while incomplete resection with ASA≥3, and BMI.</div></div><div><h3>Conclusion</h3><div>Unlike previous literature, the timing of nCRT was not associated with pCR, downstaging, intra- and postoperative complications, or incomplete resection. Timing &gt;12 weeks between SCRT completion and TME showed improved pCR with similar downstaging, intra- and post-operative complications, and incomplete resection.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102299"},"PeriodicalIF":2.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266821","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":"Single center experiences on 38 cases of transoral endoscopic thyroidectomy submental approach (TOETSA): What’s new?","authors":"Erwin Danil Yulian ,&nbsp;Diani Kartini ,&nbsp;I Gusti Ngurah Gunawan Wibisana ,&nbsp;Nataniel Jeremy G. Siahaan","doi":"10.1016/j.suronc.2025.102301","DOIUrl":"10.1016/j.suronc.2025.102301","url":null,"abstract":"<div><h3>Background</h3><div>Currently, endoscopic thyroidectomy techniques continue to evolve in response to the growing demand for better cosmetic outcomes. To date, transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) remains the only technique that leaves no visible external scar. However, this approach has certain limitations. The primary objective of this report is to present our initial experience with an alternative to TOETVA, namely the Transoral Endoscopic Thyroidectomy via Submental approach (TOETSA), in 38 patients at a single center.</div></div><div><h3>Method</h3><div>We performed the TOETSA procedure on 38 patients who met the inclusion criteria between January 2020 and Desember 2023. The procedure was successfully completed in 36 cases, while conversion to open thyroidectomy was required in 2 cases. Unlike conventional TOETSA, in which all instruments are introduced transorally, this approach utilizes two instruments inserted via the vestibular access and one instrument introduced through the submental crease.</div></div><div><h3>Results</h3><div>Among the 38 TOETSA procedures completed successfully, all specimens were extracted intact, with a mean maximum nodule size of 4.01 ± 0.80 cm (range: 2.50–6.40 cm). The mean operative time, which included procedures on large tumors and simultaneous training of novice surgeons, was 186.82 ± 19,46 (range: 147–226 Minutes). No life-threatening or permanent postoperative complications were observed. Cosmetic satisfaction after 6 months of follow-up was also favorable. However, a comprehensive assessment of oncologic safety could not yet be performed, as most patients were only monitored for 8.6 months in average.</div></div><div><h3>Conclusion</h3><div>TOETSA offers favorable therapeutic and cosmetic outcomes with low complication rates, even in larger specimens. Oncological safety should remain the main consideration in technique selection. TOETSA is also feasible as a training platform for novice surgeons.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102301"},"PeriodicalIF":2.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362490","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":"Complications of ovarian metastases from well-differentiated small bowel neuroendocrine neoplasms: a focus on bowel and ureteral obstruction","authors":"Sydney J. Wellens ,&nbsp;Nicholas J. Skill ,&nbsp;Kevin M. Sullivan ,&nbsp;Mary A. Maluccio ,&nbsp;Kristen E. Limbach","doi":"10.1016/j.suronc.2025.102300","DOIUrl":"10.1016/j.suronc.2025.102300","url":null,"abstract":"<div><h3>Introduction</h3><div>Ovarian metastasis from small bowel neuroendocrine neoplasms (SBNENs) was traditionally considered rare, but more recent series have suggested a higher prevalence. This case series seeks to examine the features and outcomes of patients with neuroendocrine ovarian metastases (NOM).</div></div><div><h3>Methods</h3><div>Female patients with histologically confirmed well-differentiated SBNENs were identified using a prospectively maintained database (2014–2024). The electronic medical record was reviewed for details of diagnosis, histopathology, biomarkers, and outcomes among patients with and without NOM.</div></div><div><h3>Results</h3><div>175 patients met inclusion criteria. 35 patients (20 %) had ovarian metastasis; for this group, 31.4 % had small bowel obstruction only, 5.7 % had ureteral obstruction only, and 14.3 % had both SBO and ureteral obstruction. 22 (62.9 %) also had peritoneal metastasis. 13 patients had ovarian metastasis but no peritoneal metastasis; within this group, 38.5 % had SBO, 15.4 % had ureteral obstruction, 76.9 % developed carcinoid syndrome, and 7.69 % died. There were no significant differences in rate of SBO (p = 0.280), ureteral obstruction (p = 0.716), or death (p = 0.091) between those with ovarian metastasis only and those with peritoneal metastasis only. Median overall survival was not reached.</div></div><div><h3>Conclusion</h3><div>This case series of female patients with SBNENs represents one of the largest available in the literature and demonstrates high rates of complications for those with ovarian metastasis, even in the absence of peritoneal metastasis. Prophylactic oophorectomy may be considered for SBNEN patients given the known development of severe complications throughout the progression of this disease where expectation for survival is lengthy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102300"},"PeriodicalIF":2.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304460","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 resected-to-original middle hepatic vein length proportion on posthepatectomy liver failure after right-sided hepatectomy for perihilar cholangiocarcinoma","authors":"Jimin Son ,&nbsp;Se Jin Choi ,&nbsp;Min Kyu Sung ,&nbsp;Woohyung Lee ,&nbsp;Ki Byung Song ,&nbsp;Dae Wook Hwang ,&nbsp;Song Cheol Kim ,&nbsp;Jae Hoon Lee","doi":"10.1016/j.suronc.2025.102302","DOIUrl":"10.1016/j.suronc.2025.102302","url":null,"abstract":"<div><h3>Background</h3><div>Middle hepatic vein (MHV) resection is often required during right-sided hepatectomy for perihilar cholangiocarcinoma (PHCC) to achieve negative margins. However, its resection may compromise hepatic regeneration, potentially increasing the risk of post-hepatectomy liver failure (PHLF).</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study included patients who underwent right-sided hepatectomy for PHCC from 2013 to 2020. Patients who had right trisectionectomy, pancreaticoduodenectomy, or contralateral vascular resection were excluded. The study assessed MHV resection and the proportion of resected-to-original MHV length using CT imaging. The primary outcome was the occurrence of either PHLF (≥ grade B) or 90-day mortality.</div></div><div><h3>Results</h3><div>Among 347 patients, the primary outcome occurred in 9.5 % (33/347). A higher remnant MHV proportion demonstrated a trend toward lower risk of the primary outcome (Odds ratio [OR] 0.989, 95 % confidence interval [CI] 0.978–1.001; p = 0.058). Although any resection of MHV did not remain an independent predictor in multivariable analysis (OR 2.039, 95 % CI 0.883–4.706; p = 0.095), it was significantly associated with the primary outcome in univariable analysis (OR 2.368, 95 % CI 1.115–4.929; p = 0.022).</div></div><div><h3>Conclusions</h3><div>Although not statistically conclusive, MHV resection may increase the risk of PHLF or 90-day mortality in right-sided hepatectomy for PHCC.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102302"},"PeriodicalIF":2.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266739","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":"Postoperative complications and their risk factors in breast cancer patients treated with neoadjuvant chemotherapy","authors":"Olga Kähkönen ,&nbsp;Harri Mustonen ,&nbsp;Meri Utriainen ,&nbsp;Laura Niinikoski ,&nbsp;Tuomo Meretoja ,&nbsp;Malin Sund","doi":"10.1016/j.suronc.2025.102303","DOIUrl":"10.1016/j.suronc.2025.102303","url":null,"abstract":"<div><h3>Introduction</h3><div>Although neoadjuvant chemotherapy (NACT) has become established treatment of breast cancer, its impact on postoperative complications varies across studies. Furthermore, association between known risk factors and different kind of complications is unclear. We aimed to characterize the type, rate and risk factors of postoperative complications in a cohort of breast cancer patients treated with NACT.</div></div><div><h3>Materials and methods</h3><div>A retrospective review of breast cancer patients treated with NACT in Helsinki University Hospital between 2020 and 2022 was performed. Complications were graded according to Clavien Dindo classification. Risk factors were identified for overall complications, chronic seroma (defined as a seroma requiring more than five needle aspirations) and hematoma or infection in a multivariable logistic regression model.</div></div><div><h3>Results</h3><div>Out of 4432 patients, 377 met the inclusion criteria. Of these, 216 (57 %) had 314 postoperative complications, commonly seroma (n = 204, 65 %), wound or seroma infection (n = 42, 13 %) and problems with wound healing (n = 19, 6 %). In multivariable analyses, higher age (OR = 1.03, p = 0.003) and undergoing mastectomy (OR = 6.45, p &lt; 0.001) and/or axillary lymph node dissection (ALND) (OR = 2.54, p &lt; 0.001) were independent risk factors of overall complications. Hypertension increased the odds of chronic seroma (OR = 2.26, p = 0.035) and overweight increased the odds of hematoma or infection (OR = 1.06, p = 0.012).</div></div><div><h3>Conclusion</h3><div>Postoperative complications were common yet in most cases treated in an outpatient setting. Patients with higher age and BMI, and those operated with mastectomy and/or ALND were in greater risk of developing postoperative complications. This study also identified that hypertension could have a role in the development of chronic seroma.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102303"},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266738","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":"Laparoscopic pancreatoduodenectomy with 3D vision compared to 2D vision is associated with less severe morbidity and improved results","authors":"Safi Dokmak ,&nbsp;Charles de Ponthaud ,&nbsp;Chihebeddine Romdhani ,&nbsp;Béatrice Aussilhou ,&nbsp;Thibaud Bertrand ,&nbsp;Mickael Lesurtel ,&nbsp;Alain Sauvanet ,&nbsp;Fadhel Samir Ftériche","doi":"10.1016/j.suronc.2025.102297","DOIUrl":"10.1016/j.suronc.2025.102297","url":null,"abstract":"<div><h3>Background</h3><div>Laparoscopic surgery with three-dimensional (3D) vision has recently been introduced, allowing enhanced visualization and improved suturing capabilities. However, its clinical impact has not been widely studied, particularly in laparoscopic pancreatoduodenectomy (LPD), where visualization and suturing are critical. In this study, we compared outcomes between 2D and 3D LPD.</div></div><div><h3>Methods</h3><div>In our center, the first 2D-LPD was performed in 2011, and 3D-LPD was introduced in 2019. To assess the impact of 3D vision while minimizing bias related to the learning curve, we compared two consecutive four-year periods before and after the implementation of 3D vision: a first period with 2D-LPD (2015–2018) and a second period with 3D-LPD (2019–2022). There were no major modifications in surgical technique between the two periods. Operative and postoperative outcomes were compared between 2D and 3D LPD, both before and after propensity score matching. A generalized linear mixed model (GLMM) was associated to account for the time-effect.</div></div><div><h3>Results</h3><div>During the study period, 162 LPDs were performed, including 79 with 2D-LPD and 83 with 3D-LPD. There was no significant difference in baseline clinical characteristics, except for ampullary tumors, which were more frequently operated on in the 2D-LPD group (16 % vs. 4.8 %; p = 0.016). Operative data and pancreatic characteristics were similar between groups. However, 3D-LPD was associated with a lower conversion rate (0 % vs. 6 %; p = 0.026) and a lower transfusion rate (0 % vs. 6 %; p = 0.027). After propensity score matching (2D-LPD: n = 39; 3D-LPD: n = 83), outcomes remained significantly better with 3D-LPD, with fewer grade C postoperative pancreatic fistulas (10 % vs. 2 %; p = 0.038) and lower readmission rates (10 % vs. 0 %; p = 0.009), while median hospital stay was similar between groups (14 vs. 15 days; p = 0.699).</div></div><div><h3>Conclusion</h3><div>This study shows that 3D-LPD, compared to 2D-LPD, is associated with a lower incidence of grade C postoperative pancreatic fistula and readmission. Given its availability and cost-effectiveness compared to robotic surgery, 3D-LPD should be promoted.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102297"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304400","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}