Surgical Oncology-Oxford最新文献

{"title":"The efficacy of thoracic duct ligation for post-esophagectomy chylothorax in esophageal cancer: a nationwide inpatient cohort study","authors":"Takashi Shigeno ,&nbsp;Keisuke Okuno ,&nbsp;Taichi Ogo ,&nbsp;Toshiro Tanioka ,&nbsp;Kenro Kawada ,&nbsp;Hisashi Fujiwara ,&nbsp;Hiroyasu Kagawa ,&nbsp;Masanori Tokunaga ,&nbsp;Kiyohide Fushimi ,&nbsp;Yusuke Kinugasa","doi":"10.1016/j.suronc.2025.102279","DOIUrl":"10.1016/j.suronc.2025.102279","url":null,"abstract":"<div><h3>Background</h3><div>Recently, thoracic duct embolization (TDE) has been increasingly adopted as a first-line minimally invasive therapy for post-esophagectomy chylothorax instead of thoracoscopic thoracic duct ligation (TTDL). However, the therapeutic efficacy and advantages of TDE over TTDL are still controversial. This study aimed to evaluate and compare the clinical and financial outcomes of TDE and TTDL for post-operative chylothorax after esophagectomy using a national database.</div></div><div><h3>Methods</h3><div>We retrieved data from patients with esophageal cancer who underwent TDE (<em>n</em> = 312) or TTDL (<em>n</em> = 167) for chylothorax after esophagectomy between April 2012 and March 2022 from the Diagnosis Procedure Combination database in Japan. We compared the success rate of the first intervention, length of post-interventional hospital stay, and total hospitalization cost between the TDE and TTDL groups using propensity score matching analysis.</div></div><div><h3>Results</h3><div>The success rate of the first intervention was significantly higher in the TTDL group than in the TDE group (odds ratio, 6.13; 95 % confidence interval [CI], 3.25 to 11.55). The length of post-interventional hospital stay was significantly shorter (regression coefficient, −14.8 days; 95 % CI, −26.7 to −2.9) and the total hospitalization cost was significantly lower in the TTDL group than in the TDE group (regression coefficient, −1,258,212 yen; 95 % CI, −2,082,407 to −434,017).</div></div><div><h3>Conclusions</h3><div>This nationwide cohort study showed that TTDL was associated with a shorter length of post-interventional hospital stay, lower total hospitalization cost, and higher success rate of the first intervention than TDE for post-esophagectomy chylothorax.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102279"},"PeriodicalIF":2.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004385","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":"Oncological and functional outcomes of salvage surgery for local oropharyngeal cancer recurrence after primary Radiation±Chemotherapy","authors":"Francisco Laxague ,&nbsp;Naif Fnais ,&nbsp;Dorsa Zabihi ,&nbsp;Kevin Fung ,&nbsp;Danielle MacNeil ,&nbsp;Adrian Mendez ,&nbsp;John Yoo ,&nbsp;Pencilla Lang ,&nbsp;Joe S. Mymryk ,&nbsp;John W. Barrett ,&nbsp;David A. Palma ,&nbsp;Anthony C. Nichols","doi":"10.1016/j.suronc.2025.102276","DOIUrl":"10.1016/j.suronc.2025.102276","url":null,"abstract":"<div><h3>Background</h3><div>We aimed to analyze the role of salvage surgery for local/locoregional OPSCC recurrences after primary radiotherapy ± chemotherapy (CRT).</div></div><div><h3>Methods</h3><div>From 1156 patients, we identified 38 patients undergoing salvage surgery for local/locoregional recurrences. We analyzed surgical and survival outcomes based on surgical approach and clinical variables.</div></div><div><h3>Results</h3><div>Thirty-eight patients underwent SS for a local/locoregional OPSCC recurrence. Patients undergoing SS experienced superior overall survival <strong>(</strong>3-year 62.1 % vs. 13 %; and OS: 5-year 34 % vs. 0 %; <em>p</em> &lt; 0.01) and progression-free survival: 3-year 61.1 % vs. 0 %; and PFS: 5-year 28.6 % vs. 0 %; <em>p</em> &lt; 0.01) compared with those undergoing non-surgical treatment. One year after the surgery, 12/27 surviving patients (44.4 %) were tracheostomy dependent, and 12/27 feeding tube dependent.</div></div><div><h3>Conclusion</h3><div>Salvage surgery for locoregional OPSCC recurrences after primary CRT is safe and feasible in selected patients. However, patients should be counselled about the possibility of long-term feeding tube and/or tracheostomy dependency post operatively.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102276"},"PeriodicalIF":2.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049599","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":"Comparison of robotic and natural orifice transluminal endoscopic surgical technique procedures in patients undergoing sentinel lymph node biopsy during endometrial cancer surgery","authors":"Erkan Şimşek ,&nbsp;Sema Karakaş ,&nbsp;Onur Karaaslan ,&nbsp;Özge Akdeniz Yildiz ,&nbsp;Sadık Gündüz ,&nbsp;Gökhan Demirayak ,&nbsp;Cihan Comba ,&nbsp;İsa Aykut Özdemir ,&nbsp;Levent Yaşar","doi":"10.1016/j.suronc.2025.102282","DOIUrl":"10.1016/j.suronc.2025.102282","url":null,"abstract":"<div><h3>Objective</h3><div>The role of sentinel lymph node dissection in the surgical management of endometrial cancer limited to the uterus is gaining recognition. The safety and applicability of two methods were assessed by examining the results of our patients in the identification of the sentinel lymph node during endometrial cancer surgery. The methods were robotic surgery, a critical component of minimally invasive surgery, and the vNOTES (Natural Orifice Transluminal Endoscopic Surgery Technique), which has recently been introduced for malignant indications.</div></div><div><h3>Methods</h3><div>Patients who had endometrial cancer surgery at our center employing robotic and vNOTES technologies between January 2023 and June 2024 were included in this retrospective study. We conducted the dissection of sentinel lymph nodes utilizing a near-infrared technology camera method with indocyanine green (ICG) in both robotic and vNOTES techniques. The patients' records were retrospectively obtained from patient files and hospital records. Among the 76 patients who underwent surgery for endometrial cancer, 24 were treated with vNOTES surgery, whereas 52 received robotic surgery.</div></div><div><h3>Results</h3><div>No statistically significant differences were seen between the two groups for age (p = 0.447), body mass index (p = 0.506), prior abdominal operations (p = 0.209), predicted blood loss (p = 0.155), and surgical duration (p = 0.298). The detection rates of sentinel lymph nodes (SLN) were similar across the groups: 97 % (n = 50) in the robotic group and 96 % (n = 23) in the vNOTES group (p = 0.493). The only statistically significant difference was observed in postoperative pain scores at the 12th hour, which were lower in the vNOTES group (p = 0.023).</div></div><div><h3>Conclusion</h3><div>The vNOTES technique demonstrates comparable sentinel lymph node detection rates to robotic surgery in the management of uterine endometrial cancer. Moreover, it has the advantage of markedly less postoperative discomfort. vNOTES is a secure and efficacious minimally invasive option, especially for patients with comorbidities or those deemed unsuitable for robotic surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102282"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989978","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":"Beyond traditional risk factors: The identification of preoperative serum ferritin as a novel predictor of anastomotic leakage after colonic surgery","authors":"Mohamed Hassin Mohamed Chairi ,&nbsp;Patricia Josefina Madroñal Escribano ,&nbsp;Alicia Ron García ,&nbsp;María José Alonso Sebastián ,&nbsp;Patricia Vílchez Fernández ,&nbsp;Mónica Mogollón González ,&nbsp;Per Anderson ,&nbsp;María Elena Rodríguez-Cabezas ,&nbsp;María del Carmen Olvera Porcel ,&nbsp;José Tomás Torres Alcalá ,&nbsp;Francisco José Huertas Peña","doi":"10.1016/j.suronc.2025.102283","DOIUrl":"10.1016/j.suronc.2025.102283","url":null,"abstract":"<div><h3>Aim</h3><div>To identify predictive risk factors associated with anastomotic leakage (AL) following colon resection surgery.</div></div><div><h3>Method</h3><div>Observational and retrospective cohort study of patients undergoing colon resection with colonic/colorectal anastomosis from January 2018 to December 2023. Demographic, patient, surgery, and outcome data were analysed. Risk factors were identified with both univariate and multivariate analysis.</div></div><div><h3>Results</h3><div>A total of 639 patients who underwent colon resection with anastomosis were included in this study. Among them, 62 patients (9.7 %) developed AL. Univariate analysis identified age, male sex, preoperative serum ferritin levels &gt;51.75 ng/mL, minimally invasive surgical approach, extended resection and preoperative C-reactive protein levels &gt;10 mg/L as factors associated with AL. Multivariate analysis revealed that preoperative serum ferritin (OR 5.55, p = 0.001) and preoperative C-reactive protein levels (OR 54.97, p &lt; 0.001) were independent and significant predictors of AL.</div></div><div><h3>Conclusion</h3><div>Our study has identified preoperative C-reactive protein as a predictor of AL, consistent with findings reported in the literature, and highlights preoperative serum ferritin as a novel predictor of AL following colonic anastomosis.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102283"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004386","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":"Minor resection for primary hepatocellular carcinoma promotes curative recurrent treatments","authors":"Mei-Pei Huang ,&nbsp;Rey-Heng Hu ,&nbsp;Hou-Ying Cheng ,&nbsp;Chih-Yang Hsiao ,&nbsp;Ming-Chih Ho ,&nbsp;Yao-Ming Wu ,&nbsp;Po-Huang Lee ,&nbsp;Cheng-Maw Ho","doi":"10.1016/j.suronc.2025.102281","DOIUrl":"10.1016/j.suronc.2025.102281","url":null,"abstract":"<div><h3>Background</h3><div>The extent of primary hepatectomy for hepatocellular carcinoma (HCC) may influence long-term outcomes, especially at recurrence. We investigated whether initial minor or major hepatectomy impacts retreatment options and survival following recurrence.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients with primary HCC who underwent either initial major or minor hepatectomy. Outcomes analyzed included overall survival (OS), and post-recurrence overall survival (OS-R). Prognostic factors were analyzed using propensity score matching (PSM).</div></div><div><h3>Results</h3><div>Among 1836 patients experienced recurrence, 873 matched cases were analyzed post-PSM. The crude 5-, 10-, and 15-year OS rates were 86.5 %, 73.9 %, and 61.5 %, respectively, in the minor hepatectomy group, and 76.8 %, 67.6 %, and 62.7 %, respectively, in the major hepatectomy group (p &lt; 0.001). OS-R was comparable between the two groups among the matched cases. The prognostic factors for OS-R included the initial cancer stage, recurrent albumin–bilirubin score, recurrence with vascular invasion or extrahepatic metastases, and the selected recurrent treatment. More patients after primary minor hepatectomy underwent re-resection or local ablation as recurrent treatment, and were able to achieve better outcomes.</div></div><div><h3>Conclusions</h3><div>While recurrence rates and post-recurrence survival were similar between groups, minor hepatectomy may preserve greater liver volume, enabling more patients to receive further curative treatments upon recurrence. Minor hepatectomy offers better retreatment options and potentially better long-term survival.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102281"},"PeriodicalIF":2.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144997700","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 relevance of CT-defined body composition in esophageal cancer patients undergoing curative treatment","authors":"Hannah Götze ,&nbsp;Stefan Niebisch ,&nbsp;Matthias Mehdorn ,&nbsp;Daniel Seehofer ,&nbsp;Gertraud Stocker ,&nbsp;Timm Denecke ,&nbsp;Hans-Jonas Meyer","doi":"10.1016/j.suronc.2025.102278","DOIUrl":"10.1016/j.suronc.2025.102278","url":null,"abstract":"<div><h3>Introduction</h3><div>Body composition including low skeletal muscle mass (LSMM) defined by skeletal muscle index (SMI) and subcutaneous and visceral adipose tissue (SAT and VAT) can be assessed using cross-sectional imaging techniques. Previous studies have shown promising prognostic value for several tumour entities, including esophageal cancer (EC). The aim of this study was to analyse possible associations of body composition parameters in patients with esophageal cancer undergoing curative treatment.</div></div><div><h3>Methods</h3><div>All patients with EC undergoing curative treatment were retrospectively evaluated between 2016 and 2023. A total of 145 patients (17 female, 11.7 %) with a mean age of 65.9 ± 10.2 years were included in the present analysis. For all patients, staging computed tomography (CT) was used to calculate LSMM, VAT, and SAT. The primary study end point was all-cause overall survival. For statistical analysis group differences were calculated using the Mann-Whitney test. Kaplan-Meier curves and multivariable Cox regression analysis was used to test the effect of body composition parameters on mortality.</div></div><div><h3>Results</h3><div>In total, 51 patients (35.2 %) of the patient cohort died within the observation period. According to the sarcopenia threshold of the SMI, 99 patients (68.2 %) were classified as sarcopenic and according to the VAT threshold, 102 patients (70.3 %) were classified as visceral obese. Sarcopenia and visceral obesity were associated with mortality with a hazard ratio (HR) of 2.05 (95%confidence interval (CI) 1.17, 3.57, p = 0.01) and 2.47 (95%CI 1.39, 4.37, p = 0.002) in univariable analysis, respectively. Only the combination of both, sarcopenic obesity was significantly associated in multivariable analysis (HR 2.47, 95 %CI 1.39; 4.37, p = 0.002)</div></div><div><h3>Conclusions</h3><div>The combination of CT-defined sarcopenia and visceral obesity showed a strong prognostic relevance in EC undergoing curative resection. The effect of sarcopenia and visceral obesity considered separately was of lesser prognostic significance. CT-defined body composition may help to better stratify patients with EC at risk of worse outcome in clinical practice.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102278"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989992","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":"A novel technology for margin extension and local control in breast conservation surgery: Saline-coupled intraoperative radiofrequency ablation (SIRA)","authors":"Alyssa Bailey ,&nbsp;Tyler R. Wanke ,&nbsp;Rhea Verma ,&nbsp;Thomas Kurth ,&nbsp;Conor Shanley ,&nbsp;Erin Mohr ,&nbsp;Scott Irving ,&nbsp;V. Suzanne Klimberg ,&nbsp;Luis Blanco ,&nbsp;Swati Kulkarni ,&nbsp;Kevin Bethke","doi":"10.1016/j.suronc.2025.102280","DOIUrl":"10.1016/j.suronc.2025.102280","url":null,"abstract":"<div><h3>Importance</h3><div>Breast-conserving therapy (BCT) results in reoperation in ∼20 % of cases due to positive margins, and a 7–13 % recurrence risk at 5 years persists despite negative margins and radiation. Enhancing margin treatment is critical to reducing local recurrence and improving survival.</div></div><div><h3>Objective</h3><div>To optimize and evaluate the performance of a Saline-coupled Intraoperative Radiofrequency Ablation (SIRA) device in producing uniform 1 cm ablations in lumpectomy cavities and compare it to prior-generation RFA technology in previous clinical studies.</div></div><div><h3>Design, setting, and participants</h3><div>This case series (2018–2023) included 55 mock lumpectomies performed on prophylactic mastectomy or cadaver breasts under an IRB-approved protocol. Inclusion required disease-free, sufficient-volume breast tissue with patient consent.</div></div><div><h3>Results</h3><div>55 ablations were performed on breasts from 44 female patients. The SIRA produced an ablation depth of 1.0 ± 0.2 cm (mean, SD), no significant difference between margins (p = 0.056). No significant difference in ablation depth across the following: BI-RADS breast composition (p = 0.212), age (p = 0.188), height (p = 0.643), weight (p = 0.522), tissue volume removed (p = 1.000), breast surgery history (p = 0.246), chest chemotherapy/radiation history (p = 0.477), or surgeon (p = 0.579). Significant difference in depth and variance between the SIRA and previous-generation technology (p &lt; 0.001 and p = 0.016), with SIRA significantly deeper and more uniform.</div></div><div><h3>Conclusion</h3><div>Lumpectomy followed by SIRA could reduce positive margin rates and treat additional tissue, resulting in reduction in re-excision rates and serve as a potential alternative to radiation therapy.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"63 ","pages":"Article 102280"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989444","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":"Prevention in non-oncologic intent sarcoma surgery","authors":"Clare E. Wise ,&nbsp;Chris Le ,&nbsp;Nicole S. Pham ,&nbsp;Christin New ,&nbsp;Deborah Ellen Kenney ,&nbsp;Raffi Avedian ,&nbsp;David Mohler ,&nbsp;Robert Steffner","doi":"10.1016/j.suronc.2025.102273","DOIUrl":"10.1016/j.suronc.2025.102273","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Non-oncologic resection of soft tissue sarcomas (STS) continue to be a common referral to multidisciplinary sarcoma centers. While previous literature has reported tumor characteristics and outcomes related to non-oncologic resections, little is known regarding the surgical specialties most likely to excise such a mass and the non-oncological manner in which they do so. Such information can facilitate preventative strategies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The goals of this study are: 1) Investigate the surgical specialties that most often perform unplanned excisions and their diagnostic imaging approach, 2) Identify the frequency of non-oncological techniques utilized in initial unplanned excisions, and 3) Define indications for the use of radiation (XRT) in patients with initial non-oncologic resections of STS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Patient data were collected from a large tertiary referral sarcoma center between 2005 and 2022. Eligible patients had a diagnosis of soft tissue sarcoma that was excised at an outside institution in a non-oncologic manner and subsequently underwent tumor bed re-excision using wide resection. Data regarding the index procedures at outside hospitals were obtained from referral documents and tumor bed re-excisions, along with follow-up care. A total of 124 patients were identified.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Forty-three percent of referrals for non-oncologic resection of soft tissue sarcomas (STS) involved tumors located deep to the fascia. The majority of these referrals originated from General Surgery (N = 54, 44 %), Orthopedic Surgery (N = 35, 28 %), and Plastic Surgery (N = 11, 9 %). Preoperative imaging was conducted in 59 % of cases. General surgeons were less likely to obtain preoperative imaging (p = 0.009) and perform MRI scans (p = 0.013) than orthopaedic surgeons. The proper orientation of the incision based on location was incorrect for general surgeons in 26 % (N = 20) of cases. General surgeons were less likely to make an appropriate incision (p = 0.052) and to use a tourniquet during the initial procedure (p &lt; 0.001). There were no differences among surgical subspecialties in the use of local anesthetic, drain use, or excision type regarding the initial non-oncologic resection. Residual disease following tumor bed re-excision was linked to masses removed in the clinic (p = 0.030) and initial stage IIIB tumors (p = 0.019). Our institutional use of radiation therapy (XRT) correlated with large initial size, high-grade histology, location deep to fascia, and tumors that were re-excised with staged coverage by plastic surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Most referrals for initial non-oncologic resection of STS come from general surgery followed by orthopaedic surgery. Indications for pre-operative MRI imaging, incision orientation, and tourniquet use are education targets for general surgeons in training. Interpretation of MRI scans","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102273"},"PeriodicalIF":2.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780099","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 the completeness of cytoreductive surgery on the prognostic role of the KELIM score in patients treated for ovarian peritoneal metastasis","authors":"Charif Khaled ,&nbsp;Lise Sogalow ,&nbsp;Laura Polastro ,&nbsp;Maxime Fastrez ,&nbsp;Michel Moreau ,&nbsp;C. Florin Pop ,&nbsp;Isabelle Veys ,&nbsp;Vincent Donckier ,&nbsp;Gabriel Liberale","doi":"10.1016/j.suronc.2025.102272","DOIUrl":"10.1016/j.suronc.2025.102272","url":null,"abstract":"<div><h3>Introduction</h3><div>The two major treatment related prognostic factors for peritoneal metastasis of ovarian cancer (PMOC) are chemosensitivity and completeness of cytoreduction (CC). Chemosensitivity can be assessed by the CA-125 elimination rate constant K (KELIM) score, based on CA-125 kinetics. CC is evaluated by residual macroscopic disease. The aim of this study was to evaluate the prognostic impact of KELIM score versus CC, in a population who underwent complete (CC-0) and near-complete (CC-1) debulking.</div></div><div><h3>Materials and methods</h3><div>Monocentric retrospective study including patients with primary PMOC treated with curative intent between January 2010 and December 2021. The Biomarker Kinetics website (CA-125 KELIM Calculator) was used to calculate the KELIM score. Univariate and multivariate analysis were performed to assess the impact of CC and KELIM score on PFS and OS.</div></div><div><h3>Results</h3><div>A total of 111 patients were included in the study. Kaplan-Meier analysis showed that PFS and OS were significantly influenced by KELIM, CC, PCI, and BRCA mutation (p &lt; 0.05). Multivariate Cox analysis showed that PFS was significantly influenced by CC (HR = 0.481, p = 0.0027), while OS was influenced by KELIM (HR 0.561, p = 0.0408).</div></div><div><h3>Conclusion</h3><div>These results suggest that PFS is more impacted by the completeness of the surgery than the KELIM score and the KELIM score influences OS more than the completeness of surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102272"},"PeriodicalIF":2.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695057","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":"Surgery versus immunotherapy in locally advanced cutaneous carcinoma of the external ear: A multicenter study","authors":"Francesco Mattioli ,&nbsp;Matteo Miglio ,&nbsp;Margherita Basso ,&nbsp;Giacomo Papi ,&nbsp;Roberto Tonelli ,&nbsp;Giulio Martinelli ,&nbsp;Massimo Dominici ,&nbsp;Daniele Marchioni ,&nbsp;Roberta Depenni","doi":"10.1016/j.suronc.2025.102271","DOIUrl":"10.1016/j.suronc.2025.102271","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Immunotherapy is a promising therapeutic strategy for cutaneous carcinoma in locally advanced and advanced stages. This study aims to compare the survival outcomes between patients treated with surgery and those treated with cemiplimab. Secondly, we evaluated how adjuvant treatment, tumor stage, and margins status may influence the oncological outcomes in the surgical group.</div></div><div><h3>Methods</h3><div>The study included 77 patients with locally advanced cutaneous carcinoma of the external ear treated between 2015 and 2023 with surgery, either followed or not by adjuvant therapy, or treated with cemiplimab.</div></div><div><h3>Results</h3><div>Immunotherapy demonstrated a benefit in the disease-specific survival both at 24 months (HR = 0.09, p = 0.02) and at 60 months (HR = 0.11, p = 0.04) when compared to patients treated by surgery, with an estimated 5-year survival of 80 % and 55.9 %, respectively (log-rank = 0.03). Conversely, surgery showed a more favorable trend for disease-free survival than cemiplimab (HR 0.58, p = 0.08), with a median survival of 25.6 and 14.2 months. Stage IV, compared to stage III, tended to have a worse survival rate when stratified by treatment strategy. The addition of adjuvant therapy improved median disease-specific survival from 12 to 40 months for stage IV. On the other hand, adjuvant radiotherapy did not significantly affect outcomes when stratified by margin status, especially when resection margins were clear (p = 0.36).</div></div><div><h3>Conclusions</h3><div>Cutaneous carcinoma of the external ear represents a rare entity, affecting elderly patients and still associated with high complication rates. Emerging therapeutic strategies, which may serve as alternatives to surgery, offer a basis for future adjustments of treatment algorithms for these neoplasms.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"62 ","pages":"Article 102271"},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695045","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}