Surgical Oncology-Oxford最新文献

{"title":"Impact of low dose superparamagnetic iron oxide tracer for sentinel node biopsy in breast conserving treatment on susceptibility artefacts on magnetic resonance imaging and contrast enhanced mammography","authors":"Elisabeth R.M. van Haaren ,&nbsp;Merel A. Spiekerman van Weezelenburg ,&nbsp;James van Bastelaar ,&nbsp;Alfred Janssen ,&nbsp;Thiemo van Nijnatten ,&nbsp;Lee H. Bouwman ,&nbsp;Yvonne L.J. Vissers ,&nbsp;Marc B.I. Lobbes","doi":"10.1016/j.suronc.2024.102045","DOIUrl":"https://doi.org/10.1016/j.suronc.2024.102045","url":null,"abstract":"<div><h3>Background</h3><p>Residual particles of superparamagnetic iron oxide (SPIO) tracer, used for sentinel node biopsy, cause susceptibility artefacts on breast Magnetic Resonance Imaging (MRI). We investigated the impact of these artefacts on the imaging quality of MRI and explored whether contrast-enhanced mammography (CEM) could be an alternative in the follow-up of breast cancer patients.</p></div><div><h3>Materials and methods</h3><p>Data on patients’ characteristics, injection site, presence, size (mm) of artefacts on full-field digital mammography (FFDM)/CEM, MRI after 1 ml SPIO was recorded. Image quality scored by two breast radiologists using a 4-point Likert system: 0: no artefacts 1: good diagnostic quality 2: impaired but still readable 3: hampered clinical assessment. Continuous variables reported as means and standard deviations (SD), categorical variables as count and percentage.</p></div><div><h3>Results</h3><p>On FFDM/CEM, performed 13 months postoperatively, no iron SPIO particles were detected, with a Likert score of 0. In all MRI (100%) images, executed at 16.6 months after SPIO injection, susceptibility artefacts at the injection sites i.e., retroareolair and lateral quadrant were observed with a mean size of 41.9 ± 9.8 mm (SD) by observer 1, and 44.8 ± 12.5 mm (SD) by observer 2, independent of the injection site. Both observers scored a Likert score of 2: locally impaired on all MRI images and sequences.</p></div><div><h3>Conclusions</h3><p>Even 1 ml SPIO tracer used for sentinel node procedure impairs the evaluation of breast MRI at the tracer injection site beyond one year of follow-up. No impairment was observed on FFDM/CEM, suggesting that CEM might be a reliable alternative to breast MRI if required.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699577","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":"Osteosarcopenia impacts treatment outcomes for Barcelona Cancer Liver Classification stage A hepatocellular carcinoma","authors":"Kyohei Abe,&nbsp;Kenei Furukawa,&nbsp;Michinori Matsumoto,&nbsp;Yasuro Futagawa,&nbsp;Hironori Shiozaki,&nbsp;Shinji Onda,&nbsp;Koichiro Haruki,&nbsp;Yoshihiro Shirai,&nbsp;Tomoyoshi Okamoto,&nbsp;Toru Ikegami","doi":"10.1016/j.suronc.2024.102043","DOIUrl":"10.1016/j.suronc.2024.102043","url":null,"abstract":"<div><h3>Aim</h3><p>To study the effect of preoperative osteosarcopenia (OSP) on the prognosis of treatment (surgery or radiofrequency ablation (RFA)) in patients with Barcelona Cancer Liver Classification stage A hepatocellular carcinoma (BCLC A HCC).</p></div><div><h3>Methods</h3><p>This study enrolled 102 patients with BCLC A HCC who underwent surgical resection (n = 45) and RFA (n = 57); the patients were divided into two groups: OSP (n = 33) and non-OSP (n = 69). Overall survival (OS) and disease-free survival (DFS) curves for both the groups and treatment methods (surgery and RFA) were generated using the Kaplan–Meier method and compared using the log-rank test. Univariate analyses for OS and DFS were performed using log-rank test. Multivariate analyses were performed for factors that were significant at univariate analysis by Cox proportional hazard model.</p></div><div><h3>Results</h3><p>Multivariate analysis showed that OSP (HR 2.44; 95 % CI 1.30–4.55; p &lt; 0.01) and treatment (HR 0.57; 95 % CI 0.31–0.99; p = 0.05) were significant independent predictors of DFS; and treatment (HR, 0.30; 95 % CI 0.10–0.85; p = 0.03) was a significant independent predictor of OS in the non-OSP group, in which the OS rate was significantly lower in patients treated with RFA than in those treated by resection (p = 0.01).</p></div><div><h3>Conclusions</h3><p>OSP is a prognostic factor for BCLC A HCC treatment. Surgical approach was associated with a significantly better prognosis in patients without OSP compared to those who underwent RFA.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139661813","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":"Double hepatic vein reconstruction during extended anatomical resection of segment 8 for colorectal liver metastasis","authors":"Katsuya Sakashita,&nbsp;Shimpei Otsuka,&nbsp;Katsuhiko Uesaka,&nbsp;Teiichi Sugiura","doi":"10.1016/j.suronc.2024.102040","DOIUrl":"10.1016/j.suronc.2024.102040","url":null,"abstract":"<div><h3>Background</h3><p>Hepatic vein reconstruction (HVR) is occasionally necessary for resecting hepatic malignancies to ensure surgical margins while preserving remnant liver function [<span>1</span>]. Reports of multiple HVR are rare due to the highly technical demanding procedure and high risk of morbidity [<span>2</span>]. We introduce our procedure of double HVR for metastatic liver tumors invading the right hepatic vein (RHV) and middle hepatic vein (MHV).</p></div><div><h3>Methods</h3><p>The patient was a 66-year-old man with colorectal liver metastasis in segment 8, invading RHV and MHV. Due to impaired liver function, extended right hemihepatectomy was unsuitable. Thus, extended anatomical resection of segment 8 with double HVR was performed. The liver was completely mobilized and the RHV and MHV were secured. After liver parenchyma dissection, the specimen was connected by RHV and MHV (<span>Fig. 1</span>). The MHV was dissected and reconstructed using a right superficial femoral vein graft while the RHV remained connected [<span>3</span>]. Reconstruction of the MHV was performed on the posterior wall of the proximal side, followed by the anterior wall, using 4-point supporting threads. Anastomosis was performed by the over-and-over suture method. On the distal side, two-point supporting threads were applied. After specimen removal, the RHV was resected and reconstructed in the same manner using a left internal jugular vein graft [<span>4</span>].</p></div><div><h3>Results</h3><p>The patient was discharged on postoperative day 14 with no signs of liver failure. Computed tomography performed six months after surgery revealed no graft occlusion (<span>Fig. 2</span>).</p></div><div><h3>Conclusion</h3><p>In appropriately selected patients, this technique may be a useful option for preserving the remnant liver function.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139661811","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":"Relationship between immune checkpoint proteins and neoadjuvant chemotherapy response in breast cancer","authors":"Umut Kina Kilicaslan ,&nbsp;Basak Aru ,&nbsp;Sibel Aydin Aksu ,&nbsp;Fugen Vardar Aker ,&nbsp;Gulderen Yanikkaya Demirel ,&nbsp;Meryem Gunay Gurleyik","doi":"10.1016/j.suronc.2024.102037","DOIUrl":"10.1016/j.suronc.2024.102037","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Following major developments in cancer immunotherapy<span>, treatments targeting immune checkpoint proteins (ICP) gained interest in breast cancer, though studies mostly focus on patients with </span></span>metastatic disease<span> as well as patients nonresponsive to the conventional treatments. Herein, we aimed to investigate the levels of ICP in tumor stroma<span><span> and tumor infiltrating lymphocytes, and tumor tissue prior to </span>neoadjuvant chemotherapy administration to evaluate the relationship between ICP levels, clinicopathological parameters, and NAC response.</span></span></p></div><div><h3>Materials and methods</h3><p>This study was conducted with 51 patients where PD-1, PD-L1, CTLA-4, TIM-3, CD24 and CD44 levels were investigated in CD45⁺<span> cells while CD326, CD24, CD44 and PD-L1 protein expression levels were investigated in CD45</span>⁻ population. In addition, CD44 and CD24 levels were evaluated in the tumor stroma. TIL levels were investigated according to the TILS Working Group. Treatment responses after NAC were evaluated according to the MD Anderson RCB score.</p></div><div><h3>Results</h3><p>Our results revealed positive correlation between CTLA-4 and CD44 expression in cases with high TIL levels as well as TIL levels and CTLA-4 expression in cases with partial response. Similarly, positive correlation was detected between TIM3 and PD-L1 levels in cases with good response. In addition, a negative correlation between TILs after NAC and PD-1/PD-L1 expression in lymphocytes in cases with partial complete response.</p></div><div><h3>Conclusions</h3><p>Our study provides preliminary data about the correlation between ICP and clinicopathological status and NAC response in breast cancer, in addition to underlining the requirement for further research to determine their potential as therapeutic targets.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589578","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":"Introduction to “Legends in oncology: Expert commentary”","authors":"Vijay P. Khatri","doi":"10.1016/j.suronc.2024.102041","DOIUrl":"10.1016/j.suronc.2024.102041","url":null,"abstract":"","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589584","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":"Repeated pancreatic resection for pancreatic metastases from renal cell Carcinoma: A Spanish multicenter study (PANMEKID)","authors":"Adela Rojas-Holguín ,&nbsp;Constantino Fondevila-Campo ,&nbsp;Alfonso Sanjuanbenito ,&nbsp;Joan Fabregat-Prous ,&nbsp;Luís Secanella-Medayo ,&nbsp;Fernando Rotellar-Sastre ,&nbsp;Fernando Pardo-Sánchez ,&nbsp;Mikel Prieto-Calvo ,&nbsp;Héctor Marín-Ortega ,&nbsp;Santiago Sánchez-Cabús ,&nbsp;Luis Diez-Valladares ,&nbsp;Óscar Alonso-Casado ,&nbsp;Carmen González-Serrano ,&nbsp;Juan Carlos Rodríguez-Sanjuan ,&nbsp;Gabriel García-Plaza ,&nbsp;Isabel Jaén-Torrejimeno ,&nbsp;Miguel Ángel Suárez-Muñoz ,&nbsp;Antonio Becerra-Massare ,&nbsp;Paula Senra-del Rio ,&nbsp;Elizabeth Pando ,&nbsp;Gerardo Blanco-Fernández","doi":"10.1016/j.suronc.2024.102039","DOIUrl":"10.1016/j.suronc.2024.102039","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Recurrent isolated pancreatic metastasis from Renal Cell Carcinoma (RCC) after pancreatic resection is rare. The purpose of our study is to describe a series of cases of relapse of pancreatic metastasis from renal cancer in the pancreatic remnant and its surgical treatment with a repeated pancreatic resection, and to analyse the results of both overall and disease-free survival.</p></div><div><h3>Methods</h3><p>Multicenter retrospective study of patients undergoing pancreatic resection for RCC pancreatic metastases, from January 2010 to May 2020. Patients were grouped into two groups depending on whether they received a single pancreatic resection (SPS) or iterative pancreatic resection. Data on short and long-term outcome after pancreatic resection were collected.</p></div><div><h3>Results</h3><p>The study included 131 pancreatic resections performed in 116 patients. Thus, iterative pancreatic surgery (IPS) was performed in 15 patients. The mean length of time between the first pancreatic surgery and the second was 48.9 months (95 % CI: 22.2–56.9). There were no differences in the rate of postoperative complications. The DFS rates at 1, 3 and 5 years were 86 %, 78 % and 78 % vs 75 %, 50 % and 37 % in the IPS and SPS group respectively (p = 0.179). OS rates at 1, 3, 5 and 7 years were 100 %, 100 %, 100 % and 75 % in the IPS group vs 95 %, 85 %, 80 % and 68 % in the SPS group (p = 0.895).</p></div><div><h3>Conclusion</h3><p>Repeated pancreatic resection in case of relapse of pancreatic metastasis of RCC in the pancreatic remnant is justified, since it achieves OS results similar to those obtained after the first resection.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0960740424000070/pdfft?md5=becc7339e8739539ff7ba847f297ee7e&pid=1-s2.0-S0960740424000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of mediastinoscopy-assisted transhiatal esophagectomy (MATHE)","authors":"Yoshio Masuda ,&nbsp;Eugene Kwong Fei Leong ,&nbsp;Jimmy Bok Yan So ,&nbsp;Asim Shabbir ,&nbsp;Timothy Lam Jia Wei ,&nbsp;Daryl Kai Ann Chia ,&nbsp;Guowei Kim","doi":"10.1016/j.suronc.2024.102042","DOIUrl":"10.1016/j.suronc.2024.102042","url":null,"abstract":"<div><h3>Background</h3><p>Transhiatal esophagectomy (THE) avoids thoracotomy but sacrifices mediastinal lymphadenectomy. Mediastinoscopy-assisted transhiatal esophagectomy (MATHE) allows for visualisation and en-bloc dissection of mediastinal lymph nodes while retaining the benefits of THE. However, given its novel inception, there is a paucity of literature. This study aimed to conduct the first meta-analysis to explore the efficacy of MATHE and clarify its role in the future of esophagectomy.</p></div><div><h3>Methods</h3><p>Four databases (PubMed, EMBASE, Scopus, and Cochrane Library) were searched from inception to May 1, 2023. Studies were included if they reported outcomes for patients with esophageal cancer who underwent MATHE. Meta-analyses of proportions and pooled means were performed for the outcomes of intraoperative blood loss, lymph node (LN) harvest, mean hospital length of stay (LOS), mean operative time, R0 resection, conversion rates, 30-day mortality rate, 5-year OS, and surgical complications (anastomotic leak, cardiovascular [CVS] and pulmonary complications, chyle leak and recurrent laryngeal nerve palsy [RLN]). Sensitivity analyses were performed for outcomes with substantial statistical heterogeneity.</p></div><div><h3>Results</h3><p>The search yielded 223 articles; 28 studies and 1128 patients were included in our analysis. Meta-analyses of proportions yielded proportion rates: 30-day mortality (0 %, 95 %CI 0-0), 5-year OS (60.5 %, 95 %CI 47.6–72.7), R0 resection (100 %, 95 %CI 99.3–100), conversion rate (0.1 %, 95 %CI 0–1.2). Among surgical complications, RLN palsy (14.6 %, 95 %CI 9.5–20.4) were most observed, followed by pulmonary complications (11.3 %, 95 %CI 7–16.2), anastomotic leak (9.7 %, 95 %CI 6.8–12.8), CVS complications (2.3 %, 95 %CI 0.9–4.1) and chyle leak (0.02 %, 95 %CI 0–0.8). Meta-analysis of pooled means yielded means: LN harvest (18.6, 95 %CI 14.3–22.9), intraoperative blood loss (247.1 ml, 95 %CI 173.6–320.6), hospital LOS (18.1 days, 95 %CI 14.4–21.8), and operative time (301.5 min, 95 %CI 238.4–364.6). There was moderate-to-high statistical heterogeneity. Findings were robust to sensitivity analyses.</p></div><div><h3>Conclusion</h3><p>MATHE is associated with encouraging post-operative mortality and complication rates, while allowing for radical mediastinal lymphadenectomy with reasonable lymph node harvest.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139661825","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":"Clinical outcomes of total femoral replacement. First Latin American experience","authors":"Jorge Cabrolier ,&nbsp;Oscar Ceballos ,&nbsp;Fabiola Rieloff ,&nbsp;Francisco Hardoy ,&nbsp;Ricardo Tolosa ,&nbsp;Orlando Wevar","doi":"10.1016/j.suronc.2024.102038","DOIUrl":"10.1016/j.suronc.2024.102038","url":null,"abstract":"<div><h3>Introduction</h3><p><span>The femur is frequently affected by primary and metastatic bone tumors. In cases with substantial </span>bone loss, Total Femur Replacement (TFR) remains the only viable limb preservation option. This study investigates the clinical outcomes of TFR patients in a Latin American setting, with a minimum 3-year follow-up.</p></div><div><h3>Methods</h3><p>Retrospective review identifying cases of TFR at a single center from 2009 to 2020. Patients who had TFR either due to oncological indications or complications arising from oncology-related surgeries were included. Data on the indications for surgery and post-operative complications were recorded. To assess functional status, the Musculoskeletal Tumor Society (MSTS) score and the Toronto Extremity Salvage Score (TESS) were used.</p></div><div><h3>Results</h3><p>Fourteen patients met the inclusion criteria. Diagnoses included eight osteosarcomas<span>, four chondrosarcomas<span>, one Ewing sarcoma<span>, and one giant cell tumor. Ten patients had undergone prior surgeries. Indication for TFR was a complication of a previous surgery in 78.6 % of cases. Post-TFR complications were experienced by 35.7 % of patients, requiring further surgeries. At the 3-year mark, average MSTS and TESS scores were 67.4 % and 70.8 %, respectively.</span></span></span></p></div><div><h3>Conclusion</h3><p>Total femur replacement serves as a valuable limb salvage solution for patients with significant femoral defects in oncological scenarios, however, there is a significant risk of complications. Given its potential benefits, it is essential for developing countries to consider incorporating TFR into their healthcare systems.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589695","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":"Improving accuracy in nodal staging of oral cancer: Proposal of a new system","authors":"Narayana Subramaniam ,&nbsp;Gillian Heller ,&nbsp;Jonathan Robert Clark ,&nbsp;Ruta Gupta ,&nbsp;David Goldstein ,&nbsp;John R. de Almeida ,&nbsp;Ali Hosni ,&nbsp;Deepak Balasubramanian ,&nbsp;Krishnakumar Thankappan ,&nbsp;Subramania Iyer ,&nbsp;Martin Batstone ,&nbsp;N. Gopal Iyer ,&nbsp;Robert I. Smee ,&nbsp;Naveen Hedne Chandrasekhar ,&nbsp;Vijay Pillai ,&nbsp;Vivek Shetty ,&nbsp;Vidyabhushan Rangappa ,&nbsp;Michael Veness ,&nbsp;Tsu-Hui (Hubert) Low","doi":"10.1016/j.suronc.2024.102033","DOIUrl":"10.1016/j.suronc.2024.102033","url":null,"abstract":"<div><h3>Background</h3><p>Despite introduction of extranodal extension (ENE) into the AJCC 8th edition of oral cancer staging, previous criticisms persist, such as limited discrimination between sub-stages and doubtful prognostic value of contralateral<span> nodal disease. The purpose of this study was to compare our novel nodal staging system, based on the number of positive nodes and ENE, to the AJCC staging system in surgically treated patients.</span></p></div><div><h3>Methods</h3><p>Retrospective analysis of 4710 patients with oral squamous cell carcinoma<span> (OSCC) treated with surgery±adjuvant therapy in 8 institutions in Australia, North America and Asia. With overall survival (OS) and disease specific survival (DSS) as endpoint, the prognostic performance of AJCC 8th and 7th editions were compared using hazard consistency, hazard discrimination, likelihood difference and balance.</span></p></div><div><h3>Results</h3><p>Our new nodal staging system (PN) a progressive and linear increase in hazard ratio (HR) from pN0 to pN3, with good separation of Kaplan Meier curves. Using the predetermined criteria for evaluation of a staging system, our proposed staging model outperformed AJCC 8th and 7th editions in prediction of OS and DSS.</p></div><div><h3>Conclusion</h3><p>PN was the lymph node staging system that provided the most accurate prediction of OS and DSS for patients in our cohort of OSCC. Additionally, it can be easily adopted, addresses the shortcomings of the existing systems and should be considered for future editions of the TNM staging system.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139393681","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 prognosis-based classification model in resectable pancreatic cancer","authors":"Norimitsu Okui,&nbsp;Masashi Tsunematsu,&nbsp;Kenei Furukawa,&nbsp;Yoshihiiro Shirai,&nbsp;Koichiro Haruki,&nbsp;Taro Sakamoto,&nbsp;Tadashi Uwagawa,&nbsp;Shinji Onda,&nbsp;Takeshi Gocho,&nbsp;Toru Ikegami","doi":"10.1016/j.suronc.2024.102035","DOIUrl":"10.1016/j.suronc.2024.102035","url":null,"abstract":"<div><h3>Aim</h3><p>Pancreatic ductal adenocarcinoma<span> treatment is mainly based on the anatomical resectability classification. However, prognosis-based classification may be more reasonable. In this study, we stratified resectable pancreatic ductal adenocarcinoma according to preoperative factors and reconsidered treatment strategies.</span></p></div><div><h3>Methods</h3><p>We retrospectively evaluated 131 patients who underwent upfront surgery for resectable pancreatic ductal adenocarcinoma between 2007 and 2019. Recurrence within 1 year after surgery was defined as early recurrence, and the risk factors for early recurrence were identified using preoperative factors. Subsequently, we calculated the scores and stratified the participant groups.</p></div><div><h3>Results</h3><p>Fifty-five (42 %) patients who relapsed within 1 year showed significantly poorer survival than those without recurrence (median overall survival, 14.0 vs. 80.6 months; <em>p</em><span> &lt; 0.01). Multivariate analysis revealed that a tumor diameter of ≥24 mm (</span><em>p</em> &lt; 0.01) and preoperative serum carbohydrate antigen 19-9 level of ≥380 U/mL (<em>p</em> = 0.04) were the independent risk factors for early recurrence. Early recurrence score was created using these factors, stratifying the participant group into three groups of 0–2 points, and the prognosis was significantly different (median overall survival, 49.3 vs. 31.2 vs. 16.0 months; <em>p</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>We stratified the upfront surgical cases of resectable pancreatic ductal adenocarcinoma. The group with a score of 0 had a good prognosis, and upfront surgery was possibly not futile on patients in poor general condition. The group with a score of 2 had a poor prognosis and may require stronger preoperative treatment.</p></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139374962","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}