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National Patterns of Hospital Admission Versus Home Recovery Following Mastectomy for Breast Cancer. 乳腺癌乳房切除术后入院与在家康复的全国模式。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-25 DOI: 10.1245/s10434-024-16107-w
Leah S Kim, Miranda S Moore, Eric Schneider, Joseph Canner, Haripriya Ayyala, Judy Chen, Pavan Anant, Elena Graetz, Melanie A Lynch, Gregory Zanieski, Alyssa Gillego, Monica G Valero, Ellie M Proussaloglou, Elizabeth R Berger, Mehra Golshan, Rachel A Greenup, Tristen S Park

Background: We examined national patterns of care and perioperative outcomes for women after mastectomy, comparing home recovery (HR) with hospital admission.

Patients and methods: Using Martketscan data (2017-2019), women ≥ 18 years old who underwent mastectomy ± reconstruction were identified and classified as either home recovery (same calendar day discharge) or hospital admission (stays > 1 calendar day). Comorbidities and receipt of chemo/immunotherapy 6 months prior to surgery and post-surgical 30-day complications were measured. Logistic regression calculated the odds of any complication by encounter type, adjusting for age, accompanying lymph node (LN) procedure, reconstruction, neoadjuvant chemo- and/or immunotherapy, and select comorbidities.

Results: Of 11,789 mastectomy encounters (N = 11,659 women), 4751 (40%) cases utilized HR while 7038 (60%) had hospital admission. HR patients were older (53.6 years old vs. 51.8 years old) with lower rates of reconstruction (60.2 vs. 74.5%, p < 0.001). Rates of neoadjuvant chemotherapy (19.6 vs. 20.9%, p = 0.099) and immunotherapy (3.6 vs. 3.9%, p = 0.445) were similar between groups. Complication rates were lower among HR patients with fewer postoperative hematomas (0.6 vs. 1.3%, p < 0.001) and decreased wound complications (8.5 vs. 9.8%, p = 0.019). In a multivariable analysis, the odds of any complication were approximately 20% lower for HR patients compared with admission patients (aOR 0.81, 95% CI 0.72-0.91, p < 0.001). Unplanned emergency room visits were similar between groups (6.7 vs. 7.2%, p = 0.374); yet fewer hospital re-admissions (2.5 vs. 3.5%, p = 0.003) occurred in women recovering at home.

Conclusion: HR is a safe option compared with in-hospital admission for clinically appropriate women after mastectomy as they are less likely to experience postoperative complications, emergency department (ED) visits, or hospitalization.

背景:我们研究了全国乳房切除术后妇女的护理模式和围手术期结果,比较了家庭康复(HR)和入院治疗:利用Martketscan数据(2017-2019年),确定了接受乳房切除术(±重建)的≥18岁女性,并将其分类为家庭康复(同一日历日出院)或入院(住院时间>1日历日)。对合并症、术前 6 个月接受化疗/免疫治疗以及术后 30 天并发症进行了测量。逻辑回归计算了不同类型并发症的发生几率,并对年龄、伴随的淋巴结(LN)手术、重建、新辅助化疗和/或免疫治疗以及选定的合并症进行了调整:在 11789 例乳房切除术中(N = 11659 名女性),4751 例(40%)使用了 HR,7038 例(60%)入院治疗。HR患者年龄较大(53.6岁对51.8岁),重建率较低(60.2%对74.5%,P 结论:与住院治疗相比,HR 是适合乳房切除术后临床妇女的安全选择,因为她们不太可能出现术后并发症、急诊科就诊或住院治疗。
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引用次数: 0
Intraoperative Fluid Balance and Perioperative Complications in Ovarian Cancer Surgery. 卵巢癌手术的术中体液平衡与围手术期并发症。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-08 DOI: 10.1245/s10434-024-16246-0
Eva K Egger, Janina Ullmann, Tobias Hilbert, Damian J Ralser, Laura Tascon Padron, Milka Marinova, Matthias Stope, Alexander Mustea

Background: Fluid overload and hypovolemia promote postoperative complications in patients undergoing cytoreductive surgery for ovarian cancer. In the present study, postoperative complications and anastomotic leakage were investigated before and after implementation of pulse pressure variation-guided fluid management (PPVGFM) during ovarian cancer surgery.

Patients and methods: A total of n = 243 patients with ovarian cancer undergoing cytoreductive surgery at the University Hospital Bonn were retrospectively evaluated. Cohort A (CA; n = 185 patients) was treated before and cohort B (CB; n = 58 patients) after implementation of PPVGFM. Both cohorts were compared regarding postoperative complications.

Results: Ultrasevere complications (G4/G5) were exclusively present in CA (p = 0.0025). No difference between cohorts was observed regarding severe complications (G3-G5) (p = 0.062). Median positive fluid excess was lower in CB (p = 0.001). This was independent of tumor load [peritoneal cancer index] (p = 0.001) and FIGO stage (p = 0.001). Time to first postoperative defecation was shorter in CB (CB: d2 median versus CA: d3 median; p = 0.001). CB had a shorter length of hospital stay (p = 0.003), less requirement of intensive medical care (p = 0.001) and postoperative ventilation (p = 0.001). CB received higher doses of noradrenalin (p = 0.001). In the combined study cohort, there were more severe complications (G3-G5) in the case of a PFE ≥ 3000 ml (p = 0.034) and significantly more anastomotic leakage in the case of a PFE ≥ 4000 ml (p = 0.006).

Conclusions: Intraoperative fluid reduction in ovarian cancer surgery according to a PPVGFM is safe and significantly reduces ultrasevere postoperative complications. PFEs of ≥ 3000 ml and ≥ 4000 ml were identified as cutoffs for significantly more severe complications and anastomotic leakage, respectively.

背景:体液超负荷和低血容量会导致卵巢癌细胞切除手术患者出现术后并发症。本研究调查了卵巢癌手术中实施脉压变化引导液体管理(PPVGFM)前后的术后并发症和吻合口漏情况:波恩大学医院共对 n = 243 名接受细胞切除手术的卵巢癌患者进行了回顾性评估。A 组(CA;n = 185 名患者)在实施 PPVGFM 之前接受治疗,B 组(CB;n = 58 名患者)在实施 PPVGFM 之后接受治疗。两组患者的术后并发症情况进行了比较:超严重并发症(G4/G5)仅出现在CA组(P = 0.0025)。两组患者在严重并发症(G3-G5)方面无差异(p = 0.062)。CB 中位阳性液体过量率较低(p = 0.001)。这与肿瘤负荷[腹膜癌指数](p = 0.001)和FIGO分期(p = 0.001)无关。CB患者术后首次排便的时间更短(CB:中位数为d2,CA:中位数为d3;p = 0.001)。CB患者的住院时间更短(p = 0.003),对重症监护的需求更少(p = 0.001),术后通气时间更短(p = 0.001)。CB 接受的去甲肾上腺素剂量更高(p = 0.001)。在合并研究队列中,PFE ≥ 3000 毫升的患者出现更多严重并发症(G3-G5)(p = 0.034),PFE ≥ 4000 毫升的患者出现更多吻合口漏(p = 0.006):结论:根据 PPVGFM 在卵巢癌手术中减少术中液体是安全的,并能显著减少超严重术后并发症。PFE≥3000毫升和≥4000毫升分别被确定为严重并发症和吻合口漏的临界值。
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引用次数: 0
The Top Ten Annals of Surgical Oncology Original Articles on Twitter/X: 2020-2023. 推特/X 上的十大《肿瘤外科年鉴》原创文章:2020-2023 年。
IF 4.3 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-13 DOI: 10.1245/s10434-024-15936-z
Anish J Jain, Kurt Schultz, Micah J Brainerd, Gilbert Z Murimwa, Andrew M Fleming, Nadege Fackche, Esra Bilir, Akiko Chiba, Allison N Martin, Puneet Singh, Christopher P Childers, Lindsay R Friedman, Syed Nabeel Zafar, Zaid Abdelsattar, Chandler Cortina, Camille Stewart, Michael D Cowher, Sabha Ganai, Belen Merck, Govind Nandakumar, Prakash K Pandalai, Raja R Narayan, Syed A Ahmad

Social media has become omnipresent in society, especially given that it enables the rapid and widespread communication of news, events, and information. Social media platforms have become increasingly used by numerous surgical societies to promote meetings and surgical journals to increase the visibility of published content. In September 2020, Annals of Surgical Oncology (ASO) established its Social Media Committee (SMC), which has worked to steadily increase the visibility of published content on social media platforms, namely X (formerly known as Twitter). The purpose of this review is to highlight the 10 ASO original articles with the most engagement on X, based on total number of mentions, since the founding of the SMC. These articles encompass a wide variety of topics from various oncologic disciplines including hepatopancreatobiliary, breast, and gynecologic surgery.

社交媒体在社会中已无处不在,尤其是它能够快速、广泛地传播新闻、事件和信息。许多外科学会越来越多地使用社交媒体平台来宣传会议和外科期刊,以提高出版内容的知名度。2020 年 9 月,《肿瘤外科年鉴》(ASO)成立了社交媒体委员会 (SMC),该委员会致力于稳步提高发表内容在社交媒体平台(即 X(前身为 Twitter))上的可见度。本综述旨在重点介绍自 SMC 成立以来,根据提及总数计算,在 X 上参与度最高的 10 篇 ASO 原创文章。这些文章涵盖了肝胆胰、乳腺和妇科手术等不同肿瘤学科的各种主题。
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引用次数: 0
Clinical Outcomes in Patients with Early Stage Node-Negative HER2-Positive Breast Cancer Receiving Upfront Surgery or Neoadjuvant Systemic Therapy. 接受前期手术或新辅助系统疗法的早期结节阴性 HER2 阳性乳腺癌患者的临床疗效。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-27 DOI: 10.1245/s10434-024-16087-x
Natasha Muppidi, Taiwo Adesoye, Min Yi, Susie X Sun, Mariana Chavez-MacGregor, Puneet Singh, Meghan Karuturi, Nina Tamirisa, Kelly K Hunt, Mediget Teshome

Background: HER2-positive breast cancer is traditionally treated with neoadjuvant systemic therapy (NST), but optimal treatment sequencing is less clear in patients with small tumors. We investigated clinicopathologic and oncologic outcomes in early stage HER2-positive breast cancer.

Patients and methods: An institutional database was queried to identify patients with cT1-2 (≤ 3 cm) N0M0, HER2-positive breast cancer treated from 2015 to 2020 and compared upfront surgery and NST cohorts. Logistic regression was performed to identify factors predicting upstaging. Survival outcomes by group were compared using log-rank tests.

Results: Of 256 patients identified, 170 (66.4%) received upfront surgery and 86 (33.6%) NST. The NST cohort was younger and had more cT2 and grade 3 tumors and negative sentinel nodes. There was no significant difference in type of breast surgery or receipt of axillary lymphadenectomy. After upfront surgery, 4 (2.4%) patients had upstaging to pT > 3 cm and 18 (10.6%) to pN1-3. No factors predicted upstaging. After NST, 47 (54.7%) achieved pathologic complete response and 3 (3.5%) had upstaging to ypN1-3 with older age (OR 1.08, p = 0.004) and hormone receptor-positive status (OR 7.07, p = 0.002) identified as predictors. At median follow-up of 3.55 years, 10 (3.9%) patients had recurrence and 5 (2.0%) patients died. There were no significant differences in oncologic outcomes between groups.

Conclusions: Patients with cT1-2 (≤ 3 cm)N0 HER2-positive breast cancer selected for NST have higher-risk disease. Low rates of pathologic upstaging were observed with no difference in surgical treatments and overall excellent oncologic outcomes in both groups. These findings may guide decision-making regarding treatment sequencing for patients with early stage HER2-positive disease.

背景:HER2阳性乳腺癌传统上采用新辅助全身治疗(NST),但小肿瘤患者的最佳治疗顺序尚不明确。我们研究了早期HER2阳性乳腺癌的临床病理学和肿瘤学结果:我们查询了一个机构数据库,以确定2015年至2020年接受治疗的cT1-2(≤3厘米)N0M0、HER2阳性乳腺癌患者,并比较了前期手术和NST队列。进行了逻辑回归以确定预测上行分期的因素。使用对数秩检验比较了各组的生存结果:在确定的 256 名患者中,170 人(66.4%)接受了前期手术,86 人(33.6%)接受了 NST。NST组患者更年轻,cT2和3级肿瘤以及前哨结节阴性者更多。乳腺手术类型和腋窝淋巴结切除术的接受情况没有明显差异。前期手术后,有4名(2.4%)患者的pT>3厘米,18名(10.6%)患者的pN1-3升高。没有任何因素可预测肿瘤的分期。NST 后,47 例(54.7%)患者获得了病理完全反应,3 例(3.5%)患者的分期上升至 ypN1-3,年龄较大(OR 1.08,p = 0.004)和激素受体阳性状态(OR 7.07,p = 0.002)被认为是预测因素。中位随访 3.55 年,10 例(3.9%)患者复发,5 例(2.0%)患者死亡。两组患者的肿瘤治疗结果无明显差异:结论:cT1-2(≤ 3 厘米)N0 HER2 阳性乳腺癌患者选择 NST 的风险较高。两组患者的病理分期率较低,手术治疗效果无差异,总体肿瘤预后良好。这些发现可为早期HER2阳性患者的治疗排序决策提供指导。
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引用次数: 0
Conversion Surgery After Chemotherapy Plus Nivolumab as the First-Line Treatment for Unresectable Advanced or Recurrent Gastric Cancer and a Biomarker Study Using the Gustave Roussy Immune Score: A Multicenter Study. 化疗加 Nivolumab 作为不可切除的晚期或复发性胃癌一线治疗后的转换手术以及使用 Gustave Roussy 免疫评分的生物标志物研究:一项多中心研究。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-03 DOI: 10.1245/s10434-024-16161-4
Nobuhiro Nakazawa, Makoto Sohda, Nobuhiro Hosoi, Takayoshi Watanabe, Yuji Kumakura, Toshiki Yamashita, Naritaka Tanaka, Kana Saito, Akiharu Kimura, Kengo Kasuga, Kenji Nakazato, Daisuke Yoshinari, Hisashi Shimizu, Yasunari Ubukata, Hisashi Hosaka, Akihiko Sano, Makoto Sakai, Hiroomi Ogawa, Ken Shirabe, Hiroshi Saeki

Background: There are few reports on conversion surgery (CS) after chemotherapy plus nivolumab as a first-line treatment in patients with unresectable advanced or recurrent gastric cancer (GC). This multicenter study was conducted to analyze real-world data on CS after chemotherapy plus nivolumab as a first-line treatment and to identify predictive biomarkers.

Methods: This multicenter study included 104 patients who received chemotherapy plus nivolumab as primary treatment for unresectable advanced recurrent GC from 12 institutes. We investigated and analyzed patient characteristics and blood test data in the presence or absence of CS, the relationship between the Gustave Roussy Immune Score (GRIm-s) and CS, and the characteristics of CS cases.

Results: CS was performed in 12 patients (11.5%). Eastern Cooperative Oncology Group Performance Status (ECOG-PS) was significantly better in patients who underwent CS (p < 0.0001). There were no CS cases with high-risk GRIm-s (0%), however there were 22 non-CS cases (23.9%). No high-risk GRIm-s cases were converted to CS. Minimally invasive surgery was performed in 50.0% of the cases, with R0 resection in all cases and only one case of urinary retention (Grade II) as a postoperative complication, indicating a good postoperative short-term outcome. There were two cases of postoperative recurrence (16.7%), both of which were grade 1b.

Conclusions: The short-term postoperative results of CS after chemotherapy plus nivolumab as the first-line treatment for GC were acceptable in this study. There were no high-risk GRIm-s cases among those who underwent CS, suggesting that the GRIm-s may be a predictor of CS.

背景:关于不可切除的晚期或复发性胃癌(GC)患者化疗加尼伐单抗一线治疗后的转换手术(CS)的报道很少。本项多中心研究旨在分析化疗加尼伐单抗一线治疗后转化手术的实际数据,并确定预测性生物标志物:这项多中心研究纳入了来自12家机构的104名接受化疗+nivolumab一线治疗的不可切除的晚期复发性胃癌患者。我们调查并分析了有无CS的患者特征和血液检测数据、Gustave Roussy免疫评分(GRIm-s)与CS之间的关系以及CS病例的特征:结果:12名患者(11.5%)进行了CS。东部合作肿瘤学组表现状态(ECOG-PS)明显优于接受 CS 的患者(p 结论:GRIm-s 与 CS 的关系非常密切:在本研究中,化疗加 nivolumab 作为 GC 一线治疗后进行 CS 的术后短期效果是可以接受的。接受CS治疗的患者中没有高危GRIm-s病例,这表明GRIm-s可能是CS的预测指标。
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引用次数: 0
Letter to the Editors: Concerning "Nodal Surgery for Patients ≥ 70 Undergoing Mastectomy for DCIS? Choose Wisely" by Elissa C. Dalton et al. 致编辑的信:关于 Elissa C. Dalton 等人撰写的 "因 DCIS 而接受乳房切除术的≥70 岁患者的结节手术?明智选择",作者 Elissa C. Dalton 等人。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-21 DOI: 10.1245/s10434-024-16061-7
Jialin Zhao, Qingli Zhu, Li Peng, Song Fang
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引用次数: 0
Maximizing Postoperative Success in NSCLC: The Critical Role of Multidisciplinary Collaboration. 最大限度地提高 NSCLC 术后成功率:多学科协作的关键作用。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-14 DOI: 10.1245/s10434-024-16234-4
Rongrui Zhao, Xinyue Ma, Jiacui Zhang
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引用次数: 0
Combined Chemotherapy and Immunotherapy Induction for Screening of Patients with Cervical Esophageal Carcinoma for Subsequent Local Treatment: A New Treatment Paradigm. 联合化疗和免疫疗法诱导用于筛查宫颈食管癌患者以便进行后续局部治疗:一种新的治疗范例
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-26 DOI: 10.1245/s10434-024-15843-3
Liang Dai, Ya-Ya Wu, Yan Sun, Rong Yu, Wan-Pu Yan, Yong-Bo Yang, Hong Cheng, Yi-Mei Gao, Bin Zhang, Ke-Neng Chen

Background: Definitive chemoradiotherapy is recommended as the primary treatment for cervical esophageal carcinoma (CEC). However, local control rates remain unsatisfactory for some patients. Therefore, in this study, we introduced a new treatment paradigm for individuals with CEC, customizing the choice between subsequent local treatments based on their response to induction chemotherapy and immunotherapy.

Patients and methods: Induction treatment comprised two to four cycles of chemotherapy combined with programmed cell death protein 1 (PD-1) inhibitors. Patients achieving complete response (CR) or near CR after induction treatment underwent definitive chemoradiotherapy (dCRT), while those not achieving CR or near CR underwent surgical resection.

Results: Among the 40 eligible patients, 14 (35.0%) achieved a CR or near CR after induction treatment. Of the ten patients achieving a CR or near CR, one developed an esophageal fistula after dCRT (10.0%). Among the eight non-CR or non-near CR patients receiving chemoradiotherapy, six developed esophageal fistula (75.0%). Among the 26 patients who did not achieve CR or near CR after induction treatment, the 1-year cancer specific survival (CSS) rates were 93.3% [95% confidence interval (CI) 0.815-1%] for the 18 patients in the surgery group, and 71.4% (95% CI 0.447-1%) for the 8 patients in the chemoradiotherapy group (p = 0.027). The overall laryngeal preservation rate was 85.0% (34/40), with a functional laryngeal preservation rate of 77.5% (31/40).

Conclusion: The approach consisting of combined immunotherapy and chemotherapy successfully identified patients who were responding well to induction treatment and who were sensitive to radiotherapy, for chemoradiotherapy; thus, improving laryngeal preservation rates. In addition, it also identified patients with poor responses to induction treatment and radiotherapy, for timely surgery; hence, reducing radiotherapy complications and enhancing survival.

背景:宫颈食管癌(CEC)的主要治疗方法推荐采用确定性化放疗。然而,部分患者的局部控制率仍不尽如人意。因此,在这项研究中,我们为CEC患者引入了一种新的治疗模式,根据患者对诱导化疗和免疫疗法的反应,定制后续局部治疗的选择:诱导治疗包括两到四个周期的化疗,并结合程序性细胞死亡蛋白1(PD-1)抑制剂。诱导治疗后获得完全应答(CR)或接近CR的患者接受确定性放化疗(dCRT),而未获得CR或接近CR的患者接受手术切除:在40名符合条件的患者中,14人(35.0%)在诱导治疗后达到CR或接近CR。在获得 CR 或接近 CR 的 10 例患者中,有 1 例在 dCRT 后出现食管瘘(10.0%)。在接受放化疗的 8 名非 CR 或非接近 CR 患者中,有 6 人出现食管瘘(75.0%)。在接受诱导治疗后未达到 CR 或接近 CR 的 26 名患者中,手术组 18 名患者的 1 年癌症特异性生存率 (CSS) 为 93.3% [95% 置信区间 (CI) 0.815-1%],化放疗组 8 名患者的 1 年癌症特异性生存率 (CSS) 为 71.4% (95% CI 0.447-1%)(P = 0.027)。总的喉保留率为85.0%(34/40),喉功能保留率为77.5%(31/40):结论:联合免疫疗法和化疗的方法成功地将对诱导治疗反应良好且对放疗敏感的患者确定为化疗患者,从而提高了喉保留率。此外,它还能识别出对诱导治疗和放疗反应不佳的患者,以便及时进行手术,从而减少放疗并发症,提高生存率。
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引用次数: 0
ASO Author Reflections: Racial and Sex Differences in Genomic Profiling of Intrahepatic Cholangiocarcinoma. ASO 作者反思:肝内胆管癌基因组剖析中的种族和性别差异。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI: 10.1245/s10434-024-16263-z
Diamantis I Tsilimigras, Timothy M Pawlik
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引用次数: 0
Plasma Ceramide C24:0/C16:0 Ratio is Associated with Improved Survival in Patients with Pancreatic Ductal Adenocarcinoma. 血浆神经酰胺 C24:0/C16:0 比率与胰腺导管腺癌患者生存率的提高有关。
IF 3.4 2区 医学 Q2 ONCOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-21 DOI: 10.1245/s10434-024-16245-1
Joshua D Mitchell, Usman Panni, Nicole Fergestrom, Adetunji T Toriola, Timothy M Nywening, S Peter Goedegebuure, Xuntian Jiang, Jacqueline L Mudd, Yin Cao, Joseph Ippolito, Ryan C Fields, William G Hawkins, Linda R Peterson

Background: Pancreatic ductal adenocarcinoma (PDAC) has a high fatality rate, with surgery as the only curative treatment. Identification of new biomarkers related to survival may help guide discovery of new pathophysiologic pathways and potential therapeutic targets. As long-chain ceramides have been linked to tumor proliferation, we sought to determine if ceramide levels were prognostic in PDAC.

Methods: Patients from two phase I studies of PDAC were followed for all-cause mortality. Ceramide levels (C24:0, C22:0, and C16:0) were quantified before treatment and at study intervals. Multivariable Cox regression models assessed the association of ceramide levels and mortality after adjusting for other univariable predictors, including time-dependent tumor resection. The ability of repeated ceramide measures to discriminate patients at risk for mortality was also assessed using multivariable modeling and the c-statistic.

Results: Higher plasma C16:0 concentration was associated with higher all-cause mortality in univariable and multivariable analysis (adjusted hazard ratio [aHR] 1.41, 95% confidence interval [CI] 1.09-1.82; p < 0.01). In contrast, a higher plasma C24:0/C16:0 ratio was associated with lower all-cause mortality in multivariable analysis (aHR 0.69, 95% CI 0.49-0.97; p = 0.032). Discrimination of mortality was significantly improved with the addition of either plasma C16:0 or C24:0/C16:0 levels, with optimal discrimination occurring using repeated measures of the C24:0/C16:0 ratio (c-statistic 0.73 vs. c-statistic 0.66; p < 0.001).

Conclusions: Higher plasma C16:0 and lower C24:0/C16:0 ratios are independently associated with mortality in PDAC and show an ability to improve discrimination of mortality in this deadly disease. Further studies are needed to confirm this association and evaluate this novel pathway for potential therapeutic targets.

背景:胰腺导管腺癌(PDAC)致死率很高,手术是唯一可治愈的治疗方法。鉴定与生存相关的新生物标志物有助于指导发现新的病理生理途径和潜在的治疗靶点。由于长链神经酰胺与肿瘤增殖有关,我们试图确定神经酰胺水平是否预示着 PDAC 的预后:方法:我们对两项 PDAC I 期研究的患者进行了全因死亡率随访。在治疗前和研究间隔期对神经酰胺水平(C24:0、C22:0 和 C16:0)进行量化。多变量 Cox 回归模型评估了神经酰胺水平与死亡率之间的关系,此前已调整了其他单变量预测因素,包括与肿瘤切除时间相关的因素。此外,还使用多变量模型和c统计量评估了重复神经酰胺测量值区分死亡风险患者的能力:结果:在单变量和多变量分析中,较高的血浆 C16:0 浓度与较高的全因死亡率相关(调整后危险比 [aHR] 1.41,95% 置信区间 [CI] 1.09-1.82;P 结论:较高的血浆 C16:0 浓度与较高的全因死亡率相关:较高的血浆C16:0和较低的C24:0/C16:0比值与PDAC的死亡率有独立的关联,并显示出改善这种致命疾病的死亡率鉴别能力。需要进一步的研究来证实这种关联,并评估这种新途径的潜在治疗目标。
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引用次数: 0
期刊
Annals of Surgical Oncology
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