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Journal Of Surgical Oncology[JOURNAL]

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Effects of Closed Continuous Irrigation and Drainage Technique Combined With Narrative Nursing in Ultra-Low Rectal Cancer Patients Who Received Anus-Preserving Operation.

Sun Y, Weng Y, Zhang Q … +2 more , Sun Y, Liu L

J Surg Oncol · 2026 Feb · PMID 41474296 · Publisher ↗

OBJECTIVES: Our study aims to retrospectively analyze the combined effects of closed continuous irrigation drainage technique (CCIDT) and narrative nursing on recovery, anxiety, and quality of life in ultra-low rectal ca... OBJECTIVES: Our study aims to retrospectively analyze the combined effects of closed continuous irrigation drainage technique (CCIDT) and narrative nursing on recovery, anxiety, and quality of life in ultra-low rectal cancer (ULRC) patients undergoing anus-preserving operation. METHODS: A total of 224 ULRC patients were analyzed with four groups: conventional drainage with routine care (Group A), conventional drainage with narrative nursing (Group B), irrigated drainage with routine care (Group C), and irrigated drainage with narrative nursing (Group D). The outcome assessment included the first postoperative exhaust time, drainage tube placement time, and length of stay. Anxiety levels were measured using the Generalized Anxiety Disorder-7 scale, and quality of life was assessed using the EORTC QLQ-C30 questionnaire. RESULTS: The CCIDT significantly shortened the first postoperative exhaust time, drainage tube placement time, and length of stay compared to conventional drainage techniques (p < 0.001 for all comparisons). However, CCIDT did not significantly affect the occurrence of anastomotic fistulas or abdominal infections. Narrative nursing significantly reduced anxiety levels (p < 0.001) and improved quality of life (p < 0.001). However, narrative nursing did not influence the incidence of anastomotic fistulas or abdominal infections. The combination of CCIDT and narrative nursing effectively enhances postoperative recovery, reduces anxiety, and improves quality of life in ULRC patients.

Treatment of Gastric Cancer: Laparoscopic Pylorus-Preserving Gastrectomy or Laparoscopic Distal Gastrectomy? A Systematic Review and Meta-Analysis.

Chen M, Peng J, Lai H … +3 more , Wang S, Liu C, Wu Q

J Surg Oncol · 2026 Feb · PMID 41472564 · Publisher ↗

BACKGROUND AND OBJECTIVES: The aim of this study is to compare the efficacy of the laparoscopic pylorus-preserving gastrectomy (LPPG) and laparoscopic distal gastrectomy (LDG) for gastric cancer (GC) on postoperative com... BACKGROUND AND OBJECTIVES: The aim of this study is to compare the efficacy of the laparoscopic pylorus-preserving gastrectomy (LPPG) and laparoscopic distal gastrectomy (LDG) for gastric cancer (GC) on postoperative complications and nutritional status. METHODS: We conducted a literature search of PubMed, EMBASE, Scopus, and Cochrane Library databases before April 20th, 2025. RESULTS: We found that the rate of delayed gastric emptying and gastric stasis after LPPG was higher than that after LDG, while there was no significant difference in the incidence of pulmonary diseases, anastomotic leakage, pulmonary fistula, or other complications. The prevention of dumping syndrome and the improvement in nutritional status seemed to be better in LPPG. CONCLUSIONS: No more valuable benefits of LDG in reducing complications was found.

Letter to the Editor: Marginal Resection Is Appropriate for Radical Surgery for Solitary Fibrous Tumors of the Pelvis.

Minhas H, Hameed A

J Surg Oncol · 2026 Feb · PMID 41466497 · Publisher ↗

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The Price of Prophylactic Fixation of the Humerus: A Nationwide Analysis of Negotiated Payor Rates.

Shenoy DA, Therien AD, Zhang Y … +6 more , Wu KA, Pean CA, Klifto CS, Visgauss JD, Brigman B, Eward WC

J Surg Oncol · 2026 Mar · PMID 41466487 · Publisher ↗

BACKGROUND: Metastatic disease in the humerus presents with severe pain, compromised upper extremity function, and impending or completed pathologic fractures. Prophylactic fixation can improve quality of life, yet littl... BACKGROUND: Metastatic disease in the humerus presents with severe pain, compromised upper extremity function, and impending or completed pathologic fractures. Prophylactic fixation can improve quality of life, yet little is known about the variability in negotiated payor rates for this procedure, which may influence surgical decision making. The objective of this study was to examine factors associated with variations in negotiated payor rates for prophylactic fixation of the proximal humerus. METHODS: A cross-sectional analysis of negotiated payor rates for current procedural terminology (CPT) code 23491 (prophylactic fixation of the proximal humerus) was conducted using data from the Turquoise Health database. Hospital size was categorized by total bed capacity; payor classes included commercial, Medicare Advantage, managed Medicaid, veterans' affairs, workers' compensation, dual Medicare-Medicaid, exchange plans, and self-pay. Rural-Urban Commuting Area (RUCA) codes, Area Deprivation Index (ADI), and median household income were used to characterize regional factors. Statistical analyses were conducted in R version 4.2.3. RESULTS: A total of 88,858 negotiated payor rates were evaluated. The average negotiated payor rate in the sample was $11,088. Hospitals with a bed capacity of 1,000-1,500 had the highest mean rates (a +$577 difference from the 0-100 bed reference group, p < 0.0001), whereas mid-sized hospitals (300-500 beds) had significantly lower rates (-$220 difference, p < 0.0001). Workers' compensation yielded the highest rates, exceeding self-pay by $11,620 (p < 0.0001). Metropolitan hospitals, on average, had lower rates than non-metropolitan hospitals ($575 difference, p < 0.0001). Median household income was associated with a clinically insignificant increase in rates ($0.005 per dollar, p < 0.0001), while ADI showed no significant effect. CONCLUSIONS: Substantial variability in negotiated payor rates for prophylactic fixation of the humerus was evident across hospital sizes, payor types, and geographic contexts. These findings underscore the importance of transparent negotiations and value-based reimbursement frameworks to ensure equitable, cost-effective access to orthopaedic oncology care.

Reassessing the 8 cm Cutoff: Continuous Tumor Size-Mortality Risk Supports Three-Tier Staging in High Grade Osteosarcoma.

Dingle E, Joachim K, Sparks O … +7 more , Lin A, Gettleman B, Hamad C, Abernethy C, Fice M, Bernthal NM, Christ AB

J Surg Oncol · 2026 Mar · PMID 41466025 · Publisher ↗

BACKGROUND AND OBJECTIVES: Primary tumor size is a key prognostic factor in osteosarcoma, but quantitative risk estimates and optimal thresholds remain undefined. We quantified the size-survival relationship in high-grad... BACKGROUND AND OBJECTIVES: Primary tumor size is a key prognostic factor in osteosarcoma, but quantitative risk estimates and optimal thresholds remain undefined. We quantified the size-survival relationship in high-grade osteosarcoma. METHODS: We analyzed 1,807 high-grade osteosarcoma patients from the Surveillance, Epidemiology, and End Results (SEER) database (2000-2021) using Cox regression, systematic threshold testing (40-150 mm with multiple testing corrections), and propensity score matching at the AJCC 80 mm threshold. RESULTS: Each 10 mm increase in tumor size was associated with a 6.6% increased hazard of death after adjusting for age, sex, tumor site, surgery, radiation, and chemotherapy (Hazard ratio [HR] = 1.066, p < 0.001; adjusted C-index = 0.694). Binary AJCC staging demonstrated limited mortality discrimination (34.4% vs 44.4%, 10-percentage-point spread), while three-tier soft tissue sarcoma (STS)-adapted staging revealed a 21-percentage-point mortality gradient (26.6% to 47.7%) with superior adjusted discrimination (C-index = 0.695 vs 0.680, p < 0.001). All tested thresholds demonstrated significant associations, with no single optimal cutpoint identified. Polynomial testing indicated a linear relationship (p = 0.334). Propensity score matching at the AJCC 8 cm threshold of 666 patient pairs confirmed the effect (HR = 1.443, 95%-confidence interval: 1.214-1.715, p < 0.001). Polynomial testing indicated a linear relationship (p = 0.253). CONCLUSION: Tumor size demonstrates a continuous dose-response relationship with survival. Three-tier STS staging outperforms binary AJCC classification for risk stratification.

Clinical Outcomes and Surgical Procedures for Patients With Osteosarcoma and Metachronous Lung Metastasis: A Chronological Analysis.

Nakabachi K, Shimizu H, Matsuoka M … +6 more , Soma T, Adachi H, Mizukami Y, Iwasaki N, Iwata A, Hiraga H

J Surg Oncol · 2026 Feb · PMID 41447363 · Publisher ↗

BACKGROUND AND OBJECTIVES: Osteosarcoma (OS) survival rates have remained unchanged for decades, while video-assisted thoracic surgery (VATS) for lung metastasis (LM) became common. We aimed to clarify clinical outcomes... BACKGROUND AND OBJECTIVES: Osteosarcoma (OS) survival rates have remained unchanged for decades, while video-assisted thoracic surgery (VATS) for lung metastasis (LM) became common. We aimed to clarify clinical outcomes of post-relapse survival (PRS) for patients with OS based on LM-free survival (LMFS) across different eras. METHODS: This single-centre retrospective study included 168 patients with OS without LM at initial diagnosis. Patients were categorised into three groups: non-LM (n = 89), synchronous LM (sLM: less than 1-year LMFS) (n = 40), and mLM (at least 1-year LMFS) (n = 39). We compared PRS in patients with sLM and mLM across periods 1 (1990-2005) and 2 (2006-2022). RESULTS: PRS for mLM was longer in period 2 than in period 1 (Hazard ratio: 0.37, 95% confidence interval: 0.12-0.97, p = 0.04), whereas no difference was observed for sLM. In mLM, ratios of surgery, radiotherapy, and chemotherapy were unchanged; the rate of VATS increased in period 2 (7/18 vs. 10/12, p = 0.01). The rate of reoperation remained unchanged (7/18 vs. 7/12, p = 0.39). CONCLUSIONS: In period 2, mLM had a better prognosis than in period 1. There was an increased use of VATS, while the rates of reoperation for LM remained unchanged. Conversely, the prognosis for sLM was not altered.

Reassessing Evidence on Omitting Radiotherapy After Breast-Conserving Surgery.

Altundag K

J Surg Oncol · 2026 Mar · PMID 41432433 · Publisher ↗

Abstract loading — click title to view on PubMed.

Survival Disparities in Early-Onset Pancreatic Cancer (EOPC): The Role of Socioeconomic Status and Healthcare Access.

Khalid A, Fazal AA, Shah M … +5 more , DePeralta D, Gholami S, Newman E, Melis M, Weiss MJ

J Surg Oncol · 2026 Mar · PMID 41432431 · Publisher ↗

INTRODUCTION: Early-onset pancreatic cancer (EOPC), defined as pancreatic ductal adenocarcinoma (PDAC) diagnosed at or before age 50, is an increasingly recognized clinical entity with a rising incidence. Despite advance... INTRODUCTION: Early-onset pancreatic cancer (EOPC), defined as pancreatic ductal adenocarcinoma (PDAC) diagnosed at or before age 50, is an increasingly recognized clinical entity with a rising incidence. Despite advancements in treatment, socioeconomic status (SES) disparities have impacted access to care and survival. This study examined the relationship between SES and survival in EOPC. METHODS: Data from the National Cancer Database (2004-2022) were analyzed for patients diagnosed with EOPC. SES was determined using a composite measure incorporating education and income levels and was categorized into four quartiles. Kaplan-Meier survival analysis and multivariable Cox proportional hazards modeling were used to assess survival differences across the SES groups. RESULTS: A total of 10,729 patients with EOPC were included, with 24.0% in the low SES group, 29.9% in mid-low SES, 30.3% in mid-high SES, and 15.8% in high SES. Higher SES was associated with increased access to multimodal therapy, including neoadjuvant and adjuvant chemotherapy, radiation, and surgical resection (p < 0.001). Private insurance coverage was significantly higher in the high-SES group (81.1% vs. 50.2% in the low-SES group, p < 0.001). Multivariable Cox regression showed that patients in the high-SES group had a significantly lower risk of mortality (HR = 0.71, 95% CI: 0.54-0.83; p = 0.033). The median survival increased from 9 months in the low SES group to 12 months in the high SES group (p < 0.001). Kaplan-Meier analysis showed that survival differences by SES were most pronounced in advanced-stage disease, particularly in stage III (p = 0.017) and stage IV (p < 0.001) cancers. CONCLUSION: Lower SES was consistently linked to worse EOPC survival, particularly in advanced stages. Addressing SES-related disparities through targeted interventions and healthcare policy reforms could improve outcomes across all disease stages. Further research into the unique tumor biology and molecular characteristics of EOPC is needed to better understand how SES influences disease progression and treatment response.

The Fibula Free Flap for Salvage of Complications After Orthopedic Extremity Bony Fixation in Oncologic Patients.

Levy J, Graziano FD, Shammas RL … +6 more , Matros E, Coriddi M, Disa JJ, Mehrara BJ, Cordeiro PG, Shahzad F

J Surg Oncol · 2026 Mar · PMID 41432354 · Publisher ↗

BACKGROUND: Advances in orthopedic oncology have significantly improved outcomes following extremity tumor resections; however, complications like nonunion, hardware failure, and radiation-induced fractures can occur aft... BACKGROUND: Advances in orthopedic oncology have significantly improved outcomes following extremity tumor resections; however, complications like nonunion, hardware failure, and radiation-induced fractures can occur after orthopedic fixation. While the vascularized fibula-free flap (FFF) is well-established in primary reconstructions, its effectiveness as a salvage option is not well described. We report our 25-year experience with the use of FFF in salvage extremity reconstruction. METHODS: This retrospective case series included patients undergoing extremity salvage with FFF after failure of primary oncologic reconstructions from 1995 to 2021. Demographics, surgical indications, reconstructive details, functional outcomes, complications, and Musculoskeletal Tumor Society (MSTS) scores were analyzed. RESULTS: Fifteen patients (ages 6-71 years) met inclusion criteria, which included nine humeral and six femoral reconstructions, with an average follow-up of 6.7 years. Indications for salvage were radiation-induced fracture (n = 6), nonunion (n = 3), allograft fracture (n = 3), and hardware failure (n = 3). The median interval between the initial surgery for tumor resection and FFF for limb salvage was 4 years 3 months (mean: 9 years, range: 10 months to 29.3 years). All lower-extremity reconstructions achieved full weight-bearing without pain. Upper-extremity reconstructions resulted in full functional restoration in six patients and minor functional deficits in three. Bony union of fibula flap was achieved in 78.5% patients. Reoperation were performed in 4 patients for wound issues (n = 2) and hardware removal (n = 2). CONCLUSION: FFF is a reliable and effective option for management of oncologic-related complications of the extremities. It can avoid amputations and improve limb function.

Neoadjuvant Chemotherapy in Resectable Biliary Tract Cancer: A Systematic Review and Metanalysis.

Pereira RA, Barcellos G, Lenz G … +2 more , Pereira AAL, Biachi de Castria T

J Surg Oncol · 2026 Mar · PMID 41424434 · Publisher ↗

BACKGROUND AND OBJECTIVES: The benefit of neoadjuvant chemotherapy in resectable biliary tract cancer remains unclear. METHODS: A systematic review and meta-analysis of 23 studies (n = 11,344) compared neoadjuvant chemot... BACKGROUND AND OBJECTIVES: The benefit of neoadjuvant chemotherapy in resectable biliary tract cancer remains unclear. METHODS: A systematic review and meta-analysis of 23 studies (n = 11,344) compared neoadjuvant chemotherapy with upfront surgery. RESULTS: Neoadjuvant therapy improved overall survival (HR = 0.69) and R0 resection rates (OR = 1.30) without increasing postoperative morbidity or mortality. CONCLUSIONS: Neoadjuvant chemotherapy may improve survival and surgical outcomes in resectable biliary tract cancer.

Evaluation of Circulating miR-155, miR-221, miR-34a, and miR-143 for Monitoring Tumor Clearance After Surgery in Colorectal Cancer.

Ham-Karim HA

J Surg Oncol · 2026 Mar · PMID 41424414 · Publisher ↗

BACKGROUND: Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide. Despite advances in surgery and adjuvant therapy, recurrence after curative resection remains a major challenge... BACKGROUND: Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide. Despite advances in surgery and adjuvant therapy, recurrence after curative resection remains a major challenge, and current surveillance tools such as carcinoembryonic antigen (CEA) and imaging lack sensitivity for detecting minimal residual disease (MRD). Circulating microRNAs (miRNAs) have emerged as promising biomarkers due to their stability in plasma and disease-specific expression profiles. OBJECTIVE: This study aimed to evaluate the clinical relevance of four circulating cell-free miRNAs-miR-155, miR-221, miR-34a, and miR-143-for monitoring tumor clearance following surgery in CRC patients. METHODS: Plasma samples were obtained from CRC patients at multiple perioperative time points and compared with samples from healthy controls. Expression levels of the selected miRNAs were quantified using real-time PCR, normalized to cel-miR-39, and analyzed in relation to clinicopathological features. Dynamic postoperative changes and diagnostic performance were assessed, including ROC curve analysis. RESULTS: Circulating miR-155 and miR-221 were significantly upregulated in CRC patients compared with controls, whereas the tumor suppressor miRNAs miR-34a and miR-143 were markedly downregulated. Postoperative samples showed progressive normalization of these markers, though variability persisted in a subset of patients. The combined four-miRNA panel achieved excellent diagnostic accuracy (AUC = 0.999), outperforming CEA in distinguishing CRC from controls. No independent predictive effect of individual miRNAs was demonstrated in multivariate models, but biologically consistent trends were observed. CONCLUSION: Circulating miR-155, miR-221, miR-34a, and miR-143 demonstrate dynamic early postoperative changes and hold promise as minimally invasive biomarkers of short-term tumor clearance after colorectal cancer surgery. While the combined panel shows strong diagnostic performance at baseline, longer-term prospective studies with multi-year follow-up are required to establish their role in recurrence surveillance alongside established markers such as CEA and ctDNA.

Comparison of Presentation and Management in Skeletal and Extraskeletal Ewing Sarcoma in Children.

Chidiac C, Ramdat C, McDermott KM … +3 more , Levin AS, Lemberg KM, Rhee DS

J Surg Oncol · 2026 Mar · PMID 41410299 · Publisher ↗

OBJECTIVE: Extraskeletal Ewing sarcoma (EES) is a variant of Ewing sarcoma that originates from soft tissues rather than bones. Our study aims to characterize the differences between EES and skeletal ES (SES) in the pedi... OBJECTIVE: Extraskeletal Ewing sarcoma (EES) is a variant of Ewing sarcoma that originates from soft tissues rather than bones. Our study aims to characterize the differences between EES and skeletal ES (SES) in the pediatric population. METHODS: We conducted a retrospective review of children ≤ 18 years with ES recorded in the National Cancer Data Base (NCDB) from 2004 to 2022. Kaplan-Meier curves and Cox proportional hazards regression analysis were used to identify risk factors associated with survival. RESULTS: Among 7446 identified patients, 1016 (20.9%) had EES and 6430 (79.1%) had SES. EES patients were older (median 14 vs. 13 years, p = 0.007), more often female (46.9% vs. 41.2%, p = 0.0009), and had smaller tumors (7.5 vs. 8.0 cm, p = 0.003). Tumor distribution differed significantly, with EES was most frequent in the thorax (49.8%) and head and neck (11.8%), while SES more common in the lower limbs (30.2%) and pelvis (25.3%) (p < 0.0001). EES patients were more likely to receive surgery alone (4.2% vs. 1.8%) or a combination of surgery, chemotherapy, and radiation (25.9% vs. 20.7%) but less likely to receive chemotherapy and radiation without surgery (19.4% vs. 29.3%, p < 0.05). Five-year overall survival was similar between SES (72.2%) and EES (73.7%) (p = 0.70). Multivariable analysis confirmed EES was not an independent predictor of survival (aHR 0.94; 95% CI 0.81-1.10). Factors independently associated with mortality were older age, metastasis at diagnosis, and positive surgical margins. CONCLUSIONS: Demographic, treatment characteristics, and prognostic factors differ between pediatric patients with SES and EES. However, survival is similar between the two groups.

Changing Practices in Axillary Surgery After Neoadjuvant Breast Cancer Therapy: Insights From the EUSOMA European Database.

Esgueva AJ, Tomatis M, Ponti A … +7 more , Marotti L, Cardoso MJ, Cheung KL, Vries J, Dam PV, Rubio IT, Eusoma Working group

J Surg Oncol · 2026 Mar · PMID 41410296 · Full text

INTRODUCTION: Sentinel lymph node biopsy (SLNB) after neoadjuvant treatment (NAT) is an increasing option for axillary surgery in patients responding to treatment, whether diagnosed as clinically node-negative (cN0) or n... INTRODUCTION: Sentinel lymph node biopsy (SLNB) after neoadjuvant treatment (NAT) is an increasing option for axillary surgery in patients responding to treatment, whether diagnosed as clinically node-negative (cN0) or node-positive (cN + ). This study evaluates SLNB trends in patients with NAT in a large European population. MATERIALS AND METHODS: Data sourced from EUSOMADB, collating prospectively collected data from certified European Breast Units, included 17,321 patients who have undergone NAT between 2010 and 2021. Of those, 9,226 and 8.095 are clinically N0 and cN1, respectively. RESULTS: During the study period, for cN0 patients, there has been a significant increase in the proportion of cases with SLNB, rising from 86% in the 2010-2015 period to 94% in the 2016-2021 period. Consequently, a decline in direct axillary dissection (AD) has been shown in both periods, dropping from 14% to 6% (p < 0.001). Similarly, in cN+ patients, SLNB increased from 25% to 40%, while direct AD decreased from 75% to 60% (p < 0.001). Regarding immunohistochemistry subtypes, higher SLNB rates were reported in triple-negative and HER2-enriched tumors. Nevertheless, SLNB rates rose significantly across all immunohistochemical subtypes (p < 0.001) between both periods. Multivariate analysis identified as statistically significant predictors of SLNB: surgery period (second period), molecular subtype (HER2-positive, triple-negative), breast-conserving surgery and type of NAT. CONCLUSION: This study evidences a substantial shift towards SLNB as the primary axillary surgery following NAT during the study period. This trend emphasizes a preference for less invasive procedures, likely due to the efficacy of neoadjuvant therapy in reducing axillary lymph node involvement.

Multimodal Care and Outcomes of Pancreatic Cancer Patients Are Influenced by Factors Beyond Biology: A Population-Based Study From Louisiana Tumor Registry.

Galatas A, Malinosky HR, Chapple AG … +7 more , McManus S, Byerley A, Littlefield E, Hemelt S, Lyons J, Danos D, Moaven O

J Surg Oncol · 2026 Mar · PMID 41410291 · Publisher ↗

BACKGROUND: This study aims to evaluate potential disparities in multimodal treatment and its impact on outcomes among pancreatic cancer patients in Louisiana. METHODS: Data on pancreatic cancer cases diagnosed between 2... BACKGROUND: This study aims to evaluate potential disparities in multimodal treatment and its impact on outcomes among pancreatic cancer patients in Louisiana. METHODS: Data on pancreatic cancer cases diagnosed between 2000 and 2020 were obtained from the Louisiana Tumor Registry. Bivariate relationships were assessed via Chi-square tests. Treatment was modeled with logistic regression models. Time-to-treatment was modeled with negative binomial regression models. Overall survival was analyzed with Cox proportional hazards models. Results are reported as odds ratio (OR), rate ratios (RR), hazards ratio (HR), and 95% Wald confidence intervals. RESULTS: A total of 8,466 patients with pancreatic cancer were included. A significantly higher proportion of nonmetastatic cases received therapy compared to metastatic cases. Non-Hispanic Black patients with nonmetastatic disease experienced a significantly longer time to treatment compared to Non-Hispanic White patients. In the metastatic model, uninsured patients and those with Medicaid had the highest odds of not receiving therapy. Primary resection was a strong predictor of improved survival. Nonsurgical therapy also contributed to better outcomes. CONCLUSION: The findings of this study are instrumental in designing a more granular investigation of multi-level determinants to identify the actionable items driving the observed disparities associated with worse outcomes.

Impact of Combined Additional Resections on the Surgical Outcomes of Robot-Assisted Resection of Thymic Epithelial Tumors.

Niedermaier B, Khan N, Eichhorn F … +10 more , Zehentmeier M, Grosch H, Griffo R, Campisi A, Margineanu A, Allgäuer M, Christopoulos P, Thomas M, Winter H, Eichhorn ME

J Surg Oncol · 2026 Mar · PMID 41410288 · Full text

BACKGROUND AND OBJECTIVES: Robot-assisted thoracoscopy (RATS) is rapidly emerging as the preferred approach for the resection of thymic epithelial tumors (TET). Current challenges include the role of RATS in locally adva... BACKGROUND AND OBJECTIVES: Robot-assisted thoracoscopy (RATS) is rapidly emerging as the preferred approach for the resection of thymic epithelial tumors (TET). Current challenges include the role of RATS in locally advanced disease and combined additional resections. METHODS: This single-center study included all consecutive robot-assisted surgeries for TET performed between 2018 and 2024. We report perioperative outcomes and findings from a large center for robotic surgery center. RESULTS: One hundred and forty-three patients underwent RATS for the resection of histologically confirmed TET, including 130 (91%) patients with thymoma and 13 (9%) patients with thymic carcinoma. The median tumor size was 54 mm (35.5-75) and most patients presented in a localized stage of disease, with 120 patients (83.9%) in TNM stage I (TNM 8th edition). The conversion rate to open surgery was 4.2% and R0 resection was achieved in 134 (93.7%) patients. Combined extended resections that included lung, pericardium or great vessels were performed in 44 (30.8%) patients and were the only independent predictor of postoperative complications in a multivariable logistic regression model (OR 2.87; p = 0.03). CONCLUSIONS: Robot-assisted surgery is feasible and without unexpected safety concerns for TET. Combined extended resections, often necessary for locally advanced disease, are a significant predictor of postoperative complications.

Predictors of Early Versus Late Recurrence in Post-Surgical Oral Cancer Patients.

Joshi P, Kole L, Bavaskar M … +4 more , Singh A, Shetty R, Nair S, Chaturvedi P

J Surg Oncol · 2026 Mar · PMID 41410259 · Publisher ↗

This retrospective study evaluated predictors of early versus late recurrence in 277 patients with oral squamous cell carcinoma (OSCC) who underwent surgical treatment between 2017 and 2020. Using receiver operating char... This retrospective study evaluated predictors of early versus late recurrence in 277 patients with oral squamous cell carcinoma (OSCC) who underwent surgical treatment between 2017 and 2020. Using receiver operating characteristic analysis, an 8-month disease-free survival cutoff effectively stratified patients into early (DFS < 8 months) and late (DFS ≥ 8 months) recurrence groups. Early recurrence was associated with significantly poorer overall survival (mean OS 24.03 months) compared to late recurrence (mean OS 35.26 months). Multivariate logistic regression identified adjuvant therapy status and type, bone involvement, positive pathological nodal stage, and perineural invasion as independent predictors of early recurrence. Local recurrences demonstrated better survival outcomes than regional or distant failures. The findings underscore the prognostic significance of recurrence timing and highlight the need for risk-adapted surveillance and tailored adjuvant strategies in high-risk OSCC patients.

Examining Surgical Margins in the Excision of Basal Cell Carcinoma and Squamous Cell Carcinoma: Evaluating Pre-Excision, Post-Excision, Post-Fixation, and Pathological Margin Measurements.

Agdoğan Ö, Arslan Aİ

J Surg Oncol · 2026 Mar · PMID 41410248 · Publisher ↗

INTRODUCTION: There remains uncertainty regarding whether the determination of a safe margin is the responsibility of the surgeon or the pathologist during the pathological analysis of tissue from various procedures. Thi... INTRODUCTION: There remains uncertainty regarding whether the determination of a safe margin is the responsibility of the surgeon or the pathologist during the pathological analysis of tissue from various procedures. This study aims to assess the alterations in surgical margin dimensions of tissue 1 h post-excision, following 24 h of formalin fixation, and pathological in comparison to the margin determined prior to excision. PATIENTS AND METHODS: Measurements and mean values were taken for each specimen at four stages: before excision, 1 h post-excision, after 24 h of 10% formalin fixation, and following pathologic examination. BCCs and SCCs were evaluated independently, and statistical analyses were performed to assess changes in the measurements of the specimens. RESULTS: Table 1 illustrates highly significant reductions of the order of 70%-80% overall in the measured specimen margin widths over time for all of the categories measured. CONCLUSION: Excised skin cancers were found to undergo significant shrinkage at every stage of pathological evaluation, resulting in a surgical margin significantly narrower than the safety margin initially determined. We have clarified what the surgical margin reported by the dermatopathologist actually means. In this way, it was aimed to eliminate the disagreement between the surgeon and the pathologist and to prevent the need for additional surgery and morbidities.

Severe Complications in Remnant Gastric Cancer: An Epiphenomenon of Tumor Biology and Surgical Complexity?

Zhang Y

J Surg Oncol · 2026 Feb · PMID 41363879 · Publisher ↗

Abstract loading — click title to view on PubMed.

Development of a Multivariable Machine Learning Model for the Prediction of Postoperative Ileus After Radical Cystectomy.

Manoharan M, Raja Iyub MJ, Zhang Y … +5 more , Prabhakar P, Pon Avudaiappan A, Eldefrawy M, Sridhar SR, Sakthivel DK

J Surg Oncol · 2026 Feb · PMID 41363875 · Publisher ↗

BACKGROUND AND OBJECTIVES: Postoperative Ileus (POI) is a common complication after Radical Cystectomy (RC) that delays recovery and extends hospital stay. Our objective was to develop machine learning (ML) models that c... BACKGROUND AND OBJECTIVES: Postoperative Ileus (POI) is a common complication after Radical Cystectomy (RC) that delays recovery and extends hospital stay. Our objective was to develop machine learning (ML) models that can predict patients at a high risk of developing POI after RC. METHODS: Data of patients who underwent RC for bladder cancer at our institution were retrospectively extracted for analysis and model creation. Data pre-processing and variable selection were applied. Several ML models were developed, evaluated, and compared using the area under the curve (AUC), F1 score, precision, sensitivity, and specificity. RESULTS: Three hundred and seven patients were included in the analysis, and of these, 30 patients (9.8%) developed POI. Overall, 78.2% of patients were male and 91.2% were White. Of the various ML models, logistic regression demonstrated the highest AUC (0.98), followed by random forest (0.97), Support Vector Machine (0.97), XGBoost (0.95), simple neural network (0.87), and decision tree (0.84). Furthermore, the first two models also displayed higher specificity (0.94 and 0.93) and F1 scores (0.78 and 0.75). All models except for the decision tree and neural network achieved 100% sensitivity. Features such as age, body mass index (BMI), American Society of Anaesthesiologists (ASA) class status, surgical approach, potassium level, and the placement of a nasogastric tube were identified as key predictors of the outcome. CONCLUSION: Based on our data, ML models can effectively predict POI after RC, especially with logistic regression and random forest. The identification of relevant predictors may contribute meaningfully to potential applications in risk stratification and personalized care.
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