World Journal Of Surgical Oncology[JOURNAL]
Sun
200 papers
LncRNA ACTA2-AS1 acts as a bladder cancer prognostic biomarker and blocks malignant advance via miR-148b-3p/DNAJB4.
Chen X, Tang Q, Wang Y … +2 more , Zhang J, Zhou L
World J Surg Oncol · 2026 Jun · PMID 42337672 · Full text
BACKGROUND: Long non-coding RNA (lncRNA) is crucial in bladder cancer (BCa) development. This research explores the clinical significance and underlying mechanisms of lncRNA ACTA2-AS1 in BCa. METHODS: From the GEO databa...
BACKGROUND: Long non-coding RNA (lncRNA) is crucial in bladder cancer (BCa) development. This research explores the clinical significance and underlying mechanisms of lncRNA ACTA2-AS1 in BCa. METHODS: From the GEO database, differentially expressed lncRNAs (DElncRNAs) in BCa were identified, and tumor, along with adjacent non-tumor tissue samples from 132 patients, were collected. RT-qPCR was employed for the quantitative measurement of ACTA2-AS1, miR-148b-3p, and DNAJB4 expression. Chi-square analysis was employed to assess the association of ACTA2-AS1 with clinical features. Kaplan-Meier and Cox regression evaluated ACTA2-AS1's prognostic value. CCK-8, Transwell, and flow cytometry assays evaluated cell proliferation, migration, invasion, apoptosis, and cell cycle arrest. DLR and RIP tests confirmed miR-148b-3p's targeting of ACTA2-AS1 and DNAJB4. RESULTS: ACTA2-AS1 showed significant downregulation in four GEO databases. Moreover, both ACTA2-AS1 and DNAJB4 were notably decreased in BCa tumor tissues, while miR-148b-3p increased significantly. Low ACTA2-AS1 expression correlates with poor tumor differentiation, positive lymph node metastasis, and TNM stage III-IV. Moreover, patients with low ACTA2-AS1 expression are associated with a significantly unfavorable prognosis. Mechanistically, miR-148b-3p targets ACTA2-AS1 and DNAJB4. The suppression impacts of ACTA2-AS1 on BCa cell proliferation, migration, and invasion, and its boost of apoptosis and cell cycle arrest were greatly reversed by miR-148b-3p. CONCLUSION: Low ACTA2-AS1 expression is a potential biomarker for unfavorable prognosis in BCa patients. Furthermore, ACTA2-AS1 may counteract BCa's malignant biological behaviors via targeting the miR-148b-3p/DNAJB4 axis.
HMGB1 promotes radiotherapy resistance in human cervical cancer HeLa cells through regulating the AMPK/mTOR signaling.
Xie Y, Yu C, Wang M … +2 more , Lin Y, Wang B
World J Surg Oncol · 2026 Jun · PMID 42337568 · Full text
Cervical cancer (CC) ranks as the third most common malignancy among women worldwide. Radiotherapy (RT) resistance represents a major cause of clinical treatment failure and disease progression. High-mobility group box-1...
Cervical cancer (CC) ranks as the third most common malignancy among women worldwide. Radiotherapy (RT) resistance represents a major cause of clinical treatment failure and disease progression. High-mobility group box-1 (HMGB1), a nuclear protein released during RT, has been implicated in the regulation of radiation resistance. This study aimed to establish HeLa RT-resistant (HeLa-R) cells and investigate the effect of HMGB1 on RT resistance and its underlying molecular pathway. HeLa-R cells were established through fractionated X-ray irradiation. Cell viability, proliferation, migration, and invasion were assessed using methyl thiazolyl tetrazolium (MTT), colony formation, Transwell migration, and invasion assays, respectively. HMGB1 expression was analyzed by quantitative RT-PCR, Western blot, and immunofluorescence. A phospho-kinase array was performed to evaluate phosphorylation levels of key kinase sites. Following fractionated X-ray irradiation, we successfully established HeLa-R cells, which exhibited significantly elevated HMGB1 expression compared to parental cells. HMGB1 knockdown suppressed RT resistance in HeLa-R cells, accompanied by increased phosphorylation of AMP-activated protein kinase (p-AMPK). Conversely, AMPK inhibition restored cell viability, colony formation, migration, and invasion in HMGB1-deficient HeLa-R cells. Mechanistically, in HeLa-R cells, mTOR was identified as a downstream effector of AMPK signaling. Separately, clinical analysis revealed that HMGB1 levels were significantly elevated, while p-AMPK levels were markedly reduced in tumor tissues from radioresistant patients compared with radiosensitive patients. In conclusion, our in vitro findings demonstrate that HMGB1 inhibition suppresses RT resistance in HeLa-R cells through activation of the AMPK/mTOR pathway. The clinical correlations between HMGB1, p-AMPK, and radiotherapy response support the potential relevance of this pathway, although further validation in patient tissues is required.
Robotic-assisted versus conventional nipple-sparing mastectomy with immediate implant-based breast reconstruction: a GRADE-assessed systematic review and meta-analysis of prospective studies.
Mirza W, Iqbal H, Khan ME … +2 more , Khan A, Khan HM
World J Surg Oncol · 2026 Jun · PMID 42337566 · Full text
BACKGROUND: Robotic nipple-sparing mastectomy with immediate implant-based reconstruction is increasingly adopted to improve cosmetic outcomes and patient experience; however, its comparative perioperative value against...
BACKGROUND: Robotic nipple-sparing mastectomy with immediate implant-based reconstruction is increasingly adopted to improve cosmetic outcomes and patient experience; however, its comparative perioperative value against conventional or open nipple-sparing mastectomy remains uncertain when restricted to prospective evidence. METHODS: We performed a PRISMA-aligned systematic review and random-effects meta-analysis of prospective comparative studies and randomized trials comparing robotic versus conventional or open nipple-sparing mastectomy with immediate implant-based reconstruction. The primary outcome was the total operative time, and the secondary outcomes were major complications, nipple-areolar complex ischemia or necrosis, and length of hospital stay. The risk of bias was assessed using RoB 2 for randomized data and ROBINS-I for nonrandomized data. Leave-one-out sensitivity analyses were conducted for outcomes with substantial heterogeneity, and the certainty of the evidence was graded using GRADE. RESULTS: Three prospective studies were included. Robotic surgery was associated with a significantly longer total operative time (mean difference 64.01 min, 95% confidence interval 8.54-119.47). Major complications did not differ between the approaches (risk ratio 0.63, 95% confidence interval 0.27-1.47), nor did nipple areolar complex ischemia or necrosis (risk ratio 0.56, 95% confidence interval 0.28-1.11) or length of hospital stay (mean difference 0.22 days, 95% confidence interval - 0.26 to 0.70). Heterogeneity was high for operative time and moderate to substantial for length of stay. The certainty of the evidence was low overall, driven by imprecision, heterogeneity, and limitations of the non-randomized design. CONCLUSIONS: Robotic nipple-sparing mastectomy is associated with a longer operative time than conventional or open approaches. No statistically significant differences were observed in major complications or nipple-areolar complex viability; however, the current prospective evidence base is limited, heterogeneous, and imprecise, and clinically important differences cannot be excluded. In experienced centers, robotic nipple-sparing mastectomy may be considered for carefully selected patients who prioritize scar concealment and minimally invasive access; however, its broader role in routine practice remains uncertain pending stronger prospective data on safety, patient-reported outcomes, and resource use.
Multi-omics integration and clinical validation identify CKAP2 as a diagnostic biomarker for bladder cancer.
Li X, Yang J, Cha J … +6 more , Xie H, Dong C, Yang Y, Li Y, Guo J, Lin C
World J Surg Oncol · 2026 Jun · PMID 42337544 · Full text
BACKGROUND: Bladder cancer (BC) remains a prevalent malignancy with a high recurrence rate; however, the lack of specific biomarkers hinders early detection and effective management. Although Cytoskeleton-Associated Prot...
BACKGROUND: Bladder cancer (BC) remains a prevalent malignancy with a high recurrence rate; however, the lack of specific biomarkers hinders early detection and effective management. Although Cytoskeleton-Associated Protein 2 (CKAP2) has been implicated in tumorigenesis, its diagnostic value and biological function in BC have not been fully elucidated. This study aimed to identify and rigorously validate CKAP2 as an important diagnostic biomarker using a multi-omics approach integrated with clinical validation. METHODS: Differential expression analysis and machine learning-based feature selection were employed to screen for candidate biomarkers, identifying CKAP2 as a key gene of interest. Mendelian randomization (MR) was used to assess the causal relationship between CKAP2 and BC risk. To evaluate clinical utility, a diagnostic model based on logistic regression was established and validated in an independent real-world cohort of 127 tissue samples, including 50 pairs of matched tumor and adjacent normal tissues, 21 independent tumor tissues, and 6 independent adjacent normal tissues. Additionally, single-cell RNA sequencing (scRNA-seq) and cell-cell communication analyses were performed to dissect the role of CKAP2 within the tumor microenvironment. RESULTS: CKAP2 expression was significantly upregulated in BC tissues compared to that in normal tissues (log2FoldChange = 1.53, p < 10⁻). MR analysis provided evidence supporting a potential causal association between elevated CKAP2 expression and increased BC risk. In the external clinical validation, the CKAP2-based model demonstrated exceptional discrimination with an Area Under the Curve (AUC) of 0.931. Calibration curves indicated a high agreement between the predicted and observed probabilities, while Decision Curve Analysis (DCA) confirmed a substantial clinical net benefit. Mechanistically, scRNA-seq localized high CKAP2 expression primarily to cancer cells, and cell-cell communication analysis suggested that CKAP2 may play an important role in modulating tumor-stroma interactions, particularly with fibroblasts. CONCLUSION: Our integrated analysis supports the potential utility of CKAP2 as a diagnostic biomarker for BC. By integrating multi-omics analysis, causal inference, and validation in an independent clinical cohort, these results consistently point to CKAP2's diagnostic potential and suggest its involvement in BC progression.
Study of phosphorylated ribosomal protein S6 (pS6) in the clinical outcomes of patients undergoing hepatectomy for metastatic colorectal cancer.
Henriques Cavalcanti Torres de Melo R, de Barros Silva PG, Neto HFEC … +5 more , Nunes RCS, de Moura Torres de Melo JR, Bezerra MJB, Dornelas CA, Hirth CG
World J Surg Oncol · 2026 Jun · PMID 42332725 · Full text
INTRODUCTION: Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide, with up to 50% of patients developing metastatic disease, predominantly involving the liver. Hepatectomy remains the gold standar...
INTRODUCTION: Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide, with up to 50% of patients developing metastatic disease, predominantly involving the liver. Hepatectomy remains the gold standard for resectable hepatic metastases; however, recurrence rates remain high and reliable prognostic biomarkers are lacking. Phosphorylated ribosomal protein S6 (pS6), a surrogate marker of PI3K/AKT/mTORC1 pathway activation, has been implicated in tumor aggressiveness across multiple cancer types, but its prognostic role after hepatectomy for metastatic colorectal cancer (mCRC) has not been established. OBJECTIVE: To evaluate the prognostic impact of pS6 expression and other molecular markers (BRAF V600E, p53, CERBB2, MSH6, PMS2, FUS, and HSPA9) assessed by immunohistochemistry on tissue microarray (TMA) on the clinical outcomes of patients undergoing hepatectomy for metastatic colorectal cancer. MATERIALS AND METHODS: A retrospective cohort study was conducted including 64 patients who underwent hepatectomy for mCRC between 2012 and 2022 at a high-complexity oncology center in Northeast Brazil. Molecular marker expression was evaluated by immunohistochemistry on TMA constructed from paraffin-embedded hepatic metastasis specimens. Disease-free survival (DFS) at 1, 3, and 5 years and overall survival (OS) were analyzed using Fisher's exact test, Kaplan-Meier curves, and Cox regression multivariate analysis. RESULTS: Median OS was 23 months (95% CI = 18.33-27.66). Among all molecular markers assessed, only pS6 positivity (20.7% of cases) showed a statistically significant association with worse DFS at 1 year (p = 0.032), 3 years (p = 0.038), and 5 years (p = 0.018). A significant association was also identified between pS6 positivity and FUS positivity (p = 0.014). In multivariate analysis for DFS, pS6 positivity was an independent predictor of recurrence at 3 years (HRa = 9.710; p = 0.028) and 5 years (HRa = 11.857; p = 0.018), as were postoperative complications at 3 years (HRa = 8.671; p = 0.014) and 5 years (HRa = 6.912; p = 0.029). For overall survival, three independent predictors of mortality were identified: adjuvant chemotherapy (HRa = 0.052; p < 0.001), absence of 1-year DFS (HRa = 3.641; p = 0.001), and pS6 positivity (HRa = 4.547; p = 0.001). CONCLUSION: Median overall survival was 23 months, reflecting the high mortality burden of mCRC after hepatectomy. Among all molecular markers evaluated, pS6 was the only one independently associated with worse disease-free survival and higher mortality risk, consistent with its role as a surrogate marker of PI3K/AKT/mTORC1 pathway activation, though a direct causal relationship cannot be established from the present data. A significant association between pS6 and FUS positivity suggests a possible convergence of oncogenic pathways warranting further investigation. Postoperative complications were independent predictors of recurrence, and adjuvant chemotherapy was the strongest independent predictor of improved overall survival. Given the retrospective single-center design and limited sample size, these findings are hypothesis-generating and require prospective multicenter validation before clinical application.
Mesopancreas excision in pancreatic ductal adenocarcinoma: recurrence patterns - a single-arm descriptive study.
Saleh SK, Saleh AG, Mohamed TA … +5 more , Hendy MM, Farahat MS, Boushra ST, Kamil CM, Saleh RK
World J Surg Oncol · 2026 Jun · PMID 42324571 · Full text
BACKGROUND: Mesopancreas excision has emerged as a critical component of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC), potentially improving oncological outcomes. However, comprehensive data on rec...
BACKGROUND: Mesopancreas excision has emerged as a critical component of pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC), potentially improving oncological outcomes. However, comprehensive data on recurrence patterns following mesopancreas excision remain limited. OBJECTIVE: To analyze recurrence patterns in patients with PDAC who underwent pancreaticoduodenectomy with mesopancreas excision at a tertiary care center in Egypt. METHODS: This single-arm, single-center, retrospective descriptive cohort study with prospective follow-up included 86 patients with PDAC who underwent pancreaticoduodenectomy with complete mesopancreas excision at Liver and GIT Hospital, Minia University, between February 2018 and February 2024. Patients were followed for a minimum of 24 months, with data collection concluding in February 2026. Data collected included demographics, tumor characteristics, surgical outcomes, pathological findings, and recurrence patterns. The primary outcome was disease recurrence; secondary outcomes included recurrence-free survival (RFS), overall survival (OS), and patterns of recurrence distribution. RESULTS: Of 86 patients (mean age 58.4 ± 9.2 years, 61.6% male), R0 resection was achieved in 73 patients (84.9%). During follow-up, 52 patients (60.5%) developed recurrence at a median of 11.3 months. Local recurrence occurred in 18 patients (34.6%), distant metastases in 21 patients (40.4%), and combined recurrence in 13 patients (25.0%). The liver was the most common site of distant recurrence, involved in 42.3% of all recurrent cases, followed by lungs (23.1%) and peritoneum (19.2%). Median RFS was 13.2 months (95% CI: 10.8-15.6), and median OS was 18.7 months (95% CI: 16.3-21.1). Lymph node positivity (HR 2.34, p = 0.003), poor differentiation (HR 1.89, p = 0.012), and elevated CA19-9 (HR 1.67, p = 0.028) were independent predictors of recurrence. CONCLUSION: Despite complete mesopancreas excision, PDAC demonstrates high recurrence rates with a predominant distant metastatic pattern. Early systemic therapy and intensive surveillance protocols may be warranted for high-risk patients. This study describes the recurrence patterns following complete mesopancreas excision; however, due to the absence of a concurrent control group and the exclusion of patients requiring vascular resection/reconstruction, any superiority in the observed R0 resection rate cannot be directly attributed to the surgical technique itself, and prospective randomized controlled trials remain necessary to establish the oncological benefit of complete mesopancreas excision over standard pancreaticoduodenectomy.
Targeting RELA and STAT3 regulates TNFRSF10A-mediated apoptosis in a novel apoptosis-based prognostic model for clear cell renal cell carcinoma.
Deng Y, Hao C, Yang X … +3 more , Yu C, Xia M, Wang T
World J Surg Oncol · 2026 Jun · PMID 42324555 · Full text
BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal malignancy and remains a major cause of cancer-related mortality worldwide. Although advances in surgery, targeted therapy, and immu...
BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal malignancy and remains a major cause of cancer-related mortality worldwide. Although advances in surgery, targeted therapy, and immunotherapy have improved outcomes for patients, reliable biomarkers for predicting prognosis remain limited. Therefore, robust gene-based prognostic models are urgently needed to improve risk stratification and guide individualized treatment strategies. METHODS: We developed a novel prognostic model integrating apoptosis and immune - related genes (AIRGs) to predict overall survival (OS) in patients with ccRCC. RESULT: Using Gene Set Enrichment Analysis (GSEA) combined with least absolute shrinkage and selection operator (LASSO) Cox regression, we identified 7 key prognostic genes, namely, CCR4, TNFRSF10A, TEK, TGFA, CD14, IFITM1, and SEMA3G, that collectively demonstrated strong predictive performance in TCGA cohort with c-index = 0.711. Functional enrichment analyses revealed that apoptosis, immune regulation, and multiple oncogenic signaling pathways were significantly associated with the risk score, highlighting the critical role of the tumor microenvironment in ccRCC progression. Transcription factor binding analysis based on the JASPAR database suggested that RELA and STAT3 with scores of 0.829 and 0.951, respectively are potential upstream regulators within the prognostic network, particularly influencing TNFRSF10A expression. External validation using the International Cancer Genome Consortium (ICGC) dataset confirmed the robustness of the prognostic model with c-index = 0.612 Furthermore, in vitro experiments demonstrated that RELA and STAT3 regulate TNFRSF10A-mediated apoptotic signaling in ccRCC cells, providing mechanistic support for the bioinformatic findings. CONCLUSION: This study establishes a biologically informed and clinically relevant prognostic framework for ccRCC. Our findings highlight the therapeutic potential of targeting the RELA/STAT3-TNFRSF10A axis and contribute to the advancement of precision medicine in ccRCC.
An LSCC-specific R-loop-related model predicts prognosis and neoadjuvant immunotherapy response and identifies EIF5A2-mediated tumor-immune crosstalk.
Dai J, Qiao Z, Wang J … +3 more , Chen Z, Yan M, Qiao J
World J Surg Oncol · 2026 Jun · PMID 42323596 · Full text
BACKGROUND: Laryngeal squamous cell carcinoma (LSCC) lacks robust biomarkers for prognostic stratification and immunotherapy prediction. R-loops have been increasingly implicated in transcriptional dysregulation and tumo...
BACKGROUND: Laryngeal squamous cell carcinoma (LSCC) lacks robust biomarkers for prognostic stratification and immunotherapy prediction. R-loops have been increasingly implicated in transcriptional dysregulation and tumor progression, but their clinical significance in LSCC remains unclear. METHODS: We generated an LSCC-specific R-loop-related gene set by intersecting R-loop-associated genes with differentially expressed genes in the TCGA-LSCC cohort, and constructed a prognostic model using LASSO-Cox regression. The model was externally validated in GSE25727 and GSE27020 and further evaluated for neoadjuvant immunotherapy relevance in GSE210287. Single-cell RNA sequencing data from GSE290927 were used to identify the core immune-regulatory gene within the model and explore its potential mechanism in tumor-immune interaction. RESULTS: We identified 56 LSCC-specific R-loop-related candidate genes and established a three-gene model that successfully stratified patients into distinct risk groups, with stable performance in external validation cohorts. The model retained prognostic value, distinguished different immune microenvironment states, and was associated with neoadjuvant immunotherapy response. Among the model genes, EIF5A2 showed the greatest consistency with the overall model in terms of high-risk association, poor prognosis, and unfavorable immune-related changes, and was therefore identified as the core gene. Single-cell analysis further showed that EIF5A2 was mainly expressed in tumor cells, while cell-cell communication analysis revealed enhanced interactions between EIF5A2-high tumor cells and exhausted CD8 T cells, with MIF-CD74-related signaling representing the dominant ligand-receptor axis. CONCLUSIONS: We established an LSCC-specific R-loop-related model with value in prognostic stratification and neoadjuvant immunotherapy prediction, and further identified EIF5A2 as a core immune-regulatory gene within the model. These findings provide a biologically interpretable framework linking R-loop-related tumor states to prognosis, immunotherapy response, and immune remodeling in LSCC.
Preoperative prediction of thymoma risk classification with machine learning-based computed tomography radiomics features.
Zhao K, Liu Y, Xu H … +8 more , Cai W, Jin J, Shen L, Zhu Z, Han H, Hu M, Lu Q, Xue Z
World J Surg Oncol · 2026 Jun · PMID 42321768 · Full text
BACKGROUND: Thymomas are primarily assessed using chest computed tomography (CT); however, this method has inherent limitations such as an overlap between the semantic features of thymomas presenting as localized lesions...
BACKGROUND: Thymomas are primarily assessed using chest computed tomography (CT); however, this method has inherent limitations such as an overlap between the semantic features of thymomas presenting as localized lesions and other histological subtypes. Therefore, this study aimed to develop a combined radiomics model, based on non-contrast CT, and investigate its potential clinical utility in preoperatively differentiating between the thymoma risk classification. METHODS: We retrospectively analyzed the clinical and imaging data of 436 patients with pathologically confirmed thymomas between January 2010 and October 2023. The cohort comprised 272 low-risk cases (types A, AB, and B1) and 164 high-risk cases (types B2 and B3), which were randomly divided into training (n = 306) and validation (n = 130) sets in a 7:3 ratio. Radiomic features were extracted from the volume of interest on non-contrast CT images. Feature selection was performed using principal component analysis, correlation analysis, least absolute shrinkage, and selection operator algorithms to identify the most discriminative features. A combined radiomics nomogram was developed by integrating significant clinical factors with radiomics scores. The discriminative performance of the model was assessed using receiver operating characteristic curve analysis. RESULTS: Two clinicoradiological and 11 radiomics features were identified and used to construct a radiomics nomogram. The diagnostic performance of the nomogram for thymoma risk stratification surpassed that of any single model. The nomogram yielded an area under the curve of 0.753 (accuracy, 71.2%; sensitivity, 62.4%; specificity, 76.7%) in the training cohort and 0.735 (accuracy, 70.8%; sensitivity, 58.8%; specificity, 78.5%) in the validation cohort. CONCLUSION: The nomogram model integrating clinical factors and radiomics features accurately differentiated the histological subtypes of thymoma. This tool may be helpful in formulating personalized treatment plans in clinical practice and is worthy of clinical promotion and application.
GPR17 Suppresses Triple-Negative Breast Cancer Progression and Serves as an Independent Prognostic Biomarke.
Liu G, Wei M, Zhang Y … +2 more , Lu Z, Zhang M
World J Surg Oncol · 2026 Jun · PMID 42321730 · Full text
BACKGROUND: G protein-coupled receptor 17 (GPR17), a Gi protein-coupled receptor, has been defined poorly about its roles and clinical significance in triple-negative breast cancer (TNBC). PURPOSE: The biological express...
BACKGROUND: G protein-coupled receptor 17 (GPR17), a Gi protein-coupled receptor, has been defined poorly about its roles and clinical significance in triple-negative breast cancer (TNBC). PURPOSE: The biological expression profile, prognostic value and functional roles of GPR17 in TNBC were elucidated in the present study. METHODS: Differentially expressed genes were screened through comprehensive bioinformatics analyses of the GSE233242 dataset. GPR17 expression patterns and their prognostic significance in TNBC were evaluated based on the UALCAN, bc-GenExMiner v4.8 and KM-Plotter databases. Prognostic correlations of GPR17 were further validated in a retrospective cohort comprising 163 TNBC patients. In vitro functional assays for cell proliferation, migration and invasion were conducted in MDA-MB-231 and MDA-MB-453 cells after GPR17 overexpression. RESULTS: GPR17 was significantly downregulated in TNBC tumor tissues (p < 0.001), and reduced GPR17 expression was associated with more aggressive tumor phenotypes in TNBC patients. GPR17 expression was closely correlated with clinical T stage and lymph node metastasis, and was identified as an independent prognostic factor for the disease. Ectopic GPR17 overexpression significantly suppressed the proliferative, migratory and invasive capacities of MDA-MB-231 and MDA-MB-453 TNBC cell lines. CONCLUSION: GPR17 holds potential as a novel prognostic biomarker for TNBC, with its expression levels closely associated with tumor progression and able to predict clinical outcomes in TNBC patients.
Tumor count and risk of lymph node metastasis in multiple rectal neuroendocrine tumors: an individual-level pooled analysis.
Xu J, Shi J, Mu Y … +8 more , Zhou N, Du Y, Lai W, Wang Z, Zhang L, Chen Z, Ma Q, Yang YP
World J Surg Oncol · 2026 Jun · PMID 42316232 · Full text
BACKGROUND: Multiple rectal neuroendocrine tumors (RM-NETs) are a rare and underrecognized subtype of rectal neuroendocrine neoplasms. Although these tumors are usually small and well differentiated, their risk of lymph...
BACKGROUND: Multiple rectal neuroendocrine tumors (RM-NETs) are a rare and underrecognized subtype of rectal neuroendocrine neoplasms. Although these tumors are usually small and well differentiated, their risk of lymph node metastasis (LNM) may be underestimated when tumor size is considered alone. Current guidelines do not distinguish RM-NETs from solitary lesions. This study investigated the association between tumor count and LNM in patients with RM-NETs. METHODS: A comprehensive literature search of PubMed, Embase, Web of Science, and Scopus was performed from database inception to September 30, 2025. Published case reports and case series describing two or more histologically confirmed rectal NETs were screened for eligibility, and one additional institutional case was included. Individual-level clinicopathological data were extracted and pooled. Receiver operating characteristic analysis was used to explore the discriminative ability of tumor count for LNM, and exploratory multivariable logistic regression was performed to identify factors associated with LNM. RESULTS: A total of 46 patients were included, comprising 45 patients from 17 published studies and one institutional case. The median age was 57 years, and 80.4% of patients were male. Most tumors measured ≤ 10 mm (91.3%). LNM was identified in 8 patients (17.4%). ROC analysis suggested an exploratory threshold of approximately seven lesions. Patients with ≥ 7 tumors had a significantly higher incidence of LNM than those with fewer than 7 tumors, with rates of 46.7% and 3.2%, respectively. In exploratory multivariable analysis, tumor count ≥ 7 remained associated with LNM. CONCLUSIONS: Tumor count may help identify patients with RM-NETs who are at increased risk of LNM. In this pooled analysis, the exploratory threshold of approximately seven lesions should be regarded as hypothesis-generating rather than as a definitive clinical cutoff. In patients with extensive multifocal disease, this finding may warrant closer nodal staging and multidisciplinary discussion, even when the maximum lesion size is small. Further validation in larger multicenter cohorts is warranted. TRIAL REGISTRATION: Not applicable.
An integrated analysis of MEN1 reveals its associations with clinical outcomes, cellular pathways, and the immune microenvironment.
Li H, Gong X, Yao Y … +4 more , Bi P, Li Q, Wang X, Peng J
World J Surg Oncol · 2026 Jun · PMID 42310775 · Full text
The menin protein, encoded by the Multiple Endocrine Neoplasia Type 1 (MEN1) gene, serves as a critical regulator of cellular processes in human cancers. While menin-targeted therapies are undergoing clinical investigati...
The menin protein, encoded by the Multiple Endocrine Neoplasia Type 1 (MEN1) gene, serves as a critical regulator of cellular processes in human cancers. While menin-targeted therapies are undergoing clinical investigation, a comprehensive pan-cancer analysis of MEN1's diagnostic, prognostic, and immunomodulatory roles remain lacking. Here, we systematically evaluated MEN1 expression patterns and clinical relevance using multi-omics databases and immunohistochemical profiles from the Human Protein Atlas (HPA). MEN1 exhibited ubiquitous expression in normal tissues but was frequently upregulated across multiple malignancies, correlating with adverse survival outcomes. Elevated MEN1 expression demonstrated strong diagnostic utility and positive associations with tumor mutation burden (TMB), suggesting complementary value in cancer detection. Immune landscape analysis revealed significant correlations between MEN1 expression and immune checkpoint genes, as well as immune cell infiltration patterns. Functional characterization implicated MEN1 in activating cell cycle progression, DNA damage response, and oncogenic signaling pathways, as validated through Gene Set Enrichment Analysis (GSEA) and single-sample Gene Set Enrichment Analysis (ssGSEA). These findings position MEN1 as a promising prognostic biomarker and therapeutic target with implications for immuno-oncology and precision medicine.
Serological signatures and pathological features for the management of CEA-negative colorectal cancer: development of combined diagnostic and prognostic nomograms.
Fu Z, Luo Z, Han C … +5 more , Zhang R, Xu Y, Zhang Y, Qin J, Huang C
World J Surg Oncol · 2026 Jun · PMID 42310752 · Full text
BACKGROUND: Colorectal cancer (CRC) remains a leading cause of malignancy-related mortality, with prognosis heavily contingent upon early detection. Notably, a significant proportion of CRC patients present with normal p...
BACKGROUND: Colorectal cancer (CRC) remains a leading cause of malignancy-related mortality, with prognosis heavily contingent upon early detection. Notably, a significant proportion of CRC patients present with normal preoperative Carcinoembryonic Antigen (CEA) levels, creating a diagnostic blind spot where malignant lesions may be indistinguishable from benign colorectal disease (BCD). This study aimed to develop and validate multidimensional nomograms to accurately diagnose and prognostically stratify patients with CEA-negative CRC. METHODS: We retrospectively analyzed data from 553 CEA-negative CRC patients and 200 BCD patients. Optimal biomarker thresholds were determined via ROC analysis. Diagnostic and prognostic predictors were identified using multivariable logistic and Cox regressions. Model performance was evaluated using C-indices, calibration plots, Decision Curve Analysis (DCA), and Clinical Impact Curves (CIC). RESULTS: Of 895 screened CRC patients, 61.8% were CEA-negative. An eight-variable diagnostic model (age, sex, CA50, CA125, CA19-9, WBC, PLR, FAR) demonstrated strong discriminative power, yielding C-indices of 0.886 (training) and 0.895 (validation). For overall survival, a prognostic signature incorporating age, tumor location, Lymph Node Ratio (LNR), Monocyte-to-Lymphocyte ratio (MLR), and Tumor-Stroma Ratio (TSP) achieved C-indices of 0.749 (training) and 0.829 (validation), showing favorable prognostic stratification compared to the AJCC 8th TNM staging system. DCA and CIC confirmed superior clinical net benefit for both models. CONCLUSION: Integrating systemic inflammatory indices and stromal features provides a potentially useful adjunctive tool for cancer detection and risk assessment. These user-friendly nomograms may assist in personalized prognostication, potentially refining clinical decision-making and patient stratification for therapeutic trials. However, independent external validation is required before clinical implementation due to the single-center design and internally derived cut-offs.
SPP1 promotes lymph node metastasis and malignant progression of head and neck squamous cell carcinoma by activating FAK-AKT signaling pathway.
Li J, Pan M, Wang M … +4 more , Wu T, Zhang Y, Wang Z, Zeng Q
World J Surg Oncol · 2026 Jun · PMID 42310749 · Full text
BACKGROUND: Lymph node metastasis is a critical determinant of poor prognosis in head and neck squamous cell carcinoma (HNSCC). Secreted phosphoprotein 1 (SPP1) has been implicated in the progression of multiple malignan...
BACKGROUND: Lymph node metastasis is a critical determinant of poor prognosis in head and neck squamous cell carcinoma (HNSCC). Secreted phosphoprotein 1 (SPP1) has been implicated in the progression of multiple malignancies; however, its clinical relevance and potential molecular mechanisms in HNSCC remain not fully understood. This study aims to comprehensively characterize the expression profile, biological functions, and potential molecular mechanisms of SPP1 during HNSCC progression. METHODS: Public datasets were analyzed to assess SPP1 expression and its association with clinicopathological features and patient outcomes. Forty surgical specimens of head and neck squamous cell carcinoma (including adjacent normal tissues, non-metastatic tumors and lymph node metastatic tumors) were collected and verified by immunohistochemistry, quantitative PCR and Western blotting. Then, cellular functional assays including CCK-8, EdU synthesis, wound healing, and Transwell assays were performed to evaluate the effects of SPP1 knockdown and overexpression on the proliferation and invasion of head and neck squamous cell carcinoma cells. Transcriptome sequencing was performed in SPP1 knockdown cells and control cells (n = 3 in each group), followed by differential expression analysis, enrichment analysis, and gene set enrichment analysis to explore potential mechanisms. RESULTS: The results showed that SPP1 expression was significantly increased in HNSCC tissues compared with adjacent normal tissues and was associated with lymph node metastasis, advanced tumor stage, and poor prognosis. Experimental validation in clinical samples confirmed that SPP1 expression was increased in tumors, especially in cases with lymph node metastasis. The results of the cell function experiments showed that the knockout of the SPP1 gene significantly inhibited the proliferation and migration abilities of HNSCC, while when the SPP1 gene was overexpressed, these functions of the cells were enhanced. Transcriptomic profiling identified 1,853 differentially expressed genes following SPP1 knockdown, with enrichment in pathways related to extracellular matrix organization, focal adhesion, and oncogenic signaling. Gene set enrichment analysis further supported the involvement of extracellular matrix remodeling and migration-related biological processes. CONCLUSIONS: SPP1 promotes the malignant progression of HNSCC and is closely associated with lymph node metastasis. Its tumor-promoting effects may be mediated, at least in part, through regulation of extracellular matrix- and adhesion-related signaling pathways. These findings highlight SPP1 as a potential biomarker and therapeutic target in HNSCC.
Effect of a multimodal bundled intervention on quality of recovery after laparoscopic colorectal cancer surgery: a single-center, single-blind, pragmatic randomized controlled trial.
Ren J, Yang Q, He H … +8 more , Li J, Gao H, Yang C, Cao Y, Wen Y, Chen C, Kandil M, Tao J
World J Surg Oncol · 2026 Jun · PMID 42310736 · Full text
BACKGROUND: Despite the minimally invasive nature of laparoscopic colorectal surgery, postoperative recovery is frequently compromised by pain, fatigue, and delayed gastrointestinal function. Current rehabilitation strat...
BACKGROUND: Despite the minimally invasive nature of laparoscopic colorectal surgery, postoperative recovery is frequently compromised by pain, fatigue, and delayed gastrointestinal function. Current rehabilitation strategies largely rely on unimodal approaches, and evidence for structured multimodal bundled interventions is limited. This study aimed to evaluate whether a multimodal bundled intervention comprising electroacupuncture, abdominal massage, structured breathing training, and symptom-titrated supervised ambulation improves quality of recovery in patients undergoing laparoscopic surgery for stage I-III colorectal cancer. METHODS: This single-center, single-blind, parallel-group, pragmatic randomized controlled trial randomized 105 patients to either a multimodal bundled intervention plus standard care or standard care alone. The intervention group received electroacupuncture and structured breathing training from postoperative day 1 to 7, with abdominal massage and symptom-titrated supervised ambulation added from postoperative day 4 to 7. The primary outcome was the trajectory of the Quality of Recovery-15 (QoR-15) score assessed at postoperative days 3, 7, and 30. Statistical analyses followed a modified intention-to-treat principle. RESULTS: Of 105 randomized patients, 90 (45 per group) were included in the final analysis. A significant group-by-time interaction was observed for QoR-15 scores (P = 0.043). While no significant between-group differences were found at postoperative days 3 or 7, the intervention group demonstrated significantly higher QoR-15 scores at postoperative day 30 (mean difference 11.33; 95% confidence interval 3.41 to 19.26; P = 0.005). Secondary outcomes, including pain intensity and perceived exertion, showed favorable between-group differences at later postoperative assessments. No serious intervention-related adverse events were reported. CONCLUSIONS: In this single-center pragmatic randomized controlled trial, the multimodal bundled intervention did not significantly improve QoR-15 scores during the early postoperative period at POD3 or POD7. However, it was associated with a clinically meaningful improvement in QoR-15 at POD30. These findings suggest a potential medium-term patient-reported recovery benefit after laparoscopic colorectal cancer surgery, but they should not be interpreted as evidence of accelerated early ERAS-related recovery. TRIAL REGISTRATION: ChiCTR2400085191. Registered on June 3, 2024.
Endoscopic resection or radical gastrectomy? Risk factors for lymph node metastasis in early gastric cancer: a systematic review and meta-analysis.
Zhang Y, Wang H, Luo T
World J Surg Oncol · 2026 Jun · PMID 42310645 · Full text
BACKGROUND: The management of EGC hinges on accurate LNM risk assessment, guiding the critical choice between endoscopic resection (ER) and radical gastrectomy. This study provides a comprehensive evidence synthesis to o...
BACKGROUND: The management of EGC hinges on accurate LNM risk assessment, guiding the critical choice between endoscopic resection (ER) and radical gastrectomy. This study provides a comprehensive evidence synthesis to optimize treatment selection. METHODS: This systematic review and meta-analysis (PROSPERO CRD420251152013) was conducted in accordance with PRISMA guidelines. A comprehensive literature search of PubMed, Web of Science, Scopus, and Embase was performed for studies published up to September 5, 2025. Study quality and risk of bias were assessed using the ROBINS-I tool, and the certainty of evidence for each association was evaluated with the GRADE framework. Statistical heterogeneity was investigated, and the sources were explored through meta-regression where appropriate. RESULTS: One hundred one studies were included. Meta-analysis identified predictors: LVI (OR = 9.04, with LVI negative as reference, 95% CI: 7.18-11.37), mucosal invasion (T1a) (OR = 0.20, with T1b as reference, 95% CI: 0.19-0.22), tumor size ≤ 2 cm (OR = 0.39, with > 2 cm as reference, 95% CI: 0.36-0.43), differentiated histology (OR = 0.45, with undifferentiated type as reference, 95% CI: 0.40-0.50), PNI (OR = 3.41, with PNI negative as reference, 95% CI: 2.46-4.71), ulceration (OR = 1.68, with ulceration negative as reference, 95% CI: 1.37-2.05), age ≤ 60 years (OR = 1.13, with > 60 years old as reference, 95% CI: 1.06-1.21), male (OR = 0.69, with females as reference, 95% CI: 0.65-0.72), middle location (OR = 0.96, with other parts as reference, 95% CI: 0.90-1.02), CEA > 0.5 ng/mL (OR = 1.35, with CEA ≤ 0.5ng/mL as reference, 95% CI: 1.04-1.75), CA199 > 37 U/mL (OR = 4.02, with CA199 ≤ 37 U/mL as reference, 95% CI: 1.46-11.11), CA125 (OR = 1.17, with CA125 ≤ 35 U/mL as reference, 95% CI: 0.48-2.81), CA724 (OR = 1.33, with CA724 ≤ 7 U/mL as reference, 95% CI: 0.84-2.11). All reported pooled ORs represent unadjusted estimates derived from univariate data. CONCLUSION: This meta-analysis provides a comprehensive evidence base for risk stratification in EGC. By distinguishing patients suitable for ER from those requiring radical operation, our findings serve as a critical guide for optimizing clinical practice and resolving the therapeutic dilemma between endoscopy and radical surgery.
Limb cold therapy for preventing paclitaxel-induced peripheral neuropathy in breast cancer patients: a randomized controlled study.
Wu D, Bai H, Zhang Y … +1 more , Wang W
World J Surg Oncol · 2026 Jun · PMID 42298608 · Full text
BACKGROUND: Paclitaxel, a widely used chemotherapeutic drug for breast cancer, often causes peripheral neuropathy, which impacts patient quality of life and limits treatment dosages. Cold therapy, involving controlled co...
BACKGROUND: Paclitaxel, a widely used chemotherapeutic drug for breast cancer, often causes peripheral neuropathy, which impacts patient quality of life and limits treatment dosages. Cold therapy, involving controlled cold application to extremities, has emerged as a potential non-pharmacological intervention to reduce such neurotoxic effects. This study evaluates the effectiveness of limb cold therapy in preventing and reducing severity paclitaxel-induced peripheral neuropathy (PIPN) in breast cancer patients. METHODS: A prospective, randomized controlled study was conducted at the Fourth Hospital of Hebei Medical University from October 2022 to August 2024, involving 200 breast cancer patients undergoing paclitaxel and platinum chemotherapy. Participants were randomized into two groups: the control group receiving standard treatment (n = 103), and the cold therapy group receiving limb cold therapy with ice gloves and socks (n = 97). Outcomes were evaluated across multiple chemotherapy cycles using the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT), National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE), and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) scales. Neurophysiological assessments and Activities of Daily Living (ADL) tests were conducted to further evaluate the effects. The primary outcome was the incidence and severity of CIPN, assessed using NCI-CTCAE and CIPNAT. Secondary outcomes included FACT/GOG-Ntx, ADL, and neurophysiological parameters. RESULTS: The cold therapy group showed a significant reduction in chemotherapy-induced peripheral neuropathy (CIPN) severity from the fourth chemotherapy cycle onwards (e.g., fourth cycle CIPN grade 0: 64.95% vs. 44.66% in control, P = 0.013). CIPNAT scores indicated less severe neuropathy symptoms at the fourth cycle (cold therapy: 124.63 ± 59.21 vs. control: 147.79 ± 77.94, P = 0.019) and sixth cycle (cold therapy: 151.93 ± 61.87 vs. control: 169.64 ± 63.82, P = 0.048). FACT/GOG-Ntx scores showed reduced neurotoxicity in the cold therapy group at the fourth cycle (15.48 ± 3.61 vs. 17.12 ± 3.57, P = 0.001) and at multiple follow-ups. ADL scores improved significantly three months post-chemotherapy (cold therapy: 76.96 ± 5.11 vs. control: 74.61 ± 5.21, P = 0.002). Neurophysiological assessments revealed better nerve conduction parameters in the cold therapy group, including decreased distal motor latency (DML) and improved compound muscle action potential amplitude. CONCLUSION: Limb cold therapy may help mitigate PIPN symptoms, improve quality of life scores, and preserve peripheral nerve function in breast cancer patients.
Intestinal SMARCA4-deficient undifferentiated carcinoma: a case series and systematic review of the literature.
Ma W, Zhou S, Huang Y … +2 more , Tang X, Wang S
World J Surg Oncol · 2026 Jun · PMID 42286625 · Full text
BACKGROUND: Intestinal SMARCA4-deficient undifferentiated carcinoma (SMARCA4-DUC) is a rare and highly aggressive malignancy. Its clinicopathological features remain poorly defined. No standardized treatment has been est...
BACKGROUND: Intestinal SMARCA4-deficient undifferentiated carcinoma (SMARCA4-DUC) is a rare and highly aggressive malignancy. Its clinicopathological features remain poorly defined. No standardized treatment has been established. METHODS: We report two new cases and review 18 previously published cases, providing a descriptive summary of clinicopathological, molecular, and therapeutic features. RESULTS: The aggregated 20 cases included 80% males, with a mean age of 56 years. The tumors exhibited diffuse sheet-like growth of epithelioid cells, with rhabdoid morphology observed in 81.25% (13/16) of cases. Necrosis and mitotic activity were frequent. Immunohistochemistry confirmed SMARCA4 loss and variable CK/CK7 expression, while CDX-2 and CK20 were consistently negative. Ki-67 was uniformly high. Although molecular profiling data in this study were limited, TP53 mutations were identified in all three cases with available NGS data. Distant metastasis was present in 41.2% of patients at initial diagnosis. The median overall survival was 11 months (range 1.5-29 months). Chemotherapy responses were poor, but responses to immune checkpoint inhibitors were heterogeneous: two patients achieved sustained complete remission (> 18 months) on pembrolizumab, while three others experienced no benefit. CONCLUSIONS: Intestinal SMARCA4-deficient carcinoma is a rare high-grade malignancy with a poor prognosis and currently no standard treatment regimen. In this small aggregated series, two patients achieved durable complete responses to pembrolizumab monotherapy, suggesting that a subset of these tumors may benefit from immune checkpoint inhibitors. However, given the inconsistent responses observed, these preliminary findings require validation in future multicenter, large-scale prospective studies.
Regulation of miR-27a-3p/FBXW7 axis by increasing the level of lncRNA AC138128.1 to mitigate gastric cancer progression.
Lu S, Ding S, Fu G … +2 more , Zhang Y, Huang X
World J Surg Oncol · 2026 Jun · PMID 42277853 · Full text
BACKGROUND: Gastric cancer (GC) has a poor prognosis due to its recurrence and metastasis. This research aims to investigate the potential regulatory mechanisms of AC138128.1 in GC. METHODS: A total of 124 GC patients we...
BACKGROUND: Gastric cancer (GC) has a poor prognosis due to its recurrence and metastasis. This research aims to investigate the potential regulatory mechanisms of AC138128.1 in GC. METHODS: A total of 124 GC patients were enrolled. RT-qPCR was used to assess AC138128.1, miR-27a-3p, and mRNA levels. Cell proliferation, migration, and invasion were assessed using CCK-8 and Transwell assays, respectively. Kaplan-Meier curves were used to validate patient survival. Targeted interactions among AC138128.1, miR-27a-3p, and FBXW7 were verified via DLR assays, with Pearson correlation analysis assessing relationships among the three groups. GO and KEGG were used to analyze the biological information of miR-27a-3p target genes. RESULTS: AC138128.1 is downregulated in GC tissues, miR-27a-3p level is upregulated. AC138128.1 negatively regulates miR-27a-3p. Patients with GC in the low AC138128.1 level group exhibited lower 5-year survival rates. Transfection with oe-AC138128.1 reduces miR-27a-3p levels, significantly inhibiting cell growth and invasiveness. However, when the miR-27a-3p level is increased, this inhibitory effect is reversed. Additionally, the downstream target genes of miR-27a-3p are primarily enriched in the PI3K-Akt signaling pathway. FBXW7 expression was downregulated in GC tissues. AC138128.1 expression positively correlated with FBXW7, whereas miR-27a-3p expression negatively correlated with FBXW7. CONCLUSIONS: This study provides the first evidence that AC138128.1 is downregulated in GC cell lines and holds significant potential as a prognostic biomarker for GC. Low levels of AC138128.1 enhance miR-27a-3p expression, thereby influencing the invasiveness of GC cells and potentially promoting GC progression.
Development of a prognostic model for postoperative survival in appendiceal pseudomyxoma peritonei based on clinical indicators.
Jiao J, Li F, Liu Q … +4 more , Zhang H, Yu G, Yu W, Wang Y
World J Surg Oncol · 2026 Jun · PMID 42277799 · Full text
BACKGROUND: Pseudomyxoma peritonei (PMP) is a rare peritoneal malignancy primarily originating from appendiceal mucinous neoplasms. Prognosis is influenced by histologic subtype, tumor markers, and the completeness of cy...
BACKGROUND: Pseudomyxoma peritonei (PMP) is a rare peritoneal malignancy primarily originating from appendiceal mucinous neoplasms. Prognosis is influenced by histologic subtype, tumor markers, and the completeness of cytoreduction. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the standard treatment. This study aims to identify key factors affecting long-term prognosis in appendiceal PMP patients and develop a dynamic nomogram for postoperative survival prediction. METHODS: This study retrospectively analyzed the clinical data of 153 patients with appendiceal-origin PMP confirmed by postoperative pathology from Jinan Central Hospital between October 2017 and December 2024. The primary endpoint was postoperative overall survival (OS). Patients were randomly divided into modeling (107 cases) and validation (46 cases) groups. Nonlinear relationships between continuous variables and survival time were assessed using restricted cubic splines (RCS) and ANOVA. Univariate Cox regression identified risk factors for postoperative OS, while Lasso regression generated a new variable, the LASSO-derived inflammation-nutrition score (LINS), from selected hematological indices. Multivariate Cox regression analysis identified independent prognostic factors, including histological type, preoperative peritoneal cancer index (PCI), CA125, LINS, and Completeness of Cytoreduction (CC) score (P < 0.05). A nomogram was developed to predict 1-, 3-, and 5-year postoperative OS. Model performance was validated using time-dependent ROC curves and calibration curves. Additionally, a dynamic nomogram was created using the Shiny application framework to predict survival probabilities in real-time. RESULTS: The 1-, 3-, and 5-year survival rates for the 153 patients were 82.54%, 66.00%, and 56.76%, respectively. The multivariate Cox regression identified LINS, CA125, preoperative PCI, histological type, and CC score as independent prognostic factors (P < 0.05). The nomogram demonstrated good predictive ability, with time-dependent ROC AUC values for the modeling group of 0.945, 0.823, and 0.736 at 1, 3, and 5 years. Calibration curves showed good agreement between predicted and observed survival. A dynamic survival prediction tool was developed and is accessible via a Shiny app ( https://lq1999.shinyapps.io/Dynamic/ ). CONCLUSION: Histological type, preoperative PCI, CA125, LINS, and CC score are independent prognostic factors in appendiceal PMP. The developed nomogram offers accurate survival predictions and can be updated with new data for improved clinical decision-making.
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