World Journal Of Surgical Oncology[JOURNAL]
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200 papers
H3K18 lactylation promotes glycolysis in bladder cancer via inhibiting GNG7 through regulating PI3K-AKT signaling pathway.
Chen R, Wu D, Wu W … +1 more , Yang J
World J Surg Oncol · 2026 May · PMID 42163331 · Full text
Bladder cancer (BLCA) is a malignant neoplasm arising from the bladder mucosa, with clinical manifestations including hematuria, dysuria, and urinary frequency. The G Protein Subunit Gamma 7 (GNG7) gene encodes the gamma...
Bladder cancer (BLCA) is a malignant neoplasm arising from the bladder mucosa, with clinical manifestations including hematuria, dysuria, and urinary frequency. The G Protein Subunit Gamma 7 (GNG7) gene encodes the gamma subunit of heterotrimeric G proteins, which is pivotal in signal transduction cascades. Lactylation, a post-translational modification induced by lactate, has been investigated in various tumor conditions. This study sought to explore the role of histone H3 lysine 18 lactylation (H3K18la) in BLCA and its underlying mechanisms. Cell viability and migration were evaluated using MTT and Transwell migration assays, respectively. The protein levels of lactylation and H3K18la were detected via Western blot. Glucose uptake, lactate production, and extracellular acidification rate were measured using commercial kits. Chromatin immunoprecipitation-qPCR was employed to determine the relative enrichment of H3K18la on the GNG7 promoter. Additionally, a tumor-bearing mouse model was established. The results indicated that GNG7 expression was downregulated in BLCA cells. Furthermore, overexpression of GNG7 inhibited glycolysis in BLCA cells and reduced tumor growth in xenograft mice. BLCA cells also exhibited elevated protein levels of pan-Kla and H3K18la. Mechanistically, H3K18la suppressed the transcriptional activity of GNG7 in BLCA cells. Moreover, deficiency of GNG7 enhanced cell viability, migration, and glycolysis in BLCA cells. It was further found that GNG7 inhibited the activation of the phosphoinositide 3-kinase-protein kinase B (PI3K-AKT) signaling pathway in BLCA. In summary, H3K18la promotes glycolysis in BLCA by inhibiting GNG7 through the regulation of the PI3K-AKT signaling pathway, which may offer a new perspective for BLCA treatment.
Safety and efficacy of PD-1/PD-L1 inhibitors combined with albumin-bound paclitaxel and fluorouracil-based agents as second-line therapy in biliary tract cancers.
Wang X, Zha Y, Li P … +5 more , Fu S, Xu L, Jiang W, Wu J, Mao Y
World J Surg Oncol · 2026 May · PMID 42157316 · Full text
BACKGROUND: Biliary tract cancers (BTCs) are a group of highly aggressive malignancies with limited therapeutic options. Gemcitabine plus cisplatin (GemCis) remains the standard first-line regimen; however, the efficacy...
BACKGROUND: Biliary tract cancers (BTCs) are a group of highly aggressive malignancies with limited therapeutic options. Gemcitabine plus cisplatin (GemCis) remains the standard first-line regimen; however, the efficacy of currently recommended second-line therapies remains unsatisfactory. Immune checkpoint inhibitors (ICIs) targeting programmed cell death protein 1 or its ligand (PD-1/PD-L1) have demonstrated antitumor activity in a subset of patients with BTC, while albumin-bound paclitaxel (nab-paclitaxel) has shown efficacy across multiple solid tumors. This study aimed to evaluate the real-world safety and efficacy of a second-line combination regimen comprising PD-1/PD-L1 inhibitors, nab-paclitaxel, and fluorouracil-based agents (capecitabine or S-1) in patients with advanced BTCs. METHODS: This retrospective study included patients with advanced BTCs who received second-line therapy with a combination of PD-1/PD-L1 inhibitors, nab-paclitaxel, and fluorouracil-based agents (capecitabine or S-1) at the Second Affiliated Hospital of Nanchang University between January 2019 and May 2025. Tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and treatment-related adverse events (TRAEs) were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), objective response rate (ORR), and TRAEs. RESULTS: A total of 36 patients were enrolled, including 17 (47.2%) with gallbladder cancer, 17 (47.2%) with intrahepatic cholangiocarcinoma, and 2 (5.6%) with extrahepatic cholangiocarcinoma. According to RECIST version 1.1, no complete responses (CR) were observed; four patients (11.1%) achieved a partial response (PR), 19 (52.8%) had stable disease (SD), and 13 (36.1%) experienced progressive disease (PD), yielding an ORR of 11.1% and a disease control rate (DCR) of 63.9%. The median progression-free survival (PFS) was 6.8 months (95% confidence interval [CI]: 4.2-10.2), and the median overall survival (OS) was 10.8 months (95% CI: 7.2-16.2). No significant differences in PFS (6.8 vs. 7.9 months, P = 0.55) or OS (11.1 vs. 10.8 months, P = 0.68) were observed between patients who had received prior immunotherapy and those who had not. The most common grade 3-4 TRAEs were chemotherapy-related myelosuppression, decreased appetite, and elevated total bilirubin. One patient developed hand-foot syndrome, and another experienced immune-mediated pneumonitis. No treatment-related deaths were reported. CONCLUSION: The combination of PD-1/PD-L1 inhibitors, nab-paclitaxel, and fluorouracil-based agents (capecitabine or S-1) demonstrated manageable toxicity and modest clinical activity as a second-line therapy for advanced BTCs. This regimen may represent a feasible treatment option for patients who progress following first-line therapy. Moreover, continued administration of this immunotherapy-based combination beyond initial progression may confer survival benefits in select patients.
Futility in adenosquamous pancreatic cancer.
Ramia JM, Villodre C, Giakoustidis D … +41 more , Chatzikomnitsa P, Addeo P, Bachellier P, Nappo G, Zerbi A, Navez J, Blanco-Fernández G, Kirkegård J, Busquets J, Björnsson B, Sánchez-Cabús S, Pando E, Staubli SM, Pandanaboyana S, Aparicio-López D, Spiers HV, Melgar P, Rhaiem R, Amaral MJ, Vallejo-Bernad C, Andersson B, Burdío F, Tzimas G, Mora-Oliver I, Rousek M, Domingo-Del-Pozo C, Mahamid A, Lytras D, Lolis ED, López-Andújar R, Sorribas M, López PA, Elghonemy H, Chikkala B, Lim W, Balakrishnan A, Villamonte Román M, Ballester C, Hörndler-Algárate C, Serradilla-Martín M, Scientific and Research Committee of the E-AHPBA
World J Surg Oncol · 2026 May · PMID 42157261 · Full text
BACKGROUND: Adenosquamous carcinoma of the pancreas (ASCP) is a rare and aggressive subtype of pancreatic cancer with a dismal prognosis. Futility in ASCP has been inadequately studied. The aim is to assess the incidence...
BACKGROUND: Adenosquamous carcinoma of the pancreas (ASCP) is a rare and aggressive subtype of pancreatic cancer with a dismal prognosis. Futility in ASCP has been inadequately studied. The aim is to assess the incidence of futility in ASCP cases within a European cohort. METHODS: Retrospective, multicenter European study including all consecutive patients who underwent surgery for ASCP between 2010 and 2024. INCLUSION CRITERIA: patients operated for ASCP during the study period. EXCLUSION CRITERIA: patients without a confirmed pathological diagnosis of ASCP, those who did not undergo surgery, or had extra-pancreatic disease. A pancreatectomy was considered futile if a patient died from postoperative complications within 90 days, or if cancer-related mortality or recurrence occurred within 6 months of the operation. RESULTS: 194 patients from 29 hospitals in 11 European countries were studied. Surgeries included 125 pancreaticoduodenectomies, 59 left pancreatectomies, and 10 total pancreatectomies. Major complications were observed in 25.3% of patients. Postoperative mortality was 5.7%. The rate of futility was 47.9%. Eleven patients (11,8%) died from postoperative complications, 69 patients (74,2%) had recurrence, and 13 patients (14%) died within 6 months due to cancer. In the multivariate analysis, a positive retroperitoneal margin, lymphatic invasion, and not receiving chemotherapy were associated with futility. CONCLUSIONS: The futility observed in ASCP is notably high and related to a positive retroperitoneal margin, lymphatic invasion, and not receiving adjuvant chemotherapy. Defining futile patients with an international consensus definition is crucial and has significant implications for shared decision-making and care optimization.
Clinical value and regulatory role of lncRNA HOXB-AS3 in gastric cancer.
Ding Y, Zhang L, Xu Y … +2 more , Cen M, Li P
World J Surg Oncol · 2026 May · PMID 42157239 · Full text
BACKGROUND: LncRNA HOXB-AS3 has been shown to exert oncogenic effects in various malignancies. However, its specific role in gastric cancer (GC) remains largely unknown. This study addressed the expression profile and cl...
BACKGROUND: LncRNA HOXB-AS3 has been shown to exert oncogenic effects in various malignancies. However, its specific role in gastric cancer (GC) remains largely unknown. This study addressed the expression profile and clinical relevance of HOXB-AS3 in GC. Moreover, we dissected its downstream regulatory circuitry in a cell model. METHODS: The cohort comprised 156 GC patients who were followed up for 5 years. Multivariate Cox analysis was employed for risk indicator identification. Relative expression of genes was calculated by RT-qPCR. Cell proliferation was detected by CCK-8 assay, while migration and invasion were assessed by transwell assay. ROC curve was applied for diagnostic efficiency. RESULTS: HOXB-AS3 was upregulated in GC tissues (P < 0.001) and exhibited promising diagnostic utility (AUC = 0.851, 95% CI: 0.810-0.892). Moreover, high HOXB-AS3 expression positively correlated with poor prognosis (P = 0.005) and was identified as another risk factor (HR = 1.642, 95%CI:1.054-2.557, P = 0.028) besides TNM stage and lymph node metastasis. Mechanistically, HOXB-AS3 overexpression promoted cell proliferation, migration, and invasion through the miR-498-5p/EP300 axis in GC cells. CONCLUSIONS: Our findings establish HOXB-AS3 as a potential diagnostic biomarker and therapeutic target in GC, acting via the miR-498-5p/EP300 axis.
A nomogram integrating p53 and Ki-67 expression for predicting recurrence risk in postoperative early gastric cancer.
Yan J, Qi Z, Zhang R
World J Surg Oncol · 2026 May · PMID 42157210 · Full text
BACKGROUND: Aberrant expression of p53 and elevated Ki-67 proliferation index have been associated with tumor progression and recurrence; however, their prognostic value in postoperative early gastric cancer (EGC) remain...
BACKGROUND: Aberrant expression of p53 and elevated Ki-67 proliferation index have been associated with tumor progression and recurrence; however, their prognostic value in postoperative early gastric cancer (EGC) remains to be fully established. This study aimed to develop and internally validate a nomogram integrating these biomarkers for individualized recurrence risk prediction. METHODS: We retrospectively analyzed 536 EGC patients from a single institution between January 2017 and October 2018, with follow-up through June 2025. Patients were randomly divided into training (n = 375) and validation (n = 161) cohorts. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify independent prognostic predictors. Model performance was assessed using time-dependent AUC, integrated Brier score, calibration curves, and decision curve analysis. RESULTS: Five independent factors were identified: Helicobacter pylori infection (HR = 1.83), Ki-67 > 30% (HR = 4.28), lymphovascular invasion (HR = 1.91), perineural invasion (HR = 4.37), and p53 (reference: mutant, HR = 0.37). The nomogram achieved good discriminative ability (1-year AUC: 0.861 training, 0.878 validation; 5-year AUC: 0.808, 0.788). Nomogram-based risk stratification demonstrated significant differences in survival outcomes (log-rank P < 0.001). CONCLUSION: This nomogram demonstrates potential utility for recurrence risk stratification in postoperative EGC patients. However, the model requires external validation in independent, multi-center cohorts before clinical implementation. The single-center retrospective design and relatively short follow-up represent important limitations.
Lnc RNA GAPLINC affects triple-negative breast cancer progression through the miR-331-3p/IGF2BP1 axis.
Wang W, Huang L, Zhang S … +3 more , Yang Z, Yan S, Yan G
World J Surg Oncol · 2026 May · PMID 42152061 · Full text
BACKGROUND: The functional mechanism of the long non-coding RNAs (lncRNA) GAPLINC in triple-negative breast cancer (TNBC) remains poorly understood. The present study aimed to explore GAPLINC in TNBC and its contribution...
BACKGROUND: The functional mechanism of the long non-coding RNAs (lncRNA) GAPLINC in triple-negative breast cancer (TNBC) remains poorly understood. The present study aimed to explore GAPLINC in TNBC and its contribution to regulating tumor progression through the microRNA (miRNA)-331-3p/ insulin-like growth factor 2 mRNA-binding protein 1(IGF2BP1) axis. METHODS: Tumor tissue samples and adjacent normal tissue samples were collected from 150 TNBC patients, and TNBC-related cell lines were cultured. mRNA expression was determined using reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR). Functional parameters were assessed through the following experimental methods: the cell counting kit-8 (CCK-8) assay was employed to evaluate proliferation capacity, the Transwell was conducted to assess migration and invasion, and the dual-luciferase assay was performed to confirm the targeted binding relationships. RESULTS: GAPLINC was significantly upregulated in TNBC tissues and cell lines (P < 0.001), and its expression was closely correlated with poor clinical prognosis. Similarly, miR-331-3p was markedly downregulated in TNBC samples (P < 0.001), while IGF2BP1 expression was significantly overexpressed (P < 0.001). Silencing GAPLINC effectively suppressed proliferation, migration, and invasion, accompanied by a notable upregulation miR-331-3p expression (P < 0.001). Importantly, inhibition of miR-331-3p partially reversed the suppressive effects induced by GAPLINC knockdown. Furthermore, miR-331-3p targeted IGF2BP1. Additional knockdown of IGF2BP1 counteracted this reversal effect, thereby effectively abrogating the tumor-promoting function of GAPLINC. CONCLUSION: This study identified GAPLINC as a crucial oncogenic lncRNA in TNBC. It promoted tumor progression by competitively binding to miR-331-3p, thereby derepressing its target IGF2BP1. These findings not only elucidated a new GAPLINC/miR-331-3p/IGF2BP1 regulatory axis, but also highlighted that GAPLINC may be a potential prognostic biomarker for triple-negative breast cancer.
LncRNA HMGA2-AS1 promotes postoperative recurrence in non-muscle-invasive bladder cancer by sponging miR-367-3p to activate YAP1.
Wang Y, Nai Z, Zhang J
World J Surg Oncol · 2026 May · PMID 42151936 · Full text
BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high postoperative recurrence rate. LncRNAs have emerged as key regulators in cancer progression. The clinical relevance and mechanistic role o...
BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high postoperative recurrence rate. LncRNAs have emerged as key regulators in cancer progression. The clinical relevance and mechanistic role of HMGA2-AS1 in NMIBC recurrence remain unclear. METHODS: Clinical samples contained paired adjacent and tumor tissues from 110 NMIBC patients. HMGA2-AS1 expression was examined using qRT-PCR, and its association with clinicopathological features and recurrence-free survival (RFS) was analyzed. Kaplan-Meier and Cox regression analyses were performed to evaluate prognostic value. Functional assays, including CCK-8, migration, and stemness- and epithelial-mesenchymal transition-related gene expression analyses, were conducted in RT4 and 5637 cells. RNA interaction analyses were performed using a dual-luciferase reporter assay. RESULTS: HMGA2-AS1 was elevated in NMIBC tissues and was closely associated with adverse clinicopathological characteristics (tumor grade and stage), and shorter RFS. HMGA2-AS1 is an independent risk factor for postoperative recurrence. Functionally, HMGA2-AS1 silencing suppressed cell proliferation, migration, stemness, and EMT in vitro. HMGA2-AS1 acted as a molecular sponge for miR-367-3p, thereby relieving repression of YAP1. Rescue experiments confirmed that inhibition of miR-367-3p or restoration of YAP1 expression reversed the influence of HMGA2-AS1 knockdown. CONCLUSION: HMGA2-AS1 is upregulated in NMIBC. HMGA2-AS1 promotes NMIBC progression through the miR-367-3p/YAP1 axis.
Identification of immune and ferroptosis-related gene cysteine dioxygenase type 1 (CDO1) as a prognostic biomarker in colorectal cancer, relating to immunotherapy response distinction.
Chen S, Xu M, Su W … +4 more , Wang K, Zhang S, Zhang X, Zhang L
World J Surg Oncol · 2026 May · PMID 42143315 · Full text
BACKGROUND: Colorectal cancer (CRC) is the third most common cause of cancer deaths worldwide, and has a poor prognosis in advanced stages. Whereas there are limited effective biomarkers of CRC. Herein, we aimed to explo...
BACKGROUND: Colorectal cancer (CRC) is the third most common cause of cancer deaths worldwide, and has a poor prognosis in advanced stages. Whereas there are limited effective biomarkers of CRC. Herein, we aimed to explore the potential prognostic value of immune and ferroptosis-related genes (IFRGs). METHODS: CRC-related data were extracted from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Kaplan-Meier, receiver operating characteristic (ROC), and multivariate Cox regression analyses were used to test the prognostic value of IFRGs. The immune cell infiltration and immunotherapy response predictive analyses were also conducted. The level of cysteine dioxygenase type 1 (CDO1) mRNA and protein expression in CRC and normal tissues was examined using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and Western blotting analysis, respectively. RESULTS: Thirty-eight IFRGs were obtained through differentially expressed gene analysis and cross-analysis. Of them, CDO1 mRNA and protein expression levels were significantly reduced in CRC tissues compared to normal tissues. CDO1 remained as an independent prognostic biomarker after multivariate Cox regression. Additionally, CDO1 hypermethylation was associated with poorer prognosis of CRC patients. CRC patients with differential CDO1 expression or methylation status both showed significantly distinct immune cell infiltration and immunotherapy responses. CONCLUSIONS: Our study revealed CDO1 as an IFRG with a prognostic role in CRC. It may provide a rationale for developing novel treatment strategies, such as demethylating agents or combination immunotherapy protocols, for CRC.
Reliability and oncological safety of pedicled skin island therapeutic mammoplasty as an alternative to Grisotti mastopexy for centrally located breast cancer patients.
Abu Elnga NE, Safina MK, Shehata MR … +2 more , Ayoub MT, Soliman A
World J Surg Oncol · 2026 May · PMID 42135779 · Full text
BACKGROUND: Centrally located breast cancers (CLBC) involving the nipple-areolar complex (NAC) pose a significant challenge for breast-conserving surgery, often necessitating mastectomy. The Grisotti flap, while a valuab...
BACKGROUND: Centrally located breast cancers (CLBC) involving the nipple-areolar complex (NAC) pose a significant challenge for breast-conserving surgery, often necessitating mastectomy. The Grisotti flap, while a valuable oncoplastic technique, has limitations in vascular reliability and applicability, especially post-neoadjuvant chemotherapy. We introduce a novel "Pedicled Skin Island Therapeutic Mammoplasty" (PSI-TM) as an alternative. METHODS: This single-center retrospective study analyzed 23 consecutive patients with CLBC infiltrating or fixed to the NAC who underwent PSI-TM between April 2018 and June 2023. All patients had medium-to-large breast volumes (Cup C/D). Data on demographics, tumor characteristics, surgical outcomes, complications, aesthetic results, and oncological safety were collected and analyzed. RESULTS: The cohort was predominantly premenopausal (82.6%) with invasive ductal carcinoma (87.0%). Most patients (73.9%) were treated post-neoadjuvant chemotherapy. The overall complication rate was 21.7% (5/23), all Clavien-Dindo Grade I-II, with no returns to the operating room. The combined ratings from the surgeon and independent observer were 'Good' or 'Very Good' in 73.9% of cases (17/23). Over a median follow-up of 50 months, there were no instances of positive margins, local recurrence, or distant metastasis. CONCLUSION: PSI-TM is a feasible and safe oncoplastic technique for CLBC with NAC involvement. It may offer improved vascular security compared to the traditional Grisotti flap based on theoretical anatomical advantages, leading to low complication rates, excellent aesthetic results, and encouraging early oncological outcomes, even in a post-neoadjuvant setting.
Maximum standardized uptake (SUVmax) is associated with pathologically upstaged and recurrence-free survival in non-small cell lung cancer after curative surgery.
Li CY, Tsai PC, Hu C … +4 more , Hsueh KY, Tseng YC, Wu FZ, Tang EK
World J Surg Oncol · 2026 May · PMID 42129795 · Full text
BACKGROUND: Timely detection of early-stage lung cancer via screening programs has improved, but unexpected advanced disease might exist and influence the prognosis. This study aimed to investigate the association betwee...
BACKGROUND: Timely detection of early-stage lung cancer via screening programs has improved, but unexpected advanced disease might exist and influence the prognosis. This study aimed to investigate the association between positron emission tomography (PET) maximum standardized uptake (SUVmax) and pathological upstaging and survival in patients with clinical stage IA (T1N0M0) non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed patients with clinical stage IA NSCLC who underwent preoperative PET scans and curative surgery at Kaohsiung Veterans General Hospital from January 2015 to December 2021. The primary outcome was the rate of pathological upstaging, and a Cox regression model was used to identify prognostic factors for recurrence-free survival (RFS). RESULTS: In total, 112 cases were included in this analysis, with a median observation time of 71.7 months. Forty-three patients (38.4%) were pathologically upstaged, and the pathologically upstaged group had a significantly higher SUVmax than the non-upstaged group (p = 0.024). Cox regression demonstrated that a SUVmax ≥ 5 was a significant independent prognostic factor for RFS (hazard ratio 6.698, 95% CI: 2.031-22.084, p < 0.001). In addition, there was a significant difference in the median RFS between the SUVmax ≥ 5 and SUVmax < 5 groups (48.1 versus 77.4 months, p < 0.001). CONCLUSION: Elevated preoperative PET SUVmax is associated with increased pathological upstaging, as well as a poorer RFS in clinical stage IA NSCLC. Although a PET SUVmax ≥ 5 was identified as a strong independent prognostic indicator of RFS in our cohort, this threshold should be interpreted cautiously.
Integrated transcriptomic and metabolomic analyses reveal targeting hexokinase 2 disrupts glycolysis and nucleotide metabolism to inhibit NSCLC growth.
Zhou J, Deng R, Pan L … +5 more , Zhao Q, Wang Y, Wang Q, Liu Y, Yu Y
World J Surg Oncol · 2026 May · PMID 42129773 · Full text
BACKGROUND: Dysregulation of glycolysis is a hallmark of non-small cell lung cancer (NSCLC), with hexokinases (HKs) playing a critical role in cancer metabolism. Among them, HK2 is particularly involved in tumor energy h...
BACKGROUND: Dysregulation of glycolysis is a hallmark of non-small cell lung cancer (NSCLC), with hexokinases (HKs) playing a critical role in cancer metabolism. Among them, HK2 is particularly involved in tumor energy homeostasis and has emerged as a potential therapeutic target. This study explores the impact of HK2 targeting on NSCLC cell growth and metabolism through a comprehensive analysis of transcriptomic and metabolomic data. METHODS: Data from The Cancer Genome Atlas (TCGA) were used to examine the correlation between the expression of different HK isoforms (HK1, HK2, HK3) and patient prognosis in NSCLC. siRNA-mediated knockdown of HK2 was performed in NCI-H1975 cells, which exhibit relatively high HK2 expression based on CCLE datasets. The effects on cell proliferation, cell cycle progression, and apoptosis were evaluated using CCK-8 assays, EdU incorporation, and flow cytometry. Integrated transcriptomic and metabolomic analyses were conducted to identify key metabolic pathways influencing cell growth and progression. RESULTS: Elevated expression of HK2 in NSCLC was associated with poor prognosis. Knockdown of HK2 led to a significant reduction in both HK1 and HK2 levels, resulting in decreased cell proliferation and a marked shift in the cell cycle to the G0/G1 phase. Integrated omics analyses revealed that HK2 depletion disrupted nucleotide metabolism, specifically impairing the pentose phosphate pathway (PPP), which is vital for ribonucleotide synthesis. CONCLUSION: Targeting HK2 disrupts NSCLC cell growth and cell cycle progression by modulating nucleotide metabolism under conditions of inhibited glycolysis, highlighting its potential as a therapeutic target in cancer metabolism.
The efficacy and predictive value of Tc-rituximab for sentinel lymph node biopsy in acral melanoma patients.
Xue R, Liu Z, Tan Z … +8 more , Cui Y, Bai C, Li S, Gao T, Zhang L, Wang X, Fan Z, Liu J
World J Surg Oncol · 2026 May · PMID 42121159 · Full text
BACKGROUND: We sought to evaluate the efficacy and predictive value of Tc-rituximab as a tracer for sentinel lymph node biopsy (SLNB) in acral melanoma (AM) patients. METHODS: We retrospectively analyzed data from 663 me...
BACKGROUND: We sought to evaluate the efficacy and predictive value of Tc-rituximab as a tracer for sentinel lymph node biopsy (SLNB) in acral melanoma (AM) patients. METHODS: We retrospectively analyzed data from 663 melanoma patients who underwent SLNB in our center between February 2009 and March 2019. Participants enrolled in the study included 374 AM and 128 cutaneous melanoma (CM) patients, who received Tc-rituximab during the SLNB procedure. The SLNB success rate, SLNB-positivity rate, prognosis and influencing factors were compared between the two groups using SPSS 25.0 software with P < 0.05 considered to be statistically significant. RESULTS: SLNs were successfully imaged using SPECT-CT and harvested from all 374 AM and 128 CM patients. Of these study participants, 19 AM and 9 CM patients were diagnosed as false negative (FN) SLN corresponding to a FN rate of 17.9% and 20.5%, respectively. The rate of positive SLN was 23.3% and 27.3% (P = 0.353) in AM and CM, respectively. No predictive factors were discovered for FN. The T stage was found to be a potential risk factor for SLNB-positive (OR: 1.311; 95% CI: 1.051-1.635; P = 0.016) cases in AM patients, whereas no significant differences were observed in CM patients (P > 0.05). Cox-regression multiple factor analysis revealed that SLNB positivity was an independent risk factor for DFS and OS in AM patients. CONCLUSION: Tc-rituximab is an effective tracer for SLNB of AM and is essential for determining patient prognosis. In addition, we show that T stage may be a risk factor for SLNB-positive cases in AM.
Adjuvant chemotherapy and lymph node examination interact to shape survival in older adults (≥ 75 years) with resected gastric cancer: a SEER-based propensity score-matched and competing-risk analysis.
Luo J, Wang Z
World J Surg Oncol · 2026 May · PMID 42116136 · Full text
BACKGROUND: Evidence for adjuvant chemotherapy (ACT) in very old gastric cancer patients is limited, and inadequate lymph node (LN) examination may affect staging and treatment selection. We assessed whether LN examinati...
BACKGROUND: Evidence for adjuvant chemotherapy (ACT) in very old gastric cancer patients is limited, and inadequate lymph node (LN) examination may affect staging and treatment selection. We assessed whether LN examination modifies the association between ACT and survival in older adults. METHODS: From SEER (2010-2015), we identified patients aged ≥ 75 years who underwent resection for gastric cancer. LN examination was grouped as < 15 vs. ≥ 15. Overall survival (OS) was evaluated using Cox models. Cancer-specific death was analyzed with cumulative incidence functions and Fine-Gray regression. To mitigate treatment-selection bias, we used multivariable adjustment, propensity score matching (PSM), and stabilized inverse probability of treatment weighting (IPTW). Effect modification was tested using ACT×LN interaction terms; LN count was also explored continuously with restricted cubic splines. RESULTS: The cohort included 825 patients; 386 were retained after PSM. ACT-outcome estimates differed by LN examination. ACT was more favorably associated with outcomes among patients with ≥ 15 nodes examined, while estimates were weaker and less consistent when < 15 nodes were assessed. Interaction signals appeared in crude and some adjusted models but were attenuated, while remaining directionally consistent, in IPTW sensitivity analyses, suggesting susceptibility to residual confounding and modeling assumptions. Competing-risk analyses highlighted substantial non-cancer mortality. In a low-risk-exclusion cohort (N = 306), ACT remained favorably associated with outcomes, with less evidence of interaction. CONCLUSIONS: Among resected gastric cancer patients aged ≥ 75 years, the observed association between ACT and survival differed by LN examination extent, with more favorable estimates generally seen when ≥ 15 nodes are examined.
Value of RASSF1A and SHOX2 methylation detection in intraoperative pleural lavage fluid for potential microdissemination and prognosis evaluation in non-small cell lung cancer.
Hou J, Xiao J, Yang B … +8 more , Yang R, Wang W, Shi Z, Niu X, Zhao Y, Guo X, Cao J, Xu B
World J Surg Oncol · 2026 May · PMID 42116130 · Full text
OBJECTIVE: To evaluate the potential of RASSF1A and SHOX2 methylation status in intraoperative pleural lavage (IPL) fluid for assessing invasiveness and predicting postoperative recurrence in non-small cell lung cancer (...
OBJECTIVE: To evaluate the potential of RASSF1A and SHOX2 methylation status in intraoperative pleural lavage (IPL) fluid for assessing invasiveness and predicting postoperative recurrence in non-small cell lung cancer (NSCLC). METHODS: Forty-three NSCLC patients who underwent lung tumor resection and IPL between November 2021 and June 2022 were prospectively enrolled. The patients included in the analysis did not receive adjuvant chemotherapy after surgery. Methylation of RASSF1A and SHOX2 in the IPL fluid was determined. Correlation of methylation status with clinicopathological or imaging features was assessed by Spearman correlation. Progression-free survival (PFS) and overall survival (OS) were compared by Kaplan-Meier curves and log-rank tests. Receiver operating characteristic curves evaluated the predictive performance of RASSF1A, SHOX2, and their combination for PFS. RESULTS: Positive methylation rates were 25.58% for RASSF1A, 27.91% for SHOX2, and 18.86% for combined detection. RASSF1A methylation positively correlated with neuron-specific enolase, CYFRA21-1, and imaging features (irregular tumor boundaries, lymph node enlargement, and tumor infiltration) (P < 0.01), and negatively with tumor density (solid) (P = 0.016). SHOX2 methylation correlated positively with CYFRA21-1 and imaging features (all P < 0.01). Kaplan-Meier analysis showed that the PFS of RASSF1A, SHOX2, and their combination positive patients was significantly shorter than that of the negative group (all P < 0.001). OS analysis also showed a similar trend, but due to the limited number of deaths, the relevant results need to be interpreted with caution. ROC analysis showed that the AUC of RASSF1A, SHOX2, and combined detection for predicting PFS were 0.817, 0.923, and 0.962, respectively, with the combined detection performing the best. CONCLUSION: RASSF1A and SHOX2 methylation in IPL fluid closely correlates with aggressive pathological features and unfavorable NSCLC prognosis. In an exploratory cohort without postoperative adjuvant therapy, combined testing showed potential value in stratifying the risk of postoperative recurrence and is more suitable as a supplementary molecular reference for postoperative adjuvant therapy decision-making and follow-up management. However, it still needs to be further validated in multi-center populations receiving standard treatment.
How much is enough? Defining the critical resection margin in myxofibrosarcoma.
Wallner C, Drysch M, Reinkemeier F … +6 more , Schmidt S, Sogorski A, Stricker I, Dadras M, Lehnhardt M, Puscz F
World J Surg Oncol · 2026 May · PMID 42116041 · Full text
BACKGROUND: Myxofibrosarcoma (MFS) is characterized by infiltrative growth and high local recurrence (LR) rates. Despite consensus on the importance of negative resection margins (R0), the prognostic significance of quan...
BACKGROUND: Myxofibrosarcoma (MFS) is characterized by infiltrative growth and high local recurrence (LR) rates. Despite consensus on the importance of negative resection margins (R0), the prognostic significance of quantitative margin width beyond R0 status remains unclear. METHODS: This single-center retrospective study included 94 patients with histologically confirmed myxofibrosarcoma treated between 2000 and 2023. Resection margins, recurrence patterns, and treatment variables were analyzed using descriptive stratification, exploratory threshold scanning with multiplicity correction, and complementary computational approaches for internal signal exploration. RESULTS: Local recurrence occurred in 28/84 patients (33%; 28/79, 35% among those with documented recurrence status). Numeric margin width was available in 38/84 cases (45%). Exploratory threshold analyses showed the smallest unadjusted signal near 0.3 mm, but this finding did not remain consistently significant after multiplicity correction. Radiotherapy was associated with numerically lower recurrence rates, although subgroup comparisons remained non-significant and vulnerable to confounding by indication. Complementary computational analyses yielded overlapping margin-related signals, but all such findings were interpreted as exploratory given the limited sample size, sparse events, and lack of external validation. CONCLUSIONS: In this exploratory analysis, very close resection margins may define a higher-risk zone for local recurrence, but the observed signal near 0.3 mm should not be interpreted as a clinically established threshold. R0 status ("tumor not on ink") and anatomical barrier quality remain the primary determinants of margin adequacy in myxofibrosarcoma. Prospective multicenter validation with standardized pathology and harmonized time-to-event data is required.
Research progress on the biological function and molecular mechanism of GDF-15 in solid malignant tumors.
Aishanjiang D, Abulajiang Y, Saidula R … +2 more , Abudusalam K, Musha K
World J Surg Oncol · 2026 May · PMID 42106752 · Full text
Growth differentiation factor 15 (GDF-15), a stress-responsive member of the transforming growth factor-β (TGF-β) superfamily, is consistently upregulated in multiple solid tumors and closely linked to poor clinical outc...
Growth differentiation factor 15 (GDF-15), a stress-responsive member of the transforming growth factor-β (TGF-β) superfamily, is consistently upregulated in multiple solid tumors and closely linked to poor clinical outcomes. This review offers a systematic overview of the pleiotropic functions and principal signaling pathways of GDF-15 in solid malignancies. Within the tumor microenvironment (TME), GDF-15 fuels tumor progression by promoting proliferation, sustaining stemness, remodeling metabolism, and conferring therapy resistance via the TGF-β, Leukemia Inhibitory Factor (LIF)-Signal Transducer and Activator of Transcription 3 (STAT3), and AKT pathways. Notably, GDF-15 orchestrates an immunosuppressive TME by limiting T cell infiltration and expanding regulatory T cells, thereby facilitating immune evasion and resistance to immune checkpoint inhibitors (ICIs). Systemically, GDF-15 contributes to cancer cachexia through activation of the brainstem glial-cell-line-derived neurotrophic factor family receptor α-like (GFRAL)-rearranged during transfection (RET) receptor axis. Accumulating preclinical evidence positions GDF-15 as a promising therapeutic target, particularly for mitigating cachexia and potentiating immunotherapy. However, the context-dependent and dualistic nature of GDF-15 signaling, varying with tumor type, microenvironment, and disease stage, poses substantial hurdles for clinical translation. Future efforts should focus on deciphering the molecular determinants underlying GDF-15's functional duality, paving the way for precise, context-tailored intervention strategies.
En bloc resection of multilevel cervicothoracic junction tumors via a combined posterior and osteomuscular-sparing transmanubrial anterior approach: a technical note and case series.
Li JX, Zhou SB, Xu ML … +3 more , Li B, Xiao JR, Xu W
World J Surg Oncol · 2026 May · PMID 42106730 · Full text
BACKGROUND: Multilevel localized tumors of the cervicothoracic junction (CTJ) pose significant surgical challenges due to the complex regional anatomy and proximity to vital neurovascular structures. Building upon the pi...
BACKGROUND: Multilevel localized tumors of the cervicothoracic junction (CTJ) pose significant surgical challenges due to the complex regional anatomy and proximity to vital neurovascular structures. Building upon the pioneering work established the combined transmanubrial and posterior approach for CTJ tumor resection in the 1990s, this study reports our institutional experience with this combined approach for the en bloc resection of multilevel localized primary CTJ tumors. CASE PRESENTATION: Three patients with multilevel localized CTJ tumors underwent the combined posterior and transmanubrial osteomuscular-sparing anterior approach (TMA). The patients included a male with a C7-T2 giant cell tumor, a male with a large osteosarcoma involving the left chest wall at the C6-T2 level, and a female with recurrent C7-T3 epithelioid hemangioendothelioma. Postoperatively, all three cases preserved osteomuscular integrity and one patient exhibited postoperative intrinsic hand muscle weakness secondary to obligatory C8/T1 nerve root sacrifice; the other two patients maintained normal neurological function and spinal stability, with no evidence of spinal dysfunction during follow-up. CONCLUSION: The combined posterior and transmanubrial osteomuscular-sparing anterior approach is a viable surgical option for patients with multilevel CTJ tumors, especially those with a narrow cervicothoracic angle and anterolateral tumor extension requiring en bloc excision.
Recurrent primary hyperparathyroidism with ipsilateral multifocal papillary thyroid carcinoma of classical, warthin-like, and follicular variants harboring distinct BRAF and NRAS mutations: a rare case report.
Maghdi SA, Moshi JM, Hakami AA … +7 more , Alahdal MAS, Ishaq AGM, Safhi AM, Alaajam F, Baity A, Abdelwahab SI, Al-Shamsi HO
World J Surg Oncol · 2026 May · PMID 42106728 · Full text
BACKGROUND: The coexistence of primary hyperparathyroidism (PHPT) and papillary thyroid carcinoma (PTC) occurs in 2-5% of surgical series. Recurrent PHPT following parathyroidectomy presents additional clinical challenge...
BACKGROUND: The coexistence of primary hyperparathyroidism (PHPT) and papillary thyroid carcinoma (PTC) occurs in 2-5% of surgical series. Recurrent PHPT following parathyroidectomy presents additional clinical challenges. While synchronous PHPT and PTC have been documented, the simultaneous occurrence of multifocal PTC exhibiting three distinct histological variants with different oncogenic driver mutations, accompanied by ipsilateral parathyroid pathology, appears not to have been previously reported in the available literature. CASE PRESENTATION: A 48-year-old Saudi female with hypothyroidism underwent left inferior parathyroidectomy and left hemithyroidectomy for biochemically confirmed PHPT. Initial histopathology revealed Hashimoto's thyroiditis and parathyroid follicular cell lesion. Six months postoperatively, she developed biochemical recurrence (serum calcium 2.77 mmol/L; PTH 21 pg/mL). Subsequent neck ultrasound demonstrated a suspicious right thyroid nodule (TIRADS 5), confirmed as Bethesda category V on fine-needle aspiration cytology. Completion right thyroidectomy with right inferior parathyroidectomy revealed multifocal PTC comprising classical variant foci, a 1.2 cm Warthin-like variant harboring BRAF V600E mutation, and a 0.2 cm follicular variant with NRAS G13R mutation. Concurrent right inferior parathyroid adenoma/hyperplasia was identified. Molecular testing (Idylla Biocartis platform) confirmed distinct mutational profiles, establishing independent clonal origins. CONCLUSION: To our knowledge, after review of the available literature, this appears to be the first reported case of recurrent PHPT with synchronous ipsilateral parathyroid adenoma/hyperplasia and multifocal PTC comprising three histological variants with distinct molecular alterations. This unique presentation underscores the necessity for comprehensive thyroid evaluation in PHPT patients, the utility of molecular profiling in establishing tumor clonality, and the importance of individualized surgical planning in complex endocrine neoplasia.
Modified subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance hook sternal elevation device in anterior mediastinal masses.
Shan Y, Bao Y, Guo H … +6 more , Feng K, Wu J, Wang G, Wu T, Lu Y, Shi Q
World J Surg Oncol · 2026 May · PMID 42106723 · Full text
OBJECTIVE: To explore the clinical value of the modified subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) with percutaneous suspension technique via "balance hook sternal elevation device" in anterior med...
OBJECTIVE: To explore the clinical value of the modified subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) with percutaneous suspension technique via "balance hook sternal elevation device" in anterior mediastinal masses. METHODS: Patients who underwent balance hook-assisted subxiphoid uniportal VATS for anterior mediastinal masses resection in the Department of Thoracic Surgery, Affiliated Hospital of Yangzhou University, between September 2025 and January 2026 were included. Clinical data and perioperative indicators were analyzed. RESULTS: A total of 16 patients were enrolled, comprising 6 males and 10 females, with ages ranging from 34 to 75 years. Tumor size ranged from 1.3 to 5.2 cm in the longest diameter. The operative time was 75-265 min, with an estimated blood loss of 10-100 mL. The Visual Analogue Scale (VAS) pain score was 4-7 on postoperative day 1, which decreased to 1-3 on postoperative day 3. Postoperative thoracic drainage duration was 2-7 days, and the postoperative hospital stay ranged from 3 to 9 days. Complete and safe resection of the tumor and thymus was successfully achieved in all patients. All patients recovered well postoperatively without significant complications. CONCLUSION: The modified "balance hook sternal elevation device" assisted technique effectively enlarges the retrosternal space, providing a satisfactory surgical field and adequate operating space for subxiphoid uniportal VATS. It ensures clear visualization of anterior mediastinal structures and facilitates the necessary extent of resection. The percutaneous suspension technique obviates the need for xiphoid resection, reduces sternal trauma, and further minimizes surgical injury. The combination of these two approaches holds potential clinical significance and application value in optimizing the efficacy and safety of minimally invasive anterior mediastinal surgery, minimizing surgical trauma and postoperative pain, and enhancing postoperative recovery for patients.
Functional outcomes and survival analysis of modular endoprostheses following resection of upper extremity tumors: a retrospective clinical study.
Öztürk Ö, Çatal S, Gündoğdu M … +2 more , Topkar OM, Erol B
World J Surg Oncol · 2026 May · PMID 42104363 · Full text
BACKGROUND: Advances in chemotherapy and radiotherapy have significantly improved patient survival. Furthermore, advancements in implant technology have enabled the successful application of endoprostheses in many cases...
BACKGROUND: Advances in chemotherapy and radiotherapy have significantly improved patient survival. Furthermore, advancements in implant technology have enabled the successful application of endoprostheses in many cases in which reconstruction via biological methods is not feasible. This study aimed to assess implant survival, overall patient survival, and functional outcomes in patients who underwent upper extremity tumor resection. METHODS: This study had a retrospective design. Patients who underwent resection and endoprosthetic reconstruction between 2011 and 2020 were evaluated. After applying the inclusion and exclusion criteria, 90 patients were included in this study. Factors potentially influencing endoprosthesis and patient survival were identified and analyzed. Functional assessment was performed by measuring the Musculoskeletal Tumor Society (MSTS) scores of patients during outpatient clinic follow-ups. RESULTS: The mean follow-up period was 36 ± 19.4 months. Implant failure occurred in eight of the 90 patients, resulting in a total endoprosthesis survival rate of 91.1%. Among the eight patients with implant failure, aseptic loosening was observed in two, infection in four, and tumor progression in two cases. During the study period, 37 patients died, resulting in an overall patient survival rate of 58.8%. The mean MSTS score for functional assessment was 22.1 ± 2.564. Studies in the literature suggest that the use of synthetic meshes contributes to improved functional outcomes. The mean MSTS score was 23.2 ± 2.370 for patients with synthetic mesh, compared to 21.5 ± 2.575 for those without, a statistically significant difference (P = 0.005). The overall patient survival rate was 58.8%. Two of the 90 patients underwent amputation, and the limb survival rate was 97.7%. The notably higher implant survival rate compared to patient survival and high limb survival rates indicate favorable outcomes consistent with the intended use of endoprosthetic reconstructions. CONCLUSION: Modular endoprostheses are a preferred successful reconstruction method following upper extremity tumor resections owing to their long-term survival and low complication rates. LEVEL OF EVIDENCE: Level IV.
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