World Journal Of Surgical Oncology[JOURNAL]
Sun
200 papers
The interactions between geriatric nutritional risk index and systemic immune-inflammation index for post-recurrence prognosis in patients with pancreatic cancer: a retrospective study.
Sakamoto T, Uehira K, Yoshida J … +10 more , Kishino M, Morimoto M, Murakami Y, Miyatani K, Shishido Y, Kihara K, Matsunaga T, Yamamoto M, Tokuyasu N, Fujiwara Y
World J Surg Oncol · 2026 Apr · PMID 42035090 · Full text
BACKGROUND: Nutritional status and systemic immune-inflammatory activity reflect dynamic interactions between tumor biology and host response and are closely implicated in cancer progression. However, the comparative pro...
BACKGROUND: Nutritional status and systemic immune-inflammatory activity reflect dynamic interactions between tumor biology and host response and are closely implicated in cancer progression. However, the comparative prognostic utility of nutritional and immune-inflammatory indices in the post-recurrence setting of pancreatic cancer remains unclear. This study investigated the prognostic interaction between established nutritional and immune-inflammatory markers in patients with recurrent pancreatic cancer following pancreatectomy. METHODS: A total of 120 patients who developed recurrence following pancreatectomy for pancreatic cancer were retrospectively analyzed. Nutritional status was assessed using serum albumin, the geriatric nutritional risk index (GNRI), and the prognostic nutritional index (PNI). Immune-inflammatory status was evaluated using the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). The prognostic significance of these indices for post-recurrence survival was examined, and their discriminative performance was compared. RESULTS: Among the nutritional markers, the GNRI demonstrated the highest discriminative ability for post-recurrence survival, while the SII showed the strongest performance among immune-inflammatory indicators. Both GNRI and SII were significantly associated with survival after recurrence. Stratification based on the combined GNRI and SII classification revealed that the integrated model provided superior prognostic discrimination compared with either marker alone. Multivariate analysis confirmed that the combined GNRI–SII classification was an independent prognostic factor in patients with recurrent pancreatic cancer (p = 0.005). CONCLUSIONS: Patients presenting with a low GNRI and high SII at the time of recurrence experienced significantly poorer survival compared with other combinatorial groups. The combined assessment of GNRI and SII represents a practical and potentially valuable tool for prognostic stratification and may assist in guiding optimal therapeutic decision-making in recurrent pancreatic cancer.
REBACIN can remove high-risk Human Papillomavirus (HPV) persistent infection efficiently as an effective non-invasive treatment: a multicenter prospective study.
Li JJ, Yang SS, Chen KJ … +12 more , Jiang LS, Fang YX, Liu CL, Wang S, Ye C, Yao LF, Chen YQ, Li X, Jiang J, He FM, Ling YL, Zhou SG
World J Surg Oncol · 2026 Apr · PMID 42035080 · Full text
OBJECTIVE: To evaluate the efficacy of REBACIN® as a non-invasive treatment for persistent high-risk HPV (HR-HPV) clearance compared with interferon and no treatment, identify optimal cutoff values for HPV E6/E7 mRNA/DNA...
OBJECTIVE: To evaluate the efficacy of REBACIN® as a non-invasive treatment for persistent high-risk HPV (HR-HPV) clearance compared with interferon and no treatment, identify optimal cutoff values for HPV E6/E7 mRNA/DNA assays, analyze clinical predictors, and validate REBACIN® as a safe alternative to invasive interventions for cervical cancer prevention. METHODS: According to the predefined inclusion and exclusion criteria, eligible patients were randomly selected and enrolled after obtaining their informed consent. Patients were allocated to three groups: the REBACIN group (received a course of intravaginal REBACIN administration), the recombinant human interferon α-2b group (received recombinant human interferon α-2b treatment), and the control group (received no treatment). After drug discontinuation, follow-up was conducted for all participants across the three groups. RESULTS: In the HPV E6/E7 mRNA and HPV-DNA testing cohorts, the clearance rates in the REBACIN® group were 54.9% and 64.0%, respectively. The optimal cutoff value of baseline HPV E6/E7 mRNA for predicting viral clearance in the REBACIN® group was 15.47 RLUs. After adjusting for confounders, patients in the REBACIN® group tested via HPV-DNA who were ≥ 50 years old [OR 0.34, 95% CI 0.14–0.81], had multiple infections [OR 0.36, 95% CI 0.17–0.76], or were HPV52-positive [OR 0.26, 95% CI 0.12–0.58] showed significantly lower viral clearance probabilities. CONCLUSION: This study suggests that REBACIN® may represent a non-invasive treatment option, providing a new option for the clinical treatment of persistent HR-HPV infections to prevent cervical cancer.
Completion of perioperative chemotherapy and tumor regression grade as independent predictors of one-year survival after total gastrectomy for gastric cancer: a retrospective cohort study.
Aldarwish M, Hoelzen JP, El-Sourani N … +12 more , Szardenings C, Abdelsamad A, Roy D, Holstein M, Eichelmann AK, Merten J, Kammer S, Shapiro D, Hartmann W, Wardelmann E, Pascher A, Juratli MA
World J Surg Oncol · 2026 Apr · PMID 42032695 · Full text
BACKGROUND: Gastric cancer remains a major global health burden, with persistently high mortality rates despite advances in multimodal treatment. Total gastrectomy (TG) constitutes a cornerstone of curative therapy; howe...
BACKGROUND: Gastric cancer remains a major global health burden, with persistently high mortality rates despite advances in multimodal treatment. Total gastrectomy (TG) constitutes a cornerstone of curative therapy; however, the factors governing early postoperative survival remain incompletely characterized. This study aimed to identify clinical and pathological predictors of 1-year overall survival (OS) following curative-intent TG, with particular emphasis on the oncological treatment strategy and tumor regression grade (TRG). METHODS: We retrospectively analyzed 145 patients who underwent TG between 2012 and 2023, excluding n = 4 adjuvant-only cases. To avoid statistical collinearity, multivariable Cox proportional hazards regression was performed in two sequential steps: Model 1 assessed the treatment strategy across the overall cohort (N = 145), while Model 2 evaluated TRG exclusively within the neoadjuvant-treated subgroup (n = 85). Both models incorporated the lymph node ratio (LNR) and surgical approach, and were adjusted for resection margin status (R-status), comorbidity burden (CCI), and severe postoperative complications (Clavien-Dindo ≥ III). A 60-day landmark analysis was conducted to mitigate immortal time bias. RESULTS: Completion of the perioperative chemotherapy sequence was independently associated with significantly improved 1-year OS compared to neoadjuvant therapy alone (HR = 0.20; 95% CI, 0.08–0.50; p = 0.001). This survival advantage remained highly significant in the 60-day landmark analysis (p = 0.004). Notably, 55.3% of patients who initiated neoadjuvant chemotherapy did not proceed to the adjuvant phase, primarily owing to patient refusal or medical contraindications. When evaluated exclusively within the neoadjuvant-treated subgroup, a poorer TRG demonstrated a prognostic trend toward decreased survival (HR = 1.60; 95% CI, 0.98–2.59; p = 0.059). Although severe complications (CD ≥ III) occurred in 55.9% of patients, their incidence did not differ significantly across treatment groups (p = 0.894) and did not diminish the independent prognostic value of treatment completion. The surgical approach (robotic vs. open) exerted no significant effect on 1-year OS (HR = 0.88; p = 0.745). CONCLUSIONS: Completion of the perioperative chemotherapy sequence and a favorable TRG represent two distinct and critical determinants of 1-year survival following TG for gastric cancer. While residual selection bias inherent to retrospective analyses must be acknowledged, the prognostic advantage conferred by treatment completion remains robust after adjustment for surgical morbidity, R-status, and immortal time bias. These findings underscore the prognostic importance of treatment adherence and tumor chemosensitivity, and highlight the need for individualized perioperative management strategies.
LncRNA LINC01579/miR-579-3p axis promotes gastric cancer progression via NOTCH1 pathway.
Geng Y, Gong S, Xue Q … +6 more , You J, Cao M, Xu B, Lin Y, Sun Z, Jin C
World J Surg Oncol · 2026 Apr · PMID 42032685 · Full text
BACKGROUND: The function of long non-coding RNAs (lncRNAs) in gastric cancer (GC) has received increasing attention. This study aims to explore the role of LINC01579 in GC. METHODS: One hundred GC subjects were included....
BACKGROUND: The function of long non-coding RNAs (lncRNAs) in gastric cancer (GC) has received increasing attention. This study aims to explore the role of LINC01579 in GC. METHODS: One hundred GC subjects were included. The abundance of LINC01579, miR-579-3p, and NOTCH1 signaling-related genes was measured in GC tissues and cell lines using qRT-PCR. Prognostic significance was evaluated through Kaplan-Meier estimator and Cox analysis. The interaction between LINC01579 and miR-579-3p was analyzed using Pearson correlation, bioinformatics prediction, and validated by dual-luciferase reporter assays. Cell proliferation was assessed using the CCK-8 assay, while apoptosis was evaluated by FITC Annexin V/PI staining followed by flow cytometry. Co-transfection experiments were performed to explore functional interactions. RESULTS: LINC01579 was elevated, whereas miR-579-3p was reduced in GC tissues and cell lines. Higher LINC01579 was associated with advanced pTNM stage, lymph node metastasis, and poor overall survival, identifying it as an independent prognostic factor. LINC01579 directly targeted miR-579-3p, with a significant negative correlation between their expression levels. Functionally, LINC01579 promoted tumor cell proliferation, inhibited apoptosis, and activated the NOTCH1 signaling (NOTCH1, DLL1, HES1), while miR-579-3p partially reversed these effects. CONCLUSION: LINC01579 was a promising prognostic candidate in GC. These findings indicated that LINC01579/miR-579-3p facilitates GC progression through cell proliferation, apoptosis, and NOTCH1 signaling, highlighting its potential as a therapeutic target.
International Delphi consensus to define textbook outcome parameters for oncological gastrectomy (togs project).
Carbonell-Morote S, Daiko H, de Manzoni G … +6 more , Gisbertz S, Yang HK, Polkowski W, Ramia JM, Pera M, Collaborators
World J Surg Oncol · 2026 Apr · PMID 42032683 · Full text
BACKGROUND: Textbook Outcome (TO) is a quality indicator representing the ideal surgical postoperative course. The lack of consensus on TO parameters in Gastric Oncological Surgery (TOGS) hinders comparative outcomes ana...
BACKGROUND: Textbook Outcome (TO) is a quality indicator representing the ideal surgical postoperative course. The lack of consensus on TO parameters in Gastric Oncological Surgery (TOGS) hinders comparative outcomes analysis. This study aimed to establish a universally accepted set of TOGS parameters using Delphi consensus made by international experts in gastric cancer surgery. METHOD: The Delphi process involved four phases: 1. Evidence Acquisition: A systematic review revealed significant variability in TOGS parameters. 2. Expert Panel Discussion: Eight international experts developed 18 preliminary questions for a survey. 3. Delphi Process: Two rounds of anonymous surveys among key opinion leaders measured agreement using a 5-point Likert scale, with consensus defined as ≥ 70%. A third round was conducted to revise questions on mortality, lymph nodes, and hospital stay. 4. Generation of Recommendations were created based on consensus from the three rounds RESULTS: Of 53 invited surgeons, 39 responded, and 34 completed both rounds. By the second round, ten parameters were agreed upon. 1) No 90-day mortality; 2) No complications ≥ III according to Clavien-Dindo classification; 3) No intraoperative complications according to the GASTRODATA classification; 4) R0 resection; 5) More than 25 lymph nodes analyzed in the surgical specimen; 6) No reoperation; 7) No readmission to the Intensive care Unit (ICU); 8) No readmission in the first 30 postoperative days; 9) Length of stay below the 75th percentile of the series; 10) Resumption of chemotherapy treatment, if indicated, within 8 weeks after surgery. CONCLUSION: TOGS consensus definition includes ten parameters specific to gastric cancer treatment. Validation in clinical practice is needed to confirm the proposed TOGS definition as a universal quality metric.
Association of preoperative insulin resistance surrogate indices with the risk of anastomotic leakage after colorectal cancer resection: a multicenter retrospective cohort.
Shamohammadi M, Mohammadi HR, Porrzani MK … +3 more , Yiasemidou M, Tizmaghz A, Bahardoust M
World J Surg Oncol · 2026 Apr · PMID 42026671 · Full text
BACKGROUND: Anastomotic leakage (AL) is a serious complication after colorectal cancer (CRC) surgery. Preoperative insulin resistance (IR) may impair anastomotic healing, but there is limited evidence regarding currently...
BACKGROUND: Anastomotic leakage (AL) is a serious complication after colorectal cancer (CRC) surgery. Preoperative insulin resistance (IR) may impair anastomotic healing, but there is limited evidence regarding currently available surrogate markers of IR. METHODS: In this multicenter retrospective cohort study conducted across three tertiary institutions between 2019 and 2024, 1,026 patients who underwent CRC resection with primary anastomosis were analyzed, of whom 128 (12.5%) developed AL. Preoperative IR was assessed with the use of the homeostasis model assessment of insulin resistance (HOMA-IR) and the triglyceride-glucose (TyG) index. The associations were evaluated using multivariable logistic regression adjusting for demographic, clinical, tumor-related, operative, and laboratory covariates. The TyG index cut-off was derived using receiver operating characteristic (ROC) analysis and internally validated using bootstrap resampling and cross-validation. RESULTS: Patients with AL had higher fasting insulin and HOMA-IR, and IR was more common in the AL group (60.9% vs. 31.1%). The TyG index was also higher in patients with AL, and TyG index ≥ 8.51 was more frequent in the AL group (63.3% vs. 45.5%). In multivariable logistic regression, HOMA-IR ≥ 2.5 (OR 2.95, 95% CI 1.75–4.16) and TyG index ≥ 8.51 (OR 1.58, 95% CI 1.08–2.09) remained independently associated with AL after adjustment for relevant demographic, tumor-related, operative, and laboratory covariates. CONCLUSIONS: Preoperative HOMA-IR and TyG index were associated with an increased risk of AL after CRC resection. Further prospective and externally validated studies are needed before routine clinical application can be considered. TRIAL REGISTRATION: Retrospectively registered.
Mesenchymal stem cells inhibited chronic myeloid leukemia cells in vitro, correlating with oxidative stress.
Zheng Y, Shi C, Chen Y … +6 more , Lai B, Wu H, Sheng L, Ge Q, Ouyang G, Yan X
World J Surg Oncol · 2026 Apr · PMID 42026586 · Full text
BACKGROUND: Chronic myeloid leukemia (CML) originates from bone marrow, and its progression to blast crisis phase is a primary cause of poor prognosis in patients. Investigating its underlying mechanisms may help improve...
BACKGROUND: Chronic myeloid leukemia (CML) originates from bone marrow, and its progression to blast crisis phase is a primary cause of poor prognosis in patients. Investigating its underlying mechanisms may help improve patient survival. METHODS: Optical microscopy and Cell Counting Kit-8 assays were utilized to observe and assess the viability of K562 cells (human cells derived from CML) treated with or without mesenchymal stem cell (MSC)-conditioned medium. Flow cytometry was employed to assess apoptosis and cell cycle changes. Intracellular reactive oxygen species (ROS) were assessed utilizing a 2’,7’-dichlorofluorescin diacetate probe. Antioxidant enzymes (total superoxide dismutase [T-SOD], catalase [CAT], glutathione peroxidase [GSH-Px]) and malondialdehyde (MDA), a marker of lipid peroxidation and oxidative stress, were measured using relevant assay kits. Western blotting was performed to evaluate inflammation-related proteins (nuclear factor erythroid 2-related factor 2 [Nrf2], inhibitor of nuclear factor kappa B alpha [IκBα]), and reverse transcription quantitative polymerase chain reaction (RT-qPCR) was utilized to assess expression of inflammatory cytokines (interleukin [IL]-6, IL-1β, IL-4, IL-10). All experiments were repeated three times, and the data were presented in mean form. Welch t-test was used to compare the treatment group and the control group. RESULTS: Compared with K562 cells without MSC-conditioned medium treatment, those cultured with MSC-conditioned medium exhibited significantly inhibited proliferation. The K562 cells treated with MSC-conditioned medium showed increased apoptosis compared with untreated cells (11.34% vs. 2.93%, P<0.0001) and cell cycle arrest (17.54% vs. 11.00%, P = 0.0007). Additionally, the K562 cell group with MSC-conditioned medium treatment elevated intracellular ROS levels (9.34% vs. 2.43%, P = 0.0002) in K562 cells. Oxidative stress factor analysis revealed decreased T-SOD (3.82 vs. 6.89, P = 0.0023), CAT (21.43 vs. 34.36, P = 0.0025), and GSH-Px (3.42 vs. 6.88, P = 0.0088) levels alongside increased MDA (6.29 vs. 3.30, P = 0.0009) in K562 cell group with MSC-conditioned medium treatment. Inflammatory protein assessment demonstrated reduced Nrf2 (0.46 vs. 1.00, P = 0.0017) and IκBα (0.71 vs. 1.00, P = 0.0002) levels in the K562 cell group with MSC-conditioned medium treatment. IL-6 (2.14 vs. 1.00, P<0.0001) and IL-1β (2.21 vs. 1.00, P<0.0001) were upregulated, whereas IL-4 (0.52 vs. 1.00, P<0.0001) and IL-10 (0.39 vs. 1.00, P<0.0001) were downregulated. CONCLUSION: MSC-conditioned medium inhibited K562 cell growth concomitant with increased oxidative stress and altered inflammatory responses.
Expression, functional role, and mechanistic insights into tRF-His-GTG-008 in lung adenocarcinoma.
Luo L, Long Z, Zhang J … +5 more , Wang Y, Yang H, Yang L, Wang L, Wang W
World J Surg Oncol · 2026 Apr · PMID 42021314 · Full text
OBJECTIVE: Transfer RNA-derived fragments (tRFs) represent a class of non-coding RNAs, typically ranging from 16 to 40 nucleotides in length, and have been implicated in the regulation of oncogenic processes. Despite eme...
OBJECTIVE: Transfer RNA-derived fragments (tRFs) represent a class of non-coding RNAs, typically ranging from 16 to 40 nucleotides in length, and have been implicated in the regulation of oncogenic processes. Despite emerging evidence of their involvement in various malignancies, the role of tRFs in lung adenocarcinoma remains unclear. The aim of this study is to investigate the expression levels, functional role, and molecular mechanisms of tRF-His-GTG-008 in lung adenocarcinoma. METHODS: tRF-His-GTG-008, a 31-nucleotide fragment derived from the D-loop at the 5′ end of tRNA-His-GTG-1-1, was identified through high-throughput sequencing. Its expression was assessed in lung adenocarcinoma tissues and cell lines (A549, H-1975) using quantitative reverse transcription polymerase chain reaction (qRT-PCR), and its diagnostic utility was evaluated using receiver operating characteristic curve. Functional assays—including cell proliferation, clone formation, migration, and invasion experiments—were conducted following overexpression or knockdown of tRF-His-GTG-008. In vivo tumorigenicity was evaluated using a xenograft model in immunodeficient mice. The potential target gene was predicted using miRanda and TargetScan databases, and its interaction with LATS2 was validated through dual-luciferase reporter assays, RT-qPCR and western blot analysis. RESULTS: tRF-His-GTG-008 was significantly upregulated in lung adenocarcinoma tissues and cell lines (AUC = 0.717). Overexpression of tRF-His-GTG-008 promoted cell proliferation, clone formation, migration, and invasion of A549 and H-1975 cells, whereas knockdown suppressed these oncogenic phenotypes without notable effects on the cell cycle or apoptosis. In vivo, knockdown of tRF-His-GTG-008 resulted in reduced tumor volume and weight, accompanied by decreased expression of Ki-67 and MMP9. Mechanistically, tRF-His-GTG-008 was found to directly bind to the 3’-UTR of the LATS2 gene, leading to its downregulation. CONCLUSION: tRF-His-GTG-008 is overexpressed in lung adenocarcinoma and demonstrates diagnostic potential. Its oncogenic effects are mediated through direct targeting and suppression of LATS2, indicating its possible utility as a novel therapeutic target in the management of lung adenocarcinoma.
Ectopic breast cancer in vulva and other non-axillary sites: a systematic review.
Loo KH, Hwang MJ
World J Surg Oncol · 2026 Apr · PMID 42015262 · Full text
BACKGROUND: Ectopic breast cancer (EBC) is a rare malignancy (0.3–0.6% of all breast cancers) that arises along the embryological milk line. While axillary EBC is better characterised and typically managed similarly to o...
BACKGROUND: Ectopic breast cancer (EBC) is a rare malignancy (0.3–0.6% of all breast cancers) that arises along the embryological milk line. While axillary EBC is better characterised and typically managed similarly to orthotopic breast cancer, the clinical features and management of non-axillary EBC remain poorly defined. AIM: To synthesise available data on the clinical presentation, histopathology, management, and outcomes of non-axillary EBC to refine treatment strategies. METHODS: A systematic review of case reports and case series was conducted following PRISMA 2020 guidelines and registered with PROSPERO (CRD420251035771). PubMed, Ovid MEDLINE, Embase, Scopus, and Cochrane Library were searched up to April 2025. Study quality was assessed using the JBI checklist. Data were analysed descriptively using Microsoft Excel, focusing on clinical presentation, diagnosis, histopathology, treatment, and outcomes. RESULTS: Sixty-one studies (63 patients) were included: 37 vulvar and 26 non-vulvar cases. Median age at diagnosis was 62. Lesions typically presented as painless nodules, with ulceration prompting attention. Invasive ductal adenocarcinoma was the most common histological subtype (39.7%), and oestrogen receptor positivity (82.5%) was frequent. Lymph node involvement was reported in 50.8% of cases. Organ metastases commonly involved bone, lung, and liver. Surgery was the main treatment, with adjuvant systemic therapy. Among cases with available follow-up (n = 50), recurrence and mortality rates were 18.0% (n = 9) and 16.0% (n = 8), respectively. Follow-up methods were poorly documented. CONCLUSION: Non-axillary EBC shares clinical and pathological characteristics with orthotopic breast cancer. Multidisciplinary, site-adapted approach is recommended with applying breast cancer principles to systemic management. Increased clinical awareness and more consistent reporting are crucial to optimise future care and outcomes.
RGS19 drives tumor progression and immunosuppression in clear cell renal cell carcinoma by modulating CAMs and EMT.
Li Z, Lian Z, Ma K … +3 more , Song W, Xue X, Li L
World J Surg Oncol · 2026 Apr · PMID 42010588 · Full text
BACKGROUND: Renal cell carcinoma (RCC) is characterized by poor prognosis and limited treatment options.This study aims to characterize the clinical significance, biological functions, and underlying mechanisms of RGS19...
BACKGROUND: Renal cell carcinoma (RCC) is characterized by poor prognosis and limited treatment options.This study aims to characterize the clinical significance, biological functions, and underlying mechanisms of RGS19 in clear cell renal cell carcinoma (ccRCC) and preliminarily analyze its association with the tumor immune microenvironment. METHODS: The expression pattern of RGS19 was analyzed using TCGA datasets, GEO databases, and clinical specimens. Its biological functions were verified through in vitro assays and in vivo experimental models. Correlations between RGS19 and cell adhesion molecules (CAMs), epithelial-mesenchymal transition (EMT)-related genes, and signaling pathways were analyzed. Immune infiltration analysis was also performed to explore the association between RGS19 expression and tumor immune microenvironment. RESULTS: RGS19 was markedly elevated in ccRCC tissues and cell lines compared with normal control groups. Its elevated expression correlated with advanced TNM stage, higher histologic grade, and poorer overall, progression-free, and disease-specific survival, establishing it as an independent prognostic factor. Furthermore, functional assays confirmed that RGS19 depletion curbed ccRCC cell proliferation, migration, and invasion in vitro, and attenuated tumor growth in xenograft models. RGS19 overexpression exerted the opposite effects. RGS19 was positively correlated with CAMs and EMT-related genes, and enriched in cell adhesion and EMT signaling pathways. Furthermore, expression of RGS19 was associated with increased infiltration of immunosuppressive cell populations and diminished infiltration of Th17 cell subsets. CONCLUSION: RGS19 promotes ccRCC progression through CAM-mediated adhesion, EMT, and immunosuppression, suggesting its clinical utility as a prognostic marker and a promising target for therapy.
Barriers to surgical treatment and diagnostic intervals among women with operable breast cancer in Benin: a retrospective study from two referral centers (2019-2023).
Gnangnon FHR, Vodouhè T, Gogan RPC … +7 more , Acakpo B, Djohou SFJ, Aboubakar M, Gbessi DG, Tonato-Bagnan JA, Denakpo JL, Aguemon CT
World J Surg Oncol · 2026 Apr · PMID 42010554 · Full text
BACKGROUND: In Benin, breast cancer is a leading cause of cancer-related morbidity and mortality among women. Surgery is central to curative management, yet a substantial proportion of women with potentially operable dis...
BACKGROUND: In Benin, breast cancer is a leading cause of cancer-related morbidity and mortality among women. Surgery is central to curative management, yet a substantial proportion of women with potentially operable disease do not ultimately undergo an operation. We assessed time-to-diagnosis intervals and factors associated with non-receipt of surgery among women with operable breast cancer managed in two referral hospitals in Cotonou between 2019 and 2023. METHODS: We conducted a retrospective analytical study at the National University Hospital Hubert Koutoukou Maga (CNHU-HKM) and the University Hospital for Mother and Child Lagune (CHU-MEL). Eligible participants were women with de novo operable breast cancer at initial presentation. Sociodemographic, clinical, care-pathway, and tumor-related variables were extracted from medical records. Associations with receipt of surgery (yes/no) were explored using bivariate analyses and multivariable logistic regression, with statistical significance set at p < 0.05. RESULTS: Among 1,362 breast cancer cases identified during the study period, 827 had usable medical records, of which 197 met the criteria for operable disease at diagnosis (operability rate: 23.8%). Data on surgical receipt were available for 187 patients, and 105 underwent surgery, yielding a surgical uptake rate of 56.1%. Mean age was 51.3 ± 13.7 years. The mean patient interval from symptom onset to specialist consultation was 252 days, and 83.3% of patients presented after more than 30 days. In multivariable analysis, lack of multidisciplinary tumor board (MTB) presentation (aOR 2.50; p = 0.004), detection of the tumor by someone other than the patient (aOR 5.67 ; p = 0.040), and tumor size > 5 cm (aOR 7.44; p < 0.001) were independently associated with non-receipt of surgery. Sociodemographic characteristics and measured diagnostic intervals were not independently associated with receipt of surgical treatment. CONCLUSIONS: Strengthening MTB processes, promoting earlier symptom recognition and presentation, and reducing financial and psychosocial barriers could raise surgical uptake and improve outcomes for operable breast cancer in Benin.
Analysis of the predictive value of age and serum IL-6 level at 24-hour postoperatively for prolonged postoperative ileus after laparoscopic colorectal cancer surgery.
Liu Z, Chen Y, Fu XA … +7 more , Guo Y, Ning XJ, Huang YS, Liu H, Wang HY, Wang C, Guo SG
World J Surg Oncol · 2026 Apr · PMID 42010422 · Full text
BACKGROUND: Prolonged postoperative ileus (PPOI) is a common complication following laparoscopic colorectal cancer surgery, which is closely associated with systemic inflammatory responses triggered by surgical trauma. O...
BACKGROUND: Prolonged postoperative ileus (PPOI) is a common complication following laparoscopic colorectal cancer surgery, which is closely associated with systemic inflammatory responses triggered by surgical trauma. OBJECTIVE: This study aimed to investigate the relationships between age, serum IL-6 levels at 24 h postoperatively, and PPOI following laparoscopic radical resection for colorectal cancer and to evaluate their indicative value for PPOI. METHODS: From March to November 2025, 106 patients who were diagnosed with colorectal cancer preoperatively were prospectively enrolled. After screening, 76 cases were ultimately included. Univariate and multivariate logistic regression analyses identified independent risk factors, and receiver operating characteristic curves clarified the predictive value of relevant indicators for PPOI.Finally, an internal validation was conducted using Bootstrap. RESULTS: The incidence of PPOI was 26.32%. After univariate and multivariate analyses were performed, age and postoperative 24-hour serum IL-6 concentration were identified as independent risk factors for PPOI. Combined analysis based on these independent risk factors yielded an area under the receiver operating characteristic curve (AUROC) of 0.822 (95% CI: 0.712–0.932).After 1000 bootstrap internal validation corrections, the AUROC of the model was 0.830 .Statistical analysis identified patients aged ≥ 65 years and with a postoperative 24-hour serum IL-6 concentration ≥ 109 pg/mL had a significantly increased incidence of PPOI. CONCLUSION: The ROC curve analysis demonstrated that patients aged ≥ 65 years and those with postoperative 24 h serum IL-6 ≥ 109 pg/mL were defined as high risk cases. These findings can guide clinicians to implement intensive monitoring and individualized intervention for such high risk postoperative patients. Meanwhile, these findings may inform future large-scale, multicenter prospective studies. TRIAL REGISTRATION: Registration Unit: China Clinical Trial Registry Registration number: ChiCTR2500096778.Register website: https://www.chictr.org.cn/secsponsorproj.html registration date༚2025-02-06
Risk factor and prediction model for malignant pancreatic intraductal papillary mucinous neoplasm.
Yu G, Guo Z, Xu X … +6 more , Zhou K, Liu L, Zang Y, Wan R, Yu G, Xiao W
World J Surg Oncol · 2026 Apr · PMID 42001163 · Full text
BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is a relatively uncommon pancreatic cystic tumor that serves as a significant precursor lesion closely associated with pancreatic cancer. This study aimed to ide...
BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is a relatively uncommon pancreatic cystic tumor that serves as a significant precursor lesion closely associated with pancreatic cancer. This study aimed to identify risk factors for malignant transformation of IPMN and develop a corresponding predictive model. METHODS: Patients with IPMN admitted to Shanghai General Hospital between May 2012 and January 2025 were included in this study. Patients were stratified into benign and malignant groups. Characteristic parameters and laboratory results were collected. The training set and test set were randomly divided at a ratio of 7:3. Least absolute shrinkage and selection operator regression was used to select potential prognostic factors. A nomogram was developed by firth penalty logistic regression. Receiver operating characteristic curves and calibration curves were used to evaluate the model’s predictive performance. RESULTS: Among 121 patients analysed, four independent predictors of malignancy were identified: CA19-9 Elevation, classified as MD/MT, MTD_Log, and MPD_bc. We developed a nomogram with an area under the curve of 0.870 in the training set and 0.808 in the test set. The model showed strong predictive ability and showed good clinical usefulness. CONCLUSIONS: CA19-9 Elevation, classified as MD/MT, MTD_Log, and MPD_bc are independent risk factors for malignant IPMN. The established prediction model demonstrates good accuracy and may provide valuable guidance for clinical decision-making.
Exploratory analysis of serial pan-immune-inflammation value and its early dynamics during neoadjuvant chemotherapy as a predictor of complete cytoreduction at interval debulking surgery in advanced ovarian cancer: a retrospective cohort study.
Su H, Tian M, Wang Y … +5 more , Li Y, Shan Y, Jin Y, Feng F, Wang T
World J Surg Oncol · 2026 Apr · PMID 42001161 · Full text
BACKGROUND: Complete cytoreduction at interval debulking surgery (IDS) is the most critical prognostic determinant for advanced ovarian cancer patients receiving neoadjuvant chemotherapy (NACT), yet accurate preoperative...
BACKGROUND: Complete cytoreduction at interval debulking surgery (IDS) is the most critical prognostic determinant for advanced ovarian cancer patients receiving neoadjuvant chemotherapy (NACT), yet accurate preoperative prediction remains challenging. Pan-immune-inflammation value (PIV) has emerged as a superior predictor in multiple malignancies compared to simple inflammatory ratios, yet its predictive value for surgical outcomes after NACT in ovarian cancer remains uninvestigated. This study aimed to explore the predictive value of PIV at multiple timepoints and its early dynamics during NACT for complete cytoreduction at IDS in patients with advanced ovarian cancer. METHODS: PIV was calculated at three timepoints in 231 enrolled patients: before NACT (PIV-0), after one cycle of NACT (PIV-1), and before IDS (PIV-2). Early PIV difference was defined as the percentage change between PIV-0 and PIV-1. Receiver operating characteristic analysis and logistic regression were performed to assess the predictive value for cytoreduction status. Associations with chemotherapy response indicators and survival outcomes were also evaluated. RESULTS: Patients with incomplete cytoreduction had significantly higher PIV levels at all timepoints and less favorable early PIV dynamics (all P < 0.001). The area under the curve for PIV-0, PIV-1, PIV-2, and early PIV difference were 0.762, 0.850, 0.754, and 0.787, with optimal cut-off values of 660.6, 404.9, 219.4, and − 19.4%, respectively. Multivariate analysis identified elevated PIV-0 (OR = 4.06), PIV-1 (OR = 5.31), and unfavorable early PIV difference (OR = 9.93) as independent predictors, while PIV-2 lost significance. High PIV levels at all timepoints and unfavorable early dynamics were associated with lower KELIM score, higher intraoperative peritoneal cancer index, lower chemotherapy response score, and worse survival. CONCLUSIONS: PIV and its early dynamics during NACT are potential predictive biomarkers for surgical outcomes in advanced ovarian cancer. Early PIV assessments may help identify patients at risk of incomplete cytoreduction and guide personalized treatment strategies.
Association between log odds of positive lymph nodes and survival in surgically treated cervical cancer patients: a SEER database-based cohort study.
Zhang L, Yang J, Zhang P … +1 more , Shang Y
World J Surg Oncol · 2026 Apr · PMID 41998619 · Full text
BACKGROUND: Conventional nodal staging (N stage) and positive lymph node ratio exhibit limitations in accurately evaluating lymph node status. The current research aims to explore the prognostic value of the logarithmic...
BACKGROUND: Conventional nodal staging (N stage) and positive lymph node ratio exhibit limitations in accurately evaluating lymph node status. The current research aims to explore the prognostic value of the logarithmic odds of positive lymph nodes (LODDS) for projecting overall survival (OS) and cancer-specific survival (CSS) in patients with cervical cancer (CC) undergoing surgery. METHODS: Patients who received surgical treatment for CC between 2004 and 2020 were identified from the Surveillance, Epidemiology, and End Results database. Propensity score matching (PSM) was applied to balance baseline characteristics. Hazard ratios (HRs) were analyzed employing Cox proportional hazards regression models. The possible nonlinear relationship was evaluated via restricted cubic splines. Survival rates were compared utilizing Kaplan-Meier curves. Subgroup analyses were also conducted. A novel LODDS-based model was established and verified. Its predictive accuracy was compared with that of the conventional Tumor-Node-Metastasis (TNM) staging model. RESULTS: A total of 9,501 subjects were initially enrolled. Following PSM, 2,092 matched cases were encompassed in the analysis cohort. Multivariable analysis indicated that High LODDS was markedly related to elevated risk of mortality (OS: HR 2.04, 95% confidence interval [CI] 1.747–2.383; CSS: HR 1.821, 95% CI 1.52–2.181; P < 0.001). Model comparison indicated superior predictive performance for the novel LODDS-based model over the conventional model incorporating TNM staging (C-index: 0.743 vs. 0.692). Both the net reclassification improvement and integrated discrimination improvement indices confirmed that the new model offered notably better predictive capability for survival at 1, 3, and 5 years (P < 0.001 for all). CONCLUSION: LODDS constitutes an independent prognostic factor for individuals with CC following surgery. Compared with conventional TNM staging, LODDS provides incremental prognostic value, facilitating the development of personalized risk assessment and more accurate follow-up strategies.
miR-3648 regulates cell functions and acts as a potential biomarker to predict prognosis in breast cancer and its bioinformatics analysis.
Guo Y, Shi L
World J Surg Oncol · 2026 Apr · PMID 41992344 · Full text
BACKGROUND: Breast cancer is an important cause of death from malignant tumors in women. This study aims to clarify the regulatory role, molecular mechanism and clinical value of miR-3648 in breast cancer. METHODS: This...
BACKGROUND: Breast cancer is an important cause of death from malignant tumors in women. This study aims to clarify the regulatory role, molecular mechanism and clinical value of miR-3648 in breast cancer. METHODS: This study analyzed 126 pairs of clinical samples of breast cancer. The expression of miR-3648 and its potential target SMAD6 was detected by qRT-PCR. Survival outcomes were assessed by Kaplan-Meier analysis and Cox regression model. In the MCF-7 and BT-474 cell lines, function gain and loss experiments were conducted using miR-3648 mimic or inhibitor. Biological behaviors modulated by miR-3648, including cell proliferation, migration and invasion were assessed using CCK-8 and Transwell assays. The target genes of miR-3648 were predicted by bioinformatics, and their relationship was verified by dual-luciferase. RESULTS: MiR-3648 was significantly upregulated in breast cancer and correlated with unfavorable clinicopathological features and predicted the survival rate of patients. In vitro experiments revealed that overexpression of miR-3648 promotes the proliferation, migration, and invasion of breast cancer cells, while inhibition of its expression yields opposite effects. Bioinformatics analysis and verification experiments jointly identified SMAD6 as the functional target of miR-3648. SMAD6 and miR-3648 expression was inversely correlated in breast cancer tissues, and SMAD6 knockdown partially reversed the effects of miR-3648 inhibition. CONCLUSIONS: miR-3648 exerts its role in promoting the progression of breast cancer by directly targeting and inhibiting SMAD6, and can serve as a potential biomarker for evaluating the prognosis of patients.
The effect of interleukin-21 on HBV-related hepatocellular carcinoma, from the perspective of genetics.
Wang X, Yao Y, Chen X … +2 more , Qiu J, Fu H
World J Surg Oncol · 2026 Apr · PMID 41992330 · Full text
BACKGROUND: Hepatocellular carcinoma (HCC) represents a major global health burden, with chronic hepatitis B virus (HBV) infection being its predominant cause. However, only a fraction of chronic HBV carriers progress to...
BACKGROUND: Hepatocellular carcinoma (HCC) represents a major global health burden, with chronic hepatitis B virus (HBV) infection being its predominant cause. However, only a fraction of chronic HBV carriers progress to HCC, suggesting a critical role for host genetic susceptibility. Interleukin-21 (IL-21) is a key immunomodulatory cytokine implicated in anti-tumor immunity, yet the association between IL-21 gene polymorphisms and HBV-related HCC risk remains unexplored. This study aimed to investigate the potential link between specific IL-21 single nucleotide polymorphisms (SNPs) and susceptibility to HBV-related HCC in a Chinese population. METHODS: A hospital-based case-control study was conducted involving 320 patients with HBV-related HCC and 560 age- and sex-matched healthy controls. Three IL-21 SNPs (rs2221903, rs907715, and rs12508721) were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: Significant associations with HBV-related HCC susceptibility were identified for rs12508721 and rs2221903 (P < 0.05), while no significant association was found for rs907715. The specific risk or protective genotypes and their corresponding ORs are detailed in the full text. CONCLUSION: This study provides preliminary evidence that genetic polymorphisms in the IL-21 gene (rs12508721 and rs2221903) may be associated with susceptibility to HBV-related HCC. These findings suggest a potential role for host genetic variation in IL-21 in influencing outcomes following chronic HBV infection, although functional validation and replication in larger, independent cohorts are required to confirm these observations.
Predictive value of PD-L1 expression and dMMR/pMMR status for immune checkpoint inhibitor combined with chemotherapy in advanced/recurrent endometrial cancer: a meta-analysis.
Lan L, Tang Z, Yao X … +2 more , Liao H, Yang Y
World J Surg Oncol · 2026 Apr · PMID 41992277 · Full text
BACKGROUND: Advanced/recurrent endometrial cancer (EC) poses a significant therapeutic challenge. Immune checkpoint inhibitor (ICI) combined with chemotherapy (CT) represents a promising first-line approach, yet the pred...
BACKGROUND: Advanced/recurrent endometrial cancer (EC) poses a significant therapeutic challenge. Immune checkpoint inhibitor (ICI) combined with chemotherapy (CT) represents a promising first-line approach, yet the predictive value of deficient/proficient mismatch repair (dMMR/pMMR) status and PD-L1 expression in therapeutic efficacy remains unclear. This study aimed to systematically evaluate the predictive value of dMMR/pMMR status and PD-L1 expression for progression-free survival (PFS) and overall survival (OS) in patients with advanced/recurrent EC treated with ICI + CT. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) from four databases (PubMed, Embase, Cochrane Library, Web of Science) was performed. PFS and OS were synthesized as hazard ratios (HRs) with 95% confidence intervals (CIs) using Review Manager 5.4. RESULTS: Five RCTs (2,707 patients) were included in this meta-analysis. Compared with CT alone, ICI + CT significantly improved PFS in all subgroups: dMMR (HR = 0.36, 95% CI:0.28–0.45, P < 0.00001), pMMR (HR = 0.78, 95% CI:0.70–0.87, P = 0.009), PD-L1-positive (HR = 0.52, 95% CI:0.38–0.70, P < 0.0001), and PD-L1-negative (HR = 0.66, 95% CI:0.44–0.98, P = 0.04). For OS, only the dMMR subgroup showed a significant benefit (HR = 0.41, 95% CI:0.28–0.61, P < 0.00001), with no improvement observed in pMMR patients (HR = 0.88, 95% CI:0.73–1.07, P = 0.20). CONCLUSION: For advanced/recurrent EC, ICI + CT enhanced PFS across dMMR/pMMR and PD-L1 expression subgroups, with OS benefit apparently confined to dMMR patients and not observed in pMMR patients. These results present the clinically valuable predictive value of MMR status for ICI + CT efficacy and suggest that PD-L1expression did not influence the benefit of ICI on patient PFS, which deserve high clinical attention. TRIAL REGISTRATION: https://inplasy.com/inplasy-2026-03-0015/ , identifier INPLASY202630015.
Prognostic impact of tumour-vessel proximity in soft tissue sarcoma: Fujiwara classification provides enhanced risk stratification.
Spiegel C, Huettl L, Weschenfelder F … +3 more , Schrenk KG, Ernst T, Weschenfelder W
World J Surg Oncol · 2026 Apr · PMID 41992231 · Full text
BACKGROUND: Tumour proximity to major neurovascular structures complicates resection of deep soft tissue sarcomas (STS), yet its independent impact on overall survival (OS) remains unclear. This study assessed whether an...
BACKGROUND: Tumour proximity to major neurovascular structures complicates resection of deep soft tissue sarcomas (STS), yet its independent impact on overall survival (OS) remains unclear. This study assessed whether anatomical proximity, measured by dichotomised distance and the Fujiwara classification, predicts oncologic outcomes after curative-intent surgery. METHODS: Patients with high-grade extremity or truncal STS treated between 2004 and 2020 were retrospectively analysed. Minimal tumour–vessel distance (> 1 cm vs. ≤ 1 cm) and Fujiwara type (I–IV) were determined from preoperative MRI. OS was evaluated using Kaplan–Meier and Cox regression. Multivariable Cox models were pre-specified to include established prognostic confounders (age, tumour size, histologic grade, and resection status), irrespective of univariate significance. Fujiwara types III and IV were pooled to improve estimate stability. RESULTS: A total of 113 patients met inclusion criteria (median follow-up 84 months); 47 deaths occurred during follow-up. Tumour proximity ≤ 1 cm was associated with significantly reduced OS (42 vs. 107 months; p = 0.003). The Fujiwara classification was associated with significant survival differences across categories (p < 0.001). In multivariable analysis (Model A), proximity ≤1 cm remained independently associated with OS (HR 3.04; 95% CI 1.38–6.67; p = 0.006), together with age ≥65 years (HR 3.42; p = 0.007) and R2 resection (HR 9.67; p = 0.002). In Model B, pooled Fujiwara type III/IV remained independently associated with impaired OS (HR 3.62; 95% CI 1.47–8.94; p = 0.005), alongside age ≥65 years (HR 3.07; p = 0.015) and R2 resection (HR 7.32; p = 0.007). Higher Fujiwara types correlated with increased local recurrence (p = 0.011), while distant metastasis rates were similar across groups. CONCLUSIONS: Tumour proximity to neurovascular structures is independently associated with OS in high-grade deep STS. The Fujiwara classification remained prognostically relevant after adjustment for established risk factors including resection status. These findings suggest that anatomical tumour–vessel relationships provide complementary prognostic information beyond conventional clinicopathologic variables. Prospective multicentre validation is warranted.
Overall survival and prognostic factors in young women with breast cancer: a retrospective cohort study from Southern Thailand.
Khongthong P, Prateepchaiboon T, Ruangsuwan T
World J Surg Oncol · 2026 Apr · PMID 41987244 · Full text
BACKGROUND: Breast cancer diagnosed at a young age is often associated with aggressive tumor characteristics and poorer survival outcomes. In Southeast Asia, data on overall survival and prognostic factors among young wo...
BACKGROUND: Breast cancer diagnosed at a young age is often associated with aggressive tumor characteristics and poorer survival outcomes. In Southeast Asia, data on overall survival and prognostic factors among young women with breast cancer remain limited, particularly from real-world clinical settings with complete mortality ascertainment. This study aimed to describe survival outcomes and identify independent prognostic factors among women aged 45 years or younger with breast cancer at a major provincial referral hospital in Southern Thailand. METHODS: We conducted a retrospective cohort study of women aged 45 years or younger diagnosed with histologically confirmed breast cancer at Hat Yai Hospital, Southern Thailand, between 2013 and 2018. Mortality was ascertained through linkage with the Thai National Civil Registration database. Molecular subtypes were classified using immunohistochemistry surrogate criteria per the St. Gallen 2013 consensus. Missing data were handled using multiple imputation by chained equations (MICE, m = 10). Overall survival (OS), disease-free survival (DFS), and distant disease-free survival (DDFS) were estimated using the Kaplan-Meier method. Prognostic factors were evaluated using univariable and multivariable Cox proportional hazards regression with the revised model including disease stage, tumour grade, molecular subtype, surgery, and hormone therapy. RESULTS: A total of 293 young women were included. Median follow-up was 93.3 months (95% CI: 89.8-98.2). The 3-year and 5-year OS rates were 75.8% (95% CI: 71.0-80.8%) and 66.2% (95% CI: 61.0-71.9%), respectively. Five-year OS by stage ranged from 87.1% (Stage I) to 33.3% (Stage IV). The 5-year DFS and DDFS were 58.0% and 61.8%, respectively. The most common molecular subtype was HR+/HER2- (52.0%), followed by HR-/HER2- (22.3%), HR+/HER2+ (16.0%), and HR-/HER2+ (9.7%). In multivariable analysis, HR+/HER2 + subtype was independently associated with poorer overall survival compared with HR+/HER2- (adjusted HR = 2.08, 95% CI: 1.07-4.07, p = 0.032). Hormone therapy receipt was independently associated with better overall survival (adjusted HR = 0.20, 95% CI: 0.10-0.42, p < 0.001). Receipt of surgery was strongly associated with overall survival but largely reflected disease operability rather than an independent treatment effect. CONCLUSIONS: This study provides systematically ascertained, registry-linked survival benchmarks for young-onset breast cancer in Southern Thailand. HR+/HER2 + subtype and hormone therapy receipt were independent prognostic factors. The relatively lower stage-specific survival rates compared with high-income country benchmarks highlight the need for improved access to HER2-targeted therapy and endocrine therapy in this resource-limited setting.
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