World Journal Of Surgical Oncology[JOURNAL]
Sun
200 papers
Clinical characteristics and prognosis of familial non-medullary thyroid carcinoma: a retrospective study of 98 families.
Yang G, Zhang Y, Xu T … +5 more , Fan Y, Ran Y, Li P, Zheng X, Wei T
World J Surg Oncol · 2026 Apr · PMID 41987180 · Full text
BACKGROUND: The differences in clinicopathological features and prognosis between familial non-medullary thyroid carcinoma (FNMTC) and sporadic non-medullary thyroid carcinoma (SNMTC) remain a subject of debate. This stu...
BACKGROUND: The differences in clinicopathological features and prognosis between familial non-medullary thyroid carcinoma (FNMTC) and sporadic non-medullary thyroid carcinoma (SNMTC) remain a subject of debate. This study aims to compare the clinicopathological features and recurrence-free survival (RFS) between FNMTC and SNMTC, with a particular focus on the subgroup differences based on the number of affected relatives. METHODS: A retrospective analysis was conducted on 672 NMTC patients who underwent thyroidectomy at West China Hospital between 2015 and 2024. The cohort included 224 FNMTC patients (from 98 families) and 448 SNMTC patients. FNMTC patients were further stratified into families with two affected members (FNMTC-2, n = 160) and families with ≥ three affected members (FNMTC-3, n = 64) subgroups. Clinicopathological characteristics and RFS were compared among the groups. RESULTS: Compared to the SNMTC group, the FNMTC group demonstrated a smaller tumor diameter (1.03 ± 0.60 cm vs. 1.15 ± 0.96 cm, p = 0.0255) but higher rates of multifocality (43.75% vs. 34.82%, p = 0.024), bilaterality (32.59% vs. 23.88%, p = 0.0163), and lymph node metastasis (52.68% vs. 44.42%, p = 0.0432). Subgroup analysis revealed that the FNMTC-3 group, compared to SNMTC, was associated with a younger age at diagnosis (43.76 ± 14.53 vs. 47.01 ± 11.28 years, p = 0.039), a smaller tumor diameter (0.89 ± 0.46 cm vs. 1.15 ± 0.96 cm, p = 0.0343), and increased rates of multifocality (50.00% vs. 34.82%, p = 0.0185), bilaterality (37.50% vs. 23.88%, p = 0.0195), lymph node metastasis (57.81% vs. 44.42%, p = 0.0444), and thyroid follicular nodular disease (57.81% vs. 44.20%, p = 0.0409). Furthermore, the FNMTC-3 group had a significantly smaller tumor diameter than the FNMTC-2 group (0.89 ± 0.46 cm vs. 1.08 ± 0.64 cm, p = 0.0343). However, no statistically significant differences in RFS were observed among the SNMTC and FNMTC groups during follow-up. CONCLUSION: FNMTC-3 exhibits more aggressive clinicopathological features than SNMTC, including earlier onset, higher multifocality, bilaterality, and metastatic potential. These findings support that the number of affected family members is a significant indicator of tumor aggressiveness in FNMTC. Although no difference in RFS was observed, the distinct pathological profile of FNMTC-3 warrants more vigilant surveillance.
Gastric schwannoma: diagnostic challenges, pathological features, and surgical management : a narrative review.
Loo GH, Md Pauzi SH, Kosai NR
World J Surg Oncol · 2026 Apr · PMID 41987179 · Full text
BACKGROUND: Gastric schwannoma is a rare benign mesenchymal tumour of the stomach that frequently mimics gastrointestinal stromal tumour (GIST) in clinical and radiologic presentation. MAIN BODY: This narrative review su...
BACKGROUND: Gastric schwannoma is a rare benign mesenchymal tumour of the stomach that frequently mimics gastrointestinal stromal tumour (GIST) in clinical and radiologic presentation. MAIN BODY: This narrative review summarises current evidence on the epidemiology, diagnostic challenges, imaging characteristics, pathological features, and management of gastric schwannoma. Available literature from major medical databases was reviewed to synthesise findings related to clinical presentation, radiologic and endoscopic features, histopathological diagnosis, and treatment outcomes. Gastric schwannoma typically presents as an incidental subepithelial lesion in middle-aged adults. Imaging findings frequently overlap with those of GIST, limiting reliable preoperative differentiation. Definitive diagnosis relies on histopathological examination demonstrating spindle cell morphology with peripheral lymphoid cuffing and strong immunoreactivity for S-100 and SOX10 with absence of CD117 and DOG-1 expression. Complete surgical resection with negative margins remains the standard treatment and is associated with excellent long-term outcomes. CONCLUSION: Although rare, gastric schwannoma should be considered in the differential diagnosis of gastric subepithelial tumours. Accurate pathological diagnosis is essential to guide appropriate management and avoid unnecessary oncologic treatment.
Surgical approaches to esophageal cancer gastrointestinal reconstruction: a systematic review of jejunum, colon, and ileocolonic interposition with comparative outcome analysis.
Liu X, Dai J, Yin M … +2 more , Zhang R, Song Y
World J Surg Oncol · 2026 Apr · PMID 41981663 · Full text
Esophageal cancer is a highly aggressive malignancy of the digestive tract, with surgical resection remaining the cornerstone of curative treatment. For patients with an intact stomach, reconstruction using a gastric con...
Esophageal cancer is a highly aggressive malignancy of the digestive tract, with surgical resection remaining the cornerstone of curative treatment. For patients with an intact stomach, reconstruction using a gastric conduit via gastric pull-up is the preferred approach following esophagectomy. However, in cases where the stomach is unavailable—due to prior gastric surgery, polyps, or concurrent tumors—alternative conduits must be considered. By reviewing relevant domestic and international research literature, this review evaluates the indications, benefits, limitations, and common complications associated with jejunal, colonic, and ileocolonic interpositions. Additionally, strategies for the prevention and management of complications are discussed. By synthesizing the latest clinical evidence, we aim to provide practical recommendations to guide surgical decision-making and improve outcomes in the management of esophageal cancer. The jejunum, colon, and ileocolon represent the primary options for esophageal reconstruction, each offering unique anatomical and functional advantages as well as distinct technical challenges and complication profiles.
Two hemi-purse-string suture for dodenal stump reinforcement during laparoscopic gastrectomy for gastric cancer.
Wang X, Chen X, Lin T … +8 more , Lin J, Deng D, Zhang X, Li Z, Liu H, Hu Y, Yu J, Zhao M
World J Surg Oncol · 2026 Apr · PMID 41981654 · Full text
BACKGROUND: We present a novel two hemi-purse-string suture technique for duodenal stump reinforcement in laparoscopic gastrectomy. However, the simplicity and safety of this technique have not yet been fully evaluated....
BACKGROUND: We present a novel two hemi-purse-string suture technique for duodenal stump reinforcement in laparoscopic gastrectomy. However, the simplicity and safety of this technique have not yet been fully evaluated. METHODS: Retrospectively collected data from 217 patients diagnosed with gastric cancer and underwent distal/total gastrectomy at Nanfang Hospital from April 2022 to April 2025, including 107 cases underwent the two hemi-purse-string suture and 110 cases underwent continuous inverting suture. Analyze and compare the clinicopathological information, intraoperative operation time and postoperative complications between two groups of patients. RESULTS: There was no statistically significant difference in baseline data between the two groups (P > 0.05), indicating comparability. Compared to the continuous inverting suture group, patients who underwent duodenal stump reinforcement with the two hemi-purse-string technique demonstrated a significantly shorter duodenal stump suture time (298.2 ± 53.8 s vs. 326.8 ± 78.4 s, t = -3.109, p = 0.002) and required fewer stitches (4.47 ± 0.63 vs. 6.35 ± 1.37, t = -12.892, p < 0.001). Regarding the success of embedding, a successful primary embedding was achieved in 100% (107/107) of cases in the two hemi-purse-string suture group, compared to 99.1% (109/110) in the continuous inverting suture group. No cases in either group experienced duodenal serosal tearing during the reinforcement procedure. The duodenal stump embedding was completed according to the predetermined plan in all patients in both groups (107/107 vs. 110/110). Importantly, no incidents of duodenal stump leakage, pancreatic fistula, or intra-abdominal haemorrhage occurred in either group, indicating comparable safety profiles between the two techniques. CONCLUSION: The two hemi-purse-string suture used for duodenal stump reinforcement can shorten the suture time and has no postoperative complications such as duodenal stump fistula. It is efficient and reliable.
Retrospective study on the magnetic resonance imaging integration rate of acellular dermal matrix and complications after breast-conserving surgery plus radiotherapy.
Shin E, Hong SJ, Eom HJ … +8 more , Yoo TK, Kim J, Chung IY, Ko BS, Kim HJ, Lee JW, Son BH, Lee SB
World J Surg Oncol · 2026 Apr · PMID 41981614 · Full text
BACKGROUND: Breast-conserving surgery (BCS) is increasingly preferred for early-stage breast cancer; however, conventional oncoplastic approaches may not adequately address large or irregular defects. Acellular dermal ma...
BACKGROUND: Breast-conserving surgery (BCS) is increasingly preferred for early-stage breast cancer; however, conventional oncoplastic approaches may not adequately address large or irregular defects. Acellular dermal matrix (ADM), particularly paste-type formulations, offers a potential solution for volume replacement, though evidence regarding safety, integration, and imaging outcomes remains limited. METHODS: This retrospective review included 74 patients who underwent BCS with intraoperative paste-type ADM between June 2022 and August 2023. MRI and ultrasonography evaluated ADM integration and postoperative morphology, and complications were recorded. Stratified statistical analyses examined associations among imaging results, clinicopathologic characteristics, ADM volume, and outcomes. RESULTS: Paste-type ADM demonstrated safe integration with a low complication rate (4.1%) and no severe events such as infection or extrusion. MRI showed favorable integration grades (G0–G1) in over half of the patients. Ultrasonography identified three post-ADM morphologies: mass-like, cystic, and gap-type, which were associated with initial ADM volume and patient characteristics. No clinical or imaging variables predicted adverse outcomes, and minor complications were managed conservatively. CONCLUSION: Paste-type ADM is a reliable, safe, and robust option for volume replacement in breast-conserving surgery, with favorable integration confirmed by MRI and ultrasonography. These findings support its broader use in oncoplastic breast surgery, improving reconstructive strategies and facilitating enhanced oncologic and aesthetic outcomes through multidisciplinary imaging surveillance.
MTHFD1L in muscle invasive bladder cancer: a multi-cohort study on prognosis and therapeutic response.
Peng S, Liu Y, Huang P … +7 more , Liu Q, Zhang L, Hsu CY, Zeng Y, Lu J, Zhao H, Cai C
World J Surg Oncol · 2026 Apr · PMID 41981612 · Full text
BACKGROUND: Bladder cancer is one of the most common malignancies of the urinary tract. Among its subtypes, muscle invasive bladder cancer (MIBC) is particularly aggressive and often associated with poor prognosis. The e...
BACKGROUND: Bladder cancer is one of the most common malignancies of the urinary tract. Among its subtypes, muscle invasive bladder cancer (MIBC) is particularly aggressive and often associated with poor prognosis. The efficacy of platinum-based neoadjuvant chemotherapy and radical cystectomy remains unsatisfactory. In recent years, immune checkpoint inhibitors have shown promising therapeutic potential in MIBC. However, reliable biomarkers for predicting treatment response are still lacking. Moreover, traditional clinical parameters, such as TNM staging, often fail to accurately assess patient outcomes. Therefore, identifying novel biomarkers is crucial for improving prognosis and optimizing treatment strategies in MIBC. METHODS: We first analyzed the expression pattern and prognostic significance of methylenetetrahydrofolate dehydrogenase (NADP + dependent) 1-like (MTHFD1L) across multiple cancer types. Subsequently, MIBC patient samples from three independent cohorts (TCGA-BLCA, GSE169455, and GSE48075) were used to evaluate the prognostic value of MTHFD1L through univariate and multivariate Cox regression analyses combined with Kaplan-Meier survival analysis. Gene Set Enrichment Analysis and Gene Set Variation Analysis were performed to explore the biological functions of MTHFD1L. Mutation characteristics and immunotherapy response-related features were further analyzed based on MTHFD1L expression levels. Finally, the results were further verified by immunohistochemistry and cell function experiments. RESULTS: MTHFD1L was upregulated in multiple cancer types, and its elevated expression was significantly associated with unfavorable outcomes. In all independent MIBC cohorts, high MTHFD1L expression served as an independent risk factor for poor prognosis. Gene Set Enrichment Analysis indicated that MTHFD1L may promote tumor progression by activating immune-related and proliferative pathways while suppressing metabolic processes. Mutation analysis revealed a higher frequency of TP53 mutations in the MTHFD1L high-expression group. Moreover, immune response prediction suggested that patients with low MTHFD1L expression were more likely to benefit from immune checkpoint inhibitors therapy. Immunohistochemistry confirmed the overexpression of MTHFD1L in MIBC tissues, and cell function experiments demonstrated that MTHFD1L knockdown markedly inhibited bladder cancer cell proliferation, colony formation, and migration. CONCLUSIONS: MTHFD1L represents a promising and reliable biomarker for predicting prognosis and immunotherapy response in MIBC, providing a new foundation for the development of precision and personalized therapeutic strategies.
Differential expression of estrogen and progesterone receptors before and after surgery in endometrial cancer and analysis of recurrence prediction model.
Fan R, Jiang P, Hu Z
World J Surg Oncol · 2026 Apr · PMID 41975474 · Full text
BACKGROUND: Endometrial cancer has rising incidence and mortality, with high recurrence rates (10%-70%) post-surgery. Discrepancies between preoperative biopsy and postoperative pathology, particularly in estrogen recept...
BACKGROUND: Endometrial cancer has rising incidence and mortality, with high recurrence rates (10%-70%) post-surgery. Discrepancies between preoperative biopsy and postoperative pathology, particularly in estrogen receptor (ER) and progesterone receptor (PR) expression, may misguide treatment. This single-center study explored ER/PR expression dynamics pre- and post-surgery and developed a recurrence prediction model for clinical reference in comparable settings. METHODS: A retrospective cohort of 600 stage I-III endometrial cancer patients (2017-2021) exclusively from a single center was analyzed. Preoperative biopsies (blind vs. hysteroscopy-guided) and postoperative specimens underwent ER/PR immunohistochemical testing. Concordance was assessed via Cohen's kappa. Survival analysis (Kaplan-Meier), ROC curves, and Cox regression identified prognostic factors. A nomogram integrating PR expression dynamics and clinicopathological parameters was developed and validated. RESULTS: ER and PR expression showed moderate-to-substantial overall concordance (86.8%, κ = 0.481; 87.1%, κ = 0.676), with hysteroscopy-guided biopsies demonstrating superior agreement (ER: 94.0%, κ = 0.733; PR: 91.4%, κ = 0.742) versus blind biopsies. Combined pre-/postoperative PR expression improved recurrence prediction (AUC = 0.680). The integrated nomogram (AUC = 0.864) effectively stratified high-risk patients (3-year recurrence-free survival: 53.40% vs. 86.05% in non-high-risk), who benefited from adjuvant therapy. CONCLUSIONS: Hysteroscopy-guided biopsy enhances ER/PR assessment accuracy. The nomogram integrating PR dynamics and clinical parameters enables precise recurrence risk stratification, aiding personalized adjuvant therapy decisions in similar clinical settings. TRIAL REGISTRATION: Not applicable.
DNA-based characterization of primary hepatic MALT lymphoma reveals a rare FAT3 missense variant and Hippo pathway activation: a case report and literature review.
Zhang R, Zhang C, Bai Z … +3 more , Zhang Y, Wei F, Zhang A
World J Surg Oncol · 2026 Apr · PMID 41975421 · Full text
BACKGROUND: Primary hepatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is exceedingly rare, and molecular evidence specific to this anatomic site remains sparse. DNA-based prof...
BACKGROUND: Primary hepatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is exceedingly rare, and molecular evidence specific to this anatomic site remains sparse. DNA-based profiling represents a powerful tool for elucidating the molecular mechanisms underlying lymphoid neoplasms; however, its application to primary hepatic MALT lymphoma remains largely unexplored. Here, we report a localized, virus-negative hepatic MALT case characterized by targeted DNA sequencing and paired tumor–normal tissue assessment of Hippo pathway activity. CASE PRESENTATION: A 55-year-old asymptomatic woman was found to have a 2.68-cm hypervascular hepatic nodule on screening ultrasound. Contrast-enhanced ultrasonography showed rapid arterial enhancement with early washout, and cross-sectional staging showed no evidence of extrahepatic disease. Laparoscopic wedge resection achieved R0 margins; histology confirmed MALT lymphoma with lymphoepithelial lesions and plasmacytoid differentiation (Lugano stage IE). Targeted DNA sequencing using a mature lymphoma panel identified a rare FAT3 missense variant with no other canonical coding drivers detected. Paired tumor versus adjacent liver analyses demonstrated increased YAP1 and TEAD1 readouts in tumor tissue. Postoperatively, PET–CT and quarterly ultrasound surveillance were performed for 24 months, with no evidence of recurrence. CONCLUSIONS: DNA-based profiling of this rare, virus-negative primary hepatic MALT lymphoma revealed a FAT3 missense variant and concomitant upregulation of YAP1 and TEAD1 expression in tumor tissue, providing hypothesis-generating evidence of Hippo pathway dysregulation specific to hepatic MALT lymphoma, which requires validation in larger, independent cohorts.
Application of modified π-shaped anastomosis in digestive tract reconstruction during totally laparoscopic total gastrectomy: a feasibility study.
Hu Y, Wan S, Liang C … +11 more , Li Z, Wang M, Zhang X, Xu L, Hu F, Zhang D, Liu Y, Wang X, Xia Y, Huang X, Xu L
World J Surg Oncol · 2026 Apr · PMID 41965758 · Full text
OBJECTIVE: To investigate the feasibility and short-term efficacy of the modified π-shaped anastomosis technique for esophagogastric anastomosis in gastrointestinal reconstruction after total gastrectomy performed entire...
OBJECTIVE: To investigate the feasibility and short-term efficacy of the modified π-shaped anastomosis technique for esophagogastric anastomosis in gastrointestinal reconstruction after total gastrectomy performed entirely by laparoscopy. METHODS: This study included 50 patients who underwent totally laparoscopic gastrectomy with modified π-shaped anastomosis for gastrointestinal reconstruction at the First Affiliated Hospital of Wannan Medical College from August 2021 to August 2023. In this study, intraoperative and postoperative indicators were measured to assess the feasibility and short-term efficacy of this technique. Our modified surgical approach involved first resecting the jejunal mesentery and dividing the jejunum during gastrointestinal tract reconstruction, followed by esophagojejunal anastomosis. RESULTS: The surgery was successfully completed for all 50 patients. The operation time was 251.3 ± 43.2 min, the postoperative hospital stay was 9.3 ± 1.3 days, the time to first postoperative ventilation from the end of the surgery was 4.3 ± 1.9 days, and the time to first postoperative feeding was 7.8 ± 1.6. No complications such as intestinal obstruction, anastomotic fistula, or anastomotic stenosis were observed. One patient developed anastomotic bleeding, one patient experienced an incisional infection, and two patients had pleural effusions. All 50 patients were followed up for more than one year, with no evidence of long-term complications or recurrence. CONCLUSION: Modified π-shaped anastomosis is effective for digestive tract reconstruction during totally laparoscopic total gastrectomy (TLTG), thereby effectively preventing mucosal eversion, reducing anastomotic tension, and decreasing the incidence of anastomotic leakage.
The lncRNA OTX2-AS1 promotes NSCLC progression via the miR-377-5p/EIF5A2 axis and EMT induction.
Song Y, Liu C, Wang L
World J Surg Oncol · 2026 Apr · PMID 41965714 · Full text
BACKGROUND: The prognosis for non-small cell lung cancer (NSCLC) remains poor, and its underlying molecular mechanisms require further elucidation. This study aimed to systematically investigate the clinical significance...
BACKGROUND: The prognosis for non-small cell lung cancer (NSCLC) remains poor, and its underlying molecular mechanisms require further elucidation. This study aimed to systematically investigate the clinical significance, biological function, and potential molecular mechanism of long non‑coding RNA OTX2-AS1 in NSCLC. METHODS: OTX2-AS1 expression was examined in a clinical cohort comprising 111 NSCLC patients, and its correlation with clinicopathological characteristics and prognosis was analyzed. OTX2-AS1 expression was modulated in cancer cells via transfection, and its impact on malignant behaviors was assessed using cell counting kit‑8, Transwell, and flow cytometry assays. The direct interactions within the OTX2-AS1/miR-377-5p/eukaryotic translation initiation factor 5A2 (EIF5A2) axis were verified by dual-luciferase reporter and RNA immunoprecipitation experiments. RESULT: OTX2-AS1 was significantly upregulated in NSCLC tissues and cell lines. Its elevated expression independently correlated with unfavorable patient prognosis. In vitro functional assays confirmed that OTX2-AS1 knockdown inhibited cell viability and invasion while promoting apoptosis in NSCLC cells. Mechanistically, OTX2-AS1 functioned as a molecular sponge to directly sequester miR-377-5p, which in turn targeted and regulated the oncogene EIF5A2. Inhibiting miR-377-5p reversed the anti-tumor effects induced by OTX2-AS1 knockdown, whereas silencing EIF5A2 counteracted the tumor-promoting effects of miR-377-5p inhibition. Activation of this axis upregulated EIF5A2, subsequently suppressing E-cadherin and promoting N-cadherin expression. CONCLUSION: This study suggests that OTX2-AS1 may promote NSCLC progression by sponging miR-377-5p, leading to EIF5A2upregulation and potential induction of epithelial‑mesenchymal transition. The OTX2-AS1/miR-377-5p/EIF5A2 axis may serve as a potential prognostic biomarker and therapeutic target for NSCLC.
Late bleeding complications after mastectomy and the role of seroma aspiration: a retrospective 12-year cohort study.
Tamminen A, Aaltonen RI, Ristola MT
World J Surg Oncol · 2026 Apr · PMID 41965704 · Full text
BACKGROUND: Surgical bleeding complications typically occur a few hours or days after the operation. Due to their rarity, late-onset bleeding complications are seldom discussed in the literature. Mastectomy is a common p...
BACKGROUND: Surgical bleeding complications typically occur a few hours or days after the operation. Due to their rarity, late-onset bleeding complications are seldom discussed in the literature. Mastectomy is a common procedure, which is often associated with the need for repeated seroma aspirations. Although seroma aspirations have also been associated with complications, the area remains insufficiently studied. This study aimed to investigate the risk of late bleeding complications after mastectomy, especially those associated with seroma aspiration. METHODS: Data from all patients undergoing simple mastectomy with or without axillary surgery for breast cancer between 2010 and 2022 at a single university hospital were collected. Medical records were reviewed for major bleeding complications and predisposing factors, especially the use of antithrombotic medications. RESULTS: In total, 2,620 patients with 2,710 mastectomies were included in the study. Forty-five patients (1.7%) suffered a major bleeding complication. Twenty-four complications (53%) occurred after the first postoperative week; most (88%, 21/24) being preceded by a seroma aspiration. The median time from mastectomy to seroma aspiration-associated bleeding complication was 76 days (range 11–536 days). Upon arrival for treatment, 691 (26%) patients were taking antithrombotic medications. The risk for major bleeding complications related to seroma aspiration was 1.9% (13/691) and 0.4% (8/1929) in patients receiving and not receiving antithrombotic medications, respectively (p < 0.0001). CONCLUSION: A significant proportion of major post-mastectomy bleeding complications occur late and are associated with seroma aspiration, particularly in patients receiving antithrombotic therapy. The indication, technique, and setting of seroma aspiration in these high-risk patients should be carefully considered.
The gene mutation pattern of urachal squamous cell carcinoma resembles that of gastrointestinal tumors: a rare case with favorable prognosis following surgery and adjuvant chemotherapy.
Lu X, You X, Liu T … +7 more , Wei Y, Sun D, Yi C, Li T, Yu J, Chen X, Xiang Z
World J Surg Oncol · 2026 Apr · PMID 41964001 · Full text
BACKGROUND: Urachal carcinoma (UrC) is a rare epithelial malignant tumor of the urinary system, with an age-standardized incidence of 0.32 per million population, accounting for 0.35–0.70% of all bladder tumors. Adenocar...
BACKGROUND: Urachal carcinoma (UrC) is a rare epithelial malignant tumor of the urinary system, with an age-standardized incidence of 0.32 per million population, accounting for 0.35–0.70% of all bladder tumors. Adenocarcinoma is the most common histological subtype of UrC, while squamous cell carcinoma is extremely rare, representing only 2% of all UrC cases, and is associated with a high mortality rate. Due to its occult onset and high malignancy, urachal squamous cell carcinoma (USC) is often diagnosed at an advanced stage, and current understanding of this disease remains limited. Herein, we report a rare case of USC with complete clinical and therapeutic records, with no evidence of recurrence or metastasis identified during a 4-year follow-up period to date. Additionally, exome sequencing was performed, revealing that the gene mutation pattern of the carcinoma cell is closer to that of gastrointestinal tumors. CASE PRESENTATION: A 58-year-old male presented to a local hospital twice with gross hematuria at a 6-month interval. No abnormalities were detected on cystoscopy, urinary exfoliative cytopathology, or pelvic magnetic resonance imaging (MRI). Five months after the second visit, the patient was referred to our hospital for the third episode of hematuria. Computed tomography urography (CTU) and pelvic MRI identified abnormal signals in the anterior wall of the urinary bladder, suggesting a urachal tumor. Subsequent cystoscopy with biopsy revealed acute and chronic mucosal inflammation with hemorrhage. The patient then underwent extended partial cystectomy combined with urachal and umbilical resection. Pathological examination confirmed moderately differentiated squamous cell carcinoma of the urachus, which had invaded the muscularis propria and lamina propria of the bladder wall. Exome sequencing was performed on DNA extracted from the patient’s tumor tissue, demonstrating that the tumor’s gene mutation pattern was closer to that of gastrointestinal tumors. Postoperatively, the patient received gemcitabine plus cisplatin chemotherapy, which was switched to docetaxel plus carboplatin adjuvant chemotherapy due to grade III myelosuppression. At the 4-year postoperative follow-up, no local or distant metastatic lesions have been identified, and long-term prognosis remains under surveillance. CONCLUSIONS: This is a rare reported case of USC with long-term survival, accompanied by gene sequencing data. Most currently reported cases of USC are diagnosed at an advanced stage; thus, early diagnosis, complete surgical resection, and adjuvant chemoradiotherapy may contribute to long-term remission. In this patient, despite clear identification of the tumor on cross-sectional imaging, cystoscopic biopsy failed to retrieve tumor tissue, indicating that USC may not penetrate the bladder wall in a very early stage. We favor ultrasound-guided percutaneous biopsy may be a more appropriate diagnostic modality than cystoscopic biopsy in patients who present with small protrusions at the urachal-bladder junction and hematuria, in the absence of other imaging evidence of urinary tract tumors. Furthermore, gene sequencing results confirmed that USC is more similar to gastrointestinal tumors, which may originate from intestinal wall residues retained in the cloaca during embryonic development.
Tyrosine kinase inhibitors combined with PD-1 inhibitors reduce peritoneal metastasis risk for patients with ruptured HCC receiving TACE/TAE: a multicenter retrospective study.
Ji J, Zhang Y, Yan L … +5 more , Sun X, Wang J, Gu J, Zhou W, Lv P
World J Surg Oncol · 2026 Apr · PMID 41957798 · Full text
PURPOSE: This study aimed to evaluate whether the combination of tyrosine kinase inhibitors (TKIs) and PD-1 inhibitors can reduce the risk of peritoneal metastasis (PM) in patients with ruptured hepatocellular carcinoma...
PURPOSE: This study aimed to evaluate whether the combination of tyrosine kinase inhibitors (TKIs) and PD-1 inhibitors can reduce the risk of peritoneal metastasis (PM) in patients with ruptured hepatocellular carcinoma (HCC) after transcatheter chemoembolization/embolization (TACE/TAE). MATERIALS AND METHODS: This study included 163 patients with ruptured HCC who received TACE/TAE at 4 centers from June 2015 to June 2023. Patients were categorized into two groups based on their treatment: the combination group, which received TKIs plus PD-1 inhibitors, and the TACE/TAE group, which did not. Propensity score matching (PSM) analysis was performed in a ratio of 1:2 to reduce bias between the groups. The PM rate, overall survival (OS) and the occurrence of adverse events were analyzed and compared between the two groups. Moreover, the independent factors associated with PM were further evaluated. RESULTS: The median follow-up duration was 801 days [95% confidence interval (CI): 720.2-925.7]. After PSM, the combination and TACE/TAE groups comprised 45 and 90 patients, respectively. A significant difference was observed in the peritoneal PM rate (combination group: 6.7% vs. TACE/TAE group: 23.3%, P = 0.032). The corresponding 3-, 6-, 12-, and 24-month PM cumulative incidence was 5.6%, 15.7%, 22.5%, and 24.1% in the TACE/TAE group, and 0%, 0%, 4.9%, and 7.7% in the combination group, respectively (P < 0.001). The combination group exhibited a significantly longer median OS compared to the TACE/TAE group (OS:566 days vs. 120 days, P < 0.001). The multivariate competing risk analysis identified hepatitis B virus (HBV) infection [subdistribution hazard ratio (SHR), 0.420; 95% CI: 0.188-0.939; P = 0.035), Barcelona Clinic Liver Cancer stage C (BCLC C) (SHR, 0.228; 95% CI: 0.059-0.874; P = 0.031), and combination therapy (SHR, 0.267; 95% CI: 0.082-0.866; P = 0.028) as the independent factors for PM. More adverse events were witnessed in the combination group compared with the monotherapy group, most of which were tolerable and manageable. CONCLUSIONS: The combination of TKIs and PD-1 inhibitors reduced the risk of PM compared with TACE/TAE in patients with ruptured HCC. Also, PM was less likely to occur in patients with HBV-related and BCLC C ruptured HCC.
Melittin enhances PD-L1 blockade in prostate cancer by inhibiting M2 macrophage polarization and recruitment.
Yan R, Zhang K, Chen J … +2 more , Pan Y, Wang H
World J Surg Oncol · 2026 Apr · PMID 41957788 · Full text
OBJECTIVE: The immunosuppressive tumor microenvironment (TME) limits the efficacy of immunotherapy in prostate cancer treatment. This study aims to investigate how melittin remodels the TME in prostate cancer and enhance...
OBJECTIVE: The immunosuppressive tumor microenvironment (TME) limits the efficacy of immunotherapy in prostate cancer treatment. This study aims to investigate how melittin remodels the TME in prostate cancer and enhances the response mechanism to anti-PD-L1 therapy. METHODS: The antitumor efficacy of melittin was evaluated using subcutaneous and orthotopic prostate cancer mouse models, in vitro co-culture systems of prostate cancer cells (PC-3, 22RV1) and THP-1-derived macrophages, and validation in primary bone marrow-derived macrophages (BMDMs). RNA sequencing, flow cytometry, qPCR, Western blot, ELISA, Transwell migration assays, CCK-8 viability analysis, and immunohistochemistry were employed to explore the underlying mechanisms. The synergistic effect of melittin combined with anti-PD-L1 antibody was assessed in vivo. RESULTS: Melittin significantly inhibited tumor growth in vivo and remodeled the tumor immune microenvironment by increasing CD8⁺ T cell infiltration while reducing macrophage accumulation. Mechanistically, melittin suppressed M2 macrophage polarization through inhibition of the JAK–STAT pathway, as evidenced by reduced phosphorylation of JAK1 and STAT3—an effect partially reversed by the JAK–STAT agonist RO8191 and mimicked by the JAK inhibitor Ruxolitinib. Melittin also attenuated macrophage recruitment via downregulation of tumor-derived CCL2, thereby compromising the CCL2–CCR2 chemotactic axis. In both subcutaneous and orthotopic models, melittin combined with anti-PD-L1 antibody synergistically reduced tumor burden, suppressed PD-L1 expression, and enhanced CD8⁺ T cell infiltration. Notably, melittin did not directly regulate PD-L1 expression in tumor cells in vitro, suggesting that its effects on PD-L1 in vivo are mediated through modulation of the TME. CONCLUSION: Melittin reverses the immunosuppressive TME in prostate cancer by inhibiting JAK-STAT mediated M2 polarization and CCL2-dependent macrophage recruitment. This reprogramming of the TME, combined with PD-L1 blockade, represents a potential combination immunotherapy strategy for prostate cancer.
Oral paraneoplastic manifestations and findings associated with extra-oral surgically treated malignancies: a prospective cross-sectional study of 300 cases.
Liskova V, Liska J, Molnarova N … +6 more , Nechutna L, Topolcan O, Pecen L, Zednikova I, Skalicky T, Molacek J
World J Surg Oncol · 2026 Apr · PMID 41947209 · Full text
BACKGROUND: To assess the prevalence of oral paraneoplastic manifestations in patients with biopsy-confirmed extra-oral malignancies and to identify oral findings with potential paraneoplastic significance that could ser...
BACKGROUND: To assess the prevalence of oral paraneoplastic manifestations in patients with biopsy-confirmed extra-oral malignancies and to identify oral findings with potential paraneoplastic significance that could serve as new targets for dental screening. METHODS: A single-center prospective cross-sectional study was performed. A total of 300 consecutive surgical oncology patients (April 2024–September 2025) underwent standardized oral examinations one day prior to planned oncologic surgery. Extraoral and intraoral findings—including mucosal changes, perfusion abnormalities, tongue morphology, and candidal colonization—were evaluated by oral medicine specialists. Only primary extra-oral malignancies were included and categorized into upper gastrointestinal, colorectal, hepatopancreatic, lung, and breast cancer. Mycological cultures were obtained in all patients. Statistical assessment used Chi-square test, multivariate stepwise selection logistic regression models and univariate models of selected confounders (SAS software). RESULTS: Classical paraneoplastic oral syndromes (e.g., paraneoplastic pemphigus, acanthosis nigricans) were not detected. Oral candidiasis was uncommon and appeared mainly in patients with advanced disease, suggesting limited usefulness as an early indicator. In contrast, labial and lingual hypoperfusion occurred significantly more often in gastrointestinal cancers (p ≤ 0.0001, labial hypoperfusion was differentiated in 25.5% (24/94) of gastrointestinal malignancies). Patients with breast cancer showed a markedly higher prevalence of tongue enlargement and dental impressions (both p < 0.0001, with tongue enlargement detected in 51,3% (80/159) of cases), as well as lateral deviation during protrusion (p = 0.0152). CONCLUSION: Traditional oral paraneoplastic manifestations were virtually absent in this cohort. However, simple clinical findings—particularly perfusion changes and tongue morphology—showed frequent tumor-specific associations and may merit further investigation for the verification as potential early paraneoplastic indicators. As a pilot study, the results should be interpreted as hypothesis-generating. Following validation in large multicenter studies, these findings may bring a promising opportunity to strengthen the role of dentists in multidisciplinary prevention programs.
Multi-omics exploration of hypoxia in gastric cancer.
Zhu Y, Wu X
World J Surg Oncol · 2026 Apr · PMID 41947143 · Full text
BACKGROUND: Hypoxia created an intratumoral oxygen gradient, promoting a more aggressive tumoral phenotype. Nevertheless, there was a lack of hypoxic panorama in gastric cancer (GC). METHODS: A total of 715 GC samples co...
BACKGROUND: Hypoxia created an intratumoral oxygen gradient, promoting a more aggressive tumoral phenotype. Nevertheless, there was a lack of hypoxic panorama in gastric cancer (GC). METHODS: A total of 715 GC samples covering two independent cohorts were used for non-negative matrix factorization clustering and subtype exploration based on a tailored hypoxic signature. The prognosis, molecular markers, pathways, infiltrating of lymphocytes and stromal cells, and response of PD-1 therapy were compared between the subtypes. RESULTS: GC patients were divided into two groups, one indicted as normoxia, while the other defined as hypoxia. Hallmarks of aggressive tumor features such as EMT, angiogenesis, and KRAS signaling up were significantly enriched under hypoxic conditions and undoubtedly, worse outcome. Additionally, hypoxia confers GC with higher immune score, CAF infiltration, and resistant to pembrolizumab therapy in patients with metastatic GC (mGC). CONCLUSIONS: Hypoxia-targeted or CAF-oriented therapy may overcome current chemoradiotherapy-resistant advanced GC but warrants further investigation.
Isolated splenic metastasis from colorectal cancer: clinical characteristics and management.
Li Y, Hu J
World J Surg Oncol · 2026 Apr · PMID 41943098 · Full text
BACKGROUND: Isolated splenic metastases from colorectal cancer (CRC) are an extremely rare clinical entity with unclear clinical characteristics. The purpose of this study was to clarify the prognostic factors, therapeut...
BACKGROUND: Isolated splenic metastases from colorectal cancer (CRC) are an extremely rare clinical entity with unclear clinical characteristics. The purpose of this study was to clarify the prognostic factors, therapeutic outcomes, diagnostic methods, and clinical patterns related to this uncommon metastatic entity. METHODS: We describe a novel instance of metachronous isolated splenic metastasis treated at our institution. Additionally, from the database’s creation to December 2025, we performed a comprehensive literature search in PubMed, Web of Science, and the Cochrane Library, finding 36 previously documented cases. Descriptive statistics were used to examine clinical and demographic features, diagnostic techniques, treatment plans, and results. RESULTS: Our patient, a 56-year-old man, developed a solitary splenic metastasis 34 months after undergoing laparoscopic left hemicolectomy for descending colon adenocarcinoma. The splenic metastasis was subsequently managed with laparoscopic splenectomy. A thorough analysis of 37 cases, including our own, showed clear clinical patterns: 86.5% (32/37) of cases presented with metachronous disease, with a median interval of 24 months; left-sided primary tumors (sigmoid colon, rectum, descending colon, and splenic flexure) predominated (29/37, 78.4%); splenectomy was associated with an 89.3% disease-free survival rate among patients with available follow-up, with metachronous cases showing particularly favorable outcomes (95.8%). CONCLUSION: This comprehensive research highlights the significance of long-term surveillance in CRC patients and indicates that complete surgical excision of isolated splenic metastases may be associated with favorable outcomes, especially in metachronous presentations.
Quilting sutures versus conventional closure after modified radical mastectomy with axillary dissection: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials with pre-specified subgroups by quilting extent.
Mirza W, Khan ME, Iqbal H … +3 more , Khan A, Moeen-Ud-Din MB, Khan HM
World J Surg Oncol · 2026 Apr · PMID 41943095 · Full text
BACKGROUND: Postoperative seroma is the most frequent complication of modified radical mastectomy (MRM) with axillary lymph node dissection (ALND). Quilting sutures mechanically obliterate the dead space between the mast...
BACKGROUND: Postoperative seroma is the most frequent complication of modified radical mastectomy (MRM) with axillary lymph node dissection (ALND). Quilting sutures mechanically obliterate the dead space between the mastectomy flaps and chest wall; however, prior syntheses included heterogeneous breast procedures. We evaluated quilting versus conventional closure after MRM with ALND using only randomized evidence. METHODS: The protocol was registered with PROSPERO (CRD420251237379). We searched MEDLINE (PubMed), Embase, Scopus, Web of Science, CENTRAL, ClinicalTrials.gov, WHO ICTRP, and Google Scholar from inception to June 1, 2025, using reference list screening. Eligibility: Parallel-group RCTs enrolling adult women undergoing MRM (or equivalent total mastectomy) with level I–II ALND, comparing quilting/flap fixation versus conventional non-quilting closure; studies of breast-conserving surgery, immediate reconstruction/oncoplastic procedures, sentinel node-only surgery, and non-randomized designs were excluded. Two reviewers independently screened/extracted data and assessed the risk of bias using the Cochrane RoB 2. Random-effects meta-analysis (REML with Hartung–Knapp–Sidik–Jonkman adjustments) was used to synthesize risk ratios (RR) and mean differences (MD). A prespecified subgroup analysis compared aggressive dead space obliteration (pectoral-plus-axillary quilting and/or drain reduction) with standard pectoral quilting. The certainty of evidence was assessed using GRADE. RESULTS: Seven randomized controlled trials (1,412 patients) were included. Quilting significantly reduced seroma incidence (RR 0.36, 95% CI 0.23–0.55; moderate-certainty evidence; ≈200 fewer seromas per 1,000 patients [95% CI 141–241 fewer]) and the need for aspiration (RR 0.29, 95% CI 0.20–0.42; moderate-certainty evidence; ≈192 fewer patients requiring aspiration per 1,000 [95% CI 157–216 fewer]), and also reduced the number of aspirations (MD − 1.03, 95% CI − 1.58 to − 0.47) and total drainage volume (MD − 214 mL, 95% CI − 402 to − 27 mL). Quilting did not significantly affect drain removal duration, surgical site infection (RR 0.71, 95% CI 0.39–1.32; ≈10 fewer SSIs per 1,000 [95% CI 10 more to 20 fewer]), or flap necrosis (RR 0.65, 95% CI 0.32–1.32; ≈22 fewer flap necroses per 1,000 [95% CI 20 more to 43 fewer]). Subgroup analysis showed that both aggressive dead space obliteration (RR 0.31, 95% CI 0.22–0.51) and standard pectoral quilting (RR 0.57, 95% CI 0.36–0.80) significantly reduced seroma without significant differences between the techniques (p = 0.89). Leave-one-out sensitivity analyses confirmed the robustness of these findings. CONCLUSIONS: Quilting sutures provide a clinically meaningful reduction in postoperative seroma following modified radical mastectomy with axillary dissection and may help support smoother postoperative recovery pathways without compromising wound healing.
NUF2 interacts with BUB3 and drives lung adenocarcinoma progression through activation of the NF-κB pathway.
Zhu D, Liang J, Li J … +9 more , Yu W, Ma L, Tang Z, Li R, Qu C, Han J, Wang D, Li L, Tian H
World J Surg Oncol · 2026 Apr · PMID 41943078 · Full text
BACKGROUND: Lung adenocarcinoma (LUAD) is the most common form of lung cancer and is often diagnosed at advanced stages. NUF2, a key component of the NDC80 kinetochore complex, is highly expressed in several malignancies...
BACKGROUND: Lung adenocarcinoma (LUAD) is the most common form of lung cancer and is often diagnosed at advanced stages. NUF2, a key component of the NDC80 kinetochore complex, is highly expressed in several malignancies, but its function and regulatory mechanism in LUAD remain unclear. METHODS: Expression profiling using TCGA, GEO datasets, and LUAD tissue microarrays revealed NUF2 dysregulation in LUAD. Functional assays (CCK-8, EdU, colony formation, Transwell, and xenograft models) were performed to assess the effects of NUF2 gain- or loss-of-function. Protein interactions were examined using immunoprecipitation and mass spectrometry. Transcriptomic sequencing and Western blotting were used to evaluate downstream signaling pathways. RESULTS: NUF2 expression was significantly elevated in LUAD tissues and cell lines and was positively associated with tumor stage and poor overall survival. NUF2 knockdown inhibited LUAD cell proliferation, migration, and tumor growth, whereas NUF2 overexpression enhanced malignant behaviors. Mechanistically, NUF2 interacted with and stabilized the spindle checkpoint protein BUB3 by preventing proteasomal degradation. Additionally, NUF2 activated the NF-κB signaling pathway, and BUB3 was required for this activation. CONCLUSIONS: NUF2 promotes LUAD progression by stabilizing BUB3 and activating NF-κB signaling. Targeting the NUF2–BUB3 axis may represent a novel therapeutic strategy for LUAD.
Analysis of clinical-imaging-pathological features and preoperative misdiagnosis status of 47 cases of gastric schwannomas: a single-center retrospective study over 13 years.
Ruan X, Zhu R, Wang W … +2 more , Wang D, Liu B
World J Surg Oncol · 2026 Apr · PMID 41943049 · Full text
OBJECTIVE: To identify the diagnostic difficulties of gastric schwannomas (GS) and provide evidence for improving the accuracy of clinical diagnosis. METHODS: A retrospective analysis was conducted on the data of 47 pati...
OBJECTIVE: To identify the diagnostic difficulties of gastric schwannomas (GS) and provide evidence for improving the accuracy of clinical diagnosis. METHODS: A retrospective analysis was conducted on the data of 47 patients with pathologically confirmed GS in Northern Jiangsu People’s Hospital of Jiangsu Province from September 2012 to March 2025. Demographic characteristics, tumor markers (CA125, CA199, CEA), preoperative diagnosis, surgical methods, and postoperative immunohistochemical results (S-100, CD117, Ki67, etc.) of the patients were statistically analyzed. Immunohistochemical detection was performed using the streptavidin-peroxidase (SP) method, with a positive criterion defined as the presence of brown-yellow granules in the cytoplasm or nucleus and a positive cell proportion ≥ 5%. RESULTS: Among the 47 patients, the male-to-female ratio was 1:2.1, with a mean age of (59.83 ± 12.02) years, and 76.6% of the patients were aged ≥ 50 years. Most preoperative tumor marker levels were within the normal range (only 1 case had slightly elevated CA125, and 5 cases had abnormal CEA, including 2 cases complicated with other malignant tumors). No patients received a definitive preoperative histological diagnosis of gastric schwannoma, and the preoperative clinical diagnostic impressions were mainly classified into two most common alternative categories: non-specific gastric submucosal tumors (66.0%) and gastrointestinal stromal tumors (GISTs, 27.7%), with only a small proportion diagnosed as gastric cancer and gastric cancer combined with other tumors (6.4%), which is attributed to the intrinsic limitations of current imaging and endoscopic modalities in distinguishing GS preoperatively. Laparoscopic gastric lesion resection was the main surgical method (55.3%), followed by endoscopic resection (31.9%) and open surgery (12.8%). Postoperative immunohistochemical results showed that all patients were positive for S-100 and negative for CD117; the positive rate of other immunohistochemical markers ranged from 2.1% to 27.7%, and 89.36% of the patients had a Ki67 index ≤ 5%. CONCLUSION: GS lacks specific clinical manifestations and is prone to preoperative misdiagnosis. Postoperative pathological examination combined with immunohistochemistry (defined by S-100 positivity and CD117 negativity) is the gold standard for GS diagnosis, and patients have a good prognosis after complete surgical resection of the tumor. This study provides a reference for the clinical diagnosis and treatment of GS; however, due to the single-center design, small sample size, and lack of long-term follow-up data, the conclusions need further verification in subsequent studies.
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