World Journal Of Surgical Oncology[JOURNAL]
Sun
200 papers
Gustave Roussy Immune (GRIm) score as a novel prognostic biomarker for gastrointestinal cancers: a meta-analysis of sixteen studies.
Deng X, Yan T, Pang H … +2 more , Wei J, Li C
World J Surg Oncol · 2026 Apr · PMID 41942974 · Full text
BACKGROUND: The Gustave Roussy immune (GRIm) score has been widely recognized as a promising prognostic biomarker in various malignancies. This study aimed to systematically evaluate the association between pretreatment...
BACKGROUND: The Gustave Roussy immune (GRIm) score has been widely recognized as a promising prognostic biomarker in various malignancies. This study aimed to systematically evaluate the association between pretreatment GRIm score and survival outcomes in patients with gastrointestinal (GI) cancers. METHODS: A systematic literature search was conducted using electronic databases (Web of Science, PubMed, Cochrane Library and Embase) from inception to January 15, 2026. The primary endpoints included long-term survival outcomes such as overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), progression-free survival (PFS), and cancer-specific survival (CSS). Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. The meta-analysis was prospectively registered with PROSPERO (CRD420261291292). RESULTS: This meta-analysis included 16 studies comprising 4,904 patients with GI cancers. The pooled outcomes demonstrated that patients with a high GRIm score had significantly worse OS (15 studies; HR = 2.01; 95% CI: 1.69–2.40; P < 0.01; I² = 63%), PFS (8 studies; HR = 1.57; 95% CI: 1.29–1.91; P < 0.01; I² = 48%), DFS (2 studies; HR = 2.15; 95% CI: 1.35–3.42; P < 0.01; I² = 55%) and CSS (2 studies; HR = 1.68; 95% CI: 1.17–2.41; P < 0.01; I² = 4%) compared to those with a low score. However, a single study assessing RFS reported that the GRIm score lacked independent prognostic significance for this endpoint (HR = 1.69; 95% CI: 0.77–3.73; P = 0.19). CONCLUSIONS: Our findings suggest that the pretreatment GRIm score may serve as a prognostic biomarker in patients with GI cancers. However, further high-quality studies are required to robustly validate its prognostic utility.
Development and implementation of personalized postoperative care plans for gynecological oncology patients under the precision medicine paradigm: strategies to enhance patient participation and self-management capacity.
Hu X, Han Y, Zhang L
World J Surg Oncol · 2026 Apr · PMID 41937146 · Full text
OBJECTIVE: This study aimed to develop and validate a personalized postoperative care pathway for gynecological oncology patients based on precision medicine principles, exploring effective strategies to improve patient...
OBJECTIVE: This study aimed to develop and validate a personalized postoperative care pathway for gynecological oncology patients based on precision medicine principles, exploring effective strategies to improve patient engagement, self-management capacity, and long-term recovery outcomes. METHODS: A prospective controlled trial was conducted, randomizing 80 postoperative gynecological cancer patients into an intervention group (n = 40) and a control group (n = 40). The control group received standard postoperative care, while the intervention group underwent a multi-module personalized care pathway incorporating the Transtheoretical Model (TTM), Patient Activation Measure (PAM), Shared Decision-Making (SDM) framework, and assessment of digital engagement and adaptability. Intervention components included collaborative rehabilitation goal-setting, digital platform tracking, stage-matched behavioral interventions, SDM support, health empowerment training, and remote psychological counseling. Scale-based outcomes were assessed over 6 months (PAM, SDM, and Health Empowerment Scale [HES]), while survival analysis (disease-free survival [DFS] and event-free survival [EFS]) was conducted over a 12-month follow-up period. RESULTS: The intervention group demonstrated significantly superior outcomes in self-management capacity (PAM score: 71.77 ± 6.9 vs. 63.01 ± 7.2, P < 0.05), shared decision-making ability (SDM score: 72.73 ± 6.8 vs. 61.54 ± 7.1, P < 0.001), and health empowerment (HES score: 35.7 ± 3.2 vs. 29.6 ± 4.1, P < 0.001). Notably, 67.5% of intervention patients reached the “action” or “maintenance” stage of health behavior change, compared to only 35% in the control group. Kaplan-Meier analysis revealed significantly prolonged 12-month disease-free survival (DFS) in the intervention group (10.37 vs. 7.32 months, P < 0.05), with Cox regression identifying personalized care as an independent protective factor (HR = 0.57, 95% CI: 0.34–0.94, P = 0.028). CONCLUSION: The precision nursing-based postoperative intervention pathway significantly enhanced gynecological oncology patients’ self-management capacity, treatment engagement, and long-term survival outcomes, demonstrating strong feasibility and scalability. This study provides empirical support for transforming postoperative care into an integrated system of behavioral empowerment, digital support, and collaborative participation.
Advances in the treatment of cutaneous tumors: from conventional therapies to targeted and immunotherapeutic strategies.
Shen H, Wu H, He Z … +2 more , Xiong S, Li R
World J Surg Oncol · 2026 Apr · PMID 41928307 · Full text
Cutaneous melanoma, one of the most common skin malignancies, has witnessed a continuously increasing incidence and is associated with a poor prognosis. In recent years, significant breakthroughs have been achieved in sy...
Cutaneous melanoma, one of the most common skin malignancies, has witnessed a continuously increasing incidence and is associated with a poor prognosis. In recent years, significant breakthroughs have been achieved in systemic therapies, particularly with the advent of targeted therapy (e.g., BRAF/MEK inhibitors) and immunotherapy (including anti-PD-1, anti-CTLA-4, and anti-LAG-3 agents, administered either as monotherapy or in combination). These advances have markedly improved survival outcomes for patients with advanced and metastatic melanoma. As these therapeutic strategies are extended to earlier stages of the disease, they are now widely employed in the adjuvant and neoadjuvant settings for patients with resectable stage II-III melanoma. In this context, the exploration of predictive and prognostic biomarkers—such as PD-L1 expression levels, tumor mutational burden (TMB), immune cell phenotypes, IFN-γ signature scores, and circulating tumor DNA (ctDNA)—has become increasingly urgent and intensive, aiming to precisely identify patients most likely to benefit and to optimize treatment decision-making. Furthermore, we discuss emerging technologies and future research directions aimed at optimizing clinical outcomes.This review aims to provide a comprehensive overview of the evolving landscape in the clinical management of cutaneous melanoma, with a particular focus on the paradigm shift from conventional therapeutic modalities towards innovative strategies such as targeted and immunological interventions. By systematically synthesizing existing literature and evidence from pivotal clinical trials, we seek to offer insightful perspectives for clinicians and researchers involved in the management of skin cancer.
Initial management strategies for right-sided malignant colonic obstruction: a systematic review and bayesian network meta-analysis.
Kitaguchi D, Forgione A, Innocenzi C … +6 more , Yang Y, Schulze FE, Dox I, Giménez M, Oda T, Marescaux J
World J Surg Oncol · 2026 Apr · PMID 41928284 · Full text
BACKGROUND: Right-sided malignant colonic obstruction (RMCO) remains challenging, as the evidence is more limited than for left-sided disease. Although primary resection is the standard approach, emergency surgery carrie...
BACKGROUND: Right-sided malignant colonic obstruction (RMCO) remains challenging, as the evidence is more limited than for left-sided disease. Although primary resection is the standard approach, emergency surgery carries higher perioperative risks, increasing interest in bridge-to-surgery (BTS) strategies. However, their optimal role remains uncertain. We conducted a systematic review and Bayesian network meta-analysis to compare initial management strategies for RMCO and evaluate short- and long-term outcomes. METHODS: A comprehensive search of PubMed, Embase, and the Cochrane Library was performed, with a last update in October 2025. Comparative studies including patients with potentially curable RMCO who underwent either immediate surgery or a BTS approach (stent, decompression stoma, or decompression tube) were eligible. A Bayesian random-effects network meta-analysis was conducted. The primary outcome was overall postoperative morbidity; secondary outcomes included postoperative mortality, stoma formation after resection, and overall survival (OS) rate. RESULTS: A total of 18 retrospective non-randomized cohort studies including 7,205 patients met the inclusion criteria. Stenting was associated with a significantly lower postoperative mortality as compared to immediate surgery (6.6 vs. 0.9%; RR: 0.33; 95% CrI: 0.10–0.75) and with a significantly lower rate of stoma formation after resection (11.8 vs. 2.3%; RR: 0.41; 95% CrI: 0.21–0.78). No significant differences were observed among treatment strategies in overall postoperative morbidity or OS rate. CONCLUSIONS: Stenting as a bridge to surgery (BTS) was associated with a lower postoperative mortality and a lower rate of stoma formation as compared to immediate surgery. These findings suggest that stenting may serve as a viable alternative for patients at high risk of postoperative mortality.
Systematic review and meta-analysis comparing postoperative and oncological outcomes between local excision plus radiotherapy versus total mesorectal excision for rectal cancer.
Kitaguchi D, Forgione A, Innocenzi C … +5 more , Yang Y, Espínola F, Giménez M, Oda T, Marescaux J
World J Surg Oncol · 2026 Apr · PMID 41928271 · Full text
BACKGROUND: Total mesorectal excision (TME) is the standard treatment for middle to lower rectal cancer. However, it is associated with significant postoperative complications and functional impairments. Local excision (...
BACKGROUND: Total mesorectal excision (TME) is the standard treatment for middle to lower rectal cancer. However, it is associated with significant postoperative complications and functional impairments. Local excision (LE) combined with neoadjuvant radiotherapy (RT) has emerged as a less invasive alternative and has shown potential for organ preservation. This study aimed to compare the short-term and long-term outcomes of LE + RT versus TME in selected patients with rectal cancer. MATERIALS AND METHODS: This systematic review and meta-analysis were conducted following a comprehensive literature search of human studies published in English, completed by April 2025. Inclusion criteria consisted of rectal cancer up to cT3 disease and/or showed a favorable response to neoadjuvant therapy. Postoperative outcomes assessed included operative time, blood loss, morbidity, length of hospital stay, and permanent stoma rate. Oncological and survival outcomes were also evaluated. RESULTS: A total of six studies were included. They consisted of five randomized controlled trials and one prospective clinical trial, with a total of 679 patients. Of these, 366 were treated with LE + RT and 313 with TME. Pooled analysis showed that the LE + RT group was associated with a significantly shorter operative time, a lower overall morbidity, and a shorter postoperative hospital stay. No significant differences were observed between the groups in oncological or survival outcomes. CONCLUSIONS: This study suggests that, in selected rectal cancer patients, LE + RT may represent a less invasive alternative with comparable oncological outcomes to TME. LE + RT may subsequently be a viable treatment option, especially in patients seeking organ preservation or in patients unfit for TME.
Immune-inflammatory indices as predictors of pathologic complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis of observational studies.
Shamohammadi M, Gholinezhad Y, Abdolvand F … +4 more , Abbasi Garavand A, Mousavie SH, Bahardoust M, Yiasemidou M
World J Surg Oncol · 2026 Apr · PMID 41928264 · Full text
BACKGROUND: Achieving a Pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) is associated with improved survival and organ preservation. Av...
BACKGROUND: Achieving a Pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) is associated with improved survival and organ preservation. Available blood-based inflammatory indices may help predict pCR and guide individualized treatment. METHODS: This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a comprehensive search of PubMed, Web of Science, Scopus, and Embase, and Cochrane Library to identify studies including adult patients with pathologically confirmed LARC treated with nCRT followed by total mesorectal excision. Included studies reported categorical analyses of pre-nCRT neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), or systemic immune-inflammation (SII) in relation to pCR. Random-effects models were used to generate pooled odds ratios for high versus low index values. Heterogeneity, small-study effects, meta-regression, and the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE framework were also assessed. RESULTS: Twenty-four studies including 6,572 patients (20 evaluating NLR, n = 6,110; 12 PLR; n = 4,601; and 5 SII, n = 1,340) met the inclusion criteria and all were rated as high quality according to the Newcastle–Ottawa Scale. Higher pre-nCRT NLR was associated with reduced odds of pCR (pooled OR 0.60, 95% CI 0.49–0.71; I²=35.4%). High PLR similarly predicted lower pCR rates (pooled OR 0.53, 95% CI 0.37–0.69; I²=54.7%), as did higher SII (pooled OR 0.42, 95% CI 0.26–0.58; I²=27.9%). Associations were consistent across cut-off values and geographic regions. Meta. Meta-regression suggested that age, sample size, cut-off value/determination methods, tumor stage, statistical adjustment (unadjusted vs. adjusted), geographic region and other potential confounders partially explained the between-study heterogeneity. CONCLUSIONS: Elevated pre-nCRT NLR and PLR were associated with lower odds of achieving pCR in patients with LARC. The evidence regarding SII was limited and should be interpreted with caution. These inexpensive and available inflammatory indices may potentially refine pre-nCRT risk stratification and identify candidates who may benefit form organ-preservation approaches.
Clinicopathological features and prognosis of HER2-low gastric cancer: a real-world retrospective cohort study.
Zhang H, Tian Y, Zhao Y … +3 more , Huang N, Cao J, Liang P
World J Surg Oncol · 2026 Apr · PMID 41928259 · Full text
BACKGROUND: HER2-low expression has recently gained considerable attention as an actionable biomarker in gastric cancer (GC). However, clinical implications of HER2-low expression in GC remains uncertain, which limited i...
BACKGROUND: HER2-low expression has recently gained considerable attention as an actionable biomarker in gastric cancer (GC). However, clinical implications of HER2-low expression in GC remains uncertain, which limited its precise management in the era of antibody‒drug conjugates. This study aims to describe the clinicopathological features and its value in predicting outcomes for GC patients. METHOD: We performed a retrospective study of 994 patients (248 with HER2-low expression and 746 with HER2-zero expression) from January 2018 to December 2023. Each cohort was further divided into non-metastatic (M0) and metastatic (M1) subgroups. Clinicopathological features and survival outcomes were collected and compared between HER2-low and HER2-zero GC. Kaplan–Meier analysis and Multivariable Cox regression analyses were utilized to confirm the prognostic value. Furthermore, a nomogram was established to predict overall survival (OS) rates at 1, 2, and 3 years. The Concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves and calibration curves were utilized to assess the discrimination and reliability of the Model. RESULTS: Significant differences were observed in age (≥ 60 years: 65.3% vs. 55.2%, P = 0.005) and ethnicity (Hui ethnicity:12.5% vs.19.4%, P = 0.001) between the HER2-low and HER2-zero GC. HER2-low GC had lower T stage than HER2-zero GC, with T3 stage (21.8% vs. 12.5%) and T4 stage (58.1% vs.65.4%) P < 0.05. HER2-low status was identified as an independent prognostic factor associated with worse survival outcomes, particularly in patients with GC at M0 stage (HR 1.420; 95% CI 1.058–1.907). The nomogram prediction model was constructed by including these factors at M0 stage. The C-index, AUC value and calibration curves demonstrated that the nomogram performed well in predicting OS at 1, 2, and 3 years. CONCLUSION: The findings from the present study demonstrated that patients with HER2-low GC exhibited distinct pathological characteristics and had a worse prognosis. Further research is warranted to refine future diagnostic and treatment strategies for this subgroup.
Effect of laparoscopic anatomical hepatectomy for hepatocellular carcinoma based on individualized three-dimensional reconstruction model of portal vein region.
Cao T, Xu H, Zhang A … +3 more , Huang W, Peng G, Wu T
World J Surg Oncol · 2026 Mar · PMID 41917966 · Full text
BACKGROUND: Hepatocellular carcinoma (HCC) accounts for 90% of primary liver tumors. With the development of laparoscopic technology, laparoscopic liver resection is safer and more effective compared to traditional open...
BACKGROUND: Hepatocellular carcinoma (HCC) accounts for 90% of primary liver tumors. With the development of laparoscopic technology, laparoscopic liver resection is safer and more effective compared to traditional open surgery. However, HCC tumors are often located near major blood vessels and bile ducts, which increases the difficulty of precise resection. To address these challenges, computer-based three-dimensional (3D) liver reconstruction technology has been widely applied. This technology converts two-dimensional imaging data into detailed three-dimensional anatomical models, clearly displaying the vascular anatomy within the liver, accurately locating the lesion, defining the surgical margin, and estimating the liver volume. Its intuitive and multi-angle visualization enhances surgical understanding and decision-making, providing crucial support for preoperative assessment, surgical planning, and intraoperative navigation.Three-dimensional watershed analysis based on hepatic veins and hepatic pedicles is one of the two major strategies for guiding anatomical liver resection. However, the existing articles lack a comparison between different methods. Therefore, we conducted a comparative study of two different resection methods for hepatocellular carcinoma (HCC) to determine their advantages in terms of clinical outcomes. METHODS: Patients diagnosed with hepatocellular carcinoma and treated with laparoscopic hepatectomy at Shenzhen People’s Hospital from 2018 to 2021 were the subjects of a retrospective study of clinical data. Two separate groups of participants, one with venous access and the other with hepatic pedicle access, were evaluated at the same time. Data was collected during the operation, immediately after the procedure, and at 36 months to compare the two surgical approaches. RESULTS: No statistically significant difference in preoperative data was found between the two groups in this study, which included 78 patients. With a p-value of only 0.033, the hepatic pedicle group lost 50 ml less blood than the vein group. In comparison to the hepatic vein group, the hepatic pedicle group had substantially lower levels of ALT (P = 0.022), AST (P = 0.036), and postoperative complication rate (P = 0.031). The hepatic pedicle group showed a 78.4% survival rate and a 56.1% tumor-free rate, whereas the hepatic vein group demonstrated a 70.7% overall survival rate and a 36.6% tumor-free survival rate. Tumor-free survival was significantly longer in the hepatic pedicle group (P = 0.040), while overall survival did not differ significantly between the two groups. (P > 0.05). CONCLUSIONS: Three-dimensional (3D) reconstruction-guided hepatic pedicle laparoscopic anatomical hepatectomy was safe and effective and demonstrated favorable perioperative and oncologic outcomes, revealing the clinical value of 3D visualization in anatomical liver resection.
FOXA2 promotes the occurrence and development of osteosarcoma cells by regulating ferroptosis through the Rheb/mTOR axis.
Xia J, Wu J, Tao Y … +3 more , Wan Z, Duan W, Weng Y
World J Surg Oncol · 2026 Mar · PMID 41917962 · Full text
BACKGROUND: Osteosarcoma (OS) is a prevalent and aggressive primary carcinoma of the bone that predominantly influences children and adolescents. Inadequate therapeutic strategies have hindered improvements in patient su...
BACKGROUND: Osteosarcoma (OS) is a prevalent and aggressive primary carcinoma of the bone that predominantly influences children and adolescents. Inadequate therapeutic strategies have hindered improvements in patient survival. The forkhead box transcription factor FOXA2 plays a role in metabolic homeostasis and tumor progression. However, its association with OS remains underexplored. METHODS: Firstly, we investigated the expression of FOXA2 in OS cells and in OS tissue samples from patients at different clinical stages using western blot and immunohistochemistry (IHC). Analysis of the R2 database revealed the association between FOXA2 and the prognosis of OS patients. Subsequently, a series of functional experiments confirmed the biological behaviors of OS caused by FOXA2. Furthermore, through western blot, chromatin immunoprecipitation (ChIP), dual-luciferase reporter assays, and other experiments, we identified a key underlying molecular mechanisms. RESULTS: The present study determined that FOXA2 is overexpressed in OS cells and tissues, affecting OS patient prognosis. FOXA2 knockdownin functional experiments on OS cells attenuated their proliferation and migration while promoting ferroptosis, thereby offering an alternative intervention for OS as a form of programmed cell death. Upregulated Rheb restored the proliferation and migration in FOXA2 knockdown OS cells by facilitating ferroptosis induced by the mTOR pathway. CONCLUSIONS: The study results corroborated that FOXA2 suppresses ferroptosis via the Rheb/mTOR axis, stimulating OS cell proliferation and migration. Targeting the FOXA2/Rheb/mTOR axis and clarifying the fundamental mechanisms are thus crucial for the clinical OS treatment.
Impact of the 2023 FIGO staging system on risk stratification in endometrial cancer: a retrospective cohort study.
Chen F, Chen L, Teng AY … +7 more , Huang LJ, Zhan ST, Zhang YY, Li Y, Xia JY, Liu MM, Yang Y
World J Surg Oncol · 2026 Apr · PMID 41917951 · Full text
OBJECTIVE: To evaluate the prognostic value of the 2023 FIGO staging system for endometrial cancer (EC) by comparing it with the 2009 FIGO system, using data from Shanghai General Hospital. METHODS: We retrospectively an...
OBJECTIVE: To evaluate the prognostic value of the 2023 FIGO staging system for endometrial cancer (EC) by comparing it with the 2009 FIGO system, using data from Shanghai General Hospital. METHODS: We retrospectively analyzed 331 EC patients (March 2016–August 2025) and re-staged them from the 2009 FIGO criteria to the 2023 FIGO criteria. Molecular subtyping was integrated where available (N = 86). The Net Reclassification Improvement (NRI) was used to evaluate risk stratification. Prognostic factors were identified using logistic and Cox regression models. RESULTS: Re-staging according to the 2023 FIGO criteria resulted in stage migration for 186 out of 331 patients (56.2%). In the subset with molecular data (n = 86), reclassification occurred in 47 patients (54.7%). Compared to the 2009 system, the 2023 system demonstrated a significant NRI of 100.76% (P < 0.001) for Stages I–II. Key clinicopathological factors independently associated with stage migration included non-endometrioid histology, high tumor grade (G3), and deep myometrial invasion. CONCLUSION: Compared with the 2009 FIGO staging, the 2023 FIGO system significantly improves risk stratification in EC. Its integration of molecular and refined pathological factors facilitates more precise prognostication and supports individualized treatment planning.
A prognostic model utilizing disulfidptosis-related long noncoding RNAs to differentiate pathological grades in hepatocellular carcinoma: functional analysis of AL031985.3.
Yang L, Li F, Yu H … +2 more , Gu X, You W
World J Surg Oncol · 2026 Mar · PMID 41913195 · Full text
Disulfidptosis, a recently identified form of cell death, plays a crucial role in cancer progression, specifically by altering intracellular disulfide bonds within the actin cytoskeleton. Our research centres on developi...
Disulfidptosis, a recently identified form of cell death, plays a crucial role in cancer progression, specifically by altering intracellular disulfide bonds within the actin cytoskeleton. Our research centres on developing a prognostic model based on disulfidptosis-related long noncoding RNAs (DRLRs) to differentiate high-grade (G3-G4) from low-grade (G1-G2) Hepatocellular Carcinoma (HCC). Utilizing transcriptomic data from The Cancer Genome Atlas (TCGA), we employed univariate Cox regression analysis, Least Absolute Shrinkage and Selection Operator(LASSO) regression, and multivariate Cox regression to ultimately identify nine key drlncRNAs (AL442125.2, AC018529.2, AL031985.3, AC119150.1, LINC02256, AC026979.4, POLH-AS1, MED8-AS1, and AC026356.1). These were subsequently used to construct a prognostic risk signature model. This 9-DRLR model demonstrated robust discriminative capacity, achieving Area Under the Curve(AUCs) of 0.845, 0.841, and 0.885 for 1-, 3-, and 5-year overall survival prediction in G3-G4 HCC patients, respectively. The model provides strong prognostic stratification of HCC patients by grade and correlates with biological processes linked to tumour aggressiveness and immune evasion, as shown by Gene Ontology (GO) and gene set enrichment analyses (GSEA). High-risk groups exhibited markers of immune dysfunction, elevated tumour mutation burden (TMB), and increased sensitivity to targeted therapies including 5-Fluorouracil and Dasatinib. AL031985.3 emerged as a key lncRNA within this model, with its significant overexpression in HCC tissues versus adjacent controls (p < 0.001) validated through quantitative Real-Time PCR (qRT-PCR). Functional analyses revealed AL031985.3 as a critical oncogenic driver, where its knockdown significantly suppressed colony formation (p < 0.01) and reduced invasive capacity (p < 0.01) in vitro. These findings were corroborated in vivo, with orthotopic implantation and experimental pulmonary metastasis models demonstrating attenuated tumour growth and modulated epithelial-mesenchymal transition markers following AL031985.3 silencing. Our findings underscore the prognostic value of the DRLR signature and establish AL031985.3 as a potential therapeutic target for advanced HCC.
Prognostic impact of tumor-associated macrophages in pediatric Ewing sarcoma, National Cancer Institute (2010-2020).
Selim MM, Hegazy RR, Eltohamy MI … +1 more , Ahmed NA
World J Surg Oncol · 2026 Mar · PMID 41896958 · Full text
BACKGROUND: Ewing sarcoma (ES) is the second most common primary malignant bone tumor in children and adolescents. Tumor-associated macrophages (TAMs) are a key component of the tumor microenvironment. While increased TA...
BACKGROUND: Ewing sarcoma (ES) is the second most common primary malignant bone tumor in children and adolescents. Tumor-associated macrophages (TAMs) are a key component of the tumor microenvironment. While increased TAMs infiltration is linked to poor prognosis in various solid tumors, limited data are available regarding their role in sarcomas. METHODS: This retrospective study aimed to evaluate the frequency, density, and prognostic impact of TAMs in pediatric patients with ES treated at the Pediatric Oncology Department, National Cancer Institute (NCI), Cairo University. Immunohistochemical analysis of CD68 and CD163 expression was performed on 74 tumor tissue samples from pediatric patients with ES, which helps us understand the density of TAMs. RESULTS: The study cohort comprised 74 patients with a median age of 12 years (range: 0.5–18 years) and a male-to-female ratio of 0.8:1. The 5-year overall survival (OS) and event-free survival (EFS) rates were 48% and 42.8%, respectively. CD68 expression showed significant correlations with age at diagnosis (p = 0.035) and tumor size (p = 0.031) and near-significant associations with skeletal tumor location (p = 0.052) and complete response following induction chemotherapy (p = 0.054). CD163 expression was significantly associated with age at diagnosis (p = 0.046). However, neither CD68 (≤ 60 vs. > 60) nor CD163 (≤ 90 vs. > 90) levels showed significant correlation with survival outcomes (OS or EFS). Initial primary tumor site, tumor stage, post-induction chemotherapy disease status, and histological response to induction chemotherapy were significant predictor of survival outcome. CONCLUSIONS: TAM markers (CD68 and CD163) did not demonstrate a significant prognostic impact on survival. Larger-scale studies are warranted to more precisely determine the role of TAMs in pediatric ES.
MiR-381-3p inhibits Warburg effect and progression in osteosarcoma via targeting PFKFB3.
Jiang H, Wu J, Wang C … +7 more , Xia J, Tao Y, Wan Z, Li D, Duan W, Weng Y, Zhang Y
World J Surg Oncol · 2026 Mar · PMID 41896887 · Full text
BACKGROUND: Osteosarcoma (OS) is a primary bone malignancy; however, its exact mechanism of development remains largely unknown. Recent studies have shown that miR-381-3p can affect the development of various cancers. Ho...
BACKGROUND: Osteosarcoma (OS) is a primary bone malignancy; however, its exact mechanism of development remains largely unknown. Recent studies have shown that miR-381-3p can affect the development of various cancers. However, its biological effects and mechanisms of OS progression have not yet been elucidated. This study aimed to examine the biological role of miR-381-3p in OS. METHODS: We screened differentially expressed microRNAs in OS using bioinformatics tools. miR-381-3p expression was assessed by quantitative real-time-polymerase chain reaction, and the effect of miR-381-3p on OS growth was evaluated in vitro and in vivo by functional assays. The direct interaction between PFKFB3 and miR-381-3p was validated by dual luciferase reporter assay. Finally, metabolic alterations in OS cells were monitored using an XF96 Metabolic Flux Analyzer. RESULTS: miR-381-3p expression was significantly downregulated in OS samples and cells. miR-381-3p also participated in suppressing OS cell growth and was associated with the Warburg effect. The PFKFB3 gene, encoding an essential glycolytic enzyme, was identified as a downstream gene of miR-381-3p, and PFKFB3 overexpression partly rescued the inhibitory impact of miR-381-3p on OS growth. CONCLUSION: miR-381-3p directly targets and negatively regulates PFKFB3 expression, thereby inhibiting OS proliferation by controlling the Warburg effect. The miR-381-3p/PFKFB3 axis may be a promising therapeutic target for OS.
Combining ultrasound and core needle histology imaging Radiopathomics model in predicting axillary lymph node metastasis in triple-negative breast cancer.
Yanhua L, Yan T, Xiaoling L … +2 more , Fanding H, Xiachuan Q
World J Surg Oncol · 2026 Mar · PMID 41888829 · Full text
OBJECTIVE: This study aims to utilize preoperative ultrasound (US) and core needle biopsy (CNB) histology image images to construct a multimodal Radiopathomics model to predict the risk of axillary lymph node metastasis...
OBJECTIVE: This study aims to utilize preoperative ultrasound (US) and core needle biopsy (CNB) histology image images to construct a multimodal Radiopathomics model to predict the risk of axillary lymph node metastasis (ALNM) in patients with triple-negative breast cancer (TNBC). MATERIALS AND METHODS: This multicenter retrospective study included TNBC patients from two medical centers between December 2021 and January 2025. Patients were randomly assigned to a training group and a validation group in a 7:3 ratio, with TNBC patients from a third medical center serving as an external testing group. Radiomic features were derived from preoperative ultrasound (US) images, while Pathomics features were obtained from CNB histology images. Key predictive features were selected through univariate analysis, correlation analysis, and the LASSO algorithm. The Radiopathomics model was then built using the XGBoost algorithm, and its performance was assessed through metrics such as the area under the curve (AUC), decision curve analysis (DCA), accuracy, specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS: A total of 243 TNBC patients were included in this study, with an average age of 51.9 ± 10.5 years, among whom 102 had ALNM and 141 did not. The AUCs for the training group, validation group, and testing group of the multimodal Radiopathomics model were 0.892, 0.848, and 0.831, respectively; the diagnostic efficiency of the multimodal Radiopathomics model was superior to clinical, Radiomics, and Pathomics models. CONCLUSION: Preoperative ALNM in TNBC patients can be accurately predicted by the multimodal Radiopathomics model based on preoperative US and CNB histology image, assisting clinicians in formulating treatment plans.
Risk factor analysis and nomogram model development for anastomotic leakage following laparoscopic radical colorectal cancer surgery.
He ZH, Zhou YY, Zhang RN … +3 more , He YS, Jin YH, Tian FH
World J Surg Oncol · 2026 Mar · PMID 41882684 · Full text
BACKGROUND: Anastomotic leakage (AL) remains a major complication after laparoscopic radical colorectal cancer resection, associated with increased morbidity and prolonged hospitalization. This study sought to determine...
BACKGROUND: Anastomotic leakage (AL) remains a major complication after laparoscopic radical colorectal cancer resection, associated with increased morbidity and prolonged hospitalization. This study sought to determine independent risk factors for AL and to develop a predictive nomogram. METHODS: We retrospectively analyzed 268 consecutive patients undergoing elective laparoscopic radical colorectal resection between January 2021 and December 2024. Anastomotic leakage was defined and graded per International Study Group of Rectal Cancer (ISREC) criteria. Demographic, tumor, and perioperative laboratory data were collected. Multivariate logistic regression identified independent predictors of AL. A nomogram incorporating these factors was constructed and internally validated by bootstrap sampling (n = 1,000). Discrimination was assessed by area under the receiver operating characteristic curve (AUC) and concordance index (C‑index), and calibration by Hosmer–Lemeshow test. Decision curve analysis (DCA) evaluated clinical utility. RESULTS: Anastomotic leakage occurred in 31 of 268 patients (11.6%). Multivariate analysis revealed four independent predictors: male sex (odds ratio [OR] 3.97; 95% confidence interval [CI] 1.20–13.19; p = 0.031), tumor distance from the anal verge < 7 cm (OR 2.55; 95% CI 1.11–5.70; p = 0.035), elevated postoperative procalcitonin (per ng/mL; OR 3.17; 95% CI 1.12–9.17; p = 0.036), and lower postoperative hemoglobin (per g/L; OR 4.15; 95% CI 1.15–15.10; p = 0.038). The nomogram achieved an AUC of 0.785 (95% CI 0.716–0.825) and a bootstrap‑corrected C‑index of 0.761. Calibration was satisfactory (Hosmer–Lemeshow χ² 2.75, p = 0.895). DCA showed net benefit across plausible threshold probabilities. CONCLUSIONS: Male sex, low tumor location, elevated postoperative procalcitonin, and decreased postoperative hemoglobin independently predict anastomotic leakage after laparoscopic colorectal cancer surgery. The validated nomogram offers individualized risk assessment to guide perioperative management.
Impact of combined vascular resection on short and long-term results following radical surgery for hilar cholangiocarcinoma: evidence from a systematic assessment.
Che S, Saad SA, Wang Y … +6 more , Teng Y, Fan Y, Luo Y, Chen Z, Tao J, You Z
World J Surg Oncol · 2026 Mar · PMID 41851745 · Full text
OBJECTIVE: To analyze the impact of portal vein resection (PVR) and hepatic artery resection (HAR) on the short-term and long-term outcomes of patients with hilar cholangiocarcinoma after surgery. METHODS: A comprehensiv...
OBJECTIVE: To analyze the impact of portal vein resection (PVR) and hepatic artery resection (HAR) on the short-term and long-term outcomes of patients with hilar cholangiocarcinoma after surgery. METHODS: A comprehensive literature search was conducted in the PubMed, Embase, and Web of Science databases for studies published from inception until August 10, 2025, focusing on hilar cholangiocarcinoma involving PVR or HAR. Postoperative mortality, hazard ratios (HR) with 95% confidence intervals (CI) for overall survival (OS), 5-year survival rates, postoperative complications, and postoperative pathological findings were used to evaluate short-term and long-term patient outcomes. RESULTS: This meta-analysis included 20 studies, encompassing a total of 3,648 hilar cholangiocarcinoma cases. Survival analysis indicated that combined vascular resection was associated with increased perioperative mortality. However, neither PVR nor HAR impaired patient OS. For patients without portal vein invasion (PVI), the 5-year survival rate after PVR showed no statistically significant difference compared to the non-resection group. Conversely, patients with confirmed PVI who underwent PVR still had a poorer 5-year survival rate than the non-vascular resection group. Analysis of complications reveals no statistically significant increase in the overall incidence of postoperative complications associated with vascular resection, although an increasing trend was observed. Both PVR and HAR were associated with an increased incidence of postoperative liver failure. CONCLUSION: Vascular resection itself does not affect the overall survival rate of hilar cholangiocarcinoma patients, but it may increase the risk of postoperative liver failure. In order to improve the R0 resection rate, it is necessary to actively perform vascular resection, including hepatic artery resection, when patients have surgical indications. After combined vascular resection, the monitoring and nursing of postoperative complications should be strengthened to avoid perioperative mortality caused by complications as much as possible.
Revisiting PIV in lung cancer: bridging prognostic insights with clinical applicability.
Wu H, Liao J, Hu L … +1 more , Li S
World J Surg Oncol · 2026 Mar · PMID 41851728 · Full text
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Correction: PTEN suppresses renal cell carcinoma proliferation and migration via inhibition of the PI3K/AKT pathway.
Xu X, Tang YY, Liang X … +3 more , Luo W, Jiang DM, Chen J
World J Surg Oncol · 2026 Mar · PMID 41845486 · Full text
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Radiogenomics and machine learning in hepatocellular carcinoma: from foundations to clinical translation.
Ye Y, Zhu W, Liu J … +4 more , Ye L, Shang Y, Xu H, An P
World J Surg Oncol · 2026 Mar · PMID 41832524 · Full text
This research aims to critically appraise the foundations, advances, and challenges of radiogenomics and machine learning (ML) in hepatocellular carcinoma (HCC), with a focus on clinical translation and future directions...
This research aims to critically appraise the foundations, advances, and challenges of radiogenomics and machine learning (ML) in hepatocellular carcinoma (HCC), with a focus on clinical translation and future directions. Radiogenomics enables non-invasive assessment of tumor biology and the tumor microenvironment by correlating imaging features with genomic data. For instance, one study utilized contrast-enhanced CT (CECT) radiomic features to predict genomic alterations in the PI3K signaling pathway, achieving an area under the curve (AUC) of 0.733 in external validation. Another model integrating MRI radiomics and exosomal miRNAs for predicting microvascular invasion reported an AUC of 0.900. ML, particularly deep learning, has significantly enhanced image analysis capabilities. In predicting response to transarterial chemoembolization (TACE), a radiomics model (AUC 0.813) outperformed traditional CT assessment. A random forest model combining ultrasound features and serum biomarkers to predict outcomes of targeted immunotherapy in advanced liver cancer demonstrated an external validation AUC of 0.899. Although these technologies show great promise in transforming HCC management towards precision medicine—facilitating early detection, risk stratification, treatment response prediction (e.g., using FDG-PET/CT features to predict mTOR pathway activation with an AUC of 0.733), and prognosis assessment (e.g., a radiogenomics model incorporating tumor microenvironment-related genes predicting overall survival with 1–3 year AUCs of 0.81–0.87)—significant challenges remain. These include methodological issues such as lack of standardization, small sample sizes, insufficient external validation, and the “black box” nature of models affecting interpretability. Furthermore, ethical considerations (e.g., data privacy and algorithmic bias) and barriers to clinical integration (e.g., workflow adaptation and regulatory approval) must be addressed. Future progress depends on conducting prospective multi-center trials, establishing standardized imaging and data analysis pipelines, developing explainable AI models, and creating robust ethical and regulatory frameworks to ultimately translate these innovative tools from research to routine clinical practice.
Oncogenic SOX9-TRAIP signaling drives gastric cancer progression by mediating the degradation of the CPEB3-mTORC1 tumor suppressor axis.
Zhou Y, Zhu J, Ouyang C … +5 more , Liu W, Huang L, Zou L, Liu B, Lu Z
World J Surg Oncol · 2026 Mar · PMID 41832516 · Full text
BACKGROUND: Gastric cancer (GC) is a leading cause of cancer mortality worldwide, driven by complex and heterogeneous molecular alterations. The ubiquitin-proteasome system, particularly E3 ubiquitin ligases, is frequent...
BACKGROUND: Gastric cancer (GC) is a leading cause of cancer mortality worldwide, driven by complex and heterogeneous molecular alterations. The ubiquitin-proteasome system, particularly E3 ubiquitin ligases, is frequently dysregulated in cancer, yet its key players in GC remain incompletely defined. This study aimed to identify novel oncogenic E3 ligases in GC and to elucidate their molecular mechanisms. METHODS: We performed a systematic multi-cohort transcriptomic analysis of public datasets (GEO, TCGA) to screen for and validate key E3 ubiquitin ligases. The oncogenic functions were validated using shRNA-mediated knockdown, overexpression, chromatin immunoprecipitation (ChIP), co-immunoprecipitation (Co-IP), ubiquitylation assays, luciferase reporter assays, and a series of cell-based functional assays (proliferation, colony formation, invasion), as well as a subcutaneous xenograft model in nude mice. RESULTS: We identified TRAF-interacting protein (TRAIP), an E3 ubiquitin ligase, as a critically overexpressed gene in GC that strongly correlates with poor patient prognosis. We delineated a complete and linear signaling cascade, demonstrating that the oncogenic transcription factor SOX9 directly binds to the TRAIP promoter and drives its transcriptional upregulation. Mechanistically, TRAIP functions as the specific E3 ligase for the RNA-binding protein and tumor suppressor, CPEB3, mediating its poly-ubiquitylation and subsequent proteasomal degradation. This TRAIP-mediated destruction of CPEB3 relieves its translational repression of key oncogenic targets, leading to the hyperactivation of the mTORC1 signaling pathway. Functionally, TRAIP is indispensable for GC cell proliferation, invasion, and in vivo tumorigenicity. Epistatic rescue experiments revealed that the oncogenic effects of TRAIP are almost entirely dependent on its ability to degrade CPEB3. CONCLUSION: Our findings define the SOX9-TRAIP-CPEB3-mTORC1 axis as a central, hierarchical signaling network driving GC progression. This work not only uncovers a novel oncogenic cascade but also provides a compelling mechanistic rationale for exploring the therapeutic potential of targeting this axis for therapeutic intervention.
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