Surgical Oncology[JOURNAL]
Sun
200 papers
Outcomes of Total Pancreatectomy Versus Pancreaticoduodenectomy for Surgical Management of Pancreatic Ductal Adenocarcinoma.
Byerley A, Danos D, Sullivan K … +3 more , Littlefield E, Galatas A, Moaven O
J Surg Oncol · 2026 Apr · PMID 41947589 · Publisher ↗
BACKGROUND: Patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) have a poor prognosis. Surgical resection provides the highest chance of improved survival. This study investigates the role of total pancreatec...
BACKGROUND: Patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) have a poor prognosis. Surgical resection provides the highest chance of improved survival. This study investigates the role of total pancreatectomy (TP) in the surgical management of PDAC based on clinicopathologic characteristics and the effect these factors have on patients' outcomes. METHODS: Data from the National Cancer Database for patients undergoing TP or pancreaticoduodenectomy (PD) was analyzed. Statistical tests included Chi-square test, logistic regression, least squared means, and Cox proportional hazard model to determine frequency and percentage, odds ratios, and hazard ratio, respectively. RESULTS: Of patients receiving PDAC resection, more TP patients were uninsured. Tumors in the pancreatic body or an overlapping locations increase the odds of receiving TP. Most statistically significant differences in clinicopathologic characteristics between the groups were not clinically meaningful. Despite a slight increase in short-term mortality for stage 2 patients receiving a TP, there was no clinically meaningful difference in overall survival. CONCLUSION: TP conferred a minimally worsened short-term survival for stage 2 PDAC, but oncologic outcomes and OS were similar for TP and PD. Therefore, surgical approach should be guided by individual patient characteristics and comorbidities, as long-term oncologic outcomes between the two procedures are comparable.
The magnetic technique as a single tracer for sentinel lymph node biopsy in breast cancer.
Guzijan A, Gajanin R, Kajkut G … +3 more , Grahovac D, Bosančić B, Gagula N
Surg Oncol · 2026 Jun · PMID 41946230 · Publisher ↗
Abstract loading — click title to view on PubMed.
Prognostic and clinicopathologic significance of BRAF mutation in colon cancer by MSI status and stage: A large cohort analysis.
El Sayed M, Youssef S, Shealy MW … +1 more , El Harati M
Surg Oncol · 2026 Jun · PMID 41946229 · Publisher ↗
BACKGROUND: BRAF mutation is a clinically important molecular alteration in colon cancer, but its prognostic significance varies and remains incompletely defined across disease stage and microsatellite instability (MSI)...
BACKGROUND: BRAF mutation is a clinically important molecular alteration in colon cancer, but its prognostic significance varies and remains incompletely defined across disease stage and microsatellite instability (MSI) status. This study evaluates the prognostic impact of BRAF mutation and its association with tumor characteristics that may explain its context-dependent behavior. METHODS: Adults with stage I-IV colon cancer in the National Cancer Database (2004-2020) who underwent surgical resection and had documented BRAF mutation and MSI status were identified. Multivariable Cox regression assessed overall survival by BRAF status, stratified by stage and MSI. Logistic regression evaluated associations between BRAF mutation and tumor features, including metastatic disease and perineural invasion (PNI). Effect modification was assessed using interaction terms with stratified analyses when significant. RESULTS: Among 5937 patients, 31.4% had BRAF-mutated tumors. BRAF mutation was strongly associated with MSI (OR = 6.66, p < 0.001). Overall, BRAF mutation was associated with worse survival (HR = 1.35, p < 0.001), but this effect was limited to stage IV disease (HR = 1.45, p < 0.001). Prognostic effects differed by MSI status: BRAF mutation was associated with worse survival in MSS tumors (HR = 1.61, p < 0.001) but not in MSI tumors (HR = 0.95, p = 0.581). Among MSS tumors, BRAF mutation was associated with higher odds of metastasis (OR = 1.30) and PNI (OR = 1.35), whereas among MSI tumors it was associated with lower odds of metastasis (OR = 0.60). CONCLUSION: BRAF-mutated colon cancer demonstrates substantial biological and prognostic heterogeneity driven by MSI status and disease stage.
Serotonin Expression and β-Cell Phenotype Are Associated With Indolent Behavior in Pancreatic Neuroendocrine Tumors With Sclerosing Morphology.
Windon AL, Revetta F, Chen W … +1 more , Shi C
J Surg Oncol · 2026 Apr · PMID 41936041 · Publisher ↗
BACKGROUND AND OBJECTIVES: ARX and PDX1 transcription factors have been considered indicators of the cell of origin for pancreatic neuroendocrine tumors (PanNETs). Some PanNETs show dense fibrosis (sclerosing morphology)...
BACKGROUND AND OBJECTIVES: ARX and PDX1 transcription factors have been considered indicators of the cell of origin for pancreatic neuroendocrine tumors (PanNETs). Some PanNETs show dense fibrosis (sclerosing morphology) and an association with serotonin expression. This study aimed to explore ARX and PDX1 expression in these tumors. METHODS: Pathology archives were searched from 2005 to 2019 for PanNETs with dense stromal fibrosis. Immunohistochemical stains for ARX, PDX1, and serotonin were performed and reviewed with pertinent clinical findings. RESULTS: Fifty-one PanNETs were evaluated. Serotonin expression was identified in 19 (37%) tumors. The mean tumor size was smaller in the serotonin-expressing group compared to the non-expressing group (1.7 ± 1.1 vs. 2.5 ± 1.2 cm, p = 0.03). Serotonin-expressing tumors demonstrated a β-cell phenotype with absence of ARX expression in the majority of tumors (n = 16; 84.2%), while the non-expressing tumors demonstrated an α-cell phenotype with ARX expression (n = 24, 75%, p < 0.01). Synchronous/metachronous liver metastasis was more frequent in the serotonin non-expressing tumors (p = 0.020). Serotonin expression was associated with a better disease-free survival. CONCLUSIONS: Serotonin-expressing PanNETs more commonly showed a β-cell phenotype, while non-expressing tumors favored an α-cell phenotype with more frequent liver metastasis. The expression of serotonin suggests more indolent behavior in this variant of PanNETs. SYNOPSIS: This study explores ARX, PDX1, and serotonin expression in pancreatic neuroendocrine tumors with sclerosing morphology. Most neuroendocrine tumors with this morphologic pattern displayed either an α-cell (ARX predominant expression) or β-cell (PDX1 predominant expression) phenotype. Serotonin expression was associated with a β-cell phenotype and more indolent behavior.
Demographic and Clinical Characteristics of Early-Onset Colorectal Cancer in Sweden and Finland: A Multicentre Retrospective Cohort Study Over Three Decades.
Charalambidi M, Hukkinen T, Kaprio T … +9 more , Edin S, Hjortborg M, Williams C, Hagström J, Haglund C, Palmqvist R, Strigård K, Böckelman C, Gkekas I
J Surg Oncol · 2026 Apr · PMID 41928416 · Publisher ↗
Colorectal cancer is the third most common cancer worldwide, and the proportion of individuals diagnosed under the age of 50 years, referred to as early-onset colorectal cancer (EOCRC), is increasing. The aim of this stu...
Colorectal cancer is the third most common cancer worldwide, and the proportion of individuals diagnosed under the age of 50 years, referred to as early-onset colorectal cancer (EOCRC), is increasing. The aim of this study was to evaluate how the demographic and clinical features of EOCR in northern Sweden and Finland have changed over time. All patient data were extracted from local hospital surgical department databases between 1995 and 2022. Two CRC cohorts, Study Cohort I (1995-2005) 1237 patients and Study Cohort II (2006-2022) 4526 patients, were compared for age, sex, disease stage, tumour grade, tumour location, and mismatch repair status. EOCRC patients comprised 7% of all CRCs in Study Cohort I and 4% in Study Cohort II. The mean ages were 42 and 43 years respectively, and 55% of patients were female. The vast part of EOCRC tumours were left-sided stage III-IV cancers. Most tumours (n = 204, 73%) were low grade, and 10% showed mismatch repair deficiency. No significant differences in demographic or tumour characteristics were seen over time. EOCRC in northern Sweden and Finland is characterised by advanced-stage, low tumour grade, a slight female predominance, and stable clinical and pathological features. These findings partly contrast with reports on EOCRC from other high-income countries, highlighting the need for further research on advanced molecular characteristics and potential gender differences in incidence and survival of this population.
Inflammatory Markers may Determine Postoperative Complications in Cases of Peritoneal Carcinomatosis of Ovarian Origin Treated With Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.
Mustafa D, Tayfun B, Berke M … +4 more , Selman S, Ecem SB, Nilay B, Sevda OO
J Surg Oncol · 2026 Apr · PMID 41923481 · Publisher ↗
BACKGROUND AND OBJECTIVES: This study aimed to evaluate the ability of perioperative inflammatory markers to discriminate postoperative complications within 6 months in patients with ovarian cancer-related peritoneal met...
BACKGROUND AND OBJECTIVES: This study aimed to evaluate the ability of perioperative inflammatory markers to discriminate postoperative complications within 6 months in patients with ovarian cancer-related peritoneal metastasis undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). MATERIALS AND METHODS: This retrospective cohort study included patients with ovarian cancer-related peritoneal metastasis who underwent CRS and HIPEC between January 2011 and August 2022. Data were obtained from the Hospital Information Management System, patient medical records, and anesthesia charts. Systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were assessed preoperatively (within 7 days before surgery) and on postoperative days 1, 3, and 5. Postoperative complications occurring within 6 months were graded according to the Clavien-Dindo classification; major complications were defined as Clavien-Dindo grade ≥III. Receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminatory performance of inflammatory markers. RESULTS: In the preoperative period, AUCs were 0.655 (95% CI: 0.568-0.742) for NLR, 0.655 (95% CI: 0.568-0.742) for PLR, and 0.689 (95% CI: 0.607-0.772) for SII. On POD3, AUCs were 0.638 (0.551-0.726), 0.619 (0.531-0.707), and 0.673 (0.589-0.758), respectively. On POD5, AUCs were 0.724 (0.645-0.803), 0.695 (0.612-0.779), and 0.740 (0.663-0.818), respectively. CONCLUSIONS: Perioperative NLR, PLR, and SII showed measurable discrimination for 6-month postoperative complications, with numerically higher AUCs on POD5.
Ultrasound texture analysis of primary tumor for predicting axillary lymph node metastasis in patients with clinical T1-T2 breast cancer.
Liu X, Hao Y, Sun S … +2 more , Xu Y, Lu H
Surg Oncol · 2026 Jun · PMID 41921257 · Publisher ↗
OBJECTIVE: To evaluate the utility of ultrasound-based texture features from primary T1-T2 breast cancer lesions for predicting axillary lymph node metastasis (ALNM), and to compare its performance with that of expert so...
OBJECTIVE: To evaluate the utility of ultrasound-based texture features from primary T1-T2 breast cancer lesions for predicting axillary lymph node metastasis (ALNM), and to compare its performance with that of expert sonographic assessment. METHODS: This retrospective study included 198 patients with pathologically confirmed T1-T2 breast cancer who underwent standardized preoperative ultrasound examinations. Randomly divided into training set (n = 159) and testing sets (n = 39) at a 4:1 ratio. Texture features were extracted from the largest cross-sectional image of each lesion. Texture features were extracted from the largest cross-sectional image of each lesion to establish and validate multivariable logistic regression nomogram models as well as MLP models. Its diagnostic performance was compared with that of artificial assessment using ROC curve analysis. RESULTS: In the testing set, the AUC values for the artificial assessment model, the nomogram model, and the MLP model were 0.638 (95% CI: 0.487-0.789), 0.774 (95% CI: 0.614-0.933), and 0.842 (95% CI: 0.713-0.971), respectively. Compared to the artificial assessment model, the MLP model demonstrated significantly better performance (DeLong test P-value <0.05). When compared with the nomogram model, the MLP model showed higher specificity (0.850 and 0.900) and negative predictive value (0.773 and 0.783). Key predictive features included measures of entropy and texture heterogeneity. CONCLUSION: Texture analysis of primary tumor ultrasound images demonstrates good performance in predicting ALNM compared to artificial assessment, and can further improve the accuracy of preoperative evaluation, especially in settings where radiological expertise is limited.
Expression of MCM2, MCM4, and MCM10 in hepatocellular carcinoma based on bioinformatic analyses and their predictive value for postoperative recurrence: An initial model development study.
He B, Tang K
Surg Oncol · 2026 Jun · PMID 41921256 · Publisher ↗
OBJECTIVE: To investigate the expression and predictive value of minichromosome maintenance proteins MCM2, MCM4, and MCM10 in hepatocellular carcinoma (HCC) for postoperative recurrence, and to develop an integrated pred...
OBJECTIVE: To investigate the expression and predictive value of minichromosome maintenance proteins MCM2, MCM4, and MCM10 in hepatocellular carcinoma (HCC) for postoperative recurrence, and to develop an integrated predictive model. METHODS: Bioinformatics analysis using the Gene Expression Profiling Interactive Analysis 2 (GEPIA2) database, the Cancer Genome Atlas Liver Hepatocellular Carcinoma (TCGA-LIHC) and Genotype-Tissue Expression (GTEx) first identified differential expression of MCM2, MCM4, and MCM10 in HCC. Subsequently, a cohort of 170 consecutive patients who underwent hepatectomy between March 2020 and February 2023 was retrospectively analyzed. After excluding 12 patients lost to follow-up, 158 patients were categorized into recurrence (n = 71) and non-recurrence (n = 87) groups based on early recurrence within two years. Quantitative real-time PCR was performed to measure MCM2, MCM4, and MCM10 mRNA levels in paired tumor and adjacent tissues. Clinicopathological data were collected. Logistic regression analysis identified independent predictors of recurrence. A predictive nomogram was constructed and internally validated using 1000 bootstrap resamples. The model's performance was assessed using the area under the receiver operating characteristic curve (AUC), decision curve analysis (DCA), and calibration. RESULTS: MCM2, MCM4, and MCM10 were significantly overexpressed in HCC tissues compared to normal and adjacent tissues (all P < 0.001). Their expression levels were higher in the recurrence group than in the non-recurrence group (all P < 0.001). Multivariable analysis identified tumor size ≥5 cm, presence of satellite nodules, AFP ≥400 ng/mL, microvascular invasion, and elevated expression of MCM2, MCM4, and MCM10 as independent predictors of early recurrence (all P < 0.05). The nomogram incorporating these factors demonstrated good discrimination, with an optimism-corrected C-index of 0.851. DCA indicated favorable clinical utility. CONCLUSION: Elevated expression of MCM2, MCM4, and MCM10 is associated with early postoperative recurrence in HCC. The novel nomogram integrating these molecular markers with key clinicopathological factors provides a promising tool for individualized recurrence risk stratification.
Mediastinal lymph node dissection in older adults with radiologically pure-solid stage I lung cancer.
Katsumata S, Tsuboi M, Ohde Y … +14 more , Okami J, Toyooka S, Ito H, Ohtsuka T, Mori T, Chida M, Saji H, Sato Y, Yoshino I, Miyaoka E, Yotsukura M, Watanabe SI, Shintani Y, Japanese Joint Committee of Lung Cancer Registry
Surg Oncol · 2026 Jun · PMID 41915950 · Publisher ↗
PURPOSE: To clarify the prognostic impact and associated complications of mediastinal lymph node dissection (MLND) in older adults with radiologically pure solid clinical stage I non-small cell lung cancer (NSCLC), using...
PURPOSE: To clarify the prognostic impact and associated complications of mediastinal lymph node dissection (MLND) in older adults with radiologically pure solid clinical stage I non-small cell lung cancer (NSCLC), using data from a nationwide surgical database in Japan (n = 18,973). PATIENTS AND METHODS: Of 2075 older adults (≥75 years of age), who underwent complete anatomical resection for clinical stage I NSCLC and registered in the database, data from 1313 with pure-solid tumours on preoperative computed tomography were included. To compare survival and the incidence of postoperative complications, patients were classified into two groups according to the extent of lymph node dissection: MLND; and non-MLND. An inverse probability of treatment weighting method with propensity scoring was used to reduce selection bias. After matching, 1162 patients were analysed for overall survival (OS), and 1153 for disease-free survival (DFS) and cumulative incidence of recurrence (CIR). RESULTS: Before matching, the MLND group exhibited significantly better DFS and OS than the non-MLND group (P = .030 and P = .013, respectively). Multivariable analysis revealed that MLND did not affect the incidence of postoperative complications (≥ grade III). After matching, there were no significant differences between the two groups in terms of DFS, OS, or CIR (P = .536, P = .409, and P = .933, respectively). CONCLUSION: MLND did not yield a survival benefit in older adults (≥75 years of age) even with radiologically pure-solid clinical stage I NSCLC. Anatomical pulmonary resection without MLND may be an alternative treatment option for these patients.
Annual hospital volume of gastrectomy and gastric cancer mortality - a population-based nationwide study in Finland.
Maharjan U, Kauppila JH
Surg Oncol · 2026 Jun · PMID 41915949 · Publisher ↗
BACKGROUND: Previous studies on hospital volume of gastrectomy and mortality in gastric cancer are conflicting, with some suggesting improved short-term outcomes in higher volume hospitals and fewer studies demonstrating...
BACKGROUND: Previous studies on hospital volume of gastrectomy and mortality in gastric cancer are conflicting, with some suggesting improved short-term outcomes in higher volume hospitals and fewer studies demonstrating consistent findings on long-term mortality benefits. This study evaluated the association between hospital volume and gastric cancer mortality in Finland during 1987-2016. METHODS: This population-based, nationwide, retrospective cohort study utilized patient data from the three national registries. Annual hospital volumes were divided into quartiles. The outcomes of interest were 30-day, 90-day and 5-year mortality. Multivariable Cox-regression hazard models provided HRs and 95% CI, adjusted for age, sex, calendar period, comorbidity, cancer stage, and neoadjuvant therapy, with missing data addressed through multiple imputation. RESULTS: A total of 10,331 gastrectomy were identified. Highest volume quartile hospitals showed a gradual decrease in gastrectomy procedures compared to low-volume hospitals in later calendar periods. While no significant association was found between hospital volume quartile and short-term or long-term mortality in the overall analysis, the subgroup analysis for the years 2005-2016 revealed an increased risk of 90-day mortality in lowest volume quartile hospitals. CONCLUSION: No significant association between hospital volume of gastrectomy and short- or long-term mortality was demonstrated. Centralization of gastric cancer patients to higher-volume hospitals might not decrease short- or long-term mortality.
Impact of Symptom Phenotype on Surgical Quality and Survival in Small-Bowel Neuroendocrine Tumours: A Quality Metrics Analysis.
Darbhamulla S, Kotecha K, Chan DL … +7 more , Chang KH, Bailey DL, Pavlakis N, Clarke S, Gill AJ, Mittal A, Samra JS
J Surg Oncol · 2026 Mar · PMID 41913096 · Publisher ↗
BACKGROUND: There is debate regarding the optimal management of small-bowel neuroendocrine tumours (SBNETs), particularly concerning upfront resection in various clinical presentations. While symptom phenotypes are known...
BACKGROUND: There is debate regarding the optimal management of small-bowel neuroendocrine tumours (SBNETs), particularly concerning upfront resection in various clinical presentations. While symptom phenotypes are known to influence survival, their impact on technical surgical quality, especially in the emergency setting, remains poorly defined. This study evaluates whether symptom phenotype compromises the delivery of guideline-concordant surgical care. METHODS: A retrospective analysis of 108 consecutive SBNET resections (2000-2023) at a specialized tertiary centre was performed. Patients were stratified into four phenotypes: obstructive/perforation (n = 54), carcinoid syndrome (22), asymptomatic/incidental (22), and other symptoms (9). Operative metrics, including lymph-node harvest (LNY) and margin status (R0/R1), were compared alongside overall survival (OS). RESULTS: Symptom phenotype was a predictor of operative urgency and approach. Obstructive cases required emergency surgery in 50% of instances compared to ≤ 11% in all other groups (p < 0.001). Synchronous liver metastases were most prevalent in the carcinoid syndrome phenotype (50%) and lowest in the asymptomatic group (5%) (p = 0.002). Despite these disparities in presentation and urgency, technical quality markers were uniform across all groups: median LNY ranged from 10 to 13 (p = 0.426), R1/R2 margin rates were statistically similar (p = 0.290), and median length of stay was 8 days for all cohorts (p = 0.311). Multivariable analysis identified the asymptomatic phenotype as independently protective for OS (HR 0.42, p = 0.032), while liver metastasis was the strongest adverse prognostic factor (HR 3.25, p < 0.001). CONCLUSIONS: Symptom phenotype dictates operative urgency and reflects disease burden but does not compromise the technical standards of surgery in a specialized unit. These findings suggest that high-quality, guideline-concordant lymphadenectomy is achievable even in emergency obstructive presentations, and correspondingly, access to specialized surgical oncology expertise may be sought even in obstructed patients to ensure technical quality is maintained.
Performance of contrast-enhanced spectral mammography for sizing breast invasive ductal carcinoma with an in situ component.
Tiberghien ME, Blanc-Lapierre A, Saib S … +5 more , Neveu M, Mascarel AM, Bocquet F, Doutriaux-Dumoulin I, Geffroy D
Surg Oncol · 2026 Jun · PMID 41903363 · Publisher ↗
Abstract loading — click title to view on PubMed.
Enucleation versus enucleoresection in robotic partial nephrectomy: Real-world data from the multicenter YAU kidney cancer database.
Bertolo R, Palumbo C, Rosiello G … +7 more , Belladelli F, Erdem S, Khene ZE, Marchioni M, Wu Z, Campi R, Amparore D
Surg Oncol · 2026 Jun · PMID 41903362 · Publisher ↗
INTRODUCTION: Robot-assisted partial nephrectomy (RAPN) represents the preferred minimally-invasive approach for localized renal tumors. Increasing attention has focused on optimizing parenchymal preservation, with enucl...
INTRODUCTION: Robot-assisted partial nephrectomy (RAPN) represents the preferred minimally-invasive approach for localized renal tumors. Increasing attention has focused on optimizing parenchymal preservation, with enucleation proposed as a potentially advantageous strategy. This study aimed to compare perioperative and functional outcomes of enucleation versus enucleoresection in a large, contemporary multicenter RAPN cohort. MATERIALS AND METHODS: Data were extracted from the multicentric and multicontinental European Association of Urology Young Academic Urologists (EAU-YAU) Renal Cancer Working Party database. Patients undergoing RAPN between 2015 and 2024 with clearly documented resection technique (enucleation vs enucleoresection) were included. The resection technique was chosen based on the surgeon's preference. Perioperative, pathological, and renal functional outcomes were evaluated. Acute kidney injury (AKI - defined according to the AKIN classification) and chronic kidney disease (CKD) worsening served as primary endpoints. Logistic regression and Cox proportional hazards models were used to assess the association between surgical technique and the risk of AKI and CKD progression; Kaplan-Meier curves were used to depict time-to-event and functional outcomes, while longitudinal eGFR analyses were performed to evaluate renal function trends over time. RESULTS: Among 1260 patients, 527 (42%) underwent enucleation and 733 (58%) enucleoresection. Adoption of both techniques remained stable over time. Baseline characteristics were comparable. Enucleoresection was associated with longer ischemia time, higher intraoperative complication rates, and a lower positive surgical margin rate (5.2% vs 8.3%, p = 0.003). Postoperative AKI occurred more frequently after enucleoresection (18% vs 3%, p < 0.001), although eGFR recovery was similar at a median follow-up of 12 vs 25 months. In the overall cohort and among patients with baseline CKD stages 1-2, enucleation was associated with a lower risk of CKD progression (p < 0.001). CONCLUSIONS: Enucleation during RAPN offers a parenchyma-sparing approach with potential functional advantages, particularly in patients with preserved baseline renal function. This benefit must be balanced against a slightly higher risk of positive margins, reinforcing the necessity of thoughtful case selection and standardized surgical technique.
Rectal predominance and annular wall thickening: Abdominal computed tomography and clinical characteristics of colorectal cancer in a resource-limited setting.
Saleh MA, Iramu R, Kazema R … +1 more , Fundikira L
Surg Oncol · 2026 Jun · PMID 41903361 · Publisher ↗
BACKGROUND: Colorectal cancer (CRC) is the second-leading cause of cancer deaths worldwide, and its incidence is rising in developing countries. In resource-limited settings, abdominal CT scans are commonly used to detec...
BACKGROUND: Colorectal cancer (CRC) is the second-leading cause of cancer deaths worldwide, and its incidence is rising in developing countries. In resource-limited settings, abdominal CT scans are commonly used to detect and stage CRC before treatment. This study examined CT scan results and associated factors in patients suspected of having CRC at Muhimbili National Hospital between August 2019 and February 2020. METHODOLOGY: This was a cross-sectional, hospital-based study of 60 patients with suspected CRC who were referred to our centre for abdominal CT. Clinical characteristics, abdominal CT findings, and histology results were recorded in a structured questionnaire. Categorical and numerical data were analyzed using frequency distribution tables, and the Chi-square (X) test was used to assess the association between the independent and dependent variables. Multivariate logistic regression was performed to evaluate independent associations after adjusting for age and sex. RESULTS: Most participants were over 40 years old (more females than males, 1.4:1). An unhealthy diet was common (71.7%). Main symptoms: constipation (61.7%) and hematochezia (58.3%). Among 60 suspected patients, colorectal tumours were confirmed in 56.7%, mostly rectal (26.7%), often with annular thickening (46.7%) and heterogeneous enhancement (43.3%). Abdominal CT showed good performance (sensitivity 88.9%, specificity 91.7%, accuracy 90.0%). Significant associations were found with lower education (p = 0.04), alcohol use (p = 0.02), and hematochezia (p = 0.03). These associations should be considered exploratory, given the small sample size and multiple comparisons performed. CONCLUSION: CRC is present in the majority of patients with suspected cases who follow an unhealthy diet, occurring most commonly in the rectum and presenting as annular wall thickening on abdominal CT. This association is also linked to educational attainment and alcohol consumption.
Surgery and the Gastrointestinal Microbiome in Cancer: Bidirectional Impacts and Therapeutic Opportunities - a Narrative Review.
Žukauskaitė K, Rauduvytė K, Baušys A … +3 more , Horvath A, Poškus T, Stadlbauer V
Surg Oncol · 2026 Jun · PMID 41895157 · Publisher ↗
Gastrointestinal cancers rank among the most common malignancies globally, and although surgical resection remains the cornerstone of curative therapy, it is associated with considerable postoperative morbidity and morta...
Gastrointestinal cancers rank among the most common malignancies globally, and although surgical resection remains the cornerstone of curative therapy, it is associated with considerable postoperative morbidity and mortality. Emerging evidence suggests that the gut microbiome is a critical determinant in the pathogenesis of postoperative complications, including surgical site infections, anastomotic leakage, and postoperative ileus. Microbiome-targeted interventions - including probiotics, prebiotics, and synbiotics - have shown promise in modulating microbial communities and supporting postoperative recovery; however, clinical efficacy remains inconsistent, and standardized perioperative protocols are yet to be established. This review summarizes current evidence on the interactions between gastrointestinal cancer surgery and the perioperative gut microbiome, emphasizing opportunities to harness microbiome-targeted interventions to reduce complications and enhance recovery.
Rectal cancer with synchronous liver metastasis undergoing hepatectomy: sequencing to the 'liver-first' reflects tumour burden of the primary.
Veen T, Kanani A, Alvestad AB … +3 more , Edland KH, Lea D, Søreide K
Surg Oncol · 2026 Jun · PMID 41886837 · Publisher ↗
BACKGROUND: Management of primary rectal cancer presenting with synchronous liver metastases (CRLM) is debated as there several treatment strategies to consider. The aim of this study was to evaluate the strategies used...
BACKGROUND: Management of primary rectal cancer presenting with synchronous liver metastases (CRLM) is debated as there several treatment strategies to consider. The aim of this study was to evaluate the strategies used in an unselected cohort. METHODS: An observational, population-derived cohort of patients treated for synchronous CRLM and rectal cancer within a prospective biomarker trial (ACROBATICC). RESULTS: Of 192 patients operated for CRLM, 35 (18%) had rectal cancer and synchronous CRLM. A total of 22 patients (63%) were treated with liver-first followed by primary resection, while 13 patients (37%) had the primary-first approach. Four patients having liver-first developed further metastasis and did not proceed to rectal surgery. A significantly higher rate of pre-operative primary tumour radiation occurred in the liver-first group, 19 (86%) vs 6 (46%) in the primary first (P = 0.038), suggesting a more advanced stage for the primary rectal cancer with planned liver surgery-first as part of operating in the "window" between radiation and eventual primary rectal cancer surgery. Also, the liver-first group received fewer cycles of chemotherapy (median 4 (4-8) vs median 8 (5-11) cycles; P = n.s.), indicating need to 'control' or 'convert' liver metastasis in the primary-first group prior to hepatectomy. Follow-up time for the cohort was 36 months (IQR 21-69), with 21 (96%) recurrences in the liver first group and 7 (58%) in the primary first (P = 0.014). CONCLUSIONS: Treatment sequencing reflects overall tumour presentation at diagnosis. The liver-first strategy was preferentially used in patients with more advanced rectal disease and was associated with high recurrence, reflecting tumour biology rather than treatment sequence.
Efficacy of Aminocaproic Acid in Preventing Postoperative Hematoma in Breast Cancer Surgery: A Prospective Study.
Caroço TV, Reis J, Saraiva RP … +6 more , Ângelo MD, Baião JM, Romano M, Silva MC, Costa A, Ferrão IC
J Surg Oncol · 2026 Mar · PMID 41872680 · Publisher ↗
BACKGROUND AND OBJECTIVES: Hemorrhage after oncologic breast surgery occurs in up to 11% of cases, remaining the leading cause of reoperation. Although antifibrinolytics are widely used in other surgical settings, their...
BACKGROUND AND OBJECTIVES: Hemorrhage after oncologic breast surgery occurs in up to 11% of cases, remaining the leading cause of reoperation. Although antifibrinolytics are widely used in other surgical settings, their role in oncologic breast surgery is not well established. This study evaluated the efficacy and safety of aminocaproic acid (ACAc) in reducing postoperative hematoma following oncological mastectomies. METHODS: A prospective randomized study was conducted between July 2020 and May 2022, including women ≥ 18 years old undergoing mastectomy. Patients were randomized into three groups: (A) topical application of 5 g of ACAc; (B) intravenous 2.5 g administered 30 min before incision; and (C) no treatment (control). Statistical tests included ANOVA, Chi-square, and multivariable regression. RESULTS: A total of 166 patients were enrolled. Postoperative hematoma occurred in 3.6% of patients in group A, 1.8% patients in group B, and 12.7% in the control. Multivariable logistic regression demonstrated a protective effect of intravenous ACAc compared with control (p = 0.021). No differences in reoperation rates were observed. No thromboembolic events nor hepatic or renal toxicity occurred. Hypertension was identified as an independent risk factor for postoperative hematoma. CONCLUSIONS: Intravenous ACAc reduces postoperative hematoma in oncologic mastectomy and may represent a low-cost, effective adjunct to bleeding prevention in this setting.
Quality of Life Following Palliative Surgery for Malignant Bowel Obstruction: A Scoping Review.
Couture T, Rioux A, Drolet S … +2 more , Ouellet JF, Brind'Amour A
J Surg Oncol · 2026 Mar · PMID 41866768 · Publisher ↗
We performed a scoping review on the quality of life (QoL) of patients with malignant bowel obstruction who underwent palliative surgery using PubMed, EBSCO, and Cochrane databases. In total, 20 articles were included (1...
We performed a scoping review on the quality of life (QoL) of patients with malignant bowel obstruction who underwent palliative surgery using PubMed, EBSCO, and Cochrane databases. In total, 20 articles were included (1467 patients). Oral diet tolerance, stoma creation, and the ability to be discharged from the hospital were the main QoL outcomes reported. Most patients seem to benefit from an improved QoL. However, the QoL outcomes reported were surrogate and not patient-reported. Further prospective studies using validated QoL instruments are required.
Listening in: Orthopaedic Oncology Physicians' Perspectives on Implementation of Audio Recording/Artificial Intelligence Assist in Office Visits.
Hsu M, Leonard AK, McGarry S … +1 more , Balach T
J Surg Oncol · 2026 Mar · PMID 41863547 · Publisher ↗
INTRODUCTION: With rapid expansion of artificial intelligence (AI) in clinical documentation, responsible implementation of this tool is imperative in preserving the patient-physician relationship. Orthopaedic oncologist...
INTRODUCTION: With rapid expansion of artificial intelligence (AI) in clinical documentation, responsible implementation of this tool is imperative in preserving the patient-physician relationship. Orthopaedic oncologists were surveyed to assess their utilization of, and attitudes towards, ambient listening software. METHODS: An anonymous, voluntary, IRB-exempt survey (Appendix) was reviewed and distributed to members of the MSTS via the society's email listserv and distributed in paper and electronic formats to attendees at the AAOS Oncology Subspeciality day from March 14 to May 22, 2025. RESULTS: Sixty-three orthopaedic oncologists responded to the survey. Most (93%) practiced in an academic setting. Twenty-seven percent reported using AI with a majority using Dax Copilot. Half of AI users noted a positive impact on clinical encounters, and one respondent reported a negative impact. Most AI users (86%) reported improved efficiency and accuracy in documentation and 40% reported saving 1-2 h per clinic day. Of non-users, 71% were considering implementation. CONCLUSION: Although most orthopaedic oncologists are not using AI, the majority are considering implementation. AI users reported improvements in their documentation efficiency and accuracy. Further research is needed to understand the risks and benefits of this clinical tool from both providers' and patients' perspectives to guide responsible, widespread implementation.
Impact of Aspirin on Recurrence Prevention After Curative Resection for Stage I-III Colorectal Cancer: A Multi-Institutional Retrospective Study.
Bekki T, Shimomura M, Yano T … +20 more , Imaoka K, Miguchi M, Sawada H, Hara T, Ono K, Kobayashi H, Sumi Y, Sada H, Sumitani D, Mukai S, Takakura Y, Yamaguchi M, Shiozaki S, Fujimori M, Taguchi K, Okuda H, Adachi T, Ishikawa S, Ohdan H, Hiroshima Surgical study group of Clinical Oncology (HiSCO)
J Surg Oncol · 2026 May · PMID 41852133 · Publisher ↗
BACKGROUND AND OBJECTIVES: Although multiple studies have reported the anti-tumor effects of aspirin on colorectal cancer, its benefit in patients with colorectal cancer following curative resection remains controversial...
BACKGROUND AND OBJECTIVES: Although multiple studies have reported the anti-tumor effects of aspirin on colorectal cancer, its benefit in patients with colorectal cancer following curative resection remains controversial. This study aimed to evaluate the effect of aspirin administration in patients with stage I-III colorectal cancer following curative resection. METHODS: This multi-institutional retrospective study included 2,863 patients with stage I-III colorectal cancer who underwent curative resection between January 2017 and December 2019. Patients were classified into two groups according to aspirin use. Clinical characteristics and oncological outcomes were analyzed. RESULTS: The aspirin group was older, and fewer patients had advanced pathological tumor stages or received postoperative adjuvant chemotherapy than non-aspirin group. Aspirin use tended to be associated with improved postoperative prognosis in patients with stage I-III colorectal cancer (overall survival: 91.1% vs. 80.9%, hazard ratio = 0.646, 95% confidence interval = 0.32-1.30; recurrence-free survival: 82.6% vs. 73.7%, hazard ratio = 0.730, 95% confidence interval = 0.44-1.20). After propensity score matching to minimize bias between groups, aspirin use was associated with improved postoperative prognosis (overall survival: 91.0% vs. 69.8%, hazard ratio = 0.306, 95% confidence interval = 0.14-0.68; recurrence-free survival: 82.4% vs. 56.6%, hazard ratio = 0.350, 95% confidence interval = 0.19-0.62). Aspirin use significantly improved recurrence-free survival in patients with advanced cancer who were recommended to receive postoperative adjuvant chemotherapy. CONCLUSIONS: This study suggests that aspirin use is associated with improved postoperative prognosis in patients with stage I-III colorectal cancer after curative resection. Aspirin may be beneficial for advanced-stage patients, for whom postoperative adjuvant chemotherapy is recommended.
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