Surgical Oncology[JOURNAL]
Sun
200 papers
Preoperative and Intraoperative Assessment of Extrathyroidal Extension in Unilateral Papillary Thyroid Carcinoma: Does It Necessitate Total Thyroidectomy?
Fei K, Bin Z, Song Y
J Surg Oncol · 2026 Mar · PMID 41852116 · Publisher ↗
BACKGROUND: The optimal surgical extent for papillary thyroid carcinoma (PTC) with extrathyroidal extension (ETE) suspected on ultrasound or intraoperative exploration remains debated. This study evaluated the diagnostic...
BACKGROUND: The optimal surgical extent for papillary thyroid carcinoma (PTC) with extrathyroidal extension (ETE) suspected on ultrasound or intraoperative exploration remains debated. This study evaluated the diagnostic accuracy of clinical ETE (cETE) assessment and compared oncologic outcomes after lobectomy between cETE-positive and cETE-negative patients. METHODS: This single-center retrospective study enrolled 213 patients with PTC who underwent lobectomy. cETE was defined as tumor extension beyond the thyroid capsule on preoperative ultrasound or intraoperative exploration. Pathologically confirmed ETE served as the gold standard for determining the sensitivity, specificity, and accuracy of both ultrasound and intraoperative ETE assessments. Recurrence-free survival was compared between groups by different ETE features. RESULTS: Preoperative/intraoperative ETE assessments exhibited limited sensitivity (12.3% and 33.6%), limited accuracy (49.3% and 55.9%), and high specificity (98.9% and 85.7%). With a mean follow-up duration of 63.5 ± 11.7 months, the recurrence rates were recorded at 1.6% (1/61) in Group cETE+ in comparison to 2.0% (3/152) in Group cETE- (p = 0.871). CONCLUSION: Clinical ETE assessment has limited accuracy but high specificity. Lobectomy offers comparable oncologic outcomes regardless of cETE status, supporting its feasibility in selected PTC patients without mandating total thyroidectomy.
Postoperative Weight Gain, Due to Fluid Retention After Ovarian Cancer Surgery-How Much Is too Much?
Egger EK, Delen M, Matthaei H … +5 more , Padron LT, Schröder C, Marinova M, Koensgen D, Mustea A
J Surg Oncol · 2026 Mar · PMID 41840979 · Publisher ↗
BACKGROUND AND OBJECTIVES: Postoperative complications after cytoreductive surgery in ovarian cancer patients are associated with impaired survival. Here, we investigated the association between postoperative weight gain...
BACKGROUND AND OBJECTIVES: Postoperative complications after cytoreductive surgery in ovarian cancer patients are associated with impaired survival. Here, we investigated the association between postoperative weight gain due to fluid retention and the development of complications and anastomotic leakage (AL). METHODS: N = 278 patients underwent cytoreductive surgery at the university hospital of Bonn in between 01/2013 and 03/2022. Postoperative weight gain on day 2 and day 5 was assessed and correlated to the occurrence of complications according to the MSKCC secondary event score and ALs. RESULTS: There were 227 surgeries (81.7%) for primary and 51 surgeries (18.3%) for recurrent ovarian cancer. Severe complications were significantly more frequent in patients with postoperative weight gain exceeding 4 kg on postoperative day 2 (26/90 vs. 13/76; p = 0.03) and exceeding 3 kg on postoperative day 5 (34/89 vs 30/134; p = 0.02). A weight gain of more than 6 kg on postoperative day 2 was significantly associated with the occurrence of AL (p = 0.021). Less weight gain on d2 and d5 was associated with a significant earlier first defecation (day-2 p-value: 0.01; day-5 p-value: 0.01). In multiple binary logistic regression analysis, the postoperative weight gain on day 2 (p = 0.0019) and the performance of an anastomosis (p = 0.0095) remained the only significant risk factors regarding severe complications. CONCLUSIONS: Postoperative weight gain, as a surrogate for fluid retention, and the creation of an anastomosis were associated with an increased risk of severe postoperative complications.
Discordance Between Breast and Nodal Pathologic Response in Triple-Negative Breast Cancer: Methodological Considerations and Contemporary Implications.
Altundag K
J Surg Oncol · 2026 Mar · PMID 41839788 · Publisher ↗
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Survival Following Colorectal Cancer Surgery in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.
Afolaranmi O, Diehl TM, Salim Virani S … +9 more , Yang Q, Christensen L, Okwunze K, Khan AH, Akhlaq Mughal N, Schroeder D, Pourdashti S, Khan S, Zafar SN
J Surg Oncol · 2026 Mar · PMID 41834407 · Publisher ↗
BACKGROUND AND OBJECTIVES: Surgery is the mainstay of treatment for localized colorectal cancer (CRC); however, little is known about survival outcomes following CRC surgery in low- and middle-income countries (LMICs). H...
BACKGROUND AND OBJECTIVES: Surgery is the mainstay of treatment for localized colorectal cancer (CRC); however, little is known about survival outcomes following CRC surgery in low- and middle-income countries (LMICs). Here, we examine the available data on long-term outcomes following CRC resections in LMICs. METHODS: A systematic review and meta-analysis were conducted on primary research studies reporting survival data after CRC resection with curative intent in LMICs. Disease-free survival (DFS) and overall survival (OS) data were extracted, and random effects modelling was used to estimate the pooled survival rates. RESULTS: One hundred and fifty-four studies representing 20,589 CRC patients were analyzed. Notably, only 27 (20%) of the 137 LMICs were represented in the literature. The pooled 5-year OS estimate was 88% (95% CI: 77-95), 76% (69-81), and 57% (49-64) for Stages I, II, and III, respectively. 5-year DFS estimates were 82% (71-90), 76% (67-84), and 59% (51-65) for stages I, II, and III, respectively. Combined OS and DFS estimates for all three stages were 76% and 69%, respectively. Survival rates varied considerably across the included studies and between income groups. CONCLUSIONS: With the rising incidence of CRC globally, our work highlights the dearth of data on long-term outcomes following CRC operations in most LMICs and emphasizes the urgent need for research capacity building.
Analysis of the Relationship Between Survival and Postoperative Infection in Patients With Osteosarcoma.
Kamio S, Ogura K, Sato K … +12 more , Fujiwara T, Ozaki T, Nakayama R, Koike H, Nishida Y, Endo M, Imura Y, Tsuda Y, Yonemoto T, Morii T, Arakawa A, Kawai A
J Surg Oncol · 2026 Mar · PMID 41832999 · Publisher ↗
BACKGROUND: Postoperative infections remain a critical concern in the management of osteosarcoma, particularly after limb salvage surgery. While infections are often perceived as detrimental, emerging evidence suggests t...
BACKGROUND: Postoperative infections remain a critical concern in the management of osteosarcoma, particularly after limb salvage surgery. While infections are often perceived as detrimental, emerging evidence suggests that under certain circumstances, localized infections may improve survival outcomes. This study evaluated the relationship between postoperative infection and survival in Japanese patients with osteosarcoma. METHODS: We retrospectively reviewed the medical records of patients diagnosed with osteosarcoma who underwent surgery between April 1990 and October 2021 at nine institutions. Patients with trunk or pelvic lesions, distant metastases at initial diagnosis, age over 60, or infections occurring more than 1 year postoperatively were excluded. RESULTS: Among 466 eligible patients, 34 (7.3%) developed postoperative infections. The 5-year overall survival rate was 84.4% in infected patients and 82.9% in non-infected patients, with no significant difference (p = 0.778). The proximal tibia was more susceptible to infection than other sites, with an odds ratio of 2.621 (p = 0.008), and larger tumors were more likely to develop infection (odds ratio, 1.093; p = 0.009). CONCLUSIONS: Postoperative infection did not improve survival in patients with osteosarcoma. Tumors in the proximal tibia and those with larger maximum diameters were more susceptible to infection.
Best Practices for the Multidisciplinary Care of Patients With Early-Stage Driver-Mutated Non-Small Cell Lung Cancer.
Sabari J, Stiles BM
J Surg Oncol · 2026 May · PMID 41814628 · Publisher ↗
Early-stage ALK-positive non-small cell lung cancer (NSCLC) represents a distinct molecular subset requiring individualized, multidisciplinary care. Advances in molecular testing and targeted therapies have transformed t...
Early-stage ALK-positive non-small cell lung cancer (NSCLC) represents a distinct molecular subset requiring individualized, multidisciplinary care. Advances in molecular testing and targeted therapies have transformed treatment paradigms, as demonstrated in trials like ALINA and ADAURA. Emerging studies, including NAUTIKA1 and NeoADAURA, explore the potential of targeted therapies in neoadjuvant settings, as well. Proper surgical staging, timely biomarker testing, multidisciplinary collaboration, and clinical trial participation are essential to refine treatment strategies and improve survival for patients with ALK-positive NSCLC.
MEMS-based near-infrared spectroscopy with AI for real-time breast cancer margin assessment.
Ibrahim HM, Aref MHF, Elhadad MK … +3 more , Hussein AA, Sharawi A, Saleh N
Surg Oncol · 2026 Jun · PMID 41812600 · Publisher ↗
BACKGROUND: Achieving clear surgical margins is essential for successful breast-conserving surgery and reducing re-excision rates. Conventional intraoperative approaches such as Frozen Section Analysis and Imprint Cytolo...
BACKGROUND: Achieving clear surgical margins is essential for successful breast-conserving surgery and reducing re-excision rates. Conventional intraoperative approaches such as Frozen Section Analysis and Imprint Cytology are accurate but time-consuming and resource-dependent, underscoring the need for rapid, label-free, and objective diagnostic alternatives. OBJECTIVE: This study presents a clinically oriented framework that integrates diffuse reflectance near-infrared (DR-NIR) spectroscopy with machine-learning (ML) and deep-learning (DL) algorithms for real-time breast-cancer diagnosis and intraoperative margin assessment. METHODS: A total of 68 tissue specimens from 34 patients were analyzed using a MEMS-based DR-NIR sensor (NeoSpectra-Micro). Spectral data were processed through linear, ensemble, and convolutional models to classify malignant and normal tissues. A novel evaluation metric-the Metric for Classification Assessment and Success (MCAS)-was introduced to capture clinically weighted trade-offs between sensitivity and specificity. A web-based interface built in Gradio enables real-time diagnostic use by surgeons without programming expertise. RESULTS: Several classifiers, including LinearSVC, VotingClassifier, MLPClassifier, and a convolutional neural network (CNN), achieved perfect discrimination (accuracy and AUROC = 1.000), confirming strong spectral separability between tissue classes. The MCAS metric provided additional insight into class-specific reliability beyond conventional performance indices. CONCLUSION: The proposed AI-enhanced DR-NIR spectroscopy system delivers rapid, accurate, and interpretable intraoperative feedback on tumor margins. By combining portable MEMS sensing, data-driven modeling, and interactive clinical deployment, this study advances toward a practical, real-time optical alternative for reliable breast-cancer margin assessment.
Prognostic determinants of survival in gastroenteropancreatic neuroendocrine tumors: A real-world evaluation of age, stage, grade, and Ki-67 dynamics.
Belev B, Goršić I, Likić R
Surg Oncol · 2026 Jun · PMID 41812599 · Publisher ↗
BACKGROUND: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are clinically heterogeneous, and accurate prognostic assessment is crucial. Although Ki-67 is a core element of the WHO classification, its prognostic...
BACKGROUND: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are clinically heterogeneous, and accurate prognostic assessment is crucial. Although Ki-67 is a core element of the WHO classification, its prognostic performance varies across real-world cohorts. We evaluated the prognostic value of age, stage, WHO grade, and Ki-67 using multiple modeling strategies in a mature single-center GEP-NET cohort. METHODS: patients with histologically confirmed GEP-NETs diagnosed between 2000 and 2024 at a tertiary academic center were evaluated. Eligible tumors arose in the small bowel, pancreas, stomach, colon, rectum, duodenum, or appendix. Overall survival (OS) was calculated from diagnosis. Survival was assessed using Kaplan-Meier estimates, univariate Cox models, and three multivariable Cox models incorporating Ki-67 as a continuous, categorical, or spline-transformed variable. RESULTS: A total of 103 patients were included. Median follow-up was 99.5 months, with 40 deaths. Higher WHO grade predicted worse OS (G3 vs G1 HR 4.38, 95 percent CI 1.45-13.18). Age and stage were significant prognostic variables and remained independently associated with OS. Ki-67 showed expected biological patterns but was not an independent linear predictor; spline models indicated possible nonlinear effects. CONCLUSIONS: Age, stage, and WHO grade were the strongest predictors of OS. Ki-67 demonstrated biologically consistent but statistically complex behavior, highlighting the need for refined modeling and standardized reporting.
Preoperative Workup by a Dedicated Geriatric Surgery Service Improves Outcomes in Elderly Patients Undergoing Pancreaticoduodenectomy.
Ilan K, Pencovich N, Zelezetski M … +8 more , Avishai N, Jacover A, Pery R, Eshkenazy R, Goldes Y, Frenkel Y, Gutman M, Nachmany I
J Surg Oncol · 2026 Mar · PMID 41808309 · Publisher ↗
INTRODUCTION: Pancreaticoduodenectomy (PD) carries substantial risks in elderly patients, emphasizing the need for optimized perioperative care. Comprehensive geriatric assessments (CGAs) - evaluating medical, functional...
INTRODUCTION: Pancreaticoduodenectomy (PD) carries substantial risks in elderly patients, emphasizing the need for optimized perioperative care. Comprehensive geriatric assessments (CGAs) - evaluating medical, functional, and psychosocial domains - may mitigate these risks. This study investigates the impact of a preoperative evaluation by a dedicated geriatric surgery service on outcomes in elderly patients undergoing PD. METHODS AND MATERIALS: This was a retrospective cohort study of elderly (age over 75 years) patients that underwent PD (GA + 75, n = 23) following preoperative workup by a specialized geriatric surgery service (GSS). Control groups included elderly patients without geriatric assessment (non-GA + 75, n = 73) and non-elderly patients ( < 75 years, n = 275). Short- and long-term outcomes were compared across the groups. RESULTS: While baseline demographics were similar between GA + 75 and non-GA + 75 groups, comorbidity profiles differed. Higher rates of chronic obstructive pulmonary disease (21.7% vs. 2.7%, p = 0.002) and asthma (26% vs. 1.4%, p < 0.001) were observed in the GA + 75 group. Despite this, GA + 75 patients had significantly lower rates of postoperative pneumonia (4.3% vs. 18.1%, p < 0.001), readmission (26.1% vs. 41.6%, p < 0.001; also lower than the non-elderly cohort), and delirium (4.3% vs. 36.1%, p < 0.001). There were no significant differences in overall major complications or 30-/90-day survival rates as well as long-term outcomes between the groups. CONCLUSIONS: Preoperative evaluation by a dedicated GSS was associated with improved postoperative outcomes in elderly patients undergoing PD. These findings support the integration of CGAs into perioperative planning to enhance recovery and reduce complications in older adults.
Patient perspectives on recovery and satisfaction after hemipelvectomy for pelvic tumors.
Werenski JO, Connolly JJ, Gonzalez MR … +6 more , Okay E, Rizk PA, Karim DS, Raskin KA, Newman ET, Lozano-Calderon SA
Surg Oncol · 2026 Jun · PMID 41806471 · Publisher ↗
INTRODUCTION: Malignant pelvic tumors often require hemipelvectomy, which can cause substantial and sometimes prolonged functional impairment. Long-term patient experience remains poorly defined. This study aimed to eval...
INTRODUCTION: Malignant pelvic tumors often require hemipelvectomy, which can cause substantial and sometimes prolonged functional impairment. Long-term patient experience remains poorly defined. This study aimed to evaluate the procedure's impact on physical and psychosocial function and quality of life (QoL), adequacy of preoperative counseling, and associations between caregiver support, care coordination, and long-term care burden. MATERIALS AND METHODS: Patients undergoing hemipelvectomy for primary bone or soft-tissue sarcoma or pelvic bone metastases at a single tertiary center from 2000 onward were retrospectively identified. Eligibility required a minimum two-year follow-up. Of 64 eligible, 30 (47%) completed validated patient-reported outcome measures: Combined Pain and Ambulatory CPAF, PROMIS-PI, PROMIS-PF, and EQ-5D-5L Utility Index, and a structured Likert survey of recovery experiences. Associations were assessed with Spearman's rank correlation coefficient (α = 0.05). RESULTS: At a median 12-year follow-up, patients demonstrated moderate impairment: PROMIS-PF 39.7, PROMIS-PI 51.8, EQ-5D-5L 0.719, and CPAF 7-below population norms. Although 90% felt adequately informed preoperatively, 73% found recovery more challenging than expected, and 63% perceived prolonged recovery. Age, body mass index, and age-adjusted Charlson Comorbidity Index did not correlate with function. Perceived caregiver well-being was associated with physical function (ρ = 0.65, p < 0.001), ambulation (ρ = 0.39, p = 0.03), and QoL (ρ = 0.43, p = 0.02). Better caregiver preparation and care coordination were associated with improved long-term care manageability (ρ = 0.61, p < 0.001; ρ = 0.41, p = 0.03). CONCLUSIONS: Hemipelvectomy recovery is often longer and harder than anticipated, even with high counseling satisfaction. Long-term function and QoL were more strongly associated with patient-perceived caregiver experience and care coordination than with traditional clinical factors, highlighting targets for patient- and caregiver-focused education. LEVEL OF EVIDENCE: Level IV.
RETRACTION: Comparison of a Risk Calculator With Frailty Indices in Patients Undergoing Lung Cancer Resection.
J Surg Oncol · 2026 Apr · PMID 41802996 · Publisher ↗
D.L. Vitello, C.D. Logan, N.N. Zaza, K.R. Bates, R. Jacobs, J. Feinglass, R.P. Merkow, and D.J. Bentrem, "Comparison of a Risk Calculator With Frailty Indices in Patients Undergoing Lung Cancer Resection," Journal of Sur...
D.L. Vitello, C.D. Logan, N.N. Zaza, K.R. Bates, R. Jacobs, J. Feinglass, R.P. Merkow, and D.J. Bentrem, "Comparison of a Risk Calculator With Frailty Indices in Patients Undergoing Lung Cancer Resection," Journal of Surgical Oncology 130, no. 8 (2024): 1532-1538. The above article, published online on 10 October 2024 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors; the journal Editor-in-Chief, Laleh Melstrom; and Wiley Periodicals LLC. The retraction has been agreed after identifying this article as a duplicate of a previously published version[1]. The authors unintentionally resubmitted the manuscript, and this duplication was not detected prior to publication. In accordance with COPE and Wiley policies, duplicate publication is prohibited; therefore, the redundant article is being retracted. [1] D.L. Vitello, C.D. Logan, N.N. Zaza, K.R. Bates, R. Jacobs, J. Feinglass, R.P. Merkow, and D.J. Bentrem, "Comparison of a Risk Calculator With Frailty Indices in Patients Undergoing Lung Cancer Resection," Journal of Surgical Oncology 130, no. 5 (2024): 1111-1118, https://doi.org/10.1002/jso.27815.
Boost Approaches in Patients Undergoing Postoperative Radiotherapy.
Pepin A, Almeida ND, Fung-Kee-Fung S … +3 more , Kassick M, Taunk NK, Freedman GM
J Surg Oncol · 2026 May · PMID 41797304 · Full text
The use of breast conservation surgery for early-stage breast cancer is common, and adjuvant radiotherapy is often recommended to reduce the risk of ipsilateral breast tumor recurrence. Historical trials have used sequen...
The use of breast conservation surgery for early-stage breast cancer is common, and adjuvant radiotherapy is often recommended to reduce the risk of ipsilateral breast tumor recurrence. Historical trials have used sequential boost techniques with favorable outcomes with reduction in local recurrence and acceptable cosmetic outcomes. In recent years, there has been renewed interest in incorporating a concurrent tumor bed boost to reduce the number of radiation treatments delivered. This focused review summarizes the literature surrounding the indications, outcomes, and treatment planning considerations for radiation tumor bed boost for early-stage breast cancer patients.
The Impact of Institutional Volume of Endoscopic Resection on Early-Stage Gastric Cancer Outcomes.
Salehi O, Somasundar P, Espat NJ … +4 more , Calvino AS, Ali M, Lightfoot S, Kwon S
J Surg Oncol · 2026 Mar · PMID 41797302 · Publisher ↗
BACKGROUND: Endoscopic resection (ER) is increasingly utilized for early gastric cancer (EGC) due to its minimally invasive profile and comparable survival to gastrectomy (GR). However, concerns regarding oncologic effic...
BACKGROUND: Endoscopic resection (ER) is increasingly utilized for early gastric cancer (EGC) due to its minimally invasive profile and comparable survival to gastrectomy (GR). However, concerns regarding oncologic efficacy and institutional volume impact persist. This study evaluates how ER volume quartiles impact outcomes and guideline adherence in EGC management. METHODS: A retrospective analysis of the NCDB from 2010 to 2021 for patients with cT1aN0M0 gastric adenocarcinoma was performed comparing ER and GR. Primary outcomes were oncologic outcomes, rates of guideline adherence, and survival stratified by institutional ER volume tertiles (high, mid, low). Multivariable logistic, linear regression, and Cox proportional hazards models were used. RESULTS: A total of 1461 patients were analyzed; 937 (61.4%) undergoing ER and 524 (35.7%) GR. 57.5% of ER occurred in the latter half of the study time period, and increasing proportional ER utilization in EGC was observed over time. When stratified by ER volume tertiles, margin positivity (14.6% high volume vs. 13.7% mid vs. 15.5% low, p = 0.85), LVI rates (6.3% high vs. 9.5% mid vs. 9.7% low, p = 0.32), guideline discordant care (22.6% high vs. 22.3% mid vs. 24.3% low, p = 0.82), and survival (vs. low volume: high HR 1.04, p = 0.87; mid HR 1.27, p = 0.39) did not differ by institutional ER volume. High-volume centers preferentially used ER (OR 1.76, p < 0.01) compared to low and mid-volume centers. Guideline-discordant ER correlated with earlier years (OR 0.69, p = 0.03) but not institutional volume (vs. low volume: high OR 0.94, p = 0.76; mid OR 0.90, p = 0.61). CONCLUSION: ER for EGC is rapidly expanding across US institutions at all volume levels. ER achieves comparable oncological outcomes and survival independent of ER volume when guideline-concordant criteria are met, suggesting centralization may be unnecessary for EGC. The guideline discordant care rate of ~24% across all institutions highlights the need for adherence to ER criteria for EGC.
Universal Risk Stratification in Stage I-III Cutaneous Melanoma Using 31-gene Expression Profiling: A Single-Center Study.
Gehle DB, Morgan PW, Fitts EM … +8 more , Hauser NL, Olson CR, Fleming AM, Freitas JP, Liu-Smith F, Nouer SS, Murphy AJ, Fleming MD
J Surg Oncol · 2026 Mar · PMID 41797300 · Publisher ↗
BACKGROUND: Patients with early-stage cutaneous melanoma (CM) have low individual risk but account for most distant recurrences. The utility of gene expression profiling (GEP) in CM risk stratification and clinical manag...
BACKGROUND: Patients with early-stage cutaneous melanoma (CM) have low individual risk but account for most distant recurrences. The utility of gene expression profiling (GEP) in CM risk stratification and clinical management remains unclear. METHODS: From 2015 to 2022, CM patients at a single center were universally referred for DecisionDx 31-GEP. Patients with prior recurrence or not undergoing excision were excluded. The Kaplan-Meier method and Cox proportional hazards models were used to evaluate primary outcomes of recurrence-free survival (RFS), distant metastasis-free survival (DMFS), and melanoma-specific survival (MSS). Secondary outcomes were sentinel lymph node biopsy (SLNB) positivity and recurrence subtype events. RESULTS: 689 patients were analyzed: 63% GEP Class 1A, 16.1% Class 1B/2A, 16.1% Class 2B, and 4.8% unclassified. After staging, 86.6% were stage I/II and 13.4% stage III. Median follow-up was 4.85 years. On multivariable analysis, GEP remained significantly predictive of RFS (Class 1B/2A HR = 4.022; Class 2B HR = 3.052), DMFS (Class 1B/2A HR = 4.403; Class 2B HR = 3.729), and MSS (Class 1B/2A HR = 6.656; Class 2B HR = 11.583) (p < 0.05 for all). Older Class 1A patients with indication for SLNB had lower SLNB positivity (2.8% ≥ 65 years, 0% ≥ 75 years). CONCLUSIONS: Our data show GEP remains a robust predictor of recurrence and MSS after adjusting for clinicopathologic factors overall but is not predictive for all outcomes in stage-stratified analyses, particularly Stage II disease. Stage IA patients should forgo GEP altogether testing due to its futility in this population. Older patients with low-risk GEP may be candidates for avoidance of SLNB given lower positivity rates. GEP Class 2B patients represent a relatively high-risk population regardless of SLNB status.
Research Progress on Financial Toxicity in Bladder Cancer Patients.
Mengyan J, Jun Q, Wen L … +2 more , Tingting P, Liyuan W
J Surg Oncol · 2026 Apr · PMID 41797296 · Publisher ↗
Bladder cancer, the most prevalent urinary system malignancy, is characterized by high recurrence rates and prolonged treatment. While therapeutic advances have substantially improved survival, they have also heightened...
Bladder cancer, the most prevalent urinary system malignancy, is characterized by high recurrence rates and prolonged treatment. While therapeutic advances have substantially improved survival, they have also heightened the prominence of financial toxicity (FT)-a treatment-related economic burden that severely impairs the quality of life of patients and their families. This review synthesizes evidence on the prevalence, influencing factors, impact on health outcomes, and management strategies of FT in bladder cancer, offering insights for individualized clinical support and health policy refinement. Future research should broaden study populations, employ diverse methodologies, and develop healthcare system-specific interventions to establish a comprehensive FT management framework.
Clinical Features of Solitary Fibrous Tumor: Insights From a Single Center Experience.
Zhou C, Zhang L, Wang H … +3 more , Cao Y, Lan X, Zhao S
J Surg Oncol · 2026 May · PMID 41797291 · Publisher ↗
BACKGROUND AND OBJECTIVES: This study investigates the clinical characteristics, pathological features, immunohistochemical profiles, and prognostic factors of solitary fibrous tumors (SFTs) to provide insights into thei...
BACKGROUND AND OBJECTIVES: This study investigates the clinical characteristics, pathological features, immunohistochemical profiles, and prognostic factors of solitary fibrous tumors (SFTs) to provide insights into their management and prognosis. METHODS: A retrospective analysis was conducted on 43 cases of SFTs diagnosed at a single center. Patient demographics, tumor characteristics, immunohistochemical (IHC) markers, and outcomes were collected. RESULTS: Among the 43 cases, the majority of tumors were infratentorial (81%), and 60% were classified as WHO Grade 1. IHC analyses revealed high expression rates of STAT6 (62.5%), CD34 (82.5%), and Ki-67 (100%). Ki-67 demonstrated the strongest correlation with tumor grade and risk scores (r = 0.62, p < 0.001; r = 0.68, p < 0.001), indicating its role as a significant prognostic marker. CD34 and STAT6 also showed moderate correlations with tumor aggressiveness. Metastatic presentations were noted in 57.5% of cases. The study highlights the heterogeneity of SFTs and the importance of IHC markers in risk stratification. CONCLUSION: The findings underscore the utility of IHC markers, particularly Ki-67, STAT6, and CD34, in assessing the aggressiveness and prognosis of SFTs. Future studies should focus on multicenter validations, integration of advanced molecular diagnostics, and long-term follow-up to refine risk models and therapeutic strategies.
Enucleation and Esophagectomy for Esophageal Gastrointestinal Stromal Tumors: A Systematic Review.
Zhang HD, Mu MC, Yin XN … +5 more , Chen HN, Cai ZL, Shen CY, Yin Y, Zhang B
J Surg Oncol · 2026 May · PMID 41797208 · Publisher ↗
Surgery remains curative for esophageal gastrointestinal stromal tumors (GISTs), while debates persist between minimally invasive enucleation and radical esophagectomy. Limited evidence from case reports and small cohort...
Surgery remains curative for esophageal gastrointestinal stromal tumors (GISTs), while debates persist between minimally invasive enucleation and radical esophagectomy. Limited evidence from case reports and small cohorts necessitates a systematic evaluation to guide clinical decisions. This review showed that enucleation may be considered for small and low-mitotic-index esophageal GISTs with benign tendency. Despite higher R1 and tumor rupture rates, survival outcomes were comparable to esophagectomy. Enucleation, including endoscopic enucleation, was safe and effective in selected cases.
Fertility-Sparing Surgery, Treatment Strategies and Survival of Women With Malignant Ovarian Germ Cell Tumours-A Descriptive Analysis of the Arbeitsgemeinschaft für Gynäkologische Onkologie CORSETT Database.
Klar M, Moubarak M, Harter P … +17 more , Heitz F, Kommoss S, Grube M, Hartkopf AD, Roser E, Sehouli J, Braicu EI, Czogalla B, Burges A, Bossart M, Staebler A, Mayr D, Buderath P, Ihorst G, Hasanov MF, Link T, Hasenburg A
J Surg Oncol · 2026 Apr · PMID 41797204 · Publisher ↗
BACKGROUND: Malignant ovarian germ cell tumours (MOGCT) are rare tumours that disproportionally affect younger women. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) study group has established a clinico-pat...
BACKGROUND: Malignant ovarian germ cell tumours (MOGCT) are rare tumours that disproportionally affect younger women. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) study group has established a clinico-pathological database (Current Ovarian geRm cell and SEx cord stromal Tumour Treatment strategies, CORSETT) to provide an overview of the current treatment strategies and survival of MOGCT patients. METHODS: Twenty German centres provided mixed retro- and prospective data of patients with tumour specimens treated between 2001 and 2014. A second opinion pathology board reviewed the tumour specimens. Descriptive analyses of the treatment strategies and fertility outcomes were conducted. Kaplan-Meier curves were plotted for disease-free and overall survival data. RESULTS: Seventy-seven MOGCT patients were included, 36 malignant dysgerminoma (MD), 21 malignant teratoma (MT) and 20 mixed MOGCT (MM) patients. Patients had a median age of 28 (MD), 38 (MT) and 33 (MM) years and fertility-sparing surgery (FSS) was offered in most (83% MD, 81% MT and 75% MM) patients. Final FIGO stage I disease was diagnosed in 78% (MD), 81% (MT) and 60% (MM) and adjuvant systemic treatment was given to 56% (MD), 53% (MT) and 70% (MM) patients. After a median observation time of 78.2 months, 5% (MD), 14% (MT) and 45% (MM) experienced disease recurrence. Overall survival was excellent in all groups (100% MD, 100% MT and 95% MM). DISCUSSION: In this descriptive analysis, FSS was the surgical method of choice for patients with MOGCT in AGO centres without negative impact on OS. MOGCTs appeared however as a heterogeneous group of tumours with particularly high recurrence rates for patients with MM.
Surgical management of gastrointestinal stromal tumor (GIST)-Induced sarcomatosis (GISTOSIS).
Gutiérrez Fernández AI, Fernández JÁ, Spanish GIST Sarcomatosis Group
Surg Oncol · 2026 Jun · PMID 41795324 · Publisher ↗
BACKGROUND AND OBJECTIVES: The optimal management of intra-abdominal dissemination of gastrointestinal stromal tumor (GISTosis) remains unclear. We performed a multi-institutional retrospective review of patients undergo...
BACKGROUND AND OBJECTIVES: The optimal management of intra-abdominal dissemination of gastrointestinal stromal tumor (GISTosis) remains unclear. We performed a multi-institutional retrospective review of patients undergoing cytoreductive surgery (CRS) to evaluate overall (OS) and recurrence-free survival (RFS), and the impact of clinical and pathological factors. METHODS: From 2000 to 2021, 49 patients with GISTosis from 10 Spanish institutions were identified; 37 underwent CRS. Clinical and pathological data were collected, and OS/RFS were calculated using Kaplan-Meier analysis. RESULTS: Among 37 patients, 53.8% were female, 56.7% under 57 years old, and 67.5% ECOG 0. GISTosis was synchronous in 37.8%. Mean peritoneal cancer index (PCI) was 17.6. At diagnosis, 16.2% had metastases. Neoadjuvant therapy followed by adjuvant tyrosine kinase inhibitors (TKI) was used in 48.6%. Complete cytoreduction (CC-0) was achieved in 83.7%, and 21.6% received HIPEC. Major complications occurred in 13%, with 2.7% postoperative mortality. After 85.6 months' median follow-up of, recurrence occurred in 24.3% (median time to recurrence was 0.97 years). RFS at 1, 3, and 5 years was 81.1%, 75.6%, and67.6%; OS was 97.2%, 86.1% and 77.8%. CONCLUSION: CRS for GISTosis, especially with adjuvant TKI, yields favourable long-term outcomes in well-selected patients.
Biology or Technical Error? Association Between Microsatellite Instability and Positive Margins in Stage I-III Colon Cancer.
Troester A, Guidolin K, Frebault J … +5 more , Mott SL, Marmor S, Jahansouz C, Hassan I, Goffredo P
J Surg Oncol · 2026 May · PMID 41787827 · Publisher ↗
BACKGROUND: Recent Danish literature examining stage III colorectal cancer patients identified microsatellite instability (MSI) as associated with an increased risk of positive surgical margins, suggesting positive margi...
BACKGROUND: Recent Danish literature examining stage III colorectal cancer patients identified microsatellite instability (MSI) as associated with an increased risk of positive surgical margins, suggesting positive margins may reflect tumor biology rather than suboptimal technique. We sought to validate these observations using a US-based national registry. METHODS: Adults with pathologic stage I-III colon adenocarcinoma were identified in the National Cancer Database (2010-2020). RESULTS: Of 105 228 patients, 21% were stage I (24% MSI), 39% II (28% MSI), and 40% III (21% MSI). MSI status was independently associated with positive margins for stage III cancers (OR 1.10, 95% CI 1.00-1.20), but not stage I and II. Positive margins were associated with worse prognosis for stage II and III cancer (HR 1.26, 95% CI 1.17-1.36; HR 1.40, 95% CI 1.33-1.48; respectively), while MSI conferred lower risk of death for stage III cancer (HR 0.87, 95% CI 0.82-0.91), but not stage I (HR 1.02, 95% CI 0.93-1.12) or II (HR 0.96, 95% CI 0.91-1.01). CONCLUSIONS: This US cohort study confirmed prior European work suggesting MSI is associated with higher odds of positive margins in stage III colon cancer. Notwithstanding the limitations of a retrospective database, these findings suggest the need for quality improvement initiatives, including the evaluation of neoadjuvant treatments to mitigate this risk.
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