World Journal Of Surgical Oncology[JOURNAL]
Sun
200 papers
Retrospective analysis of the occurrence pattern of complications and prognostic influencing factors in elderly patients with squamous cell lung cancer after radical surgery.
You J, Lang Y, Li J
World J Surg Oncol · 2026 Jul · PMID 42400058 · Full text
OBJECTIVE: To analyze the characteristics of postoperative complications and their prognostic effects in elderly patients with squamous cell lung cancer (SqCLC) who received radical surgery, identify independent prognost...
OBJECTIVE: To analyze the characteristics of postoperative complications and their prognostic effects in elderly patients with squamous cell lung cancer (SqCLC) who received radical surgery, identify independent prognostic factors, and build an individualized survival prediction model. METHODS: This retrospective study included 260 elderly patients with SqCLC who underwent radical surgery. We collected and analyzed their clinicopathological data, postoperative complications and survival outcomes. Univariate and multivariate Cox regression analyses were used to screen prognostic factors for overall survival (OS). A nomogram for 2-year OS prediction was established and validated using receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA). RESULTS: The total incidence of postoperative complications was 38.1% (99/260), and pulmonary infection (14.6%) was the most common complication. Univariate analysis indicated that age, Eastern Cooperative Oncology Group Performance Status (ECOG PS), Charlson Comorbidity Index (CCI), 8th edition TNM stage and postoperative complications were significantly correlated with OS and progression-free survival (PFS) (all P < 0.05). Multivariate Cox regression identified advanced TNM stage (III-IV) (HR = 1.65, 95%CI 1.23-2.21, P < 0.001) and ECOG PS ≥ 2 (HR = 1.25, 95%CI 1.01-1.55, P < 0.05) as independent adverse prognostic factors for OS. Postoperative complications were significantly associated with poorer survival in univariate analysis but did not remain an independent prognostic factor in multivariate analysis. The nomogram integrating age, ECOG PS, CCI, TNM stage, and postoperative complication status yielded an area under the curve (AUC) of 0.82 (95%CI 0.77-0.87) for 2-year OS prediction, with excellent calibration and clinical net benefit. CONCLUSION: Postoperative complications are highly prevalent in elderly SqCLC patients undergoing radical surgery and are significantly associated with inferior survival outcomes in univariate analysis. The proposed postoperative nomogram can accurately predict 2-year OS, and its clinical application is restricted to postoperative scenarios, including individualized prognostic counseling, surveillance planning, and risk stratification for this patient population.
Prognostic value of the immune-inflammatory indices in osteosarcoma: a systematic review and meta-analysis.
Ni L, Zheng H
World J Surg Oncol · 2026 Jul · PMID 42393726 · Full text
BACKGROUND: Systemic inflammation plays an important role in driving tumor progression. Several inflammation-related indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lympho...
BACKGROUND: Systemic inflammation plays an important role in driving tumor progression. Several inflammation-related indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and the systemic immune-inflammation index (SII), have been proposed as prognostic biomarkers across various cancers. Nevertheless, their prognostic utility in osteosarcoma remains uncertain. This systematic review and meta-analysis was conducted to evaluate the associations between these indices and survival outcomes in patients with osteosarcoma. METHODS: We conducted a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library for articles published through 30 June 2025 that assessed the relationship between pretreatment NLR, PLR, LMR, or SII and osteosarcoma patient overall survival (OS), progression-free survival (PFS), and/or event-free survival (EFS). A random-effects model was used to pool summary hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup and sensitivity analyses were also conducted, along with publication-bias assessments. RESULTS: A total of 22 studies incorporating 57 cohort comparisons met the inclusion criteria for this meta-analysis. High NLR values were significantly associated with worse OS (HR = 1.52; 95% CI, 1.29-1.78; p < 0.0001). Similarly, high SII values were correlated with reduced OS (HR = 1.84; 95% CI, 1.05-3.21; p = 0.03), and high PLR values predicted poorer OS (HR = 1.21; 95% CI, 1.07-1.37; p = 0.002). In contrast, LMR was not significantly associated with OS (HR = 1.13; 95% CI, 0.91-1.39; p = 0.26). Of the evaluated progression endpoints, only NLR was significantly associated with shorter PFS (HR = 1.84; 95% CI, 1.04-3.25; p = 0.03). CONCLUSIONS: Pretreatment immune-inflammatory indices may have prognostic relevance in osteosarcoma, with NLR showing the most consistent association with adverse survival outcomes. Although PLR and SII were associated with poorer OS in pooled analyses, these findings should be interpreted cautiously because of substantial heterogeneity, limited study numbers, potential small-study effects, and sensitivity instability, particularly for SII. Large-scale prospective multicenter studies with standardized cut-off values are required before these indices can be incorporated into routine clinical prognostic evaluation.
Prognostic impact of lymph node ratio after suboptimal lymphadenectomy in gastric cancer: a retrospective cohort study with interaction analysis.
Aytin YE, Gorca SB
World J Surg Oncol · 2026 Jul · PMID 42393701 · Full text
BACKGROUND: Accurate prognostic stratification after gastrectomy is crucial for individualized management of gastric cancer. Although examination of at least 15 lymph nodes is recommended to ensure reliable staging, this...
BACKGROUND: Accurate prognostic stratification after gastrectomy is crucial for individualized management of gastric cancer. Although examination of at least 15 lymph nodes is recommended to ensure reliable staging, this threshold is not consistently achieved in routine practice, potentially compromising prognostic accuracy. The lymph node ratio (LNR) has been proposed as an alternative nodal metric; however, its prognostic role in the context of suboptimal lymphadenectomy remains unclear. This study aimed to evaluate the prognostic impact of LNR in patients following suboptimal lymphadenectomy and to assess whether its effectiveness is influenced by the extent of nodal dissection. METHODS: This retrospective single-center cohort study included 210 patients with non-metastatic gastric adenocarcinoma who underwent curative-intent gastrectomy between January 2016 and January 2021, with a predefined 5-year follow-up period. Suboptimal lymphadenectomy was defined as the retrieval of fewer than 15 lymph nodes. Overall survival (OS) was analyzed using Kaplan-Meier estimates and Cox proportional hazards models. Multivariable analysis was performed in the suboptimal lymphadenectomy group, and an interaction term (LNR × extent of lymphadenectomy) was evaluated in the full cohort. RESULTS: Eighty-nine patients (42.4%) underwent suboptimal lymphadenectomy. Within this group, LNR independently predicted poorer overall survival (adjusted HR 2.50, 95% CI 1.14-5.47; p = 0.022), together with increasing age. In the overall cohort, a significant interaction between LNR and the extent of lymphadenectomy was identified (p = 0.030), indicating that the prognostic impact of LNR varies according to nodal retrieval adequacy. CONCLUSIONS: LNR represents an independent prognostic factor in patients following suboptimal lymphadenectomy and interacts with the extent of nodal dissection. These findings support the incorporation of LNR into postoperative risk stratification when lymph node retrieval is inadequate.
Risk-adapted nodal evaluation in stage IA non-small cell lung cancer: a population-based competing-risk analysis.
Wang Z, Xie Y, Wang T … +2 more , Song X, Liu N
World J Surg Oncol · 2026 Jul · PMID 42387634 · Full text
BACKGROUND: The oncologic value of intensified lymph node (LN) evaluation in stage IA non-small cell lung cancer (NSCLC) remains uncertain in the era of surgical de-escalation. Although expanded nodal assessment may redu...
BACKGROUND: The oncologic value of intensified lymph node (LN) evaluation in stage IA non-small cell lung cancer (NSCLC) remains uncertain in the era of surgical de-escalation. Although expanded nodal assessment may reduce understaging, whether it is associated with meaningful survival differences in this favorable-risk population is unclear. Clarifying this issue is essential to balance oncologic adequacy and surgical burden. METHOD: We conducted a population-based cohort study using the Surveillance, Epidemiology, and End Results database and included patients with surgically treated pathologic stage IA (T1N0M0) NSCLC. The extent of nodal evaluation was quantified by the number of examined lymph nodes. Propensity score matching was used to balance baseline characteristics. Cancer-specific and other-cause death were analyzed using cumulative incidence functions and Fine-Gray competing-risk models. Prespecified subgroup analyses assessed heterogeneity of association, particularly according to tumor size. RESULTS: We included 24,215 patients, with 13,812 after matching. Intensified nodal evaluation, defined as ≥ 6 examined lymph nodes (ELNs), was associated with lower cancer-specific mortality (5-year cumulative incidence, 12.9% vs. 15.3%; absolute risk reduction [ARR] 2.4%; Gray's P < 0.001). In multivariable Fine-Gray analysis, ELNs ≥ 6 remained independently associated with lower cancer-specific mortality (subdistribution hazard ratio 0.78, 95% CI 0.74-0.83). The association was minimal in tumors ≤ 1 cm but more evident in tumors > 1 cm. Sensitivity analyses using ELNs ≥ 10 yielded similar findings. CONCLUSION: The association between intensified nodal evaluation and lower cancer-specific mortality in stage IA NSCLC varies by tumor size. This association was more evident in tumors > 1 cm, supporting further investigation of a size-based, risk-adapted approach to surgical staging in early-stage NSCLC.
Oncologic outcomes after poly-4-hydroxybutyrate scaffold in post-mastectomy breast reconstruction: a retrospective, multi-center cohort study.
Gareer H, Tchou J, Iyengar NM … +5 more , Tentoni N, Hwang ES, Movassaghi K, McCracken A, Krugman K
World J Surg Oncol · 2026 Jul · PMID 42387541 · Full text
BACKGROUND: Poly-4-hydroxybutyrate (P4HB) scaffolds are increasingly used in post-mastectomy implant-based breast reconstruction. Clinical adoption has outpaced evidence regarding oncologic outcomes and recurrence detect...
BACKGROUND: Poly-4-hydroxybutyrate (P4HB) scaffolds are increasingly used in post-mastectomy implant-based breast reconstruction. Clinical adoption has outpaced evidence regarding oncologic outcomes and recurrence detection in reconstructed breasts. METHODS: We conducted a real-world cohort study via the Guardian Research Network database (2016-2023). Female patients with breast cancer undergoing mastectomy and reconstruction were identified; 269 P4HB cases were compared with 269 stratified, randomly sampled non-P4HB controls. Primary endpoints were LRR and LRRFS; secondary endpoints included disease-specific and overall survival. Cumulative incidence functions accounted for competing risk of non-breast cancer death. Administrative censoring at 3 years (as well as time aligned cohorts) was used to mitigate temporal imbalance. RESULTS: Over a median follow-up of 2.2 years in P4HB and 5.5 years in controls, LRR was uncommon (4/269 (1.5%) vs. 6/269 (2.2%)). The 3-year cumulative incidence of LRR was 1.6% in both groups. Disease-specific mortality was rare (0.7% vs. 2.6%). No early signal of differences in locoregional recurrence was observed between groups within the observed follow‑up period. CONCLUSIONS: In this real-world, multi-center analysis, no detectable signal of increased locoregional recurrence was observed between cohorts. These findings do not establish evidence of oncologic equivalence, but rather an absence of a detectable early signal of increased risk within the observed follow-up. Larger, time-aligned datasets with plane-stratified surveillance and analyses are warranted to further evaluate oncologic outcomes given the comparator cohort included a greater proportion of earlier-era reconstructions than the P4HB cohort, reflecting more recent clinical adoption of P4HB.
Impact of reinforced pancreaticojejunostomy with or without tissue adhesive glue modified cyanoacrylate following pancreaticoduodenectomy: a randomized controlled clinical trial.
Saleh SK, Farahat MS, Mohamed TA … +1 more , Hendy MM
World J Surg Oncol · 2026 Jun · PMID 42381068 · Full text
BACKGROUND: Postoperative pancreatic fistula (POPF) remains the most significant complication following pancreaticoduodenectomy (PD). This randomized controlled trial evaluated the efficacy of reinforcing the pancreatico...
BACKGROUND: Postoperative pancreatic fistula (POPF) remains the most significant complication following pancreaticoduodenectomy (PD). This randomized controlled trial evaluated the efficacy of reinforcing the pancreaticojejunostomy (PJ) with Glubran2, a modified N-butyl-2-cyanoacrylate adhesive, in reducing the rate of clinically relevant POPF. METHODS: This single-center randomized controlled trial with blinded patients and blinded outcome assessors enrolled 100 consecutive patients undergoing open PD for pancreatic head or periampullary cancer between 15 January 2025 and 15 January 2026. Patients were randomized 1:1 to Glubran2-reinforced PJ (Glubran2 group) or conventional PJ (Control group). The primary endpoint was the rate of POPF (Grade B/C per ISGPS 2016) within the 90-day postoperative period. Operating surgeons were not blinded; ward physicians, outcome assessors and statisticians were blinded. RESULTS: POPF (Grade B/C) occurred in 3 patients (6%) in the Glubran2 group versus 11 patients (22%) in the Control group (p = 0.041; Fisher's exact test). Grade B POPF was 4% versus 16% (p = 0.092) and Grade C POPF was 2% versus 6% (p = 0.617); individual-grade comparisons were prespecified as exploratory. Overall morbidity (any complication) was 18% versus 54% (p < 0.001) and severe complications (Clavien-Dindo ≥ IIIa) were 10% versus 36% (p = 0.004). The Glubran2 group had earlier drain removal (median 6 [IQR 5-7] vs. 14 [IQR 9-18] days, p < 0.001) and shorter hospital stay (10.8 ± 3.2 vs. 19.2 ± 7.1 days, p < 0.001). On multivariable analysis, Glubran2 use was an independent protective factor (adjusted OR 0.18, 95% CI 0.06-0.54, p = 0.002), after adjustment for soft pancreatic texture and main pancreatic duct ≤ 3 mm. The effect was consistent on per-protocol and surgeon-clustered sensitivity analyses. CONCLUSIONS: In this single-center randomized trial, reinforcement of pancreaticojejunostomy with Glubran2 was associated with a significantly lower rate of POPF (Grade B/C), shorter time to drain removal, lower overall morbidity, and shorter length of hospital stay, with an acceptable safety profile. These hypothesis-generating findings warrant confirmation in an adequately sized, multicenter trial with operator-independent application before any recommendation for routine clinical adoption. TRIAL REGISTRATION: ClinicalTrials.gov NCT06756074. Registered 24 December 2024 (prospective). https://clinicaltrials.gov/study/NCT06756074 .
Correction: Antitumor efficacy and molecular mechanism of lenvatinib combined with vitamin K2 against hepatocellular carcinoma.
Zhang Y, Chen D, Qian X … +2 more , Long C, Zheng Z
World J Surg Oncol · 2026 Jun · PMID 42380908 · Full text
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Radioligand therapy, vascular deprivation and surgical resection as a step-up-approach for locally advanced pancreatic neuroendocrine bleeding mass.
Deiro G, Tancredi M, Campra D … +6 more , Discalzi A, Tutino R, Bona A, Nieri A, Bartolomei M, Santarelli M
World J Surg Oncol · 2026 Jun · PMID 42374572 · Full text
BACKGROUND: Surgery for symptomatic non-functioning pancreatic neuroendocrine tumors (NF-PanNETs) represents the only definitive curative treatment option and improves the overall survival rate. The new frontier in local...
BACKGROUND: Surgery for symptomatic non-functioning pancreatic neuroendocrine tumors (NF-PanNETs) represents the only definitive curative treatment option and improves the overall survival rate. The new frontier in locally advanced NF-PanNETs treatment is Radioligand therapy (RLT) in a neoadjuvant setting. Acute gastrointestinal bleeding is a rare complication that requires immediate treatment with a multidisciplinary approach. CASE PRESENTATION: We present a case of a 36-year-old male diagnosed with locally advanced non-functioning PanNET in the pancreatic body-tail diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). RLT, proposed to reduce mass dimension in the planning of surgical resection, was performed to obtain a downstaging tumor and enabling access to radical surgery. For the acute onset of hemorrhagic shock caused by lower gastrointestinal bleeding, tumor endovascular embolization was performed using microspheres and gelatin sponge. On vascular deprivation day 4, a posterior radical antegrade modular pancreatosplenectomy (P-RAMPS), left lateral duodenectomy (III and IV portion) and resection of the left colic flexure were performed. Reconstruction of intestinal continuity was ensured by isoperistaltic side-to-side duodeno-jejuno and colo-colic anastomosis. The patient had a short hospital stay with quick recovery and a good outcome at 6 months follow-up after the surgery. CONCLUSIONS: Symptomatic non-functioning PanNETs are infrequent slow-growing tumors and some of them may present in advanced stages with local involvement of surrounding structures. Our case suggests that a step-up-approach for locally advanced pancreatic neuroendocrine bleeding mass is mandatory and aggressive surgical management is a mainstay.
CLTC expression in oral squamous cell carcinoma: insights into prognostic value and immune microenvironment modulation.
Cui Z, Gao Y, Chen K … +2 more , Zhao J, Yang K
World J Surg Oncol · 2026 Jun · PMID 42374496 · Full text
BACKGROUND: Oral squamous cell carcinoma (OSCC) has a poor prognosis because of its high metastatic potential and frequent chemoresistance. Although CLTC is aberrantly expressed and involved in fusion events in several t...
BACKGROUND: Oral squamous cell carcinoma (OSCC) has a poor prognosis because of its high metastatic potential and frequent chemoresistance. Although CLTC is aberrantly expressed and involved in fusion events in several tumors, its role in OSCC remains poorly defined. METHODS: We integrated transcriptomic and clinical data from TCGA and GEO, scRNA-seq data, immune infiltration analysis, ligand-receptor based cell-cell communication analysis, drug sensitivity prediction, molecular docking, and in vitro functional validation to evaluate CLTC expression, prognostic value, and its association with the OSCC immune microenvironment. RESULTS: CLTC was significantly overexpressed in OSCC and several other cancers. High CLTC expression was associated with poorer survival and improved prognostic stratification when combined with tumor mutation burden (TMB). Immune analyses showed that high CLTC expression was associated with reduced CD8 + T-cell infiltration, decreased cytotoxic activity, and increased immune exclusion- and suppression-related signatures. Single-cell analysis showed that CLTC was broadly expressed across OSCC cell populations, with relatively high expression in epithelial, inflammatory epithelial, macrophage, inflammatory macrophage, and endothelial cells. Macrophage-centered communication analysis further revealed prominent MIF-, CXCL-, and SPP1-related signaling interactions between macrophages and tumor, stromal, and immune cell populations. Drug sensitivity prediction and molecular docking suggested potential associations between CLTC expression and responses to several chemotherapeutic agents, although these computational results indicate possible physical interactions rather than confirmed functional drug effects. In vitro experiments confirmed that CLTC was upregulated in OSCC tissues and that CLTC knockdown suppressed SCC25 cell proliferation, migration, and invasion. CONCLUSION: CLTC may serve as a prognostic biomarker in OSCC and may contribute to tumor progression by promoting malignant cellular phenotypes and immunosuppressive remodeling of the tumor microenvironment. Future mechanistic studies are required to determine whether CLTC directly regulates chemotherapy response through clathrin-mediated trafficking, receptor recycling, adhesion signaling, or tumor-immune interactions.
Current practices and trends of axillary surgery de-escalation and lymphedema management for breast cancer in China: a nationwide cross-sectional survey.
Zhou Y, Wang Y, Meng X … +9 more , Xiu B, Yang B, Zhang Y, Xue J, Shao ZM, Chen J, Hao S, Wu J, Chinese Anti-Cancer Association; Committee of Breast Cancer Society
World J Surg Oncol · 2026 Jun · PMID 42374488 · Full text
BACKGROUND: Axillary management in breast cancer has evolved toward de-escalation to reduce complications, particularly breast cancer-related lymphedema (BCRL). This study aimed to assess current practices and trends of...
BACKGROUND: Axillary management in breast cancer has evolved toward de-escalation to reduce complications, particularly breast cancer-related lymphedema (BCRL). This study aimed to assess current practices and trends of axillary surgery and BCRL management in China. METHODS: A nationwide survey was conducted across hospitals performing ≥ 200 breast cancer surgeries annually in 2022. The questionnaire evaluated institutional characteristics, clinical practices of axillary surgery and BCRL care. Data were compared with those from the 2017 national survey involving 110 hospitals to assess temporal changes in hospital-reported practice patterns. RESULTS: The 198 hospitals surveyed performed a total of 123,237 breast cancer surgeries in 2022. SLNB for cN0 patients was routine practice, with 59.6% of hospitals performing SLNB in > 90% of these cases, whereas the use of SLNB in patients with clinically suspicious axillary nodes and FNA-confirmed metastasis remained cautious. The omission of ALND for patients with limited SLN metastasis (1-2 positive SLNs) remained conservative, particularly for mastectomy cases. However, significant increases were observed compared with the 2017 survey (breast-conserving surgery: median 30.0% vs. 9.0%, P = 0.001; mastectomy: median 11.0% vs. 6.6%, P < 0.001). The timing of SLNB in patients receiving neoadjuvant chemotherapy (NAC) shifted toward the post-NAC setting compared with 2017 (54.0% vs. 45.5%). Comprehensive assessment after NAC, including targeted axillary dissection (TAD) with dual-tracer mapping, was underutilized (23.7%). Hospital-reported BCRL care teams had been established in 52.0% of hospitals, while surgical BCRL interventions remained rare (11.6%). CONCLUSION: Compared with the 2017 national survey, hospital-reported adoption of axillary de-escalation strategies in China was broader, although implementation remained cautious and uneven across clinical scenarios and institutional settings. As a hospital-level practice-mapping survey, this study describes implementation patterns rather than patient-level oncologic safety or efficacy. These findings suggest that tracer accessibility, evidence-based protocols, and multidisciplinary BCRL care may be important areas for future improvement.
Silencing of ELFN1-AS1 induces prostate cancer cell apoptosis and autophagy by regulating miR-28-5p/BCAM axis.
Luo S, Gui D, Guo Y … +4 more , Xu Z, Fang Z, Huang G, Wu W
World J Surg Oncol · 2026 Jun · PMID 42374482 · Full text
BACKGROUND: Prostate cancer (PCa) is the most frequently diagnosed non-cutaneous malignancy in men worldwide and constitutes a leading contributor to cancer-related mortality globally. This study aimed to investigate the...
BACKGROUND: Prostate cancer (PCa) is the most frequently diagnosed non-cutaneous malignancy in men worldwide and constitutes a leading contributor to cancer-related mortality globally. This study aimed to investigate the biological functions and molecular mechanisms of long noncoding RNA ELFN1-AS1 in regulating PCa cell phenotypes. METHODS: ELFN1-AS1 expression in PCa cells was quantified via RT-qPCR analysis. CCK-8, Transwell, and flow cytometry analysis were carried out to measure PCa cell viability, invasion, and apoptosis. Monodansylcadaverine staining was used to visualize and assess autophagosome formation in PCa cells. Western blot analysis was performed to measure protein levels of apoptotic markers, autophagic markers, and the downstream factor basal cell adhesion molecule (BCAM). The binding relationship among ELFN1-AS1, miR-28-5p, and BCAM were validated by luciferase reporter assay and RNA immunoprecipitation assays. RESULTS: The results demonstrated that ELFN1-AS1 and BCAM were highly expressed in PCa cells, while miR-28-5p expression was downregulated compared with normal prostate epithelial cells. Silencing of ELFN1-AS1 effectively reduced optical density values and numbers of invaded cells while concurrently elevating apoptotic proportion. Moreover, ELFN1-AS1 knockdown promoted the formation of autophagosomes and increased LC3II/LC3I ratio. Importantly, ELFN1-AS1 acted as a molecular sponge for miR-28-5p to regulate BCAM expression. Additionally, the inhibitory effects of ELFN1-AS1 depletion on the malignant biological behaviors of PCa cells were notably reversed by BCAM overexpression. CONCLUSION: Our findings indicate that the silencing of ELFN1-AS1 promotes PCa cell apoptosis and autophagy by interacting with miR-28-5p to regulate BCAM expression.
Application of an innovative embedded parallel pancreaticojejunostomy technique in laparoscopic pancreaticoduodenectomy.
Li X, Chen H, Duan H … +4 more , Ye Q, Wang J, Wang H, Qiu K
World J Surg Oncol · 2026 Jun · PMID 42366403 · Full text
OBJECTIVE: To investigate the clinical value of an innovative embedded parallel pancreaticojejunostomy technique for laparoscopic pancreaticoduodenectomy. METHODS: We retrospectively analyzed the clinical data of 108 pat...
OBJECTIVE: To investigate the clinical value of an innovative embedded parallel pancreaticojejunostomy technique for laparoscopic pancreaticoduodenectomy. METHODS: We retrospectively analyzed the clinical data of 108 patients who underwent successful laparoscopic pancreaticoduodenectomy at The Affiliated Lihuili Hospital of Ningbo University, from January 2016 to July 2025. Patients were divided according to the type of pancreaticojejunostomy: the experimental group (n = 57) underwent an embedded parallel pancreaticojejunostomy, while the control group (n = 51) underwent duct-to-mucosa pancreaticojejunostomy. The baseline characteristics, tumor features, intraoperative and postoperative conditions, and complications were compared between the two groups. And through a multivariate logistic regression model, the independent effects of the surgical groups (experimental group, control group) were evaluated. RESULTS: The incidence of grade B/C postoperative pancreatic fistula in the experimental group (5.3%) was significantly lower than that of the control group (19.6%), and the difference was statistically significant (P < 0.05). The pancreaticojejunostomy time (21.33 ± 2.73 min), postoperative drainage tube removal time (14.00, 10.00-17.50 days), and postoperative hospitalization (16.00, 12.50-21.00 days) in the experimental group were all significantly shorter than those in the control group (31.43 ± 2.30 min; 17.00, 11.00-28.00 days; 20.00, 13.00-29.00 days, respectively; all P < 0.05). There were no significant differences (P > 0.05) between the two groups in age, American Society of Anesthesiologists, Fistula Risk Score, main pancreatic duct diameter, sex, body mass index, pathological type, maximal tumor diameter, pancreatic texture, intraoperative margin status, lymph node metastasis, operative time, intraoperative blood loss, delayed gastric emptying, or postoperative bleeding. And the intervention measure (experimental group, control group) was independent protective factors for reducing postoperative pancreatic fistula (OR=0.19, 95% Cl, 0.05-0.75, P < 0.05). CONCLUSION: The embedded parallel pancreaticojejunostomy technique can effectively reduce the incidence of postoperative pancreatic fistula and shorten pancreaticojejunostomy time. This technique is a simple and effective new method for pancreaticojejunostomy and is worthy of application in laparoscopic pancreaticoduodenectomy.
Identification and validation of stemness-associated hub genes in cervical cancer: a bioinformatics and experimental study.
Kabekkodu SP, Rodrigues AF, Hebbar P … +1 more , Bhat S
World J Surg Oncol · 2026 Jun · PMID 42365339 · Full text
Cancer stem cells (CSCs) are a subpopulation with self-renewal and differentiation capacity that drive the progression, recurrence, and therapeutic resistance of patients with cervical cancer (CC). However, the complete...
Cancer stem cells (CSCs) are a subpopulation with self-renewal and differentiation capacity that drive the progression, recurrence, and therapeutic resistance of patients with cervical cancer (CC). However, the complete set of genes that maintain stemness in CC remains incompletely defined. We aimed to identify key stemness-related genes and evaluate their prognostic utility, immune associations, and drug sensitivity. Through literature mining and CellMarker 2.0, we identified 1345 stemness-associated genes that overlapped with differentially expressed genes (DEGs) from the TCGA-CESC dataset (log2FC > 2, p < 0.05), yielding 216 stemness-related DEGs. A protein-protein interaction network (STRING) and CytoHubba (MCC algorithm) revealed ten hub genes (HGs): CCNB1, CCNA2, BUB1B, UBE2C, KIF11, CCNB2, KIF23, CDC20, CDC6, and FOXM1. Gene ontology and KEGG analyses revealed predominant enrichment in cell cycle progression. Cox regression and Kaplan‒Meier analyses identified BUB1B, CCNA2, CDC20, FOXM1, and KIF23 as risk factors for poor overall survival, with KIF11 emerging as an independent prognostic factor. HGs overexpression significantly correlated with altered infiltration of 15 immune cell types, including negative associations with CD8 + T and NK cells. We identified 661 unique drugs/chemicals targeting these HGs, including FDA-approved repurposed agents. Experimental validation via RT‒PCR confirmed significant overexpression of FOXM1 and KIF11 in CC tissues and cell lines compared with normal samples. These stemness-associated HGs, particularly FOXM1 and KIF11, may serve as potential prognostic biomarkers and therapeutic targets, warranting further investigation of stemness-driven CC progression.
Long non-coding RNA SOCS2-AS1 inhibits gastric cancer progression via the miR-324-3p/GRIK3 axis: a mechanistic study.
Zhang H, Xia Z, Xu Y … +1 more , Ouyang X
World J Surg Oncol · 2026 Jun · PMID 42351223 · Full text
BACKGROUND: Gastric cancer (GC) remains a formidable threat to global health. Although SOCS2-AS1 is abnormally expressed in various cancers, its precise function and operational mechanisms in the context of GC have not b...
BACKGROUND: Gastric cancer (GC) remains a formidable threat to global health. Although SOCS2-AS1 is abnormally expressed in various cancers, its precise function and operational mechanisms in the context of GC have not been fully elucidated. METHODS: This study collected 102 pairs of GC and adjacent normal tissue samples and cultured multiple GC cell lines. SOCS2-AS1, miR-324-3p, and glutamate ionotropic receptor kainate type subunit 3 (GRIK3) expression were detected by qRT-PCR. Bioinformatics analysis was performed using databases such as GEPIA and Starbase. Functional experiments including CCK-8 assay and Transwell assay were conducted to evaluate cellular functions. Subcellular localization was determined using nuclear-cytoplasmic separation technology. Direct molecular interactions were validated via dual luciferase reporter assays. RESULTS: The downregulation of SOCS2-AS1 in GC tissues and cell lines is significantly associated with an unfavorable patient prognosis. Overexpression of SOCS2-AS1 markedly suppressed GC cell proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) progression. Mechanistic studies revealed that SOCS2-AS1 targets miR-324-3p. and re-expression experiments confirmed its ability to reverse the anti-cancer effects of SOCS2-AS1. GRIK3 was identified as a direct downstream target of miR-324-3p. Ultimately, SOCS2-AS1 exerts its tumor-suppressive function through the miR-324-3p/GRIK3 axis. CONCLUSION: This research identifies SOCS2-AS1 as an anti-cancer lncRNA in GC and uncovers its mechanism of action via the SOCS2-AS1/miR-324-3p/GRIK3 axis in suppressing tumor progression. Thus, SOCS2-AS1 may serve as a potential diagnostic biomarker and therapeutic target for GC.
Tertiary lymphoid structures in breast cancer: Mechanistic insights, subtype-specific patterns, and therapeutic implications.
Liang Y, Wu K, Pan L … +4 more , Jia M, Zhang W, Zhang X, Gao J
World J Surg Oncol · 2026 Jun · PMID 42351178 · Full text
Breast cancer exhibits substantial molecular and immunological heterogeneity, with tertiary lymphoid structures (TLSs) emerging as key modulators of local antitumor immunity. TLSs display subtype-specific prevalence and...
Breast cancer exhibits substantial molecular and immunological heterogeneity, with tertiary lymphoid structures (TLSs) emerging as key modulators of local antitumor immunity. TLSs display subtype-specific prevalence and maturity, with mature TLSs enriched in triple-negative (TNBC) and human epidermal growth factor receptor 2-positive (HER2+) tumors, correlating with improved prognosis, response to neoadjuvant therapy, and sensitivity to immune checkpoint inhibitors, whereas hormone receptor-positive (HR+) tumors often lack organized TLSs and show limited immunogenicity. TLS formation is orchestrated by cytokine-chemokine networks, lymphoid tissue organizer/inducer interactions, and vascular remodeling via high endothelial venules, yet the regulatory mechanisms and functional heterogeneity across subtypes remain incompletely understood. Detection strategies range from histopathology and multiplex immunohistochemistry to spatial transcriptomics and radiomics, but standardization, reproducibility, and clinical scalability remain major hurdles. Emerging interventions-including chemotherapy, immune checkpoint blockade, chemokine delivery, and combinatorial strategies-can induce or mature TLSs, offering potential therapeutic leverage, yet safety, phenotypic fidelity, and context-dependent efficacy require careful evaluation. Collectively, TLSs represent a dynamic, therapeutically targetable component of the tumor microenvironment; however, translating TLS biology into precision immuno-oncology demands mechanistic insight, standardized assessment, and integration with spatial multi-omic frameworks to inform subtype-specific, clinically actionable strategies.
A fatty acid metabolism-based deep learning model predicts biochemical recurrence and identifies NUDT19 as a candidate metabolic factor in prostate cancer.
Wang C, Zhu LJ, Zhang Y … +7 more , Wu XF, Lei SQ, Hu SP, Sun MJ, Yu QZ, Zhou Y, Li J
World J Surg Oncol · 2026 Jun · PMID 42351175 · Full text
PURPOSE: To develop a fatty acid metabolism-based deep learning model for predicting biochemical recurrence (BCR) in prostate cancer (PCa) and to identify recurrence-associated metabolic regulators. METHODS: Transcriptom...
PURPOSE: To develop a fatty acid metabolism-based deep learning model for predicting biochemical recurrence (BCR) in prostate cancer (PCa) and to identify recurrence-associated metabolic regulators. METHODS: Transcriptomic data from TCGA and GEO GSE70769 were integrated to identify fatty acid metabolism-related genes and construct a deep learning model for BCR prediction. Tumor-infiltrating lymphocytes (TILs) were quantified from H&E-stained slides using a convolutional neural network-based approach. Single-cell RNA sequencing data were analyzed to identify candidate metabolic regulators enriched in malignant epithelial cells. Immunohistochemistry was performed to examine the protein expression patterns of NUDT19 and its expression associations with key fatty acid metabolism enzymes, including FASN, ACACA, and CPT1A. Functional roles were further evaluated using in vitro assays, xenograft models, and serum metabolomics. RESULTS: The model effectively stratified PCa patients into high- and low-risk groups with distinct BCR-free survival outcomes. The high-risk group showed increased TIL infiltration, suggesting a more immune-infiltrated or inflammatory tumor microenvironment. Integrated single-cell and bulk transcriptomic analyses identified NUDT19 as a candidate metabolic regulator predominantly expressed in malignant epithelial cells and positively correlated with FASN, ACACA, and CPT1A. NUDT19 knockdown suppressed PCa cell proliferation, migration, and invasion, induced apoptosis, and inhibited tumor growth in vivo. Serum metabolomics further revealed that differential metabolites were enriched in fatty acid metabolism-related pathways. CONCLUSIONS: This study establishes a fatty acid metabolism-based deep learning model for BCR prediction and identifies NUDT19 as a candidate metabolic regulator associated with lipid metabolic remodeling and PCa progression. These findings suggest a metabolically active, inflammation-associated recurrence subtype and support further investigation of NUDT19 as a potential therapeutic target in PCa.
A pathological morphology parameter-based prognostic nomogram for high-risk prostate cancer patients treated with neoadjuvant therapy followed by radical prostatectomy: a retrospective study.
Liang H, Fan J, Xu K … +8 more , Song H, Gan C, Wang G, Kang Q, Liu J, He D, Fan J, Wu K
World J Surg Oncol · 2026 Jun · PMID 42343460 · Full text
BACKGROUND: The prognostic value of these pathological morphology alterations induced by neoadjuvant therapy in high-risk prostate cancer (PCa) patients is still unclear. Hence, this study retrospectively reviewed the da...
BACKGROUND: The prognostic value of these pathological morphology alterations induced by neoadjuvant therapy in high-risk prostate cancer (PCa) patients is still unclear. Hence, this study retrospectively reviewed the data of 124 patients with high-risk PCa who underwent neoadjuvant therapy followed by radical prostatectomy (RP), and aimed to explore the prognostic value of pathological morphology alterations. METHODS: Data from 124 patients with high-risk PCa who underwent neoadjuvant therapy followed by RP were retrospectively reviewed. Pathological morphology alterations observed in RP specimens were independently recorded by two uropathologists, and the primary endpoint was biochemical progression-free survival (bPFS). Cox regression analyses were performed to explore independent predictors of bPFS, and a nomogram was developed. The C-index, calibration curves and decision curve analysis (DCA) were used to evaluate the performance of the nomogram. RESULTS: Among 124 patients, 66 patients (53.2%) were treated with neoadjuvant hormonal therapy (NHT), and 58 patients (46.8%) were treated with neoadjuvant chemohormonal therapy (NCHT). Moreover, 11 patients (8.9%) had a complete reduction in glandular density and diameter, and intraductal carcinoma of the prostate (IDC-P) was observed in 8 patients (6.5%). Cox regression revealed that NHT, pelvic lymph node (LN) metastasis, positive surgical margins, negative reduction in glandular density and diameter, and IDC-P were associated with worse bPFS (all P < 0.05), and those factors were subsequently selected to develop a nomogram. The C-index was 0.813 (95% CI: 0.626-0.863), and time-dependent C-index were 0.902 (6 months), 0.882 (12 months), and 0.951 (24 months). The calibration curves showed a high consistency between the predicted and observed bPFS probabilities, and DCA confirmed the nomogram's clinical utility across a range of threshold probabilities. CONCLUSIONS: Pelvic LN metastasis, positive surgical margins and IDC-P were independent prognostic factors for high-risk PCa, and NCHT might significantly improve bPFS compared with the NHT. In addition, the degree of reduction in glandular density and diameter was also associated with bPFS, and the nomogram based on pathological morphology parameters-intended for postoperative risk stratification-might be helpful in clinical decision-making. TRIAL REGISTRATION: Retrospectively registered.
Evaluating the prognostic significance of lymph node yield in resected pancreatic adenocarcinoma: a population-based study.
Tsai CJ, Lin PY, Ong KH … +5 more , Ho CH, Chen YC, Li CF, Yang CC, Lu CY
World J Surg Oncol · 2026 Jun · PMID 42343361 · Full text
INTRODUCTION: Surgical resection plays a pivotal role in the management of pancreatic cancer by achieving complete tumor removal and regional lymphadenectomy. Although most clinical guidelines recommend examining at leas...
INTRODUCTION: Surgical resection plays a pivotal role in the management of pancreatic cancer by achieving complete tumor removal and regional lymphadenectomy. Although most clinical guidelines recommend examining at least 15 lymph nodes for accurate staging and better prognostic assessment, the optimal threshold remains uncertain and requires validation across population-based datasets. METHODS: Using the Taiwan Cancer Registry and National Health Insurance Research Database, 885 patients with pancreatic adenocarcinoma who underwent curative resection between 2013 and 2019 were identified. Cox proportional hazards regression models were used to evaluate the association between lymph node yield (LNY ≥ 15 vs. <15) and overall survival (OS), adjusting for potential confounders. Several sensitivity analyses were performed to assess the robustness of the findings, including a subgroup analysis restricted to patients with pT1-3 pancreatic head tumors who underwent pancreatoduodenectomy. Stratified analyses were additionally performed according to pathological T and N classifications and treatment modalities. RESULTS: The median LNY was 15, with 474 patients (53.6%) having ≥ 15 nodes retrieved. Patients with adequate LNY were more likely to have tumors located in the pancreatic head, undergo pancreatoduodenectomy, and present with more advanced pT and pN stages as well as a higher number of positive nodes. No significant difference in 1- or 3-year overall survival (OS) was observed between patients with LNY ≥ 15 and those with LNY < 15 in the overall cohort. In the predefined subgroup of patients with pT1-3 pancreatic head tumors undergoing pancreatoduodenectomy, however, retrieval of ≥ 15 lymph nodes was associated with significantly improved 1- and 3-year OS compared with retrieval of < 15 lymph nodes. After adjustment for confounders, LNY ≥ 15 remained associated with improved 1- and 3-year OS in this subgroup, whereas no such association was observed in the overall cohort. Stratified analyses by pathological stage and treatment demonstrated generally consistent findings, with the most pronounced survival benefit of LNY ≥ 15 observed among patients with pT1-2 disease. CONCLUSIONS: Retrieval of ≥ 15 lymph nodes were not directly associated with improved survival in the overall cohort but was associated with better survival among patients with pT1-3 pancreatic head tumors undergoing pancreatoduodenectomy. These findings suggest that the prognostic value of the conventional 15-node threshold may vary across clinical subgroups and warrants further validation in larger population-based studies.
The crisis of manufactured scholarship: confronting AI-driven "letter-bombing" and profile inflation in medical journals.
Pandey M
World J Surg Oncol · 2026 Jun · PMID 42343338 · Full text
Post-publication peer review faces a emerging systemic vulnerability from 'letter-bombing'-the proliferation of high-volume, potentially machine-generated critiques that exploit citable correspondence units, creating a p...
Post-publication peer review faces a emerging systemic vulnerability from 'letter-bombing'-the proliferation of high-volume, potentially machine-generated critiques that exploit citable correspondence units, creating a plausible risk of academic metric inflation. Driven by the democratization of Large Language Models (LLMs), these automated submissions frequently exploit formatting loopholes to manipulate public indicators like the h-index. The problem is particularly observable in data-intensive specialties like surgical oncology, where abstract-level statistical critiques targeting complex clinical trials risk muddying translational research communication. Drawing on documented bibliometric anomalies and confirmed editorial actions, this piece discusses operational definitions of abnormal correspondence volumes and proposes a multi-layered framework. To protect the scientific record, we propose an enforceable framework for editorial boards: implementing strict metadata labeling to close indexing loopholes, verifying author history, and mandating the "Right of Simultaneous Reply" as a universal baseline publishing standard.
Triple primary synchronous liver cancer in one patient: the first case report and origin speculation through bioinformatics.
Zhou Z, Hu S, Liu T … +6 more , He D, Bu T, Mao L, Zheng X, Xie M, Shi X
World J Surg Oncol · 2026 Jun · PMID 42337761 · Full text
INTRODUCTION: A diagnosis of multiple primary liver tumors is extremely rare. Preoperative diagnosis based on imaging findings is difficult. Moreover, the clinical benefits of treatment strategies for multiple liver canc...
INTRODUCTION: A diagnosis of multiple primary liver tumors is extremely rare. Preoperative diagnosis based on imaging findings is difficult. Moreover, the clinical benefits of treatment strategies for multiple liver cancers remain unclear. Here, we report a case of three synchronous primary liver tumors with three distinct pathological types-hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular-cholangiocarcinoma (cHCC‑CCA)-in a single patient. Bioinformatics analysis supported at least two clonal origins, with cHCC‑CCA and ICC sharing a common lineage based on identical HBV integration sites. CASE PRESENTATION: A 63-year-old female with a history of hepatitis B for several years presented with three lesions in hepatic segment VIII. Multiphase magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid revealed a diagnosis of multiple lesions, namely, cHCC‑CCA, with multiple intrahepatic metastases. The AFP level was normal, while the CA 19 - 9 level was mildly elevated (normal range ≤ 30.00 U/ml). Hepatectomy was performed, and postoperative assessment confirmed that the large lesion was cHCC‑CCA. However, the small lesions close to the large lesion were HCC and ICC. Gene testing revealed distinct mutational profiles among the three tumors. Similar gene mutations were detected in cHCC‑CCA and ICC. We also found that gene fragments of hepatitis B virus-C (HBV-C) were inserted into the genomes of ICC and cHCC‑CCA rather than that of HCC. The genomic integration site of HBV-C in cHCC‑CCA and ICC was the same. CONCLUSION: We report an extremely rare case of three synchronous primary liver tumors with three distinct pathological types (HCC, ICC, and cHCC‑CCA) in a single patient. Bioinformatics analysis supported at least two clonal origins, with cHCC‑CCA and ICC sharing a common lineage based on identical HBV integration sites. Hepatectomy represents a potential radical strategy for the treatment of multiple PLCs.
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