Surgical Oncology-Oxford最新文献

{"title":"Interaction between advanced age and ASA physical status on early postoperative mortality after colorectal cancer surgery.","authors":"Nora Bredsgaard Rømer, Jesper Nors","doi":"10.1016/j.suronc.2026.102586","DOIUrl":"https://doi.org/10.1016/j.suronc.2026.102586","url":null,"abstract":"<p><strong>Background: </strong>It is unknown whether the preoperative anesthesiological risk assessment interacts with patient age in colorectal cancer (CRC) to increase the risk of early postoperative mortality beyond that explained by the independent effects of age and anesthesiological risk assessment.</p><p><strong>Methods: </strong>We conducted a nationwide cohort study (2014-2023) of all Danish non-metastatic CRC patients (UICC pathological TNM I-III) aged 70 or more years at time of surgery (n = 15,673). To analyse perioperative risk, we used the American Society of Anesthesiologists (ASA) Physical Status Classification system score. The study cohort was stratified by age at CRC surgery (70-79, 80+) and ASA classification (I, II, III). We estimated mortality rates per 1000 person-days, and calculated interaction contrasts as a measure of the excess mortality rate not explained by the independent effects of age or ASA classification.</p><p><strong>Results: </strong>90-day overall survival was lower in patients aged ≥80 years compared with those aged 70-79 years (94.0% vs. 97.9%). Increasing ASA classification was associated with progressively lower survival, with 90-day survival of 98.9% for ASA I, 97.9% for ASA II, and 93.1% for ASA III. Interaction analyses demonstrated that the combined effect of age and ASA classification exceeded their independent effects, with interaction contributing 21% of the mortality rate in ASA II patients aged ≥80 years and 36% in ASA III patients aged ≥80 years.</p><p><strong>Discussion: </strong>Old CRC patients assessed as ASA III have a high risk of perioperative mortality and may benefit from risk factor reductions or high intensity postoperative monitoring to reduce mortality.</p>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"69 ","pages":"102586"},"PeriodicalIF":2.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic thyroidectomy using Artificial Intelligence (AI) model in real-time recognizing Recurrent Laryngeal Nerves (RLN)","authors":"Hongyu Wang ,&nbsp;Rui Sun ,&nbsp;Surong Hua","doi":"10.1016/j.suronc.2026.102356","DOIUrl":"10.1016/j.suronc.2026.102356","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Robotic surgery is gaining momentum in thyroidectomy particularly among young female patients. Swallowing, voice disorders, throat discomfort and cervical scarring represent major sources of anxiety due to social and occupational concerns. This has driven demand for precise and scarless approaches to improve safe and cosmetic outcomes to reduce psychological burden [&lt;span&gt;&lt;span&gt;1&lt;/span&gt;&lt;/span&gt;]. While endoscopic thyroidectomy has gained popularity, its technical limitations including restricted endoscopic visualization, limitation of fixed magnification, and the ‘chopstick' effect of rigid instruments compromise on precision and safety during dissection along RLN. Robotic thyroidectomy emerges as a promising alternative, offering three-dimensional high-definition images, magnification, multiple forceps articulation, tremor-stabilization function and motion scale function [&lt;span&gt;&lt;span&gt;2&lt;/span&gt;&lt;/span&gt;]. Concurrently, advances in AI-powered intraoperative image recognition are enhancing real-time identification of critical structures like the RLN during procedures, further improving surgical precision and safety [&lt;span&gt;&lt;span&gt;3&lt;/span&gt;&lt;/span&gt;,&lt;span&gt;&lt;span&gt;4&lt;/span&gt;&lt;/span&gt;].&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The video demonstrates robotic thyroidectomy in a 42-year-old female patient with a 0.6 × 0.5 × 0.5cm irregularly shaped nodule (TI-RADS 4a) at the dorsal mid-portion of the right lobe, presenting ill-defined margins, taller-than-wide sign, and capsular invasion with multiple abnormal right central lymph nodes. Ultrasound-guided fine-needle aspiration (FNA) confirmed papillary thyroid carcinoma (Bethesda Category VI) with BRAF V600E mutation positivity. Given her strong preference against cervical scarring and expressed concerns regarding postoperative voice changes, she underwent robotic thyroidectomy with a novel AI-assisted real-time RLN navigation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We performed right lobectomy with isthmusectomy and concomitant right central compartment lymph nodes dissection (CCND). The AI system provided continuous real-time guidance with robust performance across diverse surgical conditions (&lt;span&gt;&lt;span&gt;Fig. 1&lt;/span&gt;&lt;/span&gt;). Total operative time was 120 minutes with minimal blood loss. The patient experienced no postoperative hoarseness and discharged on the third postoperative day. Final pathology confirmed papillary thyroid carcinoma (classical variant) with metastatic involvement in perithyroidal and right paratracheal lymph nodes (2/5).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This video demonstrates the feasibility and safety of AI-assisted real-time recognition in dissection along RLN during robotic thyroidectomy for complex cases. This approach pioneers a robotic platform plus AI real-time navigation paradigm in conjunction with intraoperative nerve monitoring (IONM) to assist accurate identification and functional confirmation of the RLN, standardizing surgical procedures across insti","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"66 ","pages":"Article 102356"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency ablation versus surgical resection as first-line treatment for very early stage hepatocellular carcinoma: a systematic review with meta-analysis","authors":"Eduardo Freitas Viana ,&nbsp;Diego Falcão Araújo ,&nbsp;Thiago Francischetto Ribeiro ,&nbsp;Vaner Paulo da Silva Fonseca Pinheiro ,&nbsp;Rodrigo Leal Alves ,&nbsp;André Luiz Aleluia da Silva ,&nbsp;Helma Pinchemel Cotrim ,&nbsp;André Castro Lyra","doi":"10.1016/j.suronc.2026.102359","DOIUrl":"10.1016/j.suronc.2026.102359","url":null,"abstract":"<div><h3>Background</h3><div>The optimal first-line treatment for single hepatocellular carcinoma (HCC) ≤ 2 cm, radiofrequency ablation (RFA) or surgical resection (SR), remains unclear. We performed a systematic review and meta-analysis to compare oncological outcomes, morbidity, and mortality rates.</div></div><div><h3>Methods</h3><div>Indexed published studies comparing RFA and SR were systematically searched in the PubMed, Embase, Scopus, and Cochrane Library databases. The outcomes evaluated included overall survival (OS), recurrence-free survival (RFS), and rates of recurrence, morbidity, and mortality. Hazard ratios (HR) and 95% confidence intervals (CI) were used to assess the outcomes.</div></div><div><h3>Results</h3><div>Fourteen studies (3551 patients), one randomized controlled trial (RCT), and 13 retrospective cohorts were included. No statistically significant difference was observed for the 1-year OS (HR: 1.30, CI: 0.56–3.02, p = 0.54). The OS at 3 and 5 years was significantly greater after SR than after RFA (HR: 2.28, CI: 1.38–3.75, p = 0.001; and HR: 1.66, CI: 1.29–2.15, p = 0.0001, respectively). The RFS at 1, 3, and 5 years was also greater after SR than after RFA (HR: 2.21, CI: 1.31–3.72, p = 0.003; HR: 2.07, CI: 1.50–2.85, p &lt; 0.001; and HR: 1.66, CI: 1.29–2.15, p &lt; 0.001, respectively). The 5-year recurrence rate was higher after RFA than after SR (HR: 1.58, CI: 1.13–2.21, p = 0.008). Insufficient data were available to measure the postoperative outcomes.</div></div><div><h3>Conclusion</h3><div>As a first-line treatment for very-early-stage HCC, SR is likely associated with better oncological outcomes than RFA. Further RCTs are required to validate this finding.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102359"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards real time AI-augmented fluorescence-guided surgery: Evidence and translational readiness across neurosurgical, gynaecological, and thoracic oncology","authors":"Omar Shafi ,&nbsp;Mirkomol Mirzarakhimov ,&nbsp;Siena Martin ,&nbsp;Darcy Gabriel ,&nbsp;Un Hou Chan ,&nbsp;Saurabh Phadnis ,&nbsp;Hasan Asif ,&nbsp;Mauro Camacho","doi":"10.1016/j.suronc.2026.102364","DOIUrl":"10.1016/j.suronc.2026.102364","url":null,"abstract":"<div><div>Fluorescence-guided surgery (FgS) is increasingly used across oncologic specialties to enhance intraoperative visualisation of tumour tissue and lymphatic drainage; however, its clinical impact remains limited by heterogeneous tracer uptake, variable signal intensity, and reliance on subjective visual interpretation, leading to inter-operator variability, uncertainty at tumour margins, residual disease, and inconsistent nodal assessment. This narrative review examines the role of artificial intelligence (AI) in addressing these limitations, synthesising evidence published between January 2000 and December 2025 across neuro-oncology, gynaecological oncology, and thoracic oncology. In neuro-oncology, early clinical and preclinical studies have directly evaluated real-time AI-enhanced interpretation of intraoperative fluorescence, including quantitative analysis of 5-aminolevulinic acid (5-ALA) and hyperspectral imaging, providing proof-of-concept evidence that AI can augment margin detection beyond subjective visual assessment. In contrast, gynaecological and thoracic oncology currently lack validated studies in which AI directly interprets intraoperative fluorescence signals, despite fluorescence imaging being clinically established in both fields; instead, AI development in these specialties has progressed primarily in adjacent domains such as radiomics, digital pathology, risk stratification, surgical planning, and intraoperative computer vision, demonstrating technical maturity but limited integration into fluorescence-guided decision-making. Overall, the available evidence supports proof-of-concept feasibility for real-time AI-enhanced fluorescence interpretation in neuro-oncology, while identifying a clear translational gap in gynaecological and thoracic oncology that warrants targeted research to integrate existing AI capabilities into intraoperative fluorescence-guided surgery.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102364"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological outcomes of concurrent nephroureterectomy during radical cystectomy: A propensity score-matched analysis with multivariable adjustment from Korean multicenter database","authors":"Sang Hun Song ,&nbsp;Jong Ho Park ,&nbsp;Sangchul Lee ,&nbsp;Seung-Hwan Jeong ,&nbsp;Ja Hyeon Ku ,&nbsp;Kyung Hwan Kim ,&nbsp;Jong Kil Nam ,&nbsp;Bumjin Lim ,&nbsp;BumSik Hong ,&nbsp;Wook Nam ,&nbsp;Sung Gu Kang ,&nbsp;Seok Ho Kang ,&nbsp;Tae Gyun Kwon ,&nbsp;Tae-Hwan Kim ,&nbsp;Jieun Heo ,&nbsp;Won Sik Ham ,&nbsp;Geehyun Song ,&nbsp;Ho Kyung Seo ,&nbsp;Wan Song ,&nbsp;Hyun Hwan Sung ,&nbsp;Jong Jin Oh","doi":"10.1016/j.suronc.2026.102362","DOIUrl":"10.1016/j.suronc.2026.102362","url":null,"abstract":"<div><h3>Background</h3><div>Oncological safety and prognostic implications of concurrent nephroureterectomy (RNU) performed during radical cystectomy (RCx) for bladder cancer remain controversial due to potential selection bias in previous studies.</div></div><div><h3>Objectives</h3><div>To evaluate oncological outcomes of concurrent RNU during RCx using propensity score matching (PSM) and multivariable Cox regression to minimize selection bias and identify independent prognostic factors.</div></div><div><h3>Materials and methods</h3><div>We analyzed 2944 patients who underwent RCx from a Korean multicenter database (2000-2022). Patients were stratified into RCx only (n = 2627) and concurrent RCx + RNU (n = 317) groups. PSM was performed using age, sex, BMI, ASA score, and clinical TNM stage, creating 284 matched pairs. Multivariable Cox proportional hazards regression was performed adjusting for demographic, clinical, and pathologic variables. Primary outcomes were recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS).</div></div><div><h3>Results</h3><div>After PSM, recurrence remained significantly higher in RCx + RNU (60.4% vs 40.9%, p &lt; 0.001), with 5-year RFS of 32.8% vs 51.6% (p = 0.0005). However, CSS (68.4% vs 71.6%, p = 0.408) and OS (52.9% vs 55.4%, p = 0.830) at 5 years showed no significant differences. Multivariable Cox regression confirmed that concurrent RNU was not an independent prognostic factor (RFS: HR 1.38, p = 0.106; CSS: HR 1.27, p = 0.223; OS: HR 1.11, p = 0.443). Independent adverse prognostic factors included pathologic N+ disease (CSS: HR 2.69, p &lt; 0.001; OS: HR 1.88, p &lt; 0.001), lymphovascular invasion (RFS: HR 1.81, p = 0.014; CSS: HR 1.92, p = 0.002; OS: HR 1.67, p = 0.002), and ASA score ≥3 (RFS: HR 1.85, p = 0.002).</div></div><div><h3>Conclusion</h3><div>Concurrent RNU during RCx is associated with higher recurrence rates but does not compromise cancer-specific or overall survival and is not an independent prognostic factor after adjusting for pathologic characteristics. The higher recurrence reflects more aggressive underlying disease biology rather than adverse surgical effects. One-stage concurrent RNU is oncologically safe in appropriately selected patients but necessitates intensive surveillance.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102362"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additional colectomy after endoscopic excision of malignant polyps: is it always necessary?","authors":"Mariana Marques,&nbsp;Mariana Peyroteo,&nbsp;Luís Lencastre,&nbsp;André Vale Guimarães,&nbsp;Maria João Madeira-Cardoso,&nbsp;Paula Ferreira Pinto,&nbsp;José Carlos Pereira,&nbsp;Flávio Videira,&nbsp;Joaquim Abreu de Sousa","doi":"10.1016/j.suronc.2026.102361","DOIUrl":"10.1016/j.suronc.2026.102361","url":null,"abstract":"<div><h3>Background</h3><div>Management of malignant colonic polyps following endoscopic excision remains controversial. Surgery is recommended after incomplete excision and/or in the presence of recognized risk factors. The objective of this study was to evaluate the short and long-term results of surgery following endoscopic excision of malignant colon polyps.</div></div><div><h3>Materials and methods</h3><div>We present a 6-year retrospective observational study, in a tertiary oncology center, analyzing all patients diagnosed with malignant colonic polyps after endoscopic excision, submitted to surgery between January 2015 and December 2020.</div></div><div><h3>Results</h3><div>124 patients were included. Four underwent polypectomy of 2 malignant polyps at the same time. Of the 128 endoscopic excision specimens, 75% (n = 96) were located at the sigmoid colon and 80.5% (n = 103) demonstrated more than one histological risk factor, namely, deep submucosal invasion (DSI) - &gt;1000 μm, tumor budding, histological grade 2 or 3, lymphatic, venous or perineural invasion. An R0 resection was achieved in 77 (60.16%) endoscopic specimens. Of these, 25 had a single histological risk factor, the majority of which (n = 19; 76%) presenting with DSI. Of these 25 patients (R0 with only one risk factor), none had residual disease in the surgical specimen (local or nodal), and none had recurrence of the disease.</div></div><div><h3>Conclusion</h3><div>The absence of disease in the surgical specimen after endoscopic excision in patients with an R0 endoscopic resection with a single risk factor, namely DSI, suggests that surgery can be spared in this subset of patients.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102361"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental peritoneal metastases in the setting of emergency surgery: Review of evidence and algorithm for oncologic decision-making","authors":"Silvia Guerrero-Macías ,&nbsp;Jorge Andrés Urrutia ,&nbsp;Vaneza Avila-Rodriguez ,&nbsp;Felipe González ,&nbsp;Ada Bustos-Guerrero ,&nbsp;Mauricio García-Mora","doi":"10.1016/j.suronc.2026.102365","DOIUrl":"10.1016/j.suronc.2026.102365","url":null,"abstract":"<div><h3>Background</h3><div>Incidental peritoneal surface metastases (PSM) identified during emergency surgery represent a challenging clinical scenario for surgeons. While peritoneal metastases are increasingly recognized as a regional disease amenable to cytoreductive surgery and intraperitoneal chemotherapy, guidelines for incidental findings in the emergency setting remain limited.</div></div><div><h3>Methods</h3><div>We performed a narrative, evidence-based review of PubMed, Scopus, and recent international consensus statements (2019–2025) addressing the management of PSM and their presentation in emergency surgical contexts. Relevant literature describing intraoperative strategies, diagnostic staging, and outcomes was synthesized.</div></div><div><h3>Results</h3><div>Approximately 15–30% of patients with PSM present in emergency settings. Key intraoperative principles include systematic peritoneal exploration, biopsy of representative implants, estimation of disease extent (Peritoneal Cancer Index, PCI), and avoidance of extensive resections or anastomoses that may preclude future cytoreductive procedures. When findings are unrelated to an oncologic diagnosis, treatment of the acute condition should proceed conservatively with adequate sampling. A proposed management algorithm emphasizes prioritizing stabilization, documentation, and referral to specialized PSM centers.</div></div><div><h3>Conclusions</h3><div>The incidental detection of peritoneal metastases during emergency surgery should be approached as a potentially treatable oncologic finding rather than a terminal event. Adherence to an evidence-based surgical pathway ensures proper staging and facilitates timely multidisciplinary management that may improve long-term outcomes.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102365"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic intracorporeal continuous double hand-sewn versus laparoscopic assisted extracorporeal anastomosis for left-colectomy: A single-center retrospective cohort","authors":"Jianing Yan ,&nbsp;Shiyu Hu ,&nbsp;Zhichao Ye ,&nbsp;Xiaofeng Wang ,&nbsp;Jiang Chen ,&nbsp;Wanbo Huang ,&nbsp;Yongfang Yin ,&nbsp;Jianming Xie ,&nbsp;Zhilong Yan","doi":"10.1016/j.suronc.2026.102363","DOIUrl":"10.1016/j.suronc.2026.102363","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer patients who underwent intracorporeal colectomy can complete anastomosis by hand-sewn or apparatus. Here we introduce a novel continuous double suture technique for robotic intracorporeal hand-sewn anastomosis in left-colectomy.</div></div><div><h3>Methods</h3><div>Patients were divided into robotic intracorporeal continuous double hand-sewn anastomosis (RICD) and the laparoscopic assisted extracorporeal anastomosis (LAEA) group. Intraoperative, postoperative and pathological outcomes were analyzed.</div></div><div><h3>Results</h3><div>Baseline characteristics had no differences. The overall operative and anastomotic time of RICD were significantly longer, and the incision length was notably shorter. Intraoperative blood loss in RICD was also significantly less. Postoperative complications had no differences. RICD exhibited shorter durations for the enhanced recovery after surgery. The maximum diameter of tumor had no differences, and the number of harvested lymph nodes in RICD was significantly higher.</div></div><div><h3>Conclusions</h3><div>RICD has a great potential for technical feasibility, reduced invasiveness and short-term accelerated recovery for left-colectomy requiring further large-scale studies.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102363"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The modified 5-item frailty index predicts long-term mortality after breast cancer surgery in elderly women: A five-year follow-up study","authors":"Daniel Otero-Romero ,&nbsp;Dolores Arribas-del-Amo","doi":"10.1016/j.suronc.2026.102369","DOIUrl":"10.1016/j.suronc.2026.102369","url":null,"abstract":"<div><h3>Purpose</h3><div>Frailty is a major determinant of outcomes in older adults with cancer, and its identification in surgical oncology patients provides an opportunity to enhance perioperative care. However, the association of frailty with long-term outcomes remains poorly characterized. This study evaluated the prognostic value of the modified 5-item frailty index (mFI-5) in predicting long-term survival among elderly women undergoing breast cancer surgery.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted including 290 women aged ≥70 years who underwent breast cancer surgery between 2016 and 2021. Frailty was assessed using the mFI-5 and categorized as fit (score = 0), pre-frail (score = 1), and frail (score ≥2). Long-term survival rates were analyzed across age groups, tumor subtypes, and TNM stages, stratified by mFI-5 category.</div></div><div><h3>Results</h3><div>Frailty was identified in 37.2% of patients and was strongly associated with reduced long-term overall survival (52.6% in frail vs. 88.4% in fit patients at 5 years). Multivariable Cox regression confirmed frailty as an independent predictor of mortality (HR 3.14, p = 0.003), primarily driven by non-cancer related deaths. The prognostic performance of the mFI-5 was consistent across all subgroups analyzed.</div></div><div><h3>Conclusion</h3><div>The mFI-5 is a simple and practical tool that identifies elderly women with breast cancer at increased risk of long-term mortality following surgery. Incorporating the mFI-5 into routine preoperative evaluation may facilitate improved treatment planning and outcomes.</div></div>","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102369"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HALP score as an independent prognostic biomarker for recurrence and progression in non–muscle-invasive bladder cancer: A retrospective cohort study","authors":"Adem Utlu,&nbsp;Tugay Aksakallı,&nbsp;Feyzullah Çelik,&nbsp;Ahmet Emre Cinislioğlu,&nbsp;Mehmet Sefa Altay,&nbsp;Fevzi Bedir,&nbsp;Hüseyin Kocatürk,&nbsp;İbrahim Karabulut","doi":"10.1016/j.suronc.2026.102357","DOIUrl":"10.1016/j.suronc.2026.102357","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to evaluate the prognostic utility of the HALP (Hemoglobin-Albumin-Lymphocyte-Platelet) score in predicting tumor recurrence in patients with non-metastatic bladder cancer (NMIBC) without muscle invasion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort analysis was conducted involving 428 NMIBC patients followed for at least five years. HALP scores were calculated using preoperative hemoglobin, albumin, lymphocyte, and platelet measurements. Tumor recurrence was defined as the appearance of new lesions during follow-up, while muscle invasion was classified as progression. Determinants of recurrence were investigated using multivariate logistic regression and Cox proportional hazards models. The discriminative performance of the HALP score was evaluated using ROC analysis, and recurrence-free survival was compared according to the median HALP threshold using Kaplan-Meier methodology.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The mean HALP score was significantly higher in patients without recurrence compared to those with recurrence (5.9 ± 1.3 vs. 4.6 ± 1.4; p &lt; 0.001). HALP score, along with tumor size and grade, remained an independent predictor of recurrence in multivariate analyses (HR ≈ 0.825; p &lt; 0.001). ROC analysis showed acceptable discrimination, and Kaplan-Meier curves showed significantly shorter recurrence-free survival in patients with lower HALP scores (log-rank p &lt; 0.005). Additionally, HALP values were significantly lower in patients with progression compared to those without (p = 0.006).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;HALP score is a simple, cost-effective biomarker reflecting immune nutrition status and is significantly associated with recurrence and progression in NMIBC. Inclusion of HALP in risk stratification models can improve individualized follow-up strategies and clinical decision-making processes in patients with non-invasive bladder cancer.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Structured abstract&lt;/h3&gt;&lt;div&gt;Recurrence and progression remain major clinical challenges in non–muscle-invasive bladder cancer (NMIBC), highlighting the need for reliable and cost-effective prognostic biomarkers. This retrospective cohort study included 428 patients with NMIBC who were followed for at least five years to evaluate the prognostic value of the hemoglobin–albumin–lymphocyte–platelet (HALP) score. The HALP score was calculated using preoperative laboratory parameters, and recurrence and progression were analyzed using multivariable logistic regression, Cox proportional hazards models, receiver operating characteristic analysis, and Kaplan–Meier survival analysis. Patients with recurrence exhibited significantly lower HALP scores compared with those without recurrence, and the HALP score remained an independent predictor of recurrence in multivariable analyses (HR ≈ 0.83; p &lt; 0.001). ROC analysis demonstrated acceptable discriminatory performance (AUC = 0.78), while Kaplan–Meier an","PeriodicalId":51185,"journal":{"name":"Surgical Oncology-Oxford","volume":"65 ","pages":"Article 102357"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}