Featured Articles Archive

2024 Featured Articles

October 10 - Clipping the Positive Lymph Node in Patients with Clinically Node Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: Impact on Axillary Surgery in the ISPY-2 Clinical Trial

Citation: Switalla, K.M., Boughey, J.C., Dimitroff, K. et al. Clipping the Positive Lymph Node in Patients with Clinically Node Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: Impact on Axillary Surgery in the ISPY-2 Clinical Trial. Ann Surg Oncol 31, 7249–7259 (2024). https://doi.org/10.1245/s10434-024-15792-x

Synopsis: Clip placement in positive axillary lymph node prior to NAC is increasingly common and may facilitate avoidance of ALND without negative impact on EFS. Localization of the clipped node increases likelihood of clipped node retrieval without increasing rates of ALND.

October 10 - Residual Nodal Burden After Neoadjuvant Chemotherapy in cN1 Breast Cancer Patients with Positive Nodes at Targeted Axillary Dissection

Citation: Moore, A.M., Caudle, A.S., Sun, S.X. et al. Residual Nodal Burden After Neoadjuvant Chemotherapy in cN1 Breast Cancer Patients with Positive Nodes at Targeted Axillary Dissection. Ann Surg Oncol 31, 7264–7270 (2024). https://doi.org/10.1245/s10434-024-15797-6

Synopsis: In N1 breast cancer patients after neoadjuvant chemotherapy and positive targeted axillary dissection (TAD), ~25% have additional disease on completion axillary dissection. TAD alone does not accurately define residual cancer burden (RCB) in 45% of RCB class I/II patients.

October 3 - Pretreatment Pan-Immune-Inflammation Value (PIV) in Predicting Therapeutic Response and Clinical Outcomes of Neoadjuvant Immunochemotherapy for Esophageal Squamous Cell Carcinoma

Citation: Feng, J., Wang, L., Yang, X. et al. Pretreatment Pan-Immune-Inflammation Value (PIV) in Predicting Therapeutic Response and Clinical Outcomes of Neoadjuvant Immunochemotherapy for Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 31, 272–283 (2024). https://doi.org/10.1245/s10434-023-14430-2

Synopsis: The present study explores the clinical utility and response of pretreatment pan-immune-inflammation value (PIV) to neoadjuvant immunochemotherapy (NICT) in esophageal squamous cell carcinoma (ESCC). Owing to better prognostic stratification, pretreatment PIV was found to be a novel, sensitive, and effective indicator in ESCC receiving NICT. The prognostic results of PIV need to be further verified in more and more prospective studies.

October 3 - Serum CEA as a Prognostic Marker for Overall Survival in Patients with Localized Pancreatic Adenocarcinoma and Non-Elevated CA19-9 Levels Treated with FOLFIRINOX as Initial Treatment: A TAPS Consortium Study

Citation: Doppenberg, D., Stoop, T.F., van Dieren, S. et al. Serum CEA as a Prognostic Marker for Overall Survival in Patients with Localized Pancreatic Adenocarcinoma and Non-Elevated CA19-9 Levels Treated with FOLFIRINOX as Initial Treatment: A TAPS Consortium Study. Ann Surg Oncol 31, 1919–1932 (2024). https://doi.org/10.1245/s10434-023-14680-0

Synopsis: Elevated serum CEA at baseline is associated with impaired overall survival (OS) and may be a useful tool, both for decision-making at staging and at time of response evaluation. Although serum CEA dynamics are not predictive for OS, serum CEA normalization seems to be a potentially valuable parameter but has to be investigated in larger studies.

September 26 - The Association of Mismatch Repair Status with Microscopically Positive (R1) Margins in Stage III Colorectal Cancer: A Retrospective Cohort Study

Citation: Smith, H.G., Schlesinger, N.H., Chiranth, D. et al. The Association of Mismatch Repair Status with Microscopically Positive (R1) Margins in Stage III Colorectal Cancer: A Retrospective Cohort Study. Ann Surg Oncol 31, 6423–6431 (2024). https://doi.org/10.1245/s10434-024-15595-0

Synopsis: Increasing evidence suggests that R1 margins in colorectal cancer may represent a surrogate for aggressive cancer biology. Here we find increased risks of R1 margins in deficient mismatch repair (dMMR) cancers, supporting this theory and providing further rationale for neoadjuvant immunotherapy in this patient group.

September 26 - Comparing Survival of Perihilar Cholangiocarcinoma After R1 Resection Versus Palliative Chemotherapy for Unresected Localized Disease

Citation: van Keulen, AM., Buettner, S., Olthof, P.B. et al. Comparing Survival of Perihilar Cholangiocarcinoma After R1 Resection Versus Palliative Chemotherapy for Unresected Localized Disease. Ann Surg Oncol 31, 6495–6503 (2024). https://doi.org/10.1245/s10434-024-15582-5

Synopsis: The authors report on a comparison of postoperative characteristics and overall survival between patients with perihilar cholangiocarcinoma (pCCA) who underwent an R1 resection and patients with localized pCCA who received palliative systemic chemotherapy. Study results indicate that palliative systemic chemotherapy should be considered instead of resection in patients with a high risk of both R1 resection and postoperative mortality.

September 19 - Management of Ipsilateral Breast Tumor Recurrence Following Breast Conservation Surgery for Ductal Carcinoma In Situ: A Data-Poor Zone

Citation: Diskin, B., Sevilimedu, V., Morrow, M. et al. Management of Ipsilateral Breast Tumor Recurrence Following Breast Conservation Surgery for Ductal Carcinoma In Situ: A Data-Poor Zone. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-16133-8

Synopsis: For women with ipsilateral breast tumor recurrence following breast-conserving surgery (BCS) for ductal carcinoma in situ, we found a higher rate of local re-recurrence with re-BCS compared to mastectomy but no difference in other oncologic outcomes.

September 19 - The Impact of D2 Versus D1 Lymphadenectomy in Siewert II Gastroesophageal Junction (GEJ) Cancer

Citation: Alcasid, N.J., Fink, D., Banks, K.C. et al. The Impact of D2 Versus D1 Lymphadenectomy in Siewert II Gastroesophageal Junction (GEJ) Cancer. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15623-z

Synopsis: There remains little consensus regarding the optimal lymph node harvest for Siewert II gastroesophageal junction (GEJ) cancers. For these tumors, a D2 lymphadenectomy (LAD) may lead to increased morbidity with no difference in survival compared to a D1 LAD alone.

September 12 - Understanding Barriers to Guideline-Concordant Treatment in Foregut Cancer: From Data to Solutions

Citation: Fonseca, A.L., Ahmad, R., Amin, K. et al. Understanding Barriers to Guideline-Concordant Treatment in Foregut Cancer: From Data to Solutions. Ann Surg Oncol 31, 6007–6016 (2024). https://doi.org/10.1245/s10434-024-15627-9

Synopsis: The objective of this study was to identify the underlying barriers to receipt of guideline-concordant treatment among patients with foregut cancers treated at an academic center in the Deep South through a root cause analysis approach.

September 12 - Predicting Survival in Mucinous Adenocarcinoma of the Appendix: Demographics, Disease Presentation, and Treatment Methodology

Citation: McClelland, P.H., Gregory, S.N., Nah, S.K. et al. Predicting Survival in Mucinous Adenocarcinoma of the Appendix: Demographics, Disease Presentation, and Treatment Methodology. Ann Surg Oncol 31, 6237–6251 (2024). https://doi.org/10.1245/s10434-024-15526-z

Synopsis: Mucinous adenocarcinoma of the appendix (MACA) is increasing in incidence, and survival is affected by both demographic and classical risk factors. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) may prolong survival, but this effect predominantly occurs in moderate-grade tumors.

September 5 - Hepatectomy for Perihilar Cholangiocarcinoma: Taking Sides

Citation: Soreide, K. Major Hepatectomy for Perihilar Cholangiocarcinoma: Taking Sides. Ann Surg Oncol 31, 4169–4172 (2024). https://doi.org/10.1245/s10434-024-15211-1

Synopsis: Perihilar cholangiocarcinoma represents a particular challenge to surgeons and patients alike. The challenges to lesions or biliary strictures in the liver hilum occur for several reasons and involve a number of aspects, from establishing a diagnosis, to preoperative management, surgical technical solutions, and the overall multimodal and multidisciplinary approach to disease management.

September 5 - The Top Ten Annals of Surgical Oncology Original Articles on Twitter

Citation: Jain, A.J., Schultz, K., Brainerd, M.J. et al. The Top Ten Annals of Surgical Oncology Original Articles on Twitter/X: 2020–2023. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15936-z

Synopsis: The purpose of this review is to highlight the ten ASO original articles with the most engagement on X, based on total number mentions, since the founding of the SMC. These articles encompass a wide variety of topics from various oncologic disciplines including hepato-pancreato-biliary, breast, and gynecologic surgery.

August 22 - Clinicopathological Predictors of Positive Resection Margins in Breast-Conserving Surgery

Citation: Chauhan, H., Jiwa, N., Nagarajan, V.R. et al. Clinicopathological Predictors of Positive Resection Margins in Breast-Conserving Surgery. Ann Surg Oncol 31, 3939–3947 (2024). https://doi.org/10.1245/s10434-024-15153-8

Synopsis: This study assesses the impact of the presence of ductal carcinoma in situ (DCIS) on the risk of a positive surgical resection margin following breast conserving surgery for invasive breast cancer (IBC) +/- DCIS. This study calculated the relative risk of an involved margin for IBC with a DCIS component compared to pure IBC without a DCIS component is 8.44 – 8.76 (prior estimates suggest 1.5).

August 22 - C-Reactive Protein/Albumin Ratio Is an Independent Risk Factor for Recurrence and Survival Following Curative Resection of Stage I–III Colorectal Cancer in Older Patients

Citation: Bekki, T., Shimomura, M., Hattori, M. et al. C-Reactive Protein/Albumin Ratio Is an Independent Risk Factor for Recurrence and Survival Following Curative Resection of Stage I–III Colorectal Cancer in Older Patients. Ann Surg Oncol 31, 4812–4821 (2024). https://doi.org/10.1245/s10434-024-14961-2

Synopsis: This study revealed the prognostic factors following curative resection of stage I–III colorectal cancer. Tumor factors were associated with a poor prognosis in patients aged < 70 years. By contrast, the preoperative status was mainly associated with poor prognosis in patients aged ≥ 70 years.

August 15 - Risk Factors for Recurrence After Surgery for Rectal Cancer in a Modern, Nationwide Population-Based Cohort

Citation: Doroudian, S., Osterman, E. & Glimelius, B. Risk Factors for Recurrence After Surgery for Rectal Cancer in a Modern, Nationwide Population-Based Cohort. Ann Surg Oncol 31, 5570–5584 (2024). https://doi.org/10.1245/s10434-024-15552-x

Synopsis: A study using the Swedish ColoRectal Cancer Registry explores risk factors (RFs) for locoregional (LRR) and distant recurrence (DM) in rectal cancer patients. Key factors influencing DM include pT4a, pN2b, tumour deposit, lymph node yield, and tumour level. Tailored surveillance based on RFs and stage is proposed.

August 15 - To Revise or Not Revise? Isolated Margin Positivity in Localized Pancreatic Ductal Adenocarcinoma

Citation: Elshami, M., Wu, V.S., Stitzel, H.J. et al. To Revise or Not Revise? Isolated Margin Positivity in Localized Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 31, 6170–6179 (2024). https://doi.org/10.1245/s10434-024-15616-y

Synopsis: The authors performed a hybrid analysis utilizing institutional and administrative databases to determine the proportion of isolated margin positivity in patients with resected pancreatic ductal adenocarcinoma and to estimate the fraction of patients that would potentially benefit from revising surgical margins.

August 8 - Long-Term Survival Outcomes After Minimally Invasive Surgery for Ileal Neuroendocrine Tumors

Citation: Yogo, A., Paciorek, A., Kasai, Y. et al. Long-Term Survival Outcomes After Minimally Invasive Surgery for Ileal Neuroendocrine Tumors. Ann Surg Oncol 31, 5507–5514 (2024). https://doi.org/10.1245/s10434-024-15468-6

Synopsis: This retrospective single-institution study shows MIS is an alternative to open surgery for ileal neuroendocrine tumors, achieving similar short- and long-term oncological outcomes. Bulky mesenteric mass and plan for concurrent liver resection are potential criteria for open surgery.

August 8 - Guideline-Concordant Surgical Care for Lobular Versus Ductal Inflammatory Breast Cancer

Citation: Iwai, Y., Perez-Rojas, S., Thomas, S.M. et al. Guideline-Concordant Surgical Care for Lobular Versus Ductal Inflammatory Breast Cancer. Ann Surg Oncol 31, 5929–5936 (2024). https://doi.org/10.1245/s10434-024-15540-1

Synopsis: In this national study comparing surgical treatment for lobular vs ductal inflammatory breast cancer (IBC), patients with lobular IBC were more likely to be node-negative at presentation but node-positive at surgery despite often undergoing less comprehensive nodal examination.

August 1 - Enucleation of Sporadic Insulinoma in the Posterior Side of the Head of the Pancreas: The Retrolaparoscopic Approach

Citation: Vega, E.A., Martí-Cruchaga, P., Salehi, O. et al. Enucleation of Sporadic Insulinoma in the Posterior Side of the Head of the Pancreas: The Retrolaparoscopic Approach. Ann Surg Oncol 31, 4635–4636 (2024). https://doi.org/10.1245/s10434-024-15215-x

Synopsis: This article introduces a novel retroperitoneal approach for laparoscopic enucleation of a 13mm insulinoma in the challenging posterior head of the pancreas. The technique, involving a 20ºleft tilt and precise identification of anatomical landmarks, expands the options for minimally invasive pancreatic surgery in intricate scenarios.

August 1 - Race and Odds of Surgery Offer in Small Bowel and Pancreas Neuroendocrine Neoplasms

Citation: Zarate Rodriguez, J.G., Raper, L., Sanford, D.E. et al. Race and Odds of Surgery Offer in Small Bowel and Pancreas Neuroendocrine Neoplasms. Ann Surg Oncol 31, 3249–3260 (2024). https://doi.org/10.1245/s10434-024-14906-9

Synopsis: Multivariate analysis of both SEER and NCDB revealed a race differential in the rate at which patients are offered resection for small bowel neuroendocrine neoplasms, but not for pancreas neuroendocrine neoplasms.

July 25: Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study

Citation: Zager, J.S., Orloff, M., Ferrucci, P.F. et al. Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study. Ann Surg Oncol 31, 5340–5351 (2024). https://doi.org/10.1245/s10434-024-15293-x

Synopsis: Unresectable liver metastases in uveal melanoma represent a therapeutic challenge. Liverdirected treatment with high-dose delivery of melphalan to the liver, followed by extracorporeal filtration of the drug, resulted in favorable efficacy and an acceptable safety profile.

July 25: Comparison of Postoperative Complications After Gastrectomy for Gastric Cancer with Antecolic Versus Retrocolic Reconstruction: A Population-Based Study

Citation: Junttila, A., Helminen, O., Helmiö, M. et al. Comparison of Postoperative Complications After Gastrectomy for Gastric Cancer with Antecolic Versus Retrocolic Reconstruction: A Population-Based Study. Ann Surg Oncol 31, 5263–5272 (2024). https://doi.org/10.1245/s10434-024-15415-5

Synopsis: This population-based nationwide study (n=2,063) in Finland showed no difference in the rate of anastomotic complications after antecolic versus retrocolic reconstruction after total or partial gastrectomy for gastric cancer.

July 18 - Oncologic Outcomes for Different Axillary Staging Techniques in Patients with Nodal-Positive Breast Cancer Undergoing Neoadjuvant Systematic Treatment: A Cancer Registry Study

Citation: Pfob, A., Kokh, D.B., Surovtsova, I. et al. Oncologic Outcomes for Different Axillary Staging Techniques in Patients with Nodal-Positive Breast Cancer Undergoing Neoadjuvant Systematic Treatment: A Cancer Registry Study. Ann Surg Oncol 31, 4381–4392 (2024). https://doi.org/10.1245/s10434-024-15292-y

Synopsis: The authors evaluated oncologic outcomes for axillary staging in nodal positive breast cancer after neoadjuvant treatment. Targeted approaches were non-inferior to complete axillary dissection in this real-world study. Studies with longer follow-up and quality of life are needed.

July 18 - The Value of Biological and Conditional Factors for Staging of Patients with Resectable Pancreatic Cancer Undergoing Upfront Resection: A Nationwide Analysis

Citation: Schouten, T.J., van Goor, I.W.J.M., Dorland, G.A. et al. The Value of Biological and Conditional Factors for Staging of Patients with Resectable Pancreatic Cancer Undergoing Upfront Resection: A Nationwide Analysis. Ann Surg Oncol 31, 4956–4965 (2024). https://doi.org/10.1245/s10434-024-15070-w

Synopsis: This study evaluated the prognostic value of biological and conditional factors for resectable pancreatic ductal adenocarcinoma (PDAC). Survival was worst in case of biologically unfavorable PDAC (carbohydrate antigen 19-9 >500 U/mL), suggesting CA19-9 should be considered in preoperative PDAC staging.

July 11: A Comparison of Near-Infrared Autofluorescence Findings in Benign Versus Malignant Adrenal Tumors

Citation: Bletsis, P., Akgun, E., Romero-Velez, G. et al. A Comparison of Near-Infrared Autofluorescence Findings in Benign Versus Malignant Adrenal Tumors. Ann Surg Oncol 31, 5122–5127 (2024). https://doi.org/10.1245/s10434-024-15430-6

Synopsis: Currently, intraoperative imaging modalities are unable to assist surgeons in predicting if preoperatively indeterminate adrenal tumors are benign or malignant. Near-infrared autofluorescence imaging of adrenal tumors may be able to provide that insight.

July 11: The Effect of Neoadjuvant Systemic Therapy on Surgical Outcomes After Lymph Node Dissections for Stage III Melanoma; An Australian Cohort

Citation: Zijlker, L.P., Chen, H., Spillane, A.J. et al. The Effect of Neoadjuvant Systemic Therapy on Surgical Outcomes After Lymph Node Dissections for Stage III Melanoma; An Australian Cohort. Ann Surg Oncol 31, 5324–5330 (2024). https://doi.org/10.1245/s10434-024-15274-0

Synopsis: The surgical outcomes following lymph node dissections for stage III melanoma were comparable in terms of complications, morbidity and textbook outcomes for patients who received neoadjuvant systemic therapy and upfront lymph node dissection.

June 27 - Differences in Lymph Node Metastases Patterns Among Non-pancreatic Periampullary Cancers and Histologic Subtypes: An International Multicenter Retrospective Cohort Study and Systematic Review

Citation: Uijterwijk, B.A., Lemmers, D.H., Fusai, G.K. et al. Differences in Lymph Node Metastases Patterns Among Non-pancreatic Periampullary Cancers and Histologic Subtypes: An International Multicenter Retrospective Cohort Study and Systematic Review. Ann Surg Oncol 31, 4654–4664 (2024). https://doi.org/10.1245/s10434-024-15213-z

Synopsis: This large cohort study from 24 centers across 9 countries and systematic review revealed differences in metastasis patterns among non-pancreatic periampullary cancers (NPPCs). Peripancreatic lymph node stations (13 and 17) were most commonly involved, station 12 for distal cholangiocarcinoma, stations 6 and 14 with station 14 emerging as a survival predictor. These findings emphasize the importance of standardized lymphadenectomy and pathology assessment in AAC, dCCA, and DAC, and contribute to a clearer understanding of NPPC metastatic behaviors.

June 27 - Is Robotic Surgery the Future for Resectable Esophageal Cancer?: A Systematic Literature Review of Oncological and Clinical Outcomes

Citation: Patel, N.M., Patel, P.H., Yeung, K.T.D. et al. Is Robotic Surgery the Future for Resectable Esophageal Cancer?: A Systematic Literature Review of Oncological and Clinical Outcomes. Ann Surg Oncol 31, 4281–4297 (2024). https://doi.org/10.1245/s10434-024-15148-5

Synopsis: Radical esophagectomy and perioperative chemotherapy/chemoradiotherapy are key to achieving potential cure in resectable esophageal cancer. Esophagectomy is a major surgical intervention, associated with considerable morbidity. This systematic review examines oncological and clinical outcomes associated with robot-assisted surgery for esophageal cancer.

June 20 - ASO Practice Guidelines Series: Surgical Management of Gastrointestinal (Midgut) Neuroendocrine Neoplasms

Citation: Hallet, J., Clarke, C.N. ASO Practice Guidelines Series: Surgical Management of Gastrointestinal (Midgut) Neuroendocrine Neoplasms. Ann Surg Oncol 31, 1704–1713 (2024). https://doi.org/10.1245/s10434-023-14802-8

Synopsis: With the fast pace of advancement in the field, it is important for surgical oncologists to remain updated on guidelines recommendations and suggested treatment pathways. This article reviews highlights of most recent practice guidelines for midgut (gastric, duodenal, small intestinal, and appendiceal) NETs.

June 20 - Defining the Biology of Estrogen Receptor-Low-Positive Breast Cancer

Citation: Higgins, T., Kantor, O., Harrison, B. et al. Defining the Biology of Estrogen Receptor-Low-Positive Breast Cancer. Ann Surg Oncol 31, 2244–2252 (2024). https://doi.org/10.1245/s10434-023-14835-z

Synopsis: Optimal treatment of estrogen receptor-low positive (ER-low+) breast cancer remains unknown. The majority of ER-low/HER2- tumors are basal-like with a Recurrence Score® (RS) ≥26, suggesting most patients with ER-low+ tumors would benefit from chemotherapy.

June 13 - Extent of Resection and Long-Term Outcomes for Appendiceal Adenocarcinoma: a SEER Database Analysis of Mucinous and non-Mucinous Histologies

Citation: Tsagkalidis, V., Choe, J.K., Beninato, T. et al. Extent of Resection and Long-Term Outcomes for Appendiceal Adenocarcinoma: a SEER Database Analysis of Mucinous and non-Mucinous Histologies. Ann Surg Oncol 31, 4203–4212 (2024). https://doi.org/10.1245/s10434-024-15233-9

Synopsis: In this SEER-database analysis, colectomy (versus appendectomy alone) was associated with improved disease-specific survival for subsets of patients with non-mucinous appendiceal adenocarcinoma. In contrast, colectomy was not associated with improved survival for any patient subsets with mucinous adenocarcinoma.

June 13 - The Influence of Surgical Complexity and Center Experience on Postoperative Morbidity After Minimally Invasive Surgery in Gynecologic Oncology: Lessons Learned from the ROBOGYN-1004 Trial

Citation: Lambaudie, E., Bogart, E., Le Deley, MC. et al. The Influence of Surgical Complexity and Center Experience on Postoperative Morbidity After Minimally Invasive Surgery in Gynecologic Oncology: Lessons Learned from the ROBOGYN-1004 Trial. Ann Surg Oncol 31, 4566–4575 (2024). https://doi.org/10.1245/s10434-024-15265-1

Synopsis: This study compared robotic-assisted to conventional laparoscopy in gynecologic oncology and found that poorer performance status, the type of surgery, and the experience of the surgical center impacted the risk of morbidity in patients undergoing robotic-assisted surgical procedures.

June 6 - Leg Lymphoedema After Inguinal and Ilio-Inguinal Lymphadenectomy for Melanoma: Results from a Prospective, Randomised Trial

Citation: Lee, T.S., Li, I., Peric, B. et al. Leg Lymphoedema After Inguinal and Ilio-Inguinal Lymphadenectomy for Melanoma: Results from a Prospective, Randomised Trial. Ann Surg Oncol 31, 4061–4070 (2024). https://doi.org/10.1245/s10434-024-15149-4

Synopsis: Lymphoedema is a known morbidity of lymphadenectomy for melanoma. In the 24 months after surgery, patients who underwent additional iliac dissection did not have an overall increased risk of developing leg lymphoedema compared to those who have inguinal dissection only.

June 6 - Robotic Versus Open Hepatic Arterial Infusion Pump Placement for Unresectable Intrahepatic Cholangiocarcinoma

Citation: Ten Haaft, B.H.E.A., Franssen, S., van Dorst, R.W.J.J. et al. Robotic Versus Open Hepatic Arterial Infusion Pump Placement for Unresectable Intrahepatic Cholangiocarcinoma. Ann Surg Oncol 31, 4022–4029 (2024). https://doi.org/10.1245/s10434-024-15127-w

Synopsis: This study compares perioperative outcomes of robotic versus open hepatic arterial infusion pump (HAIP) placement in patients with unresectable cholangiocarcinoma (iCCA).

May 30 - Contemporary Analysis of Reexcision and Conversion to Mastectomy Rates and Associated Healthcare Costs for Women Undergoing Breast-Conserving Surgery

Citation: Kim, Y., Ganduglia-Cazaban, C., Tamirisa, N. et al. Contemporary Analysis of Reexcision and Conversion to Mastectomy Rates and Associated Healthcare Costs for Women Undergoing Breast-Conserving Surgery. Ann Surg Oncol 31, 3649–3660 (2024). https://doi.org/10.1245/s10434-024-14902-z

Synopsis: In this retrospective cohort study, reoperation rates after breast-conserving surgery were 21.1% in the commercial cohort and 14.9% in the Medicare cohort. Re-operations were associated with a 24% increase in 1-year healthcare costs in both cohorts.

May 30 - Pretreatment Pan-Immune-Inflammation Value (PIV) in Predicting Therapeutic Response and Clinical Outcomes of Neoadjuvant Immunochemotherapy for Esophageal Squamous Cell Carcinoma

Synopsis: This study explored the clinical utility and response of pretreatment pan-immune-inflammation value (PIV) to neoadjuvant immunochemotherapy (NICT) in squamous cell carcinoma (ESCC). Owing to better prognostic stratification, pretreatment PIV is indicated to be a novel, sensitive, and effective indicator in ESCC receiving NICT. Further study is warranted.

May 23 - Practice Patterns and Outcomes Among Surgical Oncology Fellowship Graduates Performing Complex Cancer Surgery in the United States Across Different Career Stages

Citation: Tsilimigras, D.I., Chatzipanagiotou, O., Woldesenbet, S. et al. Practice Patterns and Outcomes Among Surgical Oncology Fellowship Graduates Performing Complex Cancer Surgery in the United States Across Different Career Stages. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15436-0

Synopsis: The objective of this study was to assess perioperative mortality and serious complications among a national representative cohort of Medicare beneficiaries undergoing complex cancer surgery by surgical oncology fellowship graduates across different career stages in the United States.

May 23 - Enhancing the Efficacy of HIPEC Through Bromelain: A Preclinical Investigation in Appendiceal Cancer

Citation: Wajih, N., Erali, R.A., Forsythe, S.D. et al. Enhancing the Efficacy of HIPEC Through Bromelain: A Preclinical Investigation in Appendiceal Cancer. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15355-0

Synopsis: Cytoreductive surgery with hyperthermic intra-peritoneal chemotherapy for appendiceal cancer is often limited by a mucinous physical barrier. We explored the efficacy of bromelain, a pineapple extract with mucolytic properties, to improve treatment effect through improved tumor-drug contact.

May 16 - Outcomes of Hepatic Artery-Based Therapies and Systemic Multiagent Chemotherapy in Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-analysis

Citation: Sugumar, K., Stitzel, H., Wu, V. et al. Outcomes of Hepatic Artery-Based Therapies and Systemic Multiagent Chemotherapy in Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-analysis. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15187-y

Synopsis: This meta-analysis shows that hepatic artery infusion and multiagent chemotherapy are effective therapies in unresectable colorectal liver metastasis. Though triplet chemotherapy appeared to outperform other arms, high toxicity and inclusion of potentially resectable patients must be considered while interpreting results.

May 16 - Postoperative Complications After Neoadjuvant Chemotherapy Versus Upfront Surgery in Gastric Adenocarcinoma: A Population-Based Nationwide Study in Finland

Citation: Putila, E., Helminen, O., Helmiö, M. et al. Postoperative Complications After Neoadjuvant Chemotherapy Versus Upfront Surgery in Gastric Adenocarcinoma: A Population-Based Nationwide Study in Finland. Ann Surg Oncol 31, 2689–2698 (2024). https://doi.org/10.1245/s10434-023-14813-5

Synopsis: This study compares postoperative complications between neoadjuvant chemotherapy and upfront surgery after gastrectomy for gastric adenocarcinoma in a population-based setting (n=1769). Neoadjuvant chemotherapy did not increase major postoperative complications after gastrectomy for gastric cancer compared to upfront surgery (OR 1.12, 95% CI 0.81-1.56). Furthermore, it did not increase reoperations or short-term mortality compared to upfront surgery.

May 9 - Adjuvant Gemcitabine Versus Neoadjuvant/Adjuvant FOLFIRINOX in Resectable Pancreatic Cancer: The Randomized Multicenter Phase II NEPAFOX Trial

Citation: Goetze, T.O., Reichart, A., Bankstahl, U.S. et al. Adjuvant Gemcitabine Versus Neoadjuvant/Adjuvant FOLFIRINOX in Resectable Pancreatic Cancer: The Randomized Multicenter Phase II NEPAFOX Trial. Ann Surg Oncol 31, 4073–4083 (2024). https://doi.org/10.1245/s10434-024-15011-7

Synopsis: Perioperative FOLFIRINOX treatment in resectable pancreatic cancer patients appeared to be safe and feasible potentially effective in well-selected cohorts of patients. In pancreatic cancer, patient selection before initiation of neoadjuvant therapy appears to be critical.

May 9 - Risk Factors of Open Surgery Conversion in Laparoscopic Partial Nephrectomy to Achieve Nephron Sparing

Citation: Keskin, E.T., Can, O., Özdemir, H. et al. Risk Factors of Open Surgery Conversion in Laparoscopic Partial Nephrectomy to Achieve Nephron Sparing. Ann Surg Oncol 31, 3880–3886 (2024). https://doi.org/10.1245/s10434-024-15106-1

Synopsis: In this study, the authors report their evaluation of risk factors in patients with renal cell carcinoma of the conversion from laparoscopic partial nephrectomy to open surgery to achieve partial nephrectomy.

May 2 - A Prospective Study of Sentinel Node Biopsy Omission in Women Age ≥ 65 Years with ER+ Breast Cancer

Citation: Chung, A.P., Dang, C.M., Karlan, S.R. et al. A Prospective Study of Sentinel Node Biopsy Omission in Women Age ≥ 65 Years with ER+ Breast Cancer. Ann Surg Oncol 31, 3160–3167 (2024). https://doi.org/10.1245/s10434-024-15000-w

Synopsis: This prospective cohort study enrolled 125 patients age ≥ 65 with clinical T1-2N0 estrogen-receptor-positive breast cancer who were treated with breast conserving surgery without sentinel node biopsy. Median follow up of 36.7 months identified 2/125 (1.6%) axillary recurrences.

May 2 - Robotic Approach for Perihilar Cholangiocarcinoma IIIA Type: Step-by-Step Procedure

Citation: Ielpo, B., Rosso, E., d’Addetta, M.V. et al. Robotic Approach for Perihilar Cholangiocarcinoma IIIA Type: Step-by-Step Procedure. Ann Surg Oncol 31, 3084–3085 (2024). https://doi.org/10.1245/s10434-024-14956-z

Synopsis: Through this multimedia article the authors aim to show the advantages of the robotic approach for performing correctly one of the most complex surgery.

April 25 - Higher Postoperative Mortality and Inferior Survival After Right-Sided Liver Resection for Perihilar Cholangiocarcinoma: Left-Sided Resection is Preferred When Possible

Citation: Olthof, P.B., Erdmann, J.I., Alikhanov, R. et al. Higher Postoperative Mortality and Inferior Survival After Right-Sided Liver Resection for Perihilar Cholangiocarcinoma: Left-Sided Resection is Preferred When Possible. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15115-0

Synopsis: This study compares 90-day postoperative mortality and long-term overall survival (OS) between right- and left-sided major liver resections in the perihilar cholangiocarcinoma (pCCA) collaboration group. Based on this comparison, when both a left and right liver resection is technically feasible in a patient with pCCA, a left-sided liver resection is preferred.

April 25 - Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial

Citation: Machado, P., Pimenta, S., Garcia, A.L. et al. Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial. Ann Surg Oncol 31, 847–859 (2024). https://doi.org/10.1245/s10434-023-14503-2

Synopsis: This study investigated the effect of preoperative home-based exercise training (PHET) on quality of life (QoL) after lung cancer (LC) surgery. PHET was shown to improve health-related QoL before LC surgery and prevent its deterioration after surgery. PHET was particularly beneficial for global QoL and physical function, which clinically improved preoperatively and remained significantly better after surgery compared to the control group.

April 18 - Adjuvant Chemoradiation in Resected Biliary Adenocarcinoma: Evaluation of SWOG S0809 with a Large National Database

Citation: Dominguez, D.A., Wong, P., Chen, YJ. et al. Adjuvant Chemoradiation in Resected Biliary Adenocarcinoma: Evaluation of SWOG S0809 with a Large National Database. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15117-y

Synopsis: SWOG S0809 findings supported using the National Cancer Database, showing association of adjuvant chemoradiation in resected biliary cancer with improved overall survival compared to chemotherapy alone.

April 18 - Expanding the Use of HIPEC in Ovarian Cancer at Time of Interval Debulking Surgery to FIGO Stage IV and After 6 Cycles of Neoadjuvant Chemotherapy: A Prospective Analysis on Perioperative and Oncologic Outcomes

Citation: Ghirardi, V., Trozzi, R., Scanu, F.R. et al. Expanding the Use of HIPEC in Ovarian Cancer at Time of Interval Debulking Surgery to FIGO Stage IV and After 6 Cycles of Neoadjuvant Chemotherapy: A Prospective Analysis on Perioperative and Oncologic Outcomes. Ann Surg Oncol 31, 3350–3360 (2024). https://doi.org/10.1245/s10434-024-15042-0

Synopsis: The outcomes of FIGO stage IV ovarian cancer patients and/or patients receiving up to VI cycles of NACT submitted to HIPEC at IDS have not been addressed in available randomized trials. In the authors’ experience, no difference in neither perioperative complications nor PFS outcomes was detected in both FIGO stage IV and/or patients receiving > IV cycles of NACT with respect to FIGO stage III and patients receiving up to IV cycles of NACT. The authors provide a background to consider offering HIPEC with cisplatin 100mg/m3 to selected FIGO stage IV patients and/or patients receiving up to VI cycles of NACT.

April 11 - Association of COVID-19 Pandemic with Colorectal Cancer Screening: Impact of Race/Ethnicity and Social Vulnerability

Citation: Khan, M.M.M., Munir, M.M., Woldesenbet, S. et al. Association of COVID-19 Pandemic with Colorectal Cancer Screening: Impact of Race/Ethnicity and Social Vulnerability. Ann Surg Oncol 31, 3222–3232 (2024). https://doi.org/10.1245/s10434-024-15029-x

Synopsis: The authors sought to determine the impact of the COVID-19 pandemic lockdown on colorectal cancer (CRC) screening relative to social vulnerability and found that the COVID-19 pandemic was associated with a decrease in CRC screening volumes. Patients who resided in high social vulnerability areas experienced the greatest pandemic-related decline.

April 11 - Review: Implant-Based Breast Reconstruction After Mastectomy for Breast Cancer: A Meta-analysis of Randomized Controlled Trials and Prospective Studies Comparing Use of Acellular Dermal Matrix (ADM) Versus Without ADM

Citation: Ng, T.P., Loo, B.Y.K., Yong, N. et al. Review: Implant-Based Breast Reconstruction After Mastectomy for Breast Cancer: A Meta-analysis of Randomized Controlled Trials and Prospective Studies Comparing Use of Acellular Dermal Matrix (ADM) Versus Without ADM. Ann Surg Oncol 31, 3366–3376 (2024). https://doi.org/10.1245/s10434-024-14943-4

Synopsis: Acellular dermal matrix (ADM) use has become a method to improve outcomes of breast reconstruction after mastectomy for breast cancer. In this systematic review and meta-analysis, we compared the post-operative complications and patient-reported outcomes between ADM and non-ADM breast reconstruction and found comparable short and long-term outcomes.

April 4 - Delta Radiomic Features Predict Resection Margin Status and Overall Survival in Neoadjuvant-Treated Pancreatic Cancer Patients

Citation: Wang, K., Karalis, J.D., Elamir, A. et al. Delta Radiomic Features Predict Resection Margin Status and Overall Survival in Neoadjuvant-Treated Pancreatic Cancer Patients. Ann Surg Oncol 31, 2608–2620 (2024). https://doi.org/10.1245/s10434-023-14805-5

Synopsis: The authors report on an externally validated delta radiomics-based model developed to predict the overall survival, disease-free survival, and most importantly, the likelihood of achieving an R0 resection in patients with pancreatic ductal adenocarcinoma who were treated with neoadjuvant chemotherapy.

April 4 - Robot-Assisted Pelvic Dissection for Enlarged Lymph Nodes in Melanoma Improves Recovery with Equivalent Oncological Outcomes to Open Pelvic Dissection

Citation: Roshan, A., Shah, B., Anderson, K.D. et al. Robot-Assisted Pelvic Dissection for Enlarged Lymph Nodes in Melanoma Improves Recovery with Equivalent Oncological Outcomes to Open Pelvic Dissection. Ann Surg Oncol 31, 2727–2736 (2024). https://doi.org/10.1245/s10434-023-14834-0

Synopsis: Robot-assisted pelvic dissection in patients with macroscopic melanoma shortens recovery and reduces interval to start adjuvant treatments by a median of 3 weeks. However, long term outcomes remain poor despite adjuvant therapy, and demonstrates the need for neoadjuvant treatments to improve disease-free survival.

March 28 - Adjuvant Trastuzumab Emtansine Versus Paclitaxel and Trastuzumab in Stage I HER2-Positive Breast Cancer: The ATEMPT Trial

Citation: Khattak, M.N., Chichura, A.M. & Lang, J.E. Adjuvant Trastuzumab Emtansine Versus Paclitaxel and Trastuzumab in Stage I HER2-Positive Breast Cancer: The ATEMPT Trial. Ann Surg Oncol 31, 1423–1427 (2024). https://doi.org/10.1245/s10434-023-14766-9

Synopsis: This ASO perspective reviews the findings of a randomized, phase II clinical trial evaluating adjuvant trastuzumab emtansine (T-DM1) compared with paclitaxel and trastuzumab (TH) in stage I human epidermal growth factor receptor 2-positive breast cancer, as reported recently by the ATEMPT trial investigators.

March 28 - Outcomes of Neoadjuvant Chemotherapy for Invasive Intraductal Papillary Mucinous Neoplasm Compared with de Novo Pancreatic Adenocarcinoma

Citation:Fogliati, A., Zironda, A., Fiorentini, G. et al. Outcomes of Neoadjuvant Chemotherapy for Invasive Intraductal Papillary Mucinous Neoplasm Compared with de Novo Pancreatic Adenocarcinoma. Ann Surg Oncol 31, 2632–2639 (2024). https://doi.org/10.1245/s10434-023-14875-5

Synopsis: This retrospective cohort study suggests that invasive intraductal papillary mucinous cystic neoplasms (IPMN) have a better prognosis when compared to de novo pancreatic ductal adenocarcinoma, and their response to neoadjuvant chemotherapy appears non-inferior.

March 21 - A Feasibility Randomized Controlled Trial of Prehabilitation During Neoadjuvant Chemotherapy for Women with Breast Cancer: A Mixed Methods Study

Citation: Brahmbhatt, P., Look Hong, N.J., Sriskandarajah, A. et al. A Feasibility Randomized Controlled Trial of Prehabilitation During Neoadjuvant Chemotherapy for Women with Breast Cancer: A Mixed Methods Study. Ann Surg Oncol 31, 2261–2271 (2024). https://doi.org/10.1245/s10434-023-14851-z

Synopsis: The authors report the results of a feasibility randomized controlled trial of multimodal prehabilitation, including individualized exercise, stress management, and dietetic support versus usual care in women with breast cancer undergoing neoadjuvant chemotherapy with planned surgery.

March 21 - Docetaxel-Based Neoadjuvant Chemotherapy Followed by En Bloc Resection for Esophageal Adenocarcinoma: A 15-Year Retrospective Analysis from a Regional Upper Gastrointestinal Cancer Network

Citation: Tankel, J., Ahmed, N., Mueller, C. et al. Docetaxel-Based Neoadjuvant Chemotherapy Followed by En Bloc Resection for Esophageal Adenocarcinoma: A 15-Year Retrospective Analysis from a Regional Upper Gastrointestinal Cancer Network. Ann Surg Oncol 31, 2461–2469 (2024). https://doi.org/10.1245/s10434-023-14779-4

Synopsis: Long-term survival data concerning neoadjuvant docetaxel-based chemotherapy for esophageal and junctional adenocarcinoma is lacking. The authors found that both the FLOT and DCF regimens provided excellent outcomes when combined with en bloc transthoracic resection with a 5-year overall survival of 50.0% and 59.7%, respectively, affirming these modalities as acceptable standards of care.

March 7 - Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks

Citation: Singh, P., Agnese, D., Amin, M. et al. Society of Surgical Oncology Breast Disease Site Working Group Statement on Contralateral Mastectomy: Indications, Outcomes, and Risks. Ann Surg Oncol 31, 2212–2223 (2024). https://doi.org/10.1245/s10434-024-14893-x

Synopsis: This statement serves as an evidence-based guide for surgeons when counseling patients on the indications, risks, and outcomes of contralateral mastectomy (CM). Surgeons can reduce CM rates by engaging in shared decision making and informed discussions that incorporate patient preferences.

March 7 - Factors Affecting Recurrence and Survival for Patients with High-Risk Stage II Melanoma

Citation: Dedeilia, A., Lwin, T., Li, S. et al. Factors Affecting Recurrence and Survival for Patients with High-Risk Stage II Melanoma. Ann Surg Oncol 31, 2713–2726 (2024). https://doi.org/10.1245/s10434-023-14724-5

Synopsis: Traditional histopathologic factors (such as Breslow thickness and mitotic rate) and specific tumor gene mutations (such as KIT and CDH1) affected the recurrence and survival of patients with stage IIB/IIC melanoma and could be used to escalate treatment and surveillance accordingly.

February 29 - Biopsychosocial Late Effects After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases from Colorectal and Appendiceal Cancer: A National Prospective Cohort Study

Citation: Balachandran, R., Thaysen, H.V., Christensen, P. et al. Biopsychosocial Late Effects After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases from Colorectal and Appendiceal Cancer: A National Prospective Cohort Study. Ann Surg Oncol 31, 1959–1969 (2024). https://doi.org/10.1245/s10434-023-14618-6

Synopsis: The authors investigated the frequency and severity of biopsychosocial late effects (LEs) experienced by patients undergoing cytoreductive surgery and HIPEC for colorectal cancer with peritoneal metastases. The authors found that LEs are a frequent and having LEs negatively impact quality of life.

February 29 - A Randomized Phase III Trial of Complete Mesocolic Excision Compared with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-in Trial)

Citation: Degiuli, M., Aguilar, A.H.R., Solej, M. et al. A Randomized Phase III Trial of Complete Mesocolic Excision Compared with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-in trial). Ann Surg Oncol 31, 1671–1680 (2024). https://doi.org/10.1245/s10434-023-14664-0

Synopsis: This report shows interim data of a multicenter randomized controlled trial (RCT) comparing Complete Mesocolic Excision (CME) vs right colectomy in patient with right colon cancer. After the enrollment of 258 patients, CME is documented to improve LN yield and quality of surgery, without increasing complications.

February 22 - Benchmarks in Liver Resection for Intrahepatic Cholangiocarcinoma

Citation: Alaimo, L., Endo, Y., Catalano, G. et al. Benchmarks in Liver Resection for Intrahepatic Cholangiocarcinoma. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-023-14880-8

Synopsis: The authors define benchmark values for hepatectomy for intrahepatic cholangiocarcinoma (ICC) across an international population. These benchmarks may facilitate comparison of outcomes among different patient cohorts, aiding in the assessment of surgical performance and oncological efficacy.

February 22 - Surgery as a Principle and Technical Consideration for Primary Tumor Resection of Small Bowel Neuroendocrine Tumors

Citation: Søreide, K., Stättner, S. & Hallet, J. Surgery as a Principle and Technical Consideration for Primary Tumor Resection of Small Bowel Neuroendocrine Tumors. Ann Surg Oncol 31, 1125–1137 (2024). https://doi.org/10.1245/s10434-023-14610-0

Synopsis: The authors focus on the role of surgical resection for small bowel neuroendocrine tumors (SB-NETs) and consider the principles of surgical oncological management of this condition to aim at cure, prevent progressive complications, and alleviate symptoms.

February 15 - Hepatectomy After Conversion Therapy Using Tyrosine Kinase Inhibitors Plus Anti-PD-1 Antibody Therapy for Patients with Unresectable Hepatocellular Carcinoma

Citation: Zhu, XD., Huang, C., Shen, YH. et al. Hepatectomy After Conversion Therapy Using Tyrosine Kinase Inhibitors Plus Anti-PD-1 Antibody Therapy for Patients with Unresectable Hepatocellular Carcinoma. Ann Surg Oncol 30, 2782–2790 (2023). https://doi.org/10.1245/s10434-022-12530-z

Synopsis: The authors reviewed a cohort of 101 patients with advanced/unresectable hepatocellular carcinoma (HCC) who received first-line treatment with a tyrosine kinase inhibitors (TKI) plus anti-PD-1 antibodies and report the rate of patients who subsequently underwent R0 resection, clinical features associated with clinical downstaging, and long-term survival outcomes in patients who underwent R0 resection.

February 15 - Circulating Tumor DNA Is Unreliable to Detect Somatic Gene Alterations in Gastrointestinal Peritoneal Carcinomatosis

Citation: Sullivan, B.G., Lo, A., Yu, J. et al. Circulating Tumor DNA Is Unreliable to Detect Somatic Gene Alterations in Gastrointestinal Peritoneal Carcinomatosis. Ann Surg Oncol 30, 278–284 (2023). https://doi.org/10.1245/s10434-022-12399-y

Synopsis: ctDNA is now routinely used to guide treatment decisions in patients with gastrointestinal (GI) cancers. The authors found that ctDNA levels are significantly low and plasma ctDNA-NGS is unreliable to detect tumor somatic gene alterations in GI peritoneal carcinomatosis.

February 8 - Trends and Determinants of Location of Death Due to Colorectal Cancer in the United States

Citation: Sonal, S., Jain, B., Bajaj, S.S. et al. Trends and Determinants of Location of Death Due to Colorectal Cancer in the United States. Ann Surg Oncol 31, 1447–1454 (2024). https://doi.org/10.1245/s10434-023-14337-y

Synopsis: The authors analyzed the locations of death in patients dying of colorectal cancer in the United States. Deaths at home and hospice gradually increased, corresponding to a decline in deaths in institutionalized settings; although with clear socio-demographic disparities.

February 8 - Management of Gastric Neuroendocrine Tumors: A Review.

Citation: Sok, C., Ajay, P.S., Tsagkalidis, V. et al. Management of Gastric Neuroendocrine Tumors: A Review. Ann Surg Oncol 31, 1509–1518 (2024). https://doi.org/10.1245/s10434-023-14712-9

Synopsis: Gastric neuroendocrine tumors are rare tumors of the stomach. As endoscopic evaluation of gastrointestinal symptoms increases, it is likely that the incidence of these neoplasms will increase. This review discusses the presentation, work-up, and surgical management of these tumors.

February 1 - Multidisciplinary Surgical Approach to Increase Survival for Advanced Ovarian Cancer in a Tertiary Gynaecological Oncology Centre

Citation: Mulligan, K., Corry, E., Donohoe, F. et al. Multidisciplinary Surgical Approach to Increase Survival for Advanced Ovarian Cancer in a Tertiary Gynaecological Oncology Centre. Ann Surg Oncol 31, 460–472 (2024). https://doi.org/10.1245/s10434-023-14423-1

Synopsis: This study shows that a multidisciplinary approach to aggressive cytoreductive surgery for advanced ovarian cancer results in increased overall/progression-free survival and complete macroscopic resection rates without a corresponding increase in morbidity.

February 1 - Oncologic Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Highly Selected Patients with Metastatic Pancreatic Ductal Adenocarcinoma

Citation: Gudmundsdottir, H., Yonkus, J.A., Thiels, C.A. et al. Oncologic Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Highly Selected Patients with Metastatic Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol 30, 7833–7839 (2023). https://doi.org/10.1245/s10434-023-14138-3

Synopsis: In this study, systemic chemotherapy followed by cytoreductive surgery and HIPEC in patients with pancreatic ductal adenocarcinoma and limited peritoneal metastases was associated with improved survival compared to systemic chemotherapy only.

January 25 - Levels of Robotic Mesopancreas Dissection According to Malignancy and Vascular Anatomy: What Surgeons Need to Know

Citation: Ielpo, B., d’Addetta, M.V., Anselmo, A. et al. Levels of Robotic Mesopancreas Dissection According to Malignancy and Vascular Anatomy: What Surgeons Need to Know. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-14686-8

Synopsis: The authors provided in this multimedia article provides a comprehensive step-by-step overview of the mesopancreas dissection during robotic pancreatoduodenectomy and its three different levels according to tumor type.

January 25 - Standardization of Colon Resection for Cancer: An Overview of the American College of Surgeons Commission on Cancer Standard 5.6

Citation: Thomas, K.K., Francescatti, A.B., Vreeland, T.J. et al. Standardization of Colon Resection for Cancer: An Overview of the American College of Surgeons Commission on Cancer Standard 5.6. Ann Surg Oncol 31, 6–9 (2024). https://doi.org/10.1245/s10434-023-14414-2

Synopsis: The authors review the American College of Surgeons Commission on Cancer Standard 5.6, which pertains to curative intent colon resections performed for cancer. A broad overview of the Operative Standard is provided followed by the underlying rationale, technical components, and documentation requirements.

January 18 - Prepectoral Versus Subpectoral Implant-Based Breast Reconstruction: A Systemic Review and Meta-Analysis

Citation: Ostapenko, E., Nixdorf, L., Devyatko, Y. et al. Prepectoral Versus Subpectoral Implant-Based Breast Reconstruction: A Systemic Review and Meta-analysis. Ann Surg Oncol 30, 126–136 (2023). https://doi.org/10.1245/s10434-022-12567-0

Synopsis: This systematic review and meta-analysis assessed and compared the clinical outcomes and efficacy between prepectoral and subpectoral implant-based breast reconstruction. Results demonstrated that prepectoral implant-based breast reconstruction is a safe modality and has similar outcomes with significantly lower rates of capsular contracture, prosthesis failure, and animation deformity compared to subpectoral implant-based breast reconstruction.

January 18 - Improved Postoperative Outcomes after Prehabilitation for Colorectal Cancer Surgery in Older Patients: An Emulated Target Trial

Citation: Heil, T.C., Verdaasdonk, E.G.G., Maas, H.A.A.M. et al. Improved Postoperative Outcomes after Prehabilitation for Colorectal Cancer Surgery in Older Patients: An Emulated Target Trial. Ann Surg Oncol 30, 244–254 (2023). https://doi.org/10.1245/s10434-022-12623-9

Synopsis: This study aimed to assess the effect of a multimodal prehabilitation program on perioperative outcomes in colorectal cancer patients using an emulated target trial design. The study identified potential benefits of prehabilitation in daily clinical practice.

January 11 - Total Versus Subtotal Gastrectomy for Distal Gastric Poorly Cohesive Carcinoma

Citation: Boubaddi, M., Teixeira Farinha, H., Lambert, C. et al. Total Versus Subtotal Gastrectomy for Distal Gastric Poorly Cohesive Carcinoma. Ann Surg Oncol 31, 744–752 (2024). https://doi.org/10.1245/s10434-023-14496-y

Synopsis: This study compared 5-year overall survival (OS) and disease-free survival (DFS) rates for subtotal gastrectomy (SG) versus total gastrectomy (TG) for distal gastric poorly cohesive carcinoma (PCC). Results did not identify significant disparities in the 5-year OS and DFS rates between patients with distal gastric poorly cohesive cell adenocarcinoma who underwent SG vs TG. Moreover, the percentage of SRC present in the tumors analyzed did not seem to affect survival outcomes in either group.

January 11 - Neoadjuvant Therapy for Duodenal and Ampullary Adenocarcinoma: A Systematic Review

Citation: Zhang, C., Lizalek, J.M., Dougherty, C. et al. Neoadjuvant Therapy for Duodenal and Ampullary Adenocarcinoma: A Systematic Review. Ann Surg Oncol 31, 792–803 (2024). https://doi.org/10.1245/s10434-023-14531-y

Synopsis: This article evaluated the current evidence regarding the use of neoadjuvant therapy (NAT) for ampullary (AA) and duodenal adenocarcinoma (DA). NAT appears safe for patients with DA and AA, but better evidence is needed to understand the preferred multidisciplinary management for DA and AA periampullary malignancies.

January 4 - Universal Germline-Genetic Testing for Breast Cancer: Implementation in a Rural Practice and Impact on Shared Decision-Making

Citation: Shelton, C., Ruiz, A., Shelton, L. et al. Universal Germline-Genetic Testing for Breast Cancer: Implementation in a Rural Practice and Impact on Shared Decision-Making. Ann Surg Oncol 31, 325–334 (2024). https://doi.org/10.1245/s10434-023-14394-3

Synopsis: Universal germline-genetic testing was successfully implemented in a rural hospital. Positive and negative results were instrumental in guiding clinical management, with surgical decision-making most impacted, followed by radiation therapy and other adjuvant care.

January 4 - Perceptions of Readiness for Practice After Complex General Surgical Oncology Fellowship: A Survey Study

Citation: Behrens, S., Lillemoe, H.A., Dineen, S.P. et al. Perceptions of Readiness for Practice After Complex General Surgical Oncology Fellowship: A Survey Study. Ann Surg Oncol 31, 31–41 (2024). https://doi.org/10.1245/s10434-023-14524-x

Synopsis: This survey study assessed the adequacy of Complex General Surgical Oncology fellowship training in preparing surgeons for their careers. Results indicated fellowship prepares surgeons for careers in surgical oncology, but there may be opportunities to refine the training model.

2023 Featured Articles

December 21 - Nationwide Use and Outcome of Surgery for Locally Advanced Pancreatic Cancer Following Induction Chemotherapy

Citation: Stoop, T.F., Seelen, L.W.F., van ’t Land, F.R. et al. Nationwide Use and Outcome of Surgery for Locally Advanced Pancreatic Cancer Following Induction Chemotherapy. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-14650-6

Synopsis: This study assessed the nationwide use and outcome of resection of locally advanced pancreatic cancer (LAPC) following induction chemo(radio)therapy. Results demonstrated that surgery for LAPC following induction chemo(radio)therapy was performed infrequently in the 16 Dutch centers for pancreatic surgery averaging only four resections per center over a seven-year period. Given these findings, a structured nationwide approach involving international centers of excellence would be needed to improve selection of patients with LAPC for surgical resection following induction therapy.

December 21 - Prognostic Significance of Sentinel Lymph Node Status in Thick Primary Melanomas (> 4 mm)

Citation: Holmberg, CJ., Mikiver, R., Isaksson, K. et al. Prognostic Significance of Sentinel Lymph Node Status in Thick Primary Melanomas (> 4 mm). Ann Surg Oncol 30, 8026–8033 (2023). https://doi.org/10.1245/s10434-023-14050-w

Synopsis: Using a large prospective national cohort, this study confirms that sentinel lymph node (SLN) status gives important prognostic information for patients in the thick (>4mm) melanoma subgroup. We recommend that current clinical guidelines be updated to reflect this prognostic value.

December 14 - Outcomes of Women Undergoing Mastectomy for Unilateral Breast Cancer Who Elect to Undergo Contralateral Mastectomy for Symmetry: A Systematic Review

Citation: Griffin, C., Fairhurst, K., Stables, I. et al. Outcomes of Women Undergoing Mastectomy for Unilateral Breast Cancer Who Elect to Undergo Contralateral Mastectomy for Symmetry: A Systematic Review. Ann Surg Oncol 31, 303–315 (2024). https://doi.org/10.1245/s10434-023-14294-6

Synopsis: Contralateral mastectomy for ‘flat symmetry’ after unilateral mastectomy for breast cancer is an alternative to reconstruction but surgeons fear women may experience decisional regret. This review demonstrates patients are satisfied with their decision, supporting surgeons to offer women this option.

December 14 - The Effect of Neoadjuvant Therapy on Esophagectomy for cT2N0M0 Esophageal Adenocarcinoma

Citation: Rodriguez-Quintero, J.H., Kamel, M.K., Jindani, R. et al. The Effect of Neoadjuvant Therapy on Esophagectomy for cT2N0M0 Esophageal Adenocarcinoma. Ann Surg Oncol 31, 228–238 (2024). https://doi.org/10.1245/s10434-023-14441-z

Synopsis: For cT2N0M0 esophageal adenocarcinomas, the benefits of neoadjuvant chemoradiotherapy prior to esophagectomy are debatable. In this study, the authors investigate 1) the perioperative impact of NT on esophagectomy and 2) the oncologic effect of NT in a homogenous group of patients with clinical stage IIA (T2N0M0) esophageal adenocarcinoma.

December 7 - 2022 Peritoneal Surface Oncology Group International Consensus on HIPEC Regimens for Peritoneal Malignancies: Colorectal Cancer

Citation: Hübner, M., van Der Speeten, K., Govaerts, K. et al. 2022 Peritoneal Surface Oncology Group International Consensus on HIPEC Regimens for Peritoneal Malignancies: Colorectal Cancer. Ann Surg Oncol 31, 567–576 (2024). https://doi.org/10.1245/s10434-023-14368-5

Synopsis: Based on the available evidence, despite the negative results of PRODIGE 7, HIPEC could be conditionally recommended to patients with peritoneal metastases of colorectal cancer after cytoreductive surgery (CRS). While more preclinical and clinical data are eagerly awaited to harmonize the procedure further, the mitomycin-C–based Dutch protocol remains the preferred regimen after primary and secondary CRS.

December 7 - The Predictive Utility of MammaPrint and BluePrint in Identifying Patients with Locally Advanced Breast Cancer Who are Most Likely to Have Nodal Downstaging and a Pathologic Complete Response After Neoadjuvant Chemotherapy

Citation: Blumencranz, P., Habibi, M., Shivers, S. et al. The Predictive Utility of MammaPrint and BluePrint in Identifying Patients with Locally Advanced Breast Cancer Who are Most Likely to Have Nodal Downstaging and a Pathologic Complete Response After Neoadjuvant Chemotherapy. Ann Surg Oncol 30, 8353–8361 (2023). https://doi.org/10.1245/s10434-023-14027-9

Synopsis: The authors evaluated the association between MammaPrint (70-gene risk of distant metastasis signature) and BluePrint (80-gene molecular subtyping signature) and nodal downstaging. A significantly greater proportion of patients with MammaPrint High Risk and BluePrint HER2 and Basal tumors had nodal downstaging.

November 30 - Cryoablation Allows the Ultimate De-escalation of Surgical Therapy for Select Breast Cancer Patients

Citation: Khan, S.Y., Cole, J., Habrawi, Z. et al. Cryoablation Allows the Ultimate De-escalation of Surgical Therapy for Select Breast Cancer Patients. Ann Surg Oncol 30, 8398–8403 (2023). https://doi.org/10.1245/s10434-023-14332-3

Synopsis: This study documents the account of ultimate de-escalation 72 of breast and axillary surgery in select patients utilizing cryoablation.

November 30 - Major Intraoperative Complications During Minimally Invasive Esophagectomy

Citation: Söderström, H., Moons, J., Nafteux, P. et al. Major Intraoperative Complications During Minimally Invasive Esophagectomy. Ann Surg Oncol 30, 8244–8250 (2023). https://doi.org/10.1245/s10434-023-14340-3

Synopsis: This study reports major intraoperative complications encountered during minimally invasive esophagectomy for cancer. Complication data from 2862 patients was collected retrospectively from 10 esophageal surgery centers. We report 101 complications in 98 patients, types of repairs and mortality.

November 16 - Role of Concurrent Ultrasound Surveillance of Sentinel Node-Positive Node Fields in Melanoma Patients Having Routine Cross-Sectional Imaging

Citation: Gjorup, C.A., Woodford, R., Li, I. et al. Role of Concurrent Ultrasound Surveillance of Sentinel Node-Positive Node Fields in Melanoma Patients Having Routine Cross-Sectional Imaging. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-14526-9

Synopsis: In sentinel node-positive melanoma patients in whom CLND was omitted, node field recurrence only occurred in 5%. Nodal recurrences were detected frequently on cross-sectional imaging.

November 16 - In-Hospital Venous Thromboembolism and Pulmonary Embolism After Major Urologic Cancer Surgery

Citation: Cano Garcia, C., Tappero, S., Piccinelli, M.L. et al. In-Hospital Venous Thromboembolism and Pulmonary Embolism After Major Urologic Cancer Surgery. Ann Surg Oncol 30, 8770–8779 (2023). https://doi.org/10.1245/s10434-023-14246-0

Synopsis: After major urological cancer surgeries, venous thromboembolism (VTE) rates increased while pulmonary embolism (PE) rates decreased. radical cystectomy (RC), radical nephrectomy (RN) and partial nephrectomy (PN) surgeries were associated with higher VTE and PE risk than radical prostatectomy (RP). Patients with VTE or PE exhibited higher mortality after RC and RN.

November 9 - Combined Hepatic Arterial Infusion Pump and Systemic Chemotherapy in the Modern Era for Chemotherapy-Naive Patients with Unresectable Colorectal Liver Metastases

Citation: Verheij, F.S., Kuhlmann, K.F.D., Silliman, D.R. et al. Combined Hepatic Arterial Infusion Pump and Systemic Chemotherapy in the Modern Era for Chemotherapy-Naive Patients with Unresectable Colorectal Liver Metastases. Ann Surg Oncol 30, 7950–7959 (2023). https://doi.org/10.1245/s10434-023-14073-3

Synopsis: Combined hepatic artery infusion and modern systemic therapy in chemotherapy-naive patients with unresectable CRLM resulted in durable and substantial response in a large proportion of patients. The majority of patients proceeded to conversion surgery, which was associated with prolonged survival.

November 9 - Lymph Node Metastases and Associated Recurrence-Free Survival in Microsatellite Stable and Unstable Colon Cancer

Citation: Hakki, L., Khan, A., Gonen, M. et al. Lymph Node Metastases and Associated Recurrence-Free Survival in Microsatellite Stable and Unstable Colon Cancer. Ann Surg Oncol 30, 8487–8494 (2023). https://doi.org/10.1245/s10434-023-14270-0

Synopsis: Lymph node metastasis (LNM) are 50% less prevalent in MSI colon cancer compared to MSS subtype, but factors associated with LNM are similar among both subtypes. The improved prognosis associated with early-stage MSI colon cancers dissipates with 4 or more LNM.

November 2 - Survival of Patients with Deficient Mismatch Repair Versus Proficient Mismatch Repair Metastatic Colorectal Cancer Receiving Curative-Intent Local Treatment of Metastases in a Nationwide Cohort

Citation: Zwart, K., van der Baan, F.H., Punt, C.J.A. et al. Survival of Patients with Deficient Mismatch Repair Versus Proficient Mismatch Repair Metastatic Colorectal Cancer Receiving Curative-Intent Local Treatment of Metastases in a Nationwide Cohort. Ann Surg Oncol 30, 6762–6770 (2023). https://doi.org/10.1245/s10434-023-13974-7

Synopsis: This nationwide study presents recurrence-free and overall survival after curative-intent local treatment of metastases in the distinct subgroup of deficient mismatch repair metastatic colorectal cancer and demonstrates comparable to more favorable outcomes compared to proficient mismatch repair tumors.

November 2 - Successful Breast Conservation After Neoadjuvant Chemotherapy in Lobular Breast Cancer: The Role of Menopausal Status in Response to Treatment

Citation: Ramalingam, K., Clelland, E., Rothschild, H. et al. Successful Breast Conservation After Neoadjuvant Chemotherapy in Lobular Breast Cancer: The Role of Menopausal Status in Response to Treatment. Ann Surg Oncol 30, 7099–7106 (2023). https://doi.org/10.1245/s10434-023-14075-1

Synopsis: Menopausal status does not predict successful breast conservation surgery after neoadjuvant chemotherapy (NAC) in invasive lobular carcinoma (ILC). Pre-menopausal patients receive more NAC, but response rates are similar, suggesting the need for improved predictors and treatments for ILC.

October 26 - Accuracy and Survival Outcomes after National Implementation of Sentinel Lymph Node Biopsy in Early Stage Endometrial Cancer

Citation: Cabrera, S., Gómez-Hidalgo, N.R., García-Pineda, V. et al. Accuracy and Survival Outcomes after National Implementation of Sentinel Lymph Node Biopsy in Early Stage Endometrial Cancer. Ann Surg Oncol 30, 7653–7662 (2023). https://doi.org/10.1245/s10434-023-14065-3

Synopsis: The implementation of sentinel lymph node biopsy for early-stage endometrial cancer in a clinical setting yields high sensitivity for detecting nodal disease. A high volume of patients with micrometastases and isolated tumor cells will be diagnosed, and tailoring adjuvant treatments will be key to achieve excellent oncologic outcomes.

October 26 - Long-Term Outcomes of Tuberous Sclerosis Complex-Associated Non-functional Pancreatic Neuroendocrine Tumors: Should We Be More Conservative?

Citation: Arya, S., Ventin, M., Nebbia, M. et al. Long-Term Outcomes of Tuberous Sclerosis Complex-Associated Non-functional Pancreatic Neuroendocrine Tumors: Should We Be More Conservative?. Ann Surg Oncol 30, 7748–7755 (2023). https://doi.org/10.1245/s10434-023-14157-0

Synopsis: The current study evaluates the clinical course of patients who have undergone surgical resection of their pancreatic neuroendocrine tumors (PNETs), specifically comparing the disease course of tuberous sclerosis complex-PNETs to patients with nonfunctional sporadic-PNETs.

October 19 - Safety and Efficacy of Oxaliplatin Pressurized Intraperitoneal Aerosolized Chemotherapy (PIPAC) in Colorectal and Appendiceal Cancer with Peritoneal Metastases: Results of a Multicenter Phase I Trial in the USA

Citation: Raoof, M., Whelan, R.L., Sullivan, K.M. et al. Safety and Efficacy of Oxaliplatin Pressurized Intraperitoneal Aerosolized Chemotherapy (PIPAC) in Colorectal and Appendiceal Cancer with Peritoneal Metastases: Results of a Multicenter Phase I Trial in the USA. Ann Surg Oncol 30, 7814–7824 (2023). https://doi.org/10.1245/s10434-023-13941-2

Synopsis: Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is a repeatable, laparoscopic procedure for locoregional drug delivery in the treatment of peritoneal metastases. This phase 1 trial demonstrates safety, feasibility, and early efficacy of oxaliplatin PIPAC in colorectal and appendiceal cancer peritoneal metastases.

October 19 - Impact of Laparoscopic Gastrectomy on the Completion Rate of the Perioperative Chemotherapy Regimen in Gastric Cancer: A Swedish Nationwide Study

Citation: Tsekrekos, A., Borg, D., Johansson, V. et al. Impact of Laparoscopic Gastrectomy on the Completion Rate of the Perioperative Chemotherapy Regimen in Gastric Cancer: A Swedish Nationwide Study. Ann Surg Oncol 30, 7196–7205 (2023). https://doi.org/10.1245/s10434-023-13967-6

Synopsis: This nationwide study examined whether laparoscopic gastrectomy for gastric cancer has a positive impact on different aspects of the completion of the perioperative chemotherapy. The results do not support that a minimally invasive approach has a substantial beneficial effect.

October 12 - Great Debate: Limb Infusion for Melanoma: A Thing of the Past?

Citation: Rhodin, K.E., Tyler, D.S., Zager, J.S. et al. Great Debate: Limb Infusion for Melanoma: A Thing of the Past? Ann Surg Oncol 30, 6319–6324 (2023). https://doi.org/10.1245/s10434-023-13765-0

Synopsis: In transit melanoma (ITM) remains heterogeneous in presentation, progression, and outcomes. Such variability can often make the treatment of ITM complex. The authors highlight a debate on the role of limb infusion in the contemporary management of advanced melanoma.

October 12 - Comparing Methods for Targeted Axillary Dissection in Breast Cancer Patients: A Nationwide, Retrospective Study

Citation: Munck, F., Jepsen, P., Zeuthen, P. et al. Comparing Methods for Targeted Axillary Dissection in Breast Cancer Patients: A Nationwide, Retrospective Study. Ann Surg Oncol 30, 6361–6369 (2023). https://doi.org/10.1245/s10434-023-13792-x

Synopsis: Targeted axillary dissection is often done with a two-marker combination. Difficulties in re-marking the lymph node affect 16% of patients, and the success of excision of the marked lymph node varies with marking method. Two-step TAD success is 82.3%.

October 5 - Impact of Postoperative Antibiotic Prophylaxis on Surgical Site Infections Rates After Mastectomy with Drains but Without Immediate Reconstruction: A Multicenter, Double-Blinded, Randomized Control Superiority Trial

Citation: Sattar, A.K., Masroor, T., Martins, R.S. et al. Impact of Postoperative Antibiotic Prophylaxis on Surgical Site Infections Rates After Mastectomy with Drains but Without Immediate Reconstruction: A Multicenter, Double-Blinded, Randomized Control Superiority Trial. Ann Surg Oncol 30, 5965–5973 (2023). https://doi.org/10.1245/s10434-023-13887-5

Synopsis: The authors explored the utility of continued postoperative antibiotic prophylaxis (PAP) in reducing surgical site infection (SSI) rates after mastectomy without immediate reconstruction and with indwelling drains.

October 5 - A Randomized Trial Comparing the Effectiveness of Pre-test Genetic Counseling Using an Artificial Intelligence Automated Chatbot and Traditional In-person Genetic Counseling in Women Newly Diagnosed with Breast Cancer

Citation: Al-Hilli, Z., Noss, R., Dickard, J. et al. A Randomized Trial Comparing the Effectiveness of Pre-test Genetic Counseling Using an Artificial Intelligence Automated Chatbot and Traditional In-person Genetic Counseling in Women Newly Diagnosed with Breast Cancer. Ann Surg Oncol 30, 5990–5996 (2023). https://doi.org/10.1245/s10434-023-13888-4

Synopsis: The feasibility of providing expanded genetic counseling services for patients with breast cancer is limited by resource availability. An artificial intelligence model (Chatbot) provides an alternative service delivery method for pre-test genetic counseling with comparable patient satisfaction and comprehension.

September 28 - Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases: Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group

Citation: Bond, M.J.G., Kuiper, B.I., Bolhuis, K. et al. Intersurgeon Variability in Local Treatment Planning for Patients with Initially Unresectable Colorectal Cancer Liver Metastases: Analysis of the Liver Expert Panel of the Dutch Colorectal Cancer Group. Ann Surg Oncol 30, 5376–5385 (2023). https://doi.org/10.1245/s10434-023-13510-7

Synopsis: Evaluation of a liver expert panel in the phase III randomised CAIRO5 study showed considerable variability among liver surgeons in prospective resectability assessments and local treatment planning for patients with initially unresectable colorectal liver metastases who received induction systemic therapy.

September 28 - Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study

Citation: Raichurkar, P., Denehy, L., Solomon, M. et al. Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-14192-x

Synopsis: The authors employ an international Delphi study to achieve consensus amongst an international multidisciplinary team of surgeons, anesthetists, nurses, and allied health staff to identify the top research priorities in prehabilitation for patients undergoing cancer surgery.

September 21 - Predictors of Early Versus Late Recurrence in Invasive Lobular Carcinoma of the Breast: Impact of Local and Systemic Therapy

Citation: Rothschild, H.T., Clelland, E.N., Mujir, F. et al. Predictors of Early Versus Late Recurrence in Invasive Lobular Carcinoma of the Breast: Impact of Local and Systemic Therapy. Ann Surg Oncol 30, 5999–6006 (2023). https://doi.org/10.1245/s10434-023-13881-x

Synopsis: Invasive carcinoma (ILC) is known for high cumulative late recurrence risk, which makes surveillance a clinical priority. In a multivariable analysis of ILC cases from an institutional database, different factors and treatment received were associated with timing of recurrence.

September 21 - Impact of Indocyanine Green Fluorescence Imaging on Lymphadenectomy Quality During Laparoscopic Distal Gastrectomy for Gastric Cancer (Greeneye): An Adaptative, Phase 2, Clinical Trial

Citation: Sposito, C., Maspero, M., Conalbi, V. et al. Impact of Indocyanine Green Fluorescence Imaging on Lymphadenectomy Quality During Laparoscopic Distal Gastrectomy for Gastric Cancer (Greeneye): An Adaptative, Phase 2, Clinical Trial. Ann Surg Oncol 30, 6803–6811 (2023). https://doi.org/10.1245/s10434-023-13848-y

Synopsis: In this Simon two-stage phase II study, preoperative peritumoral ICG injection and subsequent completion lymphadenectomy improved the quality of D2 lymphadenectomy during laparoscopic distal gastrectomy.

September 14 - Racial Disparity in Pathologic Response following Neoadjuvant Chemotherapy in Resected Pancreatic Cancer: A Multi-Institutional Analysis from the Central Pancreatic Consortium

Citation: Ogobuiro, I., Collier, A.L., Khan, K. et al. Racial Disparity in Pathologic Response following Neoadjuvant Chemotherapy in Resected Pancreatic Cancer: A Multi-Institutional Analysis from the Central Pancreatic Consortium. Ann Surg Oncol 30, 1485–1494 (2023). https://doi.org/10.1245/s10434-022-12741-4

Synopsis: In a multi-institutional retrospective study of 486 pancreatic cancer patients undergoing pancreatectomy following neoadjuvant therapy, Black race is associated with significantly reduced odds of major pathologic response.

September 14 - Hospital Designations and Their Impact on Guideline-Concordant Care and Survival in Pancreatic Cancer. Do They Matter?

Citation: Murimwa, G.Z., Karalis, J.D., Meier, J. et al. Hospital Designations and Their Impact on Guideline-Concordant Care and Survival in Pancreatic Cancer. Do They Matter?. Ann Surg Oncol 30, 4377–4387 (2023). https://doi.org/10.1245/s10434-023-13308-7MD

Synopsis: The authors compare the significance of four hospital designations on guideline concordant care (GCC) and survival (OS) of patients treated for pancreatic ductal adenocarcinoma (PDAC). Treatment at NCI designated (NCI), high-volume (HV) hospitals correlated with improved GCC and survival. Including GCC as a metric in accreditation standards could impact survival for PDAC patients.

September 7 - Implementation of a Multi-Disciplinary Team and Quality of Goals of Care Discussions in Palliative Surgical Oncology Patients

Citation: Soon, J.J.Y., Juan, D.W.K., Ong, W.S. et al. Implementation of a Multi-Disciplinary Team and Quality of Goals of Care Discussions in Palliative Surgical Oncology Patients. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-14190-z

Synopsis: The implementation of a multi-disciplinary palliative surgical intervention team was associated with an improvement in the quality of goals of care discussions amongst advanced cancer patients undergoing palliative interventions at the authors’ institution.

September 7 - Multi-organ Radiomics-Based Prediction of Future Remnant Liver Hypertrophy Following Portal Vein Embolization

Citation: Gerwing, M., Schindler, P., Katou, S. et al. Multi-organ Radiomics-Based Prediction of Future Remnant Liver Hypertrophy Following Portal Vein Embolization. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-14241-5

Synopsis: In this study, a radiomic feature assessment of the liver, spleen and bone marrow identified three radiomic features in baseline CT data to predict the standardized future remnant liver hypertrophy after portal vein embolization.

August 31 - Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer

Maki, H., Ayabe, R.I., Nishioka, Y. et al. Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer. Ann Surg Oncol 30, 5390–5400 (2023). https://doi.org/10.1245/s10434-023-13656-4

Synopsis: The reverse approach for synchronous rectal cancer liver metastases is associated with comparable survival to the classic and combined approaches and may obviate proctectomies/diversions. RAS/TP53 co-mutation is associated with a lower completion rate of the reverse approach.

August 31 - Postoperative Outcomes After Staged Versus Coordinated Breast Surgery and Bilateral Salpingo-Oophorectomy

Vemuru, S.R., Bronsert, M., Vossler, K. et al. Postoperative Outcomes After Staged Versus Coordinated Breast Surgery and Bilateral Salpingo-Oophorectomy. Ann Surg Oncol 30, 5667–5680 (2023). https://doi.org/10.1245/s10434-023-13630-0

Synopsis: In this review of 4,228 patients who underwent both breast surgery and bilateral salpingooophorectomy, staged operations were associated with similar healthcare costs but lower rates of postoperative complications compared to coordinated operations, an effect most evident among those whose breast operation was a mastectomy.

August 24 - Trends of Axillary Treatment in Sentinel Node-Positive Breast Cancer Patients Undergoing Mastectomy

Citation: Verreck, E.E.F., van Steenhoven, J.E.C., Kuijer, A. et al. Trends of Axillary Treatment in Sentinel Node-Positive Breast Cancer Patients Undergoing Mastectomy. Ann Surg Oncol 30, 5623–5632 (2023). https://doi.org/10.1245/s10434-023-13568-3

Synopsis: The ACOSOG-Z0011- and the AMAROS-trial obviated the need for axillary surgery in most sentinel node-positive (SLN+) breast cancer patients undergoing breast conserving surgery. In this study in SLN+ patients undergoing mastectomy, use of axillary surgery decreased drastically over time.

August 24 - Bidirectional Approach with PIPAC and Systemic Chemotherapy for Patients with Synchronous Gastric Cancer Peritoneal Metastases (GCPM)

Citation: Casella, F., Bencivenga, M., Brancato, G. et al. Bidirectional Approach with PIPAC and Systemic Chemotherapy for Patients with Synchronous Gastric Cancer Peritoneal Metastases (GCPM). Ann Surg Oncol 30, 5733–5742 (2023). https://doi.org/10.1245/s10434-023-13572-7

Synopsis: This study evaluates the efficacy of PIPAC with systemic chemotherapy as bidirectional approach for Gastric Cancer (GC) patients with Synchronous Peritoneal Metastases (SPM).

August 17 - Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer

Citation: Maki, H., Ayabe, R.I., Nishioka, Y. et al. Hepatectomy Before Primary Tumor Resection as Preferred Approach for Synchronous Liver Metastases from Rectal Cancer. Ann Surg Oncol 30, 5390–5400 (2023). https://doi.org/10.1245/s10434-023-13656-4

August 17 - Evaluation of National Surgical Practice for Lateral Lymph Nodes in Rectal Cancer in an Untrained Setting

Citation: Sluckin, T.C., Hazen, SM.J.A., Horsthuis, K. et al. Evaluation of National Surgical Practice for Lateral Lymph Nodes in Rectal Cancer in an Untrained Setting. Ann Surg Oncol 30, 5472–5485 (2023). https://doi.org/10.1245/s10434-023-13460-0

Synopsis: Consensus is lacking regarding the type of surgical treatment required for malignant lateral lymph nodes (LLNs) in rectal cancer. This cross-sectional multicenter study found that 64 patients in the Netherlands in 2016 underwent additional LLN-surgery, resulting in four-year lateral local recurrence rates of 14-20%.

August 10 - Minimally Invasive and Open Gastrectomy for Gastric Cancer: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials

Citation: Davey, M.G., Temperley, H.C., O’Sullivan, N.J. et al. Minimally Invasive and Open Gastrectomy for Gastric Cancer: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials. Ann Surg Oncol 30, 5544–5557 (2023). https://doi.org/10.1245/s10434-023-13654-6

Synopsis: The authors report on a network meta-analysis of randomized clinical trials comparing outcomes after open (OG), laparoscopic-assisted (LAG), and robotic gastrectomy for gastric cancer. This analysis demonstrates the non-inferiority of oncological and surgical outcomes for OG and LAG in patients being treated predominantly for early gastric cancer following at 5 years follow-up.

August 10 - The 2022 PSOGI International Consensus on HIPEC Regimens for Peritoneal Malignancies: Epithelial Ovarian Cancer

Citation: Bhatt, A., Glehen, O., Zivanovic, O. et al. The 2022 PSOGI International Consensus on HIPEC Regimens for Peritoneal Malignancies: Epithelial Ovarian Cancer. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-13932-3

Synopsis: An expert panel of over 70 gynecological and surgical oncologists voted on 38 key questions regarding the use of HIPEC in epithelial ovarian cancer. The recommendations should guide clinical practice and direct future research.

August 3 - Diffuse Sclerosing Papillary Thyroid Carcinoma: Clinicopathological Characteristics and Prognostic Implications Compared with Classic and Tall Cell Papillary Thyroid Cancer

Citation: Scholfield, D.W., Fitzgerald, C.W., Alzumaili, B. et al. Diffuse Sclerosing Papillary Thyroid Carcinoma: Clinicopathological Characteristics and Prognostic Implications Compared with Classic and Tall Cell Papillary Thyroid Cancer. Ann Surg Oncol 30, 4761–4770 (2023). https://doi.org/10.1245/s10434-023-13589-y

Synopsis: Diffuse sclerosing papillary thyroid carcinoma characteristically presents with large volume nodal metastases and lymphatic invasion. Almost half of patients develop recurrence despite aggressive initial management. Despite this, disease specific survival is excellent.

August 3 - Defining the Values and Quality of Life of Cancer Survivors Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: An International Survey Study

Citation: Knotts, C.M., Osman, M.A., Aderonmu, A.A. et al. Defining the Values and Quality of Life of Cancer Survivors Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: An International Survey Study. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-14034-w

Synopsis: This study investigated the quality of life and values of patients with cancer who underwent CRS±HIPEC. Despite long-term impairments, quality of life improved over time and is similar to other surgery survivors. Survivors prioritized longevity and independence over experience and cost.

July 27 - Survival Outcomes in Women with Unilateral, Triple-Negative, Breast Cancer Correlated with Contralateral Prophylactic Mastectomy

Citation: Fasano, G.A., Bayard, S., Chen, Y. et al. Survival Outcomes in Women with Unilateral, Triple-Negative, Breast Cancer Correlated with Contralateral Prophylactic Mastectomy. Ann Surg Oncol 30, 4648–4656 (2023). https://doi.org/10.1245/s10434-022-13056-0

Synopsis: Contralateral prophylactic mastectomy (CPM) does not improve survival among women with unilateral triple negative breast cancer (TNBC) without BRCA mutations. Further study is needed to evaluate potential benefit of CPM among TNBC patients with BRCA mutations.

July 27 - Desmoid Tumors in Familial Adenomatous Polyposis Patients: Favorable Outcomes with Multidisciplinary Management

Citation: Al-Sukhni, E., Shapiro, J., Suraweera, H. et al. Desmoid Tumors in Familial Adenomatous Polyposis Patients: Favorable Outcomes with Multidisciplinary Management. Ann Surg Oncol 30, 5142–5149 (2023). https://doi.org/10.1245/s10434-023-13675-1

Synopsis: Familial adenomatous polyposis (FAP) associated desmoid tumors represent a distinct subset of desmoid disease with potentially significant morbidity and mortality. We describe the characteristics, management, and outcomes of a group of FAP patients with desmoid tumors treated at our high-volume sarcoma center.

July 20 - Survival and Symptomatic Relief After Cytoreductive Hepatectomy for Neuroendocrine Tumor Liver Metastases: Long-Term Follow-up Evaluation of More Than 500 Patients

Citation: Gudmundsdottir, H., Habermann, E.B., Vierkant, R.A. et al. Survival and Symptomatic Relief After Cytoreductive Hepatectomy for Neuroendocrine Tumor Liver Metastases: Long-Term Follow-up Evaluation of More Than 500 Patients. Ann Surg Oncol 30, 4840–4851 (2023). https://doi.org/10.1245/s10434-023-13372-z

Synopsis: In this study, the authors describe their 20-year institutional experience with cytoreductive hepatectomy in over 500 patients with neuroendocrine tumor liver metastases, including perioperative outcomes, rates of symptom relief in patients with functional tumors, and long-term overall and progression-free survival.

July 20 - Locally Recurrent Rectal Cancer: Toward a Second Chance at Cure? A Population-Based, Retrospective Cohort Study

Citation: Swartjes, H., van Rees, J.M., van Erning, F.N. et al. Locally Recurrent Rectal Cancer: Toward a Second Chance at Cure? A Population-Based, Retrospective Cohort Study. Ann Surg Oncol 30, 3915–3924 (2023). https://doi.org/10.1245/s10434-023-13141-y

Synopsis: Three-year cumulative incidence of locally recurrent rectal cancer (LRRC) was 6.4%. More than 40% of LRRC patients received curative-intent treatment. Three-year overall survival after curative-intent treatment was 70%. The impact of prior neoadjuvant treatment on LRRC outcomes seems limited.

July 13 - Biopsy-Guided Pathological Response Assessment in Breast Cancer is Insufficient: Additional Pathology Findings of the MICRA Trial

Citation: van Hemert, A.K.E., van Duijnhoven, F.H., van Loevezijn, A.A. et al. Biopsy-Guided Pathological Response Assessment in Breast Cancer is Insufficient: Additional Pathology Findings of the MICRA Trial. Ann Surg Oncol 30, 4682–4689 (2023). https://doi.org/10.1245/s10434-023-13476-6

Synopsis: This pathology sub-study quantifies the residual disease remaining after neoadjuvant systemic therapy in breast cancer patients with a favorable response on MRI as well as residual disease missed with 14G biopsies. Substantial residual invasive disease was missed in all subtypes which may hamper local control and limits adjuvant systemic treatment options. Therefore, surgical excision remains obligatory until accuracy of imaging and biopsy techniques improve.

July 13 - Nationwide Impact of Centralization, Neoadjuvant Therapy, Minimally Invasive Surgery, and Standardized Pathology Reporting on R0 Resection and Overall Survival in Pancreatoduodenectomy for Pancreatic Cancer

Citation: Augustinus, S., Schafrat, P.J.M., Janssen, B.V. et al. Nationwide Impact of Centralization, Neoadjuvant Therapy, Minimally Invasive Surgery, and Standardized Pathology Reporting on R0 Resection and Overall Survival in Pancreatoduodenectomy for Pancreatic Cancer. Ann Surg Oncol 30, 5051–5060 (2023). https://doi.org/10.1245/s10434-023-13465-9

Synopsis: In this nationwide cohort study in 2955 patients after pancreatoduodenectomy (PD) for pancreatic cancer the R0 resection rate decreased over time (2009-2019), mostly related to more complete pathology reporting, but remained associated with improved overall survival.

July 6 - Surgical Management of Germline Gastrointestinal Stromal Tumor

Citation: Kwak, H.V., Tardy, K.J., Allbee, A. et al. Surgical Management of Germline Gastrointestinal Stromal Tumor. Ann Surg Oncol 30, 4966–4974 (2023). https://doi.org/10.1245/s10434-023-13519-y

Synopsis: Germline mutations causing gastrointestinal stromal tumors (GISTs) are rare and surgical management of some of these patients is controversial. The authors discuss this controversy and highlight key concepts in a patient with a germline KIT 579 deletion.

July 6 - Value of Ambulatory Modified Radical Mastectomy

Citation: Bryan, A.F., Castillo-Angeles, M., Minami, C. et al. Value of Ambulatory Modified Radical Mastectomy. Ann Surg Oncol 30, 4637–4643 (2023). https://doi.org/10.1245/s10434-023-13588-z

Synopsis: Though oncologic breast surgery is often ambulatory, modified radical mastectomy (MRM) is still frequently an inpatient procedure. The authors used population-level data to reveal that ambulatory MRM patients were readmitted less often, and the procedure was less expensive in the ambulatory setting. Ambulatory MRM should be performed for the appropriate patients.

June 29 - Influence of Extraperitoneal Metastases on the Curative-Intent Management of Colorectal Peritoneal Metastases

Citation: Schell, F., Kefleyesus, A., Benzerdjeb, N. et al. Influence of Extraperitoneal Metastases on the Curative-Intent Management of Colorectal Peritoneal Metastases. Ann Surg Oncol 30, 4444–4454 (2023). https://doi.org/10.1245/s10434-023-13279-9

Synopsis: In a retrospective analysis of the impact of extra-peritoneal metastases on curative-intent management of colorectal patients with peritoneal metastases, the combined resection of liver metastases did not lead to decreased survival, while retroperitoneal lymph nodes and/or two extra-peritoneal metastatic sites impaired the prognosis.

June 29 - Organ Infiltration and Patient Risk After Multivisceral Surgery for Primary Retroperitoneal Liposarcomas

Citation: Improta, L., Pasquali, S., Iadecola, S. et al. Organ Infiltration and Patient Risk After Multivisceral Surgery for Primary Retroperitoneal Liposarcomas. Ann Surg Oncol 30, 4500–4510 (2023). https://doi.org/10.1245/s10434-023-13314-9

Synopsis: This study investigated histologic organ involvement (HOI) in patients with retroperitoneal liposarcomas. HOI was a frequent finding, supporting the need for multivisceral surgery. HOI revealed itself as an independent predictor of outcome, suggesting its factoring in patients’ risk stratification.

June 15 - Feasibility and Safety of Tailored Lymphadenectomy Using Sentinel Node-Navigated Surgery in Patients with High-Risk T1 Esophageal Adenocarcinoma

Citation:

Frederiks, C.N., Overwater, A., Bergman, J.J.G.H.M. et al. Feasibility and Safety of Tailored Lymphadenectomy Using Sentinel Node-Navigated Surgery in Patients with High-Risk T1 Esophageal Adenocarcinoma. Ann Surg Oncol 30, 4002–4011 (2023). https://doi.org/10.1245/s10434-023-13317-6

Synopsis: This study investigates the feasibility and safety of a new treatment algorithm for patients with high-risk T1 esophageal adenocarcinoma, consisting of a radical endoscopic resection of the tumor followed by tailored lymphadenectomy using sentinel node-navigated surgery with a hybrid tracer of technetium-99m nanocolloid and indocyanine green.

June 15 - Association Between Metastatic Pattern and Prognosis in Stage IV Gastric Cancer: Potential for Stage Classification Reform.

Citation:

Zhan, P.L., Canavan, M.E., Ermer, T. et al. Association Between Metastatic Pattern and Prognosis in Stage IV Gastric Cancer: Potential for Stage Classification Reform. Ann Surg Oncol 30, 4180–4191 (2023). https://doi.org/10.1245/s10434-023-13287-9

Synopsis: 9% of stage IV gastric cancer patients present with distant disease limited to nonregional lymph nodes. They are managed similarly to other stage IV patients but experience a better prognosis, suggesting opportunities to introduce M1 staging subclassifications for gastric cancer.

June 8 - FOLFIRINOX or Gemcitabine-based Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: A Multi-institutional, Patient-Level, Meta-analysis and Systematic Review

Citation:

Eshmuminov, D., Aminjonov, B., Palm, R.F. et al. FOLFIRINOX or Gemcitabine-based Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: A Multi-institutional, Patient-Level, Meta-analysis and Systematic Review. Ann Surg Oncol 30, 4417–4428 (2023). https://doi.org/10.1245/s10434-023-13353-2

Synopsis: The primary aim of this meta-analysis was to assess the impact of primary chemotherapy, FOLFIRINOX or gemcitabine-based chemotherapy regimens, on survival rates of patients with borderline resectable pancreas cancer and locally advanced pancreas cancer.

June 8 - Targeted Axillary Dissection with 125I Seed Placement Before Neoadjuvant Chemotherapy in a Danish Multicenter Cohort

Citation:

Munck, F., Andersen, I.S., Vejborg, I. et al. Targeted Axillary Dissection with ¹²⁵I Seed Placement Before Neoadjuvant Chemotherapy in a Danish Multicenter Cohort. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-13432-4

Synopsis: Targeted axillary dissection varies in methodology, but using ¹²⁵I seeds without re-marking before surgery shows an excellent identification rate with detection of the sentinel node comparable to literature. This spares 41% of patients a redundant axillary dissection.

June 1 - Benchmarks and Geographic Differences in Gallbladder Cancer Surgery: An International Multicenter Study

Citation:

Vega, E.A., Newhook, T.E., Mellado, S. et al. Benchmarks and Geographic Differences in Gallbladder Cancer Surgery: An International Multicenter Study. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-13531-2

Synopsis: Surgery for gallbladder cancer (GBC) is complex, requiring expertise, and associated with significant morbidity. The present study defines benchmark values, which represent the best achievable results in patients with GBC. Such values may help promote high-quality surgery and reach excellent oncologic care.

June 1 - Long-Term Survival in Patients Treated with Cytoreduction and Heated Intraperitoneal Chemotherapy for Peritoneal Mesothelioma at a Single High-Volume Center.

Citation:

Valenzuela, C.D., Solsky, I.B., Erali, R.A. et al. Long-Term Survival in Patients Treated with Cytoreduction and Heated Intraperitoneal Chemotherapy for Peritoneal Mesothelioma at a Single High-Volume Center. Ann Surg Oncol 30, 2666–2675 (2023). https://doi.org/10.1245/s10434-022-13061-3

Synopsis: The authors report long-term survival data for patients with malignant peritoneal mesothelioma treated with cytoreduction and heated intraperitoneal chemotherapy. Analysis of a single institutional cohort (111 patients) identified key factors correlated with overall survival. The authors also report conditional survival in this context.

May 25 - Optimizing Circulating Tumour DNA Use in the Perioperative Setting for Intrahepatic Cholangiocarcinoma: Diagnosis, Screening, Minimal Residual Disease Detection and Treatment Response Monitoring

Choi, W.J., Ivanics, T., Gravely, A. et al. Optimizing Circulating Tumour DNA Use in the Perioperative Setting for Intrahepatic Cholangiocarcinoma: Diagnosis, Screening, Minimal Residual Disease Detection and Treatment Response Monitoring. Ann Surg Oncol 30, 3849–3863 (2023). https://doi.org/10.1245/s10434-023-13126-x

Synopsis: In this review, we present the current evidence and future perspectives on the use of circulating tumor DNA (ctDNA) in the diagnosis, management and understanding the prognosis of patients with intrahepatic cholangiocarcinoma undergoing surgery.

May 25 - Clinical Significance of Signal Regulatory Protein Alpha (SIRPα) Expression in Hepatocellular Carcinoma

Tomiyama, T., Itoh, S., Iseda, N. et al. Clinical Significance of Signal Regulatory Protein Alpha (SIRPα) Expression in Hepatocellular Carcinoma. Ann Surg Oncol 30, 3378–3389 (2023). https://doi.org/10.1245/s10434-022-13058-y

Synopsis: This study aimed to examine the clinical significance of SIRPα expression in HCC tumors using RNA-sequencing (RNA-seq) data from a public database and immunohistochemical data from a public database of patients who underwent surgical resection for HCC.

May 18 - The Landmark Series—Ductal Carcinoma in Situ: The Evolution of Treatment

Nash, A.L., Hwang, E.S. The Landmark Series—Ductal Carcinoma in Situ: The Evolution of Treatment. Ann Surg Oncol 30, 3206–3214 (2023). https://doi.org/10.1245/s10434-023-13370-1

Synopsis: This review describes the landmark studies on which current DCIS management is based.

May 18 - Top Pancreatic Tumor Articles from 2021 to Inform Your Cancer Patients

Hogg, M.E., Melstrom, L.G. Top Pancreatic Tumor Articles from 2021 to Inform Your Cancer Patients. Ann Surg Oncol 30, 3437–3443 (2023). https://doi.org/10.1245/s10434-023-13277-x

Synopsis: The publications highlighted in this review of 2021 articles are comprehensive on the current management of neoadjuvant therapy for resectable pancreatic cancer, the addition of radiation to neoadjuvant therapy for borderline resectable pancreatic cancer, the utility of arterial resections in unresectable pancreatic cancer, and the role of minimally invasive approach to pancreatic cancer surgical therapy.

May 11 - Understanding Potentially Preventable Mortality Following Oesophago-Gastric Cancer Surgery: Analysis of a National Audit of Surgical Mortality

Liu, D.S., Fayed, A., Evans, P. et al. Understanding Potentially Preventable Mortality Following Oesophago-Gastric Cancer Surgery: Analysis of a National Audit of Surgical Mortality. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-13571-8

Synopsis: Analysis of the Australian and New Zealand Audit of Surgical Mortality demonstrated that almost 50% of deaths following esophago-gastric cancer surgery were potentially preventable. These cases were characterized by higher rates of sepsis, multiorgan dysfunction syndrome, reoperations, and other complications.

May 11 - Race, Insurance, and Sex-Based Disparities in Access to High-Volume Centers for Pancreatectomy

Williamson, C.G., Ebrahimian, S., Sakowitz, S. et al. Race, Insurance, and Sex-Based Disparities in Access to High-Volume Centers for Pancreatectomy. Ann Surg Oncol 30, 3002–3010 (2023). https://doi.org/10.1245/s10434-022-13032-8

Synopsis: High-volume centers for pancreatic cancer operations have superior clinical outcomes compared to lower-volume centers, but treat lower proportions of female, non-White, and Medicaid populations. These findings may have implications for improving access to high-quality centers for patients with this devastating disease.

May 4 - Intraoperative Ultrasound During Surgical Exploration in Patients with Pancreatic Cancer and Vascular Involvement (ULTRAPANC): A Prospective Multicenter Study

Michiels, N., Doppenberg, D., Groen, J.V. et al. Intraoperative Ultrasound During Surgical Exploration in Patients with Pancreatic Cancer and Vascular Involvement (ULTRAPANC): A Prospective Multicenter Study. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-13112-3

Synopsis: Intraoperative ultrasound is being used during surgical exploration in patients with pancreatic cancer and vascular involvement to assess resectability, especially following chemotherapy. In this study, intraoperative ultrasound changed the resectability status in 32/85 patients (38%), mainly downstaging (30/32 patients; 94%).

May 4 - A Model to Predict Treatment Failure in Patients Undergoing Upfront Surgery for Resectable Colorectal Liver Metastases

Berardi, G., Chou, J., Gonen, M. et al. A Model to Predict Treatment Failure in Patients Undergoing Upfront Surgery for Resectable Colorectal Liver Metastases. Ann Surg Oncol 30, 2820–2827 (2023). https://doi.org/10.1245/s10434-023-13113-2

Synopsis:

This study aimed to investigate the outcomes of a large cohort of patients undergoing upfront surgery for resectable colorectal liver metastases (CRLM) and identify those experiencing early recurrence as a surrogate for a group who may be more likely to benefit from neoadjuvant chemotherapy or novel selection strategies.

April 27 - Higher Tumor Burden Status Dictates the Impact of Surgical Margin Status on Overall Survival in Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma

Endo, Y., Sasaki, K., Moazzam, Z. et al. Higher Tumor Burden Status Dictates the Impact of Surgical Margin Status on Overall Survival in Patients Undergoing Resection of Intrahepatic Cholangiocarcinoma. Ann Surg Oncol 30, 2023–2032 (2023). https://doi.org/10.1245/s10434-022-12803-7

Synopsis: The objective of this study was to define the impact of resection margin status on long-term survival relative to overall intrahepatic cholangiocarcinoma (ICC) tumor burden status. In particular, the authors assessed whether the prognostic significance of margin status, as well as wider margin width, varied based on ICC tumor burden score (TBS) and nodal status.

April 27 - Young Black Women May be More Likely to Have First Mammogram Cancers: A New Perspective in Breast Cancer Disparities

Citation:

Wilkerson, A.D., Obi, M., Ortega, C. et al. Young Black Women May be More Likely to Have First Mammogram Cancers: A New Perspective in Breast Cancer Disparities. Ann Surg Oncol 30, 2856–2869 (2023). https://doi.org/10.1245/s10434-022-12995-y

Synopsis:

Mammographic screening recommendations remain discordant. This study demonstrates that Black women may be more likely to have cancer detected on their first mammogram. It also highlights an association between first mammogram cancers, younger age and greater disease burden at diagnosis.

April 20 - Treatment of Peritoneal Metastasis with Pressurized Intraperitoneal Aerosol Chemotherapy: Results from the Prospective PIPAC-OPC2 Study

Citation:

Graversen, M., Detlefsen, S., Ainsworth, A.P. et al. Treatment of Peritoneal Metastasis with Pressurized Intraperitoneal Aerosol Chemotherapy: Results from the Prospective PIPAC-OPC2 Study. Ann Surg Oncol 30, 2634–2644 (2023). https://doi.org/10.1245/s10434-022-13010-0

Synopsis: Pressurized IntraPeritoneal Aerosol Chemotherapy is a safe treatment in patients with peritoneal metastasis. In the largest prospective, controlled study to date, the authors show that the Peritoneal Regression Grading score holds significant prognostic information.

April 20 - The Current State of Liver Transplantation for Colorectal Liver Metastases in the United States: A Call for Standardized Reporting

Citation:

Sasaki, K., Ruffolo, L.I., Kim, M.H. et al. The Current State of Liver Transplantation for Colorectal Liver Metastases in the United States: A Call for Standardized Reporting. Ann Surg Oncol 30, 2769–2777 (2023). https://doi.org/10.1245/s10434-023-13147-6

Synopsis: The interest in liver transplantation for metastatic colorectal cancer to the liver (CRLM) has exploded onto the transplant oncology scene. This study aimed to elucidate the current US situation using the United Network Organ Sharing (UNOS) database. Between December/2017-March/2022, 46 patients received transplants and their 3-year survival rate was 60.4%.

April 13 - The Cancer Hub Approach for Upper Gastrointestinal Surgery During COVID-19 Pandemic: Outcomes from a UK Cancer Centre

Citation:

Doyle, J.P., Patel, P.H., Doran, S.L.F. et al. The Cancer Hub Approach for Upper Gastrointestinal Surgery During COVID-19 Pandemic: Outcomes from a UK Cancer Centre. Ann Surg Oncol 30, 2266–2275 (2023). https://doi.org/10.1245/s10434-022-12571-4

Synopsis: This article describes the operational set-up and favorable clinical outcomes when performing upper gastrointestinal cancer surgery via the dedicated “RM Partners Cancer Hub” approach during the COVID-19 pandemic.

April 13 - Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers: A Nationwide Audit Study

Citation:

de Bakker, J.K., Suurmeijer, J.A., Toennaer, J.G.J. et al. Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers: A Nationwide Audit Study. Ann Surg Oncol 30, 2448–2455 (2023). https://doi.org/10.1245/s10434-022-12701-y

Synopsis: The aim of this multicenter, nationwide audit-based study was to determine the postoperative morbidity and mortality after pancreatoduodenectomy for duodenal adenocarcinoma compared to other periampullary cancers.

April 6 - Practice-Changing Evidence in Surgical Oncology 2021: Hepatobiliary Articles

Citation:

Wei, A.C. Practice-Changing Evidence in Surgical Oncology 2021: Hepatobiliary Articles. Ann Surg Oncol 30, 1960–1965 (2023). https://doi.org/10.1245/s10434-023-13132-z

Synopsis: The article highlights the best studies of the past year in hepatobiliary cancer and describes how this new evidence will impact clinical practice.

April 6 - The Landmark Series: The Breast Cancer Burden of the Asian American Population and the Need for Disaggregated Data

Citation:

Eden, C.M., Johnson, J., Syrnioti, G. et al. The Landmark Series: The Breast Cancer Burden of the Asian American Population and the Need for Disaggregated Data. Ann Surg Oncol 30, 2121–2127 (2023). https://doi.org/10.1245/s10434-023-13103-4

Synopsis: This Landmark Series article showcases the breadth of the breast cancer burden in the Asian American Pacific Islander (AAPI) population and highlights the need for disaggregated ethnic data.

March 9 - Plasma Exosome Gene Signature Differentiates Colon Cancer from Healthy Controls

Citation:

Vallejos, P.A., Gonda, A., Yu, J. et al. Plasma Exosome Gene Signature Differentiates Colon Cancer from Healthy Controls. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-13219-7

Synopsis: Current liquid biopsy options lack sensitivity in peritoneal carcinomatosis (PC). In this initial feasibility analysis, we have identified a plasma exosome-based gene signature of 445 genes from colon cancer patients, including those with PC, that is distinct from healthy controls.

March 9 - Preoperative Partial Breast Irradiation in Patients with Low-Risk Breast Cancer: A Systematic Review of Literature

Citation:

Civil, Y.A., Jonker, L.W., Groot Koerkamp, M.P.M. et al. Preoperative Partial Breast Irradiation in Patients with Low-Risk Breast Cancer: A Systematic Review of Literature. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-023-13233-9

Synopsis: This systematic review shows that pre-operative partial breast irradiation is a feasible treatment option in patients with low-risk breast cancer. Pathologic complete response was reported in almost half of the patients with acceptable toxicity, good oncological and cosmetic outcomes.

March 2 - Locoregionally Recurrent Colon Cancer: How Far Have We Come? A Population-Based, Retrospective Cohort Study

Swartjes, H., van Lankveld, D.W.P., van Erning, F.N. et al. Locoregionally Recurrent Colon Cancer: How Far Have We Come? A Population-Based, Retrospective Cohort Study. Ann Surg Oncol 30, 1726–1734 (2023). https://doi.org/10.1245/s10434-022-12689-5

Synopsis: Three-year cumulative incidence of LRCC was 3.8%. Curative-intent treatment was given to nearly 30% of LRCC patients. Three-year overall survival after curative-intent treatment was 71%. Outcomes of LRCC in this study were excellent in comparison with literature.

March 2 - Risk Stratification of Sentinel Node Metastasis Disease Burden and Phenotype in Stage III Melanoma Patients

Hussain, Z., Heaton, M.J., Snelling, A.P. et al. Risk Stratification of Sentinel Node Metastasis Disease Burden and Phenotype in Stage III Melanoma Patients. Ann Surg Oncol 30, 1808–1819 (2023). https://doi.org/10.1245/s10434-022-12804-6

Synopsis: An alternative staging system for micrometastatic SN+ stage III melanoma based on maximum tumor deposit size and extracapsular spread, consistently valid across pT1-pT4a melanomas, stratifying patients for either adjuvant systemic therapy or observation. The authors found no low-risk SN+ pT4b melanomas.

February 23 - Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study

Citation:

Chen, J.W., van Ramshorst, T.M.E., Lof, S. et al. Robot-Assisted Versus Laparoscopic Distal Pancreatectomy in Patients with Resectable Pancreatic Cancer: An International, Retrospective, Cohort Study. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-022-13054-2

Synopsis: In this international multicenter retrospective cohort of patients with resectable pancreatic cancer, robot-assisted distal pancreatectomy appeared as oncologically safe as laparoscopic distal pancreatectomy in terms of R0-resection and survival rates. Although the lymph node yield and conversion rate appeared favorable after RDP, LDP was associated with shorter operating time, less major complications, and shorter hospital stay.

February 23 - Delayed Sentinel Lymph Node Dissection in Patients with a Preoperative Diagnosis of Ductal Cancer In Situ by Preoperative Injection with Superparamagnetic Iron Oxide (SPIO) Nanoparticles: The SentiNot Study

Citation:

Karakatsanis, A., Eriksson, S., Pistiolis, L. et al. Delayed Sentinel Lymph Node Dissection in Patients with a Preoperative Diagnosis of Ductal Cancer In Situ by Preoperative Injection with Superparamagnetic Iron Oxide (SPIO) Nanoparticles: The SentiNot Study. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-022-13064-0

Synopsis: In this prospective cohort study of 254 women with DCIS, SPIO was injected in the breast to mark the SLN, but no upfront SLND was performed. In all, 78.3% avoided upfront SLND. In delayed SLND, SPIO outperformed the isotope in SLN detection (98.2% vs 63.6%, p<0.001).

February 16 - The Landmark Series: Intraductal Papillary Mucinous Neoplasms of the Pancreas—From Prevalence to Early Cancer Detection

Citation:

Pollini, T., Wong, P. & Maker, A.V. The Landmark Series: Intraductal Papillary Mucinous Neoplasms of the Pancreas—From Prevalence to Early Cancer Detection. Ann Surg Oncol 30, 1453–1462 (2023). https://doi.org/10.1245/s10434-022-12870-w

Synopsis: Intraductal Papillary Mucinous Neoplasms (IPMN) of the pancreas are the most common pancreatic cystic neoplasms, and are known predecessors of pancreatic adenocarcinoma.In this article, landmark data on IPMN prevalence, guidelines, surveillance, biomarkers, and

immune landscape are highlighted.

February 16 - Adjuvant Chemoradiation in Patients with Lymph Node-Positive Biliary Tract Cancers: Secondary Analysis of a Single-Arm Clinical Trial (SWOG 0809)

Citation:

Gholami, S., Colby, S., Horowitz, D.P. et al. Adjuvant Chemoradiation in Patients with Lymph Node-Positive Biliary Tract Cancers: Secondary Analysis of a Single-Arm Clinical Trial (SWOG 0809). Ann Surg Oncol 30, 1354–1363 (2023). https://doi.org/10.1245/s10434-022-12863-Synopsis: Lymph node status is a strong predictor for recurrence in biliary cancers. A secondary analysis of S0809 was performed to estimate survival benefits of adjuvant chemoradiation based on nodal status in this population compared to historic controls.

February 9 - The Association of Frailty with Outcomes after Cancer Surgery: A Systematic Review and Metaanalysis

Shaw, J.F., Budiansky, D., Sharif, F. et al. The Association of Frailty with Outcomes after Cancer Surgery: A Systematic Review and Metaanalysis. Ann Surg Oncol 29, 4690–4704 (2022). https://doi.org/10.1245/s10434-021-11321-2

Synopsis: Frailty is common among older adults. In this article, the authors systematically reviewed the association of frailty with adverse outcomes in older adults undergoing cancer surgery. Frailty was significantly associated with increased odds of postoperative mortality, complications, adverse discharge, and increased length-of-stay.

February 9 - Impact of the Histologic Pattern of Residual Tumor After Neoadjuvant Chemotherapy on Recurrence and Survival in Stage I–III Breast Cancer

Laws, A., Pastorello, R., Dey, T. et al. Impact of the Histologic Pattern of Residual Tumor After Neoadjuvant Chemotherapy on Recurrence and Survival in Stage I–III Breast Cancer. Ann Surg Oncol 29, 7726–7736 (2022). https://doi.org/10.1245/s10434-022-12054-6

Synopsis: Slides from 666 patients treated with NAC and surgery underwent central pathology review to determine pattern of residual tumor and evaluate its prognostic significance. A scattered (relative to concentric) pattern of response was associated with inferior recurrence-free and overall survival.

February 2 - Local-Regional Recurrence After Neoadjuvant Endocrine Therapy: Data from ACOSOG Z1031 (Alliance), a Randomized Phase 2 Neoadjuvant Comparison Between Letrozole, Anastrozole, and Exemestane for Postmenopausal Women with Estrogen Receptor-Positive Clinical Stage 2 or 3 Breast Cancer

Hunt, K.K., Suman, V.J., Wingate, H.F. et al. Local-Regional Recurrence After Neoadjuvant Endocrine Therapy: Data from ACOSOG Z1031 (Alliance), a Randomized Phase 2 Neoadjuvant Comparison Between Letrozole, Anastrozole, and Exemestane for Postmenopausal Women with Estrogen Receptor-Positive Clinical Stage 2 or 3 Breast Cancer. Ann Surg Oncol (2023). https://doi.org/10.1245/s10434-022-12972-5

Synopsis: ACOSOG Z1031 (Alliance) was designed to determine which aromatase inhibitor is most effective for postmenopausal women with estrogen receptor–positive stage 2 to 3 breast cancer in the neoadjuvant setting. The local-regional recurrence rate of 509 women is reported here.

February 2 - Improved Adherence to ATA Medullary Thyroid Cancer Treatment Guidelines

McMullin, J.L., Sharma, J., Gillespie, T. et al. Improved Adherence to ATA Medullary Thyroid Cancer Treatment Guidelines. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12734-3

Synopsis: The 2009 ATA guidelines for medullary thyroid cancer were created to unify national practice patterns. Treatment was discordant from guidelines in 26% of cases after 2009 compared to 33% prior. Improved adherence to guidelines correlates with improved overall survival.

January 26 - Association of Medicaid Expansion with Pancreatic Cancer Treatment and Outcomes: Evidence from the National Cancer Database

Fonseca, A.L., Cherla, D., Kothari, A.N. et al. Association of Medicaid Expansion with Pancreatic Cancer Treatment and Outcomes: Evidence from the National Cancer Database. Ann Surg Oncol 29, 342–351 (2022). https://doi.org/10.1245/s10434-021-10709-4

Synopsis: Medicaid expansion impacts access to treatment and outcomes in pancreatic cancer. In this cohort study of 41,486 patients with non-metastatic pancreatic adenocarcinoma in the National Cancer Database from 2006 to 2016, Medicaid expansion was associated with increased rates of curative intent surgical resection, multimodal therapy and treatment at high-volume facilities. Medicaid expansion was also associated with improved 30- day and 90-day survival and overall survival.

January 26 - Multimodal Prehabilitation During Neoadjuvant Therapy Prior to Esophagogastric Cancer Resection: Effect on Cardiopulmonary Exercise Test Performance, Muscle Mass and Quality of Life—A Pilot Randomized Clinical Trial.

Allen, S.K., Brown, V., White, D. et al. Multimodal Prehabilitation During Neoadjuvant Therapy Prior to Esophagogastric Cancer Resection: Effect on Cardiopulmonary Exercise Test Performance, Muscle Mass and Quality of Life—A Pilot Randomized Clinical Trial. Ann Surg Oncol 29, 1839–1850 (2022). https://doi.org/10.1245/s10434-021-11002-0

Synopsis: This randomized controlled trial demonstrates that multimodal prehabilitation can result in skeletal muscle and cardiopulmonary fitness (peak VO2) retention and improvements in quality of life in patients undergoing neoadjuvant therapy for locally advanced oesophagogastric cancer compared with control subjects.

January 19 - Impact of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Gastric Cancer with Peritoneal Carcinomatosis: A Systematic Review and Meta-analysis.

Martins, M., Santos-Sousa, H., Araújo, F. et al. Impact of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Gastric Cancer with Peritoneal Carcinomatosis: A Systematic Review and Meta-analysis. Ann Surg Oncol 29, 7528–7537 (2022). https://doi.org/10.1245/s10434-022-12312-7

Synopsis: The main aim of this systematic review with meta-analysis is to compare the survival, postoperative complications, and peritoneal recurrence between cytoreductive surgery with hyperthermic intraperitoneal chemotherapy and cytoreductive surgery alone, in gastric cancer patients with peritoneal carcinomatosis.

January 19 - Male Breast Cancer Patient and Surgeon Experience: The Male WhySurg Study.

Chichura, A., Attai, D.J., Kuchta, K. et al. Male Breast Cancer Patient and Surgeon Experience: The Male WhySurg Study. Ann Surg Oncol 29, 6115–6131 (2022). https://doi.org/10.1245/s10434-022-12135-6

Synopsis: The authors report on survey results that found that men undergoing mastectomy without reconstruction are often dissatisfied with their cosmetic outcomes. Surgeons expressed willingness to perform breast conserving surgery and offer reconstruction to men with breast cancer, but less than half had experience.

January 12 - Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer: An International Multicenter Cohort Study

van Veldhuisen, E., Klompmaker, S., Janssen, Q.P. et al. Surgical and Oncological Outcomes After Preoperative FOLFIRINOX Chemotherapy in Resected Pancreatic Cancer: An International Multicenter Cohort Study. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12387-2

Synopsis: This study comprising 423 patients with resected pancreatic cancer after preoperative FOLFIRINOX chemotherapy demonstrated a 38-month OS in patients with borderline resectable pancreatic cancer and 33 months in locally advanced pancreatic cancer. Neither the number of preoperative cycles nor the use of adjuvant therapy were associated with survival.

January 12 - Evaluation of the Impact of the COVID-19 Pandemic on Reliability of Cancer Surveillance Data in the National Cancer Database

Nogueira, L.M., Palis, B., Boffa, D. et al. Evaluation of the Impact of the COVID-19 Pandemic on Reliability of Cancer Surveillance Data in the National Cancer Database. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12935-w

Synopsis: There was a decrease in the number of cancer cases reported to the National Cancer Database (NCDB) during 2020, the first year of the COVID-19 pandemic, reflecting changes in healthcare utilization during the lockdown rather than changes in data collection.

January 3 - Educational Review: Intraoperative Parathyroid Fluorescence Detection Technology in Thyroid and Parathyroid Surgery

Citation: St. Amour, T.C., Demarchi, M.S., Thomas, G. et al. Educational Review: Intraoperative Parathyroid Fluorescence Detection Technology in Thyroid and Parathyroid Surgery. Ann Surg Oncol 30, 973–993 (2023). https://doi.org/10.1245/s10434-022-12807-3

Synopsis: Image- and probe-based near-infrared autofluorescence detection systems can be used to identify in situ parathyroid glands. While these systems each possess their own benefits and pitfalls, both require the use of contrast enhancement (ICG) to differentiate viable from devascularized glands.

January 3 - Is Routine Omentectomy a Necessary Component of Cytoreductive Surgery and HIPEC?

Citation: Khan, S., Doan, NH., Hosseini, M. et al. Is Routine Omentectomy a Necessary Component of Cytoreductive Surgery and HIPEC?. Ann Surg Oncol 30, 768–773 (2023). https://doi.org/10.1245/s10434-022-12714-7

Synopsis: The incidence of occult histologic omental metastasis in this series was 31.9%. Patients with omentectomy had no higher morbidity than those without omentectomy, and 20.9% of patients with residual omentum later developed omental recurrence.

2022 Featured Articles

Impact of BRCA Mutation Status on Tumor Dissemination Pattern, Surgical Outcome and Patient Survival in Primary and Recurrent High-Grade Serous Ovarian Cancer: A Multicenter Retrospective Study by the Ovarian Cancer Therapy-Innovative Models Prolong Survival - December 22, 2022

Glajzer, J., Castillo-Tong, D.C., Richter, R. et al. Impact of BRCA Mutation Status on Tumor Dissemination Pattern, Surgical Outcome and Patient Survival in Primary and Recurrent High-Grade Serous Ovarian Cancer: A Multicenter Retrospective Study by the Ovarian Cancer Therapy-Innovative Models Prolong Survival (OCTIPS) Consortium. Ann Surg Oncol 30, 35–45 (2023). https://doi.org/10.1245/s10434-022-12459-3

Synopsis: As surgery gains constant importance in recurrent ovarian cancer (rOC) treatment, refinement of existing patient eligibility criteria became a pivotal research question. This study evaluates the impact of BRCA mutation status on prognosis of rOC patients and subsequent conclusions for surgical decision-making.

Prepectoral Versus Subpectoral Implant-Based Breast Reconstruction: A Systemic Review and Meta-analysis - December 22, 2022

Ostapenko, E., Nixdorf, L., Devyatko, Y. et al. Prepectoral Versus Subpectoral Implant-Based Breast Reconstruction: A Systemic Review and Meta-analysis. Ann Surg Oncol 30, 126–136 (2023). https://doi.org/10.1245/s10434-022-12567-0

Synopsis: The authors report the findings of a systematic review and meta-analysis that assessed and compared the clinical outcomes and efficacy between prepectoral and subpectoral implant-based breast reconstruction.

Local Therapy for Oligoprogression or Consolidation in High Mutational Burden Stage 4 Colorectal Cancer Treated With PD-1 or PD-L1 Blockade - December 8, 2022

Klemen, N.D., Court, C.M., Fernandes, M.C. et al. Local Therapy for Oligoprogression or Consolidation in High Mutational Burden Stage 4 Colorectal Cancer Treated With PD-1 or PD-L1 Blockade. Ann Surg Oncol 29, 8373–8382 (2022). https://doi.org/10.1245/s10434-022-12095-x

Synopsis: Checkpoint inhibitors have revolutionized the management of high TMB colorectal cancers, but many patients still eventually experience PD or have incomplete responses. In this article, the authors show that oligoprogression is a frequent pattern of failure after ICI for metastatic CRC, and is associated with the initial response to ICI. Local therapy for oligoprogression achieved durable disease control in a substantial proportion of patients, indicating it should be considered an option for salvage therapy after ICI.

Clinicopathologic Features, Treatment Patterns, and Disease Outcomes in a Modern, Prospective Cohort of Young Women Diagnosed with Ductal Carcinoma In Situ - December 8, 2022

Tesch, M.E., Rosenberg, S.M., Collins, L.C. et al. Clinicopathologic Features, Treatment Patterns, and Disease Outcomes in a Modern, Prospective Cohort of Young Women Diagnosed with Ductal Carcinoma In Situ. Ann Surg Oncol 29, 8048–8057 (2022). https://doi.org/10.1245/s10434-022-12361-y

Synopsis: This article examined clinicopathologic features, local and systemic treatment patterns, and oncologic outcomes over a median follow-up of over 8 years in a modern, prospective cohort of women aged ≤ 40 years diagnosed with ductal carcinoma in situ.

Does Caudate Resection Improve Outcomes of Patients Undergoing Curative Resection for Perihilar Cholangiocarcinoma? A Systematic Review and Meta-Analysis- - December 1, 2022

Gilbert, R.W.D., Lenet, T., Cleary, S.P. et al. Does Caudate Resection Improve Outcomes of Patients Undergoing Curative Resection for Perihilar Cholangiocarcinoma? A Systematic Review and Meta-Analysis. Ann Surg Oncol 29, 6759–6771 (2022). https://doi.org/10.1245/s10434-022-11990-7

Synopsis: This review examines the impact of caudate lobe resection (CLR) concomitant to hepatectomy and choledochectomy for treatment of perihilar cholangiocarcinoma. Eight studies with 1,137 patients were included. CLR may improve rates of margin negative resection and survival without increasing morbidity.

Cytoreduction and HIPEC for Gastric Carcinomatosis: Multi-institutional Analysis of Two Phase II Clinical Trials - December 1, 2022

Green, B.L., Blumenthaler, A.N., Gamble, L.A. et al. Cytoreduction and HIPEC for Gastric Carcinomatosis: Multi-institutional Analysis of Two Phase II Clinical Trials. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12761-0

Synopsis: The authors addressed the potential role of CRS-HIPEC for gastric adenocarcinoma by analyzing data from two prospective clinical trials using CRS-HIPEC for treatment of advanced GA. The authors report the overall survival rates associated with CRS-HIPEC for gastric carcinomatosis, describe the toxicity of the treatment strategy, and identify factors associated with increased survival.

A Noninvasive Tool Based on Magnetic Resonance Imaging Radiomics for the Preoperative Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer - November 17, 2022

Li, C., Lu, N., He, Z. et al. A Noninvasive Tool Based on Magnetic Resonance Imaging Radiomics for the Preoperative Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer. Ann Surg Oncol 29, 7685–7693 (2022). https://doi.org/10.1245/s10434-022-12034-w

Synopsis: To predict pathologic complete response to neoadjuvant chemotherapy in patients with breast cancer, the authors constructed a preoperative and noninvasive tool based on both tumoral and peritumoral magnetic resonance imaging radiomic features, with AUCs over 0.9 in both cohorts.

Fertility-Sparing Treatment for Early-Stage Cervical Cancer ≥ 2 cm: A Problem with a Thousand Nuances—A Systematic Review of Oncological Outcomes - November 17, 2022

Ronsini, C., Solazzo, M.C., Bizzarri, N. et al. Fertility-Sparing Treatment for Early-Stage Cervical Cancer ≥ 2 cm: A Problem with a Thousand Nuances—A Systematic Review of Oncological Outcomes. Ann Surg Oncol 29, 8346–8358 (2022). https://doi.org/10.1245/s10434-022-12436-w

Synopsis: Fertility-sparing treatments (FST) have played a crucial role in early-stage cervical cancer ECC management. The guidelines have recognized various approaches, but no consensus for the EEC> 2cm. The aim of this systematic review is to collect the literature evidence regarding the management of this type of patient.

Prospective Multicenter Trial Assessing the Impact of Positive Peritoneal Cytology Conversion on Oncological Outcome in Patients with Endometrial Cancer Undergoing Minimally Invasive Surgery with the use of an Intrauterine Manipulator - November 10, 2022

Siegenthaler, F., Johann, S., Imboden, S. et al. Prospective Multicenter Trial Assessing the Impact of Positive Peritoneal Cytology Conversion on Oncological Outcome in Patients with Endometrial Cancer Undergoing Minimally Invasive Surgery with the use of an Intrauterine Manipulator. Ann Surg Oncol 29, 8320–8333 (2022). https://doi.org/10.1245/s10434-022-12356-9

Synopsis: This prospective multicenter trial showed positive peritoneal cytology conversion in 8.1% of endometrial cancer patients undergoing minimally invasive surgery with intrauterine manipulation. Positive cytology conversion had a negative impact on recurrence and survival rates in endometrial cancer.

Very Early Recurrence After Curative-Intent Surgery for Gastric Adenocarcinoma - November 17, 2023

Spolverato, G., Capelli, G., Mari, V. et al. Very Early Recurrence After Curative-Intent Surgery for Gastric Adenocarcinoma. Ann Surg Oncol 29, 8653–8661 (2022). https://doi.org/10.1245/s10434-022-12434-y

Synopsis: The current study utilized a large, international cohort of gastric cancer (GC) patients undergoing curative-intent surgery to define the incidence and pattern of very early recurrence (VER) among patients with GC. Two nomograms were built based on the predictive model. The nomograms performed well on internal validation, and stratified patients into distinct prognostic groups relative to 6- and 12-month VER.

Neoadjuvant Therapy Versus Upfront Resection for Nonpancreatic Periampullary Adenocarcinoma - November 3, 2022

Adam, M.A., Glencer, A., AlMasri, S. et al. Neoadjuvant Therapy Versus Upfront Resection for Nonpancreatic Periampullary Adenocarcinoma. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12257-x

Synopsis: The role of neoadjuvant chemotherapy for non-pancreatic periampullary adenocarcinomas has been poorly defined. This propensity-matched national review of 7656 patients identifies a significant association between neoadjuvant therapy and increased R0 resection rate and overall survival in patients with extrahepatic cholangiocarcinoma.

A Sonic Hedgehog Pathway Score to Predict the Outcome of Resected Non-Small Cell Lung Cancer Patients - November 3, 2022

Herreros-Pomares, A., Doria, P., Gallach, S. et al. A Sonic Hedgehog Pathway Score to Predict the Outcome of Resected Non-Small Cell Lung Cancer Patients. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12565-2

Synopsis: In this study, the authors found a gene expression score, called Hedgehog Score, which constitutes an independent biomarker of prognosis for resected non-small cell lung cancer (NSCLC) patients. The reported findings were validated in an independent cohort of NSCLC patients from TCGA.

Organ-Specific Adverse Effects After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy - October 27, 2022

Balachandran, R., Mogensen, L.Z., Christensen, P. et al. Organ-Specific Adverse Effects After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol 29, 6049–6083 (2022). https://doi.org/10.1245/s10434-022-11356-z

Synopsis: A scoping review on organ-specific adverse effects following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for gastrointestinal cancers and pseudomyxoma peritonei. Type and extent of gastrointestinal dysfunction, urological dysfunction, sexual dysfunction, pain and other adverse effects.

No One-Size-Fits-All: Sexual Health Education Preferences in Patients with Breast Cancer - October 27, 2022

Huynh, V., Vemuru, S., Hampanda, K. et al. No One-Size-Fits-All: Sexual Health Education Preferences in Patients with Breast Cancer. Ann Surg Oncol 29, 6238–6251 (2022). https://doi.org/10.1245/s10434-022-12126-7

Synopsis: This study characterizes the sexual health education that breast cancer patients received from the oncology team and explores preferences in format, content, and timing of discussions regarding potential sexual health effects of treatment.

Relationship Between Baseline Rectal Tumor Length and Magnetic Resonance Tumor Regression Grade Response to Chemoradiotherapy: A Subanalysis of the TRIGGER Feasibility Study - October 20, 2022

Hodges, N., Battersby, N., Rao, S. et al. Relationship Between Baseline Rectal Tumor Length and Magnetic Resonance Tumor Regression Grade Response to Chemoradiotherapy: A Subanalysis of the TRIGGER Feasibility Study. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-11914-5

Synopsis: Baseline rectal tumor length on MRI is not a clinically useful biomarker to predict mrTRG response to chemoradiotherapy.

Clinical and Histopathological Predictors of Recurrence in Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers - October 20, 2022

Borella, F., Cosma, S., Ferraioli, D. et al. Clinical and Histopathological Predictors of Recurrence in Uterine Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): A Multicenter Retrospective Cohort Study of Tertiary Centers. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12353-y

Synopsis: Risk factors for recurrence of uterine smooth muscle tumor of uncertain malignant potential (STUMP) were investigated in a large, multicenter retrospective series. Surgical fragmentation/morcellation, epithelioid features, high proliferation activity, low progesterone receptor, and p16 are related to recurrence.

Does Breast-Conserving Surgery with Radiotherapy have a Better Survival than Mastectomy? A Meta-Analysis of More than 1,500,000 Patients - October 13, 2022

De la Cruz Ku, G., Karamchandani, M., Chambergo-Michilot, D. et al. Does Breast-Conserving Surgery with Radiotherapy have a Better Survival than Mastectomy? A Meta-Analysis of More than 1,500,000 Patients. Ann Surg Oncol 29, 6163–6188 (2022). https://doi.org/10.1245/s10434-022-12133-8

Synopsis: Over the last decades, breast-conservative surgery with radiotherapy has been considered to have equal overall survival compared to mastectomy; however, recent studies have demonstrated different results. In this study, the authors perform a meta-analysis including all the available studies in the literature to clarify this controversy.

Patient-Specific Sarcoma Organoids for Personalized Translational Research: Unification of the Operating Room with Rare Cancer Research and Clinical Implications - October 13, 2022

Forsythe, S.D., Sivakumar, H., Erali, R.A. et al. Patient-Specific Sarcoma Organoids for Personalized Translational Research: Unification of the Operating Room with Rare Cancer Research and Clinical Implications. Ann Surg Oncol 29, 7354–7367 (2022). https://doi.org/10.1245/s10434-022-12086-y

Synopsis: This study utilized patient-derived tumor organoids as a platform to study drug efficacy in a multitude of rare sarcoma subtypes. The authors were able to generate treatment efficacy data 10 days post-resection, which fits within a clinically relevant timeline for the purpose of potentially informing treatment decisions.

Surgery Refusal Among Black and Hispanic Women with Non-Metastatic Breast Cancer - October 6, 2022

T., Ndumele, A., Bhattacharyya, O. et al. Surgery Refusal Among Black and Hispanic Women with Non-Metastatic Breast Cancer. Ann Surg Oncol 29, 6634–6643 (2022). https://doi.org/10.1245/s10434-022-11832-6

Synopsis: This study assessed the rate of surgery refusal in non-Hispanic Black and Hispanic women, identified factors associated with surgery refusal, and characterized the association between surgery refusal and characterize the association between surgery refusal and survival.

Is There a Role for Surgical Resection of Grade 3 Neuroendocrine Neoplasms? - October 6, 2022

Borbon, L.C., Tran, C.G., Sherman, S.K. et al. Is There a Role for Surgical Resection of Grade 3 Neuroendocrine Neoplasms?. Ann Surg Oncol 29, 6936–6946 (2022). https://doi.org/10.1245/s10434-022-12100-3

Synopsis: Survival outcomes in grade 3 (G3) gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) treated by surgical resection were compared with surgically-resected G1 or G2 tumors and with G3 GEP-NENs treated non-surgically. An association with improved overall survival was observed among surgically-resected G3 GEP-NEN patients.

Prognostic Factors After Pancreatectomy for Pancreatic Cancer Initially Metastatic to the Liver - Septemberr 22, 2022

Frigerio, I., Malleo, G., de Pastena, M. et al. Prognostic Factors After Pancreatectomy for Pancreatic Cancer Initially Metastatic to the Liver. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12385-4

Synopsis: The article reports on the outcomes of patients with pancreatic ductal adenocarcinoma initially metastatic to the liver who underwent resection following first-line chemotherapy and complete regression of the metastatic component. Preoperative factors that could drive the decision-making process in this challenging clinical scenario are also discussed.

The Impact of Neoadjuvant Chemotherapy on the Surgical Management of Colorectal Peritoneal Metastases: A Systematic Review and Meta-Analysis - September 22, 2022

Flood, M.P., Kong, J.C.H., Wilson, K. et al. The Impact of Neoadjuvant Chemotherapy on the Surgical Management of Colorectal Peritoneal Metastases: A Systematic Review and Meta-Analysis. Ann Surg Oncol 29, 6619–6631 (2022). https://doi.org/10.1245/s10434-022-11699-7

Synopsis: This article reports the results of a systematic review and meta-analysis to evaluate the impact of neoadjuvant chemotherapy on perioperative morbidity and mortality and long-term survival of patients with CRPM undergoing CRS and HIPEC. It is suggested that neoadjuvant chemotherapy is feasible in this setting and did not have direct ill effects on postoperative complications.

Primary Breast Neuroendocrine Tumors: An Analysis of the National Cancer Database

Martinez, E.O., Jorns, J.M., Kong, A.L. et al. Primary Breast Neuroendocrine Tumors: An Analysis of the National Cancer Database. Ann Surg Oncol 29, 6339–6346 (2022). https://doi.org/10.1245/s10434-022-12123-w

Synopsis: Primary breast neuroendocrine tumors (BNETs) are rare. 1,389 cases were identified in the NCDB. Compared to a matched invasive ductal carcinoma cohort, BNETs had more aggressive tumor biology, higher stages, and significantly lower overall survival for each disease stage.

Nodal Positivity in Early-Stage Triple-Negative Breast Cancer: Implications for Preoperative Immunotherapy

Mittendorf, E.A., Kantor, O., Weiss, A. et al. Nodal Positivity in Early-Stage Triple-Negative Breast Cancer: Implications for Preoperative Immunotherapy. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12357-8

Synopsis: Approximately 20% of cT2N0 TNBC patients are pathologically node positive supporting administering pembrolizumab preoperatively. Greater than 10% of cT1cN0 TNBC patients are pathologically node positive and axillary ultrasound can identify these patients who are then also pembrolizumab candidates.

Nationwide Validation of the 8th American Joint Committee on Cancer TNM Staging System and Five Proposed Modifications for Resected Pancreatic Cancer - September 8, 2022

Schouten, T.J., Daamen, L.A., Dorland, G. et al. Nationwide Validation of the 8th American Joint Committee on Cancer TNM Staging System and Five Proposed Modifications for Resected Pancreatic Cancer. Ann Surg Oncol 29, 5988–5999 (2022). https://doi.org/10.1245/s10434-022-11664-4

Synopsis: In this study, the 8th AJCC TNM staging system was superior to the 7th staging system, although it was not clearly improved by four proposed modifications. The new modification allows for better prognostication in patients with all stages of disease.

Evaluation of the Indications for Sentinel Node Biopsy in Early-Stage Melanoma with the Advent of Adjuvant Systemic Therapy: An International, Multicenter Study - September 8, 2022

Moncrieff, M.D., Lo, S.N., Scolyer, R.A. et al. Evaluation of the Indications for Sentinel Node Biopsy in Early-Stage Melanoma with the Advent of Adjuvant Systemic Therapy: An International, Multicenter Study. Ann Surg Oncol 29, 5937–5945 (2022). https://doi.org/10.1245/s10434-022-11761-4

Synopsis: A multicenter analysis of the outcomes of SNB for early-stage pT1b-pT2a melanomas. All patients mapped to AJCC IIIA subgroup yet 1 in 3 had deposits >1mm. A prompt re-evaluation of the role of SNB in early-stage melanoma is needed.

The Impact of COVID-19-Related Delays on Surgical Management of Peritoneal Surface Malignancies. - September 1, 2022

Sood, D., Dhiman, A., Ong, C.T. et al. The Impact of COVID-19-Related Delays on Surgical Management of Peritoneal Surface Malignancies. Ann Surg Oncol 29, 5377–5378 (2022). https://doi.org/10.1245/s10434-022-11814-8

Synopsis: This study evaluates the impact of the COVID-19 pandemic on oncologic outcomes in peritoneal surface malignancies. Delays in operative intervention had negative impacts, including disease progression, resectability, need for additional interventions, and survival.

Inflammatory Breast Cancer: Durable Breast Cancer-Specific Survival for HER2-Positive Patients with a Pathologic Complete Response to Neoadjuvant Therapy - September 5, 2022

Hieken, T.J., Boughey, J.C., Degnim, A.C. et al. Inflammatory Breast Cancer: Durable Breast Cancer-Specific Survival for HER2-Positive Patients with a Pathologic Complete Response to Neoadjuvant Therapy. Ann Surg Oncol 29, 5383–5386 (2022). https://doi.org/10.1245/s10434-022-12037-7

Synopsis: This article reports data demonstrating that patients with HER2+ inflammatory breast cancer have a high pathologic complete response rate to modern neoadjuvant chemotherapy and, importantly, that a favorable pathologic response translates into a durable survival benefit.

Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score Prediction of Metachronous Peritoneal Metastases After Radical Surgery for Colon Cancer: A Scoring System Obtained from an International Multicenter Cohort - August 25, 2022

Pedrazzani, C., Turri, G., Marrelli, D. et al. Prediction of Metachronous Peritoneal Metastases After Radical Surgery for Colon Cancer: A Scoring System Obtained from an International Multicenter Cohort. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12097-9

Synopsis: Peritoneal metastases (PM) are rare after resection for colon cancer. Factors associated with increased risk include pT4 disease, nodal metastases, elevated Ca 19-9, lympho-vascular invasion, and limited lymphadenectomy. A novel scoring system is presented to quantify the risk of PM.

Risk Factors for Anastomotic Leakage in Advanced Ovarian Cancer Surgery: A Large Single-Center Experience - August 25, 2022

Costantini, B., Vargiu, V., Santullo, F. et al. Risk Factors for Anastomotic Leakage in Advanced Ovarian Cancer Surgery: A Large Single-Center Experience. Ann Surg Oncol 29, 4791–4802 (2022). https://doi.org/10.1245/s10434-022-11686-y

Synopsis: Anastomotic leakage is a rare but severe complication in advanced ovarian cancer surgery. Improving patient’s nutritional status and maximizing blood supply to the anastomotic complex could further reduce its occurrence.

Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence - August 18, 2022

Merola, E., Pascher, A., Rinke, A. et al. Radical Resection in Entero-Pancreatic Neuroendocrine Tumors: Recurrence-Free Survival Rate and Definition of a Risk Score for Recurrence. Ann Surg Oncol 29, 5568–5577 (2022). https://doi.org/10.1245/s10434-022-11837-1

Synopsis: In this multicenter series of 441 sporadic EP-NETs, 30% of patients recurred within 5 years after radical surgery. A nomogram for recurrence risk included disease stage, lymph node ratio, margin status and grading, to select potential candidates for adjuvant treatments.

Natural History and Management of Small-Bowel Obstruction in Patients After Cytoreductive Surgery and Intraperitoneal Chemotherapy - August 18, 2022

Mor, E., Shemla, S., Assaf, D. et al. Natural History and Management of Small-Bowel Obstruction in Patients After Cytoreductive Surgery and Intraperitoneal Chemotherapy. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12370-x

Synopsis: Small bowel obstruction (SBO) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is common and complex in management. In this article the authors characterize and investigate the impact of bowel obstruction on patients’ prognosis. They report that although conservative management was successful in most patients, surgery was required more frequently in patients with malignant bowel obstruction.

One-Year Experience of Same-Day Mastectomy and Breast Reconstruction Protocol - August 11, 2022

Specht, M.C., Kelly, B.N., Tomczyk, E. et al. One-Year Experience of Same-Day Mastectomy and Breast Reconstruction Protocol. Ann Surg Oncol 29, 5711–5719 (2022). https://doi.org/10.1245/s10434-022-11859-9

Synopsis: A same-day mastectomy recovery protocol was implemented March 2020 at the authors’ institution. Postoperative recovery course was compared to a historical mastectomy cohort. Median length of stay was reduced from 24.5 hours to 5.5 hours, and overnight admissions decreased by 65.8%.

Drug-Eluting Bead, Irinotecan Therapy of Unresectable Intrahepatic Cholangiocarcinoma (DELTIC) with Concomitant Systemic Gemcitabine and Cisplatin - August 11, 2022

Martin, R.C.G., Simo, K.A., Hansen, P. et al. Drug-Eluting Bead, Irinotecan Therapy of Unresectable Intrahepatic Cholangiocarcinoma (DELTIC) with Concomitant Systemic Gemcitabine and Cisplatin. Ann Surg Oncol 29, 5462–5473 (2022). https://doi.org/10.1245/s10434-022-11932-3

Synopsis: The authors hypothesized that delivering irinotecan in drug-eluting beads via the hepatic artery would reduce systemic exposure while targeting to the location of the intra-hepatic cholangiocarcinoma of the liver. Combination Gem/Cis with DEBIRI is safe, and leads to significant improvement in downsizing to resection, improved progression-free survival, and overall survival.

Resectability Status of Pancreatic Cancer Having Tumor Contact with an Aberrant Right Hepatic Artery: Is Upfront Surgery Justified? - August 5, 2022

Miura, Y., Ohgi, K., Sugiura, T. et al. Resectability Status of Pancreatic Cancer Having Tumor Contact with an Aberrant Right Hepatic Artery: Is Upfront Surgery Justified?. Ann Surg Oncol 29, 4979–4988 (2022). https://doi.org/10.1245/s10434-022-11624-y

Synopsis: This study shows that tumor contact with an aberrant right hepatic artery (A- RHA-contact) has an adverse prognostic impact in pancreatic cancer. Multidisciplinary treatment, including neoadjuvant therapy, should be performed for pancreatic cancer with A-RHA-contact.

Systematic Review and Meta-Analysis of Prognostic Factors for Early Recurrence in Intrahepatic Cholangiocarcinoma After Curative-Intent Resection - August 4, 2022

Radosa, J.C., Solomayer, EF., Deeken, M. et al. Preoperative Sonographic Prediction of Limited Axillary Disease in Patients with Primary Breast Cancer Meeting the Z0011 Criteria: an Alternative to Sentinel Node Biopsy?. Ann Surg Oncol 29, 4764–4772 (2022). https://doi.org/10.1245/s10434-022-11829-1

Synopsis: This systematic review and meta-analysis summarize the prognostic factors for early recurrence (within 24-months) and 24-months disease-free survival after curative-intent intrahepatic cholangiocarcinoma resection. These factors could allow for improved surveillance, prognostication, and treatment decision-making for patients with intrahepatic cholangiocarcinoma.

Novel Strategies for Managing Retropharyngeal Lymph Node Metastases in Head and Neck and Thyroid Cancer with Transoral Robotic Surgery (TORS) - July 28, 2022

Garas, G., Roland, N.J., Lancaster, J. et al. Novel Strategies for Managing Retropharyngeal Lymph Node Metastases in Head and Neck and Thyroid Cancer with Transoral Robotic Surgery (TORS). Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12208-6

Synopsis: Retropharyngeal metastasis is a negative prognosticator with an emerging younger demographic promoting interest in de-escalation strategies. TransOral Robotic Surgery (TORS) may enable de-escalation in select node-negative oropharyngeal cancer cases. TORS may also be considered in the salvage setting and thyroid malignancy scenarios.

Preoperative Sonographic Prediction of Limited Axillary Disease in Patients with Primary Breast Cancer Meeting the Z0011 Criteria: an Alternative to Sentinel Node Biopsy? - July 28, 2022

Synopsis: Among 2059 patients with early-stage breast cancer meeting the Z0011 criteria, preoperative sonographic axillary staging showed a high accuracy and a false negative rate comparable to sentinel node biopsy for prediction of limited axillary disease.

Prognostic Utility of Systemic Immune-Inflammation Index After Resection of Extrahepatic Cholangiocarcinoma: Results from the U.S. Extrahepatic Biliary Malignancy Consortium - July 21, 2022

Toyoda, J., Sahara, K., Maithel, S.K. et al. Prognostic Utility of Systemic Immune-Inflammation Index After Resection of Extrahepatic Cholangiocarcinoma: Results from the U.S. Extrahepatic Biliary Malignancy Consortium. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12058-2

Synopsis: Systemic immune-inflammation index (SII) was independently associated with postoperative overall and recurrence-free survival following curative-intent resection of extrahepatic cholangiocarcinoma. High SII up-staged patients relative T- and N-categories and identified patients with high SII as the most likely to benefit from adjuvant therapy.

Primary-Site Local Therapy for Patients with De Novo Metastatic Breast Cancer: An Educational Review July 21, 2022

Citation:

Khan, S.A., Schuetz, S. & Hosseini, O. Primary-Site Local Therapy for Patients with De Novo Metastatic Breast Cancer: An Educational Review. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-11900-x

Synopsis: Improvements in breast cancer treatment have extended the life expectancy of metastatic breast cancer patients, raising key questions about the optimal management of an intact primary tumor. The possibility that local therapy to the primary site extends survival is not supported by the majority of prospective data so far, but important questions remain regarding the primary tumor management of patients with low-volume metastatic disease.

HIPEC-Induced Acute Kidney Injury: A Retrospective Clinical Study and Preclinical Model - July 14, 2022

Liesenfeld, L.F., Wagner, B., Hillebrecht, H.C. et al. HIPEC-Induced Acute Kidney Injury: A Retrospective Clinical Study and Preclinical Model. Ann Surg Oncol 29, 139–151 (2022). https://doi.org/10.1245/s10434-021-10376-5

Synopsis: Clinical data from 153 patients reveal that application of cisplatin-containing regimens represent the chief risk factor for acute kidney injury (AKI) after HIPEC. Consistently, cisplatin-containing HIPEC, but not hyperthermic perfusion per se, induce AKI in a preclinical animal model.

Disparities in Utilization and Outcomes of Minimally Invasive Techniques for Gastric Cancer Surgery in the United States - July 14, 2022

Park, J.Y., Verma, A., Tran, Z.K. et al. Disparities in Utilization and Outcomes of Minimally Invasive Techniques for Gastric Cancer Surgery in the United States. Ann Surg Oncol 29, 3136–3146 (2022). https://doi.org/10.1245/s10434-021-11193-6

Synopsis: The authors investigated national implementation patterns and perioperative outcomes of minimally invasive gastrectomy (MIG) in gastric cancer surgery in the United States. Socioeconomic differences were observed in patients undergoing MIG, which is explained by hospital level factors in MIG utilization. Establishing MIG as a safe approach to gastric cancers and understanding regional differences in implementation patterns can inform delivery of equitable high-quality health care.

A National Assessment of T2 Staging for Intrahepatic Cholangiocarcinoma and the Poor Prognosis Associated with Multifocality - July 7, 2022

Turner, K.M., Delman, A.M., Kharofa, J. et al. A National Assessment of T2 Staging for Intrahepatic Cholangiocarcinoma and the Poor Prognosis Associated with Multifocality. Ann Surg Oncol 29, 5094–5102 (2022). https://doi.org/10.1245/s10434-022-11762-3

Synopsis: Multifocal T2N0 intrahepatic cholangiocarcinoma is associated with a poor prognosis, distinct from solitary T2N0 disease. Staging algorithms should be updated to reflect the poor prognosis associated with multifocal intrahepatic cholangiocarcinoma.

Comparison of Outcomes Between BRCA Pathogenic Variant Carriers Undergoing Breast-Conserving Surgery Versus Mastectomy - July 7, 2022

Shubeck, S., Sevilimedu, V., Berger, E. et al. Comparison of Outcomes Between BRCA Pathogenic Variant Carriers Undergoing Breast-Conserving Surgery Versus Mastectomy. Ann Surg Oncol 29, 4706–4713 (2022). https://doi.org/10.1245/s10434-022-11756-1

Synopsis: The authors compare outcomes among BRCA mutation carriers undergoing BCS versus mastectomy and conclude that BCS is an option for BRCA mutation carriers willing to continue high-risk screening.

Hepatic Arterial Infusion Pump Chemotherapy for Unresectable Intrahepatic Cholangiocarcinoma: A Systematic Review and Meta-Analysis - June 30, 2022

Holster, J.J., El Hassnaoui, M., Franssen, S. et al. Hepatic Arterial Infusion Pump Chemotherapy for Unresectable Intrahepatic Cholangiocarcinoma: A Systematic Review and Meta-Analysis. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-11439-x

Synopsis: Hepatic arterial infusion pump chemotherapy (HAIP) with floxuridine has been explored as a means to control cancer in the liver. The authors conducted a systematic review to investigate survival outcomes of HAIP chemotherapy with floxuridine in patients with unresectable intrahepatic cholangiocarcinoma.

Safety and Outcomes of Combined Pancreatic and Hepatic Resections for Metastatic Pancreatic Neuroendocrine Tumors - June 30, 2022

Gudmundsdottir, H., Pery, R., Graham, R.P. et al. Safety and Outcomes of Combined Pancreatic and Hepatic Resections for Metastatic Pancreatic Neuroendocrine Tumors. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-12029-7

Synopsis: The authors compared the outcomes of patients undergoing pancreatectomy with simultaneous hepatectomy to those undergoing isolated hepatectomy for metastatic pancreatic neuroendocrine tumors. Perioperative morbidity and mortality was found to be similar; the authors conclude that combining the two procedures is safe in most circumstances.

Epigenetic Signatures Predict Pathologic Nodal Stage in Breast Cancer Patients with Estrogen Receptor-Positive, Clinically Node-Positive Disease - June 23, 2022

Citation:

Ensenyat-Mendez, M., Rünger, D., Orozco, J.I.J. et al. Epigenetic Signatures Predict Pathologic Nodal Stage in Breast Cancer Patients with Estrogen Receptor-Positive, Clinically Node-Positive Disease. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-11684-0

Synopsis: Patients with estrogen positive, node positive breast cancer who are not treated with neoadjuvant chemotherapy are recommended axillary lymph node dissection (ALND). Epigenetic signatures may provide a molecular-based strategy for identifying patients with limited nodal disease who can avoid ALND.

Association of RAS/BRAF Status and Prognosis of Metastatic Colorectal Cancer: Analysis of 1002 Consecutive Cases - June 23, 2022

Citation:

Tang, W., Liu, Y., Ji, M. et al. Association of RAS/BRAF Status and Prognosis of Metastatic Colorectal Cancer: Analysis of 1002 Consecutive Cases. Ann Surg Oncol 29, 3593–3603 (2022). https://doi.org/10.1245/s10434-021-11302-5

Synopsis: A large sample study was designed to analyze the association of RAS/BRAF status and the prognosis of patients with metastatic colorectal cancer based on multi-disciplinary team treatment mode. This study showed that regardless of metastases resection or not, RAS or BRAF mutation were associated with poor prognosis. Resection of metastases could bring survival benefits to patients regardless of RAS/BRAF status.

Technical Standards for Cancer Surgery: Improving Patient Care through Synoptic Operative ReportingTechnical Standards for Cancer Surgery: Improving Patient Care through Synoptic Operative Reporting - June 16, 2022

Citation:

Hieken, T.J., Burns, W.R., Francescatti, A.B. et al. Technical Standards for Cancer Surgery: Improving Patient Care through Synoptic Operative Reporting. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-11330-9

Synopsis: The Operative Standards for Cancer Surgery manuals define critical elements of optimal cancer surgery based on data and expert opinion. Following these surgical standards and employing synoptic operative reporting may elevate and harmonize cancer patient care.

“Going Flat” After Mastectomy: Patient-Reported Outcomes by Online Survey - June 16, 2022

Citation:

Baker, J.L., Dizon, D.S., Wenziger, C.M. et al. “Going Flat” After Mastectomy: Patient-Reported Outcomes by Online Survey. Ann Surg Oncol 28, 2493–2505 (2021). https://doi.org/10.1245/s10434-020-09448-9

Synopsis: Among 931 women surveyed in online “Going Flat” communities, 74% were satisfied with their surgical outcome after mastectomy without reconstruction. However, 22% of women experienced a low-level of surgeon support for going flat, and this “flat denial” strongly predicted dissatisfaction.

The Role of Safety-Net Hospitals in Reducing Disparities in Breast Cancer Care - June 9, 2022

Crown, A., Ramiah, K., Siegel, B. et al. The Role of Safety-Net Hospitals in Reducing Disparities in Breast Cancer Care. Ann Surg Oncol 29, 4067–4075 (2022). https://doi.org/10.1245/s10434-022-11576-3

Synopsis: While breast cancer mortality has been declining, oncologic outcomes have not improved equally among all races and ethnicities. Many factors have been implicated in breast cancer disparities; chief among them is limited access to care. Hospitals with a safety net mission, such as the essential hospitals, historically have been dedicated to providing high quality care to all populations, and have eagerly embraced the role of caring for the most vulnerable and working to eliminate health disparities.

Incidence, Timing, and Outcomes of Venous Thromboembolism in Patients Undergoing Surgery for Esophagogastric Cancer: A Population-Based Cohort Study - June 9, 2022

Hanna, N.M., Williams, E., Kong, W. et al. Incidence, Timing, and Outcomes of Venous Thromboembolism in Patients Undergoing Surgery for Esophagogastric Cancer: A Population-Based Cohort Study. Ann Surg Oncol 29, 4393–4404 (2022). https://doi.org/10.1245/s10434-022-11520-5

Synopsis: In patients undergoing surgery for esophageal and gastric cancer, the highest incidence of venous thromboembolism is within 30 days of surgery, with one third of patients diagnosed after discharge from hospital. Increased hospital length of stay and receipt of pre-operative chemotherapy are significantly associated with increased risk of venous thromboembolism.

Clinical Manifestations and Surgical Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma: Beyond the NCCN Guidelines - June 2, 2022

Citation:

Lillemoe, H.A., Miranda, R.N., Nastoupil, L.J. et al. Clinical Manifestations and Surgical Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma: Beyond the NCCN Guidelines. Ann Surg Oncol (2022). https://doi.org/10.1245/s10434-022-11838-0

Synopsis: The purpose of this article is to review the spectrum of clinical manifestations of BIA-ALCL, including the more advanced and less frequently encountered presentations, with an emphasis on a multidisciplinary approach with early involvement of a surgical oncologist.

Fighting Fire With Fire: Oncolytic Virotherapy for Thoracic Malignancies - June 2, 2022

Citation:

Ekeke, C.N., Russell, K.L., Joubert, K. et al. Fighting Fire With Fire: Oncolytic Virotherapy for Thoracic Malignancies. Ann Surg Oncol 28, 2715–2727 (2021). https://doi.org/10.1245/s10434-020-09477-4

Synopsis: Oncolytic virotherapy is a promising approach in cancer immunotherapy. This review explores the current state of oncolytic virotherapy in lung cancer, esophageal cancer, and metastatic malignant pleural effusions, and considers its potential as an emergent therapeutic for these patients.

Importance of Nodal Metastases Location in Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: Results from a Prospective, Lymphadenectomy Protocol - May 26, 2022

Malleo, G., Maggino, L., Casciani, F. et al. Importance of Nodal Metastases Location in Pancreatoduodenectomy for Pancreatic Ductal Adenocarcinoma: Results from a Prospective, Lymphadenectomy Protocol. Ann Surg Oncol 29, 3477–3488 (2022). https://doi.org/10.1245/s10434-022-11417-3

Synopsis: Prospective implementation of a lymphadenectomy protocol in 424 pancreatoduodenectomies for cancer showed that first-echelon nodal dissection was sufficient for optimal staging. Nodal metastases occurred mostly at stations 13/14, although second-echelon involvement was frequent. Only station 14 and jejunal mesentery nodes involvement was prognostically relevant.

The Impact of Surveillance Imaging Frequency on the Detection of Distant Disease for Patients with Resected Stage III Melanoma - May 5, 2022

https://doi.org/10.1245/s10434-021-11231-3

Citation:

Dieng, M., Lord, S.J., Turner, R. et al. The Impact of Surveillance Imaging Frequency on the Detection of Distant Disease for Patients with Resected Stage III Melanoma. Ann Surg Oncol 29, 2871–2881 (2022).

Synopsis: The objective of this study was to investigate distant disease-free survival (DDFS), melanoma-specific survival (MSS), post distant recurrence MSS (dMSS) and overall survival for patients with resected stage III melanoma undergoing regular computed tomography (CT) or positron emission tomography (PET)/CT surveillance imaging at different intervals. The authors report that selecting patients at higher risk of distant recurrence for more frequent surveillance imaging yields a higher proportion of imaging-detected distant recurrences, but is not associated with improved survival.

Management of Primary Retroperitoneal Sarcoma (RPS) in the Adult: An Updated Consensus Approach from the Transatlantic Australasian RPS Working Group - May 19, 2022

https://doi.org/10.1245/s10434-021-09654-z

Citation:

Swallow, C.J., Strauss, D.C., Bonvalot, S. et al. Management of Primary Retroperitoneal Sarcoma (RPS) in the Adult: An Updated Consensus Approach from the Transatlantic Australasian RPS Working Group. Ann Surg Oncol 28, 7873–7888 (2021).

Synopsis: Consensus statements for the optimal management of patients with primary retroperitoneal sarcoma were updated in view of new understanding of histologic subtype-specific biology and therapeutic response. Patients should undergo investigation and treatment by an experienced multidisciplinary team at a sarcoma referral center.

Proposal for a New Pathologic Prognostic Index After Neoadjuvant Chemotherapy in Pancreatic Ductal Adenocarcinoma (PINC) - May 19, 2022

https://doi.org/10.1245/s10434-022-11413-7

Citation:

Redegalli, M., Schiavo Lena, M., Cangi, M.G. et al. Proposal for a New Pathologic Prognostic Index After Neoadjuvant Chemotherapy in Pancreatic Ductal Adenocarcinoma (PINC). Ann Surg Oncol 29, 3492–3502 (2022).

Synopsis: Pancreatic ductal adenocarcinoma (PDAC) tumor morphology is significantly altered by NACT. Perineural invasion, lymph node ratio, and stroma to neoplasia ratio are prognostic factors for neoadjuvant chemotherapy (NACT)-treated PDAC patients. The semi quantitative pathologic prognostic index predicts patients’ outcome after NACT followed by surgery.

Iterative Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Recurrent Mucinous Adenocarcinoma of the Appendix - May 12, 2022

https://doi.org/10.1245/s10434-021-11233-1

Citation:

Lopez-Ramirez, F., Gushchin, V., Sittig, M. et al. Iterative Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Recurrent Mucinous Adenocarcinoma of the Appendix. Ann Surg Oncol 29, 3390–3401 (2022).

Synopsis: Patients with recurrent mucinous peritoneal carcinomatosis from low- and high-grade appendiceal tumors show a potential for prolonged survival when iterative CRS/HIPEC is feasible. These procedures were not associated with higher complication rates compared to the first CRS/HIPEC.

Weight Tracking as a Novel Prognostic Marker After Pancreatectomy - May 12, 2022

https://doi.org/10.1245/s10434-022-11325-6

Citation:

Hue, J.J., Ocuin, L.M., Kyasaram, R.K. et al. Weight Tracking as a Novel Prognostic Marker After Pancreatectomy. Ann Surg Oncol 29, 3450–3459 (2022).

Synopsis: Pancreatectomy for cancer is complicated by a similar degree of weight loss as benign indications. Weight loss was not associated with survival; however, the ability to regain weight was associated with improved outcomes. Weight loss after weight recovery foreshadows recurrence.

SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer - May 5, 2022

https://doi.org/10.1245/s10434-022-11671-5

Citation:

Manzour, N., Chiva, L., Chacón, E. et al. SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer. Ann Surg Oncol (2022).

Synopsis: Preoperative cone biopsy might be a protective maneuver against relapse. Tumors >2cm on imaging-assessments and minimally invasive surgery have a higher risk to relapse. Risk predictive index (RPI) allows the patient classification in groups of risk and can be a complementary tool to the classic staging.

Critical Analysis of the Updated Guidelines for Management of Gallbladder Polyps

Aziz, H., Hewitt, D.B. & Pawlik, T.M.

https://doi.org/10.1245/s10434-022-11701-2

Citation:

Aziz, H., Hewitt, D.B. & Pawlik, T.M. Critical Analysis of the Updated Guidelines for Management of Gallbladder Polyps. Ann Surg Oncol (2022).

Synopsis: Increased awareness and application of updated guidelines for management of gallbladder polyps will hopefully increase evidence-based care leading to improved cost-effectiveness and quality of care.

Recurrence After Resection of Pancreatic Cancer: Can Radiomics Predict Patients at Greatest Risk of Liver Metastasis?

Zambirinis, C.P., Midya, A., Chakraborty, J. et al.

https://doi.org/10.1245/s10434-022-11579-0

Citation:

Zambirinis, C.P., Midya, A., Chakraborty, J. et al. Recurrence After Resection of Pancreatic Cancer: Can Radiomics Predict Patients at Greatest Risk of Liver Metastasis?. Ann Surg Oncol (2022).

Synopsis: The authors describe recurrence patterns after pancreatic cancer resection and their impact on survival. They present a model combining preoperative clinicopathological and radiomic variables that predicts risk for early liver metastasis, which may be useful for treatment recommendations.

Cryoablation Without Excision for Low-Risk Early-Stage Breast Cancer: 3-Year Interim Analysis of Ipsilateral Breast Tumor Recurrence in the ICE3 Trial

Fine, R.E., Gilmore, R.C., Dietz, J.R. et al.

https://doi.org/10.1245/s10434-021-10501-4

Citation:

Fine, R.E., Gilmore, R.C., Dietz, J.R. et al. Cryoablation Without Excision for Low-Risk Early-Stage Breast Cancer: 3-Year Interim Analysis of Ipsilateral Breast Tumor Recurrence in the ICE3 Trial. Ann Surg Oncol 28, 5525–5534 (2021).

Synopsis: The ICE3 Trial is aimed to evaluate efficacy and safety of cryoablation without excision on low-risk early-stage breast cancer in women. To date, the ipsilateral breast tumor recurrence rate is comparable to breast conservation therapy.

Socioeconomic Disparities in Pancreas Cancer Resection and Survival in the Veterans Health Administration

Del Valle, J.P., Fillmore, N.R., Molina, G. et al.

https://doi.org/10.1245/s10434-021-11250-0

Citation:

Del Valle, J.P., Fillmore, N.R., Molina, G. et al. Socioeconomic Disparities in Pancreas Cancer Resection and Survival in the Veterans Health Administration. Ann Surg Oncol 29, 3194–3202 (2022).

Synopsis: Disparities in surgical resection and survival for pancreatic cancer exist even in the Veterans Health Administration (VHA), a non-fee-for-service, equal access healthcare system.

Phase II Trial of Adjuvant Dendritic Cell Vaccine in Combination with Celecoxib, Interferon-α, and Rintatolimod in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases

Ramanathan, R., Choudry, H., Jones, H. et al.

https://doi.org/10.1245/s10434-020-09464-9

Citation:

Ramanathan, R., Choudry, H., Jones, H. et al. Phase II Trial of Adjuvant Dendritic Cell Vaccine in Combination with Celecoxib, Interferon-α, and Rintatolimod in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastases. Ann Surg Oncol 28, 4637–4646 (2021).

Synopsis: Given that relapse is common after cytoreductive surgery and HIPEC for peritoneal surface malignancies, adjuvant autologous antigen loaded dendritic cell vaccines with chemokine modulation is investigated in this Phase II trial. The mucinous nature of peritoneal tumors limited feasibility of this approach, and the trial did not result in improvement in survival.

The Impact of Surveillance Imaging Frequency on the Detection of Distant Disease for Patients with Resected Stage III Melanoma - May 26, 2022

Synopsis: After a median follow-up of 6.2 years, 40% of distant recurrences were detected by surveillance CT or PET/CT, while 43% were detected clinically and 17% with other imaging. Survival after distant recurrence was shorter in those undergoing more frequent surveillance (i.e. 3-4 monthly) than 12-monthly. Selecting patients at higher risk of distant recurrence for more frequent surveillance imaging yields a higher proportion of image-detected distant recurrences, but is not associated with improved survival.

Five-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1–4N1–3M0 Breast Cancer

Herremans, K.M., Cribbin, M.P., Riner, A.N. et al.

https://doi.org/10.1245/s10434-021-10551-8

Citation:

Herremans, K.M., Cribbin, M.P., Riner, A.N. et al. Five-Year Breast Surgeon Experience in LYMPHA at Time of ALND for Treatment of Clinical T1–4N1–3M0 Breast Cancer. Ann Surg Oncol 28, 5775–5787 (2021).

Synopsis: This study investigates the use of lymphatic microsurgical preventive healing approach (LYMPHA) performed by a breast surgeon. It evaluates the feasibility and effectiveness of LYMPHA at the time of axillary lymph node dissection, while assessing risk factors for lymphedema development.

Targeting Myeloid-Derived Suppressor Cells for Premetastatic Niche Disruption After Tumor Resection

https://doi.org/10.1245/s10434-020-09371-z

Citation:

Tang, F., Tie, Y., Hong, W. et al. Targeting Myeloid-Derived Suppressor Cells for Premetastatic Niche Disruption After Tumor Resection. Ann Surg Oncol 28, 4030–4048 (2021).

Synopsis: Surgical resection is the therapeutic option for solid tumors. After surgical resection, myeloid-derived suppressor cells persist in distant organs for about two weeks. Disrupting the pre-metastatic niche by targeting myeloid-derived suppressor cells may reduce the metastatic risk after surgery.

COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes

Kennard, K., Williams, A.D., Goldblatt, L.G. et al.

https://doi.org/10.1245/s10434-020-09583-3

Citation: Kennard, K., Williams, A.D., Goldblatt, L.G. et al. COVID-19 Pandemic: Changes in Care for a Community Academic Breast Center and Patient Perception of Those Changes. Ann Surg Oncol 28, 5071–5081 (2021).

Synopsis: Half of patients experienced a change in breast cancer care due to COVID-19. The same level of anxiety and depression was seen in both change in therapy (CTX) and no change (NC). 55.6% of CTX cohort believed COVID-19 affected their treatment outlook.

Radical Hemiscrotectomy and En Bloc Orchidectomy: Surgical Technique and Perioperative and Oncologic Outcomes of a Supra-Regional UK Referral Centre

Fankhauser, C.D., Issa, A., Lee, E.W.C. et al.

https://doi.org/10.1245/s10434-021-10315-4

Citation:

Fankhauser, C.D., Issa, A., Lee, E.W.C. et al. Radical Hemiscrotectomy and En Bloc Orchidectomy: Surgical Technique and Perioperative and Oncologic Outcomes of a Supra-Regional UK Referral Centre. Ann Surg Oncol 28, 9217–9222 (2021).

Synopsis: The authors describe a radical surgical technique for men with advanced cancer in the groin and scrotum. The authors’ experience shows that this is a safe procedure with an associated short hospital stay.

The Clinical Utility of DCISionRT® on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery

Shah, C., Bremer, T., Cox, C. et al.

https://doi.org/10.1245/s10434-021-09903-1

Citation: Shah, C., Bremer, T., Cox, C. et al. The Clinical Utility of DCISionRT® on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery. Ann Surg Oncol 28, 5974–5984 (2021).

Synopsis: Utilization of DCISionRT led to a 42% change in the recommendation for adjuvant radiation with both changes to add and omit radiation therapy. As compared to traditional clinical and pathologic features, the DCISionRT result was the factor most strongly associated with RT recommendation.

Circulating Tumor Cell Transcriptomics as Biopsy Surrogates in Metastatic Breast Cancer

Ring, A., Campo, D., Porras, T.B. et al.

https://doi.org/10.1245/s10434-021-11135-2

Citation:

Ring, A., Campo, D., Porras, T.B. et al. Circulating Tumor Cell Transcriptomics as Biopsy Surrogates in Metastatic Breast Cancer. Ann Surg Oncol (2022).

Synopsis: RNA-Seq of circulating tumor cells (CTCs) may be applied to the future practice of cancer medicine as a liquid biopsy. RNA-Seq of CTCs may be utilized to identify molecular alterations in MBC patients that are potentially clinically actionable.

Impact of Surgical Margins on Overall Survival after Gastrectomy for Gastric Cancer: A Validation of Japanese Gastric Cancer Association Guidelines on a Western Series

Maspero, M., Sposito, C., Benedetti, A. et al.

https://doi.org/10.1245/s10434-021-11010-0

Citation: Maspero, M., Sposito, C., Benedetti, A. et al. Impact of Surgical Margins on Overall Survival after Gastrectomy for Gastric Cancer: A Validation of Japanese Gastric Cancer Association Guidelines on a Western Series. Ann Surg Oncol (2022).

Synopsis: In 279 consecutive Western patients undergoing gastrectomy for adenocarcinoma, margin adequacy according to the Japanese Gastric Cancer Association (JGCA) guidelines was validated. In comparison with other guidelines JGCA allowed more-organ-sparing gastrectomies while achieving improved overall, recurrence-free and local recurrence-free survival.

Role of Node Dissection in Pancreatic Tumor Resection

Dillhoff, M., Pawlik, T.M.

https://doi.org/10.1245/s10434-020-09394-6

Citation:

Dillhoff, M., Pawlik, T.M. Role of Node Dissection in Pancreatic Tumor Resection. Ann Surg Oncol 28, 2374–2381 (2021).

Synopsis: The role of extended lymphadenectomy for pancreas cancer is debated. There are six randomized controlled trials evaluating the utility of extended lymphadenectomy. No trial has demonstrated that extended lymphadenectomy improves overall survival.

Early Identification of Residual Disease After Neuroendocrine Tumor Resection Using a Liquid Biopsy Multigenomic mRNA Signature (NETest)

Modlin, I.M., Kidd, M., Oberg, K. et al.

https://doi.org/10.1245/s10434-021-10021-1

Citation: Modlin, I.M., Kidd, M., Oberg, K. et al. Early Identification of Residual Disease After Neuroendocrine Tumor Resection Using a Liquid Biopsy Multigenomic mRNA Signature (NETest). Ann Surg Oncol 28, 7506–7517 (2021).

Synopsis: A liquid biopsy (NETest) genomic biomarker for neuroendocrine tumors is 100% accurate for umor diagnosis and after R0 resection at POD30 predicts residual disease and recurrence with 94% accuracy.

The Association of Frailty with Outcomes after Cancer Surgery: A Systematic Review and Metaanalysis

Shaw, J.F., Budiansky, D., Sharif, F. et al.

https://doi.org/10.1245/s10434-021-11321-2

Citation:

Shaw, J.F., Budiansky, D., Sharif, F. et al. The Association of Frailty with Outcomes after Cancer Surgery: A Systematic Review and Metaanalysis. Ann Surg Oncol (2022).

Synopsis: Frailty is common among older adults. We systematically reviewed the association of frailty with adverse outcomes in older adults undergoing cancer surgery. Frailty was significantly associated with increased odds of postoperative mortality, complications, adverse discharge, and increased length-of-stay.

Neoadjuvant Systemic Therapy (NAST) in Patients with Melanoma: Surgical Considerations by the International Neoadjuvant Melanoma Consortium (INMC)

van Akkooi, A.C.J., Hieken, T.J., Burton, E.M. et al.

https://doi.org/10.1245/s10434-021-11236-y

Citation: van Akkooi, A.C.J., Hieken, T.J., Burton, E.M. et al. Neoadjuvant Systemic Therapy (NAST) in Patients with Melanoma: Surgical Considerations by the International Neoadjuvant Melanoma Consortium (INMC). Ann Surg Oncol (2022).

Synopsis: The INMC recommends the use of NAST in clinical trials and for those trials to align with INMC principles to allow for structured outcome reporting (according to the INMC criteria for pathological assessments), collection of morbidity data (INMC questionnaires), tissue and blood biomarker analyses to allow comparison of results across trials facilitate rapid testing of new agents to ensure a comprehensive and complete understanding of the biological impacts of these modern therapies on various aspects of clinical outcomes.

Neoadjuvant Chemotherapy Switch in Borderline Resectable/Locally Advanced Pancreatic Cancer

Alva-Ruiz, R., Yohanathan, L., Yonkus, J.A. et al.

https://doi.org/10.1245/s10434-021-10991-2

Citation:

Alva-Ruiz, R., Yohanathan, L., Yonkus, J.A. et al. Neoadjuvant Chemotherapy Switch in Borderline Resectable/Locally Advanced Pancreatic Cancer. Ann Surg Oncol 29, 1579–1591 (2022).

Synopsis: Neoadjuvant chemotherapy plays an integral role in the treatment of pancreatic cancer. Optimal treatment of patients that do not respond to first-line chemotherapy or develop toxicities is unclear. Chemotherapy switch may allow for possible surgical salvage in this patient population.

Diagnostic Performance of Artificial Intelligence-Centred Systems in the Diagnosis and Postoperative Surveillance of Upper Gastrointestinal Malignancies Using Computed Tomography Imaging: A Systematic Review and Meta-Analysis of Diagnostic Accuracy

Chidambaram, S., Sounderajah, V., Maynard, N. et al.

https://doi.org/10.1245/s10434-021-10882-6

Citation: Chidambaram, S., Sounderajah, V., Maynard, N. et al. Diagnostic Performance of Artificial Intelligence-Centred Systems in the Diagnosis and Postoperative Surveillance of Upper Gastrointestinal Malignancies Using Computed Tomography Imaging: A Systematic Review and Meta-Analysis of Diagnostic Accuracy. Ann Surg Oncol 29, 1977–1990 (2022).

Synopsis: There is moderate level of evidence to support the diagnostic accuracy of artificial intelligence based diagnosis and surveillance in oesophageal and gastric cancers; however, large-scale prospective work is required for its translation into clinical practice.

A Three-Dimensional Bioabsorbable Tissue Marker for Volume Replacement and Radiation Planning: A Multicenter Study of Surgical and Patient-Reported Outcomes for 818 Patients with Breast Cancer

Kaufman, C.S., Cross, M.J., Barone, J.L. et al.

https://doi.org/10.1245/s10434-020-09271-2

Citation:

Kaufman, C.S., Cross, M.J., Barone, J.L. et al. A Three-Dimensional Bioabsorbable Tissue Marker for Volume Replacement and Radiation Planning: A Multicenter Study of Surgical and Patient-Reported Outcomes for 818 Patients with Breast Cancer. Ann Surg Oncol 28, 2529–2542 (2021).

Synopsis: An implantable 3-D bioabsorbable surgical marker (BioZorb®) designed to identify the lumpectomy bed for radiation therapy planning was studied in 818 patients. Benefits were found in both radiation therapy targeting and cosmetic appearance of the breast with minimal side effects.

Higher Dispositional Optimism Predicts Better Health-Related Quality of Life After Esophageal Cancer Surgery: A Nationwide Population-Based Longitudinal Study

Liu, Y., Pettersson, E., Schandl, A. et al.

https://doi.org/10.1245/s10434-021-10026-w

Citation: Liu, Y., Pettersson, E., Schandl, A. et al. Higher Dispositional Optimism Predicts Better Health-Related Quality of Life After Esophageal Cancer Surgery: A Nationwide Population-Based Longitudinal Study. Ann Surg Oncol 28, 7196–7205 (2021).

Synopsis: This Swedish nationwide longitudinal study included 192 patients with esophagectomy for cancer, and it showed that higher dispositional optimism predicted better health related quality of life in several aspects after esophageal cancer surgery.

Surgery for Intraductal Papillary Mucinous Neoplasms of the Pancreas: Preoperative Factors Tipping the Scale of Decision-Making

Marchegiani, G., Crippa, S., Perri, G. et al.

https://doi.org/10.1245/s10434-022-11326-5

Citation:

Marchegiani, G., Crippa, S., Perri, G. et al. Surgery for Intraductal Papillary Mucinous Neoplasms of the Pancreas: Preoperative Factors Tipping the Scale of Decision-Making. Ann Surg Oncol (2022).

Synopsis: Based on the type of intervention, history of diabetes, BMI, age, and cyst size, patients undergoing pancreatectomy for intraductal papillary mucinous neoplasms (IPMNs) can be preoperatively stratified into groups with different risk of developing major surgical morbidity and pancreatic insufficiency. An early risk evaluation could potentially help clinical decision-making and improve patient counseling, tipping the scale of surgical management.

Physiotherapy Regimens in Esophagectomy and Gastrectomy: a Systematic Review and Meta-Analysis

Tukanova, K.H., Chidambaram, S., Guidozzi, N. et al.

https://doi.org/10.1245/s10434-021-11122-7

Citation: Tukanova, K.H., Chidambaram, S., Guidozzi, N. et al. Physiotherapy Regimens in Esophagectomy and Gastrectomy: a Systematic Review and Meta-Analysis. Ann Surg Oncol (2021).

Synopsis: The authors assess the impact of physiotherapy regimens in patients treated with esophagectomy or gastrectomy. This meta-analysis suggests that implementing an exercise intervention may be beneficial in both the preoperative and peri- or postoperative period.

COVID-19 is Affecting the Presentation and Treatment of Melanoma Patients in the Northeastern United States

Davis, C.H., Ho, J., Greco, S.H. et al.

https://doi.org/10.1245/s10434-021-11086-8

Citation:

Davis, C.H., Ho, J., Greco, S.H. et al. COVID-19 is Affecting the Presentation and Treatment of Melanoma Patients in the Northeastern United States. Ann Surg Oncol 29, 1629–1635 (2022).

Synopsis: As a result of the recent pandemic, there has been a shift away from screening and non-urgent medical care. Melanoma patients are now presenting with more advanced disease, which may have significant downstream effects on prognosis.

Atypical Lobular Hyperplasia and Classic Lobular Carcinoma In Situ Can Be Safely Managed Without Surgical Excision

Laws, A., Katlin, F., Nakhlis, F. et al.

https://doi.org/10.1245/s10434-021-10827-z

Citation: Laws, A., Katlin, F., Nakhlis, F. et al. Atypical Lobular Hyperplasia and Classic Lobular Carcinoma In Situ Can Be Safely Managed Without Surgical Excision. Ann Surg Oncol 29, 1660–1667 (2022).

Synopsis: Routine surgical excision following a core biopsy diagnosis of pure lobular neoplasia can safely be omitted in favor of observation, with low rates of subsequent cancer or need for repeat interventions.

Relationship Between Breast and Axillary Pathologic Complete Response in Women Receiving Neoadjuvant Chemotherapy for Breast Cancer

Lim, D.W., Greene, B.D. & Look Hong, N.J.

https://doi.org/10.1245/s10434-021-10519-8

Citation:

Lim, D.W., Greene, B.D. & Look Hong, N.J. Relationship Between Breast and Axillary Pathologic Complete Response in Women Receiving Neoadjuvant Chemotherapy for Breast Cancer. Ann Surg Oncol 28, 5495–5506 (2021).

Synopsis: Among 225 node-positive breast cancers receiving neoadjuvant chemotherapy and surgical therapy, the authors observed a high correlation between breast and axillary pCR for HER2-positive and triple-negative cancers. These data may inform surgical de-escalation for these receptor subtypes presenting with clinically involved nodes at presentation.

Outcomes Following Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy with and without Diaphragmatic Resection in Patients with Peritoneal Metastases

Nikiforchin, A., Gushchin, V., Sittig, M. et al.

https://doi.org/10.1245/s10434-021-10669-9

Citation: Nikiforchin, A., Gushchin, V., Sittig, M. et al. Outcomes Following Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy with and without Diaphragmatic Resection in Patients with Peritoneal Metastases. Ann Surg Oncol 29, 873–882 (2022).

Synopsis: Diaphragmatic resection, often required during cytoreductive surgery/hyperthermic intraperitoneal chemotherapy, is an independent predictor of worse survival, even after adjusting for tumor burden in appendiceal, colorectal, but not ovarian cancer. It can be useful for patient stratification and tailoring further management.

Prognosis Comparison Between Nipple-Sparing Mastectomy and Total Mastectomy in Breast Cancer: A Case-Control Study After Propensity Score Matching

Fu, M., Chen, Q., Zeng, L. et al.

https://doi.org/10.1245/s10434-021-11044-4

Citation:

Fu, M., Chen, Q., Zeng, L. et al. Prognosis Comparison Between Nipple-Sparing Mastectomy and Total Mastectomy in Breast Cancer: A Case-Control Study After Propensity Score Matching. Ann Surg Oncol (2021).

Synopsis: The authors used the Surveillance, Epidemiology, and End Results (SEER) database to analyze the long-term prognosis of nipple-sparing mastectomy (NSM) compared with total mastectomy (TM). The authors find that NSM is a proper procedure for breast cancer patients to achieve long-term survival.

Robotic Techniques in Esophagogastric Cancer Surgery: An Assessment of Short- and Long-Term Clinical Outcomes

Kamarajah, S.K., Griffiths, E.A., Phillips, A.W. et al.

https://doi.org/10.1245/s10434-021-11082-y

Citation: Kamarajah, S.K., Griffiths, E.A., Phillips, A.W. et al. Robotic Techniques in Esophagogastric Cancer Surgery: An Assessment of Short- and Long-Term Clinical Outcomes. Ann Surg Oncol (2021).

Synopsis: The authors report on a population-based cohort study aimed to compare rates of textbook outcomes and survival from robotic minimally invasive techniques for esophagogastric cancers. Consideration for wider adoption is concluded but recommendation is also given for a well-designed phase III RCT to fully evaluate the benefits of robotic techniques in esophageal and gastric cancers.

How Often Does Modern Neoadjuvant Chemotherapy Downstage Patients to Breast-Conserving Surgery?

Petruolo, O., Sevilimedu, V., Montagna, G. et al.

https://doi.org/10.1245/s10434-020-08593-5

Citation:

Petruolo, O., Sevilimedu, V., Montagna, G. et al. How Often Does Modern Neoadjuvant Chemotherapy Downstage Patients to Breast-Conserving Surgery? Ann Surg Oncol 28, 287–294 (2021).

Synopsis: The authors evaluate breast-conserving surgery (BCS) conversion rates with neoadjuvant chemotherapy (NAC) in patients with tumors too large for conservation. Borderline-BCS candidacy, HER2+/triple negative receptor status, tumor size, cN+ status, and mammographic calcifications are factors to consider when selecting patients for downstaging with NAC.

Intraperitoneal CMP-001: A Novel Immunotherapy for Treating Peritoneal Carcinomatosis of Gastrointestinal and Pancreaticobiliary Cancer

Miller, A.M., Lemke-Miltner, C.D., Blackwell, S. et al.

https://doi.org/10.1245/s10434-020-08591-7

Citation: Miller, A.M., Lemke-Miltner, C.D., Blackwell, S. et al. Intraperitoneal CMP-001: A Novel Immunotherapy for Treating Peritoneal Carcinomatosis of Gastrointestinal and Pancreaticobiliary Cancer. Ann Surg Oncol 28, 1187–1197 (2021).

Synopsis: Peritoneal carcinomatosis of gastrointestinal and pancreaticobiliary cancer is a deadly condition with limited treatment options. CMP-001 is a virus-like particle containing a TLR9 agonist that is shown here to be a new potential effective treatment when given intraperitoneally.

Surgeon Assessment of the Technical Impact of Neoadjuvant Systemic Therapy on Operable Stage III Melanoma

Hieken, T.J., Price, D.L., Piltin, M.A. et al.

https://doi.org/10.1245/s10434-021-11112-9

Citation: Hieken, T.J., Price, D.L., Piltin, M.A. et al. Surgeon Assessment of the Technical Impact of Neoadjuvant Systemic Therapy on Operable Stage III Melanoma. Ann Surg Oncol 29, 780–786 (2022).

Synopsis: The authors prespectively assessed neoadjuvant systemic therapy’s impact on the technical difficulty of therapeutic lymphadenectomy for melanoma using structured assessments completed by surgeons. No significant adverse impact on operative difficulty nor intraoperative outcomes attributable to neoadjuvant therapy were noted.

Preventing Futile Liver Resection: A Risk-Based Approach to Surgical Selection in Major Hepatectomy for Colorectal Cancer

Fromer, M.W., Scoggins, C.R., Egger, M.E. et al.

https://doi.org/10.1245/s10434-021-10761-0

Citation: Fromer, M.W., Scoggins, C.R., Egger, M.E. et al. Preventing Futile Liver Resection: A Risk-Based Approach to Surgical Selection in Major Hepatectomy for Colorectal Cancer. Ann Surg Oncol 29, 905–912 (2022).

Synopsis: A futile major hepatectomy (recurrence within six months of operation), can be predicted preoperatively based on the presence of extrahepatic disease, >3 liver lesions, and need for extended hepatectomy. Such recurrences carry a poor prognosis, and improved patient selection is needed to avoid the significant morbidity of non-therapeutic liver resection.

2021 Featured Articles

Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection

Kothari, A.N., DiBrito, S.R., Lee, J.J. et al.

https://doi.org/10.1245/s10434-021-10291-9

Citation:

Kothari, A.N., DiBrito, S.R., Lee, J.J. et al. Surgical Outcomes in Cancer Patients Undergoing Elective Surgery After Recovering from Mild-to-Moderate SARS-CoV-2 Infection. Ann Surg Oncol 28, 8046–8053 (2021).

Synopsis: A wait time of 20 days after recovering from mild to moderate SARS-CoV-2 infection appears to be safe for cancer patients undergoing low-risk elective surgery. Patients requiring inpatient treatment of COVID-19 prior to surgery are at increased risk for adverse events.

Cytoreductive Surgery With or Without HIPEC After Neoadjuvant Chemotherapy in Ovarian Cancer: A Phase 3 Clinical Trial

Antonio, C.C.P., Alida, G.G., Elena, G.G. et al.

https://doi.org/10.1245/s10434-021-11087-7

Citation: Antonio, C.C.P., Alida, G.G., Elena, G.G. et al. Cytoreductive Surgery With or Without HIPEC After Neoadjuvant Chemotherapy in Ovarian Cancer: A Phase 3 Clinical Trial. Ann Surg Oncol (2021).

Synopsis: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have shown their efficacy in multiple malignancies. The authors report the results of a single-center, randomized, prospective phase III clinical trial of interval CRS with or without HIPEC in patients with peritoneal carcinomatosis from ovarian cancer (NCT-02328716).

More is More? Total Pancreatectomy for Periampullary Cancer as an Alternative in Patients with High-Risk Pancreatic Anastomosis: A Propensity Score-Matched Analysis

Hempel, S., Oehme, F., Tahirukaj, E. et al.

https://doi.org/10.1245/s10434-021-10292-8

Citation:

Hempel, S., Oehme, F., Tahirukaj, E. et al. More is More? Total Pancreatectomy for Periampullary Cancer as an Alternative in Patients with High-Risk Pancreatic Anastomosis: A Propensity Score-Matched Analysis. Ann Surg Oncol 28, 8309–8317 (2021).

Synopsis: This retrospective analysis compares outcomes of standard pancreatoduodenectomy and total pancreatectomy for periampullary cancer and highlights total pancreatectomy as a safe treatment alternative in selected cases of high-risk pancreatic anastomosis.

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer with Synchronous Peritoneal Metastases: Multicenter Study of the Italian Peritoneal Surface Malignancies Oncoteam (S.I.C.O.)

Marano, L., Marrelli, D., Sammartino, P. et al.

https://doi.org/10.1245/s10434-021-10157-0

Citation: Marano, L., Marrelli, D., Sammartino, P. et al. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer with Synchronous Peritoneal Metastases: Multicenter Study of ‘Italian Peritoneal Surface Malignancies Oncoteam—S.I.C.O.’. Ann Surg Oncol 28, 9060–9070 (2021).

Synopsis: The authors investigated the outcomes of CRS-HIPEC for gastric cancer with peritoneal metastases from an Italian multicentric database. Selected patients experienced encouraging results showing a clinically meaningful survival.

Liver-First Approach for Synchronous Colorectal Metastases: Analysis of 7360 Patients from the LiverMetSurvey Registry

Giuliante, F., Viganò, L., De Rose, A.M. et al.

https://doi.org/10.1245/s10434-021-10220-w

Citation: Giuliante, F., Viganò, L., De Rose, A.M. et al. Liver-First Approach for Synchronous Colorectal Metastases: Analysis of 7360 Patients from the LiverMetSurvey Registry. Ann Surg Oncol 28, 8198–8208 (2021).

Synopsis: Patients resected for synchronous colorectal liver metastases (CRLM) included in the LiverMetSurvey registry were analyzed to clarify the outcome and role of the liver-first strategy. A multivariable analysis and a propensity score match stratifying patients for liver tumor burden showed a survival advantage of the liver-first approach in multiple bilobar synchronous CRLM.

Oncoplastic Breast-Conserving Surgery for Synchronous Multicentric and Multifocal Tumors: Is It Oncologically Safe? A Retrospective Matched-Cohort Analysis

De Lorenzi, F., Borelli, F., Pagan, E. et al.

https://doi.org/10.1245/s10434-021-10800-w

Citation: De Lorenzi, F., Borelli, F., Pagan, E. et al. Oncoplastic Breast-Conserving Surgery for Synchronous Multicentric and Multifocal Tumors: Is It Oncologically Safe? A Retrospective Matched-Cohort Analysis. Ann Surg Oncol (2021).

Synopsis: The authors compared patients affected by multicentric or multifocal breast tumors treated either with oncoplastic surgery or mastectomy.The overall survival was similar within the two groups suggesting the oncoplastic approach is safe for managing multifocal and multicentric breast cancers.

Geographic Disparities in Referral Rates and Oncologic Outcomes of Intrahepatic Cholangiocarcinoma: A Population-Based Study

Sutton, T.L., Walker, B.S., Nabavizadeh, N. et al.

https://doi.org/10.1245/s10434-021-10650-6

Citation:

Sutton, T.L., Walker, B.S., Nabavizadeh, N. et al. Geographic Disparities in Referral Rates and Oncologic Outcomes of Intrahepatic Cholangiocarcinoma: A Population-Based Study. Ann Surg Oncol 28, 8152–8159 (2021).

Synopsis: Patients with intrahepatic cholangiocarcinoma treated at a referral center experience improved oncologic outcomes. Increasing distance to the nearest referral center is associated with lower odds of treatment at a referral center; interventions to facilitate referral, such as telemedicine use, may lead to improved outcomes.

The Significance of the Rapid Turnover Protein Score as a Predictor of the Long-Term Outcomes in Hepatocellular Carcinoma After Hepatic Resection

Yanagaki, M., Haruki, K., Yasuda, J. et al.

https://doi.org/10.1245/s10434-021-10704-9

Citation: Yanagaki, M., Haruki, K., Yasuda, J. et al. The Significance of the Rapid Turnover Protein Score as a Predictor of the Long-Term Outcomes in Hepatocellular Carcinoma After Hepatic Resection. Ann Surg Oncol 28, 8130–8139 (2021).

Synopsis: The preoperative rapid turnover protein (RTP) score can be a prognostic factor in patients with hepatocellular carcinoma after hepatic resection, suggesting that RTP plays a significant role in the assessment of the nutritional status in cancer patients.

A Proposal for Modification of the PSOGI Classification According to the Ki-67 Proliferation Index in Pseudomyxoma Peritonei

Arjona-Sánchez, Á., Martínez-López, A., Valenzuela-Molina, F. et al.

https://doi.org/10.1245/s10434-021-10372-9

Citation:

Arjona-Sánchez, Á., Martínez-López, A., Valenzuela-Molina, F. et al. A Proposal for Modification of the PSOGI Classification According to the Ki-67 Proliferation Index in Pseudomyxoma Peritonei. Ann Surg Oncol (2021).

Synopsis: Division of the high-grade Pseudomyxoma peritonei (HG-PMP) category of the Peritoneal Surface Oncology Group International (PSOGI) classification, according to the Ki67 proliferation index, provides two well-defined sub-categories, with significant differences in terms of overall survival and disease-free survival, and hence high prognostic value.

Time to Rethink Upfront Surgery for Resectable Intrahepatic Cholangiocarcinoma? Implications from the Neoadjuvant Experience

Mason, M.C., Massarweh, N.N., Tzeng, CW.D. et al.

https://doi.org/10.1245/s10434-020-09536-w

Citation: Mason, M.C., Massarweh, N.N., Tzeng, CW.D. et al. Time to Rethink Upfront Surgery for Resectable Intrahepatic Cholangiocarcinoma? Implications from the Neoadjuvant Experience. Ann Surg Oncol 28, 6725–6735 (2021).

Synopsis: Though not currently the standard of care, neoadjuvant therapy ahead of curative-intent surgery for patients with operable intrahepatic cholangiocarcinoma is increasingly given. Neoadjuvant therapy is associated with improved survival compared to patients who receive upfront surgery.

Estimating the Prevalence of Pseudomyxoma Peritonei in Europe Using a Novel Statistical Method

Patrick-Brown, T.D.J.H., Carr, N.J., Swanson, D.M. et al.

https://doi.org/10.1245/s10434-020-08655-8

Citation:

Patrick-Brown, T.D.J.H., Carr, N.J., Swanson, D.M. et al. Estimating the Prevalence of Pseudomyxoma Peritonei in Europe Using a Novel Statistical Method. Ann Surg Oncol 28, 252–257 (2021).

Synopsis: Pseudomyxoma peritonei (PMP) is a rare abdominal cancer with undetermined incidence and prevalence. Incidence and prevalence. Incidence and prevalence rates of 3.2 and 22 people per million, respectively, were determined, meaning that 11,736 people in Europe were living with PMP in 2018.

Patient-Reported Outcome Measures for Post-mastectomy Breast Reconstruction: A Systematic Review of Development and Measurement Properties

Davies, C.F., Macefield, R., Avery, K. et al.

https://doi.org/10.1245/s10434-020-08736-8

Citation: Davies, C.F., Macefield, R., Avery, K. et al. Patient-Reported Outcome Measures for Post-mastectomy Breast Reconstruction: A Systematic Review of Development and Measurement Properties. Ann Surg Oncol 28, 386–404 (2021).

Synopsis: Patient-reported outcomes are vital to inform decision-making in breast reconstruction (BR) and patient-reported outcome measures (PROMs) should be robustly developed to ensure data are reliable. This systematic review evaluated the measurement properties of BR PROMs, recommending three for future use.

Enhanced Recovery After Surgery can Improve Patient Outcomes and Reduce Hospital Cost of Gastrectomy for Cancer in the West: A Propensity-Score-Based Analysis

Weindelmayer, J., Mengardo, V., Gasparini, A. et al.

https://doi.org/10.1245/s10434-021-10079-x

Citation:

Weindelmayer, J., Mengardo, V., Gasparini, A. et al. Enhanced Recovery After Surgery can Improve Patient Outcomes and Reduce Hospital Cost of Gastrectomy for Cancer in the West: A Propensity-Score-Based Analysis. Ann Surg Oncol 28, 7087–7094 (2021).

Synopsis: Data on Enhanced Recovery After Surgery for gastrectomy are scarce and mostly come from Eastern countries. This retrospective cohort study on 351 patients undergoing surgery for gastric cancer demonstrated Enhanced Recovery After Surgery was feasible and safe and led to a reduction of hospitalization and cost.

Does Cardiopulmonary Testing Help Predict Long-Term Survival After Esophagectomy?

Chmelo, J., Khaw, R.A., Sinclair, R.C.F. et al.

https://doi.org/10.1245/s10434-021-10136-5

Citation: Chmelo, J., Khaw, R.A., Sinclair, R.C.F. et al. Does Cardiopulmonary Testing Help Predict Long-Term Survival After Esophagectomy?. Ann Surg Oncol 28, 7291–7297 (2021).

Synopsis: Patients undergoing cardiopulmonary exercise testing followed by esophagectomy for esophageal cancer were analyzed. A high VEVCO2 before esophagectomy for malignant disease is independently predictive of patients’ long-term survival as demonstrated on cohort of patients from single high-volume center.

Postoperative Complications and Long-Term Quality of Life After Multimodality Treatment for Esophageal Cancer: An Analysis of the Prospective Observational Cohort Study of Esophageal-Gastric Cancer Patients (POCOP)

Jezerskyte, E., van Berge Henegouwen, M.I., van Laarhoven, H.W.M. et al.

https://doi.org/10.1245/s10434-021-10144-5

Jezerskyte, E., van Berge Henegouwen, M.I., van Laarhoven, H.W.M. et al. Postoperative Complications and Long-Term Quality of Life After Multimodality Treatment for Esophageal Cancer: An Analysis of the Prospective Observational Cohort Study of Esophageal-Gastric Cancer Patients (POCOP). Ann Surg Oncol 28, 7259–7276 (2021).

Synopsis: Esophageal and gastro-esophageal junction cancer patients often have a reduced health-related quality of life (HR-QoL) following surgery. In general, postoperative complications were not associated with short- and long-term HR-QoL in patients following an esophagectomy.

Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life

Kask, G., Repo, J.P., Tukiainen, E.J. et al.

https://doi.org/10.1245/s10434-021-09774-6

Citation: Kask, G., Repo, J.P., Tukiainen, E.J. et al. Soft Tissue Sarcoma of Lower Extremity: Functional Outcome and Quality of Life. Ann Surg Oncol 28, 6892–6905 (2021).

Synopsis: Although tumor and treatment-related factors had an impact, the patient-related factors as age and BMI were the most consistent and significant determinants of both functional outcome and quality of life in postoperative lower extremity soft tissue sarcoma patients.

Retrospective, Multicenter Analysis Comparing Conventional with Oncoplastic Breast Conserving Surgery: Oncological and Surgical Outcomes in Women with High-Risk Breast Cancer from the OPBC-01/iTOP2 Study

Fitzal, F., Bolliger, M., Dunkler, D. et al.

https://doi.org/10.1245/s10434-021-10809-1

Citation: Fitzal, F., Bolliger, M., Dunkler, D. et al. Retrospective, Multicenter Analysis Comparing Conventional with Oncoplastic Breast Conserving Surgery: Oncological and Surgical Outcomes in Women with High-Risk Breast Cancer from the OPBC-01/iTOP2 Study. Ann Surg Oncol (2021).

Synopsis: In this article the authors evaluated whether oncoplastic breast conservation with large resection volumes improves local recurrence compared to conventional breast conservation/low volume oncoplastic procedures. The authors found that the former allows larger tumors resection without increasing local recurrence and reduces the re-excision rate.

Is There an Optimal Definition for a Positive Circumferential Resection Margin in Locally Advanced Esophageal Cancer?

Brac, B., Dufour, C., Behal, H. et al.

https://doi.org/10.1245/s10434-021-10707-6

Citation: Brac, B., Dufour, C., Behal, H. et al. Is There an Optimal Definition for a Positive Circumferential Resection Margin in Locally Advanced Esophageal Cancer?. Ann Surg Oncol (2021).

Synopsis: The College of American Pathologists definition of a positive circumferential resection margin (CRM) is more accurate to predict prognosis and recurrence in esophageal cancer. A new cut-off value of 100 micrometers seems to be even more precise to predict overall survival.

Resection of Retro-Hepatic Vena Cava (RHVC) En-bloc with Caudate Lobe without Vascular Exclusion for a Low Grade Leiomyosarcoma of Inferior Vena Cava

Altomare, M., Sposito, C., Regalia, E. et al.

https://doi.org/10.1245/s10434-020-09428-z

Citation: Altomare, M., Sposito, C., Regalia, E. et al. Resection of Retro-Hepatic Vena Cava (RHVC) En-bloc with Caudate Lobe without Vascular Exclusion for a Low Grade Leiomyosarcoma of Inferior Vena Cava. Ann Surg Oncol 28, 6848–6849 (2021).

Synopsis: The video article shows removal of a leiomyosarcoma of the vena cava en-bloc with caudate lobe. With hybrid 3D-superimposition of vascular anatomy of the region, splanchnic circulation and liver venous outflow were maintained throughout surgery, allowing parenchyma-sparing hepatectomy and cava reconstruction.

Role of Pelvic Lymph Node Resection in Vulvar Squamous Cell Cancer: A Subset Analysis of the AGO-CaRE-1 Study

Role of Pelvic Lymph Node Resection in Vulvar Squamous Cell Cancer: A Subset Analysis of the AGO-CaRE-1 Study.

Woelber, L., Bommert, M., Harter, P. et al.

https://doi.org/10.1245/s10434-021-09744-y

Citation: Tillmann, B.W., Hallet, J., Guttman, M.P. et al. A Population-Based Analysis of Long-Term Outcomes Among Older Adults Requiring Unexpected Intensive Care Unit Admission After Cancer Surgery. Ann Surg Oncol (2021).

Synopsis: The data presented in this article provide evidence regarding the relation of inguinal and pelvic lymph node involvement. Valid prediction of pelvic involvement could be made in case of ≥6 positive groin nodes; pelvic LAE is therewith unnecessary in the majority of node-positive patients.

Surveillance of Sentinel Node-Positive Melanoma Patients Who Receive Adjuvant Therapy Without Undergoing Completion Lymph Node Dissection

Broman, K.K., Bettampadi, D., Pérez-Morales, J. et al.

https://doi.org/10.1245/s10434-021-10570-5

Citation: Broman, K.K., Bettampadi, D., Pérez-Morales, J. et al. Surveillance of Sentinel Node-Positive Melanoma Patients Who Receive Adjuvant Therapy Without Undergoing Completion Lymph Node Dissection. Ann Surg Oncol (2021).

Synopsis: Sentinel node-positive melanoma patients managed without completion node dissection have similar recurrence patterns with or without adjuvant treatment. Most nodal recurrences are within the first year and detected by exam or nodal ultrasound, supporting their continued use alongside cross- sectional imaging.

A Population-Based Analysis of Long-Term Outcomes Among Older Adults Requiring Unexpected Intensive Care Unit Admission After Cancer Surgery

Tillmann, B.W., Hallet, J., Guttman, M.P. et al.

https://doi.org/10.1245/s10434-021-10705-8

Synopsis: Among older adults who underwent high-intensity cancer surgery, patients with an unexpected ICU admission were at increased risk of death or nursing home admission for at least five years after surgery. This risk was modified by the duration of ventilation.

Increased Local Inflammatory Response to MOC31PE Immunotoxin After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

IThorgersen, E.B., Asvall, J., Frøysnes, I.S. et al.

https://doi.org/10.1245/s10434-021-10022-0

Citation: Thorgersen, E.B., Asvall, J., Frøysnes, I.S. et al. Increased Local Inflammatory Response to MOC31PE Immunotoxin After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol 28, 5252–5262 (2021).

Synopsis: Despite CRS-HIPEC most patients with peritoneal metastases from colorectal cancer experience disease relapse. A compartmentalized inflammatory response after CRS-HIPEC was enhanced by instillation of MOC31PE immunotoxin in the peritoneal cavity. The response could improve remnant cancer cell killing.

Impact of Smoking Status on Perioperative Morbidity, Mortality, and Long-Term Survival Following Transthoracic Esophagectomy for Esophageal Cancer

Kamarajah, S.K., Madhavan, A., Chmelo, J. et al.

https://doi.org/10.1245/s10434-021-09720-6

Citation: Kamarajah, S.K., Madhavan, A., Chmelo, J. et al. Impact of Smoking Status on Perioperative Morbidity, Mortality, and Long-Term Survival Following Transthoracic Esophagectomy for Esophageal Cancer. Ann Surg Oncol 28, 4905–4915 (2021).

Synopsis: Smoking is a risk factor for esophageal cancer. This study demonstrates that being a current smoker is associated with an increased risk of complications after esophagectomy but no difference in overall and recurrence free survival to ex and non-smokers.

Complications After Major Surgery for Duodenopancreatic Neuroendocrine Tumors in Patients with MEN1: Results from a Nationwide Cohort

van Beek, DJ., Nell, S., Vorselaars, W.M.C.M. et al.

https://doi.org/10.1245/s10434-020-09496-1

Citation: van Beek, DJ., Nell, S., Vorselaars, W.M.C.M. et al. Complications After Major Surgery for Duodenopancreatic Neuroendocrine Tumors in Patients with MEN1: Results from a Nationwide Cohort. Ann Surg Oncol 28, 4387–4399 (2021).

Synopsis: The incidence and severity of complications after major duodenopancreatic surgery (i.e., Whipple procedure or total pancreatectomy) for duodenopancreatic neuroendocrine tumors in patients with MEN1 were investigated in a population-based cohort. Major duodenopancreatic surgery in patients with MEN1 is associated with a very high risk of severe complications and cumulative burden of morbidity and should therefore be reserved for a selected subgroup of patients with MEN1-related dpNETs.

Disparities in Breast-Conserving Therapy for Non-Hispanic American Indian/Alaska Native Women Compared with Non-Hispanic White Women

Erdrich, J., Cordova-Marks, F., Monetathchi, A.R. et al.

https://doi.org/10.1245/s10434-021-10730-7

Citation: Erdrich, J., Cordova-Marks, F., Monetathchi, A.R. et al. Disparities in Breast-Conserving Therapy for Non-Hispanic American Indian/Alaska Native Women Compared with Non-Hispanic White Women. Ann Surg Oncol (2021).

Synopsis: American Indian/Alaska Native women have significantly higher percentage of mastectomy and lower percentage of lumpectomy for early stage breast cancer compared to White women. There were no significant differences in operations for late stage disease, and no differences in radiation.

van Kooten, R.T., Voeten, D.M., Steyerberg, E.W. et al.

https://doi.org/10.1245/s10434-021-10734-3

Citation: van Kooten, R.T., Voeten, D.M., Steyerberg, E.W. et al. Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses. Ann Surg Oncol (2021).

Synopsis: Esophagectomy is a high-risk procedure with high incidence of postoperative complications. This systematic review and meta-analysis focusses on the identification of preoperative patient-related risk factors for anastomotic leakage, major complications and mortality. This may give leads for perioperative care improvement.

Sodium Thiosulfate Reduces Acute Kidney Injury in Patients Undergoing Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy with Cisplatin: A Single-Center Observational Study

Kurreck, A., Gronau, F., Alberto Vilchez, M.E. et al.

https://doi.org/10.1245/s10434-021-10508-x

Citation: Kurreck, A., Gronau, F., Alberto Vilchez, M.E. et al. Sodium Thiosulfate Reduces Acute Kidney Injury in Patients Undergoing Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy with Cisplatin: A Single-Center Observational Study. Ann Surg Oncol (2021).

Synopsis: This retrospective analysis of 238 patients that underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with cisplatin reports a significantly lower incidence and severity of acute kidney injury in patients receiving sodium thiosulfate.

The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study

The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study.

Soran, A., Dogan, L., Isik, A. et al.

https://doi.org/10.1245/s10434-021-09621-8

Citation: Soran, A., Dogan, L., Isik, A. et al. The Effect of Primary Surgery in Patients with De Novo Stage IV Breast Cancer with Bone Metastasis Only (Protocol BOMET MF 14-01): A Multi-Center, Prospective Registry Study. Ann Surg Oncol 28, 5048–5057 (2021).

Synopsis: Locoregional treatment prolongs overall, systemic progression-free survival and decreases locoregional recurrence in de novo bone only metastatic breast cancer patients. Timing of primary breast surgery either at diagnosis or after systemic treatment provided a survival benefit similar to systemic therapy alone. Locoregional treatment should be in the treatment scheme when consulting patients diagnosed with de novo stage IV bone only metastatic breast cancer.

Outcomes of Esophageal Stent Therapy for the Management of Anastomotic Leaks

Carter, T.S., Philips, P., Egger, M. et al.

https://doi.org/10.1245/s10434-021-09669-6

Citation: Carter, T.S., Philips, P., Egger, M. et al. Outcomes of Esophageal Stent Therapy for the Management of Anastomotic Leaks. Ann Surg Oncol 28, 4960–4966 (2021).

Synopsis: Esophageal Stenting for an anastomotic leak after resection offers a safe and effective method of treatment and is successful in the majority of cases. Critical to success is optimal patient selection, adequate leak drainage, and optimal stent selection and placement.

Laparoscopic R1 Vascular Hepatectomy for Hepatocellular Carcinoma (with Video).

Libia, A., Ferraro, V., Tedeschi, M. et al.

https://doi.org/10.1245/s10434-020-09582-4

Citation: Libia, A., Ferraro, V., Tedeschi, M. et al. Laparoscopic R1 Vascular Hepatectomy for Hepatocellular Carcinoma (with Video). Ann Surg Oncol 28, 3699–3700 (2021).

Synopsis: R1 vascular hepatectomy is an emerging issue in the field of liver surgery. In this multimedia article, the authors describe two cases of laparoscopic R1 vascular hepatectomy for hepatocellular carcinoma in unfavorable position, which is technically demanding but with promising results in term of survival.

Long-term Outcomes After Surgical Resection of Pancreatic Metastases from Renal Clear-Cell Carcinoma

Malleo, G., Salvia, R., Maggino, L. et al.

https://doi.org/10.1245/s10434-021-09649-w

Citation: Malleo, G., Salvia, R., Maggino, L. et al. Long-term Outcomes After Surgical Resection of Pancreatic Metastases from Renal Clear-Cell Carcinoma. Ann Surg Oncol 28, 3100–3108 (2021).

Synopsis: This article focuses on long-term outcomes of 69 patients undergoing resection of pancreatic metastases from metastatic renal cell carcinoma (RCC) and followed for a median of 141 months. The 10-year incidence of disease-specific death was 25.5%. The only significant prognostic factor was the time to new RCC recurrence following pancreatectomy.

Management of Soft Tissue Sarcomas in Extremities: Variation in Treatment Recommendations and Surveillance According to Specialty and Continent

Acem, I., Smit, M.M., Verhoef, C. et al.

https://doi.org/10.1245/s10434-021-09946-4

Citation: Acem, I., Smit, M.M., Verhoef, C. et al. Management of Soft Tissue Sarcomas in Extremities: Variation in Treatment Recommendations and Surveillance According to Specialty and Continent. Ann Surg Oncol (2021).

Synopsis: This article provides an insight in the clinical decision making and surveillance strategy in patients with high-grade soft tissue sarcoma of the extremity.

Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers? An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery

Alasmar, M., Kausar, A., Borgstein, A.BJ. et al.

https://doi.org/10.1245/s10434-021-09885-0

Citation: Alasmar, M., Kausar, A., Borgstein, A.BJ. et al. Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers? An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery. Ann Surg Oncol 28, 4816–4826 (2021).

Synopsis: This international, multi-center study examines the safety of reintroducing major minimally invasive and open esophago-gastric surgery during the COVID-19 pandemic from the perspective of patients and healthcare workers. Consecutive cases during a two-month period were included by centers serving populations severely affected by COVID-19.

Frequency of Contralateral Prophylactic Mastectomy in Breast Cancer Patients with a Negative BRCA1 and BRCA2 Rapid Genetic Test Result

Metcalfe, K.A., Eisen, A., Poll, A. et al.

https://doi.org/10.1245/s10434-021-09855-6

Citation: Metcalfe, K.A., Eisen, A., Poll, A. et al. Frequency of Contralateral Prophylactic Mastectomy in Breast Cancer Patients with a Negative BRCA1 and BRCA2 Rapid Genetic Test Result. Ann Surg Oncol 28, 4967–4973 (2021).

Synopsis: Women receiving a risk assessment and a negative BRCA1/BRCA2 genetic test result prior to surgery use this information to guide their CPM decision. Uptake of CPM for women who were planning on CPM before genetic testing decreases after receiving a negative BRCA1/BRCA2 test result.

Survival Outcomes of Salvage Metastasectomy After Failure of Modern-Era Systemic Therapy for Melanoma.

Li, A.T., Vakharia, K., Lo, S.N. et al.

https://doi.org/10.1245/s10434-021-10489-x

Citation: Li, A.T., Vakharia, K., Lo, S.N. et al. Survival Outcomes of Salvage Metastasectomy After Failure of Modern-Era Systemic Therapy for Melanoma. Ann Surg Oncol (2021).

Synopsis: The authors analyzed the survival outcomes of 190 patients who received salvage metastasectomy following extracranial disease progression after BRAF-targeted therapy or immunotherapy. The results suggest that in appropriately selected patients, salvage metastasectomy is associated with durable survival and disease control.

Neoadjuvant Endocrine Therapy as an Alternative to Neoadjuvant Chemotherapy Among Hormone Receptor-Positive Breast Cancer Patients: Pathologic and Surgical Outcomes

Cao, L., Sugumar, K., Keller, E. et al.

https://doi.org/10.1245/s10434-021-10459-3

Citation: Cao, L., Sugumar, K., Keller, E. et al. Neoadjuvant Endocrine Therapy as an Alternative to Neoadjuvant Chemotherapy Among Hormone Receptor-Positive Breast Cancer Patients: Pathologic and Surgical Outcomes. Ann Surg Oncol (2021).

Synopsis: Tumor or nodal downstage and complete pathological response are achievable with neoadjuvant endocrine therapy (NET). NET can be offered to de-escalate surgery in patients when neoadjuvant chemotherapy is not tolerated or not effective based on genomic testing.

Meta-analysis Comparing Fluorescence Imaging with Radioisotope and Blue Dye-Guided Sentinel Node Identification for Breast Cancer Surgery.

Kedrzycki, M.S., Leiloglou, M., Ashrafian, H. et al.

https://doi.org/10.1245/s10434-020-09288-7

Citation: Kedrzycki, M.S., Leiloglou, M., Ashrafian, H. et al. Meta-analysis Comparing Fluorescence Imaging with Radioisotope and Blue Dye-Guided Sentinel Node Identification for Breast Cancer Surgery. Ann Surg Oncol 28, 3738–3748 (2021).

Synopsis: A meta-analysis of fluorescence guided sentinel node biopsy in breast cancer suggests non-inferiority to the gold standard radioisotope and blue dye approach. However, fluorescence imaging has many advantages as it is radiation free and does not lead to semi-permanent tattooing.

Failure to Cure in Patients Undergoing Surgery for Gastric Cancer: A Nationwide Cohort Study.

Voeten, D.M., van der Werf, L.R., Wilschut, J.A. et al.

https://doi.org/10.1245/s10434-020-09510-6

Citation: Voeten, D.M., van der Werf, L.R., Wilschut, J.A. et al. Failure to Cure in Patients Undergoing Surgery for Gastric Cancer: A Nationwide Cohort Study. Ann Surg Oncol 28, 4484–4496 (2021).

Synopsis: A novel outcome measure for gastric cancer surgery is described. Failure to cure, defined as unsuccessful surgery, occurred in 22.3% of 3,862 patients ranging from 14.5%-34.8% among hospitals with higher rates in hospitals with a low tendency to administer neoadjuvant chemotherapy.

Pure Laparoscopic Anatomic Resection of the Segment 8 Dorsal Area Using the Dorsal Approach of the Right Hepatic Vein.

López-Ben, S., Albiol, M.T., Falgueras, L. et al.

https://doi.org/10.1245/s10434-020-09462-x

Citation: López-Ben, S., Albiol, M.T., Falgueras, L. et al. Pure Laparoscopic Anatomic Resection of the Segment 8 Dorsal Area Using the Dorsal Approach of the Right Hepatic Vein. Ann Surg Oncol 28, 3697 (2021).

Synopsis: The key point of the procedure demonstrated in this multimedia article was to perform hepatic parenchyma transection along the middle hepatic vein. Also, the fluorescence was adjusted to ensure a precise margin and determine whether there was bile leakage on the transected surface.

Defining the Risk of Early Recurrence Following Curative-Intent Resection for Distal Cholangiocarcinoma.

Sahara, K., Tsilimigras, D.I., Toyoda, J. et al.

https://doi.org/10.1245/s10434-021-09811-4

Citation: Sahara, K., Tsilimigras, D.I., Toyoda, J. et al. Defining the Risk of Early Recurrence Following Curative-Intent Resection for Distal Cholangiocarcinoma. Ann Surg Oncol 28, 4205–4213 (2021).

Synopsis: Early recurrence (ER) occurred in one-fourth of patients undergoing resection for distal cholangiocarcinoma. A novel risk scoring model was developed to predict the probability of ER to help clinicians identify candidates for alternative treatment strategies, as well as counselling patients about prognosis.

Assessment of the Long-Term Impact of Pancreatoduodenectomy on Health-Related Quality of Life Using the EORTC QLQ-PAN26 Module.

Fong, Z.V., Sekigami, Y., Qadan, M. et al.

https://doi.org/10.1245/s10434-021-09853-8

Citation: Fong, Z.V., Sekigami, Y., Qadan, M. et al. Assessment of the Long-Term Impact of Pancreatoduodenectomy on Health-Related Quality of Life Using the EORTC QLQ-PAN26 Module. Ann Surg Oncol 28, 4216–4224 (2021).

Synopsis: While the authors reported that patients who had a pancreatoduodenectomy had better long-term global quality of life than healthy controls, a more granular, pancreas-specific questionnaire uncovered important continued abnormalities. These data can better inform clinical decision-making and potential areas for improvement.

An Improved Staging System for Locally Advanced Pancreatic Cancer: A Critical Need in the Multidisciplinary Era.

Fromer, M.W., Hawthorne, J., Philips, P. et al.

Ann Surg Oncol (2021). https://doi.org/10.1245/s10434-021-10174-z

Citation: Fromer, M.W., Hawthorne, J., Philips, P. et al. An Improved Staging System for Locally Advanced Pancreatic Cancer: A Critical Need in the Multidisciplinary Era. Ann Surg Oncol (2021).

Synopsis: This article proposes a novel subclassification system for stage III pancreatic cancers based on their pattern of vascular involvement and examines the current evidence for resection in each scenario.

Induction Chemotherapy Plus Neoadjuvant Chemoradiation for Esophageal and Gastroesophageal Junction Adenocarcinoma.

Ho, F., Torphy, R.J., Friedman, C. et al.

Ann Surg Oncol (2021). https://doi.org/10.1245/s10434-021-09999-5

Citation: Ho, F., Torphy, R.J., Friedman, C. et al. Induction Chemotherapy Plus Neoadjuvant Chemoradiation for Esophageal and Gastroesophageal Junction Adenocarcinoma. Ann Surg Oncol (2021).

Synopsis: In this retrospective study, use of induction chemotherapy before neoadjuvant chemoradiation therapy (nCRT) is associated with a significant survival benefit as well as higher pathologic complete response rates when compared to nCRT without induction chemotherapy for esophageal and gastroesophageal adenocarcinoma.

Socioeconomic and Surgical Disparities are Associated with Rapid Relapse in Patients with Triple-Negative Breast Cancer.

Obeng-Gyasi, S., Asad, S., Fisher, J.L. et al.

https://doi.org/10.1245/s10434-021-09688-3

Citation: Obeng-Gyasi, S., Asad, S., Fisher, J.L. et al. Socioeconomic and Surgical Disparities are Associated with Rapid Relapse in Patients with Triple-Negative Breast Cancer. Ann Surg Oncol (2021).

Synopsis: Rapid relapse among triple negative breast cancer patients in SEER is associated with socioeconomic factors such as Medicaid or uninsured status, single status, black race and omission of surgical management.

Failure to Cure Patients with Colorectal Liver Metastases: The Impact of the Liver Surgeon.

Vega, E.A., Salehi, O., Nicolaescu, D. et al.

https://doi.org/10.1245/s10434-021-10030-0

Citation: Vega, E.A., Salehi, O., Nicolaescu, D. et al. Failure to Cure Patients with Colorectal Liver Metastases: The Impact of the Liver Surgeon. Ann Surg Oncol (2021).

Synopsis: Lack of a liver surgeon (LS) may lead to a failure-to-cure in patients with possibly resectable colorectal liver metastases. This study demonstrates that 44% of patients who were assigned palliative chemotherapy at multidisciplinary tumor boards without an LS present, were considered resectable or potentially resectable following independent LS re-review.

Surgery for Bismuth-Corlette Type 4 Perihilar Cholangiocarcinoma: Results from a Western Multicenter Collaborative Group.

Ruzzenente, A., Bagante, F., Olthof, P.B. et al.

https://doi.org/10.1245/s10434-021-09905-z

Citation: Ruzzenente, A., Bagante, F., Olthof, P.B. et al. Surgery for Bismuth-Corlette Type 4 Perihilar Cholangiocarcinoma: Results from a Western Multicenter Collaborative Group. Ann Surg Oncol (2021).

Synopsis: In the Eastern series, surgery for Bismuth-Corlette type IV cholangiocarcinoma has been demonstrated to reach acceptable long- and short-term outcomes. In this analysis, a large cohort of patients who underwent surgery at Western centers for cholangiocarcinoma was analyzed. Resection was shown to be an acceptable curative treatment option for selected BC type IV patients even though a more technically challenging surgical approach was required.

Radiomics Texture Analysis for the Identification of Colorectal Liver Metastases Sensitive to First-Line Oxaliplatin-Based Chemotherapy.

Nakanishi, R., Oki, E., Hasuda, H. et al.

https://doi.org/10.1245/s10434-020-09581-5

Citation: Nakanishi, R., Oki, E., Hasuda, H. et al. Radiomics Texture Analysis for the Identification of Colorectal Liver Metastases Sensitive to First-Line Oxaliplatin-Based Chemotherapy. Ann Surg Oncol 28, 2975–2985 (2021).

Synopsis: The authors developed and validated a radiomics-based prediction model for the response of colorectal liver metastases to first-line oxaliplatin-based chemotherapy. This approach may allow the early prediction of chemosensitivity and support the treatment strategy for colorectal liver metastasis.

Time to Surgery and Thyroid Cancer Survival in the United States.

Fligor, S.C., Lopez, B., Uppal, N. et al.

https://doi.org/10.1245/s10434-021-09797-z

Citation: Fligor, S.C., Lopez, B., Uppal, N. et al. Time to Surgery and Thyroid Cancer Survival in the United States. Ann Surg Oncol 28, 3556–3565 (2021).

Synopsis: In the first study to investigate time to surgery in papillary thyroid cancer using the National Cancer Database, increasing surgical delay was associated with decreased overall survival.

Retroperitoneal Lymph Node Dissection Versus Surveillance for Adult Early Stage Pure Testicular Teratoma: A Nationwide Analysis.

Hajiran, A., Azizi, M., Aydin, A.M. et al.

https://doi.org/10.1245/s10434-021-09696-3

Citation: Hajiran, A., Azizi, M., Aydin, A.M. et al. Retroperitoneal Lymph Node Dissection Versus Surveillance for Adult Early Stage Pure Testicular Teratoma: A Nationwide Analysis. Ann Surg Oncol 28, 3648–3655 (2021).

Synopsis: Post-orchiectomy management of low-stage pure testicular teratoma is unclear. In a crosssectional nationwide analysis, we found that active surveillance and retroperitoneal lymph node dissection yield comparable survival outcomes, while surveillance has been increasingly adopted in recent years.

Minimally Invasive Complete Response Assessment of the Breast After Neoadjuvant Systemic Therapy for Early Breast Cancer (MICRA trial): Interim Analysis of a Multicenter Observational Cohort Study

van Loevezijn, A.A., van der Noordaa, M.E., van Werkhoven, E.D. et al.

https://doi.org/10.1245/s10434-020-09273-0

Citation: van Loevezijn, A.A., van der Noordaa, M.E., van Werkhoven, E.D. et al. Minimally Invasive Complete Response Assessment of the Breast After Neoadjuvant Systemic Therapy for Early Breast Cancer (MICRA trial): Interim Analysis of a Multicenter Observational Cohort Study. Ann Surg Oncol 28, 3243–3253 (2021).

Synopsis: The therapeutic effect of surgery in breast cancer patients with pathological complete response (pCR) after neoadjuvant therapy is questionable. We evaluated the false-negative rate (FNR) of core-biopsies assessing pCR in patients with good response on MRI, aiming to identify pCR without surgery.

Eligibility for Liver Transplantation in Patients with Perihilar Cholangiocarcinoma

Vugts, J.J.A., Gaspersz, M.P., Roos, E. et al.

https://doi.org/10.1245/s10434-020-09001-8

Citation: Vugts, J.J.A., Gaspersz, M.P., Roos, E. et al. Eligibility for Liver Transplantation in Patients with Perihilar Cholangiocarcinoma. Ann Surg Oncol 28, 1483–1492 (2021).

Synopsis: Liver transplantation has been performed in patients presenting with unresectable perihilar cholangiocarcinoma in the Mayo Clinic, with a reported 5-year survival of 53%. In a Dutch cohort of 732 patients, only 5% were eligible for transplantation under the Mayo Criteria. Without transplantation, a median survival of about 1 year and no long-term survival was observed.

Socioeconomic and Surgical Disparities are Associated with Rapid Relapse in Patients with Triple-Negative Breast Cancer

Obeng-Gyasi, S., Asad, S., Fisher, J.L. et al

https://doi.org/10.1245/s10434-021-09688-3

Venous Reconstruction During Pancreatectomy Using Polytetrafluoroethylene Grafts: A Single-Center Experience with Standardized Perioperative Management

Garnier, J., Traversari, E., Ewald, J. et al.

https://doi.org/10.1245/s10434-021-09716-2

Citation: Garnier, J., Traversari, E., Ewald, J. et al. Venous Reconstruction During Pancreatectomy Using Polytetrafluoroethylene Grafts: A Single-Center Experience with Standardized Perioperative Management. Ann Surg Oncol (2021).

Synopsis: PTFE reconstruction can be safely performed with simple perioperative management in cases requiring interposition graft use. None of the patients experienced anticoagulation-related morbidity or PTFE graft-related infection. The median long-term PTFE graft patency duration was 37 months.

Undertreatment of Gallbladder Cancer: A Nationwide Analysis

Papageorge, M.V., de Geus, S.W.L., Woods, A.P. et al.

https://doi.org/10.1245/s10434-021-09607-6

Citation: Papageorge, M.V., de Geus, S.W.L., Woods, A.P. et al. Undertreatment of Gallbladder Cancer: A Nationwide Analysis. Ann Surg Oncol 28, 2949–2957 (2021).

Synopsis: Despite national guidelines, re-resection rates for gallbladder cancer (T1b and greater) are low (7.6%). Patients who underwent re-resection had a survival advantage of 13 months. The barriers to appropriate surgical care are patient and institution specific.

Multicenter Prospective Cohort Study of the Patient-Reported Outcome Measures PRO-CTCAE and CAT EORTC QLQ-C30 in Major Abdominal Cancer Surgery (PATRONUS): A Student-Initiated German Medical Audit (SIGMA) Study

CHIR-Net SIGMA Study Group., Mihaljevic, A., Fink, C. et al.

https://doi.org/10.1245/s10434-021-09646-z

Citation: CHIR-Net SIGMA Study Group., Mihaljevic, A., Fink, C. et al. Multicenter Prospective Cohort Study of the Patient-Reported Outcome Measures PRO-CTCAE and CAT EORTC QLQ-C30 in Major Abdominal Cancer Surgery (PATRONUS): A Student-Initiated German Medical Audit (SIGMA) Study. Ann Surg Oncol 28, 3075–3089 (2021).

Synopsis: Two novel patient-reported outcome measures (PRO-CTCAE and CAT EORTC QLQ-C30) were successfully applied in patients undergoing cancer surgery. This multicenter study was performed by a student-led research network. Postoperative complications did not affect health-reported quality of life 6 months after surgery.

How Often Does Modern Neoadjuvant Chemotherapy Downstage Patients to Breast-Conserving Surgery?

Petruolo, O., Sevilimedu, V., Montagna, G. et al.

Ann Surg Oncol 28, 287–294 (2021).

https://rdcu.be/ckzXq

Petruolo, O., Sevilimedu, V., Montagna, G. et al. How Often Does Modern Neoadjuvant Chemotherapy Downstage Patients to Breast-Conserving Surgery? Ann Surg Oncol 28, 287–294 (2021).

Synopsis: In this article the authors evaluate breast-conserving surgery (BCS) conversion rates with neoadjuvant chemotherapy (NAC) in patients with tumors too large for conservation. Borderline-BCS candidacy, HER2+/triple negative receptor status, tumor size, cN+ status, and mammographic calcifications are factors to consider when selecting patients for downstaging with NAC.

Systemic Pharmacokinetics of Oxaliplatin After Intraperitoneal Administration by Electrostatic Pressurized Intraperitoneal Aerosol Chemotherapy (ePIPAC) in Patients with Unresectable Colorectal Peritoneal Metastases in the CRC-PIPAC Trial

Lurvink, R.J., Tajzai, R., Rovers, K.P. et al.

Ann Surg Oncol 28, 265–272 (2021). https://rdcu.be/ckzYV

Citation: Lurvink, R.J., Tajzai, R., Rovers, K.P. et al. Systemic Pharmacokinetics of Oxaliplatin After Intraperitoneal Administration by Electrostatic Pressurized Intraperitoneal Aerosol Chemotherapy (ePIPAC) in Patients with Unresectable Colorectal Peritoneal Metastases in the CRC-PIPAC Trial. Ann Surg Oncol 28, 265–272 (2021).

Synopsis: Electrostatic Pressurized Intraperitoneal Aerosol Chemotherapy as a palliative treatment for unresectable isolated colorectal peritoneal metastases results in concentrations equal to those reached with systemic chemotherapy.

Benefits of Surgical Treatment of Stage IV Breast Cancer for Patients With Known Hormone Receptor and HER2 Status

Stahl, K., Wong, W., Dodge, D. et al.

Ann Surg Oncol 28, 2646–2658 (2021).

https://rdcu.be/cj2eV

Citation: Stahl, K., Wong, W., Dodge, D. et al. Benefits of Surgical Treatment of Stage IV Breast Cancer for Patients With Known Hormone Receptor and HER2 Status. Ann Surg Oncol 28, 2646–2658 (2021).

Synopsis: In patients with stage IV breast cancer, surgical intervention in addition to systemic therapy is beneficial to survival, and, in patients who are ER+, PR+, or HER2+, surgical intervention after neoadjuvant chemotherapy has significant survival benefit.

Multidisciplinary Surgical Approach to Increase Complete Cytoreduction Rates for Advanced Ovarian Cancer in a Tertiary Gynecologic Oncology Center

Mulligan, K.M., Glennon, K., Donohoe, F. et al.

Ann Surg Oncol (2021).

https://rdcu.be/cj2fZ

Citation: Mulligan, K.M., Glennon, K., Donohoe, F. et al. Multidisciplinary Surgical Approach to Increase Complete Cytoreduction Rates for Advanced Ovarian Cancer in a Tertiary Gynecologic Oncology Center. Ann Surg Oncol (2021).

Synopsis: This study shows that a multidisciplinary approach to cytoreductive surgery for advanced ovarian cancer results in increased complete macroscopic resection rates without a corresponding increase in morbidity.

Impact of Socioeconomic Status on Presentation and Outcomes in Colorectal Peritoneal Metastases Following Cytoreduction and Chemoperfusion: Persistent Inequalities in Outcomes at a High-Volume Center

Rieser, C.J., Hoehn, R.S., Zenati, M. et al.

https://doi.org/10.1245/s10434-021-09627-2

Citation: Rieser, C.J., Hoehn, R.S., Zenati, M. et al. Impact of Socioeconomic Status on Presentation and Outcomes in Colorectal Peritoneal Metastases Following Cytoreduction and Chemoperfusion: Persistent Inequalities in Outcomes at a High-Volume Center. Ann Surg Oncol (2021).

Synopsis: Low socioeconomic status (SES) has been liked to disparities in access to cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS HIPEC) for colorectal peritoneal metastases. Even among patients able to access care, low SES is associated with significantly worse perioperative outcomes and overall survival (17.8 vs 32.4 mos, p=0.02).

Long-Term Outcomes of Local Excision Following Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer

D’Alimonte, L., Bao, Q.R., Spolverato, G. et al.

https://doi.org/10.1245/s10434-020-09243-6

Citation: D’Alimonte, L., Bao, Q.R., Spolverato, G. et al. Long-Term Outcomes of Local Excision Following Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer. Ann Surg Oncol 28, 2801–2808 (2021).

Synopsis: Local excision might represent an alternative to total mesorectal excision for patients with a major response after neoadjuvant. In highly selected patients, local excision after neoadjuvant chemoradiotherapy is associated with excellent long-term outcomes, and high rates of stoma-free rectum preservation.

TARGIT-R (Retrospective): 5-Year Follow-Up Evaluation of Intraoperative Radiation Therapy (IORT) for Breast Cancer Performed in North America

Stephanie A. Valente, Rahul D. Tendulkar, Sheen Cherian…Stephen R. Grobmyer

https://doi.org/10.1245/s10434-020-09432-3

Citation: Valente, S.A., Tendulkar, R.D., Cherian, S. et al. TARGIT-R (Retrospective): 5-Year Follow-Up Evaluation of Intraoperative Radiation Therapy (IORT) for Breast Cancer Performed in North America. Ann Surg Oncol 28, 2512–2521 (2021).

Synopsis: In this multi-institutional retrospective registry of patients who received intraoperative radiation (IORT) for breast cancer, the 5-year ipsilateral breast tumor recurrence rate was 6.6%. Patients who were compliant with endocrine therapy (3.9%) and those receiving IORT as a boost (1.2%) had the lowest recurrence rates among patients in this series.

The Clinical Management of Cholangiocarcinoma in the United States and Europe: A Comprehensive and Evidence-Based Comparison of Guidelines

Zhi Ven Fong, Sarah A. Brownlee, Motaz Qadan, and Kenneth K. Tanabe

https://doi.org/10.1245/s10434-021-09671-y

Citation: Fong, Z.V., Brownlee, S.A., Qadan, M. et al. The Clinical Management of Cholangiocarcinoma in the United States and Europe: A Comprehensive and Evidence-Based Comparison of Guidelines. Ann Surg Oncol 28, 2660–2674 (2021).

Synopsis: With the rising incidence of cholangiocarcinoma, clinical guidelines play an increasingly important role in the standardization of evidence-based care. Inconsistency amongst guidelines may promote practice variations. This article provides a comparison and analysis of the NCCN, ESMO, BSG, and ILCA clinical guidelines. Intra-tumor heterogeneity is a known mechanism of breast cancer progression and metastasis. The authors found that it correlates with less immune cell infiltration, less cytolytic activity, and worse survival in breast cancer utilizing computational analyses including Mutant Allele Tumor Heterogeneity (MATH) algorithm.

Tumor Heterogeneity Correlates with Less Immune Response and Worse Survival in Breast Cancer Patients

Citation: McDonald, KA., Kawaguchi, T., Qi, Q. et al. Tumor Heterogeneity Correlates with Less Immune Response and Worse Survival in Breast Cancer Patients. Ann Surg Oncol 26, 2191–2199 (2019). https://doi.org/10.1245/s10434-019-07338-3

Synopsis: Intra-tumor heterogeneity is a known mechanism of breast cancer progression and metastasis. The authors found that it correlates with less immune cell infiltration, less cytolytic activity, and worse survival in breast cancer utilizing computational analyses including Mutant Allele Tumor Heterogeneity (MATH) algorithm.

Perioperative and Long-Term Outcomes of Laparoscopic Versus Open Lymphadenectomy for Biliary Tumors: A Propensity-Score-Based, Case-Matched Analysis

Citation: Ratti, F., Fiorentini, G., Cipriani, F. et al. Perioperative and Long-Term Outcomes of Laparoscopic Versus Open Lymphadenectomy for Biliary Tumors: A Propensity-Score-Based, Case-Matched Analysis. Ann Surg Oncol 26, 564–575 (2019). https://doi.org/10.1245/s10434-018-6811-0

Synopsis: The aim of this study was to compare patients undergoing MILS and open liver resections with associated lymphadenectomy for biliary tumors (intrahepatic cholangiocarcinoma and gallbladder cancer) in a case-matched analysis using propensity scores. Laparoscopy proved to be a valid option since it allows to maintain the advantages of minimally invasive approach, without compromising the accuracy and the outcomes of nodal dissection, specifically evaluated in terms of lymphadenectomy-related morbidity.

The Peritoneal Cancer Index Is a Strong Predictor of Incomplete Cytoreductive Surgery in Ovarian Cancer

Jónsdóttir, B., Lomnytska, M., Poromaa, I.S. et al.

Ann Surg Oncol 28, 244–251 (2021).

https://doi.org/10.1245/s10434-020-08649-6

Citation: Jónsdóttir, B., Lomnytska, M., Poromaa, I.S. et al. The Peritoneal Cancer Index Is a Strong Predictor of Incomplete Cytoreductive Surgery in Ovarian Cancer. Ann Surg Oncol 28, 244–251 (2021).

Synopsis: The Peritoneal Cancer Index (PCI) is an excellent predictor of incomplete cytoreductive surgery. A PCI
higher than 24 was associated with a lower rate of surgery success and a higher rate of major complications.
Neoadjuvant chemotherapy could be considered with a PCI above this PCI cutoff.

Patient Age and Survival After Surgery for Esophageal Cancer

Lagergren, J., Bottai, M. & Santoni, G.

Ann Surg Oncol 28, 159–166 (2021).

https://doi.org/10.1245/s10434-020-08653-w

Citation: Lagergren, J., Bottai, M. & Santoni, G. Patient Age and Survival After Surgery for Esophageal Cancer. Ann Surg Oncol 28, 159–166 (2021).

Synopsis: This population-based cohort study in Sweden included 1,737 patients having undergone surgery for esophageal cancer. Compared with patients aged <70 years, those aged ≥75 years had higher odds of 90-day mortality, 5-year all-cause mortality, and 5-year disease-specific mortality.

Total Neoadjuvant Therapy for Operable Pancreatic Cancer

Citation: Kim, R.Y., Christians, K.K., Aldakkak, M. et al. Total Neoadjuvant Therapy for Operable Pancreatic Cancer. Ann Surg Oncol 28, 2246–2256 (2021). https://doi.org/10.1245/s10434-020-09149-3

Synopsis: We compared total neoadjuvant therapy (TNT) to shorter course neoadjuvant therapy (SNT) for operable pancreatic cancer and found TNT was associated with an increased likelihood of receiving at least 5 months of non-surgical therapy without negatively impacting the ability to undergo surgery.

Neoadjuvant Chemotherapy for Pancreatic Ductal Adenocarcinoma is Associated with Lower Post Pancreatectomy Readmission Rates: A Population-Based Cohort Study

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Staged Double Hepatectomy, Double Total Vascular Exclusion, and Double Venous Reconstruction by Peritoneal Patches in One Patient with Colorectal Liver Metastases.

Dokmak, S., Aussilhou, B., Levenson, G. et al.
Ann Surg Oncol 28, 2028–2029 (2021).
https://doi.org/10.1245/s10434-020-09155-5

Citation: Dokmak, S., Aussilhou, B., Levenson, G. et al. Staged Double Hepatectomy, Double Total Vascular Exclusion, and Double Venous Reconstruction by Peritoneal Patches in One Patient with Colorectal Liver Metastases. Ann Surg Oncol (2021).

Synopsis: A 47-year-old female with colorectal liver metastases treated by chemotherapy underwent two staged liver resections. Each hepatectomy was done total vascular exclusion and venous reconstruction of the vena cava and the hepatic vein were achieved by the peritoneum.

D2 Lymphadenectomy According to the Arterial Variations in Gastric and Hepatic Irrigation.

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Transthoracic Versus Transhiatal Esophagectomy for Esophageal Cancer: A Nationwide Propensity Score-Matched Cohort Analysis.

Mertens, A.C., Kalff, M.C., Eshuis, W.J. et al.

Ann Surg Oncol 28, 175–183 (2021).

https://doi.org/10.1245/s10434-020-08760-8

Citation: Mertens, A.C., Kalff, M.C., Eshuis, W.J. et al. Transthoracic Versus Transhiatal Esophagectomy for Esophageal Cancer: A Nationwide Propensity Score-Matched Cohort Analysis. Ann Surg Oncol 28, 175–183 (2021).

Synopsis: While providing a higher lymph node yield, the transthoracic group showed higher morbidity and mortality rates. (y)pN stage was higher in the transthoracic group, potentially indicating residual lymph node metastases during transhiatal resection.

Total Thyroidectomy Versus Lobectomy for Thyroid Cancer: Single-Center Data and Literature Review.

Colombo, C., De Leo, S., Di Stefano, M. et al.

Ann Surg Oncol (2021).

https://doi.org/10.1245/s10434-020-09481-8

Citation: Colombo, C., De Leo, S., Di Stefano, M. et al. Total Thyroidectomy Versus Lobectomy for Thyroid Cancer: Single-Center Data and Literature Review. Ann Surg Oncol (2021).

Synopsis: Lobectomy can be safely proposed for low risk thyroid cancer patients and total thyroidectomy should be favored in intermediate risk tumors. In patients treated with lobectomy the final outcome is confirmed after a longer follow up. In patients submitted to lobectomy, serum thyroglobulin/TSH increasing trend associates with persistence/relapse.

The Impact of Primary Tumor Surgery on Survival in HER2 Positive Stage IV Breast Cancer Patients in the Current Era of Targeted Therapy

Mudgway, R., Chavez de Paz Villanueva, C., Lin, A.C. et al.

https://rdcu.be/ce7lL

Citation: Mudgway, R., Chavez de Paz Villanueva, C., Lin, A.C. et al. The Impact of Primary Tumor Surgery on Survival in HER2 Positive Stage IV Breast Cancer Patients in the Current Era of Targeted Therapy. Ann Surg Oncol 27, 2711–2720 (2020).

Synopsis: Observational data from the National Cancer Database demonstrate that surgery of the primary site for metastatic HER2+ breast cancer is associated with improved overall survival in the current era of targeted therapy.

Extended Resections for Advanced Gallbladder Cancer: Results from a Nationwide Cohort Study

Kuipers, H., de Savornin Lohman, E.A.J., van Dooren, M. et al.

https://doi.org/10.1245/s10434-020-08858-z

Citation: Kuipers, H., de Savornin Lohman, E.A.J., van Dooren, M. et al. Extended Resections for Advanced Gallbladder Cancer: Results from a Nationwide Cohort Study. Ann Surg Oncol 28, 835–843 (2021).

Synopsis: Significant post-operative morbidity and mortality were found in patients with advanced gallbladder cancer undergoing extended resection. However, long-term survival was achieved in a subset. Therefore, extended resections do not preclude long-term survival and a subgroup of patients benefit from surgery.

Laparoscopic Right Adrenalectomy in a Large Right Adrenal Oncocytic Carcinoma

Cardenas G, Valentini M, Mellado B, et al.

https://rdcu.be/ceKWk

Citation: Cárdenas, G., Valentini, M., Mellado, B. et al. Laparoscopic Right Adrenalectomy in a Large Right Adrenal Oncocytic Carcinoma. Ann Surg Oncol (2020).

Synopsis: In this multimedial article, the authors report on a step-by-step laparoscopic approach for an unusual large right adrenal oncocytic carcinoma and description of its anatomo-pathological features.

Resection of Retro-Hepatic Vena Cava (RHVC) En-bloc with Caudate Lobe without Vascular Exclusion for a Low Grade Leiomyosarcoma of Inferior Vena Cava

Altomare M, Sposito C, Regalia E, et al

https://rdcu.be/ceKZe

Synopsis: The video of this multimedia articles shows removal of a leiomyosarcoma of the vena cava en-bloc with caudate lobe. With hybrid 3Dsuperimposition of vascular anatomy of the region, splanchnic circulation and liver venous outflow were maintained throughout surgery, allowing parenchyma-sparing hepatectomy and cava reconstruction.

Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma

Marc D. Moncrieff, Riti A. Sharma, Esther Gathura, and Martin J. Heaton

https://rdcu.be/ceqVi

Citation: Moncrieff, M.D., Sharma, R.A., Gathura, E. et al. Improved Perioperative Seroma and Complication Rates Following the Application of a 2-Layer Negative Pressure Wound Therapy System After Inguinal Lymphadenectomy for Metastatic Cutaneous Melanoma. Ann Surg Oncol 27, 3692–3701 (2020).

Synopsis: Inguinal lymphadenectomy is associated with a high incidence of perioperative morbidity. A twolayer negative pressure wound therapy system significantly reduced the incidence of seroma, return to theatre rate and the drainage period compared to traditional closed suction drainage technique.

Avoiding Unnecessary Major Rectal Cancer Surgery by Implementing Structural Restaging and a Watch-and-Wait Strategy After Neoadjuvant Radiochemotherapy

J.F. Huisman, I.J.H. Schoenaker, R.M. Brohet, O. Reerink, H. van der Sluis, F.C.P. Moll, E. de Boer, J.C. de Graaf, W.H. de Vos tot Nederveen Cappel, G.L. Beets, and H.L. van Westreenen

https://rdcu.be/ceqVr

Citation: Huisman, J.F., Schoenaker, I.J.H., Brohet, R.M. et al. Avoiding Unnecessary Major Rectal Cancer Surgery by Implementing Structural Restaging and a Watch-and-Wait Strategy After Neoadjuvant Radiochemotherapy. Ann Surg Oncol (2020).

Synopsis: This study demonstrated a significant decline in unnecessary surgery due to a Watch & Wait strategy for selected patients with good tumor response after neo-adjuvant chemoradiotherapy. Major total mesorectal excision surgery was avoided in more than 20% of the cases.

Remote Home Monitoring of Older Surgical Cancer Patients: Perspective on Study Implementation and Feasibility

Leonie T. Jonker, Matthijs Plas, Geertruida H. de Bock, Erik Buskens, Barbara L. van Leeuwen, and Maarten M. H. Lahr

https://doi.org/10.1245/s10434-020-08705-1

Citation: Jonker, L.T., Plas, M., de Bock, G.H. et al. Remote Home Monitoring of Older Surgical Cancer Patients: Perspective on Study Implementation and Feasibility. Ann Surg Oncol 28, 67–78 (2021).

Synopsis: Elderly patients in the study setting considered postoperative home monitoring following oncological surgery acceptable and usable. These results provide a valuable contribution to the discussion on the feasibility of home monitoring after surgery and are relevant for future studies.

Prognostic Role of Mismatch Repair Status, Histotype and High-Risk Pathologic Features in Stage II Small Bowel Adenocarcinomas

Alessandro Vanoli, Federica Grillo, Camilla Guerini…Antonio Di Sabatino

https://link.springer.com/article/10.1245%2Fs10434-020-08926-4

Citation: Vanoli, A., Grillo, F., Guerini, C. et al. Prognostic Role of Mismatch Repair Status, Histotype and High-Risk Pathologic Features in Stage II Small Bowel Adenocarcinomas. Ann Surg Oncol 28, 1167–1177 (2021).

Synopsis: In patients with stage II small bowel adenocarcinomas, mismatch repair deficiency and celiac disease represent favorable prognostic markers, whereas poorly cohesive histology and pT4 are associated with a worse prognosis. These features may help in selecting patients for adjuvant chemotherapy.

It Is Time to Rethink Biomarkers for Surveillance of Small Bowel Neuroendocrine Tumors

Tran CG, Sherman SK, Scott AT, et al.

https://doi.org/10.1245/s10434-020-08784-0

Citation: Tran, C.G., Sherman, S.K., Scott, A.T. et al. It Is Time to Rethink Biomarkers for Surveillance of Small Bowel Neuroendocrine Tumors. Ann Surg Oncol 28, 732–741 (2021).

Synopsis: Chromogranin A is the most commonly monitored tumor biomarker in small bowel neuroendocrine tumors. In this study, pancreastatin provided more information on survival and was more sensitive and specifi c in detecting recurrence.

Primary Tumor Location and Outcomes After Cytoreductive Surgery and Intraperitoneal Chemotherapy for Peritoneal Metastases of Colorectal Origin

Adileh M, Yuval JB, Walch HS, et al.

https://doi.org/10.1245/s10434-020-08993-7

Citation: Adileh, M., Yuval, J.B., Walch, H.S. et al. Primary Tumor Location and Outcomes After Cytoreductive Surgery and Intraperitoneal Chemotherapy for Peritoneal Metastases of Colorectal Origin. Ann Surg Oncol 28, 1109–1117 (2021).

Synopsis: In patients with peritoneal metastases of colorectal origin, location of the primary tumor was an independent predictor of survival. Worse outcomes were observed in patients with right-sided tumors. The genetic alterations were different in left-sided and right-sided tumors.

How to Select Early-Stage Cervical Cancer Patients Still Suitable for Laparoscopic Radical Hysterectomy: a Propensity-Matched Study

Pedone Anchora L, Turco LC, Bizzarri N, et al.

https://doi.org/10.1245/s10434-019-08162-5

Citation: Pedone Anchora, L., Turco, L.C., Bizzarri, N. et al. How to Select Early-Stage Cervical Cancer Patients Still Suitable for Laparoscopic Radical Hysterectomy: a Propensity-Matched Study. Ann Surg Oncol 27, 1947–1955 (2020).

Synopsis: The main determinant factor in the choice of surgical approach is a tumor diameter of 20 mm. Women with > 20 mm disease should undergo open surgery while in case of tumor < 20 mm both approaches appear safe.

The Chicago Consensus on Peritoneal Surface Malignancies: Management of Appendiceal Neoplasms

Chicago Consensus Working Group., Schuitevoerder, D., Plana, A. et al.

https://rdcu.be/cdhkJ

Citation: Chicago Consensus Working Group., Schuitevoerder, D., Plana, A. et al. The Chicago Consensus on Peritoneal Surface Malignancies: Management of Appendiceal Neoplasms. Ann Surg Oncol 27, 1753–1760 (2020).

Synopsis: The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of appendiceal neoplasms specifically related to the management of peritoneal surface malignancies.

Evolution of Esophagectomy for Cancer Over 30 Years: Changes in Presentation, Management and Outcomes

Griffin, S.M., Jones, R., Kamarajah, S.K. et al.

https://rdcu.be/ccmME

Citation: Griffin, S.M., Jones, R., Kamarajah, S.K. et al. Evolution of Esophagectomy for Cancer Over 30 Years: Changes in Presentation, Management and Outcomes. Ann Surg Oncol (2020).

Synopsis: The presentation, management and outcomes of esophageal cancer have changed greatly over the last 30 years. This study highlights these changes through the lens of a single high volume center and illustrates the huge improvement in patient survival.

The Impact of Residential Segregation on Pancreatic Cancer Diagnosis, Treatment, and Mortality

Blanco, B.A., Poulson, M., Kenzik, K.M. et al.

https://rdcu.be/ccmRy

Citation: Blanco, B.A., Poulson, M., Kenzik, K.M. et al. The Impact of Residential Segregation on Pancreatic Cancer Diagnosis, Treatment, and Mortality. Ann Surg Oncol (2020).

Synopsis: This study highlights the impact of residential segregation on pancreatic cancer outcomes and shows that with reduction in segregation, disparities in stage at diagnosis, surgical resection, and overall mortality disappear.

Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy

Robert Sucher MD, Uwe Scheuermann MD & Daniel Seehofer MD

Citation: Sucher, R., Scheuermann, U. & Seehofer, D. Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy. Ann Surg Oncol (2020).

https://doi.org/10.1245/s10434-020-09175-1

Synopsis: With the implementation of novel surgical techniques and strategies, laparoscopic liver surgery has gained momentum also in the field of perihilar cholangiocarcinoma (pCCA) surgery. To accomplish the most delicate part of the procedure – the hepatico-jejunostomy – the authors applied a parachute suturing technique, which allowed for a good view on both components of the anastomosis, the posterior wall of the hepatic duct as well as the jejunal segment which the authors intended to anastomose. This strategy hence allowed for a successful total laparoscopic operation without the need for an “open surgery service incision” to accomplish biliary reconstruction.

Robotic Resection of Hilar Cholangiocarcinoma

Marcel Autran Machado, Bruno V. Mattos, Murillo Macedo Lobo Filho, and Fabio Makdissi

Citation: Machado, M.A., Mattos, B.V., Lobo Filho, M.M. et al. Robotic Resection of Hilar Cholangiocarcinoma. Ann Surg Oncol 27, 4166–4170 (2020).

https://doi.org/10.1245/s10434-020-08514-6

Synopsis: This video shows a robotic radical resection of hilar cholangiocarcinoma which consisted in left hepatectomy, caudate lobe resection, resection of bile duct, lymphadenectomy and Roux-en-Y hepaticojejunostomy. Robotic approach has some technical advantages over laparoscopic technique for this procedure.

Assessing the Burden of Nodal Disease for Breast Cancer Patients with Clinically Positive Nodes: Hope for More Limited Axillary Surgery

Angarita, S., Ye, L., Rünger, D. et al.

Citation: Angarita, S., Ye, L., Rünger, D. et al. Assessing the Burden of Nodal Disease for Breast Cancer Patients with Clinically Positive Nodes: Hope for More Limited Axillary Surgery. Ann Surg Oncol (2020).

https://rdcu.be/caZlL

Synopsis: This article assesses the burden of nodal disease in breast cancer patients who present with clinically positive axillary nodes. The data reported demonstrate that over 40% of patients have minimal pN1 disease. Palpable lymphadenopathy does not predict for higher nodal stage.

Management of Cancer Surgery Cases During the COVID-19 Pandemic: Considerations

Bartlett, D.L., Howe, J.R., Chang, G. et al.

Citation: Bartlett, D.L., Howe, J.R., Chang, G. et al. Management of Cancer Surgery Cases During the COVID-19 Pandemic: Considerations. Ann Surg Oncol 27, 1717–1720 (2020).

https://rdcu.be/cbyD5

Synopsis: In these unprecedented times of COVID-19, surgical oncologists are being forced to consider triage and rationing of cancer surgery cases. This article presents recommendations for managing care in respective areas of cancer specialties, assuming a 3- to 6-month delay in care.

Multidisciplinary Care for Melanoma of Unknown Primary: Experience in the Era of Molecular Profiling

De Andrade, J.P., Wong, P., O’Leary, M.P., et al.

https://rdcu.be/caZlL

Citation: De Andrade, J.P., Wong, P., O’Leary, M.P. et al. Multidisciplinary Care for Melanoma of Unknown Primary: Experience in the Era of Molecular Profiling. Ann Surg Oncol 27, 5240–5247 (2020).

Synopsis: Melanoma of unknown primary (MUP) is melanoma with locoregional or distant metastases without evidence of a primary lesion. In this article, the authors review the diagnosis, treatment, and outcomes of a modern cohort of patients with MUP.

A Novel Classification of Intrahepatic Cholangiocarcinoma Phenotypes Using Machine Learning Techniques: An International Multi-Institutional Analysis

Tsilimigras, D.I., Hyer, J.M., Paredes, A.Z., et al.

https://rdcu.be/caZi5

Citation: Tsilimigras, D.I., Hyer, J.M., Paredes, A.Z. et al. A Novel Classification of Intrahepatic Cholangiocarcinoma Phenotypes Using Machine Learning Techniques: An International Multi-Institutional Analysis. Ann Surg Oncol 27, 5224–5232 (2020).

Synopsis: The current study identified 3 distinct clusters of ICC patients based purely on phenotype: common, proliferative and inflammatory ICC. Patients with inflammatory ICC had the worst long-term outcomes following resection and should be considered candidates for alternative treatment therapies such as neoadjuvant chemotherapy.

The Prognostic Index Independently Predicts Survival in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Resection

Citation: Gruber, E.S., Jomrich, G., Kaider, A. et al. The Prognostic Index Independently Predicts Survival in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Resection. Ann Surg Oncol 27, 2017–2024 (2020).

https://rdcu.be/caHPr

Synopsis: Cancer-related inflammation drives tumor development. The Prognostic Index is a simple inflammation score, that combines CRP and white blood count, whilst other prognostic scores require extended laboratory analysis. Further on, it has proven as a strong independent tool for survival prognostication in 357 patients with pancreatic cancer undergoing resection.

Three-Dimensionally Printed Patient-Specific Surgical Plates Increase Accuracy of Oncologic Head and Neck Reconstruction Versus Conventional Surgical Plates: A Comparative Study.

Citation: Yang, Wf., Choi, W.S., Wong, M.CM. et al. Three-Dimensionally Printed Patient-Specific Surgical Plates Increase Accuracy of Oncologic Head and Neck Reconstruction Versus Conventional Surgical Plates: A Comparative Study. Ann Surg Oncol (2020).

https://rdcu.be/caHRH

Synopsis: In this comparative study, 3D-printed patient-specific surgical plates increase accuracy of oncological head and neck reconstruction versus conventional surgical plates, concerning the entire maxilla or mandible, bilateral mandibular angles, and reconstructed bone grafts. This constitutes the highest level of evidence to date.

A Randomized Trial Evaluating Bioimpedance Spectroscopy Versus Tape Measurement for the Prevention of Lymphedema Following Treatment for Breast Cancer: Interim Analysis

Ridner SH, Dietrich MS, Cowher MS, et al.

https://rdcu.be/b9J85

Citation: Ridner, S.H., Dietrich, M.S., Cowher, M.S. et al. A Randomized Trial Evaluating Bioimpedance Spectroscopy Versus Tape Measurement for the Prevention of Lymphedema Following Treatment for Breast Cancer: Interim Analysis. Ann Surg Oncol 26, 3250–3259 (2019).

Synopsis: An interim analysis is reported of a randomized controlled trial comparing lymphedema progression rates using volume measurements calculated from circumference using tape measure (TM) to bioimpedance spectroscopy (BIS). Interim results demonstrate that post-treatment surveillance with BIS reduced absolute rates of progression of BCRL by approximately 10%, a clinically meaningful improvement.

Variation in Adequate Lymph Node Yield for Gastric, Lung, and Bladder Cancer: Attributable to the Surgeon, Pathologist, or Hospital?

Aquina CT, Truong M, Justiniano CF, et al.

https://rdcu.be/b9MzZ

Citation: Aquina, C.T., Truong, M., Justiniano, C.F. et al. Variation in Adequate Lymph Node Yield for Gastric, Lung, and Bladder Cancer: Attributable to the Surgeon, Pathologist, or Hospital?. Ann Surg Oncol 27, 4093–4106 (2020).

Synopsis: This study investigated trends, factors, and sources of variation related to adequate lymph node yield (ALNY) for gastric, lung, and bladder cancer resection. ALNY remains low, and the relative contributions of the surgeon/pathologist/hospital in attaining ALNY differ across organ systems.

Axillary Response in Patients Undergoing Neoadjuvant Endocrine Treatment for Node-Positive Breast Cancer: Systematic Literature Review and NCDB Analysis

Arielle Stafford, Austin Williams, Kirsten Edmiston, Costanza Cocilovo, Robert Cohen, Sara Bruce, Kahyun Yoon-Flannery, and Lucy De La Cruz

https://doi.org/10.1245/s10434-020-08905-9

Citation: Stafford, A., Williams, A., Edmiston, K. et al. Axillary Response in Patients Undergoing Neoadjuvant Endocrine Treatment for Node-Positive Breast Cancer: Systematic Literature Review and NCDB Analysis. Ann Surg Oncol 27, 4669–4677 (2020).

Synopsis: The utility of neoadjuvant endocrine therapy (NET) on axillary downstaging in clinically node-positive breast cancer is unclear. Using the National Cancer Database, the authors found that complete pathologic response in the axilla occurs after NET more frequently than previously reported.

Multiparametric MRI and Whole Slide Image-Based Pretreatment Prediction of Pathological Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer: A Multicenter Radiopathomic Study

Lizhi Shao, Zhenyu Liu, Lili Feng, Xiaoying Lou, Zhenhui Li, Xiao-Yan Zhang, Xiangbo Wan,Xuezhi Zhou, PhD2,8, Kai Sun, Da-Fu Zhang, Lin Wu, Guanyu Yang, Ying-Shi Sun, Ruihua Xu, Xinjuan Fan, and Jie Tian

https://doi.org/10.1245/s10434-020-08659-4

Citation: Shao, L., Liu, Z., Feng, L. et al. Multiparametric MRI and Whole Slide Image-Based Pretreatment Prediction of Pathological Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer: A Multicenter Radiopathomic Study. Ann Surg Oncol 27, 4296–4306 (2020).

Synopsis: This is a multicenter study combining radiological information of whole tumor and pathological information of local lesions to specifically differentiate response prior to nCRT, taking advantage of the complementary information provided by mp-MRI and WSI.

Contralateral Risk-Reducing Mastectomy in Breast Cancer Patients Who Undergo Multigene Panel Testing

Brittany L. Murphy, Min Yi, Banu K. Arun, Angelica M. Gutierrez Barrera, and Isabelle Bedrosian

https://doi.org/10.1245/s10434-020-08889-6

Citation: Murphy, B.L., Yi, M., Arun, B.K. et al. Contralateral Risk-Reducing Mastectomy in Breast Cancer Patients Who Undergo Multigene Panel Testing. Ann Surg Oncol 27, 4613–4621

Synopsis: Among patients with unilateral breast cancer who underwent multi-gene panel testing, patients with a BRCA 1/2 mutation were thirteen times more likely than those without a germline mutation to undergo CRRM, patients with a non-BRCA mutation were four times as likely, and a VUS were twice as likely.

Changing the Default: A Prospective Study of Reducing Discharge Opioid Prescription after Lumpectomy and Sentinel Node Biopsy

Tracy-Ann Moo, Kate R. Pawloski, Varadan Sevilimedu, Jillian Charyn, Brett A. Simon, Lisa M. Sclafani, George Plitas, Andrea V. Barrio, Laurie J. Kirstein, Kimberly J. Van Zee, and Monica Morrow

https://doi.org/10.1245/s10434-020-08886-9

Citation: Moo, T., Pawloski, K.R., Sevilimedu, V. et al. Changing the Default: A Prospective Study of Reducing Discharge Opioid Prescription after Lumpectomy and Sentinel Node Biopsy. Ann Surg Oncol 27, 4637–4642 (2020).

Synopsis: The authors examine outcomes following a change in standard discharge prescription from opioid/NSAID to an NSAID/acetaminophen, and conclude that most patients undergoing lumpectomy with SLNB can be discharged with an NSAID/acetaminophen, reducing the number of unused opioids in the community.

Laparoscopic Suprapancreatic Lymph Node Dissection Using a Systematic Mesogastric Excision Concept for Gastric Cancer

Tsutomu Kumamoto, Yasunori Kurahashi, Hirotaka Niwa, et al.

https://doi.org/10.1245/s10434-019-07700-5

Citation: Kumamoto, T., Kurahashi, Y., Niwa, H. et al. Laparoscopic Suprapancreatic Lymph Node Dissection Using a Systematic Mesogastric Excision Concept for Gastric Cancer. Ann Surg Oncol 27, 529–531 (2020).

Synopsis: Laparoscopic suprapancreatic lymphadenectomy using SME takes advantage of the surgical anatomy and achieves en bloc removal of the primary tumor and gastric mesentery. This series provides evidence that this procedure can be performed in a timely manner and is feasible.

Robotic Treatment for Large Duodenal Gastrointestinal Stromal Tumor

Alessandra Marano, Fabrizio Allisiardi, Enrico Perino, et al.

https://doi.org/10.1245/s10434-019-08041-z

Citation: Marano, A., Allisiardi, F., Perino, E. et al. Robotic Treatment for Large Duodenal Gastrointestinal Stromal Tumor. Ann Surg Oncol 27, 1101–1102 (2020).

Synopsis: The adoption of a robotic approach could facilitate a duodenal sparing resection of large duodenal gastrointestinal stromal tumors amenable to a conservative R0 resection.

Personalized Identification of Optimal HIPEC Perfusion Protocol in Patient-Derived Tumor Organoid Platform.

Forsythe SD, Sasikumar S, Omeed Moaven, et al.

Citation: Forsythe, S.D., Sasikumar, S., Moaven, O. et al. Personalized Identification of Optimal HIPEC Perfusion Protocol in Patient-Derived Tumor Organoid Platform. Ann Surg Oncol (2020).

https://doi.org/10.1245/s10434-020-08790-2

Synopsis: Tumor organoid HIPEC platform for determination of optimal systemic and intraperitoneal chemotherapy at the level of the individual patient, suggesting that not only type of chemotherapy, but also application of hyperthermia should be personalized.

Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients.

Leimkühler M, Hentzen JEKR, Hemmer PHJ. et al.

Citation: Leeds, I.L., Meyers, P.M., Enumah, Z.O. et al. Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients. Ann Surg Oncol 26, 936–944 (2019).

https://doi.org/10.1245/s10434-018-07136-3

Synopsis: The effect of psychosocial risks on cancer surgery remains understudied. In comorbid patients, multiple psychosocial risks conferred a three times increase in the odds of a complication. These findings support the use of psychosocial risk assessment and potential preoperative optimization.

MMR Deficiency is Homogeneous in Pancreatic Carcinoma and Associated with High Density of Cd8-Positive Lymphocytes

Fraune C, Burandt E, Simon R, et al.

Citation: Fraune, C., Burandt, E., Simon, R. et al. MMR Deficiency is Homogeneous in Pancreatic Carcinoma and Associated with High Density of Cd8-Positive Lymphocytes. Ann Surg Oncol 27, 3997–4006 (2020).

https://doi.org/10.1245/s10434-020-08209-y

Synopsis: Immune checkpoint inhibition can be effective in microsatellite instable tumors. Here, we found that about 1 percent of 597 pancreatic cancers showed microsatellite instability, which was detectable throughout the entire tumor bulk. Our data suggest that microsatellite instability can be reliably assessed in small pancreatic cancer biopsies to select patients for therapy.

Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Leimkühler M, Hentzen JEKR, Hemmer PHJ. et al.

Citation: Leimkühler, M., Hentzen, J.E.K.R., Hemmer, P.H.J. et al. Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol 27, 3973–3983 (2020).

https://doi.org/10.1245/s10434-020-08650-z

Synopsis: Quality of life deteriorates in the 6 months after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, returning to baseline by 12 months. This is negatively influenced by age, operation times, extensive disease, residual disease, adjuvant chemotherapy, complications, stoma placement, and recurrence.

Electrochemotherapy with Irreversible Electroporation and FOLFIRINOX Improves Survival in Murine Models of Pancreatic Adenocarcinoma

Neal Bhutiani, Yan Li, Qianqian Zheng, Harshul Pandit, Xiaoju Shi, Yujia Chen, Youxi Yu, Zachary R. Pulliam, Min Tan, and Robert C. G. Martin II

https://doi.org/10.1245/s10434-020-08782-2

Citation: Bhutiani, N., Li, Y., Zheng, Q. et al. Electrochemotherapy with Irreversible Electroporation and FOLFIRINOX Improves Survival in Murine Models of Pancreatic Adenocarcinoma. Ann Surg Oncol 27, 4348–4359 (2020).

Synopsis: Electrochemotherapy (ECT) with IRE and FOLFIRINOX resulted in increased tumor-cell apoptosis in mice models. In five patients, ECT with either FOLFIRINOX or gemcitabine was well tolerated and resulted in no dose-limiting toxicities.

Selecting Node-Positive Patients for Axillary Downstaging with Neoadjuvant Chemotherapy

Giacomo Montagna, Anita Mamtani, Andrea Knezevic, Edi Brogi, Andrea V. Barrio, and Monica Morrow

https://doi.org/10.1245/s10434-020-08650-z

Citation: Montagna, G., Mamtani, A., Knezevic, A. et al. Selecting Node-Positive Patients for Axillary Downstaging with Neoadjuvant Chemotherapy. Ann Surg Oncol 27, 4515–4522 (2020).

Synopsis: Here we evaluate how often node-positive patients avoid ALND with NAC and identify predictors of retrieval of ≥3 SLNs and ALND avoidance. ALND was spared in 41% of patients; this was associated with receptor status, grade, and LVI.

Extranodal Tumor Deposits in the Axillary Fat Indicate the Need for Axillary Dissection Among T1–T2cN0 Patients with Positive Sentinel Nodes

Anita Mamtani, Andrea V. Barrio, Debra A. Goldman, Hannah Y. Wen, Alain Vincent, and Monica Morrow

Citation: Mamtani, A., Barrio, A.V., Goldman, D.A. et al. Extranodal Tumor Deposits in the Axillary Fat Indicate the Need for Axillary Dissection Among T1–T2cN0 Patients with Positive Sentinel Nodes. Ann Surg Oncol 27, 3585–3592 (2020). https://doi.org/10.1245/s10434-020-08632-1

Synopsis: Among T1-T2cN0 patients with SLN metastases, the presence of extranodal tumor deposits in the axillary fat is strongly associated with ≥4 positive NSLNs. Even in patients meeting ACOSOG Z0011 criteria for omission of ALND, this finding may warrant completion ALND.

Imaging Intensity and Survival Outcomes in High-Risk Resected Melanoma Treated by Systemic Therapy at Recurrence

Citation: Ibrahim, A.M., Le May, M., Bossé, D. et al. Imaging Intensity and Survival Outcomes in High-Risk Resected Melanoma Treated by Systemic Therapy at Recurrence. Ann Surg Oncol 27, 3683–3691 (2020). https://doi.org/10.1245/s10434-020-08407-8

Synopsis: The authors examined 353 high-risk melanoma patients over a 10-year period for imaging surveillance intensity and symptom status at recurrence. Asymptomatic detection of metastatic recurrence was associated with lower burden of disease, higher rates of systemic treatment, and improved overall survival outcomes.

Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Ocular Melanoma Metastases Confined to the Liver: A Prospective Phase II Study

Susanna Meijer, Mark C. Burgmans, Eleonora M. de Leede…Alexander L. Vahrmeijer

Citation: Meijer, T.S., Burgmans, M.C., de Leede, E.M. et al. Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Ocular Melanoma Metastases Confined to the Liver: A Prospective Phase II Study. Ann Surg Oncol (2020).

https://doi.org/10.1245/s10434-020-08741-x

Synopsis: The liver is the predominant site of metastases from ocular melanoma. This study shows that percutaneous hepatic perfusion with melphalan can achieve a high overall response rate and median overall survival well beyond 1 year in patients with liver-only ocular melanoma metastases.

Effect of Surgery Type on Time to Adjuvant Chemotherapy and Impact of Delay on Breast Cancer Survival: A National Cancer Database Analysis

Amanda R. Kupstas, Tanya L. Hoskin, Courtney N. Day, Elizabeth B. Habermann, and Judy C. Boughey

Citation: Kupstas, A.R., Hoskin, T.L., Day, C.N. et al. Effect of Surgery Type on Time to Adjuvant Chemotherapy and Impact of Delay on Breast Cancer Survival: A National Cancer Database Analysis. Ann Surg Oncol 26, 3240–3249 (2019).

https://doi.org/10.1245/s10434-019-07566-7

Synopsis: Using the National Cancer Database, we evaluated how the type of breast surgery impacted the timing to adjuvant chemotherapy and factors that infl uenced any delay in therapy, and furthermore, evaluated the impact of any delay in adjuvant chemotherapy on patient outcome. Initiation of chemotherapy greater than 120 days after diagnosis was associated with poorer overall survival. The time interval from diagnosis to surgery had the greatest impact on the time from diagnosis to chemotherapy, with reconstruction resulting in the greatest delay

Robotic Extended Right Hemicolectomy with Complete Mesocolic Excision and D3 Lymph Node Dissection

Irbaz Hameed, Piyush Aggarwal, and Martin R. Weiser

https://doi.org/10.1245/s10434-019-07692-2

Citation: Hameed, I., Aggarwal, P. & Weiser, M.R. Robotic Extended Right Hemicolectomy with Complete Mesocolic Excision and D3 Lymph Node Dissection. Ann Surg Oncol 26, 3990–3991 (2019).

Synopsis: This video provides a step-by-step demonstration of a robotically assisted extended right hemicolectomy with complete mesocolic excision and D3 lymphadenectomy in a 62-year-old male with hepatic ﬂexure adenocarcinoma. The use of robotics facilitates visualization and instrument dexterity.

Pure Laparoscopic Anatomic Resection of the Segment 8 Ventral Area Using the Transfissural Glissonean Approach

Ji Hoon Kim MD and Hyeyoung Kim

https://doi.org/10.1245/s10434-019-07852-4

Citation: Kim, J.H., Kim, H. Pure Laparoscopic Anatomic Resection of the Segment 8 Ventral Area Using the Transfissural Glissonean Approach. Ann Surg Oncol 26, 4608–4609 (2019).

Synopsis: The most difﬁcult and critical step of anatomical resection of segment 8 ventral area is the determination of boundary. The transﬁssural Glissonean approach is a feasible and effective technique for laparoscopic anatomical segmentectomy. The parenchymal transection along the main portal ﬁssure allows easy and direct access to the segment 8 ventral branch.

A Systematic Review and Meta-Analysis Comparing the Short- and Long-Term Outcomes for Laparoscopic and Open Liver Resections for Hepatocellular Carcinoma: Updated Results from the European Guidelines Meeting on Laparoscopic Liver Surgery, Southampton, UK, 2017

Ruben Ciria, Irene Gomez-Luque, Sira Ocaña…Mohammed Abu Hilal

Citation: Ciria, R., Gomez-Luque, I., Ocaña, S. et al. A Systematic Review and Meta-Analysis Comparing the Short- and Long-Term Outcomes for Laparoscopic and Open Liver Resections for Hepatocellular Carcinoma: Updated Results from the European Guidelines Meeting on Laparoscopic Liver Surgery, Southampton, UK, 2017. Ann Surg Oncol 26, 252–263 (2019).

https://doi.org/10.1245/s10434-018-6926-3

Synopsis: Laparoscopic approach for liver resection of hepatocellular carcinoma (HCC) improves short-term outcomes without compromising long-term outcomes. In specific sub-analyses, the main improvement is observed in hospital stay and complications. Minimally invasive approach should be considered an adequate strategy for resection of HCC.

Prognosis After Resection of Barcelona Clinic Liver Cancer (BCLC) Stage 0, A, and B Hepatocellular Carcinoma: A Comprehensive Assessment of the Current BCLC Classification

Diamantis I. Tsilimigras, Fabio Bagante, Kota Sahara…Timothy M. Pawlik

https://doi.org/10.1245/s10434-019-07580-9

Citation: Tsilimigras, D.I., Bagante, F., Sahara, K. et al. Prognosis After Resection of Barcelona Clinic Liver Cancer (BCLC) Stage 0, A, and B Hepatocellular Carcinoma: A Comprehensive Assessment of the Current BCLC Classification. Ann Surg Oncol 26, 3693–3700 (2019).

Synopsis: This study assessed the prognosis of patients undergoing surgery for BCLC stage 0, A, and B hepatocellular carcinoma (HCC). Patients with a single large tumor had long-term outcomes comparable with patients with BCLC-B HCC following liver resection. Surgery after resection for BCLC-B HCC provided a 5-year overall survival of 49.9%.

Prognosis After Resection of Barcelona Clinic Liver Cancer

Rittal Mehta, Diamantis I. Tsilimigras, Anghela Z. Paredes…Timothy M. Pawlik

Citation: Mehta, R., Tsilimigras, D.I., Paredes, A.Z. et al. Is Patient Satisfaction Dictated by Quality of Care Among Patients Undergoing Complex Surgical Procedures for a Malignant Indication? Ann Surg Oncol 27, 3126–3135 (2020).

https://doi.org/10.1245/s10434-020-08788-w

Synopsis: Higher patient satisfaction was strongly associated with hospital structural measures such as bed number, urban location as well as nurse-to-bed ratio. Patients who had an “optimal” TO following cancer surgery had higher odds of ranking the hospital within the highest HCAPS category. High quality of care can directly lead to improved patient satisfaction among surgical patients with cancer.

Survival Outcomes of Resected BRAFV600E Mutant Colorectal Liver Metastases: A Multicenter Retrospective Cohort Study in Japan

Citation: Kobayashi, S., Takahashi, S., Takahashi, N. et al. Survival Outcomes of Resected BRAF V600E Mutant Colorectal Liver Metastases: A Multicenter Retrospective Cohort Study in Japan. Ann Surg Oncol 27, 3307–3315 (2020).

https://doi.org/10.1245/s10434-020-08817-8

Synopsis: A multicenter retrospective cohort study to investigate the survival outcomes of resected BRAF V600E mutant CRLM was conducted. A clinicopathological analysis was performed, and the future treatment strategy for this disease is discussed.

Validation of Residual Cancer Burden as Prognostic Factor for Breast Cancer Patients After Neoadjuvant Therapy

Hannah Deborah Müller, Florian Posch, Christoph Suppan…Marija Balic

Citation: Müller, H.D., Posch, F., Suppan, C. et al. Validation of Residual Cancer Burden as Prognostic Factor for Breast Cancer Patients After Neoadjuvant Therapy. Ann Surg Oncol 26, 4274–4283 (2019). https://doi.org/10.1245/s10434-019-07741-w

Synopsis: In a clinical, independent setting the value of the residual cancer burden (RCB) predictive performance was assessed. The authors conﬁrm the RCB score as externally valid prognostic marker independent of molecular subtype for relapse-free survival and overall survival.

Evaluation of the 12-Gene Molecular Score and the 21-Gene Recurrence Score as Predictors of Response to Neo-adjuvant Chemotherapy in Estrogen Receptor-Positive, HER2-Negative Breast Cancer

Hatem Soliman, Susanne Wagner, Darl D. Flake II…William Gradishar

Citation: Soliman, H., Wagner, S., Flake, D.D. et al. Evaluation of the 12-Gene Molecular Score and the 21-Gene Recurrence Score as Predictors of Response to Neo-adjuvant Chemotherapy in Estrogen Receptor-Positive, HER2-Negative Breast Cancer. Ann Surg Oncol 27, 765–771 (2020). https://doi.org/10.1245/s10434-019-08039-7

Synopsis: Neo-adjuvant chemotherapy may facilitate complete surgical resection in breast cancer. Using microarray data, two commercial breast cancer prognostic scores (12-gene MS and 21-gene RS) were signiﬁcant predictors of response to neo-adjuvant chemotherapy, though the 12-gene MS outperformed the 21-gene RS.

Legacy Genetic Testing Results for Cancer Susceptibility: How Common are Conflicting Classifications in a Large Variant Dataset from Multiple Practices?

Citation: Yin, K., Liu, Y., Lamichhane, B. et al. Legacy Genetic Testing Results for Cancer Susceptibility: How Common are Conflicting Classifications in a Large Variant Dataset from Multiple Practices?. Ann Surg Oncol 27, 2212–2220 (2020).

https://doi.org/10.1245/s10434-020-08492-9

Synopsis: By analyzing a large multipractice variant dataset, we found that 21.2% (n = 783) of the variants had discordance between lab-reported and ClinVar classifications. Of all unique variants, 2.5% (n = 121) had within-practice lab-reported discordances, and 1.2% (n = 56) had lab-reported discordances across practices.

Recurrence Patterns and Outcomes after Resection of Hepatocellular Carcinoma within and beyond the Barcelona Clinic Liver Cancer Criteria

Diamantis I. Tsilimigras, Fabio Bagante, Dimitrios Moris…Timothy M. Pawlik

Citation: Tsilimigras, D.I., Bagante, F., Moris, D. et al. Recurrence Patterns and Outcomes after Resection of Hepatocellular Carcinoma within and beyond the Barcelona Clinic Liver Cancer Criteria. Ann Surg Oncol 27, 2321–2331 (2020).

https://doi.org/10.1245/s10434-020-08452-3

Synopsis: In this multi-institutional study, 602 (79.6%) and 154 (20.4%) patients underwent resection within (i.e. BCLC-0/A) and beyond (i.e. BCLC B/C) the current BCLC resection criteria. Recurrences in both BCLC 0/A and BCLC B/C groups were mostly intrahepatic. Surgery provided a 5-year OS of 51.6% among select patients with BCLC B/C HCC.

Robotic ALPPS

Marcel Autran C. Machado, Rodrigo C. Surjan, Fabio Makdissi

Citation: Machado, M.A.C., Surjan, R.C. & Makdissi, F. Robotic ALPPS. Ann Surg Oncol 27, 1174–1179 (2020).

https://doi.org/10.1245/s10434-019-08027-x

Synopsis: This streaming video article presents a robotic ALPPS procedure to treat synchronous colorectal liver metastases. The first and second stages were totally robotic as well as the colon resection. The use of the Xi da Vinci system was useful to complete this procedure.

Technique for Robotic Ivor Lewis Esophagectomy with 6-cm Linear Stapled Side-to-Side Anastomosis

June S. Peng, Steven J. Nurkin, Steven N. Hochwald, Moshim Kukar

Citation: Peng, J.S., Nurkin, S.J., Hochwald, S.N. et al. Technique for Robotic Ivor Lewis Esophagectomy with 6-cm Linear Stapled Side-to-Side Anastomosis. Ann Surg Oncol 27, 824 (2020).

https://doi.org/10.1245/s10434-019-07933-4

Synopsis: Minimally invasive esophagectomy offers decreased postoperative complications compared with open esophagectomy, with equivalent oncologic outcomes. This streaming video article presents a technique for a completely robotic Ivor Lewis esophagectomy with a 60-mm side-to-side intrathoracic anastomosis, which is associated with low stricture and leak rates.

Factors That Influence Conversion to Resectability and Survival After Resection of Metastases in RAS WT Metastatic Colorectal Cancer (mCRC): Analysis of FIRE-3- AIOKRK0306

Dominik Paul Modest, Volker Heinemann, Gunnar Folprecht…Ingrid Ricard

Citation: Modest, D.P., Heinemann, V., Folprecht, G. et al. Factors That Influence Conversion to Resectability and Survival After Resection of Metastases in RAS WT Metastatic Colorectal Cancer (mCRC): Analysis of FIRE-3- AIOKRK0306. Ann Surg Oncol 27, 2389–2401 (2020).

https://doi.org/10.1245/s10434-020-08219-w

Synopsis: Achievement of secondary resectability of metastases from colorectal cancer is associated with disease characteristics (BRAF mutation, presence of lung lesions etc) and with early response parameters. Resection of metastases is associated with improved post-best response survival.

Distal Gastrectomy with Billroth II Reconstruction is Associated with Oralization of Gut Microbiome and Intestinal Inflammation: A Proof-of-Concept Study

Angela Horvath, Augustinas Bausys, Rasa Sabaliauskaite…Kestutis Strupas

Citation: Horvath, A., Bausys, A., Sabaliauskaite, R. et al. Distal Gastrectomy with Billroth II Reconstruction is Associated with Oralization of Gut Microbiome and Intestinal Inflammation: A Proof-of-Concept Study. Ann Surg Oncol (2020).

https://doi.org/10.1245/s10434-020-08678-1

Synopsis: This study investigates the gut microbiome composition after subtotal gastrectomy with Billroth II reconstruction. Surgery results in gut microbiome oralization and intestinal inflammation. These changes are associated with gastrointestinal symptoms.

Primary Tumor Resection Offers Survival Benefit in Patients with Metastatic Midgut Neuroendocrine Tumors

Monica Polcz, Cameron Schlegel, Gretchen C. Edwards…Christina E. Bailey

Citation: Polcz, M., Schlegel, C., Edwards, G.C. et al. Primary Tumor Resection Offers Survival Benefit in Patients with Metastatic Midgut Neuroendocrine Tumors. Ann Surg Oncol 27, 2795–2803 (2020).

https://doi.org/10.1245/s10434-020-08602-7

Synopsis: The aim of this study was to evaluate prevalence and survival impact of primary tumor resection (PTR) in patients with unresectable metastatic midgut neuroendocrine tumors. PTR was associated with improved overall survival, however 40% of patients did not undergo PTR.

Near Infrared (NIR) Fluorescence is Not a Substitute for Lymphoscintigraphy and Gamma Probe for Melanoma Sentinel Node Detection: Results from a Prospective Trial

Carlos Eduardo Barbosa de Carvalho, Renato Capuzzo, Camila Crovador…Vinicius L. Vazquez

Citation: de Carvalho, C.E.B., Capuzzo, R., Crovador, C. et al. Near Infrared (NIR) Fluorescence is Not a Substitute for Lymphoscintigraphy and Gamma Probe for Melanoma Sentinel Node Detection: Results from a Prospective Trial. Ann Surg Oncol 27, 2906–2912 (2020).

https://doi.org/10.1245/s10434-020-08409-6

Synopsis: This prospective trial of 121 melanomas shows that a combined sentinel node detection approach using blue dye, radiocolloids and ﬂuorescent tracers is the most efﬁcient. Only radiocolloids provided sufﬁcient sensitivity to be used alone.

Model of Patient-Specific Immune-Enhanced Organoids for Immunotherapy Screening: Feasibility Study

Konstantinos I. Votanopoulos, Steven Forsythe, Hemamylammal Sivakumar…Aleksander Skardal

Citation: Votanopoulos, K.I., Forsythe, S., Sivakumar, H. et al. Model of Patient-Specific Immune-Enhanced Organoids for Immunotherapy Screening: Feasibility Study. Ann Surg Oncol 27, 1956–1967 (2020).
https://link.springer.com/article/10.1245%2Fs10434-019-08143-8

Synopsis: The authors describe a patient-speciﬁc organoid platform, where melanoma and lymph node from the same patient are cocultured and used to predict tumor response to immunotherapy and generate adaptive immunity, by presenting tumor neoantigens on patient’s own nodal antigen-presenting cells (APCs).

Predictors for Survival in an International Cohort of Patients Undergoing Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma

Korrel, J. van Hilst, A. Alseidi…M. G. Besselink

Citation: Korrel, M., Lof, S., van Hilst, J. et al. Predictors for Survival in an International Cohort of Patients Undergoing Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma. Ann Surg Oncol (2020).
https://link.springer.com/article/10.1245/s10434-020-08658-5

Synopsis: It is unclear which predictors related to surgical technique are associated with improved overall survival after distal pancreatectomy for pancreatic ductal adenocarcinoma. In this international cohort including 1200 patients, predictors for improved overall survival included Gerota’s fascia resection, R0-resection, and decreased lymph node ratio.

Feasibility Study of a Novel Protease-Activated Fluorescent Imaging System for Real-Time, Intraoperative Detection of Residual Breast Cancer in Breast Conserving Surgery

Barbara L. Smith, Conor R. Lanahan, Michelle C. Specht…Michele A. Gadd

Citation: Smith, B.L., Lanahan, C.R., Specht, M.C. et al. Feasibility Study of a Novel Protease-Activated Fluorescent Imaging System for Real-Time, Intraoperative Detection of Residual Breast Cancer in Breast Conserving Surgery. Ann Surg Oncol 27, 1854–1861 (2020). https://link.springer.com/article/10.1245/s10434-019-08158-1

Synopsis: Real-time, intraoperative breast lumpectomy margin assessment was performed using LUM015, a protease-activated fluorescent imaging agent. The tumor was distinguished from benign tissue across all tumor histology, breast density, and menopausal status.

Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma

Pim B. Olthof, Luca Aldrighetti, Ruslan Alikhanov…Thomas M. van Gulik

Citation: Olthof, P.B., Aldrighetti, L., Alikhanov, R. et al. Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma. Ann Surg Oncol 27, 2311–2318 (2020). https://link.springer.com/article/10.1245/s10434-019-07157-6

Synopsis: Using data on 1667 patients who underwent resection of suspected perihilar cholangiocarcinoma across 20 centers, it was shown in a propensity matched comparison that the use of peroperative portal portal vein embolization was associated with major reductions in liver failure and mortality rates.

Intraoperative Fluorescent Angiography Predicts Pharyngocutaneous Fistula After Salvage Laryngectomy

Rebecca Hoesli, Julia R. Brennan, Andrew J. Rosko…Matthew E. Spector

Citation: Hoesli, R., Brennan, J.R., Rosko, A.J. et al. Intraoperative Fluorescent Angiography Predicts Pharyngocutaneous Fistula After Salvage Laryngectomy. Ann Surg Oncol 26, 1320–1325 (2019). https://link.springer.com/article/10.1245%2Fs10434-019-07262-6

Synopsis: Intraoperative usage of indocyaine green imaging can predict the formation of post-operative ﬁstulas, allowing for more tailored reconstructive options depending on risk of ﬁstula.

Oncology Navigation Decreases Time to Treatment in Patients with Pancreatic Malignancy

Laura M. Enomoto, Joyce Fenstermaker, Rodwige J. Desnoyers…Perry Shen

Citation: Enomoto, L.M., Fenstermaker, J., Desnoyers, R.J. et al. Oncology Navigation Decreases Time to Treatment in Patients with Pancreatic Malignancy. Ann Surg Oncol 26, 1512–1518 (2019). https://link.springer.com/article/10.1245/s10434-019-07157-6

Synopsis: Signiﬁcant delays in care may exist due to the complexity of multidisciplinary care in patients with pancreatic malignancy. Implementing an oncology navigation program signiﬁcantly decreased the time to treatment in patients with pancreatic malignancy.

The Landmark Series: Adjuvant Radiation Therapy for Breast Cancer

Stephanie A. Valente, Chirag Shah

Citation: Valente, S.A., Shah, C. The Landmark Series: Adjuvant Radiation Therapy for Breast Cancer. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08450-5

Synopsis: This landmark series evaluating radiation therapy for breast cancer is a review of milestone trials which have established treatment paradigms to improve both local control and survival for breast cancer patients.

Anastomotic Leak Does Not Impact on Long-Term Outcomes in Esophageal Cancer Patients

K. Kamarajah, M. Navidi, S. Wahed…A. W. Phillips

Citation: Kamarajah, S.K., Navidi, M., Wahed, S. et al. Anastomotic Leak Does Not Impact on Long-Term Outcomes in Esophageal Cancer Patients. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08199-x

Synopsis: The impact of anastomotic leak after esophagectomy is unclear. Long-term outcomes of patients who experienced a leak after transthoracic esophagectomy over 20 years from a single unit were reviewed. Anastomotic leak, and severe leak did not impact on longterm survival

Young Women with Breast Cancer: Fertility Preservation Options and Management of Pregnancy-Associated Breast Cancer

Nikita M. Shah, Dana M. Scott, Pridvi Kandagatla …Jacqueline S. Jeruss

Citation: Shah, N.M., Scott, D.M., Kandagatla, P. et al. Young Women with Breast Cancer: Fertility Preservation Options and Management of Pregnancy-Associated Breast Cancer. Ann Surg Oncol 26, 1214–1224 (2019). https://link.springer.com/article/10.1245/s10434-019-07156-7

Synopsis: Young breast cancer patients face the potential impact of treatment on future fertility. Additionally, a subset of patients will navigate the challenges of breast cancer treatment during pregnancy or during the postpartum period. Suggested guidelines are provided to address reproductive health in conjunction with a breast cancer diagnosis.

RAS Mutation Decreases Overall Survival After Optimal Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy of Colorectal Peritoneal Metastasis: A Modification Proposal of the Peritoneal Surface Disease Severity Score

Arjona-Sanchez, L. Rodriguez-Ortiz, D. Baratti…J. Briceno

Citation: Arjona-Sanchez, A., Rodriguez-Ortiz, L., Baratti, D. et al. RAS Mutation Decreases Overall Survival After Optimal Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy of Colorectal Peritoneal Metastasis: A Modification Proposal of the Peritoneal Surface Disease Severity Score. Ann Surg Oncol 26, 2595–2604 (2019). https://link.springer.com/article/10.1245%2Fs10434-019-07378-9

Synopsis: Adding the RAS mutations status to traditional PSDSS changes the traditional patient selection for CRS and HIPEC for peritoneal carcinomatosis from colorectal cancer scoring by adding the biological feature of the tumor to clinical-pathologic score.

Radiation Therapy After Breast-Conserving Surgery in Women 70 Years of Age and Older: How Wisely Do We Choose?

Stephanie Downs-Canner, Emily C. Zabor,Tyler Wind…Alexandra Heerdt

Citation: Downs-Canner, S., Zabor, E.C., Wind, T. et al. Radiation Therapy After Breast-Conserving Surgery in Women 70 Years of Age and Older: How Wisely Do We Choose?. Ann Surg Oncol 26, 969–975 (2019).https://link.springer.com/article/10.1245%2Fs10434-018-07151-4

Synopsis: Despite evidence that omission of RT in women with small estrogen receptor positive tumors is safe, use remains high. Neither factors consistent with risk of local recurrence or competing risk of death in 10 years predicted use of adjuvant radiation.

The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set

Song Ryo, Mitsuro Kanda, Seiji Ito…Yasuhiro Kodera

Citation: Ryo, S., Kanda, M., Ito, S. et al. The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set. Ann Surg Oncol 26, 456–464 (2019). https://link.springer.com/article/10.1245/s10434-018-07121-w

Synopsis: The authors evaluated the preoperative Controlling Nutritional Status (CONUT) score’s predictive value among patients with stage II/III gastric cancer. A multicenter dataset analysis revealed that the preoperative CONUT score may be a useful predictor of postoperative short-term and long-term outcomes.

Fluorescent-Image Guidance in Robotic Subtotal Gastrectomy

By Naruhiko Ikoma, Brian D. Badgwell, Paul Mansfield

Citation: Ikoma, N., Badgwell, B.D. & Mansfield, P. Fluorescent-Image Guidance in Robotic Subtotal Gastrectomy. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08523-5

Synopsis: Robotic surgery technology has significant advantages, but its limitations include a lack of tactile feedback. Fluorescent-imaging technology, part of the da Vinci robotic surgery system, helps to overcome this lack of feedback and improve safety.

Superior Mesenteric Vein-First Approach for Robotic Salvage Surgery with Indocyanine Green Fluorescence Angiography

By Yun Yang, Oliver Peacock, Songphol Malakorn, Thitithep Limvorapitak, Syed Nabeel Zafar, George J. Chang,

Citation: Yang, Y., Peacock, O., Malakorn, S. et al. Superior Mesenteric Vein-First Approach for Robotic Salvage Surgery with Indocyanine Green Fluorescence Angiography. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08222-1

Synopsis: Following the SMV-first approach principles provide a safe plane for dissection, and in conjunction with ICG, facilitates the delineation of the vascular anatomy, to enable robotic salvage surgery for recurrent disease within residual mesocolon to be performed.

The Chicago Consensus Guidelines for Peritoneal Surface Malignancies: Introduction

Chicago Consensus Working Group

Citation: Turaga, K., Ahuja, N., Richard Alexander, H. et al. The Chicago Consensus Guidelines for Peritoneal Surface Malignancies: Introduction. Ann Surg Oncol 27, 1737–1740 (2020). https://doi.org/10.1245/s10434-020-08318-8

Synopsis: The Chicago Consensus Working Group provides multidisciplinary recommendations for the management of peritoneal surface malignancies of various causes. These guidelines recognize and address the emerging need for increased awareness of the appropriate management of peritoneal surface disease.

2020 Featured Articles

Evolution of Esophagectomy for Cancer Over 30 Years: Changes in Presentation, Management and Outcomes

Griffin, S.M., Jones, R., Kamarajah, S.K. et al.

https://rdcu.be/ccmME

Citation: Griffin, S.M., Jones, R., Kamarajah, S.K. et al. Evolution of Esophagectomy for Cancer Over 30 Years: Changes in Presentation, Management and Outcomes. Ann Surg Oncol (2020).

The Impact of Residential Segregation on Pancreatic Cancer Diagnosis, Treatment, and Mortality

Blanco, B.A., Poulson, M., Kenzik, K.M. et al.

https://rdcu.be/ccmRy

Citation: Blanco, B.A., Poulson, M., Kenzik, K.M. et al. The Impact of Residential Segregation on Pancreatic Cancer Diagnosis, Treatment, and Mortality. Ann Surg Oncol (2020).

Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy

Robert Sucher MD, Uwe Scheuermann MD & Daniel Seehofer MD

Citation: Sucher, R., Scheuermann, U. & Seehofer, D. Total Laparoscopic Resection of Hilar Cholangiocarcinoma Type 3b: Applying a Parachute Technique for Hepaticojejunostomy. Ann Surg Oncol (2020).

https://doi.org/10.1245/s10434-020-09175-1

Robotic Resection of Hilar Cholangiocarcinoma

Marcel Autran Machado, Bruno V. Mattos, Murillo Macedo Lobo Filho, and Fabio Makdissi

Citation: Machado, M.A., Mattos, B.V., Lobo Filho, M.M. et al. Robotic Resection of Hilar Cholangiocarcinoma. Ann Surg Oncol 27, 4166–4170 (2020).

https://doi.org/10.1245/s10434-020-08514-6

Assessing the Burden of Nodal Disease for Breast Cancer Patients with Clinically Positive Nodes: Hope for More Limited Axillary Surgery

Angarita, S., Ye, L., Rünger, D. et al.

https://rdcu.be/caZlL

Management of Cancer Surgery Cases During the COVID-19 Pandemic: Considerations

Bartlett, D.L., Howe, J.R., Chang, G. et al.

Citation: Bartlett, D.L., Howe, J.R., Chang, G. et al. Management of Cancer Surgery Cases During the COVID-19 Pandemic: Considerations. Ann Surg Oncol 27, 1717–1720 (2020).

https://rdcu.be/cbyD5

Multidisciplinary Care for Melanoma of Unknown Primary: Experience in the Era of Molecular Profiling

De Andrade, J.P., Wong, P., O’Leary, M.P., et al.

https://rdcu.be/caZlL

A Novel Classification of Intrahepatic Cholangiocarcinoma Phenotypes Using Machine Learning Techniques: An International Multi-Institutional Analysis

Tsilimigras, D.I., Hyer, J.M., Paredes, A.Z., et al.

https://rdcu.be/caZi5

The Prognostic Index Independently Predicts Survival in Patients with Pancreatic Ductal Adenocarcinoma Undergoing Resection

https://rdcu.be/caHPr

Three-Dimensionally Printed Patient-Specific Surgical Plates Increase Accuracy of Oncologic Head and Neck Reconstruction Versus Conventional Surgical Plates: A Comparative Study.

https://rdcu.be/caHRH

A Randomized Trial Evaluating Bioimpedance Spectroscopy Versus Tape Measurement for the Prevention of Lymphedema Following Treatment for Breast Cancer: Interim Analysis

Ridner SH, Dietrich MS, Cowher MS, et al.

https://rdcu.be/b9J85

Variation in Adequate Lymph Node Yield for Gastric, Lung, and Bladder Cancer: Attributable to the Surgeon, Pathologist, or Hospital?

Aquina CT, Truong M, Justiniano CF, et al.

https://rdcu.be/b9MzZ

Axillary Response in Patients Undergoing Neoadjuvant Endocrine Treatment for Node-Positive Breast Cancer: Systematic Literature Review and NCDB Analysis

Arielle Stafford, Austin Williams, Kirsten Edmiston, Costanza Cocilovo, Robert Cohen, Sara Bruce, Kahyun Yoon-Flannery, and Lucy De La Cruz

https://doi.org/10.1245/s10434-020-08905-9

Multiparametric MRI and Whole Slide Image-Based Pretreatment Prediction of Pathological Response to Neoadjuvant Chemoradiotherapy in Rectal Cancer: A Multicenter Radiopathomic Study

https://doi.org/10.1245/s10434-020-08659-4

Contralateral Risk-Reducing Mastectomy in Breast Cancer Patients Who Undergo Multigene Panel Testing

Brittany L. Murphy, Min Yi, Banu K. Arun, Angelica M. Gutierrez Barrera, and Isabelle Bedrosian

https://doi.org/10.1245/s10434-020-08889-6

Citation: Murphy, B.L., Yi, M., Arun, B.K. et al. Contralateral Risk-Reducing Mastectomy in Breast Cancer Patients Who Undergo Multigene Panel Testing. Ann Surg Oncol 27, 4613–4621

Changing the Default: A Prospective Study of Reducing Discharge Opioid Prescription after Lumpectomy and Sentinel Node Biopsy

Tracy-Ann Moo, Kate R. Pawloski, Varadan Sevilimedu, Jillian Charyn, Brett A. Simon, Lisa M. Sclafani, George Plitas, Andrea V. Barrio, Laurie J. Kirstein, Kimberly J. Van Zee, and Monica Morrow

https://doi.org/10.1245/s10434-020-08886-9

Laparoscopic Suprapancreatic Lymph Node Dissection Using a Systematic Mesogastric Excision Concept for Gastric Cancer

Tsutomu Kumamoto, Yasunori Kurahashi, Hirotaka Niwa, et al.

https://doi.org/10.1245/s10434-019-07700-5

Robotic Treatment for Large Duodenal Gastrointestinal Stromal Tumor

Alessandra Marano, Fabrizio Allisiardi, Enrico Perino, et al.

https://doi.org/10.1245/s10434-019-08041-z

Citation: Marano, A., Allisiardi, F., Perino, E. et al. Robotic Treatment for Large Duodenal Gastrointestinal Stromal Tumor. Ann Surg Oncol 27, 1101–1102 (2020).

Synopsis: The adoption of a robotic approach could facilitate a duodenal sparing resection of large duodenal gastrointestinal stromal tumors amenable to a conservative R0 resection.

Personalized Identification of Optimal HIPEC Perfusion Protocol in Patient-Derived Tumor Organoid Platform.

Forsythe SD, Sasikumar S, Omeed Moaven, et al.

Citation: Forsythe, S.D., Sasikumar, S., Moaven, O. et al. Personalized Identification of Optimal HIPEC Perfusion Protocol in Patient-Derived Tumor Organoid Platform. Ann Surg Oncol (2020).

https://doi.org/10.1245/s10434-020-08790-2

Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients.

Leimkühler M, Hentzen JEKR, Hemmer PHJ. et al.

https://doi.org/10.1245/s10434-018-07136-3

MMR Deficiency is Homogeneous in Pancreatic Carcinoma and Associated with High Density of Cd8-Positive Lymphocytes

Fraune C, Burandt E, Simon R, et al.

https://doi.org/10.1245/s10434-020-08209-y

Systematic Review of Factors Affecting Quality of Life After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

Leimkühler M, Hentzen JEKR, Hemmer PHJ. et al.

https://doi.org/10.1245/s10434-020-08650-z

Electrochemotherapy with Irreversible Electroporation and FOLFIRINOX Improves Survival in Murine Models of Pancreatic Adenocarcinoma

Neal Bhutiani, Yan Li, Qianqian Zheng, Harshul Pandit, Xiaoju Shi, Yujia Chen, Youxi Yu, Zachary R. Pulliam, Min Tan, and Robert C. G. Martin II

https://doi.org/10.1245/s10434-020-08782-2

Selecting Node-Positive Patients for Axillary Downstaging with Neoadjuvant Chemotherapy

Giacomo Montagna, Anita Mamtani, Andrea Knezevic, Edi Brogi, Andrea V. Barrio, and Monica Morrow

https://doi.org/10.1245/s10434-020-08650-z

Citation: Montagna, G., Mamtani, A., Knezevic, A. et al. Selecting Node-Positive Patients for Axillary Downstaging with Neoadjuvant Chemotherapy. Ann Surg Oncol 27, 4515–4522 (2020).

Extranodal Tumor Deposits in the Axillary Fat Indicate the Need for Axillary Dissection Among T1–T2cN0 Patients with Positive Sentinel Nodes

Anita Mamtani, Andrea V. Barrio, Debra A. Goldman, Hannah Y. Wen, Alain Vincent, and Monica Morrow

Imaging Intensity and Survival Outcomes in High-Risk Resected Melanoma Treated by Systemic Therapy at Recurrence

Percutaneous Hepatic Perfusion with Melphalan in Patients with Unresectable Ocular Melanoma Metastases Confined to the Liver: A Prospective Phase II Study

Susanna Meijer, Mark C. Burgmans, Eleonora M. de Leede…Alexander L. Vahrmeijer

https://doi.org/10.1245/s10434-020-08741-x

Effect of Surgery Type on Time to Adjuvant Chemotherapy and Impact of Delay on Breast Cancer Survival: A National Cancer Database Analysis

Amanda R. Kupstas, Tanya L. Hoskin, Courtney N. Day, Elizabeth B. Habermann, and Judy C. Boughey

https://doi.org/10.1245/s10434-019-07566-7

Robotic Extended Right Hemicolectomy with Complete Mesocolic Excision and D3 Lymph Node Dissection

Irbaz Hameed, Piyush Aggarwal, and Martin R. Weiser

https://doi.org/10.1245/s10434-019-07692-2

Citation: Hameed, I., Aggarwal, P. & Weiser, M.R. Robotic Extended Right Hemicolectomy with Complete Mesocolic Excision and D3 Lymph Node Dissection. Ann Surg Oncol 26, 3990–3991 (2019).

Pure Laparoscopic Anatomic Resection of the Segment 8 Ventral Area Using the Transfissural Glissonean Approach

Ji Hoon Kim MD and Hyeyoung Kim

https://doi.org/10.1245/s10434-019-07852-4

Citation: Kim, J.H., Kim, H. Pure Laparoscopic Anatomic Resection of the Segment 8 Ventral Area Using the Transfissural Glissonean Approach. Ann Surg Oncol 26, 4608–4609 (2019).

Ruben Ciria, Irene Gomez-Luque, Sira Ocaña…Mohammed Abu Hilal

https://doi.org/10.1245/s10434-018-6926-3

Prognosis After Resection of Barcelona Clinic Liver Cancer (BCLC) Stage 0, A, and B Hepatocellular Carcinoma: A Comprehensive Assessment of the Current BCLC Classification

Diamantis I. Tsilimigras, Fabio Bagante, Kota Sahara…Timothy M. Pawlik

https://doi.org/10.1245/s10434-019-07580-9

Prognosis After Resection of Barcelona Clinic Liver Cancer

Rittal Mehta, Diamantis I. Tsilimigras, Anghela Z. Paredes…Timothy M. Pawlik

https://doi.org/10.1245/s10434-020-08788-w

Survival Outcomes of Resected BRAFV600E Mutant Colorectal Liver Metastases: A Multicenter Retrospective Cohort Study in Japan

https://doi.org/10.1245/s10434-020-08817-8

Validation of Residual Cancer Burden as Prognostic Factor for Breast Cancer Patients After Neoadjuvant Therapy

Hannah Deborah Müller, Florian Posch, Christoph Suppan…Marija Balic

Evaluation of the 12-Gene Molecular Score and the 21-Gene Recurrence Score as Predictors of Response to Neo-adjuvant Chemotherapy in Estrogen Receptor-Positive, HER2-Negative Breast Cancer

Hatem Soliman, Susanne Wagner, Darl D. Flake II…William Gradishar

Legacy Genetic Testing Results for Cancer Susceptibility: How Common are Conflicting Classifications in a Large Variant Dataset from Multiple Practices?

https://doi.org/10.1245/s10434-020-08492-9

Recurrence Patterns and Outcomes after Resection of Hepatocellular Carcinoma within and beyond the Barcelona Clinic Liver Cancer Criteria

Diamantis I. Tsilimigras, Fabio Bagante, Dimitrios Moris…Timothy M. Pawlik

https://doi.org/10.1245/s10434-020-08452-3

Robotic ALPPS

Marcel Autran C. Machado, Rodrigo C. Surjan, Fabio Makdissi

Citation: Machado, M.A.C., Surjan, R.C. & Makdissi, F. Robotic ALPPS. Ann Surg Oncol 27, 1174–1179 (2020).

https://doi.org/10.1245/s10434-019-08027-x

Technique for Robotic Ivor Lewis Esophagectomy with 6-cm Linear Stapled Side-to-Side Anastomosis

June S. Peng, Steven J. Nurkin, Steven N. Hochwald, Moshim Kukar

Citation: Peng, J.S., Nurkin, S.J., Hochwald, S.N. et al. Technique for Robotic Ivor Lewis Esophagectomy with 6-cm Linear Stapled Side-to-Side Anastomosis. Ann Surg Oncol 27, 824 (2020).

https://doi.org/10.1245/s10434-019-07933-4

Factors That Influence Conversion to Resectability and Survival After Resection of Metastases in RAS WT Metastatic Colorectal Cancer (mCRC): Analysis of FIRE-3- AIOKRK0306

Dominik Paul Modest, Volker Heinemann, Gunnar Folprecht…Ingrid Ricard

https://doi.org/10.1245/s10434-020-08219-w

Distal Gastrectomy with Billroth II Reconstruction is Associated with Oralization of Gut Microbiome and Intestinal Inflammation: A Proof-of-Concept Study

Angela Horvath, Augustinas Bausys, Rasa Sabaliauskaite…Kestutis Strupas

https://doi.org/10.1245/s10434-020-08678-1

Primary Tumor Resection Offers Survival Benefit in Patients with Metastatic Midgut Neuroendocrine Tumors

Monica Polcz, Cameron Schlegel, Gretchen C. Edwards…Christina E. Bailey

https://doi.org/10.1245/s10434-020-08602-7

Near Infrared (NIR) Fluorescence is Not a Substitute for Lymphoscintigraphy and Gamma Probe for Melanoma Sentinel Node Detection: Results from a Prospective Trial

Carlos Eduardo Barbosa de Carvalho, Renato Capuzzo, Camila Crovador…Vinicius L. Vazquez

https://doi.org/10.1245/s10434-020-08409-6

Model of Patient-Specific Immune-Enhanced Organoids for Immunotherapy Screening: Feasibility Study

Konstantinos I. Votanopoulos, Steven Forsythe, Hemamylammal Sivakumar…Aleksander Skardal

Predictors for Survival in an International Cohort of Patients Undergoing Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma

Korrel, J. van Hilst, A. Alseidi…M. G. Besselink

Feasibility Study of a Novel Protease-Activated Fluorescent Imaging System for Real-Time, Intraoperative Detection of Residual Breast Cancer in Breast Conserving Surgery

Barbara L. Smith, Conor R. Lanahan, Michelle C. Specht…Michele A. Gadd

Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma

Pim B. Olthof, Luca Aldrighetti, Ruslan Alikhanov…Thomas M. van Gulik

Intraoperative Fluorescent Angiography Predicts Pharyngocutaneous Fistula After Salvage Laryngectomy

Rebecca Hoesli, Julia R. Brennan, Andrew J. Rosko…Matthew E. Spector

Synopsis: Intraoperative usage of indocyaine green imaging can predict the formation of post-operative ﬁstulas, allowing for more tailored reconstructive options depending on risk of ﬁstula.

Oncology Navigation Decreases Time to Treatment in Patients with Pancreatic Malignancy

Laura M. Enomoto, Joyce Fenstermaker, Rodwige J. Desnoyers…Perry Shen

The Landmark Series: Adjuvant Radiation Therapy for Breast Cancer

Stephanie A. Valente, Chirag Shah

Citation: Valente, S.A., Shah, C. The Landmark Series: Adjuvant Radiation Therapy for Breast Cancer. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08450-5

Anastomotic Leak Does Not Impact on Long-Term Outcomes in Esophageal Cancer Patients

K. Kamarajah, M. Navidi, S. Wahed…A. W. Phillips

Young Women with Breast Cancer: Fertility Preservation Options and Management of Pregnancy-Associated Breast Cancer

Nikita M. Shah, Dana M. Scott, Pridvi Kandagatla …Jacqueline S. Jeruss

Arjona-Sanchez, L. Rodriguez-Ortiz, D. Baratti…J. Briceno

Radiation Therapy After Breast-Conserving Surgery in Women 70 Years of Age and Older: How Wisely Do We Choose?

Stephanie Downs-Canner, Emily C. Zabor,Tyler Wind…Alexandra Heerdt

The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set

Song Ryo, Mitsuro Kanda, Seiji Ito…Yasuhiro Kodera

Fluorescent-Image Guidance in Robotic Subtotal Gastrectomy

By Naruhiko Ikoma, Brian D. Badgwell, Paul Mansfield

Citation: Ikoma, N., Badgwell, B.D. & Mansfield, P. Fluorescent-Image Guidance in Robotic Subtotal Gastrectomy. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08523-5

Superior Mesenteric Vein-First Approach for Robotic Salvage Surgery with Indocyanine Green Fluorescence Angiography

By Yun Yang, Oliver Peacock, Songphol Malakorn, Thitithep Limvorapitak, Syed Nabeel Zafar, George J. Chang,

The Chicago Consensus Guidelines for Peritoneal Surface Malignancies: Introduction

Chicago Consensus Working Group

Dedicated Cancer Centers are More Likely to Achieve a Textbook Outcome Following Hepatopancreatic Surgery

Textbook Outcome Following Hepatopancreatic Surgery Rittal Mehta, Diamantis I. Tsilimigras, Anghela Z. Paredes…Timothy M. Pawlik

Citation: Mehta, R., Tsilimigras, D.I., Paredes, A.Z. et al. Dedicated Cancer Centers are More Likely to Achieve a Textbook Outcome Following Hepatopancreatic Surgery. Ann Surg Oncol 27, 1889–1897 (2020). https://doi.org/10.1245/s10434-020-08279-y

Synopsis: Among 21,234 Medicare patients, 8.2% patients underwent hepatopancreatic (HP) surgery at a dedicatedcancer center (DCC), whereas 32.1% underwent surgery at a National Cancer Institute affiliated cancer center (NCI-CC), and 60% underwent an operation at neither DCCs nor NCI-CCs. Even though DCC more frequently took care of patients with higher comorbidity burden, the likelihood of achieving a textbook outcome following HP surgery at DCCs was higher versus NCI-CCs and other US hospitals. The data suggest that DCCs provide higher-value surgical care for patients with HP malignancies.

The Relationship Between Tumor Budding, Tumor Microenvironment, and Survival in Patients with Primary Operable Colorectal Cancer

Hester C. van Wyk, Antonia Roseweir, Peter Alexander…Joanne Edwards

Citation: van Wyk, H.C., Roseweir, A., Alexander, P. et al. The Relationship Between Tumor Budding, Tumor Microenvironment, and Survival in Patients with Primary Operable Colorectal Cancer. Ann Surg Oncol 26, 4397–4404 (2019). https://link.springer.com/article/10.1245/s10434-019-07931-6

Synopsis: Findings from this study indicate that tumor budding effectively stratifies patient’s survival independent of recognized tumor factors, including TNM stage. Therefore, the combination of T stage and tumor budding should form the basis of a new staging system for primary operable colorectal cancer.

The Sequential Radiographic Effects of Preoperative Chemotherapy and (Chemo)Radiation on Tumor Anatomy in Patients with Localized Pancreatic Cancer

Giampaolo Perri, Laura Prakash, Giuseppe Malleo…Matthew H. G. Katz

Citation: Perri, G., Prakash, L., Malleo, G. et al. The Sequential Radiographic Effects of Preoperative Chemotherapy and (Chemo)Radiation on Tumor Anatomy in Patients with Localized Pancreatic Cancer. Ann Surg Oncol (2020). https://link.springer.com/article/10.1245%2Fs10434-020-08427-4

Synopsis: Less than one third of patients experienced either RECIST partial response or radiographic downstaging in response to preoperative therapy. The incidence of tumor downstaging was higher and the magnitude of tumor volume loss was greater following chemotherapy than after (chemo)radiation.

Preoperative Delays in the Treatment of DCIS and the Associated Incidence of Invasive Breast Cancer

William H. Ward, Lyudmila DeMora, Elizabeth Handor…Richard J. Bleicher

Citation: Ward, W.H., DeMora, L., Handorf, E. et al. Preoperative Delays in the Treatment of DCIS and the Associated Incidence of Invasive Breast Cancer. Ann Surg Oncol 27, 386–396 (2020). https://doi.org/10.1245/s10434-019-07844-4

Synopsis: A population-based study of data derived from women with clinical DCIS was conducted using the National Cancer Database. Delays to surgery impaired overall survival and was an independent predictor of invasive cancer found on surgical pathology.

Outcomes and Risk Score for Distal Pancreatectomy with Celiac Axis Resection (DP-CAR): An International Multicenter Analysis

Sjors Klompmaker, Niek A. Peters, Jony van Hilst…Marc G. Besselink

Citation: Klompmaker, S., Peters, N.A., van Hilst, J. et al. Outcomes and Risk Score for Distal Pancreatectomy with Celiac Axis Resection (DP-CAR): An International Multicenter Analysis. Ann Surg Oncol 26, 772–781 (2019). https://link.springer.com/article/10.1245%2Fs10434-018-07101-0

Synopsis: Distal pancreatectomy with celiac axis resection (DP-CAR) is occasionally performed for locally-advanced pancreatic cancer. In this study (n=191), DP-CAR was associated with 5.8% 90-day mortality in high volume centers and 19 (15-25) months survival. The authors propose a mortality risk score to improve patient selection and outcomes, with DP-CAR-volume as dominant predictor.

Update on Pheochromocytoma and Paraganglioma from the SSO Endocrine/Head and Neck Disease-Site Work Group. Part 1 of 2: Advances in Pathogenesis and Diagnosis of Pheochromocytoma and Paraganglioma

Dhaval Patel, John E. Phay, Tina W. F. Yen…Lawrence T. Kim

Citation: Patel, D., Phay, J.E., Yen, T.W.F. et al. Update on Pheochromocytoma and Paraganglioma from the SSO Endocrine/Head and Neck Disease-Site Work Group. Part 1 of 2: Advances in Pathogenesis and Diagnosis of Pheochromocytoma and Paraganglioma. Ann Surg Oncol 27, 1329–1337 (2020). https://doi.org/10.1245/s10434-020-08220-3

Synopsis: This is the first part of a two-part review on pheochromocytoma and paragangliomas that addresses clinical presentation, diagnosis, management, treatment, and outcomes. In this first part, the epidemiology, prevalence, genetic etiology, clinical presentation, biochemical and radiologic workup is discussed.

The MELFO Study: A Multicenter, Prospective, Randomized Clinical Trial on the Effects of a Reduced Stage-Adjusted Follow-Up Schedule on Cutaneous Melanoma IB–IIC Patients—Results After 3 Years

Eric A. Deckers, Josette E. H. M. Hoekstra-Weebers, Samantha Damude…Harald J. Hoekstra

Citation: Deckers, E.A., Hoekstra-Weebers, J.E.H.M., Damude, S. et al. The MELFO Study: A Multicenter, Prospective, Randomized Clinical Trial on the Effects of a Reduced Stage-Adjusted Follow-Up Schedule on Cutaneous Melanoma IB–IIC Patients—Results After 3 Years. Ann Surg Oncol 27, 1407–1417 (2020). https://doi.org/10.1245/s10434-019-07825-7

Synopsis: A reduced stage-adjusted follow-up schedule seems an appropriate, safe, and cost effective alternative to the follow-up regime as currently advised in the Dutch Melanoma guideline.

Significance of Neoadjuvant Downstaging in Carcinoma of Esophagus and Gastroesophageal Junction

K. Kamarajah, M. Navidi, S. Wahed…A. W. Phillips

Citation: Kamarajah, S.K., Navidi, M., Wahed, S. et al. Significance of Neoadjuvant Downstaging in Carcinoma of Esophagus and Gastroesophageal Junction. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08358-0

Synopsis: Pathological stage after neoadjuvant treatment is a better predictor of survival in esophageal cancer than clinical stage. Further, survival of those down staged may be better than those who are neoadjuvant naïve with a comparable pathological stage.

How to Approach Para-Aortic Lymph Node Metastases During Exploration for Suspected Periampullary Carcinoma: Resection or Bypass?

Bobby K. Pranger, Dorine S. J. Tseng, Sander Ubels…Vincent E. de Meijer

Synopsis: The value of para-aortic lymph node sampling and the consequences of different strategies on survival remain unclear. With intraoperative para-aortic lymph node metastases, resection was associated with survival benefit as compared to double bypass, but with increased postoperative morbidity.

ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study

Jun Li, Mohamed Moustafa, Michael Linecker…Silvio Nadalin

Citation: Li, J., Moustafa, M., Linecker, M. et al. ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-019-08192-z

Synopsis: This international largest cohort confirmed the role of ALPPS in the treatment of advanced intrahepatic cholangiocarcinoma. The future liver remnant to body weight (FLR/BW) ratio before the stage-2 operation and the number of lesions had an essential impact on the surgical and oncological outcomes of ALPPS.

Assessment of DIEP Flap Perfusion with Intraoperative Indocyanine Green Fluorescence Imaging in Vasopressor-Dominated Hemodynamic Support Versus Liberal Fluid Administration: A Randomized Controlled Trial With Breast Cancer Patients

Alexandra M. Anker, Lukas Prantl, Catharina Strauss… Silvan M. Klein

Citation: Anker, A.M., Prantl, L., Strauss, C. et al. Assessment of DIEP Flap Perfusion with Intraoperative Indocyanine Green Fluorescence Imaging in Vasopressor-Dominated Hemodynamic Support Versus Liberal Fluid Administration: A Randomized Controlled Trial With Breast Cancer Patients. Ann Surg Oncol 27, 399–406 (2020).

https://link.springer.com/article/10.1245/s10434-019-07758-1

Synopsis: This prospective randomized controlled trial was the first to investigate the impact of distinct hemodynamic regimens in microvascular deep inferior epigastric perforator flap breast reconstruction after mastectomy for cancer patients. Despite the dogmatic denial of vasopressors in microsurgery, neither liberal fluid administration nor norepinephrine-dominated circulatory support impaired intraoperative flap perfusion as

Incident Cases Captured in the National Cancer Database Compared with Those in U.S. Population Based Central Cancer Registries in 2012–2014

Katherine Mallin, Amanda Browner, Bryan Palis…Heidi Nelson

Citation: Mallin K, Browner A, Palis, B, et al. Incident cases captured in the national cancer database compared with those in U.S. population based central cancer registries in 2012–2014. Ann Surg Oncol. 2019; 26: 1604–1612. https://doi.org/10.1245/s10434-019-07213-1

Synopsis: Incident cancer cases in the National Cancer Data Base (NCDB) were compared to national U.S. population based cancer registry data for 2012-2014 diagnosis years. NCDB coverage was 72% with some variation by cancer site and other factors.

Indocyanine Green Fluorescence Imaging with Lymphoscintigraphy for Sentinel Node Biopsy in Melanoma: Increasing the Sentinel Lymph Node-Positive Rate

Rebecca Knackstedt, Rafael A. Couto, Jennifer Ko, Cagri Cakmakoglu, Daisy Wu, Brian Gastman

Citation: Knackstedt, R., Couto, R.A., Ko, J. et al. Indocyanine Green Fluorescence Imaging with Lymphoscintigraphy for Sentinel Node Biopsy in Melanoma: Increasing the Sentinel Lymph Node-Positive Rate. Ann Surg Oncol 26, 3550–3560 (2019). https://link.springer.com/article/10.1245%2Fs10434-019-07617-z

Synopsis: With the largest cohort of patients reported who underwent a melanoma sentinel lymph node biopsy with lymphoscintigraphy and indocyanine green, we demonstrated that this technique results in higher sentinel lymph node-positive rates than predicted.

Laparoscopic Segment 1 with Partial IVC Resection in Advanced Cirrhosis: How to Do It Safely

Related Image -Laparoscopic Segment 1 with Partial IVC Resection in Advanced Cirrhosis How to Do It Safely Eduardo A. Vega, MD, Diana C. Nicolaescu, MD, Omid Salehi, MD, Olga Kozyreva, MD, Usha Vellayappan, MD, David Ricklan, MD, Justin McCarty, DO, Fermin Fontan, MD, Frank Pomposelli, MD, and Claudius Conrad, MD, PhD

Synopsis: Laparoscopic caudate lobectomy in cirrhotic patients with partial IVC resection is technically demanding. In this video article the authors present a strategic and preplanned approach required to accomplish this type of surgery safely.

Laparoscopic Segment 1 with Partial IVC Resection in Advanced Cirrhosis: How to Do It Safely - Annals of Surgical Oncology
Background Laparoscopic versus open hepatocellular carcinoma (HCC) resection reduces morbidity without a compromise in oncologic safety.1-4 Moreover, in the subgroup of cirrhotic patients, a decreased risk of prolonged postoperative ascites and liver decompensation has been reported.5-7 Methods A 54-year-old homeless, deaf male with chronic alcoholism, hepatitis C, and advanced cirrhosis was referred with a caudate tumor from a critical access hospital.

Neoadjuvant Therapy is Associated with Improved Survival in Borderline-Resectable Pancreatic Cancer

Akhil Chawla, George Molina, Linda M. Pak…Jiping Wang

Citation: Chawla, A., Molina, G., Pak, L.M. et al. Neoadjuvant Therapy is Associated with Improved Survival in Borderline-Resectable Pancreatic Cancer. Ann Surg Oncol. 27; 4:1191–1200, 2020. https://doi.org/10.1245/s10434-019-08087-z

Synopsis: Patients with borderline-resectable pancreatic adenocarcinoma treated with neoadjuvant therapy have survival similar to that of patients with resectable pancreatic cancer and better than that of patients with borderline-resectable disease treated with adjuvant therapy.

Opioid Use after Breast-Conserving Surgery: Prospective Evaluation of Risk Factors for High Opioid Use

Graph - Opioid Use after Breast-Covering Surgery 02-2020 Ko Un Park, Kristin Kyrish, Min Yi…Sarah M. DeSnyder

Citation: Park, K.U., Kyrish, K., Yi, M. et al. Opioid Use after Breast-Conserving Surgery: Prospective Evaluation of Risk Factors for High Opioid Use. Ann Surg Oncol 27, 730–735 (2020). https://doi.org/10.1245/s10434-019-08091-3

Synopsis: In this single-institution, prospective study of patients undergoing breast-conserving surgery, both patient and surgical factors were related to high postoperative opioid use.

Prognostic Molecular Classification of Appendiceal Mucinous Neoplasms Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Jing Su, Guangxu Jin, Konstantinos I. Votanopoulos…Edward A. Levine

Citation: Su, J., Jin, G., Votanopoulos, K.I. et al. Prognostic Molecular Classification of Appendiceal Mucinous Neoplasms Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08210-5

Synopsis: Appendiceal mucinous neoplasm with peritoneal metastasis is a rare but deadly disease with few prognostic or therapy-predictive biomarkers to guide treatment decisions Specimens (n=138) derived from a single institution and uniformly treated with cytoreductive surgery with hyperthermic intraperitoneal chemotherapy were analyzed for gene expression using a custom-designed NanoString 148-gene panel. The authors’ findings suggest a greater role for the immune system for appendiceal mucinous neoplasms than previously recognized and genetic signatures which have clinical utility for predicting treatment outcomes.

Re-resection in Incidental Gallbladder Cancer: Survival and the Incidence of Residual Disease

Alexandra M. Anker, Lukas Prantl, Catharina Strauss… Silvan M. Klein

https://link.springer.com/article/10.1245/s10434-019-07758-1

Surgical and Surgeon-Related Factors Related to Long-Term Survival in Esophageal Cancer: A Review

Sheraz R. Markar and Jesper Lagergren

Citation: Markar, S.R., Lagergren, J. Surgical and Surgeon-Related Factors Related to Long-Term Survival in Esophageal Cancer: A Review. Ann Surg Oncol 27, 718–723 (2020). https://doi.org/10.1245/s10434-019-07966-9

Synopsis: Survival following esophagectomy is influenced by surgeon-related factors including surgeon volume, proficiency-gain period, surgeon age, and timing of surgery. The role of the skills of the individual surgeon may have a greater prognostic role over variations in the surgical approach.

Technique for Robotic Transhiatal Esophagectomy

Picutre of Back Related to Technique for Robotic Transhiatal Esophagectomy June S. Peng, MD, Moshim Kukar, MD, and Steven N. Hochwald, MD, MBA

Citation: Peng, J.S., Kukar, M. & Hochwald, S.N. Technique for Robotic Transhiatal Esophagectomy. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-019-08186-x

Synopsis: Minimally invasive esophagectomy is increasing performed for cancers of the esophagus and gastroesophageal junction. This video article demonstrates the setup and key steps for a robotic transhiatal esophagectomy with a cervical anastomosis.

The Impact of Education and Prescribing Guidelines on Opioid Prescribing for Breast and Melanoma Procedures

Jay S. Lee, Ryan A. Howard, Michael P. Klueh…Lesly A. Dossett

Citation: Lee JS, Howard RA, Klueh MP, et al. The impact of education and prescribing guidelines on opioid prescribing for breast and melanoma procedures. Ann Surg Oncol. 2019; 26 17–24, 2019. https://doi.org/10.1245/s10434-018-6772-3

Synopsis: In this study, the authors evaluated the impact of mandatory education and prescribing guidelines on opioid prescribing after breast and melanoma procedures. This intervention significantly reduced the quantity of opioid prescribed without increasing the frequency of opioid prescription refills.

The Landmark Series: Axillary Management in Breast Cancer - Published December 2019

Landmark Article Image 02-2020 Carla S. Fisher, Julie A. Margenthaler, Kelly K. Hunt, Theresa Schwartz

Citation: Fisher, C.S., Margenthaler, J.A., Hunt, K.K. et al. The Landmark Series: Axillary Management in Breast Cancer. Ann Surg Oncol 27, 724–729 (2020). https://doi.org/10.1245/s10434-019-08154-5

Synopsis: The management of the axilla in patients with newly diagnosed breast cancer has evolved over time with an overall de-escalation in surgical extent. The landmark trials that have contributed to this paradigm shift are discussed in this article.

The Safety of Iterative Cytoreductive Surgery and HIPEC for Peritoneal Carcinomatosis: A High Volume Center Prospectively Maintained Database Analysis - Published December 2019

Eliahu Bekhor, Jacquelyn Carr, Margaret Hofstedt…Deepa Magge

Citation: Bekhor, E., Carr, J., Hofstedt, M. et al. The Safety of Iterative Cytoreductive Surgery and HIPEC for Peritoneal Carcinomatosis: A High Volume Center Prospectively Maintained Database Analysis. Ann Surg Oncol (2019). https://doi.org/10.1245/s10434-019-08141-w

Synopsis: In this study, the authors aim to determine rates of major late complications following iterative CRS/HIPEC to provide more complete knowledge of the procedure’s safety profile to patients and clinicians.

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