Postoperative Recurrence Research Articles

Abstract 1349: Single-cell transcriptomic architecture deciphering the complexity of tumor microenvironment in ampulla of Vater carcinoma

Abstract Background: Ampulla of Vater carcinoma (AVC) is a rare gastrointestinal tumor that is associated with a high mortality rate and it’s often diagnosed at later stages due to lack of clinical symptoms. Elucidating complex ecosystems and molecular features of AVC is pivotal to proactive cancer prevention and optimal therapeutic intervention. Methods: We performed single-cell RNA sequencing (scRNA-seq) of treatment-naïve AVC biopsies (N=8), and bulk RNA sequencing of surgically resected tissues (N=62) to investigate the transcriptomic signature in tumor microenvironment (TME) of AVC. Results: We analyzed the single-cell transcriptome of 34, 672 cells and epithelial cells were classified into 4 subtypes by consensus non-negative matrix factorization (cNMF) based on their gene expression profiles. Among them, the KRAShigh subtype showed more increased copy number variation than other subtypes and was less differentiated with a high stemness score. Moreover, the KRAShigh subtype was reversely related to overall survival (OS) and enriched with granzyme K+ CD8 T cells. Deconvolution of bulk RNA-seq data validated the poor OS and progression-free survival (PFS) in the AVC patients with the KRAShigh subtype. Also, it was revealed that this subtype was associated with early tumor recurrence in AVC. Conclusions: We understood the heterogenous TME of AVC and found the prognostic biomarker to predict postoperative recurrence and survival in AVC. Citation Format: Hyemin Kim, Young Hoon Choi, Hyoung-oh Jeong, So Jeong Yoon, Yo Han Jeon, Hongbeom Kim, Sang Hyun Shin, Jin Seok Heo, In Woong Han, Kee-Taek Jang, Se-Hoon Lee, Kwang Hyuck Lee, Kyu Taek Lee, Jong Kyun Lee, Semin Lee, Joo Kyung Park. Single-cell transcriptomic architecture deciphering the complexity of tumor microenvironment in ampulla of Vater carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1349.

Abstract 3338: A CpG methylation based epigenetic signature for recurrence prediction in stage II/III colorectal cancer: The CENSURE Study

Introduction: Adjuvant chemotherapy (ACT) is the standard of care for patients with stage III or high-risk stage II colorectal cancer (CRC) following curative-intent resection. However, over 30% of these patients experience recurrence despite treatment, highlighting the urgent need for developing predictive biomarkers of response to ACT. This study sought to identify epigenetic biomarkers for predicting recurrence in stage II/III CRC. Patients and Methods: This study included three phases: discovery, training, independent testing. In the discovery phase, we performed genomewide methylation profiling analysis between recurrent (recurrence-free survival, RFS < 5 years) and non-recurrent patients with CRC. A LASSO-based machine learning algorithm was employed to refine and optimize the candidate CpG sites. Subsequently, we developed and tested a methylation biomarker panel by quantitative pyrosequencing assays, followed by eXtreme Gradient Boosting (XGB) machine-learning algorithm in both the training (n = 236) and testing (n = 175) cohorts. Finally, we established the CENSURE (CpG mEthylatioN-based epigenetic SignatURE) model, which combined the CpG methylation panel and carcinoembryonic antigen (CEA) levels, to predict recurrence in stage II/III CRC. Results: A panel of 8 CpG candidates identified in the discovery phase was refined to 6 using XGB in the training cohort. The 6-CpG panel demonstrated robust ability to predict recurrence, with AUC values of 91.2% and 79.3% in the training and testing cohorts, respectively. Multivariate Cox regression analysis revealed that CEA ≥ 5 ng/mL (HR 2.92; 95% CI: 1.81-4.70) and the CpG panel (HR 19.5; 95% CI: 8.78-43.1) were independent predictors of recurrence. Building on this, we developed the CENSURE model, which integrates the CpG panel with CEA. The CENSURE model achieved AUC values of 95.2% and 86.1%, with sensitivities of 83.9% and 83.3% in the training and testing cohorts, respectively. CENSURE high-risk patients exhibited significantly higher 5-year (71.5% vs 8.0%) and 2-year recurrent rates (48.0% vs 5.4%). Notably, the CENSURE model outperformed CEA risk stratification alone, correctly predicting an additional 46.5% (40 out of 86) of recurrence cases in the entire study cohort. Conclusions: In conclusion, the CENSURE assay represents a novel potential advance with a significant clinical impact for postoperative recurrence prediction in stage II/III CRC. Citation Format: Caiming Xu, Silei Xu, Joan Maurel, Man Li, Ajay Goel. A CpG methylation based epigenetic signature for recurrence prediction in stage II/III colorectal cancer: The CENSURE Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3338.

Abstract 5200: Patient-derived esophageal squamous cell carcinoma organoids and analysis of MDR1 expression levels in clinical specimens for promoting personalized medicine

Abstract Background: Esophageal cancer is the 7th leading cause of cancer-related mortality as of 2022, with esophageal squamous cell carcinoma (ESCC) comprising 90% of cases in Japan. The Japanese Clinical Oncology Group (JCOG) reported that preoperative DCF therapy (Docetaxel + Cisplatin + 5-Fluorouracil) improves prognosis over CF therapy (Cisplatin + 5-Fluorouracil). However, some patients exhibit resistance to DCF therapy, leading to recurrence or metastasis post-surgery. Tumor heterogeneity contributes to these outcomes. MDR1, a multidrug resistance protein, shows variable expression levels, and cancer tissues are composed of tumor cells alongside diverse microenvironmental components. To address this, accurate models are essential. Recently, three-dimensional patient-derived organoids (3D-PDOs) have gained attention as cost-effective platforms replicating cancer heterogeneity. Method: 3D-PDOs were derived from pre-treatment ESCC biopsy specimens. Their histological morphology was compared with clinical specimens, and responses to Docetaxel, Cisplatin, and 5-Fluorouracil were assessed. Additionally, 78 ESCC cases treated with preoperative DCF therapy followed by surgery (2012-2018) were analyzed. Immunohistochemistry (IHC) was performed on biopsy specimens to evaluate MDR1 expression and its association with prognosis. Results: 3D-PDOs formed three-dimensional epithelial aggregates. ESCC PDOs exhibited irregular edges compared to the spherical, well-defined shapes of normal PDOs. IHC revealed protein expression variability in 3D-PDOs, reflecting clinical specimen heterogeneity. Expression trends in PDOs matched those in clinical samples, demonstrating their histological accuracy. In one case, a therapeutic experiment with Docetaxel, Cisplatin, and 5-Fluorouracil showed significant efficacy for Docetaxel and Cisplatin but resistance to 5-Fluorouracil. MDR1 analysis in biopsy specimens indicated MDR1-positive cases had significantly shorter recurrence-free survival than MDR1-negative cases, though no significant difference was observed in 5-year overall survival. MDR1 IHC on 3D-PDOs used in treatment experiments confirmed MDR1 expression, consistent with observed 5-FU resistance and suggesting a high recurrence risk in this case. Conclusion: 3D-PDOs are valuable for analyzing histological features and therapeutic resistance in heterogeneous ESCC cases. MDR1 analysis demonstrated potential utility in predicting postoperative recurrence risk, supporting its role in personalized treatment strategies. Citation Format: Yasushige Takeda, Kazuhiro Noma, Hajime Kashima, Akito Shimizu, Tasuku Matsumoto, Seitarou Nishimura, Tatsuya Takahashi, Hijiri Matsumoto, Kento Kawasaki, Tomoyoshi Kunitomo, Maeda Naoaki, Satoru Kikuchi, Shunsuke Tanabe, Toshiaki Oohara, Hiroshi Tazawa, Hiroshi Nakagawa, Toshiyoshi Fujiwara. Patient-derived esophageal squamous cell carcinoma organoids and analysis of MDR1 expression levels in clinical specimens for promoting personalized medicine [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 5200.

Minimally invasive versus open liver resection for hepatocellular carcinoma with microvascular invasion: a propensity score-matching study.

Microvascular invasion (MVI) is one of the major risk factors for postoperative recurrence of HCC. For HCC patients with MVI, few studies have examined the differences in prognosis between minimally invasive and open liver resection. A total of 171 HCC patients with MVI who underwent curative-intent hepatectomy from September 2017 to October 2022 at Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, were enrolled in this study. Patients were categorized into minimally invasive liver resection (MILR) group (Robotic or laparoscopic) and open liver resection (OLR) group. In order to balance the baseline characteristics between the two groups, 1:4 propensity score matching (PSM) was performed on the two groups. The survival parameters and perioperative parameters were compared between the two groups before and after PSM, respectively. There was no significant difference in Recurrence Free Survival (RFS) and Overall Survival (OS) between the two groups before and after PSM. Subgroup analysis showed that there were no significant differences in OS and RFS between the two groups regarding anatomical resection, IWATE difficulty score, surgical margins, and postoperative adjuvant therapy. Perioperative parameters and the rate of major postoperative complications were comparable between the two groups. Minimally invasive approach can provide a comparable long-term survival result compared with conventional open approach for patients with HCC associated with MVI.

Impact of Routine Postoperative Care Versus Nurse-Led Lifestyle Interventions on Patient Outcomes After Radiofrequency Ablation: A Randomized Controlled Trial.

Paroxysmal atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity. Radiofrequency ablation (RFA) is a widely used treatment, but postoperative complications and recurrence remain concerns. Nurse-led lifestyle interventions have been proposed as a strategy to improve patient outcomes after RFA. The objective of this randomized controlled trial was to compare the effects of routine (usual) care versus a nurse-led lifestyle intervention on postoperative outcomes in patients undergoing RFA for paroxysmal AF. A total of 160 patients undergoing RFA for paroxysmal AF were randomly assigned in a 1:1 ratio to either the intervention group or the usual-care group. The intervention group received tailored lifestyle interventions managed by a nurse-led multidisciplinary team, focusing on exercise, diet, medication adherence, and psychological support. The usual-care group received standard postoperative care. The primary outcomes were quality of life (Short Form-36 scores) and recurrence of AF. Data were collected at baseline, 6 months, and 12 months. The nurse-led lifestyle intervention group showed significant improvements in Short Form-36 scores for Physical Functioning, Role Limitations, Vitality, General Health, and Social Functioning compared with the usual-care group at 6 months (P < .05). The recurrence rate of AF at 12 months was significantly lower in the nurse-led lifestyle intervention group (12.5%) compared with the usual-care group (26.3%, P = .021). The incidence of postoperative complications was also reduced in the nurse-led lifestyle intervention group. These findings suggest that nurse-led care models may provide a valuable approach to optimizing postoperative outcomes for AF patients, emphasizing the need for structured, personalized interventions in clinical practice.

Clinical practice guidelines for perioperative multimodality treatment of non-small cell lung cancer.

Lung cancer is currently the most prevalent malignancy and the leading cause of cancer deaths worldwide. Although the early stage non-small cell lung cancer (NSCLC) presents a relatively good prognosis, a considerable number of lung cancer cases are still detected and diagnosed at locally advanced or late stages. Surgical treatment combined with perioperative multimodality treatment is the mainstay of treatment for locally advanced NSCLC and has been shown to improve patient survival. Following the standard methods of neoadjuvant therapy, perioperative management, postoperative adjuvant therapy, and other therapeutic strategies are important for improving patients' prognosis and quality of life. However, controversies remain over the perioperative management of NSCLC and presently consensus and standardized guidelines are lacking for addressing critical clinical issues in multimodality treatment. The working group consisted of 91 multidisciplinary experts from thoracic surgery, medical oncology, radiotherapy, epidemiology, and psychology. This guideline was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The clinical questions were collected and selected based on preliminary open-ended questionnaires and subsequent discussions during the Guideline Working Group meetings. PubMed, Web of Science, Cochrane Library, Scopus, and China National Knowledge Infrastructure (CNKI) were searched for available evidence. The GRADE system was used to evaluate the quality of evidence and grade the strengths of recommendations. Finally, the recommendations were developed through a structured consensus-building process. The Guideline Development Group initially collected a total of 62 important clinical questions. After a series of consensus-building conferences, 24 clinical questions were identified and corresponding recommendation were ultimately developed, focusing on neoadjuvant therapy, perioperative management, adjuvant therapy, postoperative psychological rehabilitation, prognosis assement, and follow-up protocols for NSCLC. This guideline puts forward reasonable recommendations focusing on neoadjuvant therapy, perioperative management, adjuvant therapy, postoperative psychological rehabilitation, prognosis assessment, and follow-up protocol of NSCLC. It standardizes perioperative multimodality treatment and provides guidance for clinical practice among thoracic surgeons, medical oncologists, and radiotherapists, aiming to reduce postoperative recurrence, improve patient survival, accelerate recovery, and minimize postoperative complications such as atelectasis.

The role of CDK8 gene polymorphisms in bladder cancer susceptibility and prognosis: a study in the Chinese Han population

BackgroundCyclin-dependent kinase 8 (CDK8) has been implicated in various tumors, with its role differing across tumor types. However, the association between CDK8 polymorphisms and bladder cancer (BC) remains unclear. This study investigated the association between CDK8 polymorphisms and BC susceptibility and prognosis.MethodsThis case-control study included 271 patients with BC and 381 healthy controls. Two-tag single-nucleotide polymorphisms in the CDK8 gene (rs17083838 and rs7992670) were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Statistical analyses were performed using SNPstats and SPSS software to assess genetic associations.ResultsThe AG/AA genotypes of rs17083838 were associated with a significantly reduced risk of BC under the dominant model (P < 0.001, odds ratio [95% confidence interval] = 0.50 [0.33–0.76]). Stratified analysis revealed that the AG genotype of rs17083838 increased the risk of postoperative recurrence in patients with stage IV BC (P = 0.007). For rs7992670, females with the AG/AA genotype exhibited a 2.07-fold higher risk of BC than males, whereas smokers with the same genotype showed a 2.13-fold higher risk than non-smokers. The GG genotype of rs7992670 was associated with better overall survival in patients with stage III BC (P = 0.023). Among patients with recurrent muscle-invasive BC, those with the GG/AA genotype showed significantly improved survival compared with those carrying the AG genotype (P = 0.023).ConclusionsCDK8 polymorphisms influence BC susceptibility and prognosis, with rs17083838 showing a protective effect and rs7992670 being associated with increased risk and survival outcomes in specific subgroups.ImpactThis study highlights the potential of CDK8 polymorphisms as biomarkers for BC susceptibility and prognosis, emphasizing the need for further research.

Construction and validation of a nomogram model for predicting the risk of recurrence in patients with lower extremity arteriosclerosis obliterans after surgical intervention

ObjectiveTo explore and analyze the risk factors for recurrence in patients with lower extremity arteriosclerosis obliterans (ASO) after surgical intervention and to construct and validate a nomogram prediction model.MethodsA total of 270 patients with ASO treated at our hospital were retrospectively selected as study subjects and divided into a training cohort (189 cases) and a validation cohort (81 cases) based on a 7:3 ratio. Patients in the training cohort were further divided into recurrence and non-recurrence groups based on whether they experienced recurrence within two years post-surgery. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for postoperative recurrence, which were then used to construct a predictive model and generate a nomogram.ResultsOf the 270 patients with ASO included in the study, the training cohort consisted of 189 patients, with 76 (40.21%) in the recurrence group and 113 (59.79%) in the non-recurrence group. The validation cohort consisted of 81 patients, with 32 (39.51%) in the recurrence group and 49 (60.49%) in the non-recurrence group. Univariate analysis in the training cohort revealed significant differences in age, body mass index (BMI), diabetes, hypertension, lesion location classification, use of antiplatelet drugs, triglycerides, fibrinogen (FIB), and di-dimer (D-D) (P < 0.05, respectively). Multivariate logistic regression analysis indicated that age ≥ 60 years, BMI ≥ 24 kg/m², diabetes, hypertension, discontinuation of antiplatelet therapy, FIB, and D-D were independent risk factors for recurrence after surgical intervention in patients with lower extremity ASO (OR = 2.471, 1.625, 4.568, 2.678, 5.974, 2.073 and 3.067; P < 0.05, respectively). When the training and validation cohorts were tested in the established nomogram model, the area under the curve (AUC) of the model was 0.832 (95% CI: 0.765–0.919) in the training cohort and 0.858 (95% CI: 0.745–0.964) in the validation cohort. Calibration curves indicated high consistency between the predicted and actual outcomes in both groups, suggesting good predictive accuracy of the model. Decision curve analysis showed that using this model significantly increased net clinical benefit for patients.ConclusionThe nomogram model constructed for predicting the risk of recurrence in patients with lower extremity ASO after surgical intervention demonstrates good predictive and discriminative abilities, offering valuable guidance for clinical screening of high-risk populations.

Time Interval From Right Atrium to Coronary Sinus Predicts Postablation Atrial Fibrillation Recurrence in Current Ablation Practice.

Recurrence after ablation for atrial fibrillation (AF) may occur in patients in whom atrial remodeling progresses. Atrial conduction time is a marker of remodeling. This study investigated whether atrial conduction time is related to postoperative recurrence. This study enrolled 441 patients with AF (median age 69 years; 144 women; paroxysmal/non-paroxysmal AF=231/210) who underwent initial radiofrequency catheter ablation at Mie University Hospital between January 2018 and December 2022. The interval from the earliest potential in the right atrium (RA) to the latest potential in the coronary sinus (CS) was measured using a BeeAT catheter during sinus rhythm after ablation. The primary endpoint was AF recurrence or atrial tachycardia lasting >30 s in the 1 year after ablation. Recurrence was observed in 44 patients. Patients were categorized into 2 groups according to recurrence. The RA-CS interval was significantly longer in the recurrence group (122.5±17.7 vs. 98.5±17.7 ms; P<0.001). In Cox regression analysis, the RA-CS interval was independently associated with recurrence (hazard ratio 1.05; 95% confidence interval [CI] 1.03-1.07; P<0.001). The cut-off value for the RA-CS interval was 111 ms (area under the curve=0.845; 95% CI 0.785-0.905). The recurrence rate was significantly higher in patients with an RA-CS interval ≥111 vs. <111 ms. The RA-CS interval time was an independent predictor of recurrence after AF ablation.

Surgery-related change in cancer cell adhesion associates with recurrence in patients undergoing colorectal cancer surgery.

Surgery-related change in cancer cell adhesion associates with recurrence in patients undergoing colorectal cancer surgery.

Increased Immunoglobulin and Proteoglycan Synthesis in Resected Hippocampal Tissue Predicts Post-Surgical Seizure Recurrence in Human Temporal Lobe Epilepsy

Background/Objectives: For patients with medically refractory temporal lobe epilepsy (TLE), surgery is an effective strategy. However, post-operative seizure recurrence occurs in 20–30% of patients, and it remains challenging to predict outcomes solely based on clinical variables. Here, we ask to what extent differences in gene expression in epileptic tissue can predict the outcome after resective epilepsy surgery. Methods: We performed RNAseq on hippocampal tissue resected from eight patients who underwent anterior temporal lobectomy with amygalohippocampectomy (ATL/AH), half of whom became seizure free (SF) or non-seizure free (NSF). Results: Bioinformatic analyses revealed 1548 differentially expressed genes and statistical enrichment analyses identified a distinct set of pathways in NSF and SF cohorts that were associated with neuroinflammation, neurotransmission, synaptic plasticity, and extracellular matrix (ECM) reorganization. Resected tissue exhibiting strong pro-inflammatory processes are associated with better post-surgery seizure outcomes than patients exhibiting cellular signaling processes related to ECM reorganization, autoantibody production, and neural circuit formation. Conclusions: The results suggest that post-operative targeting of both inhibitory aspects of the ECM remodeling and the autoimmune/inflammatory components may be helpful in promoting repair and preventing the recurrence of seizures.

IPOM versus eTEP as minimally invasive approaches for ventral/incisional hernias: a systematic review and meta-analysis

PurposeEnhanced-view totally extraperitoneal (eTEP) repair of ventral hernias is an emerging modality that places synthetic mesh in the retrorectus space and obviates its fixation. We aimed to compare outcomes between eTEP and minimally invasive intraperitoneal onlay mesh (IPOM) repair techniques.MethodsA PRISMA-compliant meta-analysis searching PubMed, EMBASE and CENTRAL databases from January 2010 till August 2024, was performed. All studies comparing IPOM versus eTEP were included. The primary objective was postoperative pain at day 7 (POD7) whereas secondary objectives included operative time, length of stay (LOS), intraoperative and postoperative complications and recurrence. Random effects models were used to calculate pooled effect size estimates. Sensitivity analyses were also performed.ResultsTwelve studies (3 randomized, 9 observational) capturing 868 patients (452 IPOM, 416 eTEP) were included. Most hernias were primary ventral (n = 806). Most studies (10/12) adopted a laparoscopic approach whilst two employed robotic techniques. IPOM was associated with significantly higher pain scores at POD7 (VAS; visual analog scale; MD 3.01, 95%CI = 1.28–4.75, p = 0.0007), longer LOS (MD 0.65 days, 95%CI = 0.27–1.04, p = 0.001) but shorter operative time (MD - 53.69 min, 95%CI = - 69.65- - 37.73, p < 0.00001). However, there was no differences in intraoperative (OR 2.04, 95%CI = 0.81–5.17, p = 0.13), postoperative (OR 1.15, 95%CI = 0.54–2.46, p = 0.72) complications or recurrence (OR 2.08, 95%CI = 0.79–5.46, p = 0.14). On sensitivity analyses, comparing laparoscopic IPOM with defect closure (IPOM +) versus eTEP, similar results prevailed.ConclusionsIPOM(+) is associated with more postoperative pain at one week and a longer hospital stay. However, no differences were observed in complications or recurrence between the two techniques.

MRI based radiomics nomogram for predict recurrence of non functioning pituitary macroadenomas post surgery

Objective: To establish and validate a comprehensive predictive model combining clinical data and radiomics features to improve the accuracy of predicting recurrence within five years after surgery in patients with non-functioning pituitary macroadenomas (NFMA). Methods: This retrospective study included 292 NFMA patients who underwent surgery between January 2012 and January 2018, with an additional 123 patients as an external test set. Clinical, pathological, and conventional imaging features were collected and analyzed using univariate and multivariate logistic regression to identify independent risk factors for postoperative recurrence. Radiomic features were extracted from preoperative T1-weighted (T1WI), T2-weighted (T2WI), and T1-enhanced images using 3D Slicer software. A radiomics prediction model was developed, and a combined model integrating clinical and radiomics features was established. The predictive performance of the models was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Results: The clinical model (Cli-score), radiomics model (Rad-score) and combined model were developed. The diagnostic performance of the clinical model in the external test set, showed an AUC of 0.757 (95%CI: 0.671–0.830), with SEN, SPE, and ACC of 82.5%, 59.04%, and 71.54%, respectively. The diagnostic performance of the radiomics model in the external test set showed an AUC of 0.835 (95% CI: 0.757–0.896), with 80%, 79.52% and 63.41% for SEN, SPE and ACC%, respectively. The diagnostic performance of the combined model in the external test set showed an AUC of 0.863 (95% CI: 0.790–0.919), with SEN, SPE, and ACC of 80%, 81.93%, and 68.30%, respectively. The calibration curve indicated good predictive performance, and DCA confirmed the high clinical utility of the combined model. Conclusion: The combined model provides a more accurate prediction of NFMA recurrence. This model can guide postoperative follow-up strategies and aid in early initiation of adjuvant therapy for high-risk patients.

Arthroscopic cystectomy and open surgery for the treatment of popliteal cysts: a retrospective clinical cohort study.

To compare the clinical effects of arthroscopic cystectomy and open surgery for the treatment of popliteal cysts, in order to provide clinical basis for the selection of surgical plan for popliteal cyst. A retrospective study was conducted on the clinical data of 153 patients diagnosed with popliteal cysts from January 2020 to December 2022. Among them, 77 patients underwent arthroscopic cystectomy as the observation group, and 76 patients underwent open surgery as the control group. Compared the surgical related indicators, Rauschening and Lindgren grade, Lysholm and VAS scores between two groups. Follow up on postoperative complications and cyst recurrence. The observation group had a smaller incision length (P < 0.01), less intraoperative bleeding (P < 0.05), and shorter hospitalization time than the control group (P < 0.01), but longer surgical time (P < 0.05). Both groups of patients showed significant improvement in Rauschening and Lindgren grade, Lysholm and VAS scores after surgery, with the observation group superior to the control group(P < 0.05&P < 0.01). Follow up for 13-25 months (16.34 ± 4.25) after surgery showed no complications in the observation group, while there were two cases of nerve injury in the control group, with no statistically significant difference (P > 0.05). There were two cases of postoperative recurrence in the observation group with no symptoms and nine cases of recurrence in the control group with mild symptoms and did not require further treatment, which had statistical difference (P < 0.05). Arthroscopic cystectomy and oper surgery both have definite clinical efficacy in treating popliteal cyst, which relying on prospective research to determine the optimal solution.

Factors associated with postoperative recurrence in perforated colorectal cancer: unraveling the high recurrence rate of perforated colorectal cancer

BackgroundPerforated colorectal cancer exhibits a higher recurrence rate than non-perforated colorectal cancer; however, the reasons for this difference remain unclear. This study identifies factors affecting recurrence in patients with perforated colorectal cancer who underwent R0 surgery.MethodsThis study included consecutive patients with Stage II or III perforated colorectal cancer who underwent radical surgery at a single center between 2007 and 2020. The comparison group included patients with non-perforated, non-obstructive, non-perforated colorectal cancer who underwent surgery during the same period. Clinicopathological background factors (age, sex, localization, surgical procedure, stoma, T stage, lymphatic invasion, venous invasion, differentiation, extent of lymph node dissection, number of dissected lymph nodes, lymph node metastasis, postoperative complications, and 30-day postoperative death) of perforated and non-perforated colorectal cancers were investigated. Factors influencing recurrence were examined in patients who were followed for more than 3 years after surgery, up to 5 years postoperatively.ResultsThis study included 89 perforated and 323 non-perforated cases. The median patient ages were 74 and 73 years in the perforated and non-perforated groups, respectively. In perforated cases, the proportion of T4 stage tumors was significantly higher (39% vs. 18% in non-perforated cases, with p < 0.001). Additionally, the number of lymph node dissections was significantly lower (10 vs. 17 in non-perforated cases, p < 0.001), and the rate of postoperative complications was higher (46% vs. 7% in the non-perforated cases, p < 0.001). Postoperatively, 55 perforated and 284 non-perforated cases were available for follow-up. Univariate analysis revealed that perforation, T4 stage, lymph node metastases, and postoperative complications were associated with significantly higher recurrence rates. Multivariate analysis identified T4 stage and lymph node metastases as independent risk factors.ConclusionsThe recurrence rate of perforated colorectal cancer was higher than that of non-perforated cases, primarily due to advanced disease stages, such as T4 or lymph node metastases. Perforation itself may not directly cause recurrence but reflects cancer progression. Further research is needed to clarify the mechanisms linking cancer progression, perforation, and recurrence.

Nationwide study on clinical impact of early tumor necrosis factor-α inhibitors following first intestinal resection in biologics-naïve Crohn’s disease patients

In Crohn’s disease (CD) patients who have undergone surgery, postoperative recurrence remains a challenge, and there is a lack of investigation into the impact of early anti-tumor necrosis factor (TNF) therapy following surgery on clinical outcomes compared to late use of anti-TNF agents. Utilizing the Health Insurance Review and Assessment database, we conducted a retrospective cohort study comprising 481 CD patients who underwent their first intestinal resection and were naïve to preoperative biological therapy from 2010 to 2018. Patients initiating anti-TNF agents early (within one year post-surgery) were compared to those starting later for prognosis. Clinical outcomes, including biologics switching and surgical recurrence, were assessed. The late start group (n = 290) exhibited a higher surgical recurrence rate (27.9% vs. 18.3%, p-value = 0.021), while biologics switching rates did not significantly differ (8.3% vs. 12.6%, p-value = 0.167) compared to the early start group (n = 191). Kaplan–Meier curves revealed no significant differences in the risk of biologics switching (p-value = 0.319) or surgical recurrence (p-value = 0.380) between the early and late start groups. This study investigated the potential role of early anti-TNF therapy after first intestinal resection in biologics-naïve CD patients compared to late initiation. Further refined prospective research is warranted to validate these comparisons.

Postoperative pneumothorax occurrence in patients with Marfan syndrome.

Marfan syndrome is a congenital connective tissue disorder frequently complicated by pneumothorax. However, the long-term efficacy of surgical intervention in these cases remains underreported. This study aimed to assess the surgical outcomes of pneumothorax associated with Marfan syndrome. A retrospective review was conducted at a single center, including patients diagnosed with secondary pneumothorax associated with Marfan syndrome who underwent surgery between 2004 and 2019. Postoperative pneumothorax recurrence rates and potential predictors of postoperative recurrence were assessed. The incidence of ipsilateral pneumothorax after surgery was analyzed and compared with that before surgery. Overall, 20 patients (60% male, 40% female) with a median age of 18.5 years (range 13-40 years) were included in the analysis. Seventeen patients underwent bullectomy, while the remainder received pulmorrhaphy. The cumulative incidence of postoperative pneumothorax at 5 and 10 years was 25% and 44%, respectively. Notably, patients with pectus excavatum had a 5-year cumulative recurrence rate of 25%, and those with a flat chest had a rate of 60%, compared with 9.1% for patients without chest deformities (P = 0.017). Chest deformity emerged as a significant predictor of postoperative pneumothorax recurrence (hazard ratio 7.63; 95% confidence interval 1.29-45.1; P = 0.025). The frequency of ipsilateral pneumothorax significantly decreased postoperatively, from 1.09 ± 0.66 episodes/year (mean ± SD) pre-surgery to 0.04 ± 0.10 episodes/year post-surgery (P < 0.001). Surgical intervention is an effective treatment for pneumothorax in patients with Marfan syndrome. Chest deformity may serve as a predictor of postoperative pneumothorax recurrence in this patient population.

Management of recurrent thyroglossal duct cysts: a 15-year single-center experience

Aims: The aim of this study is twofold: firstly, to present the clinical features of thyroglossal duct cysts (TGDC) and our surgical experience; and secondly, to emphasize the importance of wide hyoid bone resection and a more thorough dissection, especially in the treatment of recurrence cases. Methods: The present study constitutes a retrospective analysis of data about patients who underwent surgical intervention for TGDC in our clinic between the years January 2010 and April 2023. A comprehensive data set was collated for all patients, encompassing demographic characteristics, presenting complaints, the presence of fistula, preoperative imaging methods, intraoperative complications, duration of hospitalization, pathology results, and postoperative recurrence rates. Results: The present study included a total of 51 patients. Of these patients, 26 (50.9%) were male and 25 (49.1%) were female. The mean age was calculated to be 7.8±4.43 years. The mean duration of hospitalization was 35±11 hours. Postoperative complications included the development of an abscess at the incision site in three patients (5.8%) and subcutaneous emphysema in one (1.9%) patient. Three (5.8%) were primary cases operated in our center, while four patients (7.8%) developed recurrence after Sistrunk procedure performed in an external center and were referred to our center. Conclusion: In conclusion, the management of recurrent cases in TGDC surgery requires careful planning. Extended surgical procedures such as the modified Sistrunk procedure are highly successful in terms of both low recurrence rates and appropriate management of recurrence cases.

Long-term outcome of radiation therapy for locoregional recurrence of upper tract urothelial carcinoma after nephroureterectomy

BackgroundThe objective was to evaluate the survival outcomes associated with radiation therapy (RT) in cases of postoperative locoregional recurrence of upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU).MethodsA total of 30 patients undergoing RT for local or regional recurrence of UTUC after RNU from 2002 to 2017 were enrolled. The median follow-up time for patients who survived was 5.9 years. The application of RT comprised two intents: (1) salvage RT for patients who did not respond to chemotherapy or who did not receive chemotherapy, and (2) consolidation RT for patients who showed complete or partial response to chemotherapy. Overall survival (OS) since recurrence, locoregional progression-free survival (LRPFS) after RT, and distant metastasis-free survival (DMFS) after RT were evaluated. Univariate Cox regression analysis was applied.ResultsThe median OS since recurrence was 40.0 months, and the 5-year OS, LRPFS, and DMFS rates were 46.6%, 45.0%, and 36.7%, respectively. For 14 patients who underwent salvage RT, the 5-year OS, LRPFS, and DMFS rates were 28.6%, 21.4%, and 21.4%, respectively; for 16 patients undergoing consolidation RT, those rates were 63.5%, 65.8%, and 50.0%, respectively. In univariate analysis, consolidation RT and primary site in the ureter were significant prognostic factors for better OS and LRPFS; an age ≤ 60.0 years was also a significant factor for OS. There was no significant factor for DMFS.ConclusionsThe patients undergoing RT for postoperative locoregional recurrence of UTUC had promising survival outcomes. Future prospective randomized trials to verify the findings are needed.

ICG fluorescence-guided sentinel lymph node biopsy for decision-making in lateral lymph node dissection in local advanced rectal cancer: a retrospective study.

Local advanced rectal cancer (LARC) carries high recurrence risks, especially with lateral lymph node (LLN) involvement. This study aims to evaluate the role of ICG-guided sentinel lymph node biopsy (SLNB) in patients with clinical negative LLNs (maximum diameter < 7mm), potentially reducing unnecessary surgeries and associated complications in patients with LARC. A retrospective analysis of 301 consecutive patients with lower LARC who underwent fluorescent lateral pelvic sentinel lymph node biopsy (FL-SLNB) or conventional LLND at the Cancer Hospital, Chinese Academy of Medical Sciences between 2018 and 2022 was conducted. Clinical and pathological data were collected, and the patients were grouped into FL-SLNB and non-SLNB groups. Postoperative complications, recurrence rates, and survival outcomes were assessed. Statistical analysis was performed using χ2 tests, Mann-Whitney U tests, Kaplan-Meier survival curves, and Cox proportional hazards models. FL-SLNB (173 patients) showed better perioperative outcomes than non-SLNB (128 patients), with shorter hospital stays (7 vs. 10days, P = 0.027), less blood loss (150 vs. 180mL, P = 0.032), and fewer complications: intraoperative bleeding (2.9% vs. 6.3%, P = 0.041), anastomotic leakage (1.7% vs. 3.9%, P = 0.045), and urinary dysfunction (3.5% vs. 7.0%, P = 0.039). No significant differences were observed in survival or recurrence rates (P > 0.05). pN stage was a significant predictor of distant metastasis (HR 1.953, P = 0.037). ICG-guided SLNB enhanced surgical precision and reduced unnecessary LLND in lower LARC with clinically negative LLNs, and improved surgical decision-making and minimizes postoperative complications.