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Social vulnerability limits clinical trial participation in cancer surgery.

An analysis of over 399,000 gastrointestinal cancer surgery patients revealed that only 1.9% participated in clinical trials, with significant barriers linked to social vulnerability. Factors such as being female, Black, having Medicaid, and residing in economically disadvantaged neighborhoods correlated with lower enrollment rates. Furthermore, patients treated at community hospitals faced even greater obstacles, as high social vulnerability compounded their likelihood of participation. The findings highlight critical disparities in access to vital cancer trials.

Journal Article by Perati SR, Mohayya SM (…) Eskander MF et 4 al. in Ann Surg

Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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High-Volume Centers Offer Better Long-Term Survival for Esophageal Cancer Surgery

Patients undergoing esophagectomy for cancer at high-volume centers exhibit improved long-term survival, as shown in a meta-analysis involving 23,194 individuals. Those treated in these centers lived an average of 4.3 months longer compared to their counterparts in low-volume centers. The analysis also indicated a significantly reduced risk of mortality over a 60-month follow-up period. This trend was consistent across various volume categories, reinforcing the importance of centralizing these surgical procedures.

Journal Article by Aiolfi A, Bona D (…) Bonavina L et 4 al. in Ann Surg Oncol

© 2025. Society of Surgical Oncology.

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Predictive model enhances surgical planning for advanced gastric cancer

A new predictive model developed for assessing surgical difficulty in distal gastrectomy for advanced gastric carcinoma shows promise. An analysis of 520 patients revealed seven independent risk factors, including BMI and tumor size. The model achieved an impressive area under the curve (AUC) of 0.787, indicating strong predictive accuracy. This tool aims to aid surgeons in identifying high-risk patients prior to surgery, facilitating better operational planning and potentially improving outcomes.

Journal Article by Yu H, Liao H (…) Yuan Y et 3 al. in Surg Endosc

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Balanced transfusion strategies show promise in hemorrhage management.

Advancements in massive transfusion protocols (MTPs) highlight the importance of balanced transfusion strategies, utilizing a 1:1:1 ratio of plasma, platelets, and red blood cells. This approach significantly enhances early hemorrhage control, though challenges persist with individual patient variability. Viscoelastic hemostatic assays facilitate personalized treatment by providing real-time clot assessments. Renewed interest in whole blood transfusions, informed by military practices, offers logistical advantages and survival benefits, prompting calls for refined protocols and precision medicine to optimize patient outcomes.

Review by Lin TL, Liu HT and Hsieh CH in J Formos Med Assoc

Copyright © 2025 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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Robotic liver resection shows improved recurrence-free survival

A multicentric analysis involving 647 hepatocellular carcinoma patients revealed that robotic liver resection (RLR) offers significant advantages over laparoscopic liver resection (LLR). RLR showed wider surgical margins (10 mm vs 5 mm) and higher rates of R0 resection (98.9% vs 93.1%), alongside a lower conversion rate and shorter hospital stays. While overall survival rates were similar, RLR was linked to significantly improved recurrence-free survival (46.8% vs 24.0%), highlighting its potential for better long-term outcomes.

Journal Article by Di Sandro S, Centonze L (…) Di Benedetto F et 25 al. in Updates Surg

© 2025. Italian Society of Surgery (SIC).

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Surgical care faces urgent need for reform and funding.

Global surgical care is at a critical juncture, with an unmet need for 160 million operations annually and 3.5 million deaths post-surgery each year. Despite inspiring engagement in policy through the Lancet Commission, progress toward achieving the 2030 targets remains insufficient, particularly in low- and middle-income countries. Chronic underfunding and workforce shortages have been exacerbated by the COVID-19 pandemic. The next decade necessitates urgent reforms to elevate surgical services as essential for health systems and economic stability.

Review by Nepogodiev D, Picciochi M (…) Bhangu A et 59 al. in Lancet

Copyright © 2025 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.

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Robotic surgery shows benefits for colon and rectal cancer patients

A retrospective analysis of over 52,000 patients revealed that robotic and laparoscopic surgeries significantly outperformed open surgery in achieving treatment goals (74.5% and 72.9% vs. 47.8%, p < 0.001) across all body mass index (BMI) categories. Robotic surgery also resulted in lower major morbidity rates compared to open surgery. Notably, rectal cancer patients with class II and III obesity exhibited similar major morbidity rates regardless of surgical approach, highlighting the robotic method's advantage.

Journal Article by Waqar U, Rupji M (…) Rosen SA et 2 al. in Surg Endosc

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Lower Income Levels Linked to Poorer Surgical Outcomes

A meta-analysis involving over 24 million patients reveals that lower income and wealth levels significantly correlate with worse postoperative outcomes within 90 days of surgery. Those with Medicaid, Medicare, or uninsured status exhibited higher odds of complications, mortality, and readmission compared to privately insured individuals. Specifically, Medicaid patients faced a 1.85 times higher risk of 30-day mortality, emphasizing the vital role of socioeconomic factors in surgical care. This insight calls for improved risk stratification in perioperative preparations.

Journal Article by Banerjee A and Rafi I in J Surg Res

Copyright © 2025 Elsevier Inc. All rights reserved.

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Intersphincteric resection with rectal eversion improves anal preservation

A novel surgical technique for low rectal cancer, intersphincteric resection combined with rectal eversion and total extra-abdominal resection (ISrer), shows promise in enhancing anal preservation rates without raising postoperative complications. In a study involving 74 patients, ISrer achieved a 94.3% anal preservation rate compared to 71.8% for conventional laparoscopic ISR, while maintaining a 100% R0 resection rate. The technique demonstrated similar costs and hospital stay duration to traditional methods, marking it as a beneficial alternative.

Randomized Controlled Trial by Yang Z, Wang A (…) Zhang C et 6 al. in World J Surg Oncol

© 2025. The Author(s).

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Delayed treatment linked to age and insurance status in CRC patients

Analysis of over 3,100 patients revealed that 35.3% experienced delays in colorectal cancer (CRC) treatment. Key predictors included older age, with those aged 80 and above having an 81% higher likelihood of delay, as well as being on Medicaid or uninsured, which increased the odds by 54%. Additionally, patients with rectal tumors were three times more likely to face treatment delays than those with right-sided tumors. Targeted interventions could mitigate these delays.

Journal Article by Tanariyakul M, Wannaphut C (…) Acoba J et 2 al. in J Gastrointest Cancer

© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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