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Appendicitis Complexity Impacts Cancer Type

Analyzing 4 studies with 4,962 appendicitis patients, the meta-analysis found a 1.98% neoplasm incidence. No overall difference emerged between complicated (3.29%) and uncomplicated (1.49%) cases. Neuroendocrine tumors (NET) were common (49.21%), with higher rates in uncomplicated cases, while adenocarcinomas were more prevalent in complicated appendicitis (50% vs. 13%). Despite similar overall neoplasm rates, the study highlights nuanced cancer type variations, emphasizing the need for tailored appendectomy considerations based on appendicitis complexity.

Journal Article by Solis-Pazmino P, Oka K (…) Nasseri Y et 8 al. in Langenbecks Arch Surg

© 2023. The Author(s).

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DNA Methylation Classifier Illuminates Sarcoma Diagnoses and Molecular Markers

Researchers evaluated a sarcoma DNA methylation classifier for soft tissue and bone tumors, including 619 cases. The classifier exhibited high sensitivity and specificity for fusion sarcomas (Ewing, synovial, cic-rearranged, bcor-rearranged), leiomyosarcoma, MPNST, and malignant vascular tumors. However, sensitivity was low for desmoid fibromatosis, neurofibroma, and schwannoma, with low specificity for certain diagnoses. MDM2 amplification and RB1 loss aided lipomatous tumor diagnosis. The classifier, though valuable, may evolve with additional entities and refine methylation classes, providing insights into sarcoma interrelationships.

Journal Article by Miettinen M, Abdullaev Z (…) Aldape KD et 7 al. in Am J Surg Pathol

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Low Morbidity and Laparoscopic Dominance: Insights from Chinese Study on Right Hemicolectomy for Colon Cancer

In a Chinese multi-center study on right hemicolectomy for colon cancer, involving 1,854 patients from 52 tertiary hospitals, laparoscopic surgery with D3 lymph node dissection was predominant. Postoperative morbidity and mortality were low at 11.7% and 0.2%, respectively. Anastomotic leak occurred in 1.4% of cases. Risk factors for morbidity included higher ASA grade, increased intraoperative blood loss, and D3 lymph node dissection. Anastomotic leak risk was associated with extracorporeal side-to-side anastomosis, higher blood loss, and neoadjuvant chemotherapy.

Journal Article by Gao J, Gu X (…) Zhang Z et 50 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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Synthetic Mesh Holds Its Own: Comparable Efficacy and Safety for Incisional Hernia Prevention in the Preloop Trial

In the “Preloop Trial,” where 102 patients underwent loop ileostomy closure, researchers compared retrorectus synthetic mesh to biological mesh for preventing incisional hernia. At 10 months, both groups showed similar low rates of incisional hernia—2% each. No significant differences were found in complications, reoperation, operating time, or hospital stay. This suggests synthetic mesh is as effective and safe as biological mesh in preventing incisional hernia during loop ileostomy closure.

Journal Article by Mäkäräinen EJ, Wiik HT (…) Rautio TT et 7 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Laparoscopic Limited Anatomic Liver Resections: Precise Technique Yields Promising Oncologic Outcomes

Exploring laparoscopic liver surgeries, researchers scrutinized 112 patients undergoing laparoscopically limited anatomic resections (LARs) for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM). Impressively, lap-LAR demonstrated precise technique, yielding promising oncologic outcomes with low complications. Five-year recurrence-free survival rates for HCC and CRLM stood at 45.1% and 36.8%, showcasing lap-LAR’s potential as an effective therapeutic option for liver malignancies.

Journal Article by Wakabayashi T, Fujiyama Y (…) Wakabayashi G et 6 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Tumor Biology and Surgical Margins Dictate Survival in Non-Metastatic Adrenocortical Carcinoma: A Paradigm Shift

In the battle against adrenocortical carcinoma (ACC), researchers find surgical approach and extent matter less than tumor biology and margins in non-metastatic cases. A cohort study (2010–2019, 1,175 subjects) reveals laparoscopic surgery, often considered minimally invasive, correlates with worse survival in advanced disease (stage III). Positive margins negatively impact survival, while chemoradiation benefits those with such margins. Tumor biology emerges as the primary survival determinant, redirecting focus in ACC management.

Journal Article by Passman JE, Amjad W (…) Wachtel H et 2 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Surgery Shines: A Viable Treatment Avenue for Stage IE Primary Thyroid Lymphoma

Surgery emerges as a viable treatment for stage IE primary thyroid lymphoma (PTL), with a cohort study of 1,596 patients (SEER database) and an external cohort of 38 patients (Shanghai, China). The 7.8-year SEER analysis showed no significant survival difference between surgery, surgery + radiotherapy/chemotherapy, and radiotherapy/chemotherapy alone. In the external cohort, surgery-alone exhibited comparable disease-specific survival, lower complications, shorter treatment duration, and reduced costs compared to radiotherapy/chemotherapy.

Journal Article by Tang Y, Yan T (…) Yang Z et 4 al. in Ann Surg Oncol

© 2023. Society of Surgical Oncology.

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Sex concordance increased specialist evaluations, potentially addressing under-referral issues in primary hyperparathyroidism.

Investigating primary hyperparathyroidism referrals, a study analyzed 1,100 patients and found that sex concordance (matching patient and practitioner sexes) correlated with increased specialist evaluations. Patients with concordant primary care practitioners had 32% higher odds of endocrinologist evaluation, and those with concordant endocrinologists had a 48% higher rate of surgeon evaluation. Stratified analysis revealed that sex discordance reduced surgeon referral rates for female patients but not males. Sex discordance may contribute to under-referral in primary hyperparathyroidism, emphasizing the importance of patient-practitioner communication.

Journal Article by Broekhuis JM, Cote MP (…) James BC et 3 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Missed Opportunities: Esophageal Adenocarcinoma Patients with Prior Colonoscopies Lack Timely Esophagogastroduodenoscopy

In the era of widespread colonoscopy, many patients later diagnosed with esophageal adenocarcinoma (EA) had prior screening colonoscopies, presenting missed opportunities for earlier detection. Among 221 referred patients, 49% had prior colonoscopies, yet only 18% had an esophagogastroduodenoscopy (EGD) before EA diagnosis. Most displayed gastroesophageal reflux disease symptoms or acid medication use during screening colonoscopy. An EGD at this stage could have identified EA earlier, emphasizing a significant diagnostic gap despite available screening tools.

Journal Article by McKay SC, DeSouza ML (…) DeMeester SR et 3 al. in J Gastrointest Surg

© 2023. The Society for Surgery of the Alimentary Tract.

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Similar Outcomes in Esophageal Cancer with Different Neoadjuvant Therapies

Comparing neoadjuvant radiochemotherapy protocols for resectable esophageal cancer, this study finds no significant differences in postoperative mortality, complications, or toxicity. Both PF-based and CROSS protocols demonstrate effectiveness and safety, with squamous cell carcinoma and favorable tumor grading independently predicting a higher pathological complete response rate. The battle of protocols concludes with similar outcomes, providing valuable insights for treatment decisions in locally advanced esophageal cancer.

Journal Article by Lorenz E, Weitz A (…) Benedix F et 3 al. in Langenbecks Arch Surg

© 2023. The Author(s).

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