Surgical Oncology

SLNB alone after neoadjuvant therapy is generally safe in ycN0 breast cancer

This multicenter real-world study compared sentinel lymph node biopsy (SLNB) alone versus axillary lymph node dissection (ALND) in 1381 breast cancer patients rendered ycN0 after neoadjuvant therapy. Local and regional recurrence rates were low and similar between SLNB and ALND, and distant metastasis rates did not differ significantly. After inverse probability weighting, disease-free survival, overall survival, and regional control were comparable between groups. Subgroup analysis showed similar survival in initial cN0 and cN+ disease, but initial cN2–3 patients had inferior local–regional control with SLNB alone. 1

Microwave ablation competes with repeat resection for recurrent intrahepatic cholangiocarcinoma

This secondary analysis of the prospective MALRIC cohort compared microwave ablation (MWA, n = 375) with repeat liver resection (rLR, n = 119) for first recurrent intrahepatic cholangiocarcinoma within Milan-equivalent criteria. After propensity matching and overlap weighting, overall survival was similar between MWA and rLR, with closely overlapping hazard ratios. Disease-free survival was also similar overall, though rLR showed advantages in patients with large duct subtype, no prior surgical complications, or early recurrence. MWA produced substantially shorter hospital stays and far fewer major complications than rLR. 2

Simple hysterectomy is adequate for many early-stage cervical cancers

This exploratory analysis from the SHAPE trial compared simple hysterectomy (SH) with radical hysterectomy (RH) in very low-risk and other early-stage cervical cancers. In the Conservative (very low-risk) group, no recurrences occurred in either arm during a median 4.5-year follow-up. In the broader Liberal group, SH achieved three-year pelvic, extrapelvic, overall recurrence-free survival, and overall survival similar to RH. Multivariable analyses did not associate SH with increased recurrence or mortality, whereas absence of residual tumor predicted lower recurrence. 3

Umbrella review confirms liver transplantation superiority over resection for HCC

This umbrella review synthesized four quantitative meta-analyses and one systematic review comparing liver transplantation (LT) with liver resection (LR) for hepatocellular carcinoma. Pooled hazard ratios favored LT for overall survival (HR 1.35) and disease-free survival (HR 2.58), indicating substantial long-term benefit. The superiority of LT was consistent across Milan and extended criteria, viral etiologies, eras, and geographic regions. Odds ratio–based summaries from recent meta-analyses were directionally concordant, despite heterogeneous endpoint definitions. 4