Surgical Oncology

Adjuvant therapy may be unnecessary for low-risk endometrial cancer with nodal isolated tumor cells

This cohort study evaluated overall survival in uterine factor–based low-risk endometrial cancer with isolated tumor cells (ITCs) in regional lymph nodes managed without adjuvant therapy. All patients had comprehensive surgical staging but did not receive postoperative radiation or systemic therapy despite nodal ITCs. The primary question was whether ITCs alone compromise overall survival enough to justify adjuvant escalation. Results support that in truly low-risk uterine primaries, isolated nodal tumor cells may not reduce survival without adjuvant treatment. 1

Arterial divestment after FOLFIRINOX in PDAC with arterial involvement yields acceptable survival

This single-centre retrospective series included 76 patients with borderline or locally advanced PDAC and radiologic arterial involvement explored after induction therapy. Fifty-nine underwent pancreatic resection with arterial divestment when arterial involvement persisted, while 17 were unresectable at laparotomy. Neoadjuvant FOLFIRINOX significantly increased odds of resection (HR 3.23; 95% CI 1.59-9.90; p = 0.040). Median overall survival from diagnosis was 33 months in resected patients versus 26 months in non-resected patients (p = 0.0176). 2

Thermal ablation rivals surgery and radiotherapy for small adrenal metastases with fewer complications

This multicenter retrospective cohort of 496 patients compared surgery, thermal ablation, and radiotherapy for adrenal metastases. After inverse probability weighting, surgery and radiotherapy achieved better local progression-free survival than ablation overall (p = 0.021). For tumors smaller than 5 cm, local progression-free survival did not differ significantly among the three modalities (p = 0.23). Surgery provided superior overall survival compared with ablation and radiotherapy in the weighted cohort (p = 0.004). 3

Perioperative CEA refines prognosis and adjuvant chemotherapy benefit in stage II–III colorectal cancer

This large two-cohort study evaluated perioperative CEA (pre- and postoperative) in stage II–III colorectal cancer for prognostic stratification and treatment decisions. Among 2496 training and 1293 validation patients, elevated perioperative CEA was associated with worse overall and disease-free survival on Kaplan-Meier analysis. Postoperative CEA was an independent prognostic factor for overall and disease-free survival in multivariable models. Nomograms incorporating perioperative CEA and clinicopathologic factors showed good prediction of 3-, 5-, and 7-year survival. 4