Surgical Oncology

Stage I ovarian cancer: MIS, capsule rupture, and survival

This cohort study evaluated how minimally invasive surgery and intraoperative capsule rupture relate to overall survival in stage I ovarian cancer. The analysis directly informs selection between MIS and laparotomy for early-stage disease. Results help quantify any survival penalty associated with capsule rupture during MIS versus open surgery. These data support more granular counseling on surgical approach, case selection, and intraoperative judgment when capsule integrity is at risk. 1

Perioperative transfusion raises short- and long-term mortality after pancreatic surgery

Using Korean National Health Insurance data, 26,175 pancreatic surgery patients were analyzed; 36.1% received perioperative transfusion. Transfusion, defined as ≥1 unit within 7 days pre- to 30 days post-op, was associated with higher mortality after propensity matching (63.3% vs 52.4%; p < 0.0001). Adjusted hazard ratios showed persistently elevated risk at 45 days (aHR 9.9), 6 months (3.0), and 5 years (1.4). Pancreaticoduodenectomy patients had higher short- and long-term mortality with transfusion, whereas distal pancreatectomy lacked a long-term signal. 2

Perioperative targeted immunotherapy plus TACE improves outcomes in borderline resectable HCC

This multicenter study included 297 borderline resectable HCC patients undergoing resection and compared perioperative targeted immunotherapy plus adjuvant TACE with adjuvant TACE alone. After propensity matching, combination therapy improved 1-, 3-, and 5-year overall survival (90.7%, 66.0%, 58.1%) versus TACE alone (86.0%, 55.2%, 35.1%; p = 0.013). Recurrence-free survival similarly favored combination therapy, with higher 1-, 3-, and 5-year rates (66.3%, 36.9%, 31.0% vs 55.8%, 23.1%, 13.8%; p = 0.007). Combination therapy independently protected OS (HR 0.619) and RFS (HR 0.665) on multivariable analysis. 3

Starting adjuvant S-1 at 6–8 weeks optimizes outcomes after pancreatectomy

This ancillary JASPAC 01 analysis grouped 187 post-pancreatectomy patients by S-1 start: Early (<6 weeks), Standard (6–8 weeks), and Delayed (>8 weeks). The Standard group had longer median OS than Early (66 vs 37 months; HR 0.61, 95% CI 0.38–0.99) and numerically better than Delayed (45 months; HR 0.68). Relapse-free survival was superior in the Standard group versus Early (46 vs 20 months; HR 0.61) and Delayed (46 vs 20 months; HR 0.59). Nonstandard initiation (<6 or >8 weeks) independently predicted worse prognosis alongside operative procedure, R1 resection, and nodal metastasis. 4