Surgical Oncology

EAST-BMS: East Asian ML model predicts survival after nonspinal bone metastasis surgery

EAST-BMS is a multinational East Asian machine-learning survival model for patients undergoing surgery for nonspinal bone metastases. In 1,045 patients from Korea, Taiwan, and Japan the model achieved a tdAUC of 0.81 at 3 months and 0.78 at 12 months with Brier scores comparable to SORG. Key routinely available clinical, functional, and laboratory predictors were identified and missing data were <4% per site. Applicability is to East Asian surgical patients with nonspinal bone metastases; external validation and assessment of impact on decision-making are still needed. 1

Network meta-analysis: perioperative taxane-triplet + ICI ranks highest in resectable G/GEJ adenocarcinoma

This Bayesian network meta-analysis compared 16 perioperative regimens across 30 RCTs (11,547 patients). Perioperative taxane-based triplet plus an immune checkpoint inhibitor ranked highest for OS (SUCRA 0.952) and DFS (0.959), with OS HR 0.79 (95% CrI 0.59–1.05) versus triplet alone. DFS benefit was more consistent (HR 0.72; 95% CrI 0.56–0.93). Most comparisons were indirect with wide credible intervals, so direct trial evidence is required before routine adoption. 2

Real-world adjuvant nivolumab linked to better DFS and OS after radical surgery for high-risk urothelial carcinoma

In a multicenter Japanese cohort (n=366) adjuvant nivolumab (n=126) was associated with improved DFS (HR 0.56, 95% CI 0.35–0.88) and OS (HR 0.40, 95% CI 0.19–0.81) versus observation in a propensity-matched analysis. Secondary analyses showed similar DFS and OS between adjuvant nivolumab and adjuvant chemotherapy. Covariate balance was adequate for bladder cancer but not for upper tract urothelial carcinoma, limiting inference for the latter. Results are hypothesis-generating and susceptible to residual confounding despite PSM. 3