Surgical Oncology

Surgery linked to longer survival in very elderly spinal ependymoma patients

In adults aged ≥75 with spinal ependymoma, surgical resection was associated with longer median overall survival (106.0 vs 59.7 months). Surgery had an independent survival benefit (HR 0.46, p=0.021) after multivariable adjustment. Very elderly patients underwent surgery less often (70% vs 85%) despite similar tumor characteristics. Chronological age alone may be an imperfect basis to deny surgery; consider comorbidity, tumor size, and functional status. 1

Perioperative chemoimmunotherapy improves outcomes in resectable NSCLC across heterogeneous studies

Systematic review of 16 studies (n=4646) found higher survival and pathological response after perioperative chemoimmunotherapy versus chemotherapy alone. Adverse events tended to be more frequent or severe with combined therapy, though results varied across studies. Heterogeneity in study design, endpoints, and conduct limited pooled quantitative synthesis. Interpret benefits in context of individual trial regimens, patient fitness, and expected TRAE profiles before changing practice. 2

Socioeconomic and geographic trial reporting is largely absent in US cancer RCTs

In 441 US randomized cancer trials (2020–2025), age and sex were nearly universally reported, and race/ethnicity reporting increased to 93.9% by 2025. No trials reported rurality, income, or area deprivation; education appeared in 2 trials and insurance in 1. Limited reporting of socioeconomic and geographic variables restricts assessment of trial generalizability to underserved populations. When counseling patients, explicitly consider differences between trial populations and your local demographics. 3