A comprehensive multicenter study involving 781 patients with locally advanced gastric cancer (LAGC) revealed significant findings about tumor deposits (TDs). The study highlighted that TDs are associated with larger tumor size (≥ 5 cm) and vascular invasion. Independent risk factors for poor prognosis include TD positivity, tumor diameter, advanced pT4a stage, and vascular invasion. Particularly, patients with TDs at pT4a and pN3b stages exhibit notably lower 5-year overall and disease-free survival rates. These insights underscore the necessity of considering TDs in the prognosis and tailored management of LAGC. For further details, refer to the full study here: https://doi.org/10.1245/s10434-024-15508-1
Risk of Advanced Neoplasia and CRC Post Adenoma Removal with HGD
A study analyzed 814 patients who had colorectal adenomas with high-grade dysplasia (HGD) removed, revealing significant risks of advanced neoplasia (AN) and colorectal cancer (CRC). Over 2000 person-years of follow-up showed AN and CRC incidence densities of 44.3 and 4.4 per 1000 person-years, respectively. Synchronous polyps and elevated baseline carcinoembryonic antigen (CEA) levels were key risk factors. However, surveillance colonoscopies markedly reduced AN and CRC incidences. Patients with these risk factors need frequent monitoring to manage their long-term cancer risks effectively. Full study available at: https://doi.org/10.1007/s00464-024-10898-5
Comparing TEM and SP Robotic Platforms for Rectal Lesions
A study comparing transanal endoscopic microsurgery (TEM) and single-port robotic transanal minimally invasive surgery (SP rTAMIS) for rectal lesion excision found that SP rTAMIS offers shorter operative times and lower postoperative morbidity. Both methods had similar rates of positive margins and piecemeal resection, with no intraoperative complications in either cohort. SP rTAMIS had fewer postoperative complications (9% vs. 20%, p = 0.031) and no mortalities. These findings support SP robotics as a promising alternative to TEM for rectal lesion excision. Full study available at: https://doi.org/10.1007/s00464-024-10895-8
Robotic Pelvic Lymph Node Dissection in Advanced Rectal Cancer
A recent meta-analysis compared robotic pelvic lateral lymph node dissection (LPLND) to laparoscopic LPLND in patients with advanced rectal cancer. The study found that robotic surgery led to more pelvic lymph nodes being harvested and fewer complications, especially regarding urinary retention, despite longer operation times. This suggests potential advantages of robotic over laparoscopic techniques in this context. Further research is needed to strengthen these findings, but the results indicate that robotic surgery could be a valuable option in treating advanced rectal cancer. Full study available at: https://doi.org/10.1007/s00464-024-10901-z
Predictive Factors for Better Outcomes in Peritoneal Metastasis of Gastric Cancer
A new study has identified significant predictive factors for patients with peritoneal metastasis of gastric cancer (PMGC) who underwent aggressive treatment strategies. The study focused on patients who received a combination of cytoreductive surgery (C-CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) after responding to induction chemotherapy.
Key findings include:
Patients with a Ki-67 index lower than 10 had significantly better recurrence-free and overall survival.
Limited lymph node involvement (LNI < 2) and smaller omental lesion size (< 0.5 cm) were associated with improved outcomes.
The study retrospectively examined 62 patients and found that those with these favorable parameters had a higher likelihood of long-term survival. Cox regression analysis further confirmed that decreased Ki-67 expression and minimal lymph node involvement were independent factors for better prognosis.
These results underscore the importance of thorough preoperative assessment to identify patients who are likely to benefit most from an aggressive multimodal treatment approach. This approach includes initial induction chemotherapy, followed by surgery and HIPEC, and aims to maximize survival outcomes.
For detailed insights, read the full study here.
New Insights in Treating Malignant Peritoneal Mesothelioma
Malignant peritoneal mesothelioma (MPeM) is a rare and aggressive cancer of the abdominal lining. A recent multi-center study has shed light on the effectiveness of various treatments for this condition. The study divided patients into two groups: those who underwent cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) and those who could not undergo curative surgery.
The CRS-HIPEC group showed significantly better outcomes, with a median overall survival (OS) of 44.6 months compared to 12.6 months for non-surgical treatments. This combination therapy is particularly beneficial for patients who can achieve complete or near-complete tumor resection. Factors such as low completeness of cytoreduction (CC) scores and low peritoneal cancer index (PCI) scores were associated with better survival rates.
For patients who are not surgical candidates, chemotherapy remains the primary treatment option. The platinum-pemetrexed regimen is particularly effective, with patients showing improved progression-free survival (PFS) and OS compared to other treatments.
The study underscores the importance of personalized treatment plans based on the patient’s specific condition and prognosis. It also highlights the role of experienced surgical centers in achieving optimal outcomes. Continuous advancements in surgical techniques and chemotherapy regimens are improving survival rates for MPeM patients.
For detailed information, read the full study here.
https://link.springer.com/article/10.1245/s10434-024-15506-3