Featured Articles Archive

Re-resection in Incidental Gallbladder Cancer: Survival and the Incidence of Residual Disease graphicAlexandra M. Anker, Lukas Prantl, Catharina Strauss… Silvan M. Klein

Citation: Anker, A.M., Prantl, L., Strauss, C. et al. Assessment of DIEP Flap Perfusion with Intraoperative Indocyanine Green Fluorescence Imaging in Vasopressor-Dominated Hemodynamic Support Versus Liberal Fluid Administration: A Randomized Controlled Trial With Breast Cancer Patients. Ann Surg Oncol 27, 399–406 (2020).


Synopsis: This prospective randomized controlled trial was the first to investigate the impact of distinct hemodynamic regimens in microvascular deep inferior epigastric perforator flap breast reconstruction after mastectomy for cancer patients. Despite the dogmatic denial of vasopressors in microsurgery, neither liberal fluid administration nor norepinephrine-dominated circulatory support impaired intraoperative flap perfusion as assessed via indocyanine green fluorescence imaging.

Neoadjuvant Therapy is Associated with Improved Survival in Borderline-Resectable Pancreatic Cancer chartAkhil Chawla, George Molina, Linda M. Pak…Jiping Wang 

Citation: Chawla, A., Molina, G., Pak, L.M. et al. Neoadjuvant Therapy is Associated with Improved Survival in Borderline-Resectable Pancreatic Cancer. Ann Surg Oncol. 27; 4:1191–1200, 2020. https://doi.org/10.1245/s10434-019-08087-z 

Synopsis: Patients with borderline-resectable pancreatic adenocarcinoma treated with neoadjuvant therapy have survival similar to that of patients with resectable pancreatic cancer and better than that of patients with borderline-resectable disease treated with adjuvant therapy.

Featured Articles ArchiveJun Li, Mohamed Moustafa, Michael Linecker…Silvio Nadalin

Citation: Li, J., Moustafa, M., Linecker, M. et al. ALPPS for Locally Advanced Intrahepatic Cholangiocarcinoma: Did Aggressive Surgery Lead to the Oncological Benefit? An International Multi-center Study. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-019-08192-z

Synopsis: This international largest cohort confirmed the role of ALPPS in the treatment of advanced intrahepatic cholangiocarcinoma. The future liver remnant to body weight (FLR/BW) ratio before the stage-2 operation and the number of lesions had an essential impact on the surgical and oncological outcomes of ALPPS.

Featured Articles ArchiveSheraz R. Markar and Jesper Lagergren

Citation: Markar, S.R., Lagergren, J. Surgical and Surgeon-Related Factors Related to Long-Term Survival in Esophageal Cancer: A Review. Ann Surg Oncol 27, 718–723 (2020). https://doi.org/10.1245/s10434-019-07966-9

Synopsis:   Survival following esophagectomy is influenced by surgeon-related factors including surgeon volume, proficiency-gain period, surgeon age, and timing of surgery.  The role of the skills of the individual surgeon may have a greater prognostic role over variations in the surgical approach.

Featured Articles ArchiveKatherine Mallin, Amanda Browner, Bryan Palis…Heidi Nelson

Citation: Mallin K, Browner A, Palis, B, et al. Incident cases captured in the national cancer database compared with those in U.S. population based central cancer registries in 2012–2014. Ann Surg Oncol. 2019; 26: 1604–1612. https://doi.org/10.1245/s10434-019-07213-1

Synopsis:  Incident cancer cases in the National Cancer Data Base (NCDB) were compared to national U.S. population based cancer registry data for 2012-2014 diagnosis years. NCDB coverage was 72% with some variation by cancer site and other factors.

Featured Articles ArchiveJay S. Lee, Ryan A. Howard, Michael P. Klueh…Lesly A. Dossett

Citation: Lee JS, Howard RA, Klueh MP, et al. The impact of education and prescribing guidelines on opioid prescribing for breast and melanoma procedures.  Ann Surg Oncol. 2019; 26 17–24, 2019. https://doi.org/10.1245/s10434-018-6772-3

Synopsis: In this study, the authors evaluated the impact of mandatory education and prescribing guidelines on opioid prescribing after breast and melanoma procedures. This intervention significantly reduced the quantity of opioid prescribed without increasing the frequency of opioid prescription refills. 

Picutre of Back Related to Technique for Robotic Transhiatal EsophagectomyJune S. Peng, MD, Moshim Kukar, MD, and Steven N. Hochwald, MD, MBA

Citation: Peng, J.S., Kukar, M. & Hochwald, S.N. Technique for Robotic Transhiatal Esophagectomy. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-019-08186-x

Synopsis: Minimally invasive esophagectomy is increasing performed for cancers of the esophagus and gastroesophageal junction. This video article demonstrates the setup and key steps for a robotic transhiatal esophagectomy with a cervical anastomosis.

Related Image -Laparoscopic Segment 1 with Partial IVC Resection in Advanced Cirrhosis How to Do It SafelyEduardo A. Vega, MD, Diana C. Nicolaescu, MD, Omid Salehi, MD, Olga Kozyreva, MD, Usha Vellayappan, MD, David Ricklan, MD, Justin McCarty, DO, Fermin Fontan, MD, Frank Pomposelli, MD, and Claudius Conrad, MD, PhD

Synopsis: Laparoscopic caudate lobectomy in cirrhotic patients with partial IVC resection is technically demanding. In this video article the authors present a strategic and preplanned approach required to accomplish this type of surgery safely.

Laparoscopic Segment 1 with Partial IVC Resection in Advanced Cirrhosis: How to Do It Safely

Laparoscopic versus open hepatocellular carcinoma (HCC) resection reduces morbidity without a compromise in oncologic safety.1-4 Moreover, in the subgroup of cirrhotic patients, a decreased risk of prolonged postoperative ascites and liver decompensation has been reported.5-7 A 54-year-old homeless, deaf male with chronic alcoholism, hepatitis C, and advanced cirrhosis was referred with a caudate tumor from a critical access hospital.

Landmark Article Image 02-2020Carla S. Fisher, Julie A. Margenthaler, Kelly K. Hunt, Theresa Schwartz

Citation: Fisher, C.S., Margenthaler, J.A., Hunt, K.K. et al. The Landmark Series: Axillary Management in Breast Cancer. Ann Surg Oncol 27, 724–729 (2020). https://doi.org/10.1245/s10434-019-08154-5

Synopsis: The management of the axilla in patients with newly diagnosed breast cancer has evolved over time with an overall de-escalation in surgical extent. The landmark trials that have contributed to this paradigm shift are discussed in this article.

Graph - Opioid Use after Breast-Covering Surgery 02-2020Ko Un Park, Kristin Kyrish, Min Yi…Sarah M. DeSnyder

Citation: Park, K.U., Kyrish, K., Yi, M. et al. Opioid Use after Breast-Conserving Surgery: Prospective Evaluation of Risk Factors for High Opioid Use. Ann Surg Oncol 27, 730–735 (2020). https://doi.org/10.1245/s10434-019-08091-3

Synopsis: In this single-institution, prospective study of patients undergoing breast-conserving surgery, both patient and surgical factors were related to high postoperative opioid use.

Featured Articles ArchiveEliahu Bekhor, Jacquelyn Carr, Margaret Hofstedt…Deepa Magge

Citation: Bekhor, E., Carr, J., Hofstedt, M. et al. The Safety of Iterative Cytoreductive Surgery and HIPEC for Peritoneal Carcinomatosis: A High Volume Center Prospectively Maintained Database Analysis. Ann Surg Oncol (2019). https://doi.org/10.1245/s10434-019-08141-w

Synopsis: In this study, the authors aim to determine rates of major late complications following iterative CRS/HIPEC to provide more complete knowledge of the procedure’s safety profile to patients and clinicians.

Featured Articles ArchiveJing Su, Guangxu Jin, Konstantinos I. Votanopoulos…Edward A. Levine

Citation: Su, J., Jin, G., Votanopoulos, K.I. et al. Prognostic Molecular Classification of Appendiceal Mucinous Neoplasms Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. Ann Surg Oncol (2020). https://doi.org/10.1245/s10434-020-08210-5

Synopsis: Appendiceal mucinous neoplasm with peritoneal metastasis is a rare but deadly disease with few prognostic or therapy-predictive biomarkers to guide treatment decisions Specimens (n=138) derived from a single institution and uniformly treated with cytoreductive surgery with hyperthermic intraperitoneal chemotherapy were analyzed for gene expression using a custom-designed NanoString 148-gene panel. The authors’  findings suggest a greater role for the immune system for appendiceal mucinous neoplasms than previously recognized and genetic signatures which have clinical utility for predicting treatment outcomes.

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