Surgery
Audio Summaries

Comparison of 2015 and 2025 ATA Risk Stratification Systems for Predicting Recurrence in Papillary Thyroid Carcinoma

This study aimed to compare the predictive performance of the 2015 and 2025 American Thyroid Association (ATA) risk stratification systems for recurrence in patients with papillary thyroid carcinoma (PTC). The authors found that while both systems had comparable predictive performance, the 2025 system demonstrated improved risk discrimination by concentrating recurrence events primarily within the high-risk group, particularly affecting patients initially classified as intermediate risk.

A Pathology-Based Model for Postoperative Recurrence or Metastasis Prediction and Adjuvant Immunotherapy Implications of Clear-Cell Renal Cell Carcinoma: A Multicenter, Retrospective Study

The authors aimed to develop a pathology-based model to predict postoperative recurrence and metastasis in patients with nonmetastatic clear cell renal cell carcinoma (ccRCC) and to assess the implications for adjuvant immunotherapy. By analyzing data from 2154 patients, they identified seven independent risk factors and constructed a prognostic model that effectively stratified patients, revealing that high-risk individuals significantly benefited from immune checkpoint inhibitors. This model outperformed current clinical trial criteria for adjuvant therapy, highlighting its potential to improve patient outcomes.

Return to intended oncologic therapy after treatment for cholecystitis in cancer patients

The authors aimed to investigate the impact of cholecystitis on the ability of cancer patients to return to their intended oncologic treatment within six weeks. They found that only 52.7% of patients were able to resume treatment in that timeframe, with lower rates observed in those with hematologic malignancies and those who underwent drainage procedures. Additionally, the study highlighted a low likelihood of patients undergoing cholecystectomy after receiving a percutaneous cholecystotomy tube, suggesting that this intervention does not facilitate a quicker return to cancer therapy.

Early-Onset Appendiceal Adenocarcinoma (Age < 50 Years): Temporal Trends in Case Proportions, Histologic Patterns, and Survival Outcomes From SEER, 2000-2023

This study investigates the clinicopathologic features and survival outcomes of early-onset appendiceal adenocarcinoma (diagnosed before age 50) using data from the SEER database between 2000 and 2023. The authors found that early-onset cases represent about 21.2% of appendiceal adenocarcinoma diagnoses and are associated with distinct demographic and histologic characteristics, while survival outcomes are primarily influenced by disease stage and tumor features rather than age alone. Additionally, the study highlights significant racial disparities in survival among early-onset patients, suggesting a need for further research in this area.

Unveiling the lessons from a virtual tobacco cessation program targeting surgical patients

The authors aimed to evaluate patient engagement in a video-based virtual tobacco cessation program tailored for surgical patients, assessing its effectiveness across various general surgery clinics. Despite the implementation of the program, engagement rates were low, with only 10.3% of patients referred to further support and 5.4% attending at least one follow-up visit. The study highlights the need for further research to identify optimal strategies for engaging the surgical patient population in smoking cessation efforts.

Dynamic DBil and TBA Trajectories for Predicting Native Liver Survival in Biliary Atresia: A Multicenter Study with an Open-Access Online Tool

The authors aimed to develop a predictive model for native liver survival (NLS) in children with biliary atresia (BA) using dynamic trajectories of postoperative direct bilirubin (DBil) and total bilirubin acid (TBA). By analyzing data from 473 patients, they identified distinct trajectory subgroups and demonstrated that a combined model of DBil and TBA trajectories significantly outperformed traditional static indicators for predicting NLS. An open-access online tool was created to facilitate individualized prognostic assessments, pending further validation.

American College of Surgeons NSQIP Hospital Benchmarking Using Bayesian Variational Inference to Adjust for Many CPT Codes

The authors aimed to evaluate the effectiveness of Bayesian automatic differentiation variational inference (ADVI) as a method for risk adjustment in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), particularly in comparison to the conventional CatBoost (CATB) approach. They found that while both methods showed similar discrimination for outcomes, ADVI provided superior calibration, significantly reduced computational time, and improved stability for sparse CPT code combinations, suggesting it as a more efficient alternative for hospital benchmarking in surgical outcomes.

Assessing Graded Histological Regression as Basis for Treatment Modification after Neoadjuvant Therapy in LAGC: An Exploratory Phase II Study

The authors aimed to determine whether graded histologic regression (GHR) of less than 50% after neoadjuvant chemotherapy could serve as an indicator for modifying adjuvant treatment in patients with locally advanced gastric cancer (LAGC). Their exploratory phase II study found that patients whose adjuvant regimen was modified based on GHR had significantly improved disease-free survival and overall survival compared to those who continued with the original regimen. The findings suggest that GHR < 50% may warrant changes in treatment, although further research is necessary to confirm these results.

Coronary Calcium Screening and Incidental Lung Cancer Detection in Patients Ineligible for US Preventive Services Task Force Screening

The authors investigate whether coronary calcium screening CT can facilitate the early detection of lung cancer in patients who do not meet the current U.S. Preventive Services Task Force screening criteria. Their retrospective study found that actionable pulmonary nodules were identified in a significant portion of patients, leading to early-stage lung cancer diagnoses and high survival rates, suggesting that integrating thoracic assessments from coronary calcium screenings could enhance lung cancer detection in underserved populations.

Rethinking Muscle Wasting in Critical Illness: A Systematic Review and Meta-Analysis of Myofiber Size and Protein Turnover

The authors aimed to investigate the biological mechanisms underlying skeletal muscle dysfunction in critically ill adults by conducting a systematic review and meta-analysis of myofiber size and protein turnover. They found that myofiber cross-sectional area was significantly reduced in critically ill patients compared to controls, while protein synthesis rates did not differ significantly; however, markers of protein degradation were notably elevated. These findings suggest that muscle wasting in critical illness is driven by complex biological changes, including myofiber atrophy and increased protein degradation.