Cardiothoracic Surgery

Salvage surgery may help selected incomplete responders with cervical esophageal cancer.

Available cervical-specific observational data suggest salvage surgery benefits biopsy-confirmed incomplete responders with resectable residual disease and good performance status. Larynx-preserving resection was feasible in 90% of T1-2 and 54% of T3-4 responders in pooled series, supporting organ-sparing attempts when anatomy allows. Authors propose a multidisciplinary selection framework integrating response depth, post-induction stage, laryngeal preservation feasibility, and biomarkers. Evidence is predominantly retrospective and heterogeneous, so the framework remains hypothesis-generating and requires prospective validation. 1

Elective cardiac surgery linked to measurable frailty improvement at one year.

In this prospective cohort of 76 elective cardiac surgery patients, median Clinical Frailty Scale fell from 4 to 3 at 12 months (P < 0.001). Frailty improved in 35.5%, was stable in 38.2%, and worsened in 5.2% of participants. Multivariable analysis associated participation in cardiac rehabilitation with greater odds of frailty improvement. These data support framing surgery plus structured rehab as a potential pathway to reduce frailty, while recognizing observational design limits causal inference. 2

Antibiotic exposure during ICI therapy associates with worse NSCLC survival in pooled observational data.

Meta-analysis of 41 studies (54,250 patients) found antibiotic exposure associated with worse OS (HR 1.47) and PFS (HR 1.32), with high heterogeneity. Objective response rate was not significantly different, and RCT post-hoc estimates were non-significant. Heterogeneity and bias analyses indicate observational design and line of therapy explain most effects, suggesting confounding by indication. The strongest evidence does not establish a uniform antibiotic–ICI pharmacologic interaction; context-specific effects remain possible. 3