30-Second Takeaway
- Minimally invasive RAMPS provides comparable oncologic and short-term outcomes to open surgery for left-sided PDAC in experienced centers.
- Adjuvant chemotherapy benefits T1bN0 but not clearly T1aN0 triple-negative breast cancers, with high survival even without treatment.
- Common prognostic scores after colorectal liver metastasectomy show only modest discrimination and should not alone drive resection decisions.
- At least 18 weeks of perioperative chemotherapy improves outcomes in TNT-treated locally advanced rectal cancer and should not be routinely shortened.
- Margin-negative resection remains crucial in ampullary carcinoma, with R1 independently worsening recurrence-free survival.
Week ending February 28, 2026
Concise updates in surgical oncology: pancreas, breast, colorectal liver, rectal, ovarian, and ampullary cancers
Minimally invasive RAMPS provides oncologic results comparable to open RAMPS
This three-center cohort included 57 RAMPS patients, 34 with PDAC, operated between 2016 and 2023. For PDAC, minimally invasive and open RAMPS achieved similar R0 rates (92.9% vs 85%) and comparable lymph node yields. Two-year overall survival did not differ between minimally invasive and open approaches, indicating oncologic equivalence. Ninety-day complications, including CR-POPF and major morbidity, were similar, with nonsignificant trends toward shorter stay and more adjuvant therapy after minimally invasive RAMPS.
Chemotherapy mainly benefits T1bN0 triple-negative breast cancer
This meta-analysis pooled 18 non-randomized studies including 16,933 patients with T1a-bN0 triple-negative breast cancer. Adjuvant chemotherapy improved overall survival versus no chemotherapy (HR 0.63, 95% CI 0.43–0.92). The benefit was concentrated in T1bN0 tumors (HR 0.51, 95% CI 0.34–0.76), with no OS advantage for T1aN0 disease. Five-year overall and distant recurrence-free survival exceeded 92% without chemotherapy, supporting omission in many T1aN0 patients.
Most colorectal liver metastasis prognostic scores have limited discriminatory power
This systematic review evaluated 48 prognostic scores across 48 external-validation studies including 33,602 patients after colorectal liver metastasectomy. For overall survival, pooled C-indices were low for Fong (0.578), GAME (0.609), and RAS mutation scores (0.579). For recurrence-free survival, the Fong score showed only modest discrimination (C-index 0.616). Scores integrating genetic, immunologic, radiomic, or perioperative variables outperformed purely clinical and preoperative models but remained ≤0.671. The authors conclude current scores offer limited reliability for individual prognosis and should not determine resection candidacy alone.
At least 18 weeks of chemotherapy improves TNT outcomes in rectal cancer
This post hoc STELLAR analysis included 539 locally advanced rectal cancer patients with documented chemotherapy duration and median follow-up of 68 months. Patients receiving ≥18 weeks of chemotherapy had the highest 5-year overall survival (82.1%) and disease-free survival (66.0%). Compared with no or 3–12 weeks of chemotherapy, ≥18 weeks significantly improved overall survival and improved disease-free survival versus no chemotherapy. In the TNT cohort, ≥18 weeks improved overall and disease-free survival versus 3–12 weeks, supporting adequate total chemotherapy duration.
References
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Additional Reads
Optional additional studies from this edition.