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Grand RoundsWeekly Evidence Brief

Surgical Oncology

Edition

30-Second Takeaway

  • For presumed early-stage endometrioid ovarian carcinoma, omission of lymph node sampling is reasonable for pelvic-confined, grade 1 tumors.
  • Perioperative blood transfusion in colorectal cancer associates with worse long-term survival, especially when >4 units.
  • Patient-directed education via community health workers increases precision-medicine uptake and reduces acute care use in underserved oncology populations.

Week ending May 9, 2026

Grand Rounds: Selected surgical oncology evidence briefs

LEOPARD: low nodal metastasis in early-stage endometrioid ovarian carcinoma supports selective lymph node sampling

GYNECOLOGIC ONCOLOGYMay 7, 2026

Large multinational cohort of 721 centrally reviewed ENOC cases found nodal metastases in 2.6% of presumed early-stage cases. No nodal metastases occurred in pelvic-confined, grade 1 tumors (0/171), supporting omission of LNS in this subgroup. When LNS was performed, systematic lymph node sampling detected more metastases than sampling alone (5.3% vs 1.6%). Grade, stage, and receipt of adjuvant chemotherapy independently predicted prognosis, suggesting tailored, type-specific management.

Chinese qualitative study: seven themes shape cancer trial participation decisions

JOURNAL OF MEDICAL INTERNET RESEARCHMay 5, 2026

Multistage qualitative analysis of 11 interviews and 219 screened online comments identified seven core themes affecting trial willingness. Key drivers included treatment expectations, financial burden, uncertain efficacy, control-group concerns, limited knowledge, misconceptions, and physician trust. LLM-assisted analyses aligned with investigator-led findings and highlighted regional and family-involved decision factors. Findings support patient-centered, culturally tailored recruitment and clearer communication about risks, benefits, and costs.

Perioperative transfusion independently associates with worse survival after colorectal cancer resection

CANCERSMay 4, 2026

Retrospective cohort of 1777 CRC resections found 41.0% received perioperative blood transfusion; after propensity matching, transfusion linked to poorer OS (HR 1.44). Massive-volume transfusion (>4 units) carried the worst prognosis and independent risk (HR 1.61). No independent survival association was seen with preoperative inflammatory markers or transfusion timing/type in supplementary analyses. Authors recommend restrictive transfusion strategies but acknowledge observational design cannot prove causality.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • In ENOC grade 1 pelvic-confined cases, discuss omitting LNS to avoid morbidity but consider systematic LNS if sampling is performed.
  • Limit perioperative transfusions and apply restrictive strategies; treat the association as observational, not proven causative.
  • Implement patient-level education when aiming to improve molecular testing and targeted therapy uptake in underserved clinics.