Surgical Oncology

Documented actionable genomic alterations associate with higher mortality in real-world gallbladder cancer

In a large TriNetX real-world cohort, patients with documented actionable genomic alterations (AGAs) had higher mortality after 1:1 propensity matching. Model 1 showed median OS 684 days with documented AGAs versus 948 days without (HR 1.23, p = 0.006). Stage- and treatment-matched Model 2 retained a higher absolute mortality (56.2% vs. 43.0%, absolute difference 13.2%). Authors highlight marked disparities in genomic documentation and recommend attention to testing access when interpreting prognosis. 1

WECARE digital platform is feasible after gastrectomy but did not change 6-month KOQUSS-40

In this multicenter randomized pilot (n=88), the WECARE platform achieved high adherence (86.7%) and 82% satisfaction. At 6 months, KOQUSS-40 scores did not differ significantly between WECARE and control (85.3 vs 83.8, p = 0.603). WECARE showed a numerically favorable recovery trajectory and a trend toward improved reflux symptoms (p = 0.0856). Authors conclude feasibility supports larger, longer trials to test clinical benefit beyond engagement metrics. 2

Network meta-analysis suggests perioperative taxane-triplet plus ICI may improve survival in resectable G/GEJ

Bayesian network meta-analysis of 30 RCTs (11,547 patients) ranked perioperative taxane-based triplet plus ICI highest for OS (SUCRA = 0.952) and DFS (SUCRA = 0.959). Compared with taxane-triplet alone, adding ICI showed a numerically favorable OS trend (HR 0.79) and a more consistent DFS benefit (HR 0.72; 95% CrI, 0.56–0.93). Toxicity estimates did not show new high-grade safety signals, but heterogeneity and sparse direct comparisons limit confidence. Authors emphasize potential benefit of intensification but caution that indirect evidence is not definitive for practice change. 3