Latest Surgical Oncology research

Top 10 this week

Week of 1 November 2026

1. 1

   Neoadjuvant short-course radiotherapy followed by camrelizumab and chemotherapy versus standard of care for locally advanced rectal cancer (UNION): a prespecified interim analysis of a multicentre, open-label, randomised, phase 3 trial

   The Lancet. Oncology · Q1 journal · RCT · Evidence level 1 (High) · 25 October 2026

   In a randomized trial of 231 patients in China, short-course radiation followed by camrelizumab and chemotherapy produced 91% 3-year event-free survival, compared with 77% with standard chemoradiotherapy and chemotherapy. Serious side effects were similar overall, but this prespecified interim analysis needs longer follow-up, and the regimen still needs comparison with current total neoadjuvant therapy strategies.

2. 2

   Durvalumab, Tremelimumab, and Enfortumab Vedotin in Muscle-Invasive Bladder Cancer

   The New England journal of medicine · Q1 journal · RCT · Evidence level 1 (High) · 24 October 2026

   In a phase 3 trial of patients unable or unwilling to receive cisplatin, perioperative durvalumab plus enfortumab vedotin increased 2-year event-free survival to 63.5%, versus 45.1% with surgery alone, and also improved overall survival. Adding tremelimumab also improved event-free survival versus surgery, but the regimens were not compared directly; severe adverse events were common, especially with tremelimumab.

3. 3

   Neoadjuvant Therapy in Patients with Upper Tract Urothelial Cancer: An Updated Systematic Review and Meta-analysis

   European urology oncology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 October 2026

   In a meta-analysis of 2,384 patients, neoadjuvant chemotherapy before surgery was associated with a 44% lower risk of death overall than surgery alone; 11% had no cancer found in the surgical specimen. Most evidence came from retrospective studies, so randomized trials are needed to determine whether chemotherapy itself drives the survival difference.

4. 4

   Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases : An Individual Participant Data Meta-analysis of Four Randomized Clinical Trials

   Annals of internal medicine · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 27 October 2026

   In pooled data from four randomized trials involving 761 patients with colorectal cancer liver metastases, complications occurred in 19% after laparoscopic resection versus 27% after open surgery. Overall and disease-free survival were similar after a median 93 months; among patients who received chemotherapy before surgery, complication rates were also similar.

5. 5

   Smoke-Free Home Intervention in Permanent Supportive Housing: A Cluster Randomized Clinical Trial

   JAMA network open · Q1 journal · RCT · Evidence level 1 (High) · 1 September 2026

   In 40 supportive-housing sites, brief personal coaching helped 6.3% of smokers achieve a verified 7-day quit at six months, compared with 1% in controls, while only 6.8% versus 4.8% maintained a smoke-free home for 90 days. The intervention markedly increased any attempt at a smoke-free home (63% vs 37%) but did not significantly boost sustained home bans, suggesting more intensive strategies are needed.

6. 6

   Minimally Invasive Versus Open CRS/HIPEC for Peritoneal Surface Malignancies: Postoperative Recovery and Long-Term Outcomes-A Systematic Review and Meta-Analysis

   Cancers · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 14 October 2026

   In 21 studies involving 1,184 patients, minimally invasive surgery with heated chemotherapy was linked to less blood loss, fewer transfusions and complications, and faster recovery than open surgery. Overall and cancer-free survival did not differ significantly, but most studies were retrospective and the findings support this approach only for appropriately selected patients treated by experienced teams.

7. 7

   Local ablative therapy plus systemic treatment versus systemic therapy alone in oligometastatic non-small cell lung cancer: a systematic review and meta-analysis of randomized trials

   International journal of clinical oncology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 28 October 2026

   A meta-analysis of 16 randomized trials involving 1,343 patients found that adding local ablative treatment lowered the hazards of progression or death by 37% and death by 32%. Benefits varied by treatment and patient subgroup, while severe side effects and pneumonitis increased; which patients gain enough to justify added treatment remains key.

8. 8

   The Effectiveness of Prehabilitation on Surgical Outcomes in Pancreatic Surgery: A Systematic Review and Meta-Analysis

   World journal of surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 October 2026

   Across 12 studies involving 1,841 patients, prehabilitation was associated with 15% fewer overall complications and 23% fewer delayed gastric emptying events after pancreatic surgery. It did not significantly change hospital stay, major complications, deaths, readmissions or pancreatic fistula; most evidence was observational, and only two small randomized trials included 128 patients, so larger trials are needed to confirm the benefits.

9. 9

   DESTINY-Lung06: trastuzumab deruxtecan and pembrolizumab as first-line treatment for HER2-overexpressing, PD-L1 TPS <50% NSCLC

   Future oncology (London, England) · Q1 journal · RCT · Evidence level 1 (High) · 2 September 2026

   The DESTINY-Lung06 trial will randomize about 686 adults with non-small cell lung cancer that overexpresses HER2 (at least 25% staining) and has PD-L1 tumor proportion scores below 50% to receive either trastuzumab deruxtecan plus pembrolizumab or pembrolizumab with pemetrexed and platinum chemotherapy. The primary goal is to see if the antibody-drug conjugate improves progression-free survival, with overall survival as a key secondary endpoint.

10. 10

    Cost-effectiveness Analysis of Robotic Versus Open Pancreatoduodenectomy (DIPLOMA-2): A Multicenter International Randomized Trial

    Annals of surgery · Q1 journal · RCT · Evidence level 1 (High) · 14 August 2026

    RCT comparing robotic vs open pancreatoduodenectomy for cancer

Paper of the day, last two weeks

• Primary Endocrine Therapy vs Upfront Surgery for Older Women With Estrogen Receptor-Positive Breast Cancer: A Systematic Review and Meta-Analysis

  JAMA network open · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 2 November 2026

  In a review of 29 studies involving 22,821 patients, randomized trials found no statistically significant overall survival difference between primary endocrine therapy and upfront surgery, although results leaned toward surgery. Disease control on endocrine therapy lasted longer in studies selecting patients by tumor biology, suggesting that biology and frailty - not age alone - should guide who might be a candidate.

• Robotic versus laparoscopic gastrectomy for gastric cancer: 5-year long-term results from a randomized controlled trial

  Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · Q1 journal · RCT · Evidence level 1 (High) · 4 November 2026

  In this randomized trial, 5-year relapse-free survival was 69% after laparoscopic surgery and 75% after robotic surgery; overall survival was 71% and 79%, respectively, with neither difference statistically significant. Subgroup analyses favored robotic surgery in men and after distal gastrectomy, but whether those signals represent a real benefit remains uncertain.

• Neoadjuvant botensilimab with or without balstilimab in pMMR and dMMR colon cancer: the phase 2 UNICORN trial

  Nature medicine · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 2 November 2026

  In this phase 2 trial, the preoperative drug combination produced major pathological responses in 36% of patients with proficient mismatch repair (pMMR) tumors and all 14 patients with deficient mismatch repair (dMMR) tumors; botensilimab alone produced no such responses in pMMR cancer. The cohorts were small and enrolled sequentially, so larger studies are needed to confirm the results and clarify who benefits.

• Estimating the clinical benefit of metastases resection in liver-limited metastatic colorectal cancer: an IPD-based pooled analysis of nine randomized trials

  ESMO open · Q1 journal · RCT · Evidence level 1 (High) · 2 November 2026

  In a pooled analysis of 855 patients with liver-limited metastatic colorectal cancer, those who underwent liver resection spent only 26% of their follow-up on systemic therapy versus 47% for unresected patients, regardless of disease-free interval. Surgery also showed a trend toward longer overall survival in patients with high baseline tumor burden, suggesting a selective benefit.

• Recurrence and surveillance intensity after prophylactic central neck dissection for papillary thyroid carcinoma: Long-term follow-up of a randomized trial

  Surgery · Q1 journal · RCT · Evidence level 1 (High) · 2 September 2026

  In a randomized trial of 57 patients followed for a median of 6.4 years, neither group had a recurrence requiring reintervention; Bayesian estimates suggested low recurrence risk with or without preventive central neck dissection. The added procedure was linked to 21% more surveillance, without meaningfully reducing recurrence or follow-up needs, though the small trial leaves uncertainty about long-term risk.

• International multicenter validation of an 18F-fluorodeoxyglucose positron emission tomography/computed tomography maximum standardized uptake value 4.0 threshold to guide surgical selection in pancreatic ductal adenocarcinoma following neoadjuvant therapy

  Surgery · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 3 August 2026

  In 923 patients who had surgery after preoperative treatment for pancreatic cancer, PET uptake of at least 4 combined with an elevated CA 19-9 level identified a subgroup in which 32% had recurrence within six months. The threshold also tracked with worse survival in an independent cohort, but the combination missed many early recurrences, so its role in guiding surgery remains to be established.

• Extent of Lymph Node Examination in Older Adults with Gastric Adenocarcinoma: Is There a Trade-off Between Survival and Short-Term Outcomes? : Benefit of Lymph Node Yield in Older Adults with Gastric Cancer

  Annals of surgical oncology · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 26 October 2026

  In a database study of 47,342 patients, examining at least 35 lymph nodes was associated with better overall survival than examining fewer than 16, including among adults aged 75 and older. Greater node counts were not linked to worse short-term outcomes such as 30-day death or readmission. Because this was observational, it cannot show that more extensive examination caused the survival benefit.

• Reappraising Liver Transplantation for Combined Hepatocellular-cholangiocarcinoma

  Annals of surgery · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 30 October 2026

  In a prospective database study, 79 transplant recipients had 89.9% overall survival at five years, compared with 65.6% among 32 patients who had resection; recurrence-free survival was also higher after transplant. Outcomes for selected patients meeting UCSF criteria resembled those for liver cancer patients with hepatocellular carcinoma, but tumor invasion into major vessels and poor differentiation predicted recurrence.

• An International Randomized Prospective Trial Comparing a Supine MRI-based Guidance System, The Breast Cancer LocatorTM, to Wire Localization for Breast-Conserving Surgery for Non-palpable Breast Cancer

  Annals of surgical oncology · Q1 journal · RCT · Evidence level 1 (High) · 22 October 2026

  In 418 patients having breast-conserving surgery, the MRI-based Breast Cancer Locator group had positive margins in 14.4%, versus 21.1% with wire localization, and fewer patients needed re-excision. The system met the trial's noninferiority test, but the primary analysis did not establish superiority; a prespecified analysis by tumor type did find fewer positive margins, warranting further scrutiny.

Evidence summaries in Surgical Oncology

• Gastric Cancer Surgical Management
• Esophageal Cancer Surgical Management