Latest Surgical Oncology research

Top 10 this week

Week of 20 September 2026

1. 1

   Sentinel lymph node biopsy in melanoma: Redundant in the neoadjuvant era

   European journal of cancer (Oxford, England : 1990) · Q1 journal · RCT · Evidence level 1 (High) · 10 September 2026

   A decision-analysis using trial data showed that patients who forgo sentinel lymph node biopsy and receive neoadjuvant anti-PD-1 plus anti-CTLA-4 therapy at nodal recurrence achieve an 8 to 19 percentage-point gain in distant metastasis-free survival compared with the traditional biopsy-then-adjuvant-immunotherapy pathway. The benefit varies with tumor thickness, prompting calls for a randomized trial to confirm whether SLNB can be safely omitted in modern melanoma care.

2. 2

   Prognostic impact of diabetes or hypertension in smokers with CRPC receiving enzalutamide or abiraterone

   International journal of clinical oncology · Q1 journal · RCT · Evidence level 1 (High) · 19 September 2026

   In a retrospective analysis of 161 castration-resistant prostate cancer patients who smoked, those with diabetes or hypertension had significantly poorer prostate-cancer specific survival than those without these conditions, an effect seen only with enzalutamide and not abiraterone. Smoking status alone did not affect outcomes, highlighting the need to manage metabolic disease in this subgroup.

3. 3

   Eplontersen with and without background transthyretin stabilizers in transthyretin amyloid cardiomyopathy: secondary analysis of a phase 3, randomized controlled trial

   Nature medicine · Q1 journal · RCT · Evidence level 1 (High) · 30 August 2026

   In the CARDIO-TTRansform trial, eplontersen lowered the combined risk of cardiovascular death and repeat events by 29% among patients who were not taking a TTR stabilizer at baseline, while showing no benefit for those already on stabilizers. Safety was comparable across groups, suggesting the drug's advantage may be limited to stabilizer-naïve patients.

4. 4

   Efficacy and safety of tiotropium in partial and uncontrolled preschool asthma (TIPP): a phase III, multicentre, randomised, double-blind, placebo-controlled trial

   EClinicalMedicine · Q1 journal · RCT · Evidence level 1 (High) · 4 September 2026

   In a 52-week trial of 86 children aged 1-5 years with high-risk asthma, adding tiotropium to inhaled steroids did not change the time to first severe exacerbation compared with placebo. Adverse events were common but similar between groups, and no new safety concerns emerged, suggesting tiotropium is safe but not effective for this age group.

5. 5

   Transfection of Hypoxia-Inducible Factor-1α in Wound Healing: A Systematic Review

   The Journal of surgical research · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 17 September 2026

   In seven pre-clinical studies, local application of HIF-1α increased angiogenesis-related gene expression two- to three-fold, boosted circulating angiogenic cells ten-fold, and reduced wound size compared with controls. Treated wounds showed more mature vessels and less necrosis, but the evidence is limited to normal and diabetic mouse models, so human safety and efficacy remain untested.

6. 6

   Quality of Outcome Reporting for Older Subgroups in FDA Registration Gastroesophageal Cancer Trials (2010-2024): A Systematic Review

   Cancers · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 24 August 2026

   Among 13 FDA-approved trials enrolling 9,320 patients (40% aged 65+), just two studies provided complete baseline characteristics and toxicity outcomes for the older subgroup. While overall survival and progression-free survival were often reported, detailed older-patient data remain sparse, underscoring a need for better trial design and reporting standards.

7. 7

   Chemotherapy Backbone and Outcomes of Immune Checkpoint Inhibitor Combinations Across Solid Tumors: A Pan-Tumor Network Meta-Analysis

   The oncologist · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 17 September 2026

   A network meta-analysis of 39 randomized trials (over 30,000 patients) found that adding immune checkpoint inhibitors to chemotherapy improved progression-free survival by roughly 30% and overall survival by about 20%, with the platinum-pemetrexed backbone delivering the largest survival gain (about a one-third reduction in death risk).

8. 8

   Short or Long Antibiotic Regimens in Orthopedics

   The New England journal of medicine · Q1 journal · RCT · Evidence level 1 (High) · 16 September 2026

   In 475 adults who received a local-antibiotic implant during surgery, definite treatment failure by 12 months occurred in 11% of those given up to 7 days of systemic antibiotics versus 14% of those given at least 4 weeks, meeting the pre-specified non-inferiority margin. Short-course patients also reported far fewer treatment-related symptoms (17% vs 45%). The finding supports limiting systemic therapy, though longer-term outcomes remain to be studied.

9. 9

   Integration of early palliative care in cancer treatment: a meta-analysis of 39 randomized controlled trials on clinical outcomes and management optimization

   Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 19 September 2026

   A meta-analysis of 39 randomized trials involving 8,400 cancer patients found that integrating palliative care within 12 weeks of diagnosis improves quality of life by a modest but consistent margin and is associated with a roughly 16% lower risk of death. The survival signal is exploratory and data from low- and middle-income settings remain limited, so broader applicability needs further study.

10. 10

    A Multicenter Randomized Phase III Trial Comparing MET Tyrosine Kinase Inhibitors vs. Immune Checkpoint Inhibitors With or Without Chemotherapy as First-Line Treatment for Patients With Advanced Non-Small Cell Lung Cancer Harboring MET Exon 14 Skipping Mutations: JCOG2506 (DECIDE-MET)

    Clinical lung cancer · Q1 journal · RCT · Evidence level 1 (High) · 20 August 2026

    An open-label, multicenter randomized study will enroll 100 treatment-naïve adults with advanced MET exon 14-skipping lung cancer, assigning them to either tepotinib or capmatinib versus pembrolizumab alone (PD-L1 at least 50%) or pembrolizumab plus chemotherapy (PD-L1 <50%). Overall survival is the primary endpoint, aiming to resolve which first-line strategy offers better efficacy and tolerability.

Paper of the day, last two weeks

• Association Between N1 Nodal Assessment, Upstaging, and Survival in Resected Non-Small Cell Lung Cancer

  The Annals of thoracic surgery · Q1 journal · Unclassified · Evidence level 5 (Expert Opinion) · 18 September 2026

  N1 nodal assessment linked to upstaging and survival

• Is Transanal Local Excision Oncologically Safe After Chemoradiotherapy? A Multicenter Phase II Study in ycT0-1 Rectal Cancer

  Cancer research and treatment · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 16 September 2026

  In a multicenter phase II trial of 80 rectal cancer patients downstaged to ycT0-1 after neoadjuvant chemoradiotherapy, full-thickness transanal excision achieved an 84.8% three-year disease-free survival, meeting the non-inferiority benchmark. Local recurrence was only 5% and serious postoperative complications occurred in 3.8%, supporting organ preservation in carefully selected responders, provided vigilant follow-up.

• Single-stapled versus double-stapled colorectal anastomosis after anterior resection: Systematic review and meta-analysis of short-term and functional outcomes

  Surgery · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 26 August 2026

  A meta-analysis of 13 studies involving 2,537 patients found no statistically significant difference in anastomotic leak, major complications, or stricture when comparing single-stapled with the standard double-stapled technique after anterior rectal resection. The single-stapled method appears safe but offers no clear clinical advantage, and larger trials are needed to confirm any benefit.

• The application value of Da Vinci linear powered stapler SureForm in robotic sphincter-preserving surgery for rectal cancer: a prospective randomized clinical trial

  Surgical endoscopy · Q1 journal · RCT · Evidence level 1 (High) · 15 September 2026

  In a randomized trial of 276 rectal cancer patients, using the da Vinci SureForm linear powered stapler lowered 30-day anastomotic leakage to 6.7% compared with 14.1% for conventional laparoscopic staplers, and severe leaks fell from 6.7% to 1.5%. The device also required fewer stapler cartridges, suggesting a safer, more efficient option, though longer-term outcomes remain to be studied.

• Comparative oncological efficacy of chemotherapy, cytoreductive surgery with or without HIPEC in recurrent ovarian cancer: A network meta-analysis

  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 11 September 2026

  A network meta-analysis of 1,831 patients showed that both secondary cytoreductive surgery alone and surgery plus HIPEC lengthened five-year progression-free survival by roughly one-quarter compared with chemotherapy, while overall survival was unchanged overall. Benefit appeared strongest in patients with complete tumor removal, and the survival advantage of adding HIPEC remains uncertain and based on indirect evidence.

• Short-term versus long-course neoadjuvant chemotherapy for resectable and borderline resectable pancreatic ductal adenocarcinoma (PACT-21 CASSANDRA): results from the second randomisation analysis of a randomised, open-label, 2 × 2 factorial phase 3 trial

  EClinicalMedicine · Q1 journal · RCT · Evidence level 1 (High) · 5 September 2026

  In the PACT-21/CASSANDRA trial, 86 patients receiving two extra months of chemotherapy before surgery and 79 receiving it after surgery had identical event-free survival (hazard ratio about 1). However, the longer regimen yielded higher CA19-9 response, a 5% complete pathological response rate and more N0 resections. Overall survival data are pending, underscoring the need for more effective neoadjuvant strategies.

• Actual Five-year Survival After Neoadjuvant Therapy and Resection for Localized Pancreatic Ductal Adenocarcinoma

  Annals of surgery · Q1 journal · Retrospective cohort · Evidence level 3 (Low) · 10 September 2026

  In a cohort of 660 patients treated at two high-volume centers, 34.5% were alive at five years post-resection, with most remaining disease-free. Recurrence was common (74%) and usually occurred within the first year, while patients who stayed recurrence-free for one or two years had 62% and 82% chances of five-year survival respectively. Early systemic failure drives outcomes, highlighting the need for better peri-operative control.

• Robot-assisted colectomy is associated with improved perioperative outcomes and favorable survival in stage I-III colon cancer: a nationwide overlap-weighted analysis

  Surgical endoscopy · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 10 September 2026

  In a nationwide analysis of over 34,000 stage I-III colon cancer patients, the robot-assisted approach had the lowest complication and mortality rates and yielded a 95% three-year overall survival, compared with 90% for open surgery. The findings suggest both short-term and survival advantages, but longer prospective data are still needed.

• Prognostic impact of low versus high inferior mesenteric artery ligation in rectosigmoid cancer: individual patient data meta-analysis of randomized trials

  BJS open · Q1 journal · SR/MA of RCTs · Evidence level 1 (High) · 4 September 2026

  In a pooled analysis of 1,152 patients from five randomized trials, low ligation of the inferior mesenteric artery produced a 1.4-month longer overall survival and a 0.7-month longer disease-free survival at five years compared with high ligation, but the differences were not statistically significant. Complication rates, lymph-node yield, and operative time were similar, indicating no clear advantage to either technique.

• Minimally invasive surgery without a uterine manipulator versus open radical hysterectomy for early-stage cervical cancer: A retrospective propensity-score-matched single-center cohort study

  Gynecologic oncology · Q1 journal · Prospective cohort · Evidence level 2 (Moderate) · 8 September 2026

  In a propensity-matched cohort of 539 early-stage cervical cancer patients per group, recurrence and death rates were similar, showing no significant difference in disease-free or overall survival between manipulator-free minimally invasive and open radical hysterectomy. MIS offered less blood loss, fewer transfusions and a day shorter hospital stay, but shorter follow-up limits conclusions about long-term equivalence.

• Conversion hepatectomy for unresectable hepatocellular carcinoma: Principles of patient selection and surgical decision-making

  Bioscience trends · Q1 journal · Non-randomized trial · Evidence level 2 (Moderate) · 10 September 2026

  In the TALENTOP phase 3 trial, patients with unresectable hepatocellular carcinoma who achieved an R0 resection after induction therapy experienced a favorable overall-survival signal compared with continued medical treatment, although the data are still immature. The authors propose a 5-D framework to identify which responders truly merit conversion hepatectomy, emphasizing tumor biology, depth and durability of response, complete clearance, liver reserve, and timing.

• Perioperative durvalumab plus fluorouracil, leucovorin, oxaliplatin, and docetaxel for resectable gastric and gastro-oesophageal junction adenocarcinoma (MATTERHORN): final results of overall survival and event-free survival by pathological response in a global, randomised, double-blind, placebo-controlled, multicentre, phase 3 trial

  Lancet (London, England) · Q1 journal · RCT · Evidence level 1 (High) · 9 September 2026

  In a phase 3 trial of 948 patients with resectable gastric or gastro-oesophageal junction adenocarcinoma, adding durvalumab to standard perioperative FLOT chemotherapy lowered the hazard of death by roughly one-fifth compared with FLOT alone. The benefit came with a low rate of treatment-related deaths, supporting durvalumab-FLOT as a new standard, though longer follow-up will clarify durability.

• Comparing Minimally-Invasive and Open Approaches to Siewert II/III Gastro-Esophageal Junction Adenocarcinoma-A Systematic Review and Network Meta-Analysis

  World journal of surgery · Q1 journal · SR of cohorts · Evidence level 2 (Moderate) · 6 September 2026

  In a meta-analysis of 16 studies involving 4,256 patients with Siewert II/III gastro-esophageal junction adenocarcinoma, robotic surgery showed overall survival at 3 and 5 years comparable to both laparoscopic and open approaches, with no clear advantage in disease-free survival. The findings suggest minimally-invasive techniques are oncologically equivalent to traditional open resection, though definitive superiority remains unproven.

Evidence summaries in Surgical Oncology

• Gastric Cancer Surgical Management
• Esophageal Cancer Surgical Management