Three-year relapse-free survival was possibly better in severe obese patients (BMI ≥28.5 kg/m²) who underwent laparoscopic surgery for colon cancer. It suggests that the prognosis of highly obese colorectal cancer patients follow the obesity paradox.

This is the second installment in the series, “The Interview with the World-Class Authorities.” We are honored to welcome Prof. Luis Diaz, the Director of the Division of Solid Tumor Oncology at Memorial Sloan Kettering Cancer Center and Editor-in-Chief of Cancer Discovery. Prof. Diaz's illustrious career has been distinguished by groundbreaking contributions to cancer genomics, immunotherapy, and liquid biopsy technologies. His landmark research on PD-1 blockade in mismatch repair-deficient cancers has revolutionized the treatment paradigm for gastrointestinal and other solid tumors. Among his many accolades are the AACR Waun Ki Hong Award and recognition as a Clarivate Highly Cited Researcher. Prof. Diaz's remarkable achievements and unwavering idealism continue to inspire not only young surgical scientists but also aspiring clinical surgeons.

This is a systematic review and meta-analysis of the efficacy of wound coverage using advanced dressings specifically for the prevention of surgical site infections (SSI) in gastrointestinal surgery. We found that the use of advanced dressings for primary wounds in gastrointestinal surgery was associated with a significantly lower risk of SSI than that associated with standard dressings.

This review explores the role of radiotherapy (RT) in the multidisciplinary treatment of pancreatic ductal adenocarcinoma (PDAC), focusing on its integration with surgical strategies to improve resectability, local control, and survival outcomes while addressing potential challenges and future research directions.

In an analysis of two RCTs of IRI-based second-line chemotherapy for AGC, patients with prior gastrectomy had better OS and PFS than patients without prior gastrectomy. Furthermore, patients with prior gastrectomy had a better prognosis in OS and PFS adjusted for background factors as well.

The MTG group had a significantly lower incidence of severe postoperative complications than the OTG group. Moreover, the incidences of pancreatic fistula and intra-abdominal abscess were also significantly lower in the MTG than in the OTG group. Additionally, the median hospital stay for the MTG group was significantly shorter than that of the OTG group.

This study examined changes in surgical volume and short-term outcomes for upper gastrointestinal cancer in the post-COVID-19 period using a nationwide Japanese database. We found that surgical treatments for gastrectomy and esophagectomy continued to be performed safely even after the COVID-19 pandemic.

This study found that the risk factors for postoperative pneumonia after endoscopic laryngopharyngeal surgery for superficial laryngopharyngeal cancer were multiple lesions and larger lesion diameter. Prior esophagectomy for esophageal cancer did not increase the incidence of pneumonia, suggesting the procedure can be safely performed with careful monitoring.

The in-hospital mortality rate for perforated peptic ulcer in this study was 5.0%, and conservative treatment was safely performed even in elderly patients. As the perforation diameter increased, the rate of gastrectomy tended to rise, and the rate of anastomotic leakage in those patients was high.

In rectal cancer surgery, this study examined the risk factors for urinary dysfunction and the effect of autonomic nervous system resection extent on urinary dysfunction. Autonomic nervous system resection and lateral lymph node dissection were independent risk factors for urinary dysfunction. The extent of autonomic nervous system resection was associated with increased urinary dysfunction.

Our study examined the characteristics of elderly patients diagnosed with ulcerative colitis-associated colorectal cancer. We showed that factors associated with aggressive tumor characteristics played a significant role in recurrence risk in the nonelderly patients, but not in the elderly patients.

This study aimed to investigate the relationship between the three timepoint perioperative CEA (ttpCEA) calculated at three timepoints and recurrence during the perioperative period in Stage II and III colorectal cancer (CRC) patients. A total of 538 patients were included for the training data and 329 patients for validation data, and 5-y time-to-recurrence was significantly greater in the ttpCEA-low subgroup than in the ttpCEA-high subgroup in both data. Perioperative CEA levels at different timepoints was a prognostic factor for recurrence in Stage II and III CRC patients.

In 2022, emergency cases with difficulties in transport markedly increased during the COVID-19 pandemic, but had little effect on short-term outcomes of colorectal perforation. These data suggest that the emergency system for patients with colorectal perforation was largely maintained during the pandemic in Japan, with no evidence indicating a serious breakdown of the system.

This study examined the effects of skeletal muscle mass on the short- and long-term outcomes of rectal cancer. This study revealed that preoperative sarcopenia was associated with more total postoperative complications, more anastomotic leakage, and worse survival in rectal cancer patients.

The body component score (BCS) consists of three key elements: skeletal muscle, bodily fat, and ectopic fat. BCS can comprehensively represent the states of body composition and predict the long-term survival of resectable colorectal cancer following radical resection.

CT of 141 patients with small bowel strangulation (SBS) was reviewed. Mesenteric edema and abnormal bowel wall thickening are prevalent in both non-necrotic and necrotic SBS, indicating the primary pathology of SBS. While bowel hypo-enhancement was detected in 76% of patients with necrotic SBS, it appeared in only 51% of those with non-necrotic SBS.

Our study validates the need for a more detailed and accurate tumor location scoring system within the IWATE criteria. The proposed classification based on subsegmental Glisson branches provides a sophisticated tool for assessing LLR difficulty. By providing a more detailed assessment, this new system has the potential to enhance surgical planning, optimize patient selection, achieve safer learning curves and improve intra- and postoperative outcomes.

The calibration plots of the updated risk models for the endpoints were analyzed in each cohort. The predicted probability of each endpoint matched the observed probability in the development and validation cohorts.

This study showed that estimated BL (e-BL) was significantly greater than intraoperative BL(i-BL) in cases of laparoscopic distal pancreatectomy (LDP), and that e-BL was significantly less than i-BL in cases of open DP (ODP), only among patients with pancreatic cancer. These results suggest the possibility of incorrect evaluation of intraoperative blood loss during DP, not only in patients who undergo LDP but also in those who undergo ODP.

The hepatospleno volume ratio and prealbumin levels 3 mo after major hepatectomy for perihilar cholangiocarcinoma are significant predictors of postoperative chronic liver failure (PCLF). The importance of this finding is that it emphasizes the need for targeted postoperative nutritional support and regular screening endoscopy to mitigate the risk of PCLF in vulnerable patients.

A multivariable logistic regression model was performed using covariates that were significant in the bivariable analyses, including bile duct cancer, longer operative times, and greater blood loss. Prefrail or frail status combined with sarcopenia remained significant in this model (OR 4.74; 95% CI, 1.10–20.29; p = 0.04).

The study aim was to clarify how nutrition was managed in patients based on surgical site during the first 7 d after gastrointestinal cancer surgery. As results, oral intake after gastrointestinal cancer surgery started earliest in patients having liver surgery and latest in patients having esophageal surgery. Substantially less than half of fasting patients were prescribed target parenteral energy and amino acid doses.

Despite the challenges posed by the coronavirus disease 2019 pandemic, the provision of safe surgical treatment for rectal cancer was maintained across all hospital volume groups. However, the disparity in short-term outcomes among hospitals was suggested in the present study.

Mortality and anastomotic leakage, two very important complications assessed in SMR, did not worsen during the pandemic compared to prepandemic levels. In Japan, laparoscopic surgery was safe and unaffected by the COVID-19 pandemic even in 2022, when the epidemic spread.