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Topic Review
Status and Clinical Significance of Lymph Node Dissection
Despite its decreasing incidence, gastric cancer remains an important global healthcare problem due to its overall high prevalence and high mortality rate. Since the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) and Fédération Nationale des Centres de Lutte contre le Cancer (FNLCC)/ Fédération Francophone de Cancérologie Digestive (FFCD) trials, the neoadjuvant chemotherapy has been recommended throughout Europe in gastric cancer. Potential benefits of preoperative treatments include a higher rate of R0 resection achieved by downstaging the primary tumor, a likely effect on micrometastases and isolated tumor cells in the lymph nodes, and, as a result, improved cancer-related survival. Nevertheless, distortion of anatomical planes of dissection, interstitial fibrosis, and sclerotic tissue changes may increase surgical difficulty. The collection of at least twenty-five lymph nodes after neoadjuvant therapy would seem to ensure removal of undetectable node metastasis and reduce the likelihood of locoregional recurrence. 
  • 276
  • 15 Jun 2023
Topic Review
Tumor Vascular Involvement and Surgical Planning
Retroperitoneal sarcomas (RPSs) are locally aggressive tumors that can compromise major vessels of the retroperitoneum including the inferior vena cava, aorta, or main tributary vessels. Vascular involvement can be secondary to the tumor’s infiltrating growth pattern or primary vascular origin. 
  • 268
  • 06 Apr 2023
Topic Review
Innovative Strategies in Microvascular Head and Neck Reconstruction
The field of reconstructive microsurgery has witnessed considerable advancements over the years, driven by improvements in technology, imaging, surgical instruments, increased understanding of perforator anatomy, and experience with microsurgery. However, within the subset of microvascular head and neck reconstruction, novel strategies are needed to improve and optimize both patient aesthetics and post-operative function. Given the disfiguring defects that are encountered following trauma or oncologic resections, the reconstructive microsurgeon must always aim to innovate new approaches, reject historic premises, and challenge established paradigms to further achieve improvement in both aesthetic and functional outcomes. 
  • 264
  • 24 Aug 2023
Topic Review
Innovations in Breast Cancer Care
Breast cancer care has seen tremendous advancements through various innovations to improve early detection, diagnosis, treatment, and survival. These innovations include advancements in imaging techniques, minimally invasive surgical techniques, targeted therapies and personalized medicine, radiation therapy, and multidisciplinary care.
  • 262
  • 07 Jun 2023
Topic Review
Anti-Angiogenic Agents in Thymic Epithelial Tumor Treatment
Thymomas and thymic carcinomas are included in the rare group of cancers of the anterior mediastinum known as thymic epithelial tumors (TET). Their origin is the thymus’ epithelial cells. Anti-angiogenics have shown their potential efficacy in many solid tumors; however, their place in the treatment of thymic epithelial tumors (TET) comprising thymoma and thymic carcinoma (TC) is less clear. Angiogenesis significantly influences TET carcinogenesis. Both thymomas and TC overexpress VEGF-A and VEGFR-1 and -2.
  • 262
  • 15 Dec 2023
Topic Review
Classifications and Treatments for Gliomas
Gliomas pose a significant challenge to neurosurgical oncology because of their diverse histopathological features, genetic heterogeneity, and clinical manifestations. Despite significant advances in understanding the molecular pathways of glioma, translating this knowledge into effective long-term solutions remains a challenge. 
  • 259
  • 29 Dec 2023
Topic Review
Surgical Management of Retroperitoneal Sarcoma
Surgery is the cornerstone of treatment for retroperitoneal sarcoma (RPS). Surgery should be performed by a surgical oncologist with sub-specialization in this disease and in the context of a multidisciplinary team of sarcoma specialists. For primary RPS, the goal of surgery is to achieve the complete en bloc resection of the tumor along with involved organs and structures to maximize the clearance of the disease. The extent of resection also needs to consider the risk of complications.
  • 258
  • 05 Jun 2023
Topic Review
Connectome-Based Neurosurgery in Primary Intra-Axial Neoplasms
Despite the therapeutical advancements in the surgical treatment of primary intra-axial neoplasms, which determined both a significative improvement in overall survival (OS) and QoL and a reduction in the incidence of surgery-induced major neurological deficits, nowadays patients continue to manifest subtle post-operative neurocognitive impairments, preventing them from a full reintegration back into social life and into the workforce. The birth of connectomics paved the way for a profound reappraisal of the traditional conception of brain architecture, in favour of a model based on large-scale structural and functional interactions of a complex mosaic of cortical areas organized in a fluid network interconnected by subcortical bundles.
  • 256
  • 23 Feb 2024
Topic Review
Preparing for and Not Waiting for Surgery
Cancer surgery is an essential treatment strategy but can disrupt patients’ physical and psychological health. Perioperative medicine is a growing speciality that aims to improve clinical outcome by preparing patients for the stress associated with surgery. Preparation should begin at contemplation of surgery, with universal screening for established risk factors, physical fitness, nutritional status, psychological health, and, where applicable, frailty and cognitive function. 
  • 253
  • 23 Feb 2024
Topic Review
Applications of Advancing Prone-Transpsoas Spine Surgery
The Prone Transpsoas (PTP) approach to lumbar spine surgery, emerging as an evolution of lateral lumbar interbody fusion (LLIF), offers significant advantages over traditional methods. PTP has demonstrated increased lumbar lordosis gains compared to LLIF, owing to the natural increase in lordosis afforded by prone positioning. Additionally, the prone position offers anatomical advantages, with shifts in the psoas muscle and lumbar plexus, reducing the likelihood of postoperative femoral plexopathy and moving critical peritoneal contents away from the approach. Furthermore, operative efficiency is a notable benefit of PTP. 
  • 253
  • 26 Feb 2024
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