Tag: statistics

Indian J Surg Oncol. 2026 Jan;17(1):72-79. doi: 10.1007/s13193-025-02280-1. Epub 2025 Apr 15.

ABSTRACT

Total neoadjuvant therapy (TNT) involves incorporating systemic chemotherapy in the interval between radiation and TME surgery for locally advanced rectal cancers (LARC). Patients who achieve complete clinical response can be considered for organ preservation by opting for watch and wait strategy. The studies focusing on patient’s preferences for treatment are scarce. This is a cross-sectional study among patients with LARC and addresses their treatment preferences in correlation with psychological parameters. All LARC (mid or lower third) patients planned for multimodality treatment were included in the study. Patients were explained about standard treatment and non-operative management. They were then interviewed with questionnaires for the assessment of their preference. In our study, a total of 60 patients with LARC planned for neoadjuvant chemo radiation were included. Non-operative management (NOM) was preferred by about 35.0% of the subjects. NOM was preferred more by patients ≤ 65 years age group (66.7%), those with less education status (43%) (p = 0.024), and those from rural background (66.7%) (p = 0.011). Psychosocial factors like fear of progression (FOP) had statistically significant association (p = 0.001) with preference for NOM, while other factors like life orientation and locus of control failed to show significant association. Our study underlines the patient preferences and factors affecting the decision making and shows the importance of the concept of “shared decision-making” by discussing the treatment options, and its related side effects and outcomes to choose a treatment strategy.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13193-025-02280-1.

PMID:41641431 | PMC:PMC12864614 | DOI:10.1007/s13193-025-02280-1

Indian J Surg Oncol. 2026 Jan;17(1):49-53. doi: 10.1007/s13193-025-02290-z. Epub 2025 Apr 11.

ABSTRACT

The aim of this study was to compare oncological effectiveness, morbidity, and perioperative outcomes between minimally invasive surgical staging and open surgical staging for endometrial cancer. This is a retrospective analysis of endometrial cancer patients who were treated in surgical oncology department in our institute between January 2015 and November 2024 (n = 217). The oncological effectiveness and morbidity of the two groups were compared based on disease-free survival, mean operative time, blood loss, lymph node harvest, intraoperative complications, postoperative complications, duration of hospitalization, etc., and the results were analyzed. Statistical analysis was performed using IBMSPSS statistics version 25, and clinical and pathological factors were compared between two groups with Fisher’s exact test and Student’s t-test for data analysis. Survival analysis was done by Kaplan-Meier method with p ≤ 0.05 considered statistically significant. Out of 217 patients, 93 underwent open surgical staging, while 124 underwent minimally invasive surgical staging. Within the minimally invasive group, 86 patients had laparoscopic surgical staging, and 38 had robotic surgical staging. The mean operative time for the minimally invasive procedure was lower than the open procedure (115 vs 136 min, p = 0.009). Intraoperative blood loss of patients undergoing minimally invasive staging was significantly less than that of laparotomy group (60 vs 140 ml, p = 0.007). There was no statistically significant difference in nodal retrieval between the two groups (13 vs 15, p = 0.09). The mean duration of hospitalization was statistically significantly higher in the laparotomy group than the minimally invasive group (6 vs 4 days, p = 0.005). Kaplan-Meier survival curve showed that the DFS rate at 3 years was more in minimally invasive group compared to open surgical staging (95.2% vs 88.3%, p = 0.003). Minimally invasive surgical staging is oncologically safe for the management of endometrial cancer with better survival rate, less morbidity compared to the open surgical staging with less blood loss, and shorter postoperative stay.

PMID:41641430 | PMC:PMC12864635 | DOI:10.1007/s13193-025-02290-z

Indian J Surg Oncol. 2026 Jan;17(1):26-35. doi: 10.1007/s13193-025-02293-w. Epub 2025 Apr 7.

ABSTRACT

Chordomas are rare malignant tumors arising from notochord remnants, predominantly in the sacral region. Due to their size and location, achieving R0 resection is challenging, with larger tumors (> 50 mm or > 25 cc) linked to worse outcomes. This study examines the surgical management and outcomes of large sacral chordomas, focusing on tumor size, resection strategy, and postoperative results. This retrospective study reviewed 14 male patients with sacral chordomas ≥ 50 mm or ≥ 25 cc. Data on demographics, tumor characteristics, surgical approaches, complications, and survival were analyzed using descriptive statistics and Kaplan-Meier survival curves. The study analyzed 14 male patients (mean age: 63.1 years) with sacral chordoma. Tumor size averaged 98.4 mm, and preoperative embolization was performed in two cases. Total sacrectomy was required in 14.3%, with spinopelvic fixation in both. Negative margins were achieved in 92.9%. Complications included wound issues (50%) and neurological deficits (57.1%)(7/12), mainly in high-level sacrectomies. High-level resections had significantly higher neurological complications (p = 0.005). Kaplan-Meier analysis estimated survival above 75% postoperatively. Surgical resection of large sacral chordomas is challenging but feasible, with high rates of R0 resection. Negative margins, tailored surgical strategies, and effective complication management are critical for optimizing outcomes.

PMID:41641427 | PMC:PMC12864548 | DOI:10.1007/s13193-025-02293-w

Indian J Surg Oncol. 2026 Jan;17(1):152-157. doi: 10.1007/s13193-025-02195-x. Epub 2025 Apr 26.

ABSTRACT

There is no data on the expression of PD-L1 in oral cavity cancers from the Indian population. Hence, this audit was done to estimate the incidence of PD-L1 expression in oral cavity cancers and detect factors affecting the same. Data of 340 cases of oral cavity cancer who were advised for PD-L1 gene expression testing were collected from the head and neck OPD of Tata Memorial Hospital from the year 2018 to 2023. These cases were evaluated for demographic details, i.e., age and gender, and also for factors such as performance status (PS) as per the Eastern Cooperative Oncology Group (ECOG) scale, subsite of oral tumor, histopathology, and grade. Descriptive statistics were used for analysis. Factors affecting PD-L1 gene expression were sorted using ordinal logistic regression analysis. In total, 340 patients were evaluated with a median age of 48 years (range, 17-79; interquartile range, 40-55), and PD-L1 expression was divided as scores and was observed that Tumor Proportion Score (TPS) 0% was seen in 34 patients (10.0%), TPS 1-5% was seen in 70 patients (20.6%), TPS 6-10% was seen in 29 patients (8.5%), TPS 11-20% was seen in 29 patients (8.5%), TPS 21-30% was seen in 33 patients (9.7%), TPS 31-50% was seen in 44 patients (12.9%), TPS 51-75% was seen in 47 patients (13.8%), and TPS > 75% was seen in 54 patients (15.9%). Univariate analysis was run to determine the distribution of TPS scores within each variable under age, gender, sample collection site, differentiation of tumor, and subsite of tumor. This is one of the first studies evaluating data on the expression of PDL-1 in oral cavity cancers in the Indian population and the factors affecting it. The data provides novel insights into many factors potentially affecting the expression of PDL-1 in oral cavity cancers and in the future, can be of help in developing treatment plans with various immunotherapies.

PMID:41641425 | PMC:PMC12864565 | DOI:10.1007/s13193-025-02195-x

Indian J Surg Oncol. 2026 Jan;17(1):13-25. doi: 10.1007/s13193-025-02285-w. Epub 2025 Apr 5.

ABSTRACT

Triple-negative breast cancer (TNBC) is molecularly diverse and lacks known treatment targets. The possible prognostic and therapeutic implications of androgen receptor (AR) expression in TNBC have drawn attention. The purpose of this study was to assess AR expression in TNBC, as well as its relationship to p53 and Ki-67 expression and its effect on clinical outcomes. Seventy-eight female patients with non-metastatic TNBC verified by histopathology were included. Clinicopathological characteristics, such as the expression of p53, Ki-67, and AR, were noted. A positive result for AR immunohistochemistry (IHC) was defined as ≥ 10% nuclear staining. To evaluate relationships between AR expression and clinical factors, statistical studies included multivariate logistic regression and bivariate comparisons (chi-squared, t-tests). Survival results were assessed using log-rank testing and Kaplan-Meier curves. There were 15.4% AR positive cases. Significant correlations were seen between AR positivity and Ki-67 expression (p = 0.034), Nottingham grades (p < 0.001), and TNM stages (p < 0.001). Overall survival (OS, 25.0 vs. 20.0 months; p = 0.001) and disease-free survival (DFS, 14.6 vs. 10.8 months; p = 0.015) were considerably shorter in AR + individuals. Shorter OS, DFS, and duration for recurrence were independently predicted by AR positivity, along with other factors, according to multivariate analysis. Worse survival outcomes and more aggressive tumor characteristics are linked to AR expression in TNBC. AR is a promising prognostic marker and therapeutic target in TNBC, despite its low prevalence (15.4%). To confirm these results and standardize AR positive levels, larger, multi-center studies are required.

PMID:41641410 | PMC:PMC12864559 | DOI:10.1007/s13193-025-02285-w

Indian J Surg Oncol. 2026 Jan;17(1):165-172. doi: 10.1007/s13193-025-02315-7. Epub 2025 Apr 29.

ABSTRACT

The omentum plays a valuable protective role post abdominal surgeries. Our goal was to determine the presence of metastatic omental lymph nodes or tumour deposits in stage I-III gastric adenocarcinoma, thus defining patterns of factors predictive of greater omental disease, which may contribute to omental sparing. Specimens of 115 patients with gastric adenocarcinoma stages I – III, operated consecutively, were analysed. The greater omentum was sent after separating it at 3 cm from the gastro – epiploic arcade. The number of total retrieved and metastatic lymph nodes in the greater omentum and the presence of tumour deposits, signet ring cell histology, and lympho-vascular invasion (LVI) of the primary tumour were noted. All calculations were carried out with IBM SPSS Statistics version 21.0. The Fisher exact chi-square test was done to evaluate the significance of association between the data, and a p-value ≤ 0.05 was considered to be significant. In total, 17.4% of patients had signet ring cell histology. A total of 34.8% were at pathological stage III. LVI was present in 25.2%. Two out of 115 patients (1.7%) had metastatic greater omental nodes, both of which were at stage III, signet ring cell histology, and LVI +ve. There was a significant association between malignant omental nodes, stage III disease, and signet ring cell type, while the association with LVI neared statistical significance. Irrespective of stage, the presence of omental disease in gastric adenocarcinoma is rare and may have a pattern of predictive features in its histology and stage, and thus set the stage for omental-sparing surgery in gastric cancer.

PMID:41641408 | PMC:PMC12864553 | DOI:10.1007/s13193-025-02315-7

Indian J Surg Oncol. 2026 Jan;17(1):41-48. doi: 10.1007/s13193-025-02288-7. Epub 2025 Apr 11.

ABSTRACT

Endometrial hyperplasia represents a spectrum of morphological and biological changes in the endometrial glands and stroma, ranging from an exaggerated physiological state to carcinoma. In recent years, numerous laboratory studies have evaluated the role of melatonin in regulating endometrial cell proliferation. Emerging evidence indicates an inhibitory role of melatonin administration in various gynecological cancers. Therefore, the present study aims to investigate melatonin’s effect on the endometrium’s histology in patients with endometrial proliferative disorders. This double-blind, randomized clinical trial was conducted at the Al-Zahra Hospital in Tabriz university of medicail scinsses. The patients with complaints of abnormal vaginal bleeding and with diagnosis of endometrial proliferative disorders or non-atypical hyperplasia were included .The patients were randomly assigned to control and intervention group. The control group received 80 mg Megestrol acetate daily, the intervention group received 80 mg Megestrol acetate daily plus 5 mg of melatonin before bedtime for three months. Both groups were homogenized regarding demographic information, including age, gravidity, parity, and body mass index. The patients were followed up for three months, and after completing of treatment, an endometrial biopsy was performed. The endometrial histology was compared between two groups after three months. Out of the 40 enrolled patients in the study, 37 were included in the final analysis. 18 out of 19 patients (94.7%) in the intervention group and 12 out of 18 patients (66.6%) in the control group had normal biopsy results after treatment . This difference was statistically significant (P<0.05). Adding melatonin to progestin for treatment of endometrial hyperplasia can enhance the treatment response in women with this condition and lead to a higher rate of treatment.

PMID:41641407 | PMC:PMC12864561 | DOI:10.1007/s13193-025-02288-7

Neurol Clin Pract. 2026 Apr;16(2):e200565. doi: 10.1212/CPJ.0000000000200565. Epub 2026 Feb 2.

ABSTRACT

BACKGROUND AND OBJECTIVES: Migraine is a significant disabling neurologic headache disorder globally. Evaluating patient-related outcomes (PROs) is necessary to assess the impact of therapeutic interventions in preventive therapy. An exploratory analysis of data from the EMPOwER study examined the effect of erenumab on PROs in patients with episodic migraine (EM) in regions underrepresented in the pivotal Phase 3 trials of erenumab, specifically Asia, the Middle East, and Latin America.

METHODS: Patients (N = 900) were randomized (2:3:3) to receive monthly subcutaneous injections of erenumab 140 mg, erenumab 70 mg, or placebo. Adjusted mean changes from baseline in the Headache Impact Test (HIT-6), Migraine Physical Function Impact Diary (MPFID), modified Migraine Disability Assessment (mMIDAS), and EuroQoL 5-dimension 5-level scale (EQ-5D-5L) scores were assessed during the double-blind treatment phase of 3 months.

RESULTS: A statistically significant reduction from baseline in the HIT-6 total score was observed for erenumab 140 mg (-9.34, p < 0.001) and 70 mg (-8.39, p = 0.004) vs placebo (-6.62) at Month 3. Improvement in MPFID scores was also greater in the erenumab groups vs the placebo group (Everyday Activity: 140 mg, -5.61 [p = 0.002]; 70 mg, -4.94 [p = 0.011]; placebo, -3.19; Physical Impairment: 140 mg, -4.27 [p = 0.014]; 70 mg, -3.95 [p = 0.021]; placebo, -2.31) at Month 3. Similar findings were observed for mMIDAS scores (140 mg -8.99 [p < 0.001], 70 mg -8.11 [p = 0.011] vs placebo [-6.59]) and the EQ-5D-5L quality-of-life visual analog scale scores (140 mg 8.13 [p = 0.017], 70 mg 7.08 [p = 0.088] vs placebo [5.22]), although no meaningful between-group difference was noted for index values.

DISCUSSION: Erenumab showed favorable effects on PROs when compared with placebo in patients with EM. These results enhance the evidence for erenumab as an effective preventive therapy for patients with EM.

TRIAL REGISTRATION INFORMATION: Clinicaltrials.gov/study/NCT03333109.

PMID:41641373 | PMC:PMC12867334 | DOI:10.1212/CPJ.0000000000200565

Front Neurol. 2026 Jan 20;17:1672882. doi: 10.3389/fneur.2026.1672882. eCollection 2026.

ABSTRACT

OBJECTIVE: To systematically evaluate the effects of motor imagery combined with brain-computer interface (MI-BCI) on stroke patients.

METHODS: Randomized controlled trials (RCTs) on MI-BCI for stroke patients were retrieved from CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science databases from inception to June 2025. Data were analyzed using RevMan 5.2 software.

RESULTS: Eight RCTs involving 357 stroke patients were included. The meta-analysis showed that MI-BCI was associated with an improvement in upper limb motor function, although this did not reach conventional statistical significance (SMD = 0.86, 95% CI = -0.04 to 1.75, p = 0.06). In contrast, a statistically significant, moderate-to-large improvement was found in activities of daily living (SMD = 1.47, 95% CI = 0.51 to 2.44, p = 0.003). Subgroup analyses indicated that the efficacy in motor function was primarily evident when MI-BCI was administered as an adjunct to conventional rehabilitation or with an intervention duration of ≥4 weeks.

CONCLUSION: The efficacy of MI-BCI is contingent upon its therapeutic context. When used as an adjunct to conventional rehabilitation, MI-BCI can significantly improve both upper limb motor function and activities of daily living in stroke patients. However, current evidence does not support its superiority over motor imagery alone when applied as a standalone therapy. An intervention duration of ≥4 weeks is recommended to achieve significant functional gains.

PMID:41641333 | PMC:PMC12866895 | DOI:10.3389/fneur.2026.1672882

Front Neurol. 2026 Jan 20;17:1729763. doi: 10.3389/fneur.2026.1729763. eCollection 2026.

ABSTRACT

BACKGROUND: The advent of flow diverters (FDs) has revolutionized the treatment of intracranial aneurysms. The Lattice Flow Diverter (LFD) is a novel, domestically developed FD in China. To date, no clinical reports have described the use of the LFD in treating small and medium-sized intracranial aneurysms. In this study, we aimed to evaluate the safety and efficacy of the LFD in the treatment of small and medium-sized aneurysms in the anterior circulation.

METHODS: We retrospectively reviewed patients with small or medium-sized anterior circulation aneurysms who underwent LFD implantation at Jingmen People’s Hospital between September 2023 and May 2025. Demographic data, aneurysm morphology, and procedural details were collected from complete clinical and imaging records. Periprocedural neurological complications, angiographic outcomes, and clinical follow-up results were systematically analyzed.

RESULTS: A total of 56 patients were included. Among 56 patients, nine patients (16.1%) underwent adjunctive coil embolization. Two patients (3.6%) experienced periprocedural complications, both minor ischemic strokes. During a mean clinical follow-up of 7.18 months, complete occlusion (OKM grade D) was achieved in 71.4% of aneurysms, and adequate occlusion (OKM grades C + D) in 85.7%. All patients had a favorable clinical outcome (mRS score 0-2). Subgroup analysis showed no statistically significant differences in complete or successful occlusion rates between patients treated with LFD alone and those treated with LFD combined with coil embolization (p > 0.05).

CONCLUSION: Our study preliminarily suggests that the use of the LFD for small and medium-sized anterior circulation aneurysms is associated with acceptable periprocedural safety and favorable short term angiographic and clinical outcomes. Further large-scale, multicenter, prospective studies are required to validate these findings.

PMID:41641331 | PMC:PMC12864136 | DOI:10.3389/fneur.2026.1729763