Human epidermal growth factor receptor 2 (HER2) mutations in non-small cell lung cancer (NSCLC) are associated with aggressive disease and poor prognosis. Improved understanding of patient characteristics is vital to advance personalized treatment and improve outcomes. In this structured protocol-based targeted literature review, we assessed the epidemiology and ‘real-world’ outcomes in patients with HER2-mutant NSCLC by region, and by mutation category (tyrosine kinase domain [TKD] and non-TKD). Across 64 studies, the frequency of HER2 mutations ranged from 1
In this study, we investigated the diagnostic performance of magnifying endoscopy (ME) with third-generation narrow-band imaging (3G-NBI) for early gastric cancer (EGC), primarily in patients with Helicobacter pylori eradication. This was a post hoc analysis of a multicenter, randomized trial comparing 3G-NBI, texture and color enhancement imaging, and white-light imaging in gastric neoplasm (GN) detection. For all detected lesions, the endoscopic diagnosis of ME using 3G-NBI was compared with the pathological diagnosis. The primary analyses focused on the sensitivity and specificity of ME with 3G-NBI for EGC or non-EGC. The diagnostic performance was analyzed according to confidence level, macroscopic type, lesion size, and H. pylori infection status. This study included 901 patients; 228 suspected GN lesions in 187 patients were analyzed. The lesions were diagnosed with EGC in 62 (27 with high confidence) and non-EGC in 166 (91 with high confidence) patients using ME with 3G-NBI and pathologically diagnosed as EGC in 61 and non-EGC in 167 patients. The overall diagnostic performance was sensitivity and specificity of 70.5
There are concerns regarding postoperative infections following laparoscopic colectomy with intracorporeal anastomosis. Thus, in this study, we aimed to determine the optimal preoperative bowel preparation to reduce postoperative infectious complications in patients undergoing laparoscopic colectomy with intracorporeal anastomosis. This secondary analysis of the ICAN study—a multicenter, retrospective cohort study involving 46 institutions affiliated with the Japan Society of Laparoscopic Colorectal Surgery—included 615 patients with colon adenocarcinoma undergoing laparoscopic colectomy with intracorporeal anastomosis between January 2020 and December 2021. Patients were analyzed after applying eligibility criteria and propensity score matching based on age ≥ 65 years, sex, body mass index ≥ 30, American Society of Anesthesiologists Physical Status, diabetes, and the number of intracorporeal anastomosis cases previously performed at the institution. Among them, 312 received combined oral antibiotics and mechanical bowel preparation, whereas 156 received other preparations (mechanical preparation alone, oral antibiotics alone, and no preparation). The primary outcome was surgical wound infection incidence (Clavien–Dindo grade ≥ II) at initial discharge. Secondary outcomes included intraperitoneal infections, anastomotic leakage, ileus, and postoperative hospital stay. Surgical wound infection (1/312 [0.3
BACKGROUND:To evaluate the dissemination and real-world implementation of recommendations from the 5th Edition of the Japanese Esophageal Cancer Practice Guidelines and to inform development of the upcoming 6th Edition, the Guideline Committee of the Japanese Esophageal Society conducted a nationwide Quality Indicator (QI) survey in Japan. METHODS:A nationwide, cross-sectional, web-based questionnaire survey was distributed to 381 certified institutions participating in the 2023 National Registry of Esophageal Cancer in Japan. Conducted in November 2024, the survey covered six domains-epidemiology, surgery, endoscopy, chemotherapy, radiation therapy, and pathology-reflecting key recommendations of the 5th Edition. Responses were summarized descriptively at the institutional level. RESULTS:Valid responses were obtained from 190 institutions (49.9%). Smoking cessation guidance was implemented in more than 90% of institutions, and over 90% also provided guidance on alcohol abstinence or moderation, although complete alcohol abstinence was less uniformly recommended. Minimally invasive, including robot-assisted, esophagectomy was adopted by over 90% of institutions. The proportion of institutions performing prophylactic cervical lymph node dissection varied by tumor location and stage, reflecting contemporary staging concepts. The DCF regimen was the predominant neoadjuvant therapy for stage II/III disease (94.7%), and immune checkpoint inhibitor-based chemotherapy was widely used for unresectable or recurrent disease. Advanced endoscopic diagnostic modalities, including magnifying and image-enhanced endoscopy, were widely adopted. CONCLUSIONS:This nationwide QI survey demonstrates broad adherence to guideline-based multidisciplinary management of esophageal cancer in Japan and provides an evidence base for refining recommendations in the 6th Edition of the Japanese Esophageal Cancer Practice Guidelines.
Artificial intelligence (AI) for surgical workflow analysis often fails to generalize because surgical actions lack a standardized, fine-grained representation. Gesture-level “tokenization” of surgery, capturing instrument–tissue interactions as the smallest intentional functional units, offers greater technical specificity than phase- or step-level labels and has demonstrated associations with proficiency and clinical outcomes. However, the field remains fragmented by heterogeneous gesture terminology, limiting dataset interoperability and model reproducibility. We conducted a SAGES-led, accelerated Delphi consensus process to establish a standardized surgical gesture taxonomy. Starting with 270 literature-derived gesture terms, we employed a novel hybrid pipeline combining large language model (LLM)-assisted semantic clustering with multi-round expert review. The process involved two Delphi surveys (open-ended, then structured agreement) with a predefined ≥ 80
