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Current status and reflections on immunotherapy and targeted therapy for unresectable biliary tract cancer YU Liqin, YAN Xiaoyu, WANG Puxiongzhi, WANG Wei, WANG Jian Journal of Surgery Concepts & Practice    2025, 30 (06): 544-550.   DOI: 10.16139/j.1007-9610.2025.06.14 Abstract （277）   HTML （48）    PDF（pc） （939KB）（695）       Knowledge map    Save Biliary tract cancer (BTC) represents a group of highly malignant solid tumors with a five-year survival rate of only 10%. For patients with unresectable BTC, gemcitabine combined with cisplatin has been the conventional first-line treatment regimen. With the remarkable efficacy of immunotherapy and targeted therapy observed in other solid tumors, numerous studies have investigated their potential in unresectable BTC. This article provides an overview of the current status of targeted and immunotherapeutic approaches for unresectable BTC, with a focus on research advancements in immune checkpoint inhibitor (ICI) and targeted agents against fibroblast growth factor receptor(FGFR), isocitrate dehydrogenase(IDH), and human epidermal growth factor receptor 2(HER2), as well as future trends in immunotherapy and targeted therapy, aiming to contribute to the development of more effective treatment strategies. Reference | Related Articles | Metrics | Comments（0）

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Characteristics of cyst fluid can predict the benign or malignant nature of intraductal papillary mucinous neoplasms WANG Jingyuan, FAN Jiayu, ZHANG Pingping, MA Hongyun, CHEN Ying, LI Gang, JIN Zhendong, JIN Gang, WANG Kaixuan Journal of Surgery Concepts & Practice    2025, 30 (06): 509-516.   DOI: 10.16139/j.1007-9610.2025.06.09 Abstract （269）   HTML （49）    PDF（pc） （1972KB）（705）       Knowledge map    Save Objective To investigate the predictive ability of cyst fluid characteristics for malignant intraductal papillary mucinous neoplasms (IPMNs). Methods We prospectively collected fresh cyst fluid from patients undergoing pancreatic resection at the Department of Hepatobiliary Pancreatic Spleen Surgery, Changhai Hospital, Shanghai, from September 2023 to December 2024, who were ultimately pathologically confirmed with IPMN. We assessed the characteristics of cyst fluid, including viscosity, clarity, and color, and explored its predictive performance for benign or malignant. Results A total of 40 patients with IPMN were included. The sensitivity of the string sign （+） for diagnosing high-grade dysplasia/ invasive carcinoma （HGD/IC） was 90.9%, specificity was 92.9%, and accuracy was 76.0%. The cyst fluid of intestinal-type IPMN often exhibited a gelatinous consistency, and there was no significant difference in the distribution of gelatinous consistency between the HGD/IC group and the low-grade dysplasia （LGD） group. There were no significant differences in CEA, glucose, and amylase levels in the cyst fluid between the HGD/IC group and the LGD group. Conclusions The characteristics of pancreatic cyst fluid, especially viscosity, can effectively predict the benign or malignant nature of IPMN. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Current status and prospects of minimally invasive surgery for breast cancer in China DUAN Shiyu, JIN Yiting Journal of Surgery Concepts & Practice    2025, 30 (06): 537-543.   DOI: 10.16139/j.1007-9610.2025.06.13 Abstract （264）   HTML （47）    PDF（pc） （928KB）（568）       Knowledge map    Save This article provided a systematic review of the current application and development prospect of minimally invasive surgery for breast cancer in China. Although application of endoscopic and robotic surgical procedures remain limited in breast surgery, they have shown advantages in cosmetic outcomes and postoperative recovery across various procedures, including axillary lymph node dissection, breast-conserving surgery, mastectomy, and breast reconstruction. Nonetheless, further high-quality clinical evidence is needed to confirm their long-term oncological safety. Despite current challenges of prolonged operation time and high medical cost, minimally invasive techniques are poised to become an integral component of breast cancer surgical care with continuous refinements of technology and accumulating clinical evidence. Reference | Related Articles | Metrics | Comments（0）

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Research progress on the mechanism of regulated cell death in thyroid carcinoma NIU Lingshan, ZHAO Yue, SHI Xu, YANG Zheyu, PAN Ruijun, CAI Wei Journal of Surgery Concepts & Practice    2025, 30 (06): 529-536.   DOI: 10.16139/j.1007-9610.2025.06.12 Abstract （238）   HTML （25）    PDF（pc） （1254KB）（581）       Knowledge map    Save Thyroid carcinoma is one of the malignant tumors with rapidly increasing incidence rates. Some refractory patients face challenges from drug toxicity and resistance, urgently requiring the discovery of new therapeutic pathways to improve prognosis. Regulatory cell death（RCD）is a highly regulated orderly death mode, including apoptosis, necroptosis, pyroptosis, ferroptosis, and cuproptosis. Recent studies have found that RCD is closely associated with tumor progression, invasion, and resistance. This article systematically reviewed various death modes in thyroid cancer, including the core signaling nodes of each death pathway, and explored their specific functions in tumor progression. It also summarized potential therapeutic strategies targeting these death pathways. However, the complexity of RCD mechanisms and the sensitivity of treatments remain controversial. Future efforts should focus on screening broad-spectrum targets and developing synergistic therapies to ultimately achieve precise treatment based on cell death, thereby improving the prognosis of refractory thyroid cancer. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Advances of prevention and management for post-pancreatectomy acute pancreatitis CHEN Haoda, SHEN Baiyong Journal of Surgery Concepts & Practice    2025, 30 (06): 524-528.   DOI: 10.16139/j.1007-9610.2025.06.11 Abstract （200）   HTML （10）    PDF（pc） （1190KB）（516）       Knowledge map    Save Post-pancreatectomy acute pancreatitis (PPAP) is a common complication following pancreatic surgery, characterized primarily by early postoperative local and systemic inflammatory responses. These responses can trigger a series of subsequent complications, significantly impacting patient’s clinical outcomes. In recent years, PPAP has been recognized as a distinct postoperative complication, and the International Study Group of Pancreatic Surgery (ISGPS) has proposed standardized definitions and grading criteria for it, which required a combination of postoperative enzyme elevation, imaging features, and changes in clinical management. This has garnered widespread attention within the field of pancreatic surgery. The occurrence of PPAP is closely related to microcirculatory disturbances. Clinically, it can manifest as self-limiting inflammation and is closely associated with pancreatic fistula development. In some cases, it may progress to necrotizing pancreatitis, potentially requiring surgical intervention. Current prevention and management strategies focus on intraoperative preservation of pancreatic blood supply, perioperative use of anti-inflammatory medications, and symptomatic supportive care. However, the diagnostic criteria, pathogenesis, and comprehensive management framework for PPAP still require further research and refinement. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Gasless subclavicular lateral approach: an anatomically tailored surgical technique for parathyroid surgery FENG Wenqing, GAO Haoji Journal of Surgery Concepts & Practice    2025, 30 (06): 503-508.   DOI: 10.16139/j.1007-9610.2025.06.08 Abstract （181）   HTML （9）    PDF（pc） （4209KB）（516）       Knowledge map    Save Objective To explore the safety and effectiveness of gasless subclavicular lateral approach in parathyroid surgery. Methods A retrospective comparative study was conducted to collect a total of 53 patients with primary hyperparathyroidism who underwent surgical treatment at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from November 2024 to April 2025. Among them, 20 patients underwent subclavicular lateral approach surgery (experimental group). The control group was matched 1∶1 based on criteria including gender, age, tumor size, and preoperative （parathyroid hormone, PTH） levels. Twenty patients who underwent conventional anterior cervical approach during the same period were selected for a case-control study. The surgical efficacy, postoperative incision pain, incidence of complications, and cosmetic effects between two groups were compared. Results There was no statistically significant difference (P>0.05) in operative time, intraoperative bleeding, hospitalization time, and surgical efficiency between the two groups. There was no statistically significant difference in the incidence of postoperative complications such as hoarseness, water choking, incision infection, incision hematoma, fever, and postoperative pain scores between the two groups during hospitalization (P>0.05). In the scar assessment one month after surgery, the score of the experimental group was lower than that of the control group (P<0.05). The satisfaction score of the beauty effect in the experimental group was significantly better than that in the control group (P<0.01). Conclusions Gasless subclavicular lateral approach for parathyroidectomy, as an emerging and anatomically optimized surgical technique, has good effectiveness and safety, without significantly increasing surgical risks. It can safely remove lesions without leaving surgical scars in the anterior neck, and has the advantage of good cosmetic effects. As a safe and feasible surgical method, it provides a new and ideal choice for patients undergoing parathyroid surgery. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Application progress of artificial intelligence in preoperative diagnosis of pancreatic cancer MAO Liang, QIU Yudong Journal of Surgery Concepts & Practice    2025, 30 (06): 479-482.   DOI: 10.16139/j.1007-9610.2025.06.04 Abstract （169）   HTML （8）    PDF（pc） （865KB）（544）       Knowledge map    Save Pancreatic cancer is the most challenging issue in the field of pancreatic surgery. Accurate preoperative diagnosis is the key to improving prognosis. Currently, there have been research reports on the application of artificial intelligence(AI) in the early diagnosis, differential diagnosis, and stratified diagnosis of pancreatic cancer. This article summarized the representative studies and focused on introducing their innovative thinking, modeling methods, research results, and clinical significance, demonstrating the application potential of AI in preoperative diagnosis of pancreatic cancer, with the aim of providing inspiration for subsequent research in this field. Reference | Related Articles | Metrics | Comments（0）

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Obesity significantly increases the risk of erectile dysfunction: a meta-analysis based on observational studies JI Lang, HAO Shaolong, SUN Haitao, SUN Wuqing, Ma Jihong, BAI Rixing, HAN Wei Journal of Surgery Concepts & Practice    2025, 30 (06): 494-502.   DOI: 10.16139/j.1007-9610.2025.06.07 Abstract （157）   HTML （8）    PDF（pc） （1865KB）（568）       Knowledge map    Save Objective To quantify the association between obesity and erectile dysfunction (ED) risk through a meta-analysis. Methods Following PRISMA guidelines, systematic searches of Chinese and English databases (up to March 2025) were conducted to include observational studies (cohort, cross-sectional, case-control). Adjusted effect sizes (OR and 95% CI) were extracted. Study quality was assessed using the Agency for Healthcare Research and Quality(AHRQ) scale, and a random-effects model was applied to pool effect sizes. Subgroup analyses (geographic region, obesity definitions) and sensitivity analyses were performed to validate robustness. Results Ten studies (n=230 744), including nine cross-sectional studies, were included. The meta-analysis revealed that obesity significantly increased ED risk (random-effects OR=1.80, 95% CI: 1.29-2.51), with high heterogeneity (I2=99.9%). Subgroup analyses indicated stronger associations in USA populations (OR=2.10, 95% CI: 1.23-3.60) than in Chinese populations (OR=1.16, 95% CI: 1.05-1.28). The highest effect size was observed when using BMI≥25 kg/m3 as the obesity threshold (OR=3.05, 95% CI: 2.06-4.51). Sensitivity analyses confirmed robust results (OR: 1.60-1.94 after excluding any single study). Conclusions Obesity is a critical risk factor for ED, with effect strength influenced by geographic region and obesity definitions. Interventions targeting BMI≥30 kg/m2 in Western populations and metabolic risks at BMI≥25 kg/m3 in Asian populations are recommended. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Anatomical classification and intraoperative management strategies of dorsal pancreatic artery in 576 standard pancreatic surgeries OU Huiyi, JIN Kaizhou, YE Longyun, WU Weiding Journal of Surgery Concepts & Practice    2025, 30 (06): 483-487.   DOI: 10.16139/j.1007-9610.2025.06.05 Abstract （154）   HTML （4）    PDF（pc） （4943KB）（532）       Knowledge map    Save Dorsal pancreatic artery (DPA) is one of the most commonly studied arteries in the pancreas. The management of DPA during pancreatic standard resection/radical surgery (pancreaticoduodenectomy, distal pancreatectomy, and total pancreatectomy) is closely related to complications such as late bleeding caused by pancreatic fistula erosion after surgery. This article collected data from patients who underwent open/minimally invasive standard pancreatic resection/radical surgery from August 2024 to July 2025, displayed different origins of DPA, and discussed the management of DPA during standard pancreatic resection/radical surgery. This article updated and improved the latest classification of DPA, and highlighted the importance of programmatic management of DPA in pancreatic surgery to reduce the risk of late postoperative bleeding. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical experience with arterial resection during radical resection for pancreatic cancer YIN Jie, JIANG Kuirong Journal of Surgery Concepts & Practice    2025, 30 (06): 469-473.   DOI: 10.16139/j.1007-9610.2025.06.02 Abstract （142）   HTML （2）    PDF（pc） （922KB）（439）       Knowledge map    Save With advancements in surgical techniques and the application of neoadjuvant and conversion therapies, arterial resection and reconstruction offers a potential curative option for patients with locally advanced pancreatic cancer. Preoperative meticulous assessment of arterial involvement using imaging, combined with biological markers and the patient's physical status, allows for strict patient selection. Intraoperative strategies such as the “artery-first approach” and “sub-adventitial divestment” can be employed to determine the feasibility of radical resection. For arteries that cannot be preserved, procedures such as celiac axis resection, hepatic artery resection, or superior mesenteric artery resection and reconstruction may be performed depending on the site of involvement. Given the technical complexity of arterial resection and the associated high morbidity and mortality rates, this procedure should be carried out in high-volume pancreatic centers with extensive experience, and further large-scale studies are needed to validate its long-term efficacy. Reference | Related Articles | Metrics | Comments（0）

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Clinical evaluation and management of checkpoint inhibitor pneumonitis with advanced biliary tract cancer: a report of 3 cases SUN Xueying, WU Bin, JIANG Yifei, LIAO Zhuojun, ZHAO Jinyan, ZHOU Ying, ZHANG Shulong, WANG Yan, LIU Houbao Journal of Surgery Concepts & Practice    2025, 30 (06): 517-523.   DOI: 10.16139/j.1007-9610.2025.06.10 Abstract （138）   HTML （7）    PDF（pc） （2436KB）（622）       Knowledge map    Save Objective To report cases of checkpoint inhibitor pneumonitis （CIP） in patients with advanced biliary tract cancer, aiming to provide additional approaches for the assessment, treatment, and monitoring of this condition. Methods Three patients developed oxygen desaturation and interstitial lung lesions during chemotherapy combined with immunotherapy, and were diagnosed with CIP in collaboration with the respiratory department. Antitumor therapy was discontinued in the acute phase, and glucocorticoids were administered, with regular monitoring of disease progression. During follow-up, case 1 developed lung metastasis; case 2 showed improvement; case 3 had concurrent infection and tumor progression. Results Glucocorticoids improved lung lesions and hypoxic symptoms in patients with CIP, but attention should be paid to the potential for concurrent infections and tumor progression. Conclusions Comprehensive assessment and early identification of CIP are crucial for patients with advanced biliary tract cancer. For those with recurrent symptoms after glucocorticoid therapy, timely and accurate adjustment of the treatment regimen is essential. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Interpretation of the Asian Consensus on systemic therapy for pancreatic ductal adenocarcinoma WEN Chenlei, ZOU Siyi, LI Fanlu, ZHAN Qian, SHEN Baiyong Journal of Surgery Concepts & Practice    2025, 30 (06): 461-468.   DOI: 10.16139/j.1007-9610.2025.06.01 Abstract （126）   HTML （5）    PDF（pc） （1020KB）（645）       Knowledge map    Save Pancreatic ductal adenocarcinoma (PDAC) is difficult to diagnose in its early stages. Most patients are diagnosed at a locally advanced or metastatic stage. Systemic therapy has become the key to improve survival. To bridge the differences in guidelines across Asian countries and address regional clinical practice needs, 14 leading experts in the Asia-Pacific region developed the “Asian Consensus on systemic therapy for pancreatic ductal adenocarcinoma” on the Delphi method. The consensus centers on 14 core recommendations (R1-R14) and proposes stratified management strategies based on disease stage. For resectable PDAC, adjuvant modified FOLFIRINOX (mFOLFIRINOX) is the preferred option, while for the patients with poor performance status gemcitabine plus capecitabine, S-1 monotherapy, and other regimens can be selected. For borderline resectable PDAC, neoadjuvant therapy is recommended, with GnP or FOLFIRINOX as the preferred regimens. For locally advanced PDAC, combination or monochemotherapy is selected based on their performance status. For metastatic PDAC, first-line options include GnP, NALIRIFOX, or mFOLFIRINOX, with second-line therapy the cross-use of gemcitabine-based and 5-FU-based regimens are emphasized. This consensus provides for the first time a comprehensive and standardized management framework for systemic therapy of PDAC in Asia, aiming to enhance regional homogeneity in clinical practice and improve patient outcomes. This article interpreted the consensus content with the goal of guiding clinical practice. Reference | Related Articles | Metrics | Comments（0）

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Technical innovation in precise enucleation of pancreatic head tumors and postoperative pancreatic fistula prevention strategies YANG Feng, XU Yecheng, FU Deliang Journal of Surgery Concepts & Practice    2025, 30 (06): 488-493.   DOI: 10.16139/j.1007-9610.2025.06.06 Abstract （125）   HTML （13）    PDF（pc） （2326KB）（537）       Knowledge map    Save Benign and low-grade malignant tumors of the pancreatic head have distinct clinicopathological features and a relatively indolent biological behavior, leading to favorable prognoses and high surgical cure rates. When indicated, enucleation enables maximal preservation of pancreatic function with minimal trauma, demonstrating considerable clinical promise. This article focused on recent technical advances in enucleation for pancreatic head tumors and postoperative pancreatic fistula (POPF) prevention strategies, offering a systematic review of current concepts and clinical practices in the field. In the context of advancing precision surgery and minimally invasive techniques, enucleation—as a pancreatic function-preserving procedure—continues to present challenges in indication selection, intraoperative technique, and perioperative management. Covered topics included preoperative multimodal imaging and three-dimensional reconstruction for tumor localization, the application of intraoperative ultrasound and fluorescence navigation, comparison and selection of surgical approaches (such as anterior, posterior, and retroperitoneal laparoscopic routes), and the advantages and limitations of minimally invasive techniques including robotic and laparoscopic surgery. Proactive strategies for POPF prevention and management were also discussed. Finally, the importance of multidisciplinary collaboration and individualized decision-making was emphasized, with the goal of improving surgical safety, reducing complications, and enhancing patient prognosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Reflections on key issues in neoadjuvant therapy for pancreatic cancer: a paradigm shift from evidence-based medicine to precision medicine KANG Xiaochao, LI Yikai, GUO Shiwei, JIN Gang Journal of Surgery Concepts & Practice    2025, 30 (06): 474-478.   DOI: 10.16139/j.1007-9610.2025.06.03 Abstract （111）   HTML （3）    PDF（pc） （925KB）（566）       Knowledge map    Save Neoadjuvant therapy for pancreatic cancer is undergoing a paradigm shift from conventional chemotherapy to precision medicine. This expert forum discussed cutting-edge issues in pancreatic cancer neoadjuvant therapy from an evidence-based perspective, incorporating the latest clinical research advances. We focused on innovative directions including immunotherapy combination strategies, liquid biopsy applications, artificial intelligence (AI)-assisted decision making, and individualized precision medicine. We proposed forward-looking concepts such as molecular subtyping-guided individualized treatment strategies, multi-omics integrated efficacy prediction models, and standardized multidisciplinary collaborative care systems. These innovative concepts will drive pancreatic cancer neoadjuvant therapy toward more precise and effective directions. Reference | Related Articles | Metrics | Comments（0）

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Construction and direction of a digital diagnosis and treatment system in breast surgery CHEN Xiaosong, SHEN Kunwei Journal of Surgery Concepts & Practice    2026, 31 (03): 183-184.   DOI: 10.16139/j.1007-9610.2026.03.01 Abstract （0）   HTML （34）    PDF（pc） （981KB）（100）       Knowledge map    Save Breast surgery diagnosis and treatment is gradually transitioning from multi-disciplinary management to digital, intelligent, and precision-based care. Multidimensional data generated during the diagnosis and treatment process—including imaging, pathology, genomics, clinical treatment, follow-up, and rehabilitation provides the foundation for a full-process digital diagnosis and treatment system. Supported by artificial intelligence (AI), cloud platforms, multimodal imaging fusion, and multi-omics integration, this system can cover screening, diagnosis, treatment decision-making, surgical planning, postoperative treatment, and long-term follow-up, thereby paving the way for the digital, intelligent, and precision-based transformation of breast surgery. Reference | Related Articles | Metrics | Comments（0）

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Large language models empower precision decision-making in breast surgery and whole-cycle patient management ZHU Nengjun, CAO Jian, CHEN Xiaosong, ZHU Siji Journal of Surgery Concepts & Practice    2026, 31 (03): 185-190.   DOI: 10.16139/j.1007-9610.2026.03.02 Abstract （0）   HTML （32）    PDF（pc） （1047KB）（109）       Knowledge map    Save Early-stage breast cancer diagnosis and treatment are characterized by long disease course, high heterogeneity, multi-source and heterogeneous data, and dynamic evolving decision-making. The traditional multidisciplinary team (MDT) decision-making model faces challenges such as low efficiency and fragmented whole-cycle management. Large language models (LLMs) provide a new approach to solving these problems by virtue of their advantages in processing unstructured text, integrating multi-source data, and assisting clinical reasoning. This paper elaborated on the application value of LLMs in breast cancer MDT decision-making, focused on analyzing three core methods: personalized treatment recommendation agents, multi-agent collaboration, and clinical decision-making evidence generation and fusion. Furthermore, it proposed future development strategies across four dimensions: dynamic update of clinical knowledge bases, in-depth integration of case databases and models, human-machine collaborative case management, and OpenClaw-style intelligent physician assistant, providing references for promoting whole-cycle precise diagnosis and treatment of breast cancer and optimizing the MDT model. Reference | Related Articles | Metrics | Comments（0）

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De-escalation trends in axillary management for breast cancer: evidence-based progress and future directions SHANG Qingyao, DONG Xubin, YUE Jiaxian, WANG Xin Journal of Surgery Concepts & Practice    2026, 31 (03): 191-195.   DOI: 10.16139/j.1007-9610.2026.03.03 Abstract （0）   HTML （30）    PDF（pc） （1030KB）（117）       Knowledge map    Save Axillary management in breast cancer is shifting from traditional extensive dissection toward a precision de-escalation approach that emphasizes risk stratification and reduced intervention. With advances in systemic therapy and imaging assessment, minimizing or even omitting certain axillary surgeries and radiotherapy procedures has become a feasible strategy, effectively lowering upper-limb complications without compromising oncologic safety. Future efforts should integrate multi-modal evaluation and individualized predictive models to refine patient selection and clinical decision-making, and further guide the development of more precise and less invasive axillary management pathways. Reference | Related Articles | Metrics | Comments（0）

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Intratumoral microbiota and breast cancer: from mechanistic exploration to novel targets for clinical intervention WANG Han, WANG Zheng, CHEN Xiaosong Journal of Surgery Concepts & Practice    2026, 31 (03): 196-203.   DOI: 10.16139/j.1007-9610.2026.03.04 Abstract （0）   HTML （25）    PDF（pc） （1070KB）（98）       Knowledge map    Save The progression of breast cancer is intimately governed by the tumor microenvironment, with emerging evidence underscoring the critical modulatory roles of intratumoral microbiota. This review comprehensively delineated the compositional profiles, pathogenic mechanisms, therapeutic modulatory effects, and targeted intervention strategies pertaining to the intratumoral microbiota in breast cancer. At the compositional level, neoplastic tissues display pronounced dysbiosis, with microbial signatures stratified by molecular subtypes and specific genera demonstrating prognostic relevance. Mechanistically, intratumoral microbiota synergistically orchestrates tumorigenesis, local invasion, and metastatic dissemination via the induction of DNA breaks, inflammatory cascade amplification and immune landscape remodeling, metabolic rewiring, epigenetic perturbation, and activation of canonical oncogenic signaling axes. With regard to therapeutic outcomes, intratumoral microbiota contributes to chemoresistance, endocrine therapy failure, and anti-HER2 refractoriness, while concurrently potentiating immunotherapeutic responses. On the interventional front, engineered bacterial vectors and nanoplatform-based drug delivery systems exhibited favorable synergistic antitumor efficacy in preclinical settings. Finally, this review addressed prevailing challenges, including assay standardization, integrative multi-omics interrogation, and the translational gap toward clinical implementation. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Prevention and screening of HPV-associated anal cancer: current status, challenges, and future perspectives SHEN Jie, JU Xingyu, ZHENG Ying Journal of Surgery Concepts & Practice    2026, 31 (02): 100-107.   DOI: 10.16139/j.1007-9610.2026.02.02 Abstract （0）   HTML （7）    PDF（pc） （993KB）（227）       Knowledge map    Save Anal cancer is a malignancy closely associated with human papillomavirus (HPV) infection, with a rising incidence globally. Persistent infection with high-risk HPV acted as the core driver of anal tumorigenesis. Currently, strategies for the prevention and control of HPV-related anal cancer primarily revolve around primary prevention (HPV vaccination) and secondary prevention (screening of high-risk populations). Based on existing evidence, HPV vaccination served as the core of primary prevention and demonstrated clear efficacy in reducing the incidence of anal intraepithelial neoplasia (AIN) by blocking persistent high-risk HPV infection. Regarding secondary prevention, domestic and international guidelines have reached a consensus recommending standardized screening based on anal cytology, high-risk HPV testing, and anoscopy for high-risk groups, such as people living with human immunodeficiency virus(HIV) and men who have sex with men (MSM), to facilitate early detection and intervention. Reference | Related Articles | Metrics | Comments（0）

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Chemotherapy for colorectal cancer: consolidation of the cornerstone and advances in precision YAO Wang, ZHANG Jun Journal of Surgery Concepts & Practice    2026, 31 (02): 108-113.   DOI: 10.16139/j.1007-9610.2026.02.03 Abstract （0）   HTML （7）    PDF（pc） （1008KB）（261）       Knowledge map    Save As the cornerstone of systemic treatment for colorectal cancer, chemotherapy (cytotoxic drug therapy) continues to evolve in clinical practice, with its scope and application significantly expanding. In the treatment of advanced disease, the combination of chemotherapy with targeted and immunotherapeutic agents has been continuously optimized, leading to the development of precision treatment strategies tailored to different molecular subtypes, which has markedly improved therapeutic efficacy. In the field of perioperative therapy, the application of neoadjuvant chemotherapy, total neoadjuvant therapy (TNT), and the precision enhancement of adjuvant chemotherapy are reshaping the treatment landscape for patients with resectable colorectal cancer. Furthermore, novel technologies such as circulating tumor DNA offer the potential for prediction and dynamic monitoring of clinical decision and chemotherapy efficacy. From the perspective of chemotherapy, this article systematically analyzed its role in the treatment system for colorectal cancer, and discussed its clinical challenges and future directions. Table and Figures | Reference | Related Articles | Metrics | Comments（0）