The Top Ten Annals of Surgical Oncology Original Articles on Twitter/X: 2020-2023.

Social media has become omnipresent in society, especially given that it enables the rapid and widespread communication of news, events, and information. Social media platforms have become increasingly used by numerous surgical societies to promote meetings and surgical journals to increase the visibility of published content. In September 2020, Annals of Surgical Oncology (ASO) established its Social Media Committee (SMC), which has worked to steadily increase the visibility of published content on social media platforms, namely X (formerly known as Twitter). The purpose of this review is to highlight the 10 ASO original articles with the most engagement on X, based on total number of mentions, since the founding of the SMC. These articles encompass a wide variety of topics from various oncologic disciplines including hepatopancreatobiliary, breast, and gynecologic surgery.

Obesity and Oral Health: The Link Between Adipokines and Periodontitis.

Periodontitis is a chronic inflammatory disease of the periodontium, or the supportive tissues around the tooth. This disease has been related to different risk factors, such as the presence of plaque and calculus, tobacco smoking, low socioeconomic status, and the immune state of the host. Importantly, the chronic inflammatory environment generated by periodontitis may lead to tooth loss and diverse systemic complications, such as cardiovascular disease, osteoarthritis and metabolic disease. Recent investigations have supported the role of obesity as a risk factor for periodontitis. Furthermore, studies have found obesity to compromise healing after periodontal therapy; however, the mechanisms underlying this association are not well understood. Proteins called 'adipokines' could be the factor linking obesity to periodontitis. Adipokines are bioactive molecules with hormonal properties and a structure similar to cytokines produced by the adipose tissue. Although adipokines have both pro-and anti-inflammatory effects, the shift towards pro-inflammatory actions occurs when the adipose tissue becomes pathological, as observe in the progression of conditions such as obesity or adiposopathy. This article reviews the role of adipokines in the pathophysiology and progression of periodontitis by focusing on their impact on inflammation and the molecular mechanisms through which adipokines contribute to the onset and development of periodontitis.

Implementing a mHealth-Based Patient and Nurse Educational Program to Reduce Wound Infection in Rural Philippines.

Background: Surgical site infection (SSI) is a prevalent but preventable complication in low-and-middle income countries (LMIC), with reported incidence varying from 8-30%. In 2018, the MEDIPINAS surgical mission to the Philippines observed a 28.8% rate of SSI despite adherence to WHO intraoperative protocols.The objective of this study was to introduce an educational program for wound care and early identification of wound infection. This program included provision of wound care materials and systematic protocol to ensure adequate and effective follow-up. Barriers to SSI prophylaxis in the Philippines include limited resources in regional hospitals and isolation of patients living in rural areas. The MEDIPINAS mission utilized mobile health software to connect with regional providers and to reinforce the wound care educational program introduced at discharge. Methods: The 2019 MEDIPINAS mission returned to the Philippines and operated on 187 patients in San Antonio de Padua Diocesan Hospital and Santa Maria Josefa Hospital. Before discharge, patients were individually consulted about maintaining the cleanliness of their surgical wound. Each patient was discharged with a wound care infographic and a kit to change dressings. In collaboration with regional care providers, we utilized a secure mobile health software to monitor wound healing 7 and 30 days following the operation. Results: Between the 2018 and 2019 surgical missions, we observed a decrease in SSI from 28.8% to 9.7%. Fourteen patients (7.5%) were lost to follow-up. Postoperative infection was diagnosed using photos provided by hospital-based nurses. Individuals with infections were treated with antibiotics and all but two SSI resolved after 30 days. Conclusions: Patient education, discharge with basic sanitary resources, and development of a mobile health-based follow-up infrastructure may contribute to significant reductions in SSI in LMICs. A limitation to implementation of such a program was integration of the mobile health software into the practice of local healthcare providers.

Training in oncoplastic surgery: an international consensus. The 7th Portuguese Senology Congress, Vilamoura, 2009.

Oncoplastic Breast Surgery (OPBS) is becoming an integral part of breast cancer management, but few surgeons have received formal training in these techniques. An International Symposium has recently debated the key issues which impact on training and specialisation in OPBS, as well as patient access to these procedures. The Symposium concluded that increasing the availability of OPBS is a major challenge, which demands much closer collaboration and cooperation between breast and plastic surgeons, backed up by new training schemes, new curricula and new guidelines.

[Consensus meeting on sentinel lymph node biopsy in breast cancer. Spanish society of mastology and breast disease]. / Reunión de Consenso sobre la Biopsia Selectiva del Ganglio Centinela en el Cáncer de Mama. Socidad Española de Senología y Patología Mamaria.

Sentinel lymph node biopsy is a useful diagnostic technique in the management of breast cancer and is widely used and accepted in clinical practice. The results of this technique allow adequate staging with lower associated morbidity. However, at present, there are numerous methodological issues that remain to be resolved in on-going trials and investigations and Consensus Meetings are required to standardize the methodological variations and indications of this procedure. The conclusions of the Consensus Meeting held in Murcia, Spain, organized by The Spanish Society of Mastology and Breast Disease, are reported in this document.

Infiltrating ductal carcinoma and synchronous malignant phyllodes tumour. Diagnostic and therapeutic approaches.

Simultaneous presentation of breast cancer and malignant phyllodes tumour is rare. A female patient presented with a nodule in her left breast (infiltrating ductal carcinoma). On magnetic nuclear resonance another suspicious lesion (malignant phyllodes) was found in the right breast. Bilateral mastectomy was performed. Thirty two months later the patient is still free of disease. The approach to dealing with synchronous breast tumours should be the same as that normally used.

[Assessment of the fifth edition of the tumor-node-metastasis (TNM) classification for gastric cancer in our setting]. / Valoración de la 5.a edición de la clasificación TNM para el cáncer gástrico en nuestro medio.

AIM: To estimate the proportion of patients with gastric carcinoma that can be classified using the criteria of the fifth edition of the TNM system and to analyze which factors could be related to the finding of an adequate number of nodes. PATIENTS AND METHOD: The influence of distinct factors that could influence the number of lymph nodes isolated was evaluated in 164 patients who underwent resection of gastric carcinoma. These factors included tumor size, surgical resection, grade, histological type, variability among the pathologists who analyzed the surgical specimens, and the surgeon's experience. RESULTS: The mean number of lymph nodes examined by the pathologists was 11.4 (10.12-12.66). Applying the criteria of the fifth edition of the TNM classification, only 31% of the patients could be correctly classified. A positive correlation was found between tumor size and the number of resected nodes (p = 0.0018). In addition, a greater number of lymph nodes were found in total gastrectomies than in subtotal gastrectomies (p = 0.034). No significant association was found with the pathologist who analyzed the surgical specimen or with the experience of the surgeon who performed the resection. CONCLUSIONS: The fifth edition of the TNM system is easily reproducible, although the number of lymph nodes required to evaluate metastatic node involvement is difficult to obtain in our environment. Our results suggest that a combined effort between surgeons and pathologists is needed to increase the number of patients that can be reliably staged with this TNM edition.

[Application of the EUSOMA criteria in breast units in countries of the European Union]. / Aplicación de los criterios de EUSOMA en las unidades funcionales de mama de los países miembros de la Unión Europea.

All the countries of the European Union face similar challenges when providing adequate and high quality treatment in oncology. A working party was established to consider what should comprise a specialist service and the Requirements of a Breast Unit, published in 2000, represent the opinion of the European Society of Mastology (EUSOMA) on the standards required for creating high quality Breast Cancer Units across Europe. We studied the application of the mandatory requisites and general recommendations of EUSOMA: critical mass, or minimum number of patients, core team (composition and specific training), quality assurance, and application of diagnostic and treatment protocols. A thorough literature search was performed and was completed with information from search tools, the web pages of scientific societies, national associations for the fight against cancer, and health ministries of the countries belonging to the European Union. We also analyzed the latest reports of the European Parliamentary Committee for breast cancer. Distinct approaches to the multidisciplinary management of breast disease can be found in the United Kingdom, Sweden, Italy, France and Spain. A common European standard would be useful to improve the care provided to patients.

[EUSOMA requirements for breast cancer units in Spain]. / Adecuación de las unidades de mama españolas a los criterios de EUSOMA.

INTRODUCTION: The optimal treatment of breast cancer consists of a multidisciplinary approach in specialized units, benefitting patients and leading to more rational resource use. Based on these premises, the European Society of Mastology (EUSOMA) drew up recommendations designed to provide all European countries with high-quality multidisciplinary teams. MATERIAL AND METHOD: We present and analyze the results obtained from a survey of breast cancer units in 241 Spanish hospitals performed by the Breast Diseases Group of the Spanish Association of Surgeons. RESULTS: Breast disease was treated in general surgery departments in 131 hospitals and Spanish surgeons showed strong interest in continuing training (41.2% had a postgraduate degree in mastology). Multidisciplinary discussions at weekly intervals took place in 95 hospitals (73.6%) hospitals for planning a diagnostic and therapeutic course of action specific for each patient. Written protocols for diagnosis and treatment were used in 119 departments (90.8%) and quality control measures were applied in 83 (63.4%). CONCLUSIONS: We stress the need for mandatory requirements in Spain for breast cancer units, preferably adapted to the EUSOMA criteria, which are accepted by the relevant committee of the European Parliament. Through its Breast Diseases Group, the Spanish Association of Surgeons should be involved in accreditation standards for breast surgeons and should promote adequate specialization programs.