[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-436874-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-436874-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","risk-stratification-system-for-preoperative-evaluation","Risk-stratification system for preoperative evaluation","","Risk-stratification for preoperative evaluation is essential for surgical cancers because complete cytoreduction or en bloc tumor resection (R0 status) improves outcomes. Preoperative assessment also enables neoadjuvant therapy to shrink or downstage locally advanced disease and increase resectability while aiming to preserve organ function and quality of life. A cited study combines multiparametric MRI and prostate health index to predict extraprostatic extension before radical prostatectomy, supporting improved preoperative counseling and selection of nerve-sparing 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Liua,b,c,d, Szu-Ting Yanga,b,c,d  \naDepartment of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cFemale Cancer Foundation, Taipei, Taiwan, ROC; dDepartment of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC  \nWith far-advanced development of technology and medical science, the precise and accurate pretherapy evaluation has become more and more reliable in recent decasdes,1–3 although it does not reach a satisfactory frontier.4–6 Preoperative assessment is particularly important, based on the fact the higher chance to achieve better outcomes if the diseases can be removed totally (complete cytoreduction surgery to no residual tumors [R0] status or en block resection of tumor) successfully.7 The above-mentioned concept nearly fits all surgical illnesses, including rectal cancer (RC), prostate cancer (PC), cervical cancer (CC), endometrial cancer (EC), ovarian cancer (OC), and others. 1,7–9 However, how to select a good candidate who fulfills the criteria and can be successfully treated is a challengeable and debated issue, particularly for those patients who are classified as locally advanced cancersand stated as potential and/or possible resectable diseases. To enhance the resectability of tumor, the new term “neoadjuvant therapy (NAT)” has been developed, which is often applied before surgery, including use of targeted agents, radiotherapy (RT), chemotherapy (CT), concurrent chemoradiation (CCRT) and combination of CT and RT, and many others.10 All efforts attempt to skink the tumor size and/or volume, downgrade the stage of diseases, and make en block resection of tumor possible. The optimal therapeutic goal of NAT not only provides a more confidence to perform a complete resection of tumor to save life but also offers a better chance to minimize the damage to the diseased organs and their surrounding tissues and organs and subsequently maintain partial or total function.10 Since the latter is involved in the good quality of life (QoL) in survived patients, this balance between the therapeutic efficacy and the less therapy-related  \n*Address correspondence. Dr. Peng-Hui Wang, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail addresses: phwang@vghtpe.gov.tw](ROC. E-mail addresses: phwang@vghtpe.gov.tw); pongpongwang@ [gmail.com](gmail.com) (P.-H. Wang).  \nConflicts of interest: Dr. Peng-Hui Wang, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2023) 86: 259-261.  \nReceived November 26, 2022; accepted November 29, 2022.  \ndoi: 10. 1097/JCMA.0000000000000860.  \nCopyright © 2022, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \n[www.ejcma.org](www.ejcma.org)  \ntoxicity has become one of the critical issues between healthproviders and patients.11  \nOur previous editorial comment has shown that an precise preoperative evaluation with a resultant appropriate surgical intervention can offer an opportunity to apply a less traumatic and/or organ-preservation strategy to maintain the physiological and morphological function of targeted diseases.10,11 However, it is sometimes difficult to make an idea come true, since the fundamental requirements should search for those “who are candidates fitting less inv","cbCaikW1CkMXpf6g","https://ap.wps.com/l/cbCaikW1CkMXpf6g","pdf",293636,"English","# Editorial\n## Importance of precise preoperative assessment\n## Role of neoadjuvant therapy in resectability\n## Prior study combining mpMRI and PHI for EPE prediction\n## Clinical implications for nerve-sparing prostatectomy","[{\"question\":\"Why is preoperative assessment critical for surgical outcomes?\",\"answer\":\"Preoperative assessment is important because higher chances of complete tumor removal are associated with better outcomes, enabling R0 status or en bloc resection.\"},{\"question\":\"What is the purpose of neoadjuvant therapy in preoperative management?\",\"answer\":\"Neoadjuvant therapy is used before surgery to shrink tumor size or volume, downgrade disease stage, and make complete resection and organ-preserving strategies more feasible.\"},{\"question\":\"How does the mpMRI and PHI approach help in prostate cancer surgery planning?\",\"answer\":\"The combined model aims to better predict extraprostatic extension preoperatively, which can guide preoperative counseling and support selection of nerve-sparing radical prostatectomy when EPE is absent.\"}]","Risk-stratification system for preoperative evaluation | PDF",1790679310]