Grzegorz Stawarz

Background: Despite advances in treatment, oral squamous cell carcinoma (OSCC) remains associated with high recurrence and mortality rates. Traditional TNM staging, while foundational, may not fully capture tumor aggressiveness. This study aimed to identify clinical and histopathological predictors of survival to enhance risk stratification and guide treatment planning in OSCC patients. Methods: A retrospective study of 100 patients with confirmed OSCC treated surgically with curative intent between January 2019 and January 2024 was analyzed. Clinicopathologic variables—including tumor volume, angioinvasion, perineural invasion, lymphatic invasion, and nodal status—were evaluated. Disease-specific survival (DSS) was assessed using Kaplan–Meier estimates, Cox regression, and logistic regression models. Results: The cohort had a mean age of 62.1 years, with a 46% OS rate and 43% DSS at study end. Perineural invasion (44%) and lymphatic invasion (42%) were the most common invasive features. Kaplan–Meier analysis revealed significantly reduced DSS in patients with angioinvasion, perineural invasion, and pN+ status. Multivariate logistic regression identified perineural invasion (OR = 3.93, p = 0.0023) and pN+ status (OR = 2.74, p = 0.0284) as independent predictors of cancer-specific mortality. Tumor volume was significantly associated with lymphatic invasion but not directly with DSS. Conclusions: Perineural invasion, angioinvasion, lymph node involvement, and tumor volume are important prognostic markers in OSCC, offering critical information beyond TNM staging. Incorporating these features into risk assessment models could improve prognostic accuracy and inform more individualized treatment strategies for high-risk OSCC patients.

Background: Urachal pathologies, while rare, carry a risk of malignant transformation. Robot-assisted urachal excision and partial cystectomy (RAUEPC) is a minimally invasive technique that offers potential advantages, but the available evidence remains limited. This study aims to evaluate the outcomes of RAUEPC for benign and malignant urachal pathologies through a systematic review and single-center experience. Methods: A systematic review was conducted using PubMed, Scopus, the Cochrane Library, and ScienceDirect (last search: 1 November 2024). Inclusion criteria encompassed studies reporting on RAUEPC for urachal pathologies, while non-robotic approaches and incomplete data were excluded. Risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies and the JBI Critical Appraisal Checklist for Case Reports. Descriptive statistics summarized continuous data (means, medians, 95% confidence intervals), and chi-square tests analyzed associations between categorical variables. Heterogeneity analysis was infeasible, necessitating narrative synthesis. Institutional retrospective data from three cases (2021–2024) were included for comparison. This study was registered in PROSPERO (CRD42024597785). No external funding was received. Results: A total of 44 studies (n = 145) met the inclusion criteria. Benign lesions accounted for 66.2% and malignant lesions for 33.8%. Mean operative time was 177.8 min (cumulative), 162.7 min (benign), 192.2 min (malignant), 85.33 min (institutional, 95% CI: 74.13–96.53). Mean blood loss was 85.4 mL (cumulative), 99.5 mL (benign), 72.7 mL (malignant), 216.66 mL (institutional). Mean hospital stay was 3.64 days (cumulative), 3.26 days (benign), 4.36 days (malignant), 6.33 days (institutional, 95% CI: 3.46–9.20). Complications occurred in 10.04% (cumulative), 11.82% (benign), 8.57% (malignant), with one minor event (Clavien–Dindo II) in institutional cases. No conversions to open surgery were reported. All cases achieved complete excision with no R1 resections. No recurrences were observed at 10.66-month (institutional) mean follow-up. Conclusions: RAUEPC appears to be a feasible and safe approach with promising short-term outcomes. The associations between symptoms and diagnostic methods highlight its utility. The limitations of the evidence include small sample sizes and retrospective designs. Further prospective studies are needed to validate these findings.

Background: Ura-chal pathologies, while rare, pose a malignant transformation risk. RAUEPC is a mini-mally invasive technique with potential benefits, yet evidence remains limited. Methods: A systematic review was conducted in PubMed, Scopus, the Cochrane Library, and Sci-enceDirect (last search: 1 November 2024). Inclusion criteria: studies on RAUEPC for ura-chal pathologies. Exclusion criteria: non-robotic approaches or incomplete data. Risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies and the JBI Critical Appraisal Checklist for case reports. Descriptive statistics summarized continuous data (means, medians, 95% CIs), and chi-square tests analyzed associations between categori-cal variables. Heterogeneity analysis was infeasible, necessitating narrative synthesis. In-stitutional data (3 cases, 2021–2024) were included for comparison. Results: Forty-four studies (n = 145) met inclusion criteria. Benign lesions constituted 66.2% (95% CI: 59.1–73.3%) and malignant lesions 33.8% (95% CI: 26.7–40.9%). Mean operative time was 177.8 min (95% CI: 96.8–300), blood loss 83.3 mL (95% CI: 50–171), and hospital stay 3.9 days (95% CI: 1–10.9). Complications occurred in 33.3%. Institutional results showed a mean operative time of 85.3 min, blood loss of 216.7 mL, and no recurrences at 10.7 months’ fol-low-up. Discussion: RAUEPC appears to be a feasible and safe approach, showing prom-ising short-term outcomes. Associations between symptoms and diagnostic methods sug-gest its utility. Limitations include small sample sizes and retrospective designs. Registra-tion: PROSPERO: CRD42024597785. Funding: No external funding.