Hernia repair following cancer surgery is often challenging due to prior radiation therapy, malnutrition, and immunosuppression. Poly-4-hydroxybutyrate (P4HB) is a biosynthetic mesh that balances strength and biocompatibility, potentially optimizing outcomes in this high-risk population. This study aimed to evaluate recurrence and surgical site complications associated with P4HB mesh in oncologic patients undergoing incisional hernia repair and to identify surgical techniques related to improved outcomes.

Oncologic research increasingly prioritizes patient-reported outcomes (PROs) to support patient-centered care. Long-term evaluation of PROs requires longitudinal data analysis, which traditional cross-sectional methods, such as linear regression, cannot adequately address. Advanced statistical models, including linear mixed-effects (LME) and generalized estimating equations (GEEs), are essential to capture the complexity of longitudinal data. This study aims to provide a framework for applying LME and GEE models to analyze longitudinal PROs in surgical oncology research using a postmastectomy breast reconstruction cohort example.

Sexual health concerns are prevalent in breast cancer patients, yet are difficult to address given the stigma, sensitivity, and cultural differences. This study aims to assess the impact of culture on Sexual Well-being after autologous breast reconstruction (ABR) by examining three different countries from different continents: South Korea for Asia, Netherlands for Europe, and United States of America (USA) for North America.

Loss of nipple projection is a common concern following local tissue nipple-areolar complex (NAC) reconstruction, with contracture leading to inevitable projection loss over time. While multiple techniques have been developed, few studies have measured long-term projection loss, and none have utilized 3D imaging for accurate assessment. This study aimed to analyze long-term nipple projection loss using 3D imaging to improve patient education and expectations. A retrospective analysis of patients who underwent skin-sparing postmastectomy breast reconstruction with local flap-based (C-V flap) NAC reconstruction between 2010 and 2022 was conducted. Patients with available 3D images were included. The VECTRA Analysis Module (VAM) was used to measure nipple projection at 3, 6, 12, and 24 months postoperatively. Subgroup analysis was performed for autologous and implant-based reconstruction. Among 136 patients (281 observational time points), nipple projection decreased by 14% at 3 months ( = .002), 15% at 6 months ( = .001), and 19% at 1 year ( < .001) compared to 1 month postoperatively. After 1 year, projection stabilized, with only a 2% decrease in height by year 2 ( = .13). C-V flap limb length was not significantly associated with long-term projection retention ( = .10). Subgroup analysis showed similar nipple projection retention patterns for autologous and implant-based reconstruction, stabilizing at 1 year postoperatively. Nipple projection following flap creation decreases significantly up to 1-year post-reconstruction and plateaus from year 1 to 2. Patients opting for local flap-based reconstruction should be counseled preoperatively regarding expected projection loss and when they can expect their nipple height to plateau.