{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:21:56Z","timestamp":1791638516325,"version":"4.3.4"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"\n Importance<\/jats:title>\n Modulating perioperative inflammation could be associated with fewer postoperative complications and better outcomes in major digestive surgery. The clinical benefit of corticosteroids with this purpose remains controversial.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess whether preoperative high-dose corticosteroids improve postoperative outcomes after surgery for digestive cancer.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This double-blind, placebo-controlled, superiority randomized clinical trial included patients undergoing elective surgery with curative intent for digestive cancer. This was a multicenter trial with the participation of 23 French hospitals working as a reference for digestive surgical oncology. Among patients referred for major digestive surgery to the participating centers, those undergoing surgery for digestive cancer with a curative intent between 2019 and 2023 were randomized. Patients undergoing only hepatic surgery without digestive anastomosis were excluded.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Patients included were randomized to receive either 20 mg\/kg of intravenous methylprednisolone at the time of anesthesia or a placebo with an identical aspect.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary end point was the onset of major postoperative complications within 30 days after surgery. Secondary end points were postoperative infections, intra-abdominal infections, wound infections, unsatisfactory wound healing within 30 days after surgery, and the length of hospital stay after surgery.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 2461 patients referred for major digestive surgery, 1210 patients (mean [SD] age, 65.9 [11.3] years; 762 male [63%]) undergoing surgery for digestive cancer were randomized. Among the 1188 patients with follow-up at postoperative day 30 (594 per arm), major postoperative complications did not significantly differ between the 2 groups (139 of 594 [23%] receiving methylprednisolone vs 119 of 594 [20%] receiving placebo;\n P<\/jats:italic>\n \u2009=\u2009.16). Secondary outcomes did not differ either between the group receiving methylprednisolone and the group receiving placebo (postoperative infections: 182 of 594 [31%] vs 177 of 594 [30%];\n P<\/jats:italic>\n \u2009=\u2009.75; intra-abdominal infections: 142 of 594 [24%] vs 126 of 594 [21%];\n P<\/jats:italic>\n \u2009=\u2009.27; unsatisfactory wound healing: 87 of 594 [15%] vs 69 of 594 [12%];\n P<\/jats:italic>\n \u2009=\u2009.13; mean [SD] length of hospital stay: 13.21\u2009[8.59] days vs 12.97\u2009[8.1] days;\n P<\/jats:italic>\n \u2009=\u2009.93).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n A preoperative pulse dose of corticosteroids had no benefit on postoperative outcomes in elective digestive cancer surgery and should not be recommended in routine practice.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT03875690<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamasurg.2026.3557","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T15:30:22Z","timestamp":1787153422000},"page":"993","source":"Crossref","is-referenced-by-count":2,"title":["Preoperative High-Dose Corticosteroids in Digestive Cancer Surgery"],"prefix":"10.1001","volume":"161","author":[{"given":"Pablo","family":"Ortega-Deballon","sequence":"first","affiliation":[{"name":"Universit\u00e9 Bourgogne Europe, CHU Dijon Bourgogne, Service de Chirurgie Digestive, Dijon, France"},{"name":"Center for Translational Medicine, INSERM UMR 1231, Universit\u00e9 Bourgogne Europe, Dijon, France"},{"name":"Universit\u00e9 Bourgogne Europe, CHU Dijon Bourgogne, Centre d\u2019Investigation Clinique, INSERM, CIC 1432, Dijon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abderrahmane","family":"Bourredjem","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Bourgogne Europe, CHU Dijon Bourgogne, 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