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The following articles appear in the September 2025 issues of the . A complimentary online subscription to JACS is a benefit of ACS membership. See more articles on the .

New Surgical Frailty Scoring Tool: Modified 4-Factor Functional Frailty Index

Alexandra Z. Agathis, MD, Jeanne Wu, MPH, and Celia M. Divino, MD, FACS

The new Modified 4-Factor Functional Frailty Index (mFF-4) includes variables that embody the frailty phenotype—history of falls, dementia, low body mass index, and non-independent functional status. The mFF-4 accurately predicts 30-day mortality, postoperative complications, and geriatric outcomes across the overall and subspecialty populations.

Association of Guideline-Concordant Care with Superior Survival Outcomes for Clinical T2N0M0 Esophageal Squamous Cell Carcinoma

Ryan C. Jacobs, MD, MS, Austin B. Chang, BA, Dominic J. Vitello, MD, and colleagues

This analysis of the National Cancer Database reveals a treatment mismatch for patients with clinical T2N0M0 esophageal squamous cell carcinoma: low-risk tumors are often undertreated with upfront esophagectomy, while high-risk tumors are frequently overtreated with chemoradiation therapy alone.

Is There Still a Need to Discuss the Use of Antibiotic Decontamination? Results of a Prospective Cohort Study Involving 999 Left-Sided Colorectal Resections

Benjamin Wiesler, MD, Jörn Markus Gass, MD, Raphaele Galli, MD, and colleaguesÌý

The implementation of antibiotic decontamination and mechanical bowel preparation in left-sided colorectal resections across an entire healthcare region was associated with reduced overall complication severity, without impacting rates of anastomotic leakage or surgical site infection, according to multivariate logistic regression analysis.

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