Laryngeal squamous cell cancer (LSCC) is a common type of head and neck cancer that is typically unrelated to human papilloma virus (HPV) infection. Late-stage laryngeal cancers are associated with greater morbidity due to obstructive symptoms, and poorer overall survival. Using data from The Cancer Genome Atlas (TCGA), we analyzed 112 patient LSCC samples, comparing patient proteome, transcriptome and genome between early and late T and N samples. We observed significant differences in SNV frequency for various genes between the early and late-stage groups. Most notably we observed that NOTCH1 mutation, which was more frequent in late N-stage supraglottic cancers, was also associated with poorer patient survival in LSCCs. Methylation analysis also revealed changes in JUN gene methylation in late N glottic cancers. Transcriptomic analysis revealed differential expression in c-JUN, HOXB7 and HOXB9 transcript levels, suggesting potential involvement of these pathways in progression and nodal involvement. Our findings illustrate that LSCC undergoes distinct molecular changes associated with different stages and subsites. We observed multiple potential markers for progression, metastases and survival, including NOTCH1 mutation, which may aid as prognostic indicators in future studies.

Breast cancer presents significant challenges in low- and middle-income countries (LMICs) due to disparities in healthcare access and outcomes. This umbrella review synthesizes data on breast cancer characteristics-age at diagnosis, staging, and molecular subtypes-to guide targeted healthcare strategies in LMICs. Our umbrella review was conducted following PRISMA 2020 and JBI guidelines. Systematic reviews from 2009 to 2024 were sourced from PubMed, Google Scholar, and Cochrane. Reviews were assessed with AMSTAR 2, and only those rated moderate or higher were included. Data synthesis and meta-analyses were performed using R. From 1165 records, 35 systematic reviews met initial criteria; nine were included in the final synthesis, representing 305 primary studies (195 relevant to LMICs). Of those, 50 % were hospital-based and 22 % population-based, limiting the generalizability of the data and the importance of promoting more population-based studies. The overall quality of systematic reviews was variable, with only a few meeting high standards. Geographic analysis revealed a significant underrepresentation of high-quality reviews in sub-Saharan Africa and Latin America. Age at diagnosis varied: sub-Saharan Africa (45-52 years), Middle East (36-56 years), and Latin America (∼49-53 years). Advanced-stage diagnoses (stages III and IV) were common, worsening prognostic outcomes. Molecular subtype analysis indicated a predominance of luminal A but highlighted treatment challenges due to limited targeted therapy access. The results emphasize a pressing need to enhance the availability and quality of primary data, including both hospital-based and population-based studies, particularly in underrepresented regions like sub-Saharan Africa and Latin America. Addressing these gaps with rigorous, locally focused studies is essential for improving breast cancer prevention, diagnosis, and treatment. Enhancing methodological standards and expanding research in these areas will be crucial to bridging global breast cancer outcomes disparities.

In the colorectum, intramucosal carcinoma (IMC), like high-grade dysplasia (HGD), should be resected endoscopically. We were interested to understand how real-world treatment of IMC cases compares to management of HGD and T1 colorectal cancer (CRC).

A multicenter cohort study was conducted. Through pathology databases, all patients diagnosed between 2010 and 2019 with HGD, IMC, or T1 CRC polyps at 3 hospitals in a regional Canadian center were identified. The primary outcome was the proportion of surgical management of IMC compared to HGD after complete endoscopic resection. Secondary outcomes were the proportion of synchronous advanced neoplasia (SAN) and the adjusted hazard ratios (aHRs) for metachronous advanced neoplasia (MAN) in the 3 groups among patients eligible for follow-up.

We identified 753 patients with IMC or HGD on a first pathology diagnosis, including 601 after complete endoscopic resection. Patients with IMC were more likely to undergo surgery after complete endoscopic resection compared to patients with HGD (10.5% [6 of 57] vs 0% [0 of 544], P < .001). A total of 455 patients had follow-up endoscopy and pathology (mean age, 67.1 years; 42.2% female; median follow-up, 3.4 years): 269 with HGD, 60 with IMC, and 126 with T1 CRC. Proportions of SAN were 24.2%, 26.7%, and 25.4% (P = .908). Compared to HGD, patients with IMC and T1 CRC had similar MAN risks (aHR, 0.82 [95% CI, 0.43-1.59] and aHR, 1.16 [95% CI, 0.66-2.05], respectively). No lymph node findings were positive (0 of 363), and no metastasis occurred among patients with IMC.

Patients diagnosed with colorectal IMC were more likely to undergo surgery after complete endoscopic resection than when HGD was diagnosed, although they were not at increased risk of SAN or MAN in this study, and the known risk of nodal metastasis with colorectal IMC is small (0%-2%). Unless a patient diagnosed with IMC is particularly concerned with this small risk, complete endoscopic resection should be considered the definitive treatment for IMC and should not be followed by surgery.

To determine the value of radiomics data extraction from baseline 18F FDG PET/CT in the prediction of tumor-infiltrating lymphocytes (TILs) among patients with primary breast cancer (BC).We retrospectively evaluated 74 patients who underwent baseline 18F FDG PET/CT scans for BC evaluation between October 2020 and April 2022. Radiomics data extraction resulted in a total of 131 radiomic features from primary tumors. TILs status was defined based on histological analyses of surgical specimens and patients were categorized as having low TILs or moderate & high TILs. The relationships between TILs groups and tumor features, patient characteristics and molecular subtypes were examined. Features with a correlation coefficient of less than 0.6 were analyzed by logistic regression to create a predictive model. The diagnostic performance of the model was calculated via receiver operating characteristics (ROC) analysis.Menopausal status, histological grade, nuclear grade, and four radiomics features demonstrated significant differences between the two TILs groups. Multivariable logistic regression revealed that nuclear grade and three radiomics features (Morphological COMShift, GLCM Correlation, and GLSZM Small Zone Emphasis) were independently associated with TIL grouping. The diagnostic performance analysis of the model showed an AUC of 0.864 (95% CI: 0.776-0.953; p < 0.001). The sensitivity, specificity, PPV, NPV and accuracy values of the model were 69.6%, 82.4%, 64%, 85.7% and 78.4%, respectivelyThe pathological TIL scores of BC patients can be predicted by using radiomics feature extraction from baseline 18F FDG PET/CT scans.

Gallbladder cancer (GBC) has a poor prognosis, particularly in advanced stages, with surgery often offering limited survival benefit. This study aimed to identify risk factors for futile surgery (FS), defined as procedures followed by early recurrence or death.

An international cohort of 788 patients who underwent up-front GBC surgery across 18 centers was analyzed. Futility was defined as recurrence within 5 months or death within 90 days after oncological surgery. A multivariate model was built, and an online calculator was developed to predict the probability of FS.

A total of 107 patients (13.6%) experienced FS, with a median survival of only 6.8 months, compared with 57.4 months for nonfutile cases. The key risk factors identified were the T3-T4 tumor stage (odds ratio [OR] 2.20; 95% confidence interval [CI] 1.30-3.71), lymph node involvement (OR 1.91; 95% CI 1.22-2.98), and multivisceral resection (OR 2.25; 95% CI 1.28-3.94). Incidental GBC diagnoses showed a lower risk of FS (OR 0.41; 95% CI 0.25-0.67). The predictive model had a strong discriminative ability (c-statistic: 0.749). Decision curve analysis demonstrated the superiority of the multivariate model over individual predictors.

Refining patient selection can reduce futile surgeries in GBC. The predictive model provides a valuable online tool ( https://aicep.website/?cff-form=25 ) to improve decision-making and outcomes by minimizing unnecessary interventions.

Clear cell renal cell carcinoma (ccRCC) is a prevalent and aggressive malignancy, with the von Hippel-Lindau (VHL) gene playing a critical role in its pathogenesis. However, the association between VHL gene variants and sporadic ccRCC risk remains unexplored in the Indian population. This study aimed to investigate the somatic and germline variants of the VHL gene in sporadic ccRCC patients from West Bengal, India, and their association with disease risk and clinicopathological parameters.

A total of 210 ccRCC patients and 255 ethnicity-matched healthy controls were enrolled. Genomic DNA from blood and tissue samples was analyzed using PCR-based Sanger sequencing. The association of VHL variants with ccRCC risk was assessed using Chi-square tests. The impact of genetic variants on patient clinicopathological features and overall survival was evaluated using Kaplan-Meier survival analysis and Cox proportional hazards models.

We identified twenty-three single nucleotide variants (SNVs) in the VHL gene, including 3 novel variants, OR250433 T > G, OR125589 C > T and OQ627404 G > C. The intronic variant rs61758376 G > C and 3'UTR variant rs1642742 A > G were significantly associated with an increased risk of ccRCC (OR = 1.676, P = 0.0074; OR = 1.735, P = 0.0171, respectively). The rs1642742 GG genotype was also significantly associated with larger tumor size (P < 0.05) and advanced tumor stage (pT4). Kaplan-Meier analysis indicated poorer overall survival for patients with the rs1642742 GG genotype (log-rank P = 0.029).

Our study is the first to document the association of VHL gene variants with sporadic ccRCC risk and clinical outcomes in the Indian population. The identified variants, particularly rs61758376 and rs1642742, could serve as potential biomarkers for ccRCC susceptibility and prognosis.

Standard neoadjuvant regimens for human epidermal growth factor receptor 2 (HER2)-positive breast cancer include trastuzumab and pertuzumab combined with chemotherapy, and the efficacy and safety of third-generation HER2-directed antibody-drug conjugate (ADC) remain to be elucidated.

This open-label, randomized, phase II study enrolled patients aged ≥18 years with stage II-III HER2-positive breast cancer. Patients were randomly assigned (1 : 1 : 1) to receive neoadjuvant treatment either with SHR-A1811 monotherapy, SHR-A1811 with pyrotinib, or nab-paclitaxel combined with carboplatin, trastuzumab, and pertuzumab (PCbHP) for 24 weeks. The primary endpoint was pathological complete response (pCR). Safety was analysed in patients who received at least one dose of study medication.

Between 27 December 2022 and 11 February 2024, 265 patients were randomly allocated to neoadjuvant, mono-SHR-A1811 (n = 87), SHR-A1811 plus pyrotinib (n = 88), or PCbHP (n = 90). The baseline characteristics were well balanced; ∼45% of the patients were hormone receptor (HR) positive, and 70% of the patients were stage III. The pCR rate was 63.2% for mono-SHR-A1811 (50% for HR positive and 74.5% for HR negative), 62.5% for SHR-A1811 plus pyrotinib (44.7% for HR positive and 76% for HR negative), and 64.4% for PCbHP (54.1% for HR positive and 71.7% for HR negative), with no significant difference between the groups. Grade ≥3 treatment-related adverse events occurred in 44.8% of patients with mono-SHR-A1811, 71.6% with SHR-A1811 plus pyrotinib, and 38.8% with PCbHP. One patient experienced grade 2 interstitial lung disease in SHR-A1811, 9.1% of patients experienced grade 3 diarrhoea in SHR-A1811 plus pyrotinib, and no treatment-related deaths occurred.

This is the first study to report the efficacy and safety of third-generation HER2-directed ADC in the neoadjuvant setting for HER2-positive breast cancer. SHR-A1811 showed robust activity, with a tolerable safety profile.

The Global Leadership Initiative on Malnutrition (GLIM) criteria, proposed in 2018, provide universal diagnostic standards for malnutrition, a known risk factor for postoperative complications in patients with various cancers. However, its impact on surgery for biliary tract cancer (BTC) remains unclear. This study evaluates the relationship between GLIM-defined malnutrition and postoperative complications after resection for BTC.

The subjects of this retrospective study were patients who underwent pancreaticoduodenectomy or major hepatectomy with extrahepatic bile duct resection for BTC between January, 2013 and December, 2021. The comprehensive complication index (CCI), an indicator of postoperative complications, was calculated based on the total number and severity of postoperative complications.

GLIM-defined malnutrition was diagnosed in143 (71.1%) of the total 201 patients. The median CCI was significantly higher in the GLIM-defined malnutrition group than in the non-malnutrition group (37.2 vs. 28.3; P < 0.001). Multivariate logistic regression analysis revealed that GLIM-defined malnutrition (odds ratio 2.87 [95% confidence interval 1.38-5.96], P = 0.005) and intraoperative blood loss > 1,000 mL (odds ratio 3.77 [95% confidence interval 1.06-13.47], P = 0.041) were independent predictors of high morbidity (CCI ≥ 37.1).

Preoperative GLIM-defined malnutrition was closely associated with increased postoperative complications in patients who underwent resection for BTC.

Accurate assessment of viable HCC on pre-transplant cross sectional imaging is important for correct organ allocation and overall patient outcome following liver transplantation.

Determine accuracy of LI-RADS TRA compared to explant pathology in patients treated with thermal ablation, using contrast enhanced multiphase CT and MRI.

Imaging studies for 119 consecutive adult HCC patients treated with thermal ablation and liver transplantation from March 2001 to September 2019 at a single tertiary care hospital were retrospectively studied by three Board-certified radiologists. LI-RADS TRA categories for each tumor were compared with explant pathology. Cohens Kappa test and inter-reader agreement by Fleiss κ test, with 95% confidence intervals obtained with bootstrap technique were used.

Of the 119 patients (median age 59 years, 95 [80%] male) with 165 HCCs treated with percutaneous thermal ablation, 68% were completely necrotic and 32% were viable on pathologic analysis. Tumors viable on explant were larger on pre-treatment imaging (median 2.4 vs. 2.1 cm; p = 0.02) with no difference in pre-transplant ablation cavity sizes between groups (4.0 vs. 3.9 cm, respectively; p = 0.58). NPV of LI-RADS TRA for viable tumor was 71% (68-74); PPV of 62.5% (39-81) (p = 0.01) with a sensitivity of 19% (9.4-32), specificity of 95% (89-98), and accuracy of 70% (63-77). On explant, 55 incidental treatment naïve viable tumors, not visible on pre-transplant imaging, were found in 33 patients.

The "non-viable" category of LI-RADS TRA even when applied to a relatively uniform percutaneous ablation cohort, demonstrated low sensitivity in predicting absence of viable tumor. MRI had more accuracy than CT in predicting tumor viability when compared to explant pathology.

Lymph node metastasis (LNM) significantly impacts prognosis in external ear squamous cell carcinoma (SCC). Identifying high-risk patients remains a challenge due to the lack of standardized criteria for elective neck dissection (END). This study aims to evaluate predictive factors for LNM in external ear SCC.

a retrospective analysis of 176 patients with T1-T3, N0 external ear SCC who underwent surgical excision between 2015 and 2019 was conducted. Patients were stratified by tumour subsite (auricle, external auditory canal, retroauricular, and preauricular regions). Histopathological parameters, including tumor size (T), depth of invasion (DOI), perineural invasion (PNI), perivascular invasion (PVI), cartilage invasion, and tumor grade, were analysed for association with LNM. Statistical analyses included univariate and multivariate logistic regression models.

LNM occurred in 5.7% (n = 10) of patients, with metastases appearing within an average of 7.1 months post-surgery. T3 tumours had a significantly higher LNM rate (p < 0.05). The preauricular region was the most frequent metastatic subsite (p = 0.001). Poorly differentiated tumours (G3/G4) were strongly associated with LNM (p = 0.001). DOI and cartilage invasion were not independent predictors. The Brigham and Women's Hospital (BWH) classification system demonstrated superior risk stratification compared to NCCN and AJCC-8.

T3 stage, preauricular location, and high tumour grade are significant predictors of LNM in external ear SCC. The findings support the need for individualised risk stratification, with consideration of END in high-risk cases. Future studies should incorporate molecular markers to refine metastatic risk assessment.

Colorectal cancer (CRC) has the second highest incidence rate among all cancers in Korea, with approximately 30% of patients with regional CRC experiencing recurrence. Understanding the genetic drivers of recurrence is essential for early detection and targeted treatment. Therefore, many studies have focused on genetic analysis using tumor-normal matched samples, as this approach provides more comprehensive insights. However, tumor-only samples are far more common in clinical practice because of the difficulty in obtaining normal tissues, making developing robust methods for analyzing tumor-only data a pressing need. This study aimed to investigate the genetic variations associated with CRC recurrence using tumor-only whole-exome sequencing data from 200 Korean patients with stage III CRC. By applying stringent filtering using public databases including Genome Aggregation Database (gnomAD), Exome Aggregation Consortium (ExAC), Single Nucleotide Polymorphism Database (dbSNP), 1000 Genomes Project (1000G), Korean Variant Archive 2 (KOVA2), and Korean Reference Genome Database (KRGDB), we identified 221 statistically significant mutations across 195 genes with distinct distributions between the recurrence and non-recurrence groups. Furthermore, statistical analysis of the clinical data revealed that the T-category, N-category, and preoperative carcinoembryonic antigen levels were correlated with CRC recurrence. Moreover, we identified nine networks through protein-protein interaction analysis and identified networks with high feature importance. We also developed a CRC recurrence prediction model using PyCaret, which achieved an area under the curve (AUC) of 0.77. Our findings highlight the importance of robust variant filtering in tumor-only sample analyses and provide insights into the genetic landscape of CRC recurrence in the Korean population.

Data on quality-of-care indicators for breast cancer patients is limited in low-and middle-income countries. We evaluated the indicators in Iran.

A total of 21 quality-of-care indicators of breast cancer management defined by EUSOMA 2017 were selected. The indicators were retrospectively evaluated based on the data from the Clinical Breast Cancer Registry established in 11 provinces of Iran.

In the study of 6,293 patients evaluated on 21 indicators, 15 indicators were more than 5% below EUSOMA's standard levels.

The defined indicators had a value lower than the suggested standards by EUSOMA. This study's results highlight important clues for intervention in improving breast cancer outcomes in Iran and other low-and middle-income countries.

Exploration of effective screening methods is imperative to improve current screening for colorectal cancer (CRC). Our aim was to systematically search the literature to identify and assess the diagnostic accuracy of both genetic and epigenetic biomarker panels for CRC detection using liquid biopsies for circulating tumour DNA (ctDNA) from stool, blood, or urine.

A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) with searches in Medline, Embase, CENTRAL, and Web Of Science from inception up to March 20, 2025, using pre-defined keywords. Study quality assessment was performed using QUADAS-2 tool (Quality Assessment for Diagnostic Accuracy Studies 2). Primary and secondary outcomes were panel performance (sensitivity and specificity) for CRC, advanced precancerous lesions (APL), and staging of disease.

Forty-four studies were included. Exceptional performance for both CRC (sensitivity and specificity) and APL (sensitivity) was displayed by biomarker panels including methylated SDC2 with methylated SFRP1/2 (CRC: 91.5%/97.3%, APL: 89.2%) or methylated TFPI2 (CRC: 94.9%/98.1%, APL: 100%), and a 5-biomarker panel of mutational targets APC, Bat-26, KRAS, L-DNA, and p53 (CRC: 91.0%/93.0%, APL: 82.0%). Suboptimal APL sensitivities up to 57.0% were exhibited by Cologuard and variant panels (including KRAS, methylated BMP3, methylated NDRG4, FIT), and 47.8% for combinations including methylated SEPT9.

High-performance, candidate ctDNA biomarker panels with exceptional diagnostic accuracy for both CRC and APL have been identified. Further work should focus on the development of large-scale studies to justify their clinical implementation.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare, via a network meta-analysis, the effectiveness and safety of different immunotherapy agents that are administered in a perioperative setting to people with resectable non small-cell lung cancer To perform indirect comparisons in order to generate a clinically meaningful hierarchy of perioperative strategies of immunotherapy administration for overall survival in operable people with resectable non small-cell lung cancer.

Osteosarcoma, accounting for 2.4% of all childhood malignancies and about 20% of primary bone cancers, primarily affects young adults, with 60% of cases occurring before age 25. Tumor thrombus (TT) formation, a type of cancer-associated thrombosis, is a rare but critical complication in osteosarcoma, leading to increased morbidity and mortality. TT is characterized by the direct extension of the tumor into adjacent vessels, displaying similar imaging characteristics and contrast enhancement as the primary tumor. Our study is a case series of five cases of extremity osteosarcoma where the presence of tumor thrombus has been diagnosed, highlighting diagnostic challenges and management strategies. Preoperative identification of TT remains difficult and is often diagnosed postoperatively or at autopsy. Advanced imaging techniques such as Computed Tomography, Magnetic Resonance Imaging, and Positron Emission Tomography can aid in the detection of TT, although they are not definitive. Surgical resection combined with thrombectomy is recommended, improving prognosis. Anticoagulation therapy aims to prevent bland thrombus formation rather than resolving TT, as the latter increases the risk of embolization. This study underscores the need for heightened suspicion and comprehensive preoperative imaging to improve outcomes in osteosarcoma patients with TT, advocating for multidisciplinary management including vascular surgeons during limb salvage procedures. Further research is essential to optimize anticoagulation protocols and validate these findings in larger cohorts.

This study aimed to develop and validate a predictive model for preoperative extrathyroidal extension (ETE) in papillary thyroid carcinoma (PTC) using MRI features.

We retrospectively analyzed 140 confirmed PTC cases, divided into training (n = 84) and validation (n = 56) groups. MRI features such as T2-weighted imaging, multiphase contrast-enhanced MRI, and diffusion-weighted imaging were evaluated along with clinical data. Univariate and multivariate logistic regression identified independent predictors of ETE and developed a predictive nomogram. We evaluated the nomogram's discrimination, calibration, and clinical utility, and performed subgroup analyses to explore the relationships between risk factors and baseline data. Predictive performance was assessed using ROC curves and DeLong tests.

Age, protrusion value, and apparent diffusion coefficient_Brightest_rate (ADC_Best_rate) were independent predictors of ETE. The nomogram effectively differentiated ETE from no-ETE, showing strong discrimination, clinical utility, and calibration in both the training (AUC = 0.826, Hosmer-Lemeshow p = 0.882) and validation cohorts (AUC = 0.805, Hosmer-Lemeshow p = 0.585). The model performed consistently across different MRI systems (1.5 T and 3.0 T) and gender subgroups. Notably, ADC_Best_rate (AUC = 0.742) outperformed ADC_mean_rate and ADC_minimum_rate. A significant interaction between ADC_Best_rate and gender (p = 0.02) showed that ADC_Best_rate predicted ETE in PTC more accurately in males (AUC = 0.897) compared to females (AUC = 0.644).

Our nomogram model, incorporating age, protrusion value, and ADC_Best_rate, effectively predicted preoperative ETE in PTC patients, aiding surgeons in optimizing therapeutic decision-making. ADC_Best_rate may be a promising potential indicator in MRI functional imaging.

Question This study addresses the challenge of accurately predicting extrathyroidal extension (ETE) in papillary thyroid carcinoma (PTC) to improve surgical decision-making. Findings A predictive nomogram incorporating age, protrusion value, and ADC_Best_rate effectively differentiates ETE from no-ETE, showing strong performance in both training and validation cohorts. Clinical relevance This nomogram aids surgeons in identifying patients at risk for ETE, enhancing therapeutic decision-making and potentially improving patient outcomes in PTC management.

Rectal cancer poses a significant global health burden. Conventional neoadjuvant chemoradiotherapy (nCRT) demonstrates limited efficacy in achieving disease-free survival (DFS) and organ preservation. Total neoadjuvant therapy (TNT), an emerging paradigm integrating systemic chemotherapy with radiotherapy, aims to address these limitations.

To evaluate the short- and long-term oncological outcomes and organ preservation feasibility of TNT in high-risk locally advanced rectal cancer (LARC) patients.

A retrospective study was conducted to analyze the short-term and long-term results after total nCRT.

This retrospective study involved 110 rectal cancer patients with high-risk features treated at the Fudan University Shanghai Cancer Center from 2008 to 2022. Patients underwent comprehensive staging and received nCRT followed by either total mesorectal excision (TME) or a watch and wait (W&W) strategy. The regimen included concurrent chemoradiotherapy with 50 Gy/25 fractions and at least six cycles of induction or consolidation chemotherapy. Both short-term and long-term outcomes were collected and analyzed.

Among the LARC patients, 73.6% were stage III, and 47.3% opted for the W&W strategy. The combined rate of clinical complete response or confirmed pathological complete response (pCR) reached 49.1%. During follow-up, 10% of patients experienced local regrowth. The 3-year DFS and overall survival (OS) rates were 75.7% and 92.4%, respectively. The W&W strategy could achieve superior outcomes than patients without pCR in DFS (p = 0.021) and OS (p = 0.006).

TNT demonstrates durable survival outcomes and facilitates organ preservation in over 50% of high-risk LARC patients. Intensive surveillance is critical for the early detection of local regrowth.

Our study is retrospective in nature, rather than a prospective clinical trial. Therefore, registration was not conducted, and the Clinical Trial Number is not applicable.

Lung cancer has become a significant global health concern due to the increasing number of cases and deaths. Recent research has suggested a potential link between parasites and lung cancer. This review aims to comprehensively analyse existing literature to highlight relevant studies evaluating this relationship. A thorough search in different databases revealed four key associations: parasites as a potential risk factor for lung cancer, suppressors of lung cancer, mimics of lung cancer leading to misdiagnosis, and coincidental infections with lung cancer. The review indicates a significant relationship between parasites and the suppression of lung cancer, emphasising the importance of further research to explore this novel avenue in the hope of identifying and developing novel biological cancer therapeutic and preventive strategies. It also stresses the importance of recognising pulmonary parasitic infections in the differential diagnosis of lung cancer to prevent misdiagnosis and subsequent unnecessary surgical intervention. Additionally, in patients with concurrent pulmonary parasitic infections and lung cancer, which may be easily overlooked, persistent symptoms despite applying appropriate anti-parasitic treatment should raise concern about the need for repetitive evaluation by appropriate diagnostic protocols and imaging follow-up for potential underlying lung cancer.

The aim of this study was to assess the number of complete resections and recurrence rates in oral and oropharyngeal squamous cell carcinoma treated with intraoperative narrow-band-imaging.

In this observational study, superficial resection margins of oral and oropharyngeal squamous cell carcinoma were intraoperatively defined using narrow-band-imaging. The number of complete resections was assessed. Patients were followed up for at least 5 years: disease free survival and the cumulative incidence of local recurrence were recorded.

93 squamous cell carcinoma were considered. Surgical resection was complete in 84.9 % of cases. The 5-years disease free survival was 76.2 % (95%CI: 67.1 %-84.4 %). Cumulative incidence of local recurrence was 9.7 % (95%CI: 4.7 %-16.7 %), lower compared to previous literature: it was higher in patients over 68 years (14.3 %, 95%CI: 6.2 %-25.6 % vs 4.5 %, 95%CI: 0.8 %-13.8 %) although without statistically significance.

In oral and oropharyngeal squamous cell carcinoma surgery, narrow-band imaging is a valuable tool for accurately identifying the true superficial extent of the tumor, facilitating complete resection and potentially reducing local recurrence.

Dystonin (DST), a potential tumor suppressor gene, plays a crucial role in regulating cancer cell proliferation and resistance to chemotherapy. However, DST's specific role in colorectal cancer (CRC) has not been thoroughly investigated, and this study aims to elucidate its molecular role in modulating cisplatin (DDP) resistance in CRC.

DST expression was analyzed in CRC tumors, DDP-resistant CRC tissues, paracancer tissues, and normal tissues. Lentiviral overexpression and shRNA knockdown were conducted in advanced CRC and DDP-resistant cell lines to assess cell viability, apoptosis, invasion, migration, proliferation, and angiogenesis. Xenograft mouse models studied DST's impact on CRC tumor growth and DDP resistance in vivo.

DST expression was significantly reduced in CRC tumor and DDP-resistant CRC tissues compared to paracancer and normal tissues (P < .001). Upregulating DST inhibited CRC and DDP-resistant cell viability, proliferation, invasion, and migration while promoting apoptosis. DST overexpression also reduced angiogenesis and attenuated DDP-induced cytotoxicity in CRC cells. Mechanistically, DST upregulation suppressed DDP resistance in CRC cells via the PI3K/Akt signaling pathway. DST upregulation reduced CRC tumor growth and mitigated DDP resistance, in vivo.

DST plays a crucial role in limiting CRC progression and overcoming DDP resistance, suggesting potential for targeted CRC therapies.

Guidelines vary in their recommendations for postoperative radioactive iodine (RAI) in differentiated thyroid cancer (DTC). Omitting RAI reduces overtreatment but poses the possibility of missing distant metastases.

This study compares 4 guidelines on RAI indications and potentially missed metastases.

DTC patients were included retrospectively, including 48 patients with distant metastases after first RAI cycle, and 469 without distant metastases. The percentage of distant metastases missed was calculated if RAI had been omitted following the 2015 American Thyroid Association (ATA), 2019 European Society for Medical Oncology (ESMO), 2022 European Thyroid Association (ETA), and 2022 American Society of Nuclear Medicine and Molecular Imaging/European Association of Nuclear Medicine (SNMMI/EANM) guidelines.

In patients without RAI indication, 1.3% to 1.6% of distant metastases may initially be missed with the ATA, ESMO, and ETA guidelines. All these cases had postoperative thyroglobulin (Tg) between 1 and 10 ng/mL or positive Tg antibodies (Tg-abs). In patients for whom RAI should be considered following the ATA, ESMO, and ETA guidelines, 2.6% to 4.0% of distant metastases may initially be missed, with all but 1 case having Tg greater than 10 ng/mL or positive Tg-abs. With the SNMMI/EANM guideline, no distant metastases would be missed, but it resulted in markedly higher RAI use in low-risk patients (82% vs 0%).

Omitting postoperative RAI in low- and intermediate-risk patients, as recommended by the 2015 ATA, 2019 ESMO, and 2022 ETA guidelines, may lead to a small number of initially undetected distant metastases. However, these metastases could potentially be detected later due to the presence of biochemical disease. In contrast, the broader RAI indications endorsed by SNMMI/EANM reduce the likelihood of missed metastases, but substantially increases RAI use, exposing patients to unnecessary treatment and side effects.

Radical management of the N3 neck for head and neck squamous cell cancer (HNSCC) remains unclear. We aimed to investigate the use of primary surgery including neck dissection versus primary radiotherapy followed by imaging.

We retrospectively reviewed consecutive patients with HNSCC and N3 nodal disease, excluding nasopharyngeal primaries. Patients had either surgical management of the primary and neck dissection followed by postoperative radiotherapy or primary radiotherapy followed by surveillance if complete response was found on post-treatment imaging. Patients were imaged at a mean of 16 weeks post radiotherapy. Patients identified with presence of resectable residual disease on imaging were treated with neck dissection.

Between July 2012 and February 2023, 53 patients with T0-4N3M0 HNSCC were treated radically. The median (range) follow-up was 25.5 (3-146) months, with an opportunity for follow-up of 64 (19-147) months. Twenty-two patients had primary surgical management and 31 had primary radiotherapy. Two-year overall survival was 64% in patients treated with primary surgery, 55% in patients treated with primary radiotherapy, 87% in patients with complete response after radiotherapy, and 92% in complete responders who were p16 positive. Response assessment was done with positron emission tomography-computed tomography (PET-CT) in 77% of patients and predicted subsequent disease-free survival better than computed tomography (CT). p16-positive patients were more likely to achieve complete response (63% vs 25%), but extracapsular spread was not predictive of response.

Surveillance for patients with complete response on postradiotherapy PET-CT is a reasonable approach, especially for p16-positive patients, sparing them the morbidity of neck dissection. Patients with p16-negative disease are less likely to achieve a complete response and may be better managed with primary neck dissection.

Deep learning is a promising approach to increase reproducibility and time-efficiency of gross tumor volume (GTV) delineation in head and neck cancer, but model evaluation primarily relies on manual GTV delineations as reference annotation, which are subjective and tend to overestimate tumor volume. This study aimed to validate a deep learning model for laryngeal and hypopharyngeal GTV segmentation with pathology and to compare its performance with clinicians' manual delineations.

A retrospective data set of 193 patients with laryngeal and hypopharyngeal cancer was used to train a deep learning model with clinical GTV delineations as reference. For validation, a data set comprising 18 patients who underwent imaging before total laryngectomy was used, with histopathology-based (n = 16) tumor delineations as ground truth. The performance of the automatic segmentations was compared with that of clinicians' manual delineations, both quantitatively and qualitatively.

Median sensitivity (0.90 and 0.91) and largest required clinical target volume margin (6.4 and 6.6 mm) were comparable between automatic and manual GTV delineations. The positive predictive value yielded the only significant difference between automatic and manual GTV delineations, with medians of 0.52 and 0.61, respectively (P = .03). Clinical target volumes derived from automatic and manual GTVs exhibited similar sizes (median of 44.5 and 40.1 mL) and achieved a sensitivity of 1.00 in 13/16 and 14/16 tumors, respectively. Automatic segmentations were considered clinically acceptable in 67% of cases, compared with 63% of manual delineations.

The proposed deep learning model for laryngeal and hypopharyngeal GTV segmentation achieved comparable results with clinicians' manual delineations, showing the potential for more consistency and efficiency in the radiation therapy workflow.

The objective of this study is to investigate the risk and prognostic factors for radioactive iodine (RAI)-refractory (RAIR) differentiated thyroid cancer (DTC) with distant metastasis.

A total of 128 patients with distant metastasis-DTC who underwent iodine-131 radiotherapy were included in this cohort study. After exclusion, 75 DTC patients who were resistant to radioiodine therapy and 53 patients in whom the treatment was successful were finally included. Clinical data as well as BRAF V600E and telomerase reverse transcriptase (TERT) promoter mutations were compared between these two groups to predict the risk of RAIR. Patients with RAIR-distant metastasis-DTC were followed up to further investigate the risk factors for disease progression after the cancer became iodine-refractory.

Univariate analysis showed that TERTp mutation, age at diagnosis, mean maximum tumor diameter, lymph node metastasis, synchronous metastasis or heterochronous metastasis, mean cumulative dose of RAI, and preoperative Tg were statistically different between the RAIR and RAIE (radioiodine efficient) groups. Logistic regression analysis further found that the TERTp mutation may be risk factor for iodine refractory occurrence. During the follow-up of RAIR-distant metastasis-DTC patients, 41 patients developed disease progression, and 24 patients had good disease control.

We found that TERTp mutation is correlated with the poor curative effect of RAI therapy in distant metastasis-DTC. Once iodine refractory occurs, patients aged 55 years or older are more likely to develop disease progression.

Oral squamous cell carcinoma (OSCC) is a common cancer, with a high propensity for regional lymph node metastasis (LnM), resulting in 5-year survival rates of only 40%-50%. The premetastatic niche (PMN), a modified lymph node microenvironment preparing for future metastasis, is poorly understood. This study analyzes the histomorphological features of nonmetastatic lymph nodes from OSCC patients, stratified by the presence or absence of regional cervical LnM.

This cohort study examined 424 nonmetastatic lymph nodes, preserved in paraffin blocks, from 45 OSCC patients. Histological analysis was performed using hematoxylin and eosin staining to evaluate architectural features, specifically capsule and trabeculae thickness, subcapsular and medullary sinus ectasia, fibrosis, follicular organization, and hyperplasia. Logistic regression models were used to assess the relationships between these features and LnM, recurrence, and survival.

Our analysis revealed that intense medullary ectasia was associated with an increased risk of lymph node metastasis (LnM) (OR = 1.63; 95% CI: 0.99-2.67; p = 0.051), whereas follicular hyperplasia appeared protective (OR = 0.27; 95% CI: 0.15-0.5; p < 0.001). Nonvisible sinusoidal trabeculae suggested a higher risk of recurrence (OR = 2.18; 95% CI: 0.99-4.81; p = 0.05). Disorganized lymphoid follicles (OR = 1.91; 95% CI: 0.97-3.77; p = 0.059), focal subcapsular ectasia (OR = 4.4; 95% CI: 1.34-14.37; p = 0.014) and marked subcapsular ectasia (OR = 3.2; 95% CI: 1.06-9.63; p = 0.038) correlated with decreased survival. Conversely, follicular hyperplasia (OR = 0.38; 95% CI: 0.19-0.74; p = 0.005) and medullary fibrosis (OR = 0.13; 95% CI: 0.02-0.67; p = 0.015) were associated with improved survival.

These results highlight the potential clinical significance of follicular hyperplasia in lymph nodes. Patients exhibiting this feature may have a more favorable prognosis, characterized by increased survival and decreased risk of lymph node metastasis, regardless of concurrent alterations in other lymph node architecture.

Neoadjuvant chemoimmunotherapy followed by adjuvant immunotherapy is the gold standard for treating patients with higher risk early triple-negative breast cancer (TNBC); however, in some cases, these patients undergo surgery followed by chemotherapy-based anthracyclines and taxanes without adhering to the guidelines.

Patients with previously untreated stage I, II, and III TNBC who received adjuvant therapy with either doxorubicin and cyclophosphamide (AC) + docetaxel (AC-D), AC + weekly paclitaxel (AC-WP), epirubicin and cyclophosphamide (EC) + docetaxel (EC-D), or EC + WP (EC-WP); older than 18 years; and diagnosed between January 1st, 2011, and December 31st, 2022, were eligible for the study. Disease-free survival (DFS) is the primary reported end point. Overall survival (OS) and safety were the secondary end points.

We included 272 female patients. At a prespecified event-driven data cutoff, with a median follow-up of 26.3 months, the 5-year DFS was 49% (95% CI, 38 to 63) in the AC-D group, 45% (95% CI, 29 to 70) in the AC-WP group, 73% (95% CI, 61 to 100) in the EC-D group, and 72% (95% CI, 44 to 100) in the EC-WP group (hazard ratio [HR], 0.2 [95% CI, 0.06 to 0.67]; P = .08). The 7-year OS was 52% (95% CI, 32 to 83) in the AC-D group, 88% (95% CI, 78 to 99) in the AC-WP group, 95% (95% CI, 88 to 100) in the EC-D group, and 83% (95% CI, 58 to 100) in the EC-WP group (HR, 0.19 [95% CI, 0.06 to 0.66]; P = .03). Most of the grade 3-4 adverse events occurred in the AC-D group, primarily neutropenia, nausea-vomiting, and alopecia.

EC-D was linked to a slightly longer survival free of invasive, noninvasive, or distant disease and a significantly longer OS with fewer adverse events. Further studies are needed to confirm and establish long-term clinical benefits.

The neutrophil-to-lymphocyte ratio (NLR) not only indicates the inflammatory response within the tumor microenvironment but may also correlate with tumor biological behavior (such as aggressiveness). The present study aimed to systematically review and conduct a meta-analysis on the impact of the NLR on the prognosis of patients with renal cell carcinoma (RCC). To this aim, a comprehensive search of multiple relevant databases, including PubMed, Embase and the Cochrane Library, was conducted to identify literature related to NLR and RCC prognosis. Following rigorous literature screening and quality assessment, a systematic quantitative analysis was ultimately performed on several studies that met the inclusion criteria. The results indicated a significant association between elevated NLR levels and poor prognosis in patients with RCC, suggesting that high NLR levels may serve as an independent predictor of unfavorable outcomes. Therefore, the present study provides important evidence for clinical decision-making, further demonstrating that NLR can serve as an independent prognostic indicator for patients with RCC, aiding healthcare professionals in making more precise judgments in patient management and treatment strategy formulation.

Robot-assisted radical prostatectomy (RARP) outcomes improve with surgical experience, but preoperative prediction of disease stage is crucial to avoid unexpected T stage upgrades, such as pT3b. This study aimed to identify preoperative predictive factors for pT3b (seminal vesicle invasion) following RARP.

Out of 299 RARP performed between 2013 and 2020, 246 cases without preoperative hormone therapy were included. Of these, 19 cases (7.7%) were pT3b. T classification was performed using magnetic resonance imaging (MRI), and 12-site prostate biopsies were conducted. Cox proportional hazards, logistic regression analysis, and Kaplan-Meier analyses were used.

The 3-year prostate specific antigen (PSA) recurrence-free survival rate was 87% but significantly lower at 70% for pT3b cases. Multivariate logistic regression analysis identified the International Society of Urological Pathology (ISUP) grade group at biopsy as the only significant preoperative predictor of pT3b.

pT3b is associated with increased postoperative biochemical recurrence risk, and ISUP grade group at biopsy serves as a significant preoperative predictive factor for pT3b.

Oropharyngeal squamous cell carcinoma (OPSCC) of human papillomavirus (HPV)-positive status is increasing relative to HPV-negative disease. Nutritional features of OPSCC patients according to HPV status is unclear.

Canadian and Spanish patients with OPSCC were assessed for body mass index (BMI), weight loss grade (WLG), and computed tomography-defined skeletal muscle index (SMI). Chi-square, t-test, Mann-Whitney-U, Kruskal-Wallis tests were conducted to compare HPV positive and negative groups. Overall survival (OS) was assessed by univariable Kaplan-Meier and Cox proportional hazard methods.

No differences in BMI, WLG, SMI, and adipose tissue index between the 308 (Canada) and 134 (Spain) patients according to HPV status; hence cohorts were pooled (n = 442). HPV-positive patients (n = 317) were overweight/obese (72.8%), had WLG of 0/1 (59.6%) and high SMI (83.4%) while HPV-negative patients were normal/underweight (61.5%), had high WLG 3/4 (50.8%), and moderate/severe SMI depletion (46.9%) (p < 0.003). These overall differences notwithstanding, there was crossover i.e. 35% of HPV-positive patients had high WLG and/or moderate/severe muscle depletion and 29% of HPV-negative patients had minimal weight loss and high SMI. HPV-negative patients had a higher risk of mortality (HR 3.78, 95% CI 2.70-5.29, P < 0.001) and this difference was retained after multivariable adjustment for WLG, SMI, age, disease stage, and planned treatment (HR 3.30, 95% CI 2.17-5.02, P < 0.001).

Nutrition features of patients with OPSCC did not differ between Canada and Spain. Distinctive nutrition features exist in patients according to HPV status. The high heterogeneity of individual nutritional profiles invites an individualized approach to nutrition care.

Primary mediastinal large B-cell lymphoma (PMLBCL) is a rare and aggressive non-Hodgkin lymphoma (NHL), considered a specific entity with proper characteristics, therapies, and prognosis. First-line treatment is not unique, and subsequent strategies in case of disease persistence or relapse are the subject of debate and studies. In this scenario, [18F]FDG PET/CT plays a pivotal role both in characterizing the mediastinal mass, the main feature of PMLBCL, in staging, in restaging during therapy (interim PET), and at the end of treatment (EoT PET), to guide clinical management and give prognostic insights. The main issue with PMLBCL is distinguishing viable disease from residual fibrotic/inflammatory mass after therapy and, consequently, settling the next clinical strategy. Novel therapeutic approaches are ongoing and associated with the deepening of [18F]FDG PET/CT potentials as a principal tool in this context. In this review, we will explore PMLBCL from a Nuclear Medicine point of view to help clinicians in the management of these patients.

Every year, almost 900.000 people are diagnosed with head and neck cancer (HNC) worldwide. HNC contains many different subsites and a large variability in tumor biology. This often results in small and/or heterogeneous study populations. Developing overarching databases is an efficient solution to collect and analyze data of these smaller subsets of patients and to facilitate data sharing among research groups. The few existing large databases often include only basic characteristics. In addition, hospital-based cohorts that include more variables are often not collected consecutively, resulting in selection bias. Therefore, we established a hospital-based cancer registry system "Rotterdam Oncology Documentation" (RONCDOC), a complete and consecutive data warehouse and tissue collection for HNC, directly registered at the source. The primary aim of this paper is to report on our data collection protocol in order to make the RONCDOC data accessible and reusable for other researchers, and to offer a blue print to other consortia planning to establish their own data warehouse.

Data collected in the Netherlands Cancer Registry (NCR) of patients with HNC were obtained from the Netherlands comprehensive cancer organization (IKNL) and merged with corresponding data from the electronic patient file (EPF). The data were manually verified using the EPF, and enriched with additional variables from the EPF according to an extensive data entry protocol. Furthermore, a comprehensive validation protocol was developed to guarantee the quality of the data. Tissue microarrays (TMAs) were constructed from resection specimens of patients with primary oral squamous cell carcinoma.

With RONCDOC, we have established a consecutive and high-quality data warehouse for HNC. This paper outlines the essential steps for establishing such a data warehouse, offering a blueprint for other consortia.

This study was approved by the ethics committee of the Erasmus Medical Center (MEC-2016-751).

This study aimed to develop lymph node ratio (LNR)-integrated nomograms to predict overall survival (OS) and disease-specific survival (DSS) in palate squamous cell carcinoma (PSCC) and to guide postoperative radiotherapy (PORT) decisions.

Data from PSCC patients were analyzed to identify prognostic factors, and nomograms were constructed. Performance was assessed using the area under the curve (AUC), calibration plots, and decision curve analysis. PORT benefits were evaluated across risk groups.

Among 959 patients, 5-year OS and DSS were 47.0% and 60.9%, respectively. LNR > 6% was associated with significantly increased mortality. The nomograms showed favorable accuracy (OS 1/3/5-year AUC: 0.780/0.703/0.745; DSS 1/3/5-year AUC: 0.789/0.714/0.700), with calibration plots showing excellent agreement between predicted and observed survival. High-risk patients had significantly poorer survival outcomes than low-risk patients, with PORT benefiting only high-risk groups.

The LNR-based nomograms improve prognostic prediction and optimize PORT selection, offering valuable guidance for personalized treatment.

Neoadjuvant immunotherapy combined with chemotherapy or chemoradiotherapy has emerged as a promising approach in the treatment of esophageal cancer. However, there is a lack of comprehensive understanding regarding the clinical factors that can predict patient response to this therapy. The aim of this study was to develop a predictive model for assessing the efficacy of neoadjuvant immunotherapy in patients undergoing surgical treatment.

This study retrospectively enrolled 220 consecutive patients with preoperative immunotherapy combined chemotherapy or chemoradiotherapy. A logistic regression was used to evaluate the association between pathologic complete response (pCR) and endoscopic ultrasound parameters, constructing a predictive model for treatment response. Additional, overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method, and Cox regression analyses were introduced to explore the associations between EUS factors after neoadjuvant immunotherapy.

Logistic regression analysis identified that the significant predictors of pCR were treatment regimen, negative biopsy findings, RECIST assessment, endoscopic ultrasound responder, and downstaging in uN. A predictive model including above five variables was generated, and area under the curve was 0.840(95%CI 0.78-0.89), this nomogram was also adequately validated internally. In the cox regression analyses, EUS responder was found to be a significant predictor of overall survival with a hazard ratio (HR) of 0.38(95%CI 0.15-0.98), whereas only pCR status was a significant predictor of PFS (HR 0.80; 95%CI 0.01-0.60).

EUS responder can serve as a valuable predictor of the efficacy of adjuvant immunotherapy combined with chemotherapy or chemoradiotherapy, as well as of survival outcomes.

The lymphatic system plays a crucial role in the spread of solid tumors and is often the first site of metastasis, as cancer cells typically invade nearby lymph nodes (LN) before potentially spreading to other LNs through the lymphatic system and distant organs through the bloodstream [...].

This study aimed to develop a comprehensive nomogram model by integrating clinical pathological and full-field digital mammography (FFDM) radiomic features to predict the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer patients, thereby providing personalized treatment recommendations.

A retrospective analysis was conducted on the clinical and imaging data of 227 breast cancer patients from 2016 to 2024 at the Second Affiliated Hospital of Harbin Medical University. The patients were divided into a training set (n = 159) and a test set (n = 68) with a 7:3 ratio. The region of interest (ROI) was manually segmented on FFDM images, and features were extracted and gradually selected. The rad-score was calculated for each patient. Five machine learning classifiers were used to build radiomics models, and the optimal model was selected. Univariate and multivariate regression analyses were performed to identify independent risk factors for predicting the efficacy of NAC in breast cancer patients. A nomogram prediction model was further developed by combining the independent risk factors and rad-score, and probability-based stratification was applied. An independent cohort was collected from an external hospital to evaluate the performance of the model.

The radiomics model based on support vector machine (SVM) demonstrated the best predictive performance. FFDM tumor density and HER-2 status were identified as independent risk factors for achieving pathologic complete response (PCR) after NAC (p < 0.05). The nomogram prediction model, developed by combining the independent risk factors and rad-score, outperformed other models, with areas under the curve (AUC) of 0.91 and 0.85 for the training and test sets, respectively. Based on the optimal cutoff points of 103.42 from the nomogram model, patients were classified into high-probability and low-probability groups. When the nomogram model was applied to an independent cohort of 47 patients, only four patients had incorrect diagnoses. The nomogram model demonstrated stable and accurate predictive performance.

The nomogram prediction model, developed by integrating clinical pathological and radiomic features, demonstrated significant performance in predicting the efficacy of NAC in breast cancer, providing valuable reference for clinical personalized prediction planning.