Background and objectives: Prostate-specific antigen (PSA) concentration is considered an important prognostic marker, with rapid and large reductions associated with a favorable outcome and prolonged survival. Material and Methods: We conducted a single institution and tertiary cancer center retrospective analysis of metastatic hormone-sensitive prostate cancer (mHSPC) patients undergoing active treatment at Division of Oncology and Radiotherapy, University Hospital Dubrava, between December 2022 and August 2025. This study aimed to assess the association between the PSA levels and survival in mHSPC patients undergoing active treatment. Results: A total of 42 (59.2%) in our cohort achieved UL PSA levels, while 29 patients (40.8%) had PSA levels > 0.2 ng/mL. Cox regression analysis identified age > 71 years at the diagnosis of mHSPC and UL PSA levels as statistically significant factors associated with favorable outcome. Conclusions: Our real-world data demonstrated that UL PSA is a favorable prognostic factor associated with prolonged survival and improved prognosis. However, we identified patients achieving UL PSA levels, who experienced radiographic progression. Our finding suggests that even among "best" PSA responders, some might develop resistant clones that manifest via imaging progression without PSA rise.

Background and Objectives: Previous surgical approach comparisons in endometrial cancer may be confounded by inadequate control for tumour biology-the primary driver of outcomes. This study provides the first surgical approach comparison incorporating molecular classification to control for case selection bias. Materials and Methods: Retrospective analysis of 512 consecutive patients with stage I-II endometrial cancer (FIGO 2009) treated with open (n = 83), laparoscopic (n = 278), or robotic (n = 151) surgery between 2018 and 2024. Molecular classification was available for 219 patients (42.8%) using TCGA criteria and incorporated into analyses to control for case selection bias, with molecular subtype incorporated to control for biological bias rather than as a primary endpoint. Primary outcomes included perioperative metrics and oncological safety. The primary objective was to determine whether apparent surgical outcome differences reflect genuine technique effects or case selection bias based on tumour biology. Results: Molecular subtype distribution varied significantly by surgical approach, with high-risk subtypes concentrated in open surgery, explaining apparent outcome differences. After controlling for molecular subtype and other confounders, minimally invasive approaches demonstrated superior perioperative outcomes: reduced blood loss (laparoscopic 129.8 mL, robotic 157.9 mL vs. open 261.4 mL, p < 0.001), shorter hospital stays (2.4 and 2.2 vs. 5.3 days, p < 0.001), and lower complications (5.7% and 6.6% vs. 21.6%, p < 0.001). In our cohort, recurrence-free survival showed significant differences favouring minimally invasive approaches, with 2-year RFS rates of 92.8%, 96.4%, and 100.0% (p = 0.008) and 3-year RFS rates of 90.4%, 95.0%, and 100.0% (p = 0.003) for open, laparoscopic, and robotic surgery, respectively, although robotic surgery had a shorter follow-up (median 33 vs. 42 months). Within-approach exploratory analyses revealed that p53-abnormal tumours were associated with significantly longer operative times and greater blood loss across all surgical approaches (p < 0.05), although complication rates did not differ significantly by molecular subtype within any approach (open p = 0.124, laparoscopic p = 0.656, robotic p = 0.287). Apparent surgical approach differences largely reflected appropriate case selection based on tumour biology rather than technique superiority. Conclusions: When controlling for tumour biology, minimally invasive approaches offer superior perioperative outcomes with equivalent oncological safety. Higher complication rates in open surgery primarily reflect the inherent morbidity of this approach and appropriate surgeon selection for high-risk cases. Within-approach analyses suggest possible molecular influences on operative parameters that warrant prospective validation. Molecular stratification is essential for fair surgical approach comparison in the contemporary era.

We conducted the first epidemiologic study to examine the dose-response relationship between body mass index (BMI) and the likelihood of reporting an overall cancer diagnosis, along with the association between overweight or obese and cancer diagnosis among college students in the United States.

The American College Health Association-National College Health Assessment (ACHA-NCHA) self-reported, cross-sectional data on demographic information, physical activity, BMI, smoking status, and overall cancer from 2019 to 2022 (n = 275,185; 0.08% cancer cases) were used. A cubic spline model and logistic regression analyses were performed to evaluate associations between BMI and the likelihood of reporting a cancer diagnosis, adjusting for relevant covariates.

The cubic spline observed that higher BMI (kg/m²) was associated with a greater likelihood of reporting an overall cancer diagnosis after adjusting for age, sex, race, ethnicity, education level, physical activity, and smoking status (p for linear relation = 0.02 and p for overall association < 0.0001). Specifically, each 1 kg/m² increase in BMI was associated with a 1% increase in the odds of a cancer diagnosis. Multivariable-adjusted logistic regression analyses revealed that both overweight (30 > BMI ≥ 25 kg/m²) [odds ratio (OR): 1.20 (95% confidence interval (CI): 1.08-1.34)], and obesity (BMI ≥ 30 kg/m²) [1.48 (1.32-1.65)] were positively associated with a cancer diagnosis.

Higher BMI, especially overweight/obesity, was associated with a greater likelihood of reporting a cancer diagnosis among college students in the United States. To prevent and control cancer, targeted interventions aimed at maintaining a healthy weight in this population are warranted.

Owing to concerns about overdiagnosis and overtreatment associated with prostate-specific antigen (PSA) screening for early prostate cancer detection, recent guidelines have lowered the PSA cutoff value for recommending biopsy. This study aimed to evaluate the diagnostic accuracy of a lower PSA cutoff value in Korean men and to explore whether additional clinically useful criteria can be proposed.

A retrospective cohort study of 17,539 Korean men who underwent their first prostate biopsy due to lower urinary tract symptoms was conducted at six tertiary hospitals between 2011 and 2019. The diagnostic performance of various PSA and PSA density (PSAD) cutoff values across age groups was evaluated by analyzing the data on demographics, PSA levels, PSAD, and biopsy results.

Among the participants, 44.1% were diagnosed with prostate cancer, of whom 73.7% had clinically significant cancer (Gleason score ≥7). No significant differences in cancer detection rates were found between PSA levels of 3-4 ng/mL and 4-5 ng/mL across age groups. PSAD further increased the area under the receiver operating characteristic curve by 5.5%-11.4%.

These findings suggest that diagnostic yield may not be impacted by merely lowering the PSA cutoff. Rather, combining PSA, PSAD, and patient age enhances screening accuracy while minimizing unnecessary biopsies and overdiagnosis. Our results highlight the need for more data to refine national screening guidelines and promote a more tailored approach to prostate cancer screening in Korea.

Radical cystectomy (RC), which is the standard of care for muscle-invasive and high-grade noninvasive bladder cancer, is accompanied by postoperative renal function deterioration. We aimed to evaluate the effect of serum albumin level on postoperative renal function decline after RC.

A total of 272 patients with estimated glomerular filtration rate (eGFR) ≥60 mL/minute/1.73 m² who underwent RC between October 2003 and December 2020 were included. Acute kidney injury (AKI) was defined according to the KDIGO (Kidney Disease Improving Global Outcomes) criteria, while postoperative chronic kidney disease (CKD) progression was defined as an eGFR <60 mL/minute/1.73 m² at ≥3 months after RC.

In our cohort, 20 (7.4%) and 99 (36.4%) patients experienced postoperative AKI and CKD progression, respectively, with a median follow-up period of 51.5 months. The median preoperative serum albumin level and eGFR were 4.1 g/dL and 82.0 mL/minute/1.73 m², respectively. Preoperative serum albumin less than the median (4.1 g/dL) was associated with postoperative AKI (odds ratio [OR] 3.76, p=0.027) and CKD progression (OR 2.87, p<0.001) after adjusting for other factors.

Serum albumin level <4.1 g/dL was associated with short- and long-term renal function decline after RC, suggesting that close monitoring of renal function after RC might be considered in these patients.

To develop and validate an artificial intelligence (AI)-based personalized outcome prediction model for upper-urinary tract urothelial carcinoma patients undergoing radical nephroureterectomy.

Data from patients who underwent radical nephroureterectomy between 2010 and 2020 across three hospitals were retrospectively analyzed. A model was developed using one tertiary center's data and externally validated with data from two other hospitals. An AI model using XGBoost as risk estimator and bootstrapped Weibull Accelerated Failure Time model for 10-year survival probability was employed. Hyperparameter tuning used Optuna method. Model efficacy was assessed using concordance index, average Brier score, D-calibration, and six-month interval time-dependent area under the curve (AUC).

Of 1,039 patients, 627 qualified after excluding 50 with neoadjuvant chemotherapy. Model development used 564 patients (507 training, 57 test) with 9:1 stratified random split, plus 63 for internal validation and 362 for external validation. Significant parameters included preoperative glomerular filtration rate (p<0.001), hydroureteronephrosis (p=0.013), pathological N stage (p<0.001), concurrent carcinoma in situ (p<0.001), disease progression (p<0.001), and survival rate (p<0.001). Disease-free survival (DFS) model's concordance index: internal validation 0.789, external validations 0.734 and 0.771. Overall survival (OS) model's concordance index: internal validation 0.819, external validations 0.780 and 0.771. Mean time-dependent AUC was 0.66-0.77 for DFS and 0.67-0.80 for OS during 10-year periods.

AI-based model effectively predicts disease-free and OS outcomes for upper-urinary tract urothelial carcinoma patients with post-radical nephroureterectomy, showcasing robust performance across multicenter settings.

Bladder cancer ranks as the 11th most frequent form of cancer and is the most common malignancy of urinary tract cells. A major contributor to bladder cancer development is oxidative stress. The nuclear factor erythroid 2-related factor 2 (NRF2) is a transcription factor that regulates the expression of the transcriptional coactivator with PDZ-binding motif (TAZ) and is found to regulate oxidative stress in cancer cells. This study aimed to investigate the relationship between oxidative stress and the NRF2/TAZ pathway in bladder cancer. In this study, a total of 35 bladder cancer patients and 35 healthy subjects were recruited. The expression of NRF2 and TAZ genes was evaluated using real-time PCR. Total Oxidant Status (TOS) and total antioxidant capacity (TAC) of the samples were measured. Our findings revealed a higher expression of NRF2 (p < 0.001) and TAZ (p < 0.001) mRNA in cancerous tissue as compared to healthy subjects. We also found that there is a positive correlation between tumor grading and NRF2 (r = 0.522, p = 0.001) as well as TAZ (r = 0.462, p = 0.02) genes mRNA expression. Also, our results revealed that there is a significant correlation between TAZ and NRF2 genes mRNA expression in bladder cancer patients. Furthermore TAC level was considerably lower in bladder cancer patients (p < 0.01), while the TOS level was significantly higher compared to the control group(p < 0.05). Finally, our findings suggested that NRF2 and TAZ, as transcriptional factors, are associated with higher grades of bladder cancer as well as oxidative stress in patients with bladder cancer.

Gastric cancer (GC) has a high incidence in China. There is a closed-loop structure in circRNAs, which is involved in various cellular biological processes such as tumor development. However, there is a lack of research on the function of circRNAs in GC. In this study, we aimed to explore the potential of circXPO1 as a diagnostic biomarker and the role of circXPO1 in the progression of GC. We screened out circXPO1 through circRNA sequencing. Using exonuclease digestion assay, agarose gel electrophoresis (AGE), Sanger sequencing, and gDNA experiment, we proved that circXPO1 contained a cyclic structure. Quantitative real-time fluorescent Polymerase Chain Reaction (qRT-PCR) was used to detect the expression of circXPO1 in plasma and GC tissues. The receiver operating characteristic curve (ROC curve) was established to evaluate the diagnostic efficacy of circXPO1. The role of circXPO1 was assessed in vitro. The binding sites between circXPO1 and miRNAs were predicted by CircBank, Circinteractome, CircAtlas and miRanda databases. CircXPO1 was up-regulated in 67 GC tissues compared with the adjacent normal tissues (p = 0.0002). It was stable and hard to be degraded, which made it an ideal tumor biomarker. Compared with the patients in the normal control group, the expression level of circXPO1 in plasma was higher in GC patients (p < 0.001) and those with benign lesions (p = 0.0031) with statistically significant differences. CircXPO1 was proved to have satisfactory diagnostic efficacy in distinguishing GC patients from healthy donors (AUC = 0.813, 95% CI: 0.749-0.877). Besides, the diagnostic efficacy, sensitivity, and specificity could achieve 0.853, 78% and 86%, respectively, when circXPO1, CEA and CA199 were used together in diagnosis. In addition, in vitro experiments indicated that circXPO1 knockdown significantly weakened the proliferation, invasion and migration of GC cells. It was also predicted that circXPO1 could serve as a sponge of miR-1248 to regulate the progression of GC.

The "gold standard" for neuroblastoma (NB) imaging is [¹²³I]I-meta-iodobenzylguanidine ([¹²³I]I-MIBG) scintigraphy. This article presents a case of a child with an abdominal tumor that was suspected to be neuroblastoma. At the age of 2 months, a positive [¹²³I]I-MIBG scan initially supported the diagnosis. Active surveillance was initiated, and a follow-up [¹²³I]I-MIBG study at the age of 7 months revealed no radiotracer accumulation in the tumor. Despite the imaging findings, surgery was performed, and the tumor was found to be a subdiaphragmatic pulmonary sequestration. This case highlights the importance of correlating imaging findings with clinical and laboratory data to ensure an accurate diagnosis.

Sézary syndrome is a rare cutaneous T-cell lymphoma characterized by erythroderma and circulating malignant T cells. This study presents the case of a 31-year-old man with extensive skin involvement detected by 2-deoxy-2-[¹⁸F]fluoro-D-glucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT), demonstrating widespread hypermetabolic lesions across the body. In contrast to computed tomography (CT) or magnetic resonance imaging (MRI), which may overlook subtle or millimetric cutaneous lesions, [¹⁸F]FDG PET/CT accurately delineated the extent of disease and provided critical information for staging, therapeutic decision-making, and response assessment. This case underscores the clinical value of [¹⁸F]FDG PET/CT in evaluating extensive cutaneous involvement in Sézary syndrome.