This study aimed to assess the impact of peer-led cooking workshops on dietary knowledge, skills, and behavioral changes in adopting protein-rich cereals such as spelt, emmer, and einkorn among post-treatment cancer patients. It addressed barriers to sustainable dietary practices, contributing to improved well-being and alignment with the planetary health diet (PHD).

This cohort observational study, part of the BIOQUALIM protocol, adhered to STROBE guidelines and evaluated six post-cancer patients attending six bi-weekly, 2-h cooking workshops at Lyon Sud Hospital, France, between March and June 2024. Workshops focused on savory and sweet recipes using protein-rich cereals (spelt, einkorn, and emmer). Data were collected and analyzed following Kirkpatrick's four-level model using pre- and post-workshop questionnaires (Wilcoxon test analysis) and semi-structured interviews (thematic analysis).

Participants demonstrated a significant increase in knowledge of protein-rich cereals (mean score improvement from 1.9 to 4.0, p = 0.035) and a non-significant improvement in their skills (from 2.5 to 4.1, p = 0.063). Participants reported improved digestion, well-being, and increased confidence in adopting such plant-based diets. The thematic analysis showed that group dynamics fostered social support and self-efficacy. Obstacles such as ingredient availability and preparation time were identified.

Peer-led cooking workshops effectively promote dietary knowledge, sustainable practices, and well-being in post-cancer patients, aligning with PHD principles. This intervention demonstrates potential as a scalable approach for integrating sustainable and health-promoting dietary behaviors. Further research with larger, diverse samples is needed to enhance generalizability and long-term impact assessment.

The role of axillary lymph node dissection (ALND) in breast cancer patients with sentinel lymph node (SLN) micrometastases, particularly after neoadjuvant therapy, remains debated. The present study aimed to assess whether adding ALND provides a survival benefit in this population. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database (2010-2021) and a validation cohort from the First Affiliated Hospital of Xi'an Jiaotong University (2018-2024) for female breast cancer patients with SLN micrometastases (pTxN1miM0) after neoadjuvant therapy. Machine learning techniques (LASSO, random forest, and SVM-RFE) were used to identify key prognostic factors. Survival analyses were conducted using Kaplan‒Meier, Cox regression, and competing risk models to evaluate the impact of ALND on overall survival (OS), disease-free survival (DFS), breast cancer-specific survival (BCSS), and death from other causes (OCSD). After propensity-score matching, 2166 patients from the SEER cohort and 116 from the hospital cohort were included. Survival analysis revealed no significant differences in OS (HR 1.26, P = 0.118), BCSS (HR 1.16, P = 0.378), or DFS (HR 1.88, P = 0.239) between the sentinel lymph node biopsy (SLNB) only group and the SLNB with complete ALND group. No significant differences in the BCSD (P = 0.378) or OCSD (P = 0.121) were found. Machine learning identified 10 prognostic factors, and higher tumor grade, T stages 3-4, PR-negative status, and HER2-negative status were identified as independent unfavorable factors. ALND does not improve survival in breast cancer patients with SLN micrometastases after neoadjuvant therapy. These findings support a more conservative approach to axillary management.

Pediatric ependymomas account for 6-10% of central nervous system tumors in children and are the third most common pediatric brain tumor. However, survival and outcome data from low- and middle-income countries (LMICs), particularly in South Asia, are limited. This study aims to evaluate the clinical profile, treatment approaches, and survival outcomes of pediatric patients with ependymoma in a tertiary care setting in Pakistan.

This retrospective cohort study included 48 pediatric and young adult patients (aged 0-21 years) diagnosed with ependymoma and treated at Aga Khan University Hospital, Karachi, from January 2012 to December 2021. Data were collected on demographics, clinical presentation, tumor location, histopathology, treatment modalities, and follow-up. Survival analysis was conducted using SPSS version 23.0, with Kaplan-Meier estimates for overall survival (OS) and progression-free survival (PFS), and comparisons performed using the log-rank test.

Of the 48 patients, 64.6% were male, with a median age of 7.5 years. Presenting symptoms included headache and vomiting (43.75%), limb weakness (25%), back pain (20.83%), and ataxia (18.75%). Tumors were located in the posterior fossa (50%), supratentorial region (29.2%), and spinal cord (20.8%). All patients underwent surgical resection; postoperative complications were noted in a subset. Histopathological subtypes included anaplastic (62.5%), classic (33.3%), and myxopapillary ependymoma (4.2%). Adjuvant radiotherapy was given to 62.5% and chemotherapy to 10.4%. The 10-year overall survival (OS) and progression-free survival (PFS) rates were 79.2% and 66.7%, respectively. Tumor recurrence was observed in 18.8% of cases.

Multimodal treatment yielded favorable outcomes despite resource constraints. Early diagnosis and individualized management are crucial for enhancing survival in low- and middle-income country (LMIC) settings.

This study aimed to assess the health-related quality of life (HRQoL) in patients with locally advanced rectal cancer (LARC) undergoing total neoadjuvant therapy (TNT), comparing outcomes with the German general population and colorectal cancer (CRC) patients treated with curative intent.

In a multicenter, cross-sectional study within the "TNTox" study framework (DRKS 00033000), EORTC QLQ-C30 and QLQ-CR29 questionnaires were distributed to LARC patients who had completed TNT. Mean reference values were compared descriptively, and further exploratory comparisons based on clinical features were performed.

The study included responses from 72 patients. Compared to the German general population, a reduction in mean HRQoL across most domains was observed; the strongest effect was observed for role functioning (- 28.7 points, Cohen's d = - 0.95), social functioning (- 25.3 points, d = - 0.89), and for diarrhea (+ 9.9 points, d = 0.80). General HRQoL was similar to that of CRC patients following curative treatment. However, some symptom scores, notably fecal incontinence (+ 13.4 points, d = 0.52), impotence (+ 29.0 points, d = 0.73), and dyspareunia (+ 10.4 points, d = 0.40) appeared to be higher. Significant factors associated with HRQoL included the presence of chronic treatment-related toxicity and duration of TNT; no major differences were observed between patients with or without NOM or stoma.

LARC patients undergoing TNT showed comparable HRQoL outcomes to CRC patients treated with curative intent, but with reductions when compared to the general population. The presence of chronic toxicity significantly impacts HRQoL. Survivors may experience HRQoL impairments post-TNT, underscoring the necessity for ongoing management of chronic toxicity tailored to their needs.

Solid pseudopapillary neoplasm of the pancreas (SPN-P) is a rare entity, accounting for about 0.9-2.7% of all exocrine and 5% of cystic pancreatic neoplasms. There is limited evidence on the clinical, surgical, and oncological characteristics of SPN-P, as well as surgical short- and long-term outcomes. A systematic review was conducted searching four databases (MEDLINE/PubMed, Web of Science, Scopus and Cochrane Library) from January 2004 to August 2024, adhering to the reporting standards for systematic reviews. Eligible studies of provided information on key clinical features of SPN-P, surgical management, and surgical and oncological outcomes were reviewed. A total of 1315 studies were identified, of which 54 met the inclusion criteria. Data from 1.888 SPN-P patients, comprising 1.617 women (85.6%) and 271 men (14.4%), with a mean age of 30, 7 years (range: 7-87 years) were collected. Of these patients, 1.882 underwent surgical intervention, and 1.869 received pancreatic resection. The most common postoperative complication was postoperative pancreatic fistula, which was more prevalent in cases of parenchyma-preserving surgery (23%). Other complications included wound infections, intra-abdominal collections, delayed gastric emptying, and pancreatic insufficiency. Surgical intervention remains the gold standard for the treatment of SPN-P, offering favourable oncological outcomes and an excellent prognosis. Nonetheless, further research is required to address unresolved aspects of SPN-P surgical management and optimize treatment protocols.

A deep learning model integrating CT radiomics and clinical features was developed to predict perioperative complications and risk grade in patients undergoing partial nephrectomy, and was compared to traditional anatomical classification models.

Between June 2014 and July 2024, 1214 patients diagnosed with renal cell carcinoma or renal cysts who underwent partial nephrectomy were included. A deep learning model incorporating CT radiomics (segmented by nnU-Net and extracted by pyradiomics) and clinical features was developed. Logistic regression models using RENAL or PADUA scores were also developed for comparison. An external validation cohort (n = 260) was used to assess the model's generalizability.

In predicting complications, the deep learning model achieved an area under the curve (AUC) of 0.87 (95%CI: 0.80-0.93), outperforming the RENAL (0.68, 95%CI: 0.60-0.70) (p < 0.001) and PADUA models (0.69, 95%CI: 0.55-0.71) (p < 0.001). For risk grades, the deep learning model outperformed RENAL/PADUA models for the no-risk group (AUC = 0.83 [95%CI: 0.81-0.87] vs. 0.68 [95%CI: 0.58-0.71], p = 0.01; 0.66 [95%CI: 0.65-0.67], p < 0.001) and low-risk group (AUC = 0.79 [95%CI: 0.75-0.82] vs. 0.64 [95%CI: 0.60-0.74], p = 0.03; 0.66 [95%CI: 0.63-0.73], p = 0.04). However, no significant differences were found for moderate- and high-risk groups (p > 0.05). In the external validation cohort, the model achieved a prediction accuracy of 0.854 and an AUC of 0.83.

The CT-based deep learning model showed superior performance in predicting complications and risk grades for no-risk and low-risk patients undergoing partial nephrectomy. No significant differences were found for moderate- and high-risk groups.

Anticipatory nausea and vomiting can impose a significant physical and psychological burden on children and their families, but the risk factors for the development of anticipatory nausea and vomiting in children receiving chemotherapy are unclear. The aim of this study was to investigate the risk factors for anticipatory nausea and vomiting in children receiving chemotherapy, to provide a basis for medical personnel to formulate a pre-chemotherapy anti-vomiting program, to reduce the discomfort experience of children undergoing chemotherapy, and to improve the quality of life.

A prospective cohort study using the Baxter Facial Scale and the Department of Health and Human Services Vomiting Severity was conducted to collect risk factors for anticipatory nausea and vomiting in children receiving chemotherapy at a tertiary-level children's hospital in China in 2022, and logistic regression analysis was performed.

Of the 378 children with chemotherapy, 155 (41.01%) had anticipatory nausea and 40 (10.58%) had anticipatory vomiting. Logistic regression analysis showed that negative emotions and concomitant discomfort are independent risk factors for anticipatory nausea in children undergoing chemotherapy (P < 0.05); negative emotions, concomitant discomfort, and history of CINV are independent risk factors for anticipatory vomiting in children undergoing chemotherapy(P < 0.05).

Patient trust is fundamental to ensuring optimal cancer care, especially for vulnerable patients who may face additional challenges. However, there is a limited understanding of what it entails for nurses to establish and maintain trust among vulnerable patients. Grounded in the concept of Trust Work, this study explored nurses' efforts to nurture patient trust.

Drawing on qualitative insights from NAVIGATE, a multicenter randomized controlled trial, we explored the interaction between nurses and vulnerable patients with lung cancer in clinical encounters. We included 16 patients and eight nurses from five Danish hospital sites. Among other sources, data comprised 45 audio-recorded clinical encounters conducted over one year, 15 of which were also observed in clinic settings or patients' homes, as well as semi-structured interviews with all participating patients and nurses. Analyses were based on thematic analysis principles.

We found that nurses were continuously engaged in nurturing trust. This trust work involved three interrelated aspects: (1) 'Recognition' - meticulous preparation to remember individual patients and recognize their lived experiences, (2) 'Witnessing' or 'Guarding' - sustained support, though with varying levels of engagement, and (3) 'Involvement' or 'Detachment'-engaging with affirming resources or disengaging from colleagues' or the broader healthcare system. These aspects were shaped by contextual factors, including nurses' available time and continuity of care, professional affiliations and roles, and collegial and institutional relationships.

This study highlights nurses' critical role in nurturing patient trust and identifies important contextual factors for improving care targeting vulnerable cancer patients.

Endoscopic submucosal dissection (ESD), though effective in the treatment of gastric stromal tumor (GST), is limited by difficult procedures, a long learning curve and a high hospital cost. It is of great clinical value to explore new effective, simple, and safe surgical methods.

The basic data were collected from 25 patients with GSTs < 1.0 cm in diameter who were randomized into endoscopic ligator-assisted mucosal resection (EMR-L) group (n = 12) and ESD group (n = 13). The efficacy in 2 groups was compared in terms of operation duration, cost, complication, length of stay (LOS) and complete resection rate.

The complete resection rate of GST was 100% in both groups. In the EMR-L group, the average operation duration was 16.92 ± 4.76 minutes, the average LOS was 6.12 ± 1.55 days, and the average hospital cost was 17,136.87 ± 2959.80 yuan. In the ESD group, the average operation duration was 46.46 ± 12.27 min, the average LOS was 7.53 ± 2.24 days, and the average hospital cost was 22,760.24 ± 5199.45 yuan.

EMR-L and ESD can achieve the same safety and complete resection rate, but the former has the advantages of simple operation, short operation duration and low hospital cost. EMR-L may serve as a new option for the treatment of GSTs.

This study aimed to investigate the correlations between short- and long-term efficacy of immune checkpoint inhibitors (ICIs) and pretreatment laboratory/imaging parameters in advanced non-small cell lung cancer (NSCLC), and to construct risk prediction models. We enrolled 137 NSCLC patients with stage IIIB-IV disease who completed 4 cycles of PD-1/PD-L1 inhibitor monotherapy or combination therapy. All participants underwent pretreatment laboratory assessments encompassing inflammatory markers, lymphocyte subsets, tumor biomarkers, coagulation profiles, and contrast-enhanced computed tomography (CE-CT) scans. The primary endpoints were objective response rate (ORR) and overall survival (OS), with progression-free survival (PFS) as the secondary endpoint. Univariate and multivariate logistic regression analyses were performed to identify significant predictors of short-term treatment response and develop an efficacy prediction model. For long-term outcomes, univariate and multivariate Cox proportional hazards regression analyses were conducted to establish a prognostic risk model. The final models were presented as nomograms and validated through receiver operating characteristic (ROC) curve analysis, calibration curves, and decision curve analysis (DCA). CD4+ T-cell count (P = .007), fibrinogen (FIB, P = .047), and mediastinal lymph node enlargement (P = .028) emerged as independent predictors of ORR. The prediction model demonstrated an area under the ROC curve (AUC) of 0.838, with bootstrap validation (1000 resamples) yielding a mean AUC of 0.867. Calibration analysis, DCA, and clinical impact curve (CIC) collectively confirmed the model's robust predictive performance. For OS, metastatic site (P = .007), neutrophil-to-lymphocyte ratio (NLR, P = .025), carbohydrate antigen 125 (CA125, P = .020), cytokeratin 19 fragment (CYFRA 21-1, P = .004), FIB (P < .001), and pleural effusion (P < .001) were identified as significant prognostic determinants. The model achieved AUC values of 0.858 and 0.860 for 1- and 2-year survival prediction, respectively. Calibration plots revealed excellent concordance between predicted and observed survival probabilities at both timepoints. Furthermore, DCA indicated superior net clinical benefit of the prognostic model compared to random chance models across threshold probability ranges. Comprehensive prediction models integrating clinical characteristics, laboratory biomarkers, and imaging parameters were developed for both short- and long-term efficacy evaluation of immunotherapy, offering clinically actionable guidance for personalizing treatment strategies in advanced NSCLC.