Residence may influence cancer management. However, the role of residence in primary bone cancer is not well explored. In this study, patients diagnosed with primary bone cancer were identified from the surveillance, epidemiology, and end results (SEER) database and divided into urban and rural groups based on residence. Multivariable ordinal logistic regression was used to determine the relationship between residence and stage at diagnosis. Multivariable logistic regression was used to explore the association between residence and receipt of local surgery, radiotherapy, and chemotherapy. Propensity score matching (PSM) was used to balance the baseline between the 2 groups, and Kaplan-Meier curves were used to estimate the overall survival (OS) and cancer-specific survival (CSS) of the 2 groups. A total of 13,876 patients with primary bone cancer were included. Compared with urban patients, rural patients were less likely to receive local surgery (OR = 0.78, 95% CI: 0.70-0.89, P < .001), radiotherapy (OR = 0.69, 95% CI: 0.60-0.88, P < .001), and chemotherapy (OR = 0.85, 95% CI: 0.77-0.94, P < .001). After PSM, rural patients had significantly worse OS (HR = 1.10, 95% CI: 1.03-1.19, P = .029) and CSS (HR = 1.08, 95% CI: 1.02-1.18, P = .036) than urban patients. However, residence was not associated with the stage at diagnosis (Rural vs Urban, OR = 1.00, 95% CI: 0.88-1.14, P = .989). In conclusion, rural residence is associated with lower likelihood of receiving definitive treatments (local surgery, radiotherapy, and chemotherapy) and worse survival for primary bone cancer. However, residence is not associated with stage at diagnosis.

The causal links between serum amino acids (AAs) and hepatobiliary neoplasms remain unclear. This study aimed to systematically investigate these associations using Mendelian randomization (MR). Summary-level data on 20 serum AAs were obtained from publicly available genome-wide association studies. Genome-wide association studies data on hepatobiliary neoplasms - including primary liver cancer (PLC), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), gallbladder and extrahepatic bile duct carcinoma, secondary liver cancer, benign liver tumors, and benign tumors of the extrahepatic bile ducts - were derived from FinnGen and 2 UK Biobank-based studies. A meta-analysis was conducted to calculate pooled effect sizes. Inverse variance weighting was the primary method, supplemented by MR-Egger, weighted median, MR.RAPS, maximum likelihood, and MR-PRESSO methods for sensitive analyses. Higher serum methionine was associated with lower risks of PLC (OR = 0.84, 95% CI: 0.72-0.97, P = .021) and HCC (OR = 0.87, 95% CI: 0.80-0.94, P < .001), but not ICC. Alanine increased PLC risk (OR = 1.19, 95% CI: 1.00-1.42, P = .047), with no significant effect on HCC or ICC. No AAs were linked to gallbladder and extrahepatic bile duct carcinoma or secondary liver cancer. For benign tumors, aspartate (OR = 1.13, 95% CI: 1.01-1.26, P = .037), cysteine (OR = 0.72, 95% CI: 0.57-0.92, P = .008), and lysine (OR = 1.49, 95% CI: 1.15-1.93, P = .003) were significantly associated with benign liver tumors or benign tumors of the extrahepatic bile ducts. This study offers robust evidence of causal associations between specific serum AAs and hepatobiliary neoplasms, emphasizing their potential as biomarkers and modifiable targets for early intervention.

Sacrococcygeal tumors are rare, slow-growing, and locally invasive, with surgical management complicated by proximity to critical neural structures. Wide resection remains the standard for local control but often results in significant morbidity, particularly voiding dysfunction. Intraoperative navigation has the potential to improve margin accuracy and facilitate nerve preservation. We retrospectively reviewed 6 consecutive patients who underwent navigation-guided sacrococcygeal tumor resection at a single-institution between November 2022 and June 2023. Clinical data included demographics, pathology, resection margin status (R0-R2), preservation of S3 roots, and postoperative voiding dysfunction requiring clean intermittent catheterization. The median patient age was 52.5 years; chordoma accounted for 67% of cases. R0 resection was obtained in 50% of patients. The median follow-up was 18.6 months (range, 10.1-24.2), with an overall median progression-free survival of 18.4 months. Patients with R0 resection showed a trend toward longer PFS compared with those with R1/R2 resections (23.1 vs 18.2 months). Both patients who underwent bilateral sacrifice of the S3 roots developed permanent voiding dysfunction. Among the 4 patients with preserved S3 roots, 3 experienced transient dysfunction that resolved over a median of 3.2 months, and one had no postoperative symptoms. Navigation-guided resection of sacrococcygeal tumors is technically feasible and may facilitate oncological precision while preserving critical nerve function. These early findings underscore the potential role of navigation in balancing local tumor control with quality-of-life outcomes. However, given the small sample size and short follow-up, the results should be considered preliminary, and larger prospective studies are warranted.

Anaplastic thyroid cancer (ATC) is an extremely aggressive subtype of thyroid cancer associated with poor prognosis. Thus, the necessity to develop innovative treatment approaches is critical. Lenvatinib is the one of the drugs approved for ATC in clinic, however, its efficacy is limited. The present study investigated the combined effect of ultrasound stimulated microbubble cavitation (USMC) and Lenvatinib on tumor growth.

Undifferentiated thyroid carcinoma C643 cells were subcutaneously inoculated into mice to establish transplanted tumor model and mice were allocated into 4 groups (model group, Lenvatinib group, USMC group, and Lenvatinib + USMC group). Blood perfusion in tumors was estimated with contrast-enhanced ultrasound (CEUS) and the microvascular structures were observed by transmission electron microscopy. H&E and Masson staining was applied. Immunohistochemical staining for CD31, Ki67, Caspase 3 expression, ELISA for VEGFA, NO, and PGF2 levels, western blot for HIF-1α and Akt/PI3K proteins, and immunofluorescence for VEGFA and ICAM-1.

USMC caused mild enlargement and congestion of tumor microvessels. Moreover, upon exposure to USMC, the area under the curve and peak intensity of CEUS (MI = 0.4) showed an increase, indicating that USMC has the potential to augment blood flow within tumors. The combination of USMC and Lenvatinib meaningfully suppressed tumor growth, induced apoptosis, inhibited Ki67 expression and extended the survival of mice bearing C643 tumor. USMC also improved the anti-angiogenesis effect of Lenvatinib, as demonstrated by decreased expression of collagen fiber, CD31, HIF-1α and VEGFA in tumors and inactivation of PI3K/Akt pathway. Increment in ICAM-1, PGF₂ and NO expression was also observed in the combination group.

These results indicated that the combination of Lenvatinib and USMC could serve as a promising and innovative method for ATC therapy, surpassing the effectiveness of Lenvatinib monotherapy.

To evaluate the feasibility and diagnostic utility of a deep learning (DL)-based super-resolution (SR) reconstruction algorithm applied to pancreatobiliary MRI for assessing pancreatic intraductal papillary mucinous neoplasms (IPMNs).

This retrospective study included 162 patients with presumed pancreatic IPMN (≥ 1 cm) who underwent pancreatobiliary MRI between May 2019 and May 2022. Two portal venous phase (PVP) images of dynamic T1-wegithed imaging were sequentially acquired: early PVP image obtained using standard compressed sensing (CS)-volumetric interpolated breath-hold examination (VIBE) (standard CS-VIBE) and late PVP image obtained using CS-VIBE with DL-based SR reconstruction algorithm to generate 1 mm-thickness images (DL-SR CS-VIBE). Arterial phase and 3-min delayed phase were also acquired using DL-SR CS-VIBE. The image quality of standard and DL-SR CS-VIBE PVP sequences was compared using Wilcoxon signed-rank test. The diagnostic performance of full-sequence pancreatobiliaryMRI including DL-SR CS-VIBE for predicting malignant IPMN was assessed using multi-reader multi-case analysis. Diagnostic accuracy was assessed using receiver operating characteristic analysis, while sensitivity and specificity were estimated with corresponding 95% confidence intervals.

Among 162 patients, 15 had malignant IPMN, while 147 had benign IPMN. DL-SR CS-VIBE demonstrated significantly better overall image quality (3.73 ± 0.33 vs. 3.22 ± 0.43) and cystic lesion conspicuity (3.37 ± 0.50 vs. 2.71 ± 0.52) than standard CS-VIBE (all Ps < 0.001). The area under the ROC curve (AUC) for predicting malignant IPMN was 0.858 (95% CI: 0.807, 0.909). Using the presence of high-risk stigmata as an indicator of test-positive, pooled sensitivity and pooled specificity of pancreatobiliary MRI including DL-SR CS-VIBE for malignant IPMN were 71.1% (95% confidence interval [CI]: 55.7, 83.6) and 82.8% (95% CI: 78.9, 86.2), respectively. Among MRI features, diagnostic accuracy was highest for mural nodules ≥ 5 mm (AUC, 0.736) and main pancreatic duct size ≥ 10 mm (AUC, 0.720).

Pancreatobiliary MRI with DL-SR CS-VIBE enhances image quality and lesion conspicuity, offering promising diagnostic accuracy for malignant IPMN, though further studies with larger cohorts are needed to refine these findings and evaluate clinical impact.

Clonal hematopoiesis of indeterminate potential (CHIP) is a known risk factor for hematologic malignancies (HM), but its distribution and clinical implications across diverse ancestries remain poorly characterized. In this study, we investigated CHIP and its progression to HM in a large, racially diverse cohort from the All of Us Research Program, comprising 245,388 participants. We identified 10,446 CHIP driver mutations in 9,476 individuals. Our analysis revealed clear racial disparities in CHIP prevalence and mutational profiles: African American (AA) individuals had higher odds of CHIP and exhibited distinct mutation patterns compared to White American (WA) individuals. Consistent with prior studies, CHIP was associated with an increased risk of HM, particularly myeloid malignancies. Notably, ancestry influenced the subtype of myeloid malignancy observed; CHIP was more strongly linked to myeloproliferative neoplasms in AA individuals compared with WA individuals. These findings demonstrated significant racial differences in CHIP biology and HM progression, highlighting the need for ancestry-informed approaches to CHIP risk assessment and HM prevention.

The growing population of cancer survivors faces persistent physical and emotional challenges that significantly impact health-related quality of life (HRQL). To address these multifaceted needs, robust and culturally adapted patient-reported outcome measures (PROMs), such as the Measure Yourself Concerns and Wellbeing (MYCaW) questionnaire, are essential for understanding and improving survivors' subjective experiences.

This protocol aimed to outline the systematic translation and cultural adaptation of the MYCaW questionnaire into German. The MYCaW questionnaire, a PROM, is designed to capture individualized concerns and assess overall well-being, particularly in cancer care settings. By adhering to common guidelines, this research will provide a tool for assessing individualized concerns and patient needs among German-speaking patients with cancer.

Following International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines, this study will use a structured methodology involving forward and backward translation, expert review, patient review process, and preliminary validation to ensure linguistic and cultural equivalence. This study is approved by the ethics committee of the Medical Association Berlin (reference Eth-27/10). Construct validity will be assessed through comparison with the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) and the MIDOS (Minimal Documentation System; in German: Minimales Dokumentationssystem) questionnaire, to evaluate both quality of life and symptom burden.

Funding of the study was obtained in January 2023. Patient recruitment started in the first quarter of 2023, and the cognitive debriefing phase is ongoing. Validation with the larger patient sample (N=120) is scheduled to conclude in the fourth quarter of 2025, with publication of the study results anticipated in the first quarter of 2026. The adaptation process will include translation, expert review, and cognitive debriefing with patients and health care professionals to ensure linguistic clarity and cultural relevance.

The translation and adaptation of MYCaW into German will contribute to expanding the availability of validated PROMs for German-speaking populations. By following rigorous international guidelines, this study aims to produce a reliable, culturally appropriate, and linguistically adapted German version of the MYCaW questionnaire for assessing patient concerns and well-being in oncology and supportive care settings. Future validation studies will be necessary to assess the psychometric properties of the adapted questionnaire and its applicability in clinical and research contexts. Potential challenges, such as maintaining conceptual equivalence in translation and ensuring broad representativeness in the validation process, will be addressed through iterative refinement. Once validated, the German MYCaW will provide a valuable resource for patient-centered research and care, helping to capture individualized concerns that might be overlooked by standardized instruments.

Polycystic ovary syndrome (PCOS) is associated with altered hypothalamic-pituitary-ovarian function, which may affect the success of GnRH agonist triggers used during IVF. Identifying reliable predictors of oocyte yield in these patients remains a clinical challenge.

To evaluate possible predictors of suboptimal oocyte retrieval per aspirated follicle when ovulation is triggered with GnRH agonist in PCOS patients.

Between 30/04/2021 and 30/12/2022, a prospective cohort study was conducted among women with PCOS (n = 104) in which a GnRH agonist trigger was employed during a GnRH antagonist protocol. Hormonal and clinical parameters were tested for their ability to predict the oocyte per aspirated follicle (OPF) rate in in-vitro fertilization (IVF) treatment.

The mean age of the patients, mean number of aspirated follicles, number of collected oocyte cumulus complexes and OPF were 28.6 ± 3.9 years, 31.4 ± 10.2, 21.7 ± 8.9, and 70.2 ± 19.1%, respectively. When patients were stratified into three groups according to their OPF percentiles (Q1:0-25th percentile, Q2:26-75th percentile, Q3:76-100th percentile), body mass index (BMI) and antral follicle count (AFC) were significantly higher in the Q1 group compared to the Q2 and Q3 groups. However, regression analysis revealed that only AFC was an independent predictor of the OPF rate (RR: -0.005, 95% CI: -0.008 to -0.002, p = 0.001), but not BMI or serum LH levels on the day of triggering. Notably, the predictive validity of AFC to recognize a low OPF rate was poor (AUC = 0.561).

A high AFC was the only identifiable predictor of the OPF rate and a suboptimal response when a GnRH agonist trigger was used for final follicular maturation. However, since a low AUC for AFC suggests a poor performance, we conclude that this study was not able to find any reliable prediction markers for the OPF rate in PCOS patients triggered with GnRHa.

There is limited evidence regarding lung cancer awareness in developing countries. In Ethiopia, 92.2% of lung cancer patients present at facilities with late stages, leading to poor treatment outcomes. This emphasizes the importance of early detection. Symptom awareness is crucial for reducing delays. This study aimed to identify latent classes of lung cancer symptom awareness and their predictors, guiding class-specific interventions.

A population-based cross-sectional survey was conducted from October to December 2023 among a randomly selected 2388 adults in Addis Ababa, Ethiopia. A face-to-face interview was conducted using the validated Lung Cancer Awareness Measure (Lung CAM). Latent class analysis and latent class multinomial logistic regression were used to identify classes and predictors of class membership.

Three distinct classes of participants were identified: "poor awareness" (Class 1: 38%), "fair awareness" (Class 2: 37.5%), and "good awareness" (Class 3: 24.5%). The average symptom awareness score was 7.8 out of 14. The most commonly recognized symptom was coughing up blood (72%), while changes in the shape of fingers were the least recognized (20%). Being male, employed, having a higher education level, using out-of-pocket money for health expenses, and knowing someone with cancer significantly increased the odds of belonging to the "good awareness" class, with adjusted odds ratios ranging from 1.66 to 12.60.

Only one-fourth of participants were classified as class 3, denoted as "good awareness," indicating a significant gap in symptom awareness. Respiratory symptoms were mostly well-known. Class membership varied across sociodemographic and related characteristics. Hence, there is a need for class-specific educational intervention and a focus on non-respiratory symptoms.

Autoimmune diseases (ADs) frequently coexist with myasthenia gravis (MG), suggesting shared genetic and immunological mechanisms. However, the impact of comorbid ADs on MG prognosis remains unclear. This study aimed to investigate the prevalence, clinical characteristics, and prognosis of MG patients with comorbid ADs in a Turkish cohort.

We retrospectively analyzed 302 MG patients treated at a tertiary center between 2010 and 2024. Patients were grouped based on the presence of comorbid ADs. Clinical characteristics, disease severity, treatment response, and prognosis were compared.

Among 302 MG patients, 41 (13.6%) had at least one comorbid AD, with autoimmune thyroid disease (AITD) being the most common (10.6%). ADs were more frequent in females. Patients with and without comorbid ADs showed no significant differences in MG severity, thymectomy rates, myasthenic exacerbations, or overall outcomes (p > 0.05). However, female patients with ADs experienced more frequent myasthenic exacerbations and had a higher rate of rituximab use (p < 0.05).

Comorbid ADs do not significantly impact MG severity or prognosis. Female MG patients with ADs have a higher frequency of myasthenic exacerbations and rituximab use, warranting further research. Early identification of ADs remains essential for optimal patient management.