The fundal cerebrospinal fluid (CSF) cap is a radiological finding correlating to a pocket of CSF lateral to vestibular schwannomas in the fundus of the internal acoustic meatus. Its presence may increase the likelihood of good facial nerve outcome and hearing preservation after microsurgical resection. A systematic review of the literature was performed. Studies that reported the association of a fundal fluid cap with postoperative outcomes including facial nerve outcome, hearing preservation and extent of resection were included. A total of 17 studies were included, comprising 2370 patients. Studies were generally at high risk of bias. The presence of a fundal cap was associated with significantly higher rate of good (HB I-II) facial nerve outcome after retrosigmoid approaches (OR 6.04; 95%CI 2.79-13.11), but not after translabyrinthine and middle fossa approaches. A fundal cap was associated with an increased rate of gross total resection (OR 2.13; CI: 1.51-3.00) and hearing preservation after retrosigmoid (OR 3.37; 95% CI: 2.32-4.90), but not middle fossa approaches (OR 1.47; 95% CI: 0.89-2.44). A fundal cap was also predictive of hearing preservation after radiosurgery. The fundal CSF cap is an important predictor of facial nerve function and hearing preservation after retrosigmoid craniotomy for vestibular schwannoma. Its importance in middle fossa and translabyrinthine surgery is less clear, which reflects the anatomical considerations of each approach. The presence or absence of a fundal cap should be documented preoperatively and used to guide more nuanced risk assessment for preoperative patient counselling.

Artificial intelligence (AI)-assisted endoscopy has been developed for the early detection of upper gastrointestinal cancer; however, its clinical effectiveness remains insufficiently evaluated. This study assessed its effectiveness in a health screening facility.

This retrospective cohort study compared AI-assisted and non-AI-assisted upper gastrointestinal endoscopy at Omiya City Clinic, Japan (April 2021-March 2024). Participants who underwent endoscopy between April 2021 and March 2023 were classified as the non-AI group, while those examined between April 2023 and March 2024 comprised the AI group. The AI-assisted system was introduced in April 2023. The primary outcome was cancer detection rate (CDR), with secondary outcomes including biopsy rate and positive predictive value (PPV). Propensity score matching (PSM) was performed for age, sex, alcohol consumption, smoking, Helicobacter pylori infection history, endoscopist experience, and prior-year endoscopy to minimize bias.

In total, 17,662 were included in the AI group and 32,318 in the non-AI group. PSM created 17,662 matched pairs. In the AI group, the CDR for gastric cancer (GC) was significantly higher compared to the non-AI group (0.10% vs. 0.03%, p < 0.05). The biopsy rate was slightly higher in the AI group, with no significant difference, whereas the PPV of biopsy for gastric cancer and esophageal cancer was significantly increased (4.84% vs. 2.16%, p < 0.05).

In a clinical screening setting, AI-assisted endoscopy significantly improved the CDR of GC and enhanced the PPV of biopsies. These findings highlight AI-assisted endoscopy as a valuable tool for early GC diagnosis in screening environments.

The incidence of lung cancer increases with age. On average, patients diagnosed with lung cancer are about 70 years. It is known that older patients are more prone to complications after major lung resection due to physiological changes; however, there is still a lack of knowledge of predictive factors associated with a higher complication risk.

In this study the association of age and postoperative complication rates in lung cancer patients is analyzed. Further, predictors of postoperative complications in the era of minimally invasive surgery in older patients are identified.

We retrospectively analyzed 180 consecutive patients with pathologically proven lung adenocarcinoma and squamous cell carcinoma. Patients were categorized into septuagenarians and octogenarians. Univariate and multivariate analyses were conducted to detect risk factors of postoperative morbidity.

There were 141 (78.33%) and 39 patients (21.67%) in the septuagenarian group and octogenarian group, respectively. 67 (37.2%) patients experienced postoperative complications. The thirty-day mortality rate was 1.6%. The groups did not differ in terms of postoperative complications. Upon multivariate analysis, ECOG score ≥ 1 (p = 0.032), lowered FEV1/FVC (p = 0.029), and hypoalbuminemia (p = 0.027) were significant predictors for the development of major complications after lung cancer surgery.

Age over 80 years was not found to be an independent risk factor for the complication rates after lung cancer surgery. However, ECOG performance status ≥ 1, reduced FEV1/FVC, and lower serum albumin levels were independently associated with major postoperative complications.

Malignant pleural effusion (MPE) is associated with a poor prognosis and quality of life in patients with non-small cell lung cancer (NSCLC). Additionally, cerebral edema can lead to neurological symptoms that adversely affect activities of daily living. While bevacizumab has demonstrated efficacy in treating both MPE and cerebral edema, there is limited research on ramucirumab, an angiogenesis inhibitor. Therefore, this study aimed to evaluate the efficacy of docetaxel combined with ramucirumab for the management of MPE and cerebral edema.

We retrospectively analyzed medical records of patients with advanced NSCLC who received docetaxel in conjunction with ramucirumab at Shizuoka Cancer Center between August 2016 and March 2023. The primary endpoints were pleural effusion progression-free survival (PE-PFS) and the cerebral edema control rate. Secondary endpoints included response rate, progression-free survival (PFS), overall survival (OS), and the incidence of toxicities.

A total of 163 patients were included. The median PE-PFS was 8.1 months (95% CI: 4.8-12.0 months). The pleural effusion control rate was 87%, whereas the cerebral edema control rate was 26%. The response rate was 26%, with a median PFS of 4.4 months (95% confidence interval [CI]: 3.7-5.1 months) and a median OS of 11.1 months (95% CI: 9.2-16.0 months). Adverse events leading to discontinuation of treatment occurred in 30% of patients for docetaxel and 33% for ramucirumab, with fatigue being the most common reason for discontinuation.

Docetaxel plus ramucirumab was effective in controlling pleural effusion but showed limited effects on cerebral edema.

Skin cancer comprises a significant global health challenge, exacerbated by escalating ultraviolet radiation exposure, inherent genetic predispositions, and inequities in access to early diagnostic interventions. This chapter integrates contemporary insights concerning both melanoma and non-melanoma skin cancers, elucidating their epidemiological patterns, biological determinants, and the diagnostic complexities related with early or atypical manifestations. Traditional diagnostic modalities-such as clinical assessment, dermoscopy, and self-evaluation of the skin are crucial yet constrained by subjectivity, variability in practitioner expertise, and challenges in recognizing subtle lesions. These constraints have catalyzed the progression of sophisticated non-invasive technologies, including reflectance confocal microscopy, total body photography, teledermatology, electrical impedance spectroscopy, and genomic adhesive-patch testing, each of which promises improved diagnostic accuracy and the capability to mitigate unnecessary biopsies. Current treatment approaches emphasize surgery for localized disease, supplemented by radiotherapy, photodynamic therapy, and laser techniques when surgery is impractical. Targeted therapies like BRAF and MEK inhibitors provide precision for specific tumors, while combination strategies aim to overcome resistance and improve treatment durability. Swift advancements in nanotechnology, microneedle delivery systems, and topical or patch-based formulations present promising strategies for improved and enhanced dermal penetration, and minimized systemic toxicity. The chapter emphasizes the persistent evolution towards previous detection, minimally invasive diagnostic techniques, and personalized therapeutic approaches. Ongoing progressions in imaging technologies, molecular profiling, immunotherapeutic strategies, and nanomedicine are anticipated to redefine future therapeutic standards.

Nanotechnology has transformed oncology, providing novel approaches for the detection, treatment, and management of skin cancer. This chapter examines the economic and healthcare ramifications of nanotechnology in skin cancer, emphasizing cost-effectiveness, accessibility, and the possible strain on healthcare systems. The incorporation of nanotechnology-driven therapeutics, including nanoparticle drug carriers, targeted treatments, and diagnostic nanodevices, has shown greater patient outcomes, less side effects, and increased drug bioavailability. Nonetheless, the substantial expenses associated with research, development, and regulatory approval provide obstacles to wider use. The chapter assesses the cost-benefit analysis of nanomedicine relative to traditional therapies from an economic standpoint, taking into account manufacturing expenses, reimbursement regulations, and market accessibility. Although early expenditures in nanotechnology are substantial, the long-term advantages-such as decreased hospitalizations, tailored treatment approaches, and improved therapeutic efficacy-could result in total cost reductions for healthcare systems. From a healthcare standpoint, nanotechnology offers prospects for enhancing early diagnosis, tailored medication delivery, and less invasive therapies, hence diminishing treatment-related problems. Nonetheless, issues like nanoparticle toxicity, prolonged safety concerns, and regulatory obstacles must be resolved. This chapter emphasizes the capability of nanotechnology to transform the economic and healthcare framework of skin cancer therapy. By harmonizing innovation with cost-effectiveness and accessibility, nanomedicine might enhance sustainable and efficient healthcare solutions, facilitating future progress in cancer.

Skin cancer is one of the most prevalent malignancies worldwide, with increasing incidence due to factors such as excessive ultraviolet (UV) radiation exposure, genetic mutations, and immunosuppression. It is broadly classified into melanoma and non-melanoma types, with melanoma being the most aggressive and lethal form. Recent advances in understanding the molecular pathogenesis have highlighted key signalling pathways such as MAPK, PI3K/AKT, and Notch, along with mutations in genes like BRAF and p53, contributing to uncontrolled cell proliferation and tumour progression. Non-melanoma skin cancers, including basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and Merkel cell carcinoma (MCC), present distinct pathological and histological features, yet share overlapping risk factors and challenges in diagnosis and treatment. Despite advances in histopathology, imaging technologies like confocal laser microscopy, optical coherence tomography, and high-frequency ultrasonography, as well as artificial intelligence-based models, early detection remains a significant hurdle, especially in darker skin types where presentation differs. Treatment efficacy is further complicated by the skin's complex biological barriers, drug resistance mechanisms, and the tumour microenvironment (TME), which impedes therapeutic delivery and immune responses. Emerging nanotechnology, novel biosensors, and AI-driven diagnostic tools hold promise for overcoming these barriers, offering potential for more precise, non-invasive detection and targeted therapies. Nonetheless, challenges such as high recurrence rates, treatment-associated toxicities, and substantial healthcare costs persist. A comprehensive understanding of skin cancer's molecular mechanisms, improved diagnostic accuracy, and development of innovative therapeutics remain critical for improving patient outcomes and reducing the global burden of skin cancer.

The rising prevalence of skin cancer worldwide emphasizes the critical need for novel therapeutic and diagnostic approaches that go beyond conventional methods. Through improved drug delivery, targeted therapy, and sophisticated diagnostic applications, nanotechnology holds revolutionary promise in the field of oncology. The safety, ethical, and regulatory aspects of nanotechnology's multifaceted role in the treatment of skin cancer are highlighted in this chapter. Systemic toxicity is reduced by nanoparticles with enhanced biocompatibility, site-specific drug delivery, and imaging precision, such as liposomes, polymeric carriers, metallic nanostructures, and quantum dots. In spite of these developments, issues with biodistribution, long-term toxicity, and possible genotoxic effects still continue to impact nanomedicine. Informed consent, fair access, environmental sustainability, and data privacy are ethical factors to be taken into account in clinical applications and nanomedical research. ssAdditionally, regulatory frameworks are still evolving as international organizations like the FDA and EMA keep establishing guidelines for post-market surveillance, safety evaluation, and characterization. The chapter emphasizes the value of interdisciplinary cooperation in ensuring the responsible development, moral application, and thorough evaluation of nanotechnology-based interventions. Transforming nanotechnological advancements into safe and efficient treatments for patients with skin cancer requires the integration of safety testing, ethical consideration, and standardized international regulation.

Skin cancer continues to be a major and increasing health problem all over the world, with increasing incidence rates of melanoma and non-melanoma skin cancers. Conventional therapeutic treatments like surgery, chemotherapy, and radiotherapy are often limited by systemic toxicity, poor selectivity, and issues with drug resistance. Nanotechnology offers innovative strategies to address these limitations by enabling targeted drug delivery, reducing off-target side effects, and enhancing therapeutic efficacy. Various nanocarrier formulations, including liposomes, polymeric nanoparticles, metal nanoparticles (especially gold and silver), dendrimers and hybrids, are described for enhancing drug solubility, targeted delivery to specific sites and combination therapy. These platforms show promise in both topical and systemic administration for melanoma and nonmelanoma skin cancers. Preclinical studies have suggested that nanocarriers facilitate increased drug accumulation in tumor tissue, controlled release kinetics, and lower systemic toxicity. In vitro and in vivo studies, especially utilizing cell line and animal models, illustrate enhanced anti-tumor efficacy, immune modulation, and synergistic effects when multiple agents are co-delivered. Clinical trials primarily focus on adapting nanomedicine platforms, originally designed for other cancers, to skin cancer treatment. Examples include liposomal formulations like doxorubicin, nanoemulsion-based gels, and polymeric micelles. Early data suggest improved safety, higher local drug concentrations, and lower adverse effects compared to conventional drugs, but full regulatory approval specific to skin cancer is pending. The review emphasizes the main obstacles in translation, such as interspecies variation of response, technical challenges of making large quantities at scale, worries about long-term toxicity, red-tape and high development costs. However, personalized nanomedicine, AI incorporation, and theranostic nanocarriers provide a bright future to overcome these challenges. In conclusion, nanotechnology-enabled approaches show the potential to revolutionize skin cancer treatment through their ability to address challenges associated with conventional therapies and provide opportunities for specific, safe and efficient patient management. Continued interdisciplinary investigations and strong clinical verification will be necessary for their effective translation into routine practice.

One of the most common cancers in the world is still skin cancer, which includes both melanoma and non-melanoma forms like squamous cell carcinoma and basal cell carcinoma. Non-specificity, drug resistance, recurrence, and patient response variability are some of the drawbacks of traditional treatment modalities. In order to overcome these obstacles and improve the treatment of skin cancer, this review investigates the combination of personalized nanomedicine and patient-centric care models. Patient-centric approaches place a high value on shared decision-making, customized treatment plans, and ongoing feedback via mobile health technologies and patient-reported outcome measures (PROMs). At the same time, personalized nanomedicine uses sophisticated nanocarriers like liposomes, dendrimers, and gold nanoparticles to deliver targeted, effective, and less toxic therapies by utilizing molecular profiling and biomarker-guided strategies. When these paradigms are applied in concert, precise drug delivery is made possible, therapeutic results are improved, and treatments are tailored to the biological and psychosocial characteristics of the patients. The potential for these integrative approaches to revolutionize standard care in dermatologic oncology is highlighted in this paper along with their recent developments, clinical uses, and potential future directions.