The aim of this study was to evaluate the safety and clinical benefits of adding concurrent radiotherapy to neoadjuvant chemoimmunotherapy in patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC). This multicenter retrospective study enrolled eligible ESCC patients treated between November 2019 and July 2020 from four hospitals. Baseline characteristics were collected, and patients were categorized into two groups based on neoadjuvant regimens: the chemoimmunotherapy group (CI group) and the chemoimmunotherapy with concurrent radiotherapy group (CIR group). Treatment-related complications, surgical outcomes, pathological response, tumor recurrence, and survival were analyzed. A total of 78 eligible patients were included: 49 in the CI group and 29 in the CIR group. Baseline characteristics (age, sex, clinical stage, cardiopulmonary function) were balanced between groups. During neoadjuvant therapy, the CI group had significantly lower incidences of grade 3 and grade 4 leukopenia/neutropenia (15/49 vs. 15/29, P = 0.025), and lower incidences of grade 3 and grade 4 checkpoint inhibitor pneumonitis (CIP) (1/49 vs. 8/29, P = 0.002). All CI group patients achieved R0 resection after 1-3 neoadjuvant cycles versus 24/29 in the CIR group (P > 0.05). The CIR group showed higher major pathological response (including pathological complete response) rates (16/24 vs. 10/49), though statistically non-significant (P = 0.121). No significant differences were observed in 5-year progression-free survival or overall survival. Adding concurrent radiotherapy to neoadjuvant chemoimmunotherapy increased hematologic toxicity and CIP in resectable locally advanced ESCC patients, without conferring survival benefits.

The main objective of dose finding trials is to find an optimal dose amongst a candidate set for further research. The trial design in oncology proceeds in stages with a decision as to how to treat the next group of patients made at every stage until a final sample size is reached or the trial stopped early. This work applies a Bayesian decision-theoretic approach to the problem, proposing a new utility function based on both efficacy and toxicity and grounded in von Neumann-Morgenstern (VNM) utility theory. Our proposed framework seeks to better capture real clinical judgments by allowing attitudes to risk to vary when the judgments are of gains or losses, which are defined with respect to an intermediate outcome known as a reference point. We call this method Reference Dependent Decision Theoretic dose finding (R2DT). A simulation study demonstrates that the framework can perform well and produce good operating characteristics. The simulation results demonstrate that R2DT is better at detecting the optimal dose in scenarios where candidate doses are around minimum acceptable efficacy and maximum acceptable toxicity thresholds. The proposed framework shows that a flexible utility function, which better captures clinician beliefs, can lead to trials with good operating characteristics, including a high probability of finding the optimal dose. Our work demonstrates proof-of-concept for this framework, which should be evaluated in a broader range of settings.

An 8-year-old neutered female Labradoodle presented with acute restlessness and inability to stand. Point-of-care ultrasound revealed a large abdominal mass, prompting further imaging. Computed tomography (CT) demonstrated a mass with marked mineralization, a thick, enhancing rim, and signs of intra-abdominal dissemination. Surgical excision of the mass was performed, and histopathology confirmed extraskeletal osteosarcoma (ESOSA) secondary to a retained surgical sponge (gossypiboma). Four months post-surgery, the dog developed pulmonary metastases and was euthanized. This report is the first to describe CT findings of ESOSA secondary to a retained surgical sponge in a dog.

Peripheral T-cell lymphomas are rare, aggressive malignancies with significant diagnostic challenges due to their heterogeneity.

This retrospective study analysed 43 nodal Peripheral T-cell lymphomas cases diagnosed between 2019 and 2024 at the Blood Transfusion Hematology Hospital in Southern Vietnam and reclassified them using the World Health Organization 2022 classification.

Nodal T-follicular helper cell lymphoma, angioimmunoblastic type, emerged as the most prevalent subtype (51.2%), markedly exceeding rates reported in Western (32.5%) and East Asian studies (36.2%). Despite the higher prevalence of Epstein-Barr Virus in Vietnam, the proportion of Epstein-Barr Virus positive in Peripheral T-cell lymphomas was not elevated (20%), suggesting additional genetic or environmental factors influencing lymphoma pathogenesis.

These findings underscore the critical role of updated diagnostic standards and the utility of advanced markers in improving Peripheral T-cell lymphomas classification. This study provides rare insights into Peripheral T-cell lymphomas pathology in Vietnam, contributing valuable data to the global understanding of these rare lymphomas.

Previous exposure to hepatitis B virus (HBV) may influence the risk of developing hepatocellular carcinoma (HCC) and other liver-related events (LRE), in particular in patients after HCV cure. Previous studies were not conclusive and there are only few large studies on this topic from Europe.

We analysed clinical endpoints (≥ 3-point increase in MELD score, oesophageal variceal bleeding, ascites, encephalopathy, liver transplantation, death, with/without HCC; HCC alone) in patients cured from HCV. Data were obtained from the German Hepatitis C Registry. Patients after organ transplantation, a history of HCC, HIV co-infection, or HBsAg positivity were excluded. A subanalysis was conducted in patients with cirrhosis. Statistical analyses included logistic regression to identify predictors of clinical endpoints and Kaplan-Meier curves to analyse the influence of HBV serological markers.

A cohort of 6198 patients fulfilled inclusion criteria, the median time of follow-up was 2.5 years (range 0.04-8.01). Serological evidence of previous HBV exposure was present in 1889 patients (anti-HBc positive). In patients with cirrhosis, univariate analyses identified anti-HBc positivity (odds ratio [OR], 1.48), cirrhosis (OR, 4.89), features of portal hypertension (ascites (OR, 5.66), oesophageal varices (OR, 4.88)), diabetes (OR, 3.23), and malignancies (OR, 10.34) as risk factors for composite LRE. In multivariable analysis, anti-HBc positivity (OR, 1.53) and cirrhosis (OR, 4.63) remained independent risk factors for the composite endpoints, whereas anti-HBc positivity was not associated with HCC or Kaplan-Meier survival analyses.

Resolved HBV infection was not associated with the development of HCC or survival in Caucasians after HCV cure. Although anti-HBc positivity was linked to composite outcomes, its clinical relevance appears limited.

The registry was registered at the German Clinical Trials Register (DRKS; IDDRKS00009717).

IntroductionWhile largely preventable, cervical cancer remains a major cause of morbidity and mortality in low- and middle-income countries (LMICs), where gaps in screening uptake persist despite expanding prevention efforts. In many patriarchal settings, men play influential roles in household decision-making and access to healthcare, positioning them as critical but under-engaged stakeholders. There remains limited understanding of how educational strategies to improve health literacy can be designed to effectively engage men in supporting women's screening participation.MethodsWe conducted a qualitative study in northern Ghana to explore men's understanding, priorities, and values related to cervical cancer prevention to inform male-focused educational strategies. Guided by the Consolidated Framework for Implementation Research and the Health Belief Model, 9 in-depth semi-structured interviews were conducted with married adult men recruited from community settings, examining household roles, perceptions of cervical cancer and screening, and preferences for education and engagement approaches. Interviews were conducted in English or Dagbani, audio-recorded, transcribed, and analyzed thematically using a hybrid inductive and deductive approach.ResultsThree cross-cutting themes emerged. Men viewed healthcare professionals as trusted sources of cervical cancer information and described their roles as primary financial decision-makers, with cost and competing household priorities influencing support for screening. Masculine responsibility, particularly related to fertility and family wellbeing, strongly motivated engagement, and messages framed around these themes were more compelling than disease-focused messaging alone. Participants recommended integrating education into routine health services, leveraging healthcare workers, offsetting screening-related costs, and using mass media to initiate awareness and information seeking.ConclusionMen represent pivotal yet underutilized partners in cervical cancer prevention. Educational strategies that align with men's roles, economic realities, and trusted sources of information and address household decision-making barriers may enhance screening uptake while supporting women-centered care. These findings provide implementation-relevant insights to inform male-engaged cervical cancer prevention strategies across diverse LMIC settings.

Acute lymphoblastic leukemia (ALL) treatment is frequently complicated by infections, emergency visits, and therapy interruptions, yet early prediction of short-term clinical deterioration remains challenging. Traditional prognostic markers rely on static laboratory values, whereas dynamic hematologic fluctuations may provide earlier warning signals. This study presents and internally validates a clinically applicable prediction model based on dynamic hematologic parameters and clinician-documented symptoms for predicting short-term (7-day) clinical events in children with ALL.

Included in this retrospective study were 44 pediatric ALL patients treated with Berlin-Frankfurt-Münster-based protocols between January 2023 and June 2025. Weekly observation units were created by aggregating complete blood count values and clinician-documented symptoms. Dynamic hematologic indices included mean absolute neutrophil count (ANC), coefficient of variation (ANC-CV), and time in target range (ANC-TTR). The composite outcome was defined as any of the following occurring within 7 days: unplanned emergency visit, ≥48-h chemotherapy interruption, or infection requiring systemic antibiotics. Mixed-effects logistic regression was used to account for within-patient clustering. Model performance was assessed using discrimination, calibration, decision curve analysis, and bootstrap internal validation.

A total of 1136 weekly observations were analyzed. Composite clinical events occurred in 32.3% of weeks. Event weeks demonstrated lower ANC, higher ANC-CV, reduced ANC-TTR, lower hemoglobin levels, and higher symptom burden (all p <0.01). In the hematology-only model, ANC, ANC-CV, ANC-TTR, hemoglobin levels, and platelet counts were independent predictors (AUROC = 0.77). Adding the symptom score improved discrimination (AUROC = 0.83) and calibration. Decision curve analysis demonstrated greater net clinical benefit for the combined model across threshold probabilities of 10-40%.

Dynamic hematologic trajectories and clinician-documented symptoms enable accurate early prediction of short-term clinical events in pediatric ALL. This low-cost, accessible prediction model may support individualized risk stratification and proactive supportive care.

Tumor budding (TB) and poorly differentiated clusters (PDCs) are histopathological parameters that have been associated with poor prognosis in various malignancies, particularly colorectal carcinoma. Although numerous studies have demonstrated an association between the microcystic, elongated, and fragmented (MELF) pattern in endometrial carcinomas and lymphovascular invasion as well as lymph node metastasis, the literature regarding TB and PDCs in this context remains limited.This study aimed to investigate the potential associations of the MELF pattern, TB, and PDCs with overall survival, progression-free survival, and clinicopathological parameters in cases of endometrioid endometrial carcinoma (EEC).

A total of 190 cases diagnosed with EEC through hysterectomy specimens between 2010 and 2023, with complete hospital records, were selected from the archives of the Department of Pathology at Manisa Celal Bayar University Faculty of Medicine.

The presence of TB and PDCs was significantly associated with high histological grade (p < 0.001), deep myometrial invasion (p < 0.001), lymphovascular invasion (p < 0.001), lymph node metastasis (p < 0.001), cervical stromal involvement (p < 0.001), serosal involvement (p < 0.001), advanced stage (p < 0.001), and larger tumor size (p = 0.042 and p = 0.027, respectively). The presence of TB and PDCs was found to be associated with reduced overall survival (p = 0.001 and p < 0.001, respectively) and reduced progression-free survival (p = 0.043 and p = 0.004, respectively). The MELF pattern was not significantly associated with overall survival (p = 0.772).

These findings suggest that the presence of TB and PDCs may be valuable in stratifying prognostic risk in EEC and support the inclusion of these parameters in routine pathology reporting.

Skin adnexal tumours are a morphologically heterogeneous group of neoplasms arising from cutaneous appendages. Their clinical similarity to common benign lesions renders preoperative diagnosis challenging, and systematic concordance data from Indian tertiary institutions remain limited.

The objectives of this study are to characterise the histopathological spectrum and clinicopathological associations of skin adnexal tumours and to quantify clinical-histopathological concordance.

A cross-sectional, descriptive-analytical study was conducted at a tertiary care teaching hospital over six years using consecutive sampling. Data were analysed using descriptive statistics, Fisher's exact test, Chi-square test, Mann-Whitney U test, and Cohen's Kappa coefficient.

Forty-seven cases were studied (M:F = 1.47:1; mean age 42.32 ± 15.37 years). Eccrine differentiation predominated (66.0%), followed by follicular (23.4%) and sebaceous (10.6%) lineages. The consolidated Hidradenoma group was the most frequent individual diagnosis (17.0%), followed by pilomatricoma (10.6%). Benign tumours constituted 83.0%, whereas malignant tumours constituted 17%; the head and neck was the predominant site (44.7%). No clinicopathological variable was significantly associated with biological behaviour. The overall concordance rate was 21.3% (Cohen's κ = -0.575; 95% CI: -0.792 to -0.357; poor agreement). Differentiation type (χ² = 11.655, p = 0.003) and anatomical site (χ² = 7.881, p = 0.049) were the only significant concordance predictors; sebaceous tumours (80.0%; OR = 28.0) and head and neck location (38.1%) showed the highest rates, while extremity tumours were uniformly discordant (0%).

A 78.7% discordance rate confirms the indispensability of histopathological examination for all excised adnexal lesions. Sebaceous differentiation and head-and-neck location predict better clinical recognition; extremity lesions require heightened diagnostic vigilance.

High-Grade Serous Ovarian Carcinoma (HGSOC) and Low-Grade Serous Ovarian Carcinoma (LGSOC) are distinct subtypes of epithelial ovarian cancer with significant differences in pathogenesis and prognosis, posing challenges for precise diagnosis. Identifying reliable biomarkers is crucial for improving differential diagnosis and clinical management.

Transcriptome RNA-seq data of HGSOC and LGSOC were obtained from the GEO database (GSE27651, GSE126132). Differentially expressed immune-related genes (DIRGs) were identified. Functional enrichment analysis and protein-protein interaction (PPI) network construction were performed. The Least Absolute Shrinkage and Selection Operator (LASSO) regression and multiple Support Vector Machine Recursive Feature Elimination (mSVM-RFE) algorithms were used to select predictive genes. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves, and a nomogram was developed. Findings were validated in an independent dataset and via immunohistochemistry (IHC). The CIBERSORT algorithm assessed correlations between key DIRGs and tumor-infiltrating immune cells, with false discovery rate (FDR) correction applied for multiple testing.

Seventy-one DIRGs were identified in HGSOC versus LGSOC, predominantly enriched in cytokine-mediated signaling, cytokine-cytokine receptor interaction, and JAK-STAT pathways. STAT1 and IL-7 were selected as diagnostic biomarkers, with area under the curve (AUC) values of 0.908 and 0.842 in the train group. Respectively, validation in an independent merged cohort (GSE14001, GSE73168, GSE146965; 55 HGSOC, 13 LGSOC) yielded AUCs of 0.703 (95% CI: 0.517-0.889) for STAT1 and 0.706 (95% CI: 0.501-0.912) for IL-7. IHC confirmed significantly higher STAT1 and lower IL-7 protein expression in HGSOC tissues (P < 0.05). Immune microenvironment analysis revealed that HGSOC exhibited significantly higher fractions of naïve B cells, M2 macrophages, and neutrophils, and lower fractions of resting memory CD4+ T cells and eosinophils after FDR correction (all q < 0.05). STAT1 expression was strongly positively correlated with M1 macrophages (ρ = 0.688, q = 9.9×10^{- 8}), and showed correlation trends with other immune cell types that did not remain significant after FDR correction. IL-7 expression exhibited a negative correlation trend with neutrophils (ρ = -0.372, raw P = 0.0048, q = 0.100).

STAT1 and IL-7 are consistently differentially expressed between HGSOC and LGSOC and may serve as ancillary diagnostic biomarkers in histologically ambiguous cases. However, their clinical utility-particularly in multi-gene combinations-requires prospective validation.