IntroductionAdolescent and young adult (AYA) cancer survivors (ages 15-39 at diagnosis) who identify as sexual and gender minorities [SGM] and/or Black, Indigenous, and Persons of Color [BIPOC]) experience survivorship challenges compounded by discrimination, mistrust, and culturally incongruent care. These factors contribute to inequities in health outcomes and research participation. This qualitative study explored the experiences of underrepresented AYA cancer survivors and key stakeholders in research engagement.MethodsParticipants were recruited through five US-based academic cancer centers and five community-based organizations. Interviews were conducted via two-way video conferencing, and transcripts were analyzed using inductive thematic analysis. A Community Advisory Panel (CAP) consisting of 10 underrepresented AYAs co-developed semi-structured interview guides and contributed to study interpretation.ResultsTwenty-eight participants completed interviews (n=22 survivors, n=5 healthcare professionals, n=1 caregiver). Participants identified as BIPOC (64.3%), SGM (46.4%), and both (23.1%). Four themes shaped research engagement: (1) Awareness (visibility and pathways to research opportunities); (2) Accessibility (emotional, logistical, and institutional feasibility); (3) Authenticity (trust and perceived legitimacy); and (4) Appropriateness (alignment with identity and lived context).ConclusionResearch engagement among underrepresented AYA cancer survivors is shaped by interconnected multilevel factors. Advancing equity requires moving beyond recruitment to redesign research approaches that enhance visibility, reduce structural barriers, build trust, and align participation with AYAs' identities and lived experiences.

Long-term renal function is an important follow-up after radical nephrectomy for renal carcinoma. Predictive models can help identify patients at risk for chronic kidney disease (CKD) progression and enable early intervention.

We retrospectively analyzed 649 patients who underwent radical nephrectomy at eight medical centers. The primary cohort from the Affiliated Hospital of Qingdao University comprised 329 patients, randomly divided into training sets (n = 229) and internal validation sets (n = 100) at a 7:3 ratio. An additional 320 patients from seven other centers constituted a multicenter external evaluation cohort. Five machine learning models were developed, including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM). Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), confusion matrices, and calibration curves.

224 (34.51%) patients experienced postoperative CKD stage progression within three years. LightGBM achieved the highest discriminative performance among the five evaluated algorithms, with an AUC of 0.7508 (95% CI, 0.6399-0.8617) and an accuracy of 0.7200 in the internal validation set, and an AUC of 0.7549 (95% CI, 0.7022-0.8076) and an accuracy of 0.6813 in the external evaluation set. SHAP analysis identified preoperative eGFR, tumor size, post-to-preoperative serum creatinine ratio, preoperative serum creatinine, and age as the five most influential predictors.

We developed and externally evaluated machine-learning models for predicting CKD stage progression after radical nephrectomy. Long-term decline in renal function is an important complication that requires urologists' attention and early prevention during follow-up.

The Gold standard treatment for muscle-invasive bladder cancer (MIBC) in medically fit patients is neoadjuvant chemotherapy (NAC), followed by radical cystectomy (RC), usually urethra-sparing. Swedish guidelines recommend yearly urethroscopies for 5 years post-RC to detect urethral recurrences (URs). Evidence is limited regarding optimal urethral surveillance in the NAC-era for patients with MIBC. The goal was to evaluate UR-frequency across NAC-response groups: complete response (CR), i.e. pT0N0M0, and Non-CR-responses (partial response, stable disease, and progressive disease), compared with cystectomy-only controls.

A multicenter retrospective cohort study including 241 patients with ≥T2 disease in clinical and/or pathological staging (post-RC), urothelial or mixed urothelial histology, and undergoing urethra-sparing cystectomy between 2010 and 2024. Data were retrieved from medical records and transferred into an ethically approved database. UR was biopsy-confirmed; time to UR was analyzed using Aalen-Johansen cumulative incidence functions with the Gray's test.

40% (50/123) of the NAC-patients were complete responders. Nine UR-events occurred (3.7%) in the total material. UR was observed in 3/123 (2.4%) NAC-treated and 6/118 (5.1%) in No-NAC patients (Gray's, p = 0.291). No UR occurred among complete responders to NAC (0/50) versus 3/73 in non-complete responders (Gray's, p = 0.150). Four UR-cases (44.4%) were symptom-detected (urethral bleeding).

The total absence of urethral recurrences in NAC- and RC-treated MIBC-patients with complete responses suggests that the current Swedish recommendation of yearly urethroscopies could be reviewed since a more individualized surveillance strategy based on NAC-response may reduce unnecessary procedures.

BackgroundPreoperative differentiation of thyroid follicular tumors remains challenging because cytology has a limited ability to assess capsular and vascular invasion. This study aimed to develop a nomogram integrating multimodal ultrasound and clinical features to predict the risk of malignancy in follicular thyroid tumors.MethodsA total of 483 patients with pathologically confirmed follicular thyroid tumors were retrospectively enrolled. Follicular thyroid adenoma was defined as the benign group, whereas follicular tumor of uncertain malignant potential and follicular thyroid carcinoma were combined into the high-risk group. Clinical data and multimodal ultrasound features were collected. Independent predictors were identified using univariate and multivariate logistic regression analyses, and a nomogram was constructed. Model performance was evaluated using the area under the receiver operating characteristic curve, calibration curve, Hosmer-Lemeshow test, and decision curve analysis.ResultsSex, lesion multiplicity, preoperative thyroglobulin, halo characteristics, "nodule-in-nodule" appearance, and trabecular structure were identified as independent predictors of malignancy (all p < 0.05). The nomogram demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.94 (95% confidence interval: 0.90-0.97). Internal validation using 1000 bootstrap resamples yielded a mean area under the receiver operating characteristic curve of 0.928 (95% confidence interval: 0.915-0.934). Calibration analysis showed good agreement between predicted and observed outcomes (Hosmer-Lemeshow test, p = 0.578). Decision curve analysis indicated a significant net clinical benefit across a threshold probability range of 15%-85%.ConclusionIn this exploratory retrospective study, the proposed nomogram showed preliminary potential for the preoperative prediction of malignant risk in thyroid follicular tumors. However, because of the lack of external validation, these findings should be considered hypothesis-generating. The model requires validation in independent cohorts before clinical application.

IntroductionVarious industrial pollutants have been implicated in tumorigenesis. However, the cancer risk associated with microplastics, a pervasive environmental pollutant, remains poorly understood. This study aimed to evaluate the association between basin-level environmental microplastic contamination and cancer incidence.MethodsIn this secondary analysis of a prospective UK Biobank cohort, 378,985 participants were linked to basin-level river microplastic measurements using residential coordinates. The 2019 measurements were treated as an ecological proxy for regional environmental microplastic contamination. Participants were categorized into low, moderate, or high exposure groups, and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring a mean follow-up of 12.39 years, 37,322 participants developed at least one of the 24 cancer outcomes. Compared with participants in low-exposure basins, participants in high-exposure basins had increased risks of liver cancer (HR, 1.252; 95% CI, 1.031-1.520), colon cancer (HR, 1.167; 95% CI, 1.088-1.252), and lung cancer (HR, 1.198; 95% CI, 1.095-1.309). These estimates represent modest relative increases and should be interpreted alongside absolute event counts and confidence intervals.ConclusionsHigher basin-level river microplastic contamination was associated with modestly higher incidence of selected digestive and respiratory cancers.Patient or Public ContributionThis study was a secondary analysis of de-identified data from the prospective UK Biobank cohort. Patients, service users, and members of the public were not directly involved in the design, analysis, interpretation, or preparation of this study.

Conventional dose selection in oncology, which focuses on the maximum tolerated dose (MTD), has certain limitations for targeted agents and immunotherapies, where the efficacy-toxicity relationship may not be monotonic. Regulatory initiatives such as FDA's Project Optimus highlight the need for improved dose optimization methods early in drug development. Although recent Bayesian dose-finding designs enhance flexibility by integrating efficacy data and adopting adaptive monitoring, most depend on binary response outcomes and lack sufficient proof-of-concept (PoC) assessment before advancing doses to confirmatory trials. To address these gaps, we propose BEACON, an extended Bayesian optimization framework for randomized phase II oncology trials. BEACON incorporates time-to-event endpoints into both dose selection and PoC assessment. Extending from the DODII method (Bayesian dose optimization for randomized phase II trials), BEACON combines Bayesian safety and futility monitoring with a pick-the-winner strategy for both survival and binary outcomes. The design dynamically borrows information across dose levels during PoC to enhance decision-making. By allowing both survival and binary outcomes within a unified dose optimization with PoC strategy, BEACON enhances design flexibility and delivers robust confirmation of clinical benefit, aligned with regulatory expectations for dose justification in early-phase oncology studies. Simulation studies demonstrate that the BEACON design exhibits favorable operating characteristics, effectively controlling false go and selection error rates for the recommended doses and reducing the total sample sizes of the trial. With adaptive borrowing across dose levels, the design robustly maintains the desired proof-of-concept power.

To record the incidence of polyps, new primary tumours or other pathologies and thus evaluate the value of colorectal cancer (CRC) surveillance beyond standard 5-years period. The American Society of Colon and Rectal Surgeons (ASCRS) recommend surveillance for 5-years following colorectal cancer (CRC) resection. The oncological value of extended surveillance remains controversial.

A retrospective cohort study was performed. Patients who underwent curative surgery for CRC between 2004-2023 with endoscopic and commuted tomography (CT) surveillance were identified from a prospectively maintained database. A comprehensive review of electronic medical, endoscopic, and radiological records was performed. Descriptive statistics were preformed using SPSS v26.0.

Overall, 217 patients were included, with overall incidence of polyps, new primary tumours and distant metastases discovered during surveillance were 33 (17.6%), 14 (7.4%), and 47 (26.7%) respectively. Of these, 2 patients (14.3%) diagnosed with new primary tumours were diagnosed after 5-years surveillance, as were 4 (9.2%) of those who developed distant metastases. Furthermore, 11 (33.3%) of polyps were detected after 5-years surveillance.

The study suggests the possibility that current ASCRS guidelines may result in a proportion of pathology occurrence to be missed in surveillance. Ultimately, the provision of well-designed, prospective randomised clinical trials will be necessary to ratify and support any potentially practice changing results.

To evaluate a pilot lung cancer symptom-awareness advertisement campaign targeting a North Dublin area with elevated lung cancer incidence. The primary aim was to assess changes in symptom awareness and behaviour intent. The secondary aim was to examine for changes to rapid access lung cancer (RALC) e-referrals.

Face-to-face surveys were conducted pre- and post-campaign in target and control areas matched for deprivation, and assessed for differences. RALC referral changes were assessed comparing 6 weeks pre-, during, and post- campaign. Pearson's chi-squared and Kruskall-Wallis tests were used.

Six-hundred surveys were completed. After advertisement exposure, 119 (79%) and 118 (79%) in the campaign area indicated that it would increase lung cancer symptom awareness, and help-seeking intent respectively. Prompted awareness of 'persistent cough' remained similar, increasing from 109 (73.6%) to 121 (80.7%), which was not statistically significant. There was a decline in unprompted awareness of cough from 94 (64%) to 75 (50%). RALC e-referral increase from 63 (pre-campaign) to 78 (post-campaign) was not statistically significant.

These unexpected findings may reflect methodological limitations and limited follow-up duration. They underscore the need for multi-model campaigns to improve symptom awareness and help-seeking behaviour. Future evaluations should include longer follow-up and primary care data linkage to better assess intervention impact.

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is an alternative procedure for malignant biliary obstruction after failure of endoscopic retrograde cholangiopancreatography. When performing EUS-HGS, either plastic or metal stents are used, but selection often depends on the discretion of the endoscopist. We compared the efficacy and safety of plastic and metal stents during EUS-HGS.

We performed a systematic meta-analysis of all relevant articles listed by searching PubMed, Medline, and Web of Science databases. Random-effects or fixed-effects models were used to compare time to recurrent biliary obstruction (TRBO), clinical success rate, adverse event rate, rate of recurrent biliary obstruction, and re-intervention success rate after EUS-HGS with plastic and metal stents.

This meta-analysis included six eligible studies. The TRBO of the metal stent group was significantly longer than that of the plastic stent group (hazard ratio 1.83; 95% confidence interval [CI] 1.42-2.36). The total procedure-related adverse event rate of the metal stent group was significantly higher than that of the plastic stent group (odds ratio [OR] 0.48; 95% CI 0.30-0.77). The recurrent biliary obstruction rate of the plastic stent group was significantly higher than that of the metal stent group (OR 1.75; 95% CI 1.06-2.88). No significant difference was found for the clinical success rate or re-intervention success rate.

In this meta-analysis, metal stents showed longer TRBO, lower recurrent biliary obstruction rate, and higher adverse event rate than plastic stents.

Physical examinations have been essential in the delineation of the spectrum of teratogenic effects of teratogens, such as valproate, isotretinoin and thalidomide, as well as chorionic villus sampling (CVS). CVS became an alternative to amniocentesis in the 1980s, because results were provided earlier in pregnancy. In 1991, a dramatic report of 5 CVS-exposed infants, out of 289 exposed, with severe limb and craniofacial defects raised the question of a significant risk, particularly when the procedure was carried out before 70 days of gestation. Some epidemiologic studies using data from birth defects registries showed an increase in the number of CVS-exposed infants with limb reduction defects and others did not. However, case reports of physical examination findings showed a wider range of abnormalities, including hypoplasia of two or three fingers or toes in CVS-exposed children as well as terminal transverse limb defects with nubbins. In addition, hemangiomas were found to be a common non-limb malformation in CVS-exposed children.

Presented here are the findings from a case-control study of 38 CVS-exposed and 41 unexposed, matched children.

The physical examinations identified a spectrum of abnormalities from terminal transverse limb defects with nubbins to hypoplastic, shortened or stiff fingers and toes with small or absent nails.