To explore the relationship between intolerance of uncertainty (IU) and executive function (EF) in individuals with breast cancer.

21 postmenopausal women aged 45-75 years with stage I-III breast cancer who completed chemotherapy 3-12 months before enrollment were included.

In this pilot cross-sectional study, participants completed a task to probe neural responses to unpredictable threats, and anterior insula activation indicated objective IU. EF was measured by a neuropsychological test. Other self-reported measures were used to assess anxiety and fatigue.

Results indicated that individuals with high objective IU demonstrated lower EF. No main effect of subjective IU on EF was found, and no mediation effect of anxiety on the relationship between IU and EF was found.

Healthcare providers need to consider IU when planning and providing survivorship education. Further research is needed to enhance the understanding of the role of IU on EF problems among individuals with breast cancer.

To assess the impact of Snyder's hope theory-guided nursing care combined with continuity of care on postoperative individuals with glioma undergoing chemotherapy.

112 patients with glioma receiving postoperative chemotherapy were randomly assigned to control and observation groups.

The control group received routine nursing whereas the observation group received additional care based on Snyder's hope theory, combined with continuous nursing. Negative emotions, self-care agency, cancer-related fatigue, hope levels, quality of life, adverse reactions, and nursing satisfaction were compared between the groups.

The observation group showed significantly lower anxiety and depression (p < 0.05) and higher self-care advocacy, hope levels, and quality of life than the control group (p < 0.05). Fatigue and the incidence of adverse reactions were significantly lower in the observation group (p < 0.05). Nursing satisfaction in the observation group was significantly higher.

Snyder's hope theory-guided nursing care with continuity of care improves psychological well-being, self-care agency, and quality of life, and reduces fatigue and side effects among individuals with glioma undergoing chemotherapy.

Richter transformation (RT) is a serious complication of chronic lymphocytic leukaemia (CLL), with poor outcomes. While CAR T-cells have shown promise in large B-cell lymphoma, their efficacy in RT remains unclear, and the role of allogeneic stem cell transplant (alloSCT) post-CAR T-cells has not been established. This study aimed to assess the clinical response and survival of patients with RT treated with anti-CD19 CAR T-cells. This retrospective multicentre study, conducted by the European Research Initiative on CLL (ERIC), included patients with RT who received anti-CD19 CAR T-cells between 06/2018 and 01/2024. Progression-free survival (PFS) and overall survival (OS) were evaluated from CAR T-cell infusion. Fifty-four patients with RT were treated with anti-CD19 CAR T-cells (academic products, n = 29; commercial products, n = 25). The median age was 63 years, with 72% having an ECOG performance status (PS) of 0 to 1. Seven patients (13%) underwent alloSCT following CAR T-cell infusion, with the indications being consolidation therapy (n = 4) and relapse/progression (n = 3). The overall response rate was 65%, with 46% achieving complete response (CR) at 1 month and 50% at 3 months. The median PFS was 8.0 months (95% CI: 2.1-13.8) and the median OS was 14.4 months (95% CI: 8.8-19.2). The median PFS was 31.6 months for patients achieving CR at 1 or 3 months post CAR T-cells. Significant factors associated with mortality included high ECOG PS (p < 0.001), high LDH at CAR T infusion (p = 0.005), ICANS (p = 0.046) and no response at 1 month (p = 0.02). Multivariable Cox regression analysis identified treatment response at 1 month (p = 0.001) and increasing age (p = 0.5) as significant predictors of mortality. This study shows encouraging response rates and manageable toxicity for patients with RT treated with both academic and commercially available CAR T-cell products.

To evaluate the diagnostic value of ultrasound-guided fine-needle aspiration cytology (US-FNAC) and ultrasound-guided fine-needle non-aspiration cytology (US-FNNAC) on cervical lymphadenopathies, in which the authors specifically analysed the influence of lymph node size.

A total of 500 lymphadenopathies were retrospectively enrolled from January 2019 to July 2023. The lymph nodes were divided into four size groups: ≤5.0 mm, from 5.1 to 10.0 mm, from 10.1 to 15.0 mm and >15.0 mm. The cytohistologic diagnosis was evaluated based on the Sydney System: I. inadequate/nondiagnostic; II. benign; III. atypical cells with uncertain significance/atypical lymphoid cells with undetermined significance; IV. Suspicious and V. malignant. The diagnostic yield of US-FNAC and US-FNNAC were assessed based on sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV) and accuracy calculations.

The overall SEN, SPE, PPV, NPV and accuracy of ultrasound-guided fine-needle cytology were 88.7%, 89.7%, 96.2%, 72.9%, 88.9%, respectively. The diagnostic accuracy and SEN of US-FNAC were superior to that of US-FNNAC in the overall cases (95.1% vs 83.9%, p < 0.001;95.6% vs 83.4%, p < 0.001) and in lymph nodes that measured from 5.1 to 10.0 mm(94.5% vs 85.1%, p = 0.022; 95.8% vs 84.4%, p = 0.021) as well as that from 10.1 to 15.0 mm (98.6% vs 86.0%, p = 0.011; 98.2% vs 83.3%, p = 0.011), while there was no significant difference between US-FNAC and US-FNNAC in the diagnostic yield among the other two subgroups.

The current findings supported the preferential use of US-FNAC over US-FNNAC in routine clinical practice for lymph node evaluation, particularly for nodes measuring 5.1-15.0 mm. For lymphadenopathies ≤5.0 mm, additional tests were required to enhance the diagnostic performance of US-FNC, with US-FNAC often being necessary. Thus, we recommended using US-FNAC to obtain cytological specimens for definitive diagnosis of cervical lymphadenopathies that ≤15.0 mm.

The safety and efficacy of minimally invasive adrenalectomy (MIA) for large pheochromocytoma (PHEO) remains a hotly debated topic. This study aims to shed light on the feasibility and safety of MIA for PHEOs > 5 cm.

We conducted a comprehensive retrospective analysis of 135 patients who underwent MIA for PHEOs at our centre from January 2016 to February 2023. After propensity score-matching (PSM) to balance baseline variables, 91 patients with tumours ≤ 5 cm and 44 patients with tumours > 5 cm were grouped into 33 pairs. Patient demographics and perioperative data were meticulously recorded and compared.

After PSM, 33 pairs of patients were included (the larger group: 13 males, 20 females; mean age 50.0 ± 14.8 years; the smaller group: 12 males, 21 females; mean age 53.7 ± 11.8 years). There was no significant difference in baseline characteristics between the two groups except for tumour size (6.4 vs. 3.4 cm, p < 0.001). The larger group had longer operative time (130 vs. 95 min, p = 0.020) and drainage tube removal time (4.0 vs. 3.0 days, p = 0.005). However, no significant differences were observed in intraoperative hemodynamic outcomes, transfusion rate and perioperative complications. Logistic regression analysis revealed that hypertension was an independent risk factor for hemodynamic instability (OR = 6.681, 95% CI: 1.270-35.148, p = 0.025).

Although MIA for PHEOs > 5 cm had longer operative time and drainage tube removal time, it did not affect intraoperative hemodynamic outcomes and perioperative complications. Thus, minimally invasive adrenalectomy represents a viable and effective surgical option for managing large PHEO.

To assess the preliminary efficacy and safety of a dose-intensified C5VD regimen (cisplatin, 5-fluorouracil, vincristine, and doxorubicin) in children with locally advanced hepatoblastoma.

This prospective study enrolled 24 children with newly diagnosed, locally advanced hepatoblastoma who received the dose-intensified C5VD regimen at Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, and Shanghai Children's Hospital between January 2020 and December 2023. Clinical characteristics, treatment outcomes, and chemotherapy-related toxicities were analyzed.

Of the 24 patients, 13 were male and 11 were female, with a median age at diagnosis of 18.7 months (range: 3.5-79.4 months). All patients achieved complete macroscopic resection of hepatic lesions without liver transplantation. Serum alpha-fetoprotein levels decreased significantly after two chemotherapy cycles. During a median follow-up of 38.4 months (range: 15.8-50.7 months), all patients maintained continuous complete remission, with 3-year event-free survival and overall survival rates of 100%. Across 144 chemotherapy cycles, the incidence rates of grade 3-4 neutropenia, thrombocytopenia, and infections were 97%, 77%, and 71%, respectively; no treatment-related deaths occurred. Notably, 5 patients (21%) developed Brock grade ≥3 hearing loss, of whom 1 required a hearing aid.

The dose-intensified C5VD regimen demonstrates significant efficacy with an overall favorable safety profile in the treatment of newly diagnosed, locally advanced pediatric hepatoblastoma. Grade 3-4 myelosuppression and infection are the predominant toxicities. However, high‑dose cisplatin-induced ototoxicity remains a concern, highlighting the need for improved otoprotective strategies.

T1rho imaging showed potential applications in cancer imaging but little research explored the underlying biological processes that contribute to the T1rho values in cancer. This study aimed to investigate the potential associations between quantitative imaging biomarkers from T1rho imaging and the well-established diffusion weighted imaging (DWI), with tumour-stromal, immunohistochemical (IHC), and tumour-infiltration-lymphocytes (TIL) biomarkers in nasopharyngeal carcinoma (NPC).

Pre-treatment T1rho and DWI imaging of primary NPCs were performed in 50 prospectively recruited patients. The mean T1rho and apparent diffusion coefficient (ADC) of NPC were obtained and correlated with tumour-stromal, IHC, TIL biomarkers using the Pearson Correlation test and the coefficients (R) were calculated.

The mean T1rho values negatively correlated with collagenous stroma-lymphoid stroma (R=-0.314, p = 0.03) and positively correlated with percentage of tumour cells positive for Ki-67 (R = 0.402, p < 0.01), but there were no associations between T1rho values and the other tumour-stromal, IHC or TIL biomarkers (p = 0.16-0.98) or between ADC values and any of these biomarkers (p = 0.07-0.82).

Our results showed the possible underlying biological mechanisms of T1rho imaging in head and neck cancer. T1rho imaging negatively correlated with the ratio of collagenous to lymphoid stroma, and positively correlated with tumour cell proliferation, which are both known to be predictors of outcome, suggesting that T1rho imaging may have a valuable role in head and neck cancer imaging. As this is a preliminary study with small sample size, further studies are encouraged to validate our findings.

Triple-negative breast cancer (TNBC) is characterized by aggressive biological behavior and poor prognosis. However, TNBC exhibits higher immunogenicity than other breast cancer subtypes, making it more responsive to immunotherapy. Neoadjuvant chemotherapy (NAC) is the standard treatment for early high-risk TNBC; however, reliable biomarkers for predicting NAC response remain elusive. Tumor-infiltrating lymphocytes (TIL) are recognized as predictive markers of NAC response in TNBC, yet discordant cases remain, such as tumors with high TIL levels but poor response. This study aimed to further elucidate the immune environment of TNBC by analyzing TIL, programmed death-ligand 1 (PD-L1) expression, and tumor-stroma ratio using pretreatment biopsy tissue slides from 16 patients with TNBC treated with NAC.

Multiplexed immunofluorescence for CD8, FOXP3, CD4, CD20, and CK was employed to investigate immune cell (IC) composition and spatial interactions within the tumor immune microenvironment. Cell to cell distance and comparison of subcellular proportion of IC and were analyzed by treatment response, TIL, and PD-L1 status.

Significant differences were found in IC composition and distribution between patients achieving pathologic complete response (pCR) and those with residual disease (non-pCR). The pCR group exhibited significant enrichment of cluster of differentiation CD8 + IC and CD20 + IC in both tumor and stromal regions, suggesting their critical role in mediating an effective NAC response. In contrast, non-pCR cases showed higher proportions of immunosuppressive CD4 + FOXP3 + IC, particularly in the tumor region. High TIL levels were associated with pronounced B-T cell interactions, as evidenced by the significant clustering of CD20 + and CD8 + ICs near tumor cells, highlighting their cooperative role in antitumor immunity.

In conclusion, our findings suggest that tumoral CD8 + and CD20 + ICs are pivotal determinants of NAC response in TNBC. The enrichment of CD20 + IC under high-TIL conditions underscores the potential role of B-T cell interactions in shaping immune-mediated chemotherapy responses. These insights provide a foundation for leveraging immune-based biomarkers to stratify patients with TNBC and optimize NAC outcomes.

This study aimed to compare the short-term outcomes of Indocyanine Green (ICG) assisted minimally invasive surgery (MIS) with Intraoperative Ultrasound (IOUS) against conventional MIS with IOUS alone and open surgery with tactility and IOUS for colorectal liver metastases (CRLM). And identify risk factor of R1 resection (tumor-negative margin < 1 mm) by statistical analysis.

A retrospective cohort analysis was conducted on 86 patients with 158 CRLM tumors undergoing hepatectomy. Patients were categorized into three groups: Group A (ICG + IOUS MIS, n = 14, tumor = 23), Group B (IOUS only MIS, n = 16, tumor = 20), and Group C (tactile + IOUS Open surgery, n = 56, tumor = 115). Statistical analysis involved univariate analysis and multivariable logistic regression were performed.

Group A demonstrated superior R0 resection (tumor-negative margin ≥ 1 mm) rates, shorter median hospital stays compared to Groups C. Intraoperatively, Group A exhibited reduced blood loss and shorter operative times (213.5 vs. 351.5 min, p = 0.02) compared to Group C. Multivariable analysis identified surgical approach, lower Ki-67 expression, higher body weight and more metastatic lesions as independent predictors of R1 resection.

ICG assisted MIS significantly reduces R1 resection rates, postoperative hospitalization time and costs compared to conventional MIS or open surgery.

Robotic Peritoneal Mesometrial Resection and Targeted Compartmental Lymphadenectomy (PMMR + TCL) is a procedure following Cancer Field Surgery concept for endometrial cancer (EC), enabling superior locoregional control without adjuvant irradiation. We aimed to test the feasibility and safety of performing the PMMR + TCL by a newly trained team in a robotic approach.

A single-institution, retrospective analysis of patients undergoing robotic surgery (DaVinci) for EC was performed. The PMMR + TCL was compared to a robotic simple hysterectomy (rSH) and sentinel lymph node dissection (SLND). The primary outcomes were the rate of PMMR + TCL among all robotic surgeries and the 30-day complications (Clavien-Dindo classification).

The PMMR + TCL was performed on 79 (66.9%), rSH + SLND with afferent lymphatic vessels on 17 (14.4%), rSH + SLND alone on 20 (16.9%), and radical hysterectomy with SLND/lymphadenectomy on 2 (1.6%) patients, with the median number (range) of removed lymph nodes of 8 (2-12), 6 (2-10), 6 (1-7), and 26 (4-26), respectively. Patients in whom the PMMR + TCL was performed were younger, had lower BMI, and fewer co-morbidities as compared to those who underwent other procedures. Thirteen (11%) patients experienced complications, with 3 (2.5%) grade IIIb, of which none could be directly linked to any type of procedure. Ten (8.5%) patients experienced postoperative grade I-II complications, which tended to be more frequent after PMMT + TCL. Endometriosis and carcinoma deposits were found between uterus and lymph nodes in 7 (8.8%) of PMMR + TCL specimens.

Performing PMMT + TCL by a team newly trained in robotic surgery was feasible and relatively safe. Further research on locoregional control after PMMR + TLC without adjuvant irradiation should be conducted.