Small nucleolar RNA host genes (SNHGs) are a distinctive subgroup of long non-coding RNAs whose loci can generate both host lncRNA transcripts and intronic small nucleolar RNAs. In hepatocellular carcinoma (HCC), dysregulated SNHGs have been linked to tumor growth, epithelial-mesenchymal transition, metastasis, stemness, immune remodeling, extracellular vesicle communication, and therapeutic resistance. However, the clinical meaning of these associations remains uneven because many reported mechanisms are based on limited cell-line experiments, retrospective cohorts, or non-stratified HCC models. This structured narrative review examines SNHG biology in HCC through an evidence-weighted and etiology-aware framework. Rather than cataloguing individual SNHG-miRNA-mRNA axes, we distinguish mechanistically stronger pathways from preliminary or hypothesis-generating findings and separate diagnostic, prognostic, predictive, and therapeutic implications. We also emphasize non-ceRNA mechanisms, including nuclear epigenetic regulation, RNA-protein interaction, protein-stability control, extracellular-vesicle signaling, and the dual-output architecture of SNHG loci. Particular attention is given to quantitative constraints of ceRNA models, differences among HBV-, HCV-, alcohol-related, and MASLD/MASH-associated HCC, and the current barriers to clinical translation. Overall, SNHGs represent promising but not yet clinically mature biomarkers or therapeutic targets. Their future value will depend on prospective validation, standardized assays, etiology-defined models, isoform-aware targeting, and integration into multi-omic and functional precision oncology frameworks.

Brain metastases (BrM) are a major cause of morbidity among patients with breast cancer (BC), particularly those with HER2+ or triple-negative disease. The relationship between neoadjuvant chemotherapy (NAC) and subsequent risk of BrM in patients with early-stage BC remains poorly defined.

We conducted a single-centre retrospective cohort study of 457 consecutive patients who were treated with NAC for early-stage BC at Sunnybrook Odette Cancer Centre between 2008 to 2019, among whom 25 developed BrM (cohort 1). To evaluate factors associated with shorter time to BrM development, an additional 129 patients with BC who received NAC and were subsequently diagnosed with BrM were identified (cohort 2). Descriptive statistics were used to summarize patient and treatment characteristics. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and identify factors associated with the development of BrM. Univariable analyses (UVA) were performed for all covariates. Bayesian Information Criteria determined best models from subsets of covariates when performing multivariable analyses (MVA).

Among 586 patients, the median age at BC diagnosis was 49.0 (IQR: 42-58) years. The most common BC subtype was HER2+ (n = 225, 38.4%), followed by hormone receptor (HR)+/HER2- (n = 213, 36.3%) and triple negative BC (n = 132, 22.5%). Following NAC, 134 patients (22.9%) had a pathologic complete response (pCR) and 409 (69.8%) had residual disease. In the overall cohort, the median time from BC diagnosis to BrM development was 38.0 (IQR 19.1-70.9) months. In cohort 1, 25 patients (5.5%) developed BrM with a median follow-up of 43.1 months. Median time to BrM was shortest for patients with triple-negative BC (18.0 months), followed by those with HER2+ (32.0 months), and HR+/HER2- disease (49.1 months). In the pooled cohort (n=586), multivariable analysis identified residual nodal involvement (HR 4.46 [95% CI 2.67-7.45], p<0.0001), inflammatory BC (HR 3.11 [95% CI 1.95-4.96], p<0.0001), and HER2+ or triple-negative subtype (HR 2.87 [95% CI 1.80-4.58], p<0.0001) as independently associated with shorter time to BrM development.

Among patients treated with NAC for early-stage BC, residual nodal disease, inflammatory BC, and HER2+ or triple-negative subtype are associated with a higher risk of BrM development. Whether BrM screening is warranted among patients with these high-risk features warrants evaluation.

Not applicable.

Survival rates for pediatric acute lymphoblastic leukemia (ALL) have markedly improved; however, survivors remain at risk of long-term hepatic complications, including progressive fibrosis related to chemotherapy and prior viral infections. The objective of this study is to evaluate hepatic fibrosis in pediatric ALL survivors using a sequential non-invasive algorithm combining transient elastography (TE) and enhanced liver fibrosis (ELF) score. This comparative cross-sectional study included 159 pediatric ALL survivors who had completed therapy at least 2 years earlier and 99 age- and sex-matched healthy controls from two Egyptian oncology centers. Liver fibrosis was assessed using TE and serum biomarkers for calculation of the ELF score. The mean age at diagnosis was 6.9 ± 2.7 years, and at assessment, 11.1 ± 2.7 years. Hepatitis C virus (HCV) prevalence declined significantly from 75% during treatment to 5% at enrollment following antiviral therapy (p < 0.001). Fibrosis was detected in 75% of survivors by TE, predominantly moderate (F2) fibrosis. Combined TE/ELF assessment identified advanced fibrosis (≥ F3) in 6% of patients, while most survivors had mild-to-moderate fibrosis. Mean ELF score was significantly higher in survivors than controls (9.3 ± 1.2 vs. 4.5 ± 1.03, p < 0.0001). Agreement between TE and ELF was fair (Cohen's κ = 0.34-0.39). HCV-positive survivors had significantly higher ELF scores than HCV-negative peers.Conclusion: Persistent hepatic fibrosis in pediatric ALL survivors was observed predominantly among patients with current or previous HCV exposure. A combined TE/ELF approach represents an effective non-invasive strategy for early detection and monitoring.

Residential segregation is recognized as an upstream driver of poor health, yet few studies have evaluated its impact on breast cancer incidence at a local level. We examined associations of neighborhood residential segregation with breast cancer (BC) incidence in the Multiethnic Cohort Study (MEC).

Measures of Index of Concentration at the Extremes were developed to assess residential segregation by income, education, race and ethnicity, and racialized income. A prospective study (1993-1996 through December 2019) was conducted to examine associations of these measures and breast cancer incidence for 101,785 African American, Japanese American, Latina, Native Hawaiian, and White female participants in the MEC, aged 45-75 years at baseline and residing in California and Hawai'i. Multivariable Cox regression was conducted to evaluate the associations of several residential segregation measures with breast cancer incidence (cases = 7,381) adjusting for demographic, lifestyle, and reproductive factors.

In California, BC risk was higher for females residing in neighborhoods with the highest compared to lowest concentration of privilege by income segregation (quintile 5 [Q5] vs. Q1: hazard ratio [HR] 1.12, 95% confidence interval [CI] 1.00-1.25, P_trend = 0.001) and education segregation (Q5 vs. Q1: HR 1.15, 95% CI 1.01-1.31; P_trend = 0.01). For Latina females, risks increased with increasing privilege for measures of income, education, race and ethnicity, and racialized income residential segregation (P_trends < 0.05). No associations were observed in Hawai'i.

In California, residential economic privilege was independently associated with increased BC risk. Future studies should examine neighborhood- and individual-level pathways placing females residing in privileged areas at greater risk.

Pleural mesothelioma (PM) is a malignancy with a relevant genetic component, with germline mutations identified in up to 12% of cases. International guidelines recommend universal germline testing; however, its implementation in routine clinical practice remains inconsistent. This nationwide survey aimed to assess current clinical practice, attitudes, and barriers related to genetic testing among Italian specialists within the Mesothelioma Team Italy (MET-I) network. A 24-item questionnaire was distributed to MET-I members in 2025, exploring access to testing, clinical use, and perceived obstacles to both germline and somatic DNA sequencing. Forty-five physicians responded (53.6%). Although access to germline testing was relatively high (77.8%), only 6.7% of respondents routinely recommended it. Conversely, somatic NGS was widely available (95.6%) and primarily used for clinical trial screening (66.7%). The main barriers to germline testing included costs (62.2%), limited access to genetic counseling (51.1%), and insufficient physician awareness (48.8%). Despite the availability of genetic testing technologies, germline genetic testing in PM is underutilized in Italy.

Sarcomas are rare, aggressive and unpredictable tumors that arise from mesenchymal tissues. Despite treatment, outcomes for advanced or metastatic cases remain poor. Anlotinib is a new oral tyrosine kinase inhibitor that blocks multiple angiogenic pathways and has shown encouraging results in solid tumors. This review aims to summarize and clarify the current evidence on anlotinib's role in treating sarcoma.

A systematic search across five major databases up to February 2025 identified clinical studies that evaluate anlotinib in sarcoma patients. Eligible studies included randomized controlled trials and observational studies evaluating anlotinib in advanced or metastatic sarcoma. Pooled estimates for median progression-free survival (mPFS) and overall survival (mOS) were calculated using random-effects models.

Twenty-one studies involving 1,230 patients were included. The pooled mPFS was 6.7 months and the mOS was 19.3 months. Results varied widely due to differences in sarcoma subtype, disease stage, and prior therapies, yet most studies showed meaningful tumor control and manageable toxicity.

Anlotinib appears to be a promising therapy for refractory or metastatic sarcomas. It offers modest yet real improvements in survival and quality of life. Larger, multicenter and biomarker-guided studies are needed to define which patients benefit most and how this drug can be best integrated into future treatment strategies.

Dopamine agonists, particularly cabergoline, are the first-line treatment for prolactinomas, but have been associated with impulse control disorders (ICDs). However, data on impulsivity and related behaviors in this population remain limited and inconsistent.

To evaluate impulsivity and ICDs in patients with prolactinoma treated with cabergoline and to compare these findings with healthy controls.

This case-control study included 131 patients with prolactinoma receiving cabergoline and 131 healthy controls. Impulsivity was assessed using the Barratt Impulsiveness Scale (BIS-11), and ICDs were evaluated using specific questionnaires addressing hypersexuality, gambling, compulsive shopping, and punding. Multivariable analyses were performed to assess independent associations.

Patients treated with cabergoline exhibited higher overall impulsivity, reflected by increased BIS-11 scores and a higher proportion of individuals with increased impulsivity (BIS-11 ≥ 60). Attentional impulsivity remained significantly higher in patients after multivariable adjustment. Patients also had more than fourfold higher odds of compulsive shopping compared with controls, whereas no significant differences were observed for other ICDs. Lower educational level was also associated with higher impulsivity across all BIS-11 domains and with compulsive shopping.

Patients with prolactinoma treated with cabergoline exhibit increased impulsivity, particularly in the attentional domain, along with higher odds of compulsive shopping. These results highlight the role of dopaminergic modulation and the influence of sociodemographic factors, supporting the importance of actively assessing impulsivity during clinical follow-up.

Although red meat and processed meat are well-established risk factors of colorectal cancer (CRC), the mechanisms underlying this association are less clear. Heme iron, abundant in red and processed meats, is one plausible etiologic factor. In addition, calcium, a well-established independent protective factor against CRC, may prevent heme-induced colorectal carcinogenesis by binding to heme iron in the gut.

We prospectively examined the association between heme iron and CRC risk and whether these associations differed by calcium intake in the Nurses' Health Study, Nurses' Health Study II and Health Professionals Follow-Up Study. We used Cox proportional hazards regression analyses to calculate cohort-specific hazard ratios (HRs) and pooled results using a fixed-effect model.

We analyzed data from 211,851 participants and documented 2983 incident CRC cases during up to 36 years of follow-up. Comparing the highest to lowest quintile, the pooled multivariable HRs (95% CIs) for CRC were 1.03 (0.91, 1.17) for total heme iron intake, 1.02 (0.91, 1.16) for heme iron from red and processed meat, and 1.02 (0.90, 1.15) for heme iron from non-red and non-processed meat sources. Total heme iron intake, heme iron from red and processed meat, and heme iron from non-red meat and non-processed meat sources were largely not associated with CRC risk. Moreover, the association between heme iron and CRC did not appear to differ by calcium status.

Overall, our study does not support a strong role of heme iron intake in CRC risk and suggests that the protective association of calcium intake on CRC risk does not depend on heme iron.

Superior mesenteric vein/portal vein (SMV/PV) resection is often required in borderline resectable or locally advanced pancreatic ductal adenocarcinoma (BR/LA PDAC) after neoadjuvant therapy (NAT), but its prognostic relevance and the role of histopathologic venous invasion remain unclear.

We retrospectively analyzed BR/LA PDAC patients undergoing pancreatectomy after NAT and compared perioperative and oncologic outcomes between patients requiring SMV/PV resection and those with venous preservation. Subgroup analyses assessed histopathologic venous invasion within the resection cohort. Kaplan-Meier analysis was used to evaluate overall survival (OS) and disease-free survival (DFS), and Cox regression was used to identify factors associated with OS.

Among 117 patients, 65 (55.6%) underwent SMV/PV resection and 52 (44.4%) had venous preservation. Although baseline demographic and clinical characteristics were broadly similar, the resection cohort showed greater local anatomic and operative complexity. Postoperative morbidity and mortality did not differ significantly between groups. Median OS was similar between the SMV/PV resection and preservation groups (16.0 vs. 22.0 months; P = 0.965), as was median DFS (10.0 vs. 12.0 months; P = 0.843). Within the resection cohort, histopathologically confirmed venous invasion was associated with significantly shorter OS (8.3 vs. 24.0 months; P < 0.0001) and DFS (5.0 vs. 17.0 months; P = 0.0002), whereas survival was similar between patients with venous preservation and those who underwent resection without venous invasion. R0 resection was associated with longer OS and DFS than R1 resection. In multivariable analysis, R1 resection and histopathologically confirmed SMV/PV invasion were independently associated with poorer OS.

In our cohort, patients requiring SMV/PV resection had outcomes broadly comparable to those with venous preservation despite greater operative complexity. Histopathologic venous invasion and R1 status were associated with worse OS and DFS. These findings support interpreting SMV/PV resection primarily as a marker of local anatomic disease extent rather than an independent adverse prognostic factor.

Neurofibromatosis (NF) comprises genetic tumor predisposition syndromes with multisystem involvement, yet pediatric mortality data remain scarce in middle-income settings. Malignant peripheral nerve sheath tumors (MPNST) represent the leading cause of premature death in this population. This study analyzed 16-year temporal trends and regional disparities in pediatric NF/MPNST mortality and hospitalizations in Brazil.

We conducted a nationwide ecological study of individuals aged 0-19 years from 2008 to 2023. Mortality data were obtained from the Mortality Information System (SIM) and hospital admissions from the Hospital Information System (SIH/SUS), with temporal trends assessed using Prais-Winsten regression. We calculated Age-Specific Mortality Rates (ASMRs) and assessed excess mortality risk using Standardized Mortality Ratios (SMR) to identify regional disparities.

A total of 177 pediatric deaths were identified, with MPNST accounting for 64.9% (N = 115) and NF for 35.1% (N = 62). SMR analysis revealed significant geographic inequalities. Children aged 0-9 in the South region faced a mortality risk double that of the reference population (SMR = 2.02; 95% CI 1.08-3.46; p = 0.010), whereas adolescents in the North region exhibited significantly lower-than-expected mortality. Despite global therapeutic advances, mortality rates in Brazil remained statistically stagnant across all age groups and conditions (p values were non-significant). Conversely, NF-related hospitalizations demonstrated an increasing trend (+ 2.98% annually for ages 0-9; + 1.94% for ages 10-19), while MPNST admissions remained stable.

Pediatric mortality from NF and MPNST in Brazil has remained unchanged for 16 years, contrasting with the rising trend in NF-related hospitalizations. This discrepancy, coupled with marked regional disparities, suggests persistent structural challenges in early diagnosis and equitable access to specialized oncology care. These findings highlight a critical need for national notification systems and improved therapeutic strategies for affected children and adolescents.