Returning to work after cancer offers important psychological and economic benefits. However, individuals with head and neck (H&N) cancer face a higher risk of leaving the workforce due to the functional consequences of treatments. This study examined the association between H&N cancer and job separation within 2 years of diagnosis and identified patient profiles at higher risk.

An integrated database was created by linking the Turin Longitudinal Study, the regional Mandatory Communications archive, and the national INPS archive. Incident H&N cancer cases were identified through hospital discharge records, and employment status was defined using occupational data. Each worker with H&N cancer was matched with four cancer-free workers of similar sociodemographic characteristics (non-cases). Patient profiles were defined through latent class analysis. Robust Poisson models were used to estimate the risk of job separation.

Between 2008 and 2020, 255 employed individuals were diagnosed with H&N cancer. They showed a twofold higher risk of job separation compared with matched non-cases (RR = 2.00, 95% CI: 1.59-2.51). Some profiles were more likely to exit the workforce, particularly workers with more severe disease (RR = 2.14, 95% CI: 1.04-4.42) or with lower education and higher socioeconomic deprivation (RR = 1.74, 95% CI: 1.02-2.95).

H&N cancer diagnosis substantially increases the likelihood of job separation, particularly among socioeconomically disadvantaged workers.

Identifying vulnerability profiles is essential for developing targeted return-to-work strategies. Integrated health and administrative data can support tailored interventions that better address survivors' long-term employment needs.

In robot-assisted radical prostatectomy (RARP), surgical techniques aimed at preserving urinary continence-such as bladder neck preservation, nerve sparing, and dorsal venous complex (DVC) preservation-are increasingly adopted to improve postoperative quality of life. However, whether an excessive emphasis on functional preservation compromises oncological outcomes remains unclear.

We retrospectively analyzed 235 consecutive patients who underwent RARP performed by a single experienced surgeon. Patients were stratified according to (1) extent of bladder neck preservation (< 8 mm, 8-16 mm, > 16 mm), (2) nerve-sparing status (bilateral, unilateral, none), and (3) degree of DVC preservation (long, standard, short). Urinary continence at 3 months postoperatively (≤ 1 safety pad/day), positive surgical margin (PSM) rates, and biochemical recurrence (BCR) were evaluated.

Bladder neck preservation was associated with improved early continence recovery without increasing PSM or BCR rates. Bilateral nerve sparing resulted in superior continence outcomes; higher PSM rates in the non-nerve-sparing group reflected a more advanced pathological stage. DVC preservation showed the strongest association with continence recovery; however, aggressive DVC preservation was associated with a significantly higher PSM rate, predominantly at the apical and anterior regions. No significant differences in BCR were observed among groups.

Bladder neck preservation and nerve sparing can improve urinary continence without compromising oncological outcomes when appropriately applied. In contrast, aggressive DVC preservation may increase the risk of positive surgical margins and should be performed cautiously with careful patient selection.

Antibody-drug conjugates (ADCs) have become an increasingly important component of the therapeutic landscape of many solid tumors. Currently, there are eight ADCs approved for solid tumors, with hundreds being developed and in clinical trials. Initially being approved in the advanced or metastatic settings, ADCs are also being incorporated as neoadjuvant or adjuvant therapies. In this review, we discuss the important components of ADC design in the context of clinical successes and failures. We further evaluate mechanisms of intrinsic and acquired resistance and strategies to overcome these barriers. Finally, we discuss the landscape of potential combination partners to increase efficacy of ADC therapies.

Pediatric oncology drug development remains uniquely challenging due to the rarity and biological heterogeneity of childhood cancers, ethical considerations in trial conduct, and the limited feasibility of large, randomized studies. Despite these barriers, recent years have seen a notable acceleration in the approval of oncology therapies for pediatric populations, driven by advances in molecularly targeted treatments, evolving regulatory requirements, and innovation in trial design. Reducing nonclinical data requirements and increasing the adaptation of model‑informed drug development approaches are also contributing to advances in pediatric oncology treatment by supporting dose selection, optimizing study design, and reducing unnecessary patient burden. In this review, recent regulatory requirements from the United States, the EU, and other key regions on pediatric oncology drug development are discussed. Thirty-three drugs with oncology indications in pediatric populations approved by the US FDA between 2018 and 2025 are reviewed. These approvals provide examples of how nonclinical and clinical data were generated with a focus on strategies for dose-finding and justification. Common challenges and considerations related to clinical operations and formulation development in pediatric populations and the emerging use of real-world data, external controls, and artificial intelligence/machine learning are also discussed.

Purpose To develop a fully automated method for measuring apparent diffusion coefficient (ADC) for breast tumors in diffusion-weighted MRI that is objective, repeatable, and reproducible for assessing early response to neoadjuvant chemotherapy. Materials and Methods This study was a retrospective analysis of American College of Radiology Imaging Network 6698 trial data (August 2012-January 2015). Regions of interest (ROIs) were automatically derived by transferring the tumor ROI from dynamic contrast-enhanced MRI to diffusion-weighted MRI via image registration, and the ΔADC were calculated from baseline to early treatment. The ΔADC performance was assessed for predicting a pathologic complete response (pCR) using receiver operating characteristic curve analysis. The analysis was performed in all participants and in subgroups defined by tumor human epidermal growth factor receptor 2 (HER2) status. The reproducibility of automated tumor ADC measurements was assessed in a test-retest subcohort. Results The analysis cohort included 226 participants with breast cancer (mean age, 48 years ± 10 [SD]). Automated ADC measurements were reproducible in the test-retest subcohort (n = 71; estimated agreement index, 0.82 [95% CI: 0.77, 0.85]). The ΔADC from the automated ROI predicted pCR, with an area under the receiver operating characteristic curve (AUC) of 0.61 (95% CI: 0.53, 0.69; P = .008). The AUC in the HER2-positive subcohort (0.69 [95% CI: 0.54, 0.93]) was higher than that in the HER2-negative subcohort (0.52 [95% CI: 0.41, 0.62]; P = .06). Conclusion The automated ADC measurement method was reproducible, and tumor ΔADC could predict pCR early. External validation will be included in future work. Keywords: Breast, MRI, DWI, Diffusion-weighted Imaging, Tumor Response, DCE, Dynamic Contrast-enhanced, MR Imaging, MR-Diffusion-weighted Imaging, MR-Dynamic Contrast-enhanced Clinical trial registration no. NCT01564368 Supplemental material is available for this article. © RSNA, 2026.

In pathology-enriched referred hospital cohorts, stable radiologic-pathologic linkage is often unavailable, so patient-level malignant pathology may be a more reliable endpoint than lesion-specific malignancy. We aimed to develop and internally validate a blood-based model for patient-level malignant-versus-benign pathology discrimination.

We retrospectively reviewed 283 consecutive eligible source records from 22 February 2023 to 12 May 2025. After excluding unclassifiable pathology, lesions > 30 mm when verifiable, and obvious extrapulmonary primary tumors, we defined a strict primary cohort. A prespecified complete-case logistic regression model including FR + CTC, peripheral CD8 count, age, and sex was developed and internally validated with bootstrap resampling.

The strict primary cohort included 234 patients (166 malignant, 68 benign). In the main model (n = 232), FR + CTC was associated with higher odds of malignant pathology (OR 1.31 per 1 FU/3 mL, 95% CI: 1.14-1.50; p < 0.001), whereas peripheral CD8 count was inversely associated (OR 0.50 per 100 cells/μL, 95% CI: 0.41-0.61; p < 0.001). Apparent and optimism-corrected AUCs were 0.877 and 0.867, respectively. Adding an adjudicated patient-level CT vascular sign yielded limited incremental value.

In this retrospective single-center, pathology-enriched cohort, FR + CTC and peripheral CD8 provided useful internally validated discrimination for patient-level malignant pathology. The model requires external validation and setting-appropriate recalibration before broader clinical use.

The World Health Organization recommends high-risk human papillomavirus (hrHPV) testing as the primary method for cervical cancer screening. Combining samples in a pool can reduce the expense associated with large numbers of commercially available tests. This study simulated the potential test-saving impact of pooled hrHPV testing using real-world data from two low- and middle-income countries (LMICs).

We simulated a two- and three-stage hrHPV pooling in Bangladesh (hrHPV prevalence 2.10%) and Uganda (hrHPV prevalence 22.52%) using real-world laboratory data. Measurements included the number of tests per stage, the total number of tests, and the percentage of tests saved. We performed sensitivity analysis to assess the impact of a 1.00% loss of sensitivity and specificity per additional sample in the pool on the false-negative rate (FNR).

In Bangladesh, the two-stage strategy (eight samples per pool) and the three-stage strategy saved 71.21% and 77.21% of tests, respectively, compared to testing individually. In Uganda, the two-stage strategy (three samples per pool) reduced the number of tests by 15.34% compared to testing individually. Assuming loss of sensitivity and specificity due to pooling, the FNR was higher (FNR = 0.012-0.134) when hrHPV prevalence was low under the two-stage strategy.

Pooled hrHPV testing has the potential to reduce the number of tests used and enhance screening capacity in resource-limited settings. Notably, a lower prevalence of hrHPV allows for more efficient pooled testing. Despite the potential loss of sensitivity and specificity, pooled hrHPV testing could offer benefits for LMICs and warrant further verification.

To compare sleeve gastrectomy, semaglutide therapy, and the Diet, Exercise, Accompany and Refresh (DEAR) weight management programme for weight control, metabolic improvement, and oncological outcomes in patients with endometrial cancer receiving fertility-sparing treatment.

In this prospective observational study, 53 patients received sleeve gastrectomy (n = 10), semaglutide therapy (n = 23), or the DEAR programme (n = 20) after multidisciplinary assessment and shared decision-making. Anthropometric and metabolic measures and tumour response were assessed over two years.

At 1 year, all groups lost weight; the sleeve gastrectomy group had the largest body mass index reduction compared with the semaglutide group (difference = 4.04 kg/m², p < 0.05) and the DEAR group (difference = 2.12 kg/m², p < 0.05). By 2 years, weight regain was less frequent in the DEAR group (14.3%) than in the semaglutide (55.6%) and sleeve gastrectomy (66.7%) groups (p = 0.037). The DEAR group showed more stable metabolic improvements and the highest complete tumour remission rate (85.0%), followed by the semaglutide group (73.9%) and the sleeve gastrectomy group (60.0%).

Sleeve gastrectomy produced rapid short-term weight loss, whereas the DEAR programme showed better medium-term weight maintenance, metabolic stability, and tumour response. Integrated lifestyle support may be a useful medium-term strategy for patients seeking fertility preservation.

Reconstruction of buccal mucosal defects requires thin, pliable, and well-vascularized tissue to preserve oral function and cheek mobility. While the radial forearm free flap remains widely used, alternative ultra-thin options are needed, particularly in obese patients where conventional perforator flaps may be excessively thick. We report the case of a 59-year-old obese man (BMI 32 kg/m²) undergoing resection of a superficial squamous cell carcinoma of the left buccal mucosa, resulting in a wide 6 × 6 cm defect. Reconstruction was performed using a super-thin external pudendal artery (STEPA) free flap harvested from the hemiscrotum. The fasciocutaneous flap, measuring 6 × 6 cm, demonstrated uniform near-millimetric thickness (2-3 mm), allowing direct intraoral inset without the need for thinning. Microvascular anastomoses were performed to the facial vessels, and donor-site closure was achieved primarily. The postoperative course was uneventful, with early enteral feeding, progressive oral intake from day 10, and no complications. At 3 months of follow-up, the flap showed complete integration with preserved cheek mobility and satisfactory mouth opening. This case highlights that the STEPA free flap may represent a useful ultra-thin reconstructive option for buccal mucosal defects in selected patients, particularly when minimal flap thickness is required.

Immune checkpoint inhibitors (ICI) are widely used in cancer therapy, but biomarkers for thromboembolic risk, treatment response, and survival remain limited. We evaluated the association of systemic inflammatory indices with these clinical outcomes.

In this retrospective cohort study, 580 ICI-treated patients at the Medical University of Vienna, Austria, were included. Inflammatory indices including neutrophil-lymphocyte-ratio (NLR), platelet-lymphocyte-ratio (PLR), lymphocyte-monocyte-ratio (LMR), systemic immune-inflammation-index (SII) and C-reactive-protein-albumin-ratio (CAR) were calculated at ICI-start and longitudinally within 3 months. Co-primary outcomes were risk of venous thromboembolism (VTE), assessed using competing risk analysis, and overall- and progression-free-survival (OS/PFS), evaluated with Cox regression, whereas longitudinal biomarker dynamics were analysed using time-dependent analyses.

Higher baseline NLR (HR 1.65, 95% CI: 1.28-2.12), CAR (HR 1.99, 95% CI: 1.67-2.38), and SII (HR 1.18, 95% CI: 1.00-1.39) were independently associated with shorter OS, while higher LMR (HR 0.44, 95% CI: 0.30-0.67) was associated with longer survival. For PFS, elevated NLR (HR 1.29, 95% CI: 1.05-1.57), higher PLR (HR 1.18, 95% CI: 1.00-1.39), lower LMR (HR 0.57, 95% CI: 0.43-0.70), and higher CAR (HR 1.42, 95% CI: 1.28-1.62) predicted poorer outcomes. None of the indices at treatment start were associated with VTE, yet doubling of levels within 3 months indicated higher VTE risk for PLR (sub-distribution hazard ratio [SHR]: 3.03 95% confidence interval [CI]: 1.05-8.08) and a borderline-significant association for CAR (SHR: 2.02, 95% CI: 0.89-4.60).

We found that selected inflammatory indices were associated with poor OS and PFS in ICI-treated patients, and longitudinal dynamics might identify patients at higher risk for VTE.