To explore patients' lived experiences of the Nurse Case Manager (NCM) within the GRACE-M radical cystectomy pathway, focusing on relational support, care coordination, continuity and recovery-related challenges.

A qualitative phenomenological study was conducted, following Giorgi's methodology.

Qualitative data were collected through 16 semi-structured interviews conducted 6 months after discharge with patients who had undergone elective RC within a multidisciplinary care pathway at a tertiary university hospital in Northern Italy. Data were analysed using Giorgi's phenomenological method to explore in depth patients' perceptions of the role of the NCM and their overall care experience.

Patients perceived the NCM as both a reassuring presence and an accessible care coordinator who facilitated information, specialist contact and continuity after discharge. No distinct NCM-related barrier theme emerged; reported difficulties concerned post-operative recovery and adaptation.

Patients perceived the NCM as combining emotional support with coordination and navigation. Given the single-centre qualitative design and interview self-selection, these findings describe perceived contributions and do not demonstrate causal effects on satisfaction, adherence or clinical outcomes.

The data consists of answers given by patients in interviews.

Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy for patients with hematologic malignancies, but its success is limited by graft‑versus‑host disease (GVHD), which carries considerable clinical and economic burden. A cost-effectiveness model was developed to evaluate whether the higher upfront costs of allogeneic regulatory T cell-based immunotherapy with HSPC and T cells-vldq (Tregzi [Orca-T; Orca Bio, Menlo Park, CA, USA]) are offset by reductions in GVHD and associated healthcare costs compared with conventional allo-HCT using TAC/MTX or PTCy.

A three-state partitioned survival model (relapse-free, relapsed, and dead) with a lifetime horizon and monthly cycles was developed. Overall survival and relapse-free survival data from the Phase 3 Precision-T study (ClinicalTrials.gov Identifier NCT05316701) were incorporated using a cure-mixture modeling approach to estimate long-term survival, relapse status, and cure fraction for patients. Costs included transplant procedure, GVHD management, infection management, and terminal care. Outcomes included life-years, quality-adjusted life-years (QALYs), and direct healthcare costs. Both costs and outcomes were discounted at 3% annually. A scenario analysis was conducted to determine the cost-effectiveness of Orca-T vs allo-HCT with PTCy for GVHD prophylaxis, and sensitivity analyses were conducted to test the uncertainty of the model inputs.

Orca‑T was associated with lower lifetime costs ($1,026,856 vs $2,170,875) and higher QALYs (15.28 vs 13.00) than conventional allo‑HCT with TAC/MTX, yielding cost savings of $1,144,019 and a gain of 2.28 QALYs per patient. GVHD-related costs were substantially lower with Orca‑T ($495,447 vs $1,998,621). Compared with PTCy, Orca‑T remained dominant, with cost savings of $158,144, a gain of 2.85 QALYs, and lower GVHD-related costs ($476,448 vs $999,945).

Orca‑T reduced costs and increased QALYs versus conventional allo‑HCT with TAC/MTX or PTCy, driven by lower GVHD and infection burden. These findings support Orca‑T as a high‑value treatment option.

Cervical cancer poses a significant burden globally, particularly in developing countries, with China accounting for 20% of the global incidence. This study aimed to examine temporal changes in the pathological distribution of cervical cancer, particularly squamous cell carcinoma (SCC) and adenocarcinoma (ADC), in China from 2013 to 2022.

A nationwide, multicenter, retrospective study analyzed 6645 cervical cancer cases diagnosed between 2013 and 2022 across seven tertiary hospitals in China. The study analyzed demographic, obstetric, and reproductive factors to identify trends in the proportions of SCC and ADC. Multivariable logistic regression was further performed among women with SCC or ADC to identify factors independently associated with histological type.

SCC accounted for 86.9% and ADC for 10.4% of invasive cervical cancer (ICC) cases. Although no significant change in SCC proportion was observed overall, declines were observed in specific subgroups-unemployed women, premenopausal women, and those with a history of reproductive system disease (p_trend = 0.012, 0.021, and 0.011, respectively). In multivariable analysis, compared with Central China, the odds of ADC relative to SCC were significantly higher in North China, Southwest China, East China, and South China, whereas menopausal women, Uyghur women, and rural residents showed lower odds of ADC relative to SCC.

Although the overall proportion of SCC among ICC cases remained statistically stable during 2013-2022, SCC showed a decreasing trend in several high-risk subpopulations. Compared with our 2005-2010 series, the present 2013-2022 study showed a higher ADC proportion and a lower SCC proportion. These findings suggest a gradual shift in the pathological landscape of ICC in China and provide up-to-date nationwide multicenter data that may help refine future screening and prevention strategies.

Chimeric antigen receptor (CAR) T-cell therapy targeting B-cell maturation antigen (BCMA) is a highly effective treatment option for patients with relapsed refractory multiple myeloma (RRMM). However, reliable biomarkers predicting long-term treatment response remain elusive. Germline single-nucleotide polymorphisms (SNPs) in immune checkpoint regulators, including cytotoxic T-lymphocyte-associated protein 4 (CTLA4) and lymphocyte activation gene 3 (LAG3) may affect CAR T-cell functionality and clinical efficacy. We conducted a retrospective analysis of 87 patients with RRMM treated with BCMA-directed CAR T-cells at a single academic center between May 2021 and September 2025, evaluating the impact of CTLA4 rs231775 and LAG3 rs870849 on relapse, progression-free survival (PFS), and overall survival (OS). The minor allele rs231775 of CTLA4 was present in 48%, while the minor allele of LAG3 rs870849 was observed in 87% of patients. Carriers of the CTLA4 rs231775 minor allele demonstrated lower relapse (40 vs. 53%) and mortality rates (31 vs. 44%) compared with major allele homozygotes, accompanied by significantly prolonged PFS and OS. Likewise, patients homozygous for the LAG3 rs870849 minor allele experienced reduced relapse (36 vs. 52%) and mortality rates (28 vs. 42%), significantly longer PFS, and a trend toward improved OS relative to carriers of the major allele. In conclusion, in our study, the minor alleles of CTLA4 rs231775 and LAG3 rs870849 were associated with superior clinical outcomes following BCMA-directed CAR T-cell therapy in RRMM patients. These findings suggest to further evaluate whether immune checkpoint SNPs could be biomarkers predicting response to BCMA-directed CAR T-cell therapy in MM which needs prospective studies and validation.

Opioid use in pediatric oncology is poorly characterized. The primary objective was to describe opioid administration or prescription patterns in pediatric oncology patients.

In this multi-center retrospective study conducted across three sites, we included patients aged 0-19 years with a malignant neoplastic disease who received their first chemotherapy between January 2019 and March 2024. Data were extracted from each site's Observational Medical Outcomes Partnership Common Data Model. We described patient characteristics based on: (1) first opioid administration or prescription, overall and for each specific opioid; and (2) all opioid administrations or prescriptions, overall and for each specific opioid. We also evaluated variability in opioid and naloxone use.

Of 2903 pediatric patients with cancer, 2707 (93.2%) were administered or prescribed at least one opioid. Among these patients, fentanyl was the most common (92.4%), followed by morphine (68.7%), hydromorphone (55.3%), and oxycodone (38.6%). Across centers, the proportion of patients receiving fentanyl ranged from 90.9% to 94.9%, morphine from 34.0% to 89.2%, oxycodone from 0.9% to 76.1%, and naloxone from 2.4% to 29.5%. Overall, 10.9% were administered or prescribed naloxone, but among 169 methadone patients, 43.5% were administered or prescribed it. Of the 153,849 total opioid administrations or prescriptions, 22.4% occurred more than 12 months after initiating chemotherapy.

Among pediatric patients with cancer who receive chemotherapy, 93.2% were administered or prescribed at least one opioid; fentanyl was the most common. There was heterogeneity in opioid choice and naloxone use across sites. These findings lay preliminary groundwork for understanding opioid use patterns and identifying potential areas for practice improvement in pediatric oncology.

Efficient and safe mobilization of peripheral blood CD34⁺ stem cells is essential for successful autologous stem cell transplantation (ASCT) in patients with lymphoid malignancies. However, current mobilization strategies are often limited by suboptimal yield, significant toxicity, or high cost. We conducted a prospective observational study including 59 patients with lymphoma or multiple myeloma undergoing ASCT. Patients received fractionated intermediate-dose etoposide (175 mg/m² twice on days 1 and 2) followed by granulocyte colony-stimulating factor (G-CSF, 10 μg/kg daily). Mobilization efficacy, safety profile, and subsequent transplantation outcomes were evaluated. Successful mobilization (≥ 2 × 10⁶ CD34+ cells/kg) was achieved in 96.6% of patients within three days of apheresis. The median CD34⁺ cell yield was 5.35 × 10⁶ CD34+ cells/kg on the first day. Notably, 61.0% and 49.2% of patients collected ≥ 4 × 10⁶ and ≥ 6 × 10⁶ CD34⁺ cells/kg on the first day, respectively. Despite frequent grade 3-4 cytopenias, clinically significant complications were limited, with febrile neutropenia occurring in 16.9% of patients and no treatment-related mortality (TRM). All patients achieved neutrophil and platelet engraftment. Fractionated intermediate-dose etoposide combined with G-CSF achieved a high mobilization success rate, with most patients requiring a limited number of apheresis sessions and no TRM.

Right-sided colon cancer (RSCC) exhibits distinct characteristics, yet specific prognostic determinants remain insufficiently defined. This multicentre retrospective study evaluated clinicopathological and surgical factors influencing survival in a real-world cohort undergoing curative resection for non-metastatic RSCC.

We analysed 800 adults undergoing curative-intent resection for non-metastatic RSCC across 28 centres (2018-2024). The primary outcome was 3-year overall survival (OS). Multivariate Cox model identified prognostic factors. An exploratory, post hoc subgroup analysis evaluated the impact of complete mesocolic excision (CME) on OS, stratified by tumour anatomical subsite.

The mean age was 62.8 years, and 24% required emergency surgery. CME was performed in 57.1% of patients, with baseline characteristics reflecting significant real-world selection bias against CME in complex clinical presentations. At 3 years (OS: 86%), multivariate analysis identified age (HR 1.071, 95% CI: 1.023-1.122, p = 0.004) and adjacent organ invasion (HR 3.642, 95% CI: 1.360-9.750, p = 0.010) as independent mortality predictors. Unadjusted post hoc analysis suggested CME was associated with improved OS for ascending colon and hepatic flexure tumours (p = 0.003).

Although CME showed an exploratory site-specific survival advantage, the critical lack of molecular profiling (MSI, RAS, BRAF) prevents adjustment for major biological confounders. Consequently, these findings are strictly hypothesis-generating, highlighting real-world surgical bias and require prospective multi-institutional validation before altering standard practice.

Hereditary cancer awareness has entered a new phase. For decades, awareness has focused on recognizing familial risk, identifying pathogenic germline variants, and helping families access counselling, surveillance and prevention. Yet in 2026, the main challenge is no longer only whether a variant can be detected, but how inherited risk can be interpreted, communicated and translated into action in the biological context of each tissue and tumor. The recent publication landscape of Hereditas illustrates this shift: cancer genetics is now inseparable from RNA regulation, epigenetics, metabolism, immune context, cellular plasticity, therapy resistance, computational modelling and precision intervention. This Editorial argues that hereditary cancer awareness must move beyond the variant without moving away from the familial risk. One step in this direction could be to use multi-omics as a bridge between genetic risk and precision prevention.

Polycystic ovary syndrome (PCOS) / Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a complex endocrine and metabolic disorder in women of reproductive age. This study aimed to evaluate the relationship between serum leptin, uric acid and soluble neprilysin levels and metabolic and hormonal parameters in women with PCOS/PMOS. The evaluation of new metabolic biomarkers in conjunction with hormonal parameters may contribute to a better understanding of the metabolic aspects and pathophysiology of PCOS/PMOS.

This case-control study was conducted on 90 women, including 60 patients diagnosed with PCOS/PMOS and 30 healthy age-matched controls. The PCOS/PMOS group was further divided into obese and non-obese subgroups according to body mass index (BMI). Demographic characteristics, Ferriman-Gallwey (FG) scores, anthropometric measurements, hormonal profiles (anti-Müllerian hormone (AMH), thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, progesterone, prolactin, estradiol), and metabolic parameters (fasting blood glucose, insulin, triglycerides, uric acid) were recorded. Venous blood samples were collected after an 8-12-hour fast during the early follicular phase of the menstrual cycle. Serum leptin and soluble neprilysin levels were measured using the ELISA method. Group comparisons, post-hoc analyses, correlation analysis, ROC analysis, age- and BMI-adjusted ANCOVA, and penalized LASSO logistic regression were performed to evaluate biomarker associations and discriminatory performance for PCOS/PMOS.

LH, AMH, testosterone, HOMA-IR, triglycerides, uric acid, and leptin levels were significantly higher in the PCOS/PMOS group than in controls, with the most pronounced metabolic abnormalities observed in the obese PCOS/PMOS subgroup. Leptin levels were highest in obese women with PCOS/PMOS (p < 0.001), whereas soluble neprilysin levels did not differ significantly among groups (p = 0.233). Correlation analyses showed that leptin was strongly associated with adiposity and insulin-resistance-related parameters, including BMI, HOMA-IR, and uric acid. ROC analysis demonstrated strong discriminatory performance for waist-to-height ratio (AUC = 0.899), testosterone (AUC = 0.895), waist-to-hip ratio (AUC = 0.891), and AMH (AUC = 0.882), while HOMA-IR, leptin, and TyG index showed acceptable discriminatory ability. After adjustment for age and BMI, only TyG index and WHR remained significantly different among groups, whereas leptin and soluble neprilysin did not. LASSO logistic regression retained AMH, testosterone, WHR, and log-transformed leptin in a parsimonious classification model, indicating that hormonal markers and central adiposity indices contributed most consistently to PCOS/PMOS classification, while the independent contribution of leptin appeared limited by its close association with adiposity.

Collectively, these findings indicate that the metabolic phenotype of PCOS/PMOS is driven primarily by obesity, central adiposity, and insulin-resistance-related disturbances rather than by leptin or soluble neprilysin as independent disease-specific biomarkers. Central adiposity indices and insulin-resistance-related markers, particularly WHR and TyG index, may therefore provide useful metabolic information in PCOS/PMOS assessment. Leptin appears to reflect adiposity-related metabolic burden, while soluble neprilysin did not show diagnostic or independent adjusted discriminatory value in this cohort.

Not applicable.

Postoperative nausea and vomiting (PONV) remains a frequent complication following laparoscopic gynecologic surgery, particularly in female patients with multiple established risk factors receiving volatile anesthetics. Remimazolam, a short-acting benzodiazepine, is an alternative intravenous anesthetic, but its effect on PONV compared with sevoflurane remains unclear.

In this single-center, prospective randomized controlled trial, 116 patients were enrolled and 113 were included in the final analysis (sevoflurane n = 56, remimazolam n = 57). Patients were randomly assigned to receive either sevoflurane-based or remimazolam-based maintenance of anesthesia. The primary outcome was the incidence of PONV within 24 h after surgery. Exploratory analyses were performed to evaluate the associations between PONV and perioperative factors, including intraoperative hemodynamic variables, fluid administration, and opioid consumption.

The incidence of PONV within 24 h was lower in the remimazolam group than in the sevoflurane group (21.1% vs. 44.6%, P = 0.013). Remimazolam was associated with reduced PONV incidence compared with sevoflurane. Although remimazolam was associated with higher intraoperative mean arterial pressure (MAP), exploratory analyses did not identify a significant association between intraoperative MAP and PONV. The observed absolute reduction in PONV incidence was 23.6%, which was slightly lower than the predefined effect size used for sample size estimation.

Remimazolam-based anesthesia was associated with a lower incidence of PONV compared with sevoflurane in patients undergoing laparoscopic gynecologic oncology surgery. Although statistically significant, the observed reduction was slightly smaller than the effect size predefined during sample size estimation, and its clinical relevance requires further evaluation.

ChiCTR2600128362. (Retrospectively registered). The initial registration date was 07/17/2026.