Hyperprogressive disease (HPD) refers to a phenomenon characterized by a significant acceleration in tumor growth during treatment with immune-checkpoint inhibitors (ICIs), far exceeding the pre-treatment growth rate, leading to rapid deterioration in the patient's condition. HPD typically occurs within the first two months of treatment and often results in early mortality. While sex differences in immune responses have been extensively studied, the relationship between sex and HPD risk remains unclear.

We systematically searched MEDLINE (PubMed), Embase, and Scopus databases to identify studies reporting HPD in patients treated with ICIs, with available gender-stratified data. The search encompassed all records from database inception until 30 June 2025. Meta-analyses were performed using RevMan 5.4.1 software, with pooled odds ratios and 95% confidence intervals calculated under either fixed-effects or random-effects model, depending on heterogeneity. The primary objective was to evaluate the association between biological sex and the risk of HPD. The research protocol has been registered on the PROSPERO platform (CRD420261324007).

This meta-analysis included 20 studies involving 2,291 patients (1,612 male patients and 679 female patients), all of which were retrospective. The overall incidence of HPD was 18.67% in male patients and 18.26% in female patients. Pooled analysis revealed no statistically significant association between biological sex and the risk of HPD development (I ² = 27%; p = 0.13).

Our findings demonstrate that sex should not be considered a determinative factor for HPD risk in patients receiving ICIs.

Neuronavigational surgery has become a cutting-edge technique that improves surgical accuracy, increases tumor excision rates, and preserves neurological function in glioma patients.

This meta-analysis was conducted to assess the efficacy of neuronavigational and advanced imaging-assisted surgery compared to traditional glioma surgery.

In total, 30 articles published between 2006 and 2026, including randomized controlled trials, prospective cohort studies, retrospective cohort studies, and case series, were evaluated. The intervention involved intraoperative MRI (iMRI), ultrasound-guided navigation, functional neuronavigation, and other advanced navigational technologies. Meta-analysis was carried out using random effects models with inverse variance to calculate pooled odds ratios (ORs), 95% confidence intervals (CIs), I ² and τ ² measures of heterogeneity, and publication bias using funnel plots and Egger's regression test. The risk of bias was assessed through the Cochrane RoB 2 for 7 randomized controlled trials and ROBINS-I for 23 observational studies.

Overall analysis demonstrated significant improvement with neuronavigation-guided surgery (OR = 2.37, 95% CI: 2.05-2.74, p < 0.05; I ² = 22.8%). Subgroup analyses showed significant benefits for iMRI-guided surgery (OR = 2.49, 95% CI: 1.92-3.23, z = 6.88, I ² = 22.6%, τ ² = 0.0428, p = 0.2286), ultrasound-based navigation (OR = 1.97, 95% CI: 1.47-2.66, z = 4.50, I ² = 4.9%, τ ² = 0.0084, p = 0.3685), functional neuronavigation (OR = 2.11, 95% CI: 1.59-2.80, z = 5.17, I ² = 0%), advanced navigation technologies (OR = 2.33, 95% CI: 1.67-3.25, z = 4.99, I ² = 16.4%), and other specialized techniques (OR = 2.16, 95% CI: 1.63-2.86, z = 5.34, I ² = 8.3%). Leave-one-out analysis confirmed the stability of the pooled effect, with minimal changes after exclusion of individual studies.

Neuronavigation-based and image-enhanced surgical procedures can significantly improve glioma surgery outcomes, with low heterogeneity and strong pooled effects. Large-scale multicenter studies are needed in order to prove their efficacy in the long term.

Background  Non-melanoma skin cancer is common, but its health-system burden is incompletely represented by incidence and mortality estimates because most care is delivered outside conventional inpatient settings. We assessed long-term trends and regional variation in publicly financed hospital admissions and admission-related reimbursement associated with non-melanoma skin cancer in Brazil's Unified Health System (SUS). Methods  We conducted a nationwide ecological time-series study of admission authorizations recorded in the Hospital Information System of the Brazilian Unified Health System (SIH/SUS) from 2008 to 2023. SIH/SUS records reimbursed admission episodes rather than unique patients; readmissions, transfers, and multiple admissions for the same tumor cannot be identified. Admissions with a principal diagnosis coded as ICD-10 C44 were included as an operational measure of hospital care associated with non-melanoma malignant skin neoplasms and were classified according to the place of hospitalization. Annual crude and age-standardized admission rates were calculated for Brazil and its five macro-regions; direct standardization used the age distribution of the 2022 Brazilian Census. Approved SUS reimbursement was adjusted to 2023 Brazilian reais using the national consumer price index. Temporal trends in log-transformed admission counts, rates, total reimbursement, reimbursement per admission, and mean length of stay were estimated using Prais-Winsten regression and reported as annual percentage changes (APCs) with 95% CIs. Results  Between 2008 and 2023, 535,750 admission episodes were recorded. Annual admissions increased from 13,974 to 60,075 (APC 9.44%, 95% CI 7.43 to 11.50), and the age-standardized rate increased from 10.4 to 28.0 per 100,000 population (APC 6.07%, 95% CI 4.10 to 8.07). Rates increased in the North, Southeast, South, and Central-West, whereas the Northeast showed no evidence of a temporal trend. Cumulative inflation-adjusted approved reimbursement was R$949.3 million, and annual reimbursement increased by 6.92% (95% CI 4.96 to 8.91). Reimbursement per admission decreased by 2.22% annually (95% CI -2.80 to -1.64), and mean length of stay decreased by 6.77% annually (95% CI -8.47 to -5.04). In 2023, the age-standardized rate ranged from 9.2 per 100,000 population in the North to 57.4 per 100,000 population in the South. Conclusions Publicly financed hospital admissions and total approved SUS reimbursement associated with ICD-10 C44 increased substantially in Brazil between 2008 and 2023, with marked regional variation. The increase in recorded reimbursement occurred alongside substantial growth in admission volume, despite declining reimbursement per episode and shorter recorded stays. These findings quantify the publicly financed hospital component of service use and should not be interpreted as population incidence, the number of unique patients, or total treatment costs.

IntroductionPublic awareness of modifiable cancer risk factors remains limited, and fatalistic prevention beliefs and cancer information overload may hinder information seeking and engagement in preventive behaviors. Brief communication interventions may help address these barriers, but evidence comparing different communication strategies in cancer prevention remains scarce. This randomized study evaluated the effects of four theory-based intervention materials on cancer prevention beliefs, cancer information overload, and prevention-related intentions.MethodsIn a population-based online study, 1,191 adults from Stuttgart, Germany, were randomly assigned to one of four intervention conditions that varied by presentation modality (audiovisual animation vs. text) and mode (narrative vs. non-narrative) or to a control condition. Interventions were self-developed based on the Protection Motivation Theory, addressing modifiable cancer prevention behaviors, particularly physical activity and healthy diet. Cancer prevention beliefs and cancer information overload were assessed pre- and post-intervention using items from the Health Information National Trends Survey; behavioral intentions were assessed post-intervention. Baseline-adjusted ANCOVAs and robust linear models were used.ResultsAudiovisual and narrative materials showed small advantages over text-based and non-narrative materials for the belief that cancer risk can be reduced (F(1,892)=7.33, p=.007, ηp²=.007; F(1,892)=6.71, p=.010, ηp²=.005, respectively). Narrative materials were associated with comparatively higher perceived cancer information overload than non-narrative materials (F(1,856)=11.90, p<.001, ηp²=.02). Compared with the control condition, all four intervention conditions were associated with stronger behavioral intentions (all p ≤ .009), with no significant differences between the intervention conditions.ConclusionBrief theory-based cancer prevention materials can positively influence prevention-related beliefs, perceived information overload, and behavioral intentions. The findings suggest a trade-off in cancer prevention communication: audiovisual and narrative materials showed advantages in strengthening prevention-related beliefs, whereas non-narrative materials were associated with lower perceived cancer information overload. All intervention conditions were associated with stronger intentions, highlighting the potential of diverse theory-based communication strategies to promote cancer-preventive behaviors.

We analyzed the incidence and risk factors associated with urinary retention following transurethral resection of the bladder tumors (TURBT). This retrospective study included a total of 218 TURBT cases we experienced from September 2021 to April 2023. Twenty-six patients (12%) experienced urinary retention after the procedure. The use of a thick urethral catheter (20 Fr or larger) post-surgery (p＝0.013) was identified as a significant risk factor. Of the 26 patients with urinary retention, 18 were able to recover spontaneous urination, while the remaining 8 required either permanent urethral catheter placement or intermittent catheterization. Healthcare professionals should be vigilant of urinary retention as a potential adverse event following TURBT.

In this issue of Cancer Discovery, Chen and colleagues leverage single-cell RNA sequencing of neutrophils in the tumor microenvironment of colorectal cancer liver metastases to characterize neutrophil heterogeneity within the metastatic immune landscape. They show that the glucose-deprived metastatic microenvironment drives BHLHE40 upregulation in neutrophils, inducing a senescent tumor-associated neutrophil (TAN) population, TAN1, that actively promotes angiogenesis and excludes CD8+ T cells from the tumor, thereby supporting tumor growth and survival. See related article by Chen et al., p. 2130.

Molecular biomarkers are crucial for the diagnosis, prognosis, and enrollment in biomarker-driven neuro-oncology clinical trials, but their inequitable availability in low- and middle-income countries (LMICs) hinders uptake of the 2021 WHO Classification of CNS tumours. This scoping review reports an analysis of existing evidence concerning challenges to molecular biomarker testing within the context of neuro-oncology clinical trial recruitment in resource-limited settings.

An Arksey and O'Malley-based scoping review was conducted from May to July 2026 across PubMed, Scopus, and Web of Science (January 2021-April 2026). This review included articles on molecular diagnostic infrastructure, biomarker testing, clinical trial enrollment, and the management of neuro-oncologic patients in resource-restricted settings.

Seventeen studies met the inclusion criteria. Restricted access to next-generation sequencing (NGS), DNA methylation profiling, and fluorescence in situ hybridization (FISH) preclude WHO CNS5-compliant diagnoses, thus often resulting in "not otherwise specified" (NOS) and less eligibility to access molecularly stratified trials. Of the 223 LMIC clinicians surveyed, lack of investigator-initiated funding and personal time allocation were the key systemic barriers. Diagnostic delay, limited neuropathology skills, and non-standardized biomarker reporting hindered clinical trial enrollment. Emerging liquid biopsy technologies including CSF cell-free DNA, showed high rate (82.5% of glioma cases) in ctDNA detection, however was restricted due to invasiveness and costs for sequencing. Collaborative capacity-building, virtual molecular tumour boards and modified consensus guidelines, all appear to be effective and evidence-based solutions.

Biomarker testing facility gaps constitute a major, modifiable obstacle to LMIC participation in neurooncology trials. Implementing a collaborative and structured approach to investment in diagnostics, standardized reporting, and international collaboration is essential for LMIC engagement with trials. Future trial designs should incorporate multi-tiered approaches to biomarkers reflecting available laboratory capacity in different locations.

Central nervous system (CNS) tumours are the leading cause of cancer-related mortality among children and adolescents worldwide, surpassing leukaemia. Pakistan has a predominantly young population but lacks a national cancer mortality registry. This study aimed to characterize temporal trends and sex disparites in childhood and adolescent CNS tumour mortality in the United States and propose a reproducible surveillance model applicable to registry-lacking settings such as Pakistan.

A retrospective population-based ecological ti me-trend study was conducted using CDC WONDER mortality data for individuals aged 0-19 years from 1999 to 2024, including race-bridged files (1999- 2020) and single-race files (2021-2024). Crude mortality rates per 100,000 population were analyzed by sex using Joinpoint regression. Annual Percent Change (APC), Average Annual Percent Change (AAPC), and 95% confidence intervals were calculated. Tests of parallelism and coincidence assessed sex-specific trend differences. Reporting followed the STROBE guideline.

A total of 13,901 CNS tumour-related deaths were identified, including 7,547 males and 6,354 females. Overall mortality declined from 0.68 to 0.63 per 100,000, demonstrating a single- segment trend without joinpoints (AAPC -0.31%; 95% CI -0.61 to -0.01; p=0.044). No significant sex-specific differences in temporal decline were observed (female AAPC -0.25%; male AAPC -0.32%). Mortality trends were parallel (p=0.82); however, male mortality remained consistently higher than female mortality throughout the study (coincidence p=0.0002), with an overall period rate ratio of 1.13 (0.69 vs. 0.61 per 100,000).

Childhood and adolescent CNS tumour mortality in the United States demonstrated a modest but significant decline between 1999 and 2024, while maintaining a persistent male predominance. This populationbased analysis provides an evidence-based framework for monitoring paediatric neuro-oncology outcomes and offers a scalable surveillance model for countries without national cancer mortality registries, including Pakistan.

Accurate estimation of survival is fundamental to guiding surgical decision-making in patients with spinal metastases. Several prognostic scoring systems have been developed, yet their relative accuracy remains uncertain. This review aimed to compare the discriminatory performance of six widely used models, Revised Tokuhashi, Tomita, Modified Bauer, Skeletal Oncology Research Group (SORG) Machine Learning, SORG Classic, and SORG Nomogram, in predicting postoperative survival.

This review adhered to the PRISMA 2020 guidelines and was prospectively registered with PROSPERO (CRD420251056914). PubMed, Scopus, and Web of Science were systematically searched to identify studies from 2014 until July/2025 and researched on 26th/January/2026, involving adults with spinal metastases treated surgically that reported time-specific AUROC or concordance index (C-index) for at least two of the aforementioned prognostic models. Data extraction and quality assessment were independently performed using the QUADS-2 tool. Random-effects meta-analyses (REML) of logit-transformed AUROCs were conducted at 3, 6, and 12 months intervals.

Seventeen studies encompassing 4465 patients published between 2014 and 2025 were included. Tomita, Revised Tokuhashi, Modified Bauer scores demonstrated moderate discriminatory performance (pooled AUROC 0.60-0.69) across all time intervals, while the SORG Nomogram achieved the highest pooled performance with AUROC values of 0.72 (95% CI, 0.68-0.76) at 3 months and 0.73 (95% CI, 0.68-0.79) at 12 months while high heterogeneity (I² = 52-96%) indicated variable performance across studies.

As prognostic models exhibit only moderate accuracy in survival prediction, with the SORG Nomogram performing best. Integration of such models within multidisciplinary frameworks like LMNOP may improve individualized surgical planning and optimize patient outcomes with metastatic spine disease.

To determine the clinical pattern and surgical outcomes of patients with meningioma.

A retrospective observational study was conducted among 51 patients in the Department of Neurosurgery, People's University of Medical and Health Sciences, Nawabshah. Data were retrospectively collected of the period June 1, 2024, to May 31, 2025 by the authors from 16 July 2025 to 15th September 2025. Patients of all ages and both sexes diagnosed with meningioma and scheduled for surgery were included. Patients with a history of previous meningioma surgery or recurrent tumours were excluded. The minimum sample size was calculated as 50 using a 95% confidence level, an expected proportion of 20%, and a margin of error of 11%; 51 patients were included in the study. Ethical approval was obtained from the Institutional Review Board (IRB No. PUMHS/SBA/DME/543) on 15/07/2025.

The study included 51 patients, comprising 37 (72.5%) females and 14 (27.5%) males, with a mean age of 44.5 ± 16.53 years (range, 30-70 years). According to the reported Simpson grading, 17 (33.3%) patients underwent grade 0 resection, 6 (11.8%) grade 1, 19 (37.3%) grade 2, 8 (15.7%) grade 3, and 1 (2.0%) grade 4 resection. At 10- month follow-up, 39 (76.5%) patients had good surgical outcomes. Postoperative wound infection occurred in 5 (9.8%) patients. Thirty-seven (72.5%) patients had no postoperative neurological deficit, while 7 (13.7%) developed a neurological deficit. Seven (13.7%) patients were lost to follow-up. Thirteen (25.5%) patients who initially presented with weakness showed improvement over time.

Most patients with meningioma had favourable surgical outcomes following resection. Postoperative wound infection and new neurological deficits occurred in a minority of patients. Careful surgical planning and appropriate postoperative management remain important for optimizing outcomes.