HCC frequently recurs after curative treatment, requiring surveillance with imaging and tumor markers. Some patients, however, present with persistent tumor marker elevation despite no radiologic recurrence evidence. This study evaluated outcomes following radiofrequency ablation (RFA) in such cases.

We retrospectively analyzed 1620 patients who achieved complete ablation for primary HCC during 1999-2015. Surveillance included quarterly imaging and serum tumor markers, alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP). Patient characteristics at tumor marker elevation and recurrent HCC characteristics were compared between the early recurrence group (recurrence within 180 days of tumor marker elevation) and the late recurrence group (recurrence after 180 days of tumor marker elevation). We also estimated post-recurrence survival using the Kaplan-Meier method.

Tumor marker elevation occurred in 907 cases in 509 patients. Recurrence was detected in 886 cases: 707 in the early and 179 in the late recurrence groups. The median (interquartile range) interval between marker elevation and recurrence was 89.0 (81.0-97.0) days. At tumor marker elevation, AFP ≥ 20 ng/mL was more frequent in the early versus late recurrence group (71.0% vs. 58.1%, p < 0.01), as was AFP ≥ 200 ng/mL (29.4% vs. 20.1%, p = 0.02). AFP-L3 ≥ 15% (60.0% vs. 62.6%, p = 0.58) and DCP ≥ 200 mAU/mL (19.7% vs. 16.2%, p = 0.34) showed no significant differences between groups. Recurrence patterns, including number of tumors, vascular invasion, distant metastasis, and tumor size, were comparable between groups. Local cure was achieved in 83.5% and 78.8% of the early and late recurrence groups, respectively, with no significant difference (p = 0.17). Median post-recurrence survival was 3.55 years for the early versus 3.31 years for the late recurrence group (p = 0.2).

Even when HCC was undetected on imaging despite elevated tumor markers, many recurrence cases were subsequently detected, and curative treatment was possible through appropriate surveillance.

Transcatheter arterial chemoembolization (TACE) is widely used for intermediate-advanced hepatocellular carcinoma (HCC). The efficacy and safety of TACE combined with systemic treatments as conversion therapy for HCC remain to be explored.

Patients with intermediate-advanced HCC were divided as following groups based on therapy: (1) TACE; (2) TACE combined with tyrosine kinase inhibitors (TACE+TKI); (3) TACE+TKI and immune checkpoint inhibitors (TACE+TKI+ICI); and (4) TACE combined with Bevacizumab and ICI. The progression-free survival (PFS), overall survival (OS), treatment responses, and adverse events (AEs) were evaluated.

Of the enrolled 518 patients, the overall objective response rate (ORR) was 21.0% and disease control rate (DCR) was 63.7%, while the TACE+TKI+ICI group showed highest ORR (28.9%) and DCR (72.8%). 147 (28.4%) patients experienced AEs during treatments. The TACE+TKI+ICI group significantly improved survival compared to TACE (mPFS: 20.7 vs. 10.9 months, p < 0.001; mOS: 44.0 vs. 13.3 months, p < 0.001) or TACE+TKI (mPFS: 20.7 vs. 15.6 months, p = 0.011; mOS: 44.0 vs. 25.0 months, p < 0.001). Of the 117 (22.6%) patients who underwent conversion liver resection, both mPFS (p = 0.016) and mOS (p < 0.001) were significantly better than those without subsequent resection.

This study demonstrated that TACE+TKI+ICI had a better ORR, manageable AEs, and superior PFS and OS compared to other TACE-based conversion therapies. Undergoing subsequent liver resection significantly enhanced long-term survival compared to non-resection counterparts.

Epigenetic aging bridges the gap between biological and chronological age by exploiting DNA methylation (DNAm) patterns. Over the past decade, successive DNAm-based clocks have been introduced, beginning with the first-generation Horvath and Hannum models and extending to second-generation PhenoAge and the GrimAge family; complementary measures include DNAm-estimated telomere length and mitotic indices such as epiTOC/pcgtAge. We previously conducted a side-by-side evaluation of these metrics in colorectal cancer using publicly available data from The Cancer Genome Atlas (TCGA) COAD and READ cohorts, but an equally systematic assessment in breast cancer has been lacking.

Here, using TCGA-BRCA tumor methylomes linked to clinical data (analytic n = 781), we compared seven metrics (Horvath, Hannum, PhenoAge, GrimAge1, GrimAge2, epiTOC/pcgtAge, DNAmTL) via Kaplan-Meier grouping (median and tertiles) and Cox models adjusted for menopausal status, age at diagnosis, receptor subtype, stage, race, and ethnicity, with overall survival truncated at 4000 days. Our analysis reproduced expected benchmark patterns: Triple Negative Breast Cancer (TNBC) had the worst outcomes, Luminal A the best, and higher stage and older age predicted poorer survival, supporting analytic validity. We found first-generation clocks did not separate survival, whereas PhenoAge and GrimAge2 stratified outcomes; in multivariable analyses, only GrimAge1 provided independent prognostic information. DNAmTL was inversely associated with mortality in univariate models, and epiTOC stratified tertiles but showed wide, nonsignificant Cox estimates.

Second-generation clocks demonstrated stronger prognostic signal than first-generation models in unadjusted analyses. Among them, GrimAge1 retained independent prognostic value beyond established clinicopathologic factors in breast cancer, supporting further external validation with richer covariates to refine clinical utility.

To systematically elucidate Chinese prostate cancer patients' perceptions and needs regarding sexual health and sexual experience following radical prostatectomy from dual perspectives of both patients and healthcare professionals. It further analyzes barriers and facilitators in physician-patient communication about sexual health problems during clinical interactions, thereby providing scientific evidence for developing effective sexual health support interventions.

A qualitative study.

An interpretive phenomenological research methodology was conducted using semi-structured interviews with purposive sampling that were audio-recorded and transcribed verbatim. Interviews covered dimensions including sexual function changes, psychological adjustment, physician-patient interaction and social support. Data analysis was performed using the content analysis method. Content analysis method was conducted using Nvivo 12 software.

Four themes and thirteen sub-themes were identified: Sexual health awareness within psychological and sociocultural contexts (Passive acceptance within practical constraints; Implicit constraints of traditional sexual cultural norms; Mapping of age-directed psychological expectations; Externalisation tendency in attributing sexual dysfunction); Partner Relationship Dynamics and Intimate Interactions (decline in sexual needs and lack of communication; partner support's critical role in sexual health adaptation; decoupling of emotional bonding from sexual functioning experience); Perception and Expression of Sexual Health Needs (prioritization of treatment-related symptom management; physician-patient information asymmetry hindering sexual need expression; illness-experience-driven health support-seeking behaviours); Physician-Patient Interaction Experience and Need for Supportive Environment (desire for professional medical care guidance; fostering supportive environments to facilitate expression of sexual health problems and recovery; demand for diversified rehabilitation strategies and information acquisition channels). Chinese prostate cancer patients exhibit multidimensional complexity in sexual health experiences and needs following radical prostatectomy, where psychosocial and cultural factors, partner relationship dynamics, impaired expression of needs and healthcare support environment play crucial roles. Future clinical practice urgently requires healthcare professionals to enhance awareness and skills regarding sexual health and education, foster supportive environments, and develop precision intervention strategies integrating the biopsychosocial medical model for prostate cancer patients' sexual health.

This study systematically delineates the cognitive characteristics of sexual health among prostate cancer patients within the Chinese sociocultural context (e.g., passive acceptance), proposes 'emotional detachment' as a novel and constructive adaptive strategy, introduces a routinized sexual health assessment framework at the nursing operational level, and further examines barriers and influencing factors related to patient sexual health from the healthcare provider perspective.

This study systematically examined the factors influencing sexual health-related issues among prostate cancer patients from multiple dimensions, including psychological cultural factors, partner relationship dynamics, impaired expression of needs, and healthcare support environments in sexual health outcomes. It offers a China-oriented perspective on the sexual health experiences of prostate cancer patients globally. This research contributing a valuable addition to the international literature on prostate cancer of sexual health. Furthermore, it provides a foundational reference for future development of precise predictive models that integrate the 'biopsychosocial' medical framework and are specifically tailored to prostate cancer patients.

The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used.

Patients and healthcare professionals provided valuable insights into the core domains of sexual health needs after prostatectomy through their active participation in this study.

The E6 and E7 oncoproteins are significant contributors to HPV-induced cervical cancer and promising candidates for screening methods. However, clinical evidence for detecting E6/E7 by immunocytochemistry (ICC) remains limited. This study evaluated the diagnostic accuracy of a novel E6/E7 immunocytochemistry assay for primary cervical cancer screening and triage of women with high-risk human papillomavirus (hrHPV). In this cross-sectional diagnostic study conducted in 2023, 3,108 women aged 21-81 from Moyu County, Xinjiang, China, underwent HPV testing, cytology, and E6/E7 ICC. Women with abnormal results were referred for colposcopy and biopsy as indicated, and histologically confirmed CIN2+ served as the gold standard. Among 3,049 participants with complete primary screening results, E6/E7 ICC positivity was 7.4% (n = 226), intermediate between SureX hrHPV positivity (8.5%, n = 258) and cytology ASC-US+ (6.1%, n = 185). E6/E7 positivity was strongly associated with HPV16/18 infection (OR = 20.2, 95%CI:13.1-31.0), high-grade cytology (OR = 73.4, 95%CI:20.5-262.8), and increasing histology-confirmed CIN grades (OR: 14.2 ~ 149.0). A total of 3,039 women had evaluable screening outcomes within 12 months, and 36 cases of CIN2+ were identified. The E6/E7 ICC alone detected 86.1% (31/36) of CIN2+ lesions with 93.6% specificity, yielding a 7.4% referral rate. A combined strategy-referring all HPV16/18 positive women to colposcopy and triaging other hrHPV positive women using E6/E7 ICC-detected 88.9% (32/36) of CIN2+ cases with 96.2% specificity and a 4.8% colposcopy referral rate. This first population-based, cross-sectional evaluation provides preliminary evidence that the E6/E7 ICC, particularly in combination with HPV16/18 genotyping, may be an effective strategy for cervical cancer screening and triage. Prospective studies are essential to confirm its long-term predictive value before clinical implementation.

Management of intraductal papillary mucinous neoplasms (IPMNs) requires choosing between surgical resection and active surveillance, yet current diagnostic tools cannot reliably distinguish which lesions harbor high-grade dysplasia or invasive cancer. As a result, many patients undergo major pancreatic surgery for low-grade disease, while others are observed until progression emerges. This uncertainty contributes to substantial variation in surgeon risk estimates, intervention thresholds, and treatment recommendations. Patients likewise differ in their tolerance for cancer risk, views on surgical morbidity, perceived burden of ongoing surveillance, and desired role in decision-making, making IPMN a distinctly preference-sensitive clinical scenario. Although recent international guidelines acknowledge the importance of incorporating patient values into management decisions, practical frameworks for doing so remain underdeveloped.

We performed a narrative review of the literature examining sources of uncertainty in IPMN management, variation in surgeon and patient risk perception, and existing approaches to shared decision-making (SDM) in preference-sensitive surgical decisions. We also evaluated communication strategies and decision-support tools relevant to improving decision quality in the setting of uncertain malignant potential.

Evidence demonstrates substantial heterogeneity in both clinician and patient interpretation of malignancy risk, operative morbidity, and acceptable thresholds for surgical intervention. Surgeons and patients often weigh competing risks diff erently, contributing to variation in management recommendations even when clinical characteristics are similar. SDM provides a structured approach to integrating individualized malignancy risk estimates, discussion of treatment trade-off s, and elicitation of patient values. Conceptual frameworks and emerging decision-support tools suggest that SDM may improve calibration of risk perception, reduce unwarranted variation in care, and enhance alignment between treatment decisions and patient preferences.

IPMN management represents a high-stakes clinical decision made under conditions of incomplete information. SDM off ers a pragmatic strategy to integrate clinical evidence with patient values when choosing between resection and surveillance. Incorporating SDM into routine IPMN care may improve decision quality, promote transparency in risk communication, and support more patient-centered recommendations while preserving clinical judgment.

The prevalence of incidentally detected pancreatic cystic lesions has increased substantially with the widespread use of high-resolution CT and MRI. Differentiating mucinous from non-mucinous cystic lesions is a central diagnostic task, as mucinous lesions are associated with a risk of malignant transformation and distinct management pathways. In clinical practice, this distinction is primarily driven by imaging findings. This review summarizes the key CT and MRI features that allow differentiation between mucinous and non-mucinous pancreatic cystic lesions, with a focus on reproducible criteria applicable in routine practice. Particular emphasis is placed on the assessment of communication with the main pancreatic duct, lesion morphology, wall thickness and enhancement pattern, internal architecture, calcification pattern, cyst multiplicity, and associated ductal or parenchymal abnormalities. Common diagnostic challenges are discussed, including atypical lesion location, atypical presentation and imaging overlap between cystic lesions. These scenarios illustrate the limitations of relying on a single imaging criterion and highlight the need for a comprehensive, pattern-based approach. The review also underscores the importance of integrating imaging findings with patient demographics, lesion distribution, clinical context, and longitudinal imaging behavior. In selected cases, CT and MRI may not allow definitive classification, and diagnostic uncertainty should be explicitly acknowledged to guide appropriate multidisciplinary decision-making. Emerging imaging techniques, including artificial intelligence algorithms, are briefly addressed. While preliminary results are encouraging, current evidence remains insufficient to support routine clinical implementation. At present, systematic analysis of CT and MRI findings, supported by multidisciplinary expert interpretation, remains the cornerstone for differentiating mucinous from non-mucinous pancreatic cystic lesions.

This study investigated risk factors associated with HNC by subsite including oral cavity cancer (OCC), oropharyngeal cancer (OPC), and laryngeal cancer (LC) among former smokers in the International Head and Neck Cancer Epidemiology Consortium (INHANCE). Case-control study including former smokers from the pooled INHANCE data, with information on sociodemographic, smoking, and alcohol history. Associations were assessed using logistic regression with 95% confidence intervals (CI). The study included 2143 cases with HNC and 5799 controls. Cancer cases were categorized by their respective subsites: 954 LC (44.5%), 685 OPC (32.0%), 504 OCC (23.5%). The risk of developing OCC was 2.8-fold higher [CI: 1.9-4.1], LC 2.6-fold higher [CI: 1.9-3.5], and OPC 2.1-fold higher [CI: 1.5-2.8] in individuals who smoked > 50 pack-years, compared to < 10 pack-years. The risk of OCC/OPC/LC increased with tobacco consumption in North-America, whereas in Western/Southern-Europe and South-America the association plateaued beyond 31-50 pack-years. Cessation after age 55 increased the risk of LC by 3.0-fold [CI: 2.2-4.2], and OCC by 2.2-fold [CI: 1.4-3.3] versus cessation age ≤ 45 years. Consuming ≥ 5 drinks/day was associated with 5-fold higher risk of OPC [CI: 3.7-6.6], 4.4-fold higher risk of OCC [CI: 3.2-6.1] and 3.1-fold higher risk of LC [CI: 2.4-3.9] compared to 0-0.9 drinks/day. The risk of HNC among former smokers is not homogeneous across regions and that there were distinct patterns for OCC, OPC, and LC. The amount of tobacco and alcohol consumption are key risk factors, with alcohol being more important for OCC/OPC, and tobacco being more strongly associated with LC risk.

Artificial intelligence (AI) platforms based on large language models such as ChatGPT, are increasingly being used by both the public and medical professionals to obtain medical information. This rapid growth in reliance makes it essential to systematically evaluate the accuracy and clinical reliability of AI-generated medical content. The objective of this study was to evaluate the accuracy of responses provided by ChatGPT regarding prevention, screening, treatment, and risk factors of common gynecological cancers. The assessment focused primarily on the use of ChatGPT by primary care providers and the public with limited subject-specific knowledge.

We evaluated the reliability of ChatGPT (version 3.5) in answering questions about two of the most common gynecological cancers. ChatGPT was posed a total of 40 questions on the prevention, screening, and treatment of endometrial cancer (20 questions) and cervical cancer (20 questions). Responses were independently reviewed and categorized as accurate, inadequate, or inaccurate by five physicians with a mean of 18 ± 3 years of experience in gynecological oncology. Reviewers provided reasons for deeming some responses as inadequate or inaccurate.

Overall, 20 out of 40 (50%) responses by ChatGPT 3.5 were regarded as either inaccurate or inadequate. Most of the deficient responses were related to questions on the treatment of the two cancers, while responses to questions about prevention were mostly accurate.

atGPT may provide accurate information about prevention of gynecological cancers, but the public and health professionals should not rely on its responses to make medical decisions, as many responses in this domain were inadequate or inaccurate. Consultation with qualified physicians or specialists is essential for individualized decision-making. Medical information sourced from AI tools such as ChatGPT should be integrated with clinician oversight to improve reliability.