To compare the effects of high-intensity focused ultrasound (HIFU) ablation and laparoscopic myomectomy on ovarian function and endometrial receptivity in patients with uterine fibroids.

In this prospective, non-randomized cohort study, 60 patients with uterine fibroids were either treated with HIFU (n = 30) or laparoscopic myomectomy (n = 30) based on patient preference after standardized counseling. Ovarian function and endometrial receptivity were evaluated preoperatively and at 1, 3, and 6 months post‑treatment. Ovarian reserve was assessed using anti‑Müllerian hormone (AMH), sex hormone levels of luteinizing hormone (LH), follicle‑stimulating hormone (FSH), estradiol (E2), and antral follicle count (AFC). Endometrial receptivity was evaluated using endometrial thickness and vascular indices, including endometrial artery resistance index (RI), pulsatility index (PI), and the systolic/diastolic velocity ratio (S/D).

Regarding endometrial receptivity, the HIFU group exhibited significantly greater endometrial thickness at the 1‑month follow‑up compared to the laparoscopic group (mean difference: 1.5 mm, 95% CI: 0.6 to 2.4 mm; Cohen's d = 0.72, p < 0.05). Both groups showed a reduction in PI after treatment, though the change was not statistically significant. RI and S/D ratios were comparable between the two groups at any time point (p > 0.05).

Both HIFU and laparoscopic myomectomy preserved ovarian function in patients with uterine fibroids. HIFU was associated with faster short-term endometrial recovery at 1 month post-treatment, but no differences in ovarian function or other receptivity markers were observed between the two groups of patients. Randomized trials with pregnancy outcomes are needed before clinical recommendations can be made.

Cyst enucleation is a common procedure performed in oral and maxillofacial surgery to remove cystic lesions. Conventional surgical techniques have traditionally been used for this purpose. However, piezosurgery, a relatively new technology, has gained popularity in recent years. This systematic review aims to compare the efficacy, safety and clinical outcomes of piezosurgery and conventional surgery for cyst enucleation.A comprehensive literature search was conducted using electronic databases, including PubMed, EBSCOhost, Scopus, ProQuest, and ScienceDirect. Studies published from inception up to May 2023 were included. Randomized controlled trials (RCTs) comparing piezosurgery with conventional surgery for cyst enucleation were considered. The primary outcomes included surgical duration, intraoperative bleeding, postoperative complications, and healing outcomes. Secondary outcomes comprised postoperative pain, edema and recurrence. The quality of the included studies was assessed using the revised Cochrane risk of bias tool for RCTs (RoB 2.0).The initial search identified 160 relevant articles, of which 6 studies met the inclusion criteria. Piezosurgery was shown to have a longer operation time, but higher visibility and a similar ease of operation. Clinical outcomes showed less postoperative pain, swelling and trismus in the piezosurgery group.This systematic review suggests that piezosurgery is a promising alternative to conventional surgery for cyst enucleation, offering advantages in terms of reduced surgical duration, intraoperative bleeding, postoperative pain, and edema, as well as proven not to cause any recurrence. However, further well-designed RCTs with larger sample sizes are warranted to validate these findings and evaluate long-term outcomes.

Current European expert consensus definitions for esophagogastric oligometastatic disease (OMD) primarily relate to adenocarcinoma. Oligometastatic esophageal squamous cell carcinoma (OMESQ) may require a distinct definition and treatment strategy. This systematic review and meta-analysis aimed to identify applied OMESQ definitions and assess the impact of local treatment on overall survival (OS). A systematic search of PubMed, Embase, CENTRAL, and ClinicalTrials.gov was conducted (February 2026). Studies or protocols were eligible if they reported an OMESQ definition or outcomes of local treatment in patients with limited metastatic ESCC. The primary outcomes were the maximum number of involved organs and metastases defined as OMD. Agreement across studies was scored as absent/poor (< 50%), fair (50%-75%), or strong (≥ 75%). A meta-analysis of OS after local treatment (+/- systemic therapy) versus systemic therapy alone was conducted through a random-effects pooled analysis of hazard ratios (HRs). Of the 3844 screened articles, 27 studies (23 retrospective, 4 prospective [one randomized]) and 7 protocols were included. Agreement was observed for defining synchronous OMESQ as disease in one organ with ≤3 metastases and metachronous OMESQ as disease in one organ with ≤2 metastases. Across 10 studies, meta-analysis showed that local treatment (+/- systemic therapy) was associated with improved OS compared with systemic therapy alone (pooled HR 0.61, 95% confidence interval: 0.52-0.72; I2 = 50.7%). Current literature and trial protocols considers OMESQ as ≤3 synchronous or ≤ 2 metachronous metastases in 1 organ. Local treatment is associated with improved OS compared with systemic therapy alone.

Methods: In addition to traditional testing methods, the use of PSMA-directed imaging to guide biopsy procedures using Multiparametric Magnetic Resonance Imaging (mpMRI) allows for better localization and characterization of lesions. Researchers have begun to develop and continue to innovate Molecular & Imaging processes, called Liquid Biopsies, that are now being used to assess health risk factors associated with PC, by sampling macro-molecules from various biological liquids. Recently, the use of Artificial Intelligence (AI) and Machine Learning Models for improving the speed and accuracy of lesion detection and gland segmentation has significantly increased both precision and consistency in these areas. Results: However, there is still great concern regarding overdiagnosis and lack of standardization associated with all types of molecular and imaging techniques currently available. Conclusion: This review provides a comprehensive overview of the currently available diagnostic modalities for prostate cancer, including their weaknesses as well as gaps in clinical translation and standardization, which can assist with providing guidance for future development of diagnostic innovations..

ObjectivesTo examine associations of a general cost-related barrier to medical care and BRFSS-defined poor mental health-day categories with cervical cancer screening adherence among U.S. female respondents.MethodsWe conducted a cross-sectional analysis of female BRFSS respondents. The primary outcome (_RFPAP37) identified Pap testing within the past 3 years among respondents aged 21-65 years with an intact cervix; the sensitivity outcome (_PAPHPV1) additionally incorporated HPV testing within the past 5 years for those aged 30-65 years. MEDCOST1 measured inability to see a doctor because of cost during the previous 12 months. _MENT14D classified respondents by 0, 1-13, or 14-30 poor mental health days. Survey-weighted adjusted logistic regression incorporated BRFSS weights, strata, and clustering.ResultsThe primary analytic sample included 101,580 female respondents; survey-weighted complete-case models included 84,705. Pap adherence was lower among respondents reporting a general cost-related barrier to medical care than among those without the barrier (54.5% vs 68.6%). In survey-weighted adjusted models, the barrier remained associated with lower Pap adherence (OR 0.79, 95% CI 0.65-0.95). Formal interaction terms were not statistically significant, and the ordinal poor mental health-day trend was attenuated (OR 1.02, 95% CI 0.97-1.07). Findings for Pap+HPV adherence were directionally similar but weaker.ConclusionsA general cost-related barrier to medical care was consistently associated with lower cervical cancer screening adherence. BRFSS-defined poor mental health days may indicate a co-occurring vulnerability, but adjusted interaction evidence was limited. Access-focused and mental health-informed strategies warrant evaluation in future intervention studies.

Fecal immunochemical testing (FIT) remains the cornerstone of organized, population-based colorectal cancer (CRC) screening owing to its noninvasive nature, affordability, and proven mortality reduction. FIT facilitates early detection; however, its population impact depends on sustained participation, adequate colonoscopy capacity for positive results, and data-driven optimization of thresholds and intervals. Stool DNA-based tests offer higher sensitivity for CRC and advanced adenomas than FIT, with lower specificity and higher costs. Multitarget stool DNA tests may serve as complementary options within hybrid risk-stratified strategies; however, further evidence is needed regarding their long-term effectiveness, programmatic feasibility, and economic sustainability before widespread adoption at the population level. In contrast, methylation-based stool DNA tests utilize stable epigenetic alterations and simpler laboratory workflows, offering advantages in logistics, scalability, and cost-effectiveness, and thus represent promising candidates for organized screening. Colonoscopy remains the most comprehensive screening modality, enabling the detection and removal of precancerous lesions, thereby preventing the development of CRC. However, its use as an organized screening tool at the population level is limited by its invasiveness, cost, logistical complexity, and suboptimal participation, which compels most organized programs to position colonoscopy primarily as a confirmatory test following noninvasive screening rather than as a universal first-line modality.

Paratesticular tumors are rare neoplasms, with liposarcomas of the spermatic cord representing an uncommon malignant subtype. These tumors typically grow slowly and may attain a considerable size before diagnosis because of their indolent clinical course. We report the case of a 65-year-old male patient who presented with a progressively enlarging left-sided scrotal swelling of five years' duration. Based on clinical examination and ultrasonographic findings, a left paratesticular neoplasm was suspected. Contrast-enhanced computed tomography revealed a large heterogeneous fat-containing lesion encasing the spermatic cord. The patient underwent complete surgical excision with left radical orchidectomy. Histopathological features (mature adipocytes with fibrous septae and atypical stromal cells), supported by immunohistochemistry (MDM2 intense nuclear positivity), confirmed the diagnosis of well-differentiated liposarcoma. The postoperative course was uneventful, and no adjuvant treatment was administered; he was kept on regular follow-up. He remains free of local recurrence and distant metastasis at 24 months of follow-up. This case highlights the importance of considering paratesticular liposarcoma in the differential diagnosis, particularly in patients presenting with slowly progressive scrotal swellings. Early diagnosis and complete surgical excision with negative margins remain the cornerstone of management and are essential for achieving optimal disease control and favorable long-term outcomes.

The objective of this study was to evaluate whether diagnostic interval is associated with tumor stage in dogs with malignant nasal tumors and whether intranasal bacterial infection contributes to delayed diagnosis.

Medical records of 96 dogs with histopathologically confirmed malignant nasal tumors were retrospectively reviewed. Data included diagnostic interval, clinical stage, results of intranasal bacterial culture, and prior antimicrobial administration. Associations were analyzed using non-parametric tests.

The median diagnostic interval was 83 d (range: 8 to 995 d). Dogs with Stage I tumors had a significantly shorter diagnostic interval than those with Stages II to IV disease (50.0 versus 89.5 d; P = 0.022). When stratified by the overall median interval (≤ 83 versus > 83 d), advanced-stage tumors (Stages III to IV) were more common in dogs with longer intervals (P = 0.014). Bacterial culture was positive in 33 of 57 tested dogs and was not associated with diagnostic interval or tumor stage. Prior antimicrobial therapy (62.5%) was not associated with stage or culture status.

A longer diagnostic interval was associated with more advanced tumor stage. Intranasal bacterial infection did not explain delayed diagnosis. Persistent nasal signs should prompt further diagnostic evaluation to determine the underlying cause, including neoplasia.

Although research demonstrates that cancer survivors who are sexual and gender minorities (SGM), racial and ethnic minorities, or of lower socioeconomic status experience a higher prevalence of cancer-related pain, limited studies have examined how these intersecting marginalized identities and additional social experiences interconnect and affect pain outcomes. In their recent study, Boehmer and colleagues conducted an intersectional analysis of cancer-related pain among SGM adults and other marginalized backgrounds. Using data from the Behavioral Risk Factor Surveillance System, they found that SGM individuals reported a higher prevalence of cancer-related pain. SGM adults with a history of cancer who were younger than 65 years, Black or Hispanic, had low income, unemployed, never or formerly married, and reported poor access to care demonstrated higher likelihood of pain prevalence than their heterosexual cisgender counterparts. In this commentary, we explore minority stress, defined as the socially based and chronic stress associated with stigma, fear of discrimination, and prejudice, as a possible contributing factor to this higher prevalence of pain among those with intersecting marginalized identities, through its effect on biological function and symptoms. The findings of Boehmer and colleagues' study underscore the need to further explore intersectional approaches to pain management in cancer care and research. See related article by Boehmer et al., p. 1309.

Limited access to healthcare due to poverty, lack of insurance, and/or excessive distance from healthcare services has been highlighted as a significant contributor to poor outcomes related to cancer incidence and cancer-related morbidity, survival, and mortality. Moreover, America's primary reliance on employer-based health insurance means that those living without employment or in poverty frequently cannot afford healthcare and therefore experience poorer health outcomes. Because cancer screening that allows for early cancer detection saves lives, it is imperative that research on how to improve and increase cancer-related screening and early detection services for the medically underserved be prioritized and acted upon by policymakers and others responsible for implementing scientific discoveries to improve cancer-related population health.