The objective of the study is to investigate the value of preoperative 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) combined with contrast-enhanced CT (CECT) for predicting negative resection (R0) in pancreatic ductal adenocarcinoma (PDAC).

This retrospective study included patients with PDAC who underwent surgical exploration/resection and received both preoperative 18F-FDG PET/CT and CECT. Resection margin status was determined histopathologically and categorized as R0 versus non-R0 (R1/R2). Clinical variables, CECT features, and PET/CT parameters [including metabolic tumor volume (MTV) and total lesion glycolysis] were compared between groups. Univariate and multivariate logistic regression analyses were performed to identify predictors of R0 resection. Diagnostic performance was evaluated using receiver operating characteristic analysis. Vascular invasion was assessed using intraoperative findings as the reference.

A total of 48 patients (mean age: 61 years; 31 men) were included; 27 (56.25%) achieved R0 resection. Univariate analysis identified tumor shape, tumor width, tumor height, MTV, and total lesion glycolysis as significant predictors. On multivariate analysis, MTV remained an independent predictor and showed the highest diagnostic performance for R0 resection (area under the curve = 0.854). For vascular invasion, the diagnostic accuracy of CECT and MTV was 93.0 and 84.6%, respectively.

Preoperative 18F-FDG PET/CT provides additional value in predicting R0 resection in PDAC. MTV is an independent imaging predictor and may aid assessment of vascular invasion when interpreted in combination with CECT.

Understanding the availability of various supportive care services for patients and caregivers is essential for informing national healthcare strategies and research priorities. Given the crucial role of healthcare professionals (HCPs) in delivering supportive care, this study examined their perspectives on assessing cancer-related unmet needs and differences in service provision for patients versus caregivers in Türkiye, a lower-middle-income country.

Data were drawn from the Turkish subsample of the International Psycho-Oncology Society Survivorship Online Survey who provided valid responses (n = 52). Participants reported on institutional practices related to the assessment and service provision for 13 kinds of unmet needs for patients and caregivers.

Most institutions systematically assessed (≥ 50%) and provided services to address unmet needs (≥ 51.9%) for patients, whereas only few did so for caregivers (19.2%, ≤ 23.1%, respectively). Medical concerns for patients (78.8%) and psychosocial issues for caregivers (19.2%) were most frequently assessed, and services for emotional distress were most frequently provided for both patients and caregivers (82.7% and 23.1%, respectively). Sexuality/intimacy and financial concerns were least assessed and addressed (≤ 50.0% for patients, ≤ 15.4% for caregivers). Differences in assessments and service provision between patients and caregivers were significant across all unmet needs with large effect sizes (all p < 0.001, Cramer's V = 0.52 - 0.62).

Findings highlight both strengths and gaps in supportive care service provision and guide the development of integrated, comprehensive, and equitable programs for populations affected by cancer in Türkiye. These results also provide an initial foundation for future large-scale and longitudinal studies aimed at addressing the unmet needs of individuals affected by cancer.

Emerging evidence suggests that GRIP and coiled-coil domain-containing two enriched small extracellular vesicles (sEV-GCC2) may serve as diagnostic biomarkers of early-stage lung adenocarcinomas. However, the roles of these molecules remain unclear. This study evaluated the diagnostic and prognostic potential of sEV-GCC2 for detecting early-stage lung adenocarcinoma and its tumourigenic role in vitro and in vivo. This retrospective multicentre study analyzed 470 plasma samples (320 lung adenocarcinoma patients, 150 controls; mean follow-up: 34.7 ± 24.0 months) across five institutions. Size-exclusion chromatography and enzyme-linked immunosorbent assay were used to measure sEV-GCC2 levels, whereas immunohistochemistry was used to confirm GCC2 expression in tumour tissues. Functional studies were performed using the PC9 and H1650 lung adenocarcinoma cell lines in vitro and the corresponding PC9-based preclinical models in vivo to evaluate the tumour-related effects of sEV-GCC2. Patients exhibited significantly elevated sEV-GCC2 levels compared to controls (area under the receiver operating characteristic (ROC) curve [AUC]: 0.904, P < 0.001), with similar results in stage TisN0-T1miN0 disease (AUC: 0.781, P < 0.001). sEV-GCC2 levels were associated with the pathological TNM stage and tumour location. Higher sEV-GCC2 levels were correlated with poorer recurrence-free survival (RFS), overall survival and recurrence rates, even in patients with stage 0-IA1 disease. Functional studies have revealed that sEV-GCC2, but not GCC2-deficient sEVs, promote cancer cell proliferation, tumour growth and lymph node metastasis in vitro and in vivo. These findings highlight the diagnostic and prognostic potential of sEV-GCC2 and its tumourigenic role in early-stage lung adenocarcinoma. This study was registered at ClinicalTrials.gov (NCT04529915).

Micro-neurosurgery and minimally invasive neurosurgery have become more common in intracranial procedures for lesions such as Intraventricular tumors, intracranial hematomas, and Posterior fossa tumors. Deep seated lesions require bidirectional retraction of normal overlying brain tissue for better surgical access. For past many decades, conventional retractor systems are in use without any significant modification or innovation. Here we are introducing a novel retractor system suitable for ergonomics of neurosurgeons without disturbing microscopic and endoscopic vision.

A total of eighty (80) patients of deep-seated intracranial lesions were included in the study between January 1, 2024 and April 1, 2025. Forty patients were operated by the Conventional retractor system and rest 14 were operated by our novel retractor system. Surgical and radiological parameters of both the retractor system were calculated and compared along with outcome assessment. CT perfusion was conducted pre- and post-operatively in both the groups. A questionnaire regarding assistance, ergonomics, and instrument handling compared to the conventional retractor system was performed. All patients were followed up for 3 months to observe for any new neurological deficits.

In microsurgery for deep seated tumors, conventional retractor got replaced with our novel retractor system. The mean operative time with novel Saraj Retractor was similar as with conventional retractor. However, time of application and adjustment were reduced. The mean cerebral blood flow and mean transit time were similar in both the retractor groups without any ischemic changes on the surrounding brain parenchyma. There were no intra-operative complications directly related to the use of the device.

Our Novel retractor system is facilitating safe separation of brain parenchyma bilaterally with minimal retraction pressure. It effectively reduces the time for assembly and attachment as compared to conventional retractor system. It reduces the surgeon's fatigue and minimizes the dependency on assistant surgeon.

Glioblastoma (GBM) is the most frequent primary malignant brain tumor characterized by aggressive growth and poor prognosis, frequently accompanied by cognitive and affective deficits that severely impair quality of life (QoL). However, the short-term course of these cognitive and emotional functions after surgical resection remains insufficiently understood.

This study aimed to investigate changes in cognitive performance and affective symptoms before and 3 months after GBM resection and to explore the influence of tumor characteristics such as lateralization and location. We hypothesized that cognitive function and affective symptoms would improve or remain stable postoperatively and that tumor-related factors would modulate these trajectories.

In this multicenter pre-post observational study, 37 adults with histopathologically confirmed GBM (World Health Organization [WHO] 2021) were assessed using the Montreal Cognitive Assessment (MoCA) and the Hospital Anxiety and Depression Scale (HADS). Paired t-tests, Wilcoxon tests, ANOVA, and linear regression were conducted to evaluate pre- to postoperative changes and correlations with tumor characteristics.

Cognitive performance remained stable after resection. Although the HADS total score showed no significant pre- to postoperative change, patients with preoperative anxiety or depressive symptoms demonstrated significant postoperative improvement (HADS-A p = 0.010; HADS-D p = 0.012). Higher preoperative HADS scores predicted greater symptom reduction. Higher affective burden was shown in patients with right-hemispheric and parieto-occipital tumors, while temporal lobe tumors were associated with anxiety that decreased after resection (p = 0.009).

GBM resection maintained cognitive function while improving affective symptoms in patients with elevated preoperative distress. Systematic psychological screening and tailored psychosocial interventions may enhance emotional resilience and QoL in GBM care.

Amelanotic melanoma lacks melanin and is more challenging to diagnose than pigmented melanoma, often leading to delayed detection and worse outcomes. We conducted a retrospective cohort study of 322 patients (28 with amelanotic melanoma and 294 with melanotic melanoma) treated at Sheba Medical Center between 2017 and 2023. Clinical features, treatment modalities, and 1-year outcomes were analyzed. Tumor stage at diagnosis was the strongest predictor of remission, disease progression, and mortality in both groups. Pigmentation was associated with a higher likelihood of treatment modification (p = 0.02) and showed a borderline association with progression (p = 0.08). Subgroup analysis by stage revealed no significant outcome differences except for increased therapy change in stage 2 melanotic melanoma. The findings reinforce the importance of early detection, especially in amelanotic melanoma.

Plant Homeodomain Finger Protein 6 (PHF6) gene mutations are rare in acute myeloid leukemia (AML), with unclear mechanisms and uncertain prognostic value. They may compromise risk stratification and treatment decisions. This study analyzed clinical features and survival outcomes in PHF6-mutated AML patients, evaluating the impact of allogeneic hematopoietic stem cell transplantation (HSCT) and co-mutations on prognosis. Precise stratification helps optimize prognostic models and guide individualized therapy.

This study retrospectively analyzed 45 AML patients with PHF6 gene alterations at our institution. Clinical features, treatment approaches, therapeutic outcomes, and gene co-mutation profiles were comprehensively assessed to determine their prognostic significance. Overall survival (OS), disease-free survival (DFS), and event-free survival (EFS) among different groups were compared using the Kaplan-Meier method and log-rank test. A multivariate Cox regression model identified independent prognostic predictors.

PHF6-mutated AML was associated with shorter OS compared with wild-type (p = 0.003), but PHF6 mutation was not an independent predictor of OS in multivariate Cox analysis. HSCT improved OS, DFS, and EFS compared with no transplantation (all p < 0.05). Median WBC at diagnosis was 2.04 × 10⁹/L; WBC ≥ 9.70 × 10⁹/L independently predicted poor prognosis. RUNX1 co-mutation correlated with shorter OS; IDH1/IDH2 co-mutation with longer OS. Neither affected DFS or EFS.

This study provides clinical evidence for prognosis assessment in PHF6-mutated AML, enabling more precise risk stratification, individualized treatment, and further pathogenesis research.

BACKGROUND Splenic marginal zone lymphoma (SMZL) is a low-grade B-cell lymphoma associated with chronic hepatitis C infection. It typically presents with diffuse splenomegaly rather than a focal splenic mass. Focal splenic lesions with vascular enhancement patterns are usually due to vascular tumors which may be benign or malignant, examples of which include sclerosing angiomatoid nodular transformation, hemangiomas, or angiosarcomas. CASE REPORT A 60-year-old man with newly diagnosed hepatitis C-related Child-Pugh A cirrhosis was incidentally found to have a splenic lesion during index abdominal imaging. He was initiated on hepatitis C treatment and successfully achieved a sustained virologic response. Despite viral eradication, serial imaging over 3 years demonstrated a sudden increase in size from 3.3 cm to 5.7 cm. Multiphasic computed tomography (CT) of the abdomen demonstrated a progressive peripheral-to-central enhancement pattern, mimicking a vascular splenic tumor. A review by a multidisciplinary tumor board recommended splenectomy due to progressive enlargement, rupture risk, and inability to exclude a malignant lesion. Histopathological examination revealed SMZL with extensive central infarction and granulomatous reaction, confirming the diagnosis with characteristic biphasic architecture and CD20-positive B-cell populations. No features of aggressive transformation were identified. CONCLUSIONS Our case highlights an unusual presentation of SMZL as a focal splenic mass, rather than diffuse splenomegaly, which grew despite hepatitis C eradication. Tumor infarction and slow organization can produce radiologic features that mimic vascular splenic lesions. This demonstrates the importance of clinicoradiological-pathological correlation and the necessity of histological confirmation in indeterminate splenic masses to avoid delays in management.

Sarcopenia has emerged as a potential prognostic factor in patients with advanced prostate cancer (PCa), requiring interventions for its prevention and treatment.

We aimed to systematically identify, critically assess and synthesize the available evidence on the effectiveness and safety of interventions for preventing or treating sarcopenia in advanced PCa patients.

MEDLINE, Embase and Web of Science were searched. Randomized and non-randomized controlled trials or longitudinal observational studies with a control group focusing on PCa patients aged 60 years and older were considered. Study selection, data extraction and risk-of-bias assessment of the included studies were performed in duplicate. When possible, pooled effect estimates were calculated.

Twenty studies (n = 1275) were included. Resistance training (RT) (MD = 3.22 kg; 95% CI 0.69, 5.75) and the use of antimyostatin peptibody (MD = 2.2 kg; SE 0.8%) demonstrated statistically significant prevention of lean body mass loss in men undergoing androgen deprivation therapy (ADT). Exercise improved leg press (MD = 25.17 kg; 95% CI [8.71, 41.62]), leg extension (MD = 9.63 kg; 95% CI [4.83, 14.42]), seated row (MD = 4.38 kg; 95% CI [1.54, 7.22]) and chest press strength (MD = 1.70 kg; 95% CI [-1.48, 4.88]) and enhanced patients' physical functioning in chair sit-to-stand tests (MD = -1.02 kg; 95% CI [-1.70, -0.34]). RT improved health-related quality of life (HRQoL) in both general and specific domains and also reduced somatization (MD = -0.69 kg; 95% CI [-1.32, -0.07]) and psychological distress (MD = -1.63 kg; 95% CI [-3.10, -0.15]).

The findings highlight the potential benefits of RT and selected pharmacological interventions on muscle-related and functional outcomes. However, the significant heterogeneity and lack of comprehensive outcome reporting underscore the need for more standardized and long-term research through larger, well-designed randomized controlled trials with standardized measurement methods to draw conclusive evidence and enhance the reliability and applicability of findings in clinical practice.

While atherosclerosis is a disease of vascular hypercholesterolemia, reports have also shown the presence of intracellular hypercholesterolemia in cancer tumor cells. Since the dietary cholesterol in the blood vessel is the major source of intracellular cholesterol, a low blood cholesterol level is maintained in people having carcinogenesis. Because of the variance found in blood cholesterol level, the carotid artery intimal media thickness (CIMT) was considered as a confirmation marker to distinguish these two diseases. 50 patients of each category and 25 disease-free healthy subjects were included in a single-center study. Subjects were classified into two groups viz., normoglycemic and hyperglycemic. Since both atherosclerosis and carcinogenesis are inflammatory, stressful diseases; the relative variations of plasma or serum concentrations of different characteristic discriminating markers related to inflammation and stress were evaluated in this study to compare the severity of stress between these two dreadful diseases. The respective inflammatory and stress markers were Ox-LDL, TNF-α, IL-10, Cortisol, PERK, and NF-kB. ELISA-based commercial kits were used for the assay of the respective parameters. Based on the relative severity of the bio-marker values, subjects were also divided into risk liable sub-groups. Linear regression analysis against serum low density lipoprotein (LDL) concentration for each of the inflammation (Ox-LDL, TNF-α, and IL-10) and stress (Cortisol, PERK, and NF-kB) factors was carried out for a clear outcome of the absolute severity of each component in the pathogenicity of these two disease processes. Calculated fold alarming severity earmarked hyperglycemic carcinogenesis as the most stressful alarming disease over the others.