Choosing the proper metrics to define quality for pulmonary resection for cancer is an important, yet complex task. The Society of Thoracic Surgeons has developed both short-term and long-term lung cancer resection risk models that have been used for risk estimation and quality improvement purposes. Based on real-world data, these models are now available for direct application to patient care.

This article outlines key performance indicators for thymic epithelial tumors and esophageal cancer, emphasizing accurate staging, complete resection, and multidisciplinary care to optimize outcomes. For thymoma, priorities include computed tomography-based preoperative assessment, cautious use of biopsy, total thymectomy when feasible, selective use of neoadjuvant or adjuvant therapy, and 10-year surveillance. Evidence supports esophagectomy in high-volume centers with adequate lymph node harvest, synoptic pathology reporting and use of enhanced recovery after surgery protocols. Finally, monitoring 90-day mortality, and incorporating both clinical outcomes and patient-reported outcomes into quality assessments that can be compared to benchmarks are strongly recommended.

Modern performance measurement in health care builds on Codman's "end result" concept and Donabedian's triad of structure, process, and outcomes as interdependent components of quality. These domains support perioperative thoracic oncology care by guiding the selection of validated, measurable key performance indicators. Structure indicators address capacity and resources; process indicators assess adherence to evidence-based pathways; and outcome indicators capture clinical results. In non-small cell lung cancer, key themes include timely multidisciplinary treatment-driven care, accurate staging, appropriate surgery and adjuvant therapy, Enhanced Recovery after Surgery use, systematic quality review, and integration of patient-reported outcome measures to complement traditional outcomes.

With improved survival rates, there is a growing population of cancer survivors who experience sexual health concerns following cancer treatment. These are widely recognised sequelae of cancer and cancer treatment, negatively impacting intimate relationships and quality of life. At least 40% (up to 100%) of people affected by cancer report concerns in this area. However, despite being well documented long-term challenges, they remain largely unaddressed by healthcare teams leading to further deterioration in sexual health. Healthcare providers identify this as an important quality of life issue; however, this does not translate into action. Barriers identified by healthcare providers include lack of knowledge, comfort and confidence, misconception of limited interventions and referral pathways available, and considerations regarding how to raise and discuss this topic. Coordinated systematic approaches for assessment and management of SFI concerns are lacking. The SexFICC Programme will address these gaps. SexFICC is an educational programme designed to improve sexual health outcomes in people affected by cancer by upskilling the cancer workforce in detecting and managing these issues throughout the cancer experience. No such training currently exists in the Australian context.

A multi-phase mixed-methods design will be employed. Through co-design with key stakeholders (anticipated n=40), we will co-develop, user test (n=10 participants), evaluate (minimum n=50) and disseminate a clinically integrated education programme aimed at increasing knowledge, confidence and skills in addressing sexual health concerns with anticipated positive changes on practice. The programme will include an educational course and practical evidence-based resources for cancer healthcare providers and approaches to address sexual health unmet needs in all people affected by cancer, with a unique focus on identified priority populations. This programme is informed by overwhelming evidence demonstrating major gaps in health services designed for detecting and managing sexual health-related issues; priorities for people affected by cancer, healthcare providers and policy makers.

Ethics approval was obtained from the University of Sydney Human Ethics Committee (Study Protocol #2025/HE001690). Results will be published in appropriate peer-reviewed journals, presented at conferences, disseminated to participants in the form of a plain language summary and widely disseminated to consumer and professional stakeholders.

Prostate cancer (PCa) is the most commonly diagnosed cancer in men worldwide. A rising proportion of men present with de novo metastatic disease, a state associated with poor survival outcomes and limited curative treatment options. Within this group, a subset of patients exhibit oligometastatic disease, defined by a limited number of metastases, which may represent a distinct clinical entity with potential for long-term disease control. Emerging evidence suggests that metastasis-directed radiotherapy (MDRT), including stereotactic body radiation therapy (SBRT), may improve progression-free survival in this population. However, current evidence is largely limited to phase II trials in the metachronous setting and retrospective studies in the synchronous setting. Furthermore, predictive biomarkers of treatment response in these patients remain undefined. We aim to evaluate, within a large randomised multicentre phase II trial, the efficacy and biological impact of MDRT in men with de novo oligometastatic PCa.

Patients with de novo oligometastatic hormone-sensitive prostate cancer (omHSPC), defined as up to 10 sites of metastatic disease by prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/CT or up to five sites of metastatic disease by conventional imaging, are randomised (1:1) to standard of care (SOC) or SOC plus MDRT. SOC includes 12 months of androgen deprivation therapy plus an androgen receptor pathway inhibitor, with definitive treatment to the prostate by radiotherapy (RT). A predefined subset is allowed to undergo radical prostatectomy if clinically appropriate. MDRT involves SBRT to all metastatic sites identified on conventional imaging or PSMA PET/CT. Target enrolment is 200 patients, stratified by diagnostic imaging modality, number of bone metastases, plan to MDRT all sites of metastases and local therapy approach.Prostate RT may be delivered using moderate (20 fractions) or ultra-hypofractionation (five fractions), with optional simultaneous-integrated-boost to dominant intraprostatic lesions. MDRT regimens aim for a biologically effective dose ≥100 Gy (α/β=1.5) using 1-5 fractions. Gross tumour volumes are delineated based on MRI, CT and PSMA PET/CT.The primary endpoint is failure-free survival, defined using cause-specific PCa death. The study is powered at 80% to detect a HR of 0.58 using a one-sided alpha of 0.05. Secondary endpoints include radiographic progression-free survival, overall survival (OS), time to next intervention, time to castration-resistant PCa, PCa-specific mortality and patient-reported outcomes. Biospecimen collection and imaging data will support future translational analyses. Data from this trial is preplanned to be pooled with the STAMPEDE 2 (NCT06320067) trial, a phase III randomised trial to assess OS benefit of MDRT in men with de novo omHSPC.

This clinical trial is approved by the Case Comprehensive Cancer Center Institutional Review Board (STUDY20231440). The results will be disseminated via peer-reviewed scientific journals and conference presentations.

NCT06150417 (https://clinicaltrials.gov/study/NCT06150417).

Gastric cancer remains a significant cause of mortality worldwide. This study analyzed gastric cancer mortality trends over 24 years, projections for 2030, and their relationship with indigenous populations and gastroenterology services in Mexico.

The study was based on mortality data from the Ministry of Health covering the 2000-2023 period. A total of 137,629 death records with ICD-10 codes C16.0-16.9 (gastric cancer) were extracted, including information on residence (state/municipality), sex, age (>20), and indigenous language-speaking status. Age-standardized mortality rates (ASMR)/100,000 inhabitants, linear regression trends, Joinpoint analysis projections, annual/average percentage changes (APC/AAPC), excess risk by municipality, and the annual gastroenterologist rate were estimated.

A notable decrease in ASMR was observed, from 11.0 in 2000 and 6.8 in 2023, with an AAPC of -2.1. Differences based on age and sex were documented: a moderate AAPC decrease among older women (≥50 years) of -1.8 and among older men of -2.1; however, a non-significant upward trend of 0.4 was observed in younger women (≤50 years), as well as a stable trend in men (0.03). Projections for 2030 suggest that gastric cancer mortality will continue to decline among older adults. The ASMR was higher in the central-southern-southeastern regions of the country and in populations with a high proportion of indigenous people who have limited access to specialized gastroenterological care.

Gastric cancer mortality trend was age-dependent, declining in older adults but rising among young people. Significant regional disparities persist, underscoring the need for targeted interventions and equitable access to specialized care.

Lung cancer is the leading cause of cancer-related death globally, with a significant burden in China, which accounts for more than one-third of the world's new cases and 40% of related mortalities. Despite evidence that low-dose computed tomography screening can reduce mortality, its limited uptake in China means that most patients are diagnosed at an advanced stage, contributing to a low 5-year survival rate compared to high-income countries. Although overall incidence trends have been well documented, there is a scarcity of population-based data on the temporal trends of different histological subtypes of lung cancer in China.

This study aimed to analyze population-based cancer registry data to assess lung cancer incidence trends by histological subtype and sex from 2001 to 2020 and to forecast future incidence rates through 2030 in Xihu District, Hangzhou, Zhejiang Province, eastern China.

The study used population-based surveillance data from the Xihu Cancer Registry from 2001 to 2020. Statistical analyses were conducted to assess the burden of each tumor subtype, including the average annual percentage change (AAPC) to evaluate temporal trends and the Bayesian age-period-cohort (BAPC) model to forecast incidence rates through 2030.

Lung cancer incidence rates were generally low among individuals aged <45 years but escalated markedly with age, reaching a peak of 567.6 per 100,000 person-years in among those aged 80 to 84 years. Notably, a significant rise in incidence was observed among those aged 30 to 44 years in recent years. Sex-based differences in histological distribution were pronounced. Adenocarcinoma accounted for 66.65% (2322/3484) of female cases compared to 37.1% (1795/4838) of male cases, while squamous-cell carcinoma was substantially less common in female cases (86/3484, 2.47% compared to 829/4838, 17.13% in male cases). Among male cases, the age-standardized incidence rates (ASIRs) of adenocarcinoma increased from 1.39 to 42.18 per 100,000 between 2001 and 2020; among female cases, the corresponding increase was even more pronounced, rising from 2.81 to 67.37 per 100,000. Joinpoint regression analysis demonstrated a consistent long-term increase in adenocarcinoma (AAPC=35.1, 95% CI 14.2-50.2), with peak acceleration observed from 2005 to 2012 (annual percentage change [APC]=76.7, 95% CI 45.2-124.2), and a steady increase in large-cell and other specified carcinomas (AAPC=32.7, 95% CI 12.5-45.7), while unspecified carcinoma showed a long-term decline (AAPC=-3.1, 95% CI -14.2 to -1.1). BAPC projections indicated that adenocarcinoma ASIR will continue to surge between 2020 and 2030, emerging as the dominant histological subtype, while unspecified carcinoma, squamous-cell carcinoma, and small-cell lung cancer are anticipated to decline modestly.

The increase in lung cancer incidence, particularly among female participants, underscores the need for effective prevention and control strategies, including targeted interventions to reduce smoking.

The identification of novel estrogen receptor (ER)-targeted anticancer compounds from marine fungal secondary metabolites was performed using a combined computational and experimental approach. A library of 461 marine fungal metabolites was analyzed using chemical space visualization, structural similarity assessment using Tanimoto indices, and target-prediction tools to identify potential ER ligands. Scaffold analysis of predicted hits suggested decalin/bicyclic terpenoid (6-6), tricyclic 6-6-6 terpenoid, bicyclic 5-6 system and several polycyclic system chemotypes as novel for ER ligands. The ER-dependence of the proposed hits cytotoxicity was tested in vitro against ER-positive human breast cancer MCF-7 cells using a 4-hydroxytamoxifen (4-OHT)-competitive viability assay. The compounds virescenoside M, cladosporin, zosteropenilline S, and griseofulvin exhibited ER-dependent cytotoxic effects on MCF-7 cells, confirming the in silico predictions. In 48 h experiments, cladosporin, zosteropenilline S, and griseofulvin at 100 µM decreased the MCF-7 cell viability by 73.6%, 33.2%, and 45.8%, respectively, but statistically significant cytotoxic effect of griseofulvin also was observed at its concentration of 1 µM. Surface plasmon resonance (SPR) experiments confirmed the direct binding of griseofulvin to ERα, with a dissociation constant (Kd) of 8.00 µM. These findings highlight marine fungi as a valuable source of novel ER-targeted anticancer agents and suggest a novel ER-dependent mechanism for the antifungal drug griseofulvin, providing a basis for its potential repositioning in ER-positive breast cancer therapy. This integrated computational-experimental strategy provides a framework for discovering new lead compounds for breast cancer treatment.

Approximately 96% of myelofibrosis (MF) patients express wild-type (WT) p53. MF hematopoietic stem/progenitor cells (HSPCs) overexpress MDM2 that degrades WTp53, thereby supporting MF HSPC survival. Although MDM2 small-molecule inhibitors (SMIs) are clinically effective, their benefit is compromised by an inability to sufficiently deplete MF HSPCs. KT-253 degrades MDM2 and overcomes the p53-dependent feedback loop that restores MDM2 levels observed with the use of MDM2 SMIs such as AMG-232. We evaluated the effects of KT-253 using MPN cell lines, primary MF CD34⁺ cells, and a mouse xenograft model. KT-253 activity was correlated with activation of the p53 pathway and upregulation of p53 downstream genes, including p21, NOXA, and PUMA in WTp53 UKE-1 cells but not p53 mutant cells. KT-253 treatment induced apoptosis of primary MF CD34⁺ cells at a tenfold lower concentration than AMG-232 and prevented the upregulation of MDM2 seen with AMG-232. Low doses of KT-253 reduced total MF colony and JAK2V617F⁺ colony numbers to a far greater extent than log-higher doses of AMG-232 (60% and 71% versus 20% and 10%, respectively). Mouse xenograft studies indicated that KT-253 more effectively depleted JAK2V617F⁺ MF marrow-repopulating cells. These findings support the further clinical evaluation of MDM2 degraders for the treatment of MF patients.

Dietary and nutritional interventions have gained popularity among patients with cancer undergoing treatment due to the high cost of medical treatment and increased health awareness. Diet, nutrition, psychological stress, and adverse events during treatment have a significant impact on the quality of life of patients with cancer. This study aimed to review published studies and guidelines on diet and exercise for cancer survivors.

Although several academic associations have published guidelines on the impact of diet and nutrition on cancer treatment, physicians typically do not consider this impact.

This study summarizes recent findings on the effects of diet and nutrition, particularly fasting-mimicking diet, on the prognosis and adverse events of chemotherapy. Furthermore, this study outlines future perspectives on cancer treatment based on "Precision Nutrition" and "Molecular Precision Medicine".