Osteosarcoma (OS), the most frequent primary malignant bone tumor in children and adolescents, is characterized by substantial inter- and intra-tumoral heterogeneity and an immunosuppressive tumor microenvironment (TME), constraining the efficacy of both standard chemotherapy and emerging immunotherapies. Recent advances in single-cell and single-nucleus RNA sequencing (scRNA-seq and snRNA-seq) have enabled high-resolution profiling of OS tumors, revealing diverse malignant, immune, and stromal cell populations. These studies have identified proliferative, inflammatory, and angiogenic tumor states, immunosuppressive myeloid subsets, exhausted T cells, and complex cell-cell communication networks that contribute to tumor progression and immune evasion. However, several challenges constrain the broader application of single-cell approaches in OS. The mineralized structure of bone tissue complicates dissociation into viable single cells, and the rarity of OS limits access to fresh specimens. Most existing datasets are based on small, heterogeneous cohorts and are generated using diverse protocols, which complicate data integration and comparison. Emerging methods are beginning to overcome these barriers. These include snRNA-seq for frozen and archival tissue, improved dissociation protocols for mineralized tumors, and integration with spatial transcriptomics to retain spatial context. Moving forward, combining single-cell transcriptomics with complementary modalities, such as immune repertoire analysis, chromatin accessibility profiling, and spatial proteo-genomics, combined with functional validation, will provide deeper insights into immune dynamics, regulatory mechanisms, and the cellular architecture of the OS TME. This review summarizes the current landscape of single-cell transcriptomics in OS and highlights methodological challenges in single-cell studies in OS tumors, recent biological insights, and their implication for immunotherapies.

This study examined the influence of socioeconomic status (SES) on physical, psychological, and wellbeing symptom burden among palliative cancer patients in New Delhi, India, to identify manifestations of inequity across the cancer care continuum. A secondary analysis of a prospective cohort dataset of 240 cancer patients receiving palliative care was conducted. Participants completed a baseline survey (T1); 120 were followed up after 1 month (T2). Symptom burden was measured using Likert scales for physical, psychological, and wellbeing outcomes. Chi-square tests assessed associations between SES and symptom severity. Ordinal logistic regressions examined the predictive effects of education, income, and slum residence, adjusting for age, sex, and cancer stage. Low education and financial insecurity were associated with higher symptom burden. At T1, patients with no formal education reported more severe weakness than those with tertiary education (OR = 2.84, 95% CI 1.25-6.42, p = 0.012). Not coping on income was associated with greater weakness (OR = 2.67, 95% CI 1.48-4.82, p = 0.001) and depression (OR = 1.94, 95% CI 1.10-3.40, p = 0.021). At T2, this was also associated with more pain (OR = 2.44, 95% CI 1.02-5.81, p = 0.044) and feeling less informed (OR = 2.58, 95% CI 1.03-6.44, p = 0.043). Slum residence was associated with higher odds of depression (OR = 0.25, 95% CI 0.09-0.70, p = 0.008). SES strongly shaped symptom burden, with low-income, less-educated, and slum-resident patients disproportionately affected. Findings highlight the need for cancer care strategies integrating financial protection, patient education, and mental health services to mitigate inequities in LMICs.

Brain cancer diagnoses often disrupt patient function, well-being, and financial stability, but population-level economic outcomes remain underexplored. Our aim was to determine if survivors of brain cancer face greater odds of post-diagnosis unemployment and lower odds of working full-time, benefit-providing jobs following diagnosis compared to survivors of other cancers.

We analyzed pooled 2019-2023 National Health Interview Survey data of adults who reported a cancer diagnosis ≥ 1 year prior to survey completion. Weighted logistic regressions evaluated the association between cancer type and post-diagnosis unemployment and work-related health benefits, adjusting for age, disability (physical, sensory, and cognitive), and social drivers of health.

The cohort represented 22.9 million US adult survivors of cancer, including 198,961 with brain cancer. People with a diagnosis of brain cancer faced higher odds of post-diagnosis unemployment compared to other cancer types, adjusting for age, disability, and social drivers of health (OR 2.54, 95% CI 1.12, 5.77). In addition, employed survivors of brain cancer were less likely to work full-time (OR 0.26, 95% CI 0.09, 0.74) or have jobs offering health insurance (OR 0.37, 95% CI 0.15, 0.96) or paid sick leave (OR 0.40, 95% CI 0.17, 0.96).

These findings reveal markedly higher socioeconomic vulnerability for survivors of brain cancer compared to those with other cancer types.

Immune checkpoint inhibitors (ICIs) have transformed cancer care, extending survival across multiple malignancies. Yet quality-of-life (QoL) outcomes remain underreported and inconsistently integrated into research and practice. Standard frameworks and instruments do not fully capture immune-related adverse events (irAEs) and may overlook the experiences of racially, socioeconomically, linguistically, and digitally marginalized groups.

This review examines how methodological limitations, and systemic inequities constrain the assessment of QoL in immune checkpoint inhibitor (ICI) therapy. It evaluates existing QoL instruments and frameworks guiding patient-reported outcomes (PROs) and identifies opportunities for advancing equity-centered, patient-informed approaches.

This narrative review synthesized evidence identified through literature searches and reference screening across oncology, regulatory science, digital health, equity, and community-engaged research. QoL assessment domains analyzed included methodological rigor, trial design, digital integration, intersectionality, literacy, and social determinants of health.

Quality-of-life reporting in ICI trials remains limited, with only about 14% of trials publishing PRO results and fewer than 12% including them in the primary publication. Existing tools inadequately capture irAEs, while trial designs neglect long-term survivorship and diverse populations. Frameworks such as SPIRIT-PRO and CONSORT-PRO improve methodological rigor, but provide limited guidance on equity, cultural adaptation, or caregiver perspectives. Barriers, including digital exclusion, linguistic gaps, and underrepresentation of racial and age groups, further bias QoL evidence.

Quality of life should be recognized as a core clinical endpoint and an indicator of equity in ICI therapy evaluation. Future research must integrate culturally validated instruments, inclusive digital strategies, and community-engaged approaches to ensure survivorship outcomes reflect the realities of all patients. By moving beyond survival, QoL assessment can anchor cancer care in equity and patient-centered lived experience.

Advances in systemic cancer therapies such as immune checkpoint inhibitors (ICIs), tyrosine kinase inhibitors (TKIs), and anti-angiogenic agents have markedly improved survival in patients with solid and hematologic malignancies. As survivorship increases, oral rehabilitation with dental implants is increasingly sought to restore quality of life. However, these therapies may adversely affect bone healing, angiogenesis, and immune regulation, raising concerns regarding implant-related complications. This systematic review aimed to evaluate reported dental implant outcomes and complications in patients receiving novel systemic cancer therapies, emphasizing the implications for supportive oncology.

This review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251142681). PubMed/MEDLINE, Scopus, ScienceDirect, and the Cochrane Library were searched for English-language clinical reports describing dental implant outcomes in patients treated with ICIs, TKIs, or anti-angiogenic agents. Study selection, data extraction, and quality appraisal using the Joanna Briggs Institute checklist for case reports were performed independently by two reviewers.

Seven case reports (2017-2024) were included, representing Level IV evidence. Two cases involving TKIs reported successful osseointegration and long-term survival. In contrast, five cases described adverse outcomes including early failure and MRONJ predominantly associated with anti-angiogenic agents, either alone or in combination with ICIs and antiresorptive agents. These complications often resulted in significant functional morbidity and the need for invasive surgical intervention.

Based on limited case report evidence, anti-angiogenic therapies were more frequently observed in cases with adverse outcomes, including implant-related MRONJ and failure, while TKIs were associated with favorable outcomes in limited cases. The role of ICIs remains unclear due to sparse data, particularly regarding monotherapy effects. Given the preliminary nature of current evidence derived from case reports, prospective studies with appropriate control groups are urgently needed to establish evidence-based guidelines.

CRD420251142681; 08/09/2025.

To assess the benefit of night-time compression in addition to daytime compression on arm excess volume after 3 months of maintenance treatment in patients with secondary upper limb breast cancer-related lymphedema (BCRL).

This multicenter, controlled, randomized study was carried out in six centers in France and Turkey. Women with upper limb BCRL who had undergone the intensive phase of decongestive lymphedema therapy (DLT) were randomized into two groups: the Control group wore a daytime compression sleeve without any night compression for 3 months and the MOBIDERM Autofit (MobA) group used a night-time compression sleeve in addition to the daytime compression. The primary outcome was the change in arm excess volume between day 0 (D0) and D90. The main secondary endpoints were: quality of life (QoL), sleep quality, skin thickness and suppleness, satisfaction, compliance, and safety.

Fifty-six patients were recruited (mean (± SD) age: 61.4 ± 12.3 years). Between D0 and D90, the mean excess volume decreased by 29.2% in the MobA group and increased by 10.7% in the Control group (p = 0.001). Only 3.6% of patients in the MobA group presented with treatment failure vs. 23.1% in the Control group. At D90, patients in the MobA group had a significantly greater improvement in QoL (p < 0.05), sleep quality (p = 0.018), skin suppleness (p = 0.01) reduced skin thickness (p = 0.025) compared with the Control group.

MOBIDERM Autofit used in addition to daytime compression for 3 months during the maintenance phase after DLT was superior to daytime compression alone for the reduction of arm excess volume. Registered on ClinicalTrials.gov (NCT04203069; 17/12/2019).

To investigate mammographic features associated with high artificial intelligence (AI) risk scores as provided by two AI models applied to screening mammograms.

This retrospective study included 130,031 screening mammograms from 42,371 women attending BreastScreen Norway, 2008-2018. Two AI models (A and B) developed for cancer detection on screening mammograms were applied. An informed radiological review was conducted for mammograms within the highest 5% of AI risk scores by both models in two study samples: (1) High AI risk score, but no breast cancer detected within 6 years (n = 120), and (2) High AI risk score in mammograms with screen-detected cancers (n = 120). Mammographic density (BI-RADS a-d), features (mass, spiculated mass, asymmetry, architectural distortion, calcification alone, and density with calcification), and radiologists' interpretation scores (1-5) were analyzed descriptively.

Mammographic density was higher in sample 1 compared to sample 2 (BI-RADS d: 11% vs 3%, respectively). In sample 1, calcifications alone were the most frequent AI-marked feature (model A: 72%; model B: 68%), predominantly with amorphous morphology and a cluster distribution, and 76% were interpreted as benign by the radiologists (interpretation score 1). In sample 2, a spiculated mass was the most frequent mammographic feature among the screen-detected cancers (29%).

Mammograms assigned high AI risk scores exhibit distinct features depending on screening outcome. Systematic characterization of these features may help refine AI thresholds, improve specificity, reduce AI false-positive findings, and decrease the recall rate in breast cancer screening.

Question Knowledge about mammographic features associated with high AI risk scores is essential for distinguishing cancer from non-cancer cases. Findings Calcifications were the dominant feature in non-cancers in screening mammograms with high AI risk score, whereas spiculated mass was the most frequent feature among cancers. Clinical relevance Calcifications in non-cancer screening mammograms with a high AI risk score were frequently interpreted as benign or probably benign by radiologists. This knowledge may help refine AI thresholds and thereby improve specificity and reduce false-positive results in mammographic screening.

Telepresence enables real-time observation and remote mentoring across distances, potentially accelerating the dissemination of advanced minimally invasive techniques. The da Vinci 5 platform integrates Telepresence within the My Intuitive digital ecosystem, facilitating remote case observation, collaboration, and mentoring.

This technology paper reports an international telepresence session in which an expert colorectal robotic surgeon located in Daegu, Republic of Korea, provided real-time remote mentoring during a robot-assisted colorectal procedure performed in Saitama, Japan. A representative clinical implementation involved a patient with rectosigmoid cancer (clinical stage T1bN0M0) and obesity (BMI 30.1 kg/m²). The telepresence-mentored segment focused on the most technically demanding phase: peritoneal incision, dissection around the superior rectal artery (SRA), and vascular handling.

The mentored phase lasted 40 min. During this segment, the remote mentor provided step-by-step guidance on exposure strategy, traction direction, and plane selection. Additionally, console-integrated objective force visualization ("Force Gauge") was used as a shared reference to optimize retraction. The operation was completed without intraoperative complications (operative time: 214 min; estimated blood loss: 5 mL).

These findings demonstrate the feasibility of cross-border telepresence mentoring on the da Vinci 5 platform. Coupling remote mentoring with objective intraoperative force feedback may improve shared situational awareness and support safe decision-making during complex robotic colorectal surgery.

The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing, and human papillomavirus (HPV)-associated OPSCC is contributing substantially to this trend. Salivary HPV testing enables early detection of HPV-driven OPSCC. The GeneXpert system (Cepheid) is an automated polymerase chain reaction (PCR)-based diagnostic platform designed primarily for cervical cancer screening using vaginal swabs. Our goal was to adapt this platform for HPV testing using salivary oral rinse (SOR) samples to enable early detection of HPV-driven OPSCC.

Patients suspected of having any type of head and neck cancers and people at higher risk of acquiring HPV infections were recruited (n = 67). A volume of 5 to 10 mL of SOR samples was tested using the GeneXpert system. Genomic DNA was extracted from the same SOR samples and analyzed using quantitative real-time PCR for human papillomavirus type 16 (HPV-16). The detection status of HPV-16 was used to evaluate the efficiency of HPV detection using the GeneXpert system.

The GeneXpert system had excellent specificity of 100% and sensitivity of 72.09%. There was strong agreement with quantitative real-time PCR results (κ = .649). This confirms the suitability of SOR as a sample medium on the GeneXpert system to detect oral HPV with minimal bias.

The GeneXpert system can effectively detect HPV in SOR samples. It offers rapid HPV detection, helps identify people at high risk of developing HPV-associated OPSCC, thereby holding promise for the early detection of HPV-driven OPSCC.

The results of this study showed the feasibility of using SOR samples on the GeneXpert platform as a scalable, noninvasive screening approach for the early detection of patients at higher risk of developing HPV-associated OPSCC.

To explore the clinical phenotypes and genetic characteristics of two patients with Familial adenomatous polyposis (FAP) due to variants of MUTYH gene.

Two patients presenting with multiple colorectal polyps on gastrointestinal endoscopy at Xinxiang Central Hospital respectively in June and October 2022 were selected as study subjects. A retrospective study design was employed to collect their clinical data and summarize their clinical and genetic features. Whole exome sequencing (WES) was carried out for both patients. Candidate variants were validated by Sanger sequencing of their family members. Bioinformatic analysis was conducted for the candidate variants. Pathogenicity of the variants was assessed based on the guidelines from American College of Medical Genetics and Genomics (ACMG). This study was approved by the Medical Ethics Committee of the hospital [Ethics No.: 2024-282-01 (K)].

Patient 1 was a 7-year-old girl who presented with "pigmentation on the lips, buccal mucosa, hard palate, eyelids and fingers for 5 years." Colonoscopy revealed multiple colonic polyps. WES revealed that she has harbored compound heterozygous variants of the MUTYH gene, namely c.857G>A (p.Gly286Glu) and c.1118C>T (p.Ala373Val), which were inherited from her mother and father, respectively. Based on the ACMG guidelines, the variants were classified as pathogenic (PS4+PM1+PM2_Supporting+PP3) and variant of uncertain significance (VUS) (PM2_Supporting+PP3), respectively. Patient 2 was a 42-year-old male who presented with "increased frequency of bowel movements for 2 month." Colonoscopy revealed multiple colorectal polyps. WES revealed that he has harbored compound heterozygous variants of the MUTYH gene, namely c.53C>T (p.Pro18Leu) and c.880C>T (p.Arg294Cys), which were inherited from his father and mother, respectively. Based on the ACMG guidelines, the variants were classified as likely pathogenic (PS4+PM1+PM2_Supporting+PP3) and VUS (PM2_Supporting+PM1), respectively.

Compound heterozygous variants of the MUTYH gene probably underlay the pathogenesis of FAP in these patients. Above findings have enriched the mutational spectrum of the MUTYH gene.