We investigated whether prior holmium laser enucleation of the prostate (HoLEP) influences perioperative, oncologic, and continence outcomes following robot-assisted radical prostatectomy (RARP).

A total of 419 patients who underwent RARP, including 27 with prior HoLEP, were retrospectively analyzed using 1:2 propensity score matching. Urinary continence was assessed longitudinally using pad counts at scheduled intervals, with 12-month continence as the primary endpoint. Secondary endpoints included perioperative outcomes and biochemical recurrence (BCR).

No significant differences were observed in perioperative outcomes, pathological findings, or BCR-free survival between patients with and without prior HoLEP. At 12 months, functional continence (≤ 1 pad/day) was achieved in 100.0% of patients without prior HoLEP and in 85.2% of those with prior HoLEP (p = 0.011). Kaplan-Meier analysis demonstrated no significant difference in time to recovery (log-rank p = 0.068); however, a subset of patients with prior HoLEP experienced persistent incontinence beyond 12 months. Exploratory analyses implied an association between longer adjunctive transurethral coagulation time during HoLEP and worse functional continence.

Perioperative and oncologic outcomes after RARP were generally comparable regardless of prior HoLEP in this cohort. However, persistent incontinence at 12 months may occur in a subset of patients with prior HoLEP.

Robot-assisted laparoscopic partial nephrectomy (RAPN) for highly complex renal tumors can be challenging. However, determinants of oncological and functional outcomes after RAPN in this high-risk population remain poorly characterized.

We retrospectively evaluated the clinical data of 396 consecutive patients who underwent RAPN for cT1N0M0 renal tumors of high complexity, defined as a RENAL nephrectomy score ≥ 10. Factors associated with trifecta (negative surgical margin, warm ischemic time ≤ 25 min, and no surgical complications) and pentafecta achievement (≥ 90% estimated glomerular filtration rate preservation and no chronic kidney disease stage upgrade at 1 year postoperatively, along with trifecta achievement) were investigated.

Trifecta was achieved in 201 patients (51%). Multivariable analysis showed that right-side tumors (p = 0.0217), non-hilar tumors (p = 0.0056), shorter operating times (p < 0.0001), and unexposed urinary systems (p = 0.0022) were independent factors for trifecta achievement. Among 334 patients with eligible data for pentafecta evaluation, 104 (31%) achieved pentafecta. After covariate adjustment, non-hilar tumors (p = 0.0449), shorter operating times (p = 0.0003), and unexposed urinary systems (p = 0.0004) were independent factors for pentafecta achievement.

Factors associated with trifecta and pentafecta achievement after RAPN were identified for highly complex renal tumors. These perioperative factors may be utilized for postoperative outcome prediction after RAPN in this challenging population.

Understanding how cells interact to coordinate tissue function and respond to disease remains a central challenge in biology. Recently developed multiplex bioimaging technologies [multiplex immunofluorescence (MxIF)] can quantify multiple protein markers at a single-cell resolution in spatially preserved tissue, offering the opportunity to understand how cellular organization relates to disease mechanisms and treatment response. Spatial generalized linear mixed models for cell co-localization offer a flexible framework for these analyses, accommodating cell-, image-, or subject-level predictors while accounting for correlation arising from repeated cells per image, repeated images per subject, and spatial dependence among nearby cells. However, as MxIF data typically have hundreds of thousands to millions of cells per study, fitting the full spatial model is computationally infeasible due to the large, dense, spatial covariance matrix. We present a scalable inference strategy that uses parallelizable eigen-decomposition of an empirically estimated spatial correlation matrix to approximate the full spatial model. This approach enables fast estimation of fixed effects of interest without requiring formal estimation of spatial parameters or surface prediction. In simulations, our proposed method could be fitted to large datasets ($ \sim $ 285,000 observations) in under a minute, with runtime linearly increasing by only $ \sim $ 7 s per 50,000 additional observations. This scalability makes cell-level modeling in the presence of spatial correlation feasible for real-world MxIF datasets, as we demonstrate through applications to metastatic melanoma and high-grade serous ovarian carcinoma.

Post-traumatic stress symptoms (PTSS) are a substantial yet underrecognised mental health concern in oncology. Large-scale epidemiological data across diverse cancer types are scarce. This study aimed to estimate the prevalence of post-traumatic stress disorder (PTSD) and to identify socio-demographic and psychosocial correlates in a large, unselected outpatient cohort.

In this cross-sectional study, 4,103 adult outpatients with solid tumours or haematologic malignancies were screened during routine care using the PTSS-8-Cancer scale. Socio-demographic, clinical and psychosocial variables were collected concurrently. Associations between screening results and patient characteristics were examined using correlational and chi-square analyses.

Overall, 32.5% screened positive for probable PTSD. Prevalence was highest in breast cancer (39.7%), female genital cancers (37.2%) and head and neck cancers (36.1%). A positive screening for PTSD was more common among women, younger patients, those with lower income, without a partner and with a history of psychiatric illness. While these associations were statistically significant, effect sizes were generally small.

One in three cancer outpatients experience substantial PTSS, with elevated prevalence in certain diagnostic groups. Small effect sizes for socio-demographic predictors underscore that psychological distress is broadly distributed. Findings support universal psychosocial screening and integration of trauma-informed care into oncology services to address a significant, population-level mental health burden.

Claudin 18.2 (CLDN18.2), a tight junction protein largely confined to normal gastric mucosa, is overexpressed and mislocalized on the surface of gastric, gastroesophageal, pancreatic, and other gastrointestinal cancers. This pattern has made CLDN18.2 a leading target in solid tumor immunotherapy. This review traces its path from a structural junctional component to a clinically relevant antigen and assesses the therapeutic platforms built around it. We discuss monoclonal antibodies, especially zolbetuximab, whose phase III SPOTLIGHT and GLOW trials improved survival in CLDN18.2-positive, HER2-negative gastric and gastroesophageal junction adenocarcinoma and led to regulatory approval. We then evaluate antibody-drug conjugates, bispecific T-cell engagers, and CAR T-cell therapies, comparing their mechanisms, efficacy, toxicity, and resistance. We also examine the rationale for combining CLDN18.2-directed agents with immune checkpoint inhibitors, although clinical evidence for synergy remains indirect. Major challenges include antigen loss and heterogeneity, autophagy-mediated ADC resistance, on-target gastrointestinal toxicity, cytokine release syndrome, and unstandardized expression thresholds. Because optimal cutoffs differ by modality, patient selection should follow the intended therapeutic class rather than a universal biomarker score. Overall, CLDN18.2-directed therapy is a maturing precision oncology strategy; its impact will depend on randomized data, better biomarkers, and rational combinations.

Acute promyelocytic leukemia (APL) has evolved from one of the most rapidly fatal neoplasms into the most curable acute myeloid leukemia subtype, following the sequential clinical introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). Despite cure rates now approaching 100% in non-high-risk disease, early death occurring before or shortly after treatment initiation and relapse/refractory APL cases remain the principal obstacles to achieving a definitive cure.

This review summarizes current standard-of-care APL management, including risk stratification, induction, consolidation and maintenance strategies. It then reviews emerging pharmacotherapeutic strategies, including oral arsenic formulations, tamibarotene, anti-CD33 antibody-based and cellular therapies, and other investigational agents. A literature search of PubMed/MEDLINE was performed from the 1950s to 2026 using terms including 'acute promyelocytic leukemia,' 'ATRA,' 'arsenic trioxide,' 'oral arsenic,' 'tamibarotene,' 'gemtuzumab ozogamicin,'and other keywords, prioritizing recent randomized trials, prospective studies and expert consensus guidelines.

Reducing early mortality through faster diagnostic suspicion, extending chemotherapy-free regimens to high-risk disease, and transitioning toward oral, outpatient-based arsenic formulations represent the most promising paths toward a cure. Tailored strategies for rare variant and resistant APL subtypes, including targeted triplet combinations represent a promising treatment for complex APL case, but warrant structured evaluation in prospective clinical trials.

Pediatric primary liver malignancies comprise a heterogeneous group of tumors requiring individualized multidisciplinary management. Hepatoblastoma and hepatocellular carcinoma remain the most common malignant liver tumors in children, whereas rare hepatic neoplasms account for a small but clinically significant proportion of cases. Over the past two decades, advances in tumor biology, standardized radiologic staging, multidisciplinary treatment planning, and liver transplantation have substantially improved outcomes, particularly for children with unresectable hepatoblastoma. Contemporary management has shifted from an anatomy-based approach to individualized treatment strategies that integrate molecular characterization, PRETEXT staging, response to neoadjuvant therapy, and careful assessment of surgical resectability. Liver transplantation is now recognized as a definitive oncologic treatment for carefully selected children with unresectable hepatoblastoma, selected cases of hepatocellular carcinoma, and, in exceptional circumstances, other rare hepatic malignancies. In parallel, improvements in post-transplant oncologic surveillance and immunosuppressive management have expanded opportunities for long-term disease control while emphasizing the need to balance graft preservation with recurrence risk. Emerging technologies, including molecular biomarkers, liquid biopsy, artificial intelligence, and advanced surgical planning, together with international collaborative initiatives, are expected to further refine patient selection and post-transplant management. This review summarizes current evidence on the role of liver transplantation in pediatric liver malignancies and discusses contemporary advances reshaping pediatric transplant oncology.

Platinum compounds preferably create intrastrand G-G adducts to halt replication in cancer cells. When successfully bypassed, resulting somatic variants end up in the genome. Unexpectedly, current double-base substitution signatures associated with platinum lack a GG component, and we hypothesized that deletion was missing from the possible solutions to circumvent a double-base lesion. We investigated a large pan-cancer metastatic cohort and generated platinum specific de novo double-base substitution and deletion (DBSD) signatures. One of the oxaliplatin associated DBSD signatures had GG deletion as dominant characteristic and also included new and known substitutions associated with platinum. Unforeseen among the additional results, DBSD signatures with deletion of TT as singular characteristic were strongly associated with microsatellite instability in multiple cohorts and provisionally in liquid biopsies. This study showed that DBSD signatures increase our understanding and cataloging of the effects caused by platinum and, in general, may aid in the discovery of new biological insights.

Somatic aldosterone-driver mutations are identified in >90% of patients with primary aldosteronism undergoing adrenalectomy, and they display distinct demographic clustering. ATP1A1 and ATP2B3 mutations, encoding the Na⁺/K⁺ ATPase α1 subunit and the Ca²⁺ ATPase 3, respectively, are relatively rare and are often grouped as ATPase mutations. Differences in their clinical and biochemical phenotypes remain understudied.

This international collaboration of 16 centers included patients with primary aldosteronism harboring pathogenic variants in ATP1A1 and ATP2B3. Clinical data were collected from medical records. Where available, we compared histopathologic features and steroid profiles (from peripheral and adrenal vein samples) by liquid chromatography-tandem mass spectrometry.

We included 300 patients (mean age, 57±11 years; 85% men) with aldosterone-producing lesions harboring ATP1A1 (204) and ATP2B3 (96) mutations. Age and sex distributions were similar. ATP2B3 mutations were associated with lower serum potassium, higher lateralization indices, and stronger contralateral suppression. Postoperative biochemical cure was achieved in 96% of patients with ATP2B3 mutations versus 83% of those with ATP1A1 mutations (P=0.02). Multiple CYP11B2-positive lesions were observed in 47% of ATP1A1 versus 27% of ATP2B3 cases (P=0.03). Baseline peripheral steroid profiling was available in 126 patients (84 with ATP1A1 and 42 with ATP2B3) and showed higher aldosterone concentrations in the ATP2B3 group (median [interquartile range], 31 ng/dL [20-43] versus 23 ng/dL [11-38]; P=0.03).

ATPase mutations are most common in middle-aged men with lateralized primary aldosteronism. Compared with ATP1A1, ATP2B3 mutations are associated with a more severe primary aldosteronism phenotype, stronger lateralization, and higher rates of single aldosterone-producing lesions and postoperative biochemical cure.

Patients with pituitary adenoma often experience anxiety due to hormonal changes and the stress associated with transsphenoidal surgery. Digital storytelling, as an innovative multimedia-based training method, has recently been used in patient education. This study investigated the effect of digital storytelling on the anxiety of patients with pituitary adenoma undergoing transsphenoidal surgery.

This randomized controlled trial was conducted on 70 patients with pituitary adenoma scheduled for transsphenoidal surgery at a teaching hospital affiliated with Tehran University of Medical Sciences. Participants were randomly assigned to an intervention or a control group. The intervention group received a 15-20-minute digital storytelling program that included experiences shared by patients and nurses regarding preoperative and postoperative care, while the control group received routine hospital education. Anxiety levels were measured a day before surgery, a day after surgery, and three weeks later using Spielberger's State Anxiety Scale. Data were analyzed by SPSS-25 software using descriptive and inferential statistics.

The mean score of anxiety in the intervention group decreased by 12.45 (1.24) units a day after the surgery and by 24.82 (1.32) units three weeks after the surgery compared to baseline (p < 0.001). A significantly lower anxiety level was observed in the intervention group at both post-intervention time periods compared to the pre-intervention time (F = 17.05, p < 0.001). Repeated measures Analysis of Variance confirmed a significant interaction between time and group (F = 25.31, p < 0.001).

Digital storytelling was effective in reducing anxiety among patients with pituitary adenoma undergoing transsphenoidal surgery and may serve as a valuable educational intervention.