Whether the time-of-day administration (ToDA) of programmed cell death 1 (PD-1) inhibitor infusion influences survival in advanced gastric cancer (AGC) remains unclear. This research aimed to evaluate the impact of ToDA on the prognosis of AGC patients.

This multicenter retrospective study enrolled 416 AGC patients receiving PD-1 inhibitor therapy, who were divided into early and late ToDA groups based on sensitivity analyses using 30-minute intervals of the administration time window. After 1:2 propensity score matching (PSM), progression-free survival (PFS) and overall survival (OS) were compared between groups, and subgroup analyses were conducted. Subsequently, prognostic risk score models were established based on independent prognostic factors.

A cutoff time of 15:00 was established via sensitivity analyses in the overall cohort. Patients were categorized into early and late ToDA groups. After PSM, multivariable Cox analyses identified late ToDA as an independent risk factor for both PFS (P < 0.001) and OS (P = 0.004). Kaplan-Meier curves demonstrated significantly better PFS (P = 0.003) and OS (P = 0.003) for the early ToDA group. In the overall cohort, prognostic risk score models incorporating ToDA, metastasis sites, treatment lines, neutrophil-to-lymphocyte ratio (NLR), human epidermal growth factor receptor 2 (HER-2) status and programmed cell death ligand 1 (PD-L1) status effectively stratified patients into low-, middle-, and high-risk groups with distinct survival (P < 0.001). The detrimental effect was observed across most major subgroups, though several subgroup analyses were not statistically significant.

This research provides real-world evidence that early ToDA of PD-1 inhibitors is associated with improved prognosis in AGC patients, providing a rationale for chronotherapy optimization and introducing a preliminary risk stratification model for AGC immunotherapy. The risk scoring model requires prospective validation.

We investigated the association between prefecture-level colorectal cancer (CRC) mortality and contributing factors, including the regional availability of Board-Certified Fellows of the Japan Gastroenterological Endoscopy Society (BCFJGES), using publicly available data from all 47 Japanese prefectures.

This prefecture-level ecological cross-sectional study used publicly available national data from e-Stat, Cancer Statistics by the Japan National Cancer Center, and JGES records. The dependent variable was the CRC-specific age-standardized mortality rate (AMR) among individuals aged < 75 years in 2021. Independent variables (2010-2016) included CRC screening and follow-up rates, smoking, alcohol consumption, obesity, physical activity, diabetes prevalence, red meat consumption, mean income, gastroenterologist and BCFJGES density per 10 000 population, CRC stage distribution, and regional classification. Simple linear regression showed that smoking, alcohol consumption, and obesity were significantly associated with higher CRC AMR, whereas physical activity, income, and BCFJGES density were associated with lower AMR. Multiple linear regression confirmed independent associations for smoking (regression coefficient [b] = 0.213, p = 0.011), alcohol consumption (b = 0.045, p = 0.003), physical activity (b = -0.087, p = 0.024), and BCFJGES density (b = -1.339, p < 0.001). The Pearson correlation coefficient between AMR and BCFJGES density was -0.482 (p < 0.001).

Higher prefecture-level smoking and alcohol consumption were associated with higher CRC mortality, while higher physical activity and higher BCFJGES density were associated with lower mortality. Regional disparities in BCFJGES distribution across Japan may contribute to CRC mortality and warrant continued surveillance and policy attention.

Secretory carcinoma (SC) is a rare, low-grade malignant neoplasm of the salivary glands, most commonly arising in the parotid gland. Involvement of the minor salivary glands of the buccal mucosa is exceedingly rare, with only a handful of cases reported in the literature. A 30-year-old female presented with a one-year history of a swelling over the left cheek. On clinical examination, a 2 × 2 cm, lobulated, cystic swelling was identified in the left buccal mucosa. Fine-needle aspiration of the swelling showed predominantly eosinophilic material with occasional scattered cells. The lesion was surgically excised and submitted for histopathological examination. Gross examination revealed a gray-brown, soft-tissue mass measuring 2.5 × 2 × 1 cm. On serial sectioning, a well-circumscribed cystic, gray-white lesion measuring 1 cm in diameter was identified. Histopathological examination of the lesion showed features consistent with SC. The tumor cells were positive for GATA3, mammaglobin, S100, and CK7. The postoperative positron emission tomography-computed tomography revealed no tumor deposit, and the patient remained free of local recurrence during the six-month follow-up period.

Angiosarcomas are rare and aggressive malignant neoplasms of vascular or lymphatic endothelial origin, accounting for approximately 2% of soft-tissue sarcomas. They occur predominantly in the skin and superficial soft tissues, particularly in the head and neck region and the breast, whereas gastrointestinal involvement is exceptionally rare. Previous radiotherapy is a well-established risk factor for secondary angiosarcoma. However, radiation-associated gastrointestinal angiosarcomas are extremely uncommon and have been reported predominantly in the small bowel. We report the case of a 55-year-old woman who presented with abdominal pain, hemorrhagic ascites, intermittent rectal bleeding, severe anemia, anorexia, and weight loss 16 years after pelvic radiotherapy and cisplatin-based chemotherapy for cervical squamous cell carcinoma. Computed tomography revealed circumferential thickening of the cecum and right colon with abundant hyperdense ascites. Colonoscopy showed an obstructing, ulcerated, and contact-bleeding mass involving the cecum and right colon. Histopathological examination of endoscopic biopsies revealed a poorly differentiated malignant vascular neoplasm. Immunohistochemical staining was positive for cluster of differentiation (CD)31 and CD34 and negative for cytokeratin, CD3, CD20, and Human Herpesvirus (HHV)8, with a Ki-67 proliferation index of 40%, supporting the diagnosis of colonic angiosarcoma. Surgical resection was considered; however, the patient developed a massive bilateral pulmonary embolism and died seven days after admission. Given the prolonged latency and the histological distinction from the primary cervical carcinoma, a possible radiation-associated etiology was considered. Nevertheless, the original radiotherapy plan was unavailable, preventing definitive confirmation that the tumor arose within the irradiated field. This case highlights the diagnostic difficulty, aggressive clinical course, and poor prognosis of colonic angiosarcoma following pelvic radiotherapy.

Cervical cancer is one of the most common cancers in women, particularly among women living with HIV. High-risk human papillomavirus (Hr-HPV) is the main causative agent of this cancer, but the prevalence of Hr-HPV infection among women living with HIV in Kinshasa remains poorly documented. The objective of this study was to determine this prevalence and identify associated risk factors.

A cross-sectional study was conducted among women living with HIV aged 25-65 years receiving antiretroviral therapy at the DREAM Center in Kinshasa. Participants were consecutively recruited among eligible women attending the center during the study period. Cervical samples were collected using the Abbott Cervi-Collect kit and analyzed for Hr-HPV genotyping using the Abbott RealTime HPV assay on the m2000 platform, a real-time PCR method detecting HPV-16, HPV-18, and a pooled group of 12 additional high-risk HPV types with an internal β-globin control for sample quality assurance. Sociodemographic and clinical data were collected using structured questionnaires.

A total of 436 women were included in the analysis. The prevalence of Hr-HPV infection was 47.7%. Of these, 23.79 % were infected with oncogenic HPV-16 and-18 types (alone or in co-infection with other types). In a logistic regression analysis, WHO clinical stage 3 and 4, duration of antiretroviral therapy for less than 2 years, and HIV viral load greater than or equal to 1,000 copies/ml showed statistically significant associations with Hr-HPV infection, with adjusted ORs of 1.75 (1.16-2.64; p = 0.008), 1.91 (1.07-3.41; p = 0.028), and 3.13 (1.30-7.54; p = 0.011), respectively.

This study reveals a high prevalence of Hr-HPV infection among women living with HIV in Kinshasa. Non-16/18 HPV types were predominant, while HPV-16 and HPV-18 were detected in approximately one in four Hr-HPV-positive women. Advanced HIV disease (WHO clinical stages 3 and 4), unsuppressed HIV viral load, and shorter duration of antiretroviral therapy were independently associated with Hr-HPV infection. These findings underscore the potential value of broader HPV vaccine coverage, including higher-valent vaccines, alongside strengthened cervical cancer screening as part of comprehensive cervical cancer prevention strategies.

To systematically evaluate the efficacy and safety of thymosin α1 combined with chemotherapy in the treatment of gastric cancer.

A systematic search of 8 electronic databases was conducted to identify relevant RCTs. Meta-analysis was performed using Stata 18.0. Meta-regression, subgroup analyses, sensitivity analyses, and publication bias analyses were conducted to further examine results, and reliability of findings was assessed using TSA and GRADE.

20 RCTs involving 1,704 patients were included. Meta-analysis results showed that, thymosin α1 combined with chemotherapy was associated with higher ORR (RR = 1.39), DCR (RR = 1.16), and KPS scores (WMD = 8.27). Regarding immune function, combination therapy resulted in higher CD3⁺% (WMD = 7.73), CD4⁺% (WMD = 6.87), CD4⁺/CD8⁺ (WMD = 0.42), and NK cell (WMD = 4.73). Regarding tumor markers, combination therapy resulted in lower levels of CEA (WMD = -5.48) and CA199 (WMD = -9.06). Regarding inflammatory factors, combination therapy may reduce levels of MMP-2, MMP-9, IL-4, and IL-10, while increasing levels of IFN-γ and TNF-α. Regarding safety, combination therapy was associated with reductions in gastrointestinal reactions (RR = 0.63), myelosuppression (RR = 0.60), abnormal liver function (RR = 0.54), and neurotoxicity (RR = 0.47). However, included RCTs did not systematically report long-term survival outcomes, and their methodological quality was limited; and GRADE indicated that quality of evidence for outcomes ranged from very low to moderate.

The combination of thymosin α1 with chemotherapy is associated with improved short-term efficacy, enhanced immune function, improved quality of life, and a reduced incidence of adverse reactions in patients with gastric cancer, indicating good potential for clinical application. However, it remains unclear whether this approach can provide long-term benefits for patients with gastric cancer. Furthermore, given that studies included were all small-sample studies conducted in China and were of limited quality, certainty of evidence is low; these conclusions require further validation through additional high-quality studies.

https://www.crd.york.ac.uk/PROSPERO/, Identifier CRD420261282679.

Cervical cancer is the first cancer that can be eliminated, yet it remains a leading cause of cancer-related mortality among women in low- and middle-income countries. India accounts for a substantial share of the global burden, making its trajectory central to global elimination efforts. Although effective tools-including HPV vaccination, HPV-based screening, and treatment of precancerous lesions-are well established, progress has been uneven. The central challenge is no longer scientific discovery but large-scale implementation, building on India's demonstrated capacity for nationwide public health delivery through polio eradication, HIV/AIDS control, and COVID-19 vaccination.

We conducted a conference-informed policy and implementation synthesis drawing on expert presentations from the International Papillomavirus Society (IPVS) 2025 "The World Could End Cervical Cancer If it Tried: spotlight on India" session, complemented by peer-reviewed literature and policy documents. A rapid thematic synthesis approach was used to identify and organize implementation priorities across the prevention and care continuum.

Five interrelated priorities emerged. First, demand generation must move beyond awareness to trust-driven uptake through credible messengers and clear service pathways. Second, strengthening provider capacity is essential to improve vaccine confidence and recommendation practices across the clinical workforce. Third, screening programmes must be redesigned around completion of the care cascade rather than participation alone, with integrated pathways for triage and treatment. Fourth, community engagement should be embedded within service delivery and navigation systems to translate trust into sustained participation and follow-through. Fifth, governance, financing, and digital infrastructure-including national registries and interoperable data systems-are critical to enable coordinated, accountable scale-up. Across all domains, trust functions as a central cross-cutting mechanism linking awareness to uptake and continuity of care.

Cervical cancer elimination in India is achievable but requires a shift from fragmented initiatives to coordinated national implementation. Bridging the gap between evidence and delivery will depend on aligning communication, workforce capacity, service integration, community engagement, and system-level governance with urgency and accountability. India's success will not only determine national outcomes but will be pivotal to achieving global cervical cancer elimination within this generation.

Central lymph node metastasis in clinically node-negative papillary thyroid carcinoma is regulated by the tumor immune microenvironment, yet existing studies have addressed molecular, systemic immune, and local imaging signals in isolation without examining their cross-scale associations.

A retrospective cohort of 1,000 cN0 PTC patients was enrolled. BRAF V600E mutation status, six peripheral blood immune-inflammatory indices, and an ultrasound radiomics deep learning score were integrated into four progressive LightGBM models. Cross-scale Spearman correlations, BRAF-stratified Fisher z-transformation tests, and TCGA-THCA immune deconvolution analysis were performed.

The three-scale integrated model achieved a validation AUC of 0.824, with all DeLong incremental comparisons reaching statistical significance. The DLR-score was significantly correlated with all six immune-inflammatory indices after Bonferroni correction. BRAF-positive subgroup exhibited significantly stronger imaging-immune coupling for NLR and SII, and this enhanced coupling persisted after adjustment for age, tumor size, multifocality, and Hashimoto's thyroiditis in partial correlation analyses. TCGA tissue immune infiltration patterns were directionally consistent with peripheral observations. Calibration assessment confirmed probability accuracy across the predicted range, and decision curve analysis demonstrated sustained net benefit superiority of the integrated model over single-scale alternatives within the clinically relevant 10% to 50% threshold interval.

Three-scale noninvasive immune signals provide complementary CLNM prediction and exhibit directionally consistent cross-scale statistical associations at the correlation level, suggesting that they may serve as noninvasive surrogates reflecting partially overlapping aspects of the same tumor immune dysregulation process, although confirmation of the underlying biological mechanisms requires prospective studies incorporating direct tissue-level immune profiling.

The Mediterranean Diet (MedDiet) has been linked to lower breast cancer incidence through anti-inflammatory and antioxidant effects. This study evaluated adherence to the MedDiet among women undergoing mammographic screening provided by mobile units in Italy and explored its association with breast cancer risk factors.

A cross-sectional study was carried out between January and December 2023 as part of the mobile "Prevention Caravan programme." Eligible participants included women aged 18 years or older who underwent breast ultrasound or mammography and completed the 14-item "Mediterranean Diet Adherence Screener (MEDAS)." Descriptive analyses and differences across groups defined by known breast cancer risk factors, stratified by MedDiet adherence levels, were performed, and a multivariable logistic regression analysis was conducted to further explore these patterns.

A total of 7,492 women were included, most of whom were ≤45 years of age (69%) and from Central Italy (59%). The mean MEDAS score was 7.0 (SD 1.6), with 62% categorized as having low adherence to the MedDiet. Only 1.21% of participants achieved an excellent level of adherence to the MedDiet. MEDAS score increased with increasing age (p = 0.036), women aged 46-74 years and postmenopausal women were also overrepresented among those with excellent adherence (37 and 27% of the excellent-adherence group, respectively; p = 0.022 and p < 0.001). A significant association emerged with family history of breast conditions (p < 0.001), particularly benign lesions, which was associated with lower adherence. These findings were broadly supported by the multivariable analysis.

Mobile programmes like the "Prevention Caravan programme" may help promote healthy lifestyles and improve access to prevention services. Future studies should confirm these results in larger, more diverse populations and explore associations with lesion type and severity.

Tertiary lymphoid structures (TLS) are ectopic immune aggregates that form in response to chronic inflammation, and their presence across many solid tumors has been associated with improved survival and enhanced responses to immunotherapy. Although current models primarily characterize TLS through the lens of immune aggregation and organization, their formation also depends on reciprocal interactions with the non-immune tumor microenvironment. Fibroblasts, vasculature, extracellular matrix architecture, and tumor metabolism collectively influence TLS development, suggesting that these structures function as emergent tissue ecosystems rather than as immune aggregates alone. In this review, we summarize current evidence on how cancer-associated fibroblasts and the tumor vasculature regulate immune cell recruitment and organization through context-dependent expression of chemokines, adhesion molecules, structural barriers, and vascular niches, before considering how extracellular matrix remodeling and tumor metabolism further shape TLS neogenesis and maturation. Across these processes, non-immune components exhibit dual functions, promoting TLS formation in some contexts while reinforcing immune exclusion and antagonizing TLS in others. We further discuss current spatial technologies that enable in-depth quantification of TLS structure and maturity and clarify the contribution of non-immune components to TLS biology. Due to this increased appreciation of their biological relevance, we discuss the promise of non-immune components as rational targets for combination strategies to enhance TLS function and immunotherapy efficacy.