Accurate preoperative assessment of peritoneal dissemination is essential in ovarian cancer because it influences surgical strategy and the achievement of complete gross resection. However, [¹⁸F]FDG-PET may be limited in detecting lesions with low glycolytic activity and in differentiating malignancy from inflammatory changes. This case series evaluated the clinical relevance of [¹⁸F]FAPI-74 PET/CT for preoperative assessment of peritoneal dissemination in ovarian cancer.

Four patients underwent [¹⁸F]FAPI-74 PET/CT as part of preoperative evaluation, with comparison to [¹⁸F]FDG-PET/CT when available. Imaging findings were correlated with intraoperative observations and histopathological results, including immunohistochemical assessment of fibroblast activation protein and α-smooth muscle actin.

FAPI-PET detected peritoneal dissemination not identified by FDG-PET in several cases, including occult metastasis confirmed histologically and additional lesions after neoadjuvant chemotherapy. FAPI-avid lesions showed stromal activation on immunohistochemistry, supporting the biological basis of FAPI uptake. In one case, additional FAPI uptake may have been partly influenced by inflammatory changes associated with bloody ascites.

FAPI-PET may provide complementary information by visualizing stromal components of ovarian cancer and may support preoperative mapping of peritoneal dissemination, although interpretation should consider inflammatory conditions.

Patients with cancer often experience intertwined symptom burden and functional decline that contribute to falls, unsafe transfers, uncontrolled symptoms, caregiver strain, and crisis-driven care. Physical medicine and rehabilitation (PM&R), also known as physiatry, and specialty PC both address suffering and quality of life through complementary clinical approaches; however, collaborative care with and between these two specialties is inconsistent in routine oncology practice. This paper presents a clinical implementation framework informed by targeted literature synthesis for bidirectional referral and co-management between PM&R and PC in oncology. The framework was informed by the PC referral criteria literature, cancer rehabilitation triage literature, trigger-based serious illness identification models, and implementation science. Four clinic-usable tools are proposed, including a scope and overlap map, a clinical-needs gradient, a referral trigger table linking common clinical signals to the reason for referral and expected clinical actions, and a primary-service triage workflow. This framework is intended to clarify which service is best positioned to be the primary supportive service according to the patient's current needs, when rehabilitation therapy alone may be sufficient, and when co-management should be the default. This concept-to-practice model is designed to facilitate early, needs-based referrals and coordinated supportive care in oncology settings.

Patients with BRAF^V600E-mutated metastatic lung cancer benefit from both BRAF plus MEK inhibitors and immune checkpoint inhibitor (ICI)-chemotherapy. This study evaluated the cost-effectiveness of first-line ICI-chemotherapy compared with BRAF plus MEK inhibitors in these patients. This economic analysis, with a 15-year time horizon and an annual 3% discount, was conducted from the perspective of the healthcare sectors in Taiwan and the US. Simulated patients were entered into partitioned survival models upon initiation of first-line therapies. The model inputs were derived from the FRONT-BRAF study (progression-free/overall survival, adverse events, and subsequent therapies), insurance payments or retail prices (costs of drugs, physician visits, monitoring, adverse events, and end-of-life care), and a hospital cohort (health utility). Deterministic and probabilistic analyses were performed. The incremental cost-effectiveness ratios (ICERs) of ICI-chemotherapy compared with BRAF plus MEK inhibitors (Taiwan: $73,561/QALY; US: $290,279/QALY) exceeded the willingness-to-pay (WTP) thresholds (Taiwan: $70,000/QALY; US: $150,000/QALY). The drug costs of subsequent therapies and the utility values of the progressive-disease state were the major determinants of ICERs. In Taiwan, ICI-chemotherapy had a 41.0% probability of being cost-effective at the WTP threshold. ICI-chemotherapy had a higher probability of being cost-effective than BRAF plus MEK inhibitors when the WTP exceeded $300,000/QALY in the US. Our analysis suggests that, despite the longer survival of first-line ICI-chemotherapy compared with BRAF plus MEK inhibitors, ICI-chemotherapy is not a cost-effective strategy for patients with BRAF^V600E-mutated metastatic lung cancer.

Membranous nephropathy (MN) and minimal change disease (MCD) are the most common causes of nephrotic syndrome following hematopoietic stem cell transplantation (HSCT), a complication conventionally attributed to chronic graft-versus-host disease (GVHD). Paraneoplastic MCD is well described in lymphoid malignancies but is rarely reported in myeloid neoplasms. We report two cases of biopsy-confirmed MCD presenting as the initial manifestation of acute myeloid leukemia (AML) relapse following allogeneic HSCT. Both patients were White men in their sixties with relapsed/refractory AML who developed nephrotic-range proteinuria and acute kidney injury after matched unrelated donor HSCT without histologic evidence of GVHD. Renal biopsies confirmed MCD in both cases. Corticosteroid therapy was ineffective in halting renal deterioration; renal function improved only after initiation of leukemia-directed therapy, with one patient achieving dialysis independence. These cases highlight a rare paraneoplastic presentation of AML relapse. Nephrotic syndrome due to MCD may signal post-HSCT leukemia recurrence, and evaluation for AML relapse warrants consideration in steroid-refractory cases or those without concurrent GVHD. In such cases, control of the underlying malignancy, rather than escalation of immunosuppression, may be central to renal recovery.

Renal cell carcinoma (RCC) is a biologically heterogeneous malignancy characterized by variable clinical behavior and diverse molecular phenotypes. Although immune checkpoint inhibitors and targeted therapies have transformed the treatment landscape of advanced RCC, clinically validated biomarkers capable of improving risk stratification, therapeutic-decision making and disease monitoring remain lacking. Kidney injury molecule-1 (KIM-1), also known as hepatitis A virus cellular receptor-1 (HAVCR1) or T-cell immunoglobulin and mucin domain-containing protein-1 (TIM-1), has emerged as a biologically compelling investigational biomarker e because of its close relationship to proximal tubular epithelial injury and renal carcinogenesis. KIM-1 is a transmembrane glycoprotein minimally expressed in normal kidney tissue but markedly upregulated in dedifferentiated proximal tubular epithelial cells following injury, and in clear cell RCC, where its extracellular domain can be shed into plasma and urine. Beyond its role as a marker of tubular injury, KIM-1 participates in immune regulation, phagocytosis, inflammatory signaling and tissue remodeling, supporting its potential relevance to tumor biology. Clinical studies have demonstrated associations between elevated circulating KIM-1 levels and RCC diagnosis, recurrence risk, and survival outcomes, particularly in localized and postoperative disease settings. KIM-1 has additionally been investigated as a therapeutic target through antibody-drug conjugate approaches. Despite promising translational data, important limitations yet remain. Current evidence is predominantly prognostic rather than predictive, and substantial analytical and biological challenges continue to limit implementation. Assay standardization, clinically meaningful cutoffs, specimen selection, timing of sampling, and confounding by chronic kidney disease or nonmalignant renal injury remain incompletely resolved. Furthermore, evidence supporting incremental value beyond established clinicopathologic models remains limited. This review critically evaluates the biological rationale, analytical considerations and clinical evidence supporting KIM-1 in RCC. Particular emphasis is placed on distinguishing prognostic, predictive, pharmacodynamic, and therapeutic applications, as well as defining the evidentiary gaps that must be addressed before clinical implementation. Current evidence is derived predominantly from retrospective and exploratory analyses, and important limitations remain regarding assay standardization, biological specificity, chronic kidney disease-related confounding, and prospective validation. The review concludes with a summary of the evolving landscape of KIM-1-directed biomarker strategies in RCC, which may ultimately contribute to improved biologic risk stratification and biomarker-driven clinical investigation in RCC.

Aim: Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm with few reported mandibular cases. This review aims to describe the clinical characteristics, surgical management and outcomes of 13 mandibular IMT cases, and to introduce the Jaw in a Day (JIAD) approach as a novel surgical option. Methods: PubMed, Web of Science and Embase were searched systematically. From an initial pool of 261 articles, 13 studies met the inclusion criteria and were reviewed. Results: Thirteen mandibular IMT cases were identified in the literature. A new case is also presented: a 15-year-old female treated with surgical excision using the JIAD approach. At 12-month follow-up, oral function was restored with no disease recurrence. Discussion: Mandibular IMT is exceedingly rare. The JIAD approach offers immediate reconstruction with satisfactory functional outcomes, as supported by both the current case and the reviewed literature. Conclusions: The JIAD surgical approach may represent an effective management strategy for mandibular IMT. Further cases are needed to validate this approach and establish standardized treatment protocols.

Hepatocellular carcinoma (HCC) imposes a substantial health burden in China. Finotonlimab plus bevacizumab recently prolonged progression-free survival (PFS) and overall survival (OS) vs. sorafenib, but its economic value remains unknown. Here we evaluated the cost-effectiveness of finotonlimab plus bevacizumab vs. sorafenib from the Chinese healthcare system perspective. Parametric survival models were fitted to extrapolate PFS and OS. Total costs, life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), incremental net monetary benefit (INMB), and incremental net health benefit (INHB) were estimated at a willingness-to-pay (WTP) threshold of $27,906 per QALY. Uncertainty was evaluated by one-way and two-way sensitivity analyses, probabilistic sensitivity analysis (PSA), subgroup analyses, scenario analyses, and price simulations. In the base-case analysis, sorafenib yielded 1.74 LYs and 1.25 QALYs at a total cost of $10,303.10, whereas finotonlimab plus bevacizumab yielded 3.01 LYs and 2.18 QALYs at a total cost of $58,595.49. Compared with sorafenib, the combination increased costs by $48,292.39 and generated gains of 1.27 LYs and 0.93 QALYs, resulting in ICERs of $38,203.46 per LY and $51,899.31 per QALY. INMB (-$22,325.82) and INHB (-0.80 QALYs) were negative. Sensitivity analyses identified PFS utility and bevacizumab cost as key drivers, but all ICERs remained above the WTP threshold. In PSA, the mean ICER was $50561.81 per QALY, and the probability of cost-effectiveness was 0% at the prespecified threshold. Based on the assumptions and inputs used in the present model, finotonlimab plus bevacizumab was unlikely to be cost-effective compared with sorafenib at the prespecified WTP in China.

The therapeutic management of intermediate-risk differentiated thyroid carcinoma (DTC) remains a clinical conundrum, often caught between the Scylla of over-treatment and the Charybdis of disease persistence. While conventional risk stratification models predominantly emphasize histopathological and tumour-specific characteristics, the study by Piticchio et al. offers a salient contribution by shifting the focus towards the host's systemic immune landscape. By identifying the pre-radioiodine, RAI, Monocyte-to-Lymphocyte Ratio (MLR) as a robust, independent predictor of early recurrence, the authors provide a potentially transformative biomarker that enhances prognostic granularity beyond traditional staging. However, the interpretation of these haematological indices necessitates a nuanced understanding of the physiological milieu at the time of sampling. Specifically, the influence of profound iatrogenic hypothyroidism, induced by levothyroxine withdrawal, poses a significant confounding variable that may modulate circulating leucocyte dynamics independently of tumour biology. Furthermore, while the lack of prognostic utility for nutritional indices like the PNI and NRI underscores the preserved metabolic status of this cohort, it also invites a reassessment of whether more sensitive markers of body composition are required. This abstract evaluates the clinical implications of utilizing inflammatory ratios to refine postoperative surveillance and argues for the integration of host-immune interfaces into future oncological frameworks. Ultimately, while the MLR demonstrates significant potential for personalizing follow-up, prospective validation across diverse ethnic cohorts and under varying thyroid-stimulating hormone stimulation protocols is essential to establish its universal clinical utility.

Pseudomyxoma peritonei (PMP) is characterized by progressive mucus accumulation, extensive stromal fibrosis, rare extraperitoneal metastasis, limited therapeutic options, and frequent recurrence. However, the microenvironmental ecosystem of PMP, particularly in metastatic lesions, remains poorly understood. Here, we integrated single-cell RNA sequencing, whole-exome sequencing, bulk RNA sequencing, and histopathologic validation to construct a high-resolution atlas of primary and paired metastatic tumors. Epithelial cells showed distinct functional states, including a TFF3⁺ mucus secretion-associated state and a MACC1⁺ malignant-associated state. Metastatic lesions showed coordinated microenvironmental reprogramming, including POSTN⁺ fibrosis-associated fibroblasts, CXCL5⁺ macrophages linked to local immunosuppressive signaling, and immune exclusion associated with a collagen-rich stromal barrier. We also observed extensive lipid metabolic activity and identified a candidate pro-angiogenic network involving POSTN⁺ fibroblasts, RSPO3⁺ pericytes, and endothelial cells, potentially mediated by VEGFA-VEGFR2 signaling. Retrospective observations from three recurrent PMP cases further suggested the potential therapeutic value of VEGFR2-targeted anti-angiogenic therapy. Overall, this study provides a comprehensive single-cell transcriptomic atlas of PMP and a resource for developing novel and combination therapeutic strategies.

Bronchiolar adenoma (BA) is a generally benign peripheral lung neoplasm with a bilayered structure of basal and luminal cells. Recently, an increasing number of bronchiolar adenoma-like tumor with squamous epithelial metaplasia (BATSM) have been reported, raising the question of whether they represent variant subtypes of BA or potentially novel tumor entities. Pulmonary metastasis of ameloblastoma (MA) shares morphological similarities with BATSM, exhibiting TTF-1/Napsin A-positive luminal cells and P40/P63-positive basal cells; this overlap can lead to misdiagnosis of MA as BATSM. We collected 5 MA and 10 BATSM cases, analyzing their morphology, immunohistochemistry, elastic fiber staining and molecular pathology. MA presents as well-circumscribed bronchiole-unrelated nodules with alveolar destruction, intraluminal serous secretions, and Calretinin-positive stellate reticulum-like cells. BATSM is bronchiole-associated, preserves alveolar architecture, and is Calretinin-negative with weak basal TTF-1 positivity. 80% of MA cases harbored BRAF V600E mutations; 30% of BATSM cases exhibited EGFR exon 20 insertions. This study highlights the need for integrating clinical history, morphology, immunohistochemistry and molecular testing to avoid misdiagnosing MA as BATSM.