The prognostic significance of next-generation sequencing (NGS) findings during the hormone-sensitive phase of prostate cancer remains incompletely characterized. This retrospective cohort study included 92 patients who underwent NGS analysis on tumor tissue between 2019 and 2025. The primary endpoint was time to castration-resistant prostate cancer (CRPC) from androgen deprivation therapy (ADT) initiation; secondary endpoints were overall survival from ADT initiation (OS-ADT) and from diagnosis. Kaplan-Meier and Cox regression analyses were performed. CRPC developed in 66 patients (71.7%) at a median of 21.1 months. The most frequently altered genes were ATR (35.9%), PTEN (28.3%), TP53 (26.1%), and BRCA2 (15.2%). KMT2C alteration (5.4%) was the strongest independent genomic predictor of shorter time to CRPC (HR = 6.804, p = 0.003) and OS-ADT (HR = 4.730, p = 0.019). TP53 alteration independently predicted shorter OS-ADT (HR = 1.810, p = 0.038). High genomic burden independently predicted shorter time to CRPC (HR = 1.917, p = 0.032). Homologous recombination repair deficiency was not associated with outcomes, attributable to high ATR alteration frequency introducing pathway heterogeneity. Mismatch repair deficiency showed a borderline association with shorter OS-ADT (20.7 vs. 44.0 months; p = 0.060). An exploratory composite risk score stratified patients into three prognostic groups with markedly different outcomes (HR = 7.904, p = 0.001). NGS analysis during the hormone-sensitive phase identifies independent predictors of castration resistance, supporting its integration at ADT initiation for risk stratification and biomarker-guided treatment planning.

Immune fitness (IF) reflects the body's ability to mount appropriate immune responses. Monitoring IF could improve tailored treatment in oncological rehabilitation. The Immune Status Questionnaire (ISQ) and the Single-Item Scale (SIS) were developed to assess IF, but their clinimetric properties in cancer rehabilitation remain unknown.

To evaluate the construct validity, responsiveness, and correlation between the ISQ and the SIS in oncological rehabilitation.

The study population included people participating in oncological rehabilitation during or within one year after medical treatment. Data were collected prospectively via questionnaires. Construct validity and responsiveness were assessed through predefined hypotheses, including correlations with fatigue, sleep problems, malnutrition risk, activity impairment, and physical functioning.

In total, 97 individuals were included in the analyses. Median ISQ and SIS scores were 8/10 and 7/10, respectively. Correlations ranged from r = -0.21 to r = -0.50. Only the SIS correlations with fatigue and physical functioning, and the ISQ correlation with fatigue, met the predefined thresholds. Responsiveness hypotheses were not confirmed.

The ISQ and the SIS demonstrated low construct validity and responsiveness in this population. IF scores were higher than expected. Correlations showed links between fatigue, physical functioning, and IF. Future research should develop tools tailored to the complex immune disturbances experienced by cancer survivors.

Cutaneous squamous cell carcinomas (cSCC) of the head and neck district are among the most common non melanocytic malignant skin carcinomas. The proposal to differentiate, within the N stage, parotid metastases from lateral cervical metastases, originates from the different prognostic value of the metastatic region involved.

We retrospectively evaluated 61 patients, surgically treated for parotid metastases from cSCC between January 2002 and June 2023, in four Departments of Surgery, to assess the geographic distribution of parotid metastases and to describe their recurrence patterns, to evaluate the prognostic value of the number of affected lateral cervical lymph nodes (LN) and the number of positive intra-glandular lymph nodes (IGLN) and to identify the main prognostic histopathological factors.

Our results did not show significant differences between participating centers in the distribution of parotid metastases, nor in their recurrence rates. However, our results highlight how adjuvant radiotherapy is deeply associated with the Overall Survival (OS), improving survival rates in patients with advanced-stage neoplasms (Odds Ratio 5.0), although causality cannot be inferred because of the retrospective study design. Moreover, a statistically significant correlation was found between the major inflammatory biomarkers and the OS. The presence of IGLN was identified as one of the main factors associated with recurrence and poor prognosis in patients with cSCC and in particular, in patients with N3b nodal stage.

our findings suggest that both LN and IGLN could be used to propose an additional staging stratification for the N parameter, thereby guiding the treatment strategy and postoperative follow-up for patients with parotid metastases from cSCC of the head and neck district.

Genomic testing is a key component of precision oncology; however, Black patients receive genomic testing at lower rates. The purpose of this qualitative study was to identify individual and health system drivers of genomic testing disparities at a National Cancer Institute-designated comprehensive cancer center. We conducted interviews with 15 oncology providers and 11 Black cancer patients between September 2023 and October 2024. These patients were eligible for genomic testing based on National Comprehensive Cancer Network (NCCN) guidelines, being diagnosed within last 10 years (2014-2023), at least 18 years old, and English-speaking. Providers included oncologists and oncology patient navigators. Topics included motivators, barriers, and knowledge of genomic testing and factors influencing decision-making. The Penchansky and Thomas theoretical framework of healthcare access (e.g., availability, accessibility, accommodation, affordability, and acceptability) guided thematic analysis. Among patients eligible for genomic testing, most participants (n = 7) received genomic testing as part of their cancer treatment based on EMRs, however many patients (n = 7) could not recall discussing genomic testing with their oncologist. Most patients and all providers highlighted affordability as a challenge: patients were concerned about unexpected costs associated with testing, while providers were concerned about costs of matched molecular targeted therapy. Both patients and providers highlighted patient-centered communication to mitigate mistrust and promote patient engagement in care. Despite limited awareness, Black patients view genomic testing positively. Addressing multiple dimensions of access is key to improving system-level processes and ensuring that more patients benefit from lifesaving targeted therapy.

Background: Adolescents and young adults (AYAs; aged 15-39) diagnosed with cancer face distinct challenges that are poorly addressed within traditional cancer care models. This qualitative study explored AYAs' unmet supportive cancer care needs in Eastern Ontario (Canada) to inform the development of a tailored multidisciplinary program. Methods: As part of a larger mixed-methods study, AYAs receiving/post-cancer treatment in the Champlain region of Eastern Ontario were purposively recruited to complete a survey and a semi-structured interview. Demographic and interview data were analyzed descriptively and via thematic analysis, respectively. Results: Sixteen AYAs (M_age = 32.2 years [range: 19-42]; 56.3% female) were interviewed virtually using a co-designed, semi-structured guide between October 2024 and February 2025. Analysis revealed five themes (i.e., major care gaps) and 12 sub-themes, including: (1) lack of standardized fertility counselling, (2) neglected psycho-emotional impact, (3) limited sexual health education and support, (4) difficulty navigating the healthcare system, and (5) financial toxicity and the cost of being sick young. Conclusions: AYAs in Eastern Ontario face persistent gaps in supportive cancer care that undermine their quality of life. Our findings underscore the need for targeted system-level improvements and offer a foundation for co-designing an evidence-based regional AYA care model that better addresses the holistic needs of this growing population.

Laparoscopically harvested pedicled omental flap (LHPOF) reconstruction is a minimally invasive autologous option for immediate breast reconstruction, but prior reviews have largely examined omental flaps broadly, combining open and laparoscopic harvests, free and pedicled transfers, and mixed reconstructive indications. This systematic review evaluated operative characteristics, peri-operative complications, and esthetic outcomes following LHPOF after oncologic breast surgery. MEDLINE, Cochrane and Embase were searched without language or date restrictions, with backward citation searching of included studies. Eligible studies included female patients undergoing immediate unilateral breast reconstruction with LHPOF after mastectomy or BCS. Twenty-two studies published between 2001 and 2025 were included, representing 1869 patients. Operative techniques were broadly consistent, most commonly involving transverse-colon-first omental harvest, preservation of the right gastroepiploic vessels, and tunnelling from the inframammary fold toward the xiphoid. Reported complications included omental fat necrosis, partial flap loss, hematoma, infection, epigastric bulging, and incisional or tunnel-site hernia. Esthetic outcomes were generally favourable but assessed using heterogeneous methods. Current evidence suggests this technique is feasible in selected patients and may offer favourable esthetic outcomes with limited donor-site morbidity. However, prospective comparative studies with standardized reporting are needed to define optimal patient selection, long-term safety, and esthetic durability.

Clinical outcomes remain heterogeneous among patients with unresectable stage III non-small cell lung cancer treated with definitive chemoradiotherapy. We evaluated the prognostic value of the systemic immune-inflammation index (SII) and explored survival outcomes according to the concurrent chemotherapy backbone in this setting. This retrospective study included 101 patients treated with definitive chemoradiotherapy before consolidation durvalumab became standard practice. Baseline SII was calculated using routine blood counts. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method and Cox proportional hazards models. With a median follow-up of 40.6 months, patients with low SII had significantly longer OS (26.1 vs. 10.9 months, p = 0.004) and PFS (15.6 vs. 7.2 months, p = 0.018) than those with high SII. Elevated SII remained independently associated with inferior OS in multivariable analysis (HR 1.99, 95% CI 1.21-3.27, p = 0.007). Although survival was numerically longer with cisplatin/etoposide than with carboplatin/paclitaxel, the difference was not statistically significant. Subgroup analysis according to SII level and chemotherapy regimen showed the poorest outcomes among patients with high SII receiving carboplatin/paclitaxel. These findings support the prognostic value of SII and suggest a potential role for risk stratification in patients with unresectable stage III NSCLC undergoing definitive chemoradiotherapy in the pre-durvalumab era.

Biliary tract cancers (BTCs), including cholangiocarcinoma and gallbladder cancers, are characterized by their rarity, poor prognosis, limited treatment options, and significant psychosocial burden among affected individuals. Hope and loneliness are known to play significant roles in shaping cancer-related experiences and outcomes; however, their trajectories in the context of rare cancers remain unexplored. The Canadian Cholangiocarcinoma Collaborative (C3) was founded to enhance access to treatment, research, and support for individuals affected by BTC in Canada. This mixed-methods study aimed to measure hope and loneliness among patients and caregivers over time and to gain a deeper understanding of their experiences. A total of 92 patients and 44 informal caregivers, self-, peer-, or physician-referred, consented to participate in this study. Participants completed electronic self-reported measures of hope (Hope Herth Index (HHI), 12 items) and loneliness (UCLA Loneliness scale, 20 items) upon joining C3 (baseline, T0), following the first informational session with a C3 research navigator (T1), and after two to three months (T2). A subsample (n = 14) also participated in two online focus groups. At baseline, participants reported relatively high levels of hope (patients: M = 39.8, SD = 4.9; caregivers: M = 38.9, SD = 4.68), with the HHI ranging from 12 to 48, where higher scores indicate higher hope. They also reported low-to-moderate levels of loneliness (patients: M = 32.13, SD = 9.63; caregivers: M = 36.69, SD = 12.37), with the scale ranging from 20 to 80, where low loneliness: 20-34; moderate: 35-49; moderately high: 50-64; and high: 65-80. At T1, a significant decrease in hope (mean difference [MD] = -1.38, 95% CI [-2.64, -0.11], p = 0.029) and a significant increase in loneliness (MD = 1.75, 95% CI [0.27, 3.23], p = 0.016) were found among patients, with no further significant changes from T1 to T2. Among caregivers, no significant changes were observed from baseline to T1; however, at T2, there was a significant decrease in hope (MD = -2.01, 95% CI [-3.61, -0.40], p = 0.010) and a significant increase in loneliness (MD = 4.54, 95% CI [1.31, 7.77], p = 0.004). No significant differences in hope or loneliness were found between participants who engaged in C3 activities and those who did not. Dyadic analysis revealed significant correlations between patients' and caregivers' hope and loneliness at baseline and at T2. Despite the significant changes, findings indicate consistently high levels of hope and low-to-moderate levels of loneliness over time. Focus group analyses further contextualize quantitative findings by highlighting patients' and caregivers' experiences in greater depth. The results serve to inform current and future initiatives aimed at providing timely, personalized psychosocial support to patients and caregivers affected by BTC.

This study aimed to identify risk factors for major postoperative complications (TMM) and their impact on overall survival in patients aged ≥80 years undergoing lung cancer surgery, a group at increased risk of morbidity. A total of 88 patients aged ≥80 years who underwent anatomical lung resections were retrospectively analyzed. Postoperative complications were classified into minor or no complications (TMM 0-2) and major (TMM ≥ 3) complications. Logistic regression analysis was performed to identify independent predictors of major complications. Kaplan-Meier estimates were used to measure overall survival. Major complications occurred in 24 patients (27.3%). Multivariable regression analysis identified perioperative blood transfusion as an independent risk factor for major complications (p = 0.0009). Patients with major complications exhibited significantly reduced overall survival (p = 0.0009). Subgroup analysis revealed that patients who underwent minimally invasive surgery had significantly better survival (p = 0.01). Moreover, perioperative transfusion correlated with diminished overall survival (p = 0.0027). In patients aged ≥80 years undergoing lung resections, the occurrence of major postoperative complications is associated with significantly impaired survival. Minimally invasive surgical approaches and blood conservation strategies may mitigate complications and enhance long-term outcomes in this high-risk group.

The incremental value of iodine-125 (I-125) seed implantation in advanced refractory lung squamous cell carcinoma (LUSC) with hemoptysis treated with bronchial artery chemoembolization (BACE) and immunotherapy remains unclear.

This retrospective cohort study included 90 patients treated between June 2023 and June 2025. Patients receiving BACE plus immunotherapy were classified according to whether I-125 seed implantation was performed within 7 days after BACE: G1, BACE plus immunotherapy (n = 42), and G2, BACE, I-125 seed implantation, and immunotherapy (n = 48). Inverse probability of treatment weighting (IPTW) served as the primary adjustment method.

After IPTW, baseline covariates were well balanced; propensity score matching yielded 26 patients per group. Compared with G1, G2 was associated with longer hemoptysis-free survival (not reached vs. 11 months; HR = 0.34, 95% CI 0.18-0.64, p < 0.05), overall survival (19 vs. 14 months; HR = 0.26, 95% CI 0.15-0.44, p < 0.05), and progression-free survival (12 vs. 9 months; HR = 0.34, 95% CI 0.21-0.56, p < 0.05). The 6-month objective response rate (ORR) and disease control rate (DCR) were higher in G2, whereas no significant difference in 24-h hemostasis or recorded grade 3 or higher adverse events was observed.

Adding I-125 seed implantation to BACE plus immunotherapy was associated with improved outcomes in selected patients, and prospective validation is warranted.