Silent corticotroph adenomas (SCAs) and silent gonadotroph adenomas (SGAs) are subtypes of non-functioning pituitary adenomas (NFPAs).However, studies comparing SCAs and SGAs are scarce, and their differences in clinical features, behavior, and prognosis are not well understood. This retrospective cohort study included 603 NFPA patients (188 SCAs, 415 SGAs) who underwent surgery at Beijing Tiantan Hospital between 2020 and 2025. Data were collected to compare features between groups, and Cox models identified predictors of postoperative radiological progression/recurrence. A nomogram was developed and evaluated using ROC, calibration, and decision curve analysis. SCAs were more common in younger women, while SGAs predominated in men. SCAs had larger tumor size (29.7 ± 10.8 mm vs. 27.9 ± 9.3 mm, P = 0.043), more cavernous sinus invasion (69% vs. 41%, P < 0.001), and more intratumoral hemorrhage (10.1% vs. 2.9%, P < 0.001) compared to SGAs, but a lower gross total resection rate (GTR) (86.7% vs. 92.5%, P = 0.022). Postoperative venous thromboembolism (VTE) was more frequent in SCAs (16% vs. 9.6%, P = 0.025). Multivariate Cox analysis identified distinct recurrence predictors: for SCAs, younger age, recurrent tumors, subtotal resection, and firm consistency increased recurrence risk; for SGAs, larger tumor size, subtotal resection, firm consistency, and Ki-67 ≥ 3% were predictive. The nomograms showed good apparent discrimination, and bootstrap internal validation demonstrated that both models retained good discriminative ability after correction for optimism. The AUCs for 2- and 4-year radiological progression/recurrence prediction were 0.934 and 0.914 for SCAs, and 0.898 and 0.882 for SGAs, respectively. Calibration and decision curve analyses suggested acceptable model performance within this cohort; however, external validation is required before clinical application. SCAs and SGAs differ in demographics, tumor behavior, and postoperative outcomes. SCAs are more invasive with lower GTR and higher VTE risk, while SGAs are firmer and more likely to cause pituitary dysfunction. The recurrence model supports individualized follow-up and early identification of high-risk patients.

Oral anticancer medications are standard care for cancer. Medication adherence influences health outcomes, but valid, reliable measures assessing self-reported medication adherence are limited. Psychometric properties of the PROMIS^® Medication Adherence Scale (PMAS) were evaluated in patients prescribed oral anticancer medications for multiple myeloma.

This was a secondary analysis from a longitudinal observational study examining medication adherence, symptoms, quality of life, and financial hardship among individuals prescribed oral anticancer medications for multiple myeloma. PMAS measured self-reported medication adherence. Self-report and medical record data assessed participant characteristics and adherence correlates. Objective medication adherence indices were generated from continuous electronic event monitored data. Internal consistency reliability was estimated using Cronbach's alpha. Dimensionality was assessed with confirmatory factor analysis. Construct validity was assessed considering adherence correlates. Spearman rank-order correlations summarized associations between PMAS and electronic event monitored data.

PMAS items had limited variability, with high adherence over time. Reliability of PMAS scores was adequate (T1 α = 0.82, 95% CI: 0.75, 0.87; T2 α = 0.84, 95% CI: 0.78, 0.89). Confirmatory factor analysis fit was better for sub-scales (Medication Beliefs and Knowledge and Medication Taking Behaviors) than Total scale, particularly for the Medication Beliefs and Knowledge subscale. Adherence correlates were observed as expected between PMAS and age, self-reported cognitive function, symptom severity, and depression. Weak/moderate positive associations were found between PMAS and electronic event monitored data.

Reliability, two-factor dimensionality, and construct validity were supported, with some evidence of concurrent criterion validity with electronic event monitored adherence data. Additional validation testing is needed to support findings. Evidence supports the feasibility of longitudinal oral anticancer medication adherence assessment monitoring using PMAS.

The use of electronic patient-reported outcome measures (ePROMs) has demonstrated benefits in oncology; however, their use in hematological malignancies remains limited. We aimed to identify bespoke ePROM platforms used in hematology settings and describe their features, acceptability, usability, feasibility, implementation and uptake rates, and outcome data.

A systematic review was conducted following PRISMA 2020 guidelines. Electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane) and Google Play were searched for studies and mobile applications (apps) reporting on ePROM platforms in hematological cancer populations. Data were extracted about the following: characteristics, features, uses, and patient or clinician-reported data on platform acceptability, usability, feasibility, implementation, and evaluation outcomes.

Fourteen total platforms were identified from 18 studies (reporting 13 unique ePROM platforms) and one platform known to authors. No additional platforms were identified through Google Play search. The included platforms were used in hematological research, clinical care, and registry settings and captured symptoms and quality of life using validated and customized PROMs. Delivery modes included websites and apps that featured automated prompts, clinician alerts, graphical feedback, and electronic medical record integration. Overall, usability was reported to be high; most platforms were acceptable to patients and clinicians. Feasibility and uptake varied, but several studies reported high patient engagement (> 80% completion rates). Positive outcomes included reduced symptom burden, improved treatment adherence, and enhanced patient-clinician communication.

The diversity of identified platforms reflects the wide range of hematological diseases, treatments, and care settings in which ePROMs may be applied, highlighting their flexibility and adaptability. Existing ePROM platforms used in hematological cancers vary substantially in features, purposes, and settings. Future work should focus on tailoring content, supporting implementation, and evaluating the impact of ePROM platforms on patient, clinician, and service outcomes.

This study aimed to develop a Nursing Competency Scale for Patients with Comorbid Cancer and Dementia in Acute Care Hospitals (NCS-CD) and examine its reliability and validity.

The study was conducted in two phases. In Phase 1, a preliminary scale was developed based on interviews with Japanese specialists in cancer and dementia nursing and a comprehensive literature review. The draft was refined through a questionnaire survey of 10 specialists and a consensus meeting with five experts. In Phase 2, the reliability and validity of the scale were evaluated using data from 305 nurses working in acute care hospitals. Exploratory and confirmatory factor analyses were conducted to assess construct validity. Criterion-related validity was examined using the Self-Assessment Scale of Nursing Practice for Elderly People with Cognitive Impairment (SSNP). Internal consistency and test-retest reliability were assessed.

The NCS-CD comprised 23 items across five factors. Confirmatory factor analysis demonstrated acceptable model fit (χ²/df = 1.953, goodness-of-fit index [GFI] = 0.894, adjusted goodness-of-fit index [AGFI] = 0.867, comparative fit index [CFI] = 0.919, Tucker-Lewis index [TLI] = 0.908, and root mean square error of approximation [RMSEA] = 0.056). The scale exhibited high internal consistency (Cronbach's alpha = 0.902) and good test-retest reliability (intraclass correlation coefficient = 0.746). Significant positive correlations were observed between the NCS-CD and SSNP (r = 0.714, p < 0.001), supporting criterion-related validity.

The NCS-CD demonstrated preliminary reliability and validity for assessing nursing competencies in caring for patients with comorbid cancer and dementia in acute care hospitals. This scale can contribute to the improvement of nursing practice and educational programs for patients.

Identifying reproducible biomarkers associated with treatment outcomes remains a major unmet clinical need in advanced non-small cell lung cancer (NSCLC). METLUNG evaluated whether plasma metabolomic profiling, alone or combined with clinical variables, could identify biomarkers associated with clinical response and survival outcomes in patients with NSCLC treated with immune checkpoint inhibitors.

METLUNG is a prospective observational cohort (ISRCTN98848959) that enrolled 128 patients with stage III-IV NSCLC eligible for immune checkpoint inhibitors between October 2020 and December 2022 at Hospital Universitari Sant Joan de Reus, Reus (Spain). Clinical response classification was based on Immune Response Evaluation Criteria in Solid Tumors criteria, and subsequent clinical and radiological course. Baseline plasma metabolomic profiling was followed by univariate analyses and multivariate modeling. Survival models were built using clinical variables, metabolomic variables, significant metabolites, and an integrated clinical-metabolomic composite model. Predictive performance was evaluated using integrated area under the receiver operating characteristic curve and concordance index (C-index).

Among 127 evaluable patients, 52.8% achieved a clinical response. Most had adenocarcinoma (n=94), followed by squamous carcinoma (n=28). Treatment included first-line immunotherapy monotherapy (n=39), first-line chemo-immunotherapy (n=47), or second-line immunotherapy (n=41). Clinical response differed by sex and Eastern Cooperative Oncology Group performance status but showed no association with smoking history or PD-L1 expression.Univariate analyses identified 41 baseline metabolites associated with response, and 69 and 71 metabolites associated with progression-free survival and overall survival (OS), respectively. Five metabolites (histidine, citric acid, uracil, lactic acid, and sarcosine) remained consistently significant across all endpoints. Higher histidine and citric acid levels were associated with improved outcomes, whereas uracil, lactic acid, and sarcosine correlated with worse outcomes. The integrated clinical-metabolomic model showed the highest prognostic performance compared with clinical or metabolomic prognostic models alone, providing better early survival discrimination. In the immunotherapy monotherapy subgroup, only the integrated model was significant for OS, while metabolomic signatures showed stronger prognostic value.

Metabolomic profiling identified metabolic signatures associated with clinical response and survival outcomes in NSCLC patients treated with immune checkpoint inhibitors. An integrated clinical-metabolomic model showed improved prognostic stratification, supporting the potential value of plasma metabolomics for patient risk stratification. These findings remain exploratory and require validation in independent, ideally multicenter, cohorts before clinical implementation.

ISRCTN98848959.

To compare the risk of new primary cancer, locoregional progression or metastasis across different disease-modifying antirheumatic drugs (DMARDs) strategies in real-world patients with rheumatoid arthritis (RA) and prior cancer.

The ARthritis and CAncer registry is a nationwide retrospective study, including patients with RA and prior cancer. Collected variables included RA characteristics, DMARDs received, cancer type and demographics. The primary outcome was the occurrence of new primary cancer, locoregional progression or metastasis during follow-up. Adjusted Cox regression models were used to estimate HRs for cancer events. Treatment strategies involving conventional synthetic (cs)DMARDs served as the reference for comparison.

Among 728 patients with RA, 80 cases of cancer were identified over a cumulative exposure period of 11 022 years, with an overall cancer incidence rate of 7.3 (95% CI 5.8 to 9.0) per 1000 person-years. Adjusted HRs for all cancers (95% CI) compared with csDMARDs were 0.94 (0.73 to 1.21) for tumour necrosis factor inhibitors, 1.03 (0.61 to 1.74) for IL6-inhibitors, 0.81 (0.46 to 1.42) for CD20 inhibitors, 0.6 (0.26 to 1.4) for targeted synthetic DMARDs and 0.74 (0.41 to 1.34) for cytotoxic T-lymphocyte-associated protein 4-analogue. No differences in cancer risk were observed after adjusting for duration of exposure, line of advanced therapy or prior cancer status.

This real-world data did not identify differences in the risk of new primary cancer, locoregional progression or metastasis across different DMARDs strategies in patients with RA and prior cancer.

Head and neck cancer (HNC) patients are uniquely susceptible to adverse oral health outcomes following head and neck radiation therapy (RT). Various risk factors for these oral health outcomes post-RT were identified in the OraRad study, which followed HNC patients from pre-RT to 2 y post-RT. Chronic oral complications include hyposalivation, trismus, dental caries, periodontal disease, tooth loss, exposed bone, and osteoradionecrosis of the jaw. Results from OraRad provide a framework for oral health care providers both in preparing patients for RT and in managing sequelae of RT for best outcomes for the HNC patient population.

Specific considerations must be made in the treatment course of oral cavity carcinoma (OCC). Given the role of oral cavity in important functions such as speaking, eating, and esthetics, the choice of the optimal reconstructive option is of utmost importance. For small residual defects local flaps provide an acceptable solution, while for larger defects the adoption of the more complex revascularized free flaps is considered the gold standard. Another challenge is the management of recurrent OCC, which is characterized by a dismal prognosis. In this case, surgery is the first treatment option, when feasible, sometimes integrated with radiotherapy or chemotherapy.

Oral cavity carcinoma management always requires the involvement of a multidisciplinary team. Surgery is the mainstay of treatment, although other therapeutic modalities such as chemotherapy and radiotherapy are often needed in a multimodal treatment approach. Accurate staging is of great importance to better define the best therapeutic strategy, in addition to specific pathologic characteristics, tumor location, and patient-specific considerations. Guidelines help the clinicians in defining the best treatment plan. These guidelines define 2 major groups of patients, early stage and late stage disease, for which they provide specific algorithms/flow charts for an updated evidence-based decision-making process.

An association between periodontitis and oral cancer risk and progression has been suggested. It seems most likely that periodontitis plays an indirect role in oral cancer risk and progression in which its contribution to a chronic inflammatory state characterized by the persistent release of pro-inflammatory cytokines contributes to oxidative stress and DNA damage, potentially favoring carcinogenic processes. Periodontal health status of an individual may serve as a surrogate for general health as those factors which contribute to good general health, environment, lifestyle, and access to care are also determinants of oral health and impact cancer risk.