To test whether pre-operative primary CT-based 3D tumor volume (TV) improves prediction of cervical spread in oral squamous cell carcinoma (OSCC) beyond conventional size metrics.

We retrospectively analyzed 132 consecutive primary OSCC patients (2014-2019). Contrast-enhanced CT datasets were semi-automatically segmented to obtain 3D TV (cm³), verified by a second observer. Multivariable logistic regression related log-TV to pathologic lymph-node metastasis (LNM), extranodal extension (ENE), and skip metastasis. Performance of radiologic TV, depth of invasion (DOI), and ellipsoid pathologic volume was compared by ROC/AUC and decision-curve analyses.

Median CT-derived TV was 12.6 cm³. Log-TV independently predicted LNM (odds ratio 3.00, 95% CI 1.21-7.68; AUC 0.815), outperforming DOI (AUC 0.541) and pathologic volume (AUC 0.498). A non-linear pattern linked very small (< 1.8 cm³) and large (> 16 cm³) tumors to increased skip-metastasis probability (AUC 0.733). Radiologic and pathologic volumes showed minimal concordance (R² = 0.0002). Decision-curve analysis demonstrated consistent net benefit of the volume model across clinically relevant threshold probabilities for elective neck dissection.

CT-based 3D volumetry is an independent pre-operative predictor of cervical LNM, flags tumors prone to skip spread, and offers greater clinical utility than linear measures.

Integrating radiologic volumetry into staging could refine nodal management-particularly in clinically node-negative patients-by supporting risk-adapted selection between sentinel lymph-node biopsy and elective neck dissection; prospective validation is warranted.

Prostate cancer is the second-highest cause of cancer-related incidence and the fifth-highest cause of cancer mortality in males. Prostate cancer is a heterogeneous disease with a wide spectrum of clinical behaviour, ranging from indolent to highly aggressive. Molecular approaches, such as genomic testing, can augment existing clinical risk stratifications and tailor management to the individual. Genomic tests that sample biopsy or surgical tissue can provide a molecular risk assessment and identify actionable therapy targets. Liquid biopsy, while still emerging, may provide a non-invasive alternative to tissue tests and enable longitudinal monitoring of tumour status. We first discuss the molecular landscape of prostate cancer, before providing a detailed overview of the molecular approaches available for early detection and prognostication. Furthermore, methodological considerations and barriers towards clinical implementation for these tests are discussed, highlighting areas of future research.

With the widely increasing implementation of modern next generation sequencing (NGS) technologies in routine molecular pathology practice, the fraction of cancers with a definite or probable hereditary background has been steadily increasing. Currently, it is assumed that 5-10% of all malignancies develop in the context of germline predisposition diseases. Not rarely, the diagnosis and recognition of cancer predisposition syndromes rely on distinctive histopathological and/or immunophenotypical findings that proved to be highly reliable and reproducible in uncovering hereditary neoplastic diseases that would otherwise have gone undetected by clinicians. This is especially true in patients with new mutations and, hence, negative family history. Examples of such neoplasms are the fumarate hydratase-deficient renal cell carcinoma (FH-RCC), succinate dehydrogenase-deficient RCC (SDH-RCC), and hereditary gastrointestinal stromal tumor (GIST) syndromes. Notably, many of these inherited cancer syndromes may present as unifocal lesions at advanced age of onset so that they are mostly misinterpreted as sporadic on clinical grounds. The availability of effective disease-specific specialized cancer screening and follow-up programs for several hereditary cancer syndromes underlines the importance of timely recognition of these disorders to enable enrollment of "at-risk individuals" in such programs for early detection and timely prevention/treatment of these mostly aggressive neoplasms. This review highlights and discusses the major clinicopathological, topographic-anatomical, and histological features that are highly suggestive of a hereditary neoplastic disease. The details of some of the entities are dealt with in review articles devoted to them in this special issue.

IDH-wt diffuse gliomas with histologic grade 2-3 features and distinct molecular characteristics are now classified as molecular glioblastoma, yet outcomes and optimal management remain incompletely defined in a contemporary cohort.

Adults with histologic grade 2-3 IDH-wt gliomas diagnosed from 1996 to 2019 were retrospectively identified. Overall survival (OS) and progression-free survival (PFS) were estimated using Kaplan-Meier methods, with Cox regression used to assess prognostic factors. To account for noncanonical IDH mutations, subgroup analyses were performed in those age > 55 or with next generation sequence (NGS) IDH testing.

A total of 134 patients were included, with a median follow-up of 29.8 months. Median OS was 35 months (95% CI: 28.8-43), and median PFS was 20.9 months (95% CI: 14.5-27.4). Grade 2 tumors demonstrated significantly improved outcomes compared to grade 3 tumors (median OS 94.5 vs. 29.8 months; median PFS 50.6 vs. 15.3 months). Among grade 3 tumors, sequential radiation and chemotherapy yielded a median OS of 29.8 months versus 29.8 months with concurrent chemoradiation followed by chemotherapy (p = 0.17); median PFS was 22.2 months versus.

IDH-wt gliomas with grade 2-3 histology have heterogeneous outcomes. Grade 3 tumors show survival comparable to molecular glioblastoma, while a subset of grade 2 tumors exhibit prolonged survival. Concurrent chemoradiation did not confer a survival advantage over sequential therapy in grade 3 tumors, supporting reevaluation of treatment intensity in selected patients.

Differentiating prolactinomas from non-functional pituitary adenomas (NFPAs) with stalk effect relies on biochemical thresholds that assume a linear relationship between tumor size and prolactin secretion. We applied a pathology-informed Prolactin Secretory Efficiency (PSE) framework to characterize diagnostic overlap between prolactinomas and NFPAs and evaluate the limitations of current prolactin thresholds.

Retrospective study of 425 patients undergoing first-time surgery for pituitary adenomas: 115 pathology-confirmed lactotroph adenomas, 291 NFPAs, and 19 mammosomatotrophs. Patients with clinical or biochemical evidence of ACTH- or GH-secreting tumors were excluded. PSE was calculated as the serum prolactin-to-tumor volume ratio [Formula: see text]). Primary outcomes included PSE-based group separation and diagnostic accuracy of the 200 ng/mL threshold.

While no NFPA exceeded 200 ng/mL, 42% of pathology-confirmed macroprolactinomas and 49% of macro-NFPAs fell within the diagnostic grey zone (ULN < prolactin < 200 ng/mL). PSE achieved superior group separation versus raw prolactin, yet a paradox emerged: high-efficiency stalk effect in some NFPAs produced PSE values exceeding those of low-efficiency macroprolactinomas.

Rigid biochemical thresholds fail to capture the full spectrum of lactotroph adenoma biology. Significant secretory ambiguity exists for macroadenomas below 200 ng/mL, creating risk of misclassification. D2-agonist trials may serve as a low-risk diagnostic probe in this grey zone, ensuring low-efficiency prolactinomas receive appropriate first-line medical management.

Whether gross total resection (GTR) remains associated with survival among MGMT-methylated IDH-wildtype glioblastoma patients receiving chemoradiation remains uncertain. We evaluated whether GTR versus less-than-GTR (< GTR) was associated with overall survival across MGMT promoter methylation and chemoradiation strata.

We retrospectively reviewed 261 patients undergoing biopsy or resection for newly diagnosed IDH-wildtype glioblastoma at a single institution from 2010 to 2024. Extent of resection was dichotomized as GTR versus < GTR, and chemoradiation was coded as receipt of postoperative radiation and temozolomide. Overall survival was assessed using Kaplan-Meier analysis and multivariable Cox models with prespecified EOR × MGMT × chemoradiation interaction testing, adjusted for age, KPS, tumor location, and mFI-5.

GTR was associated with longer overall survival than < GTR in the overall cohort and within all four MGMT × chemoradiation strata. MGMT-methylated patients receiving chemoradiation had a median overall survival of 17.02 months after GTR versus 10.65 months after < GTR (log-rank p = 0.001), and the model-derived adjusted hazard ratio for < GTR versus GTR was 2.12 (95% CI 1.27-3.54; p = 0.004). The three-way EOR × MGMT × chemoradiation interaction was not significant (likelihood-ratio p = 0.309). In a 6-week sensitivity analysis, all survival associations remained, but EOR × chemoradiation was no longer significant.

GTR was associated with longer survival across all MGMT and chemoradiation-defined subgroups, including MGMT-methylated patients receiving chemoradiation. These findings are consistent with maximal safe resection when feasible but should be interpreted cautiously because of small subgroups as well as treatment-selection and immortal-time biases.

Complete resection of skull base meningiomas (SBMs) is often limited by their proximity to critical neurovascular structures, potentially increasing the risk of postoperative progression. This study quantified long-term progression risk after SBM resection, identified predictors of progression, and developed a data-driven MRI surveillance protocol using Bayesian methods.

Patients undergoing SBM resection between 2002 and 2020 at two neurosurgical centres were analysed. Kaplan-Meier and Cox regression analyses were used to estimate intervention-free survival (IFS). Conditional probability modelling was used to derive an MRI surveillance schedule that maintained a ≤ 3% risk of progression requiring intervention, stratified by extent of resection.

A total of 358 SBMs were included. Median age at diagnosis was 57 years (IQR 18), and 76.0% of patients were female. WHO Grade 1 tumours accounted for 80.3% of cases and Grade 2 for 19.7%. Median follow-up was 97 months (IQR 64-128). Progression requiring re-intervention occurred in 14.1% of patients. Subtotal resection (STR) increased the risk of re-intervention (HR 2.62, 95% CI 1.30-5.30, p = 0.009), whereas higher comorbidity burden (HR 0.78, 95% CI 0.62-0.98, p = 0.038) and incidental presentation (HR 0.11, 95% CI 0.01-0.88, p = 0.038) were associated with lower risk. Conditional probability modelling demonstrated higher annual progression risk following STR, supporting more intensive imaging surveillance. Recommended MRI schedules were: gross total resection (GTR), scans at 3 months, 2, 5, 8, and 10 years; STR, scans at 3 months, 1 year, 18 months, annually from years 2-8, and at 10 years.

Progression requiring re-intervention occurs in approximately 17% of patients after SBM resection and is strongly associated with extent of resection. A conditional-risk-based MRI surveillance protocol provides an evidence-based framework for long-term follow-up.

This study aimed to examine the perceived challenges and attitudes toward home-based treatment for hematology and hemato-oncology patients among physicians and nurses.

A qualitative study was conducted based on 23 semistructured interviews with physicians (n = 11) and nurses (n = 12) from eight hospitals across Israel. The participants were recruited using opportunistic sampling, and the interviews were analyzed thematically using an inductive reflexive thematic analysis approach. Data saturation was achieved.

Three overarching themes emerged: (1) the hospital as a safe haven: the conflict between hospital safety and the benefits of home treatment; participants emphasized the importance of hospital-based monitoring and expressed concerns about patient safety in home settings; (2) building a well-functioning home treatment system vs. fearing loss of control; while envisioning an organized, hospital-led model, participants stressed the need for trained staff, dedicated coordination, and clinical oversight; and (3) balancing costs, risks, and institutional support; participants highlighted financial disincentives, infrastructure gaps, and the role of professional trust in promoting patient acceptance.

Although healthcare professionals recognize the potential benefits of home-based treatment, their support is contingent upon robust clinical protocols, institutional alignment, and clear coordination mechanisms. These findings underscore the central role of provider engagement in advancing safe and sustainable models of home care for hematology and hemato-oncology patients. The study offers practical insights that will assist in implementing health policies, developing clinical programs, and organizational planning for the safe and sustainable implementation of nonpalliative home care in hematology and hemato-oncology.

Spirituality is important in cancer care. Few studies have assessed the spiritual needs (SN) of cancer patients. The aim of this study was to assess the SN of cancer patients and evaluate its relationship with their health-related quality of life (HRQOL).

We conducted a unicenter cross-sectional study of patients undergoing cancer treatment. We used validated instruments (Duke University Religion Index-DUREL, Functional Assessment of Chronic Illness Therapy Spiritual Well Being-FACIT-SP, and Spiritual Needs Assessment for Patients-SNAP) and a questionnaire about the healthcare team's approach to spirituality.

From March to October/2022, 150 patients were included: 75 receiving curative-intent and 75 under palliative cancer-directed therapy. Patients who wished a spirituality approach by the healthcare team had higher SN than patients who did not want it (p < 0.0001), but lower HRQOL scores (p = 0.004). Neither SN nor HRQOL differed according to treatment intention (p = 0.444 and p = 0.159 respectively). There was a weak correlation between SN and HRQOL. The answers about the wish for a spirituality approach were grouped in four categories: (1) approach by the health team, (2) comprehension of spirituality/religiosity, (3) impact of the spirituality/religiosity approach, and (4) self-referential or other-referential responses. Participants perceived very few discussions on spirituality.

In our study, patients who wished a spiritual approach had higher SN and lower QOL. SN were not related to cancer treatment intentions. Further studies could evaluate screening and interventions in this area.

Black men experience the highest prostate cancer (CaP) burden among all racial and ethnic groups, underscoring the urgent need for research to guide the development and implementation of culturally tailored strategies aimed at reducing disparities and improving health outcomes. Survivorship care resources are recommended to educate patients and provide them with better information about their cancer diagnosis, treatment, and follow-up care, thereby empowering them to be active participants in their own survivorship care for improved quality of life and well-being. Due to the lack of culturally relevant survivorship care, we aimed to develop a survivorship care toolkit (SCT) that includes a survivorship care roadmap template tailored to Black men to address the unique survivorship care needs of Black prostate cancer survivors (CaPS). Our approach is grounded in the science of survivorship and rooted in the science of community engagement, which requires a genuine, bidirectional relationship between scientists and survivor-advocates.

Following literature and guideline review of the American Society of Clinical Oncology (ASCO) survivorship care template, we employed a three-pronged method to develop the toolkit that included a literature review, a consensus-building approach with diverse stakeholders, and in-depth interviews with Black prostate cancer survivors (CaPS).

Following community-engaged research, we included 22 diverse Black CaPS to review and tailor the SCT. Results supported the enhancement of the ASCO template by incorporating and expanding domains including family history, care team contacts, follow-up and surveillance, symptom management, quality of life, survivor-specific concerns, major comorbidities, health advisories, and culturally relevant resources.

Black CaPS expressed satisfaction with the tailored SCT as a tool and a credible, clinically, and community-responsive resource to improve follow-up and survivorship care, patient documentation, activation, and communication about their survivorship concerns and needs.