Bone marrow carcinomatosis (BMC) is a rare but clinically relevant manifestation of metastatic breast cancer (mBC), characterized by diffuse marrow infiltration and hematologic dysfunction. Evidence on epidemiology, clinical presentation, prognosis, and optimal treatment is limited. We performed a bicentric retrospective real-world analysis of patients diagnosed with BMC, representing the largest reported European cohort to date.

We retrospectively analyzed 37 patients diagnosed with BMC at two German university breast cancer centers between 2010 and 2023. Clinical characteristics, hematologic abnormalities, metastatic patterns, treatments, and overall survival (OS) were evaluated. Incidence estimates were calculated based on institutional breast cancer and mBC populations. A systematic literature review contextualized the findings.

The estimated incidence of BMC was 2.6% among patients with mBC and 0.5% among all breast cancer cases. Most patients had HR-positive/HER2-negative disease (89%). Hematologic abnormalities were frequent, including anemia (84%), thrombocytopenia (76%), and pancytopenia (57%). Median OS after BMC diagnosis was 12 months (95% CI 6.0-38.0). Patients with bone-only metastases did not reach median OS, whereas those with additional metastatic sites had a median OS of 9 months (95% CI 5.0-12.0). Patients receiving endocrine therapy plus CDK4/6 inhibition showed numerically longer OS (34 months, 95% CI 5.0-NA) compared with chemotherapy alone (12 months, 95% CI 5.0-38.0).

BMC remains a rare but challenging complication of mBC. Endocrine-based targeted therapy may improve outcomes in selected HR-positive/HER2-negative patients. Larger multicenter studies are needed to optimize diagnosis and treatment strategies.

This study investigated variations in breast cancer mortality among women in San Luis Potosí, Mexico using an epidemiologicalspatial approach covering the period 2009-2019. Additionally, global and specific survival and its associations with clinical stage, age at diagnosis, marginalization index, recurrence and arsenic concentration in water were evaluated. We conducted a retrospective ecological, study involving1, 626 confirmed breast cancer cases and 264 related deaths registered at a public hospital. Survival analysis was performed using the Kaplan-Meier method and Log-Rank tests. Spatial distribution patterns of municipal average mortality were assessed using Moran's I and visualized in ArcMap 10.1. At the state-level the mean age at diagnosis among deceased patients was 53.49 years, with 84% presenting at advanced stages (IIB-IV). A progressively increased mortality, particularly in Health Jurisdiction IV and the municipality of Cerro de San Pedro, was observed, with peaks in 2016. The 5-year global survival rate was 83.78%. Factors significantly associated with reduced survival included advanced stage, older age, higher marginalization index and recurrence. Although arsenic exposure was not statistically significant, patients exposed to levels exceeding 0.025 mg/L exhibited longer survival times. The integration of spatial epidemiology with survival analysis underscored critical geographic and sociodemographic disparities and offer valuable insights for targeted healthcare planning and resource allocation, particularly in high-priority regions.

Post-transplant malignancy is a major determinant of long-term outcomes after solid organ transplantation. Whether simultaneous pancreas-kidney (SPK) transplantation confers a differential post-transplant cancer risk compared With kidney transplantation alone (KA) remains uncertain.

We conducted a retrospective propensity score-matched cohort study of adult transplant recipients at three Mayo Clinic sites between 2001 and 2017. SPK recipients (n = 484) were matched 1:1 with KA recipients using propensity scores. The primary outcome was post-transplant cancer incidence analyzed using Fine-Gray competing risks regression with death as a competing event. Standardized incidence ratios (SIRs) were calculated relative to the US general population. Cox proportional hazards models with cancer modeled as a time-varying covariate evaluated associations with mortality and death-censored graft failure.

Over a median follow-up of 10 years, overall cancer incidence was similar between SPK and KA recipients (subdistribution hazard ratio [sHR] 0.80, 95% CI 0.63-1.02; p = 0.07). The observed trend toward lower cancer incidence in SPK recipients was driven by a lower incidence of non-melanoma skin cancer (NMSC) (sHR 0.72, 95% CI 0.53-0.97; p = 0.03), which was attenuated after age adjustment (sHR 0.76, p = 0.07). Incidence of other malignancies did not differ between groups. Compared with the US general population, cancer risk excluding NMSC was approximately twofold higher in both cohorts (SIR 2.18 for SPK vs. 2.23 for KA). Incident malignancy was strongly associated with increased mortality (HR 3.40 in KA and 2.07 in SPK) but not with a statistically significant increase in graft failure.

In this propensity score-matched cohort study, overall post-transplant malignancy incidence was comparable between SPK and KA recipients. Both groups experienced substantially elevated cancer risk relative to the general population, and incident malignancy was strongly associated with mortality. These findings suggest that malignancy risk is driven primarily by shared immunologic and demographic factors rather than transplant type.

Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive peripheral T-cell lymphoma with poor outcomes, and the role of autologous stem cell transplantation (ASCT) as consolidation after frontline therapy remains controversial. We conducted a retrospective cohort study using the National Cancer Database, including adults diagnosed with AITL between 2004 and 2020 who received frontline systemic therapy. Patients were categorized as chemotherapy alone (Chemo) or chemotherapy followed by ASCT (Chemo + ASCT). To mitigate immortal time bias, prespecified landmark analyses were performed, with a 6-month landmark analysis as the primary approach and a 9-month landmark analysis as a sensitivity analysis. Multivariable Cox regression and propensity score weighting using inverse probability of treatment weighting for the average treatment effect were used to address measured confounding. Among 3996 patients receiving systemic therapy, 686 (17.2%) underwent ASCT. In the 6-month landmark analysis, ASCT was associated with improved overall survival (HR, 0.53; 95% CI, 0.45-0.62; p < 0.001). Findings were consistent in the 9-month landmark analysis (HR, 0.58; 95% CI, 0.49-0.69; p < 0.001) and IPTW-adjusted model (HR, 0.51; 95% CI, 0.44-0.60; p < 0.001). In this large real-world cohort, ASCT consolidation was consistently associated with improved survival in patients with AITL. Although treatment-response data were unavailable and residual confounding cannot be excluded, these findings provide supportive real-world evidence and warrant prospective studies with treatment-timing and response data to better define patient selection.

To evaluate pregnancy, peripartum, neonatal, and oncologic outcomes in pregnant patients with cervical cancer treated with neoadjuvant paclitaxel-carboplatin chemotherapy followed by cesarean radical hysterectomy (CRH).

This retrospective single-center study included nine pregnant women diagnosed with histologically confirmed cervical cancer during pregnancy who received neoadjuvant chemotherapy and subsequently underwent CRH between 2011 and 2023. Maternal clinical characteristics, chemotherapy-related toxicities, surgical outcomes, placental pathology, and neonatal outcomes were reviewed. Disease-free survival and overall survival were descriptively assessed.

The median gestational age at diagnosis was 14.1 weeks (range, 4.2-28.1 weeks). All patients received paclitaxel-carboplatin chemotherapy after the first trimester (median, three cycles). The median gestational age at CRH was 33.5 weeks (range, 30.6-36.3 weeks). Median estimated blood loss was 1800 mL, and most patients required perioperative transfusion. Placental examination frequently demonstrated maternal underperfusion. One infant was small for gestational age, and most neonates were admitted to the NICU for prematurity-related monitoring; all complications resolved without long-term sequelae. During a median follow-up of 62 months, no recurrence or death was observed.

Neoadjuvant paclitaxel-carboplatin chemotherapy followed by CRH allowed continuation of pregnancy until delivery in this small cohort of patients with cervical cancer during pregnancy. Despite frequent NICU admission, prematurity-related complications, and substantial surgical morbidity, neonatal complications were mostly transient and long-term oncologic outcomes appeared reassuring. These findings support the feasibility of this multidisciplinary treatment approach in carefully selected patients who wish to continue their pregnancy.

ObjectiveDifferentiation of simple and type 1 hepatic hydatid cysts is challenging because of their similar contents and radiological appearance. We aimed to compare the density values of simple and Type 1 hepatic hydatid cysts measured on computed tomography.MethodsPatients with histopathologically, serologically, or macroscopically confirmed Type 1 hydatid or simple hepatic cysts were included in the study. Mean density values, expressed in Hounsfield units, were measured on axial images of contrast-enhanced abdominal computed tomography scans. The results of the two groups were compared using statistical analysis, and p < 0.05 was considered statistically significant.ResultsA total of 51 Type 1 hydatid and 36 simple cysts were included in the study. The mean age of patients with hydatid cysts was significantly lower than that of patients with simple cysts (p = 0.015). The mean diameter of lesions in the hydatid group was significantly larger than that in the simple cyst group (p < 0.001). Multiple-segment extension, as well as involvement of segments I, II, III, V, VI, and VII, was more common in the hydatid group, whereas involvement of segments IV and VIII was more frequent in the simple cyst group. The mean density of hydatid cysts (9.2 ± 8.8 Hounsfield units) was slightly higher than that of simple cysts (7.3 ± 6.5 Hounsfield units), but this difference was not statistically significant (p = 0.301). The area under the receiver operating characteristic curve was 54.6%. Male gender (p = 0.026) and younger patient age (p = 0.002) were significantly associated with the presence of a hydatid cyst. Additionally, increasing lesion size positively correlated with the likelihood of a hydatid cyst diagnosis (p = 0.001).ConclusionComputed tomography densitometry is not a reliable tool for discriminating between Type 1 hydatid and simple hepatic cysts, consistent with previous findings for other quantitative measurements using magnetic resonance imaging and elastosonography. Additionally, younger male patients with larger cysts were more likely to have a diagnosis of hepatic hydatid cyst.

Cyclin-dependent kinase (CDK) 4/6 inhibitors are standard for treating hormone receptor-positive metastatic breast cancer when combined with endocrine therapy. However, comparisons of first-line treatments are scarce.

In this retrospective study, we aimed to determine the effects and safety of ribociclib and palbociclib as first-line treatments for metastatic hormone receptor-positive breast cancer in real-world settings at two tertiary medical centers.

This retrospective observational study, conducted in two tertiary medical centers, included patients receiving palbociclib or ribociclib in combination with endocrine therapy. Treatment responses were assessed by imaging studies according to RECIST 1.1 criteria. The primary endpoint was 24-month progression-free survival (PFS). Safety outcomes were also recorded and compared between the treatment groups. The median follow-up times for the ribociclib and palbociclib groups were 19.7 and 24.6 months, respectively. The 24-month PFS rates were comparable between the ribociclib and palbociclib cohorts (55.4% vs. 55.2%, respectively; hazard ratio [HR] = 1.110, 95% confidence interval [CI]: 0.605-2.035; p = 0.736), but the objective response rate was significantly higher in the palbociclib group than in the ribociclib group (43.2% vs. 30.2%, p = 0.035). A high rate of dose reduction was observed in both cohorts due to treatment-related toxicities (41.2% in the palbociclib group vs. 47.2% in the ribociclib group). The adverse effect profiles were comparable, although the incidence of grade 1 fatigue was slightly higher in the ribociclib group than in the palbociclib group (p = 0.043).

In Taiwanese real-world practice, ribociclib and palbociclib demonstrated comparable 24-month efficacy. Our findings show that dose reductions do not compromise targeted treatment efficacy, supporting proactive toxicity-guided dose to optimize patient tolerability without sacrificing oncological outcomes in Asian populations.

Bevacizumab (BEV) is pivotal for anti-angiogenic therapy in recurrent ovarian cancer (ROC), but its real-world bleeding risk profile and standardized management remain to be refined, demanding tailored pharmacovigilance data for clinical decision-making.

This single-center retrospective study characterized BEV-related bleeding events, explored the association between vascular protection management and coagulation-fibrinolysis/inflammation markers and provided bleeding risk prevention guidance.

This single-center retrospective study was conducted in Nanjing, China, from October 2024 to September 2025, with follow-up completed by December 2025. Data were extracted from electronic medical records, laboratory information systems, pharmacy records, infusion records, and nursing documentation. Bleeding was graded per CTCAE v5.0; vascular protection metrics and dynamic changes of biochemical markers (Hb, PLT, FIB, D-dimer, and CRP) were collected and analyzed.

22.5% had any-grade bleeding and 15.8% grade ≥2 bleeding, mostly mucocutaneous and clustered in early treatment. Compared to the non-bleeding group, the bleeding group exhibited higher concomitant drug use, a higher prevalence of hypertension, and lower vascular protection compliance (all P < 0.05). Additionally, this group experienced significant declines in Hb, PLT, and FIB, alongside elevated D-dimer and CRP levels (all P < 0.05).

BEV-related bleeding has distinct features, associated with concomitant drugs, inadequate vascular protection and abnormal coagulation/inflammation markers. Integrating pharmacovigilance and multispecialty vascular protection strategies can effectively mitigate bleeding risk and reduce treatment disruptions.

Accurate diagnosis of peripheral pulmonary lesions (PPLs) remains challenging. Conventional forceps biopsy frequently yields small samples compromised by crush artifact. Transbronchial cryobiopsy (TBCB) offers larger, better-preserved specimens. This study evaluated the diagnostic yield and safety of radial endobronchial ultrasound (r-EBUS)-guided TBCB using a 1.1-mm cryoprobe.

This prospective single-center study enrolled 73 consecutive patients with PPLs. Procedures were performed under general anesthesia using a laryngeal mask airway, a flexible bronchoscope, r-EBUS for localization, and a 1.1-mm cryoprobe inserted through a guide sheath. A prophylactic bronchial balloon blocker was employed for hemorrhage control. The primary outcome was diagnostic yield; secondary outcomes included bleeding severity and pneumothorax incidence.

Mean lesion diameter was 21 mm, with 79.5% of patients exhibiting a positive bronchus sign. A definitive histological diagnosis was established in 55 of 73 patients (75.3%). Malignancies accounted for 60.3% of diagnoses, whereas benign etiologies, including tuberculosis, represented 15.1%. Bleeding occurred in 19.2% of cases; all events were mild and managed with the balloon blocker. No severe hemorrhage was observed. Pneumothorax occurred in six patients (8.2%), with four requiring chest tube drainage.

r-EBUS-guided TBCB using a 1.1-mm cryoprobe is feasible and effective for diagnosing PPLs, with a diagnostic yield of 75.3%. Protocolized use of a balloon blocker effectively prevents severe hemorrhagic complications. Pneumothorax risk warrants vigilance, particularly in patients with infectious cavitary disease.

Multigene signatures like Oncotype DX and Prosigna Prediction Analysis of Microarray 50 (PAM50) help estimate distant recurrence risk in patients with luminal breast cancer receiving endocrine therapy. Determining the benefit of adjuvant chemotherapy, tests are costly and not always supported through reimbursement. We aimed to assess the utility of the APIS Breast cancer subtyping kit (BCSK) and its proliferation score (PS), as a potential prognostic assay. We analysed 141 adult patients with early luminal HER2- breast cancer diagnosed between 2020 and 2022 at Cantonal Hospital Basel-Land and Basel University Hospital. All patients had a valid OncotypeDX^® Recurrence Score (RS) and received at least one line of adjuvant therapy. Molecular subtype and PS were obtained using the APIS BCSK. We performed the Prosigna PAM50 risk of recurrence (ROR) test on a subset of 59 patients. Our findings showed high concordance at the single marker level (estrogen receptor -ESR1, progesterone receptor - PGR, human epidermal growth factor receptor 2 - ERBB2 and marker of proliferation Ki-67 - MKI67), and between the BCSK and PAM50 subtype (overall percent agreement, OPA-71.2%). Notably, BCSK showed stronger agreement with immunohistochemistry (IHC)-based subtypes (OPA: 71.2%) than PAM50 with IHC (OPA: 54.2%). The BCSK PS correlated moderately with Prosigna PAM50 ROR (ρ = 0.4787) and more weakly with Oncotype DX RS (ρ = 0.4006). The correlation between ROR and RS was weak (ρ = 0.2255). In this preliminary comparison, the APIS BCSK and PS demonstrate promising potential as an initial molecular subtyping and risk stratification tool for breast cancer patients.