Percutaneous thermal ablation has become an important local treatment option for patients with primary or metastatic lung tumors who are not optimal surgical candidates. Radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CA) are increasingly used in selected patients, with expanding evidence supporting their safety and effectiveness. This review summarizes current techniques, patient selection considerations, clinical outcomes, and future directions in percutaneous lung tumor ablation.

A narrative review of the literature was performed using PubMed, MEDLINE, major radiology and oncology journals, and reference lists from key manuscripts. Searches focused on percutaneous thermal ablation modalities, outcomes, complications, and emerging technologies in lung tumor management. Representative studies were selected to illustrate current evidence and practice patterns.

Patient selection for lung ablation depends on tumor size, number, location, and pulmonary reserve. MWA provides more predictable heating zones and is less affected by heat-sink effects, while RFA is more limited in this setting. CA allows controlled ablation margins and preservation of adjacent lung parenchyma, with favorable tolerance near critical structures. Across modalities, percutaneous ablation achieves meaningful local control and survival in early-stage non-small cell lung cancer (NSCLC) and oligometastatic disease. Long-term survival after MWA for stage IA NSCLC can approach surgical outcomes in well-selected patients, though disease-free survival remains higher with resection. Compared with stereotactic body radiotherapy (SBRT), ablation generally yields lower local control but similar overall survival (OS) in some cohorts. Complications such as pneumothorax, pleural effusion, and hemorrhage are usually manageable, with CA often associated with fewer major adverse events. Emerging innovations, including bronchoscopic ablation systems, non-thermal energy platforms, and artificial intelligence (AI)-assisted planning, may enhance precision and broaden indications.

Percutaneous lung ablation is a safe and effective local therapy for selected patients with primary or metastatic lung tumors, particularly those with limited pulmonary reserve or requiring repeat local treatment. Ongoing advances in technology and patient selection strategies are likely to strengthen its role within multidisciplinary lung cancer management.

Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide. Its persistence may lead to cervical dysplasia and, eventually, cervical cancer. Currently, there are no approved treatments specifically targeting HPV infection or low-grade squamous intraepithelial lesions (LSILs). A multicomponent vaginal gel containing Trametes versicolor extract, prebiotics, moisturizing agents, and anti-inflammatory coadjuvants has been developed to support natural HPV clearance and promote lesion healing or regression. The aim of this review is to summarize the available evidence regarding a multi-ingredient vaginal gel for HPV infection and cervical low-grade dysplasia treatment and to provide a critical review of the literature.

A structured literature search was performed in MEDLINE, Embase, and Scopus without language or date restrictions. Additional records were identified through ClinicalTrials.gov and Google Scholar. Both peer-reviewed publications and conference abstracts reporting clinical outcomes of Trametes versicolor-based vaginal gel (Papilocare® or Palomacare®) were included.

Papilocare®/Palomacare® is available in over 65 countries across Europe, Africa, Asia, and Latin America. The clinical evidence includes two pilot studies, two prospective non-controlled interventional studies, one randomized clinical trial, and one retrospective observational study. This narrative review summarizes their design, results, strengths, and limitations. Ethical issues related to trial design, lack of biopsy confirmation, absence of blinding, and retrospective registration are discussed. Although some preliminary data suggest potential benefits in epithelial repair and HPV clearance, current evidence remains insufficient to support its routine clinical use.

Further independent, well-designed, and adequately powered randomized trials are required to confirm the safety and efficacy of this formulation. Strengthening methodological rigor will be essential to define its role in HPV-related cervical disease management.

Anticoagulants, classified as high-risk medications, are commonly used and are associated with significant potential harm in postoperative patients. Patients with colorectal cancer (CRC) are among the most susceptible populations. Single-component pharmacist intervention has demonstrated conflicting efficacy in improving anticoagulant safety. Meanwhile, it remains unclear whether comprehensive medication therapy management (MTM), which integrates medication review, personalized education, and long-term follow-up, can effectively reduce adverse drug events (ADEs). This study aims to assess the impact of a comprehensive MTM pathway on anticoagulant-related ADEs in this high-risk population.

This study will be a prospective, multicenter, open-label, randomized, parallel-group trial designed to assess the impact of the MTM pathway on anticoagulant efficacy and safety in patients diagnosed with CRC, admitted for elective radical surgery, and developing acute venous thromboembolism (VTE) that requires long-term anticoagulant therapy in comparison with the current clinical standard of care. In total, 327 patients will be enrolled with randomization at a 1:1 ratio into intervention and control groups. Patients in the intervention group will receive MTM interventions at three key time points: during hospitalization, at discharge, and post-discharge. A total of 9 times of MTM services will be provided to patients within 6 months after discharge. The primary outcome is anticoagulant-related clinically important medication errors (CIME), including preventable or ameliorable ADEs and potential ADEs. The secondary outcomes are (I) preventable or ameliorable ADEs; (II) potential ADEs due to discrepancies or non-adherence; and (III) preventable or ameliorable ADEs judged to be serious, life-threatening, or fatal. Intention-to-treat (ITT) analysis will serve as the primary analytical approach.

This study will provide evidence on whether the MTM pathway improves the efficacy and safety of anticoagulant therapy in patients with CRC who develop postoperative VTE.

NCT06998745 (date of registration: 2025-5-10) (Protocol version: 2024-7-16, Version 2.0).

Pharmacokinetic studies suggest that specific prostate cancer therapies may alter the metabolism of direct oral anticoagulants (DOACs), leading to elevated risks of thrombosis or bleeding.

To assess the risk of thrombosis or bleeding, population-based, retrospective, parallel analyses were conducted in Ontario and Alberta, Canada, among adults patients with prostate cancer who were prescribed a DOAC and a potentially interacting androgen receptor pathway inhibitor (including enzalutamide, apalutamide, or abiraterone) compared with non-DOACs between 2012 and 2023. Analyses were stratified based on a DOAC-inducer cohort (enzalutamide or apalutamide, which might increase the risk of thrombosis) and a DOAC-inhibitor cohort (abiraterone, which might increase the risk of bleeding). Overlap weighted Cox proportional hazard models accounting for 37 covariates were performed independently in each jurisdiction and were pooled using random-effects meta-analysis.

In total, 2997 individuals were included (2107 from Ontario and 890 from Alberta). In patients who received enzalutamide or apalutamide, there was no increased risk of all thrombosis in the DOAC groups compared with the non-DOAC groups (pooled hazard ratio, 0.83; 95% confidence interval, 0.36-1.93). In patients who received abiraterone, no significant differences were observed in any bleeding events comparing the DOAC and non-DOAC groups (pooled hazard ratio, 1.16; 95% confidence interval, 0.10-13.99). The results were consistent in multiple sensitivity analyses.

The concurrent use of enzalutamide, apalutamide, or abiraterone with DOACs did not contribute to clinically meaningful changes in the risk of thrombosis or bleeding in individuals with prostate cancer.

Cholangiocarcinoma (CCA) is the second most common primary liver cancer and is being diagnosed with increasing frequency worldwide. We performed a systematic review on radiofrequency (RFA), microwave (MWA), irreversible electroporation (IRE), trans-arterial chemoembolization (TACE) and selective internal radiation therapy (SIRT) in CCA. Thirty-one ablation studies (1526 patients), 21 TACE studies (1594 patients), and 38 SIRT studies (1954 patients) were included; most cohorts involved intrahepatic CCA (iCCA) and originated from Asia. For RFA/MWA, overall survival (OS) typically exceeded 25 months and recurrence-free survival (RFS) 7-9 months. The ideal candidate profile for percutaneous ablation was an uninodular iCCA measuring ≤ 2-3 cm developed on cirrhosis. For TACE, median objective response rate (ORR) was 35%, with median OS 11.7 months and RFS of 4 months. Hypervascularity, low tumour burden (< 30%-50% of liver involvement), and preserved liver function were associated with better outcomes and may be used to identify suitable candidates for TACE in case of unresectable iCCA. For SIRT, median ORR was 36.3%, OS 14.5 months, and RFS 8.7 months. A large unilobar tumour with personalised dosimetry appears the best candidate for SIRT in unresectable iCCA, with potential for downstaging to surgery in some cases. However, the literature regarding locoregional treatment is predominantly retrospective and heterogeneous, with inconsistent reporting of staging, cirrhosis, and endpoints, and almost no randomised trials. Locoregional radiological therapies remain viable options for carefully selected, liver-dominant iCCA, but prospective multicenter studies are needed to define indications, and to optimise sequencing and combination strategy with systemic treatments.

The life-threatening nature of cancer can precipitate posttraumatic stress symptoms (PTSS) in family caregivers. PTSS can lead to unhealthy coping and maladaptive health behaviors.

We explored the extent to which PTSS are associated with health behaviors of caregivers and the moderating role of gender.

Spousal caregivers (N = 144) of patients who were newly diagnosed with colorectal cancer were enrolled. The sample was comprised of mostly Hispanic, middle-aged, and female caregivers. Four types of cancer-related PTSS (intrusions, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) and health behaviors (substance use and improper healthcare utilization) were self-reported. Study hypotheses were tested using logistic and negative binomial regression models.

Caregivers overall reported higher alcohol use than CDC recommendations. Male caregivers reported greater alcohol use and more improper healthcare utilization compared with their female counterparts (p < 0.03). Among female caregivers only, greater avoidance was associated with less improper healthcare utilization, and greater negative alterations in cognitions and mood was associated with more improper healthcare utilization (p ≤ 0.01).

Findings that male caregivers are more vulnerable to alcohol use and improper healthcare utilization highlight the need for healthy lifestyle coping interventions tailored specifically to male caregivers. In contrast, female caregivers who exhibit elevated negative alterations in cognitions and mood are at greater risk for improper healthcare utilization than male counterparts. Findings suggest that interventions targeting cancer-related PTSS may help improve engagement of proper healthcare utilization and reduce the risk for premature morbidity among female caregivers.

Sentinel lymph node (SLN) biopsy (SLNB) is the preferred surgical treatment for patients with clinically diagnosed node-negative breast cancer. However, failure to detect SLN(s) and postoperative adverse reactions have led to continuous refinement regarding this procedure. As such, the present study explored the application of preoperative lymphatic drainage imaging using indocyanine green (ICG) for more precise SLNB.

A total of 144 patients with breast cancer were divided into two groups, intraoperative localization (IOL) and preoperative localization (POL) groups, and the chi-squared test was used to compared SLN detection rates. ICG concentration and injection time were evaluated to determine the appropriate preoperative localization procedure. The application of preoperative lymphatic drainage imaging in breast-conserving surgery was further assessed in another 7 patients.

SLNs were successfully detected in 134 of 144 patients with breast cancer; more specifically, SLN detection rates in the IOL and POL groups were 88.10% and 100%, respectively (P=0.015). Injection of ICG solution diluted 1:100 three days before surgery clearly developed a lymphatic drainage pathway without residual fluorescence affecting intraoperative SLN detection. Moreover, the application of preoperative lymphatic drainage imaging facilitated the identification of SLNs in all seven patients with breast cancer who underwent breast-conserving surgery through a single-point injection of tracers.

This study describes a reliable means of achieving preoperative localization of the lymphatic drainage pathways, which can not only avoid SLN detection failure due to intraoperative biopsy-caused lymphatic injury, but also help to actualise single-point injection to improve the postoperative aesthetics of the breast.

The Day 14 bone marrow biopsy (D14 BMB) has historically been a key tool for early treatment response assessment in acute myeloid leukemia (AML), particularly following intensive chemotherapy. Traditionally, a blast count of <5% at D14 is associated with higher complete remission (CR) rates and improved overall survival (OS), while persistent disease often prompts re-induction therapy. However, emerging evidence suggests that while re-induction may increase CR rates, it does not consistently improve OS and is associated with significant morbidity. With the emergence of venetoclax-based and other targeted therapies, the traditional role of D14 BMB is being reconsidered, as these agents exhibit slower response kinetics, making later assessments and measurable residual disease (MRD) monitoring more reliable for treatment adaptation. This review critically examines the prognostic utility of D14 BMB in AML, its relevance across different treatment modalities, and its correlation with long-term outcomes. By synthesizing current evidence, we explore whether D14 BMB remains a valuable clinical tool or if a paradigm shift toward later assessments and MRD-guided decision-making is warranted in modern AML therapy.

Langerhans Cell Histiocytosis (LCH) is an inflammatory myeloid neoplasm with heterogeneous outcomes. This study aimed to identify independent risk factors influencing event-free survival (EFS) in pediatric LCH, focusing on initial white blood cell (WBC) counts and disease extent.

We retrospectively analyzed 67 pediatric LCH patients with bone involvement treated at Hebei Children's Hospital, Hebei Clinical Medicine Research Center for Children's Health and Diseases between 2013 and 2022. The primary endpoint was EFS. Cox proportional hazards regression models determined predictors of adverse outcomes.

The 3-year EFS rate was 76.1% (median follow-up: 48 months). Univariate analysis linked multiple disease sites, risk-organ involvement, CNS risk site involvement, diabetes insipidus, and elevated WBC count to poor EFS. In multivariate analysis, only multiple site involvement (Hazard Ratio [HR] = 3.12, p = 0.025) and an elevated initial WBC count (>10 × 10⁹/L) (HR = 2.89, p = 0.034) remained independent predictors.

While risk-organ involvement is a traditional stratifier, systemic inflammatory burden, reflected by leukocytosis, offers independent prognostic value. Patients with elevated WBC counts or multisite disease warrant intensive monitoring.

Elevated initial WBC count and multiple site involvement independently predict shorter EFS in pediatric LCH. Integrating these markers into risk stratification could optimize therapies.

To assess the effectiveness and safety of hepatic arterial infusion chemotherapy (HAIC) in patients with mismatch repair proficient (pMMR)/microsatellite stable (MSS) colorectal cancer liver metastases (CRLM) who are resistant to standard treatments.

This study retrospectively evaluated 137 consecutive patients with pMMR/MSS CRLM who underwent HAIC from July 2019 to September 2023. Progression-free survival (PFS) was the primary outcome, with secondary outcomes being overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. The Cox proportional hazards model was used to identify prognostic factors for survival.

In total, 78 patients participated, with a median age of 58 years (IQR, 50.75-64.00), and 50 were male. Among these, 28 were treated with a combination of HAIC and targeted therapy, whereas 50 were given HAIC monotherapy. For all patients, the median PFS and OS were 5.10 months (95% CI: 2.85, 7.35) and 16.80 months (95% CI: 13.07, 20.53), respectively. The ORR and DCR for intrahepatic lesions were 1.37% and 58.9%, respectively. All lesions had an ORR of 2.74% and a DCR of 30.14%. The 1-year OS rate was 67.63 (95% CI, 57.22, 79.91). Patients undergoing HAIC, whether with or without targeted therapy, showed no significant differences in ORR and DCR. Multivariable analysis showed that the combination of HAIC and targeted therapy was not an independent risk factor for PFS and OS. No adverse events of grade 4 or higher were observed.

HAIC shows effectiveness and tolerance in pMMR/MSS CRLM patients who are refractory to systemic therapy. However, the additive value of targeted therapy for HAIC in these patients needs to be further investigated.