Multidisciplinary team meetings (MDTMs) in breast cancer care improve outcomes but are time-consuming and costly. This study investigates using data from the Dutch national cancer registry (NCR) and hospital electronic medical records (EMR) to efficiently calculate MDTM discussion durations, while complying with privacy laws.

This retrospective study analyzed breast cancer MDTM discussion durations using NCR and EMR data from 2014 to 2018. Discussion times were estimated from EMR timestamps, excluding outliers, and analyzed statistically. Ethical approval was obtained, including only non-opt-out patients.

The final dataset included 1,048 tumors, 996 patients, and 1,487 MDTM discussion times after exclusions for missing data, duplicates, and outliers. Discussion durations varied significantly, with pre-operative and no-surgery discussions being longer than post-operative ones (p = 0.000), and factors such as MRI availability, tumor differentiation, malignancy, menopausal status, and cancer stage influencing duration in pre-operative cases. In post-operative discussions, molecular subtype, cancer stage, and tumor size were significant, while age, tumor differentiation, and menopausal status had no impact.

This study evaluates discussion durations in breast cancer MDTMs using retrospective data from the NCR and EMR, demonstrating a feasible approach to assess MDTM functioning. Differences in discussion duration based on patient and tumor characteristics may help optimize MDTM efficiency.

Not applicable.

Large prostate volume (> 100 mL) remains a technical challenge during robot-assisted radical prostatectomy (RARP), with limited long-term outcome data available in contemporary series. To evaluate perioperative, functional, and oncologic outcomes following RARP in patients with large-volume prostate cancer. A retrospective multicenter cohort study was performed including 201 consecutive patients with prostate volume > 100 mL who underwent RARP between January 2017 and December 2021, with follow-up extending through December 2023. The primary endpoint was biochemical recurrence-free survival (BCRFS). Secondary endpoints included overall survival (OS), cancer-specific survival (CSS), perioperative outcomes, urinary continence recovery, and erectile function recovery. Kaplan-Meier analyses, multivariable Cox proportional hazards regression, and logistic regression analyses were performed. Median prostate volume was 121 mL (IQR 108-142), and median follow-up was 58 months (IQR 46-60). Mean operative time was 121 ± 28 min, while estimated blood loss was 152 ± 70 mL. Major complications (Clavien-Dindo ≥ III) occurred in 4.5% of patients. Positive surgical margins were observed in 15.9%, and pT3 disease was identified in 46.2%. Five-year BCRFS, OS, and CSS were 79.8% and 95.8%, respectively. Urinary continence recovery reached 84.1% at 12 months and 90.6% at 5 years. Erectile function recovery among patients undergoing bilateral nerve-sparing was 48.6% at 12 months and 62.3% at 5 years. On multivariable analysis, Gleason score ≥ 8 (HR 2.63, p < 0.001), pT3 stage (HR 3.02, p < 0.001), and positive surgical margins (HR 2.11, p = 0.01) independently predicted biochemical recurrence. Bilateral nerve-sparing independently predicted improved continence recovery (OR 1.82, p = 0.02). RARP in patients with large-volume prostates is safe and oncologically effective, with favorable long-term functional outcomes. Tumor biology rather than prostate size appears to be the principal determinant of oncologic outcomes.

The da Vinci single-port (SP) system enables robotic urologic surgery through a single incision, unlike the conventional multiport (MP) approach. Although SP surgery may reduce postoperative pain and improve cosmesis, its adoption remains limited by a steep learning curve, high costs, and limited long-term oncologic data. This study evaluated patient perspectives on SP versus MP robotic-assisted urologic surgery, focusing on the relative importance of surgical and cosmetic outcomes. We conducted a cross-sectional survey of 51 adults scheduled for robotic-assisted genitourinary oncologic procedures in a single surgeon's practice between 2024 and 2025. Participants completed a Likert-scale questionnaire assessing cosmetic outcomes, cancer control, postoperative pain, complication risk, cost, and marketing influence, and ranked five surgical factors by importance. Statistical analyses included Friedman rank testing, Wilcoxon signed-rank tests, Mann-Whitney U tests, and Kruskal-Wallis tests. Of 58 eligible patients approached, 51 completed the survey. Cancer control was ranked as the most important factor (mean rank 1.47 ± 0.81, p < 0.001), followed by complication risk and postoperative pain. Cost and cosmetic appearance were ranked least important. Cosmetic prioritization did not differ significantly across age, sex, or diagnosis groups. Male patients placed greater importance on cancer control than female patients (p = 0.002). Among men, those without prostate cancer placed greater importance on postoperative pain than those with prostate cancer (p = 0.006). Patients undergoing robotic genitourinary oncologic surgery prioritize cancer control, complication risk, and postoperative pain over cost and cosmetic outcomes when choosing between SP and MP robotic platforms.

To summarize randomized evidence assessing robotic surgery in relation to conventional laparoscopic and open abdominal approaches for endometrial cancer treatment, with particular attention to perioperative outcomes and conversion to open surgery. Randomized controlled trials evaluating robot-assisted surgical treatment of endometrial cancer were identified across major biomedical databases up to December 2025. Eligible studies compared the robotic approach against laparoscopic or open abdominal surgery. Quantitative pooling was undertaken only when outcome reporting was sufficiently consistent across studies. Eight randomized trials including 647 patients met the inclusion criteria. Overall, 322 patients underwent robotic surgery, 244 conventional laparoscopy, and 81 laparotomy. Most perioperative endpoints were reported heterogeneously, limiting formal pooling. Operative time varied across trials when robotics was compared with laparoscopy and was generally longer than laparotomy. Intraoperative blood loss and postoperative hospitalization did not show consistent differences between the two minimally invasive approaches. Compared with laparotomy, the robotic approach was linked to reduced postoperative stay. Conversion to laparotomy occurred less frequently after robotic surgery than after laparoscopy (0.7% vs. 8.4%; OR 0.17; p = .03). Complication reporting was inconsistent, although trials comparing robotics with laparotomy generally favored the robotic approach. Direct procedural costs were higher for robotics, whereas indirect costs favored robotics in the single study evaluating them. The robotic approach resulted in a lower need for open conversion compared with conventional laparoscopy. Other perioperative outcomes appeared broadly comparable between the two minimally invasive approaches, while comparisons with laparotomy suggested shorter hospital stay and fewer postoperative complications, although these findings should be interpreted cautiously because of the limited and heterogeneous randomized evidence.

Gallbladder carcinoma (GBC) is an aggressive malignancy characterized by late-stage presentation, poor prognosis, and limited therapeutic options. Gallstones (GS) represent a major risk factor and are implicated in the majority of GBC cases; however, the molecular distinctions between GS-associated GBC (GBCGS) and GS-independent/de novo GBC (dnGBC) remain poorly defined. To date, no GBC subtype-specific molecular biomarkers have been established. In this study, we employed an integrative transcriptomic and systems biology framework to delineate coding and non-coding RNA signatures underlying GBC pathogenesis. Transcriptomic profiling was performed on tumor tissues representing dnGBC and GBCGS subtypes, followed by comprehensive computational analyses including differential expression analysis, protein-protein interaction (PPI) networks construction, lncRNA-mRNA correlation networks, and competing endogenous RNA (ceRNA) network integration to identify key regulatory nodes. Systems-level analysis revealed distinct pathway enrichments between the two subtypes, indicating molecular heterogeneity in their pathobiology. In dnGBC, lncRNA DIO3OS and a novel transcript MSTRG.16633.1 were identified as highly connected candidate regulatory lncRNAs associated with genes involved in cell adhesion molecule (CAM) pathways. In contrast, GBCGS was characterized by lncRNA LINC00852 and novel transcript MSTRG.53675.1, which were associated with hub mRNAs enriched in the oncogenic signaling pathway. Expression of candidate mRNAs and lncRNAs identified from network analyses were validated by quantitative RT-PCR. This pilot study highlights the complex molecular heterogeneity within the two GBC subtypes and identifies potential RNA signatures involved in dnGBC and GBCGS pathogenesis that may contribute to improved understanding of molecular stratification and targeted therapeutic development.

To identify dyadic patterns of family resilience among adolescents and young adults (AYAs) with cancer and their caregivers, and to explore associated factors and their relationships with quality of life (QoL) in both parties.

This cross-sectional study recruited 202 AYA patient-caregiver dyads from four tertiary hospitals in Wuhan and Taiyuan between July 2022 and March 2024. Data were collected through a self-designed general information questionnaire and validated instruments assessing family resilience, individual resilience, social support, and QoL. Family resilience clusters were identified using K-means clustering in R 4.4.3, followed by regression analyses in SPSS 20.0.

Two family resilience clusters were identified: the low and high family resilience clusters. High resilience clusters were characterized by having an only child, a shorter disease course (1 ~ 3 months), having a smaller family size (≤ 3 family members), and shorter daily caregiving hours. Caregiver QoL was associated with family resilience cluster, caregiver employment changes, and social support, whereas patient QoL was primarily influenced by their individual resilience.

This study identified heterogeneity in family resilience among AYA patient-caregiver dyads, with smaller family size, a shorter disease course, and shorter caregiving hours associated with membership in the high resilience cluster. Caregiver well-being was closely linked to family resilience and social-contextual factors, while patient QoL depended more on individual resilience. These findings advance understanding of family resilience in AYA oncology and underscore the importance of family-centered psychosocial support to strengthen family functioning, alleviate caregiver burden, and foster patient resilience.

This studyaims to systematically elucidate the mechanisms underlying hematologic toxicity in ²²⁵Ac-PSMA-617 treatment for metastatic castration-resistant prostate cancer (mCRPC), establish a clinical risk stratification framework, and propose an integrated management strategy to optimize the therapeutic safety margin and efficacy.

By integrating and analyzing existing clinical and mechanistic research evidence, a "triple-hit" toxicity mechanism model was proposed. Based on this, key risk factors were identified, risk stratification criteria were established, and a structured clinical management pathway encompassing prevention, monitoring, and intervention was developed.

The hematologic toxicity of ²²⁵Ac-PSMA-617. results from the synergistic effects of direct α-particle damage, tumor microenvironment(TME)-mediated bone marrow function hijacking, and cumulative depletion of bone marrow reserve. Based on this, we established baseline bone marrow tumor burden, prior treatment history, and hematopoietic function as core risk factors, and proposed stratification criteria for low, intermediate, and high-risk groups along with corresponding differential monitoring and intervention strategies.

A thorough understanding of the triple-hit mechanism and implementation of risk stratification management facilitate safer and more effective application of ²²⁵Ac-PSMA-617 in the treatment of mCRPC. Future efforts should focus on expanding the therapeutic window of this therapy through individualized dosing, optimization of combination therapies, and development of multidimensional biomarkers.

Generalized myasthenia gravis (gMG) is a rare, chronic autoimmune disorder with substantial healthcare resource utilization (HRU) and high economic burden. This study evaluated HRU, costs, and predictors of high-cost events in adults with gMG, using data from VIVACITY-MG3.

Post-hoc analyses used the primary efficacy dataset from VIVACITY-MG3, a randomized, double-blind, placebo-controlled study of nipocalimab and standard-of-care (SoC) versus placebo and SoC in seropositive adults with gMG. HRU endpoints included hospital admissions (HA), emergency department visits (EDV), and hospital days. Logistic regression analysis identified clinical and demographic HA/EDV predictors. Hospital costs per patient per year (PPPY) were estimated using United States (US) cost data from published sources and from a claims database, adjusted to 2024 US dollars.

Among 153 patients, nipocalimab numerically reduced the proportion experiencing ≥1 all-cause (9.1% vs 15.8%) and gMG-related (3.9% vs 7.9%) HA/EDV events versus placebo. The incidence rate of HA/EDV events was 51% numerically lower with nipocalimab. Mean hospital stay duration was numerically shorter with nipocalimab for all-cause (8.4 vs 14.6 days) and gMG-related admissions (11.2 vs 17.6 days). All-cause and gMG-related hospital days per 100 patient-years were statistically significantly reduced by 60% and 68% with nipocalimab, respectively. Estimated cost offsets for reduced HRU were $10,860-$13,253 PPPY. Multivariate analysis identified worsening in Myasthenia Gravis-Activities of Daily Living (MG-ADL) total score and higher baseline Quantitative Myasthenia Gravis (QMG) respiratory total score as independent predictors. Patients switching from placebo to nipocalimab in the VIVACITY-MG3 open-label extension experienced a 64% reduction in hospital days PPPY.

Study limitations include the post-hoc nature of the analysis and the relatively short study duration. Nipocalimab added to SoC significantly reduces overall HRU and associated costs in adults with gMG, particularly by lowering rates and severity of HA/EDV events. Clinical deterioration and high baseline disease severity independently predict high-cost events.

IntroductionProgress in acute lymphoblastic leukemia (ALL) affecting adolescents and young adults (AYAs), aged 15-39 years, has been challenged by aggressive disease biology, low clinical trial participation, unique supportive care needs, and heterogeneity across treatment settings with lack of age-based standardized therapy. In 2012, the National Comprehensive Cancer Network (NCCN) first issued AYA ALL treatment guidelines. In the absence of formal evaluation of the 2012 NCCN guidelines on the delivery of guideline-concordant care at National Cancer Institute (NCI) Community Oncology Research Program (NCORP) practices, we conducted a qualitative study, as part of the Children's Oncology Group-led cancer care delivery trial ACCL16N1CD.MethodsStructured focus groups, moderated by study members, were convened to identify barriers and facilitators to NCCN guideline-concordant treatment delivery and documentation. Healthcare professionals at NCORP sites that activated ACCL16N1CD were invited to participate if they were involved in AYA ALL care. Nine focus groups were held with 55 participants. Nominal group technique was used to rank statements about delivery and documentation. Qualitative data were analyzed using directed content analysis methodology to describe facilitators and barriers and assess emerging themes.ResultsFive main themes were identified for delivery (Care Model, Care Organization, Supportive Care, Therapeutic Approach, Individual Factors [patient; provider]) and six for documentation (Care Model, Hospital Type, Care Organization, Supportive Care, Therapeutic Approach, Individual Factors) of NCCN-concordant treatment. Supportive Care was ranked first for delivery of guideline-concordant care and Care Organization was ranked first for documentation, with Individual Factors ranking close behind for both. Theme ranking varied by focus group type and professional roles of participants.ConclusionIdentified barriers and facilitators impacting guideline-concordant care of AYA ALL across NCORPs were aligned with institutional supportive care resources, care organization for AYA, and individual factors. Top ranked statements may be utilized as implementation strategies in future care delivery trials.

Eliminating both senescent and cancer cells through pharmacological intervention presents a powerful therapeutic strategy against aging and tumor progression. Navitoclax has emerged as a promising candidate with both senolytic and antitumor activity, but its clinical application remains limited due to dose-dependent thrombocytopenia and tumor-specific resistance. To overcome these limitations, we combined dichloroacetate and metformin with a 10-fold reduced dose of Navitoclax (ABT-263) and show that this pharmacology, termed, DMA, selectively targets the metabolic vulnerabilities underlying senescent and malignant cells. We demonstrate that DMA effectively ablates different types of senescent and cancer cells in vitro by exacerbating their defects in ATP production. Notably, the treatment is well tolerated by healthy human cells and in mice in vivo, and in fact improves the functional performance of aged mice after acute administration and extends lifespan after prolonged dosing. While the in vivo effects of DMA are yet to be fully explored, our findings suggest that it might represent a new, clinically viable way to combat cancer and senescence without toxicity to healthy cells and tissues.