IntroductionThe long-acting somatostatin analogues (LA-SSAs) octreotide LAR (OCT) and lanreotide (LAN) improve progression-free survival (PFS) in gastrointestinal neuroendocrine tumors (NETs), however, no head-to-head comparison exists. We compared treatment patterns and efficacy in a small bowel and pancreatic NET population-based cohort from British Columbia, Canada.MethodsWe identified 321 patients receiving either LAN or OCT for retrospective chart review. These somatostatin analogs were evaluated for impact on progression-free and overall survival.ResultsAge, sex, ECOG, and primary site did not differ by treatment, however, LAN was more commonly used in higher grade tumors (P = 0.019). PFS was longer for patients receiving LAN than OCT (Hazard Ratio (HR) 0.60, 95% CI 0.40-0.89, P = 0.011). Similarly, overall survival (OS) was longer for patients receiving LAN than OCT (HR 0.45, 95% CI 0.28-0.73, P = 0.016). Sensitivity analysis among patients diagnosed after both agents were reimbursed showed similar results for PFS (HR 0.50, 95% CI 0.28-0.90, P = 0.018). There was similar dose escalation with LAN vs OCT (OR: 0.80, CI 0.38-1.77, P = 0.70), with 29.4% of patients in the LAN group requiring LA-SSA dose escalation compared to 34.3% in the OCT group. There was numerically less short acting octreotide use in the LAN group (P = 0.087), with none of these patients requiring short acting octreotide, compared to 8.7% of the OCT group.ConclusionLAN was associated with longer time to cancer progression, as well as less use of short acting rescue octreotide in our population-based cohort. However, given the retrospective design and reimbursement-era differences, these findings should be interpreted cautiously and warrant confirmation in prospective or head-to-head studies.

Posterior fossa syndrome is a debilitating surgical complication affecting communication, motor skills, mood, language, and working memory in children treated for posterior fossa tumors. Although many recover from acute symptoms, the lifetime impact of posterior fossa syndrome remains unknown.

To evaluate the long-term neurological, neurocognitive, social, and quality of life outcomes associated with posterior fossa syndrome among survivors of medulloblastoma.

This retrospective cohort study included survivors of childhood medulloblastoma diagnosed between 1985 and 2012, with more than 5 years from diagnosis. All participants were treated at a tertiary academic center. Data were analyzed from January 1, 2024, to December 1, 2025.

History of posterior fossa syndrome.

Outcomes of interest included neurocognitive functioning (attention, cognitive flexibility, and visuomotor speed), neurological outcomes (cerebellar dysfunction, cranial nerve disorders, dysarthria, headaches, movement disorders, paralytic disorders, peripheral motor or sensory neuropathy, and seizures), physical performance, and social functioning. Statistical analysis included Mann-Whitney U, χ2, or Fisher exact tests, with multivariable linear regression used to assess the associations of posterior fossa syndrome with outcomes while adjusting for confounders.

A total of 158 participants (median [range] age at assessment, 25 [11-44] years; 96 [60.8%] male) were assessed, including 37 (23%) who developed posterior fossa syndrome and 121 controls who did not, with no differences in age at diagnosis, radiation dose, or age at assessment a median (range) follow-up of 14.2 (7.8-33.1) years. In adjusted models, participants with posterior fossa syndrome performed worse than those without in focused attention (β = -1.04 [95% CI, -1.62 to -0.45]; P < .001), motor-processing speed (β = -0.62 [95% CI, -1.16 to -0.09]; P = .02), cognitive flexibility (β = -0.85 [95% CI, -1.44 to -0.27]; P = .005), visuomotor processing speed (β = -0.65 [95% CI, -0.97 to -0.33]; P < .001), and physical performance test scores (β = -3.65 [95% CI, -5.36 to -1.93]; P < .001). Participants with posterior fossa syndrome were also more likely to require assistance with routine daily needs (odds ratio, 8.00 [95% CI, 2.56 to 25.04]; P < .001).

In this long-term cohort study of survivors of medulloblastoma, individuals with history of posterior fossa syndrome exhibited persistent neurocognitive and physical deficits compared with those without history of posterior fossa syndrome. Despite resolution of acute postoperative symptoms, posterior fossa syndrome was associated with lasting impairment, underscoring the need for improved surgical approaches, continued surveillance, and tailored interventions to optimize functional outcomes.

Cutaneous melanoma (CM) is the most aggressive cutaneous malignancy. The aim of the study was to determine the predictive value of primary tumor histopathologic features and laboratory findings used in routine CM follow-up for sentinel lymph node biopsy (SLNB) results and progression-free survival (PFS).

This retrospective study included 157 patients. Planar images were acquired after an intradermal injection of 18 to 30 MBq of 99mTc-nanocolloid in 0.3 ml at two to eight sites 5 to 10 mm from the surgical scar. SLN excision was performed a day after lymphoscintigraphy.

In a logistic regression analysis, Breslow thickness, ulceration status, and mitotic rate showed possible predictive significance for SLNB results, with serum lactate dehydrogenase (LDH) being the only independent predictor (p = 0.042). The difference in survival distributions reached statistical significance for Breslow thickness, mitotic rate, and LDH (p < 0.05, Kaplan-Meier, log-rank test). In a Cox regression analysis, Breslow thickness was a possible predictor of PFS and mitotic rate was an independent predictor (p = 0.025).

LDH is an independent predictor of SLN histopathology findings, and mitotic rate is an independent predictor of PFS.

Cell death is a fundamental process that maintains tissue homeostasis and shapes the tumour microenvironment. Cancer cells often evade or reprogram cell death pathways, which leads to malignancy and therapy resistance. On the other hand, the cell death of non-malignant cells significantly influences the adverse effects of anticancer therapy, such as the onset of mucositis or enteritis. Emerging evidence identifies both the tumour and gut microbiomes as critical modulators of these processes. In turn, cell death reshapes the microbial ecosystem by altering nutrient landscapes and immune signalling. Although both cell death and the microbiome are well-studied in cancer, their intersection remains underexplored. This review article addresses this gap by summarising how microbes and microbial metabolites modulate cancer cell death pathways and shape responses to anticancer therapy. We integrated current knowledge on this complex interplay, focusing on key metabolic mediators that can influence cell fate decisions. Understanding this bidirectional crosstalk offers new opportunities to "preserve the good and eliminate the bad" within the tumour-microbiome axis, paving the way for precision microbiome-informed cancer therapies.

To assess the proportion of adverse effects (AEs) associated with the use of PENTO or PENTOCLO protocols for the prevention and management of osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ).

A systematic literature search was conducted across six databases (PubMed, Scopus, Embase, Web of Science, LILACS, and Cochrane Library) and gray literature, with no restrictions on date or language. Studies were eligible if they involved adults (≥ 18 years) with or at risk for ORN or MRONJ and reported AEs associated with PENTO or PENTOCLO for prevention or treatment. A proportion meta-analysis estimated the overall frequency of AEs. Subgroup analyses compared AE rates between prevention and treatment contexts and between the two regimens.

Of 1,075 records screened, 9 studies met the inclusion criteria. No studies reported AEs in MRONJ patients; all focused on ORN. The pooled AE proportion was 15% (95% CI: 3.6%-11.5%; p < 0.1; I² = 55.8%). Gastrointestinal symptoms were the most reported AEs (46.38%), followed by neurovegetative effects (18.84%). AEs were more frequent in treatment settings and more prevalent in patients using PENTOCLO (28%).

The PENTO(CLO) protocols were associated with a 15% overall AE rate, predominantly gastrointestinal symptoms. AEs occurred more often during treatment and with the PENTOCLO regimen. These findings highlight the need for close monitoring and further studies to assess safety in MRONJ patients.

Fat-containing soft-tissue tumors encompass a broad spectrum of entities, ranging from indolent lipomas to aggressive liposarcomas, many of which share overlapping MRI features that pose diagnostic challenges even for experienced radiologists. In this review, we provide a focused, evidence-based synthesis of the current literature to outline a practical framework for the imaging evaluation of adipocytic soft-tissue lesions. Key MRI features that aid in distinguishing benign from intermediate and malignant tumors are discussed, with emphasis on imaging-pathology correlation and common diagnostic pitfalls. While conventional MRI criteria, such as lesion size, depth, septal thickness, and nodularity, remain central to risk stratification, we also review the complementary role of contrast-enhanced MRI and molecular testing, including MDM2 amplification and FUS::DDIT3 fusion analysis, particularly in indeterminate cases. Emerging tools, such as radiomics and artificial intelligence-based approaches, are briefly addressed as evolving adjuncts. By integrating classical imaging principles with contemporary classification frameworks, this article aims to serve as a comprehensive and clinically relevant reference for radiologists involved in the assessment and management of fat-containing soft-tissue tumors.

Esophageal squamous cell carcinoma (ESCC) lacks a standardized classification system, resulting in inconsistent clinical management and a suboptimal prognosis. This study addresses the urgent need for a robust consensus taxonomy to facilitate precision treatment for ESCC. We employed a network-based approach to elucidate the interconnections among eight existing classification systems, leading to the identification of four distinct consensus molecular subtypes (ECMSs): ECMS1-MET (metabolic), characterized by dysregulated metabolic pathways and NFE2L2 activation; ECMS2-CLS (classical), featuring upregulated cell cycle and canonical signaling pathways; ECMS3-IM (immunomodulatory), marked by robust immune activation and elevated PD-1 expression; and ECMS4-MES (mesenchymal), associated with mesenchymal transition, stromal activation, and VEGF signaling. To improve clinical applicability, we developed an image-based framework (imECMS) that utilizes spatial organization features (SOFs) quantified from autodelineated hematoxylin‒eosin (H&E)-stained whole-slide images through deep learning algorithms. The imECMS classifier assigns patients to one of the four ECMS subtypes, which correlate with distinct molecular characteristics, prognoses, and responses to neoadjuvant chemotherapy and immunotherapy. Validation across multiple independent cohorts confirmed that the imECMS accurately classifies ESCC subtypes from histopathological images, offering a robust and effective tool for precision medicine. In summary, the ECMS/imECMS subtyping systems we developed are the most robust frameworks for ESCC to date, providing clear biological insights and a foundation for clinical stratification and targeted therapies.

Lung cancer has a remarkably high global incidence and ranks among the most frequent malignancies, with mortality rates placing it first worldwide. Although lung cancer typically metastasizes to the brain, bone, adrenal glands, and liver, the advent and efficacy of novel treatments such as immunotherapy and tyrosine kinase inhibitors have been associated with an increasing incidence of metastases in atypical sites, including peritoneal involvement in Non-Small Cell Lung Cancer. Adenocarcinoma is the histological subtype most frequently responsible for peritoneal carcinomatosis. Little is known about the underlying pathogenic mechanisms leading to peritoneal implantation, and diagnosis is often delayed until advanced disease stages, as symptoms are frequently nonspecific and may be mistaken for the natural progression of advanced lung cancer under systemic oncological treatment. Diagnosis is primarily clinical when ascites develops, but imaging modalities such as computed tomography and fluorodeoxyglucose positron emission tomography/computed tomography can be highly informative. Cytological and molecular analysis of peritoneal fluid obtained via drainage also contributes to diagnosis. Treatment mainly relies on systemic therapy for lung cancer with peritoneal metastases, while loco-regional interventions are generally reserved for symptom control. Considerable progress is still needed in the prevention, early diagnosis, and optimal management of peritoneal carcinomatosis, and future research, despite the rarity of cases, should focus on these aspects. In this review, we aim to analyze the limited literature currently available and explore future directions in the approach to peritoneal carcinomatosis in Non-Small Cell Lung Cancer.

To clarify overlapping post-market obligations under the EU Artificial Intelligence Act (AIA) and EU Medical Device Regulation (MDR) for high-risk artificial intelligence (AI) Software as a Medical Device (SaMD), and to map the regulatory landscape for manufacturers, healthcare providers, AI providers, and AI deployers.

We conducted a qualitative doctrinal legal analysis of post-market provisions in the AIA and MDR, using a case study of a high-risk Class III AI SaMD for prostate cancer radiology. No empirical clinical or performance data were collected. The analysis focused on key stakeholders, including device manufacturers and deployers (e.g., healthcare providers). We sought to identify (1) convergence, where both regulations impose overlapping or complementary requirements, and (2) divergence, where obligations are addressed by only one regulation, revealing potential regulatory gaps.

We organized the extracted post-market obligations into ten categories. Overall, both regulations place increasing emphasis on lifecycle traceability and continuous monitoring. We identified convergence in areas such as documentation and performance monitoring, while divergences emerged in domains like human oversight (in the AIA) and reporting non-serious patterns (in the MDR). We also identified gaps in regulatory guidance, particularly regarding system updates, human oversight, and the evolving responsibilities of healthcare providers.

The AIA and MDR share common ground in some post-market areas but also diverge in key responsibilities. To ensure safe and effective use of high-risk AI in healthcare, clearer coordination between the two frameworks is needed, especially in areas such as human oversight and system modification, where current guidance remains limited.